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Плейотропные эффекты витамина D: необходимый элемент терапии при коморбидности
Климова О.Ю., Бердникова Н.Г., Казаков Р.Е. Плейотропные эффекты витамина D: необходимый элемент терапии при коморбидности. Consilium Medicum. 2017; 19 (9): 114–121. DOI: 10.26442/2075-1753_19.9.114-121
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Klimova O.Yu., Berdnikova N.G., Kazakov R.E. Pleiotropic effects of vitamin D: an essential element of comorbidity therapy. Consilium Medicum. 2017; 19 (9): 114–121. DOI: 10.26442/2075-1753_19.9.114-121
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Аннотация
Витамин D имеет важное значение в регуляции кальциево-фосфорного гомеостаза. Дефицит витамина D приводит не только к рахиту, остеомаляции и остеопорозу, но и ассоциирован с «внекостными» патологиями, такими как метаболический синдром, сахарный диабет типа 2, увеличением риска сердечно-сосудистых заболеваний. Одним из патофизиологических факторов этих заболеваний является системное воспаление. Остеопороз часто сопровождает тяжелое течение хронической обструктивной болезни легких. Потенциальными механизмами, связывающими хроническую обструктивную болезнь легких с внелегочными проявлениями и сопутствующими заболеваниями, являются также системное воспаление и хроническая гипоксия. Кальцитриол регулирует обмен кальция и обладает иммуномодулирующими свойствами, что обусловливает защитный эффект при системном воспалении. Альфакальцидол – активный метаболит витамина D, используемый для профилактики и лечения D-дефицитных состояний.
Ключевые слова: витамин D, кальцитриол, остеопороз, системное воспаление, хроническая обструктивная болезнь легких, метаболический синдром, альфакальцидол.
Ключевые слова: витамин D, кальцитриол, остеопороз, системное воспаление, хроническая обструктивная болезнь легких, метаболический синдром, альфакальцидол.
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Vitamin D plays an important role in the management of calcium metabolism and maintenance of calcium-phosphorus homeostasis. Deficiency of vitamin D due to "extra-skeletal effects" can influence the development of various somatic diseases. This relationship is confirmed by epidemiological studies. However, pathophysiological mechanisms continue to be investigated. One of the mechanisms that bind vitamin D deficiency and obesity, metabolic syndrome, diabetes, chronic obstructive pulmonary disease, cardiovascular disease is systemic inflammation. Calcitriol regulates calcium metabolism and has immunomodulatory properties, which gives a protective effects in systemic inflammation. Alfacalcidol is an activity metabolism of vitamin D, used to prevent and treat D-deficiency conditions.
Key words: vitamin D, calcitriol, osteoporosis, systemic inflammation, chronic obstructive pulmonary disease, metabolic syndrome, alfacalcidol.
Полный текст
Список литературы
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2. Ben-Shoshan M. Vitamin D deficiency/insufficiency and challenges in developing global vitamin D fortification and supplementation policy in adults. J Vitam Nutr Res 2012; 82 (4): 237–59.
3. Calvo MS, Whiting SJ. Prevalence of vitamin D insufficiency in Canada and the United States: importance to health status and efficacy of current food fortification and dietary supplement use. Nutr Rev 2003; 61 (3): 107–13.
4. Calvo MS, Whiting SJ, Barton CN. Vitamin D Intake: A Global Perspective of Current Status. J Nutr 2005; 135 (2): 310–6.
5. Дефицит витамина D у взрослых: диагностика, лечение и профилактика. Клинические рекомендации. Российская ассоциация эндокринологов. М., 2015. / Defitsit vitamina D u vzroslykh: diagnostika, lechenie i profilaktika. Klinicheskie rekomendatsii. Rossiiskaia assotsiatsiia endokrinologov. M., 2015. [in Russian]
6. Cranney A, Horsley T et al. Effectiveness and safety of vitamin D in relation to bone health. Evid Rep Technol Assess (Full Rep) 2007; 158: 1–235.
7. Macdonald HM, Mavroeidi A, Barr RJ et al. Bone 2008; 42: 996–1003.
8. Hayes CE, Donald Acheson E. A unifying multiple sclerosis etiology linking virus infection, sunlight, and vitamin D, through viral interleukin-10. Med Hypotheses 2008; 71: 85–90.
9. Holick MF. The vitamin D deficiency pandemic and consequences for nonskeletal health: mechanisms of action. Mol Aspects Med 2008; 29 (6): 361–8. DOI: 10.1016/j.mam.2008.08.008
10. Boland R. Role of vitamin D in skeletal muscle function. Endocr rev 1986; 4: 434–48.
11. IARC Working Group on Vitamin D: Vitamin D and Cancer. Report number 5. Geneva, Switzerland, WHO Press, 2008.
12. 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
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. 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]
15. 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.
16. 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.
17. 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.
18. https://www.vitamindcouncil.org/
19. Holick MF. Vitamin D deficiency. N Engl J Med 2007; 357: 266–81.
20. Adams JS, Hewison M. Update in vitamin D. J Clin Endocrinol Metab 2010; 95: 471–8.
21. 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/
22. Lerchbaum E. Vitamin D and menopause: a narrative review. Maturitas 2014; 79 (1): 3–7. DOI: 10.1016/j.maturitas.2014.06.003
23. Vuksanovic M, Mihajlovic G, Beljic Zivkovic T et al. Cross-talk between muscle and bone in postmenopausal women with hypovitaminosis D. Climacteric 2017; 20 (1): 31–6. DOI: 10.1080/13697137.2016.1249840.
24. Godala M, Materek-Kuśmierkiewicz I, Moczulski D et al. Assessment of 25(OH)D vitamin concentration in plasma of residents of Lodz with metabolicsyndrome in pre- and postmenopausal period. Prz Menopauzalny 2014; 13 (5): 293–7. DOI: 10.5114/pm.2014.46473
25. Song HR, Park CH. Low serum vitamin D level is associated with high risk of metabolic syndrome in post-menopausal women. J Endocrinol Invest 2013; 36: 791–96.
26. Veloudi P, Jones G, Sharman JE. Effectiveness of Vitamin D Supplementation for Cardiovascular Health Outcomes. Pulse (Basel) 2017; 4 (4): 193–207. DOI: 10.1159/000452742
27. Lewis JR, Radavelli-Bagatini S, Rejnmark L et al. The effects of calcium supplementation on verified coronary heart disease hospitalization and death in postmenopausal women: a collaborative meta-analysis of randomized controlled trials. J Bone Miner Res 2015; 30 (1): 1 65–75. DOI: 10.1002/jbmr.2311
28. Danik JS, Manson JE. Vitamin D and Cardiovascular Disease. Curr Treat Options Cardiovasc Med 2012; 14 (4): 414–24. DOI: 10.1007/s11936-012-0183-8
29. Graat-Verboom L, Wouters EF, Smeenk FW et al. Current status of research on osteoporosis in COPD: a systematic review. Eur Respir 2009; 34: 209–18.
30. Leech JA, Dulberg C, Kellie S et al. Relationship of lung function to severity of osteoporosis in women. Am Rev Respir Dis 1990; 141: 68–71.
31. Carter JD, Patel S, Sultan FL et al. The recognition and treatment of vertebral fractures in males with chronic obstructive pulmonary disease. Respir Med 2008; 102: 1165–72.
32. Regan EA, Radcliff TA, Henderson WG et al. Improving hip fractures outcomes for COPD patients. COPD 2013; 10: 11–9.
33. Sin DD, Man JP, Man SF. The risk of osteoporosis in Caucasian men and women with obstructive airways disease. Am J Med 2003; 114: 10–4.
34. Kjensli A, Mowinckel P, Ryg MS, Falch JA. Low bone mineral density is related to severity of chronic obstructive pulmonary disease. Bone 2007; 40: 493–7.
35. Ohara T, Hirai T, Muro S et al. Relationship between pulmonary emphysema and osteoporosis assessed by CT in patients with COPD. Chest 2008; 134: 1244–9.
36. Kiyokawa H, Muro S, Oguma T et al. Impact of COPD exacerbations on osteoporosis assessed by chest CT scan. COPD 2012; 9: 235–42.
37. Duckers JM, Evans BA, Fraser WD et al. Low bone mineral density in men with chronic obstructive pulmonary disease. Respir Res 2011; 12: 101.
38. Dam TT, Harrison S, Fink HA et al; Osteoporotic Fractures in Men (MrOS) Research Group. Bone mineral density and fractures in older men with chronic obstructive pulmonary disease or asthma. Osteoporos Int 2010; 21: 1341–9.
39. Sakurai-Iesato Y, Kawata N, Tada Y et al The Relationship of Bone Mineral Density in Men with Chronic Obstructive Pulmonary Disease Classified According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) Combined Chronic Obstructive Pulmonary Disease (COPD) Assessment System. Intern Med 2017; 15; 56 (14): 1781–90.
40. Kanis JA. Assessment of fracture risk and its application to screening for postmenopousal osteoporosis: synopsis of a WHO report. WHO Study Group. Osteoporos Int 1994; 4: 368–81.
41. Gan WQ, Man SF, Senthilselvan A, Sin DD. Association between chronic obstructive pulmonary disease and systemic inflammation: a systematic review and a meta-analysis. Thorax 2004; 59: 574–80.
42. Gregory R, Mundy MD. Osteoporosis and Inflammation. Nutrition Reviews 2007; 65: 147–S151. DOI: 10.1301/nr.2007.dec.S147-S151
43. McLean RR. Proinflammatory cytokines and osteoporosis. Curr Osteoporos Rep 2009; 7: 134–9. DOI: 10.1007/s11914-009-0023-2.
44. Bai P, Sun Y, Jin J et al. Disturbance of the OPG/RANK/RANKL pathway and systemic inflammation in COPD patients with emphysema and osteoporosis. Respir Res 2011; 12 (1): 157. DOI: 10.1186/1465-9921-12-157
45. Урясьев О.М., Шаханов А.В. Остеопороз при бронхообструктивных заболеваниях. Наука молодых. 2013; 3: 60–7. / Uryasev O.M., Shakhanov A.V. Osteoporoz pri bronkhoobstruktivnykh zabolevaniiakh. Nauka molodykh. 2013; 3: 60–7. [in Russian]
46. Barnes PJ. Chronic Obstructive Pulmonary Disease: Effects beyond the Lungs. PLoS Med 2010; 7(3): e1000220. https://doi.org/10.1371/journal.pmed.1000220
47. Sabit R, Bolton CE, Edwards PH et al. Arterial stiffness and osteoporosis in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2007; 175: 1259–65.
48. Maclay JD, McAllister DA, Mills NL et al. Vascular dysfunction in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2009; 180: 513–20.
49. Rutten FH, Vonken EJ, Cramer MJ et al. Cardiovascular magnetic resonance imaging to identify left-sided chronic heart failure in stable patients with chronic obstructive pulmonary disease. Am Heart J 2008; 156: 506–12.
50. Loke YK, Cavallazzi R, Singh S. Risk of fractures with inhaled corticosteroids in COPD: systematic review and meta-analysis of randomised controlled trials and observational studies. Thorax 2011; 66: 699–708.
51. Ferguson GT, Calverley PM, Anderson JA et al. Prevalence and progression of osteoporosis in patients with COPD: results from the TOwards a Revolution in COPD Health study. Chest 2009; 136: 1456–65.
52. Johnell O, Pauwels R, Lofdahl CG et al. Bone mineral density in patients with chronic obstructive pulmonary disease treated with budesonide Turbuhaler. Eur Respir J 2002; 19: 1058–63.
53. Leech JA, Dulberg C, Kellie S et al. Relationship of lung function to severity of osteoporosis in women. Am Rev Respir Dis 1990; 141: 68–71.
54. Lehouck A, Boonen S, Decramer M, Janssens W. COPD, bone metabolism, and osteoporosis. Chest 2011; 139: 648–57.
55. Nuti R, Siviero P, Maggi S et al. Vertebral fractures in patients with chronic obstructive pulmonary disease: the EOLO Study. Osteoporos Int 2009; 20: 989–98.
56. Seymour JM, Spruit MA, Hopkinson NS et al. The prevalence of quadriceps weakness in COPD and the relationship with disease severity. Eur Respir J 2010; 36: 81–8.
57. Graat-Verboom L, van den Borne BE, Smeenk FW et al. Osteoporosis in COPD outpatients based on bone mineral density and vertebral fractures. J Bone Miner Res 2011; 26: 561–8.
58. Myers AH, Robinson EG, Van Natta ML et al. Hip fractures among the elderly: factors associated with in-hospital mortality. Am J Epidemiol 1991; 134: 1128–37.
59. Barnes PJ, Celli BR. Systemic manifestations and comorbidities of COPD. Eur Respir J 2009; 33: 1165–85.
60. Sabit R, Bolton CE, Edwards PH et al. Arterial stiffness and osteoporosis in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2007; 175: 1259–65.
61. Dole NS, Delany AM. MicroRNA variants as genetic determinants of bone mass. Bone 2016; 84: 57–68.
62. Гребенникова Т.А., Белая Ж.Е., Рожинская Л.Я. и др. Эпигенетические аспекты остеопороза. Вестн. РАМН. 2015; 70 (5): 541–8. / Grebennikova T.A., Belaya Zh.E., Rozhinskaya L.Ya. i dr. Epigeneticheskie aspekty osteoporoza. Vestn. RAMN. 2015; 70 (5): 541–8. [in Russian]
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66. Salamone LM, Ferrell R, Black DM et al. The association between vitamin D receptor gene polymorphisms and bone mineral density at the spine, hip and whole-body in premenopausal women. Osteoporos Int 1996; 6 (1): 63–8.
67. Jia F, Sun RF, Li QH et al. Vitamin D receptor BsmI polymorphism and osteoporosis risk: a meta-analysis from 26 studies. Genet Test Mol Biomarkers 2013; 17 (1): 30–4.
68. Ringe JD et al. Alfacalcidol versus plain vitamin D in the treatment of glucocorticoid/inflammation-induced osteoporosis. J Rheumatol Suppl 2005; 76: 33–40.
69. 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.
________________________________________________
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60. Sabit R, Bolton CE, Edwards PH et al. Arterial stiffness and osteoporosis in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2007; 175: 1259–65.
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67. Jia F, Sun RF, Li QH et al. Vitamin D receptor BsmI polymorphism and osteoporosis risk: a meta-analysis from 26 studies. Genet Test Mol Biomarkers 2013; 17 (1): 30–4.
68. Ringe JD et al. Alfacalcidol versus plain vitamin D in the treatment of glucocorticoid/inflammation-induced osteoporosis. J Rheumatol Suppl 2005; 76: 33–40.
69. 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.
Авторы
О.Ю.Климова*1, Н.Г.Бердникова1,2, Р.Е.Казаков3
1 ФГАОУ ВО «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 ФГАОУ ВО «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. Yauzskaya, 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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