Holick Michael F
Department of Medicine, Section of Endocrinology, Nutrition, and Diabetes, Vitamin D, Skin and Bone Research Laboratory, Boston University Medical Center, Boston, Massachusetts, USA.
Clin J Am Soc Nephrol. 2008 Sep;3(5):1548-54. doi: 10.2215/CJN.01350308. Epub 2008 Jun 11.
Vitamin D deficiency is a worldwide health problem. The major source of vitamin D for most humans is sensible sun exposure. Factors that influence cutaneous vitamin D production include sunscreen use, skin pigmentation, time of day, season of the year, latitude, and aging. Serum 25-hydroxyvitamin D [25(OH)D] is the measure for vitamin D status. A total of 100 IU of vitamin D raises blood level of 25(OH)D by 1 ng/ml. Thus, children and adults who do not receive adequate vitamin D from sun exposure need at least 1000 IU/d vitamin D. Lack of sun exposure and vitamin D deficiency have been linked to many serious chronic diseases, including autoimmune diseases, infectious diseases, cardiovascular disease, and deadly cancers. It is estimated that there is a 30 to 50% reduction in risk for developing colorectal, breast, and prostate cancer by either increasing vitamin D intake to least 1000 IU/d vitamin D or increasing sun exposure to raise blood levels of 25(OH)D >30 ng/ml. Most tissues in the body have a vitamin D receptor. The active form of vitamin D, 1,25-dihydroxyvitamin D, is made in many different tissues, including colon, prostate, and breast. It is believed that the local production of 1,25(OH)(2)D may be responsible for the anticancer benefit of vitamin D. Recent studies suggested that women who are vitamin D deficient have a 253% increased risk for developing colorectal cancer, and women who ingested 1500 mg/d calcium and 1100 IU/d vitamin D(3) for 4 yr reduced risk for developing cancer by >60%.
维生素D缺乏是一个全球性的健康问题。大多数人维生素D的主要来源是适度的阳光照射。影响皮肤维生素D生成的因素包括使用防晒霜、皮肤色素沉着、一天中的时间、一年中的季节、纬度和衰老。血清25-羟维生素D[25(OH)D]是衡量维生素D状态的指标。100国际单位的维生素D可使血液中25(OH)D水平升高1纳克/毫升。因此,未从阳光照射中获得足够维生素D的儿童和成年人每天至少需要1000国际单位的维生素D。缺乏阳光照射和维生素D缺乏与许多严重的慢性疾病有关,包括自身免疫性疾病、传染病、心血管疾病和致命癌症。据估计,通过将维生素D摄入量增加到至少每天1000国际单位或增加阳光照射以使血液中25(OH)D水平>30纳克/毫升,患结直肠癌、乳腺癌和前列腺癌的风险可降低30%至50%。体内大多数组织都有维生素D受体。维生素D的活性形式1,25-二羟维生素D在许多不同组织中产生,包括结肠、前列腺和乳腺。据信,1,25(OH)(2)D的局部产生可能是维生素D抗癌益处的原因。最近的研究表明,维生素D缺乏的女性患结直肠癌的风险增加253%,而每天摄入1500毫克钙和1100国际单位维生素D3持续4年的女性患癌症的风险降低>60%。