Vitamin D deficiency in patients receiving home parenteral nutrition.
Vitamin D deficiency in patients receiving home parenteral nutrition.
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DOI：
10.1177/0148607110381269
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发表时间：
2011-07
期刊：
影响因子：
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通讯作者：
P. Thomson;D. Duerksen
中科院分区：
文献类型：
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作者：
P. Thomson;D. Duerksen
背景：维生素D除了在骨代谢中发挥作用外，还具有重要的免疫调节和抗肿瘤作用。接受家庭非肠外营养(HPN)的患者从静脉补充(IV)中获得大部分维生素D。维生素D缺乏在普通人群中很常见，HPN患者补充维生素D的充分性尚不清楚。本研究的目的是确定服用HPN的患者的维生素D状况。方法对连续参加地区家庭营养计划的患者进行口服和静脉注射维生素D摄入量的测定。所有患者均测定血浆25-羟基维生素D水平。还测定了钙、镁和磷的摄入量。结果接受HPN治疗的22例患者中，维生素D缺乏15例(68%)，维生素D缺乏6例(27%)，平均33.5个月(1~177个月)。平均膳食维生素D摄入量为79.5IU/d，而静脉补充量平均为166IU/d。结论：在这项对加拿大地区HPN计划的研究中，维生素D缺乏/不足的发病率很高，几乎影响到所有患者。所有接受HPN的患者都应该补充维生素D，并监测他们的25-羟基维生素D水平。需要进一步的研究来确定使用口服补充剂或紫外线疗法替代维生素D的最佳方法和剂量。
BACKGROUND In addition to its role in bone metabolism, vitamin D has important immunomodulatory and antineoplastic effects. Patients on home parenteral nutrition (HPN) receive most of their vitamin D from intravenous (IV) supplementation. Vitamin D deficiency is common in the general population, and the adequacy of vitamin D supplementation in HPN patients is unclear. The purpose of this study is to determine the vitamin D status of patients on HPN. METHODS Consecutive patients seen in a regional home nutrition program had their oral and IV vitamin D intakes determined. Plasma 25-hydroxyvitamin D levels were measured in all patients. Intake of calcium, magnesium, and phosphate were also determined. RESULTS The mean 25-hydroxyvitamin D level in 22 patients receiving HPN for a mean of 33.5 months (range, 1-177) was 42 nmol/L. Vitamin D deficiency was present in 15 (68%) patients and vitamin D insufficiency in 6 (27%) patients. The mean dietary vitamin D intake was 79.5 IU per day, while the mean IV supplementation was 166 IU per day. CONCLUSIONS In this study of a regional Canadian HPN program, there was a high prevalence of vitamin D deficiency/insufficiency affecting virtually all patients. All patients receiving HPN should be supplemented with vitamin D and have their 25-hydroxyvitamin D levels monitored. Further studies are required to determine optimal methods and dosing of vitamin D replacement using oral supplements or ultraviolet light therapy.