Vieth Reinhold
Department of Laboratory Medicine and Pathobiology, University of Toronto, and Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Canada M5G 1X5.
J Steroid Biochem Mol Biol. 2004 May;89-90(1-5):575-9. doi: 10.1016/j.jsbmb.2004.03.038.
The physiologic range for circulating 25-hydroxyvitamin D3 [25(OH)D; the measure of Vitamin D nutrient status] concentration in humans and other primates extends to beyond 200 nmol/L (>80 ng/mL). This biologic "normal" value is greater than current population norms for 25(OH)D. Concentrations of 25(OH)D that correlate with desirable effects extend to at least 70 nmol/L, with no obvious threshold. Randomized clinical trials using 20 mcg (800 IU) per day of Vitamin D show that this suppresses parathyroid hormone, preserves bone mineral density, prevents fractures, lowers blood pressure and improves balance. Calcium absorption from diet correlates with 25(OH)D in the normal range. Health effects of Vitamin D beyond osteoporosis are mostly supported by the circumstantial evidence of epidemiologic studies and laboratory research. These include prevention of cancer and the autoimmune diseases, insulin-dependent diabetes and multiple sclerosis. One mcg per day of Vitamin D(3) (cholecalciferol) increases circulating 25(OH)D by about 1 nmol/L (0.4 ng/mL). A recommended dietary allowance (RDA) is the long-term daily intake level that meets the total requirements for the nutrient by nearly all healthy individuals (it would presume no sunshine). If 70 nmol/L is regarded as a minimum desirable target 25(OH)D concentration, then current recommendations of 15 mcg per day do not meet the criterion of an RDA.
人类和其他灵长类动物体内循环的25-羟基维生素D3[25(OH)D;维生素D营养状况的衡量指标]浓度的生理范围超过200 nmol/L(>80 ng/mL)。这个生物学上的“正常”值高于目前25(OH)D的人群标准。与理想效果相关的25(OH)D浓度至少延伸至70 nmol/L,且无明显阈值。每天使用20 mcg(800 IU)维生素D的随机临床试验表明,这能抑制甲状旁腺激素、维持骨密度、预防骨折、降低血压并改善平衡。正常范围内,饮食中钙的吸收与25(OH)D相关。维生素D对骨质疏松症以外健康影响的证据大多来自流行病学研究和实验室研究的间接证据。这些影响包括预防癌症和自身免疫性疾病、胰岛素依赖型糖尿病和多发性硬化症。每天1 mcg维生素D(3)(胆钙化醇)可使循环中的25(OH)D增加约1 nmol/L(0.4 ng/mL)。推荐膳食摄入量(RDA)是几乎所有健康个体满足该营养素总需求的长期每日摄入量水平(假设不晒太阳)。如果将70 nmol/L视为25(OH)D浓度的最低理想目标,那么目前每天15 mcg的建议不符合RDA的标准。