Pannu Poonam K, Calton Emily K, Soares Mario J
School of Public Health, Curtin Health Innovation Research Institute-Metabolic Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.
School of Public Health, Curtin Health Innovation Research Institute-Metabolic Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.
Adv Food Nutr Res. 2016;77:57-100. doi: 10.1016/bs.afnr.2015.11.001. Epub 2016 Feb 9.
There is a pandemic of lifestyle-related diseases. In both developed and lesser developed countries of the world, an inadequacy of calcium intake and low vitamin D status is common. In this chapter, we explore a mechanistic framework that links calcium and vitamin D status to chronic conditions including obesity, systemic inflammation, endothelial dysfunction, dyslipidemia and cardiovascular disease, and type 2 diabetes mellitus. We also update the available clinical evidence, mainly from randomized controlled trials, to provide a synthesis of evidence in favor or against these hypotheses. There is consistent data to support calcium increasing whole body fat oxidation and increasing fecal fat excretion, while there is good cellular evidence for vitamin D reducing inflammation. Clinical trials support a marginal reduction in circulating lipids and some meta-analysis support an increase in insulin sensitivity following vitamin D. However, these mechanistic pathways and intermediate biomarkers of disease do not consistently transcribe into measurable health outcomes. Cementing the benefits of calcium and vitamin D for extraskeletal health needs a reexamination of the target 25(OH)D level to be achieved and the minimum duration of future trials.
与生活方式相关的疾病正在流行。在世界上的发达国家和欠发达国家，钙摄入不足和维生素D水平低的情况都很常见。在本章中，我们探讨了一个机制框架，该框架将钙和维生素D状态与包括肥胖、全身炎症、内皮功能障碍、血脂异常和心血管疾病以及2型糖尿病在内的慢性疾病联系起来。我们还更新了现有临床证据，主要来自随机对照试验，以综合支持或反对这些假设的证据。有一致的数据支持钙增加全身脂肪氧化和增加粪便脂肪排泄，而有良好的细胞证据表明维生素D可减轻炎症。临床试验支持维生素D使循环脂质略有降低，一些荟萃分析支持维生素D可提高胰岛素敏感性。然而，这些机制途径和疾病的中间生物标志物并不能始终转化为可测量的健康结果。要巩固钙和维生素D对骨骼外健康的益处，需要重新审视要达到的目标25(OH)D水平以及未来试验的最短持续时间。
