Endocrinology Research Group, Institute of Clinical Medicine, University of Tromsø, and Medical Clinic, University Hospital of North Norway, 9038 Tromsø, Norway.
Prog Lipid Res. 2011 Oct;50(4):303-12. doi: 10.1016/j.plipres.2011.05.001. Epub 2011 May 27.
Considering that the vitamin D receptor as well as the 1-α-hydroxylase enzyme that converts 25-hydroxyvitamin D (25(OH)D) to its active form 1,25-dihydroxyvitamin D have been found in tissues throughout the body, it is likely that vitamin D is important for more than the calcium balance. Accordingly, low serum levels of 25(OH)D have been associated with mortality, cardiovascular disease, type 2 diabetes, hypertension and obesity. Low serum levels of 25(OH)D have also been associated with an unfavourable lipid profile, which could possible explain the relation with cardiovascular disease and mortality. However, the relation between vitamin D and lipids have so far received little attention and is therefore the main focus of the present review. A PubMed search identified 22 cross-sectional studies where serum levels of 25(OH)D and lipids were related and that included a minimum of 500 subjects, and 10 placebo-controlled double-blind intervention studies with vitamin D where more than 50 subjects were included. In all the cross-sectional studies serum 25(OH)D was positively associated with high-density lipoprotein cholesterol (HDL-C) resulting in a favourable low-density lipoprotein cholesterol (LDL-C) (or total cholesterol) to HDL-C ratio. There was also a uniform agreement between studies on a negative relation between serum 25(OH)D and triglycerides (TG). On the other hand, the intervention studies gave divergent results, with some showing a positive and some a negative effect of vitamin D supplementation. However, none of the intervention studies were specifically designed for evaluating the relation between vitamin D and lipids, none had hyperlipemia as an inclusion criterion, and none were sufficiently powered. In only one study was a significant effect seen with an 8% (0.28 mmol/L) increase in serum LDL-C and a 16% (0.22 mmol/L) decrease in serum TG in those given vitamin D as compared to the placebo group. Accordingly, the effect of vitamin D supplementation on serum lipids is at present uncertain. Considering the numerous other promising vitamins and minerals that when properly tested have been disappointing, one should wait for the results of forthcoming vitamin D intervention studies before drawing conclusions on potential beneficial effects of vitamin D.
考虑到维生素 D 受体以及将 25-羟基维生素 D（25(OH)D）转化为其活性形式 1,25-二羟基维生素 D 的 1-α-羟化酶存在于全身的组织中，维生素 D 可能不仅对钙平衡很重要。因此，血清 25(OH)D 水平低与死亡率、心血管疾病、2 型糖尿病、高血压和肥胖有关。血清 25(OH)D 水平低也与不良的血脂谱有关，这可能可以解释与心血管疾病和死亡率的关系。然而，维生素 D 与脂质之间的关系到目前为止还没有受到太多关注，因此是本综述的主要重点。通过 PubMed 搜索确定了 22 项横断面研究，这些研究将血清 25(OH)D 和脂质相关联，且每个研究都包含至少 500 名受试者，以及 10 项维生素 D 的安慰剂对照双盲干预研究，其中包括 50 多名受试者。在所有的横断面研究中，血清 25(OH)D 与高密度脂蛋白胆固醇（HDL-C）呈正相关，导致 LDL-C（或总胆固醇）与 HDL-C 的比值有利。研究之间也存在一致的共识，即血清 25(OH)D 与甘油三酯（TG）之间呈负相关。另一方面，干预研究得出了不同的结果，有些研究表明维生素 D 补充有积极影响，有些则有消极影响。然而，没有一项干预研究是专门设计来评估维生素 D 与脂质之间的关系的，没有一项研究将高脂血症作为纳入标准，也没有一项研究具有足够的效力。只有一项研究显示，与安慰剂组相比，给予维生素 D 的患者血清 LDL-C 增加 8%（0.28mmol/L），血清 TG 降低 16%（0.22mmol/L），具有显著的效果。因此，目前尚不确定维生素 D 补充对血清脂质的影响。考虑到其他许多有前途的维生素和矿物质，如果经过适当的测试，结果令人失望，在得出关于维生素 D 潜在有益效果的结论之前，人们应该等待即将进行的维生素 D 干预研究的结果。
