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Дефицит витамина D: причина или следствие ожирения?
Дефицит витамина D: причина или следствие ожирения?
Каронова Т.Л., Шмонина И.А., Андреева А.Т. и др. Дефицит витамина D: причина или следствие ожирения? Consilium Medicum. 2016; 18 (4): 49–52. DOI: 10.26442/2075-1753_2016.4.49-52
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Аннотация
Настоящая статья посвящена оценке причинно-следственных взаимоотношений между такими метаболическими нарушениями, как ожирение и дефицит витамина D, каждое из которых представляет собой важную проблему современной медицины. Проведенное исследование продемонстрировало высокую коморбидность данных состояний и негативную роль избыточного количества жировой массы в развитии недостатка и дефицита витамина D. Полученные данные свидетельствуют о необходимости снижения массы тела более чем на 5% от исходного значения и использования больших доз колекальциферола у больных ожирением для лечения недостатка и дефицита витамина D.
Ключевые слова: ожирение, избыточная масса тела, дефицит витамина D, 25(ОН)D.
Key words: obesity, overweight, vitamin D deficiency, 25(OH)D.
Ключевые слова: ожирение, избыточная масса тела, дефицит витамина D, 25(ОН)D.
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Key words: obesity, overweight, vitamin D deficiency, 25(OH)D.
Полный текст
Список литературы
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28. Никитина И.Л., Тодиева А.М., Каронова Т.Л. и др. Взаимосвязь уровня витамина D, содержания адипоцитокинов и метаболических нарушений у детей с ожирением. Бюл. ФЦСКЭ им. В.А.Алмазова. 2013; 20 (3): 37–46. / Nikitina I.L., Todieva A.M., Karonova T.L. i dr. Vzaimosviaz' urovnia vitamina D, soderzhaniia adipotsitokinov i metabolicheskikh narushenii u detei s ozhireniem. Biul. FTsSKE im. V.A.Almazova. 2013; 20 (3): 37–46. [in Russian]
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30. Rock CL, Emond JA, Flatt SW et al. Weight loss is associated with increased serum 25-hydroxyvitamin D in overweight or obese women. Obesity 2012; 20: 2296–301.
31. Pludowski P, Karczmarewicz E, Bayer M et al Practical guidelnes for te supplementation of vitamin D and the treatment of deficits in Central Europe – reccomendation of vitamin D intakes in the general population and groups at risk of vitamin D deficiency. Endokrynol Pol 2013; 64: 319–27.
2. Muscogiuri G, Sorice GP, Ajjan R et al. Can vitamin D deficiency cause diabetes and cardiovascular diseases? Present evidence and future perspectives. Nutr Metab Cardiovasc Dis 2012; 22 (2): 81–7.
3. Somjen D, Weisman Y, Kohen F et al. 25-hydroxyvitamin D3-1-alpha-hydroxylase is expressed in human vascular smooth muscle cells and is upregulated by parathyroid hormone and estrogenic compounds. Circulation 2005; 111 (Iss. 11): 1666–71.
4. Holick MF. High prevalence of vitamin D inadequacy and implications for health. Mayo Clin Proc 2006; 81 (3): 353–73.
5. Adams JS, Hewison M. Update in vitamin D. J Clin Endocrinol Metab 2010; 95: 471–8.
6. Karonova T.L., Grineva E.N., Nikitina I.L. i dr. Rasprostranennost' defitsita vitamina D v Severo-Zapadnom regione RF sredi zhitelei g. Sankt-Peterburga i g. Petrozavodska. Osteoporoz i osteopatii. 2013; 3: 3–7. [in Russian]
7. Goldner WS, Stoner JA, Thompson J et al. Prevalence of vitamin D insufficiency in morbidly obese patients: comparison with non-obese controls. Obes Surg 2008; 18: 145–50.
8. Nikitina I.L., Karonova T.L., Grineva E.N. Defitsit vitamina D i zdorov'e. Arterial'naia gipertenziia. 2010; 16 (3): 277–81. [in Russian]
9. Earthman CP, Beckman LM, Masodkar K, Sibley SD. The link between obesity and low circulating 25-hydroxyvitamin D concentrations: considerations and implications. International J Obes Advance online publication. 21 jun 2011.-doi:10.1038/ijo.2011.119.
10. Karonova T.L., Grineva E.N., Mikheeva E.P. i dr. Uroven' vitamina D i ego vzaimosviaz' s kolichestvom zhirovoi tkani i soderzhaniem adipotsitokinov u zhenshchin reproduktivnogo vozrasta. Problemy endokrinologii. 2012; 6: 19–24. [in Russian]
11. Kull M, Kallikorm R, Lember M. Body mass index determines sunbathing habits: implications on vitamin d levels. Int Med J 2009; 39 (4): 256–8.
12. Wortsman J, Matsuoka LY, Chen TC et al. Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr 2000; 72: 690–3.
13. Li J, Byrne ME, Chang E et al. 1Alpha,25-Dihydroxyvitamin D hydroxylase in adipocytes. J Steroid Biochem Mol Biol 2008; 112: 122–6.
14. Targher G, Bertolini L, Scala L al. Associations between serum 25-hydroxyvitamin D3 concentrations and liver histology in patients with non-alcoholic fatty liver disease. Nutr Metab Cardiovasc Dis 2007; 17: 517–24.
15. Fisher L, Fisher A. Vitamin D and parathyroid hormone in outpatients with noncholestatic chronic liver disease. Clin Gastroenterol Hepatol 2007; 5 (4): 513–20.
16. Canavan B, Salem RO, Schurgin S et al. Effects of physiological leptin administration on markers of inflammation, platelet activation, and platelet aggregation during caloric deprivation. J Clin Endocrinol Mеtab 2005; 90 (10): 5779–85.
17. 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 (12): 2813–8.
18. Matsunuma A, Horiuchi N. Leptin attenuates gene expression for renal 25-hydroxyvitamin D(3) –1 alpha-hydroxylase in mice via the long form of the leptin receptor. Arch Biochem Biophys 2007; 463 (1): 118–27.
19. Kong J, Li YC. Molecular mechanism of 1,25-dihydroxyvitamin D3 inhibition of adipogenesis in 3T3-L1 cells. Am J Physiol Endocrinol Metab 2006; 290: 916–24.
20. Gonzales AM, Orlando RA. Role of adipocyte–derived lipoprotein lipase in adipocyte hypertrophy. Nutr Metab (London) 2007; 4 (1): 22.
21. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: The Evidence Report. National Institutes of Health. National Heart, Lung, and Blood Institute. Obes Res 1998; 6 (2): 51S–209S.
22. IDF Consensus Worldwide Definition of Metabolic Syndrome: booklet [Electronic resourse]. International Diabetes Federation. Worldwide Definition of Metabolic Syndrome 2006. Mode of access: Internet via World Wide Web. URL: http://www.idf.org/webdata/docs/IDF_Metasyndrome_difinition.pdf. Title from title screen: 24.
23. Heaney RP, Murad MH, Weaver. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2011; 96: 1911–30.
24. Clinical recomendation of Russian association of endocrinologists. Vitamin D deficiency in adults: diagnosis, treatment and prevention. 2015. http://www.endocrincentr.ru/images/material-images/D/2019042014.pdf / [in Russian]
25. Lesniak O.M., Nikitinskaia O.A., Toroptsova N.V. i dr. Profilaktika, diagnostika i lechenie defitsita vitamina D i kal'tsiia u vzroslogo naseleniia Rossii i patsientov s osteoporozom (po materialam podgotovlennykh klinicheskikh rekomendatsii). Nauchno-prakticheskaia revmatologiia. 2015; 53 (4): 403–8. [in Russian]
26. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: The Evidence Report / National Institutes of Health. National Heart, Lung, and Blood Institute. Obes Res 1998; 6 (Suppl. 2): 51S–209S.
27. Natsional'nye rekomendatsii po kardiovaskuliarnoi profilaktike Vserossiiskogo nauchnogo obshchestva kardiologov. Kardiovaskuliarnaia terapiia i profilaktika (Pril. 2.). 2011; 10 (6). [in Russian]
28. Nikitina I.L., Todieva A.M., Karonova T.L. i dr. Vzaimosviaz' urovnia vitamina D, soderzhaniia adipotsitokinov i metabolicheskikh narushenii u detei s ozhireniem. Biul. FTsSKE im. V.A.Almazova. 2013; 20 (3): 37–46. [in Russian]
29. Karonova T.L., Beliaeva O.D., Chubenko E.A. i dr. Sposob povysheniia urovnia vitamina D u zhenshchin s abdominal'nym ozhireniem i vysokim riskom razvitiia metabolicheskogo sindroma : pat. 2560345 Ros. Federatsiia : MPK7 H 04 V 1/38, N 04 J 13/00. 20.08.15. Biul. №23. [in Russian]
30. Rock CL, Emond JA, Flatt SW et al. Weight loss is associated with increased serum 25-hydroxyvitamin D in overweight or obese women. Obesity 2012; 20: 2296–301.
31. Pludowski P, Karczmarewicz E, Bayer M et al Practical guidelnes for te supplementation of vitamin D and the treatment of deficits in Central Europe – reccomendation of vitamin D intakes in the general population and groups at risk of vitamin D deficiency. Endokrynol Pol 2013; 64: 319–27.
2. Muscogiuri G, Sorice GP, Ajjan R et al. Can vitamin D deficiency cause diabetes and cardiovascular diseases? Present evidence and future perspectives. Nutr Metab Cardiovasc Dis 2012; 22 (2): 81–7.
3. Somjen D, Weisman Y, Kohen F et al. 25-hydroxyvitamin D3-1-alpha-hydroxylase is expressed in human vascular smooth muscle cells and is upregulated by parathyroid hormone and estrogenic compounds. Circulation 2005; 111 (Iss. 11): 1666–71.
4. Holick MF. High prevalence of vitamin D inadequacy and implications for health. Mayo Clin Proc 2006; 81 (3): 353–73.
5. Adams JS, Hewison M. Update in vitamin D. J Clin Endocrinol Metab 2010; 95: 471–8.
6. Каронова Т.Л., Гринева Е.Н., Никитина И.Л. и др. Распространенность дефицита витамина D в Северо-Западном регионе РФ среди жителей г. Санкт-Петербурга и г. Петрозаводска. Остеопороз и остеопатии. 2013; 3: 3–7. / Karonova T.L., Grineva E.N., Nikitina I.L. i dr. Rasprostranennost' defitsita vitamina D v Severo-Zapadnom regione RF sredi zhitelei g. Sankt-Peterburga i g. Petrozavodska. Osteoporoz i osteopatii. 2013; 3: 3–7. [in Russian]
7. Goldner WS, Stoner JA, Thompson J et al. Prevalence of vitamin D insufficiency in morbidly obese patients: comparison with non-obese controls. Obes Surg 2008; 18: 145–50.
8. Никитина И.Л., Каронова Т.Л., Гринева Е.Н. Дефицит витамина Д и здоровье. Артериальная гипертензия. 2010; 16 (3): 277–81. / Nikitina I.L., Karonova T.L., Grineva E.N. Defitsit vitamina D i zdorov'e. Arterial'naia gipertenziia. 2010; 16 (3): 277–81. [in Russian]
9. Earthman CP, Beckman LM, Masodkar K, Sibley SD. The link between obesity and low circulating 25-hydroxyvitamin D concentrations: considerations and implications. International J Obes Advance online publication. 21 jun 2011.-doi:10.1038/ijo.2011.119.
10. Каронова Т.Л., Гринева Е.Н., Михеева Е.П. и др. Уровень витамина D и его взаимосвязь с количеством жировой ткани и содержанием адипоцитокинов у женщин репродуктивного возраста. Проблемы эндокринологии. 2012; 6: 19–24. / Karonova T.L., Grineva E.N., Mikheeva E.P. i dr. Uroven' vitamina D i ego vzaimosviaz' s kolichestvom zhirovoi tkani i soderzhaniem adipotsitokinov u zhenshchin reproduktivnogo vozrasta. Problemy endokrinologii. 2012; 6: 19–24. [in Russian]
11. Kull M, Kallikorm R, Lember M. Body mass index determines sunbathing habits: implications on vitamin d levels. Int Med J 2009; 39 (4): 256–8.
12. Wortsman J, Matsuoka LY, Chen TC et al. Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr 2000; 72: 690–3.
13. Li J, Byrne ME, Chang E et al. 1Alpha,25-Dihydroxyvitamin D hydroxylase in adipocytes. J Steroid Biochem Mol Biol 2008; 112: 122–6.
14. Targher G, Bertolini L, Scala L al. Associations between serum 25-hydroxyvitamin D3 concentrations and liver histology in patients with non-alcoholic fatty liver disease. Nutr Metab Cardiovasc Dis 2007; 17: 517–24.
15. Fisher L, Fisher A. Vitamin D and parathyroid hormone in outpatients with noncholestatic chronic liver disease. Clin Gastroenterol Hepatol 2007; 5 (4): 513–20.
16. Canavan B, Salem RO, Schurgin S et al. Effects of physiological leptin administration on markers of inflammation, platelet activation, and platelet aggregation during caloric deprivation. J Clin Endocrinol Mеtab 2005; 90 (10): 5779–85.
17. 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 (12): 2813–8.
18. Matsunuma A, Horiuchi N. Leptin attenuates gene expression for renal 25-hydroxyvitamin D(3) –1 alpha-hydroxylase in mice via the long form of the leptin receptor. Arch Biochem Biophys 2007; 463 (1): 118–27.
19. Kong J, Li YC. Molecular mechanism of 1,25-dihydroxyvitamin D3 inhibition of adipogenesis in 3T3-L1 cells. Am J Physiol Endocrinol Metab 2006; 290: 916–24.
20. Gonzales AM, Orlando RA. Role of adipocyte–derived lipoprotein lipase in adipocyte hypertrophy. Nutr Metab (London) 2007; 4 (1): 22.
21. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: The Evidence Report. National Institutes of Health. National Heart, Lung, and Blood Institute. Obes Res 1998; 6 (2): 51S–209S.
22. IDF Consensus Worldwide Definition of Metabolic Syndrome: booklet [Electronic resourse]. International Diabetes Federation. Worldwide Definition of Metabolic Syndrome 2006. Mode of access: Internet via World Wide Web. URL: http://www.idf.org/webdata/docs/IDF_Metasyndrome_difinition.pdf. Title from title screen: 24.
23. Heaney RP, Murad MH, Weaver. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2011; 96: 1911–30.
24. Клинические рекомендации Российской ассоциации эндокринологов. Дефицит витамина D у взрослых: диагностика, лечение и профилактика. 2015. http://www.endocrincentr.ru/images/material-images/D/ 2019042014.pdf [Clinical recomendation of Russian association of endocrinologists. Vitamin D deficiency in adults: diagnosis, treatment and prevention. 2015. http://www.endocrincentr.ru/images/material-images/D/2019042014.pdf] / [in Russian]
25. Лесняк О.М., Никитинская О.А., Торопцова Н.В. и др. Профилактика, диагностика и лечение дефицита витамина D и кальция у взрослого населения России и пациентов с остеопорозом (по материалам подготовленных клинических рекомендаций). Научно-практическая ревматология. 2015; 53 (4): 403–8. / Lesniak O.M., Nikitinskaia O.A., Toroptsova N.V. i dr. Profilaktika, diagnostika i lechenie defitsita vitamina D i kal'tsiia u vzroslogo naseleniia Rossii i patsientov s osteoporozom (po materialam podgotovlennykh klinicheskikh rekomendatsii). Nauchno-prakticheskaia revmatologiia. 2015; 53 (4): 403–8. [in Russian]
26. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: The Evidence Report / National Institutes of Health. National Heart, Lung, and Blood Institute. Obes Res 1998; 6 (Suppl. 2): 51S–209S.
27. Национальные рекомендации по кардиоваскулярной профилактике Всероссийского научного общества кардиологов. Кардиоваскулярная терапия и профилактика (Прил. 2.). 2011; 10 (6). / Natsional'nye rekomendatsii po kardiovaskuliarnoi profilaktike Vserossiiskogo nauchnogo obshchestva kardiologov. Kardiovaskuliarnaia terapiia i profilaktika (Pril. 2.). 2011; 10 (6). [in Russian]
28. Никитина И.Л., Тодиева А.М., Каронова Т.Л. и др. Взаимосвязь уровня витамина D, содержания адипоцитокинов и метаболических нарушений у детей с ожирением. Бюл. ФЦСКЭ им. В.А.Алмазова. 2013; 20 (3): 37–46. / Nikitina I.L., Todieva A.M., Karonova T.L. i dr. Vzaimosviaz' urovnia vitamina D, soderzhaniia adipotsitokinov i metabolicheskikh narushenii u detei s ozhireniem. Biul. FTsSKE im. V.A.Almazova. 2013; 20 (3): 37–46. [in Russian]
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29. Karonova T.L., Beliaeva O.D., Chubenko E.A. i dr. Sposob povysheniia urovnia vitamina D u zhenshchin s abdominal'nym ozhireniem i vysokim riskom razvitiia metabolicheskogo sindroma : pat. 2560345 Ros. Federatsiia : MPK7 H 04 V 1/38, N 04 J 13/00. 20.08.15. Biul. №23. [in Russian]
30. Rock CL, Emond JA, Flatt SW et al. Weight loss is associated with increased serum 25-hydroxyvitamin D in overweight or obese women. Obesity 2012; 20: 2296–301.
31. Pludowski P, Karczmarewicz E, Bayer M et al Practical guidelnes for te supplementation of vitamin D and the treatment of deficits in Central Europe – reccomendation of vitamin D intakes in the general population and groups at risk of vitamin D deficiency. Endokrynol Pol 2013; 64: 319–27.
Авторы
Т.Л.Каронова*1,2, И.А.Шмонина2, А.Т.Андреева1, А.А.Байрамов1, О.Д.Беляева2
1 ФГБУ Северо-Западный федеральный медицинский исследовательский центр им. В.А.Алмазова Минздрава России. 197341, Россия, Санкт-Петербург, ул. Аккуратова, д. 2;
2 ГБОУ ВПО Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П.Павлова Минздрава России. 197022, Россия, Санкт-Петербург, ул. Льва Толстого, д. 6/8
*karonova@mail.ru
1 V.A.Almazov North-West federal medical research center of the Ministry of Health of the Russian Federation. 197341, Russian Federation, Saint Petersburg, ul. Akkuratova, d. 2;
2 I.M.Pavlov First Saint Petersburg State Medical University of the Ministry of Health of the Russian Federation. 197022, Russian Federation, Saint Petersburg, ul. L'va Tolstogo, d. 6/8
*karonova@mail.ru
1 ФГБУ Северо-Западный федеральный медицинский исследовательский центр им. В.А.Алмазова Минздрава России. 197341, Россия, Санкт-Петербург, ул. Аккуратова, д. 2;
2 ГБОУ ВПО Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П.Павлова Минздрава России. 197022, Россия, Санкт-Петербург, ул. Льва Толстого, д. 6/8
*karonova@mail.ru
________________________________________________
1 V.A.Almazov North-West federal medical research center of the Ministry of Health of the Russian Federation. 197341, Russian Federation, Saint Petersburg, ul. Akkuratova, d. 2;
2 I.M.Pavlov First Saint Petersburg State Medical University of the Ministry of Health of the Russian Federation. 197022, Russian Federation, Saint Petersburg, ul. L'va Tolstogo, d. 6/8
*karonova@mail.ru
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