Does the High Prevalence of Vitamin D Deficiency in African Americans Contribute to Health Disparities?
Does the High Prevalence of Vitamin D Deficiency in African Americans Contribute to Health Disparities?
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DOI：
10.3390/nu13020499
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发表时间：
2021-02-03
期刊：
影响因子：
5.9
通讯作者：
Willett WC
中科院分区：
文献类型：
--
作者：
Ames BN;Grant WB;Willett WC
非裔美国人有更高的发病率和死亡率，从许多健康相关的问题比欧洲裔美国人。他们严重缺乏维生素D的患病率也高出15至20倍。在这里，我们总结了以下证据：（i）这种健康差异部分是由于维生素D生产不足，这是由皮肤中的黑色素阻止其合成所需的UVB太阳辐射造成的;（ii）由于深色皮肤与较低的UVB辐射水平相结合，维生素D不足在高纬度地区加剧;和（iii）具有深色皮肤的个体的健康可以通过纠正缺乏和获得最佳维生素D状态而显著改善，如可以通过补充和/或强化获得的。有中到强有力的证据表明，高水平的25-羟基维生素D和/或维生素D补充剂可降低许多不良健康结果的风险，包括全因死亡率、不良妊娠和出生结局、癌症、糖尿病、阿尔茨海默病和痴呆、多发性硬化症、急性呼吸道感染、COVID-19、哮喘加重、佝偻病和骨软化症。我们建议维生素D水平低的人，包括生活在高纬度地区的大多数深色皮肤的人，沿着他们的医疗保健提供者，考虑服用维生素D3补充剂，将血清25-羟基维生素D水平提高到30 ng/mL（75 nmol/L）或更高。
African Americans have higher incidence of, and mortality from, many health-related problems than European Americans. They also have a 15 to 20-fold higher prevalence of severe vitamin D deficiency. Here we summarize evidence that: (i) this health disparity is partly due to insufficient vitamin D production, caused by melanin in the skin blocking the UVB solar radiation necessary for its synthesis; (ii) the vitamin D insufficiency is exacerbated at high latitudes because of the combination of dark skin color with lower UVB radiation levels; and (iii) the health of individuals with dark skin can be markedly improved by correcting deficiency and achieving an optimal vitamin D status, as could be obtained by supplementation and/or fortification. Moderate-to-strong evidence exists that high 25-hydroxyvitamin D levels and/or vitamin D supplementation reduces risk for many adverse health outcomes including all-cause mortality rate, adverse pregnancy and birth outcomes, cancer, diabetes mellitus, Alzheimer’s disease and dementia, multiple sclerosis, acute respiratory tract infections, COVID-19, asthma exacerbations, rickets, and osteomalacia. We suggest that people with low vitamin D status, which would include most people with dark skin living at high latitudes, along with their health care provider, consider taking vitamin D3 supplements to raise serum 25-hydroxyvitamin D levels to 30 ng/mL (75 nmol/L) or possibly higher.
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影响因子：
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