Cardiology Service, Hospital Clínica Benidorm, Alicante, Spain; Glorieta Policlinic, Denia, Alicante, Spain; REMA Sports Cardiology Clinic, Denia, Alicante, Spain.
Faculty of Sports Sciences and Physiotherapy, Universidad Europea de Madrid, Madrid, Spain.
Clin Nutr. 2021 May;40(5):2946-2957. doi: 10.1016/j.clnu.2020.12.025. Epub 2020 Dec 29.
The principal source of vitamin D in humans is its biosynthesis in the skin through a chemical reaction dependent on sun exposure. In lesser amounts, the vitamin can be obtained from the diet, mostly from fatty fish, fish liver oil and mushrooms. Individuals with vitamin D deficiency, defined as a serum level of 25 hydroxyvitamin D < 20 ng/dl, should be supplemented. Vitamin D deficiency is a prevalent global problem caused mainly by low exposure to sunlight. The main role of 1,25 dihydroxyvitamin D is the maintenance of calcium and phosphorus homeostasis. However, vitamin D receptors are found in most human cells and tissues, indicating many extra-skeletal effects of the vitamin, particularly in the immune and cardiovascular (CV) systems. Vitamin D regulates blood pressure by acting on endothelial cells and smooth muscle cells. Its deficiency has been associated with various CV risk factors and appears to be linked to a higher mortality and incidence of CV disease (CVD). Several mechanisms have been proposed relating vitamin D deficiency to CV risk factors such as renin-angiotensin-aldosterone system activation, abnormal nitric oxide regulation, oxidative stress or altered inflammatory pathways. However, in the latest randomized controlled trials no benefits of vitamin D supplementation for CVD have been confirmed. Although more work is needed to establish the protective role of vitamin D in this setting, according to current evidences vitamin D supplements should not be recommended for CVD prevention.
人类维生素 D 的主要来源是通过皮肤在阳光照射下的化学反应合成的。在较少的情况下，维生素可以从饮食中获得，主要来自多脂鱼、鱼肝油和蘑菇。维生素 D 缺乏的定义为血清 25 羟维生素 D 水平<20ng/dl，应进行补充。维生素 D 缺乏是一个普遍存在的全球性问题，主要是由于阳光照射不足引起的。1,25 二羟维生素 D 的主要作用是维持钙和磷的体内平衡。然而，维生素 D 受体存在于大多数人体细胞和组织中，表明维生素具有许多骨骼外的作用，特别是在免疫和心血管（CV）系统中。维生素 D 通过作用于内皮细胞和平滑肌细胞来调节血压。其缺乏与各种 CV 危险因素有关，似乎与更高的死亡率和心血管疾病（CVD）发病率有关。已经提出了几种将维生素 D 缺乏与 CV 危险因素相关联的机制，例如肾素-血管紧张素-醛固酮系统的激活、一氧化氮调节异常、氧化应激或改变炎症途径。然而，最近的随机对照试验并未证实维生素 D 补充对 CVD 的益处。尽管需要做更多的工作来确定维生素 D 在这种情况下的保护作用，但根据目前的证据，不建议将维生素 D 补充剂用于 CVD 的预防。
