Adv Exp Med Biol. 2014;810:500-25. doi: 10.1007/978-1-4939-0437-2_28.
Recent evidence suggests that vitamin D deficiency has harmful effects on health and that recent vitamin D intake recommendations may be associated with better health outcomes. In this chapter, evidence is summarized from different studies that evaluate threshold levels for serum 25(OH)D levels in relation to bone mineral density (BMD), lower extremity function, dental health, risk of falls, fractures, cancer prevention, incident hypertension and mortality. For all endpoints, levels in the deficient range (< 50 nmol/l; < 20 ng/ml) are associated with no benefit or adverse effects, while the most advantageous serum levels for 25(OH)D appeared to be close to 75 nmol/l (30 ng/ml). An intake of 800 IU (20 microg) of vitamin D3 (cholecalciferol) per day for all adults may bring 97% of the population to level of at least 50 nmol/l and about 50% up to 75 nmol/l. Thus, higher doses of vitamin D than currently recommended are needed to bring most individuals to75 nmol/l. While estimates suggest that 1600 to 2000 IU vitamin D3 per day may successfully and safely achieve this goal, the implications of higher doses for the total adult population need to be addressed in future studies.
最近的证据表明，维生素 D 缺乏对健康有害，而最近的维生素 D 摄入建议可能与更好的健康结果有关。在本章中，总结了不同研究的证据，评估了血清 25(OH)D 水平与骨密度 (BMD)、下肢功能、口腔健康、跌倒风险、骨折、癌症预防、高血压发生和死亡率之间的阈值水平。对于所有终点，在缺乏范围内的水平 (<50nmol/l；<20ng/ml) 与无益处或不良影响相关，而对于 25(OH)D 最有利的血清水平似乎接近 75nmol/l (30ng/ml)。对于所有成年人，每天摄入 800IU(20μg)维生素 D3(胆钙化醇)可能使 97%的人群达到至少 50nmol/l 的水平，约 50%的人群达到 75nmol/l。因此，需要比目前建议的更高剂量的维生素 D 才能使大多数人达到 75nmol/l。虽然估计表明每天摄入 1600 至 2000IU 维生素 D3 可能成功且安全地实现这一目标，但更高剂量对成年总人口的影响需要在未来的研究中解决。
