Palabras clave
deficiencia
tamización
tratamiento
riesgo
desenlaces
Cómo citar
Resumen
Contexto: la Asociación Colombiana de Endocrinología, Diabetes y Metabolismo (ACE) realizó este consenso de expertos para establecer guías para la tamización y el tratamiento del déficit de vitamina D, adaptadas a las necesidades de los pacientes en Colombia.
Objetivo: unificar los criterios sobre la tamización, el diagnóstico, el tratamiento y los resultados clínicos del déficit de vitamina D en Colombia, a través de un enfoque multidisciplinario.
Metodología: entre julio de 2023 y octubre de 2024, la ACE empleó la metodología Delphi en un proceso de tres fases, las cuales incluyeron una revisión sistemática de literatura, evaluación de desenlaces primarios (sarcopenia, osteoporosis, etc.) y secundarios (asma, cáncer, etc.), y la formulación y validación de recomendaciones utilizando el sistema GRADE y la revisiones por pares.
Resultados: se definió la deficiencia de vitamina D como niveles de 25(OH)D <20 ng/ml. No se recomendó la tamización rutinaria en la población general, incluyendo mujeres embarazadas, aunque, sí podría considerarse en pacientes oncológicos con antecedentes de cirugía gastrointestinal. No se aconsejó la suplementación de vitamina D de manera rutinaria en gestantes, personas con prediabetes o diabetes tipo 2, ni para prevenir eventos cardiovasculares, sin embargo, cinco subgrupos podrían beneficiarse de la suplementación:
- Pacientes oncológicos con cánceres de buen pronóstico.
- Adultos mayores con sarcopenia de leve a moderada.
- Mujeres embarazadas en riesgo de preeclampsia.
- Personas con un alto riesgo cardiovascular.
- Personas mayores de 70 años para prevenir fracturas, especialmente en instituciones de cuidado a largo plazo.
Conclusiones: se aconseja un enfoque individualizado para la suplementación de vitamina D, centrado en grupos específicos con deficiencia. Se desaconseja el uso generalizado. Se necesita más investigación en Colombia para evaluar el impacto de estas recomendaciones en la práctica clínica y resultados de salud a largo plazo.
Citas
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