Guidelines for Preventing and Treating Vitamin D Deficiency: A 2023 Update in Poland

Paweł Płudowski¹, Beata Kos-Kudła², Mieczysław Walczak³, Andrzej Fal⁴, Dorota Zozulińska-Ziółkiewicz⁵, Piotr Sieroszewski⁶, Jarosław Peregud-Pogorzelski⁷, Ryszard Lauterbach⁸, Tomasz Targowski⁹, Andrzej Lewiński¹⁰, Robert Spaczyński¹¹, Mirosław Wielgoś¹², Jarosław Pinkas¹³, Teresa Jackowska¹⁴, Ewa Helwich¹⁵, Artur Mazur¹⁶, Marek Ruchała¹⁷, Arkadiusz Zygmunt¹⁰, Mieczysław Szalecki¹⁸, Artur Bossowski¹⁹, Justyna Czech-Kowalska²⁰, Marek Wójcik¹, Beata Pyrżak²¹, Michał A Żmijewski²², Paweł Abramowicz²³, Jerzy Konstantynowicz²³, Ewa Marcinowska-Suchowierska²⁴, Andrius Bleizgys²⁵, Spirydon N Karras²⁶, William B Grant²⁷, Carsten Carlberg²⁸, Stefan Pilz²⁹, Michael F Holick³⁰, Waldemar Misiorowski³¹

Affiliations

¹ Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children's Memorial Health Institute, 04-730 Warsaw, Poland.
² Department of Endocrinology and Neuroendocrine Tumors, and the Department of Pathophysiology and Endocrinology in Zabrze, Medical University of Silesia, 40-952 Katowice, Poland.
³ Department of Pediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of Developmental Age, Pomeranian Medical University, 70-204 Szczecin, Poland.
⁴ Department of Allergy, Lung Diseases and Internal Medicine of the Central Clinical Hospital, Ministry of Interior, 02-507 Warsaw, Poland.
⁵ Department and Clinic of Internal Diseases and Diabetology, Medical University of Poznan, 60-834 Poznan, Poland.
⁶ Department of Fetal Medicine and Gynecology, Medical University of Łodz, 90-419 Łodz, Poland.
⁷ Department of Pediatrics, Oncology and Pediatric Immunology, Pomeranian Medical University, 70-204 Szczecin, Poland.
⁸ Department of Neonatology, Jagiellonian University Hospital, 31-501 Krakow, Poland.
⁹ Department of Geriatrics, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, Poland.
¹⁰ Department of Endocrinology and Metabolic Diseases, Medical University of Łodz, 93-338 Łodz, Poland.
¹¹ Center for Gynecology, Obstetrics and Infertility Pastelova, 60-198 Poznan, Poland.
¹² Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland.
¹³ School of Public Health, The Center of Postgraduate Medical Education, 01-826 Warsaw, Poland.
¹⁴ Department of Pediatrics, Centre for Postgraduate Medical Education, 01-813 Warsaw, Poland.
¹⁵ Department of Neonatology and Neonatal Intensive Care, Institute of Mother and Child, 01-211 Warsaw, Poland.
¹⁶ Institute of Medical Sciences, Medical College of Rzeszow University, 35-310 Rzeszow, Poland.
¹⁷ Department of Endocrinology, Metabolism and Internal Medicine, Medical University of Poznan, 60-355 Poznan, Poland.
¹⁸ Department of Endocrinology and Diabetology, The Children's Memorial Health Institute, 04-730 Warsaw, Poland, and the Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland.
¹⁹ Department of Pediatrics, Endocrinology, Diabetology with Cardiology Unit, Medical University of Bialystok, 15-274 Bialystok, Poland.
²⁰ Department of Neonatology and Neonatal Intensive Care, The Children's Memorial Health Institute, 04-730 Warsaw, Poland.
²¹ Department of Pediatrics and Endocrinology, Medical University of Warsaw, 02-091 Warsaw, Poland.
²² Department of Histology, Medical University of Gdansk, 80-211 Gdansk, Poland.
²³ Department of Pediatrics, Rheumatology, Immunology and Metabolic Bone Diseases, Medical University of Bialystok, 15-274 Bialystok, Poland.
²⁴ Department of Internal Medicine and Geriatric Cardiology, and the Department of Geriatrics and Gerontology, School of Public Health, The Center of Postgraduate Medical Education, 02-673 Warsaw, Poland.
²⁵ Clinic of Internal Diseases, Family Medicine and Oncology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, 08661 Vilnius, Lithuania.
²⁶ Laboratory of Biological Chemistry, Medical School, Aristotle University, 55535 Thessaloniki, Greece.
²⁷ Sunlight, Nutrition and Health Research Center, San Francisco, CA 94164, USA.
²⁸ Institute of Animal Reproduction and Food Research, Polish Academy of Science, 10-748 Olsztyn, Poland.
²⁹ Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, 8036 Graz, Austria.
³⁰ Section Endocrinology, Diabetes, Nutrition and Weight Management, Department of Medicine, Boston University School of Medicine, Boston, MA 02118, USA.
³¹ Department of Endocrinology, Centre of Postgraduate Medical Education, Bielanski Hospital, 01-809 Warsaw, Poland.

PMID: 36771403
PMCID: PMC9920487
DOI: 10.3390/nu15030695

Review

Guidelines for Preventing and Treating Vitamin D Deficiency: A 2023 Update in Poland

Paweł Płudowski et al. Nutrients. 2023.

. 2023 Jan 30;15(3):695.

doi: 10.3390/nu15030695.

Authors

Affiliations

¹ Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children's Memorial Health Institute, 04-730 Warsaw, Poland.
² Department of Endocrinology and Neuroendocrine Tumors, and the Department of Pathophysiology and Endocrinology in Zabrze, Medical University of Silesia, 40-952 Katowice, Poland.
³ Department of Pediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of Developmental Age, Pomeranian Medical University, 70-204 Szczecin, Poland.
⁴ Department of Allergy, Lung Diseases and Internal Medicine of the Central Clinical Hospital, Ministry of Interior, 02-507 Warsaw, Poland.
⁵ Department and Clinic of Internal Diseases and Diabetology, Medical University of Poznan, 60-834 Poznan, Poland.
⁶ Department of Fetal Medicine and Gynecology, Medical University of Łodz, 90-419 Łodz, Poland.
⁷ Department of Pediatrics, Oncology and Pediatric Immunology, Pomeranian Medical University, 70-204 Szczecin, Poland.
⁸ Department of Neonatology, Jagiellonian University Hospital, 31-501 Krakow, Poland.
⁹ Department of Geriatrics, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, Poland.
¹⁰ Department of Endocrinology and Metabolic Diseases, Medical University of Łodz, 93-338 Łodz, Poland.
¹¹ Center for Gynecology, Obstetrics and Infertility Pastelova, 60-198 Poznan, Poland.
¹² Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland.
¹³ School of Public Health, The Center of Postgraduate Medical Education, 01-826 Warsaw, Poland.
¹⁴ Department of Pediatrics, Centre for Postgraduate Medical Education, 01-813 Warsaw, Poland.
¹⁵ Department of Neonatology and Neonatal Intensive Care, Institute of Mother and Child, 01-211 Warsaw, Poland.
¹⁶ Institute of Medical Sciences, Medical College of Rzeszow University, 35-310 Rzeszow, Poland.
¹⁷ Department of Endocrinology, Metabolism and Internal Medicine, Medical University of Poznan, 60-355 Poznan, Poland.
¹⁸ Department of Endocrinology and Diabetology, The Children's Memorial Health Institute, 04-730 Warsaw, Poland, and the Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland.
¹⁹ Department of Pediatrics, Endocrinology, Diabetology with Cardiology Unit, Medical University of Bialystok, 15-274 Bialystok, Poland.
²⁰ Department of Neonatology and Neonatal Intensive Care, The Children's Memorial Health Institute, 04-730 Warsaw, Poland.
²¹ Department of Pediatrics and Endocrinology, Medical University of Warsaw, 02-091 Warsaw, Poland.
²² Department of Histology, Medical University of Gdansk, 80-211 Gdansk, Poland.
²³ Department of Pediatrics, Rheumatology, Immunology and Metabolic Bone Diseases, Medical University of Bialystok, 15-274 Bialystok, Poland.
²⁴ Department of Internal Medicine and Geriatric Cardiology, and the Department of Geriatrics and Gerontology, School of Public Health, The Center of Postgraduate Medical Education, 02-673 Warsaw, Poland.
²⁵ Clinic of Internal Diseases, Family Medicine and Oncology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, 08661 Vilnius, Lithuania.
²⁶ Laboratory of Biological Chemistry, Medical School, Aristotle University, 55535 Thessaloniki, Greece.
²⁷ Sunlight, Nutrition and Health Research Center, San Francisco, CA 94164, USA.
²⁸ Institute of Animal Reproduction and Food Research, Polish Academy of Science, 10-748 Olsztyn, Poland.
²⁹ Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, 8036 Graz, Austria.
³⁰ Section Endocrinology, Diabetes, Nutrition and Weight Management, Department of Medicine, Boston University School of Medicine, Boston, MA 02118, USA.
³¹ Department of Endocrinology, Centre of Postgraduate Medical Education, Bielanski Hospital, 01-809 Warsaw, Poland.

PMID: 36771403
PMCID: PMC9920487
DOI: 10.3390/nu15030695

Abstract

Introduction: All epidemiological studies suggest that vitamin D deficiency is prevalent among the Polish general population. Since vitamin D deficiency was shown to be among the risk factors for many diseases and for all-cause mortality, concern about this problem led us to update the previous Polish recommendations. Methods: After reviewing the epidemiological evidence, case-control studies and randomized control trials (RCTs), a Polish multidisciplinary group formulated questions on the recommendations for prophylaxis and treatment of vitamin D deficiency both for the general population and for the risk groups of patients. The scientific evidence of pleiotropic effects of vitamin D as well as the results of panelists' voting were reviewed and discussed. Thirty-four authors representing different areas of expertise prepared position statements. The consensus group, representing eight Polish/international medical societies and eight national specialist consultants, prepared the final Polish recommendations. Results: Based on networking discussions, the ranges of total serum 25-hydroxyvitamin D concentration indicating vitamin D deficiency [<20 ng/mL (<50 nmol/L)], suboptimal status [20-30 ng/mL (50-75 nmol/L)], and optimal concentration [30-50 ng/mL (75-125 nmol/L)] were confirmed. Practical guidelines for cholecalciferol (vitamin D₃) as the first choice for prophylaxis and treatment of vitamin D deficiency were developed. Calcifediol dosing as the second choice for preventing and treating vitamin D deficiency was introduced. Conclusions: Improving the vitamin D status of the general population and treatment of risk groups of patients must be again announced as healthcare policy to reduce a risk of spectrum of diseases. This paper offers consensus statements on prophylaxis and treatment strategies for vitamin D deficiency in Poland.

Keywords: 25-hydroxyvitamin-D; calcifediol; cholecalciferol; general population guidelines; risk groups; vitamin D deficiency.

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Conflict of interest statement

W.B.G. receives funding from Bio-Tech Pharmacal, Inc. (Fayetteville, AR, USA). The other authors have no conflicts of interest to declare.

References

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Guidelines for Preventing and Treating Vitamin D Deficiency: A 2023 Update in Poland

Affiliations

Guidelines for Preventing and Treating Vitamin D Deficiency: A 2023 Update in Poland

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

Substances

LinkOut - more resources

Full Text Sources

Medical