College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Mol Nutr Food Res. 2010 Aug;54(8):1077-84. doi: 10.1002/mnfr.200900536.
We conducted an examination of recent studies to determine whether older adults (>or=65 years) need higher levels of supplementary vitamin D than young adults when attempting to replete vitamin D status in deficient subjects, i.e. those with levels of 25-hydroxyvitamin D less than 75 nmol/L. As data on repletion with vitamin D(2) have recently been published, we restricted our discussion to the use of vitamin D(3) from dietary supplements, prescriptions for large oral doses, and bolus dosing or injections. Most published dosing regimens failed to achieve 75 nmol/L in most all subjects, whether young adults (<65 years) or older adults (>or=65 years). Whether as daily or bolus oral supplementation, elderly subjects appeared to need more vitamin D3 compared with younger adults, however, baseline levels, endpoints, study duration, compliance, and other factors were different among studies. To ensure most subjects are replete in vitamin D, a daily dose of more than 50 microg (2000 IU) in younger and 125 microg (5000 IU) is required. Other strategies including bolus and loading doses are described. No study reported adverse effects of using oral intakes about the current upper level of 50 microg (2000 IU).
我们对近期的研究进行了评估，以确定在试图补充维生素 D 状态（即 25-羟维生素 D 水平低于 75nmol/L 的缺乏受试者）时，老年（>或=65 岁）人群是否比年轻成人（<65 岁）需要更高水平的补充维生素 D。由于最近已经公布了维生素 D(2)补充的数据，我们将讨论仅限于从膳食补充剂、大剂量口服处方和推注或注射使用维生素 D(3)。大多数已发表的剂量方案都未能使大多数受试者（无论是年轻成人还是老年成人）达到 75nmol/L。无论是每日或推注口服补充，老年受试者似乎比年轻成人需要更多的维生素 D3，但各研究之间的基线水平、终点、研究持续时间、依从性和其他因素不同。为了确保大多数受试者补充维生素 D，年轻成人每天需要超过 50μg（2000IU），而老年成人需要 125μg（5000IU）。还描述了其他策略，包括推注和负荷剂量。没有研究报告使用目前 50μg（2000IU）的口服摄入量上限会产生不良反应。
