Guidelines for Preventing and Treating Vitamin D Deficiency: A 2023 Update in Poland

Paweł Płudowski, Beata Kos-Kudła, Mieczysław Walczak, Andrzej Fal, Dorota Zozulińska-Ziółkiewicz, Piotr Sieroszewski, Jarosław Peregud-Pogorzelski, Ryszard Lauterbach, Tomasz Targowski, Andrzej Lewiński, Robert Spaczyński, Mirosław Wielgoś, Jarosław Pinkas, Teresa Jackowska, Ewa Helwich, Artur Mazur, Marek Ruchała, Arkadiusz Zygmunt, Mieczysław Szalecki, Artur Bossowski, Justyna Czech-Kowalska, Marek Wójcik, Beata Pyrżak, Michał A Żmijewski, Paweł Abramowicz, Jerzy Konstantynowicz, Ewa Marcinowska-Suchowierska, Andrius Bleizgys, Spirydon N Karras, William B Grant, Carsten Carlberg, Stefan Pilz, Michael F Holick, Waldemar Misiorowski, Paweł Płudowski, Beata Kos-Kudła, Mieczysław Walczak, Andrzej Fal, Dorota Zozulińska-Ziółkiewicz, Piotr Sieroszewski, Jarosław Peregud-Pogorzelski, Ryszard Lauterbach, Tomasz Targowski, Andrzej Lewiński, Robert Spaczyński, Mirosław Wielgoś, Jarosław Pinkas, Teresa Jackowska, Ewa Helwich, Artur Mazur, Marek Ruchała, Arkadiusz Zygmunt, Mieczysław Szalecki, Artur Bossowski, Justyna Czech-Kowalska, Marek Wójcik, Beata Pyrżak, Michał A Żmijewski, Paweł Abramowicz, Jerzy Konstantynowicz, Ewa Marcinowska-Suchowierska, Andrius Bleizgys, Spirydon N Karras, William B Grant, Carsten Carlberg, Stefan Pilz, Michael F Holick, Waldemar Misiorowski

Abstract

Introduction: All epidemiological studies suggest that vitamin D deficiency is prevalent among the Polish general population. Since vitamin D deficiency was shown to be among the risk factors for many diseases and for all-cause mortality, concern about this problem led us to update the previous Polish recommendations. Methods: After reviewing the epidemiological evidence, case-control studies and randomized control trials (RCTs), a Polish multidisciplinary group formulated questions on the recommendations for prophylaxis and treatment of vitamin D deficiency both for the general population and for the risk groups of patients. The scientific evidence of pleiotropic effects of vitamin D as well as the results of panelists' voting were reviewed and discussed. Thirty-four authors representing different areas of expertise prepared position statements. The consensus group, representing eight Polish/international medical societies and eight national specialist consultants, prepared the final Polish recommendations. Results: Based on networking discussions, the ranges of total serum 25-hydroxyvitamin D concentration indicating vitamin D deficiency [<20 ng/mL (<50 nmol/L)], suboptimal status [20-30 ng/mL (50-75 nmol/L)], and optimal concentration [30-50 ng/mL (75-125 nmol/L)] were confirmed. Practical guidelines for cholecalciferol (vitamin D3) as the first choice for prophylaxis and treatment of vitamin D deficiency were developed. Calcifediol dosing as the second choice for preventing and treating vitamin D deficiency was introduced. Conclusions: Improving the vitamin D status of the general population and treatment of risk groups of patients must be again announced as healthcare policy to reduce a risk of spectrum of diseases. This paper offers consensus statements on prophylaxis and treatment strategies for vitamin D deficiency in Poland.

Keywords: 25-hydroxyvitamin-D; calcifediol; cholecalciferol; general population guidelines; risk groups; vitamin D deficiency.

Conflict of interest statement

W.B.G. receives funding from Bio-Tech Pharmacal, Inc. (Fayetteville, AR, USA). The other authors have no conflicts of interest to declare.

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