Assessment of dietary vitamin D requirements during pregnancy and lactation.
Assessment of dietary vitamin D requirements during pregnancy and lactation.
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DOI：
10.1093/ajcn/79.5.717
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发表时间：
2004-05
期刊：
影响因子：
--
通讯作者：
B. Hollis;C. Wagner
中科院分区：
文献类型：
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作者：
B. Hollis;C. Wagner
对维生素D的担忧在医学和科学文献中重新出现，因为美国维生素D缺乏症的患病率，特别是在深色肤色的人中，已经增加。本综述的主要目的是讨论过去和当前的文献，并重新评估成人维生素D的膳食参考摄入量，特别关注妊娠期和哺乳期妇女。怀孕和哺乳期间维生素D的适当剂量尚不清楚，尽管它似乎高于目前的膳食参考摄入量200-400 IU/d（5-10微克/d）。在许多情况下，90 ng/mL的剂量，而< 1000 IU/d的剂量似乎不足以维持15 - 80 ng/mL的正常循环25-羟基维生素D浓度。维生素D在心脏瓣膜疾病中不起病因学作用，例如在威廉姆斯综合征中观察到的，因此，涉及维生素D中毒的动物模型显示对心脏疾病的影响是有缺陷的，并且不能提供对正常人类生理学的见解。大部分美国人需要更高剂量的维生素D才能达到与在阳光充足的环境中生活和工作的人相当的浓度。需要进一步研究以确定孕妇和哺乳期妇女的最佳维生素D摄入量与纬度和种族的关系。
Concerns about vitamin D have resurfaced in medical and scientific literature because the prevalence of vitamin D deficiency in the United States, particularly among darkly pigmented persons, has increased. The primary goals of this review were to discuss past and current literature and to reassess the dietary reference intake for vitamin D in adults, with particular focus on women during pregnancy and lactation. The appropriate dose of vitamin D during pregnancy and lactation is unknown, although it appears to be greater than the current dietary reference intake of 200-400 IU/d (5-10 microg/d). Doses of 90 ng/mL, whereas doses < 1000 IU/d appear, in many cases, to be inadequate for maintaining normal circulating 25-hydroxyvitamin D concentrations of between 15 and 80 ng/mL. Vitamin D plays no etiologic role in cardiac valvular disease, such as that observed in Williams syndrome, and, as such, animal models involving vitamin D intoxication that show an effect on cardiac disease are flawed and offer no insight into normal human physiology. Higher doses of vitamin D are necessary for a large segment of Americans to achieve concentrations equivalent to those in persons who live and work in sun-rich environments. Further studies are necessary to determine optimal vitamin D intakes for pregnant and lactating women as a function of latitude and race.