vit d 维生素D.ppt

文档介绍：Vitamin D, how much is enough
高冠民
郑大一附院
内容
维生素D,不仅仅是骨质疏松
维生素D的正常需要量
如何补充维生素D
Vitamin D (抗佝偻病维生素)
﹡种类:VitD2(麦角钙化醇)
VitD3(胆钙化醇)
﹡VitD2原:麦角固醇
VitD3原: 7-脱氢胆固醇
麦角固醇→VitD2
胆固醇→7-脱氢胆固醇→VitD3
﹡VitD3的活性形式: 1, 25- (OH)2-VitD3
钙和维生素是骨质疏松治疗基础用药
Chapuy, M. C., et al. N Engl J Med 1992 327:1637-42, with permission, Copyright © 1992 Massachusetts Medical Society. All rights reserved.Dawson-Hughes, B., et al. N Engl J Med 1997 337:670-6, with permission, Copyright © 1997 Massachusetts Medical Society. All rights reserved.
Vitamin D Metabolism
Calcitriol (Active)
Supplements
Vitamin D 2
5
Vitamin D 预防跌倒荟萃分析: Meta-analysis
(95% Cl)
(-)
(-)
(-)
(-)
(-)
(-)
Odds Ratio
Source
Pfeifer et al, 2000
Bischoff et al, 2003
Gallagher et at, 2001
Dukas et al, 2004
Graafmans et al, 1996
Pooled (Uncorrected)
Odds Ratio
Favors
Control
Favors
Vitamin D





Redrawn from Bischoff-Ferrari H et al JAMA. 2004 Apr 28;291(16):1999-2006, with permission, Copyright © 2004 American Medical Association. All rights reserved.
–49%
Bischoff et al
JBMR 2003; 18:343-351
维生素D
1、影响钙磷和骨代谢,最早在幼年时的佝偻病,成年期的骨软化症病人中发现————1937年
2、不只是维生素,更像激素具有很多新的功能:
对白血病细胞的分化诱导作用、对免疫系统、皮肤毛囊、胰岛细胞、卵巢、乳腺上皮、脑、心肌等都有功能
Vitamin D & 恶性肿瘤
72 nmol/L
96 nmol/L
Lappe J et al
2007
Northern vs. Southern .
1 – 2 extra skin cancer deaths (per 100,000)
30 – 40 extra deaths for other major cancers (per 100,000)
UV-B & 乳腺癌
US breast CA deaths (1970 – 1994) vs. solar UV exposure
Grant WB
Cancer 2002; 94:1867