补充钙和维生素D防治骨质疏松症的全球临床指南进展

发布时间：2018-04-18 06:25

本文选题：钙 + 维生素D　；参考：《中国骨质疏松杂志》2017年03期

【摘要】：补充钙和维生素D防治骨质疏松症一直是全球权威学术机构临床指南的基本策略。然而,近来一些研究对过量补充钙和维生素D的健康骨骼益处提出不同的观点,从而干扰了国际公认的防治骨质疏松症的基本策略,混淆了临床医师的视听。因此,笔者综述近几年来中国、美国、加拿大、英国、波兰、日本、韩国等权威学术机构的临床指南的观点,重点介绍骨质疏松症的发病机制和病理生理学关注的骨重建的主要局部调节剂[受体激活剂核因子kb(RANK)及其配体RANKL和诱饵受体骨保护素(OPG);罗列各国为防治骨质疏松症推荐的钙和维生素D摄入量;联合补充钙和维生素D有利于防治骨质疏松症和骨质疏松性骨折;分析补充钙和维生素D的健康骨骼争议,一般健康人每天服用钙补充剂不应该超过1000 mg。特别是基于亚洲人(中国人、日本人、韩国人)的膳食钙摄入量、血脂水平、身体体重指数(BMI)和维生素D营养状况,参考中国、日本、韩国的补充钙和维生素D防治骨质疏松症的临床指南,提出钙和维生素D补充的方法:每日一次服用碳酸钙和维生素D3补充剂的剂量以元素钙500~600 mg和维生素D3200 IU为宜,比较适合中国成年人群预防骨质疏松症。如果需要补充更多剂量的钙和维生素D,必须分成多次服用。这些信息供我国临床医师参考使用。
[Abstract]:Calcium and vitamin D supplementation has been a basic strategy for clinical guidelines of leading academic institutions around the world.However, some recent studies have put forward different views on the health and skeletal benefits of excessive calcium and vitamin D supplementation, thus interfering with internationally accepted basic strategies for the prevention and treatment of osteoporosis, and confusing clinicians.Therefore, the author summarizes the clinical guidelines of China, the United States, Canada, the United Kingdom, Poland, Japan, Korea and other authoritative academic institutions in recent years.This paper focuses on the pathogenesis of osteoporosis and the main local modulators of bone remodeling (receptor activator kbRANKK), its ligand RANKL and decoy receptor osteoprotegerin, which are concerned by pathophysiology. All countries are listed for the prevention and treatment of osteoporosis.Recommended calcium and vitamin D intake;A combination of calcium and vitamin D supplementation is beneficial to the prevention and treatment of osteoporosis and osteoporotic fracture. In the analysis of the healthy bone dispute of calcium and vitamin D supplementation, the average healthy person should not take calcium supplement more than 1000 mg per day.In particular, based on the dietary calcium intake, blood lipid levels, body mass index (BMI) and vitamin D nutritional status of Asians (Chinese, Japanese, Korean), refer to China, Japan,The Korean clinical guidelines for calcium and vitamin D supplementation for the prevention and treatment of osteoporosis suggest that calcium and vitamin D supplementation methods: calcium carbonate and vitamin D 3 supplementation should be given once a day at a dose of 500mg calcium and 3200 IU vitamin D,It is suitable for Chinese adult population to prevent osteoporosis.If additional doses of calcium and vitamin D are needed, they must be divided into multiple doses.This information can be used for reference by Chinese clinicians.
【作者单位】：《今日维生素D》网站;《中国骨质疏松杂志》社;
【分类号】：R580

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