Kaur Jasleen, Khare Swapnil, Sizar Omeed, Givler Amy
HealthPartners, St. Paul
Indiana University
Vitamin D is a fat-soluble nutrient essential for calcium homeostasis and bone metabolism. Deficiency of this beneficial substance can lead to nutritional rickets in children and osteomalacia in adults. In the 1930s, North America began fortifying milk with vitamin D to eradicate dietary rickets in children. The recommended daily intake for adults ranges from 400 to 800 international units (IU). However, subclinical vitamin D deficiency remains prevalent worldwide, affecting up to 1 billion people in both developed and developing countries. Subclinical vitamin D deficiency is linked to osteoporosis, increased risk of falls, and fragility fractures. Recent observational studies have shown a potential correlation between vitamin D deficiency and cancer, cardiovascular disease, diabetes, autoimmune diseases, and depression. The optimal blood concentration of vitamin D remains controversial. According to the 2019 Endocrine Society guidelines, vitamin D sufficiency is defined as having a serum total 25-hydroxyvitamin D level greater than 30 ng/mL (50 nmol/L). Vitamin D insufficiency is defined as having a total 25-hydroxyvitamin D level between 12 and 30 ng/mL (30 to 77 nmol/L), while vitamin D deficiency is defined as having a level below 12 ng/mL (30 nmol/L).
维生素D是一种脂溶性营养素,对钙稳态和骨骼代谢至关重要。缺乏这种有益物质会导致儿童营养性佝偻病和成人骨软化症。20世纪30年代,北美开始在牛奶中添加维生素D以消除儿童膳食性佝偻病。成年人的每日推荐摄入量为400至800国际单位(IU)。然而,亚临床维生素D缺乏在全球范围内仍然普遍存在,在发达国家和发展中国家影响着多达10亿人。亚临床维生素D缺乏与骨质疏松症、跌倒风险增加和脆性骨折有关。最近的观察性研究表明,维生素D缺乏与癌症、心血管疾病、糖尿病、自身免疫性疾病和抑郁症之间存在潜在关联。维生素D的最佳血液浓度仍存在争议。根据2019年内分泌学会指南,维生素D充足定义为血清总25-羟基维生素D水平大于30 ng/mL(50 nmol/L)。维生素D不足定义为总25-羟基维生素D水平在12至30 ng/mL(30至77 nmol/L)之间,而维生素D缺乏定义为水平低于12 ng/mL(30 nmol/L)。