维生素D不足和缺乏:寻找一种骨疾病
Siobhan E M Brodrick1, Ego Seeman2
1Departments of Endocrinology and Medicine, Austin Health, Heidelberg, Vic, Australia.
Pathology
|November 28, 2025
概括
定义维生素D缺乏是很困难的,因为目前的值缺乏一致的临床证据. 大多数社区居民不太可能患有维生素D缺乏症,但缺乏症可能会影响弱势群体,如养老院居民.
科学领域:
- 内分泌学 在内分泌学.
- 营养科学 营养科学
- 骨的新陈代谢 骨的新陈代谢
背景情况:
- 目前的维生素D值 (不足时<30nmol/L,不足时30-75nmol/L) 缺乏一致的临床或生化验证.
- 现有的门值与社区居民中二次性甲状腺功能增强症,骨健康损害或骨质疏松症没有可靠的相关性.
研究的目的:
- 批判性地评估维生素D缺乏和不足的既定定义和值.
- 评估25-基维生素D [25(OH) D]水平与骨健康和二次性甲状腺功能障碍症相关的临床相关性.
主要方法:
- 对临床,生化,骨密度测量,微架构和体形测量证据的审查.
- 对维生素D补充剂及其对骨健康和骨折疗效的影响的元分析和安慰剂对照研究的分析.
- 考虑具有维生素D缺乏风险增加的特定人群.
主要成果:
- 很少有令人信服的证据支持维生素D缺乏 (30-75nmol/L) 作为社区居民的独特疾病状态.
- 副甲状腺激素的适度升高可能在30nmol/L以下,但大多数人没有表现出生物化学或骨异常.
- 关于维生素D有效性和安全性的精心设计的研究是有限的,并且元分析是混的.
结论:
- 维生素D缺乏和不足的定义需要根据可靠的临床证据进行重新评估.
- 维生素D缺乏更有可能影响特定高风险群体的骨健康,包括养老院居民和吸收不良或阳光照射有限的人.
- 这些高风险人群可能需要调查和适当的维生素D补充剂,以解决潜在的骨病.
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