Международный эндокринологический журнал Том 19, №1, 2023

Останніми роками було доведено, що одним із факторів метаболічних порушень є гіповітаміноз D. Вважають, що дефіцит вітаміну D спричиняє підвищення інсулінорезистентності й зниження секреції інсуліну, унаслідок чого виникають цукровий діабет та ожиріння. З такими метаболічними порушеннями тісно пов’язана серцево-судинна патологія. Показано, що вітамін D демонструє складний багатоступеневий метаболізм і діє як гормон на багато позаскелетних мішеней. У поданому огляді проведено комплексний аналіз сучасної літератури в базах даних Scopus, Web of Science, MedLine, The Cochrane Library, EMBASE, Global Health, а також у базах даних державних наукових бібліотек України, Європейського Союзу, Великої Британії, США та інших країн з метою виявлення й аналізу наукових публікацій, у яких обговорювалися різноманітні біологічні ефекти вітаміну D і його застосування в комплексній терапії різноманітних патологічних станів. Крім відомої раніше ролі вітаміну D у метаболізмі кальцію і регуляції роботи опорно-рухового апарату, за останні роки було відкрито широкий спектр його плейотропних ефектів. Сучасні дослідження виявили зв’язок між низькими рівнями вітаміну D і розвитком нейрокогнітивної дисфункції, психічних і неврологічних порушень, безплідності, імунної реактивності й автоімунних порушень, різними видами раку, серцево-судинними патологіями. Окремо стоять дослідження, що показали зв’язок дефіциту вітаміну D з майже всіма аспектами метаболічного синдрому, а саме із цукровим діабетом 1-го і 2-го типів, глікемією, дисліпідемією, ожирінням, артеріальною гіпертензією та інсулінорезистентністю. Зроблено висновок, що дані сучасної літератури стосовно ефективності вітаміну D у лікуванні й профілактиці метаболічних порушень і структурно-функціональних змін печінки при цукровому діабеті й неалкогольній жировій хворобі доволі суперечливі: поряд із численним пулом публікацій про дієве застосування вітаміну D трапляються дослідження щодо непідтвердженої ефективності терапії і навіть токсичності при вказаних патологіях.

The relationship between vitamin D deficiency and the metabolic syndrome has recently been revealed. Vitamin D deficiency was hypothesized to cause increased insulin resistance and decreased insulin secretion, which can result in the development of diabetes mellitus and obesity. Cardiovascular diseases are also closely related to the metabolic syndrome. Vitamin D has been shown to have complex multistep metabolism and act as a hormone at many extraskeletal targets. In this literature review, a comprehensive analysis of publications from Scopus, Web of Science, MedLine, The Cochrane Library, EMBASE, Global Health databases, as well as scientific libraries of Ukraine, European Union, Great Britain, USA and other countries was performed. Our goal is to identify and analyze scientific publications discussing various biological effects of vitamin D and its use in the comprehensive treatment of various diseases. In addition to the previously known role of vitamin D in calcium metabolism and the musculoskeletal system functionality, a wide range of its pleiotropic effects has been discovered recently. Modern studies have shown a relationship between low levels of vitamin D and development of neurocognitive dysfunction, mental and neurological disorders, infertility, immune reactivity and autoimmune disorders, various types of cancer, and cardiovascular pathologies. More recent data also revealed a relationship of vitamin D deficiency with practically all aspects of metabolic syndrome, namely diabetes mellitus type 2 and type 1, hyperglycemia, dyslipidemia, obesity, hypertension, and insulin resistance. It was concluded that the data of the modern literature regarding the effectiveness of vitamin D in the treatment and prevention of metabolic disorders and structural and functional changes of the liver in diabetes and non-alcoholic fatty liver disease are quite contradictory: at the same level as the numerous publications on the effective use of vitamin D, there are studies with unconfirmed effectiveness of therapy and even its toxicity for the indicated pathologies.

огляд; дефіцит вітаміну D; неалкогольна жирова хвороба печінки; цукровий діабет; інсулінорезистентність

review; vitamin D deficiency; non-alcoholic fatty liver disease; diabetes; insulin resistance

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