Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.
Austrian Academic Institute of Clinical Nutrition, Univ. Montevideo, Uruguay.
Clin Nutr ESPEN. 2023 Oct;57:691-696. doi: 10.1016/j.clnesp.2023.07.005. Epub 2023 Jul 26.
BACKGROUND & AIMS: Vitamin D deficiency is a condition with different causes. It is associated with numerous comorbidities such as autoimmune diseases, bone diseases, cancer, cardiovascular diseases, neurodegenerative diseases, psychiatric diseases, and respiratory infections like COVID-19. Due to its high prevalence all over the world, it is a major task for health care systems worldwide. Through a combination of low sunlight exposure, insufficient nutrition, and age-related changes in skin, liver, and kidney function, especially seniors and nursing home residents, in particular, have a significantly increased risk of developing a vitamin D deficiency.
This retrospective study analyzed the prevalence of vitamin D deficiency (serum 25-hydroxyvitamin D [25(OH)D] < 12 ng/ml) amongst selected Austrian nursing home seniors. It also examined whether demographic data and other laboratory values like calcium correlate with vitamin D levels by using the Pearson correlation coefficient. This correlation was graphically illustrated with a scatter plot and regression line. A total of 478 patients admitted to a nursing home in Vienna between January 3, 2017, and August 31, 2020, were included.
A total of 106 seniors (22,2%) suffered from a manifest vitamin D deficiency. The vitamin D level of the men was significantly lower than the level of the women (22.9 ± 12.6 ng/ml vs. 26.2 ± 14.8 ng/ml, p = 0.027). The vitamin D serum levels significantly correlated with the serum calcium levels of the participants (r = 0.19, p < 0.001). 39.5% (189 out of 478) of the nursing home residents had inadequate serum vitamin D levels.
In summary, it can be said that the prevalence of vitamin D deficiency among nursing home residents is considerably high. Inadequate vitamin D levels were often associated with reduced calcium levels. Given the high prevalence, the numerous negative health consequences of inadequate levels, and the large therapeutic index, this risk group should get a general supplementation with a dose of 25 μg (1000 IU) vitamin D3 per day. In addition, a blood examination should be performed as early as three months after the start of the supplementation therapy. If some residents do not achieve an adequate vitamin D concentration, the substitution has to be adapted to the individual needs to treat them as precisely as possible.
维生素 D 缺乏是一种由多种原因引起的病症。它与许多合并症有关,如自身免疫性疾病、骨骼疾病、癌症、心血管疾病、神经退行性疾病、精神疾病以及 COVID-19 等呼吸道感染。由于其在全球的高患病率,这是全球医疗保健系统的一项主要任务。由于低阳光照射、营养不足以及皮肤、肝脏和肾脏功能随年龄的变化,尤其是老年人和养老院居民,患维生素 D 缺乏症的风险显著增加。
本回顾性研究分析了奥地利养老院老年人中维生素 D 缺乏症(血清 25-羟维生素 D [25(OH)D]<12ng/ml)的患病率。它还通过使用皮尔逊相关系数检查了人口统计学数据和其他实验室值(如钙)是否与维生素 D 水平相关。通过散点图和回归线直观地说明了这种相关性。共纳入 2017 年 1 月 3 日至 2020 年 8 月 31 日期间在维也纳一家养老院住院的 478 名患者。
共有 106 名老年人(22.2%)患有明显的维生素 D 缺乏症。男性的维生素 D 水平明显低于女性(22.9±12.6ng/ml 比 26.2±14.8ng/ml,p=0.027)。参与者的维生素 D 血清水平与血清钙水平显著相关(r=0.19,p<0.001)。478 名养老院居民中,39.5%(189 人)的血清维生素 D 水平不足。
总之,可以说养老院居民中维生素 D 缺乏症的患病率相当高。维生素 D 水平不足通常与钙水平降低有关。鉴于高患病率、维生素 D 水平不足的众多负面健康后果以及较大的治疗指数,该风险组应每天补充 25μg(1000IU)维生素 D3。此外,应在补充治疗开始后三个月进行血液检查。如果一些居民未达到足够的维生素 D 浓度,则必须根据个体需求调整替代治疗,以尽可能精确地治疗他们。