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维生素D与肾结石之间的复杂关系:平衡、风险及预防策略。

The complex relationship between vitamin D and kidney stones: balance, risks, and prevention strategies.

作者信息

Zhang Fan, Li Wenjian

机构信息

Department of Endocrinology, Changzhou Third People's Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, China.

Department of Clinical Nutrition, Changzhou Third People's Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, China.

出版信息

Front Nutr. 2024 Sep 13;11:1435403. doi: 10.3389/fnut.2024.1435403. eCollection 2024.

Abstract

The association between vitamin D and kidney stones is characterized by a remarkable multi-dimensional complexity involving numerous physiological and metabolic pathways. Vitamin D is pivotal in maintaining calcium-phosphorus metabolic homeostasis and bone health. However, fluctuations in its intake, whether excessive or insufficient, May potentially increase the risk of kidney stones. Vitamin D exerts its influence on kidney stone formation indirectly by increasing the efficiency of intestinal calcium absorption and regulating renal calcium excretion. Moreover, there is a robust correlation between various states of vitamin D, particularly its active form, 1,25-dihydroxyvitamin D, and the development of numerous kidney stones. This finding underscores the necessity of individualized medical treatment in vitamin D supplementation and kidney stone prevention. When developing treatment strategies, it is essential to consider the patient's genetic background, lifestyle, environmental factors, and overall health. To prevent the formation of kidney stones, it is recommended that patients adopt a comprehensive approach, which May include measures such as moderate sun exposure, dietary modification, moderate exercise, and weight management. These preventive measures are designed to maintain healthy calcium and phosphorus metabolism and reduce kidney stone formation risk. Future studies should aim to elucidate the detailed mechanisms of vitamin D metabolism, individual differences, and the role of genes in this process. Furthermore, the role of lifestyle interventions in preventing kidney stones requires greater attention. Moreover, the implementation of large-scale, long-term prospective studies and randomized controlled trials will facilitate the assessment of the actual effects of diverse vitamin D supplementation strategies, thereby providing a robust scientific foundation for advancing more precise prevention strategies and clinical guidelines.

摘要

维生素D与肾结石之间的关联具有显著的多维度复杂性,涉及众多生理和代谢途径。维生素D在维持钙磷代谢稳态和骨骼健康方面起着关键作用。然而,其摄入量的波动,无论是过量还是不足,都可能增加患肾结石的风险。维生素D通过提高肠道钙吸收效率和调节肾脏钙排泄间接影响肾结石的形成。此外,维生素D的各种状态,特别是其活性形式1,25 - 二羟基维生素D,与众多肾结石的发生之间存在密切关联。这一发现强调了在维生素D补充和肾结石预防中进行个体化医疗的必要性。在制定治疗策略时,必须考虑患者的遗传背景、生活方式、环境因素和整体健康状况。为预防肾结石的形成,建议患者采取综合方法,这可能包括适度晒太阳、饮食调整、适度运动和体重管理等措施。这些预防措施旨在维持健康的钙磷代谢,降低肾结石形成风险。未来的研究应旨在阐明维生素D代谢的详细机制、个体差异以及基因在此过程中的作用。此外,生活方式干预在预防肾结石中的作用需要更多关注。而且,开展大规模、长期的前瞻性研究和随机对照试验将有助于评估各种维生素D补充策略的实际效果,从而为推进更精确的预防策略和临床指南提供坚实的科学基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd17/11427370/7976d35c829e/fnut-11-1435403-g001.jpg

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