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Sportverletz Sportschaden 2017; 31(01): 37-44
DOI: 10.1055/s-0042-121748
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Bedeutung von Vitamin D im Sport: Reduziert ein Mangel die Leistungsfähigkeit?

Impact of Vitamin D in Sports: Does Vitamin D Insufficiency Compromise Athletic Performance?
Sebastian Butscheidt
,
Tim Rolvien
,
Peter Ueblacker
,
Michael Amling
,
Florian Barvencik
Further Information

Publication History

Publication Date:
20 February 2017 (online)

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Zusammenfassung

Einleitung Vitamin D spielt eine Rolle in der Kalziumhomöostase und beeinflusst die Expression von über 900 Genen mit Folgen für die muskuloskelettale Gesundheit und Funktion. Darüber hinaus konnten durch Nachweis des Vitamin D-Rezeptors (VDR) in vielen Geweben des Organismus weitere Effekte von Vitamin D beobachtet werden.

Material und Methoden Im Rahmen der vorliegenden Arbeit wurde die Literatur im Hinblick auf die Bedeutung von Vitamin D für die muskuloskelettale Gesundheit und die maximale sportliche Leistungsfähigkeit untersucht.

Ergebnisse und Diskussion Die hohe Prävalenz für einen Vitamin D-Mangel, die bereits aus der Allgemeinbevölkerung bekannt ist, konnte für Athleten unterschiedlicher Sportarten bestätigt werden. Somit ergibt sich eine Relevanz für den Leistungssport. Hierfür sind u. a. die geografische Lage, das vorherrschende Klima, die Tages- und Jahreszeit sowie die Sportart (Indoor/Outdoor) verantwortlich. Es konnten Zusammenhänge zwischen verschiedenen Serumkonzentrationen von 25-OH-D3 und unterschiedlichen Aspekten des Leistungssports beobachtet werden. So gewährleistet eine Serumkonzentration oberhalb von 30 ng/ml eine regelrechte Mineralisation der Knochenmatrix und trägt entscheidend zur Knochengesundheit bei. Auch konnte in diesem Bereich ein positiver Zusammenhang mit einer beschleunigten Regeneration der muskulären Kraft gezeigt werden. Höhere Werte, oberhalb von 40 ng/ml, hatten einen protektiven Effekt bei der Genese von Stressfrakturen. Hinsichtlich der Leistungsfähigkeit vermuten Forscher Werte von ≥ 50 ng/ml als Voraussetzung für die Entwicklung der maximalen körperlichen Leistung. Während der Nutzen von höheren Serumkonzentrationen umstritten ist, zeigen sich deutliche Defizite der Mineralisation (Rachitis, Osteomalazie) und muskulären Funktion (Reversible Myopathie) bei Unterschreiten einer Konzentration 30 ng/ml.

Schlussfolgerung Sportmedizinische Untersuchungen sollten die laborchemische Bestimmung von 25-OH-D3, Kalzium, Kreatinin und Parathormon enthalten und somit die Vitamin D-abhängige Kalziumhomöostase adressieren. Im Falle eines Mangelzustandes kann durch Optimierung der Lebensweise und ggf. orale Substitution von Cholecalciferol eine Normalisierung auf ≥ 30 ng/ml herbeigeführt werden. Eine solche Konzentration zeigt einen protektiven und leistungssteigernden Effekt. Sie ist wichtig für die Wiederherstellung und Erhaltung der muskuloskelettalen Gesundheit und Leistungsfähigkeit.

Abstract

Introduction Vitamin D is essential for calcium homeostasis and regulates the expression of over 900 genes. It thereby influences musculoskeletal health and function. Additionally, multiple other effects were observed through the detection of vitamin D receptors (VDR) in numerous tissues of the human body.

Material and Methods We reviewed the literature regarding evidence of the impact of vitamin D on musculoskeletal health and peak athletic performance.

Results and Discussion It is well known that there is a high prevalence of vitamin D deficiency in the average European population. This article confirmed the same for athletes in different disciplines. Therefore, vitamin D deficiency and its effects are relevant for competitive sports. The surprisingly high prevalence of inadequate vitamin D levels depends on the geographic location, the time of day and year, local climate conditions, and sports disciplines (indoor vs. outdoor). Based on the analysed literature, we found several correlations between 25-OH-D3 serum levels and different aspects of competitive sports. A serum level ≥ 30 ng/ml provides sufficient mineralisation of non-mineralised bone matrix and is therefore crucial for skeletal health. Furthermore, this concentration was positively correlated with an accelerated regeneration of muscular force. Levels above 40 ng/ml provided a protective effect on the development of stress fractures. Researchers suspect that levels above 50 ng/ml are required for athletes to achieve maximal physical performance. While there is an ongoing discussion amongst researchers regarding beneficial effects of such high levels, it is well known that blood levels lower than 30 ng/ml lead to mineralisation defects in bone (rickets, osteomalacia) and muscular function (reversible myopathy).

Conclusion This review suggests that athletes should have an evaluation of vitamin D-dependent calcium homeostasis based on laboratory tests of 25-OH-D3, calcium, creatinine, and parathyroid hormone. In case of vitamin D insufficiency, normal blood levels of ≥ 30 ng/ml may be restored by optimising the athlete’s lifestyle and, if appropriate, oral substitution of cholecalciferol. This concentration is associated with a protective effect and enhancement of physical performance. Consequently, it is a requirement for restoring and maintaining musculoskeletal health and athletic performance.

Schlüsselwörter

Vitamin D - Skelettmuskulatur - Leistungsfähigkeit - Verletzungsrisiko

Key words

vitamin D - skeletal muscles - performance - risk of injury
 

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