Clin Lab. 2023 Mar 1;69(3). doi: 10.7754/Clin.Lab.2022.220518.
We aimed to evaluate the risk of hypercalcemia in the elderly population with hypervitaminosis D and vitamin D intoxication.
A total of 121 patients with a 25(OH) vitamin D level > 100 ng/mL from patients aged ≥ 65 years who applied to our hospital between 2014 and 2020 were included in this study. Sixty-nine patients with 25(OH) vitamin D levels of 100 - 150 ng/mL were determined as D hypervitaminosis; 52 patients with 25(OH) vitamin D levels > 150 ng/mL were determined as vitamin D intoxication. People with a calcium level above 10.2 mg/dL were considered as hypercalcemic patients.
Of 121 patients with D hypervitaminosis and vitamin D intoxication, 103 (85.1%) were normocalcemic, and 18 (14.9%) were hypercalcemic. Hypercalcemia was detected in 9 out of 69 patients with hypervitaminosis D; 8 of them had mild hypercalcemia and 1 person had severe hypercalcemia. Hypercalcemia was detected in 9 of 52 patients with vitamin D intoxication; mild hypercalcemia was found in 7 people, moderate hypercalcemia in 1 person, severe hypercalcemia in 1 person. There was no statistically significant difference between the incidence of hypercalcemia in patients with D hypervitaminosis and vitamin D intoxication (p = 0.514). It was observed that a total of 3 (16.7%) of the hypercalcemic patients with D hypervitaminosis and vitamin D intoxication died.
In the elderly population with hypervitaminosis D and vitamin D intoxication, most of the patients were seen as normocalcemic. However, severe hypercalcemia, which was life-threatening and resulted in death, was also observed. Using vitamin D in elderly patients should be performed according to the guideline recommendations. Calcium level and clinical findings should be checked during follow-up.
我们旨在评估维生素 D 过量和维生素 D 中毒的老年人群发生高钙血症的风险。
本研究纳入了 2014 年至 2020 年间来我院就诊的年龄≥65 岁、25（OH）维生素 D 水平＞100ng/ml 的 121 例患者。25（OH）维生素 D 水平在 100-150ng/ml 的 69 例患者被确定为 D 型维生素 D 过量；25（OH）维生素 D 水平＞150ng/ml 的 52 例患者被确定为维生素 D 中毒。血钙水平＞10.2mg/dL 的患者被认为患有高钙血症。
在 121 例 D 型维生素 D 过量和维生素 D 中毒的患者中，103 例（85.1%）血钙正常，18 例（14.9%）血钙升高。9 例维生素 D 过量患者中检测到高钙血症；其中 8 例为轻度高钙血症，1 例为重度高钙血症。52 例维生素 D 中毒患者中检测到 9 例高钙血症；7 例为轻度高钙血症，1 例为中度高钙血症，1 例为重度高钙血症。D 型维生素 D 过量和维生素 D 中毒患者高钙血症的发生率无统计学差异（p=0.514）。观察到 3 例（16.7%）D 型维生素 D 过量和维生素 D 中毒的高钙血症患者死亡。
在维生素 D 过量和维生素 D 中毒的老年人群中，大多数患者表现为血钙正常。然而，也观察到了危及生命并导致死亡的严重高钙血症。在老年患者中使用维生素 D 应根据指南建议进行。在随访中应检查血钙水平和临床发现。
