University of Missouri School of Medicine, Columbia, MO, USA.
John Peter Smith Family Medicine Residency, Fort Worth, TX, USA.
Am Fam Physician. 2018 Feb 15;97(4):254-260.
Measurement of vitamin D levels and supplementation with oral vitamin D have become commonplace, although clinical trials have not demonstrated health benefits. The usefulness of serum 25-hydroxyvitamin D levels to assess adequate exposure to vitamin D is hampered by variations in measurement technique and precision. Serum levels less than 12 ng per mL reflect inadequate vitamin D intake for bone health. Levels greater than 20 ng per mL are adequate for 97.5% of the population. Routine vitamin D supplementation does not prolong life, decrease the incidence of cancer or cardiovascular disease, or decrease fracture rates. Screening asymptomatic individuals for vitamin D deficiency and treating those considered to be deficient do not reduce the risk of cancer, type 2 diabetes mellitus, or death in community-dwelling adults, or fractures in persons not at high risk of fractures. Randomized controlled trials of vitamin D supplementation in the treatment of depression, fatigue, osteoarthritis, and chronic pain show no benefit, even in persons with low levels at baseline.
维生素 D 水平的测量和口服维生素 D 补充已变得很普遍，尽管临床试验并未显示出对健康有益。由于测量技术和精度的差异，血清 25-羟维生素 D 水平评估维生素 D 充足暴露的有用性受到阻碍。血清水平低于 12ng/ml 反映了骨骼健康的维生素 D 摄入不足。水平大于 20ng/ml 对 97.5%的人群是足够的。常规维生素 D 补充并不能延长寿命、降低癌症或心血管疾病的发病率，也不能降低骨折率。对无症状个体进行维生素 D 缺乏筛查并治疗被认为是缺乏的个体并不能降低癌症、2 型糖尿病或社区居住成年人的死亡率，也不能降低非高风险骨折者的骨折率。维生素 D 补充治疗抑郁症、疲劳、骨关节炎和慢性疼痛的随机对照试验显示没有益处，即使在基线水平较低的人群中也是如此。
