在COVID-19的老年患者中,维生素D状态诊断器的效率
Caroline Charonnat1,2, Dolores Sanchez-Rodriguez3,4,5,6, Spyridon N Karras7
1Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity CeRAL, University Hospital, 49000 Angers, France.
Nutrients
|March 28, 2024
概括
维生素D状态诊断器 (VDSD) 工具有效地识别了85岁及以上的COVID-19患者的维生素D缺乏. 这种诊断辅助工具有助于确定在老年护理中是否需要维生素D补充剂.
科学领域:
- 老年医学 老年医学
- 营养生物化学 营养生物化学
- 传染性疾病 传染性疾病
背景情况:
- 评估维生素D状况至关重要,特别是在老年人和COVID-19大流行期间.
- 低维他命症D在老年人群中普遍存在,并与各种健康结果有关.
- 维生素D状态诊断器 (VDSD) 是一种旨在识别低维生素D水平的工具.
研究的目的:
- 评估16项VDSD在确定COVID-19老年患者的低维生素D (维生素D缺乏和不足) 的有效性.
- 评估VDSD在指导对这种脆弱人群的维生素D测试和补充的决策中的有用性.
主要方法:
- 一项涉及102名未补充治疗的老年住院患者 (平均年龄85.0±5.9岁) 的研究,这些患者患有COVID-19并入院于安格斯大学医院.
- 医生管理的VDSD与血清25-氧维生素D (25(OH) D) 测量同时进行.
- 低维他命症D定义为25(OH) D ≤75nmol/L (缺乏) 和 ≤50nmol/L (缺乏).
主要成果:
- 在研究队列中观察到维生素D缺乏 (61.8%) 和缺乏 (85.3%) 的高患病率.
- VDSD在识别维生素D缺乏方面表现出很高的准确性 (AUC = 0.81,OR = 40).
- 鉴定维生素D缺乏症的VDSD的准确性不那么精确 (AUC=0.57).
结论:
- 16项VDSD是识别老年COVID-19患者维生素D缺乏症的有效工具.
- 在老年患者的COVID-19初期,VDSD可以帮助临床医生决定是否补充维生素D.
- 作为一个查工具,VDSD显示出有希望,以指导针对性维生素D测试和对COVID-19的老年人进行干预.
相关概念视频
01:15Myasthenia Gravis: Diagnostic Tests
3.3K
Myasthenia gravis is an autoimmune condition affecting neuromuscular transmission, causing generalized weakness in skeletal muscles. Initial diagnoses rely on patients' signs, symptoms, and medical history. The challenge lies in distinguishing myasthenia from other muscular dystrophies. An important diagnostic feature is the significant improvement of symptoms after administering anticholinesterase inhibitors.
The edrophonium test is a diagnostic tool for myasthenia gravis. It involves...
The edrophonium test is a diagnostic tool for myasthenia gravis. It involves...
3.3K
01:15Drug Dosing: Geriatric Patients
395
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
395
01:22Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption
861
As individuals age, their body's physiology evolves, affecting drug pharmacokinetics. The most apparent changes occur in the gastrointestinal tract, where an increase in gastric pH, a delay in gastric emptying, and a reduction in gastrointestinal motility are observed. Remarkably, these changes do not substantially modify the absorption of orally administered drugs, particularly those absorbed via passive diffusion.Transdermal drug delivery emerges as a highly viable method for older adults due...
861
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism
400
Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...
400
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
354
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
354
01:27Pharmacodynamics in Geriatric Patients: Effects of Age
367
Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
367