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维生素D缺乏:预防还是治疗?

Vitamin D deficiency: prevention or treatment?

作者信息

Zipitis C S, Markides G A, Swann I L

机构信息

Burnley General Hospital, Casterton Avenue, Burnley, Lancashire, BB10 2PQ, UK.

出版信息

Arch Dis Child. 2006 Dec;91(12):1011-4. doi: 10.1136/adc.2006.098467. Epub 2006 Aug 31.

Abstract

BACKGROUND

Vitamin D deficiency is a chronic condition which contributes to general ill health and seems to be re-emerging in our catchment area since funding of vitamin D supplementation by Primary Care Trusts ceased. This study aims to verify this situation and to assess the cost effectiveness of reintroducing vitamin D supplementation in the Burnley Health Care NHS Trust.

METHODS

Vitamin D deficient patients presenting between January 1994 and May 2005 were identified and data retrospectively collected from their case notes. The cost of treatment and the theoretical cost of primary prevention for the Trust population were calculated using previous and current DoH guidelines.

RESULTS

Fourteen patients were identified, of whom 86% presented in the last 5 years and 93% were of Asian origin. The incidence of vitamin D deficiency for our population is 1 in 923 children overall and 1 in 117 in children of Asian origin. The average cost of treatment for each such child is pound2500, while the theoretical cost of prevention of vitamin D deficiency in the Asian population through primary prevention according to COMA guidance is pound2400 per case.

CONCLUSIONS

Vitamin D deficiency is re-emerging in our Trust. The overwhelming majority of our patients are of Asian origin. The cost of primary prevention for this high risk population compares favourably both medically and financially with treatment of established disease. We suggest that Primary Care Trusts provide funds for vitamin D supplementation of Asian children for at least the first 2 years of life.

摘要

背景

维生素D缺乏是一种导致全身健康状况不佳的慢性疾病,自初级保健信托基金停止提供维生素D补充剂资金以来,在我们的服务区域似乎又重新出现。本研究旨在核实这种情况,并评估在伯恩利医疗保健国民保健服务信托基金重新引入维生素D补充剂的成本效益。

方法

确定1994年1月至2005年5月期间出现维生素D缺乏的患者,并从他们的病历中回顾性收集数据。使用以前和当前的卫生部指南计算信托人群的治疗成本和一级预防的理论成本。

结果

确定了14名患者,其中86%在过去5年中出现,93%为亚洲血统。我们人群中维生素D缺乏的发生率总体上是每923名儿童中有1例,亚洲血统儿童中是每117名中有1例。每个此类儿童的平均治疗成本为2500英镑,而根据医学方面的食品政策委员会指南,通过一级预防在亚洲人群中预防维生素D缺乏的理论成本为每例2400英镑。

结论

维生素D缺乏在我们的信托基金服务区域又重新出现。我们的绝大多数患者是亚洲血统。对这一高危人群进行一级预防的成本在医学和经济方面与治疗已确诊疾病相比都更具优势。我们建议初级保健信托基金至少为亚洲儿童生命的头两年提供维生素D补充剂资金。

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Vitamin D intake and incidence of multiple sclerosis.维生素D摄入量与多发性硬化症的发病率
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