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成人维生素 D 补充剂 - 指南。

Vitamin D supplementation in adults - guidelines.

机构信息

Medical Centre of Postgraduate Education, Warszawa, Poland.

出版信息

Endokrynol Pol. 2010 Nov-Dec;61(6):723-9.

Abstract

Vitamin D is necessary in maintaining appropriate calcium and phosphate homeostasis in the body (classical function) and ensuring appropriate functioning of many tissues, organs and cells, unrelated to mineral economy (non-classical function). Vitamin D deficiency in adults may cause osteomalacia, increase fracture risk in osteoporosis, induce cardiovascular diseases, diabetes type 1 and 2, multiple sclerosis, Lesniowski-Crohn disease, and cancer, including colon, breast, and prostate cancer. Possible causes of vitamin D deficiency in a healthy population include decreased cutaneous synthesis and an inadequate intake of vitamin D, both in food and in supplements. Vitamin D deficiency level (25(OH) D. 〈 20 ng/mL), is fairly widespread, being found in a substantial percentage of healthy subjects around the world, regardless of race, gender and age. Daily vitamin D dose, as determined by the Food and Nutrition Board in 1997, is now rather insufficient, the biggest problem being associated with maximal vitamin D levels (50 μg/day) in actually available food supplements. Nowadays, it is recommended that adults need a minimum of 800-1,000 U/day when their exposure to the sun is inadequate (in Poland from October to April). This dosage should be provided to all subjects who avoid sunlight, as well as to those aged over 65 because of their slower skin synthesis of vitamin D and for its proven anti-fracture and anti-fall effects.

摘要

维生素 D 对于维持体内适当的钙和磷平衡(经典功能)以及确保许多组织、器官和细胞的适当功能(非经典功能)是必需的。成年人维生素 D 缺乏可导致佝偻病,增加骨质疏松症骨折风险,诱发心血管疾病、1 型和 2 型糖尿病、多发性硬化症、莱什尼奥斯基-克罗恩病和癌症,包括结肠癌、乳腺癌和前列腺癌。健康人群中维生素 D 缺乏的可能原因包括皮肤合成减少和食物及补充剂中维生素 D 摄入不足。维生素 D 缺乏水平(25(OH)D. 〈 20ng/mL)相当普遍,在世界各地的健康受试者中都有相当大的比例存在,无论种族、性别和年龄如何。1997 年,食品和营养委员会确定的每日维生素 D 剂量现在相当不足,最大的问题与实际可用的食品补充剂中最大维生素 D 水平(50μg/天)有关。如今,建议在阳光不足时(在波兰为 10 月至 4 月),成年人每天至少需要 800-1000IU。对于避免阳光照射的所有受试者,以及 65 岁以上的老年人,都应提供这种剂量,因为他们的皮肤合成维生素 D 的速度较慢,并且有预防骨折和跌倒的效果。

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