title: Vitamin D status correction in Saudi Arabia: an experts' consensus under the auspices of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis, and Musculoskeletal Diseases (ESCEO).
abstract: BACKGROUND
  Vitamin D deficiency is common in the Middle East and in Saudi Arabia, in particular. While several international recommendations on the management of vitamin D deficiency have been documented and practiced globally, these recommendations should be adapted to the conditions of the Middle Eastern region. To address this challenge, the Prince Mutaib Chair for Biomarkers of Osteoporosis (PMCO) in King Saud University (KSU), Riyadh, KSA, together with local experts and in cooperation with the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO), organized a panel that formulated unified recommendations in the diagnosis and treatment of vitamin D deficiency in the region.
  
  
  METHODS
  The selection of local and international experts commenced during the 2nd International Vitamin D Symposium conducted in Riyadh, Saudi Arabia, last January 20--21, 2016. Reviews of the most recent literature were done, and face-to-face meetings were conducted for revisions and final recommendations.
  
  
  RESULTS
  Vitamin D sufficiency is defined as circulating serum 25(OH)D ≥50 nmol (≥20 ng/ml) for the general population and vitamin D adequacy as serum 25(OH)D >75 nmol/L l (>30 ng/ml) for the frail and osteoporotic elderly. Despite overwhelming prevalence of vitamin D deficiency, universal screening is not recommended. Recommendations for the general population, children, pregnant/lactating women, post-menopausal women, the elderly, and those with subsequent metabolic diseases were provided.
  
  
  RESULTS
  Vitamin D sufficiency is defined as circulating serum 25(OH)D ≥50 nmol (≥20 ng/ml) for the general population and vitamin D adequacy as serum 25(OH)D >75 nmol/L l (>30 ng/ml) for the frail and osteoporotic elderly. Despite overwhelming prevalence of vitamin D deficiency, universal screening is not recommended. Recommendations for the general population, children, pregnant/lactating women, post-menopausal women, the elderly, and those with subsequent metabolic diseases were provided.
  
  
  CONCLUSIONS
  Vitamin D supplementation/correction is advised in all persons whose serum 25(OH)D falls below 50 nmol/l (20 ng/ml), and achieving a target of 75 nmol/l (30 ng/ml) is particularly suited for frail, osteoporotic, and older patients. Conducting well-designed clinical trials in the region that will address economic implications and investigations on the treatment persistence and compliance to vitamin D treatment in the region are encouraged.
authors.affiliation: Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia. aldaghri2011@gmail.com.|Biomarkers Research Program, Biochemistry Department, College of Science, King Saud University|, PO Box, 2455, Riyadh, 11451, Saudi Arabia. aldaghri2011@gmail.com.
authors.forename: Nasser M
authors.initials: NM
authors.lastname: Al-Daghri
authors.affiliation: Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia.|College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, 14229, Saudi Arabia.
authors.forename: Yousef
authors.initials: Y
authors.lastname: Al-Saleh
authors.affiliation: Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia.|Obesity, Endocrine and Metabolism Center, King Fahad Medical City, Faculty of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, 11525, Saudi Arabia.
authors.forename: Naji
authors.initials: N
authors.lastname: Aljohani
authors.affiliation: Department of Medicine, College of Medicine, King Saud University, Riyadh, 11426, Saudi Arabia.
authors.forename: Riad
authors.initials: R
authors.lastname: Sulimani
authors.affiliation: Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia.|Sehhati National Medical Co., Riyadh, 11321, Saudi Arabia.
authors.forename: Abdulaziz M
authors.initials: AM
authors.lastname: Al-Othman
authors.affiliation: Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia.|Department of Food Science and Nutrition, College of Food Science and Agriculture, King Saud University, Riyadh, 11451, Saudi Arabia.
authors.forename: Hanan
authors.initials: H
authors.lastname: Alfawaz
authors.affiliation: Department of Medicine, College of Medicine, King Saud University, Riyadh, 11426, Saudi Arabia.
authors.forename: Mona
authors.initials: M
authors.lastname: Fouda
authors.affiliation: Osteoporosis Control Program, Ministry of Health, Riyadh, Saudi Arabia.
authors.forename: Fahad
authors.initials: F
authors.lastname: Al-Amri
authors.affiliation: College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, 14229, Saudi Arabia.
authors.forename: Awad
authors.initials: A
authors.lastname: Shahrani
authors.affiliation: Diabetes Centers and Units Administration, Ministry of Health, Riyadh, Saudi Arabia.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Alharbi
authors.affiliation: Department of Family Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, 14229, Saudi Arabia.
authors.forename: Fahad
authors.initials: F
authors.lastname: Alshahrani
authors.affiliation: Department of Pathology and Lab Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, 14229, Saudi Arabia.
authors.forename: Waleed
authors.initials: W
authors.lastname: Tamimi
authors.affiliation: Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia.|Biomarkers Research Program, Biochemistry Department, College of Science, King Saud University|, PO Box, 2455, Riyadh, 11451, Saudi Arabia.
authors.forename: Shaun
authors.initials: S
authors.lastname: Sabico
authors.affiliation: Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, 1211, Geneva, Switzerland.
authors.forename: Rene
authors.initials: R
authors.lastname: Rizzoli
authors.affiliation: Department of Public Health, Epidemiology and Health Economics, University of Liège, 4000, Liège, Belgium.
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Reginster
mesh_terms: D019587:Dietary Supplements; D019468:Disease Management; D006801:Humans; D015995:Prevalence; D012529:Saudi Arabia / Q000453:epidemiology; D014807:Vitamin D / Q000097:blood / Q000494:pharmacology; D014808:Vitamin D Deficiency / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D014815:Vitamins / Q000097:blood / Q000494:pharmacology
chemical_list: D014815:Vitamins; D014807:Vitamin D
keywords: Consensus; ESCEO; Recommendations; Saudi Arabia; Vitamin D