Mohr Sharif B
Department of Family and Preventive Medicine, University of California San Diego, La Jolla, California 92093-0631, USA.
Ann Epidemiol. 2009 Feb;19(2):79-83. doi: 10.1016/j.annepidem.2008.10.003.
To review the history of vitamin D and its use in cancer prevention.
The literature on published studies of vitamin D and its role in human health was reviewed and summarized.
The modern history of vitamin D began in the mid-1800s, when it was noticed that city children were more likely to have rickets than rural children. Half a century later, Palm reported that children raised in sunny climates virtually never developed rickets. McCollum isolated vitamin D, and Windaus its precursors, receiving the Nobel Prize. Other scientists later observed that people with skin cancer had lower prevalence of nonskin cancers, and that lower overall mortality rates from all internal cancers combined existed in sunnier areas. These observations went largely unnoticed, and the field stagnated until 1970, when maps were created of cancer mortality rates. Through study of these maps, Cedric and Frank Garland of Johns Hopkins University reported a strong latitudinal gradient for colon cancer mortality rates in 1980, and hypothesized that higher levels of vitamin D compounds in the serum of people in the south were responsible, and that calcium intake also would reduce incidence. Edward Gorham and colleagues carried out cohort and nested studies, including the first study that found an association of a serum vitamin D compound with reduced cancer risk. William B. Grant then carried out numerous ecologic studies that extended the vitamin D-cancer theory to other cancers.
The history of the role of vitamin D in human health is rich and much of that history is yet to be written not only by scientists, but by policy makers with the vision and leadership necessary to bridge the gap between research and policy.
回顾维生素D的历史及其在癌症预防中的应用。
对已发表的关于维生素D及其在人类健康中作用的研究文献进行回顾和总结。
维生素D的现代历史始于19世纪中叶,当时人们注意到城市儿童比农村儿童更容易患佝偻病。半个世纪后,帕尔姆报告说,在阳光充足地区长大的儿童几乎从不患佝偻病。麦科勒姆分离出了维生素D,温道斯分离出了其前体,两人因此获得了诺贝尔奖。后来其他科学家观察到,皮肤癌患者非皮肤癌的患病率较低,而且在阳光更充足的地区,所有内部癌症合并后的总体死亡率较低。这些观察结果在很大程度上未被注意到,该领域一直停滞不前,直到1970年绘制了癌症死亡率地图。通过对这些地图的研究,约翰·霍普金斯大学的塞德里克和弗兰克·加兰在1980年报告了结肠癌死亡率存在很强的纬度梯度,并推测南方人群血清中维生素D化合物水平较高是原因所在,而且钙的摄入量也会降低发病率。爱德华·戈勒姆及其同事进行了队列研究和巢式研究,其中第一项研究发现血清维生素D化合物与降低癌症风险有关。威廉·B·格兰特随后进行了大量生态研究,将维生素D与癌症的理论扩展到其他癌症。
维生素D在人类健康中作用的历史丰富,而且不仅科学家,政策制定者也需要书写这段历史,他们要有弥合研究与政策之间差距所需的远见和领导力。