成人维生素 D 缺乏症的诊断、预防和治疗:乌克兰专家共识声明

N. Grygorieva, M. Tronko, V. Kovalenko, S.V. Komisarenko, T. Tatarchuk, N. Dedukh, M.M. Veliky, S. Strafun, Y. Komisarenko, A. Kalashnikov, V. Orlenko, V.I. Pankiv, O.V. Shvets, I. Gogunska, S. Regeda
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引用次数: 0

摘要

背景。维生素 D 缺乏症(VDD)在全球普遍存在;其比例在不同人群中差异很大,并取决于多种原因。到目前为止,乌克兰还没有关于成人维生素 D 缺乏症的诊断、预防和治疗的国家建议。制定这些建议是这项工作的目的。方法。使用德尔菲法达成共识,使用 SurveyMonkey® 平台进行投票。在批准共识小组的组成、商定共识的形成顺序和结构、创建和修正主要声明以及两轮投票后,形成了主要共识声明,并成功进行了投票。文章的 15 位作者是参与投票的 15 位专家。本文介绍了最终的 14 项共识声明。每项声明前都有基于现有文献中高质量证据的理由说明。结果。尽管近年来乌克兰人口中的 VDD 有所减少,但专家建议提高医疗界和乌克兰人口对这一问题的认识以及克服这一问题的方法,对高危人群的血清中 25- 羟维生素 D (25(OH)D) 的总水平进行筛查,以达到 30-50 纳克/毫升(75-125 毫摩尔/升)的目标浓度。为确保达到这一目标,我们建议根据个人情况选择维生素 D 的预防剂量(健康年轻人为 800-2000 IU/天,患有影响维生素 D 代谢的疾病和病症的患者为 3000-5000 IU/天)。对于 VDD 的治疗,我们建议短期摄入较高剂量(4000-10000 IU/d)的维生素 D,并在治疗 4-12 周后控制 25(OH)D 水平,随后使用维持剂量。此外,我们还建议骨质疏松症及其并发症患者在开始抗骨质疏松治疗前测定血清 25(OH)D 水平,以防止治疗无效并提高安全性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Diagnosis, prevention and treatment of vitamin D deficiency in adults: Ukrainian experts consensus statement
Background. Vitamin D deficiency (VDD) is widespread in the world; its proportion varies considerably in different populations and depends on many causes. Up to now, there were no National recommendations for the diagnosis, prevention, and treatment of VDD in adults in Ukraine. Their creation became the purpose of this work. Methodology. Consensus was created using the Delphi method, voting was conducted using the SurveyMonkey® platform. After approval of the composition of the Consensus Group, agreement on the order of formation and structure of the Consensus, creation and correction of the main statements, and two voting rounds, the main Consensus statements were formed and were successfully voted on. The 15 authors of the article are 15 experts who participated in the voting. The final 14 Consensus statements are presented in this article. Each statement is preceded by a justification based on high-quality evidence available in the current literature. Results. Despite the reduction of VDD in the Ukrainian population in recent years, experts have recommen­ded increasing the awareness of the medical community and the Ukrainian population about the problem and ways to overcome it, with a screening of the total serum level of 25-hydroxyvitamin D (25(OH)D) in subjects from the groups of risk to achieve the target concentration of 30–50 ng/ml (75–125 nmol/l). To ensure it, we recommend the individual selection of a prophylactic dose of vitamin D (800–2000 IU/d for young healthy persons and 3000–5000 IU/d for patients with diseases and conditions that affect the metabolism of vitamin D). For the treatment of VDD, we recommend short-term intake of higher doses (4000–10,000 IU/d) of vitamin D with control of the 25(OH)D level after 4–12 weeks of treatment and subsequent use of maintenance doses. Also, we re­commend the determination of serum 25(OH)D level before the initiation of antiosteoporotic therapy in patients with osteoporosis and its complications to prevent its ineffectiveness and increase the safety profile.
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