Haq Afrozul, Wimalawansa Sunil J, Pludowski Pawel, Anouti Fatme Al
Research & Development, VPS Healthcare, Abu Dhabi, United Arab Emirates.
Endocrinology, Metabolism & Nutrition, Cardio Metabolic Institute, NJ, USA.
J Steroid Biochem Mol Biol. 2018 Jan;175:4-11. doi: 10.1016/j.jsbmb.2016.09.021. Epub 2016 Sep 28.
In the UAE and the Gulf region in general, there are several intricate public health issues in the context of vitamin D deficiency that needs to be addressed. Changes in lifestyle such as diet, lack of exercise, cultural habits, avoiding sun exposure due to excessive heat, and other risk factors predispose those who live in GULF countries, such as Emiratis likely to becoming vitamin D deficient. Consequently, the prevalence of vitamin D deficiency is high, and new guidelines are needed to overcome this major public health issue. Peer-reviewed papers related to guidelines and those vitamin D-related papers relevant to the Middle-Eastern region were extracted from multiple research databases using key words according to the general guidelines from the Preferred Reporting Items for Systematic Analysis. This guideline was prepared focusing on the United Arab Emirate and the Gulf populations, to overcome the high incidence of vitamin D deficiency and to improve overall health. We recommend the following vitamin D supplementations for different groups of people: (A) Breastfed infants supplement with 400 IU/day up to age 6 months, and 400-600 IU/day between 6 and 12 months, depending on daily intake of total vitamin D and sun exposure; (B) for children and adolescents of age 1-18 years supplement with 600-1000 IU/day depending on the body weight; (C) adults greater than 18 years', supplementation with 1000-2000 IU/day is recommended, while, (D) the elderly (over 65 years) should be supplemented with 2000 IU/day, throughout the year; (E) pregnant and breast feed women, 2000 IU/day from the first trimester of pregnancy. (F) Premature infants, supplementation of 400-800 IU/daystart from the first days of life. (G) For obese, individuals and those with metabolic syndrome, supplementation of 2000 IU/day (H) For individuals with dark skin complexions and for night workers, supplementation of 1000-2000 IU/day (25-50μg/day), throughout the year, depending on body weight. The goal of supplementation is to achieve and longer term maintenance of serum 25(OH)D concentration of 30-50ng/mL.
总体而言，在阿联酋和海湾地区，维生素D缺乏背景下存在若干复杂的公共卫生问题亟待解决。生活方式的改变，如饮食、缺乏运动、文化习惯、因酷热而避免日晒以及其他风险因素，使生活在海湾国家的人群，如阿联酋人，更容易出现维生素D缺乏。因此，维生素D缺乏的患病率很高，需要新的指南来解决这一重大公共卫生问题。根据系统分析的首选报告项目的一般指南，使用关键词从多个研究数据库中提取了与指南相关以及与中东地区相关的维生素D相关论文。本指南的制定重点是阿联酋和海湾地区人群，以克服维生素D缺乏的高发病率并改善整体健康。我们建议不同人群补充以下剂量的维生素D：(A) 母乳喂养的婴儿，6个月龄前每天补充400国际单位，6至12个月龄时根据每日维生素D总摄入量和日晒情况，每天补充400 - 600国际单位；(B) 1至18岁的儿童和青少年，根据体重每天补充600 - 1000国际单位；(C) 18岁以上的成年人，建议每天补充1000 - 2000国际单位，而 (D) 老年人（65岁以上）全年应每天补充2000国际单位；(E) 孕妇和哺乳期妇女，从妊娠早期开始每天补充2000国际单位。(F) 早产儿，从出生第一天开始每天补充400 - 800国际单位。(G) 肥胖者、患有代谢综合征的人，每天补充2000国际单位 (H) 肤色较深的人和夜班工作者，全年根据体重每天补充1000 - 2000国际单位（25 - 50微克/天）。补充的目标是使血清25(OH)D浓度达到并长期维持在30 - 50纳克/毫升。
