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Front Endocrinol (Lausanne). 2018 May 31;9:246. doi: 10.3389/fendo.2018.00246. eCollection 2018.

Vitamin D Supplementation Guidelines for General Population and Groups at Risk of Vitamin D Deficiency in Poland-Recommendations of the Polish Society of Pediatric Endocrinology and Diabetes and the Expert Panel With Participation of National Specialist Consultants and Representatives of Scientific Societies-2018 Update.

Author information

1
Department of Paediatric Propedeutics and Bone Metabolic Diseases, Medical University of Lodz, Lodz, Poland.
2
Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children's Memorial Health Institute, Warsaw, Poland.
3
Department of Pediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age, Pomeranian Medical University, Szczecin, Poland.
4
Neonatal and Intensive Care Department, Medical University of Warsaw, Warsaw, Poland.
5
Department of Pediatrics, Endocrinology and Diabetology with Cardiology Divisions, Medical University of Bialystok, Bialystok, Poland.
6
Department of Neonatology and Neonatal Intensive Care Unit, The Children's Memorial Health Institute, Warsaw, Poland.
7
Mossakowski Medical Research Center, Polish Academy of Sciences, Department of Internal Diseases, Endocrinology and Diabetology, Central Hospital MSWiA, Warsaw, Poland.
8
Department of Neonatology, Institute of Mother and Child, Warsaw, Poland.
9
Department of Pediatrics, The Medical Centre of Postgraduate Education, Warsaw, Poland.
10
Division of Clinical Genetics, Department of Molecular Biology and Genetics, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
11
Department of Pediatric Rheumatology, Immunology, and Metabolic Bone Diseases, Medical University of Bialystok, Bialystok, Poland.
12
Department of Pediatrics, Nutrition and Metabolic Diseases, The Children's Memorial Health Institute, Warsaw, Poland.
13
Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, Polish Mother's Memorial Hospital - Research Institute, Lodz, Poland.
14
Faculty of Pharmacy with Laboratory Medicine, Medical University of Warsaw, Warsaw, Poland.
15
Department of Geriatrics, The Centre of Postgraduate Medical Education, Warsaw, Poland.
16
2nd Department of Pediatrics, Endocrinology, Diabetology, University of Rzeszow, Rzeszow, Poland.
17
Department of Pediatrics and Pediatric Oncology, Pomeranian Medical University, Szczecin, Poland.
18
Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland.
19
Department of Gastroenterology, Hepatology, Nutritional Disorders and Pediatrics, The Children's Memorial Health Institute, Warsaw, Poland.
20
Clinic of Endocrinology and Diabetology, The Children's Memorial Health Institute, Warsaw, Poland.
21
Faculty of Medicine and Health Sciences, Jan Kochanowski Univeristy, Kielce, Poland.
22
1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland.
23
Department of Pediatric Nephrology, Wroclaw Medical University, Wroclaw, Poland.

Abstract

Introduction:

Vitamin D deficiency is an important public health problem worldwide. Vitamin D deficiency confers a significant risk for both skeletal and non-skeletal disorders and a number of lifelong negative health outcomes. The objectives of this evidence-based guidelines document are to provide health care professionals in Poland, an updated recommendation for the prevention, diagnosis and treatment of vitamin D deficiency.

Methods:

A systematic literature search examining the prevention and treatment strategies for vitamin D deficiency was conducted. Updated recommendations were developed using the Grading of Recommendations, Assessment, Development and Evaluation system describing the strength of the recommendation and the quality of supporting evidence. Twenty-seven contributors representing different areas of expertise and medical specialties, including pediatricians, geriatricians, endocrinologists, epidemiologists, nephrologists, gynecologists and obstetricians evaluated the available published evidence related to vitamin D, formulated the goals of this document and developed a common consolidated position. The consensus group, representing six national specialist consultants and eight Polish and international scientific organizations/societies, participated in the process of grading evidence and drawing up the general and specific recommendations.

Results:

The updated recommendations define the diagnostic criteria for the evaluation of vitamin D status and describe the prevention and treatment strategies of vitamin D deficiency in the general population and in groups at increased risk of the deficiency. Age- and weight-specific recommendations for prevention, supplementation and treatment of vitamin D deficiency are presented, and detailed practice guidance is discussed regarding the management in primary and specialized health care.

Conclusion:

Vitamin D deficiency remains still highly prevalent in Poland, in all age groups. Currently, there is a great necessity to implement a regular supplementation with recommended doses and to develop an effective strategy to alleviate vitamin D deficiency in the population. These updated recommendations are addressed to health professionals and the authorities pursuing comprehensive health policies and should also be included in public health programs aimed at preventing a broad spectrum of chronic diseases.

KEYWORDS:

recommendations of the experts; supplementation; treatment; vitamin D; vitamin D deficiency; vitamin D in Poland

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