Falk Steffi S I, Schröder Guido, Mittlmeier Thomas
Clinic of Trauma, Hand and Reconstructive Surgery, University of Rostock, Schillingallee 35, 18057 Rostock, Germany.
Nutrients. 2024 Nov 30;16(23):4174. doi: 10.3390/nu16234174.
BACKGROUND/OBJECTIVES: Vitamin D is a key factor in bone metabolism, especially in patients who have suffered fractures, a group in need of a healthy bone metabolism. In Germany, a 70-year-old person requires 20 min of sun exposure daily for sufficient endogenous production in April. While this appears to be a sufficient period on paper, it raises the question of whether sufficient synthesis is achieved, given the time and the implementation of skin cancer prevention. Furthermore, it is necessary to determine whether self-medication is a safe option.
This was an analysis of vitamin D levels in patients with fractures over a one-year period. To avoid bias due to vitamin D intake, patients were divided into groups (self-medication, without, prescribed). The differences due to age, gender, fracture type and fluctuation over the year were analysed.
613 patients with a mean age of 73 years (45-97) were enrolled. The mean vitamin D level across all groups was 51 nmol/L, with a mean of 40 nmol/L for patients without supplementation ( = 449). Monthly comparisons revealed significant differences between January/February and August/September. Similarly, a comparison by gender showed a significant difference ( = 0.028). However, there were no significant differences between osteoporosis-associated and non-osteoporosis-associated fractures.
The majority of patients did not achieve sufficient vitamin D levels through endogenous synthesis and substitution did not lead to toxic levels. This suggests that substitution is reasonable and safe even during the summer months.
背景/目的:维生素D是骨代谢的关键因素,对于骨折患者尤为如此,这是一个需要健康骨代谢的群体。在德国,70岁的人在4月份每天需要20分钟的日照时间才能实现足够的内源性合成。虽然从理论上看这似乎是一段足够的时间,但考虑到时间因素和皮肤癌预防措施的实施,就会产生是否能实现足够合成的问题。此外,有必要确定自我药疗是否是一种安全的选择。
这是一项对骨折患者为期一年的维生素D水平分析。为避免因维生素D摄入导致的偏差,将患者分为几组(自我药疗组、未补充组、处方补充组)。分析了年龄、性别、骨折类型以及一年中的波动所造成的差异。
共纳入613例平均年龄为73岁(45 - 97岁)的患者。所有组的平均维生素D水平为51 nmol/L,未补充维生素D的患者平均水平为40 nmol/L( = 449)。月度比较显示1月/2月和8月/9月之间存在显著差异。同样,按性别比较也显示出显著差异( = 0.028)。然而,骨质疏松相关骨折和非骨质疏松相关骨折之间没有显著差异。
大多数患者通过内源性合成未达到足够的维生素D水平,补充也未导致中毒水平。这表明即使在夏季,补充维生素D也是合理且安全的。