In this review, we discuss the main reasons for the vitamin D insufficiency in Russian Federation, as well as data on the prevalence of vitamin D deficiency among various population groups and regions, which confirm the widespread prevalence of vitamin D deficiency in the country. The discussed data suggest that the current vitamin D insufficiency in Russian population (reduced levels of 25(OH)D occurs in 50 - 94% of general population) is due to both a low level of its endogenous synthesis and insufficient intake from food : the territory of the country is located in a zone of low insolation, and at the same time, the main natural sources of vitamin D (sea fish of fatty varieties) and fortified with vitamin D products are very limited in the diet of the population. Taking measures to improve the status of vitamin D and maintaining the optimal serum levels of 25(OH)D in children and adults, adequate vitamin D intake will improve the condition of the musculoskeletal system, as well as reduce the risk of development and improve the control of some chronic diseases.
Остеопороз и остеопатии / Osteoporosis and Bone Diseases | 90 REVIEW ВВЕДЕНИЕФактор, недостаточность которого приводит к раз-витию рахита, был открыт и назван витамином D око-ло 100 лет назад; на протяжении прошедшего с тех пор времени было получено множество данных, свидетель-ствующих о том, что это вещество не только необхо-димо для нормального развития и функционирования костной ткани, но и является гормоном, опосредующим разнообразные эффекты в других тканях организма. В связи с этим значительный интерес представляет подробное изучение физиологической роли витами-на D в организме, его значения в функционировании тканей и органов, а также вклада, который вносит из-менение его метаболизма в развитие хронических за-болеваний, течение и исход беременности. Достижение специфических для отдельных тканей результатов при коррекции уровня витамина D ставит вопрос о возмож-ной целесообразности проведения профилактических и терапевтических мероприятий при соответствующих состояниях. ОСОБЕННОСТИ МЕТАБОЛИЗМА ВИТАМИНА D, РЕЦЕПТОРА ВИТАМИНА D, ВИТАМИН D-СВЯЗЫВАЮЩЕГО БЕЛКАВитамин D3 (колекальциферол) образуется в коже из 7-дегидрохолестерола в два этапа. На первом этапе под действием УФ-излучения (280-320 нм) образуется пре-витамин D3, который изомеризуется в D3 в резуль-тате термочувствительного, но некаталитического про-цесса. Витамин D может быть также получен из пищи, растительной (D2, или эргокальциферол) или животной (D3). В большинстве продуктов, за исключением жирных сортов рыбы, содержится незначительное количество витамина D. Since the discovery of vitamin D, interest in role of vitamin D in human body is consistently growing, and there is increasing evidence that vitamin D is not only essential to bone health but may also be involved in physiology of many other tissues. Thus understanding of its aspects in particular tissues appears to be important because of possible contribution to pathophysiologic processes. Intracrine regulatory systems associated with widely expressed vitamin D metabolizing enzymes, ways of cellular intake and signal pathways involved are of particular interest. Association of local effects with vitamin D level in blood is under investigation on animal models as well as in clinical studies; values of vitamin D level that mediate extraskeletal effects should be determined. In this review, we discuss impact of vitamin D on immune function and its association with skin, nervous system, cardiovascular system, obesity and diabetes mellitus, cancer, reproductive function, prevention of falls and quality of life improvement. НЕКЛАССИЧЕСКИЕ ЭФФЕКТЫ ВИТАМИНА D NON-CLASSICAL EFFECTS OF VITAMIN D
Clinical symptoms of vitamin D deficiency may be quite misleading and masked as rare hereditary syndromes. We describe a family, sister and brother presented with the pain in lower extremities at the age of 14 and 16years accordingly, with severe vitamin D deficiency that was misdiagnosed in the course of the disease with pseudohypoparathyroidism and 1-alpha-hydroxylase deficiency. They benefited from treatment with alfacalcidol and ossein-hydroxyapatite complex supplement which were further discontinued due to socioeconomic factors. At presentation after 2 years without treatment extremely low 25(OH)D levels were revealed. The patients' family history was remarkable for the same clinical features in mother and her Indian ancestry. Thus we describe an uncommon manifestation of severe vitamin D deficiency in a familial setting which emphasizes the necessity of vitamin D testing in calcium or parathyroid disorders.
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