生物与医学2020pubmed.ncbi.nlm.nih.gov
维生素 D 补充改善认知功能：一项为期 12 个月的随机对照试验
Vitamin D Supplementation Improves Cognitive Function: 12-month RCT
入门 · 约 30 分钟读完前置知识：基础统计学、临床试验设计常识
导读
这项为期 12 个月的随机对照试验（RCT）研究维生素 D 补充剂对认知功能的影响，结论是补充维生素 D 可改善认知功能。HN 讨论中有人指出另一项同期研究（使用 5 倍剂量）却显示维生素 D 几乎无益处，因此证据尚有争议。
HN 关注点：维生素 D 是否真能改善认知/健康是 HN 长期关注的话题，且与疫情期间关于维生素 D 降低新冠重症率的讨论相呼应，评论焦点集中在相互矛盾的研究结果上。
HN 评论精选
这几条评论里：质疑 1 补充 2 亲历 1
亲历亲历案例：严重维生素 D 缺乏导致认知障碍，补充后显著恢复
我妹妹读博士期间得了白血病。缓解后她无法长时间记住新信息，连读论文都做不到，只能暂停学业。后来一位医生做了包含维生素 D 水平的血液检查，发现她的数值只有个位数（正常应至少为 20）。开始补充后，她今年春天顺利毕业了。虽然只是一个个例，但很明显，纠正缺乏症带来了显著改善。
aidenn0查看英文原文
My sister got leukemia while part way through her doctorate. After it went into remission, she was unable to recall new information long enough to read papers and had to put her studies on hold. Eventually a doctor did a blood test that included vitamin d levels, and she was in the single digits (don't remember units but it was supposed to be at least 20). She started supplementing and graduated this spring. Just one data point, but it was pretty clear that remedying a deficiency made a marked improvement in her case.
质疑指出存在剂量更高但结论相反的竞争研究，证据尚无定论
有意思——我刚好在消化另一项最近发布的研究，它显示维生素 D、Omega-3 脂肪酸和运动（单独或组合）几乎没有益处。那项研究使用的每日维生素 D 剂量是这项的 5 倍。所以看来结论还没定，我可能会继续选择补充维生素 D 以防万一。
ezekiel68查看英文原文
Funny -- I was just digesting a competing study released recently[0] which showed little-to-no benefit from vitamin D, Omega 3 fatty acids, and exercise (either alone or in combinations). That study used 5X the daily vitamin D as this one. So I guess the jury's still out and I may choose to continue to err on the side of supplementing vitamin D. [0] https://www.upi.com/Health_News/2020/11/10/Study-Little-benefit-for-vitamin-D-omega-3-exercise-in-seniors/2191605028709/
补充成本/收益分析：维生素 D 成本和风险极低，即使效果存疑也值得补充
值得注意的是，维生素 D 有很多高置信度但效果较小的研究结果，包括针对多种健康结局的大量强荟萃分析。我的意思是，它通常要么确有轻微益处，要么几乎无效，偶尔也有非常显著的益处（比如最近与新冠相关的一些研究）。虽然维生素 D 不是什么令人兴奋的补剂，但这不是忽视它的理由——正确的决策方式是做成本/收益分析。它的成本几乎低到极限，每天约 0.01 到 0.05 美元，副作用等非财务成本也几乎不存在。所以即使对某些结果持健康怀疑态度的人，也应考虑补充——潜在益处很多，即使有些很小，而风险和实际成本几乎为零。最佳做法是补充前后各做一次血液检测以确定合适剂量，但这并非必需。我认为成本/收益分析明显偏向补充，所以我毫不犹豫地把它加进了每日补剂清单。
ve55查看英文原文
It's worth noting that vitamin D has a lot of high-confidence but low-effect results going for it, including a lot of strong meta-analysis over many health outcomes. What I mean by this is that it usually seems to conclusively either do something beneficial, but minor, almost nothing in the case of many studies, and in the case of some others, something very beneficial (as we've seen a few of in relation to covid recently). Although Vitamin D isn't a particularly exciting supplement most of the time, that isn't enough of a reason for us to ignore it, as the proper way to make the decision of taking it or not would be to perform a cost/benefit analysis (as we should with any other supplements, lifestyle changes, etc). The costs of vitamin D are just about as low as any supplement gets, and can be between $0.01 and $0.05 per day. The non-financial costs such as side effects or potential adverse effects are practically non-existent as well. So I do think that even those that have a healthy bit of skepticism over some results should still consider supplementation - there are a lot of potential benefits even if some are minor, and almost no risks or real costs. The optimal way to supplement is to get a blood test before+after starting supplementation in order to be confident you're taking the correct amount, but this isn't required of course. But I think the cost/benefit analysis is clearly in favor, so I didn't hesitate to add Vitamin D to my list of supplements that I take daily (https://nearcyan.com/supplements/ if curious), along with many others at this point.
补充补充关联资料：维生素 D 或通过减缓氧化应激降低新冠重症率
有趣的是，据 Roger Seheult 医生对 SARS-CoV-2 在人体内的生化分析，氧化应激被认为是新冠感染重症的主要原因。他还解释了为什么维生素 D 有助于降低新冠死亡率，因为维生素 D 能减缓氧化应激。Seheult 是热门 YouTube 频道 MedCram 的主讲人，是内科、肺部疾病、重症监护和睡眠医学的委员会认证医师。
devy查看英文原文
Interestingly, Oxidative stress is considered to the main cause of COVID-19 infection severity, according to Dr. Roger Seheult in his bio-chemistry analysis of SARS-CoV-2 in human body. He also explained why Vitamin D could help reduce the mortality of COVID-19 due to Vitamin's ability to slow down oxidative stress.[2] Dr. Seheult is the main lecturer of his popular YouTube channel MedCram[3] and is a board certified physician in Internal Medicine, Pulmonary Diseases, Critical Care Medicine and Sleep Medicine. [1]: https://youtu.be/gzx8LH4Fjic?t=28 [2]: https://www.youtube.com/watch?v=Mdc7T2UTHBI [3]: https://www.youtube.com/channel/UCG-iSMVtWbbwDDXgXXypARQ
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