Vitamin D deficiency is associated with osteoporosis and is thought to increase the risk of cancer and CVD. Despite these numerous potential health effects, data on vitamin D status at the population level and within key subgroups are limited. The aims of the present study were to examine patterns of 25-hydroxyvitamin D (25(OH)D) levels worldwide and to assess differences by age, sex and region. In a systematic literature review using the Medline and EMBASE databases, we identified 195 studies conducted in forty-four countries involving more than 168 000 participants. Mean population-level 25(OH)D values varied considerably across the studies (range 4·9-136·2 nmol/l), with 37·3 % of the studies reporting mean values below 50 nmol/l. The highest 25(OH)D values were observed in North America. Although age-related differences were observed in the Asia/Pacific and Middle East/Africa regions, they were not observed elsewhere and sex-related differences were not observed in any region. Substantial heterogeneity between the studies precluded drawing conclusions on overall vitamin D status at the population level. Exploratory analyses, however, suggested that newborns and institutionalised elderly from several regions worldwide appeared to be at a generally higher risk of exhibiting lower 25(OH)D values. Substantial details on worldwide patterns of vitamin D status at the population level and within key subgroups are needed to inform public health policy development to reduce risk for potential health consequences of an inadequate vitamin D status.

译文

维生素D缺乏症与骨质疏松症相关,被认为会增加罹患癌症和CVD的风险。尽管有许多潜在的健康影响,但在人群水平和关键亚组内维生素D状况的数据仍然有限。本研究的目的是检查世界范围内25-羟基维生素D(25(OH)D)水平的模式,并评估年龄,性别和地区的差异。在使用Medline和EMBASE数据库进行的系统文献综述中,我们确定了在44个国家进行的195项研究,涉及168 000多名参与者。在整个研究中,平均人群水平25(OH)D值相差很大(范围4·9-136·2 nmol / l),其中37·3%的研究报告平均值低于50 nmol / l。在北美观察到最高的25(OH)D值。尽管在亚太地区和中东/非洲地区发现了与年龄有关的差异,但在其他地区未发现与年龄有关的差异,在任何地区都未发现与性别有关的差异。研究之间的实质性异质性无法在人群水平上得出总体维生素D状况的结论。然而,探索性分析表明,来自全球多个地区的新生儿和机构化老年人似乎普遍具有较低的25(OH)D值风险。需要在人群水平和关键亚组内提供有关世界范围内维生素D状况的大量细节,以告知公共卫生政策制定工作,以减少维生素D状况不足对潜在健康后果的风险。

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