医学总维生素D检测的重要性及临床意义培训.ppt

总维生素D检测的重要性及临床意义

维生素D营养状况的评判标准

聊城地区育龄女性VD状况统计成人共636人 VD10 263 41.35%10≤VD20 313 49.21%20≤VD30 37 5.82%VD≥30 23 3.62%

聊城地区儿童VD状况儿童统计364人 VD10 11 3.02%10≤VD20 65 17.86%20≤VD30 130 35.71%VD≥30 158 43.41%

5维生素D的内分泌、旁分泌和自分泌功能

维生素D在钙平衡中的作用

维生素D可减低自身免疫性疾病发病率VitaminDsupplementationisassociatedwithalowerriskofautoimmunediseases.InaFinnishbirthcohortstudyof10,821children,supplementationwithvitaminDat2000IU/dreducedtheriskoftype1diabetesbyapproximately78%,whereaschildrenwhowereatriskforricketshada3-foldhigherriskfortype1diabetes.Inacase-controlstudyof7millionUSmilitarypersonnel,highcirculatinglevelsofvitaminDwereassociatedwithalowerriskofmultiplesclerosis.SimilarassociationshavealsobeendescribedforvitaminDlevelsandrheumatoidarthritis.

维持充足的维生素D水平可以

减低多种自身免疫病的发病风险AprospectivecohortstudyofchildrenborninFinlandduringtheyear1966andfollowedforthirtyyearsfoundthatthosewhoreceivedsupplementalvitaminDduringthefirstyearoflifehadasignificantlylowerriskofdevelopingIDDMArecentcase-controlstudyinU.S.militarypersonnel,including257casesofdiagnosedMS,foundthatwhitesubjectsinthehighestquintileofserum25-hydroxyvitaminD(99.1nmol/L)hada62%lowerriskofdevelopingMS.postmenopausalwomenwiththehighesttotalvitaminDintakeswereatsignificantlylowerriskofdevelopingRAafter11yearsoffollow-upthanthosewiththelowestintakes

多发性硬化症与纬度的关系PeoplelivingclosertotheequatorareatdecreasedriskofdevelopingMSSimilartrends:cancer,hypertension

促进细胞分化、抑制增殖

---维生素D降低肿瘤发生率TheactiveformofvitaminD,1,25-dihydroxyvitaminD,inhibitsproliferationandstimulatesthedifferentiationofcells.?HolickMF.VitaminD:importanceinthepreventionofcancers,type1diabetes,heartdisease,andosteoporosis.AmJClinNutr.2004;79(3):362-371.

促进细胞分化、抑制增殖

---维生素D降低肿瘤发生