School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia; Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
Nutr Rev. 2013 Sep;71(9):611-21. doi: 10.1111/nure.12047. Epub 2013 Aug 15.
Results of recent studies suggest that circulating levels of vitamin D may play an important role in cancer-specific outcomes. The present systematic review was undertaken to determine the prevalence of vitamin D deficiency (<25 nmol/L) and insufficiency (25-50 nmol/L) in cancer patients and to evaluate the association between circulating calcidiol (the indicator of vitamin D status) and clinical outcomes. A systematic search of original, peer-reviewed studies on calcidiol at cancer diagnosis, and throughout treatment and survival, was conducted yielding 4,706 studies. A total of 37 studies met the inclusion criteria for this review. Reported mean blood calcidiol levels ranged from 24.7 to 87.4 nmol/L, with up to 31% of patients identified as deficient and 67% as insufficient. The efficacy of cholecalciferol supplementation for raising the concentration of circulating calcidiol is unclear; standard supplement regimens of <1,000 IU D₃ /day may not be sufficient to maintain adequate concentrations or prevent decreasing calcidiol. Dose-response studies linking vitamin D status to musculoskeletal and survival outcomes in cancer patients are lacking.
最近的研究结果表明，循环维生素 D 水平可能在癌症特异性结局中发挥重要作用。本系统评价旨在确定癌症患者中维生素 D 缺乏（<25nmol/L）和不足（25-50nmol/L）的患病率，并评估循环骨化二醇（维生素 D 状况的指标）与临床结局之间的关系。对癌症诊断时、治疗过程中和生存期间的骨化二醇的原始同行评审研究进行了系统检索，共产生了 4706 项研究。共有 37 项研究符合本综述的纳入标准。报告的平均血液骨化二醇水平范围为 24.7 至 87.4nmol/L，多达 31%的患者被确定为缺乏，67%为不足。胆钙化醇补充剂升高循环骨化二醇浓度的疗效尚不清楚；<1000IU D₃ /天的标准补充方案可能不足以维持足够的浓度或防止骨化二醇降低。缺乏将维生素 D 状态与癌症患者的肌肉骨骼和生存结局联系起来的剂量反应研究。
