维生素D缺乏和恶性肿瘤

V. V. Krivosheev, E. V. Bilan
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摘要

通过对国内外文献的分析表明,肿瘤疾病最常伴有患者血清25(OH)D水平低,维生素D缺乏和严重缺乏的发生率高,可以肯定地说,肿瘤患者血清血液25(OH)D水平平均低于相应性别和年龄的健康人。在这方面,进行了统计研究,表明欧洲和北美国家维生素D缺乏症的流行程度与每年癌症死亡率和癌症、任何类型的心血管疾病、糖尿病和慢性呼吸系统疾病的死亡概率成正比,这种关系在统计上是显著的(p <0.001)。俄罗斯联邦的肿瘤发病率和癌症死亡率自然增加,特别是在高纬度地区,这与人体皮肤在紫外线辐射影响下有效生产维生素D3的持续时间有限有关。一些将补充维生素D作为治疗药物的临床研究显示,在癌症治疗方面有明显的积极效果,其积极效果远远超过安慰剂组。然而,在对这一问题的数百篇研究文章的研究中,并没有建立对参与临床实验的患者有害的负面结果。补充维生素D最常见的有益效果是在治疗乳腺癌和结直肠癌方面,这在25(OH)D基线水平较低和25(OH)D3每日补充剂量高的患者中尤其明显,远高于每天400-800国际单位的标准推荐剂量。由于癌症患者中维生素D缺乏症的高发,结合国际上的积极经验,建立国内科学基础,扩大维生素D补充剂作为癌症治疗剂的临床实践,似乎是非常有益和必要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Vitamin D deficiency and malignancies
The analysis of domestic and foreign literature shows that oncological diseases are most often accompanied by a low level of 25(OH)D in the blood serum of patients and a high prevalence of deficiency and severe deficiency of vitamin D. It can be confidently stated that the level of 25(OH)D in serum blood of oncological patients, on average, is lower than in healthy people of the corresponding sex and age. In this regard, statistical studies were carried out, which demonstrated the prevalence of vitamin D deficiency in the countries of Europe and North America, which is directly proportional to the level of annual mortality from cancer and the probability of death from cancer, any type of cardiovascular disease, diabetes and chronic respiratory diseases, and this relationship is statistically significant (p < 0.001). Oncological morbidity and mortality from cancer in the Russian Federation naturally increases especially in higher latitudes, which, along with other reasons, is associated with a limitation in the duration of the effective production of vitamin D3 in human skin under the influence of ultraviolet radiation. Some clinical studies of vitamin D supplementation as a therapeutic agent are showing measurable positive results in cancer, with far more positive than in placebo groups. However, negative results that are harmful to patients participating in clinical experiments have not been established in the study of many hundreds of studied articles on this issue. The most commonly seen beneficial effects of vitamin D supplementation have been in the treatment of breast and colorectal cancer, which are particularly noticeable in patients with low baseline serum levels of 25(OH)D and high daily doses of 25(OH)D3 supplementation well above standard recommendations of 400–800 IU daily. Due to the high prevalence of vitamin D deficiency among cancer patients, taking into account international positive experience, it seems very useful and necessary to create domestic scientific foundations and expand the clinical practice of using vitamin D supplements as a therapeutic agent for cancer.
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