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Витамин D в профилактике костных и метаболических нарушений
Витамин D в профилактике костных и метаболических нарушений
Пигарова Е.А., Мазурина Н.В., Трошина Е.А. Витамин D в профилактике костных и метаболических нарушений. Consilium Medicum. 2019; 21 (4): 84–90. DOI: 10.26442/20751753.2019.4.190342
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Аннотация
Лекция, адресованная врачам различных специальностей, посвящена роли витамина D в профилактике костных и метаболических нарушений. Современные данные о физиологических эффектах витамина D подтверждают его многофакторное влияние на костную и мышечную систему – как прямое, так и опосредованное. Взаимное влияние ожирения и дефицита витамина D определяется несколькими механизмами, при этом снижение биодоступности витамина D при ожирении становится причиной развития вторичного гиперпаратиреоза. Существующие алгоритмы профилактики и лечения дефицита витамина D учитывают не только исходный уровень 25(ОН)D, но и возраст пациента, его индекс массы тела, а также наличие сопутствующих заболеваний. Современные клинические рекомендации Российской ассоциации эндокринологов по профилактике и лечению дефицита витамина D являются эффективным инструментом в ведении пациентов. При профилактике и лечении дефицита витамина D лицам, страдающим ожирением, требуются более высокие дозы колекальциферола. Коррекцию дефицита (ниже 20 нг/мл) и недостаточности витамина D (20–29 нг/мл) у взрослых рекомендуется начинать с суммарной насыщающей дозировки колекальциферола с дальнейшим переходом на поддерживающие дозы. Насыщение может проводиться с использованием различных схем терапии.
Ключевые слова: витамин D, ожирение, инсулинорезистентность, остеопороз, остеомаляция, гиперпаратиреоз, 25(OH)D, паратгормон, вторичный гиперпаратиреоз.
Ключевые слова: витамин D, ожирение, инсулинорезистентность, остеопороз, остеомаляция, гиперпаратиреоз, 25(OH)D, паратгормон, вторичный гиперпаратиреоз.
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The lecture is addressed to doctors of various specialties and devoted to the role of vitamin D in the prevention of bone and metabolic disorders. Modern data on the physiological effects of vitamin D confirm its multifactorial effect on the skeletal and muscular systems, both direct and indirect. The mutual influence of obesity and vitamin D deficiency is determined by several mechanisms, while the decrease in the bioavailability of vitamin D in obesity causes the development of secondary hyperparathyroidism. The existing algorithms for prevention and treatment of vitamin D deficiency involve not only the initial level of 25(OH)D, but also the patient's age, body mass index, and the presence of concomitant diseases. Modern clinical guidelines of the Russian Association of Endocrinologists on prevention and treatment of vitamin D deficiency are an effective instrument in patients’ management. For prevention and treatment of vitamin D deficiency in obese patients higher doses of colecalciferol are required. In adult patients it is recommended to start correction of vitamin D deficiency (lower than 20 ng/ml) and insufficiency (20–29 ng/ml) with a saturating colecalciferol dose with further switch to the use of maintenance doses. Saturation can be conducted with the use of various therapy regimens.
Key words: vitamin D, obesity, insulin resistance, osteoporosis, osteomalacia, hyperparathyroidism, 25(OH)D, parathyroid hormone, secondary hyperparathyroidism.
Key words: vitamin D, obesity, insulin resistance, osteoporosis, osteomalacia, hyperparathyroidism, 25(OH)D, parathyroid hormone, secondary hyperparathyroidism.
Полный текст
Список литературы
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[Pigarova E.A., Rozhinskaia L.Ia., Belaia Zh.E. et al. Klinicheskie rekomendatsii rossiiskoi assotsiatsii endokrinologov po diagnostike, lecheniiu i profilaktike defitsita vitamina D u vzroslykh. Problemy endokrinologii. 2016; 62 (4): 60–84 (in Russian).]
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[Pigarova E.A., Petrushkina A.A. Neklassicheskie effekty vitamina D. Osteoporoz i osteopatii. 2017; 20 (3): 90–101. DOI: 10.14341/osteo2017390-101 (in Russian).]
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[Petrushkina A.A., Pigarova E.A., Rozhinskaia L.Ia. Epidemiologiia defitsita vitamina D v Rossiiskoi Federatsii. Osteoporoz i osteopatii. 2018; 21 (3): 15–20. DOI: 10.14341/osteo10038 (in Russian).]
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7. Masuyama R, Nakaya Y, Katsumata S et al. Dietary calcium and phosphorus ratio regulates bone mineralization and turnover in vitamin D receptor knockout mice by affecting intestinal calcium and phosphorus absorption. J Bone Miner Res 2003; 18 (7): 1217–26.
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9. Benn BS, Ajibade D, Porta A et al. Active intestinal calcium transport in the absence of transient receptor potential vanilloid type 6 and calbindin-D9k. Endocrinology 2008; 149 (6): 3196–205.
10. Wasserman RH. Vitamin D and the dual processes of intestinal calcium absorption. J Nutr. 2004; 134 (11): 3137–9.
11. Reyes-Fernandez PC, Fleet JC. Compensatory Changes in Calcium Metabolism Accompany the Loss of Vitamin D Receptor (VDR) From the Distal Intestine and Kidney of Mice. J Bone Miner Res 2016; 31 (1): 143–51.
12. Dunn PM. Sir Robert Hutchison (1871–1960) of London and the causes and treatment of rickets. Arch Dis Child Fetal Neonatal Ed 2005; 90 (6): F537–9.
13. Global Consensus Recommendations on Prevention and Management of Nutritional Rickets. J Clin Endocrinol Metab 2016; 101 (2): 394–415.
14. Kim S, Yamazaki M, Zella LA et al. Activation of receptor activator of NF-kappaB ligand gene expression by 1,25-dihydroxyvitamin D3 is mediated through multiple long-range enhancers. Mol Cell Biol 2006; 26 (17): 6469–86.
15. Lieben L, Masuyama R, Torrekens S et al. Normocalcemia is maintained in mice under conditions of calcium malabsorption by vitamin D-induced inhibition of bone mineralization. J Clin Invest 2012; 122 (5): 1803–15.
16. Bonewald LF. Osteocytes as dynamic multifunctional cells. Ann N Y Acad Sci 2007; 1116: 281–90.
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[Chernova T.O. Vizualizatsiia i kolichestvennyi analiz pri osteoporoze i osteomaliatsii. Med. vizualizatsiia. 2005; 1: 111–21 (in Russian).]
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[Mel'nichenko G.A., Belaia Zh.E., Rozhinskaia L.Ia. et al. Kratkoe izlozhenie klinicheskikh rekomendatsii po diagnostike i lecheniiu osteoporoza Rossiiskoi assotsiatsii endokrinologov. Osteoporoz i osteopatii. 2016; 19 (3): 28–36 (in Russian).]
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[Pleshcheva A.V., Pigarova E.A., Dzeranova L.K. Vitamin D i metabolizm: fakty, mify i predubezhdeniia. Ozhirenie i metabolizm. 2012; 9 (2): 33–42 (in Russian).]
23. Bischoff-Ferrari HA, Dawson-Hughes B, Staehelin HB et al. Fall prevention with supplemental and active forms of vitamin D: A meta-analysis of randomised controlled trials. Br Med J 2009; 339: 843–6. DOI: 10.1136/bmj.b3692
24. Winzenberg T, van der Mei I, Mason RS et al. Vitamin D and the musculoskeletal health of older adults. Aust Fam Physician 2012; 41: 92–9.
25. Gendelman O, Itzhaki D, Makarov S et al. A randomized double-blind placebo-controlled study adding high dose vitamin D to analgesic regimens in patients with musculoskeletal pain. Lupus 2015; 24: 483–9. DOI: 10.1177/0961203314558676
26. Worthman J, Matsuoka L, Chen T et al. Decreased bioavaillability of vitamin D in obesity. Am J Clin Nutr 2000, 72: 690–3.
27. Arunabh S, Pollak S, Yeh J et al. Body fat content and 25-hydroxyvitamin D levels in healthy women. J Clin Endocrinol Metab 2003, 88: 157–61.
28. Hypponen E, Power C. Vitamin D status and glucose homeostasis in the 1958 British Birth Cohort. Diabetes Care 2006; 29 (10): 2244–6.
29. Lagunova Z, Porojnicu A, Lindberg F et al. The dependency of vitamin D status on body mass index, gender, age and season. Anticancer Res 2009; 29 (9): 3713–20.
30. McGill A, Stewart J, Lithander F et al. Relationships of low serum vitamin D3 with anthropometry and markers of metabolic syndrome and diabetes in overweight and obesity. Nutrition J 2008; 7: 4.
31. Aasheim E, Hofso D, Hjelmesaeth J et al. Vitamin status in morbidly obese patients: a cross-sectional study. Am J Clin Nutr 2008; 87: 362–9.
32. Ybarra J, Sanchez-Hernandez J, Perez A. Hypovitaminosis D and morbid obesity. Nurs Clin North Am 2007; 42: 19–27.
33. Carlin A, Rao D, Meslemani A et al. Prevalence of vitamin D depletion among morbidly obese patients sеeking gastric bypass surgery. Surg Obes Relat Dis 2006; 2: 98–103.
34. Sanchez-Hernandez J, Ybarra J, Gich I et al. Effects of bariatric surgery on vitamin D status and secondary hyperparathyroidism: a prospective study. Obes Surg 2005; 15: 1389–95.
35. Snijder MB, van Dam RM, Visser M et al. Adiposity in relation to vitamin D status and parathyroid hormone levels: a population-based study in older men and women. J Clin Endocrinol Metab 2005; 90: 4119–23.
36. Hultin H, Edfeldt K, Sundbom M, Hellman P. Left-Shifted Relation between Calcium and Parathyroid Hormone in Obesity. J Clin Endocrin Metab 2010; 95 (8): 3973–81.
37. Heaney RP, Davies KM, Chen TC et al. Human serum 25-hydroxychole-calciferol response to extended oral dosing with cholecalciferol. Am J Clin Nutr 2003; 77 (1): 204–10.
38. Evaluation, Treatment and Prevention of vitamin D Deficiency. An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2011; 96 (7): 1911–30.
39. Клинические рекомендации Российской ассоциации эндокринологов по диагностике, лечению и профилактике дефицита витамина D у взрослых. Проблемы эндокринологии. 2016; 4: 60–84.
[Klinicheskie rekomendatsii Rossiiskoi assotsiatsii endokrinologov po diagnostike, lecheniiu i profilaktike defitsita vitamina D u vzroslykh. Problemy endokrinologii. 2016; 4: 60–84 (in Russian).]
40. Lee P, Greenfield J, Seibel M et al. Adequacy of vitamin D replacement in severe deficiency is dependent on body mass index. Am J Med 2009; 122 (11): 1056–60.
2. Pigarova E.A., Petrushkina A.A. Neklassicheskie effekty vitamina D. Osteoporoz i osteopatii. 2017; 20 (3): 90–101. DOI: 10.14341/osteo2017390-101 (in Russian).
3. Wacker M, Holick MF. Sunlight and Vitamin D: A global perspective for health. Dermatoendocrinol 2013; 5 (1): 51–108.
4. Petrushkina A.A., Pigarova E.A., Rozhinskaia L.Ia. Epidemiologiia defitsita vitamina D v Rossiiskoi Federatsii. Osteoporoz i osteopatii. 2018; 21 (3): 15–20. DOI: 10.14341/osteo10038 (in Russian).
5. Holick MF, Binkley NC, Bischoff-Ferrari HA et al; Endocrine Society. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2011; 96 (7): 1911–30. DOI: 10.1210/jc.2011-0385. Erratum in: J Clin Endocrinol Metab. 2011; 96 (12): 3908.
6. Martin A, David V, Quarles LD. Regulation and function of the FGF23/klotho endocrine pathways. Physiol Rev. 2012; 92 (1): 131–55.
7. Masuyama R, Nakaya Y, Katsumata S et al. Dietary calcium and phosphorus ratio regulates bone mineralization and turnover in vitamin D receptor knockout mice by affecting intestinal calcium and phosphorus absorption. J Bone Miner Res 2003; 18 (7): 1217–26.
8. Hochberg Z, Tiosano D, Even L. Calcium therapy for calcitriol-resistant rickets. J Pediatr 1992; 121 (5 Pt. 1): 803–8.
9. Benn BS, Ajibade D, Porta A et al. Active intestinal calcium transport in the absence of transient receptor potential vanilloid type 6 and calbindin-D9k. Endocrinology 2008; 149 (6): 3196–205.
10. Wasserman RH. Vitamin D and the dual processes of intestinal calcium absorption. J Nutr. 2004; 134 (11): 3137–9.
11. Reyes-Fernandez PC, Fleet JC. Compensatory Changes in Calcium Metabolism Accompany the Loss of Vitamin D Receptor (VDR) From the Distal Intestine and Kidney of Mice. J Bone Miner Res 2016; 31 (1): 143–51.
12. Dunn PM. Sir Robert Hutchison (1871–1960) of London and the causes and treatment of rickets. Arch Dis Child Fetal Neonatal Ed 2005; 90 (6): F537–9.
13. Global Consensus Recommendations on Prevention and Management of Nutritional Rickets. J Clin Endocrinol Metab 2016; 101 (2): 394–415.
14. Kim S, Yamazaki M, Zella LA et al. Activation of receptor activator of NF-kappaB ligand gene expression by 1,25-dihydroxyvitamin D3 is mediated through multiple long-range enhancers. Mol Cell Biol 2006; 26 (17): 6469–86.
15. Lieben L, Masuyama R, Torrekens S et al. Normocalcemia is maintained in mice under conditions of calcium malabsorption by vitamin D-induced inhibition of bone mineralization. J Clin Invest 2012; 122 (5): 1803–15.
16. Bonewald LF. Osteocytes as dynamic multifunctional cells. Ann N Y Acad Sci 2007; 1116: 281–90.
17. Qing H, Ardeshirpour L, Pajevic PD et al. Demonstration of osteocytic perilacunar/canalicular remodeling in mice during lactation. J Bone Miner Res 2012; 27 (5): 1018–29.
18. Chernova T.O. Vizualizatsiia i kolichestvennyi analiz pri osteoporoze i osteomaliatsii. Med. vizualizatsiia. 2005; 1: 111–21 (in Russian).
19. Mel'nichenko G.A., Belaia Zh.E., Rozhinskaia L.Ia. et al. Kratkoe izlozhenie klinicheskikh rekomendatsii po diagnostike i lecheniiu osteoporoza Rossiiskoi assotsiatsii endokrinologov. Osteoporoz i osteopatii. 2016; 19 (3): 28–36 (in Russian).
20. Pike JW, Christakos S. Biology and Mechanisms of Action of the Vitamin D Hormone. Endocrinol Metab Clin North Am 2017; 46 (4): 815–43. DOI: 10.1016/j.ecl.2017.07.001
21. Christakos S, Dhawan P, Verstuyf A et al. Vitamin D: Metabolism, Molecular Mechanism of Action, and Pleiotropic Effects. Physiol Rev 2016; 96 (1): 365–408.
22. Pleshcheva A.V., Pigarova E.A., Dzeranova L.K. Vitamin D i metabolizm: fakty, mify i predubezhdeniia. Ozhirenie i metabolizm. 2012; 9 (2): 33–42 (in Russian).
23. Bischoff-Ferrari HA, Dawson-Hughes B, Staehelin HB et al. Fall prevention with supplemental and active forms of vitamin D: A meta-analysis of randomised controlled trials. Br Med J 2009; 339: 843–6. DOI: 10.1136/bmj.b3692
24. Winzenberg T, van der Mei I, Mason RS et al. Vitamin D and the musculoskeletal health of older adults. Aust Fam Physician 2012; 41: 92–9.
25. Gendelman O, Itzhaki D, Makarov S et al. A randomized double-blind placebo-controlled study adding high dose vitamin D to analgesic regimens in patients with musculoskeletal pain. Lupus 2015; 24: 483–9. DOI: 10.1177/0961203314558676
26. Worthman J, Matsuoka L, Chen T et al. Decreased bioavaillability of vitamin D in obesity. Am J Clin Nutr 2000, 72: 690–3.
27. Arunabh S, Pollak S, Yeh J et al. Body fat content and 25-hydroxyvitamin D levels in healthy women. J Clin Endocrinol Metab 2003, 88: 157–61.
28. Hypponen E, Power C. Vitamin D status and glucose homeostasis in the 1958 British Birth Cohort. Diabetes Care 2006; 29 (10): 2244–6.
29. Lagunova Z, Porojnicu A, Lindberg F et al. The dependency of vitamin D status on body mass index, gender, age and season. Anticancer Res 2009; 29 (9): 3713–20.
30. McGill A, Stewart J, Lithander F et al. Relationships of low serum vitamin D3 with anthropometry and markers of metabolic syndrome and diabetes in overweight and obesity. Nutrition J 2008; 7: 4.
31. Aasheim E, Hofso D, Hjelmesaeth J et al. Vitamin status in morbidly obese patients: a cross-sectional study. Am J Clin Nutr 2008; 87: 362–9.
32. Ybarra J, Sanchez-Hernandez J, Perez A. Hypovitaminosis D and morbid obesity. Nurs Clin North Am 2007; 42: 19–27.
33. Carlin A, Rao D, Meslemani A et al. Prevalence of vitamin D depletion among morbidly obese patients sеeking gastric bypass surgery. Surg Obes Relat Dis 2006; 2: 98–103.
34. Sanchez-Hernandez J, Ybarra J, Gich I et al. Effects of bariatric surgery on vitamin D status and secondary hyperparathyroidism: a prospective study. Obes Surg 2005; 15: 1389–95.
35. Snijder MB, van Dam RM, Visser M et al. Adiposity in relation to vitamin D status and parathyroid hormone levels: a population-based study in older men and women. J Clin Endocrinol Metab 2005; 90: 4119–23.
36. Hultin H, Edfeldt K, Sundbom M, Hellman P. Left-Shifted Relation between Calcium and Parathyroid Hormone in Obesity. J Clin Endocrin Metab 2010; 95 (8): 3973–81.
37. Heaney RP, Davies KM, Chen TC et al. Human serum 25-hydroxychole-calciferol response to extended oral dosing with cholecalciferol. Am J Clin Nutr 2003; 77 (1): 204–10.
38. Evaluation, Treatment and Prevention of vitamin D Deficiency. An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2011; 96 (7): 1911–30.
39. Klinicheskie rekomendatsii Rossiiskoi assotsiatsii endokrinologov po diagnostike, lecheniiu i profilaktike defitsita vitamina D u vzroslykh. Problemy endokrinologii. 2016; 4: 60–84 (in Russian).
40. Lee P, Greenfield J, Seibel M et al. Adequacy of vitamin D replacement in severe deficiency is dependent on body mass index. Am J Med 2009; 122 (11): 1056–60.
[Pigarova E.A., Rozhinskaia L.Ia., Belaia Zh.E. et al. Klinicheskie rekomendatsii rossiiskoi assotsiatsii endokrinologov po diagnostike, lecheniiu i profilaktike defitsita vitamina D u vzroslykh. Problemy endokrinologii. 2016; 62 (4): 60–84 (in Russian).]
2. Пигарова Е.А., Петрушкина А.А. Неклассические эффекты витамина D. Остеопороз и остеопатии. 2017; 20 (3): 90–101. DOI: 10.14341/osteo2017390-101
[Pigarova E.A., Petrushkina A.A. Neklassicheskie effekty vitamina D. Osteoporoz i osteopatii. 2017; 20 (3): 90–101. DOI: 10.14341/osteo2017390-101 (in Russian).]
3. Wacker M, Holick MF. Sunlight and Vitamin D: A global perspective for health. Dermatoendocrinol 2013; 5 (1): 51–108.
4. Петрушкина А.А., Пигарова Е.А., Рожинская Л.Я. Эпидемиология дефицита витамина D в Российской Федерации. Остеопороз и остеопатии. 2018; 21 (3): 15–20. DOI: 10.14341/osteo10038
[Petrushkina A.A., Pigarova E.A., Rozhinskaia L.Ia. Epidemiologiia defitsita vitamina D v Rossiiskoi Federatsii. Osteoporoz i osteopatii. 2018; 21 (3): 15–20. DOI: 10.14341/osteo10038 (in Russian).]
5. Holick MF, Binkley NC, Bischoff-Ferrari HA et al; Endocrine Society. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2011; 96 (7): 1911–30. DOI: 10.1210/jc.2011-0385. Erratum in: J Clin Endocrinol Metab. 2011; 96 (12): 3908.
6. Martin A, David V, Quarles LD. Regulation and function of the FGF23/klotho endocrine pathways. Physiol Rev. 2012; 92 (1): 131–55.
7. Masuyama R, Nakaya Y, Katsumata S et al. Dietary calcium and phosphorus ratio regulates bone mineralization and turnover in vitamin D receptor knockout mice by affecting intestinal calcium and phosphorus absorption. J Bone Miner Res 2003; 18 (7): 1217–26.
8. Hochberg Z, Tiosano D, Even L. Calcium therapy for calcitriol-resistant rickets. J Pediatr 1992; 121 (5 Pt. 1): 803–8.
9. Benn BS, Ajibade D, Porta A et al. Active intestinal calcium transport in the absence of transient receptor potential vanilloid type 6 and calbindin-D9k. Endocrinology 2008; 149 (6): 3196–205.
10. Wasserman RH. Vitamin D and the dual processes of intestinal calcium absorption. J Nutr. 2004; 134 (11): 3137–9.
11. Reyes-Fernandez PC, Fleet JC. Compensatory Changes in Calcium Metabolism Accompany the Loss of Vitamin D Receptor (VDR) From the Distal Intestine and Kidney of Mice. J Bone Miner Res 2016; 31 (1): 143–51.
12. Dunn PM. Sir Robert Hutchison (1871–1960) of London and the causes and treatment of rickets. Arch Dis Child Fetal Neonatal Ed 2005; 90 (6): F537–9.
13. Global Consensus Recommendations on Prevention and Management of Nutritional Rickets. J Clin Endocrinol Metab 2016; 101 (2): 394–415.
14. Kim S, Yamazaki M, Zella LA et al. Activation of receptor activator of NF-kappaB ligand gene expression by 1,25-dihydroxyvitamin D3 is mediated through multiple long-range enhancers. Mol Cell Biol 2006; 26 (17): 6469–86.
15. Lieben L, Masuyama R, Torrekens S et al. Normocalcemia is maintained in mice under conditions of calcium malabsorption by vitamin D-induced inhibition of bone mineralization. J Clin Invest 2012; 122 (5): 1803–15.
16. Bonewald LF. Osteocytes as dynamic multifunctional cells. Ann N Y Acad Sci 2007; 1116: 281–90.
17. Qing H, Ardeshirpour L, Pajevic PD et al. Demonstration of osteocytic perilacunar/canalicular remodeling in mice during lactation. J Bone Miner Res 2012; 27 (5): 1018–29.
18. Чернова Т.О. Визуализация и количественный анализ при остеопорозе и остеомаляции. Мед. визуализация. 2005; 1: 111–21.
[Chernova T.O. Vizualizatsiia i kolichestvennyi analiz pri osteoporoze i osteomaliatsii. Med. vizualizatsiia. 2005; 1: 111–21 (in Russian).]
19. Мельниченко Г.А., Белая Ж.Е., Рожинская Л.Я. и др. Краткое изложение клинических рекомендаций по диагностике и лечению остеопороза Российской ассоциации эндокринологов. Остеопороз и остеопатии. 2016; 19 (3): 28–36.
[Mel'nichenko G.A., Belaia Zh.E., Rozhinskaia L.Ia. et al. Kratkoe izlozhenie klinicheskikh rekomendatsii po diagnostike i lecheniiu osteoporoza Rossiiskoi assotsiatsii endokrinologov. Osteoporoz i osteopatii. 2016; 19 (3): 28–36 (in Russian).]
20. Pike JW, Christakos S. Biology and Mechanisms of Action of the Vitamin D Hormone. Endocrinol Metab Clin North Am 2017; 46 (4): 815–43. DOI: 10.1016/j.ecl.2017.07.001
21. Christakos S, Dhawan P, Verstuyf A et al. Vitamin D: Metabolism, Molecular Mechanism of Action, and Pleiotropic Effects. Physiol Rev 2016; 96 (1): 365–408.
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[Pleshcheva A.V., Pigarova E.A., Dzeranova L.K. Vitamin D i metabolizm: fakty, mify i predubezhdeniia. Ozhirenie i metabolizm. 2012; 9 (2): 33–42 (in Russian).]
23. Bischoff-Ferrari HA, Dawson-Hughes B, Staehelin HB et al. Fall prevention with supplemental and active forms of vitamin D: A meta-analysis of randomised controlled trials. Br Med J 2009; 339: 843–6. DOI: 10.1136/bmj.b3692
24. Winzenberg T, van der Mei I, Mason RS et al. Vitamin D and the musculoskeletal health of older adults. Aust Fam Physician 2012; 41: 92–9.
25. Gendelman O, Itzhaki D, Makarov S et al. A randomized double-blind placebo-controlled study adding high dose vitamin D to analgesic regimens in patients with musculoskeletal pain. Lupus 2015; 24: 483–9. DOI: 10.1177/0961203314558676
26. Worthman J, Matsuoka L, Chen T et al. Decreased bioavaillability of vitamin D in obesity. Am J Clin Nutr 2000, 72: 690–3.
27. Arunabh S, Pollak S, Yeh J et al. Body fat content and 25-hydroxyvitamin D levels in healthy women. J Clin Endocrinol Metab 2003, 88: 157–61.
28. Hypponen E, Power C. Vitamin D status and glucose homeostasis in the 1958 British Birth Cohort. Diabetes Care 2006; 29 (10): 2244–6.
29. Lagunova Z, Porojnicu A, Lindberg F et al. The dependency of vitamin D status on body mass index, gender, age and season. Anticancer Res 2009; 29 (9): 3713–20.
30. McGill A, Stewart J, Lithander F et al. Relationships of low serum vitamin D3 with anthropometry and markers of metabolic syndrome and diabetes in overweight and obesity. Nutrition J 2008; 7: 4.
31. Aasheim E, Hofso D, Hjelmesaeth J et al. Vitamin status in morbidly obese patients: a cross-sectional study. Am J Clin Nutr 2008; 87: 362–9.
32. Ybarra J, Sanchez-Hernandez J, Perez A. Hypovitaminosis D and morbid obesity. Nurs Clin North Am 2007; 42: 19–27.
33. Carlin A, Rao D, Meslemani A et al. Prevalence of vitamin D depletion among morbidly obese patients sеeking gastric bypass surgery. Surg Obes Relat Dis 2006; 2: 98–103.
34. Sanchez-Hernandez J, Ybarra J, Gich I et al. Effects of bariatric surgery on vitamin D status and secondary hyperparathyroidism: a prospective study. Obes Surg 2005; 15: 1389–95.
35. Snijder MB, van Dam RM, Visser M et al. Adiposity in relation to vitamin D status and parathyroid hormone levels: a population-based study in older men and women. J Clin Endocrinol Metab 2005; 90: 4119–23.
36. Hultin H, Edfeldt K, Sundbom M, Hellman P. Left-Shifted Relation between Calcium and Parathyroid Hormone in Obesity. J Clin Endocrin Metab 2010; 95 (8): 3973–81.
37. Heaney RP, Davies KM, Chen TC et al. Human serum 25-hydroxychole-calciferol response to extended oral dosing with cholecalciferol. Am J Clin Nutr 2003; 77 (1): 204–10.
38. Evaluation, Treatment and Prevention of vitamin D Deficiency. An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2011; 96 (7): 1911–30.
39. Клинические рекомендации Российской ассоциации эндокринологов по диагностике, лечению и профилактике дефицита витамина D у взрослых. Проблемы эндокринологии. 2016; 4: 60–84.
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40. Lee P, Greenfield J, Seibel M et al. Adequacy of vitamin D replacement in severe deficiency is dependent on body mass index. Am J Med 2009; 122 (11): 1056–60.
________________________________________________
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14. Kim S, Yamazaki M, Zella LA et al. Activation of receptor activator of NF-kappaB ligand gene expression by 1,25-dihydroxyvitamin D3 is mediated through multiple long-range enhancers. Mol Cell Biol 2006; 26 (17): 6469–86.
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16. Bonewald LF. Osteocytes as dynamic multifunctional cells. Ann N Y Acad Sci 2007; 1116: 281–90.
17. Qing H, Ardeshirpour L, Pajevic PD et al. Demonstration of osteocytic perilacunar/canalicular remodeling in mice during lactation. J Bone Miner Res 2012; 27 (5): 1018–29.
18. Chernova T.O. Vizualizatsiia i kolichestvennyi analiz pri osteoporoze i osteomaliatsii. Med. vizualizatsiia. 2005; 1: 111–21 (in Russian).
19. Mel'nichenko G.A., Belaia Zh.E., Rozhinskaia L.Ia. et al. Kratkoe izlozhenie klinicheskikh rekomendatsii po diagnostike i lecheniiu osteoporoza Rossiiskoi assotsiatsii endokrinologov. Osteoporoz i osteopatii. 2016; 19 (3): 28–36 (in Russian).
20. Pike JW, Christakos S. Biology and Mechanisms of Action of the Vitamin D Hormone. Endocrinol Metab Clin North Am 2017; 46 (4): 815–43. DOI: 10.1016/j.ecl.2017.07.001
21. Christakos S, Dhawan P, Verstuyf A et al. Vitamin D: Metabolism, Molecular Mechanism of Action, and Pleiotropic Effects. Physiol Rev 2016; 96 (1): 365–408.
22. Pleshcheva A.V., Pigarova E.A., Dzeranova L.K. Vitamin D i metabolizm: fakty, mify i predubezhdeniia. Ozhirenie i metabolizm. 2012; 9 (2): 33–42 (in Russian).
23. Bischoff-Ferrari HA, Dawson-Hughes B, Staehelin HB et al. Fall prevention with supplemental and active forms of vitamin D: A meta-analysis of randomised controlled trials. Br Med J 2009; 339: 843–6. DOI: 10.1136/bmj.b3692
24. Winzenberg T, van der Mei I, Mason RS et al. Vitamin D and the musculoskeletal health of older adults. Aust Fam Physician 2012; 41: 92–9.
25. Gendelman O, Itzhaki D, Makarov S et al. A randomized double-blind placebo-controlled study adding high dose vitamin D to analgesic regimens in patients with musculoskeletal pain. Lupus 2015; 24: 483–9. DOI: 10.1177/0961203314558676
26. Worthman J, Matsuoka L, Chen T et al. Decreased bioavaillability of vitamin D in obesity. Am J Clin Nutr 2000, 72: 690–3.
27. Arunabh S, Pollak S, Yeh J et al. Body fat content and 25-hydroxyvitamin D levels in healthy women. J Clin Endocrinol Metab 2003, 88: 157–61.
28. Hypponen E, Power C. Vitamin D status and glucose homeostasis in the 1958 British Birth Cohort. Diabetes Care 2006; 29 (10): 2244–6.
29. Lagunova Z, Porojnicu A, Lindberg F et al. The dependency of vitamin D status on body mass index, gender, age and season. Anticancer Res 2009; 29 (9): 3713–20.
30. McGill A, Stewart J, Lithander F et al. Relationships of low serum vitamin D3 with anthropometry and markers of metabolic syndrome and diabetes in overweight and obesity. Nutrition J 2008; 7: 4.
31. Aasheim E, Hofso D, Hjelmesaeth J et al. Vitamin status in morbidly obese patients: a cross-sectional study. Am J Clin Nutr 2008; 87: 362–9.
32. Ybarra J, Sanchez-Hernandez J, Perez A. Hypovitaminosis D and morbid obesity. Nurs Clin North Am 2007; 42: 19–27.
33. Carlin A, Rao D, Meslemani A et al. Prevalence of vitamin D depletion among morbidly obese patients sеeking gastric bypass surgery. Surg Obes Relat Dis 2006; 2: 98–103.
34. Sanchez-Hernandez J, Ybarra J, Gich I et al. Effects of bariatric surgery on vitamin D status and secondary hyperparathyroidism: a prospective study. Obes Surg 2005; 15: 1389–95.
35. Snijder MB, van Dam RM, Visser M et al. Adiposity in relation to vitamin D status and parathyroid hormone levels: a population-based study in older men and women. J Clin Endocrinol Metab 2005; 90: 4119–23.
36. Hultin H, Edfeldt K, Sundbom M, Hellman P. Left-Shifted Relation between Calcium and Parathyroid Hormone in Obesity. J Clin Endocrin Metab 2010; 95 (8): 3973–81.
37. Heaney RP, Davies KM, Chen TC et al. Human serum 25-hydroxychole-calciferol response to extended oral dosing with cholecalciferol. Am J Clin Nutr 2003; 77 (1): 204–10.
38. Evaluation, Treatment and Prevention of vitamin D Deficiency. An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2011; 96 (7): 1911–30.
39. Klinicheskie rekomendatsii Rossiiskoi assotsiatsii endokrinologov po diagnostike, lecheniiu i profilaktike defitsita vitamina D u vzroslykh. Problemy endokrinologii. 2016; 4: 60–84 (in Russian).
40. Lee P, Greenfield J, Seibel M et al. Adequacy of vitamin D replacement in severe deficiency is dependent on body mass index. Am J Med 2009; 122 (11): 1056–60.
Авторы
Е.А.Пигарова*, Н.В.Мазурина, Е.А.Трошина
ФГБУ «Национальный медицинский исследовательский центр эндокринологии» Минздрава России, Москва, Россия
*kpigarova@gmail.com
ФГБУ «Национальный медицинский исследовательский центр эндокринологии» Минздрава России, Москва, Россия
*kpigarova@gmail.com
________________________________________________
Ekaterina A. Pigarova*, Natalya V. Mazurina, Ekaterina A. Troshina
Endocrinology Research Centre, Moscow, Russia
*kpigarova@gmail.com
Endocrinology Research Centre, Moscow, Russia
*kpigarova@gmail.com
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