201310血清总25oh总维生素d检测的重要性及临床应用医学课件.ppt

细胞分泌1,25-（OH）2-维生素D由细胞作用于局部发挥作用，不进入循环 1,25(OH)2D has a wide range of biological actions, including inhibiting cellular proliferation and inducing terminal differentiation, inhibiting angiogenesis,stimulating insulin production, inhibiting renin production, and stimulating macrophage cathelicidin production (3, 12–14). Holick The findings of an international epidemiologic study indicate that vitamin D inadequacy is highly prevalent among postmenopausal women with osteoporosis throughout the world, even in regions with ample sunlight. This cross-sectional, observational, single-visit study enrolled 2589 postmenopausal women with osteoporosis between May 2004 through March 2005 who were living independently within the community in 18 countries in Europe, Latin America, the Middle East, Asia, and Australia.1 Vitamin D inadequacy was defined by serum 25(OH)D level 30 ng/ml.2 The mean 25(OH)D concentration among the study population as a whole was 26.8 ng/ml. Nearly 64% of the study population demonstrated a serum 25(OH)D concentration 30 ng/ml and approximately 31% had a concentration 20 ng/ml. The prevalence of vitamin D inadequacy (30 ng/ml) was at least 53% in all five regions involved in the study and was highest in the Middle East (81.8%) and Asia (71.4%).1-3 Nearly 58.4% of the study participants used a medication approved for the treatment of osteoporosis, such as bisphosphonates, selective estrogen-receptor modulators, calcitonin, or parathyroid hormone, and approximately 54.2% used vitamin D supplements.3 * * 现代生活方式减少维生素D的摄入 Traditionally living populations in East Africa have a mean serum 25-hydroxyvitamin D concentration of 115?nmol/l. Br J Nutr. 2012 Jan 23:1-5. Luxwolda MF, Kuipers RS, Kema IP, Janneke Dijck-Brouwer DA, Muskiet FA. 坦桑尼亚的部落人群血清维生素D水平可达115ng/ml * Holick MF. E Engl J Med 2007; 357 维生素D缺乏是普通问题 如孕妇，老年人群等 维生素D缺乏是全球问题 * 英国维生素D水平状况（50°N-58°N） Nutrition Rev 2008 (10ng/mL) (20ng/mL) * 维生素D缺乏现状 据估测全世界有十亿人存在维生素D缺乏或不足 40-100% 欧美老人存在维生素D缺