生物与医学2021pubmed.ncbi.nlm.nih.gov
Covid-19 死亡率风险与维生素 D3 水平呈负相关
Covid-19 Mortality Risk Correlates Inversely with Vitamin D3 Status
进阶 · 约 30 分钟读完前置知识：流行病学基础、统计相关性与混杂因素、维生素D与免疫
导读
这篇论文（2021 年发表）考察维生素 D3 水平与 Covid-19 死亡率之间的关系，结论是二者呈负相关：维生素 D3 状态越差，死亡风险越高。从标题和评论看，这属于基于人群数据的关联性研究，并非随机对照试验，因此只能说明相关性而非因果关系。
HN 关注点：维生素 D 是否真能防重症是一个反复出现在 HN 上的话题，读者争论的焦点是：这类观察性研究能否成立、是否又是在重复以往对维生素 D 的过度期待。
HN 评论精选
这几条评论里：质疑 1 补充 2 亲历 1
质疑历史上维生素 D 的观察性结论在大规模 RCT 中几乎全部落空，因此对这项研究保持怀疑。
维生素 D 缺乏与癌症、心脏病、呼吸道感染、中风、糖尿病和死亡之间的关联由来已久。详细讨论见这篇博客：Vitamin D - The evidence（链接）。文中写道："我们目前已有超过 1500 项维生素 D 补充剂的 RCT 结果。……当测试其预防疾病的能力时，维生素 D 没能达到预期。" 曾有成千上万篇同行评审论文声称维生素 D 确实对癌症、中风等有效，但正如博客指出的，一旦做了规模更大、设计更严谨的 RCT，这些说法无一站得住。唯一被证明能靠补充维生素 D 治愈的疾病是……维生素 D 缺乏症。因此我对这项研究同样相当怀疑。把维生素 D 当作灵丹妙药的热情，与伊维菌素或羟氯喹的热潮并无二致。治愈 COVID 没那么简单——人们太希望它简单了，所以才愿意相信。
glofish查看英文原文
There is a long history of Vitamin D deficiency being linked to cancer, heart disease, respiratory infection, stroke, diabetes, and death. For a detailed discussion of the subject see the blog post: Vitamin D - The evidence https://www.devaboone.com/post/vitamin-d-part-3-the-evidence?postId=5f4e8bf673d853002ded6cd3 > "We now have results for over 1500 RCTs on Vitamin D supplementation. Some of the largest and most significant trials are listed and summarized at the end of this article. When tested on its ability to prevent disease, Vitamin D has failed to live up to expectations." Thousands of peer reviewed research papers have been published that Vitamin D does truly work for cancer and stroke etc and all the above. But then, as the blog points out, none of the claims held once bigger and properly designed RCTs were performed. The only disease provably cured by Vitamin D supplementation was ... Vitamin D deficiency. Hence I am quite skeptical here as well. The eagerness to embrace Vitamin D as a silver bullet is no different than that of Ivermectin or Hydroxychloroquine. It is not that simple to cure COVID - people dearly wish it were hence they want to believe.
亲历亲历：长期补充维生素 D、水平理想，抗体阳性却始终无症状。
仅供参考：我二十五六岁体检时医生发现我维生素 D 水平偏低，建议我补充。我每周大约 5 次服用 10,000 IU 维生素 D 加维生素 K。现在 35 岁，2020 年 1 月我特意查了一次水平，确认没有过量，结果是 53 ng/mL，非常理想。疫情来了之后，身边很多人都病了，我却一直没病，不过我也一直认真戴口罩。所以 2020 年 8 月医生给我做新冠抗体检测（抽血）时我有点意外——结果是阳性，而我在那整段时间里毫无感觉。几个月后我伴侣感染了新冠，感染期我们显然有非常密切的接触，我依然完全没事。我不想当维生素 D 的传教士，当然也可能我只是新冠方面的幸运儿，但如果你目前没有在补充，我觉得这算是成本很低、很容易一试的事。当然我现在也接种了疫苗。
jliptzin查看英文原文
For what it’s worth, I had a physical in my mid-20s where my doctor saw my vitamin D levels were low, so he told me to supplement with vitamin D. I take 10,000 IU with vitamin K about 5x/week. I am 35 now and I happened to check my levels around Jan 2020, to make sure I wasn’t overdoing it. I was at 53 ng/mL, which was perfect. The pandemic came around, and while a lot of people around me got sick, I never did, but I had also been good about mask adherence. So I was a little surprised in August 2020 when my doctor gave me a COVID antibody test (blood draw), just to see, had come back positive, considering I had felt completely fine through that whole period. Then again a few months later, when my SO came down with covid, needless to say we had extremely close contact during the infectious period, and I was still completely fine. I’m not trying to be a vitamin D evangelist or anything, of course I could just be one of the lucky ones when it comes to covid, but I feel like it’s a cheap and easy thing to try if you aren’t currently supplementing. And of course, I am vaccinated as well now.
补充补充两项关于维生素 D 与呼吸道感染的 RCT 文献。
我一直在收集关于普通感冒治疗和预防的研究，每次感冒就花点时间扩充这个列表。到目前为止，维生素 D3 是列表里比较有希望的一种。这里有两项关于维生素 D 与呼吸道感染的有趣 RCT：维生素 D 对季节性流感的预防效果（链接）；维生素 D 补充用于预防急性呼吸道感染（链接）。
mg查看英文原文
I have been collecting studies related to treatment and prevention of the common cold for a while now. Every time I have a cold, I spend some time growing the list. So far, Vitamin D3 is one of the more promising treatments in the list. Here are two interesting RCTs regarding Vitamin D and respiratory tract infections: Preventive Effects of Vitamin D on Seasonal Influenza: https://journals.lww.com/pidj/fulltext/2018/08000/preventive_effects_of_vitamin_d_on_seasonal.5.aspx Vitamin D Supplementation for the Prevention of Acute Respiratory Tract Infection: https://academic.oup.com/jid/article/202/5/809/1746565
补充该结论早有报道，肥胖等混杂因素也值得考虑，并由此引申到防疫政策的取舍。
这事不是一年半前就已经知道了吗？这也不是第一篇关于维生素 D 的研究。HN 上以往的讨论（三个链接）。另一个共病是肥胖，肥胖也会导致维生素 D 缺乏（链接）。这一切的一个有趣含义是：用于管理疫情的威权措施实际上是一种补贴——年轻、健康或饮食营养均衡的人承受着痛苦（封锁、强制令），来为其他人营造更低风险的环境。我个人认为政府最好提供教育和明确指导，但最终应偏向个人选择，远离自上而下的措施。就新冠而言，年轻人的 IFR 本来就极低，他们本可以照常生活、自然产生抗体，这反过来也会让其他人更安全。
throwawaysea查看英文原文
Hasn’t this been known for over a year and a half now? This isn’t the first study on Vitamin D. Some past discussions on HN: https://news.ycombinator.com/item?id=24912172 https://news.ycombinator.com/item?id=23119949 https://news.ycombinator.com/item?id=23023703 Another comorbidity is obesity, which can also cause Vitamin D deficiency. https://news.ycombinator.com/item?id=26924786 An interesting implication of all this is that the authoritarian measures used to manage the pandemic are effectively a subsidy. Those who are young or healthy or have a nutritionally balanced diet are taking on pains (lockdowns, mandates) to create a lower risk situation for everyone else. Personally I feel it is better for governments to provide education and strong guidance, but to ultimately favor individual choice and stay away from top down measures. With COVID, those who are young have incredibly low IFR to begin with, and they could have gone about their lives and built up antibodies naturally, which would then make it safer for everyone else anyways.
历次讨论
- 2021Hacker News 讨论帖174 分 · 131 评
同领域还值得读
CRISPR 在活体动物中消除 HIV-1 感染
CRISPR eliminates HIV-1 infection in live animals
报告利用 CRISPR/Cas9 基因编辑技术在活体动物中清除 HIV-1 感染：研究人员通过腺病毒载体递送特定的 Cas9 系统，从被感染细胞中切除嵌入的 HIV 病毒 DNA。
生物与医学2017 · 1,455 分 · 239 评入门 · 约 30 分钟编辑精选保护区飞行昆虫生物量27年下降75%
75% decline over 27 years in total flying insect biomass in protected areas
这篇发表于 PLOS ONE 的研究通过在德国保护区长达 27 年的昆虫生物量监测，发现飞行昆虫总量下降了约 75%。
生物与医学2017 · 901 分 · 432 评入门 · 约 45 分钟编辑精选为什么大多数已发表的研究发现是错的
Why Most Published Research Findings Are False (2005)
这篇 2005 年发表于 PLOS Medicine 的经典论文由 John Ioannidis 撰写，论证了在统计功效不足、研究偏倚和多重检验等因素下，大多数已发表的医学研究发…
生物与医学2022 · 388 分 · 351 评入门 · 约 60 分钟编辑精选人类免疫系统的物理接线图
A physical wiring diagram for the human immune system
这篇 Nature 论文系统绘制了人类免疫系统的“物理接线图”：通过大规模实验鉴定免疫细胞表面受体之间的相互作用（包括约 30 种此前未知的受体互作），并结合定量计算模型模拟免疫…
生物与医学2022 · 342 分 · 49 评专业 · 约 90 分钟编辑精选脂肪组织在减重后仍保留肥胖的表观遗传记忆
Adipose tissue retains an epigenetic memory of obesity after weight loss
这篇 Nature 论文研究了肥胖对脂肪组织的长期影响：即使减重成功，脂肪细胞仍保留着肥胖时期的表观遗传记忆，可能解释为什么减重后容易反弹。
生物与医学2025 · 263 分 · 327 评进阶 · 约 45 分钟编辑精选