Department of Internal Medicine, VieCuri Medical Centre Noord-Limburg, PO Box 1926, 5900 BX, Venlo, The Netherlands.
Curr Osteoporos Rep. 2011 Mar;9(1):36-42. doi: 10.1007/s11914-010-0041-0.
Inadequate serum 25-hydroxyvitamin D (25[OH]D) concentrations are associated with muscle weakness, decreased physical performance, and increased propensity in falls and fractures. This paper discusses several aspects with regard to vitamin D status and supplementation when treating patients with osteoporosis in relation to risks and prevention of falls and fractures. Based on evidence from literature, adequate supplementation with at least 700 IU of vitamin D, preferably cholecalciferol, is required for improving physical function and prevention of falls and fractures. Additional calcium supplementation may be considered when dietary calcium intake is below 700 mg/day. For optimal bone mineral density response in patients treated with antiresorptive or anabolic therapy, adequate vitamin D and calcium supplementation is also necessary. Monitoring of 25(OH)D levels during follow-up and adjustment of vitamin D supplementation should be considered to reach and maintain adequate serum 25(OH)D levels of at least 50 nmol/L, preferably greater than 75 nmol/L in all patients.
血清 25-羟维生素 D（25[OH]D）浓度不足与肌肉无力、身体机能下降以及跌倒和骨折风险增加有关。本文讨论了在治疗骨质疏松症患者时与跌倒和骨折风险及预防相关的维生素 D 状态和补充的几个方面。基于文献证据，为改善身体机能和预防跌倒和骨折，至少需要补充 700IU 的维生素 D，最好是胆钙化醇。当饮食中的钙摄入量低于 700mg/天时，可考虑额外补充钙。对于接受抗吸收或合成代谢治疗的患者，为了获得最佳的骨矿物质密度反应，也需要补充足够的维生素 D 和钙。在随访期间监测 25（OH）D 水平并调整维生素 D 补充剂，以达到并维持所有患者至少 50nmol/L、最好大于 75nmol/L 的足够血清 25（OH）D 水平，应被考虑。
