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维生素D补充剂:胆钙化醇、骨化二醇和骨化三醇。

Vitamin D supplementation: cholecalciferol, calcifediol, and calcitriol.

作者信息

Vieth Reinhold

机构信息

Department of Laboratory Medicine and Pathobiology, and Department of Nutritional Sciences, Faculty of Medicine, University of Toronto Medical Sciences Building, 5th Floor, Room 5253A 1 King's College Circle, M5S 1A8, Toronto, ON, Canada.

出版信息

Eur J Clin Nutr. 2020 Nov;74(11):1493-1497. doi: 10.1038/s41430-020-0697-1. Epub 2020 Jul 23.

Abstract

The specific compound that is meant for use in the context of vitamin D supplementation is often ambiguous. The term "supplementation" has been used in the context of cholecalciferol, ergocalciferol, calcidiol, and calcitriol. In nature, by far the major form of vitamin D that nurtures the body is cholecalciferol. In contrast, ergocalciferol is primarily a synthetic and less stable product which is less potent per microgram dose than is cholecalciferol. Calcidol is the major circulating metabolite of cholecalciferol, while calcitriol is the hormone that upregulates the active transport of calcium from the gut, and which suppresses parathyroid hormone secretion. Nutrition policy papers and guidelines leave unstated the obvious fact that calcidiol and calcitriol are not nutrients, and that those metabolites are not pertinent to food fortification or dietary supplementation. Recent evidence shows that ergocalciferol is not stable with storage, and it is far more susceptible to breakdown with cooking and baking than is cholecalciferol. Therefore, it must be concluded that cholecalciferol is the only form of vitamin D that should be considered in the context of the nutritional functions of fortification and supplementation.

摘要

用于维生素D补充的特定化合物通常并不明确。“补充”一词在胆钙化醇、麦角钙化醇、骨化二醇和骨化三醇的语境中都有使用。在自然界中,滋养身体的维生素D的主要形式是胆钙化醇。相比之下,麦角钙化醇主要是一种合成产物,稳定性较差,每微克剂量的效力低于胆钙化醇。骨化二醇是胆钙化醇的主要循环代谢产物,而骨化三醇是一种激素,它上调钙从肠道的主动转运,并抑制甲状旁腺激素的分泌。营养政策文件和指南没有说明一个明显的事实,即骨化二醇和骨化三醇不是营养素,并且这些代谢产物与食品强化或膳食补充无关。最近的证据表明,麦角钙化醇储存时不稳定,并且与胆钙化醇相比,它在烹饪和烘焙过程中更容易分解。因此,必须得出结论,在强化和补充的营养功能方面,胆钙化醇是唯一应被考虑的维生素D形式。

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