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优化维生素D水平以降低结直肠癌风险:一项证据综述。

Optimizing vitamin D status to reduce colorectal cancer risk: an evidentiary review.

作者信息

Zhou Guiyun, Stoitzfus Jill, Swan Beth Ann

机构信息

Vita Hematology/Oncology, Bethlehem, PA Jefferson School of Nursing, Thomas Jefferson University, Philadelphia, PA, USA.

出版信息

Clin J Oncol Nurs. 2009 Aug;13(4):E3-E17. doi: 10.1188/09.CJON.E3-E17.

Abstract

Vitamin D deficiency is common in the general public and in patients with cancer. Optimizing vitamin D intake is increasingly recognized in cancer risk reduction, particularly in decreasing colorectal cancer risk. Therefore, summarizing the current evidence to promote best practices related to vitamin D intake and colorectal cancer risk reduction is important. The objectives of this article are to examine the current evidence regarding the impact of vitamin D on colorectal cancer risk reduction and provide practice recommendations for clinicians. Relevant research articles from 2002-2008 were retrieved from multiple electronic databases. Reference lists of relevant articles also were searched manually. Twenty-five research reports were selected for this article: 4 randomized, controlled trials; 11 cohort or case-control studies measuring serum 25-OH-D levels; and 10 cohort studies reporting vitamin D intake. This review generated three themes: raising 25-OH-D levels to a vitamin D sufficient state (32-100 ng/ml) achieved colorectal cancer risk reduction, increasing the intake of vitamin D reduced colorectal cancer risk, and increasing vitamin D intake to 1,000 IU daily is safe and likely sufficient to raise serum 25-OH-D levels above 32 ng/ml to achieve colorectal cancer risk reduction. Several practice recommendations are suggested.

摘要

维生素D缺乏在普通人群和癌症患者中都很常见。优化维生素D摄入量在降低癌症风险,尤其是降低结直肠癌风险方面日益受到认可。因此,总结当前证据以推广与维生素D摄入及降低结直肠癌风险相关的最佳实践非常重要。本文的目的是研究关于维生素D对降低结直肠癌风险影响的当前证据,并为临床医生提供实践建议。从多个电子数据库中检索了2002年至2008年的相关研究文章。还手动搜索了相关文章的参考文献列表。本文选择了25篇研究报告:4项随机对照试验;11项测量血清25-羟基维生素D水平的队列或病例对照研究;以及10项报告维生素D摄入量的队列研究。本综述产生了三个主题:将25-羟基维生素D水平提高到维生素D充足状态(32 - 100纳克/毫升)可降低结直肠癌风险,增加维生素D摄入量可降低结直肠癌风险,以及每天将维生素D摄入量增加到1000国际单位是安全的,并且可能足以将血清25-羟基维生素D水平提高到32纳克/毫升以上以降低结直肠癌风险。文中提出了若干实践建议。

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