Bruyère Olivier, Cavalier Etienne, Buckinx Fanny, Reginster Jean-Yves
aResearch Unit in Public Health, Epidemiology and Health Economics, University of Liège bDepartment of Clinical Chemistry, University of Liège, CHU Sart-Tilman, Liège, Belgium.
Curr Opin Clin Nutr Metab Care. 2017 Jan;20(1):26-29. doi: 10.1097/MCO.0000000000000334.
This article reviews recently published evidence regarding the role of vitamin D in the physiopathology of physical frailty in elderly populations and its role in the management of this geriatric condition.
Some recent studies have found a low level of 25-hydroxyvitamin D, considered the best marker of vitamin D status, in frail individuals. All prospective studies consistently report that low vitamin D status is associated with an increased risk of becoming frail. Recent studies also suggest that the relationship between vitamin D status and frailty is largely mediated by the development of sarcopenia. Very few well designed randomized controlled trials are available that assess the effectiveness of vitamin D supplementation in the prevention or management of frailty. In the absence of specific guidelines, a minimal serum 25-hydroxyvitamin D level of 75 nmol/l is proposed for frail elderly patients by some scientific societies. The doses necessary to reach this target are between 800 and 2000 IU/day.
Several studies suggest a potential effect of vitamin D on physical frailty but large clinical trials are lacking at this time to provide solid evidence of clinical benefit.
本文综述了近期发表的有关维生素D在老年人群身体虚弱的生理病理学中的作用及其在这种老年疾病管理中的作用的证据。
一些近期研究发现,在身体虚弱的个体中,25-羟基维生素D水平较低,25-羟基维生素D被认为是维生素D状态的最佳标志物。所有前瞻性研究一致报告,维生素D水平低与身体虚弱风险增加有关。近期研究还表明,维生素D状态与身体虚弱之间的关系很大程度上是由肌肉减少症的发展介导的。很少有设计良好的随机对照试验评估补充维生素D在预防或管理身体虚弱方面的有效性。在缺乏具体指南的情况下,一些科学协会建议身体虚弱的老年患者血清25-羟基维生素D的最低水平为75纳摩尔/升。达到这一目标所需的剂量为每天800至2000国际单位。
多项研究表明维生素D对身体虚弱可能有影响,但目前缺乏大型临床试验来提供临床益处的确凿证据。