Research supports the role of vitamin D in regulating inflammation, cardiovascular health, bone metabolism, and cognitive function. Vitamin D activates nuclear vitamin D receptors (VDRs) in vascular endothelial cells and cardiomyocytes, influencing cardiovascular health by reducing oxidative stress, and improving myocardial contractility. Additionally, vitamin D modulates the immune response, promoting anti-inflammatory cytokines while limiting pro-inflammatory ones, making it valuable in reducing inflammation and pain in perioperative care. It also supports insulin production, decreases renin synthesis, and reduces parathyroid hormone levels, maintaining calcium balance and aiding in muscle and bone health. Recent studies further indicate vitamin D’s role in cognitive health by supporting neurotrophic factors critical for brain function and repair.

Mechanisms of Action and Benefits:

• Cardiovascular Health Regulation:

1. Activation of VDRs in Cardiomyocytes and Endothelial Cells: Vitamin D activates nuclear VDRs in cardiovascular cells, which has been associated with reduced blood pressure, improved myocardial contractility, and decreased oxidative stress. These actions may reduce the risk of hypertension and enhance overall cardiovascular function modulation.
2. Anti-Inflammatory and Pro-Inflammatory Cytokine Modulation: Vitamin D supports immune function by promoting anti-inflammatory cytokines and suppressing pro-inflammatory ones, which is particularly beneficial for perioperative care by aiding in pain reduction and inflammation control.

• Bone Metabolism 

1. Parathyroid Hormone (PTH) Reduction and Calcium Balance: Vitamin D plays a critical role in decreasing PTH synthesis, thereby promoting calcium balance and aiding in bone and muscle health through improved bone resorption and mineralization, ultimately reducing osteoporosis risk.

• Metabolic Support:

1. Insulin Synthesis: Vitamin D aids insulin production, supports metabolic health and glycemic control, and decreases renin synthesis, which has implications for reducing metabolic syndrome risk and improving overall endocrine health.

• Cognitive Health Support:

1. Research indicates that vitamin D supports cognitive health by stimulating neurotrophic factors like brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF), which are vital for brain cell repair and cognitive function maintenance.

References:

1. Adorini, L., Penna, G. Control of autoimmune diseases by the vitamin D endocrine system. Nat Rev Rheumatol 4, 404–412 (2008).
2. Aiello G, Lombardo M, Baldelli S. Exploring Vitamin D Synthesis and Function in Cardiovascular Health: A Narrative Review. Applied Sciences. 2024; 14(11):4339.
3. Cosentino N, Campodonico J, Milazzo V, De Metrio M, Brambilla M, Camera M, Marenzi G. Vitamin D and Cardiovascular Disease: Current Evidence and Future Perspectives. Nutrients. 2021; 13(10):3603.
4. Holick MF, Mazzei L, García Menéndez S, Martín Giménez VM, Al Anouti F, Manucha W. Genomic or Non-Genomic? A Question about the Pleiotropic Roles of Vitamin D in Inflammatory-Based Diseases. Nutrients. 2023; 15(3):767.