Vitamin-D-Mangel bei hospitalisierten internistischen Patienten

Zusammenfassung

Das Thema Vitamin D gewinnt weltweit an Bedeutung. Grund für dieses gesteigerte Interesse ist einerseits die zunehmende Häufigkeit des Vitamin-D-Mangels, andererseits auch das wachsende Wissen über dessen Auswirkungen. Es gibt keine einheitlichen und allgemein akzeptierten Empfehlungen, ob und wann das Screening für einen Vitamin-D-Mangel sinnvoll ist. Ebenso werden die vermeintlich positiven Auswirkungen einer Substitution kontrovers diskutiert. Dieser Artikel bezieht sich auf einen kürzlich veröffentlichten systematischen Review und fasst die aktuelle Datenlage zum Einfluss eines Vitamin-D-Mangels und einer Substitution auf verschiedene Endpunkte bei hospitalisierten internistischen Patienten zusammen. Beobachtungsstudien legen einen Zusammenhang zwischen einem tiefen Vitamin-D-Spiegel und erhöhter Mortalität, verlängerter Hospitalisationsdauer, erhöhter Infektionsrate und Krankheitsschwere sowie vermehrt funktionellen Einschränkungen nahe. Randomisierte kontrollierte Studien, welche den Benefit einer Vitamin-D-Therapie beweisen würden, existieren nur wenige, und diese liefern zudem widersprüchliche Daten. Zusammenfassend können zum jetzigen Zeitpunkt, in Anbetracht der aktuellen kontroversen Datenlage, keine Empfehlungen zu Vitamin-D-Screening und Substitution bei hospitalisierten Patienten gemacht werden. Größere interventionelle Studien sind notwendig, um diese Wissenslücke zu schließen.

Abstract

Vitamin D deficiency is an issue of growing global significance. The increasing prevalence and the more profound knowledge of negative consequences of a deficiency have led to an increased interest in the topic. There are no consistent recommendations about the benefit of vitamin D screening and substitution of a deficiency. This report refers to the results of a recently published systematic review and aims at summarizing current evidence regarding the impact of a vitamin D deficiency and supplementation on various adverse outcomes in the medical inpatient population. Several observational studies have implied that a connection between an inadequate vitamin D status and increased mortality, longer length of stay, higher risk of infections, increased disease severity and functional impairment. There are only few randomized controlled studies investigating this effect reporting contradicting results. In conclusion, screening and supplementation of vitamin D deficiency can currently not be recommended for the medical inpatient population. Larger randomized trials are needed to fill this gap.

Schlüsselwörter

Vitamin-D-Mangel - Hospitalisation - klinische Endpunkte

Keywords

vitamin D deficiency - medical inpatients - clinical outcomes

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