Tirabassi Giacomo, Salvio Gianmaria, Altieri Barbara, Ronchi Cristina L, Della Casa Silvia, Pontecorvi Alfredo, Balercia Giancarlo
Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Ancona, Italy.
Division of Endocrinology and Metabolic Diseases, Catholic University of the Sacred Heart, Rome, Italy.
Rev Endocr Metab Disord. 2017 Sep;18(3):355-362. doi: 10.1007/s11154-016-9391-y.
An emerging branch of research is examining the linkage between Vitamin D and nonskeletal disorders, including endocrine diseases. In this regard, a still little studied aspect concerns the involvement of vitamin D in adrenal gland disorders. Adrenal gland disorders, which might be theoretically affected by vitamin D unbalance, include adrenal insufficiency, Cushing's syndrome, adrenocortical tumors and hyperaldosteronism. In this review, we provide an updated document, which tries to collect and discuss the limited evidence to be found in the literature about the relationship between vitamin D and adrenal disorders. We conclude that there is insufficient evidence proving a causal relationship between vitamin D levels and adrenal disorders. Evidence coming from cross-sectional clinical studies can hardly clarify what comes first between vitamin D unbalance and adrenal disease. On the other hand, longitudinal studies monitoring the levels of vitamin D in patients with adrenal disorders or, conversely, the possible development of adrenal pathologies in subjects affected by impaired vitamin D levels would be able to elucidate this still unclear issue.
一个新兴的研究分支正在探究维生素D与非骨骼疾病(包括内分泌疾病)之间的联系。在这方面,一个仍未得到充分研究的方面是维生素D在肾上腺疾病中的作用。理论上可能受维生素D失衡影响的肾上腺疾病包括肾上腺功能不全、库欣综合征、肾上腺皮质肿瘤和醛固酮增多症。在这篇综述中,我们提供了一份更新的文献,试图收集并讨论文献中关于维生素D与肾上腺疾病关系的有限证据。我们得出结论,没有足够的证据证明维生素D水平与肾上腺疾病之间存在因果关系。来自横断面临床研究的证据很难阐明维生素D失衡和肾上腺疾病谁先出现。另一方面,监测肾上腺疾病患者维生素D水平的纵向研究,或者相反,监测维生素D水平受损受试者肾上腺病变可能发展情况的纵向研究,将能够阐明这个仍不清楚的问题。