背景:维生素D缺乏是全球公共卫生问题,会导致严重的疾病,如儿童的病和成人的骨软化症。大多数研究比较了等摩尔单位剂量的维生素D2和D3。
目的:本研究旨在回答以下研究问题:“维生素D2(600,000U/1.5ml)与维生素D3(300,000U/1ml)肠外补充剂在提高在初级卫生保健机构接受治疗的成年患者的血清维生素D水平方面的有效性如何?”多哈。卡塔尔位于阿拉伯半岛的东海岸,夏天非常炎热,阳光明媚,沙漠气候。
方法:这是一项回顾性观察性队列研究。
方法:在伦理批准后招募了15,716名参与者。他们是通过电子病历(EMR)确定的,描述了18至60岁的个人的临床遭遇,他们在2017年1月1日至2020年6月30日的3.5年研究期间参加了由PHCC运营的健康中心。PHCCEMR系统使用SNOMED代码(系统组织的计算机可处理的医学术语集合,提供代码,names,同义词,以及为临床文档和报告实施的定义)。根据维生素D注射的类型和替代治疗的口服形式创建了四个研究组。分析方案使用前4周内的血清维生素D水平(预处理),然后给予治疗剂量。治疗后血清测试值应该在最多12周内可用。社会科学统计软件包(IBMSPSS;IBMCorp.,Armonk,NY,美国)23版软件用于统计分析。
结果:比较了四种治疗方案,包括注射维生素D2,维生素D3注射,联合使用维生素D2注射液+D2片剂,并联合使用维生素D3注射液+D2片剂。所有四个治疗组在最长12周的随访期间均与血清维生素D的统计学显着增加相关。单独注射维生素D2与平均3.2ng/ml的血清浓度最低增加相关。相比之下,单独或与D2片剂一起注射维生素D3可使血清维生素D增加6.1和5.6ng/ml,分别。使用维生素D2注射剂和片剂的组合,仅在单独施用D2注射剂后获得的3.2ng/ml增加的基础上,血清维生素D仅增加了2.3ng/ml。
结论:使用可注射形式的维生素D3是恢复严重维生素D缺乏的最佳选择。此外,它优于维生素D2的可注射形式,即使维生素D2具有两倍的摩尔单位。
BACKGROUND: Vitamin
D deficiency is a worldwide public health concern, which can lead to severe diseases, such as rickets in children and osteomalacia in adults. Most studies have compared equimolar unit-to-unit doses of vitamin D2 and D3.
OBJECTIVE: The current study aimed to answer the research question: \"How effective is vitamin D2 (600,000 U/1.5 ml) compared to vitamin D3 (300,000 U/1 ml) parenteral supplementation for raising serum vitamin
D levels in adult patients treated in a primary health care setting?\"
METHODS: Primary Health Care Corporation (PHCC) runs 28 health centers distributed throughout the State of Qatar and its capital city, Doha. Qatar is on the east coast of the Arabic peninsula, with very hot and sunny summers and a desert climate.
METHODS: This was a retrospective observational cohort study.
METHODS: A total of 15,716 participants were recruited following ethical approval. They were identified by electronic medical records (EMR) describing the clinical encounters of individuals aged 18 to 60-years-old who attended a health center operated by the PHCC during the 3.5-year study period from January 1, 2017 to June 30, 2020. The PHCC EMR system uses SNOMED codes (a systematically organized computer-processable collection of medical terms providing codes, names, synonyms, and definitions implemented for clinical documentation and reporting). Four study groups were created depending on the type of vitamin D injection and the oral form of replacement therapy. The analysis scheme used the serum vitamin
D level within the preceding 4 weeks (pretreatment), followed by administration of the treatment dose. The post-treatment serum testing value should have been available within a maximum of 12 weeks. The Statistical Package for Social Sciences (IBMSPSS; IBM Corp., Armonk, NY, USA) version 23 software was used for the statistical analysis.
RESULTS: Four treatment options were compared, including a vitamin D2 injection, a vitamin D3 injection, combined use of a vitamin D2 injection + a D2 tablet, and combined use of a vitamin D3 injection + a D2 tablet. All four treatment groups were associated with a statistically significant increase in serum vitamin D within a maximum of 12 weeks of follow-up. The vitamin D2 injection alone was associated with the lowest increase in serum concentration by a mean of 3.2 ng/ml. In contrast, the vitamin D3 injection alone or with a D2 tablet increased serum vitamin
D by 6.1 and 5.6 ng/ml, respectively. Using the combination of a vitamin D2 injection and a tablet only added a marginal increase of 2.3 ng/ml in serum vitamin
D on top of the 3.2 ng/ml increase attained after administering the D2 injection alone.
CONCLUSIONS: Utilizing vitamin D3 in an injectable form is the best choice to restore severe vitamin D deficiency. Furthermore, it was superior to the injectable form of vitamin D2, even though vitamin D2 has double the molar units.