Vitamin D has effects on bone, muscles, and non-musculoskeletal conditions. It is very common for risk groups like children, older adults, pregnant women, and immigrants to be vitamin D deficient. While vitamin D supplements can help with bone health, the evidence for other benefits is less clear. Large ongoing clinical trials are investigating the effects of vitamin D supplements on conditions like fractures, cardiovascular disease, respiratory infections, diabetes, and cancer. Recommendations for vitamin D intake vary between health organizations.
This document discusses Dent's disease, a rare inherited kidney disorder characterized by low molecular weight proteinuria, hypercalciuria, nephrocalcinosis, and chronic kidney disease. It provides details on the genetics, pathophysiology, diagnosis, and treatment of the two main types - Dent's disease type 1 caused by mutations in the CLCN5 gene, and type 2 caused by mutations in the OCRL1 gene. The document reviews the characteristic features and clinical presentation of each type, as well as supportive treatments aimed at preventing kidney stone formation and slowing kidney function decline. Prognosis is outlined, with affected males having a high risk of end stage renal disease by the 3rd to 5th decade
1) The document discusses vitamin D deficiency and its link to various health issues. It reports that 61-82% of postmenopausal women and 98% of patients with osteoporotic fractures have inadequate vitamin D levels.
2) Several causes of vitamin D deficiency in the elderly are described, including lack of sun exposure and less effective vitamin D synthesis in the skin.
3) The text reviews results from studies that show vitamin D supplementation can reduce fracture risk by 33%, falling risk by 49%, and improve lower limb function. It is suggested that maintaining higher vitamin D levels may provide significant economic savings in healthcare costs.
The document discusses the high prevalence of vitamin D deficiency in India, ranging from 47.8% to 96% across different age groups. It outlines the various factors that contribute to vitamin D deficiency in India, including reduced sun exposure, lifestyle changes, dietary habits, and cultural practices. The document also examines the methods used to test vitamin D status and the effects of vitamin D deficiency on health.
This document discusses possible links between vitamin D deficiency and various geriatric syndromes and common comorbidities. It begins by outlining how vitamin D receptors are present in many tissues beyond the musculoskeletal system. It then examines potential associations between vitamin D deficiency and increased risks of frailty, urinary incontinence, dementia/cognitive impairment, and depression in elderly populations. While evidence is limited and relationships are not clearly causal, several observational studies have found correlations between low vitamin D levels and higher rates of these conditions. More research is still needed, but maintaining adequate vitamin D status may help reduce risks of age-related diseases and functional decline.
CASE STUDY POSTER - Kimberly Eades - Adam S Rosen - IAdam S. Rosen
The document discusses evidence on nutritional interventions for renal disease. It summarizes four studies that examined the relationship between BMI and mortality in patients with end-stage renal disease as well as the effectiveness of cholecalciferol supplementation in raising vitamin D levels in patients with chronic kidney disease. The studies reported mixed results, with some indicating benefits of higher BMI or cholecalciferol supplementation and others finding no clear associations or effects. Additional research is needed to better understand these relationships.
IOSR Journal of Pharmacy (IOSRPHR), www.iosrphr.org, call for paper, research...iosrphr_editor
This study examined the prevalence of vitamin B12 deficiency in 866 higher socioeconomic subjects in Bhuj, India. Blood tests found 44.2% of subjects were deficient in vitamin B12, with the most common age group affected being 21-40 years old. Increasing age, vegetarian diets without animal products, low dairy intake in females, and malnutrition in elders were identified as main risk factors. The study concludes vitamin B12 deficiency is common in this population due to low intake of milk and animal products in their diet.
Vitamina D ed Asma - Prof. Boner Attilio Università di VeronaRoberto Conte
1) Several studies show high rates of vitamin D deficiency and insufficiency among children with asthma. Low vitamin D levels are associated with worse asthma control, including increased exacerbations and hospitalizations.
2) Observational studies link higher maternal vitamin D intake during pregnancy to lower rates of wheezing and asthma in offspring. However, the evidence for a causal relationship is still insufficient.
3) Maintaining adequate vitamin D levels, especially during pregnancy and childhood, may help reduce asthma risk and severity by supporting lung development and function. Further research is still needed.
1. The document discusses vitamin D functions, deficiency, testing, and treatment recommendations. It provides guidelines on screening for deficiency, preferred tests, dosing for deficiency treatment in different populations, and use of vitamin D supplements for non-skeletal benefits like immunity and cancer reduction.
2. Treatment of vitamin D deficiency requires supplementation, not just dietary changes, with recommendations to use cholecalciferol over ergocalciferol. Dosing depends on factors like age and compliance monitoring is advised.
3. Beyond bone health, evidence is mixed on other benefits of vitamin D supplementation though fall prevention is recommended. Judicious evaluation of other causes is advised when vitamin D replacement does not resolve symptoms.
This document discusses Dent's disease, a rare inherited kidney disorder characterized by low molecular weight proteinuria, hypercalciuria, nephrocalcinosis, and chronic kidney disease. It provides details on the genetics, pathophysiology, diagnosis, and treatment of the two main types - Dent's disease type 1 caused by mutations in the CLCN5 gene, and type 2 caused by mutations in the OCRL1 gene. The document reviews the characteristic features and clinical presentation of each type, as well as supportive treatments aimed at preventing kidney stone formation and slowing kidney function decline. Prognosis is outlined, with affected males having a high risk of end stage renal disease by the 3rd to 5th decade
1) The document discusses vitamin D deficiency and its link to various health issues. It reports that 61-82% of postmenopausal women and 98% of patients with osteoporotic fractures have inadequate vitamin D levels.
2) Several causes of vitamin D deficiency in the elderly are described, including lack of sun exposure and less effective vitamin D synthesis in the skin.
3) The text reviews results from studies that show vitamin D supplementation can reduce fracture risk by 33%, falling risk by 49%, and improve lower limb function. It is suggested that maintaining higher vitamin D levels may provide significant economic savings in healthcare costs.
The document discusses the high prevalence of vitamin D deficiency in India, ranging from 47.8% to 96% across different age groups. It outlines the various factors that contribute to vitamin D deficiency in India, including reduced sun exposure, lifestyle changes, dietary habits, and cultural practices. The document also examines the methods used to test vitamin D status and the effects of vitamin D deficiency on health.
This document discusses possible links between vitamin D deficiency and various geriatric syndromes and common comorbidities. It begins by outlining how vitamin D receptors are present in many tissues beyond the musculoskeletal system. It then examines potential associations between vitamin D deficiency and increased risks of frailty, urinary incontinence, dementia/cognitive impairment, and depression in elderly populations. While evidence is limited and relationships are not clearly causal, several observational studies have found correlations between low vitamin D levels and higher rates of these conditions. More research is still needed, but maintaining adequate vitamin D status may help reduce risks of age-related diseases and functional decline.
CASE STUDY POSTER - Kimberly Eades - Adam S Rosen - IAdam S. Rosen
The document discusses evidence on nutritional interventions for renal disease. It summarizes four studies that examined the relationship between BMI and mortality in patients with end-stage renal disease as well as the effectiveness of cholecalciferol supplementation in raising vitamin D levels in patients with chronic kidney disease. The studies reported mixed results, with some indicating benefits of higher BMI or cholecalciferol supplementation and others finding no clear associations or effects. Additional research is needed to better understand these relationships.
IOSR Journal of Pharmacy (IOSRPHR), www.iosrphr.org, call for paper, research...iosrphr_editor
This study examined the prevalence of vitamin B12 deficiency in 866 higher socioeconomic subjects in Bhuj, India. Blood tests found 44.2% of subjects were deficient in vitamin B12, with the most common age group affected being 21-40 years old. Increasing age, vegetarian diets without animal products, low dairy intake in females, and malnutrition in elders were identified as main risk factors. The study concludes vitamin B12 deficiency is common in this population due to low intake of milk and animal products in their diet.
Vitamina D ed Asma - Prof. Boner Attilio Università di VeronaRoberto Conte
1) Several studies show high rates of vitamin D deficiency and insufficiency among children with asthma. Low vitamin D levels are associated with worse asthma control, including increased exacerbations and hospitalizations.
2) Observational studies link higher maternal vitamin D intake during pregnancy to lower rates of wheezing and asthma in offspring. However, the evidence for a causal relationship is still insufficient.
3) Maintaining adequate vitamin D levels, especially during pregnancy and childhood, may help reduce asthma risk and severity by supporting lung development and function. Further research is still needed.
1. The document discusses vitamin D functions, deficiency, testing, and treatment recommendations. It provides guidelines on screening for deficiency, preferred tests, dosing for deficiency treatment in different populations, and use of vitamin D supplements for non-skeletal benefits like immunity and cancer reduction.
2. Treatment of vitamin D deficiency requires supplementation, not just dietary changes, with recommendations to use cholecalciferol over ergocalciferol. Dosing depends on factors like age and compliance monitoring is advised.
3. Beyond bone health, evidence is mixed on other benefits of vitamin D supplementation though fall prevention is recommended. Judicious evaluation of other causes is advised when vitamin D replacement does not resolve symptoms.
This document discusses vitamin D deficiency in critical illness based on several studies. It finds that vitamin D deficiency is common in critically ill patients, with 100% of sepsis patients and 92% of non-sepsis ICU patients found to be vitamin D insufficient or deficient in one study. Low vitamin D levels are associated with higher illness severity and mortality. However, whether vitamin D replacement can improve outcomes in critical illness is still unclear due to challenges in dosing and administration in ICU patients. One study found a single high dose improved vitamin D levels in most patients.
1. The document discusses team-based care for chronic kidney disease (CKD), which involves staged goals for patient monitoring and treatment based on glomerular filtration rate (GFR) levels.
2. It emphasizes a multidisciplinary team approach including education by nurses, dieticians, and nephrologists to help slow kidney function decline, manage complications, and prepare patients for renal replacement therapies like dialysis.
3. The risks of cardiovascular disease are increased even in early CKD stages, so monitoring and preventative measures are important parts of care.
A New Perspective on Chronic Kidney Diseasestevechendoc
1. The document discusses team-based care for chronic kidney disease (CKD), which involves staged goals for patient care and monitoring based on glomerular filtration rate (GFR) levels and a multidisciplinary team approach.
2. It outlines the various risks associated with CKD including cardiovascular disease, metabolic complications, mineral and bone disorders, and anemia.
3. Maintaining adequate blood bicarbonate levels, controlling potassium levels, treating vitamin D deficiency, and managing secondary hyperparathyroidism are all important aspects of CKD care discussed.
1. The document discusses bone metabolism and prostate cancer, describing how factors like RANK ligand and osteoprotegerin regulate the balance between bone formation and resorption.
2. It summarizes a clinical trial comparing denosumab, a RANK ligand inhibitor, to zoledronic acid for treating bone metastases in prostate cancer patients. Denosumab delayed time to first skeletal-related event compared to zoledronic acid and reduced risk of multiple events.
3. Rates of adverse events were generally similar between the treatments, though denosumab resulted in fewer acute phase reactions and more cases of osteonecrosis of the jaw compared to zoledronic acid.
1. Calcium and vitamin D supplements are effective at reversing secondary hyperparathyroidism in older individuals and are associated with increased bone mineral density and reduced bone loss.
2. Vitamin D supplementation lowers the risk of falling by 14-23% and a daily dose of at least 800 IU is most effective. While data is limited in men, they appear to benefit similarly to women in terms of fall reduction.
3. Calcium and vitamin D supplementation have proven antifracture efficacy when targeted to individuals with documented deficiencies or insufficiencies, through mechanisms of reducing bone loss and fall risk.
KidneyVite is a state of the art multivitamin supplement specially designed for ALL patients:
- with kidney disease
- receiving hemodialysis and peritoneal dialysis
- and kidney transplant recipients
- with diabetes or hypertension, and therefore at risk for kidney disease.
Mrs. H, an 82-year old woman, broke her hip after falling. She underwent surgery to repair her intra-trochanteric fracture and was discharged to a rehabilitation facility. The physician started her on alendronate to treat her osteoporosis and prevent future fractures.
Ms. T had declining bone density despite alendronate therapy. She was found to be non-compliant with calcium and vitamin D supplementation and had low vitamin D levels. She was prescribed vitamin D supplementation to address this.
Mrs. M refused bisphosphonate therapy despite vertebral fractures. She was prescribed teriparatid as an alternative to reduce her risk of future fractures.
Vitamin D deficiency is very common globally, including in Saudi Arabia where prevalence is around 90-95%. Vitamin D is important for bone and skeletal health and development during childhood, as it regulates calcium and phosphorus balance and bone mineralization. Beyond skeletal benefits, vitamin D has roles in reducing infection risk, autoimmune disease, asthma, COPD and cancer. Deficiency is diagnosed through blood tests measuring vitamin D levels, with normal being 30-100 ng/ml. Deficiency can cause rickets or osteomalacia and is often due to lack of sun exposure or intake of vitamin D sources like fortified foods. Prevention involves sun exposure, intake of vitamin D foods or supplements. Treatment requires high dose vitamin D
Vitamin D deficiency is common, affecting approximately 66% of the global population. It is defined as a serum 25-hydroxyvitamin D level below 20 ng/mL. Symptoms include bone and muscle pain. At-risk groups include those with dark skin, obesity, or malabsorption issues. Screening is recommended for high-risk individuals. Treatment involves oral vitamin D supplements of 50,000 IU weekly or 6000 IU daily to raise levels above 30 ng/mL. Maintenance doses of 800-1000 IU daily are used thereafter to prevent recurrence.
This document discusses several B vitamins and vitamin C. It provides information on their functions, sources, toxicity, deficiency symptoms, and absorption. The vitamins covered are B1, B2, B3, B5, B6, B7, B8, B9, B12, and C. Their roles in energy production, metabolism, growth, and immune function are summarized.
This document provides an overview of water soluble vitamins, including their classification, recommended daily allowances, sources, properties, and individual details. It discusses 8 water soluble vitamins - thiamine, riboflavin, niacin, pyridoxine, vitamin C, folic acid, and vitamin B12. For each vitamin, it describes structure, active forms, biochemical functions, causes of deficiency, and deficiency manifestations. The document is intended as an educational reference on essential water soluble vitamins and their roles in human nutrition and health.
Vitamins are organic compounds that are required in small amounts to maintain normal health. The word "vitamin" comes from the Latin word "vita" meaning life. There are two types of vitamins - fat soluble (A, D, E, K) and water soluble (B complex, C). Vitamin A is important for vision, epithelial cell integrity, reproduction, resistance to infection, and bone remodeling. Symptoms of vitamin A deficiency include night blindness, dry eyes, and corneal damage.
This document provides information on B-complex vitamins, including their classification and properties. It then focuses on thiamine (B1) and riboflavin (B2), discussing their history, structures, roles as coenzymes, dietary sources, deficiencies, investigations and treatments. For thiamine and riboflavin, key details are provided on their specific coenzymes, metabolic reactions they participate in, risk factors for deficiency, clinical signs, recommended intake levels, and management approaches. The document synthesizes information from various biochemistry textbooks and references.
1. Vitamin D plays an important role in maintaining calcium and phosphorus balance for bone health and has protective functions for kidneys, heart, diabetes prevention, immune regulation, and cancer prevention.
2. Vitamin D deficiency is not uncommon in Taiwan, and people with vitamin D deficiency may need vitamin D supplementation treatment.
3. Currently there is no evidence that high-dose vitamin D is more effective.
4. Vitamin D supplementation is beneficial for bone health protection, but more research is still needed to confirm its protective effects on non-skeletal diseases.
This talk discusses the physiology of vitamin D and the consequences of vitamin D deficiency. It also presents the evidence for the effects of Vitamin D therapy on Bone density, It also presents the evidence of the effects of vitamin D supplementation on the development of cancer and cardiovascular events
Vitamin D deficiency is common worldwide and can cause many health issues. It is involved in calcium absorption and bone health. Deficiency leads to osteomalacia and rickets in children, and increases risk of fractures in adults. It may also play roles in cardiovascular disease, diabetes, cancer prevention, autoimmune disease, pregnancy complications, muscle weakness, and mortality. Treatment involves dietary sources of vitamin D, supplementation, and sunlight exposure.
The document provides an overview of vitamin D, including its dietary sources, role in bone and overall health, and prevalence of vitamin D deficiency in New Zealand. Key points include:
- Vitamin D status is best determined by measuring 25-hydroxyvitamin D levels in the blood.
- Many New Zealanders, despite a sunny climate, have suboptimal vitamin D levels year-round due to indoor lifestyles.
- Maintaining adequate vitamin D levels may help reduce the risk of osteoporosis, influenza, cancer, cardiovascular disease, and other conditions.
Vitamin D supplementation, especially at doses of 700-800 IU/day of cholecalciferol, has been shown to reduce the risk of hip fractures and nonvertebral fractures when combined with calcium intake of at least 500 mg/day. Several meta-analyses found the greatest benefits in individuals with vitamin D levels <50 nmol/L or calcium intake <700 mg/day. While vitamin D alone showed no significant fracture reduction, supplementation that achieved 25(OH)D levels >75 nmol/L or included additional calcium intake was more effective in preventing fractures.
Raccomandazioni della iof (international osteoporosis foundation) sull’impieg...Merqurio
This position paper from the International Osteoporosis Foundation makes recommendations for vitamin D intake in older adults. Based on randomized controlled trials, daily vitamin D intake of 20-25 μg (800-1000 IU) is estimated to achieve a target serum 25OHD level of 75 nmol/L (30 ng/ml), which is associated with reduced risk of falls and fractures. Higher daily intakes may be needed for those with risk factors like obesity, limited sun exposure, or malabsorption. Doses above 20 μg/day have not been thoroughly evaluated, so higher intakes cannot be generally recommended at this time.
This document discusses vitamin D deficiency in critical illness based on several studies. It finds that vitamin D deficiency is common in critically ill patients, with 100% of sepsis patients and 92% of non-sepsis ICU patients found to be vitamin D insufficient or deficient in one study. Low vitamin D levels are associated with higher illness severity and mortality. However, whether vitamin D replacement can improve outcomes in critical illness is still unclear due to challenges in dosing and administration in ICU patients. One study found a single high dose improved vitamin D levels in most patients.
1. The document discusses team-based care for chronic kidney disease (CKD), which involves staged goals for patient monitoring and treatment based on glomerular filtration rate (GFR) levels.
2. It emphasizes a multidisciplinary team approach including education by nurses, dieticians, and nephrologists to help slow kidney function decline, manage complications, and prepare patients for renal replacement therapies like dialysis.
3. The risks of cardiovascular disease are increased even in early CKD stages, so monitoring and preventative measures are important parts of care.
A New Perspective on Chronic Kidney Diseasestevechendoc
1. The document discusses team-based care for chronic kidney disease (CKD), which involves staged goals for patient care and monitoring based on glomerular filtration rate (GFR) levels and a multidisciplinary team approach.
2. It outlines the various risks associated with CKD including cardiovascular disease, metabolic complications, mineral and bone disorders, and anemia.
3. Maintaining adequate blood bicarbonate levels, controlling potassium levels, treating vitamin D deficiency, and managing secondary hyperparathyroidism are all important aspects of CKD care discussed.
1. The document discusses bone metabolism and prostate cancer, describing how factors like RANK ligand and osteoprotegerin regulate the balance between bone formation and resorption.
2. It summarizes a clinical trial comparing denosumab, a RANK ligand inhibitor, to zoledronic acid for treating bone metastases in prostate cancer patients. Denosumab delayed time to first skeletal-related event compared to zoledronic acid and reduced risk of multiple events.
3. Rates of adverse events were generally similar between the treatments, though denosumab resulted in fewer acute phase reactions and more cases of osteonecrosis of the jaw compared to zoledronic acid.
1. Calcium and vitamin D supplements are effective at reversing secondary hyperparathyroidism in older individuals and are associated with increased bone mineral density and reduced bone loss.
2. Vitamin D supplementation lowers the risk of falling by 14-23% and a daily dose of at least 800 IU is most effective. While data is limited in men, they appear to benefit similarly to women in terms of fall reduction.
3. Calcium and vitamin D supplementation have proven antifracture efficacy when targeted to individuals with documented deficiencies or insufficiencies, through mechanisms of reducing bone loss and fall risk.
KidneyVite is a state of the art multivitamin supplement specially designed for ALL patients:
- with kidney disease
- receiving hemodialysis and peritoneal dialysis
- and kidney transplant recipients
- with diabetes or hypertension, and therefore at risk for kidney disease.
Mrs. H, an 82-year old woman, broke her hip after falling. She underwent surgery to repair her intra-trochanteric fracture and was discharged to a rehabilitation facility. The physician started her on alendronate to treat her osteoporosis and prevent future fractures.
Ms. T had declining bone density despite alendronate therapy. She was found to be non-compliant with calcium and vitamin D supplementation and had low vitamin D levels. She was prescribed vitamin D supplementation to address this.
Mrs. M refused bisphosphonate therapy despite vertebral fractures. She was prescribed teriparatid as an alternative to reduce her risk of future fractures.
Vitamin D deficiency is very common globally, including in Saudi Arabia where prevalence is around 90-95%. Vitamin D is important for bone and skeletal health and development during childhood, as it regulates calcium and phosphorus balance and bone mineralization. Beyond skeletal benefits, vitamin D has roles in reducing infection risk, autoimmune disease, asthma, COPD and cancer. Deficiency is diagnosed through blood tests measuring vitamin D levels, with normal being 30-100 ng/ml. Deficiency can cause rickets or osteomalacia and is often due to lack of sun exposure or intake of vitamin D sources like fortified foods. Prevention involves sun exposure, intake of vitamin D foods or supplements. Treatment requires high dose vitamin D
Vitamin D deficiency is common, affecting approximately 66% of the global population. It is defined as a serum 25-hydroxyvitamin D level below 20 ng/mL. Symptoms include bone and muscle pain. At-risk groups include those with dark skin, obesity, or malabsorption issues. Screening is recommended for high-risk individuals. Treatment involves oral vitamin D supplements of 50,000 IU weekly or 6000 IU daily to raise levels above 30 ng/mL. Maintenance doses of 800-1000 IU daily are used thereafter to prevent recurrence.
This document discusses several B vitamins and vitamin C. It provides information on their functions, sources, toxicity, deficiency symptoms, and absorption. The vitamins covered are B1, B2, B3, B5, B6, B7, B8, B9, B12, and C. Their roles in energy production, metabolism, growth, and immune function are summarized.
This document provides an overview of water soluble vitamins, including their classification, recommended daily allowances, sources, properties, and individual details. It discusses 8 water soluble vitamins - thiamine, riboflavin, niacin, pyridoxine, vitamin C, folic acid, and vitamin B12. For each vitamin, it describes structure, active forms, biochemical functions, causes of deficiency, and deficiency manifestations. The document is intended as an educational reference on essential water soluble vitamins and their roles in human nutrition and health.
Vitamins are organic compounds that are required in small amounts to maintain normal health. The word "vitamin" comes from the Latin word "vita" meaning life. There are two types of vitamins - fat soluble (A, D, E, K) and water soluble (B complex, C). Vitamin A is important for vision, epithelial cell integrity, reproduction, resistance to infection, and bone remodeling. Symptoms of vitamin A deficiency include night blindness, dry eyes, and corneal damage.
This document provides information on B-complex vitamins, including their classification and properties. It then focuses on thiamine (B1) and riboflavin (B2), discussing their history, structures, roles as coenzymes, dietary sources, deficiencies, investigations and treatments. For thiamine and riboflavin, key details are provided on their specific coenzymes, metabolic reactions they participate in, risk factors for deficiency, clinical signs, recommended intake levels, and management approaches. The document synthesizes information from various biochemistry textbooks and references.
1. Vitamin D plays an important role in maintaining calcium and phosphorus balance for bone health and has protective functions for kidneys, heart, diabetes prevention, immune regulation, and cancer prevention.
2. Vitamin D deficiency is not uncommon in Taiwan, and people with vitamin D deficiency may need vitamin D supplementation treatment.
3. Currently there is no evidence that high-dose vitamin D is more effective.
4. Vitamin D supplementation is beneficial for bone health protection, but more research is still needed to confirm its protective effects on non-skeletal diseases.
This talk discusses the physiology of vitamin D and the consequences of vitamin D deficiency. It also presents the evidence for the effects of Vitamin D therapy on Bone density, It also presents the evidence of the effects of vitamin D supplementation on the development of cancer and cardiovascular events
Vitamin D deficiency is common worldwide and can cause many health issues. It is involved in calcium absorption and bone health. Deficiency leads to osteomalacia and rickets in children, and increases risk of fractures in adults. It may also play roles in cardiovascular disease, diabetes, cancer prevention, autoimmune disease, pregnancy complications, muscle weakness, and mortality. Treatment involves dietary sources of vitamin D, supplementation, and sunlight exposure.
The document provides an overview of vitamin D, including its dietary sources, role in bone and overall health, and prevalence of vitamin D deficiency in New Zealand. Key points include:
- Vitamin D status is best determined by measuring 25-hydroxyvitamin D levels in the blood.
- Many New Zealanders, despite a sunny climate, have suboptimal vitamin D levels year-round due to indoor lifestyles.
- Maintaining adequate vitamin D levels may help reduce the risk of osteoporosis, influenza, cancer, cardiovascular disease, and other conditions.
Vitamin D supplementation, especially at doses of 700-800 IU/day of cholecalciferol, has been shown to reduce the risk of hip fractures and nonvertebral fractures when combined with calcium intake of at least 500 mg/day. Several meta-analyses found the greatest benefits in individuals with vitamin D levels <50 nmol/L or calcium intake <700 mg/day. While vitamin D alone showed no significant fracture reduction, supplementation that achieved 25(OH)D levels >75 nmol/L or included additional calcium intake was more effective in preventing fractures.
Raccomandazioni della iof (international osteoporosis foundation) sull’impieg...Merqurio
This position paper from the International Osteoporosis Foundation makes recommendations for vitamin D intake in older adults. Based on randomized controlled trials, daily vitamin D intake of 20-25 μg (800-1000 IU) is estimated to achieve a target serum 25OHD level of 75 nmol/L (30 ng/ml), which is associated with reduced risk of falls and fractures. Higher daily intakes may be needed for those with risk factors like obesity, limited sun exposure, or malabsorption. Doses above 20 μg/day have not been thoroughly evaluated, so higher intakes cannot be generally recommended at this time.
Vitamin D deficiency and nutritional management of patients within FLS_Slidek...dinaismail27
This document summarizes a presentation on vitamin D and nutritional management of patients in fracture liaison services. It discusses:
- The high prevalence of vitamin D deficiency and insufficiency in Qatar and other regional countries.
- Recommendations that vitamin D levels below 30 ng/ml are insufficient for fracture prevention and muscle function. Supplementation with calcium and vitamin D can reduce fracture risk.
- The importance of adequate protein intake of 0.8-1.3 g/kg daily for older adults to prevent sarcopenia and fractures. Malnutrition in hospitals can increase risks of poor outcomes.
- Fracture liaison services provide an opportunity to address secondary fracture prevention through vitamin D and nutritional
Vitamin D has important roles in bone health, immune function, cell growth and many other physiological processes. It is produced in the skin upon exposure to sunlight, but can also be obtained through dietary sources. Deficiency is associated with increased risk of various diseases such as cancer, cardiovascular disease, diabetes and autoimmune disorders. Maintaining sufficient vitamin D levels through sunlight exposure and/or supplementation may provide protective health benefits.
This document summarizes guidelines for managing vitamin D deficiency and osteoporosis. It discusses vitamin D metabolism and functions, manifestations of deficiency, relationships between vitamin D and bone and cardiovascular health, risk groups for deficiency in the UK, recommended thresholds and dosing strategies for treatment, and recommendations regarding supplements for pregnant/breastfeeding women. It also notes that high calcium doses are not needed to treat vitamin D deficiency alone, and that licensed preparations should be used where possible.
This document discusses the management of vitamin D deficiency and osteoporosis. It provides an overview of calcium homeostasis and vitamin D metabolism. It describes the manifestations and symptoms of vitamin D deficiency as well as its relationships to musculoskeletal health, fractures, cardiovascular risk, and hospital length of stay. It discusses the high prevalence of vitamin D insufficiency in the UK population and identifies at-risk groups. It recommends thresholds and dosing strategies for vitamin D treatment and supplements. Specifically for pregnancy and lactation, it recommends all women take a daily 10mcg vitamin D supplement. Overall, the document provides guidance to healthcare professionals on screening, diagnosing, and treating vitamin D deficiency.
—Chronic patients of spinal cord injury has been detected severe reduction of bone density. Patients with SCI show mostly osteopenia or osteoporosis of the hip and spine. Vitamin D deficiency may contribute to development of osteoporosis in SCI. So a study was conducted on 100 chronic SCI patients to find out status of correlation of Vitamine D and bone mineral density (BMD). Blood samples were collected and investigated routine biochemistry with serum 25(OH)D. DXA scan of hip and spine was also done. This study observed that 55% patients had suboptimal vitamin D. Positive correlation was found between vitamin D & bone mineral density. It is concluded from this study that monitoring of Serum 25(OH)D levels and annual surveillance of bone mineral density is crucial among persons with chronic SCI to reduce progression of osteoporosis and minimize the risk for further fractures. Keywords: 25(OH)D: 25 Hydroxy Vitamin D, DXA: Dual Energy X-Ray Absorptiometry, BMD: Bone Mineral Density.
This document provides recommendations and guidelines regarding vitamin D. It discusses the forms and dietary sources of vitamin D, causes and epidemiology of vitamin D deficiency worldwide and in Saudi Arabia. It covers approaches to evaluating and diagnosing vitamin D deficiency, including which patient populations to screen. Treatment guidelines are presented for vitamin D supplementation based on age. Research associations between vitamin D and cancer, cardiovascular outcomes, and osteoporosis are summarized. Recommendations are also provided regarding vitamin D in pediatrics, pregnancy, older adults, and sun exposure.
A 68-year-old woman is concerned about falling and fracturing bones after a friend's injury and asks if vitamin D supplements could help. A review of 4 randomized controlled trials found no evidence that vitamin D reduces fall-related fractures in older adults, and one study found it increased falls. The woman would not likely benefit from vitamin D for fracture prevention based on current evidence.
This trial aimed to evaluate the efficacy and safety of vitamin D supplementation on the residual moderate and deep pockets following nonsurgical periodontal therapy.
Vitamin D deficiency is of concern now a days, it has important role in skeletal and non skeletal functions of the body. Good sunlight exposure, consumption of vitamin D rich foods, chemotherapy with vitamin D and supplements of vitamin D has shown positive effect on various non skeletal diseases like cancer, diabetes, diarrhoea, tuberculosis etc. Although Indians are blessed with ample sunlight, still 70 to 100% population is suffering from the vitamin D deficiency. Vitamin D deficiency is likely to play an important role in the very high prevalence of rickets, osteoporosis, cardiovascular diseases, diabetes, cancer and infections such as tuberculosis in India. Fortification of staple foods with vitamin D is the most viable population based strategy to achieve vitamin D sufficiency. Unfortunately, even in advanced countries like USA and Canada, food fortification strategies with vitamin D have been only partially effective and have largely failed to attain vitamin D sufficiency
This document discusses vitamin D, including its role, metabolism, clinical assessment, and relevance to various diseases. It covers how vitamin D is obtained from skin exposure to sunlight and diet, converted to its active form in the liver and kidneys, and acts through vitamin D receptors. Deficiency can cause bone diseases like rickets and osteomalacia or muscle weakness. Low vitamin D may also exacerbate autoimmune diseases and increase cancer and infection risks. Testing for vitamin D levels is important and supplementation can help treat deficiency. Further research is still needed on vitamin D's complex anti-inflammatory and immunoregulatory functions.
Vitamin D plays an important role in regulating calcium levels and bone health. It is also involved in insulin regulation and may protect against cancer, cardiovascular disease, and infections. Vitamin D deficiency can lead to rickets in children and osteomalacia in adults as well as increased risk of falls in older adults. Supplementation is recommended for those with inadequate sunlight exposure or dietary intake, with dosage depending on age.
Vitamin D deficiency is widespread in both the pediatric and adult chronic kidney disease CKD population. CKD is characterized by dysregulation of vitamin D and mineral metabolism. Secondary hyperparathyroidism and its management puts patients with CKD at increased cardiovascular risk. Emergence of experimental and some clinical data suggesting beneficial effects of vitamin D on proteinuria, blood pressure, inflammation and cardiovascular outcomes has pushed it to the center stage of CKD research. Pediatric data on vitamin D dysregulation and its consequences are still in its infancy. Ongoing prospective studies such as Chronic Kidney disease in Children CKiD and the Cardiovascular Comorbidity in Children with CKD 4 C should help to delineate the evolution of disturbances in mineral metabolism and its adverse effects on growth, CKD progression and cardiovascular outcomes. Dr. Prafull Dawale | Neha Jain "Vitamin D in Chronic Kidney Disease" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-5 , August 2019, URL: https://www.ijtsrd.com/papers/ijtsrd26778.pdfPaper URL: https://www.ijtsrd.com/medicine/other/26778/vitamin-d-in-chronic-kidney-disease/dr-prafull-dawale
Vitamin D plays an important role in many body systems beyond bone health. The document discusses Vitamin D's role in cardiovascular health and diabetes mellitus. It summarizes that Vitamin D deficiency is associated with hypertension possibly through effects on the renin-angiotensin system and vascular endothelium. Deficiency is also linked to insulin resistance and type 2 diabetes, likely through direct and indirect molecular mechanisms involving pancreatic beta cell function, insulin signaling, and calcium regulation. Studies show high rates of Vitamin D deficiency in patients with diabetes and hypertension. Oral supplementation improves related outcomes such as vascular function and oxidative stress.
This document discusses vitamin D and pain. It provides information on vitamin D metabolism and transformation to its active form. It discusses vitamin D's mechanism of actions, roles in epigenetics, immunomodulation, and relationship to conditions like pain, cardiovascular risk factors, depression, asthma control, testosterone levels, and mortality in the elderly. The document also addresses vitamin D deficiency, testing and interpretation of vitamin D levels, recommended intake, risk factors for deficiency, and treatment of deficiencies. Safety of vitamin D supplementation is discussed. The summary concludes by noting some natural substances like curcumin that have synergistic anti-inflammatory activity with vitamin D.
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IWO Meeting 16 November 2022 - ASBMR young talent: Silvia Storoni (Amsterdam): Prevalence and Hospital Admissions in Patients With Osteogenesis Imperfecta in The Netherlands: A Nationwide Registry Study
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1. Vitamine D: effecten op bot,
spieren en op niet-
musculoskeletale aandoeningen
Paul Lips
Endocrinologie/Interne Geneeskunde
VU Medisch Centrum
Amsterdam
Prof.Lips
3. Heilzaam effect van ultraviolet licht
Tuberculose huisje
UV licht voor rachitis
Prof.Lips
4. Vitamine D en kwaliteit van leven
Rafiq R et al J Clin Endocrinol Metab 2014; 99:3136-43
Longitudinal Aging Study
Amsterdam n= 862
Instrument SF-12
Mediators: physical
performance,
depressive symptoms,
chronic diseases
Prof.Lips
5. Significance of the clinical problem
• Vitamin D deficiency is very common in risk groups:
children, adolescents, older persons (institution),
pregnant women, immigrants
• Deficiency: 25-hydroxyvitamin D < 30 nmol/l
• Optimal: 25(OH)D > 50 nmol/l (Institute of Medicine)
25(OH)D > 75 nmol/l (Endocrine Society)
• Variation in 25(OH)D measurement
• Extraskeletal effects of vitamin D?
Prof.Lips
6. Vitamine D
• Meting van 25-hydroxyvitamine D
• Vitamine D en bot
• Effecten buiten het skelet
• Aanbevelingen
Prof.Lips
7. 25(OH)D assay variations (DEQAS) and
impact on clinical decision making
Barake M et al J Clin Endocrinol Metab 2012; 97: 835-843
Prof.Lips
8. 25(OH)D assay variations and impact on
clinical decision making
Classification IDS Diasorin
25(OH)D
• < 25 nmol/l 6 % 17 %
• 25-50 nmol/l 29 % 34 %
• >50 nmol/l 65 % 49 %
Needing treatment: 35 % 51 %
(< 50 nmol/l = 20 ng/ml)
Barake M et al J Clin Endocrinol Metab 2012; 97: 835-843
Prof.Lips
9. Storende factoren
• Vitamine D bindend eiwit (DBP) beinvloedt
totale serum 25(OH)D (zwangerschap, ziekte)
• Genetische varianten van DBP
• 24,25(OH)2D kan kruisreageren, leidt tot
overschatting van 25(OH)D
Prof.Lips
10. Variation in 25(OH)D assays
Quality control
• International Vitamin D External Quality
Assessment Scheme (DEQAS); comparison to
mean value (>900 labs participate)
• Vitamin D Metabolites Quality Assurance
Program (NIH, NIST), standard sera to improve
accuracy
• Vitamin D Standardization Program (VDSP);
standardization of assays, surveys, research
Prof.Lips
11. Seasonal variation of
serum 25(OH)D in the
Longitudinal Aging Study
Amsterdam
Younger cohort 55-65 yr
Mean variation 22 nmol/l
Older cohort 65-88 yr
Mean variation 14 nmol/l
Van Schoor N et al
Osteoporos Int 2014
Prof.Lips
12. Vitamin D and bone cells
• 25(OH)D and 1,25(OH)2D reduce proliferation of
human osteoblasts and enhance differentiation,
increase alk phosphatase and osteocalcin
expression. Van der Meijden et al PLOS One 2014;9:e110283
• VDR overexpression in osteoblasts and osteocytes
prevents bone loss during vitamin D deficiency
Lam et al J Steroid Biochem Mol Biol 2014; 144: 128-31
• Osteoblast cell line culture with 25(OH)D leads to
increase of 1,25(OH)2D in medium and enhanced
osteoblast and osteocyte maturation
Turner et al J Steroid Biochem Mol Biol 2014; 144: 114-18
Prof.Lips
13. Results: increase at the femoral neck 0.8%, 95% CI 0.2-1.4 with
heterogeneity among trials
Reid et al Lancet 2014; 383: 146-55
Effects of vitamin D supplements on bone mineral
density: a systematic review and meta-analysis.
Inclusion : 23 studies (mean duration 23·5 months, comprising
4082 participants)
Baseline serum 25-hydroxyvitamin D concentration < 50
nmol/L in eight studies
Conclusion: Widespread use of vitamin D for osteoporosis
prevention in community-dwelling adults without specific risk
factors for vitamin D deficiency seems to be inappropriate.
Prof.Lips
15. The effect of vitamin D ± calcium on
fracture incidence: trials and meta-analyses
• Randomized controlled clinical trials n=19
5 showed decrease of fracture incidence
1 borderline decrease
1 decrease in per protocol analysis (WHI)
10 trials no effect
2 trials increase of fracture incidence (1 dose/yr)
• Meta-analyses, trial level, individual patient data n=15
Bischoff-Ferrari 2005, Boonen 2007, Jackson 2007, Tang 2007,
Cranney 2007, Reid 2008, Chung 2009, Avenell 2009, Bischoff-
Ferrari 2009, Dipart Group 2010, Bergman 2010, Lai 2010,
Chung 2011, Bischoff-Ferrari 2012, Bolland 2014
Prof.Lips
16. Annual high-dose (500 000 IU vs placebo) oral vitamin D
and falls and fractures in 2256 women >70 yrs
Sanders K et al JAMA 2010; 303: 1815-22
Prof.Lips
17. Conclusions from meta-analyses on vitamin D
and fracture prevention
Vitamin D is more effective:
• In the institutionalized than in community–living
elderly
• With a dose ≥ 800 IU/d than with < 800 IU/d
• In 80+ and 70-80 year persons than in 60-70
years.
• When compliance > 80 % than with lower
compliance.
• When combined with calcium
Tang et al Lancet 2007; 370: 657-66
Bischoff-Ferrari et al N Engl J Med 2012; 367: 40-49
Bolland et al Lancet diabetes-endocrinology 2014
Prof.Lips
18. Conclusions from meta-analyses on vitamin D
and fracture prevention (2)
• Effect on fracture prevention less than 15 % in
community dwelling elderly
• Studies are heterogeneous
• Studies have often been performed in non-
deficient persons.
• A high dose once per year has a negative effect on
fall and fracture incidence.
Tang et al Lancet 2007; 370: 657-66
Bischoff-Ferrari et al N Engl J Med 2012; 367: 40-49
Bolland et al Lancet diabetes-endocrinology 2014
Prof.Lips
19. VDR -/- mouse
• Alopecia
• Decreased longitudinal
growth, rickets
• Altered immunity
• Hypertension and
cardiac hypertrophy
• Prone to chemically
induced cancer
• Changed grooming
behaviour
Bouillon et al Endocr Rev 2008; 29: 726-76
Prof.Lips
20. Effecten buiten het skelet: Update
• Vitamine D, spierkracht en vallen
• Vitamine D en luchtweginfecties/COPD exacerbaties
• Vitamine D en bloeddruk, cardiovasculaire
uitkomsten
• Vitamine D en diabetes
• Buiten beschouwing: multiple sclerose, depressie,
kanker
Prof.Lips
22. Exercise and vitamin D for fall prevention among
older women
Uusi-Rasi K et al JAMA Intern Med 2015; 175: 703-11
Clinical trial with factorial design
409 women 70-80 yr
- Placebo without exercise
- Vitamin D3 800 IU/d
- Placebo and exercise
- Vitamin D3 and exercise
Hazard ratios for injured fallers
were lower in exercise groups.
Vitamin D did not enhance exercise
effects on physical functioning.
Prof.Lips
23. Vitamin D dose and fall prevention: a
randomized controlled clinical trial
• Ref D: 24000 IU/month (800 IU/d),
• High D: 60000 IU/month (2000 IU/d)
• Combined D: 24000 IU/month + calcidiol 300 ug/month
• Lower extremity strength: no difference between groups
• 275 falls: 141 in first 6 and 134 in second 6 months
• 24000 IU: lowest n of falls and % of fallers
• Lower replete range 50-75 nmol/l (median 67) optimal
• Conclusion: Ref D (lower dose) is optimal!!
Bischoff-Ferrari H Vitamin D Workshop Delft 2015
Prof.Lips
24. Vitamin D and peak expiratory flow in 454 men from the
Longitudinal Aging Study Amsterdam
Van Schoor et al J Clin Endocrinol Metab 2012; 97:2164-71
Multivariate
longitudinal
association between
serum 25(OH)D and
PEF in men
25(OH)D
PEF
Prof.Lips
25. Vitamin D for the prevention of acute
respiratory infection in older adults (ViDiFlu):
increased risk for upper resp infection
Martineau et al Thorax 2015, june 10 10.1136
2.4 mg (96,000 IU) once per 2 month for 1 year
Prof.Lips
26. Vitamin D vs placebo in 250 adults with asthma
(ViDiAs); 120,000 IU per 2 months
Martineau et al Thorax 2015; 70: 451-7
Prof.Lips
27. Vitamin D vs placebo in patients with COPD (ViDiCo)
Martineau et al Lancet Resp Med 2015; 3: 120-30
240 patients with COPD
Randomized to:
- Vitamin D3 120,000 IU/2 months
- Placebo
Study duration 1 year
Outcomes:
- First exacerbation
- First upper respiratory infection
Subgroup analysis in patients
with
Serum 25(OH)D < 50 nmol/l
vs > 50 nmol/l
< 50
> 50
Prof.Lips
28. Systematic review: vitamin D and
cardiometabolic outcomes
• Significant associations between
vitamin D status and diabetes risk,
incident hypertension, and incident
cardiovascular disease.
• In randomized trials with vitamin D,
effects on glycemia,blood pressure
(see figure) and cardiovascular
outcomes were not significant.
• Pittas AG et al Ann Intern Med 2010;
152: 307-314
Prof.Lips
29. Vitamin D supplementation and systolic blood pressure:
individual patient data meta-analysis
Beveridge LA JAMA Intern Med 2015; 175: 745-54
Prof.Lips
30. Effect of vitamin D and calcium on pancreatic β-cell
function, and insulin sensitivity
Mitri J et al Am J Clin Nutr 2011; 94: 486-94
Vitamin D3 2000 IU/d vs placebo for 16 weeks in 92 adults with high risk.
Disposition index: insulin secretion x insulin sensitivity
Prof.Lips
31. Effects of calcium and vitamin D suplementation on
metabolic profiles in vitamin D insufficient people with
type 2 diabetes: a randomized controlled trial
• 118 patients with type 2 diabetes, serum 25(OH)D < 75 nmol/l,
factorial design, 8 weeks
Vitamin D 50,000 IU/wk + calcium plac
Vitamin D plac + calcium 1000 mg/d
Vitamin D 50,000 IU/wk + calcium 1000 mg/d
Vitamin D plac + calcium plac
Tabesh M et al Diabetologia 2014; 57: 2038-47
Prof.Lips
32. 120 overweight
subjects with
prediabetes
25(OH)D< 50 nmol/l
Vitamin D3 1200 IU/d
vs placebo
Posthoc: when
25(OH)D > 60 nmol/l
insulinogenic index
Effect of vitamin D supplementation on insulin sensitivity
in vitamin D–deficient non-Western immigrants in the
Netherlands: a randomized placebo-controlled trial
Oosterwerff et al Am J Clin Nutr 2014; 100:152-60
Prof.Lips
33. Effect of vitamin D supplementation on glycemic
control in 275 patients with Type 2Diabetes (SUNNY
Trial): A randomized placebo-controlled trial
Krul-Poel et al. Diabetes Care 2015;38:1420
Prof.Lips
34. Conclusie vitamine D en diabetes
• Een aantal gerandomiseerde trials laat enig effect
zien van vitamine D3 op insuline afgifte en
resistentie.
• De effecten zijn vooral zichtbaar bij patienten met
vitamine D deficientie.
• De effecten zijn gering bij een groep die al zonder
meer voor vitamine D in aanmerking komt.
• Klinisch van belang?
Prof.Lips
35. Megatrials with multiple outcomes,
currently going on
Consortium number dose outcome
ViDA 5110 100,000IU/m fract, CVD, ARI
VITAL 28,875 2000 IU/d cancer, CVD
TIPS-3 5,500 60,000 IU/m CVD, fract, cancer
FIND 18,000 3200 vs 1600 vs P CVD, cancer
DO-HEALTH 2,152 2000 IU/om-3/exerc fract,BP,infect/decl
D-Health 25,000 60,000 IU/m CVD, DM, cancer
VIDI-Kids 6,750 60,000 IU/m tuberculosis
Results are expected between 2016 and 2020
Investigators: R Scrag, JE Manson, S Yusuf, TP Tuomainen, H Bischoff-Ferrari,
R Neale, A Martineau,
Prof.Lips
36. Cod liver oil for the prevention of rickets
Prof.Lips
37. RDA, upper limit of intake (UL) according to the Institute of
Medicine and requirement and UL according to the
Endocrine Society.
Inst of Med Endocrine Soc
Age RDA UL Requirement UL
Children 1-8 yr 600 2500 600-1000 4000
Children 9-18 yr 600 4000 600-1000 4000
Adults 19-70 yr 600 4000 1500-2000 10,000
Adults > 70 yr 800 4000 1500-2000 10,000
Pregnancy 600 4000 1500-2000 10,000
Lactation 600 4000 1500-2000 10,000
Prof.Lips
38. Gezondheidsraad 2012: aanbevelingen
• Dagelijks 10 g (400 IU) extra voor:
- kinderen t/m 4 jaar
- vrouwen 4-50 jaar, mannen 4-70 jaar met donkere huid
en weinig zonblootstelling.
- gesluierde vrouwen tot 50 jaar
- zwangeren, borstvoeding
- vrouwen 50-70 jaar
• Dagelijks 20 g (800 IU) extra voor:
- alle ouderen vanaf 70 jaar
Gezondheidsraad 2012; publicatie 2012/15
Prof.Lips
39. Effect of vitamin D3 400 or 800 IU/day vs control on
serum 25(OH)D and PTH in institutionalized elderly
800
400
cont
cont
Lips et al J Clin Endocrinol Metab 1988
400
800
• Randomized clinical trial
• Serum 25(OH)D by HPLC
and CPB.
• No non-responders
• Non-linear increase
Prof.Lips
40. Dose response to vitamin D supplementation
in postmenopausal women
Gallagher JC et al Ann Intern Med 2012; 156: 425-37
Prof.Lips
41. A reverse J-shaped associaton of all-cause mortality with
serum 25-hydroxyvitamin D in 247,574 subjects from
general practices
Durup et al J Clin Endocrinol Metab 2012; Epub
Prof.Lips
43. Overdosering vitamine D
• Diermodellen: FGF23 -/- muis heeft hoge spiegels van
1,25(OH)2D, hoog Ca en PO4, botresorptie,
vaatverkalking en vervroegde veroudering.
• Cohortonderzoek en klinische trials wijzen op een U-
vormig verband: te veel vitamine D leidt tot meer
vallen en fracturen, en mogelijk hogere mortaliteit.
Prof.Lips
44. Conclusies
• De optimale 25-hydroxyvitamine D-spiegel voor
botstofwisseling en spierfunctie is 50 tot 80 nmol/l.
• De nauwkeurigheid van 25(OH)D bepalingen is nog
steeds onvoldoende. Internationale programma’s
zoals DEQAS en VDSP brengen hierin verbetering.
• Vitamine D en calcium supplementen kunnen ca 15
% van de heup- en niet-wervelfracturen voorkomen
bij ouderen in instellingen.
• Vitamine D kan mogelijk vallen voorkomen.
Prof.Lips
45. Conclusies (2)
• Vitamine D heeft mogelijk een preventief effect op
luchtweginfecties/exacerbaties bij COPD.
• Vitamine D heeft mogelijk een gering effect op
insuline afgifte en gevoeligheid.
• Met een dosis vitamine D3 1 dd 800 IE is de 25(OH)D
spiegel bij 95 % van de behandelden boven 50
nmol/l.
• Het verband tussen dosis en effect is voor vitamine D
waarschijnlijk U-vormig. Er is een optimum en
daarboven een negatief effect.
Prof.Lips