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维生素 D 补充对瘦和肥胖女性血清 25(OH)D 的影响。

The effect of vitamin D supplementation on serum 25(OH)D in thin and obese women.

机构信息

Bone Metabolism Unit, Creighton University Medical Center, Omaha, NE, United States.

出版信息

J Steroid Biochem Mol Biol. 2013 Jul;136:195-200. doi: 10.1016/j.jsbmb.2012.12.003. Epub 2012 Dec 11.

Abstract

Obese people are known to have lower serum 25OHD levels compared to non-obese people. It is not known whether it is due to storage of vitamin D in fat, inadequate input from sunlight, diet or other unknown factors. We examined the relationship at study baseline of serum 25OHD, PTH, 1,25(OH)2D with body composition measurements using dual energy X-ray absorptiometry. The results showed a significant inverse relation between total body fat mass and serum 25OHD (p<0.0001) and serum 1,25(OH2)D (p=034) and an independent positive correlation between serum PTH and total body fat mass (p<0.0001). In a randomized controlled study of seven doses of vitamin D (400-4800IU/d) the increase in serum 25OHD levels was compared in women with a normal body mass index to obese women. The response to the low doses of vitamin D (400-800IU/d) was significantly less than that of the medium (1600-2400IU/d) and high doses groups (3200-4800IU) (p<0.0001) in all BMI categories. The increase in serum 25OHD in the medium and high dose groups was not significantly different with increasing level of obesity. But thinner women with a normal BMI (<25kg/m(2)) showed a much higher response to vitamin D at any dose level compared to other BMI groups. There was no significant change in total body fat mass after treatment with vitamin D or calcitriol in our randomized trials. In summary, the response to vitamin D is dependent on body weight. Women with BMI <25kg/m(2) develop much higher levels of serum 25OHD after vitamin D supplementation compared to those with BMI of >25kg/m(2). The differences in serum 25OHD levels between normal and obese women may be due to differences in volume dilution. After vitamin D supplementation, all obese women reach adequate levels of serum 25OHD but normal women (BMI<25kg/m(2)) reach much higher levels of 25OHD and in this group smaller doses of vitamin D used should be used. This article is part of a Special Issue entitled 'Vitamin D Workshop'.

摘要

肥胖人群的血清 25OHD 水平通常低于非肥胖人群。目前尚不清楚这是由于维生素 D 在脂肪中的储存、阳光摄入不足、饮食还是其他未知因素造成的。我们使用双能 X 射线吸收仪检查了研究基线时血清 25OHD、甲状旁腺激素(PTH)和 1,25(OH)2D 与身体成分测量之间的关系。结果显示,全身脂肪量与血清 25OHD(p<0.0001)和血清 1,25(OH2)D(p=0.034)呈显著负相关,血清 PTH 与全身脂肪量呈独立正相关(p<0.0001)。在一项比较 7 种维生素 D 剂量(400-4800IU/d)对正常体重指数和肥胖女性影响的随机对照研究中,我们比较了血清 25OHD 水平升高的情况。低剂量维生素 D(400-800IU/d)的反应明显低于中剂量(1600-2400IU/d)和高剂量组(3200-4800IU)(p<0.0001),所有 BMI 类别均如此。中、高剂量组的血清 25OHD 升高幅度随肥胖程度的增加而无显著差异。但是,BMI<25kg/m2 的正常体重女性在任何剂量水平下对维生素 D 的反应均明显高于其他 BMI 组。在我们的随机试验中,维生素 D 或骨化三醇治疗后,全身脂肪量没有明显变化。总之,维生素 D 的反应取决于体重。与 BMI>25kg/m2 的女性相比,BMI<25kg/m2 的女性在补充维生素 D 后血清 25OHD 水平升高幅度更大。正常体重和肥胖女性之间血清 25OHD 水平的差异可能是由于容量稀释所致。在补充维生素 D 后,所有肥胖女性的血清 25OHD 水平均达到足够水平,但正常体重女性(BMI<25kg/m2)的血清 25OHD 水平升高幅度更大,且在该组中,应使用更小剂量的维生素 D。本文是题为“维生素 D 研讨会”的特刊的一部分。

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