Which of the following vitamin enhances intestinal absorption of calcium?
**Core Concept**
Vitamin D plays a central role in regulating calcium homeostasis by increasing intestinal absorption of calcium from the diet. It acts on the small intestine to upregulate calcium transport mechanisms, primarily through the activation of vitamin D receptor (VDR) in enterocytes.
**Why the Correct Answer is Right**
Vitamin D is converted to its active form, calcitriol, in the kidneys. Calcitriol binds to the vitamin D receptor in intestinal epithelial cells, triggering the expression of calcium-binding proteins and the calcium channel TRPV6. This enhances passive and active calcium absorption in the duodenum. Without sufficient vitamin D, calcium absorption drops significantly, leading to hypocalcemia and bone disorders like rickets.
**Why Each Wrong Option is Incorrect**
Option B: Vitamin K does not influence calcium absorption; it primarily regulates bone metabolism by activating osteocalcin and matrix GLA protein, and it is involved in anticoagulation, not intestinal calcium uptake.
Option C: Vitamin B1 (thiamine) is essential for carbohydrate metabolism and neuronal function, with no known role in calcium absorption.
Option D: Vitamin B2 (riboflavin) is a cofactor in mitochondrial energy metabolism and does not affect calcium transport in the gut.
**Clinical Pearl / High-Yield Fact**
Vitamin D deficiency is a common cause of secondary hyperparathyroidism and osteomalacia. Always assess vitamin D status in patients with bone pain or low calcium levels—supplementation can dramatically improve calcium absorption and bone health.
✓ Correct Answer: A. Vitamin D