RESUMEN
Serum phosphorus levels range from 2.5 and 4.5mg/dL (0.81-1.45 mmol/L) in adults, with higher levels in childhood, adolescence, and pregnancy. Intracellular phosphate is involved in intermediary metabolism and other essential cell functions, while extracellular phosphate is essential for bone matrix mineralization. Plasma phosphorus levels are maintained within a narrow range by regulation of intestinal absorption, redistribution, and renal tubular absorption of the mineral. Hypophosphatemia and hyperphosphatemia are common clinical situations, although changes are most often mild and oligosymptomatic. However, acute and severe conditions that require specific treatment may occur. In this document, members of the Mineral and Bone Metabolism Working Group of the Spanish Society of Endocrinology and Nutrition review phosphate disorders and provide algorithms for adequate clinical management of hypophosphatemia and hyperphosphatemia.
Asunto(s)
Hiperfosfatemia/diagnóstico , Hiperfosfatemia/terapia , Hipofosfatemia/diagnóstico , Hipofosfatemia/terapia , Árboles de Decisión , Homeostasis , Humanos , Fosfatos/fisiologíaRESUMEN
OBJECTIVE: To provide recommendations based on evidence on the management of vitaminD deficiency in the general population. PARTICIPANTS: Members of the Bone Metabolism Working Group of the Spanish Society of Endocrinology. METHODS: Recommendations were formulated using the GRADE system (Grading of Recommendations, Assessment, Development, and Evaluation) to describe both the strength of recommendations and the quality of evidence. A systematic search was made in MEDLINE (Pubmed) using the term VitaminD and the name of each issue. Papers in English and Spanish with publication date before 17 March 2016 were included. Recommendations were jointly discussed by the Working Group. CONCLUSIONS: This document summarizes the data about vitaminD deficiency in terms of prevalence, etiology, screening indications, adequate levels and effects of supplementation on bone and non-skeletal health outcomes.
Asunto(s)
Vitamina D , Accidentes por Caídas/prevención & control , Anciano , Enfermedades Óseas/complicaciones , Suplementos Dietéticos , Medicina Basada en la Evidencia , Femenino , Fracturas Óseas/prevención & control , Humanos , Enfermedades Renales/complicaciones , Hepatopatías/complicaciones , Síndromes de Malabsorción/complicaciones , Masculino , Metaanálisis como Asunto , Persona de Mediana Edad , Debilidad Muscular/etiología , Debilidad Muscular/prevención & control , Necesidades Nutricionales , Obesidad/complicaciones , Osteoporosis/prevención & control , Factores de Riesgo , Vitamina D/análogos & derivados , Vitamina D/sangre , Deficiencia de Vitamina D/etiología , Deficiencia de Vitamina D/prevención & control , Deficiencia de Vitamina D/terapiaRESUMEN
OBJECTIVE: To update previous recommendations developed by the Working Group on Osteoporosis and Mineral Metabolism of the Spanish Society of Endocrinology and Nutrition for the evaluation and treatment of osteoporosis associated to different endocrine and nutritional diseases. PARTICIPANTS: Members of the Working Group on Osteoporosis and Mineral Metabolism of the Spanish Society of Endocrinology and Nutrition. METHODS: Recommendations were formulated according to the GRADE system (Grading of Recommendations, Assessment, Development, and Evaluation) to describe both the strength of recommendations and the quality of evidence. A systematic search was made in MEDLINE (Pubmed) using the following terms associated to the name of each condition: AND "osteoporosis", "fractures", "bone mineral density", and "treatment". Papers in English with publication date between 18 October 2011 and 30 October 2014 were included. The recommendations were discussed and approved by all members of the Working Group. CONCLUSIONS: This update summarizes the new data regarding evaluation and treatment of osteoporosis associated to endocrine and nutritional conditions.
Asunto(s)
Enfermedades del Sistema Endocrino/complicaciones , Enfermedades Metabólicas/complicaciones , Minerales/metabolismo , Osteoporosis/etiología , Absorciometría de Fotón , Anorexia Nerviosa/complicaciones , Antineoplásicos Hormonales/efectos adversos , Densidad Ósea , Huesos/metabolismo , Neoplasias de la Mama/complicaciones , Neoplasias de la Mama/tratamiento farmacológico , Complicaciones de la Diabetes , Enfermedades del Sistema Endocrino/inducido químicamente , Enfermedades del Sistema Endocrino/terapia , Femenino , Fracturas Espontáneas/etiología , Fracturas Espontáneas/prevención & control , Humanos , Enfermedades Inflamatorias del Intestino/complicaciones , Masculino , Desnutrición/complicaciones , Enfermedades Metabólicas/terapia , Osteoporosis/diagnóstico por imagen , Osteoporosis/terapia , Neoplasias de la Próstata/complicaciones , Neoplasias de la Próstata/tratamiento farmacológicoRESUMEN
OBJECTIVE: To provide practical recommendations for evaluation and treatment of osteoporosis associated to endocrine diseases and nutritional conditions. PARTICIPANTS: Members of the Bone Metabolism Working Group of the Spanish Society of Endocrinology, a methodologist, and a documentalist. METHODS: Recommendations were formulated according to the GRADE system (Grading of Recommendations, Assessment, Development, and Evaluation) to describe both the strength of recommendations and the quality of evidence. A systematic search was made in MEDLINE (Pubmed), using the following terms associated to the name of each condition: AND "osteoporosis", "fractures", "bone mineral density", and "treatment". Papers in English with publication date before 18 October 2011 were included. Current evidence for each disease was reviewed by two group members, and doubts related to the review process or development of recommendations were resolved by the methodologist. Finally, recommendations were discussed in a meeting of the Working Group. CONCLUSIONS: The document provides evidence-based practical recommendations for evaluation and management of endocrine and nutritional diseases associated to low bone mass or an increased risk of fracture. For each disease, the associated risk of low bone mass and fragility fractures is given, recommendations for bone mass assessment are provided, and treatment options that have shown to be effective for increasing bone mass and/or to decreasing fragility fractures are listed.