Журнал «Боль. Суставы. Позвоночник» Том 13, №2, 2023

Актуальність. Дефіцит вітаміну D (ДВД) є значно поширеним у світі, його частка істотно варіює в різних популяціях і залежить від багатьох причин. До цього часу національних рекомендацій щодо діагностики, профілактики та лікування ДВД у дорослих в Україні не було. Їх створення і стало метою даної роботи. Методологія. Консенсус створювали за допомогою методу Дельфі, голосування проводили за допомогою платформи SurveyMonkey®. Після затвердження складу консенсусної групи, узгодження порядку формування та структури Консенсусу, формулювання і корекції основних положень, двох раундів голосування сформовано основні положення Консенсусу, за які група успішно проголосувала. 15 авторів статті є 15 експертами, які брали участь у голосуванні. Остаточні 14 положень Консенсусу подані в даній статті. Перед кожним положенням наведено його обґрунтування, викладене на основі існуючих у сучасній літературі високоякісних доказів. Результати. Незважаючи на зменшення ДВД в українській популяції протягом останніх років, експертами рекомендовано підвищення обізнаності медичної спільноти та населення щодо проблеми і шляхів її подолання зі скринінгом сироваткового загального рівня 25-гідроксивітаміну D (25(ОН)D) в осіб у певних групах ризику для досягнення цільової концентрації 30–50 нг/мл (75–125 нмоль/л). Для її забезпечення рекомендовано індивідуальний підбір профілактичної дози вітаміну D (800–2000 МО/д молодим здоровим особам і 3000–5000 МО/д — хворим із захворюваннями та станами, які впливають на метаболізм вітаміну D в організмі). Для лікування ДВД рекомендовано короткостроковий прийом більш високих доз (4000–10 000 МО/д) вітаміну D з контролем рівня 25(ОН)D через 4–12 тижнів лікування і подальшим використанням підтримуючих доз. Рекомендовано визначення сироваткового рівня 25(OH)D у хворих з остеопорозом і його ускладненнями перед ініціацією антиостеопоротичної терапії для запобігання її неефективності й підвищення профілю безпеки.

Background. Vitamin D deficiency (VDD) is widespread in the world; its proportion varies considerably in different populations and depends on many causes. Up to now, there were no National recommendations for the diagnosis, prevention, and treatment of VDD in adults in Ukraine. Their creation became the purpose of this work. Methodology. Consensus was created using the Delphi method, voting was conducted using the SurveyMonkey® platform. After approval of the composition of the Consensus Group, agreement on the order of formation and structure of the Consensus, creation and correction of the main statements, and two voting rounds, the main Consensus statements were formed and were successfully voted on. The 15 authors of the article are 15 experts who participated in the voting. The final 14 Consensus statements are presented in this article. Each statement is preceded by a justification based on high-quality evidence available in the current literature. Results. Despite the reduction of VDD in the Ukrainian population in recent years, experts have recommen­ded increasing the awareness of the medical community and the Ukrainian population about the problem and ways to overcome it, with a screening of the total serum level of 25-hydroxyvitamin D (25(OH)D) in subjects from the groups of risk to achieve the target concentration of 30–50 ng/ml (75–125 nmol/l). To ensure it, we recommend the individual selection of a prophylactic dose of vitamin D (800–2000 IU/d for young healthy persons and 3000–5000 IU/d for patients with diseases and conditions that affect the metabolism of vitamin D). For the treatment of VDD, we recommend short-term intake of higher doses (4000–10,000 IU/d) of vitamin D with control of the 25(OH)D level after 4–12 weeks of treatment and subsequent use of maintenance doses. Also, we re­commend the determination of serum 25(OH)D level before the initiation of antiosteoporotic therapy in patients with osteoporosis and its complications to prevent its ineffectiveness and increase the safety profile.

вітамін D; Консенсус; рекомендації; діагностика дефіциту вітаміну D; профілактика дефіциту вітаміну D; лікування дефіциту вітаміну D

vitamin D; consensus; recommendations; diagnosis of vitamin D deficiency, prevention of vitamin D deficiency; treatment of vitamin D deficiency

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