胃肠道和肝脏疾病中的维生素D状况。
Vitamin D status in gastrointestinal and liver disease.
作者信息
Pappa Helen M, Bern Elana, Kamin Daniel, Grand Richard J
机构信息
Division of Gastroenterology and Nutrition, Department of Medicine, and General Clinical Research Center, Children's Hospital Boston, Boston, Massachusetts, USA.
出版信息
Curr Opin Gastroenterol. 2008 Mar;24(2):176-83. doi: 10.1097/MOG.0b013e3282f4d2f3.
PURPOSE OF REVIEW
The purpose of this review is to report on the vitamin D status and its relationship with bone health in individuals with gastrointestinal and liver disorders. In addition, recommendations regarding replacement and maintenance of optimal vitamin D stores, as well as the state of knowledge regarding its effect on the disease through its actions on the immune system, will be reviewed.
RECENT FINDINGS
The scientific community has revised upward the serum levels of vitamin D considered optimal, and doses of vitamin D much larger than those currently recommended may be needed to maintain these levels, especially in individuals with gastrointestinal and liver disorders. The relationship between vitamin D and bone health in this population is controversial. The role of vitamin D in the regulation of the immune system continues to be elucidated.
SUMMARY
Hypovitaminosis D is prevalent among individuals with gastrointestinal and liver disease. Although replacement and supplementation guidelines have not been well defined, practitioners should aim for a serum 25-hydroxyvitamin D level of at least 32 ng/ml. The contribution of vitamin D to the bone health of these individuals and its role in altering disease course through its actions on the immune system remain to be elucidated.
综述目的
本综述旨在报告胃肠道和肝脏疾病患者的维生素D状况及其与骨骼健康的关系。此外，还将综述关于补充和维持最佳维生素D储备的建议，以及维生素D通过作用于免疫系统对疾病影响的知识现状。
最新发现
科学界已上调了对最佳维生素D血清水平的认识，可能需要比目前推荐剂量大得多的维生素D才能维持这些水平，尤其是在胃肠道和肝脏疾病患者中。维生素D与该人群骨骼健康之间的关系存在争议。维生素D在免疫系统调节中的作用仍在不断阐明。
总结
维生素D缺乏在胃肠道和肝脏疾病患者中普遍存在。尽管补充和替代指南尚未明确界定，但从业者应将血清25-羟基维生素D水平目标设定为至少32 ng/ml。维生素D对这些个体骨骼健康的贡献及其通过作用于免疫系统改变疾病进程的作用仍有待阐明。
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