D Vitamini Bakılmasının Gerekliliği ve Düzeylerinin Yorumu

Yıl 2018, Cilt: 18 Sayı: 3, 97 - 102, 01.10.2018

Evrim Şenkal Emin Ünüvar Lale Seren Canan Göl Ferit Durankuş

https://doi.org/10.5222/j.child.2018.79037

Öz

D vitamini yetersizliği günümüzde tam adı konulmamış bir salgındır. Günlük gereksinimin karşılanmasında güneş ışınları temel yoldur ve vücudumuzdaki D vitaminin %95’i ultraviyole B etkisiyle deriden sentezlenir. Serum 25-OH-D vitamini düzeyinin 20-30 ng/mL olması yetersizliği

Anahtar Kelimeler

Çocuk, D vitamini, vitamin yetersizliği

Necessity of Determination and Interpretation of the Serum Vitamin D Levels

Öz

Vitamin D insufficiency is an unnamed epidemic. In meeting the daily requirement, sun rays are essential and 95% of vitamin D in our body is synthesized by our skin under the effect of ultraviolet B rays. Serum 25-OH-D levels 20-30 ng/ mL, and below 20 ng / mL. indicate vitamin D insufficiency and deficiency, respectively. Patients who are at risk for vitamin D deficiency need evaluation of their serum vitamin D status and those who are not in the risk group do not need routine evaluation. Insufficiency is much more prevalent today than deficiency. Recommended Daily Allowance RDA recommendations of 400 IU/day for the first year and 400-600 IU/day for 1-3 years of age, cover the daily average vitamin D requirement of 97.5% of the population. Although higher doses are given in the presence of chronic illness and risk for vitamin D deficiency, daily doses exceeding 4000 IU in healthy subjects, 6000-10000 IU in those in the risk group should not be prescribed. Today, the use of higher single doses of vitamin D in children should not be preferred due to the high risk of intoxication

Anahtar Kelimeler

Child, vitamin D, vitamin deficiency

Kaynakça

• Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357:266-81.
• https://doi.org/10.1056/NEJMra070553
• Rosen CJ. Vitamin D insufficiency N Engl J Med. 2011;364:248-54.
• https://doi.org/10.1056/NEJMcp1009570
• Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment and prevention of vitamin D deficiency: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2011;96:1911-30.
• https://doi.org/10.1210/jc.2011-0385
• Manson JE, Brannon PM, Rosen CJ. Vitamin D defici- ency. Is there really a pandemic? N Engl J Med. 2016;375:1817-9.
• https://doi.org/10.1056/NEJMp1608005
• An Endocrine Society Clinical Practice Guideline: Evaluation, treatment, and prevention of vitamin D deficiency. J Cain Endocrinol Metab. 2011;97:9111- 1930.
• South Australian Paediatric Clinical Guidelines Reference Committee.Clinical guideline: Management of vitamin D deficiency in children. South Australia, 2012.
• Braegger C, Campoy C, Colomb V, et al. Vitamin D in healthy European paediatric population. JPGN 2013;56:692-701.
• https://doi.org/10.1097/MPG.0b013e31828f3c05
• Demiral M, Sırmagül B, Kırel B. Endokrin polikliniği- ne başvuran çocuklarda D vitamini düzeyleri. J Curr Pediatr. 2016;14:60-6.
• Taşkıran B, Cansu GB. Güneydoğu bölgesinde erişkin- lerde D vitamini eksikliği. Osmangazi Journal of Medicine 2016;39:13-20.
• https://doi.org/10.20515/otd.52389
• Aykal G, Cerit N, Tekeli SÖ. Ameliyathane personelin- de D vitamini eksikliği ve yetersizliği prevalansı. Türk Klinik Biyokimya Derg. 2016;14:18-26.
• Cashman KD, Dowling KG, Skrabakova Z, et al. Vitamin D deficiency in Europa: pandemic? Am J Clin Nutr. 2016;103:1033-44.
• https://doi.org/10.3945/ajcn.115.120873
• Pearce SHS, Cheetham TD. Diagnosis and manage- ment of vitamin D deficiency. BMJ. 2010;340:b5664.
• https://doi.org/10.1136/bmj.b5664
• Uçar F, Taşlıpınar MY, Soydaş AÖ, Özcan N. Ankara Etlik İhtisas Eğitim Araştırma Hastanesi’ne başvuran hastalarda 25-OH vitamin D düzeyleri. Eur J Basic Med Sci. 2012;2:12-5.
• Varkal MA, Yıldız I, Saygılı S, Kılıç A, Darendeliler F, Oğuz F, Ünüvar E. D vitamin eksikliğinde riskli grup- lardan biri: sağlık çalışanları. One of the risk groups for vitamin d deficiency: health workers. İstanbul Tıp Fakültesi Dergisi 2015;78:2.
• Erol M, İşman FK, Kucur M, Hacıbekiroğlu M. Annede D vitamini eksikliğinin değerlendirilmesi. Türk Ped Arfl. 2007;42:29-32.
• Weng FL, Shults J, Leonard MB, et al. Risk factors for low serum 25-hydroxy vitamin D concentrations in otherwise healthy children and adolescents. Am J Clin Nutr. 2007;86:150-8.
• https://doi.org/10.1093/ajcn/86.1.150
• Wagner CL, Greer FR. Prevention of rocket and vita- min D deficiency in infants, children and adolescents. Pediatrics 2008;122:1142-52.
• https://doi.org/10.1542/peds.2008-1862
• Misra M, Pacaud D, Petryk A, et al. Vitamin D defici- ency in children and its management: review of current knowledge and recommendations. Pediatrics 2008;122:398-417.
• https://doi.org/10.1542/peds.2007-1894
• Institute of Medicine. Dietary reference intakes: calci- um and vitamin D. Washington DC: National Academy Press, 2011.
• Munns CF, Shaw N, Kiely M, et al. Global consensus recommendations on prevention and management of nutritional rickets. J Cain Endocrinol Metab. 2016;101:394-415.
• https://doi.org/10.1210/jc.2015-2175
• T.C. Sağlık Bakanlığı Ana Çocuk Sağlığı ve Aile Planlaması Genel Müdürlüğü. Türkiye’de 6-17 aylık çocuklarda ve annelerinde hemoglobin, ferritin, D vita- mini düzeyleri ve demir eksikliği anemisi durum belir- lemesinde yürütülen programların değerlendirilmesi araştırması. Ankara, 2011.
• Kurşun ÖS. Şişman çocuklarda D vitamini düzeyleri ve insulin direnci ile ilişkisinin araştırılması. Uzmanlık tezi, Trakya Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Edirne, 2008.