porozendoОстеопороз и остеопатииOsteoporosis and Bone Diseases2072-26802311-0716Endocrinology Research Centre10.14341/osteo2012310-13porozendo-4090Research ArticleСтатьиArticlesРАСПРОСТРАНЁННОСТЬ И ВЫРАЖЕННОСТЬ ГИПОВИТАМИНОЗА D У БОЛЬНЫХ РАССЕЯННЫМ СКЛЕРОЗОМ В СВЕРДЛОВСКОЙ ОБЛАСТИ»PREVALENCE AND SEVERITY OF HYPOVITAMINOSIS D IN PATIENTS WITH MULTIPLE SCLEROSIS IN THE SVERDLOVSK REGIONTurovaE L

vrach-nevrolog, k.m.n., nevrologicheskoe otdeleniya

eturova@mail.ruLesnyakO M

d.m.n., professor, zav. kafedroy semeynoy meditsiny FPK i PP

-201215122012153№3 (2012)1013Copyright © Turova E.L., Lesnyak O.M., 20122012Turova E.L., Lesnyak O.M.Turova E.L., Lesnyak O.M.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.osteo-endojournals.ru/jour/article/view/4090

Целью исследования было изучение распространённости и выраженности гиповитаминоза D у пациентов с рассеянным склерозом (PC) в Свердловской области. Обследован 61 пациент с РС в возрасте 18-61 г.(средний возраст 38,0± 10,6 лет). Контрольную группу составили 32 здоровых добровольца. Группы были сопоставимы по возрасту и полу. Исследование было проведено в марте-начале апреля в 2010 и 2011 гг. Установлено, что все больные РС и 94 % лиц контрольной группы имели недостаточность витамина D3. Однако пациенты с РС имели достоверно более низкие цифры концентрации 25 (OH)D3 в сравнении с контрольной группой (р = 0,01), и половина из них имела дефицит витамина D, в то время как в контрольной группе дефицит выявлен лишь у 21,9 % (р = 0,04). Не выявлено корреляции концентрации 25-гидроксивитамина D3 в сыворотке крови с полом больных, длительностью и типом течения заболевания, степенью инвалидизации по шкале EDSS, уровнем депрессии. Обнаружена умеренная прямая достоверная связь между возрастом больных и концентрацией 25 (OH)D3 в сыворотке крови.

The purpose of the study was to investigate the prevalence and severity of vitamin D insufficiency in multiple sclerosis (MS) patients in Sverdlovsk region. Was examined 61 patients with MS of 18 to 61 year old (38,0 ± 10,6). The study was performed in March-April in 2010 and 2011. The control group included 32 healthy volunteers. The groups were comparable in age and sex. All MS patients and 94 % of control group had hypovitaminosis D3. However, patients with MS had clearly lower 25 (OH) D3 concentration as compared to control group (p = 0,01). Half of the patients had vitamin D deficiency, whereas in the control group the deficit was identified only in 21.9% (р = 0,04). We did not found any correlation between concentration of serum 25-hydroxyvitamin D3 and sex, duration and type of MS, degree of disability on EDSS scale, as well as with depression. A moderate direct correlation between patients’age and concentration of 25 (OH) D3 in serum was found.

рассеянный склерозвитамин Dmultiple sclerosisvitamin DReferencesKurtzke J.F. On the fine structure of the distribution of multiple sclerosis. Acta Neurol Scand. 1967; 43: 257-282.Kurtzke J.F. On the fine structure of the distribution of multiple sclerosis. Acta Neurol Scand. 1967; 43: 257-282.Acheson E.D., Bachrach C.A., Wright F.M. Some comments on the relationship of the distribution of multiple sclerosis to latitude, solar radiation and other variables. Acta Psychiatr Scand Suppl. 1960; 35: 37-42.Acheson E.D., Bachrach C.A., Wright F.M. Some comments on the relationship of the distribution of multiple sclerosis to latitude, solar radiation and other variables. Acta Psychiatr Scand Suppl. 1960; 35: 37-42.Ascherio A., Munger K.L. Environmental risk factors for multiple sclerosis. Part II: non-infectious factors. Ann Neurol. 2007; 61: 504—513.Ascherio A., Munger K.L. Environmental risk factors for multiple sclerosis. Part II: non-infectious factors. Ann Neurol. 2007; 61: 504—513.Giovannoni G., Ebers G. Multiple sclerosis: the environment and causation. Curr Opin Neurol 2007; 20: 261-268.Giovannoni G., Ebers G. Multiple sclerosis: the environment and causation. Curr Opin Neurol 2007; 20: 261-268.Munger Kl, Levin L.I., Hollis B.W., Howard N.S., Ascherio A. (2006) Serum 25-hydroxyvitamin D levels and risk of multiple sclerosis. JAMA. 2006; 296: 2832-2838.Munger Kl, Levin L.I., Hollis B.W., Howard N.S., Ascherio A. (2006) Serum 25-hydroxyvitamin D levels and risk of multiple sclerosis. JAMA. 2006; 296: 2832-2838.Hiremath G.S., Cettomai D., Baynes M., Ratchford J.N., Newsome S., Harrison D., Kerr D., Greenberg B.M., Calabresi P.A. (2009) Vitamin D status and effect of low-dose cholecalciferol and high-dose ergocalciferol supplementation in multiple sclerosis. Mult Scler 15: 735-740.Hiremath G.S., Cettomai D., Baynes M., Ratchford J.N., Newsome S., Harrison D., Kerr D., Greenberg B.M., Calabresi P.A. (2009) Vitamin D status and effect of low-dose cholecalciferol and high-dose ergocalciferol supplementation in multiple sclerosis. Mult Scler 15: 735-740.Kragt J., van Amerogen B., Killestein J., Dijkstra C.D., Vitdehaag B.M.J., Polman C.H. et al. Higher levels of 25-hydroxyvitamin D are associated with a lower incidence of multiple sclerosis only in women. Mult Scler. 2009; 15: 9-15.Kragt J., van Amerogen B., Killestein J., Dijkstra C.D., Vitdehaag B.M.J., Polman C.H. et al. Higher levels of 25-hydroxyvitamin D are associated with a lower incidence of multiple sclerosis only in women. Mult Scler. 2009; 15: 9-15.Soilu-Hanninen M., Laaksonen M., Laitinen I., Eralinna J.P., Lilius E.M., Mononen I (2008). A longitudinal study of serum 25-hydroxyvitamin D and intact parathyroid hormone levels indicatethe importance of vitamin D and calcium homeostasis regulation in multiple sclerosis. J Neurol Neurosurg Psychiatry 79: 152-157.Soilu-Hanninen M., Laaksonen M., Laitinen I., Eralinna J.P., Lilius E.M., Mononen I (2008). A longitudinal study of serum 25-hydroxyvitamin D and intact parathyroid hormone levels indicatethe importance of vitamin D and calcium homeostasis regulation in multiple sclerosis. J Neurol Neurosurg Psychiatry 79: 152-157.Ginde A.A., Liu M.C., Camargo C.A. Jr. Demographic differences and trends of vitamin D insufficiency in the US population, 1988-2004. Arch Intern Med. 2009 169: 626-632.Ginde A.A., Liu M.C., Camargo C.A. Jr. Demographic differences and trends of vitamin D insufficiency in the US population, 1988-2004. Arch Intern Med. 2009 169: 626-632.Chapuy M.C., Preziosi P., Maamer M., Arnaud S., Galan P., Hercberg S., Meunier P.J., Prevalence of vitamin D insufficiency in an adult normal population. Osteoporos Int. 1996 7: 439-443.Chapuy M.C., Preziosi P., Maamer M., Arnaud S., Galan P., Hercberg S., Meunier P.J., Prevalence of vitamin D insufficiency in an adult normal population. Osteoporos Int. 1996 7: 439-443.Rucker D., Allan J.A., Fick G.H., Hanley D.A. (2002) Vitamin D insufficiency in a population of healthy western Canadians. CMAJ. 2002; 166: 1517-1524.Rucker D., Allan J.A., Fick G.H., Hanley D.A. (2002) Vitamin D insufficiency in a population of healthy western Canadians. CMAJ. 2002; 166: 1517-1524.Välimäki V.V., Alfthan H., Lehmuskallio E., Löyttyniemi E., Petterson K., Stenman U.H. et al. Vitamin D status as a determinant of peak bone mass in young Finnish men. J Clin Endocrinol Metab.2004; 89: 76-80.Välimäki V.V., Alfthan H., Lehmuskallio E., Löyttyniemi E., Petterson K., Stenman U.H. et al. Vitamin D status as a determinant of peak bone mass in young Finnish men. J Clin Endocrinol Metab.2004; 89: 76-80.Bischoff-Ferrari H.A., Giovannucci E., Willett W.C., Dietrich T., Dawson-hughes B. Estimation of optimal serum concentration of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr.2006; 84: 18-28.Bischoff-Ferrari H.A., Giovannucci E., Willett W.C., Dietrich T., Dawson-hughes B. Estimation of optimal serum concentration of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr.2006; 84: 18-28.Cannel J.J., Hollis B.W. Use of vitamin D in clinical practice. Altern Med Rev; 13(1): 6-20.Cannel J.J., Hollis B.W. Use of vitamin D in clinical practice. Altern Med Rev; 13(1): 6-20.Шилин Д.Е. Витамин - гормон D в клинике XXI века: плей-отропные эффекты и лабораторная оценка (лекция). Клиническая лабораторная диагностика. № 12; 2010; 17-23.Шилин Д.Е. Витамин - гормон D в клинике XXI века: плей-отропные эффекты и лабораторная оценка (лекция). Клиническая лабораторная диагностика. № 12; 2010; 17-23.Bakhtiyarova S., Lesnyak O., Kyznesova N., Blankenstein M.A., Lips P. Vitamin D status among patients with hip fracture and elderly control subjects in Yekaterinburg, Russia. Osteoporos Int. 2006; 17: 441-446Bakhtiyarova S., Lesnyak O., Kyznesova N., Blankenstein M.A., Lips P. Vitamin D status among patients with hip fracture and elderly control subjects in Yekaterinburg, Russia. Osteoporos Int. 2006; 17: 441-446Barnes M.S., Bonham M.P., Robson P.J., Strain J.J., Lowe-Strong A.S., Eaton-Evans J., Ginty F., Wallace J.M. (2007) Assessment of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D3 concentrations in male and female multiple sclerosis patients and control volunteers. Mult Scler 13: 670-672.Barnes M.S., Bonham M.P., Robson P.J., Strain J.J., Lowe-Strong A.S., Eaton-Evans J., Ginty F., Wallace J.M. (2007) Assessment of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D3 concentrations in male and female multiple sclerosis patients and control volunteers. Mult Scler 13: 670-672.Cosman F., Nieves J., Komar L., Ferrer G., Herbert J. et al. (1998). Fracture history and bone loss in patients with MS. Neurology 51: 1161-1165.Cosman F., Nieves J., Komar L., Ferrer G., Herbert J. et al. (1998). Fracture history and bone loss in patients with MS. Neurology 51: 1161-1165.Soilu-Hänninen M., Airas L., Monnonen I., Heikkilä A., Viljanen N., Hänninen A. 25-Hydroxyvitamin D levels in serum at the onset of multiple sclerosis. Mult Scler. 2005; 11: 266-271.Soilu-Hänninen M., Airas L., Monnonen I., Heikkilä A., Viljanen N., Hänninen A. 25-Hydroxyvitamin D levels in serum at the onset of multiple sclerosis. Mult Scler. 2005; 11: 266-271.Soilu-Hanninen M., Laaksonen M., Laitinen I., Eralinna J.P., Lilius E.M., Mononen I. (2008) A longitudinal study of serum 25-hydroxyvitamin D and intact parathyroid hormone levels indicatete importance of vitamin D and calcium homeostasis regulation in multiple sclerosis. J Neurol Neurosurg Psychiatry 79: 152-157.Soilu-Hanninen M., Laaksonen M., Laitinen I., Eralinna J.P., Lilius E.M., Mononen I. (2008) A longitudinal study of serum 25-hydroxyvitamin D and intact parathyroid hormone levels indicatete importance of vitamin D and calcium homeostasis regulation in multiple sclerosis. J Neurol Neurosurg Psychiatry 79: 152-157.Deseilligny C.P. Clinical implication of a possible role of vitamin D in multiple sclerosis. J.Neurolog. 2009; 256(9): 1468-1479.Deseilligny C.P. Clinical implication of a possible role of vitamin D in multiple sclerosis. J.Neurolog. 2009; 256(9): 1468-1479.Mei I.A., Ponsonby A.-L., Dwyer T., Blizzard L., Taylor B.V., Kilpatrick T., Butzkueven H., McMichael A.J. (2007). Vitamin D levels in people with multiple sclerosis and community controls in Tasmania, Australia. J Neurol 254: 581-590.Mei I.A., Ponsonby A.-L., Dwyer T., Blizzard L., Taylor B.V., Kilpatrick T., Butzkueven H., McMichael A.J. (2007). Vitamin D levels in people with multiple sclerosis and community controls in Tasmania, Australia. J Neurol 254: 581-590.Smolders J., Menheere P., Kessels A., Damoiseaux J., Hupperts R. Association of vitamin D metabolite levels with relapse rate and disability in multiple sclerosis. Mult Scler. 2008; 14(9): 1220-1224.Smolders J., Menheere P., Kessels A., Damoiseaux J., Hupperts R. Association of vitamin D metabolite levels with relapse rate and disability in multiple sclerosis. Mult Scler. 2008; 14(9): 1220-1224.Jorge Correale, Maria Celica Ysrraelit, Maria ines Gaitan. Immunomodulatory effects of Vitamin D in multiple sclerosis. Oxford Journal Brain V132, Issue 5: 1146-1160.Jorge Correale, Maria Celica Ysrraelit, Maria ines Gaitan. Immunomodulatory effects of Vitamin D in multiple sclerosis. Oxford Journal Brain V132, Issue 5: 1146-1160.Thiago Sotero, Andrea Tavares Dantas, Claudia Diniz Lopes Marques et al. 25-Hydroxyvitamin D3 levels in patient with systemic lupus erythematosus and its association with clinical parameters and laboratory tests. Rev Bras Reumatol 2012; 52(1): 55-65.Thiago Sotero, Andrea Tavares Dantas, Claudia Diniz Lopes Marques et al. 25-Hydroxyvitamin D3 levels in patient with systemic lupus erythematosus and its association with clinical parameters and laboratory tests. Rev Bras Reumatol 2012; 52(1): 55-65.Michael P. Pender. CD8+T-Cell deficiency, Epstein-Barr Virus infection, vitamin D deficiency, and steps to autoimmunity: a unifying hypothesis. Autoimmune diseases.Michael P. Pender. CD8+T-Cell deficiency, Epstein-Barr Virus infection, vitamin D deficiency, and steps to autoimmunity: a unifying hypothesis. Autoimmune diseases.Goldberg P., Fleming M.C., Picard E.H. Multiple sclerosis: decreased relapse rate through dietary supplementation with calcium, magnesium and vitamin D. Med Hypotheses 1986; 21: 193-200.Goldberg P., Fleming M.C., Picard E.H. Multiple sclerosis: decreased relapse rate through dietary supplementation with calcium, magnesium and vitamin D. Med Hypotheses 1986; 21: 193-200.Kimball S.M., Ursell M.R., O’Connor P., Vieth R. Safety of vitamin D3 in adults with multiple sclerosis. Am J Clin Nutr 2007; 86: 645-651.Kimball S.M., Ursell M.R., O’Connor P., Vieth R. Safety of vitamin D3 in adults with multiple sclerosis. Am J Clin Nutr 2007; 86: 645-651.Viet R., Rimball S., Hu A., Walfish P.G. Randomized comparison of the effects of the vitamin D3 adequate intake versus 100 mcg (4000 IU) per day on biochemical responses and the wellbeing of patients. Nutr J 2004; 3: 8.Viet R., Rimball S., Hu A., Walfish P.G. Randomized comparison of the effects of the vitamin D3 adequate intake versus 100 mcg (4000 IU) per day on biochemical responses and the wellbeing of patients. Nutr J 2004; 3: 8.Knippenberg S., Boi Y., Damoiseaux J., Hupperts R., Smolders J. Vitamin D status in patient with MS is negatively correlated with depression, but not with fatigue. Acta Neurol Scand. 2011 Sep; 124(3): 171-5.Knippenberg S., Boi Y., Damoiseaux J., Hupperts R., Smolders J. Vitamin D status in patient with MS is negatively correlated with depression, but not with fatigue. Acta Neurol Scand. 2011 Sep; 124(3): 171-5.

The authors declare that there are no conflicts of interest present.