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首页> 外文期刊>Italian Journal of Medicine >Potential role of vitamin D in prevention of skeletal and extraskeletal diseases in older people
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Potential role of vitamin D in prevention of skeletal and extraskeletal diseases in older people

机译：维生素D在预防老年人骨骼和骨骼外疾病中的潜在作用

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Vitamin D and calcium are essential for bone health. An adequate calcium-phosphorus product determines a high quality mineralization long lifetime. In older people, both calcium and vitamin D levels may be lower causing osteomalacia and/or osteoporosis with a higher risk of fracture. Epidemiological data have clearly associated serum vitamin D lower levels (deficiency) with bone fracture in older people, however, not univocal data exist in regard to a beneficial effect of vitamin D supplementation in general population. Although not systematic, the present review aims to make a narrative synthesis of the most recent published data on vitamin D effect not only on bone, classical target associated with vitamin D studies, but namely on extraskeletal diseases. In fact, recently, there has been an increasing interest on this latter issue with surprising findings. Vitamin D, and in particular its deficiency, seems to have a role in pathophysiological pathways in several diseases involving cardiovascular, central nervous system and neoplastic process. On the other hand, vitamin D supplementation may modify the outcome of a wide range of illnesses. Up to date the data are conflicting mainly because of difficulty to establish a consensus on the threshold of vitamin D deficit. The US Institute of Medicine recommends to distinguish a level of insufficiency [defined as 30-50 nmol/L or 16-25 ng/mL of 25(OH)D] and another of deficiency identified by 25(OH)D levels lower than 30 nmol/L (or <16 ng/mL). This latter level is considered a minimum level necessary in older adults to minimize the risk of falls, fracture and probably to have some effects of vitamin D supplementation in extraskeletal diseases. Although there are no absolute certainties in such issue, the most recent data suggest that vitamin D deficiency, and its supplementation, may play an important role in a wide range of diseases other than in bone metabolic diseases in older but not in general population. For such reason a widespread measurement of vitamin D levels in general population, and not only in older, seems to be inappropriate and it could induce an overuse of vitamin D supplementation in situations in which its efficacy and cost-effectiveness have not been proven.
机译：维生素D和钙对骨骼健康至关重要。适当的钙磷产品决定了长寿命的高质量矿化作用。在老年人中，钙和维生素D含量可能较低，从而导致骨软化症和/或骨质疏松症的骨折风险更高。流行病学数据清楚地表明，老年人血清中维生素D的较低水平（缺乏）与骨折有关，但是，就补充维生素D对普通人群的有益影响而言，尚无明确的数据。尽管不是系统性的，但本综述旨在叙述有关维生素D效果的最新出版数据，这些数据不仅对骨骼，与维生素D研究相关的经典靶标，而且还涉及骨骼外疾病。实际上，最近，对后一个问题的兴趣日益浓厚，令人惊讶。维生素D，尤其是维生素D的缺乏，似乎在涉及心血管，中枢神经系统和赘生物形成过程的几种疾病的病理生理途径中起作用。另一方面，补充维生素D可能会改变多种疾病的结果。迄今为止，数据存在矛盾，主要是因为难以就维生素D缺乏症的阈值达成共识。美国医学研究所建议区分供血不足的水平[定义为30-50 nmol / L或16-25 ng / mL的25（OH）D]和另一种供血不足的水平，其中25（OH）D低于30 nmol / L（或<16 ng / mL）。后一水平被认为是老年人最低的水平，以使跌倒，骨折的风险最小化，并可能在骨骼外疾病中补充维生素D。尽管在此类问题上没有绝对的确定性，但最新数据表明，维生素D缺乏症及其补充在老年人中而非骨骼代谢疾病中可能在多种疾病中起重要作用，但在普通人群中却没有。因此，在一般人群中，不仅在老年人中，广泛测量维生素D的水平似乎是不合适的，并且在尚未证明其有效性和成本效益的情况下，可能会导致过度使用维生素D。

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