Holick Michael F
Vitamin D, Skin, and Bone Research Laboratory, Section of Endocrinology, Diabetes, and Nutrition, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts 02118, USA.
Semin Dial. 2005 Jul-Aug;18(4):266-75. doi: 10.1111/j.1525-139X.2005.18402.x.
Vitamin D is taken for granted and is not appreciated for its importance in overall health and well-being. Vitamin D, known as the sunshine vitamin, is appreciated as being important for the prevention of rickets in children. It is now recognized that vitamin D is important for not only the growing skeleton, but for the maintenance of a healthy musculoskeletal system throughout life. Vitamin D deficiency in adults precipitates and exacerbates osteoporosis and causes the painful bone disease osteomalacia. The revelation that vitamin D is biologically inactive and requires sequential hydroxylations in the liver and kidney to form 1,25-dihydroxyvitamin D helps explain why patients with renal failure are often resistant to vitamin D and suffer from secondary hyperparathyroidism and renal osteodystrophy. In addition to its role in maintaining calcium and phosphorus homeostasis, vitamin D is now being recognized as important for maintaining maximum muscle strength and for the prevention of many chronic diseases, including type I diabetes, multiple sclerosis, rheumatoid arthritis, hypertension, cardiovascular heart disease, and many common cancers. Vitamin D status is best determined by the measurement of circulating levels of 25-hydroxyvitamin D. Vigilance for maintaining a 25-hydroxyvitamin D level of at least 20 ng/ml and preferably 30-50 ng/ml has important benefits for both healthy children and adults, as well as children and adults suffering from chronic kidney disease.
维生素D常常被人们忽视，其对整体健康和幸福的重要性并未得到充分认识。维生素D，即所谓的“阳光维生素”，因对预防儿童佝偻病很重要而为人所知。现在人们认识到，维生素D不仅对正在生长的骨骼很重要，而且对终生维持健康的肌肉骨骼系统也很重要。成年人维生素D缺乏会引发并加剧骨质疏松症，还会导致疼痛的骨病——骨软化症。维生素D在生物学上无活性，需要在肝脏和肾脏中进行一系列羟基化反应才能形成1,25 - 二羟基维生素D，这一发现有助于解释为什么肾衰竭患者常常对维生素D有抵抗性，并患有继发性甲状旁腺功能亢进和肾性骨营养不良。除了在维持钙和磷的体内平衡方面发挥作用外，维生素D现在还被认为对维持最大肌肉力量以及预防许多慢性疾病很重要，这些疾病包括I型糖尿病、多发性硬化症、类风湿性关节炎、高血压、心血管疾病以及许多常见癌症。维生素D状态最好通过测量循环中的25 - 羟基维生素D水平来确定。对于健康儿童和成年人以及患有慢性肾病的儿童和成年人来说，保持25 - 羟基维生素D水平至少为20 ng/ml，最好为30 - 50 ng/ml，具有重要益处。
