Hochwald Ori, Harman-Boehm Ilana, Castel Hana
Department of Pediatrics, Bnei Zion Medical Center, Haifa, Israel.
Isr Med Assoc J. 2004 Feb;6(2):82-7.
Hypovitaminosis D is an important risk factor for osteoporosis and its complications. Previous studies found that the incidence of hypovitaminosis D among patients in an internal medicine ward reached up to 57%.
To determine the prevalence and determinants of hypovitaminosis D among patients in internal medicine wards in a sunny country.
We measured 25-hydroxyvitamin D, parathyroid hormone and various other laboratory parameters, and assessed the amount of sun exposure, dietary vitamin D intake and other risk factors for hypovitaminosis D in 296 internal medicine inpatients admitted consecutively to the Soroka University Medical Center, which is situated in a sunny region of Israel.
We found hypovitaminosis D (serum 25-HO-D < 15 ng/ml) in 77 inpatients (26.27%). The amount of sunlight exposure, serum albumin concentration, being housebound or resident of a nursing home, vitamin D intake, ethnic group, cerebrovascular accident and glucocorticoid therapy were all significantly associated with hypovitaminosis D. Multivariate analysis showed a significant association between hypovitaminosis D and Bedouin origin, sun exposure, vitamin D intake, and stroke. Hypovitaminosis D was also found among inpatients who reported consuming more than the recommended daily amount of vitamin D. Parathyroid hormone levels were significantly higher in patients with 25-OH-D levels below 15 ng/ml. In a subgroup of 74 inpatients under 65 years old with no known risk factors for hypovitaminosis D, we found 20.3% with hypovitaminosis D.
Hypovitaminosis D is common in patients hospitalized in internal medicine wards in our region, including patients with no known risk factors for this condition. Based on our findings, we recommend vitamin D supplementation during hospitalization and upon discharge from general internal medicine wards as a primary or secondary preventive measure.
维生素D缺乏是骨质疏松症及其并发症的重要危险因素。既往研究发现，内科病房患者中维生素D缺乏的发生率高达57%。
确定阳光充足国家内科病房患者维生素D缺乏的患病率及其决定因素。
我们测量了296例连续入住位于以色列阳光充足地区的索罗卡大学医学中心内科病房患者的25-羟维生素D、甲状旁腺激素及其他各种实验室指标，并评估了日照量、饮食中维生素D摄入量及维生素D缺乏的其他危险因素。
我们发现77例患者（26.27%）存在维生素D缺乏（血清25-OH-D<15 ng/ml）。日照量、血清白蛋白浓度、居家不出或居住在养老院、维生素D摄入量、种族、脑血管意外和糖皮质激素治疗均与维生素D缺乏显著相关。多因素分析显示，维生素D缺乏与贝都因族裔、日照、维生素D摄入量及中风之间存在显著关联。在报告维生素D摄入量超过推荐日剂量的患者中也发现了维生素D缺乏。25-OH-D水平低于15 ng/ml的患者甲状旁腺激素水平显著更高。在74例65岁以下且无已知维生素D缺乏危险因素的内科住院患者亚组中，我们发现20.3%的患者存在维生素D缺乏。
在我们地区的内科病房住院患者中，维生素D缺乏很常见，包括无已知该疾病危险因素的患者。基于我们的研究结果，我们建议在内科病房住院期间及出院时补充维生素D，作为一级或二级预防措施。
