黎巴嫩基于GRADE的维生素D指南:MENA地区的一个范例
Marlene Chakhtoura1, Elie Akl2, Asma Arabi1
1Calcium Metabolism and Osteoporosis Program, WHO Collaborating Center for Metabolic Bone Disorders, American University of Beirut Medical Center, P.O. Box 113-6044/C8, Beirut, Lebanon.
概括
新的黎巴嫩指南建议不要对成年人进行广泛的维生素D查和补充. 高危人群仍可能受益于有针对性的查和特定的维生素D (600-2000 IU) 或补充剂.
科学领域:
- 内分泌学 在内分泌学.
- 公共卫生 公共卫生
- 临床指南 临床指南
背景情况:
- 中东和北非 (MENA) 地区传统上面临高维生素D缺乏率.
- 最近的趋势表明,MENA地区的血清25-基维生素D (25OHD) 水平正在上升.
- 针对黎巴嫩成年人群体的维生素D查和补充的指导方针被制定出来,考虑了社区居住和机构住院的个人.
研究的目的:
- 建立基于证据的指导方针,用于对黎巴嫩成年患者的维生素D查和补充.
- 解决黎巴嫩社区生活和制度化个体的特定需求.
- 根据最新的科学证据和当地情况提供建议.
主要方法:
- 一个由临床和方法专家组成的指南小组提出了关键问题.
- 对全球骨折数据,区域维生素D试验以及患者的价值/偏好进行了系统审查.
- 使用推评估,开发和评价 (GRADE) 方法来评估证据的确定性并提出建议.
主要成果:
- 对于一般的黎巴嫩成年人群 (社区居住和住院),不建议对维生素D缺乏症进行查 (有条件的建议,非常低的确定性证据).
- 在社区生活的成年人中不建议补充和维生素D (有条件的建议,中等确定性的证据).
- 建议对住院成年人补充和维生素D (有条件的建议,中等确定性的证据),每日维生素D剂量为600-2000 IU,建议那些接受补充剂的人.
结论:
- 基于黎巴嫩GRADE的指导方针建议不要对一般人群进行查和定期补充维生素D.
- 确定了可能从查和补充中受益的特定高风险子组.
- 这些指导方针考虑了当地上下文因素,可适应中东和北非地区的其他国家.
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