Savastano Silvia, Barrea Luigi, Savanelli Maria Cristina, Nappi Francesca, Di Somma Carolina, Orio Francesco, Colao Annamaria
Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy.
I.O.S. & COLEMAN Srl, 80011 Acerra, Naples, Italy.
Rev Endocr Metab Disord. 2017 Jun;18(2):215-225. doi: 10.1007/s11154-017-9410-7.
Low vitamin D status and obesity have concomitantly reached epidemic levels worldwide. Up to now the direction of the association between low vitamin D status and obesity, the exact mechanisms responsible for this association and the clinical usefulness to increase vitamin D status for reducing adiposity still warrant further evaluation. The aim of the present review was to examine the current evidence linking low vitamin D status and obesity in relation to the role of the nutritionist. On the one side, considering obesity as a causal factor, low sun exposure in obese individuals due to their sedentary lifestyle and less outdoor activity, vitamin D sequestration in adipose tissue, and volumetric dilution of ingested or cutaneously synthesized vitamin D in the large fat mass of obese patients, might represent some of the factors playing a major role in the pathogenesis of the low vitamin D status. On the other side, the expression of both vitamin D receptors and enzymes responsible for vitamin D metabolism in adipocytes depicted a role for the low vitamin D status per se in the development of obesity by modulating adipocyte differentiation and lipid metabolism. Nutritionists need to accurately address the aspects influencing the low vitamin D status in obesity and the vitamin D supplementation in obese individuals.
维生素D水平低下和肥胖在全球范围内已同时达到流行程度。到目前为止，维生素D水平低下与肥胖之间关联的方向、造成这种关联的确切机制以及提高维生素D水平以减少肥胖的临床实用性仍有待进一步评估。本综述的目的是审查目前将维生素D水平低下与肥胖联系起来的证据，以及营养师在其中所起的作用。一方面，将肥胖视为一个致病因素，肥胖个体由于久坐不动的生活方式和较少的户外活动而日照不足、脂肪组织对维生素D的隔离，以及肥胖患者大量脂肪对摄入或经皮肤合成的维生素D的容积稀释，可能是导致维生素D水平低下发病机制的一些主要因素。另一方面，脂肪细胞中维生素D受体和负责维生素D代谢的酶的表达表明，维生素D水平低下本身通过调节脂肪细胞分化和脂质代谢在肥胖发展中起作用。营养师需要准确处理影响肥胖中维生素D水平低下的因素以及肥胖个体的维生素D补充问题。
