Clinical Practice in the Prevention, Diagnosis and Treatment of Vitamin D Deficiency: A Central and Eastern European Expert Consensus Statement

Nutrients, Journal Year: 2022, Volume and Issue: 14(7), P. 1483 - 1483

Published: April 2, 2022

Vitamin D deficiency has a high worldwide prevalence, but actions to improve this public health problem are challenged by the heterogeneity of nutritional and clinical vitamin guidelines, with respect diagnosis treatment deficiency. We aimed address issue providing respective recommendations for adults, developed European expert panel, using Delphi method reach consensus. Increasing awareness efforts harmonize guidelines should be pursued. argue against general screening suggest 25-hydroxyvitamin (25(OH)D) testing in certain risk groups. recommend supplementation dose 800 2000 international units (IU) per day adults who want ensure sufficient status. These doses also recommended deficiency, higher (e.g., 6000 IU day) may used first 4 12 weeks if rapid correction is clinically indicated before continuing, maintenance day. Treatment success evaluated after at least 6 groups patients malabsorption syndromes) measurement serum 25(OH)D, aim target concentrations 30 50 ng/mL (75 125 nmol/L).

Language: Английский

---

Vitamin D in the older population: a consensus statement

Endocrine, Journal Year: 2022, Volume and Issue: 79(1), P. 31 - 44

Published: Oct. 26, 2022

This paper reports results from the 5th International Conference “Controversies in Vitamin D” that was held Stresa, Italy, 15–18 September 2021. The conference is part of this series started 2017 and has been conducted annually since. objective these conferences to identify timely controversial topics related D. Dissemination through publications peer-reviewed journals an important means by which most up date information can be shared with physicians, investigators, other health care professionals. D aging, subject featured at conference. Participants were selected review available literature on assigned vitamin aging present their findings illustrative material, intent stimulate discussion arrive a consensus. presentations directed towards following areas: impact production levels; skeletal effects deficiency older population; falls aging; potential extra D; strategies prevent deficiency. A final topic how might influence efficacy vaccines for Covid-19. Hypovitaminosis lead several extra-skeletal outcomes. Older adults are risk as both metabolism change due factors, such reduced sun exposure capacity skin. Skeletal consequences age-related changes include bone mineral density, osteomalacia fractures. Potential added risks falls, muscle strength, diabetes, cancer, cardiovascular disease. Strategies avoid deficiency-related negative outcomes exposure, food fortification, supplementation. While does not diminish sufficient reserve cutaneous production, concerns about skin cancers practical matters institutionalized elderly limit option. Supplementation best option either pharmacologically or fortification. Regardless treatment strategies, interventions restore status will show positive only those who truly deficient. Thus, goals should focus avoiding 25(OH)D serum levels <30 nmol/l, goal reach >50 nmol/l. led consensus issues. supplementation combined calcium reduce fractures population. adequate level It appears daily low-dose regimens falling, especially elderly, compared infrequent, large bolus doses may increase it. role strength remains clarified. On hand, decreases progression T2D prediabetes among Ddeficient. Of three possible establish sufficiency – sunshine latter seems effective

Language: Английский

---

Consensus Statement on Vitamin D Status Assessment and Supplementation: Whys, Whens, and Hows

Endocrine Reviews, Journal Year: 2024, Volume and Issue: 45(5), P. 625 - 654

Published: April 26, 2024

Abstract The 6th International Conference, “Controversies in Vitamin D,” was convened to discuss controversial topics, such as vitamin D metabolism, assessment, actions, and supplementation. Novel insights into mechanisms of action suggest links with conditions that do not depend only on reduced solar exposure or diet intake can be detected distinctive noncanonical metabolites. Optimal 25-hydroxyvitamin (25(OH)D) levels remain debated. Varying recommendations from different societies arise evaluating clinical public health approaches. lack assay standardization also poses challenges interpreting data available studies, hindering rational pooling meta-analyses. Beyond the well-known skeletal features, interest D's extraskeletal effects has led trials cancer, cardiovascular risk, respiratory effects, autoimmune diseases, diabetes, mortality. initial negative results are likely due enrollment D-replete individuals. Subsequent post hoc analyses have suggested, nevertheless, potential benefits reducing cancer incidence, events, diabetes. Oral administration is preferred route. Parenteral reserved for specific situations. Cholecalciferol favored safety minimal monitoring requirements. Calcifediol may used certain conditions, while calcitriol should limited disorders which active metabolite readily produced vivo. Further studies needed investigate relation recommended 25(OH)D efficacy supplementary formulations achieving biochemical outcomes within multifaced D.

Language: Английский

---

Low Vitamin D Levels Are Associated With Long COVID Syndrome in COVID-19 Survivors

The Journal of Clinical Endocrinology & Metabolism, Journal Year: 2023, Volume and Issue: 108(10), P. e1106 - e1116

Published: April 13, 2023

Long COVID is an emerging syndrome affecting 50% to 70% of COVID-19 survivors that still lacks predicting factors.Due the extraskeletal effects vitamin D, we retrospectively assessed association between 25(OH) D levels and long in 6 months after hospitalization.Long was defined according NICE guidelines. Fifty 50 non-long-COVID subjects matched on a 1:1 basis were enrolled from outpatient clinic post-COVID cohort seen August November 2020. Therapies/comorbidities calcium/vitamin D/bone metabolism, and/or admission intensive care unit during hospitalization exclusion criteria. Vitamin measured at hospital discharge.We observed lower levels, evaluated follow-up, with than those without (20.1 vs 23.2 ng/mL, P = .03). Regarding affected health areas entire cohort, neurocognitive symptoms follow-up (n 7) 93) (14.6 20.6 .042). In patients presenting deficiency (<20 ng/mL), both 42), by 22) presented not 20) (12.7 15.2 .041). multiple regression analyses, only variable significantly associated our (P .008, OR 1.09, CI 1.01-1.16).COVID-19 have COVID. Our data suggest should be discharge. The role supplementation as preventive strategy sequelae tested randomized controlled trials.

Language: Английский

---

Vitamin D Supplementation: A Review of the Evidence Arguing for a Daily Dose of 2000 International Units (50 µg) of Vitamin D for Adults in the General Population

Nutrients, Journal Year: 2024, Volume and Issue: 16(3), P. 391 - 391

Published: Jan. 29, 2024

Vitamin D deficiency is considered a public health problem due to its worldwide high prevalence and adverse clinical consequences regarding musculoskeletal health. In addition, vitamin may also be crucial for the prevention of certain extraskeletal diseases. Despite decades intensive scientific research, several knowledge gaps remain precise definition sufficiency, benefits improving status, required intakes. Consequently, various societies expert groups have released heterogeneous recommendations on dosages supplementation. this brief narrative review, we outline discuss recent advances evidence arguing daily supplementation with 2000 international units (IU) (50 µg) D3 prevent treat deficiency. According data from randomized controlled trials (RCTs), such dose improve some outcomes sufficient raise maintain serum 25(OH)D concentrations above 50 nmol/L (20 ng/mL) 75 (30 in >99% >90% general adult population, respectively. large RCTs, there are no significant safety concerns supplementing years, even individuals an already status at baseline. A IU simple, effective, safe dosage population.

Language: Английский

---

A view on vitamin D: a pleiotropic factor?

Nature Reviews Endocrinology, Journal Year: 2024, Volume and Issue: 20(4), P. 202 - 208

Published: Jan. 22, 2024

Language: Английский

---

Definition, Assessment, and Management of Vitamin D Inadequacy: Suggestions, Recommendations, and Warnings from the Italian Society for Osteoporosis, Mineral Metabolism and Bone Diseases (SIOMMMS)

Nutrients, Journal Year: 2022, Volume and Issue: 14(19), P. 4148 - 4148

Published: Oct. 6, 2022

In the recent years, both prescriptions of serum 25(OH)D levels assay, and vitamin D supplementation are constantly increasing, as well costs to be incurred relating these specific aspects. As in many other countries, risk deficiency is particularly high Italy, recently confirmed by cohort studies general population patients with metabolic bone disorder. Results North-South gradient described among European despite wide use supplements. Although also recommended Italian Medicine Agency for at fragility fracture or initiating osteoporotic medication, therapeutic gap osteoporosis Italy very high. There a consistent proportion not receiving therapy following fracture, poor adherence recommendations provided national guidelines position paper documents. The failure inadequate on antiresorptive anabolic treatment thought further amplify problem exposes re-fracture mortality. Therefore, it important that attention its possible clinical consequences must given. Thus, light new evidence from literature, SIOMMMS board felt need revise update, GRADE/PICO system approach, previous original about definition, prevention, adults, released 2011. Several key points have been here addressed, such definition status: normality values optimal values; who subjects considered hypovitaminosis D; opportunity performing biochemical assessment evaluate baseline candidate pharmacological osteoporosis; how whether supplement candidates active agents, population; chronic kidney disease and/or liver diseases under drugs interfering hepatic metabolism; finally, if may toxic effects subject supplementation.

Language: Английский

---

Vitamin D in Osteosarcopenic Obesity

Nutrients, Journal Year: 2022, Volume and Issue: 14(9), P. 1816 - 1816

Published: April 26, 2022

Osteosarcopenic obesity is a unique clinical condition where low bone and muscle mass coexist in individuals with obesity. Alterations adipose tissue, skeletal are strictly interconnected, vitamin D plays key roles several metabolic pathways that involved maintaining musculoskeletal health glucose homeostasis. We reviewed the available literature on mechanisms underlying osteosarcopenic obesity, focus role of pathogenesis treatment condition. found that, although evidence from large observational studies pre-clinical experiments strongly supports deficiency common belief improves lacks solid evidence, as trials specifically aimed at assessing effects supplementation patients not available, investigated other patient populations either showed no or even detrimental effects. conclude interventional including representative different sex, age race needed to better define this

Language: Английский

---

Low vitamin D levels predict outcomes of COVID-19 in patients with both severe and non-severe disease at hospitalization

Endocrine, Journal Year: 2023, Volume and Issue: 80(3), P. 669 - 683

Published: March 1, 2023

Language: Английский

---

Vitamin D status and supplementation before and after Bariatric Surgery: Recommendations based on a systematic review and meta-analysis

Reviews in Endocrine and Metabolic Disorders, Journal Year: 2023, Volume and Issue: 24(6), P. 1011 - 1029

Published: Sept. 4, 2023

Bariatric surgery is associated with a postoperative reduction of 25(OH) vitamin D levels (25(OH)D) and skeletal complications. Currently, guidelines for 25(OH)D assessment supplementation in bariatric patients, pre- post-surgery, are still lacking. The aim this work to analyse systematically the published experience on status supplementation, propose, basis, recommendations management. Preoperatively, 18 studies including 2,869 patients were evaluated. Prevalence insufficiency as defined by < 30 ng/mL (75 nmol/L) was 85%, whereas when 20 (50 57%. median preoperative level 19.75 ng/mL. After surgery, 39 5,296 analysed among those undergoing either malabsorptive or restrictive procedures, lower rate higher postoperatively observed treated high-dose oral ≥ 2,000 IU/daily (mostly D3-formulation), compared low-doses (< IU/daily). Our based systematic review meta-analysis should help clinical practice management before after surgery. Assessment be performed all Regardless type procedure, recommended

Language: Английский

---