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비타민 D 작용에 대한 새로운 조명

New Insight into the Action of Vitamin D

최희정
대한가정의학회 (The Korean Academy Of Family Medicine)|2011.02|Korean Journal of Family Medicine|제32권 제2호|pp. 89-96

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참고문헌

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골다공증Vitamin D비타민 D비타민SunlightSupplementCholecalciferolVitamin D Deficiency햇빛
주제분류가정의학

초록

비타민 D는 칼슘과 뼈의 대사 외에, 골격근이나 당 대사,혈관과 심장, 면역기능, 세포증식과 연관된 다양한 작용이 밝혀지면서 새롭게 주목을 받고 있으나, 우리나라를 비롯한 전세계인구의 반 이상이 비타민 D 결핍 위험에 놓여있어 비타민D 부족은 이제 세계적인 유행질환이 되었다. 지금까지의 실험실 연구나 역학연구 결과는 적정 비타민 D 농도를 유지하는것이 최적의 건강상태를 유지하는데 필요한 또 하나의 필수요건임을 시사하고 있다. 그러나 비타민 D 부족과 연관이 있는 것으로 알려진 임상질환들은 대부분 역학연구를 통해 밝혀진 것으로 식이나 기저 비타민 D 상태, 체질량지수, 나이, 질환, 계절, 순응도, 신체활동량과 같은 혼란변수를 보정하지 못한 경우가 대부분이다. 또한 칼슘이나 다른 영양소에 의한 영향을 배제하고 비타민 D의 효과를 단독으로 실험하였던 연구나 비타민 D 보충제를 이용한 중재연구가 거의 없고, 결과 또한 일관성을 보이지 않고 있어 비타민 D 부족과 이들 질환 간에 인과관계를 증명하기 위한 무작위 대조군 중재연구가 필요한 실정이다. 현재로는 골연화증을 제외한 나머지 임상질환에서 중재연구를 통한 비타민 D의 효과에 대한 근거가 부족한 상황이지만 비타민 D는 보충제를 통해 쉽고 안전하게 투여가 가능하므로 비타민 D 부족이 있는 환자에게는 적당량의 비타민 D 투여를 고려해야 할 것이다.

Abstract

Vitamin D deficiency is now recognized as a pandemic with more than half of the world’s population currently at risk. Traditionally, vitamin D has been associated primarily with bone and calcium metabolism. However, it is now known that adequate vitamin D status is important for optimal function of many organs and tissues throughout the body. This discovery has provided new insights into the action of vitamin D. Many epidemiologic studies have demonstrated an association between vitamin D deficiency and the risk of various chronic diseases, including cardiovascular disease,diabetes, cancers, autoimmune diseases, and infectious diseases. However, it is not enough to limit definitive conclusions. Large randomized controlled trials are needed to establish the relevance of vitamin D status to such as chronic diseases. Vitamin D deficiency and insufficiency can be both treated and prevented safely through supplementation. Recommendation of adequate vitamin D intake should be considered in appropriate patients to optimize general health. In this article, I review its role in skeletal and extraskeletal health and the adverse impact of vitamin D deficiency on musculoskeletal system, cardiometabolic health, immune system, and oncogenesis, and suggest strategies for prevention and treatment of vitamin D deficiency.

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