Faculty of Health & Medical Sciences, University of Copenhagen, DK-1870, Frederiksberg C, Denmark.
Redox Biol. 2020 Jul;34:101532. doi: 10.1016/j.redox.2020.101532. Epub 2020 May 23.
For decades, the potential beneficial effect of vitamin C on human health-beyond that of preventing scurvy-has been subject of much controversy. Hundreds of articles have appeared either in support of increased vitamin C intake through diet or supplements or rejecting the hypothesis that increased intake of vitamin C or supplementation may influence morbidity and mortality. The chemistry and pharmacology of vitamin C is complex and has unfortunately rarely been taken into account when designing clinical studies testing its effect on human health. However, ignoring its chemical lability, dose-dependent absorption and elimination kinetics, distribution via active transport, or complex dose-concentration-response relationships inevitably leads to poor study designs, inadequate inclusion and exclusion criteria and misinterpretation of results. The present review outlines the differences in vitamin C pharmacokinetics compared to normal low molecular weight drugs, focusses on potential pitfalls in study design and data interpretation, and re-examines major clinical studies of vitamin C in light of these.
几十年来，维生素 C 对人类健康的潜在有益作用——除了预防坏血病之外——一直是争议的焦点。数百篇文章要么支持通过饮食或补充剂增加维生素 C 的摄入量，要么否定增加维生素 C 摄入或补充可能影响发病率和死亡率的假设。维生素 C 的化学和药理学很复杂，在设计临床试验以测试其对人类健康的影响时，往往很少考虑到这一点。然而，当忽略其化学不稳定性、剂量依赖性吸收和消除动力学、通过主动转运的分布或复杂的剂量-浓度-反应关系时，不可避免地会导致研究设计不佳、纳入和排除标准不足以及对结果的误解。本综述概述了维生素 C 药代动力学与普通低分子量药物的差异，重点介绍了研究设计和数据解释中的潜在陷阱，并根据这些重新审视了维生素 C 的主要临床研究。
