Uwaezuoke Samuel N
Department of Paediatrics, College of Medicine, University of Nigeria, Nsukka.
Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku-Ozalla, Nigeria.
Pediatric Health Med Ther. 2017 May 10;8:47-55. doi: 10.2147/PHMT.S129362. eCollection 2017.
There has been renewed scientific interest in the sequelae of vitamin D deficiency, given the emerging evidence on the diverse biologic functions of vitamin D, besides its fundamental role in bone and mineral metabolism. For the past decade, the evidence in the medical literature pointing to a relationship between anemia risk and vitamin D deficiency has been accumulating. This paper critically reviews the current evidence linking vitamin D deficiency to anemia risk in children. The synthesized evidence indicates that the studies, which were preponderantly conducted among the adult population, not only reported a bidirectional relationship between vitamin D deficiency and anemia but also showed a racial effect. In studies conducted among children, similar results were reported. Although the causal association of vitamin D deficiency with anemia risk (especially iron-deficiency anemia) remains debatable, the noncalcemic actions of the vitamin and its analogs hold prospects for several novel clinical applications. There is, however, unanimity in many reports suggesting that vitamin D deficiency is directly associated with anemia of chronic disease or inflammation. Despite the advances in unraveling the role of vitamin D in iron homeostasis, further research is still required to validate causality in the relationship between vitamin D deficiency and anemia, as well as to determine its optimal dosing, the ideal recipients for therapeutic intervention, and the preferred analogs to administer.
鉴于维生素D除了在骨骼和矿物质代谢中发挥重要作用外，还具有多种生物学功能，科学界对维生素D缺乏症的后遗症重新产生了兴趣。在过去十年中，医学文献中关于贫血风险与维生素D缺乏之间关系的证据不断积累。本文对目前将维生素D缺乏与儿童贫血风险联系起来的证据进行了批判性综述。综合证据表明，这些主要在成年人群中进行的研究不仅报告了维生素D缺乏与贫血之间的双向关系，还显示出种族效应。在儿童中进行的研究也报告了类似的结果。尽管维生素D缺乏与贫血风险（尤其是缺铁性贫血）之间的因果关系仍存在争议，但维生素及其类似物的非钙调节作用为一些新的临床应用带来了希望。然而，许多报告一致认为，维生素D缺乏与慢性病或炎症性贫血直接相关。尽管在揭示维生素D在铁稳态中的作用方面取得了进展，但仍需要进一步研究来验证维生素D缺乏与贫血之间关系的因果性，以及确定其最佳剂量、治疗干预的理想接受者和首选的给药类似物。
