总维生素D检测的重要性及临床意义.ppt

1、1,血清总25OH维生素D检测的重要性及临床应用The Importance and Clinical Application of Total 25OH-D,维生素D营养状况的评判标准,聊城地区育龄女性VD状况,统计成人共 636人 VD10 26341.35% 10VD20 31349.21% 20VD30 375.82% VD30 233.62,聊城地区儿童VD状况,儿童统计364人 VD10 113.02% 10VD20 65 17.86% 20VD30 13035.71% VD30 15843.41,5,维生素D的内分泌、旁分泌和自分泌功能,维生素D在钙平衡中的作用,维生素D可减低自

2、身免疫性疾病发病率,Vitamin D supplementation is associated with a lower risk of autoimmune diseases. In a Finnish birth cohort study of 10,821 children, supplementation with vitamin D at 2000 IU/d reduced the risk of type 1 diabetes by approximately 78%, whereas children who were at risk for rickets had a 3-

3、fold higher risk for type 1 diabetes. In a case-control study of 7 million US military personnel, high circulating levels of vitamin D were associated with a lower risk of multiple sclerosis. Similar associations have also been described for vitamin D levels and rheumatoid arthritis,维持充足的维生素D水平可以减低多

4、种自身免疫病的发病风险,A prospective cohort study of children born in Finland during the year 1966 and followed for thirty years found that those who received supplemental vitamin D during the first year of life had a significantly lower risk of developing IDDM A recent case-control study in U.S. military pers

5、onnel, including 257 cases of diagnosed MS, found that white subjects in the highest quintile of serum 25-hydroxyvitamin D (99.1 nmol/L) had a 62% lower risk of developing MS . postmenopausal women with the highest total vitamin D intakes were at significantly lower risk of developing RA after 11 ye

6、ars of follow-up than those with the lowest intakes,多发性硬化症与纬度的关系,People living closer to the equator are at decreased risk of developing MS Similar trends: cancer, hypertension,促进细胞分化、抑制增殖-维生素D降低肿瘤发生率,The active form of vitamin D, 1,25-dihydroxyvitamin D, inhibits proliferation and stimulates the di

7、fferentiation of cells . Holick MF. Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis. Am J Clin Nutr. 2004;79(3):362-371,促进细胞分化、抑制增殖-维生素D降低肿瘤发生率,12,Vit D and Disease,Brain： 精神分裂症 schizophrenia 抑郁症 depression Lung： 哮喘 Asthma Circulation： 高血压 Hyperte

8、nsion 冠心病 CHD 中风 Stroke Immunosystem: I型糖尿病 DM 多发性硬化症 MS 风湿性关节炎 RH 可降低结核、流感活其他感染 性疾病的临床症状 TB etc. infection disease,肿瘤Tumor： 乳腺癌 (breast) 前列腺癌(prostate) 结肠癌(colon) 卵巢癌(ovary) 骨骼与肌肉Musculoskeletone: 骨软化(osteomalacia） 代谢性骨病 (Metabolic Bone Disease) 肌无力(myasthenia) 孕妇及胎儿、新生儿,维生素D:每个人、人生的每个阶段都要关注,15,维生素D检测的临床应用,儿科： 佝偻病、骨软化症、儿童骨骼发育不良、骨折、小儿精神抑郁、自闭症，疗效监测、预防维生素D中毒 产科: 孕期和哺乳期维生素D检测，预防产科并发症和新生儿维生素D缺乏；预防产后骨质疏松症和抑郁症 -中华儿科学会推荐：妊娠3个月查25OHD，确定维生素D的补充剂量,维