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Клинико-фармакологические аспекты применения витамина D: от известных фактов к поиску новых мишеней
Климова О.Ю., Бердникова Н.Г., Казаков Р.Е. Клинико-фармакологические аспекты применения витамина D: от известных фактов к поиску новых мишеней. Consilium Medicum. 2016; 18 (2): 109–116. DOI: 10.26442/2075-1753_2016.2.109-116
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Klimova O.Yu., Berdnikova N.G., Kazakov R.E. Clinical and pharmacological aspects of the use of vitamin D: from the known facts to look for new targets. Consilium Medicum. 2016; 18 (2): 109–116. DOI: 10.26442/2075-1753_2016.2.109-116
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Аннотация
Витамин D не только занимает важнейшее место в регуляции кальциево-фосфорного гомеостаза, но и обладает множеством «внекостных» эффектов. Выявленная в эпидемиологических исследованиях взаимосвязь между дефицитом витамина D и развитием разных заболеваний в настоящее время проходит изучение в рандомизированных клинических исследованиях. Выраженность клинических эффектов витамина D может зависеть от генетического полиморфизма VDR (рецепторов витамина D), экспрессирующихся более чем в 40 тканях-мишенях. Для профилактики и лечения витамин D-дефицитных состояний рекомендуются инсоляция и применение препаратов витамина D, в частности, его активного метаболита альфакальцидола.
Ключевые слова: витамин D, паратиреоидный гормон, кальцидиол, кальцитриол, VDR, остеопороз, холекальциферол, эргокальциферол, альфакальцидол.
Ключевые слова: витамин D, паратиреоидный гормон, кальцидиол, кальцитриол, VDR, остеопороз, холекальциферол, эргокальциферол, альфакальцидол.
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Vitamin D not only occupies an important place in the regulation of calcium-phosphorus homeostasis, but also has many "non-bone" effects. Revealed in epidemiological studies the link between vitamin D deficiency and the development of various diseases is currently under study in randomized clinical trials. Severity of clinical effects of vitamin D may be dependent on the genetic polymorphism of VDR (vitamin receptors D), over-expressed in the 40 target tissues. For the prevention and treatment of vitamin D-deficient conditions and insolation recommended application of vitamin D, in particular, its active metabolite alfacalcidol is used.
Key words: vitamin D, parathyroid hormone, calcidiol, calcitriol, the VDR, osteoporosis, cholecalciferol, ergocalciferol, alfacalcidol.
Полный текст
Список литературы
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26. Malinovschi А, Masoero М, Bellocchia М. Severe vitamin D deficiency is associated with frequent exacerbations and hospitalization in COPD patients. http://respiratory-research.com/content/15/1/131
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2. Мелентьева А.А., Барышева О.Ю., Везикова Н.Н. и др. Роль фактора роста фибробластов 23 и фактора Klotho в развитии минерально-костных нарушений при хронической болезни почек. Курский научно-практ. вестн. «Человек и его здоровье». 2014; 3: 102–9. / Melent'eva A.A., Barysheva O.Iu., Vezikova N.N. i dr. Rol' faktora rosta fibroblastov 23 i faktora Klotho v razvitii mineral'no-kostnykh narushenii pri khronicheskoi bolezni pochek. Kurskii nauchno-prakt. vestn. “Chelovek i ego zdorov'e”. 2014; 3: 102–9. [in Russian]
3. Гребенникова Т.А., Белая Ж.Е., Цориев Т.Т. и др. Эндокринная функция костной ткани. Остеопороз и остеопатии. 2015; 1: 28–37. / Grebennikova T.A., Belaia Zh.E., Tsoriev T.T. i dr. Endokrinnaia funktsiia kostnoi tkani. Osteoporoz i osteopatii. 2015; 1: 28–37. [in Russian]
4. Holick MF. Vitamin D deficiency. N Engl J Med 2007; 357: 266–81.
5. Heaney RP. Functional indices of vitamin D status and ramifications of vitamin D deficiency. Am J Clin Nutr 2004; 80 (6): 1706S–1709S.
6. Holick MF, Binkley NC et al. Weaver Evaluation, Treatment, and Prevention of Vitamin D. Deficiency: an Endocrine Society Clinical Practice Guideline. J Clin Endocrin Metab 2011; 6: 1911–30
7. Adams JS, Hewison M. Update in vitamin D. J Clin Endocrinol Metab 2010; 95: 471–8.
8. Holick MF, Binkley NC, Heike A et al. Guidelines for preventing and treating vitamin D deficiency and insufficiency revisited. J Clin Endocrinol Metab 2012; 97 (4): 1153–8.
9. Клинические рекомендации. Дефицит витамина D у взрослых: диагностика, лечение и профилактика. Российская Ассоциация Эндокринологов. ФГБУ «Эндокринологический Научный Центр Министерства здравоохранения РФ». М., 2015 http://www.endocrincentr.ru/images/material-images/Rek_Vit%20D_2015.pdf / Klinicheskie rekomendatsii. Defitsit vitamina D u vzroslykh: diagnostika, lechenie i profilaktika. Rossiiskaia Assotsiatsiia Endokrinologov. FGBU “Endokrinologicheskii Nauchnyi Tsentr Ministerstva zdravookhraneniia RF”. M., 2015 http://www.endocrincentr.ru/images/material-images/Rek_Vit%20D_2015.pdf [in Russian]
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11. Peterlik M, Boonen St, Cross HS, Lamberg-Allardt C. Vitamin D and Calcium Insufficiency – Related Chronic Diseases: an Emerging World-Wide Public Health Problem. J Environ Res Public Health 2009; 6 (10): 2585–607. http://dx.doi.org/10.3390/ijerph6102585
12. Grant WB, Mohr SF. Ecological studies of ultraviolet B, vitamin D and cancer since 2000. Ann Epidemiol 2009; 19: 446–54.
13. Lappe JM, Travers-Gustafson D, Davies KM et al. And calcium supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr 2007; 85 (6): 1586–91.
14. Kendrick J, Targher G, Smits G, Chonchol M. 25-Hydroxyvitamin D deficiency is independently associated with cardiovascular disease in the Third National Health and Nutrition Exam Surv Atheroscler 2009; 205 (1): 255–60.
15. Егшатян Л.В., Дудинская Е.Н., Ткачева О.Н., Каштанова Д.А. Роль витамина D в патогенезе хронических неинфекционных заболеваний. Остеопороз и остеопатии. 2014; 1: 27–30. / Egshatian L.V., Dudinskaia E.N., Tkacheva O.N., Kashtanova D.A. Rol' vitamina D v patogeneze khronicheskikh neinfektsionnykh zabolevanii. Osteoporoz i osteopatii. 2014; 1: 27–30. [in Russian]
16. Li C, Qiao G, Uskokovic M et al. Vitamin D: a negative endocrine regulator of the reninangiotensin system and blood pressure. J of Steroid Bioch and Molec Biol 2004; 89–90 (1–5): 387–92.
17. Afzal S, Nordestgaard BG. Low vitamin D and hypertension: a causal association? 2014. www.thelancet.com/diabetes-endocrinology. http://dx.doi.org/10.1016/S2213-8587(14)70119-6
18. Konradsen S, Ag H, Lindberg F et al. Serum 1.25-dihydroxy vitamin D is inversely associated with body mass index. Eur J Nutr 2008; 47 (2): 87–91.
19. Scragg R, Sowers M, Bell C. Serum 25-hydroxyvitamin D, diabetes, and ethnicity in the Third National Health and Nutrition Examination Survey. Diabetes Care 2004; 27: 2813–8.
20. Chiu KC, Chu A, Go VL, Saad MF. Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction. Am J Clin Nutr 2004; 79 (5): 820–5.
21. Harinarayan ChV. Vitamin D and diabetes mellitus. Hormones 2014; 13 (2): 163–81.
22. Вельков В.В. С-реактивный белок – в лабораторной диагностике острых воспалений и в оценке рисков сосудистых патологий. Клинико-лабораторный консилиум. 2008; 2 (21): 37–48. / Vel'kov V.V. S-reaktivnyi belok – v laboratornoi diagnostike ostrykh vospalenii i v otsenke riskov sosudistykh patologii. Kliniko-laboratornyi konsilium. 2008; 2 (21): 37–48. [in Russian]
23. Liu PT, Stenger S, Li H et al. Vitamin D3-Triggered Antimicrobial Response – Another Pleiotropic Effect beyond Mineral and Bone Metabolism. Science 2006; 311: 1770–3.
24. Chun RF, Liu NQ, Lee T et al. Vitamin D supplementation and antibacterial immune responses in adolescents and young adults with HIV/AIDS. J Steroid Biochem Mol Biol 2014; 8: 148. http://dx.doi.org/10.1016/j.jsbmb.2014.07.013
25. Skaaby T, Nystrup Husemoen LL, Thuesen BH. Vitamin D Status and Chronic Obstructive Pulmonary Disease: A Prospective General Population Study. 2014; http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0090654
26. Malinovschi А, Masoero М, Bellocchia М. Severe vitamin D deficiency is associated with frequent exacerbations and hospitalization in COPD patients. http://respiratory-research.com/content/15/1/131
27. Ringe JD et al. Alfacalcidol versus plain vitamin D in the treatment of glucocorticoid/inflammation-induced osteoporosis. J Rheumatol Suppl. 2005; 76: 33–40.
28. Ringe JD, Farahmand P, Schacht E. Alfacalcidol in men with osteoporosis: a prospective, observational, 2-year trial on 214 patients. Rheumatol Int 2013; 33 (3): 637–43.
29. Скрипникова И.А. Предотвращение падений – один из способов профилактики переломов, связанных с остеопорозом. Consilium Medicum. Неврология и ревматология. (Прил.). 2014; 16 (2): 66–70. / Skripnikova I.A. Predotvrashchenie padenii – odin iz sposobov profilaktiki perelomov, sviazannykh s osteoporozom. Consilium Medicum. Neurology and Rheumatology (Suppl.). 2014; 16 (2): 66–70. [in Russian]
30. Richy F, Dukas L, Schacht E. Differential effects of D-Hormone analogs and native vitamin D on the risk of falls: a comparative meta-analysis. Calcif Tissue Int 2008; 82: 102–7.
31. Ito S, Harada A, Kasai T et al. Use of alfacalcidol in osteoporotic patients with low muscle mass might increase muscle mass: an investigation using a patient database. Geriatr Gerontol Int 2014; 14: 122–8.
32. Hamdy NA, Kanis JA, Beneton MN et al. Effect of alfacalcidol on natural course of renal bone disease in mild to moderate renal failure. BMJ 1995; 310 (6976): 358–63.
33. Schact E, Richy F. Reduction of Falls in Elderly. The central role of Alfacalcidol in a multi-dimensional paradigm. Internet J Epidemiol 2008. http://ispub.com/IJE/7/1/5839
34. Dobnig H, Pilz S, Scharnagl H et al. Independent Association of Low Serum 25-Hydroxyvitamin D and 1,25-Dihydroxyvitamin D Levels With All-Cause and Cardiovascular Mortality. Arch Intern Med 2008; 168 (12): 1340–9. http://archinte.jamanetwork.com/
35. Ярмолинская М.И. Постменопаузальный остеопороз: клиника, диагностика, профилактика, лечение. СПб., 2014; с. 30–5. / Iarmolinskaia M.I. Postmenopauzal'nyi osteoporoz: klinika, diagnostika, profilaktika, lechenie. SPb., 2014; s. 30–5. [in Russian]
36. Rang HP, Dale MM, Ritter JM. Rang and Dale's Pharmacology. 6th Revised edition 2007.
37. Бердникова Н.Г. Клиническая фармакология лекарственных средств, применяющихся при остеопорозе. Глава 33. Клиническая фармакология и фармакотерапия: учебник. Под ред. В.Г.Кукеса, А.К.Стародубцева. 3-е изд., доп. и перераб. М.: ГЭОТАР-Медиа, 2011. / Berdnikova N.G. Klinicheskaia farmakologiia lekarstvennykh sredstv, primeniaiushchikhsia pri osteoporoze. Glava 33. Klinicheskaia farmakologiia i farmakoterapiia: uchebnik. Pod red. V.G.Kukesa, A.K.Starodubtseva. 3-e izd., dop. i pererab. M.: GEOTAR-Media, 2011. [in Russian]
38. Heller HJ. The role of calcium in the prevention of kidney stones. J Am Coll Nutr 1999; 18 (5 Suppl.): 373S–378S.
39. Hall WD, Pettinger M, Oberman A et al. Risk factors for kidney stones in older women in the southern United States. Am J Med Sci 2001; 322 (1): 12–8.
40. Curban GC, Willett WC, Rimm EB et al. A prospective study of dietary calcium and other nutrients and risk symptomatic kidney stones. N Engl J Med 1993; 328: 833–8.
41. Генетический паспорт – основа индивидуальной и предиктивной медицины. Под ред. В.С.Баранова. СПб., 2009; с. 527. / Geneticheskii pasport – osnova individual'noi i prediktivnoi meditsiny. Pod red. V.S.Baranova. SPb., 2009; s. 527. [in Russian]
42. Mohammadi Z, Fayyazbakhsh F, Ebrahimi M et al. Association between vitamin D receptor gene polymorphisms (Fok1 and Bsm1) and osteoporosis: a systematic review. J Diabetes Metab Disord 2014; 13: 98.
43. Xu C, Tang P, Ding C et al. Vitamin D Receptor Gene FOKI Polymorphism Contributes to Increasing the Risk of HIV-Negative Tuberculosis: Evidence from a Meta-Analysis. PLoS One. Doi:10.1371/journal.pone.0140634 October 20, 2015.
44. Sei Won Kim, Jong Min Lee, Jick Hwan Ha et al. Association between vitamin D receptor polymorphisms and osteoporosis in patients with COPD. Int J COPD 2015; 10: 1809–17.
45. McCarty MF, DiNicolantonio JJ. The molecular biology and pathophysiology of vascular calcification. Postgrad Med 2014; 126 (2): 54–64.
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Авторы
О.Ю.Климова*1, Н.Г.Бердникова1,2, Р.Е.Казаков3
1 ГБОУ ВПО Первый Московский государственный медицинский университет им. И.М.Сеченова Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2;
2 ГБУЗ Городская клиническая больница №23 им. И.В.Давыдовского Департамента здравоохранения г. Москвы. 119027, Россия, Москва, ул. Яузская, д. 11;
3 ФГБУ Научный центр экспертизы средств медицинского применения Минздрава России. 127051, Россия, Москва, Петровский б-р, д. 8
*oklimova2009@gmail.com
1 ГБОУ ВПО Первый Московский государственный медицинский университет им. И.М.Сеченова Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2;
2 ГБУЗ Городская клиническая больница №23 им. И.В.Давыдовского Департамента здравоохранения г. Москвы. 119027, Россия, Москва, ул. Яузская, д. 11;
3 ФГБУ Научный центр экспертизы средств медицинского применения Минздрава России. 127051, Россия, Москва, Петровский б-р, д. 8
*oklimova2009@gmail.com
________________________________________________
O.Yu.Klimova*1, N.G.Berdnikova1,2, R.E.Kazakov3
1 I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation. 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2;
2 I.M.Davidovckiy City Clinical Hospital №23. 119027, Russian Federation, Moscow, ul. Iauzskaia, d. 11;
3 Scientific Center for Expertise of Pharmaceuticals for Medical Use of the Ministry of Health of the Russian Federation. 127051, Russian Federation, Moscow, Petrovskii b-r, d. 8
*oklimova2009@gmail.com
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