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绝经后补充维生素D。

Vitamin D supplementation after the menopause.

作者信息

Pérez-López Faustino R, Chedraui Peter, Pilz Stefan

机构信息

Department of Obstetrics and Gynecology, Instituto de Investigaciones Sanitarias de Aragón, University of Zaragoza Faculty of Medicine, Domingo Miral s/n, Zaragoza, 50009, Spain.

Instituto de Investigación e Innovación en Salud Integral, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador, and Facultad de Ciencias de la Salud, Universidad Católica Nuestra Señora de la Asunción, Asunción, Paraguay.

出版信息

Ther Adv Endocrinol Metab. 2020 Jun 5;11:2042018820931291. doi: 10.1177/2042018820931291. eCollection 2020.

Abstract

The purpose of this review was to assess recent evidence regarding the effects of low vitamin D levels on some highly prevalent clinical conditions of postmenopausal women. We reviewed and selected recent literature regarding menopause-related conditions associated with vitamin D deficiency and interventions to manage them. Low circulating 25-hydroxyvitamin D (25(OH)D) levels related to menopause are linked to diet, lifestyle, changes in body composition, insulin sensitivity, and reduced physical activity. Vitamin D supplementation increases serum 25(OH)D levels while normalizing parathyroid hormone and bone markers, and in women with serum 25(OH)D levels below 10 ng/ml supplementation may improve bone mineral density. Low vitamin D status has been associated with the metabolic syndrome, high triglyceride levels, and low high-density lipoprotein cholesterol levels. When compared with placebo, vitamin D supplementation may lower the risk of the metabolic syndrome, hypertriglyceridemia, and hyperglycemia. There is an inverse relationship between fat mass and serum 25(OH)D levels and, therefore, the dosage of supplementation should be adjusted according to the body mass index. Although vitamin D supplementation may improve glucose metabolism in prediabetic subjects, data regarding muscle strength are conflictive. There is evidence that vitamin D over-treatment, to reach extremely high circulating 25(OH)D levels, does not result in better clinical outcomes. The identification and treatment of vitamin D deficiency in postmenopausal women may improve their general health and health outcomes. Vitamin D supplementation should preferably be based on the use of either cholecalciferol or calcifediol.

摘要

本综述的目的是评估近期有关低维生素D水平对绝经后女性一些高发性临床病症影响的证据。我们回顾并筛选了近期有关与维生素D缺乏相关的绝经相关病症及其管理干预措施的文献。与绝经相关的循环25-羟基维生素D(25(OH)D)水平低与饮食、生活方式、身体成分变化、胰岛素敏感性及体力活动减少有关。补充维生素D可提高血清25(OH)D水平,同时使甲状旁腺激素和骨标志物正常化,对于血清25(OH)D水平低于10 ng/ml的女性,补充维生素D可能会改善骨密度。低维生素D状态与代谢综合征、高甘油三酯水平及低高密度脂蛋白胆固醇水平有关。与安慰剂相比,补充维生素D可能会降低代谢综合征、高甘油三酯血症和高血糖的风险。脂肪量与血清25(OH)D水平呈负相关,因此,补充剂的剂量应根据体重指数进行调整。虽然补充维生素D可能会改善糖尿病前期受试者的糖代谢,但有关肌肉力量的数据存在冲突。有证据表明,过度补充维生素D以使循环25(OH)D水平达到极高值,并不会带来更好的临床结果。识别和治疗绝经后女性的维生素D缺乏症可能会改善她们的总体健康状况和健康结局。补充维生素D最好使用胆钙化醇或骨化二醇。

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