维生素 D 状态评估和补充共识声明:为什么、何时、如何?

IF 22 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Andrea Giustina, John P Bilezikian, Robert A Adler, Giuseppe Banfi, Daniel D Bikle, Neil C Binkley, Jens Bollerslev, Roger Bouillon, Maria Luisa Brandi, Felipe F Casanueva, Luigi di Filippo, Lorenzo M Donini, Peter R Ebeling, Ghada El-Hajj Fuleihan, Angelo Fassio, Stefano Frara, Glenville Jones, Claudio Marcocci, Adrian R Martineau, Salvatore Minisola, Nicola Napoli, Massimo Procopio, René Rizzoli, Anne L Schafer, Christopher T Sempos, Fabio Massimo Ulivieri, Jyrki K Virtanen
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引用次数: 0

摘要

第六届国际会议 "维生素 D 的争议 "旨在讨论有争议的话题,如维生素 D 的代谢、评估、作用和补充。对维生素 D 作用机制的新认识表明,维生素 D 与一些疾病的联系并不仅仅取决于日晒或饮食摄入量的减少,而且还可以通过独特的非典型维生素 D 代谢物来检测。25- 羟基维生素 D(25(OH)D)的最佳水平仍存在争议。由于对不同的临床或公共卫生方法进行评估,不同学会提出了不同的建议。缺乏标准化的检测方法也给解释现有研究数据带来了挑战,阻碍了合理的数据汇总和荟萃分析。除了众所周知的骨骼特征外,人们还对维生素 D 的骨骼外效应产生了兴趣,并由此开展了有关癌症、心血管风险、呼吸系统影响、自身免疫性疾病、糖尿病和死亡率的临床试验。最初的负面结果很可能是由于维生素 D 摄入不足造成的。不过,随后的事后分析表明,维生素 D 对降低癌症发病率、自身免疫性疾病、心血管疾病和糖尿病有潜在的益处。口服维生素 D 是首选途径。肠外给药仅用于特定的临床情况。胆钙化醇因其安全性和最低监测要求而受到青睐。钙化二醇可用于某些情况,而钙化三醇应仅限于活性代谢物不易在体内产生的特定疾病。还需要进一步研究维生素 D 对不同推荐 25(OH)D 水平的影响,以及不同补充剂配方在维生素 D 的多方面骨骼和骨骼外潜在影响中实现生化和临床结果的功效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Consensus Statement on Vitamin D Status Assessment and Supplementation: Whys, Whens, and Hows.

The 6th International Conference, "Controversies in Vitamin D," was convened to discuss controversial topics, such as vitamin D metabolism, assessment, actions, and supplementation. Novel insights into vitamin D mechanisms of action suggest links with conditions that do not depend only on reduced solar exposure or diet intake and that can be detected with distinctive noncanonical vitamin D metabolites. Optimal 25-hydroxyvitamin D (25(OH)D) levels remain debated. Varying recommendations from different societies arise from evaluating different clinical or public health approaches. The lack of assay standardization also poses challenges in interpreting data from available studies, hindering rational data pooling and meta-analyses. Beyond the well-known skeletal features, interest in vitamin D's extraskeletal effects has led to clinical trials on cancer, cardiovascular risk, respiratory effects, autoimmune diseases, diabetes, and mortality. The initial negative results are likely due to enrollment of vitamin D-replete individuals. Subsequent post hoc analyses have suggested, nevertheless, potential benefits in reducing cancer incidence, autoimmune diseases, cardiovascular events, and diabetes. Oral administration of vitamin D is the preferred route. Parenteral administration is reserved for specific clinical situations. Cholecalciferol is favored due to safety and minimal monitoring requirements. Calcifediol may be used in certain conditions, while calcitriol should be limited to specific disorders in which the active metabolite is not readily produced in vivo. Further studies are needed to investigate vitamin D effects in relation to the different recommended 25(OH)D levels and the efficacy of the different supplementary formulations in achieving biochemical and clinical outcomes within the multifaced skeletal and extraskeletal potential effects of vitamin D.

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来源期刊
Endocrine reviews
Endocrine reviews 医学-内分泌学与代谢
CiteScore
42.00
自引率
1.00%
发文量
29
期刊介绍: Endocrine Reviews, published bimonthly, features concise timely reviews updating key mechanistic and clinical concepts, alongside comprehensive, authoritative articles covering both experimental and clinical endocrinology themes. The journal considers topics informing clinical practice based on emerging and established evidence from clinical research. It also reviews advances in endocrine science stemming from studies in cell biology, immunology, pharmacology, genetics, molecular biology, neuroscience, reproductive medicine, and pediatric endocrinology.
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