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Dtsch Med Wochenschr 2015; 140(22): 1661-1666
DOI: 10.1055/s-0041-103272
Dossier
Vitamin D/Osteoporose
© Georg Thieme Verlag KG Stuttgart · New York

Vitamin-D-Substitution: immer notwendig?

Vitamin D supplementation for everybody everytime?
Jan Kramer
1   Medizinische Klinik I, Universität zu Lübeck
2   LADR GmbH Ihr Labor vor Ort, MVZ Dr. Kramer & Kollegen, Geesthacht
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Publication History

Publication Date:
04 November 2015 (online)

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Zusammenfassung

Nur wenige Nahrungsmittel enthalten Vitamin D in hoher Konzentration. Die Hauptquelle für Vitamin D ist die Synthese in der Haut unter dem Einfluss von UV-Strahlung. Durch enzymatische Konvertierung entsteht in der Leber das 25-Hydroxy-Vitamin D (25-Vitamin D) und im Anschluss in der Niere das hormonell aktive 1,25-Dihydroxy-Vitamin D (1,25-Vitamin D), das eine wichtige Rolle im Kalzium- und Knochenstoffwechsel spielt. Vitamin-D-Mangel kann zur Demineralisation des Knochens führen. Der Vitamin-D-Rezeptor wird von allen kernhaltigen Zellen des Körpers exprimiert. Vitamin D reguliert somit zahlreiche weitere zelluläre Funktionen. Ein subklinischer Vitamin-D-Mangel, festgestellt anhand eines erniedrigten 25-Vitamin-D-Spiegels, ist relativ häufig auch in der gesunden Population. In dieser leichten Form trägt er zu der Entstehung der Osteoporose und der Häufung von Stürzen bei älteren Menschen bei. In einigen Ländern wird daher eine Ergänzung von ausgewählten Nahrungsmitteln mit Vitamin D vorgenommen. Auch in Deutschland ist ein Vitamin-D-Mangel relativ häufig. Somit stellt sich die berechtigte Frage, ob eine Vitamin-D-Substitution immer notwendig ist?

Abstract

Only few foods contain vitamin D in higher concentrations. Therefore, the main source of vitamin D is the dermal synthesis under the influence of UVB-light. By enzymatic hydroxylation vitamin D is converted to 25-hydroxy-vitamin D and finally to the active hormone 1,25-dihydroxy-vitamin D, which plays an important role in calcium- and bone metabolism. Vitamin D-deficiency can result in demineralisation of the bone. The vitamin D-receptor is expressed by all nucleated cells of the body and vitamin D regulates many cellular functions. Sublinical vitamin D-deficiency is common even in the normal population resulting in a risk situation for at least osteoporosis and falls in older people. This is the reason for fortification of food in some countries by vitamin D. Also in Germany vitamin D-deficiency can be detected in many people leading to the question: is vitamin D supplementation necessary for everyone?

Schlüsselwörter

Vitamin-D-Supplementation - Calcitriol - Calcidiol - Osteomalazie - Osteoporose

Keywords

Vitamin D supplementation - Calcitriol - Calcidiol - osteomalacia - osteoporosis
 

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