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《囊性纖維化患者維D缺乏診療的最新循證建議》內容預覽

V. Tangpricha, A. Kelly, A. Stephenson, K. Maguiness, J. Enders, K. A. Robinson,B. C. Marshall, and D. Borowitz, for the Cystic Fibrosis Foundation Vitamin DEvidence-Based Review CommitteeEmory University (V.T., J.E.), Atlanta, Georgia 30322; Children’s Hospital of Philadelphia (A.K.),Philadelphia, Pennsylvania 19104; St. Michael’s Hospital (A.S.), Toronto, Ontario, Canada M5B 1W8;Riley Hospital for Children (K.M.), Indianapolis, Indiana 46202; The Johns Hopkins University (K.A.R.),Baltimore, Maryland 21287; Cystic Fibrosis Foundation (B.C.M.), Bethesda, Maryland 20814; and StateUniversity of New York (D.B.), Buffalo, New York 14222Objective: The objective was to develop evidence-based clinical care guidelines for the screening,diagnosis, management, and treatment of vitamin D deficiency in individuals with cystic fibrosis(CF).
Participants: The guidelines committee was comprised of physicians, registered dietitians, a phar-macist, a nurse, a parent of an individual with CF, and a health scientist, all with experience in CF.Process: Committee members developed questions specific to vitamin D health in individuals withCF. Systematic reviews were completed for each question. The committee reviewed and graded theavailable evidence and developed evidence-based recommendations and consensus recommen-dations when insufficient evidence was available. Each consensus recommendation was votedupon by an anonymous process.
Conclusions: Vitamin D deficiency is common in CF. Given the limited evidence specific to CF, thecommittee provided consensus recommendations for most of the recommendations. The commit-tee recommends yearly screening for vitamin D status, preferably at the end of winter, using theserum 25-hydroxyvitamin D measurement, with a minimal 25-hydroxyvitamin D concentration of30 ng/ml (75 nmol/liter) considered vitamin D sufficient in individuals with CF. Recommendationsfor age-specific vitamin D intake for all individuals with CF, form of vitamin D, and a stepwiseapproach to increase vitamin D intake when optimal vitamin D status is not achieved aredelineated. (J Clin Endocrinol Metab 97: 0000 – 0000, 2012)

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