“Understanding Vitamin D Deficiency: Causes, Risks, and Solutions”

[Voice of Hope May 8, 2023](Editor: Li Wenhan) 26-year-old Xiao Zhang (pseudonym) got the physical examination report and saw that the 25-hydroxyvitamin D was only 8.9 ng/mL, which was far lower than the normal value (>30ng/mL). He quickly took the physical examination report and asked: “doctor , does it matter? Should I take vitamin D?” The doctor told him: “Don’t worry, you need to know about vitamin D…”

The detection of 25-hydroxyvitamin D level has been recognized as the most reasonable indicator of vitamin D status.

Vitamin D deficiency is related to environmental and genetic factors. Common influencing factors include: age, skin color, season, geographical latitude, altitude, clothing habits, sunshine time, sun protection measures, eating habits, air pollution, obesity, and factors that affect vitamin D metabolism. drugs etc. More than 1 billion people worldwide have serum 25-hydroxyvitamin D levels below those recommended for bone and muscle health. It is recommended to screen blood levels of 25-hydroxyvitamin D. Vitamin D deficiency high-risk groups are as follows: 1. Special populations: pregnant and lactating women, elderly people with a history of falls and/or non-traumatic fractures, and people who lack sunlight (indoor work, night work, etc.), obese children and adults (body mass index ≥ 30 kg/㎡), people undergoing bariatric surgery.

2. Disease state Rickets, osteomalacia, osteoporosis, hyperparathyroidism, chronic kidney disease, liver failure, intestinal malabsorption syndrome (acute and chronic diarrhea, steatorrhea, pancreatic cystic fibrosis, inflammatory enteropathy, radiation enteritis), lymphoma, granulomatous diseases (sarcoidosis, tuberculosis, AIDS, histoplasmosis, coccidioidomycosis, etc.).

3. Certain drugs Antiepileptic drugs (phenytoin sodium, phenobarbital, etc.), glucocorticoids (prednisone, etc.), anti-tuberculosis drugs (rifampin, etc.), azole antifungal drugs (ketoconazole, etc.), Certain lipid-lowering drugs (cholestyramine, etc.).

1. Bone and muscle strength For infants and children, vitamin D deficiency, abnormal metabolism and abnormal function of vitamin D are important causes of rickets and osteomalacia. Multiple studies have shown that vitamin D deficiency is associated with increased parathyroid hormone levels, increased bone resorption, bone loss, and increased risk of falls and fractures in middle-aged and elderly people. Severe vitamin D deficiency has decreased muscle strength and increased risk of falls.

2. Type 2 diabetes Vitamin D insufficiency is associated with an increased incidence of type 2 diabetes, and vitamin D deficiency is a potential risk factor for type 2 diabetes. Vitamin D may affect glucose metabolism by affecting islet β-cell function, improving insulin sensitivity and glucose transport, and inducing increased conversion of proinsulin to insulin.

3. Cardiovascular disease Low vitamin D levels are associated with atherosclerosis, coronary artery disease, myocardial infarction, heart failure, stroke, cardiovascular mortality, and all-cause mortality. Vitamin D may affect or regulate inflammatory cytokines, Vascular calcification and renin-angiotensin-aldosterone system are involved in cardiovascular protection.

4. Immunity and tumor Animal experiments and cell experiments have shown that vitamin D can promote cell differentiation, inhibit tumor cell proliferation, and has anti-inflammatory, pro-apoptotic, and angiogenesis-inhibiting properties. However, large-scale randomized controlled studies are still needed to confirm the relationship between vitamin D and tumors.

1. Increase sunlight. It is recommended that people at high risk of vitamin D deficiency expose their skin to sunlight for a certain period of time to promote vitamin D synthesis. Need to pay attention to avoid using sunscreen, no glass, no umbrella. At the same time, of course, avoid strong sunlight to prevent skin burns.

2. Intake of foods rich in vitamin D. In dietary supplementation, give priority to supplementing foods rich in vitamin D, such as deep-sea fish, cod liver oil, mushrooms, egg yolks, etc.

3. Vitamin D supplementation The recommended intake of dietary nutrients for residents of all age groups and the recommended vitamin D supplementation dose for high-risk groups of vitamin D deficiency are as follows. In addition, it is recommended that pregnant and lactating women should supplement vitamin D at 1500-2000 IU/d.

4. People with vitamin D deficiency should seek medical treatment in time. It is recommended that people with vitamin D deficiency seek medical treatment in time, screen for concurrent diseases, and follow the doctor’s advice for timely treatment and reexamination. Excessive vitamin D supplementation may lead to increased urinary calcium, and urinary calcium exceeding 10 mmol/d may increase the risk of kidney stones and renal calcium deposits.

Editor in charge: Li Zhi

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