Vitamin D status correction in Saudi Arabia: an experts\u2019 consensus under the auspices of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis, and Musculoskeletal Diseases (ESCEO)

Nasser M Al-Daghri,Fahad Al-Amri,Mona Fouda,Awad Shahrani,Hanan Alfawaz,Rene Rizzoli,Jean-Yves Reginster,Shaun Sabico,Fahad Alshahrani,Riad Sulimani,Abdulaziz M Al-Othman,Waleed Tamimi,Naji Aljohani,Yousef Al-Saleh,Mohammed Alharbi

doi:10.1007/s11657-016-0295-y

Abstract

BackgroundVitamin D deficiency is common in the Middle East and in Saudi Arabia, in particular. While several international recommendations on the management of vitamin D deficiency have been documented and practiced globally, these recommendations should be adapted to the conditions of the Middle Eastern region. To address this challenge, the Prince Mutaib Chair for Biomarkers of Osteoporosis (PMCO) in King Saud University (KSU), Riyadh, KSA, together with local experts and in cooperation with the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO), organized a panel that formulated unified recommendations in the diagnosis and treatment of vitamin D deficiency in the region.MethodsThe selection of local and international experts commenced during the 2nd International Vitamin D Symposium conducted in Riyadh, Saudi Arabia, last January 20-–21, 2016. Reviews of the most recent literature were done, and face-to-face meetings were conducted for revisions and final recommendations.Results: Vitamin D sufficiency is defined as circulating serum 25(OH)D ≥50 nmol (≥20 ng/ml) for the general population and vitamin D adequacy as serum 25(OH)D >75 nmol/L l (>30 ng/ml) for the frail and osteoporotic elderly. Despite overwhelming prevalence of vitamin D deficiency, universal screening is not recommended. Recommendations for the general population, children, pregnant/lactating women, post-menopausal women, the elderly, and those with subsequent metabolic diseases were provided.ResultsVitamin D sufficiency is defined as circulating serum 25(OH)D ≥50 nmol (≥20 ng/ml) for the general population and vitamin D adequacy as serum 25(OH)D >75 nmol/L l (>30 ng/ml) for the frail and osteoporotic elderly. Despite overwhelming prevalence of vitamin D deficiency, universal screening is not recommended. Recommendations for the general population, children, pregnant/lactating women, post-menopausal women, the elderly, and those with subsequent metabolic diseases were provided.ConclusionVitamin D supplementation/correction is advised in all persons whose serum 25(OH)D falls below 50 nmol/l (20 ng/ml), and achieving a target of 75 nmol/l (30 ng/ml) is particularly suited for frail, osteoporotic, and older patients. Conducting well-designed clinical trials in the region that will address economic implications and investigations on the treatment persistence and compliance to vitamin D treatment in the region are encouraged.

Highlights

During the last decade, no other micronutrient has gained and sustained massive interest in the fields of health and biomedical research community as much as vitamin D
Vitamin D sufficiency is defined as circulating serum 25(OH)D ≥50 nmol (≥20 ng/ml) for the general population and vitamin D adequacy as serum 25(OH)D >75 nmol/L l (>30 ng/ ml) for the frail and osteoporotic elderly
The global consensus defines vitamin D deficiency as serum 25(OH)D < 30 nmol/l [5], while the guidelines and position statements adopted in the USA, central Europe, South America, and Korea define Bdeficiency^ as

Summary

Introduction

No other micronutrient has gained and sustained massive interest in the fields of health and biomedical research community as much as vitamin D. Given that the management for vitamin D deficiency remains an evolving focus in biomedical research, several wellrecognized international organizations have created their own evidence-based guidelines and consensuses for the general public [1, 2], including recommendations based on harder outcomes such as the preservation of bone health [3], prevention of fractures [4], and of nutritional rickets [5]. While several international recommendations on the management of vitamin D deficiency have been documented and practiced globally, these recommendations should be adapted to the conditions of the Middle Eastern region To address this challenge, the Prince Mutaib Chair for Biomarkers of Osteoporosis (PMCO) in King Saud University (KSU), Riyadh, KSA, together with local experts and in cooperation with the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO), organized a panel that formulated unified recommendations in the diagnosis and treatment of vitamin D deficiency in the region

Methods

Results

Conclusion