生物与医学2021ncbi.nlm.nih.gov
维生素 D 水平对 COVID-19 的影响：系统综述与荟萃分析
The Impact of Vitamin D Level on Covid-19: Systematic Review Meta-Analysis
入门 · 约 45 分钟读完前置知识：基础统计学（荟萃分析概念）、维生素D代谢基础
导读
这篇系统综述与荟萃分析研究了维生素D水平与新冠（COVID-19）感染及严重程度之间的关系，汇总多项研究评估维生素D缺乏是否与更高的感染风险或更差的预后相关。结论方向上支持维生素D不足与新冠不良结局存在关联，但作为观察性汇总，因果关系仍需谨慎解读。
HN 关注点：疫情期间维生素D能否预防或减轻新冠是HN读者长期争论的话题，讨论焦点集中在补充剂量的安全性、证据强度以及维生素D网络热潮带来的过度宣传。
HN 评论精选
这几条评论里：质疑 1 补充 1 亲历 1
补充科普如何正确检测维生素D水平及解读标准，并指出深肤色人群更易缺乏
你可以申请检测来确认自己的维生素D水平，但一定要选对检测项目！25(OH)D在血液中停留时间更长（半衰期约3周），是更准确的检测。许多专家建议水平至少达到30 ng/ml，有些人甚至建议50 ng/ml。检测结果的解读标准为：缺乏：<10 ng/mL；不足：10–30 ng/mL；充足：30–100 ng/mL；中毒：>100 ng/mL。血液循环中的25-OH维生素D大部分来自皮肤中7-脱氢胆固醇经UVB（290–315 nm）照射转化而成，生成量主要取决于照射时长和强度，通常在日晒30分钟内达到平台。此外，维生素D不足在非裔美国人中比其他美国人更普遍，北美大多数年轻健康的黑人在一年中任何时候都达不到最佳25(OH)D浓度。
tannerbrockwell查看英文原文
You can request a test to confirm your level of Vitamin D. If you get the test make sure it is the right one! 25 (OH) stays in the blood longer, so this is the more accurate test. (half life of 3 weeks in your blood). Many experts recommend a level of at least 30 ng/ml ... some actually suggest that 50 ng/ml is recommended. The scale on the test results is: Interpretive Data: Deficiency: <10 ng/mL Insufficiency: 10 to 30 ng/mL Sufficiency: 30 to 100 ng/mL Toxicity: >100 ng/mL "The majority of 25-OH vitamin D (25-D) in the circulation is derived from the conversion of 7-dehydrocholesterol in the skin that is irradiated with ultraviolet radiation in the UVB range (wavelength 290 nm to 315 nm).1-5 The extent of vitamin D formation is not tightly controlled and depends primarily on the duration and intensity of the UV irradiation. Levels produced typically reach a plateau within 30 minutes of exposure." [1] "Vitamin D insufficiency is more prevalent among African Americans (blacks) than other Americans and, in North America, most young, healthy blacks do not achieve optimal 25-hydroxyvitamin D [25(OH)D] concentrations at any time of year." [2] [1]: https://www.labcorp.com/test-menu/36721/vitamin-d-25-hydroxy [2]: https://www.ncbi.nlm.nih.gov/pubmed/16549493
亲历亲历提醒：适度补充有益，但网络上的维生素D热潮导致剂量建议过高，自己5000 IU/天已接近过量
维生素D缺乏与呼吸道感染风险增加之间的关联是众所周知的，在冬季或饮食欠佳的人群中适度补充是个好主意。但我注意到近年来维生素D在互联网上形成了一种近乎狂热的追随，一些健康主张已经失控，某些圈子的补充建议剂量也过高。我承认自己也中过招：在读了大量关于维生素D缺乏和益处的文章后，我开始每天补充5000 IU，但验血时发现已接近过量水平，连一位非常支持补充维生素D的医生都警告我要大幅减量。可怕的是，如今Twitter和健康论坛上到处都是更高的剂量建议，'越多越好'的观念被想标新立异的健康网红和维生素D作为神奇维生素的狂热地位不断放大。鼓励适度补充（或改善饮食）是正确方向，但……
PragmaticPulp查看英文原文
The association between Vitamin D deficiency (VDD as referred to in this article) and increased risk of respiratory infections is well-known. Mild to moderate Vitamin D supplementation, especially during winter or in those with subpar dietary habits, is a good idea. However, I've noticed that Vitamin D has been garnered an almost cult-like following on parts of the internet in recent years. Some of the health claims around Vitamin D are getting out of control, and the recommendations for Vitamin D supplementation are far too high in certain circles. I have to admit that I fell for this to some degree. I started supplementing 5000 IU/day after reading all of the writings about Vitamin D deficiency, the health benefits of Vitamin D, and the arguments that current Vitamin D supplementation recommendations were far too low. But that 5000 IU/day put me near overdose territory when I got my serum levels checked. Even my doctor, who is very pro-Vitamin D supplementation, warned me to significantly cut my supplementation. The scary part is that I see recommendations for significantly higher Vitamin D dosing all over Twitter and health forums lately. There's a growing idea that more is better, amplified by health influencers trying to stand out from the crowd and the growing cult-like status of Vitamin D as a wonder vitamin. I think encouraging mild vitamin d supplementation (or improved dietary patterns with more Vitamin D) is a good step in the right direction, but I'm also worried to see how much of this is being exaggerated and taken to unhealthy extremes. When in doubt, get a blood test.
质疑提出疑问：维生素D缺乏是否是新冠对深肤色族群影响更严重的因素之一
据我了解，天生肤色较深的人维生素D缺乏风险更大，因为深色皮肤会减少对紫外线的吸收。我想知道维生素D缺乏在多大程度上可能是新冠对美国不同族裔社区造成差异影响的一个因素（至少在美国如此）。有人知道这方面是否已有相关研究吗？
superfunny查看英文原文
From what I understand, individuals with naturally darker skin tend to be at greater risk from vitamin D deficiency. This is because naturally darker skin reduces the absorption of UV rays. I wonder to what extent vitamin D deficiency could be a contributing factor to the disparate impact that Covid-19 has had on different ethnic communities (at least in the United States). Is anyone aware of any studies done in this regard?
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