Pérez-López Faustino R, Pérez-Roncero Gonzalo, López-Baena María T
Grupo de Investigación sobre Salud de la Mujer en Aragón (GRISAMAR), Universidad de Zaragoza, Hospital Clínico Zaragoza, Spain.
Adolesc Health Med Ther. 2010 Jan 26;1:1-8. doi: 10.2147/AHMT.S7472. eCollection 2010.
Vitamin D is a hormone sequentially produced at different body sites, and which plays a significant role in human health, particularly bone health. However, other roles are emerging. When the serum concentration of vitamin D is very low, the risk of rickets, osteomalacia and osteoporosis is increased. In children and adolescents there is a high prevalence of low vitamin D status, especially in females and during the winter-the prevalence being lower than during the summer. Although there is no unanimous agreement over the minimum values necessary for good health, serum 25-hydroxyvitamin D [25(OH)D] levels below 20 ng/mL may be regarded as a vitamin D-deficient condition, and levels between 20-30 ng/mL may be the range of vitamin D insufficiency. Mild low levels have been associated with bone mass accrual alterations in children and adolescents, diminished muscle strength, negative cardiovascular outcomes, insulin resistance and obesity, and neurological disorders. Effective preventive strategies are needed to guarantee adequate vitamin D levels throughout childhood and adolescence, taking into account the geographical setting, season of the year, the level of environmental pollution, skin characteristics, eating habits and body weight, with a view to securing optimum health during these phases, and the prevention of complications in adulthood. There needs to be a renewed appreciation of the beneficial effect of moderate sunlight for providing all humans with the vitamin D needed for ensuring good health. Prolonged sun exposure is not advised, however, due to the risk of skin cancer. In addition, a balanced diet is indicated, since vitamin D-rich foods are better assimilated than supplements. When such conditions cannot be met, then the supplementation of 400 IU/day of vitamin D is advised in children and adolescents-though correcting vitamin D insufficiency or deficiency may require 1000 IU/day or more. High-dose calcifediol depots are an alternative for guaranteeing treatment adherence and in patients with liver disease.
维生素D是一种在身体不同部位依次产生的激素，对人体健康，尤其是骨骼健康起着重要作用。然而，它的其他作用也在不断显现。当血清维生素D浓度极低时，患佝偻病、骨软化症和骨质疏松症的风险会增加。在儿童和青少年中，维生素D水平低的情况很普遍，尤其是女性以及在冬季——患病率低于夏季。尽管对于健康所需的最低值尚无一致意见，但血清25-羟基维生素D[25(OH)D]水平低于20 ng/mL可被视为维生素D缺乏状态，而20-30 ng/mL之间的水平可能属于维生素D不足范围。轻度低水平与儿童和青少年的骨量积累改变、肌肉力量减弱、不良心血管结局、胰岛素抵抗和肥胖以及神经紊乱有关。需要有效的预防策略来确保儿童和青少年时期的维生素D水平充足，要考虑到地理环境、一年中的季节、环境污染程度、皮肤特征、饮食习惯和体重，以期在这些阶段确保最佳健康状态，并预防成年期的并发症。需要重新认识适度阳光照射对为所有人提供确保健康所需维生素D的有益作用。然而，由于存在皮肤癌风险，不建议长时间晒太阳。此外，建议保持均衡饮食，因为富含维生素D的食物比补充剂更易被吸收。当无法满足这些条件时，建议儿童和青少年每天补充400 IU的维生素D——不过纠正维生素D不足或缺乏可能需要每天1000 IU或更多。高剂量的钙化二醇储存剂是保证治疗依从性以及用于肝病患者的一种替代方法。
