下面幾個重點詮釋取自功能醫學界一位很有名的醫學博士今天早上的郵件分享，是我一直在追隨的 克里斯·馬斯特約翰博士。Key takeaways below are from a newsletter I received from Chris Masterjohn, PhD. this morning.
在3月2日至4月24日之間，從印尼政府醫院的780例實驗室確認的COVID-19病例的電子健康記錄中檢索了有關維生素D狀況，包括入院前的維生素D狀況，年齡，性別，既往狀況和死亡率的數據。 維生素D狀態分成三個等級：正常（≥30ng / mL），不足（21-29 ng / mL）或嚴重不足（≤20ng / mL）。
The electronic health records of 780 laboratory-confirmed COVID-19 cases from the government hospitals of Indonesia between March 2 and April 24 was searched for data on vitamin D status prior to admission, age, sex, preexisting conditions, and mortality. Vitamin D status was classified as normal (≥30 ng/mL), insufficient (21-29 ng/mL), or deficient (≤20 ng/mL).
！只有不到一半(49.7％)的患者維生素D狀態 正常，這群人裡頭只有 4％ 的患者死亡。
！！！超過四分之一(27％)患者維生素D狀態 不足，其中 88％死亡。
！！！患者裡23％的維生素D狀態 嚴重不足，這群患者裡 99％ 死亡。
Just under half (49.7%) of cases had normal vitamin D status, and only 4% of them died.
Just over a quarter (27%) had insufficient vitamin D status, and most of them (88%) died.
Just under a quarter (23%) had deficient vitamin D status, and almost all of them (99%) died.
在不調整年齡，性別或既存條件的情況下，維生素D狀態不足者的死亡可能性為(相較於維生素D狀態正常者) 12.55倍，而維生素D狀態嚴重不足者的死亡可能性則飆高到 19.12倍。
Without adjusting for age, sex, or preexisting conditions, those with vitamin D insufficiency were 12.55 times as likely to die and those with deficiency were 19.12 times as likely to die.
如果把年齡，性別和既存條件調整後，維生素D狀態不足的死亡機率則是7.63倍，而而維生素D狀態嚴重不足者的死亡機率是10.12倍。
After adjusting for age, sex, and preexisting conditions, those with insufficiency were 7.63 times as likely to die and those with deficiency were 10.12 times as likely to die.
防彈大叔補充說明:
1.補充維生素D最好方法是每天曬太陽30~60分鐘(穿短袖，不要塗防曬油)，或含在舌頭下的油脂性維生素D補充滴液。
2.體內(血液裡)維生素D含量一般生裡檢驗所都可以做，費用大約台幣$500。
3.這也解釋了為什麼陽光充足的地區冠狀肺癌和流感的死亡率比較低，不一定是因為陽光直接殺死病毒，而是因為陽光增加了人體內的維生素D含量，進而提升了人體對病毒的抵抗力。
Notes from Coach Denys:
- The best ways to ensure you have enough vitamin D in your body include exposure to sunshine without sunscreen lotion and taking vitamin D supplements in liposomal from.
- You can get your vitamin D level ( 25(OH)D ) tested in most clinics that provide blood test panels. In Taiwan, it cost about NT$500.
- This report further explains why the fatality rate for coronavirus and flu‘s are lower in regions with more sunshine. Sunshine doesn’t necessarily kill the virus directly. More likely it increases vitamin D in human body thus enhances our immunity to the virus.
克里斯·馬斯特約翰博士的提醒：
目前還是有充分的理由對(維生素D含量在減低冠狀肺炎風險的效果上的)U形曲線的保持謹慎態度，因為 “維生素D可以通過增加ACE2來增加感染風險或疾病嚴重性” 這個假設目前還未被推翻。 因此，除非數據能夠你不顯示與該範圍有關的風險，否則我們應避免維生素D狀態超過34 ng / mL(防彈大叔補充：也就是維生素D的吸收或服用並不是越多越好)，除非較高的攝取量顯示明確的效益，或是在療程上確定有必要。
Reminder from Chris Masterjohn:
There is ample reason to be cautious of the risk of a U-shaped curve, given that it remains a viable hypothesis that vitamin D could increase infection risk or disease severity by increasing ACE2. Therefore, we should avoid vitamin D status above 34 ng/mL until data arrives shedding light on the risk associated with that range, unless receiving clear and conclusive benefits from higher levels for other reasons, or unless higher levels are medically necessary.
(Photo credit: AFP)
