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The vitamin D receptor (VDR) is a nuclear transcriptional regulator that activates by binding to 1a,25-dihydroxycholecalciferol (1a,25(OH)2D), known as calcitriol, which forms a heterodimer with the retinoid X receptor (RXR). Calcitriol signalling is responsible for regulating a range of biological effects, including calcium as well as metabolism of phosphorous, parathormone release, cell proliferation, and control of adaptive and innate immunity.

A T > C base change in the promoter region of the VDR variant rs11568820 removes the binding site for transcription factor Cdx2 downstream of exon 1e and leads to the production of a lower amount of protein and decreased transcriptional activity. The F allele of this variant can be found at a high frequency among Asians and Europeans and at a lower frequency in Sub-Saharan Africa.

The results of this study advance our understanding of the role that VDR gene polymorphisms could have in regulating the response to diet supplementation with calcium calcitriol. Carriers of the TaqI polymorphism and the FF genotype of the FokI polymorphism show higher transcriptional activation of VDR and are associated with improved calcium absorption and bone mineral density as well as a reduction in the risk of fractures [34, 35]. Further research with a more homogenous design is needed to improve our understanding of how these genetic variations influence vitamin D supplementation as well as its clinical significance.

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