肠易激综合征患者的维生素 D 状况,以及补充维生素 D 对症状的影响:我们知道什么,我们还需要知道什么?
Vitamin D status in irritable bowel syndrome and the impact of supplementation on symptoms: what do we know and what do we need to know?
机构信息
Molecular Gastroenterology Research Group, Academic Unit of Surgical Oncology, Department of Oncology & Metabolism, University of Sheffield, Beech Hill Road, Sheffield, S10 2RX, UK.
Department of Oncology & Metabolism, Human Nutrition Unit, University of Sheffield, Beech Hill Road, Sheffield, S10 2RX, UK.
出版信息
Eur J Clin Nutr. 2018 Oct;72(10):1358-1363. doi: 10.1038/s41430-017-0064-z. Epub 2018 Jan 25.
BACKGROUND
Low vitamin D status is associated with risk of colorectal cancer and has been implicated in inflammatory bowel disease. Irritable bowel syndrome (IBS) is a chronic, relapsing, functional bowel disorder. A nascent literature suggests a role for vitamin D in IBS, but this has not been collated or critiqued. To date, seven studies have been published: four observational studies and three randomised controlled trials (RCTs). All observational studies reported that a substantial proportion of the IBS population was vitamin D deficient. Two intervention studies reported improvement in IBS symptom severity scores and quality of life (QoL) with vitamin D supplementation. There are limited data around the role of vitamin D in IBS.
CONCLUSIONS
The available evidence suggests that low vitamin D status is common among the IBS population and merits assessment and rectification for general health reasons alone. An inverse correlation between serum vitamin D and IBS symptom severity is suggested and vitamin D interventions may benefit symptoms. However, the available RCTs do not provide strong, generalisable evidence; larger and adequately powered interventions are needed to establish a case for therapeutic application of vitamin D in IBS.
背景
维生素 D 水平低与结直肠癌风险相关,并与炎症性肠病有关。肠易激综合征(IBS)是一种慢性、复发性、功能性肠病。新出现的文献表明维生素 D 在 IBS 中的作用,但尚未进行整理和评估。迄今为止,已有七项研究发表:四项观察性研究和三项随机对照试验(RCT)。所有观察性研究都报告说,相当一部分 IBS 患者存在维生素 D 缺乏。两项干预研究报告说,维生素 D 补充剂可改善 IBS 症状严重程度评分和生活质量(QoL)。目前关于维生素 D 在 IBS 中的作用的数据有限。
结论
现有证据表明,IBS 患者中维生素 D 水平低很常见,仅出于一般健康原因就值得进行评估和纠正。血清维生素 D 与 IBS 症状严重程度呈负相关,维生素 D 干预可能对症状有益。然而,现有的 RCT 并未提供强有力的、可推广的证据;需要更大规模和足够效力的干预措施来确定维生素 D 在 IBS 中的治疗应用的案例。