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The Lebanese GRADE-based vitamin D guidelines: a paradigm for the MENA region

Chakhtoura M, Akl E, Arabi A, Ahmadieh H, Antoun S, Atallah P, Baddoura R, Barake M et al.

Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2025

2 citations

Abstract

BACKGROUND: The Middle East and North Africa region are traditionally known as regions with a high prevalence of vitamin D deficiency. However, serum 25-hydroxyvitamin D (25OHD) levels seem to be increasing lately. We developed guidelines on the screening and supplementation of adult Lebanese patients with vitamin D. These guidelines address community-dwelling and institutionalized individuals.

METHODS: Our guideline panel consisted of clinical and methodology experts that formulated the guidelines questions. We conducted a systematic review to gather global data on fracture (CRD42019129540), regional data on vitamin D trials (CRD42014010488), and on patients' values and preferences (CRD42022320022). We also complemented the latter with results from a cross-sectional local study. We followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to assess the quality and certainty of evidence, and to develop recommendations.

RESULTS: For community-dwelling and institutionalized Lebanese adult population, the panel suggests no screening for vitamin D deficiency, over screening for vitamin D deficiency (conditional recommendation, based on very low certainty evidence). For community-dwelling Lebanese adult population, the panel suggests no supplementation with calcium and vitamin D, over supplementation (conditional recommendation, based on moderate certainty evidence). For institutionalized Lebanese adult population, the panel suggests…

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