Рецепт. 2022; : 20-30
Гиповитаминоз D у взрослых – актуальная проблема в Республике Беларусь в условиях пандемии COVID-19
https://doi.org/10.34883/PI.2022.25.1.009Аннотация
Дефицит витамина D приводит к нарушениям регуляции гомеостаза кальция, костного метаболизма, деятельности других систем человеческого организма, в последнее время активно изучается его роль в патогенезе инфекции COVID-19. Цель исследования – определить частоту встречаемости гиповитаминоза D у взрослого населения Республики Беларусь. Были проанализированы результаты лабораторного определения 25(OH)D у лиц старше 18 лет за период 2019 и 2020 гг. Средний уровень витамина D в обследованной популяции за указанный период не достигал нормальных значений во всех возрастных группах как у мужчин, так и у женщин. Частота гиповитаминоза D составила более 70% в зимний и более 50% в летний период у всех обследованных независимо от возраста. В статье проведен анализ современных подходов к диагностике дефицита и недостаточности витамина D у взрослых, показаниям к назначению и тактике выбора доз препаратов витамина D. Мероприятия по профилактике и лечению дефицита и недостаточности витамина D должны быть одним из приоритетных направлений деятельности врачей и медицинских работников в условиях пандемии с учетом его потенциальных эффектов на течение и исходы инфекции COVID-19, особенно у пациентов групп риска.
Список литературы
1. Holick M.F. The vitamin D deficiency pandemic: approaches for diagnosis, treatment and prevention. Rev Endocr Metab Disord. 2017;18(2):153– 165. DOI: 10.1007/s11154-017-9424-1.
2. Lips P., Cashman K.D., Lamberg‐Allardt C. Current vitamin D status in European and Middle East countries and strategies to prevent vitamin D deficiency: a position statement of the European Calcified Tissue Society. Eur J Endocrinol. 2019;180:23–54.
3. Pludowski P., Grant W.B., Bhattoa H.P. Vitamin D status in Central Europe. International Journal of Endocrinology. 2014. DOI:10.1155/2014/589587.
4. Huotari A., Herzig K. Vitamin D and living in northern latitudes – an endemic risk area for vitamin D deficiency. Int J Circumpolar Health. 2008;67:164–178.
5. Christakos S., Dhawan P., Verstuyf A. () Vitamin D: Metabolism, Molecular Mechanism of Action, and Pleiotropic Effects. Physiol. Reviews. 2016;96(1):365–408.
6. Morris H.A., O’Loughlin P.D., Anderson P.H. Experimental evidence for the effects of calcium and vitamin D on bone: a review. Nutrients. 2010;2(9):1026–35. DOI: 10.3390/nu2091026.
7. Pludowski P., Grant W.B., Konstantynowicz J. Editorial: classic and pleiotropic actions of vitamin D. Front. Endocrinol. 2019;10:341.
8. Wimalawansa S.J. Associations of vitamin D with insulin resistance, obesity, type 2 diabetes, and metabolic syndrome. J.Steroid. Biochem. Mol. Biol. 2016;20:0960–0760.
9. Song Y., Wang L., Pittas A.G. Blood 25-hydroxyvitamin D levels and incident type 2 diabetes: a meta-analysis of prospective studies Diabetes Care. 2013;36:1422–1428.
10. Takahashi R., Mizoue T., Otake T. Circulating vitamin D and colorectal adenomas in Japanese men. Cancer Sci. 2010;101(7):1695–700. DOI: 10.1111/j.1349-7006.2010.01575.x.
11. Shao T., Klein P., Grossbard M.L. Vitamin D and breast cancer. Oncologist. 2012;17(1):36–45. DOI:10.1634/theoncologist.2011-0278.
12. Zhao Y., Chen C., Pan W., Gao M. Comparative efficacy of vitamin D status in reducing the risk of bladder cancer: a systematic review and network meta-analysis. Nutrition. 2016;32(5):515–523.
13. Chen G.C., Zhang Z.L., Wan Z. Circulating 25-hydroxyvitamin D and risk of lung cancer: a dose-response meta-analysis. Cancer Causes Control. 2015;26(12):1719–1728.
14. Ebadi M., Montano‐Loza A.J. Perspective: improving vitamin D status in the management of COVID‐19. Eur J Clin Nutr. 2020;74:856–859.
15. Sulli A., Gotelli E., Casabella A. Vitamin D and lung outcomes in elderly COVID-19 patients. Nutrients. 2021;13(3):717. DOI: 10.3390/nu13030717.
16. De Smet D., De Smet K., Herroelen P. Serum 25(OH)D level on hospital admission associated with COVID-19 stage and mortality. Am J Clin Pathol. 2021;155(3):381–388. DOI: 10.1093/ajcp/aqaa252.
17. Karonova T.L., Andreeva A.T., Golovatuk K.A. Low 25(OH)D level is associated with severe course and poor prognosis in COVID-19. Nutrients. 2021;13(9):3021. DOI: 10.3390/nu13093021.
18. Rizzoli R., Boonen S., Brandi M.L. Vitamin D supplementation in elderly or postmenopausal women: a 2013 update of 2008 recommendations from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) Cur. Med. Research and Opinion. 2013;29:1–9.
19. Holick M.F. Biological effects of sunlight, ultraviolet radiation, visible light, infrared radiation and vitamin D for health. Anticancer Res. 2016;36(3):1345–56.
20. Alfredsson L., Armstrong B.K., Butterfield D.A. Insufficient sun exposure has become a real public health problem. Int J Environ Res Public Health. 2020;17(14):5014. DOI: 10.3390/ijerph17145014.
21. Holick M.F., Chen T.C. Vitamin D deficiency: a worldwide problem with health consequences. Am J Clin Nutr. 2008;87(4):1080–6. DOI: 10.1093/ajcn/87.4.1080S.
22. Alfieri C., Ruzhytska O., Vettoretti S. Native hypovitaminosis D in CKD patients: from experimental evidence to clinical practice. Nutrients. 2019;11(8):1918. DOI:10.3390/nu11081918.
23. Berridge M.J. Vitamin D deficiency and diabetes. Biochem J. 2017;474(8):1321–1332. DOI: 10.1042/BCJ20170042. PMID: 28341729.
24. Nettore I.C., Albano L., Ungaro P. Sunshine vitamin and thyroid. Rev Endocr Metab Disord. 2017;18(3):347–354. DOI: 10.1007/s11154-017-9406-3.
25. Van Orten-Luiten A.C., Janse A., Dhonukshe-Rutten R.A. Vitamin D deficiency as adverse drug reaction? A cross-sectional study in Dutch geriatric outpatients. Eur J Clin Pharmacol. 2016;72(5):605–614. DOI: 10.1007/s00228-016-2016-2.
26. Wahl D.A., Cooper C., Ebeling P.R. A global representation of vitamin D status in healthy populations. Arch Osteoporos. 2012;7:155–172.
27. Grant W.B., Al Anouti F., Moukayed M. Targeted 25‐hydroxyvitamin D concentration measurements and vitamin D3 supplementation can have important patient and public health benefits. Eur J Clin Nutr. 2020;74:366–376. DOI: 10.1038/s41430-020-0564-0.
28. McCartney D.M., Byrne D.G. Optimisation of vitamin D status for enhanced immuno‐protection against covid‐19. Ir Med J. 2020;113:58.
29. Adams K.K., Baker W.L., Sobieraj D.M. Myth Busters: dietary Supplements and COVID‐19. Ann Pharmacother. 2020;54:820–826. DOI: 10.1177/1060028020928052.
30. Rusinska A., Pludowski P., Walczak M. Vitamin D supplementation guidelines for general population and groups at risk of vitamin D deficiency in Poland‐recommendations of the polish society of pediatric endocrinology and diabetes and the expert panel with participation of national specialist consultants and representatives of scientific societies‐2018 update. Front Endocrinol. 2018;9:246. DOI: 10.3389/fendo.2018.00246.
31. Grant W.B., Lahore H., McDonnell S.L. Evidence that vitamin D supplementation could reduce risk of influenza and COVID‐19 infections and deaths. Nutrients. 2020;12:988. DOI: 10.3390/nu12040988.
32. Hribar C.A., Cobbold P.H., Church F.C. Potential role of vitamin D in the elderly to resist COVID‐19 and to slow progression of Parkinson’s disease. Brain Sci. 2020;10:284. DOI: 10.3390/brainsci10050284.
33. Charoenngam N., Holick M.F. Immunologic effects of vitamin D on human health and disease. Nutrients. 2020;12:2097. DOI: 10.3390/nu12072097.
34. Martin Gimenez V.M., Inserra F., Tajer C.D. Lungs as target of COVID‐19 infection: Protective common molecular mechanisms of vitamin D and melatonin as a new potential synergistic treatment. Life Sci. 2020;254:117808. DOI: 10.1016/j.lfs.2020.117808.
Recipe. 2022; : 20-30
Hypovitaminosis D in Adults as a Topical Problem in the Republic of Belarus in Terms of the COVID-19 Pandemic
https://doi.org/10.34883/PI.2022.25.1.009Abstract
Vitamin D deficiency leads to dysregulation of calcium homeostasis, bone metabolism, and activity of other systems of the human body. Recently, its role in the pathogenesis of COVID-19 infection has been actively studied. The purpose of the study was to determine the frequency of hypovitaminosis D in the adult population of the Republic of Belarus. The results of laboratory measurement of 25(OH)D in individuals over the age of 18 were analyzed for the years 2019 and 2020. The average level of vitamin D in the surveyed population during the study period did not reach normal values in all age groups, both in men and women. The frequency of hypovitaminosis D was more than 70% in winter and more than 50% in summer in all examined patients, regardless of age. Current approaches to the diagnosis of vitamin D deficiency and insufficiency in adults, indications for prescribing adequate doses of vitamin D preparations are analyzed in the article. Measures for the prevention and treatment of vitamin D deficiency and insufficiency should be one of the priorities for health practitioners in pandemic conditions, taking into account the potential effects of vitamin D on the course and outcomes of COVID-19 infection, especially in at-risk patients.
References
1. Holick M.F. The vitamin D deficiency pandemic: approaches for diagnosis, treatment and prevention. Rev Endocr Metab Disord. 2017;18(2):153– 165. DOI: 10.1007/s11154-017-9424-1.
2. Lips P., Cashman K.D., Lamberg‐Allardt C. Current vitamin D status in European and Middle East countries and strategies to prevent vitamin D deficiency: a position statement of the European Calcified Tissue Society. Eur J Endocrinol. 2019;180:23–54.
3. Pludowski P., Grant W.B., Bhattoa H.P. Vitamin D status in Central Europe. International Journal of Endocrinology. 2014. DOI:10.1155/2014/589587.
4. Huotari A., Herzig K. Vitamin D and living in northern latitudes – an endemic risk area for vitamin D deficiency. Int J Circumpolar Health. 2008;67:164–178.
5. Christakos S., Dhawan P., Verstuyf A. () Vitamin D: Metabolism, Molecular Mechanism of Action, and Pleiotropic Effects. Physiol. Reviews. 2016;96(1):365–408.
6. Morris H.A., O’Loughlin P.D., Anderson P.H. Experimental evidence for the effects of calcium and vitamin D on bone: a review. Nutrients. 2010;2(9):1026–35. DOI: 10.3390/nu2091026.
7. Pludowski P., Grant W.B., Konstantynowicz J. Editorial: classic and pleiotropic actions of vitamin D. Front. Endocrinol. 2019;10:341.
8. Wimalawansa S.J. Associations of vitamin D with insulin resistance, obesity, type 2 diabetes, and metabolic syndrome. J.Steroid. Biochem. Mol. Biol. 2016;20:0960–0760.
9. Song Y., Wang L., Pittas A.G. Blood 25-hydroxyvitamin D levels and incident type 2 diabetes: a meta-analysis of prospective studies Diabetes Care. 2013;36:1422–1428.
10. Takahashi R., Mizoue T., Otake T. Circulating vitamin D and colorectal adenomas in Japanese men. Cancer Sci. 2010;101(7):1695–700. DOI: 10.1111/j.1349-7006.2010.01575.x.
11. Shao T., Klein P., Grossbard M.L. Vitamin D and breast cancer. Oncologist. 2012;17(1):36–45. DOI:10.1634/theoncologist.2011-0278.
12. Zhao Y., Chen C., Pan W., Gao M. Comparative efficacy of vitamin D status in reducing the risk of bladder cancer: a systematic review and network meta-analysis. Nutrition. 2016;32(5):515–523.
13. Chen G.C., Zhang Z.L., Wan Z. Circulating 25-hydroxyvitamin D and risk of lung cancer: a dose-response meta-analysis. Cancer Causes Control. 2015;26(12):1719–1728.
14. Ebadi M., Montano‐Loza A.J. Perspective: improving vitamin D status in the management of COVID‐19. Eur J Clin Nutr. 2020;74:856–859.
15. Sulli A., Gotelli E., Casabella A. Vitamin D and lung outcomes in elderly COVID-19 patients. Nutrients. 2021;13(3):717. DOI: 10.3390/nu13030717.
16. De Smet D., De Smet K., Herroelen P. Serum 25(OH)D level on hospital admission associated with COVID-19 stage and mortality. Am J Clin Pathol. 2021;155(3):381–388. DOI: 10.1093/ajcp/aqaa252.
17. Karonova T.L., Andreeva A.T., Golovatuk K.A. Low 25(OH)D level is associated with severe course and poor prognosis in COVID-19. Nutrients. 2021;13(9):3021. DOI: 10.3390/nu13093021.
18. Rizzoli R., Boonen S., Brandi M.L. Vitamin D supplementation in elderly or postmenopausal women: a 2013 update of 2008 recommendations from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) Cur. Med. Research and Opinion. 2013;29:1–9.
19. Holick M.F. Biological effects of sunlight, ultraviolet radiation, visible light, infrared radiation and vitamin D for health. Anticancer Res. 2016;36(3):1345–56.
20. Alfredsson L., Armstrong B.K., Butterfield D.A. Insufficient sun exposure has become a real public health problem. Int J Environ Res Public Health. 2020;17(14):5014. DOI: 10.3390/ijerph17145014.
21. Holick M.F., Chen T.C. Vitamin D deficiency: a worldwide problem with health consequences. Am J Clin Nutr. 2008;87(4):1080–6. DOI: 10.1093/ajcn/87.4.1080S.
22. Alfieri C., Ruzhytska O., Vettoretti S. Native hypovitaminosis D in CKD patients: from experimental evidence to clinical practice. Nutrients. 2019;11(8):1918. DOI:10.3390/nu11081918.
23. Berridge M.J. Vitamin D deficiency and diabetes. Biochem J. 2017;474(8):1321–1332. DOI: 10.1042/BCJ20170042. PMID: 28341729.
24. Nettore I.C., Albano L., Ungaro P. Sunshine vitamin and thyroid. Rev Endocr Metab Disord. 2017;18(3):347–354. DOI: 10.1007/s11154-017-9406-3.
25. Van Orten-Luiten A.C., Janse A., Dhonukshe-Rutten R.A. Vitamin D deficiency as adverse drug reaction? A cross-sectional study in Dutch geriatric outpatients. Eur J Clin Pharmacol. 2016;72(5):605–614. DOI: 10.1007/s00228-016-2016-2.
26. Wahl D.A., Cooper C., Ebeling P.R. A global representation of vitamin D status in healthy populations. Arch Osteoporos. 2012;7:155–172.
27. Grant W.B., Al Anouti F., Moukayed M. Targeted 25‐hydroxyvitamin D concentration measurements and vitamin D3 supplementation can have important patient and public health benefits. Eur J Clin Nutr. 2020;74:366–376. DOI: 10.1038/s41430-020-0564-0.
28. McCartney D.M., Byrne D.G. Optimisation of vitamin D status for enhanced immuno‐protection against covid‐19. Ir Med J. 2020;113:58.
29. Adams K.K., Baker W.L., Sobieraj D.M. Myth Busters: dietary Supplements and COVID‐19. Ann Pharmacother. 2020;54:820–826. DOI: 10.1177/1060028020928052.
30. Rusinska A., Pludowski P., Walczak M. Vitamin D supplementation guidelines for general population and groups at risk of vitamin D deficiency in Poland‐recommendations of the polish society of pediatric endocrinology and diabetes and the expert panel with participation of national specialist consultants and representatives of scientific societies‐2018 update. Front Endocrinol. 2018;9:246. DOI: 10.3389/fendo.2018.00246.
31. Grant W.B., Lahore H., McDonnell S.L. Evidence that vitamin D supplementation could reduce risk of influenza and COVID‐19 infections and deaths. Nutrients. 2020;12:988. DOI: 10.3390/nu12040988.
32. Hribar C.A., Cobbold P.H., Church F.C. Potential role of vitamin D in the elderly to resist COVID‐19 and to slow progression of Parkinson’s disease. Brain Sci. 2020;10:284. DOI: 10.3390/brainsci10050284.
33. Charoenngam N., Holick M.F. Immunologic effects of vitamin D on human health and disease. Nutrients. 2020;12:2097. DOI: 10.3390/nu12072097.
34. Martin Gimenez V.M., Inserra F., Tajer C.D. Lungs as target of COVID‐19 infection: Protective common molecular mechanisms of vitamin D and melatonin as a new potential synergistic treatment. Life Sci. 2020;254:117808. DOI: 10.1016/j.lfs.2020.117808.
