دورية أكاديمية
Vitamin D for the Prevention of Disease: An Endocrine Society Clinical Practice Guideline.
| العنوان: | Vitamin D for the Prevention of Disease: An Endocrine Society Clinical Practice Guideline. |
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| المؤلفون: | Demay MB; Department of Medicine, Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA., Pittas AG; Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Tufts Medical Center, Boston, MA 02111, USA., Bikle DD; Departments of Medicine and Dermatology, University of California San Francisco, San Francisco VA Medical Center, San Francisco, CA 94158, USA., Diab DL; Department of Internal Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Cincinnati, Cincinnati, OH 45267, USA., Kiely ME; Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences and INFANT Research Centre, University College Cork, Cork, T12 Y337, Ireland., Lazaretti-Castro M; Department of Internal Medicine, Division of Endocrinology, Universidade Federal de Sao Paulo, Sao Paulo 04220-00, Brazil., Lips P; Endocrine Section, Amsterdam University Medical Center, Internal Medicine, 1007 MB Amsterdam, Netherlands., Mitchell DM; Pediatric Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA., Murad MH; Evidence-Based Practice Center, Mayo Clinic, Rochester, MN 55905, USA., Powers S; Bone Health and Osteoporosis Foundation, Los Gatos, CA 95032, USA., Rao SD; Division of Endocrinology, Diabetes and Bone & Mineral Disorders, Henry Ford Health, Detroit, MI 48202, USA.; College of Human Medicine, Michigan State University, Lansing, MI 48824, USA., Scragg R; School of Population Health, The University of Auckland, Auckland 1142, New Zealand., Tayek JA; Department of Internal Medicine, Harbor-UCLA Medical Center, Torrance, CA 90509, USA.; The Lundquist Institute, Torrance, CA 90502, USA., Valent AM; Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, OR 97239, USA., Walsh JME; Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA 94143, USA., McCartney CR; Department of Medicine, University of Virginia, Charlottesville, VA 22908, USA.; Department of Medicine, West Virginia University, Morgantown, WV 26506, USA. |
| المصدر: | The Journal of clinical endocrinology and metabolism [J Clin Endocrinol Metab] 2024 Jul 12; Vol. 109 (8), pp. 1907-1947. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press Country of Publication: United States NLM ID: 0375362 Publication Model: Print Cited Medium: Internet ISSN: 1945-7197 (Electronic) Linking ISSN: 0021972X NLM ISO Abbreviation: J Clin Endocrinol Metab Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2017- : New York : Oxford University Press Original Publication: Springfield, Ill. : Charles C. Thomas |
| مستخلص: | Background: Numerous studies demonstrate associations between serum concentrations of 25-hydroxyvitamin D (25[OH]D) and a variety of common disorders, including musculoskeletal, metabolic, cardiovascular, malignant, autoimmune, and infectious diseases. Although a causal link between serum 25(OH)D concentrations and many disorders has not been clearly established, these associations have led to widespread supplementation with vitamin D and increased laboratory testing for 25(OH)D in the general population. The benefit-risk ratio of this increase in vitamin D use is not clear, and the optimal vitamin D intake and the role of testing for 25(OH)D for disease prevention remain uncertain. Objective: To develop clinical guidelines for the use of vitamin D (cholecalciferol [vitamin D3] or ergocalciferol [vitamin D2]) to lower the risk of disease in individuals without established indications for vitamin D treatment or 25(OH)D testing. Methods: A multidisciplinary panel of clinical experts, along with experts in guideline methodology and systematic literature review, identified and prioritized 14 clinically relevant questions related to the use of vitamin D and 25(OH)D testing to lower the risk of disease. The panel prioritized randomized placebo-controlled trials in general populations (without an established indication for vitamin D treatment or 25[OH]D testing), evaluating the effects of empiric vitamin D administration throughout the lifespan, as well as in select conditions (pregnancy and prediabetes). The panel defined "empiric supplementation" as vitamin D intake that (a) exceeds the Dietary Reference Intakes (DRI) and (b) is implemented without testing for 25(OH)D. Systematic reviews queried electronic databases for publications related to these 14 clinical questions. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology was used to assess the certainty of evidence and guide recommendations. The approach incorporated perspectives from a patient representative and considered patient values, costs and resources required, acceptability and feasibility, and impact on health equity of the proposed recommendations. The process to develop this clinical guideline did not use a risk assessment framework and was not designed to replace current DRI for vitamin D. Results: The panel suggests empiric vitamin D supplementation for children and adolescents aged 1 to 18 years to prevent nutritional rickets and because of its potential to lower the risk of respiratory tract infections; for those aged 75 years and older because of its potential to lower the risk of mortality; for those who are pregnant because of its potential to lower the risk of preeclampsia, intra-uterine mortality, preterm birth, small-for-gestational-age birth, and neonatal mortality; and for those with high-risk prediabetes because of its potential to reduce progression to diabetes. Because the vitamin D doses in the included clinical trials varied considerably and many trial participants were allowed to continue their own vitamin D-containing supplements, the optimal doses for empiric vitamin D supplementation remain unclear for the populations considered. For nonpregnant people older than 50 years for whom vitamin D is indicated, the panel suggests supplementation via daily administration of vitamin D, rather than intermittent use of high doses. The panel suggests against empiric vitamin D supplementation above the current DRI to lower the risk of disease in healthy adults younger than 75 years. No clinical trial evidence was found to support routine screening for 25(OH)D in the general population, nor in those with obesity or dark complexion, and there was no clear evidence defining the optimal target level of 25(OH)D required for disease prevention in the populations considered; thus, the panel suggests against routine 25(OH)D testing in all populations considered. The panel judged that, in most situations, empiric vitamin D supplementation is inexpensive, feasible, acceptable to both healthy individuals and health care professionals, and has no negative effect on health equity. Conclusion: The panel suggests empiric vitamin D for those aged 1 to 18 years and adults over 75 years of age, those who are pregnant, and those with high-risk prediabetes. Due to the scarcity of natural food sources rich in vitamin D, empiric supplementation can be achieved through a combination of fortified foods and supplements that contain vitamin D. Based on the absence of supportive clinical trial evidence, the panel suggests against routine 25(OH)D testing in the absence of established indications. These recommendations are not meant to replace the current DRIs for vitamin D, nor do they apply to people with established indications for vitamin D treatment or 25(OH)D testing. Further research is needed to determine optimal 25(OH)D levels for specific health benefits. (© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com. See the journal About page for additional terms.) |
| معلومات مُعتمدة: | The Endocrine Society |
| فهرسة مساهمة: | Keywords: 25-hydroxyvitamin D; clinical practice guidelines; infection; mortality; prediabetes; pregnancy; systematic reviews; vitamin D; vitamin D deficiency |
| تواريخ الأحداث: | Date Created: 20240603 Latest Revision: 20240712 |
| رمز التحديث: | 20240712 |
| DOI: | 10.1210/clinem/dgae290 |
| PMID: | 38828931 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1945-7197 |
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| DOI: | 10.1210/clinem/dgae290 |