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Osteomalazili hastalarda vitamin D tedavisine verilen cevabın değerlendirilmesi

Yıl 2022, Cilt: 7 Sayı: 5, 124 - 131, 30.12.2022

Selin Genç , Omer Genc Fatih Kılıçlı

https://doi.org/10.22391/fppc.1127577

Öz

Giriş: Bu çalışmada Türkiye’nin bir Orta Anadolu kentinde yaşayan, osteomalazi tanısı alan hastalarda 25 hidroksivitamin D [25(OH)D] düzeylerinin demografik, klinik ve laboratuvar parametreleriyle olan ilişkisi ve tedaviye yanıtının incelenmesi amaçlandı.

Yöntem: Karasal iklimdeki şehirde, 25(OH)D <30 ng/ml, > 18 yaşından büyük olan 533 hasta prospektif olarak dahil edildi. Hastaların yaşı, vücut kitle indeksi (VKİ), giyim şekli, tanı aldığı mevsim, tedavi şekli ve süresi kaydedildi. Hastalar tanı anında, 1., 2. ve 4. aylarda klinik ve laboratuvar parametreleri ile değerlendirildi.

Bulgular: Tanı anında ortalama serum 25(OH)D 7,59±4,41 ng/mL idi. Hastaların %74’ünde ciddi eksiklik (<10), %24,2’sinde eksiklik (<20), %1,3’ünde yetersizlik (20-29,99) olup tedavi sonrası 25(OH)D: 24,42±14,77 ng/ml idi. Kadınların %74,4’ü kapalı giyim tarzına sahipti. Tanı sırasında ve tedavi sonunda Vitamin D düzeyleri, BKİ ve tanı mevsimine göre farklılık göstermedi (p>0,05). Ancak VKİ arttıkça tedaviye verilen cevabın azaldığı bulundu.

Sonuç: Bu çalışma, bölgemizde vitamin D eksikliğinin yaygın olarak görüldüğünü ortaya koymuştur. Bulgularımız D vitamini düzeyini yeterli seviyeye çıkarmak için coğrafik ve etnik yapıların da göz önünde bulundurularak, normal serum 25(OH)D düzeyine ulaşıncaya kadar tedavi ve takibe devam edilmesi gerektiğini göstermektedir.

Anahtar Kelimeler: 25-hidroksivitamin D; osteomalazi, vitamin D yetersizliği

Anahtar Kelimeler

25-hidroksivitamin D osteomalazi vitamin D yetersizliği

Kaynakça

  • 1. Saponaro F, Saba A, Zucchi R. An update on vitamin d metabolism. Int J Mol Sci 2020;21(18):6573.https://doi.org/10.3390/ijms21186573
  • 2. Chun RF, Shieh A, Gottlieb C, Yacoubian V, Wang J, Hewison M, et al. Vitamin D binding protein and the biological activity of vitamin D. Front Endocrinol (Lausanne) 2019;10:718. https://doi.org/10.3389/fendo.2019.00718
  • 3. Silva MC, Furlanetto TW. Intestinal absorption of vitamin D: a systematic review. Nutr Rev 2018;76(1):60-76. https://doi.org/10.1093/nutrit/nux034
  • 4. Uday S, Högler W. Nutritional rickets & osteomalacia: A practical approach to management. Indian J Med Res 2020;152(4):356-67. https://doi.org/10.4103/ijmr.ijmr_1961_19
  • 5. Onalan E, Yakar B. The effect of vitamin D level on body composition and metabolic parameters in adults with different body mass index. Med Sci 2020;9(2):370-5. http://doi.org/10.5455/medscience.2019.08.9198
  • 6. Awal W, Bindra R, Price N, Sadler A, Robinson A, Hymer I, Chen J. Vitamin D deficiency in proximal femur fracture patients of South-East Queensland. Australas J Ageing. 2020;39(3):271-7. https://doi.org/10.1111/ajag.12791
  • 7. Goktaş O, Ersoy C, Ercan I, Can FE. Vitamin D status in the adult population of Bursa-Turkey. Eur J Gen Pract. 2020;26(1):156-2. https://doi.org/10.1080/13814788.2020.1846712
  • 8. Solak I, Cihan FG, Mercan S, Kethuda T, Eryilmaz MA. Evaluation of 25-Hydroxyvitamin D Levels in Central Anatolia, Turkey. Biomed Res Int 2018;2018:4076548. https://doi.org/10.1155/2018/4076548
  • 9. Alpdemir M, Alpdemir MF. Vitamin D deficiency status in Turkey: A meta-analysis. Int J Med Biochem 2019;2(3):118-31. https://dx.doi.org/10.14744/ijmb.2019.04127
  • 10. Yakar B, Kaya MO. Vitamin D deficiency during pregnancy in Turkey and the effect of the sunlight: a systematic review and meta-analysis. Turk J Biochemistry 2021;46(2):129-35. https://doi.org/10.1515/tjb-2020-0059
  • 11. Vieth R. Vitamin D supplementation: cholecalciferol, calcifediol, and calcitriol. Eur J Clin Nutr 2020;74(11):1493-7. https://doi.org/10.1038/s41430-020-0697-1
  • 12. Rastad H, Mahdavi Gorabi A, Qorbani M, Seif E, Asayesh H, Motlagh ME, Heshmat R, Kelishadi R. Prevalence and determinants of vitamin D deficiency in Iranian children and adolescents: the CASPIAN-V study. J Diabetes Metab Disord 2021;20(1):383-9. https://doi.org/10.1007/s40200-021-00757-8
  • 13. Neale RE, Khan SR, Lucas RM, Waterhouse M, Whiteman DC, Olsen CM. The effect of sunscreen on vitamin D: a review. Br J Dermatol 2019;181(5):907-15. https://doi.org/10.1111/bjd.17980
  • 14. Walter Siegenthaler. Differential diagnosis in internal medicine from symptom to diagnosis. Germany; Thieme, 2007:371-6
  • 15. Mark LS, Simon S, Valerie ES. Vitamin D. Aust Fam Physician. 2008;37:1002-5.
  • 16. Yeşiltepe-Mutlu G, Aksu ED, Bereket A, Hatun S. Vitamin D Status Across Age Groups in Turkey: Results of 108,742 samples from a single laboratory. J Clin Res Pediatr Endocrinol 2020;12(3):248-55. https://doi.org/10.4274%2Fjcrpe.galenos.2019.2019.0097
  • 17. Sezgin G, Ozturk G, Turkal R, Caykara B. Vitamin D levels of outpatients admitted to a university hospital in the Marmara region of Turkey Over 3 Years. J Med Biochem. 2019;38(2):181-7. https://doi.org/10.2478%2Fjomb-2018-0027
  • 18. Roth DE, Abrams SA, Aloia J, Bergeron G, Bourassa MW, Brown KH, et al. Global prevalence and disease burden of vitamin D deficiency: a roadmap for action in low- and middle-income countries. Ann N Y Acad Sci. 2018;1430(1):44-79. https://doi.org/10.1111/nyas.13968
  • 19. Thomas MK, Lloyd-Jones DM, Thadhani RI, Shaw AC, Deraska DJ, Kitch BT, et al. Hypovitaminosis D in medical in patients. N Engl J Med. 1998;338:777-83. https://doi.org/10.1056/nejm199803193381201
  • 20. Heath DA, Shaw NJ. Calcium and bone metabolism. In:Brook CGD, Hindmarsch PC, editors. Clinical Pediatreic Endocrinology Oxford: Blackwell science Press; 2001;377-89.
  • 21. Kechichian E, Ezzedine K. Vitamin D and the skin: an update for dermatologists. Am J Clin Dermatol. 2018;19(2):223-35. https://doi.org/10.1007/s40257-017-0323-8
  • 22. Pludowski P, Holick MF, Grant WB, Konstantynowicz J, Mascarenhas MR, Haq A, et al. Vitamin D supplementation guidelines. J Steroid Biochem Mol Biol 2018;175:125-35. https://doi.org/10.1016/j.jsbmb.2017.01.021
  • 23. Bouillon R, Antonio L. Nutritional rickets: Historic overview and plan for worldwide eradication. J Steroid Biochem Mol Biol 2020;198:105563. https://doi.org/10.1016/j.jsbmb.2019.105563
  • 24. Eloi M, Horvath DV, Szejnfeld VL, Ortega JC, Rocha DA, Szejnfeld J, Castro CH. Vitamin D deficiency and seasonal variation over the years in São Paulo, Brazil. Osteoporos Int 2016;27(12):3449-56. https://doi.org/10.1007/s00198-016-3670-z
  • 25. Fiamenghi VI, Mello ED. Vitamin D deficiency in children and adolescents with obesity: a meta-analysis. J Pediatr (Rio J) 2021;97(3):273-9. https://doi.org/10.1016/j.jped.2020.08.006
  • 26. Gatti D, El Ghoch M, Viapiana O, Ruocco A, Chignola E, Rossini M, et al. Strong relationship between vitamin D status and bone mineral density in anorexia nervosa. Bone 2015;78:212-5. https://doi.org/10.1016/j.bone.2015.05.014
  • 27. Holick MF. The vitamin D deficiency pandemic: Approaches for diagnosis, treatment and prevention. Rev Endocr Metab Disord 2017;18(2):153-65. https://doi.org/10.1007/s11154-017-9424-1

Evaluation of the response given to the vitamin D treatment in patients with osteomalacia

Yıl 2022, Cilt: 7 Sayı: 5, 124 - 131, 30.12.2022

Selin Genç , Omer Genc Fatih Kılıçlı

https://doi.org/10.22391/fppc.1127577

Öz

Introduction: The current study aimed to examine the relationship between 25 hydroxyvitamin D [25(OH)D] levels and demographic, clinical and laboratory parameters and response to treatment in patients living in a Central Anatolian city of Turkey and diagnosed with osteomalacia.

Methods: A total of 533 patients who live in the continental climate, older than 18 years old, and have 25(OH)D levels lower than 30 ng/ml were enrolled prospectively. Patients' age, body mass index (BMI), type of clothing, season in which they were diagnosed, type of treatment and duration were recorded. At the time of diagnosis, the patients were evaluated with clinical and laboratory parameters at 1st, 2nd, and 4th months.

Results: Mean serum 25(OH)D level was 7.59±4.41 ng/mL at the time of diagnosis. 25(OH)D level was 24.42±14.77 ng/ml after treatment, with severe deficiency (<10 ng/mL) in 74% of patients, deficiency (<20 ng/mL) in 24.2%, insufficiency in 1.3% (20-29.99 ng/mL). 74.4% of the women had a closed clothing style. Vitamin D levels during diagnosis and at the end of treatment did not differ according to the BMI and the diagnosis period (p> 0.05). However, as BMI increased, the response given to the treatment decreased.

Conclusions: The current study showed that vitamin D deficiency is common in study population. The current findings demonstrate that treatment and follow-up should be continued until achieving normal serum 25(OH)D levels, taking into account geographic and ethnical structures to bring vitamin D levels to adequate levels.

Keywords: 25-hydroxytamin D; Osteomalacia; vitamin D deficiency

Anahtar Kelimeler

25-hydroxytamin D Osteomalacia vitamin D deficiency

Kaynakça

  • 1. Saponaro F, Saba A, Zucchi R. An update on vitamin d metabolism. Int J Mol Sci 2020;21(18):6573.https://doi.org/10.3390/ijms21186573
  • 2. Chun RF, Shieh A, Gottlieb C, Yacoubian V, Wang J, Hewison M, et al. Vitamin D binding protein and the biological activity of vitamin D. Front Endocrinol (Lausanne) 2019;10:718. https://doi.org/10.3389/fendo.2019.00718
  • 3. Silva MC, Furlanetto TW. Intestinal absorption of vitamin D: a systematic review. Nutr Rev 2018;76(1):60-76. https://doi.org/10.1093/nutrit/nux034
  • 4. Uday S, Högler W. Nutritional rickets & osteomalacia: A practical approach to management. Indian J Med Res 2020;152(4):356-67. https://doi.org/10.4103/ijmr.ijmr_1961_19
  • 5. Onalan E, Yakar B. The effect of vitamin D level on body composition and metabolic parameters in adults with different body mass index. Med Sci 2020;9(2):370-5. http://doi.org/10.5455/medscience.2019.08.9198
  • 6. Awal W, Bindra R, Price N, Sadler A, Robinson A, Hymer I, Chen J. Vitamin D deficiency in proximal femur fracture patients of South-East Queensland. Australas J Ageing. 2020;39(3):271-7. https://doi.org/10.1111/ajag.12791
  • 7. Goktaş O, Ersoy C, Ercan I, Can FE. Vitamin D status in the adult population of Bursa-Turkey. Eur J Gen Pract. 2020;26(1):156-2. https://doi.org/10.1080/13814788.2020.1846712
  • 8. Solak I, Cihan FG, Mercan S, Kethuda T, Eryilmaz MA. Evaluation of 25-Hydroxyvitamin D Levels in Central Anatolia, Turkey. Biomed Res Int 2018;2018:4076548. https://doi.org/10.1155/2018/4076548
  • 9. Alpdemir M, Alpdemir MF. Vitamin D deficiency status in Turkey: A meta-analysis. Int J Med Biochem 2019;2(3):118-31. https://dx.doi.org/10.14744/ijmb.2019.04127
  • 10. Yakar B, Kaya MO. Vitamin D deficiency during pregnancy in Turkey and the effect of the sunlight: a systematic review and meta-analysis. Turk J Biochemistry 2021;46(2):129-35. https://doi.org/10.1515/tjb-2020-0059
  • 11. Vieth R. Vitamin D supplementation: cholecalciferol, calcifediol, and calcitriol. Eur J Clin Nutr 2020;74(11):1493-7. https://doi.org/10.1038/s41430-020-0697-1
  • 12. Rastad H, Mahdavi Gorabi A, Qorbani M, Seif E, Asayesh H, Motlagh ME, Heshmat R, Kelishadi R. Prevalence and determinants of vitamin D deficiency in Iranian children and adolescents: the CASPIAN-V study. J Diabetes Metab Disord 2021;20(1):383-9. https://doi.org/10.1007/s40200-021-00757-8
  • 13. Neale RE, Khan SR, Lucas RM, Waterhouse M, Whiteman DC, Olsen CM. The effect of sunscreen on vitamin D: a review. Br J Dermatol 2019;181(5):907-15. https://doi.org/10.1111/bjd.17980
  • 14. Walter Siegenthaler. Differential diagnosis in internal medicine from symptom to diagnosis. Germany; Thieme, 2007:371-6
  • 15. Mark LS, Simon S, Valerie ES. Vitamin D. Aust Fam Physician. 2008;37:1002-5.
  • 16. Yeşiltepe-Mutlu G, Aksu ED, Bereket A, Hatun S. Vitamin D Status Across Age Groups in Turkey: Results of 108,742 samples from a single laboratory. J Clin Res Pediatr Endocrinol 2020;12(3):248-55. https://doi.org/10.4274%2Fjcrpe.galenos.2019.2019.0097
  • 17. Sezgin G, Ozturk G, Turkal R, Caykara B. Vitamin D levels of outpatients admitted to a university hospital in the Marmara region of Turkey Over 3 Years. J Med Biochem. 2019;38(2):181-7. https://doi.org/10.2478%2Fjomb-2018-0027
  • 18. Roth DE, Abrams SA, Aloia J, Bergeron G, Bourassa MW, Brown KH, et al. Global prevalence and disease burden of vitamin D deficiency: a roadmap for action in low- and middle-income countries. Ann N Y Acad Sci. 2018;1430(1):44-79. https://doi.org/10.1111/nyas.13968
  • 19. Thomas MK, Lloyd-Jones DM, Thadhani RI, Shaw AC, Deraska DJ, Kitch BT, et al. Hypovitaminosis D in medical in patients. N Engl J Med. 1998;338:777-83. https://doi.org/10.1056/nejm199803193381201
  • 20. Heath DA, Shaw NJ. Calcium and bone metabolism. In:Brook CGD, Hindmarsch PC, editors. Clinical Pediatreic Endocrinology Oxford: Blackwell science Press; 2001;377-89.
  • 21. Kechichian E, Ezzedine K. Vitamin D and the skin: an update for dermatologists. Am J Clin Dermatol. 2018;19(2):223-35. https://doi.org/10.1007/s40257-017-0323-8
  • 22. Pludowski P, Holick MF, Grant WB, Konstantynowicz J, Mascarenhas MR, Haq A, et al. Vitamin D supplementation guidelines. J Steroid Biochem Mol Biol 2018;175:125-35. https://doi.org/10.1016/j.jsbmb.2017.01.021
  • 23. Bouillon R, Antonio L. Nutritional rickets: Historic overview and plan for worldwide eradication. J Steroid Biochem Mol Biol 2020;198:105563. https://doi.org/10.1016/j.jsbmb.2019.105563
  • 24. Eloi M, Horvath DV, Szejnfeld VL, Ortega JC, Rocha DA, Szejnfeld J, Castro CH. Vitamin D deficiency and seasonal variation over the years in São Paulo, Brazil. Osteoporos Int 2016;27(12):3449-56. https://doi.org/10.1007/s00198-016-3670-z
  • 25. Fiamenghi VI, Mello ED. Vitamin D deficiency in children and adolescents with obesity: a meta-analysis. J Pediatr (Rio J) 2021;97(3):273-9. https://doi.org/10.1016/j.jped.2020.08.006
  • 26. Gatti D, El Ghoch M, Viapiana O, Ruocco A, Chignola E, Rossini M, et al. Strong relationship between vitamin D status and bone mineral density in anorexia nervosa. Bone 2015;78:212-5. https://doi.org/10.1016/j.bone.2015.05.014
  • 27. Holick MF. The vitamin D deficiency pandemic: Approaches for diagnosis, treatment and prevention. Rev Endocr Metab Disord 2017;18(2):153-65. https://doi.org/10.1007/s11154-017-9424-1
Toplam 27 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular İç Hastalıkları
Bölüm Araştırma Makalesi (Original Article)
Yazarlar

Selin Genç 0000-0002-0139-2574

Omer Genc 0000-0002-4252-1029

Fatih Kılıçlı 0000-0001-8962-7835

Yayımlanma Tarihi 30 Aralık 2022
Gönderilme Tarihi 7 Haziran 2022
Kabul Tarihi 6 Eylül 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 7 Sayı: 5

Kaynak Göster

APA Genç, S., Genc, O., & Kılıçlı, F. (2022). Evaluation of the response given to the vitamin D treatment in patients with osteomalacia. Family Practice and Palliative Care, 7(5), 124-131. https://doi.org/10.22391/fppc.1127577
AMA Genç S, Genc O, Kılıçlı F. Evaluation of the response given to the vitamin D treatment in patients with osteomalacia. Fam Pract Palliat Care. Aralık 2022;7(5):124-131. doi:10.22391/fppc.1127577
Chicago Genç, Selin, Omer Genc, ve Fatih Kılıçlı. “Evaluation of the response given to the vitamin D treatment in patients with osteomalacia”. Family Practice and Palliative Care 7, sy. 5 (Aralık 2022): 124-31. https://doi.org/10.22391/fppc.1127577.
EndNote Genç S, Genc O, Kılıçlı F (01 Aralık 2022) Evaluation of the response given to the vitamin D treatment in patients with osteomalacia. Family Practice and Palliative Care 7 5 124–131.
IEEE S. Genç, O. Genc, ve F. Kılıçlı, “Evaluation of the response given to the vitamin D treatment in patients with osteomalacia”, Fam Pract Palliat Care, c. 7, sy. 5, ss. 124–131, 2022, doi: 10.22391/fppc.1127577.
ISNAD Genç, Selin vd. “Evaluation of the response given to the vitamin D treatment in patients with osteomalacia”. Family Practice and Palliative Care 7/5 (Aralık2022), 124-131. https://doi.org/10.22391/fppc.1127577.
JAMA Genç S, Genc O, Kılıçlı F. Evaluation of the response given to the vitamin D treatment in patients with osteomalacia. Fam Pract Palliat Care. 2022;7:124–131.
MLA Genç, Selin vd. “Evaluation of the response given to the vitamin D treatment in patients with osteomalacia”. Family Practice and Palliative Care, c. 7, sy. 5, 2022, ss. 124-31, doi:10.22391/fppc.1127577.
Vancouver Genç S, Genc O, Kılıçlı F. Evaluation of the response given to the vitamin D treatment in patients with osteomalacia. Fam Pract Palliat Care. 2022;7(5):124-31.
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Family Practice and Palliative Care      ISSN 2458-8865       E-ISSN 2459-1505