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维生素 D 补充剂在呼吸系统疾病中的应用:来自随机对照试验的证据。

Vitamin D supplementation in respiratory diseases: evidence from randomized controlled trials.

出版信息

Pol Arch Intern Med. 2017 Nov 30;127(11):775-784. doi: 10.20452/pamw.4134. Epub 2017 Nov 2.

Abstract

Pulmonary diseases are one of the most important causes of morbidity and mortality. Although vitamin D is best known for its role in calcium, phosphorus, and bone homeostasis, it has gained attention in the recent years because of a wide range of extraskeletal effects, including its immunomodulatory and antibacterial potential. Vitamin D deficiency is highly prevalent in chronic pulmonary diseases such as chronic obstructive pulmonary disease (COPD), cystic fibrosis, tuberculosis, and asthma, and several clinical studies have been conducted investigating the effect of vitamin D supplementation on disease outcomes. In this review, we searched for positive evidence on vitamin D supplementation from randomized controlled trials and elaborated on the optimal serum vitamin D levels and dosing regimens for an effective intervention. While vitamin D supplementation seems to be beneficial as an add‑on treatment for adult patients with asthma and a potent intervention to reduce exacerbations in patients with COPD, there is little evidence for its therapeutic use in cystic fibrosis, pneumonia, and tuberculosis.

摘要

肺部疾病是发病率和死亡率的重要原因之一。虽然维生素 D 最广为人知的作用是在钙、磷和骨骼的动态平衡中发挥作用,但近年来由于其广泛的骨骼外作用,包括其免疫调节和抗菌潜力,引起了人们的关注。维生素 D 缺乏在慢性肺部疾病中很常见,如慢性阻塞性肺疾病(COPD)、囊性纤维化、结核病和哮喘,并且已经进行了多项临床研究来研究维生素 D 补充对疾病结局的影响。在这篇综述中,我们搜索了随机对照试验中关于维生素 D 补充的阳性证据,并详细阐述了有效的干预措施所需的最佳血清维生素 D 水平和剂量方案。虽然维生素 D 补充似乎作为一种附加治疗对成年哮喘患者有益,并且是减少 COPD 患者恶化的有效干预措施,但在囊性纤维化、肺炎和结核病中,其治疗用途的证据很少。

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