a INSERM, UMR1062, Nutrition, Obesity and Risk of Thrombosis , Marseille , France.
Crit Rev Food Sci Nutr. 2015;55(9):1193-205. doi: 10.1080/10408398.2012.688897.
There has been renewed interest in vitamin D since numerous recent studies have suggested that besides its well-established roles in bone metabolism and immunity, vitamin D status is inversely associated with the incidence of several diseases, e.g., cancers, cardio-vascular diseases, and neurodegenerative diseases. Surprisingly, there is very little data on factors that affect absorption of this fat-soluble vitamin, although it is acknowledged that dietary vitamin D could help to fight against the subdeficient vitamin D status that is common in several populations. This review describes the state of the art concerning the fate of vitamin D in the human upper gastrointestinal tract and on the factors assumed to affect its absorption efficiency. The main conclusions are: (i) ergocalciferol (vitamin D2), the form mostly used in supplements and fortified foods, is apparently absorbed with similar efficiency to cholecalciferol (vitamin D3, the main dietary form), (ii) 25-hydroxyvitamin D (25OHD), the metabolite produced in the liver, and which can be found in foods, is better absorbed than the nonhydroxy vitamin D forms cholecalciferol and ergocalciferol, (iii) the amount of fat with which vitamin D is ingested does not seem to significantly modify the bioavailability of vitamin D3, (iv) the food matrix has apparently little effect on vitamin D bioavailability, (v) sucrose polyesters (Olestra) and tetrahydrolipstatin (orlistat) probably diminish vitamin D absorption, and (vi) there is apparently no effect of aging on vitamin D absorption efficiency. We also find that there is insufficient, or even no data on the following factors suspected of affecting vitamin D bioavailability: (i) effect of type and amount of dietary fiber, (ii) effect of vitamin D status, and (iii) effect of genetic variation in proteins involved in its intestinal absorption. In conclusion, further studies are needed to improve our knowledge of factors affecting vitamin D absorption efficiency. Clinical studies with labeled vitamin D, e.g., deuterated or (13)C, are needed to accurately and definitively assess the effect of various factors on its bioavailability.
自大量近期研究表明，除了在骨骼代谢和免疫方面的既定作用外，维生素 D 状态与多种疾病的发病率呈负相关以来，人们对维生素 D 重新产生了兴趣，例如癌症、心血管疾病和神经退行性疾病。令人惊讶的是，尽管人们承认膳食维生素 D 有助于对抗几种人群中普遍存在的维生素 D 亚缺乏状态，但关于影响这种脂溶性维生素吸收的因素的数据却很少。本文综述了有关维生素 D 在人体上消化道中的命运以及假设影响其吸收效率的因素的最新知识。主要结论是：(i)麦角钙化醇（维生素 D2），是补充剂和强化食品中最常用的形式，其吸收效率显然与胆钙化醇（维生素 D3，主要的膳食形式）相似，(ii)25-羟维生素 D（25OHD），在肝脏中产生的代谢产物，可在食物中找到，其吸收优于非羟维生素 D 形式的胆钙化醇和麦角钙化醇，(iii)与维生素 D 一起摄入的脂肪量似乎不会显著改变维生素 D3 的生物利用度，(iv)食物基质显然对维生素 D 的生物利用度影响很小，(v)蔗糖聚酯（奥利斯特）和四氢脂抑素（奥利司他）可能会降低维生素 D 的吸收，(vi) 维生素 D 吸收效率似乎不受衰老的影响。我们还发现，有一些因素对维生素 D 的生物利用度有影响，但目前的数据不足，甚至没有，这些因素包括：(i)膳食纤维的类型和数量的影响，(ii)维生素 D 状态的影响，以及 (iii)涉及其肠道吸收的蛋白质的遗传变异的影响。总之，需要进一步的研究来提高我们对影响维生素 D 吸收效率的因素的认识。需要用标记的维生素 D（例如氘代或（13）C）进行临床研究，以准确和明确地评估各种因素对其生物利用度的影响。
