UpToDate
Official reprint from UpToDate®
www.uptodate.com ©2017 UpToDate®

水溶性维生素概述

Authors
Sassan Pazirandeh, MD
Clifford W Lo, MD, MPH, ScD
David L Burns, MD
Section Editor
Timothy O Lipman, MD
Deputy Editor
Alison G Hoppin, MD
Translators
刘英华, 副主任医师，副教授

引言

维生素是多种化学结构不相同的有机物质家族，人类自身无法合成，需要从膳食中少量摄取以预防代谢紊乱。维生素可分为水溶性和脂溶性维生素(表 1)。

在发达国家，许多维生素缺乏性疾病几乎已被完全消除，例如佝偻病(维生素D)、坏血病(维生素C)、脚气病(硫胺素)和糙皮病(烟酸)。目前的热点和争议仍集中在补充维生素是否可预防癌症、心脏病、上呼吸道感染和其他常见疾病。 (参见“疾病预防中的维生素补充”)

水果和蔬菜是大多数水溶性维生素最好的膳食来源，这些食物中还含有许多其他相关物质，例如黄素类和类胡萝卜素，这些物质通常不被视为维生素，但它们可能有对抗各种疾病的保护作用。本专题将着重讨论水溶性维生素，但不包括叶酸和维生素B12，这两种物质将单独讨论。 (参见“维生素B12及叶酸缺乏的病因及临床表现”)

有关矿物质和脂溶性维生素的内容也参见其他专题。 (参见“Overview of vitamin A”和“维生素D概述”和“Overview of vitamin E”和“维生素K概述”和“膳食微量矿物质概述”)

定义

一些指标体系已被用于描述人群的营养素需求。膳食营养素参考摄入量(Dietary Reference Intakes, DRIs)由美国医学研究所食品和营养委员会提出的，用以指导多种情况下的营养素摄入。在该体系下，可用推荐膳食摄入量(Recommended Dietary Allowance, RDA)来表示营养素需求量，RDA是指能充分满足某一特定生命阶段群体中97%的个体每日营养素需求量的膳食摄入量。如果没有足够的数据来确定某种营养素的RDA，则可用适宜摄入量(Adequate Intake, AI)来表示营养素需求量，AI是指维持健康状态所必需的估计营养素摄入量。这些术语将在单独的专题中做更为详细的介绍。 (参见“儿童膳食史和推荐膳食摄入量”)

                                                                   

Subscribers log in here

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:
Literature review current through: 2017-06 . | This topic last updated: 2017-03-24.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2017 UpToDate, Inc.
References
Top
  1. Tanphaichitr V. Modern Nutrition in Health and Medicine, 9th, Shils M (Ed), Lippincott, Philadelphia 2000. p.381.
  2. Tanphaichitr V, Wood B. Thiamin. In: Present Knowledge in Nutrition, 5th, Olson RE, Broquist CO, et al (Eds), Nutrition Foundation, Washington, DC 1984. p.273.
  3. Gubler CJ. Thiamin. In: Handbook of vitamins: Nutritional, biochemical, and clinical aspects, Machlin LJ (Ed), Marcel Dekker, New York 1984. p.245.
  4. Davis RE, Icke GC, Thom J, Riley WJ. Intestinal absorption of thiamin in man compared with folate and pyridoxal and its subsequent urinary excretion. J Nutr Sci Vitaminol (Tokyo) 1984; 30:475.
  5. Sauberlich HE, Daude RP, Skala JH. Laboratory Tests for the Assessment of Nutritional Status, CRC Press, Boca Raton, Florida 1974.
  6. Talwar D, Davidson H, Cooney J, St JO'Reilly D. Vitamin B(1) status assessed by direct measurement of thiamin pyrophosphate in erythrocytes or whole blood by HPLC: comparison with erythrocyte transketolase activation assay. Clin Chem 2000; 46:704.
  7. Chaitiraphan S, Tanphaichitr V, Cheng TO. Nutritional heart disease. In: The international textbook of cardiology, Cheng TO (Ed), Pergamon Press, New York 1986. p.864.
  8. Tanphaichitr V. Epidemiology and clinical assessment of vitamin deficiencies in Thai children. In: Child health in the tropics, Eeckels RE, Ransome-kuti O, Kroonenberg CC (Eds), Martinus Nijhoff, Dordrect 1985. p.157.
  9. Fattal-Valevski A, Kesler A, Sela BA, et al. Outbreak of life-threatening thiamine deficiency in infants in Israel caused by a defective soy-based formula. Pediatrics 2005; 115:e233.
  10. Fattal-Valevski A, Bloch-Mimouni A, Kivity S, et al. Epilepsy in children with infantile thiamine deficiency. Neurology 2009; 73:828.
  11. Mimouni-Bloch A, Goldberg-Stern H, Strausberg R, et al. Thiamine deficiency in infancy: long-term follow-up. Pediatr Neurol 2014; 51:311.
  12. Fattal-Valevski A, Azouri-Fattal I, Greenstein YJ, et al. Delayed language development due to infantile thiamine deficiency. Dev Med Child Neurol 2009; 51:629.
  13. Towbin A, Inge TH, Garcia VF, et al. Beriberi after gastric bypass surgery in adolescence. J Pediatr 2004; 145:263.
  14. Chaves LC, Faintuch J, Kahwage S, Alencar Fde A. A cluster of polyneuropathy and Wernicke-Korsakoff syndrome in a bariatric unit. Obes Surg 2002; 12:328.
  15. Lawson ML, Kirk S, Mitchell T, et al. One-year outcomes of Roux-en-Y gastric bypass for morbidly obese adolescents: a multicenter study from the Pediatric Bariatric Study Group. J Pediatr Surg 2006; 41:137.
  16. Hahn JS, Berquist W, Alcorn DM, et al. Wernicke encephalopathy and beriberi during total parenteral nutrition attributable to multivitamin infusion shortage. Pediatrics 1998; 101:E10.
  17. Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995; 98:485.
  18. Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991; 91:151.
  19. Rieck J, Halkin H, Almog S, et al. Urinary loss of thiamine is increased by low doses of furosemide in healthy volunteers. J Lab Clin Med 1999; 134:238.
  20. Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996; 131:1248.
  21. Singleton CK, Pekovich SR, McCool BA, Martin PR. The thiamine-dependent hysteretic behavior of human transketolase: implications for thiamine deficiency. J Nutr 1995; 125:189.
  22. Food and Nutrition Board, National Research Council Recommended dietary allowances. 10th edition. Washington DC: National Academy Press, 1989. p.125.
  23. Food and Nutrition Board-Institute of Medicine. Dietary reference intakes. Thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline, National Academy Press, Washington DC 1998.
  24. McCormick DB. Metabolism of riboflavin. In: Riboflavin, Rivlin RS (Ed), Plenum press, New York 1975. p.153.
  25. McCormick DB. Riboflavin. In: Present knowledge in nutrition, 6th, Brown ML (Ed), International Life Sciences Institute Nutrition Foundation, 1990. p.146.
  26. Merrill AH Jr, Lambeth JD, Edmondson DE, McCormick DB. Formation and mode of action of flavoproteins. Annu Rev Nutr 1981; 1:281.
  27. Said HM, Ma TY. Mechanism of riboflavine uptake by Caco-2 human intestinal epithelial cells. Am J Physiol 1994; 266:G15.
  28. Wilson JA. Vitamin deficiency and excess. In: Harrison's Principles of Internal Medicine, 14th, Fauci AS, Braunwald E, Isselbacher K (Eds), McGraw-Hill, New York 1998. p.481.
  29. Nichoalds GE. Riboflavin. Symposium in laboratory medicine. In: Symposium on laboratory assessment of nutritional status. Clinics in laboratory medicine, Labbae RF (Ed), WB Saunders, Philadelphia 1981. Vol 1, p.685.
  30. DiDonato S, Gellera C, Peluchetti D, et al. Normalization of short-chain acylcoenzyme A dehydrogenase after riboflavin treatment in a girl with multiple acylcoenzyme A dehydrogenase-deficient myopathy. Ann Neurol 1989; 25:479.
  31. Ohkawa H, Ohishi N, Yagi K. New metabolites of riboflavin appear in human urine. J Biol Chem 1983; 258:5623.
  32. Food and Nutrition Board, National Research Council. Riboflavin. In: Recommended dietary allowances, 10th ed, National Academy Press, Washington, DC 1989. p.132.
  33. Fouty B, Frerman F, Reves R. Riboflavin to treat nucleoside analogue-induced lactic acidosis. Lancet 1998; 352:291.
  34. Weiner M, Van Eys J. The discovery of nicotinic acid as a nutrient. In: Nicotinic acid: Nutrient-cofactor-drug, Clinical pharmacology, Weiner M (Ed), Marcel Dekker, New York 1983. p.3.
  35. VILTER RW, MUELLER JF, BEAN WB. The therapeutic effect of tryptophane in human pellagra. J Lab Clin Med 1949; 34:409.
  36. Kim H, Jacobson EL, Jacobson MK. Position of cyclization in cyclic ADP-ribose. Biochem Biophys Res Commun 1993; 194:1143.
  37. Cervantes-Laurean N, McElvaney G, Moss J. Niacin. In: Modern Nutrition in Health and Medicine, Shils M (Ed), Lippincott, Philadelphia 2000. p.401.
  38. Ashourian N, Mousdicas N. Images in clinical medicine. Pellagra-like dermatitis. N Engl J Med 2006; 354:1614.
  39. Prousky JE. Pellagra may be a rare secondary complication of anorexia nervosa: a systematic review of the literature. Altern Med Rev 2003; 8:180.
  40. Wan P, Moat S, Anstey A. Pellagra: a review with emphasis on photosensitivity. Br J Dermatol 2011; 164:1188.
  41. Elsas LS, Longo N, Rosenberg LE. Inherited defects of membrane transport. In: Harrison's Principles of Internal Medicine, 14th, Fauci AS, Braunwald E, Isselbacher K, et al (Eds), McGraw-Hill, New York 1998. p.2203.
  42. Levy HL. Hartnup disorder. In: The Molecular and Metabolic Basis of Inherited Disease, 7th, Scriver S, et al (Eds), McGraw-Hill, New York 1995. p.3629.
  43. Bean WB. Some aspects of pharmacologic use and abuse of water soluble vitamins. In: Nutriton and drug interrelations, Hathcock JN, Coon J (Eds), Academic Press, New York 1978. p.667.
  44. Hathcock JN. Vitamins and minerals: efficacy and safety. Am J Clin Nutr 1997; 66:427.
  45. DiPalma JR, Thayer WS. Use of niacin as a drug. Annu Rev Nutr 1991; 11:169.
  46. Gharavi AG, Diamond JA, Smith DA, Phillips RA. Niacin-induced myopathy. Am J Cardiol 1994; 74:841.
  47. Rader JI, Calvert RJ, Hathcock JN. Hepatic toxicity of unmodified and time-release preparations of niacin. Am J Med 1992; 92:77.
  48. McKenney JM, Proctor JD, Harris S, Chinchili VM. A comparison of the efficacy and toxic effects of sustained- vs immediate-release niacin in hypercholesterolemic patients. JAMA 1994; 271:672.
  49. Petley A, Macklin B, Renwick AG, Wilkin TJ. The pharmacokinetics of nicotinamide in humans and rodents. Diabetes 1995; 44:152.
  50. ALTSCHUL R, HOFFER A, STEPHEN JD. Influence of nicotinic acid on serum cholesterol in man. Arch Biochem Biophys 1955; 54:558.
  51. Elliott RB, Pilcher CC, Stewart A, et al. The use of nicotinamide in the prevention of type 1 diabetes. Ann N Y Acad Sci 1993; 696:333.
  52. Robinson FA. The vitamin co-factors if enzyme systems, Pergamon Press, Oxford 1966. p.406.
  53. Plesofsky-Vig N. Pantothenic acid. In: Modern nutrition in health and disease, Shils ME, Olson JA, Shike M, et al (Eds), Lippincott, Philadelphia 2000. p.423.
  54. Said HM, Ortiz A, McCloud E, et al. Biotin uptake by human colonic epithelial NCM460 cells: a carrier-mediated process shared with pantothenic acid. Am J Physiol 1998; 275:C1365.
  55. Fenstermacher DK, Rose RC. Absorption of pantothenic acid in rat and chick intestine. Am J Physiol 1986; 250:G155.
  56. Robishaw JD, Berkich D, Neely JR. Rate-limiting step and control of coenzyme A synthesis in cardiac muscle. J Biol Chem 1982; 257:10967.
  57. Wittwer CT, Burkhard D, Ririe K, et al. Purification and properties of a pantetheine-hydrolyzing enzyme from pig kidney. J Biol Chem 1983; 258:9733.
  58. Plesofsky-Vig N, Brambl R. Pantothenic acid and coenzyme A in cellular modification of proteins. Annu Rev Nutr 1988; 8:461.
  59. HODGES RE, BEAN WB, OHLSON MA, BLEILER R. Human pantothenic acid deficiency produced by omega-methyl pantothenic acid. J Clin Invest 1959; 38:1421.
  60. Sander JE, Packman S, Townsend JJ. Brain pyruvate carboxylase and the pathophysiology of biotin-dependent diseases. Neurology 1982; 32:878.
  61. Rall LC, Meydani SN. Vitamin B6 and immune competence. Nutr Rev 1993; 51:217.
  62. Leklem JE. Vitamin B6. In: Handbook of Vitamins, 2nd, Machlin LJ (Ed), Marcel Dekker, New York 1991.
  63. Rimm EB, Willett WC, Hu FB, et al. Folate and vitamin B6 from diet and supplements in relation to risk of coronary heart disease among women. JAMA 1998; 279:359.
  64. Burtis CA, Ashwood ER, Bruns DE. Vitamins and trace elements. In: Tietz Textbook of Clinical Chemistry and Molecular Diagnostics, 5e, Saunders/Elsevier, St. Louis, MO 2012. p.895.
  65. Leklem JE. Vitamin B-6: a status report. J Nutr 1990; 120 Suppl 11:1503.
  66. Schaumburg H, Kaplan J, Windebank A, et al. Sensory neuropathy from pyridoxine abuse. A new megavitamin syndrome. N Engl J Med 1983; 309:445.
  67. Silva CD, D'Cruz DP. Pyridoxine toxicity courtesy of your local health food store. Ann Rheum Dis 2006; 65:1666.
  68. Katan MB. [How much vitamin B6 is toxic?]. Ned Tijdschr Geneeskd 2005; 149:2545.
  69. Food and Nutrition Board-Institute of Medicine. Dietary reference intakes. Thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline, National Academy Press, Washington DC 1998. www.nap.edu (Accessed on June 06, 2008).
  70. Dupuis L, Campeau E, Leclerc D, Gravel RA. Mechanism of biotin responsiveness in biotin-responsive multiple carboxylase deficiency. Mol Genet Metab 1999; 66:80.
  71. Mock D. Biotin. In: Modern Nutrition in Health and Disease, 9th, Shils M (Ed), Lippincott Williams and Wilkins, Philadelphia 2000. p.459.
  72. Kopinski JS, Leibholz J, Bryden WL. Biotin studies in pigs. 3. Biotin absorption and synthesis. Br J Nutr 1989; 62:767.
  73. Mock DM. Biotin. In: Present knowledge in nutrition, Ziegler EE, Filer LJ Jr (Eds), International Life Sciences Institutes Nutrition Foundation, Washington DC 1996. p.220.
  74. Cole H, Reynolds TR, Lockyer JM, et al. Human serum biotinidase. cDNA cloning, sequence, and characterization. J Biol Chem 1994; 269:6566.
  75. Mock DM, Mock NI, Dankle JA. Secretory patterns of biotin in human milk. J Nutr 1992; 122:546.
  76. Baumgartner ER, Suormala T. Multiple carboxylase deficiency: inherited and acquired disorders of biotin metabolism. Int J Vitam Nutr Res 1997; 67:377.
  77. Carpenter KJ. The History of scurvy and vitamin C, Cambridge University Press, New York 1986.
  78. Szent-Gyorgyi A, The function of hexuronic acid in the respiration of the cabbage leaf. Biochem J 1931; 90:385.
  79. Svirbely JL, Szent-Györgyi A. The chemical nature of vitamin C. Biochem J 1933; 27:279.
  80. Food and Nutrition Board - Institute of Medicine. Dietary reference intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids, National Academy Press, Washington DC 2000 www.nap.edu (Accessed on April 07, 2009).
  81. Kallner A, Hornig D, Pellikka R. Formation of carbon dioxide from ascorbate in man. Am J Clin Nutr 1985; 41:609.
  82. Glatthaar BE, Hornig DH, Moser U. The role of ascorbic acid in carcinogenesis. Adv Exp Med Biol 1986; 206:357.
  83. Jacob R. Vitamin C. In: Modern nutrition in health and disease, Shils M, Olson J, Shike M, Ross AC (Eds), Lippincott, Philadelphia 2000. p.467.
  84. Bigley RH, Stankova L. Uptake and reduction of oxidized and reduced ascorbate by human leukocytes. J Exp Med 1974; 139:1084.
  85. Schorah CJ. The transport of vitamin C and effects of disease. Proc Nutr Soc 1992; 51:189.
  86. Rebouche CJ. Renal handling of carnitine in experimental vitamin C deficiency. Metabolism 1995; 44:1639.
  87. Ronchetti IP, Quaglino D Jr, Bergamini G. Ascorbic acid and connective tissue. In: Subcellular biochemistry Ascobic acid: Biochemistry and biomedial cell biology, Harris JR (Ed), Plenum Press, New York 1996. p.41.
  88. Katsuki H. Vitamin C and nervous tissue. In: Subcellular biochemistry Ascobic acid: biochemistry and biomedial cell biology, Harris JR (Ed), Plenum Press, New York 1996. p.293.
  89. Horrobin DF. Ascorbic acid and prostaglandin synthesis. In: Subcellular biochemistry Ascorbic acid: biochemistry and biomedial cell biology, Harris JR (Ed), Plenum Press, New York 1996. p.109.
  90. Millar J. The nitric oxide/ascorbate cycle: how neurones may control their own oxygen supply. Med Hypotheses 1995; 45:21.
  91. Reuler JB, Broudy VC, Cooney TG. Adult scurvy. JAMA 1985; 253:805.
  92. Smith A, Di Primio G, Humphrey-Murto S. Scurvy in the developed world. CMAJ 2011; 183:E752.
  93. Monget AL, Galan P, Preziosi P, et al. Micronutrient status in elderly people. Geriatrie/Min. Vit. Aux Network. Int J Vitam Nutr Res 1996; 66:71.
  94. American Academy of Pediatrics. Water-soluble vitamins. In: Pediatric Nutrition, 7th ed., Kleinman RE, Greer FR. (Eds), American Academy of Pediatrics, Elk Grove Village 2011. p.527.
  95. Hirschmann JV, Raugi GJ. Adult scurvy. J Am Acad Dermatol 1999; 41:895.
  96. Weinstein M, Babyn P, Zlotkin S. An orange a day keeps the doctor away: scurvy in the year 2000. Pediatrics 2001; 108:E55.
  97. Jaffe RM, Kasten B, Young DS, MacLowry JD. False-negative stool occult blood tests caused by ingestion of ascorbic acid (vitamin C). Ann Intern Med 1975; 83:824.
  98. Urivetzky M, Kessaris D, Smith AD. Ascorbic acid overdosing: a risk factor for calcium oxalate nephrolithiasis. J Urol 1992; 147:1215.
  99. Block G. Vitamin C and cancer prevention: the epidemiologic evidence. Am J Clin Nutr 1991; 53:270S.
  100. Hatch GE. Asthma, inhaled oxidants, and dietary antioxidants. Am J Clin Nutr 1995; 61:625S.
  101. Seddon JM, Ajani UA, Sperduto RD, et al. Dietary carotenoids, vitamins A, C, and E, and advanced age-related macular degeneration. Eye Disease Case-Control Study Group. JAMA 1994; 272:1413.
  102. McLaran CJ, Bett JH, Nye JA, Halliday JW. Congestive cardiomyopathy and haemochromatosis--rapid progression possibly accelerated by excessive ingestion of ascorbic acid. Aust N Z J Med 1982; 12:187.
  103. Smith JL, Hodges RE. Serum levels of vitamin C in relation to dietary and supplemental intake of vitamin C in smokers and nonsmokers. Ann N Y Acad Sci 1987; 498:144.
  104. Cody MM. Substances without vitamin status. In: Handbook of Vitamins, 2nd, Marcel Dekker, New York 1991.