Department of Dermatology, University of Connecticut Health Center, 263 Farmington Ave, Farmington,CT 06030-6230, USA.
Clin Dermatol. 2010 Nov-Dec;28(6):663-8. doi: 10.1016/j.clindermatol.2010.03.030.
Vitamin D is a fat-soluble nutrient that humans obtain through the diet and by synthesis in the skin upon exposure to ultraviolet B. Vitamin D is then converted by the liver to 25-hydroxyvitamin D, its major circulating form. This form is the best indicator of vitamin D nutritional status and is easily measured. Under the influence of parathyroid hormone, the kidney then converts 25-hydroxyvitamin D to 1,25-dihydroxyvitamin D, the biologically active, hormonal form of the nutrient that is important in the metabolism of calcium and phosphorus and is critical in building and maintaining healthy bones. Many cell types outside of the skeletal system, including various cells in the skin, also express the vitamin D receptor. In addition, many cell types convert circulating 25-hydroxyvitamin D to 1,25-dihydroxyvitamin D for local use. This metabolite has been shown to exert potent effects on cellular differentiation, cellular proliferation, and immune regulation. It is theorized that by these mechanisms vitamin D and its analogues are effective treatment options for psoriasis and other skin diseases. Insufficient vitamin D nutritional status has been associated with a host of other diseases, most notably cancer. There is evidence that supplementation with vitamin D reduces the overall incidence of cancer, although current evidence is insufficient to prove a causative effect. Sunscreen use blocks the ability of the skin to photosynthesize vitamin D, although the effect this has on the vitamin D status of the general population is unclear.
维生素 D 是一种脂溶性营养素,人体可通过饮食和皮肤在暴露于紫外线 B 时的合成来获取。维生素 D 随后在肝脏中转化为 25-羟维生素 D,这是其主要的循环形式。这种形式是维生素 D 营养状况的最佳指标,且易于测量。在甲状旁腺激素的影响下,肾脏将 25-羟维生素 D 转化为 1,25-二羟维生素 D,这是营养素的生物活性、激素形式,对于钙和磷的代谢非常重要,对骨骼的健康构建和维持至关重要。骨骼系统以外的许多细胞类型,包括皮肤中的各种细胞,也表达维生素 D 受体。此外,许多细胞类型将循环 25-羟维生素 D 转化为 1,25-二羟维生素 D 以供局部使用。该代谢物已被证明对细胞分化、细胞增殖和免疫调节具有强大的作用。据推测,通过这些机制,维生素 D 及其类似物是治疗银屑病和其他皮肤病的有效选择。维生素 D 营养不足与许多其他疾病有关,尤其是癌症。有证据表明,补充维生素 D 可降低癌症的总体发病率,尽管目前的证据还不足以证明其具有因果关系。防晒霜会阻止皮肤合成维生素 D 的能力,尽管这对普通人群的维生素 D 状况有何影响尚不清楚。