Zusammenfassung
Knochenfrakturen tragen in signifikantem Ausmaß zu Morbidität und Mortalität in der Postmenopause bei. Schätzungen des mortalitätsadjustierten Frakturrisikos in der verbleibenden Lebenszeit für Frauen im Alter ≥60 liegen zwischen 44 und 65 %. Unbedingt notwendig sind also effektive Präventionsstrategien. Im Review-Beitrag wird die verfügbare Evidenz zur Vitamin-D3-Supplementierung (800 I.E. täglich) für eine 20–30 %ige Reduzierung von Sturzereignissen und (Hüft-)Frakturen bei postmenopausalen Frauen zusammengefasst. Diese Empfehlung wird gestützt von Positionspapieren der International Osteoporosis Foundation, des 2011 World Osteoporosis Day Report und der US-amerikanischen Endocrine Society, ferner von der hohen Prävalenz eines Vitamin-D-Mangels bei postmenopausalen Frauen. Die Vitamin-D-Mangel-Prävalenz (Serum-Konzentrationen <50 nmol/l bzw. 20 ng/ml) bei jüngeren wie älteren postmenopausalen Frauen wurde in vielen Ländern weltweit mit etwa 50 % angegeben, am höchsten (80 %) war sie bei älteren Frauen mit Hüftfrakturen.
Abstract
Fractures contribute significantly to morbidity and mortality of postmenopausal women. Among postmenopausal women aged 60 years and older, the mortality-adjusted residual lifetime risk of fracture has been estimated to be 44–65 %. Thus, effective strategies are urgently needed to prevent fractures among postmenopausal women. This review summarizes the available evidence that supports vitamin D3 supplementation at a dose of 800 IU per day as a strategy to reduce falls and fractures, including hip fractures, among postmenopausal women by about 20–30 %. This recommendation is supported by the Position Statement on Vitamin D of the International Osteoporosis Foundation, the 2011 World Osteoporosis Day Report, and the US Endocrine Society. Further, this recommendation is supported by the high prevalence of vitamin D deficiency among postmenopausal women. The prevalence of vitamin D deficiency (serum levels below 50 nmol/l or 20 ng/ml) among younger and older postmenopausal women has been found to be about 50 % in many countries around the world, with the highest prevalence (80 %) in older women with hip fractures.
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Prof. H.A. Bischoff-Ferrari erhielt in den letzten 3 Jahren Vortragseinladungen zum Thema Vitamin D und Fraktur/Sturz Epidemiologie von folgenden Firmen: MSD, Amgen, Roche, Lilly, WILD, DSM Nutritional Products.
Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.
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Die englische Version dieses Beitrags ist online unter doi: 10.1007/s00129-015-3727-7 verfügbar.
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Bischoff-Ferrari, H. Vitamin D und postmenopausale Knochengesundheit. Gynäkologe 48, 377–382 (2015). https://doi.org/10.1007/s00129-015-3723-y
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DOI: https://doi.org/10.1007/s00129-015-3723-y