Narvaez Jemina, Maldonado Genessis, Guerrero Roberto, Messina Osvaldo Daniel, Rios Carlos
Rheumatology Department, Espíritu Santo University, Guayaquil, Ecuador.
Rheumatology Department, Hospital Cosme Argerich, Buenos Aires, Argentina.
Open Access Rheumatol. 2020 Jun 11;12:105-115. doi: 10.2147/OARRR.S252245. eCollection 2020.
Currently, approximately more than one billion people around the world are considered to have deficient levels of vitamin D. International consensus recommends vitamin D supplementation to high-risk patients (advanced age, osteoporosis, liver failure, malabsorption syndromes, etc.) and those with levels below 30 ng/mL. There are several vitamin D formulations and dosages available, including megadoses. At the moment, there is no consensus on the definition of megadoses. The purpose of this review is to define what is a megadose and analyze its effectiveness in bone metabolism, risk of fractures and falls.
The administration of doses higher than 100,000 IU of vitamin D is considered a megadose. It is evident that the use of megadoses increases serum concentrations of vitamin D; however, there has been no evidence of a decrease in the risk of falls, vertebral fractures or changes in bone mineral density.
目前,全球约有超过10亿人被认为维生素D水平不足。国际共识建议对高危患者(高龄、骨质疏松、肝功能衰竭、吸收不良综合征等)以及维生素D水平低于30 ng/mL的患者补充维生素D。有几种维生素D制剂和剂量可供选择,包括大剂量。目前,对于大剂量的定义尚无共识。本综述的目的是界定什么是大剂量,并分析其在骨代谢、骨折风险和跌倒方面的有效性。
维生素D剂量高于100,000 IU的给药被视为大剂量。显然,使用大剂量会提高维生素D的血清浓度;然而,尚无证据表明跌倒风险、椎体骨折或骨矿物质密度变化有所降低。