Vitamin D deficiency has a high worldwide prevalence, but actions to improve this public health problem are challenged by the heterogeneity of nutritional and clinical vitamin D guidelines, with respect to the diagnosis and treatment of vitamin D deficiency. We aimed to address this issue by providing respective recommendations for adults, developed by a European expert panel, using the Delphi method to reach consensus. Increasing the awareness of vitamin D deficiency and efforts to harmonize vitamin D guidelines should be pursued. We argue against a general screening for vitamin D deficiency but suggest 25-hydroxyvitamin D (25(OH)D) testing in certain risk groups. We recommend a vitamin D supplementation dose of 800 to 2000 international units (IU) per day for adults who want to ensure a sufficient vitamin D status. These doses are also recommended for the treatment of vitamin D deficiency, but higher vitamin D doses (e.g., 6000 IU per day) may be used for the first 4 to 12 weeks of treatment if a rapid correction of vitamin D deficiency is clinically indicated before continuing, with a maintenance dose of 800 to 2000 IU per day. Treatment success may be evaluated after at least 6 to 12 weeks in certain risk groups (e.g., patients with malabsorption syndromes) by measurement of serum 25(OH)D, with the aim to target concentrations of 30 to 50 ng/mL (75 to 125 nmol/L).

Introduction: Insulin-like growth factor-1 (IGF-1) is a potent mitogen for glomerular mesangial cells which can stimulate cell migration and the production of fibronectin, proteoglycan, and type IV collagen, thereby promoting the development of the chronic kidney disease (CKD) in patients with diabetes. Objectives: The aim of the study was to assess the associations between serum levels of IGF-1 and insulin-like growth factor-binding protein-3 (IGFBP-3) and CKD in diabetic patients. Patients and Methods: We investigated 102 Belarusian men and women with diabetes type 2 aged 56.67±0.81 years. Control group included 68 healthy people the same age. We estimated GFR with the use of the CKD-EPI creatinine-cystatin C equation to determine eGFRcr_cys. Serum total IGF-1 and IGFBP-3 levels were measured using immunoradiometric assay (IRMA) (Beckman Coulter, Czech Republic s.r.o.). Results: Patients with diabetes had significantly lower level of IGF-1 than controls. However, IGFBP-3 levels were similar in the two groups. Diabetic patients with CKD had significantly higher levels of IGF-1 and IGFBP-3 than diabetic patients without CKD (P=0.0031). However, according to multivariate analysis, only IGF-1 and cystatin C were associated with renal impairment. In detail, the odds of having eGFR<60 mL/min/1.73 m2 increased with rising IGF-1 levels (OR: 1.025, [CI 1.002-1.048]). Conclusion: Our study revealed that higher serum IGF-1 levels were positively associated with CKD in patients with diabetes. We suggest that IGF-1 might be a predictor of CKD in patients with diabetes. Further research is necessary to confirm the observed this association and to detect the causal relations.

There is a strategy being implemented now in Belarus that involves obligatory application of high quality iodized salt in food industry; it has resulted in iodine deficiency elimination among population. Sales of iodized salt account for more than 70 % of the overall salt sales in retail outlets. However, attention paid to the issue has started to decline recently, including mass media; at present there is no social advertising that informs people about iodized salt being useful for their health. Our research object was population awareness about various aspects related to prevention of diseases caused by iodine deficiency and objective indicators of iodine provision. Our research goal was to determine probable risks of iodine deficiency prophylaxis becoming less efficient and to substantiate ways how to prevent negative trends. Data and methods. We assessed population awareness on iodine deficiency via questioning; overall, 805 people living in Belarus took part in it. Alimentary exposure to iodine was calculated for various scenarios taking into account natural iodine contents and artificially added iodine in food products as well as consumption volumes. Ioduria was assessed with cerium-arsenite technique. We considered dynamics in morbidity with simple goiter and congenital hypothyroidism to be indicators of iodine provision. Basic results. We detected that most respondents, 658 (81.7 %, 95 % CI 78.8-84.7) to be exact, thoughts that their therapists were the primary source of knowledge on health-related issues; 176 (21.9 %, 95 % CI 15.8-28.0) trusted mass media including the Internet. More than half respondents (61.4 %, 95 % CI 60.8-62.0 %) and medical personnel statistically significantly more frequently (77.1 %, 95 % CI 70.7-83.61 %) believed there was a iodine deficiency problem existing in the country. We didn't detect any risk of excessive iodine introduction with food products. Selective monitoring over ioduria among children proves their iodine provision is quite appropriate as it amounts to more than 100 µg/l. Dynamics of primary morbidity with congenital hypothyroidism confirms that stable positive results have been achieved in the sphere; in 2006 primary morbidity was equal to 1.96 per 100 thousand people, but in 2017 it dropped to 0.96 per 100 thousand people. It proves that Belarus is among countries where population consume proper amounts of iodine. But an arising trend for lower awareness about iodine deficiency calls for more active risk communication about possible diseases related to iodine deficiency, including mass media campaigns.

Белорусская академия последипломного образования 4 Республиканский научно практический центр гигиены 5 Белорусский государственный экологический университет им. А.Д. Сахарова 6 Республиканский научно практический центр "Мать и дитя" 7 Международный совет по контролю за йододефицитными заболеваниями (ICCIDD) В.И. Качан-заместитель министра здравоохранения, Главный государственный санитарный врач Республи ки Беларусь; Т.В. Мохорт-профессор Белорусского государственного медицинского университета; Н.Д. Ко ломиец-заведующая кафедрой Белорусской академии последипломного образования; В.П. Филонов-ди ректор Республиканского научно практического центра гигиены; С.В. Петренко-заведующий лабораторией Белорусского государственного экологического университета им. А.Д. Сахарова; Н.Б. Гусина-заведующая клинико диагностической генетической лабораторией Республиканского научно практического центра "Мать и дитя"; Г.А. Герасимов-региональный координатор Международного совета по контролю за йододе фицитными заболеваниями (ICCIDD) Strategy for elimination of iodine deficiency in Belarus: evaluation of 10 years experience V

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