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防治维生素 D 缺乏症指南:波兰 2023 年更新版。

Guidelines for Preventing and Treating Vitamin D Deficiency: A 2023 Update in Poland.

机构信息

Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children's Memorial Health Institute, 04-730 Warsaw, Poland.

Department of Endocrinology and Neuroendocrine Tumors, and the Department of Pathophysiology and Endocrinology in Zabrze, Medical University of Silesia, 40-952 Katowice, Poland.

出版信息

Nutrients. 2023 Jan 30;15(3):695. doi: 10.3390/nu15030695.

Abstract

All epidemiological studies suggest that vitamin D deficiency is prevalent among the Polish general population. Since vitamin D deficiency was shown to be among the risk factors for many diseases and for all-cause mortality, concern about this problem led us to update the previous Polish recommendations. After reviewing the epidemiological evidence, case-control studies and randomized control trials (RCTs), a Polish multidisciplinary group formulated questions on the recommendations for prophylaxis and treatment of vitamin D deficiency both for the general population and for the risk groups of patients. The scientific evidence of pleiotropic effects of vitamin D as well as the results of panelists' voting were reviewed and discussed. Thirty-four authors representing different areas of expertise prepared position statements. The consensus group, representing eight Polish/international medical societies and eight national specialist consultants, prepared the final Polish recommendations. Based on networking discussions, the ranges of total serum 25-hydroxyvitamin D concentration indicating vitamin D deficiency [<20 ng/mL (<50 nmol/L)], suboptimal status [20-30 ng/mL (50-75 nmol/L)], and optimal concentration [30-50 ng/mL (75-125 nmol/L)] were confirmed. Practical guidelines for cholecalciferol (vitamin D) as the first choice for prophylaxis and treatment of vitamin D deficiency were developed. Calcifediol dosing as the second choice for preventing and treating vitamin D deficiency was introduced. Improving the vitamin D status of the general population and treatment of risk groups of patients must be again announced as healthcare policy to reduce a risk of spectrum of diseases. This paper offers consensus statements on prophylaxis and treatment strategies for vitamin D deficiency in Poland.

摘要

所有的流行病学研究表明,维生素 D 缺乏在波兰普通人群中很普遍。由于维生素 D 缺乏被证明是许多疾病和全因死亡率的危险因素之一,因此我们对这个问题的关注导致了我们更新了之前的波兰建议。在回顾了流行病学证据、病例对照研究和随机对照试验(RCT)之后,一个波兰多学科小组就普通人群和患者高危人群的维生素 D 缺乏症的预防和治疗建议提出了问题。维生素 D 多效性作用的科学证据以及小组成员投票的结果进行了审查和讨论。34 名代表不同专业领域的作者撰写了立场声明。代表 8 个波兰/国际医学协会和 8 个国家专家顾问的共识小组制定了最终的波兰建议。基于网络讨论,确定了血清总 25-羟维生素 D 浓度(ng/ml 或 nmol/L)指示维生素 D 缺乏症的范围:<20 ng/ml(<50 nmol/L)、亚最佳状态[20-30 ng/ml(50-75 nmol/L)]和最佳浓度[30-50 ng/ml(75-125 nmol/L)]。制定了胆钙化醇(维生素 D)作为预防和治疗维生素 D 缺乏症的首选药物的实用指南。介绍了钙三醇作为预防和治疗维生素 D 缺乏症的二线药物。再次宣布改善普通人群的维生素 D 状况和治疗患者高危人群是医疗保健政策,以降低一系列疾病的风险。本文提供了波兰维生素 D 缺乏症预防和治疗策略的共识声明。

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