Marcinowska-Suchowierska Ewa, Walicka Magdalena, Tałałaj Marek, Horst-Sikorska Wanda, Ignaszak-Szczepaniak Magdalena, Sewerynek Ewa
Klinika Medycyny Rodzinnej, Chorób Wewnętrznych i Chorób Metabolicznych Kości, Centrum Medycznego KształceniaPodyplomowego, Warszawa.
Endokrynol Pol. 2010;61 Suppl 1:39-45.
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.
维生素D对于维持体内适当的钙和磷稳态(经典功能)以及确保许多组织、器官和细胞的正常功能(与矿物质代谢无关的非经典功能)至关重要。成年人维生素D缺乏可能导致骨软化症,增加骨质疏松症患者的骨折风险,引发心血管疾病、1型和2型糖尿病、多发性硬化症、莱什尼奥夫斯基-克罗恩病以及癌症,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以及食物和补充剂中维生素D摄入不足。维生素D缺乏水平(25(OH)D<20 ng/mL)相当普遍,在世界各地相当比例的健康受试者中都能发现,无论种族、性别和年龄。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获得的食品补充剂中的最大维生素D水平(每日50μg)有关。如今,建议成年人在阳光照射不足时(在波兰为10月至4月)每天至少需要800 - 1000国际单位。这个剂量应提供给所有避免阳光照射的人,以及65岁以上的人,因为他们皮肤合成维生素D的速度较慢,且维生素D已被证实具有抗骨折和防跌倒的作用。