钙和维生素D补充减缓了老年人的牙齿丢失

口腔骨和牙齿丢失与非口腔骨丢失有关。补充钙和维生素D减缓了不同骨骼部位骨丢失的比率，但尚不了解钙和维生素D的摄入是否对口腔骨、从而对牙齿保留有影响。对此，进行了随机取样试验和随访研究。调研结果显示针对预防骨质疏松的钙和维生素D摄入水平对牙齿保留有益。     

维生素D的补充与摄入

维生素D是一种脂溶性维生素 ,自然存在于鳕鱼肝油中 ,人体皮肤经光照可产生维生素D。 3万年以来 ,陆地上的有机体一直依赖阳光产生维生素D。在进化早期 ,脊锥动物离开富含钙的海洋环境来到大陆 ,他们依赖于皮肤合成维生素D以增加肠道对饮食中少量钙的吸收。人类饮食中含维生素D较少 ,一些国家向一些食物加入维生素D进行强化 ,其目的是通过强化饮食满足人们对维生素D的需求。大多数人并不了解阳光是维生素D的重要来源 ,有关接触阳光有致皮肤癌的危险使得人们避免暴露于阳光下 ,结果是 50岁以上成年人中普遍缺乏维生素D。Sniadecki在 1 82…     

补充维生素D对骨质疏松的防治作用

在防治骨质疏松中,补充维生素D远不如补钙受到重视。近十年来研究表明：各种原因造成的维生素D缺乏或亚临床缺乏很普遍,需要额外补充,才能更有效地预防和治疗骨质疏松症。     

合理补充维生素D

随着医学科技的发展和人们生活水平的提高,人均寿命逐渐延长,人们对生活质量也有了更高的要求。骨质疏松症作为老年人的一种常见病日益受到关注。而充足的钙和维生素D的摄入是防治骨质疏松的最基础措施,所以越来越多的中老年朋友关心如何合理补充钙剂和维生素D。今天就给大家讲解一些有关维生素D需要关注的问题。     

个体化维生素D补充治疗绝经后妇女骨质疏松症的临床应用

目的 探讨绝经后骨质疏松症患者血清25-羟维生素D的水平,在患者中进行个体化维生素D补充的临床应用价值与意义。方法 回顾性分析2021年6月至2023年6月于河南科技大学第一附属医院诊断为骨质疏松症并接受地舒单抗治疗的绝经后妇女患者的临床数据。86例初次诊断为绝经后骨质疏松症的患者纳入研究。根据维生素D补充方式将患者分为两组,对照组45例(固定剂量组)和观察组41例(个体化剂量组：依据患者血清维生素D水平,以≥30ng/mL为目标进行补充)。观察并对比两组患者骨密度值及骨代谢情况。结果 治疗前两组患者在年龄、身高、体重、血清25(OH)D浓度、BMI和腰椎股骨颈的骨密度方面均无显著性差异(P>0.05)。治疗后观察组β-1型胶原交联羧基端肽(β-CTX)、1型原胶原氨基端前肽(P1NP)水平降低较对照组更显著,25羟维生素D水平高于对照组,差异有统计学意义(t值分别为2.052,2.608和9.167,P<0.05);观察组股骨颈、腰椎L2节段骨密度水平均高于对照组,差异有统计学意义(t值分别为2.275,2.560,P<0.05)。结论 接受地舒单抗药物治疗的绝经后...     

维生素D和钙防治乳腺癌的研究进展

流行病学调查和试验研究表明，维生索D和钙对防治乳腺癌有作用。维生素D及其类似物有望成为抗癌新药。本文综述了维生索D和钙对防治乳腺癌的研究进展。     

老年人骨质疏松症的维生素D治疗

骨质疏松症是老年人的常见病。流行病学调查发现,60岁以上的老年人骨质疏松发病率高达56％。骨质疏松后骨脆性增加．轻微外伤、跌倒甚至无外伤在用力情况下,也易发生骨折。     

老年人补钙和补维生素D

老年人的骨质疏松症是生理性衰老的特殊表现,由于破骨细胞的吸收增加,成骨细胞功能衰退,导致骨矿成分和骨基质等比例减少,骨质变薄、骨小梁数量减少,骨脆性增加和骨折危险性升高。骨质疏松症的发生是无声无息的,常不为人们所注意。而当出现腰背疼痛或骨折时,骨质疏松往往已比较严重。     

骨质疏松症三部曲

第一步：补足营养 治疗骨质疏松症，很重要的一个步骤就是补允骨骼里缺失的元素，其中，最主要的就是要补充钙、维生素D和雌激素：     

补充维生素D防治多种慢性疾病的研究进展

既往认为维生素D的主要生理功能是维持血钙稳定,而目前的研究发现维生素D具有更多重要作用,如直接作用于肌细胞的维生素D受体,增强肌力,预防跌倒;干预自身免疫系统,防治多发性硬化症、炎症性肠病等自身免疫性疾病;降低多种肿瘤如结直肠癌、乳腺癌等的发生风险。     

孕晚期妇女服用钙及维生素D初步观察

目的观察孕晚期妇女服用钙及维生素D对孕期妇女低钙和维生素D缺乏的效果.方法对24例孕28周后的晚期妊娠妇女,每日服用碳酸钙加维生素D1片.并与同期11例不服任何钙剂及维生素D3的晚期妊娠妇女(对照组)进行比较.结果(1)用药组产前血清钙(Ca)、磷(P)、骨钙素(BGP)及25羟基D3(25OHD3)明显高于用药前的孕28周(P＜0.001);而对照组产前与孕28周比较无明显变化.(2)给药组产前尿羟脯氨酸与肌酐比值(HOP/cr)、尿钙(Ca)与肌酐比值(Ca/cr)比孕28周明显减少.(3)尿中Ⅰ型胶原交联C末端肽与肌酐比值(crosslaps/cr)给药组,和对照组在产前明显高于孕28周(P＜0.001),但产后42天,给药组明显低于对照组(P＜0.001).(4)两组血清碱性磷酸酶(AKP)产前明显均高于孕28周时水平(P＜0.001),表明胎盘产生大量AKP.结论孕期服用碳酸钙加维生素D3有明显促进骨形成,抑制骨吸收的作用和提高血清钙、磷的作用.给药8～10周后,虽然25OHD3比治疗前有明显升高,但仍低于同年龄健康妇女的水平,提示对孕产妇应适当增加维生素D3的用量.     

Effect of vitamin D and calcium supplementation on bone turnover in institutionalized adults with Down's Syndrome

OBJECTIVE: To assess the status of vitamin D and the effects of calcium and vitamin D3 supplementation on the bone metabolism in a group of adults with Down's syndrome (DS). DESIGN: Randomized, parallel, controlled and open clinical trial. SETTING: Institution for mentally handicapped: Fundación Uliazpi, Diputación Foral de Guipúzcoa, San Sebastián, Spain. SUBJECTS: A total of 23 persons with DS, residents at the Uliazpi Foundation were recruited and all completed the study. INTERVENTION: In all, 12 participants were randomly allocated to receive 1 g of calcium and 800 IU of vitamin D once daily for 1 year while 11 were assigned to the control group, receiving no supplementation. RESULTS: We found no differences between groups regarding serum calcium and phosphorous levels. The remaining parameters showed differences between the two groups consistent with a beneficial effect of the intervention: serum levels of parathyroid hormone, osteocalcin and crosslaps diminished while serum 25 OH vitamin D3 level increased. CONCLUSIONS: The results obtained allow to include people with DS as a risk group with regards to vitamin D deficit, which that can be corrected with vitamin D and calcium supplementation, and giving rise to an improvement of the biochemical markers related to the phospho-calcium metabolism and bone remodelling.     

Importance of calcium, vitamin D and vitamin K for osteoporosis prevention and treatment

Throughout the life cycle the skeleton requires optimum development and maintenance of its integrity to prevent fracture. Bones break because the loads placed on them exceed the ability of the bone to absorb the energy involved. It is now estimated that one in three women and one in twelve men aged >55 years will suffer from osteoporosis in their lifetime and at a cost in the UK of > 1.7 pounds x 10(9) per year. The pathogenesis of osteoporosis is multifactorial. Both the development of peak bone mass and the rate of bone loss are determined by key endogenous and exogenous factors. Ca supplements appear to be effective in reducing bone loss in women late post menopause (>5 years post menopause), particularly in those with low habitual Ca intake (<400 mg/d). In women early post menopause (<5 years post menopause) who are not vitamin D deficient, Ca supplementation has little effect on bone mineral density. However, supplementation with vitamin D and Ca has been shown to reduce fracture rates in the institutionalised elderly, but there remains controversy as to whether supplementation is effective in reducing fracture in free-living populations. Re-defining vitamin D requirements in the UK is needed since there is evidence of extensive hypovitaminosis D in the UK. Low vitamin D status is associated with an increased risk of falling and a variety of other health outcomes and is an area that requires urgent attention. The role of other micronutrients on bone remains to be fully defined, although there are promising data in the literature for a clear link between vitamin K nutrition and skeletal integrity, including fracture reduction.     

Effect of vitamin D supplementation on vitamin D status and bone turnover markers in young adults

OBJECTIVE: To assess the vitamin D status of healthy young people living in Northern Ireland and the effect of vitamin D supplementation on vitamin D status and bone turnover. DESIGN: Double-blinded randomised controlled intervention study. SETTING: University of Ulster, Coleraine, Northern Ireland. SUBJECTS: In total, 30 apparently healthy students (15 male and 15 female subjects), aged 18-27 years, were recruited from the university, with 27 completing the intervention. INTERVENTIONS: Subjects were randomly assigned, to receive either 15 microg (600 IU) vitamin D(3) and 1,500 mg calcium/day (vitamin D group), or 1,500 mg calcium/day (control group) for 8 weeks between January and March. Vitamin D status, bone turnover markers, serum calcium and parathyroid hormone concentrations were measured at baseline and post intervention. RESULTS: At baseline, vitamin D status was low in both the vitamin D group (47.9 (s.d. 16.0)) and the control group (55.5 (s.d. 18.6) nmol/l 25(OH)D). Post intervention vitamin D status was significantly higher in the vitamin D-treated group (86.5 (s.d. 24.5)) compared to the control group (48.3 (s.d. 16.8) nmol/l) (P<0.0001). There was no significant effect of supplementation on bone turnover markers or PTH concentrations. CONCLUSIONS: This study suggests that young adults in Northern Ireland do not consume an adequate daily dietary intake of vitamin D to maintain plasma vitamin D concentrations in the wintertime. A daily supplement of 15 microg vitamin D(3) significantly increased vitamin D status in these individuals to levels of sufficiency. Achievement of an optimum vitamin D status among young adults may have future positive health implications.     

A quality improvement study on calcium and vitamin D supplementation in long-term care

OBJECTIVES: The objectives of this study were to evaluate the impact of a quality improvement (QI) study on improving calcium and vitamin D supplementation in a long-term care setting. DESIGN: Retrospective chart review. SETTING: An academic long-term care facility that specializes in dementia care in St Louis, MO. PARTICIPANTS: Participants consisted of 83 long-term care residents. INTERVENTION: The quality improvement team created an educational letter that was signed by the medical director and sent to the facilities' primary care physicians. This letter provided clinicians with the rationale and method to achieve adequate calcium supplementation, assess vitamin D status, and provide adequate vitamin D supplementation in our long-term care setting. Following the letter, the facility pharmacist reviewed the orders during monthly medication reviews and faxed requests to the primary care physicians for appropriate supplements or laboratory tests when necessary. MEASUREMENTS: We reviewed the charts for the presence of calcium supplementation orders, vitamin D levels, and vitamin D supplementation before and after our QI intervention. RESULTS: Of the 83 resident charts that were reviewed, only 37 (44.6%) had calcium supplementation, 19 (22.8%) had assessment of their vitamin D status, and 29 (34.9%) had ongoing vitamin D supplementation prior to implementation of the study. After the QI intervention, calcium supplementation was present in 66 residents (79.5%), vitamin D status had been assessed in 61 residents (73.4%), and vitamin D supplementation had been initiated in 65 residents (78.3%). These changes were statistically significant (P < .05). CONCLUSION: A quality improvement project that used an educational letter from the medical director combined with a medication and laboratory review by the pharmacist was able to increase the number of residents in our long-term care setting with calcium supplementation, increase the number of residents who had vitamin D status assessed, identify many residents with low vitamin D levels, and increase supplementation of vitamin D when indicated.     

Effect of vitamin and trace-element supplementation on cognitive function in elderly subjects

OBJECTIVE: To determine whether supplementation with vitamins and trace elements in modest amounts influences cognitive function in apparently healthy, elderly subjects. METHODS: The study was designed as a randomized, double-blind, placebo-controlled trial. Ninety-six, apparently healthy, independent men and women older than 65 y of age were recruited and randomized to receive a supplement of trace elements and vitamins or a placebo daily for 12 mo. Blood-nutrient levels were estimated at baseline and at the end of the study. The major outcome measure assessed was cognitive function consisting of immediate and long-term memory, abstract thinking, problem-solving ability, and attention. RESULTS: Eighty-six subjects completed the 1-y trial. The supplemented group showed a significant improvement in all cognitive tests (P < 0.001 to 0.05) except long-term memory recall (P > 0.1). Those whose blood-nutrient levels were below the reference standard showed lower responses on cognitive tests. There was no significant correlation between individual nutrient levels and performance on various cognitive function tests. CONCLUSIONS: Cognitive functions improved after oral supplementation with modest amounts of vitamins and trace elements. This has considerable clinical and public health significance. We recommend that such a supplement be provided to all elderly subjects because it should significantly improve cognition and thus quality of life and the ability to perform activities of daily living. Such a nutritional approach may delay the onset of Alzheimer's disease.     

Effect of withdrawal of calcium and vitamin D supplements on bone mass in elderly men and women

BACKGROUND: Supplementation with calcium and vitamin D reduces bone loss and prevents fractures in elderly people, but it is not known whether any lasting benefit remains if the supplements are discontinued. OBJECTIVE: The objective was to determine whether gains in bone mineral density (BMD) induced by calcium and vitamin D supplementation persist after supplement withdrawal. DESIGN: Two-hundred ninety-five healthy, elderly men and women (aged >/=68 y) who had completed a 3-y randomized, placebo-controlled trial of calcium and vitamin D supplementation were followed for an additional 2 y during which no study supplements were given. BMD was measured by dual-energy X-ray absorptiometry, and biochemical variables related to calcium metabolism and bone turnover were measured. RESULTS: In the 128 men, supplement-induced increases in spinal and femoral neck BMD were lost within 2 y of supplement discontinuation, but small benefits in total-body BMD remained. In the 167 women, there were no lasting benefits in total-body BMD or at any bone site. Consistent with the observations on BMD, the bone turnover rates in both men and women (as measured by serum osteocalcin concentrations) returned to their original higher concentrations within the same 2-y period. CONCLUSION: Discontinued calcium and vitamin D supplementation has limited cumulative effect on bone mass in men and women aged >/=68 y.