de Jongh Renate T, van Schoor Natasja M, Lips Paul
Department of Internal Medicine and Endocrinology, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
Amsterdam Public Health Research Institute, Department of Epidemiology and Biostatistics, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
Mol Cell Endocrinol. 2017 Sep 15;453:144-150. doi: 10.1016/j.mce.2017.06.005. Epub 2017 Jun 7.
Worldwide, vitamin D deficiency is a common finding. Within individuals 25-hydroxyvitamin D (25OH)D) concentrations remain fairly stable over time although large differences in individual longitudinal changes exist. During aging vitamin D metabolism and activity changes in several different ways. Intestinal resistance to 1,25(OH)2D develops which hampers intestinal calcium uptake. Vitamin D receptor number decreases with aging in several organs involved in calcium metabolism and 1alpha-hydroxylase activity decreases mainly due to a decrease in renal function reducing vitamin D activation. Effects of 1,25(OH)2D on cell proliferation and differentiation may influence potential anti-cancer effects whereas regulation of telomere length may result in longevity. In older individuals, vitamin D supplementation has positive effects on fracture risk, number of falls and physical function. Supplementation in older populations warrants specific attention. Effects on "non-classical" outcomes may be revealed by ongoing large randomized clinical trials with high doses of vitamin D.
在全球范围内，维生素D缺乏是一个常见现象。个体体内25-羟基维生素D（25OHD）的浓度随时间推移保持相对稳定，尽管个体纵向变化存在很大差异。在衰老过程中，维生素D的代谢和活性会以几种不同的方式发生变化。肠道对1,25(OH)2D产生抵抗，这会阻碍肠道对钙的吸收。在参与钙代谢的几个器官中，维生素D受体数量随年龄增长而减少，并且1α-羟化酶活性降低，主要是由于肾功能下降导致维生素D活化减少。1,25(OH)2D对细胞增殖和分化的影响可能会影响潜在的抗癌作用，而端粒长度的调节可能会导致长寿。在老年人中，补充维生素D对骨折风险、跌倒次数和身体功能有积极影响。老年人群中的补充问题值得特别关注。正在进行的高剂量维生素D大型随机临床试验可能会揭示其对“非经典”结局的影响。
