The potential vitamin D deficiency is often underestimated. According to statistics, the deficit or deficiency of vitamin D is about 1 billion inhabitants of the Earth, which reflects both the demographic (aging of the population) and the environmental changes occurring on the planet in recent decades, according to the Internet publication for girls and women from 14 to 35 years Pannochka. net D-HORMONE OR D-VITAMIN?.
Vitamin D belongs to the group of fat-soluble, but is not a vitamin in the classical sense of the term, since it is biologically inactive. As a result of a two-stage metabolism, vitamin D is converted into an active hormone form in the body and has various biological effects due to interaction with specific receptors located in the nuclei of cells of tissues and organs. In this respect, the active metabolite of vitamin D - calcitriol - manifests itself as a true hormone, in connection with which it was called "D-hormone". It is he, together with hydroxylating enzymes, which is the active component of the D-endocrine system.
D-DEFICIT.
The need for vitamin D varies from 200 IU / day in adults to 400 IU / day in children. In the human body, vitamin D2 comes in relatively small amounts - no more than 20-30% of the need. According to a number of studies, 40 to 100% of elderly people in the US and Europe, living in normal conditions (not in nursing homes), have vitamin D deficiency.
In Europe, where few foods are artificially enriched with vitamin D, children and adults are at particularly high risk of vitamin D deficiency.
It is believed that a short-term (within 10-30 min) solar irradiation of the face and hands is equivalent to the intake of approximately 200 IU of vitamin D. Re-exposure to the sun with the appearance of moderate cutaneous erythema promotes an increase in the concentration of vitamin D to a higher level than with repeated administration of it at a dose of 10,000 IU per day. [1] This fact allows us to assert that the D-hormone-vitamin is "gifted" to us by the sun. In the body of an adult healthy person, 0.3-1 ?g of vitamin per day.
There are two main types of deficiency of D-hormone, sometimes also called D-deficiency syndrome. The first of them is caused by deficiency / deficiency of vitamin D3 - a natural pro-hormonal form, from which active metabolites are formed. This type of vitamin D deficiency is associated with inadequate sun exposure, as well as its low intake with food, the constant wearing of body-covering clothing, which reduces the formation of natural vitamin in the skin. A similar situation was observed earlier, mainly in children, and was in fact synonymous with rickets.
Another type of vitamin D deficiency is characterized by a normal or slightly increased production of D-hormone in the kidneys, but there is a decrease in its reception in tissues (resistance to D-hormone), which is often found in people over the age of 65.
In addition, deficiency of D-hormone is revealed in the syndrome of malabsorption, Crohn's disease, conditions after subtotal resection of the stomach and intestinal surgery, with insufficient secretion of pancreatic juice, liver cirrhosis, congenital pathology of the bile duct, prolonged use of anticonvulsants, nephrosis.
A high level of D-deficiency is also associated with a number of diseases (cardiovascular, oncological, neurological, etc.. Currently, active research is underway to determine the possibilities of treating these diseases with the help of preparations of the active metabolite group of vitamin D. These drugs have a preventive and curative effect in various types and forms of osteoporosis, reduce the risk of fractures in falls.
They can be used both as monotherapy and in combination with other agents, for example, with bisphosphonates, hormone replacement therapy and calcium salts.
By pharmacological activity, vitamin D preparations are divided into two groups (table).
Individual selection of dosages of vitamin D preparations allows to minimize the risk of side effects, which along with preventing the emergence of new fractures, the elimination of pain and improvement of motor activity contributes to improving the quality of life of patients, especially the elderly and senile.
nedug. en.