Gonçalves de Carvalho C M R, Ribeiro S M L
Federal University of Piauí, Health Sciences Center, Department of Nutrition, Teresina, Piauí, Brazil.
University of São Paulo, Public Health School, Department of Nutrition; School of Arts, Sciences and Humanities, Department of Gerontology, São Paulo, Brazil.
Eur J Clin Nutr. 2017 Apr;71(4):434-440. doi: 10.1038/ejcn.2016.177. Epub 2016 Sep 28.
We conducted a mini-review of the literature, focusing on aging-related systemic inflammation and its association with vitamin D (VitD). As main findings, data indicate that inflammation in aging seems to have multiple origins, including immunosenescence, and from intestinal and adipose tissue, where VitD may modulate these three factors, through mechanisms not totally known. From the selected studies, three randomized clinical trials of VitD supplementation showed improvements in inflammatory status, whereas two studies did not. Ten epidemiological studies showed associations between VitD and inflammation, whereas two studies did not. One case study reinforced this association. As such, we can assume a reasonable association between VitD and inflammation in the elderly, and a promising role of supplementation in some situations. However, most studies did not take into account environmental and individual factors such as the season of the year, latitude, skin color or even the use of some medicines; in addition, the doses, time of intervention and the sample sizes differed between the studies. In conclusion, although more controlled VitD studies, both clinical and epidemiological, are necessary, it is important to remember the network of factors involved in systemic inflammation in the elderly; an understanding of the dietetic and non-dietetic factors is needed to offer a realistic approach.
我们对文献进行了一项小型综述,重点关注与衰老相关的全身炎症及其与维生素D(VitD)的关联。主要研究结果表明,衰老过程中的炎症似乎有多种起源,包括免疫衰老,以及来自肠道和脂肪组织,维生素D可能通过尚未完全明确的机制调节这三个因素。在所选取的研究中,三项维生素D补充剂的随机临床试验显示炎症状态有所改善,而两项研究则未显示出改善。十项流行病学研究表明维生素D与炎症之间存在关联,而两项研究则未发现这种关联。一项病例研究强化了这种关联。因此,我们可以假定老年人中维生素D与炎症之间存在合理关联,且在某些情况下补充维生素D具有前景。然而,大多数研究并未考虑环境和个体因素,如一年中的季节、纬度、肤色甚至某些药物的使用;此外,各项研究之间在剂量、干预时间和样本量方面也存在差异。总之,尽管需要更多临床和流行病学方面的对照维生素D研究,但重要的是要记住老年人全身炎症所涉及的因素网络;需要了解饮食和非饮食因素,以便提供切实可行的方法。