25羟维生素D和降钙素原在妊高症孕妇体内的表达及临床意义研究

目的 检测正常孕妇和妊高症孕妇不同孕周的血清25羟维生素D和降钙素原的表达及临床意义.方法 选择152例于2015年12月至2016年12月在本院定期做产检并最终发展为妊娠期高血压疾病的孕妇作为本次研究的对象,将其从早孕时期的检查报告整理建档.其中52人发展为妊娠期高血压作为A组,58人发展为轻度子痫前期划为B组,42人发展为重度子痫前期作为C组,并随机抽查同期检查的96例正常孕妇作为对照组,采用电化学发光免疫分析法检测孕妇在妊娠早孕、中孕和晚孕时血清25羟维生素D和降钙素原PCT水平并进行回顾性研究,比较各组各阶段血清25羟维生素D及降钙素原PCT水平.结果 早孕期,妊娠期高血压疾病组与正常妊娠组的孕妇体内25羟维生素D和降钙素原PCT的水平无显著差异,P＞0.05;中孕和晚孕期,妊娠期高血压组与正常妊娠组的孕妇体内25羟维生素D和降钙素原PCT的水平比较差异均有统计学意义(P＜0.05),并且随着妊娠期高血压疾病的病情逐渐加重,25羟维生素D和PCT水平呈下降趋势.结论 血清25羟维生素D和降钙素原PCT在妊高症患者中水平均下降,且妊高症高血压＞轻度子痫前期＞重度子痫前期,说明随着妊娠期高血压病情的加重,血清25羟维生素D水平与降钙素原PCT水平逐渐降低,因此其妊娠期水平与妊高症的发展有着密切关系,定期监测孕妇体内的25羟维生素D水平与降钙素原PCT水平有助于临床的病情诊断.     

维生素缺乏对老年人髋部骨折的影响

目的 对比老年髋部骨折患者与老年非骨折的骨病患者维生素水平及缺乏情况,分析维生素缺乏对老年髋部骨折的影响。方法 回顾性病例对照研究。纳入2020年11月—2022年2月深圳市第二人民医院均行血清维生素水平检测的老年髋部骨折患者172例（骨折组）及老年非骨折的髋膝关节骨病患者345（非骨折组）例。骨折组患者中男50例、女122例,年龄65~97（81.0±8.2）岁;非骨折组中男89例、女256例,年龄65~90（72.1±5.9）岁。采用液相色谱串联质谱法检测血清维生素A、B1、B2、B3、B5、B6、B9、E、K1,以及25-羟基维生素D（D2和D3）的含量,将维生素水平低于正常值下限定义为相应维生素缺乏。观察指标：（1）观察骨折组与非骨折组是否缺乏维生素,并比较2组患者维生素水平的差异。（2）将标准化后的维生素水平作为自变量,骨折与否作为因变量,年龄和性别作为协变量,采用多因素logistic回归分析标准化后维生素水平对老年髋部骨折的影响。结果 （1）骨折组患者维生素A、B1、B3、B9、E缺乏情况更为严重,骨折组占比分别为62.8% （59/94）、62.4% （58/93）、19.4% （18/93）、50.0% （52/104）、14.9% （14/94）,非骨折组为20.2% （49/243）、41.2% （100/243）、5.0% （12/241）、16.3% （41/251）、4.5% （11/243）,差异均有统计学意义（χ²=56.49、12.15、15.82、43.10、10.61,P值均<0.05）。骨折组患者的血清25-羟维生素D、D3,以及维生素A、B1、B3、B5、B6、B9、E、K1水平较非骨折组明显降低,差异均有统计学意义（Z=-4.41、-2.53、-7.08、-3.43、-5.25、-2.08、-2.46、-6.80、-3.26、-7.93,P值均<0.05）;25-羟维生素D2和维生素B2水平2组差异均无统计学意义（P值均>0.05）。（2）多因素回归分析显示,维生素A[比值比（OR）=0.30,95%可信区间（CI）0.20~0.45]、维生素K1（OR=0.31,95% CI 0.21~0.46）、维生素B9（OR=0.33,95% CI 0.23~0.47）、维生素B3（OR=0.50,95% CI 0.36~0.70）、维生素B5（OR=0.50,95% CI 0.37~0.69）、维生素B1（OR=0.52,95% CI 0.38~0.72）、维生素E（OR=0.61,95% CI 0.45~0.83）、25-羟基维生素D（OR=0.70,95% CI 0.55~0.89）和维生素B6（OR=0.71,95% CI 0.54~0.95）水平的降低均会导致老年髋部骨折的风险增加（P值均<0.05）。结论 老年髋部骨折患者和老年非骨折的髋膝关节退行性骨病患者都普遍存在各种维生素缺乏,而且以25-羟基维生素D的缺乏最为严重。髋部骨折患者相对于非骨折患者的多种维生素水平更低,血清维生素A、B1、B3、B5、B6、B9、E、K1、25-羟基维生素D水平的降低会增加髋部骨折的风险。     

郑州地区1180例儿童维生素A、D、E水平研究

目的 了解郑州地区儿童维生素的水平,为临床诊治提供参考.方法 以2016年3月至12月期间在郑州大学第三附属医院儿科门诊健康体检的儿童为研究对象,测量血清25羟维生素D[25(OH)D]、维生素A、E的水平.结果 1180名儿童中,男童755例,女童425例,维生素A平均水平0.22±0.07 mg/L,总体缺乏率为45.34％;维生素D平均水平为64.25±19.65 nmol/L,总体缺乏率为30.51％;维生素E平均水平为4.95±1.64 mg/L,总体缺乏率为51.10％.男童和女童血清维生素E水平差异具有统计学意义(P＜0.05);郑州市城乡儿童三种血清维生素水平差异均具有统计学意义(P＜0.05).结论 儿童维生素的水平缺乏情况,应引起我们的重视,尤其是维生素E,城乡儿童仍然需要进行及时的维生素补充,以预防儿童维生素缺乏症及其并发症的发生.     

孕早中期血清PLGF、PAPP-A检测联合B超对子痫前期的预测分析

目的探讨孕早中期血清胎盘生长因子(PLGF)、妊娠相关蛋白(PAPP-A)检测联合B超检查对子痫前期的预测作用。方法回顾性分析2018年4月～2018年12月在我院妇产科建档产检、且跟踪随访确诊为子痫前期的38例孕早中期(孕11～孕13~(+6)w)妇女的临床资料,记为疾病组;另回顾性分析同时间段在我院妇产科建档产检、且跟踪随访未发生子痫前期的462例孕早中期(孕11～孕13~(+6)w)妇女的临床资料,记为健康组。2组均于孕早中期进行PLGF、PAPP-A检测和B超检查。对比2组血清PLGF、PAPP-A水平、B超检查结果(子宫动脉PI、RI及S/D指标)。采用ROC曲线分析血清PLGF、PAPP-A联合B超检查指标对子痫前期的预测价值。结果疾病组血清PLGF水平明显低于健康组(P0.05),PAPP-A水平明显高于健康组(P0.05);疾病组子宫动脉PI、RI及S/D均明显高于健康组(P0.05);血清PLGF、PAPP-A水平联合B超检查对子痫前期预测的灵敏度、特异度和AUC分别为89.47%、98.48%和0.897,均分别高于血清PLGF、PAPP-A、PI、RI及S/D检查。结论子痫前期患者孕早中期血清PLGF水平显著降低,PAPP-A水平明显升高,子宫动脉PI、RI及S/D也异常升高,血清PLGF、PAPP-A检测联合B超检查对子痫前期有良好的预测价值。     

维生素D_3对缺乏维生素D的多囊卵巢综合征患者晚期糖基化终末产物受体的影响

目的研究维生素D3摄入对缺乏维生素D的多囊卵巢综合征(PCOS)患者血清AMH和sRAGE的影响。方法 54例患者分为25例缺乏维生素D合并PCOS的观察组和29例仅缺乏维生素D的对照组,给予口服8周维生素D3,检测口服前和口服8周后血清25-羟基维生素D(25 OH-D),AMH和sRAGE浓度。结果观察组和对照组摄入维生素D3后血清25 OH-D升高,且观察组血清sRAGE水平上升,AMH水平下降。结论缺乏维生素D合并PCOS患者摄入维生素D3可以通过增加sRAGE抑制AGEs的活性起到保护性作用。此外,维生素D3促进观察组患者血清AMH水平降低,改善卵泡生长发育环境。     

青海省儿童轮状病毒腹泻与维生素A、D、E水平研究

目的:研究青海省高原地区儿童轮状病毒腹泻儿童的维生素A、D、E水平,为轮状病毒腹泻患儿诊治提供科学依据。方法:选择青海省妇女儿童医院2017年4月—2018年6月就诊的371例轮状病毒腹泻患儿,定量检测血中维生素A、D、E水平,对比正常儿童血清维生素水平推荐值以及青海省儿童抽样调查血清维生素水平,分析不同年龄、不同性别...     

女性弥漫性脱发患者的微量营养素分析

目的 对三种类型的女性弥漫性脱发患者的微量营养素水平进行分析。方法 回顾性分析2018年1月至2021年6月就诊于大坪医院皮肤性病科门诊的299例不同类型女性弥漫性脱发患者的临床资料。结果 弥漫性脱发患者血清25-羟基维生素D和铁蛋白水平均显著低于对照组,且与弥漫性脱发的类型无关;弥漫性斑秃患者血清锌浓度也显著低于对照组。分别以铁蛋白≤50 ng/mL为铁缺乏的界限值,以25-羟基维生素D≤20 ng/mL作为血清25-羟基维生素D缺乏的界限时,三种类型的弥漫性脱发患者血清25-羟基维生素D和血清铁蛋白缺乏的比例均高于对照组(P<0.05)。即缺乏铁和血清25-羟基维生素D与女性弥漫性脱发的发生有关。结论 铁代谢障碍和血清25-羟基维生素D水平在女性弥漫性脱发中起关键作用,而铜和锌对头发生长和脱发周期的影响仍需进一步研究。     

HBeAg阴性慢性乙型肝炎患者血清25-羟基维生素D3的检测及临床意义

目的 探究HBeAg阴性慢性乙型肝炎患者血清25-羟基维生素D3的水平变化及临床意义。方法 选取2015年3月~2018年5月81例HBeAg阴性且非肝硬化的慢性乙型肝炎患者作为观察组,依据血清谷丙转氨酶（ALT）水平分为观察组A 41例（ALT处于正常水平且HBV DNA水平＜2000 IU/ml,持续时间高于6个月）和观察组B 40例（ALT处于升高水平且HBV DNA水平≥2000 IU/ml,持续时间高于6个月）。同时选取同期健康体检人群40例作为对照组。分别检测三组血清25-羟基维生素D3的浓度。结果 观察组血清25-羟基维生素D3低于健康人群,统计学意义显著（P＜0.001）,三组间比较,统计学意义显著（P＜0.001）。观察组患者血清25-羟基维生素D3与年龄、BMI、ALT、AST、Hb、WBC、PLT及AFP均无明显相关性（P＞0.05）。而与HBV DNA含量间存在显著负相关（r=-3.981,P＜0.05）。结论 HBeAg阴性慢性乙型肝炎患者血清25-羟基维生素D3存在异常,并与乙肝病毒复制相关,可能参与机体和乙肝病毒的免疫反应过程。     

孕中期孕妇外周血维生素D水平与贫血的相关性研究

目的 分析孕中期孕妇外周血25-羟维生素D[25(OH)D]水平与贫血的关系.方法 选取2019年1月至2020年12月期间在我院就诊的贫血孕妇322例为本研究的贫血组,选取同期血红蛋白在正常参考区间内的孕妇322例为本研究的孕期对照组,选取同期在我院体检的血红蛋白在正常参考区间内的正常未孕女性100例为未孕对照组,收集受试者的一般资料及贫血相关检测(包括血红蛋白、铁蛋白、孕前BMI、红细胞计数)结果及25(OH)D检测结果,进行比较分析.结果 贫血组血清25(OH)D水平明显低于孕期对照组和未孕对照组,差异有统计学意义(P<0.05).各组血清25(OH)D水平整体分布情况差异有统计学意义(P<0.05),贫血组的维生素D缺乏比例高于孕期对照组和未孕对照组,差异有统计学意义(P<0.05).贫血组的血红蛋白、铁蛋白、孕前BMI、红细胞计数均低于孕期对照组和未孕对照组,差异有统计学意义(P<0.05).贫血组孕妇血清25(OH)D与血红蛋白、铁蛋白、红细胞计数呈显著正相关(P<0.05),与BMI呈显著负相关(P<0.05).孕妇血清25(OH)D水平对贫血具有较高的辅助诊断及评估价值,AUC(0.95CI)为0.767(0.612～0.961).结论 25(OH)D水平与孕中期孕妇贫血情况密切相关,对孕妇贫血有较好的辅助诊断和评估价值,临床应重视对于妊娠期女性的维生素D水平监测.     

25 羟维生素D 在原发性胆汁性肝硬化中的诊断价值

目的:初步探讨25-羟维生素D[25-(OH)D]在原发性胆汁性肝硬化(PBC)中的诊断价值。方法:收集宁夏医科大学总院2013 年12 月到2015 年6 月期间住院的44 例确诊为PBC 的患者,随机收集确诊为乙肝肝硬化患者41 例及我院体检健康人群110 例作为对照组,分析患者组和对照组的生化指标及血清25-羟维生素D 含量,并对PBC 患者血清中25-羟维生素D 绘制ROC 曲线进行统计分析。结果:生化指标TBIL、DBIL、IBIL、GLB、AST、ALT、ALP、-GT 在PBC 组中均显著高于正常对照组和乙肝肝硬化组,差异有统计学意义。25-羟维生素D 含量在PBC 患者中显著低于正常对照组和乙肝肝硬化组,差异有统计学意义。PBC 患者血清中25-羟维生素D 绘制ROC 曲线下的面积(AUC)为0.926,筛选其最佳截断点:当25-(OH)D=17.275 ng/ ml 时,敏感性为92.8%,特异性为84.1%。结论:25 羟维生素D 在PBC 患者血清中的含量明显下降,对PBC 的诊断具有一定的价值,25-(OH)D=17.275 ng/ ml 可能是一个诊断的界值。     

Vitamin D Repletion in Korean Postmenopausal Women with Osteoporosis

PurposeUp to 71% of South Korean postmenopausal women have vitamin D deficiency {serum 25-hydroxyvitamin D [25(OH) D] level <50 nmol/L}. Data on vitamin D supplementation was collected during the screening phase of an efficacy/safety study of denosumab in Korean postmenopausal women with osteoporosis. This report describes the effect of vitamin D supplementation on repletion to 25(OH)D levels ≥50 nmol/L in Korean postmenopausal women with osteoporosis.ResultsOf 371 subjects screened, 191 (52%) required vitamin D supplementation, and 88% (168 of 191) were successfully repleted. More than half of the subjects (58%) who were successfully repleted received doses of 2000 IU daily. The mean time to successful repletion was 31 days (standard deviation 8.4 days; range 11–48 days).ConclusionSupplementation with daily median doses of 2000 IU vitamin D successfully repleted 88% of Korean postmenopausal women with osteoporosis within 48 days to a serum vitamin D level of 50 nmol/L.     

Vitamin D and aging: beyond calcium and bone metabolism

Background

Low serum 25-hydroxyvitamin D (25[OH]D) levels are common and may be associated with morbidity and mortality (and indeed with frailty more generally). This association is not restricted to the links between vitamin D and calcium and bone metabolism.

Objective

To review the influences of vitamin D on the aging process other than those related to bone and calcium. Its effect on mortality is also assessed.

Methods

The PubMed database was searched for English-language articles relating to vitamin D, using the following MeSH terms: vitamin D, mortality, cardiovascular diseases, and frailty. In addition, searches were carried out with Google.

Results

Although some of the reported results have proved controversial, overall the evidence seems to support an association between low serum 25[OH]D levels and mortality rates (all-cause and cardiovascular). Frailty is a condition frequently associated with low serum 25[OH]D levels.

Conclusion

The aging process and mortality are associated with low vitamin D levels. Prospective controlled trials are warranted to determine whether vitamin D supplements can increase longevity and reduce the incidence of certain conditions.     

血清胱抑素C、叶酸、维生素B12在慢性肾脏病早期肾损伤中的应用价值

目的 探讨血清胱抑素C(Cys-C),叶酸(FA)、维生素B12(Vit B12)在慢性肾脏病早期肾损伤中的应用价值.方法 选择2014年3月至2016年8月在我院就诊的慢性肾脏病患者167例作为研究对象,按照慢性肾脏病的分期分为五组:第1期组(A组,32例)、第2期组(B组,32例)、第3期组(C组,33例)、第4期组(D组,34例)、第5期组(E组,36例),选择同期体检健康志愿者30例作为健康对照组,采用胶乳免疫比浊法测定血清Cys-C,电化学发光法测定血清FA和VitB12,尿素酶-谷氨脱氢酶法测定血清尿素(Urea),苦味酸法测定血清肌酐(Scr)含量水平.结果 A组各指标测定结果与对照组比较差异无统计学意义(P＞0.05);B组Scr、Urea与对照组及A组比较差异也无统计学意义(P＞0.05),而血清Cys-C高于对照组和A组(P＜0.05);C组、D组和E组各指标测定结果与对照组及A组比较差异均有统计学意义(P＜0.05).ROC曲线显示,Cys-C、Urea、FA、Vit B12、Scr的AUC及95％ CI分别为:0.697 (0.668 ～0.887)、0.538(0.491～0.792)、0.502(0.504～0.822)、0.481(0.532 ～0.865)、0.457(0.484 ～0.775).结论 血清胱抑素C、叶酸和维生素B12检测有助于早期肾功能损伤的判断,对控制慢性肾脏病发展有重要的临床意义.     

早产儿血清维生素D水平与智能发育的相关性研究

目的探讨早产儿维生素D(vitamin D,VitD)水平与智能发育的相关性。方法选取我院2017年1月至2018年1月收治的685例早产儿开展回顾性分析,以出生后24h内血清25-羟维生素D[25-hydroxyvitamin D,25(OH)D]水平≥所有早产儿的平均水平为高水平组,血清25(OH)D水平<所有早产儿的平均水平为低水平组,比较两组的一般临床资料、维生素D情况,评估两组的智力发育水平;依据早产儿胎龄不同分为极早早产儿组(<28周)和常规早产儿组(28~32周),比较两组的DST及BSID评分,采用Pearson相关性分析血清25(OH)D水平与智能水平之间的相关性。结果纳入685例早产儿的血清25(OH)D水平为56.59±15.43nmol/L,高水平组365例,血清25(OH)D水平为83.41±12.64nmol/L,低水平组320例,血清25(OH)D水平为38.42±13.22nmol/L;高水平组的MDI、PDI及DQ、MI评分显著高于低水平组(P<0.05);经相关性分析,血清25(OH)D水平与MDI、PDI及DQ、MI均呈正相关(P<0.05)。结论早产儿维生素D水平与其智力发育水平呈正相关,其能促进神经发育,提高智力水平。     

Serum 25-Hydroxy Vitamin D Levels and Association of Vitamin D Receptor Gene Polymorphisms in Vitiligo

BackgroundThe role of vitamin D deficiency and vitamin D receptor (VDR) gene polymorphisms has been established in many autoimmune diseases, including vitiligo, but the result is still controversial.ObjectivesThe aim of this study was to investigate the serum vitamin D levels in vitiligo patients and to compare the association of VDR gene polymorphisms in vitiligo patients and healthy controls.MethodsWe collected the data of age, sex, serum 25-hydroxy vitamin D (25[OH]D) level, thyroid autoantibodies, disease duration, types of vitiligo, family history and the affected body surface area of vitiligo from 172 patients. And we analyzed the VDR gene polymorphisms in 130 vitiligo and 453 age-sex-matched control subjects.ResultsThe mean serum level of 25(OH)D in 172 vitiligo patients was 18.75 ± 0.60 ng/mL, which had no significant difference with a mean serum value of 25(OH)D in the Korean population. However, there were significant differences according to the duration of the disease and family history. Also, there were no significant differences in the genotypic and allelic distributions of 37 examined SNPs of VDR gene between vitiligo patients and healthy controls.ConclusionSerum level of 25(OH)D in vitiligo patients was not significantly different from the mean serum value of the Korean population. Also, there were no significant differences in the genotypic distributions of VDR gene between vitiligo patients and healthy controls.     

宫颈脱落细胞miR34a检测在HR-HPV阳性患者 分流中的作用分析

目的 探讨宫颈脱落细胞miR34a检测在HR-HPV阳性患者分流中的作用。方法 采用第二代杂交捕获技术（HC2）进行宫颈癌初筛,HPV阳性者行TCT及miRNA检查。TCT结果异常者（≥意义不明确的非典型鳞状细胞）阴道镜下活检行病理学检查。TCT阴性者行阴道镜检查,阴道镜异常者阴道镜下活检取材,比较不同级别宫颈病变中miR34a水平,探讨miR34a、Pap在宫颈病变中的诊断作用。结果 ①Pap对宫颈高度鳞状上皮内病变预测值的灵敏度为64.90%,特异度为80.70%,AUC为0.728（95%CI:0.657~0.779,P＜0.001）。②miRNA34a对宫颈高度鳞状上皮内病变预测值的灵敏度为77.00%,特异度为62.30%,AUC为0.824（95%CI:0.756~0.892,P＜0.001）,cut off值为0.623。③miRNA34a对宫颈高度鳞状上皮内病变预测值的灵敏度高于Pap检测,特异度低于Pap。④宫颈脱落细胞miRAN34a值随着宫颈病变加重逐渐降低。结论 检测宫颈脱落细胞miR34a水平可有效分流HR-HPV阳性患者,敏感性高于Pap检查。     

Vitamin D Insufficiency and Asthma Severity in Adults From Costa Rica

Purpose

Non-classical actions of vitamin D as a cytokine are related to the immunopathology of asthma. Few studies have examined vitamin D levels and asthma severity in adults. The aim of this research was to assess the relationship between vitamin D levels, atopy markers, pulmonary function, and asthma severity.

Methods

We analyzed 25-hydroxyvitamin D levels in serum collected from 121 asthmatic adults from Costa Rica to investigate the association between vitamin D levels (categorized as sufficient, ≥30 ng/mL, or insufficient, <30 ng/mL), allergic rhinitis, total IgE and peripheral blood eosinophils (as markers of atopy), asthma severity, baseline forced expiratory volume in 1 second (FEV1), and forced vital capacity (FVC). Univariate and multivariate analyses were performed to assess these relationships.

Results

When the population was stratified by vitamin D status, 91% of asthmatic patients with vitamin D levels below 20 ng/mL (n=36) and 74% of patients with vitamin D levels between 20 and 30 ng/mL (n=73) had severe asthma versus 50% of those with vitamin D sufficiency (n=12; P=0.02). Vitamin D insufficiency was associated with a higher risk of severe asthma (odds ratio [OR], 5.04; 95% Confidence interval [CI], 1.23-20.72; P=0.02). High vitamin D levels were associated with a lower risk of hospitalization or emergency department visit during the last year (OR, 0.90; 95% CI, 0.84-0.98; P=0.04). Although there appeared to be a direct relationship between vitamin D levels and FEV1 (regression coefficient=0.48; r²=0.03), it did not reach statistical significance (P=0.07).

Conclusions

Our findings suggest that vitamin D insufficiency is common among our cohort of asthmatic adults. Lower vitamin D levels are associated with asthma severity.     

EMAS position statement: Vitamin D and postmenopausal health

Introduction

There is emerging evidence on the widespread tissue effects of vitamin D.

Aims

To formulate a position statement on the role of vitamin D in postmenopausal women.

Materials and methods

Literature review and consensus of expert opinion.

Results and conclusions

Epidemiological and prospective studies have related vitamin D deficiency with not only osteoporosis but also cardiovascular disease, diabetes, cancer, infections and neurodegenerative disease. However the evidence is robust for skeletal but not nonskeletal outcomes where data from large prospective studies are lacking. The major natural source of vitamin D is cutaneous synthesis through exposure to sunlight with a small amount from the diet in animal-based foods such as fatty fish, eggs and milk. Vitamin D status is determined by measuring serum 25-hydroxyvitamin D [25(OH)D] levels. Optimal serum 25(OH)D levels are in the region of 30–90 ng/mL (75–225 nmol/L) though there is no international consensus. Levels vary according to time of the year (lower in the winter), latitude, altitude, air pollution, skin pigmentation, use of sunscreens and clothing coverage. Risk factors for low serum 25(OH)D levels include: obesity, malabsorption syndromes, medication use (e.g. anticonvulsants, antiretrovirals), skin aging, low sun exposure and those in residential care. Fortified foods do not necessarily provide sufficient amounts of vitamin D. Regular sunlight exposure (without sunscreens) for 15 min, 3–4 times a week, in the middle of the day in summer generate healthy levels. The recommended daily allowance is 600 IU/day increasing to 800 IU/day in those aged 71 years and older. Supplementation can be undertaken with either vitamin D2 (ergocalciferol) or vitamin D3 (cholecalciferol) with monitoring depending on the dose used and the presence of concomitant medical conditions such as renal disease.