Grant William B, Wimalawansa Sunil J, Holick Michael F, Cannell John J, Pludowski Pawel, Lappe Joan M, Pittaway Mary, May Philip
Sunlight, Nutrition, and Health Research Center, PO Box 641603, San Francisco, CA 94164-1603, USA.
Department of Medicine & Endocrinology, Cardio Metabolic Institute, Somerset, NJ 08873, USA.
Nutrients. 2015 Feb 27;7(3):1538-64. doi: 10.3390/nu7031538.
People with neurodevelopmental disorders and intellectual disabilities have much greater health care needs. Mainly staying indoors, such people generally have low 25-hydroxyvitamin D (25(OH)D) concentrations. The Vitamin D Task Force of the American Academy of Developmental Medicine and Dentistry (AADMD) reviewed the evidence of 25(OH)D concentrations that benefit the health of persons with developmental disabilities. Maintaining recommended optimal serum 25(OH)D concentrations year long will benefit skeletal development in infants, children, and adolescents, and benefit musculoskeletal health and neuromuscular coordination in adult patients, and decrease risk of falls. Maintaining optimal concentrations decreases risks and severities of autoimmune diseases, cardiovascular disease, many types of cancer, dementia, types 1 and 2 diabetes mellitus, and respiratory tract infections. Other benefits include improved dental and oral health and improved physical performance. The Task Force recommends that 25(OH)D concentrations for optimal health to be in the range of 75 to 125 nmol/L, which can be achieved using between 800 and 4000 IU/day vitamin D3 and sensible exposure to solar UVB radiation. The paper also discusses the potential risks of higher 25(OH)D concentrations, the evidence from and limitations of randomized controlled trials, and the recommendations by various groups and agencies.
患有神经发育障碍和智力残疾的人有更大的医疗保健需求。这类人主要待在室内,其25-羟维生素D(25(OH)D)浓度普遍较低。美国发育医学与牙科学会(AADMD)的维生素D特别工作组审查了有益于发育障碍患者健康的25(OH)D浓度证据。全年维持推荐的最佳血清25(OH)D浓度,将有益于婴儿、儿童和青少年的骨骼发育,有益于成年患者的肌肉骨骼健康和神经肌肉协调,并降低跌倒风险。维持最佳浓度可降低自身免疫性疾病、心血管疾病、多种癌症、痴呆症、1型和2型糖尿病以及呼吸道感染的风险和严重程度。其他益处包括改善牙齿和口腔健康以及提高身体机能。特别工作组建议,为实现最佳健康状态,25(OH)D浓度应在75至125 nmol/L范围内,这可通过每天服用800至4000国际单位的维生素D3以及适度暴露于太阳紫外线B辐射来实现。本文还讨论了25(OH)D浓度较高时的潜在风险、随机对照试验的证据和局限性,以及各团体和机构的建议。