Narusheniya metabolizma vitamina D pri ozhirenii

Дедов, И И; Мазурина, Н. В.; Огнева, Н А; Трошина, Е А; Rozhinskaya, L Ya; Yashkov, Yu I

doi:10.14341/2071-8713-4946

Cited by 7 publications

(6 citation statements)

References 35 publications

(35 reference statements)

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“…Другими причинами дефицита витамина D яв-ляются нарушение переваривания и всасывания жиров при различных синдромах мальабсорбции, в том числе у пациентов после бариатрических опера-ций, а также потеря витамина D с мочой в комплек-се со связывающим его белком при нефротическом синдроме [2, 3,[40][41][42]. Также некоторые лекар-ственные препараты оказывают значимое влияние на метаболизм витамина D в организме и связаны с его повышенной деградацией в неактивные формы [43].…”

Section: недостаточность и дефицит витамина Dunclassified

Russian Association of Endocrinologists recommendations for diagnosis, treatment and prevention of vitamin D deficiency in adults

Pigarova¹,

Рожинская²,

Белая³

et al. 2016

Probl Endokrinol (Mosk)

131

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Background. Adequate intake of vitamin D and its concentration in serum is important for the health of bones and calcium-phosphorus metabolism and for the optimal functioning of many organs and tissues. Most epidemiological studies have shown that vitamin D deficiency is widespread among the population in Russian Federation.Material and methods. We reviewed relevant literature on the epidemiology of insufficiency and deficiency, skeletal and extraskeletal effects of vitamin D and summarized recommendations for the diagnosis, prevention and treatment of vitamin D deficiency in the general population, which were subsequently discussed and amended in conjunction with leading endocrinologists of the Russian Federation who are experts in this subject.Results. The optimal concentration of 25(OH)D in the serum as the best indicator of vitamin D body stores is recognized as 30—100 ng/ml (75—250 nmol/l), insufficiency — from 20 to 30 ng/ml (50 to 75 nmol/l), deficiency — less than 20 ng/ml (less than 50 nmol/l). In prevention and treatment it is recommended to stick to the target serum levels of 25(OH)D in the range of 30—60 ng/ml (75—150 nmol/l). We’ve developed a general practice recommendations for the prevention, diagnosis and treatment of vitamin D deficiency in adults, including pregnant and lactating women, persons over 50 years old and subjects suffering from various diseases affecting the metabolism of vitamin D.Conclusions. Increased sufficiency of vitamin D in the population should be included as one of the priorities of modern healthcare due to proven preventive health effects on the musculoskeletal system and the potential positive impact on many socially significant diseases. This publication is a detailed version of the Federal Guideline.

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Section: недостаточность и дефицит витамина Dunclassified

Russian Association of Endocrinologists recommendations for diagnosis, treatment and prevention of vitamin D deficiency in adults

Pigarova¹,

Рожинская²,

Белая³

et al. 2016

Probl Endokrinol (Mosk)

131

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“…153 After GBy, most patients also develop deficiencies of vitamin D, calcium, zinc, copper, magnesium, and selenium. [156][157][158][159][160][161][162][163] For the prevention of calcium metabolism disorders in patients, on the 7th to 10th day after GBy, 1500 to 1800 mg of alimentary calcium and 800 to 1000 IU of vitamin D per day are prescribed. Calcium metabolism as well as 25(OH)D levels should be measured after 6 months of having surgery and appropriate therapy should be selected to correct the abnormality.…”

Section: Bpdmentioning

confidence: 99%

Bariatric Surgery

et al. 2022

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Today, bariatric surgery is the most effective treatment of obesity. Restrictive surgeries are aimed at reducing the volume of the stomach. Such operations have the least adverse effects in terms of the physiology of digestion. However, they are less effective in losing weight. Mixed operations (gastric bypass surgery, biliopancreatic diversion) decrease the volume of the stomach and the length of the small intestine. Mixed operations tend to provide more pronounced results in a short time. However, by seriously disrupting the digestion and absorption of the food, they may result in severe micronutrient deficiencies. The assimilation of lipophilic substances is severely impaired as the biliopancreatic system is almost disconnected from the digestive tract. Furthermore, the assimilations of not only fats and essential fatty acids but also all fat-soluble vitamins are interrupted. In most cases, these patients need to take high-dose micronutrient supplements for their whole life. Usually, deficiencies of vitamins A, D, E, C, and vitamins of group B, especially B1, B6, B12, niacin, and folate, as well as iron, calcium, phosphate, magnesium, zinc, copper, and selenium, are found after operations. Restrictive operations, although less traumatic for the digestive system, significantly disrupt the digestion and absorption of nutrients, especially those in which the stomach plays a significant role in its digestion. These are proteins, folate, niacin, vitamin B12, iron, and copper. Bariatric surgical procedures are like a double-edged sword. They can be highly effective in the treatment of obesity and related complications; nevertheless, they are surgeries with serious potential for complications.

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“…Как известно, основным источником витамина D (80-90%) для человека является синтез колекальциферола в коже под воздействием ультрафиолетового излучения [10]. В связи с этим низкую концентрацию 25(ОН)D у лиц с ожирением можно объяснить меньшим воздействием солнечного излучения на кожные покровы, поскольку люди с избытком веса меньше времени проводят на солнце, чем лица с нормальной массой тела [11]. К дополнительным, отягощающим факторам риска развития дефицита витамина D относятся использование солнцезащитных средств и ношение закрытой одежды, которые могут уменьшать образование эндогенного витамина D более чем на 95% [12,13].…”

Section: внешние причины развития дефицита витамина D у лиц с ожирениемunclassified

“…Основным патогенетическим механизмом, посредством которого ожирение отрицательно влияет на уровень 25(OH)D, является перераспределение витамина D в большом количестве жировой ткани ввиду его жирорастворимой природы, что приводит к снижению концентрации 25(OH)D в сыворотке крови. Несмотря на то что в ряде исследований, проведенных еще в 80-90-е годы ХХ в., было продемонстрировано, что уровень предшественника витамина D в кожных покровах (7-дегидрохолестерола) при избытке массы тела сопоставим с его уровнем у лиц с нормальной массой тела, у людей с избыточным весом 25(OH)D распределяется в большем объеме, что снижает его концентрацию в сыворотке крови [11,[23][24][25]. 25(ОН)D распределяется преимущественно в жировой ткани и в печени -«органах-мишенях», которые закономерно увеличиваются при ожирении [14].…”

Section: снижение биодоступности 25(он)d на фоне его депонирования в жировой тканиunclassified

To the question of the pathogenetic mechanisms of the influence of obesity on the level of vitamin D

Суплотова

Rozhinskaya

2021

Obes. metabol.

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The influence of obesity on human health, as a multifactorial and multigenic disorder, is a rather complex, interdisciplinary and at the same time extremely urgent problem of modern society. Vitamin D deficiency is one of the consequences of obesity that negatively affects a person’s life expectancy. Vitamin D deficiency is rightfully considered a silent, non-infectious metabolic pandemic of the 21st century. Its significant role in the functioning of the human body is deep and multifaceted, since vitamin D is an integral regulator of the transcriptional activity of genes that control 3–5% of the human genome. There are ongoing discussions among experts in the medical community about the negative impact of obesity on 25 (OH) D levels, and the opposite hypothesis is also being discussed, where vitamin D deficiency is considered an independent risk factor for obesity. Both external causes of the formation of vitamin D deficiency against the background of excessive deposition of adipose tissue and internal metabolic processes underlying the pathogenetic association are analyzed two pathological conditions.

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Narusheniya metabolizma vitamina D pri ozhirenii

Cited by 7 publications

References 35 publications

Russian Association of Endocrinologists recommendations for diagnosis, treatment and prevention of vitamin D deficiency in adults

Russian Association of Endocrinologists recommendations for diagnosis, treatment and prevention of vitamin D deficiency in adults

Bariatric Surgery

To the question of the pathogenetic mechanisms of the influence of obesity on the level of vitamin D

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