Beacon Hospital, 1, Jalan 215, Section 51, Off Jalan Templer, 46050, Petaling Jaya, Selangor, Malaysia.
Division of Nutrition and Dietetics, School of Health Sciences, International Medical University, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia.
Osteoporos Int. 2023 Nov;34(11):1837-1850. doi: 10.1007/s00198-023-06841-4. Epub 2023 Jul 11.
Vitamin D deficiency and insufficiency is common among populations globally, and in Asia and Malaysia. The purpose of this Position Paper is to propose recommendations for both clinicians and non-clinicians to promote vitamin D sufficiency in Malaysian adults. Formation of a national multisector, multidisciplinary alliance is also proposed to progress initiatives relating to safe sun exposure, adequate vitamin D intake through food fortification, and vitamin D supplementation for high-risk groups.
Literature reviews were undertaken to inform summaries of the following: vitamin D status globally and in Asian and Malaysian populations, vitamin D status among individuals with common medical conditions, and current recommendations to achieve vitamin D sufficiency through sun exposure, food intake and supplementation. Recommendations were based on the findings of the literature reviews, recent European guidance on vitamin D supplementation, the 2018 road map for action on vitamin D in low- and middle-income countries, and research recommendations proposed by the Malaysian Ministry of Health in 2017.
Recommendations on assessment of vitamin D in the adult Malaysian population include using serum or plasma 25-hydroxyvitamin D concentration as a biomarker, widespread participation by Malaysian laboratories in the Vitamin D Standardization Program, adoption of the US Endocrine Society definitions of vitamin D deficiency and insufficiency, and development of a comprehensive nationwide vitamin D status study. Specific high-risk groups are identified for vitamin D assessment and recommendations relating to loading doses and ongoing management are also made.
This Position Paper provides individual clinicians and national stakeholder organisations with clear recommendations to achieve vitamin D sufficiency in the adult population of Malaysia.
维生素 D 缺乏和不足在全球范围内以及在亚洲和马来西亚都很常见。本立场文件的目的是为临床医生和非临床医生提出建议，以促进马来西亚成年人的维生素 D 充足。还建议成立一个国家多部门、多学科联盟，以推进与安全日晒、通过食物强化摄入足够的维生素 D 以及为高风险人群补充维生素 D 相关的倡议。
进行文献回顾，以总结以下内容：全球和亚洲及马来西亚人群的维生素 D 状况、常见疾病患者的维生素 D 状况，以及通过日晒、饮食摄入和补充来实现维生素 D 充足的当前建议。建议基于文献综述的发现、最近的欧洲维生素 D 补充指南、2018 年中低收入国家维生素 D 行动路线图，以及马来西亚卫生部在 2017 年提出的研究建议。
关于评估马来西亚成年人口维生素 D 的建议包括使用血清或血浆 25-羟维生素 D 浓度作为生物标志物，马来西亚实验室广泛参与维生素 D 标准化计划，采用美国内分泌学会对维生素 D 缺乏和不足的定义，以及制定一项全面的全国性维生素 D 状况研究。还确定了具体的高风险人群进行维生素 D 评估，并提出了与负荷剂量和持续管理相关的建议。
本立场文件为个别临床医生和国家利益相关组织提供了明确的建议，以实现马来西亚成年人口的维生素 D 充足。
