D Vitamini Eksikliği ve Palyatif Bakım
Özet
Palyatif bakım hastalarında semptom kontrolü ve yaşam kalitesini artırmak için D vitamini düzeylerinin takibi kritik bir öneme sahiptir. Yapılan araştırmalar, düşük D vitamini seviyelerinin kanser, kronik ağrı, enfeksiyon yükü ve depresyon gibi durumlarla doğrudan ilişkili olduğunu, yeterli takviyenin ise mortalite riskini ve opioid ihtiyacını azalttığını göstermektedir. Özellikle yaşlı ve evde bakım gören bireylerde kas gücünü korumak ve kırılganlığı önlemek adına D vitamini değerlerinin düzenli izlenmesi ve eksikliğin giderilmesi temel bir gerekliliktir.
Monitoring vitamin D levels is of critical importance for symptom control and improving the quality of life in palliative care patients. Research indicates that low vitamin D levels are directly associated with conditions such as cancer, chronic pain, infection burden, and depression, while adequate supplementation reduces mortality risk and opioid requirements. Regular monitoring of vitamin D values and addressing deficiencies is a fundamental necessity for preserving muscle strength and preventing frailty, especially in elderly individuals and those receiving home care.
Referanslar
Black A, McGlinchey T, Gambles M, et al. The ‘lived experience’of palliative care patients in one acute hospital setting–a qualitative study. BMC palliative care. 2018; 17(1): 1-10. https://doi.org/10.1186/s12904-018-0345-x
Perpiñá-Galvañ J, Orts-Beneito N, Fernández-Alcántara M, et al. Level of burden and health-related quality of life in caregivers of palliative care patients. International Journal of Environmental Research and Public Health. 2019; 16(23): 4806. https://doi.org/10.3390/ijerph16234806
Shah I, Akhtar MK, Hisaindee S, et al. Clinical diagnostic tools for vitamin D assessment. The Journal of Steroid Biochemistry and Molecular Biology. 2018; 180: 105-17. https://doi.org/10.1016/j.jsbmb.2017.10.003
Erbay E, Mersin S, İbrahimoğlu Ö. D Vitamini ve vücut sistemleri üzerine etkisi. Sağlık Akademisyenleri Dergisi. 2019; 6(3): 201-206.
Reis AF, Hauache OM, Velho G. Vitamin D endocrine system and the genetic susceptibility to diabetes, obesity and vascular disease. A review of evidence. Diabetes and Metabolism. 2005; 31: 318-25. https://doi.org/10.1016/S1262-3636(07)70200-8
Vitamin Council-Testing for vitamin D. (15.06.2022 tarihinde https://www. vitamindcouncil.org/about-vitamin-d/testing-for-vitamin-d/. adresinden ulaşılmıştır.)
Björkhem-Bergman L, Bergman P. BMJ Supportive & Palliative Care. 2016; 6: 287–291. doi:10.1136/bmjspcare-2015-000921
Helde Frankling M, Klasson C, Sandberg C, et al. ‘Palliative-D’—Vitamin D Supplementation to Palliative Cancer Patients: A Double Blind, Randomized Placebo-Controlled Multicenter Trial. Cancers. 2021; 13(15): 3707. https://doi.org/10.3390/cancers13153707
Chun RF, Liu PT, Modlin RL, et al. Impact of vitamin D on immune function: lessons learned from genome-wide analysis. Front Physiol. 2014; 5: 151. https://doi.org/10.3389/fphys.2014.00151
Martineau AR, Nhamoyebonde S, Oni T, et al. Reciprocal seasonal variation in vitamin D status and tuberculosis notifications in Cape Town, South Africa. Proc Natl Acad Sci USA. 2011; 108: 19013–17. https://doi.org/10.1073/pnas.1111825108
Bergman P, Lindh AU, Björkhem-Bergman L, et al. Vitamin D and respiratory tract infections: a systematic review and meta-analysis of randomized controlled trials. PLoS ONE. 2013; 8: e65835. https://doi.org/10.1371/journal.pone.0065835
Camargo CA Jr, Ganmaa D, Frazier AL, et al. Randomized trial of vitamin D supplementation and risk of acute respiratory infection in Mongolia. Pediatrics. 2012; 130: e561–7. https://doi.org/10.1542/peds.2011-3029
Bergman P, Norlin AC, Hansen S, et al. Vitamin D3 supplementation in patients with frequent respiratory tract infections: a randomised and double-blind intervention study. BMJ Open. 2012; 2. http://dx.doi.org/10.1136/bmjopen-2012-001663
Bergman P, Norlin AC, Hansen S, et al. Vitamin D supplementation to patients with frequent respiratory tract infections: a post hoc analysis of a randomized and placebo-controlled trial. BMC Res Notes. 2015; 8: 391. https://doi.org/10.1186/s13104-015-1378-3
Bruns H, Büttner M, Fabri M, et al. Vitamin D-dependent induction of cathelicidin in human macrophages results in cytotoxicity against high-grade B cell lymphoma. Sci Transl Med. 2015; 7: 282ra47. https://doi.org/10.1126/scitranslmed.aaa3230
Der T, Bailey BA, Youssef D, et al. Vitamin d and prostate cancer survival in veterans. Mil Med. 2014; 179: 81–4. https://doi.org/10.7205/MILMED-D-12-00540
Shi L, Nechuta S, Gao YT, et al. Correlates of 25-hydroxyvitamin D among Chinese breast cancer patients. PLoS ONE. 2014; 9: e86467. https://doi.org/10.1371/journal.pone.0086467
Spedding S, Vanlint S, Morris H, et al. Does vitamin D sufficiency equate to a single serum 25-hydroxyvitamin d level or are different levels required for non-skeletal diseases? Nutrients. 2013; 5: 5127–39. https://doi.org/10.3390/nu5125127
Naesgaard PA, León de la Fuente RA, Nilsen ST, et al. Vitamin d predicts all-cause and cardiac mortality in females with suspected acute coronary syndrome: a comparison with brain natriuretic peptide and high-sensitivity C-reactive protein. Cardiol Res Pract. 2013; 2013: 398034. https://doi.org/10.1155/2013/398034
Rohrmann S, Braun J, Bopp M, et al. Inverse association between circulating vitamin D and mortality—dependent on sex and cause of death? Nutr Metab Cardiovasc Dis. 2013; 23: 960–6. https://doi.org/10.1016/j.numecd.2013.05.005
Bjelakovic G, Gluud LL, Nikolova D, et al. Vitamin D supplementation for prevention of mortality in adults. Cochrane Database Syst Rev. 2014; (1): CD007470. https://doi.org/10.1002/14651858.CD007470.pub3
Bergman P, Sperneder S, Höijer J, et al. Low vitamin d levels are associated with higher opioid dose in palliative cancer patients—results from an observational study in Sweden. PLoS ONE. 2015; 10: e0128223. https://doi.org/10.1371/journal.pone.0128223
Spedding S, Vanlint S, Morris H, et al. Does vitamin D sufficiency equate to a single serum 25-hydroxyvitamin d level or are different levels required for non-skeletal diseases? Nutrients. 2013; 5: 5127–39. https://doi.org/10.3390/nu5125127
Li G, Mbuagbaw L, Samaan Z, et al. Efficacy of vitamin D supplementation in depression in adults: a systematic review. J Clin Endocrinol Metab. 2014; 99: 757–67. https://doi.org/10.1210/jc.2013-2952
Ovesjö ML, Skilving I, Bergman P, et al. Low vitamin D levels and genetic polymorphism in the vitamin D receptor are associated with increased risk of statin-induced myopathy. Basic Clin Pharmacol Toxicol. 2016; 118(3): 214–18. https://doi.org/10.1111/bcpt.12482
Whitehurst JL, Reid CM. Vitamin D deficiency as a cause of chronic pain in the palliative medicine clinic: two case reports. Palliat Med. 2014; 28: 87–9. https://doi.org/10.1177%2F0269216313511142
Kuru P, Akyuz G, Yagci I, et al. Hypovitaminosis D in widespread pain: its effect on pain perception, quality of life and nerve conduction studies. Rheumatol Int. 2015; 35: 315–22. https://doi.org/10.1007/s00296-014-3099-7
Maser RE, Lenhard MJ, Pohlig RT. Vitamin D insufficiency is associated with reduced parasympathetic nerve fiber function in type 2 diabetes. Endocr Pract. 2015; 21: 174–81. https://doi.org/10.4158/EP14332.OR
Chabas JF, Stephan D, Marqueste T, et al. Cholecalciferol (vitamin D3) improves myelination and recovery after nerve injury. PLoS ONE. 2013; 8: e65034. https://doi.org/10.1371/journal.pone.0065034
Wilhelm-Leen ER, Hall YN, DeBoer IH, Chertow GM. Vitamin D deficiency and frailty in older Americans. J Intern Med. 2010; 268(2): 171–80. https://doi.org/10.1111/j.1365-2796.2010.02248.x
Zhou J, Huang P, Liu P, Hao Q, Chen S, Dong B, et al. Association of vitamin D deficiency and frailty: A systematic review and meta-analysis. Maturitas. 2016; 94: 70–6. https://doi.org/10.1016/j.maturitas.2016.09.003
Artaza-Artabe I, Sáez-López P, Sánchez-Hernández N, et al. The relationship between nutrition and frailty: Effects of protein intake, nutritional supplementation, vitamin D and exercise on muscle metabolism in the elderly. A systematic review. Maturitas. 2016; 93: 89–99. https://doi.org/10.1016/j.maturitas.2016.04.009
Watson M, Campbell R, Vallath N, et al. The essential, holistic guide to palliative care. Oxford Handbook of Palliative Care. ABD: Oxford University Press; 2019.
Balducci L. Geriatric oncology, spirituality, and palliative care. Journal of pain and symptom management. 2019; 57(1): 171-175. https://doi.org/10.1016/j.jpainsymman.2018.05.009
Lam DY, Scherer JS, Brown M, et al. A conceptual framework of palliative care across the continuum of advanced kidney disease. Clinical Journal of the American Society of Nephrology. 2019; 14(4): 635-641. https://doi.org/10.2215/CJN.09330818
Nguyen V, Steiner J, Krieger E, et al. Trends in Palliative Care Use in Patients With Adult Congenital Heart Disease at the End-Of-Life. Circulation. 2019; 140(Suppl_1): A14215-A14215.
Chan KY, Chan ML. Enhanced psychosocial support as important component of neuro-palliative service. Annals of palliative medicine. 2018; 7(3): 355-358. doi: 10.21037 / apm.2017.08.19
Hofmeister M, Memedovich A, Dowsett LE, et al. Palliative care in the home: a scoping review of study quality, primary outcomes, and thematic component analysis. BMC palliative care. 2018; 17(1): 41. https://doi.org/10.1186/s12904-018-0299-z
Verberne LM, Kars MC, Schepers SA, et al. Barriers and facilitators to the implementation of a paediatric palliative care team. BMC Palliative Care. 2018; 17(1): 1-8. https://doi.org/10.1186/s12904-018-0274-8
Swami M, Case AA. Effective palliative care: what is involved?. Oncology. 2018; 32(4): 180-184.
Gündoğdu H. Evde nütrisyon desteği. İç Hastalıkları Dergisi. 2010; 17(4): 257-267.
Shatnawei A, Bharadwaj S, Konrad D, et al. Home parenteral care. Diet Nutr Crit Care. 2015; 1791-1804.
Villar-Taibo R, Martínez-Olmos MA, Bellido-Guerrero D, et al. Burden assessment in caregivers of patients with home artificial nutrition: a need and a challenge. European journal of clinical nutrition. 2017; 71(2): 192-197. https://doi.org/10.1038/ejcn.2016.239
