Prevalence of vitamin D deficiency/insufficiency in routine clinical practice
The objective. to study the prevalence of vitamin D deficiency / insufficiency and to conduct a retrospective analysis of the effectiveness of various regimes of its pharmacological correction in primary patients in routine clinical practice. Determination of 25(OH)-Vitamin D3 level in peripheral blood by liquid chromatography-tandem mass spectrometry was carried out (ng/ml). When vitamin D deficiency / insufficiency was detected, therapy with 25 (OH)-Vitamin D3 (cholecalciferol) was administered to all patients, regardless of diagnosed diseases, for at least 2 months. Results and discussion. There were no significant gender differences in plasma levels of 25(OH)-Vitamin D3 in persons of the same age, as well as there were no marked fluctuations of this index in patients in different age groups under the age of 40 (20, 30 and 40, respectively) (p < 0.1). The plasma level of 25(OH)-Vitamin D3 in the first-come patients at the clinic ranged from 13.85 ng/ml to 29.97 ng/ml (the average was 19.4 ± 4.3 ng/ml), which reflected severe violations of the D-status of the body (deficiency/insufficiency of vitamin D) in almost 100% of primary patients. However, in the group of patients older than 50 years, the baseline level of vitamin D in the blood was statistically significantly higher at 3.93 ng/ml than in younger patients (p < 0.05). Retrospective analysis of 25(OH)-Vitamin D3 concentration in blood in patients after 2 months of therapy demonstrated a significant increase in its plasma level by an average of 74% compared to baseline before treatment (p < 0.05). Patients treated in 2013-2014 (n = 1890), the absolute increase in the plasma level of 25(OH)-Vitamin D3 after treatment averaged 41.62 ± 1.1 ng/ml, and in patients treated in 2015 (n = 1310) for a more optimized and personalized scheme, taking into account the individual selection of the daily dose, depending on the initial plasma level of 25(OH)-Vitamin D3, the relative average increase of this indicator was 86% (12% more than in patients 2013-2014, «Empirical» scheme, p < 0.05), and in absolute figures - 45.11 ± 0.8 ng/ml (p < 0.05). No clinical side effects of cholecalciferol therapy at a daily dose of 5,000-10,000 IU were observed, which allows it to be considered as the most effective and safe in correcting vitamin D deficiency / deficiency.