Global prevalence and disease burden of vitamin D deficiency: a roadmap for action in low- and middle-income countries.
Global prevalence and disease burden of vitamin D deficiency: a roadmap for action in low- and middle-income countries.
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DOI：
10.1111/nyas.13968
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发表时间：
2018-10
影响因子：
5.2
通讯作者：
Whiting SJ
中科院分区：
文献类型：
--
作者：
Roth DE;Abrams SA;Aloia J;Bergeron G;Bourassa MW;Brown KH;Calvo MS;Cashman KD;Combs G;De-Regil LM;Jefferds ME;Jones KS;Kapner H;Martineau AR;Neufeld LM;Schleicher RL;Thacher TD;Whiting SJ
维生素 D 是骨骼健康的必需营养素，可能会影响呼吸道疾病、不良妊娠结局和成年慢性疾病的风险。由于许多国家富含维生素 D 的食物供应量相对较低，且阳光中天然紫外线 B (UVB) 辐射的暴露不足，因此全球很大一部分人口面临维生素 D 缺乏的风险。人们普遍认为，预防维生素 D 缺乏相关骨病的最低血清/血浆 25-羟基维生素 D 浓度 (25(OH)D) 约为 30 nmol/L；因此，该阈值适合在人口调查中定义维生素D缺乏症。然而，由于具有代表性的 25(OH)D 数据有限，评估低收入和中等收入国家人群维生素 D 状况的努力受到阻碍，特别是最容易受到维生素 D 状况低下的骨骼和潜在骨骼外后果影响的亚组人群，即纯母乳喂养的婴儿、儿童、青少年、孕妇和哺乳期妇女以及老年人。在缺乏 25(OH)D 数据的情况下，确定可从改善维生素 D 状况的公共卫生干预措施中受益的社区可能需要维生素 D 缺乏人群风险的代理指标，例如佝偻病的患病率或通常 UVB 暴露的指标。如果确定维生素 D 缺乏症患病率较高（25(OH)D 患病率 >20% < 30 nmol/L）或根据替代指标确定维生素 D 缺乏风险较高（例如佝偻病患病率 >1%），则可以实施食品强化和/或有针对性的维生素 D 补充政策，以减轻维生素 D 缺乏相关疾病的负担 弱势群体。
Vitamin D is an essential nutrient for bone health and may influence the risks of respiratory illness, adverse pregnancy outcomes, and chronic diseases of adulthood. Because many countries have a relatively low supply of foods rich in vitamin D and inadequate exposure to natural ultraviolet B (UVB) radiation from sunlight, an important proportion of the global population is at risk of vitamin D deficiency. There is general agreement that the minimum serum/plasma 25-hydroxyvitamin D concentration (25(OH)D) that protects against vitamin D deficiency–related bone disease is approximately 30 nmol/L; therefore, this threshold is suitable to define vitamin D deficiency in population surveys. However, efforts to assess the vitamin D status of populations in low- and middle-income countries have been hampered by limited availability of population-representative 25(OH)D data, particularly among population subgroups most vulnerable to the skeletal and potential extraskeletal consequences of low vitamin D status, namely exclusively breastfed infants, children, adolescents, pregnant and lactating women, and the elderly. In the absence of 25(OH)D data, identification of communities that would benefit from public health interventions to improve vitamin D status may require proxy indicators of the population risk of vitamin D deficiency, such as the prevalence of rickets or metrics of usual UVB exposure. If a high prevalence of vitamin D deficiency is identified (>20% prevalence of 25(OH)D < 30 nmol/L) or the risk for vitamin D deficiency is determined to be high based on proxy indicators (e.g., prevalence of rickets >1%), food fortification and/or targeted vitamin D supplementation policies can be implemented to reduce the burden of vitamin D deficiency–related conditions in vulnerable populations.
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影响因子：
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