Investigation Group on Osteoporosis and Mineral Metabolism, University of Las Palmas de Gran Canaria, 35001 Las Palmas, Spain.
Bone Metabolic Unit-Hospital University Insular, 35016 Gran Canaria, Spain.
Nutrients. 2020 May 31;12(6):1617. doi: 10.3390/nu12061617.
Vitamin D deficiency is a global health problem due to its high prevalence and its negative consequences on musculoskeletal and extra-skeletal health. In our comparative review of the two exogenous vitamin D supplementation options most used in our care setting, we found that cholecalciferol has more scientific evidence with positive results than calcifediol in musculoskeletal diseases and that it is the form of vitamin D of choice in the most accepted and internationally recognized clinical guidelines on the management of osteoporosis. Cholecalciferol, unlike calcifediol, guarantees an exact dosage in IU (International Units) of vitamin D and has pharmacokinetic properties that allow either daily or even weekly, fortnightly, or monthly administration in its equivalent doses, which can facilitate adherence to treatment. Regardless of the pattern of administration, cholecalciferol may be more likely to achieve serum levels of 25(OH)D (25-hydroxy-vitamin D) of 30-50 ng/mL, an interval considered optimal for maximum benefit at the lowest risk. In summary, the form of vitamin D of choice for exogenous supplementation should be cholecalciferol, with calcifediol reserved for patients with liver failure or severe intestinal malabsorption syndromes.
维生素 D 缺乏是一个全球性的健康问题，因为它的高患病率及其对骨骼肌肉和骨骼外健康的负面影响。在我们对我们治疗环境中最常用的两种外源性维生素 D 补充剂选项的比较综述中，我们发现胆钙化醇在骨骼肌肉疾病方面比骨化二醇具有更多的科学证据和积极结果，并且它是在最被接受和国际公认的骨质疏松症管理临床指南中选择的维生素 D 形式。与骨化二醇不同，胆钙化醇以 IU（国际单位）的维生素 D 精确剂量保证，并具有药代动力学特性，允许每日甚至每周、每两周或每月以其等效剂量给药，这可以促进治疗的依从性。无论给药模式如何，胆钙化醇都更有可能达到血清 25(OH)D（25-羟维生素 D）水平为 30-50ng/ml，这一区间被认为是在最低风险下获得最大益处的最佳水平。总之，外源性补充的首选维生素 D 形式应为胆钙化醇，而骨化二醇则保留给肝功能衰竭或严重肠道吸收不良综合征的患者。
