維他命D並非萬靈丹－矯正醫生的狂想曲--- Straight teeth and life

**降低心臟血管疾病維他命D並非萬靈丹

幾個月前有研究指出，服用維他命D可以降低心臟血管疾病，因此維他命D突然暴紅！

最近經由系統性文獻回顧，顯示高劑量維他命D並非萬靈丹，並未有效降低心臟血管疾病。

維他命D仍證實主要作用於骨骼系統！因此一般大眾不需要特地增加維他命D劑量。

不過另外的期刊論文顯示，洗腎易造成患者較缺乏維他命D，所以洗腎患者服用維他命D有助於降低心臟血管疾病。

--Part II

D Is for Discord ：Not All Studies Support Vitamin-D--CVD Link

**Too Soon for Definitive Conclusions

March 5, 2010 — The value of vitamin D in improving cardiovascular health or reducing the risk of diabetes and other risk factors remains unclear, although some hint of benefit for the popular supplement should support ongoing research in this field. That's the upshot of two new literature reviews and an editorial appearing in the March 2, 2010 issue of the Annals of Internal Medicine.

Excitement over the hypothesis that vitamin-D deficiency might play a role in the development of cardiovascular disease has appealed to an ever-growing number of researchers and led to wide use of the inexpensive supplement in the general population, often at doses higher than historically recommended by health authorities. Whether enthusiasm for vitamin D is warranted by the available evidence remains unclear

According to the systematic review by Dr Lu Wang (Brigham and Women's Hospital, Boston, MA) and colleagues, vitamin D and calcium insufficiency are highly prevalent among elderly persons in the United States. The Institute of Medicine recommends supplementation at 200, 400, and 600 IU daily in those aged 19 to 50 years, 51 to 70 years, and 71 years and older, respectively. Both vitamin D and calcium supplementation have received attention for potential benefits on nonskeletal health including CVD risk, but data are inadequate regarding the role of supplementation on CVD outcomes.

Clinical Implications

Vitamin D supplementation in patients undergoing dialysis is associated with a reduction in CVD mortality rates.
Vitamin D at moderate to high doses may reduce CVD risk, but calcium supplements have minimal CVD effects in the general population.

References

Wang L, Manson JE, Song Y, et al. Systematic review: Vitamin D and calcium supplementation in prevention of cardiovascular events. Ann Intern Med 2010; 152:315-323.
Pittas AG, Chung M, Trikalinos T, et al. Systematic review: Vitamin D and cardiometabolic outcomes. Ann Intern Med 2010; 152:307-314.
Guallar E, Miller ER. Vitamin D supplementation in the age of lost innocence. Ann Intern Med 2010; 152:327-329.