Maine Medical Center Research Institute, 81 Research Drive, Scarborough, ME 04074, USA.
Nat Rev Endocrinol. 2013 Jul;9(7):434-8. doi: 10.1038/nrendo.2013.75. Epub 2013 Apr 23.
Misconceptions about vitamin D continue to grow despite publications in the past few years that have attempted to clarify risk. We present our perspective, and offer several conclusions. Calcium and vitamin D supplementation can reduce fracture risk by ∼10%. On the other hand, little evidence exists to support a threshold measure for vitamin D status (serum levels of 25-hydroxyvitamin D) above which fractures are reduced. The association of serum concentrations of 25-hydroxyvitamin D with other chronic diseases is confounded by multiple factors and conflicting outcomes that cannot be used to support a causal association. High doses of vitamin D supplements might not be completely harmless and should be avoided until additional data becomes available. Similarly, scant rationale exists for aggressive vitamin D supplementation for pregnant or lactating women. Dispelling misconceptions about vitamin D will ultimately benefit health-care providers and patients alike.
尽管过去几年有一些出版物试图澄清风险，但关于维生素 D 的误解仍在不断增加。我们提出了自己的观点，并得出了几个结论。钙和维生素 D 补充剂可以将骨折风险降低约 10%。另一方面，几乎没有证据支持维生素 D 状态（血清 25-羟维生素 D 水平）存在一个阈值，高于该阈值可以降低骨折风险。血清 25-羟维生素 D 浓度与其他慢性疾病的关联受到多种因素和相互矛盾的结果的影响，这些结果不能用于支持因果关系。维生素 D 补充剂的高剂量可能并非完全无害，应在获得更多数据之前避免使用。同样，对于孕妇或哺乳期妇女进行积极的维生素 D 补充也没有充分的理由。消除关于维生素 D 的误解最终将使医疗保健提供者和患者受益。
