Center for Clinical and Experimental Photodermatology, Saarland University, Campus Homburg, 66421 Homburg, Germany.
Department of Dermatology, The Saarland University Hospital, 66421 Homburg, Germany.
Nutrients. 2019 Nov 6;11(11):2682. doi: 10.3390/nu11112682.
During the last decade, our scientific knowledge of the pleiotropic biological effects of vitamin D metabolites and their relevance to human health has expanded widely. Beyond the well-known key role of vitamin D in calcium homeostasis and bone health, it has been shown that vitamin D deficiency is associated with a broad variety of independent diseases, including several types of cancer, and with increased overall mortality. Moreover, recent findings have demonstrated biological effects of the vitamin D endocrine system that are not mediated via activation of the classical nuclear vitamin D receptor (VDR) by binding with high affinity to its corresponding ligand, the biologically active vitamin D metabolite 1,25-dihydroxyvitamin D (1,25(OH)D). In contrast, many of these new biological effects of vitamin D compounds, including regulation of the circadian clock and many metabolic functions, are mediated by other vitamin D metabolites, including 20-hydroxyvitamin D and 20,23-dihydroxyvitamin D, and involve their binding to the aryl hydrocarbon receptor (AhR) and retinoid-orphan receptor (ROR). In most populations, including the German population, UVB-induced cutaneous vitamin D production is the main source for fulfilling the human body's requirements of vitamin D. However, this causes a dilemma because solar or artificial UVR exposure is associated with skin cancer risk. In addition to UVB-induced vitamin D production in skin, in humans, there are two other possible sources of vitamin D: from diet and supplements. However, only a few natural foods contain substantial amounts of vitamin D, and in most populations, the dietary source of vitamin D cannot fulfill the body´s requirements. Because an increasing body of evidence has convincingly demonstrated that vitamin D deficiency is very common worldwide, it is the aim of this paper to (i) give an update of the vitamin D status in a population with a western diet, namely, the German population, and to (ii) develop strategies to optimize the vitamin D supply that consider both the advantages as well as the disadvantages/risks of different approaches, including increasing vitamin D status by dietary intake, by supplements, or by UVB-induced cutaneous synthesis of vitamin D.
在过去的十年中，我们对维生素 D 代谢物的多效生物学效应及其与人类健康的相关性的科学认识已经大大扩展。除了众所周知的维生素 D 在钙稳态和骨骼健康中的关键作用外，已经表明维生素 D 缺乏与多种独立疾病有关，包括多种类型的癌症，以及总死亡率增加。此外，最近的研究结果表明，维生素 D 内分泌系统的生物学效应并非通过维生素 D 经典核受体（VDR）与高亲和力结合其相应配体，即生物活性维生素 D 代谢物 1,25-二羟维生素 D（1,25（OH）D）来介导的。相比之下，维生素 D 化合物的许多这些新的生物学效应，包括昼夜节律的调节和许多代谢功能，都是由其他维生素 D 代谢物介导的，包括 20-羟维生素 D 和 20,23-二羟维生素 D，并涉及它们与芳香烃受体（AhR）和视黄酸孤儿受体（ROR）的结合。在包括德国人群在内的大多数人群中，UVB 诱导的皮肤维生素 D 生成是满足人体对维生素 D 需求的主要来源。然而，这造成了一个困境，因为太阳或人工 UVR 暴露与皮肤癌风险相关。除了皮肤中 UVB 诱导的维生素 D 生成外，在人类中，还有另外两种可能的维生素 D 来源：饮食和补充剂。然而，只有少数天然食物含有大量的维生素 D，而且在大多数人群中，饮食来源的维生素 D 无法满足身体的需求。由于越来越多的证据令人信服地表明，维生素 D 缺乏在全球范围内非常普遍，因此本文的目的是：（i）更新具有西方饮食的人群（即德国人群）的维生素 D 状态，并（ii）制定策略来优化维生素 D 供应，既要考虑到不同方法的优势，也要考虑到劣势/风险，包括通过饮食摄入、补充剂或通过 UVB 诱导的皮肤合成维生素 D 来提高维生素 D 状态。
