Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Belgium.
Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Belgium.
Best Pract Res Clin Endocrinol Metab. 2018 Oct;32(5):669-684. doi: 10.1016/j.beem.2018.09.014. Epub 2018 Oct 3.
Severe vitamin D deficiency can be defined as the dose of vitamin D or serum 25OHD concentrations needed to prevent nutritional rickets or osteomalacia. There is large international consensus that these diseases can be prevented by 400 IU of vitamin D/d and 25OHD above 30 nmol/l (12 ng/ml). Vitamin D deficiency can also accelerate the risk of fractures and probably also of falls in elderly subjects but there is no consensus on the required daily doses or minimal 25OHD threshold for these endpoints. The majority of experts consider 800 IU/d and serum 25OHD above 50 nmol/l (20 ng/ml) as sufficient, with a minority opinion aiming for 75 nmol/l or even higher. For other extra-skeletal endpoints, no hard evidence is available to define whether or not this is causally related to vitamin D status. Therefore, for these endpoints no minimal dosage or 25OHD threshold can be defined.
严重维生素 D 缺乏可定义为预防营养性佝偻病或骨软化症所需的维生素 D 剂量或血清 25-羟维生素 D 浓度。国际上有很大共识认为，通过每天摄入 400IU 的维生素 D 和血清 25-羟维生素 D 浓度高于 30nmol/L（12ng/ml）可以预防这些疾病。维生素 D 缺乏也会加速骨折和老年人跌倒的风险，但对于这些终点所需的每日剂量或最低 25-羟维生素 D 阈值尚无共识。大多数专家认为每天 800IU 和血清 25-羟维生素 D 浓度高于 50nmol/L（20ng/ml）为充足，少数专家认为 75nmol/L 甚至更高为充足。对于其他骨骼外终点，尚无确凿证据表明这与维生素 D 状态是否存在因果关系。因此，对于这些终点，无法确定最小剂量或 25-羟维生素 D 阈值。
