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精神障碍、认知障碍与血清维生素D水平之间的关联:现状

Association between mental disorders, cognitive disturbances and vitamin D serum level: Current state.

作者信息

Lerner Paul P, Sharony Laura, Miodownik Chanoch

机构信息

Mental Health Center Geha, Petakh Tikva, Israel.

Mental Health Center Geha, Petakh Tikva, Israel; Mazor Mental Health Center, Acre, Israel.

出版信息

Clin Nutr ESPEN. 2018 Feb;23:89-102. doi: 10.1016/j.clnesp.2017.11.011. Epub 2017 Dec 23.

Abstract

BACKGROUND & AIMS: Vitamin D deficiency has been identified as a global problem. Approximately 14% of the world population has inadequate vitamin D levels. This vitamin has been usually associated with bone disorders such as rickets, osteomalacia, and osteoporosis. However, these disorders present only a small part of all the disturbances which can be induced by its deficiency. Low serum vitamin D is associated with development of cardiovascular diseases, hypertension, neurodegenerative diseases, diabetes mellitus, metabolic syndrome and even cancer. This vitamin may be an important factor in the development of psychiatric illnesses, therefore clinicians should not leave this serious issue unresolved. The aim of this review is to describe the current data concerning the association between vitamin D serum levels, cognition and mental disorders.

METHODS

We conducted a systematic bibliographical research, of PubMed, MedLine literature and Cochrane database without language restriction to identify all publications concerning this issue from 1995 to the first quarter of 2017.

RESULTS

We found 48,937 articles concerning vitamin D, published during the last 22 years and 3 months (1995-2017). We selected only those publications focused on the association between vitamin D serum deficiency and mental disturbances (depression, schizophrenia, cognitive disturbances, attention deficit disorder, and autism). One hundred and sixty-seven papers were found suitable to our selection criteria. Careful evaluation of the relevant literature demonstrates that addition of vitamin D to conventional antidepressive agents can improve antidepressive effect in contrast to placebo. Regarding other mental conditions there are no clear-cut conclusions.

CONCLUSIONS

An association between low vitamin D serum levels and different mental disorders was found. Yet, nonetheless there is no clear consensus that addition of vitamin D improves or is related to a beneficial effect on mental health. More randomized clinical control trials should be performed in order to reach evidence based conclusions.

摘要

背景与目的

维生素D缺乏已被认定为一个全球性问题。全球约14%的人口维生素D水平不足。这种维生素通常与佝偻病、骨软化症和骨质疏松症等骨骼疾病相关。然而,这些疾病只是其缺乏可能引发的所有紊乱中的一小部分。血清维生素D水平低与心血管疾病、高血压、神经退行性疾病、糖尿病、代谢综合征甚至癌症的发生有关。这种维生素可能是精神疾病发展的一个重要因素,因此临床医生不应忽视这个严重问题。本综述的目的是描述目前有关血清维生素D水平、认知与精神障碍之间关联的数据。

方法

我们对PubMed、MedLine文献和Cochrane数据库进行了系统的文献检索,无语言限制,以确定1995年至2017年第一季度所有关于此问题的出版物。

结果

我们发现了在过去22年零3个月(1995 - 2017年)期间发表的48937篇关于维生素D的文章。我们仅选择了那些关注血清维生素D缺乏与精神障碍(抑郁症、精神分裂症、认知障碍、注意力缺陷障碍和自闭症)之间关联的出版物。发现有167篇论文符合我们的选择标准。对相关文献的仔细评估表明,与安慰剂相比,在传统抗抑郁药中添加维生素D可提高抗抑郁效果。关于其他精神状况,尚无明确结论。

结论

发现血清维生素D水平低与不同的精神障碍之间存在关联。然而,对于添加维生素D是否能改善心理健康或与之产生有益效果,尚无明确共识。应进行更多随机临床对照试验以得出基于证据的结论。

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