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现行日光暴露建议能否充分提高血清维生素 D 水平?:一项为期 1 个月的随机临床试验。

Can Current Recommendations on Sun Exposure Sufficiently Increase Serum Vitamin D Level?: One-Month Randomized Clinical Trial.

机构信息

Department of Preventive Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.

Department of Biomedical Science, Kyungpook National University Graduate School, Daegu, Korea.

出版信息

J Korean Med Sci. 2020 Mar 2;35(8):e50. doi: 10.3346/jkms.2020.35.e50.

Abstract

BACKGROUND

Lack of sunlight exposure is the primary reason for the worldwide epidemic of vitamin D deficiency. Although recommended sunlight exposure guidelines exist, there is no evidence regarding whether current guidelines are optimal for increasing vitamin D levels among individuals with vitamin D deficiency.

METHODS

Sixty Korean adults aged 20-49 years with serum 25-hydroxyvitamin D (25[OH]D) levels of < 20 ng/mL were randomly assigned to three groups: sunlight exposure (n = 20), vitamin D supplementation groups (n = 20), and daily living (n = 20) for 1 month. The sunlight exposure group had sunlight exposure on 20% to 30% of their body surface areas for 30-60 minutes per day, 3 times a week during the summer season. Vitamin D supplementation was prescribed with 800 IU/day of vitamin D. The serum levels of 25(OH)D were measured at baseline and at 1-month follow-up examinations.

RESULTS

The largest change in serum 25(OH)D was observed among the vitamin D supplementation group (+3.5 ng/mL, < 0.001). The sunlight exposure group showed a slight increase in serum 25(OH)D level, but the absolute increase was less than one-third that of the vitamin D supplementation group (+0.9 ng/mL, = 0.043). Only two participants in the sunlight exposure reached serum concentrations of 25(OH)D ≥ 20 ng/mL at follow-up. The daily living group showed no difference in vitamin D levels (-0.7 ng/mL, = 0.516).

CONCLUSION

Sunlight exposure was not sufficient to overcome vitamin D insufficiency or deficiency in the current study subjects. Effectiveness of current sunlight exposure guidelines among various populations should be reassessed in larger clinical studies.

TRIAL REGISTRATION

Clinical Research Information Service Identifier: KCT0002671.

摘要

背景

缺乏阳光照射是导致全球维生素 D 缺乏症流行的主要原因。尽管存在推荐的阳光照射指南,但尚无证据表明目前的指南是否有利于增加维生素 D 缺乏个体的维生素 D 水平。

方法

将 60 名年龄在 20-49 岁之间、血清 25-羟维生素 D(25[OH]D)水平<20ng/ml 的韩国成年人随机分为三组:阳光照射组(n=20)、维生素 D 补充组(n=20)和日常生活组(n=20),持续 1 个月。阳光照射组在夏季每周 3 次,每次在身体 20%-30%的表面积上暴露于阳光 30-60 分钟。维生素 D 补充剂的处方剂量为 800IU/天。在基线和 1 个月随访检查时测量血清 25(OH)D 水平。

结果

血清 25(OH)D 变化最大的是维生素 D 补充组(+3.5ng/ml,<0.001)。阳光照射组血清 25(OH)D 水平略有升高,但绝对增加量不到维生素 D 补充组的三分之一(+0.9ng/ml,=0.043)。只有两名阳光照射组的参与者在随访时达到血清 25(OH)D 浓度≥20ng/ml。日常生活组的维生素 D 水平没有差异(-0.7ng/ml,=0.516)。

结论

在当前研究对象中,阳光照射不足以克服维生素 D 不足或缺乏。在更大的临床研究中,应重新评估当前阳光照射指南对不同人群的有效性。

临床试验注册

临床研究信息服务标识符:KCT0002671。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c33d/7049620/373c0185bb5d/jkms-35-e50-g001.jpg

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