Vitamin-D-Mangel und sekundärer Hyperparathyreoidismus im Ruhrgebiet (Nordrhein-Westfalen/Deutschland)

Zusammenfassung

Bei 2 500 unausgewählten Patienten einer nuklearmedizinischen Praxis im Ruhrgebiet wurde 25-(OH)-Vitamin-D-Unterversorgung (25–75 nmol/l) festgestellt bei Residenten/Immigranten in 55,6/30,1% und -Mangel (<25 nmol/l) bei 35,1/65,2%. Dementsprechend fanden sich erhöhte iPTH-Werte (>65 pg/ml) im Sinne des sekundären Hyperparathyreoidismus bei Residenten/Immigranten in 37/43,5%. Diese Abweichungen von der gewohnten Norm waren ausgeprägter bei >73 kg Körpergewicht. Vitamin-D-Mangel wirkt sich wegen seiner endokrinen (Ca-Stoffwechsel) und autokrinen/parakrinen Effekte (Muskelkraft, Infektresistenz, Wundheilung, Immunsystem usw.) auf die Entwicklung der Körpergewebe sehr ungünstig aus, sodass die Patienten zuerst auf die sinnvolle Nutzung des Sonnenlichtes aufmerksam gemacht werden müssen. Dafür wurden Informationsschriften in allen relevanten Sprachen entwickelt. Zur medikamentösen Substitution im Sinne der Prävention sind 1 000–2 000 IE Vitamin D3/Tag erforderlich, die Dosierung ist bei gesunden Menschen nach derzeitiger Expertenmeinung unbedenklich. Für die volle Prävention ist nach diesen Daten für das Ruhrgebiet ein 25-(OH)-Vitamin-D-Wert von >100 nmol/l erforderlich

Abstract

In 2 500 unselected patients of an outpatient nuclear medical practice in the Ruhr county (Germany) 25-(OH)-vitamin D insufficiency (25–75 nmol/l) was found in resident/immigrant subjects in 55,6/30,1 % and deficiency (<25 nmol/l) in 35,1/65,2%) concomitant with increased intact parathyroid hormone as a sign of secondary hyperparathyroidism in 37/43,5%. These deviations from normal were more intensive at >73 kg bodyweight. Vitamin D deficiency exerts severe negative influence on all body tissues because of its endocrine (calcium metabolism) and paracrine/autocrine (muscle tension, infect resistance, skin lesion healing, immune system etc.) effects. Therefore patients receive information for the prudent use of sunlight and substitution by tablets or oily solutions with the help of a special information flyer available in all relevant languages. The recommendation for prevention of vitamin D insufficiency und -deficiency for so far healthy subjects is 1 000–2 000 IE vitamin D3/day, the dosage being without of harm according to relevant experts meaning. For full prevention in the Ruhr county of Germany serum 25-(OH)-vitamin D levels should exceed 100 nmol/l.

Schlüsselwörter

Vitamin-D-Unterversorgung - Vitamin-D-Mangel - sekundärer Hyperparathyreoidismus

Key words

vitamin D insufficiency - vitamin D deficiency - secondary hyperparathyroidism

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