de Hoop Geestelijke GezondheidsZorg (GGZ), Ambulatory Addiction Care, Dordrecht, Netherlands.
Unit of PharmacoTherapy, -Epidemiology and -Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, Netherlands.
Acta Neuropsychiatr. 2021 Feb;33(1):1-8. doi: 10.1017/neu.2020.41. Epub 2020 Nov 13.
Vitamin D deficiency may be a clinical problem in patients with addictions. The authors systematically searched for studies addressing vitamin D and addiction and develop a hypothesis which can direct future research of the possible mechanistic role of vitamin D in the process of addiction.
Systematic review of the literature found in PubMed and EMBASE followed by narrative review combined with clinical experiences leading to hypotheses for future research.
Only five articles were identified about a role of vitamin D in the pathophysiology of addiction. Their results are in line with a possible influence of vitamin D in dopaminergic transmission. The cerebral vitamin D status depends on the functionality of genetic variants of vitamin D receptor and other involved genes. Routine serum calcidiol levels may not adequately reflect cerebral vitamin D status. Uncertainty exists regarding appropriate calcidiol blood levels and proper dosages for affecting the central nervous system (CNS).
The putative pathophysiological role of vitamin D in substance abuse has been insufficiently studied which calls to more studies how to measure cerebral vitamin D status in clinical practice. Research is indicated whether vitamin D supplementation should use higher dosages and aim to reach higher calcidiol serum levels. Measuring dopaminergic functioning within the prefrontal cortex as reflected by neuropsychological tests selected as suitable could be a appropriate proxy for the cerebral vitamin D status when studying the pharmacogenomics of this functionality in patients.
维生素 D 缺乏症可能是成瘾患者的临床问题。作者系统地搜索了关于维生素 D 和成瘾的研究，并提出了一个假设，该假设可以指导未来研究维生素 D 在成瘾过程中可能的机制作用。
对 PubMed 和 EMBASE 中发现的文献进行系统评价，然后进行叙述性综述，并结合临床经验提出未来研究的假设。
只有五篇文章探讨了维生素 D 在成瘾病理生理学中的作用。他们的研究结果表明，维生素 D 可能会影响多巴胺能传递。大脑中的维生素 D 状态取决于维生素 D 受体和其他相关基因的遗传变异的功能。常规的血清钙二醇水平可能不能充分反映大脑中的维生素 D 状态。关于适当的钙二醇血液水平和适当的剂量以影响中枢神经系统（CNS）尚存在不确定性。
关于维生素 D 在物质滥用中的潜在病理生理学作用的研究还不够充分，这需要更多的研究来了解如何在临床实践中测量大脑中的维生素 D 状态。研究表明，维生素 D 补充剂是否应使用更高的剂量并旨在达到更高的血清钙二醇水平。在研究患者这种功能的药物遗传学时，通过选择合适的神经心理学测试来测量前额叶皮层中的多巴胺能功能可以作为大脑维生素 D 状态的合适替代指标。
