V článku je uveden přehled současných poznatků o vitaminu D z klinického hlediska. Jsou shrnuta základní fakta o jeho formách, fyziologických účincích a metabolismu. Z klinického hlediska se článek věnuje stavu zásobení vitaminem D, defi- citu vitaminu D a jeho klinickým projevům a léčbě. V části věnované léčbě jsou shrnuty současné poznatky o používaných formách vitaminu D, jejich indikacích, strategiích léčby a doporučeném dávkování.
The article reviews current knowledge about vitamin D from the clinical point of view. The basic facts about its forms, physiological effects and metabolism are summarized. From clinical point of view the article deals with the state of supply of vitamin D, vitamin D deficiency and its clinical signs, symptoms and therapy. In paragraphs devoted to the treatment the current knowledge about forms of vitamin D, their indication, doses and dosage regimens are summarized.
To evaluate vitamin D levels in children treated with fractures during the healing period. A four-year prospective study, including healthy children treated with diaphyseal fracture of femur or forearm bones. Vitamin D levels were examined four times: at the time of the injury and then one, three, and five months after the injury, together with P1NP, ALP, GGT, and parathormone. In the beginning, patients were blindly divided into two groups, one supplemented with vitamin D3 for the entire follow-up period, the other non-supplemented. Altogether, 107 children underwent examination at the time of their injuries. Of these, 63 were included in the study and examined for the entire follow-up period - 36 supplemented, 27 non-supplemented. At the time of injury, 42 % had a deficit of vitamin D, 36.5 % had insufficiency, only 21.5 % had normal levels. In the children supplemented with cholecalciferol, vitamin D levels increased statistically significantly during the follow-up period (already after 1 month), in contrast with non-supplemented patients, where they did not. When we divided patients according to the initial vitamin D levels (deficit/insufficiency/normal levels) or fracture type (femur/forearm), we also observed significantly better results in supplemented groups. We observed a high prevalence of vitamin D deficit or insufficiency in healthy children at the time of their injuries. Patients supplemented with vitamin D3 had normal levels already after one month and this persisted throughout the follow-up period, in contrast with non-supplemented patients. Therefore, we recommend vitamin D testing and administration for children treated for fractures. Keywords: Vitamin D, Pediatric fracture, Children, Vitamin D supplementation.
- MeSH
- cholekalciferol krev terapeutické užití MeSH
- dítě MeSH
- fraktury femuru krev epidemiologie MeSH
- hojení fraktur * účinky léků MeSH
- lidé MeSH
- mladiství MeSH
- následné studie MeSH
- nedostatek vitaminu D * krev epidemiologie farmakoterapie MeSH
- potravní doplňky MeSH
- předškolní dítě MeSH
- prospektivní studie MeSH
- vitamin D * krev terapeutické užití MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
INTRODUCTION: SARS-CoV-2 respiratory infection is associated with significant morbidity and mortality, especially in hospitalized high-risk patients. We aimed to evaluate the effects of treatment options (vitamin D, anticoagulation, isoprinosine, ivermectin) on hospital mortality in non-vaccinated patients during the 2021 spring wave in the Czech Republic. METHODS: Initially, 991 patients hospitalized in the period January 1, 2021, to March 31, 2021, with PCR-confirmed SARS-CoV-2 acute respiratory infection in two university and five rural hospitals were included in the study. After exclusion of patients with an unknown outcome, a total of 790 patients entered the final analysis. The effects of different treatments were assessed in this cohort by means of propensity score matching. RESULTS: Of the 790 patients, 282 patients died in the hospital; 37.7% were male and 33.3% were female. Age, sex, state of the disease, pneumonia, therapy, and several comorbidities were matched to simulate a case-control study. For anticoagulation treatment, 233 cases (full-dose) vs. 233 controls (prophylactic dose) were matched. The difference in mortality was significant in 16 of the 50 runs. For the treatment with isoprinosine, ivermectin, and vitamin D, none of the 50 runs led to a significant difference in hospital mortality. CONCLUSION: Prophylactic-dose anticoagulation treatment in our study was found to be beneficial in comparison with the full dose. Supplementation with vitamin D did not show any meaningful benefit in terms of lowering the hospital mortality. Neither ivermectin nor, isoprinosine was found to significantly decrease hospital mortality.
- MeSH
- antikoagulancia terapeutické užití MeSH
- COVID-19 * MeSH
- inosin pranobex * MeSH
- ivermektin terapeutické užití MeSH
- lidé MeSH
- retrospektivní studie MeSH
- SARS-CoV-2 MeSH
- studie případů a kontrol MeSH
- tendenční skóre MeSH
- vitamin D terapeutické užití MeSH
- vitaminy MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- bisfosfonáty aplikace a dávkování škodlivé účinky terapeutické užití MeSH
- denzitometrie metody MeSH
- inhibitory kostní resorpce aplikace a dávkování škodlivé účinky terapeutické užití MeSH
- klinické laboratorní techniky MeSH
- kostní denzita MeSH
- lidé MeSH
- metabolické nemoci kostí diagnóza terapie MeSH
- osteoporóza * diagnóza prevence a kontrola terapie MeSH
- plošný screening MeSH
- vitamin D metabolismus terapeutické užití MeSH
- Check Tag
- lidé MeSH
It was to investigate the clinical efficacy of the combination therapy of fluticasone propionate inhalation aerosol and vitamin D (VD) in pediatric bronchial asthma (BA) and analyze the correlation between serum 25-(OH)-D3 levels and immune function, as well as calcium-phosphorus metabolism. A total of 110 patients with BA were recruited. Regarding treatment plan, patients were randomly rolled into a single-drug treatment group (SDT, treated with fluticasone propionate inhalation aerosol alone) and a dual-drug treatment group (TDT, treated with the combination of fluticasone propionate inhalation aerosol and VD). The changes in serum 25-(OH)-D3 levels, immunoglobulins, T lymphocyte subsets, and inflammatory cytokine levels in children with BA under different treatment modalities were compared. Clinical symptom disappearance, asthma control, and quality of life (QoL) were assessed, and the total effective rate and adverse reactions (ARs) were compared. A control group consisting of 60 healthy children who underwent concurrent physical examinations was included. The differences in serum 25-(OH)-D3 levels, immunoglobulins, and T lymphocyte subset levels between children with BA and healthy controls were compared, and their correlations were analyzed. The TDT group showed a drastic reduction in the disappearance time of lung wheezing and dyspnea relative to the SDT group. Furthermore, the TDT group exhibited notable improvements in lung function parameters, including forced vital capacity (FVC), forced expiratory volume at one second (FEV1), FEV1/FVC, and peak expiratory flow (PEF). Blood gas analysis revealed a great decrease in PaCO2 and an increase in PaO2. The Childhood Asthma Control Test (C-ACT) scores for asthma control and Pediatric Asthma Quality of Life Questionnaire (PAQLQ) scores for QoL showed marked increases in the TDT group. Moreover, the TDT group demonstrated notable increases in serum 25-(OH)-D3 levels, immunoglobulins (IgA, IgG, and IgM), T lymphocyte subsets (CD4+ and CD8+), as well as blood calcium and phosphorus levels. Additionally, the TDT group exhibited a prominent increase in the anti-inflammatory cytokine interleukin (IL)-10 level and a drastic decrease in the pro-inflammatory cytokines IL-6 and tumor necrosis factor alpha (TNF-alpha) levels (all P<0.05). The total effective rates of treatment in the SDT group and TDT group were 83.64 % and 96.36 %, respectively, with AR rates of 16.36 % and 7.27 %. The TDT group exhibited a superior total effective rate and an inferior incidence of ARs to the SDT group (both P<0.05). Additionally, in contrast to the control group, the BA group showed notable decreases in serum 25-(OH)-D3 levels, immunoglobulins (IgA, IgG, and IgM), T lymphocyte subsets (CD4+, CD8+, and CD4+/CD8+), as well as blood calcium and phosphorus levels (all P<0.05). Prior to treatment, there was a positive correlation between serum 25-(OH)-D3 levels and immunoglobulins (IgA, IgG, and IgM), T lymphocyte subsets (CD4+ and CD8+), as well as blood calcium and phosphorus levels in children with BA (P<0.05). In patients with BA, combined treatment with inhaled fluticasone propionate aerosol and VD may have a regulatory effect on serum 25-hydroxyVD levels, immune function, and calcium-phosphate metabolism. The correlation between serum 25-(OH)-D3 levels and immune function, as well as calcium-phosphate metabolism, suggested that VD may play a crucial role in the immune regulation and calcium-phosphate metabolism of BA.
- MeSH
- aplikace inhalační MeSH
- bronchiální astma * farmakoterapie krev imunologie MeSH
- bronchodilatancia aplikace a dávkování terapeutické užití MeSH
- dítě MeSH
- flutikason aplikace a dávkování terapeutické užití MeSH
- fosfáty krev MeSH
- kombinovaná farmakoterapie * MeSH
- kvalita života MeSH
- lidé MeSH
- mladiství MeSH
- předškolní dítě MeSH
- vápník krev MeSH
- vitamin D * krev analogy a deriváty terapeutické užití MeSH
- výsledek terapie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
As of the 7th of July 2024, 775,754,322 confirmed cases of COVID-19, including 7,053,902 deaths worldwide, had been reported to the WHO (World Health Organization). Nevertheless, untill the 15th of July 2024, a total of 13,578,710,228 vaccine doses had been administered, with almost no country spared from COVID-19 attacks. The pathophysiology of this virus is complicated, and several symptoms require a deep understanding of the actual mechanisms. It is unclear why some patients develop severe symptoms while others do not, although literature suggests a role for vitamin D. Vitamin D plays a crucial role in the infection or in ameliorating the severity of symptoms. The mechanism of action of vitamin D and vitamin D deficiency (VDD) is well understood. VDD is associated with increased hospitalization of severely ill patients and increased levels of COVID-19-caused mortality. Recent studies suggest that vitamin D levels and genetic variations in the vitamin D receptor (VDR) gene significantly impact the severity and outcomes of COVID-19, especially in the infections caused by Delta and Omicron variants. Furthermore, VDD causes immune system dysregulation upon infection with SARS-CoV-2, indicating that vitamin D sufficiency is crucial in fighting against COVID-19 infection. The therapeutic effect of vitamin D raises interest in its potential role as a prophylactic and treatment adjunct. We evaluate the immunomodulatory effects of vitamin D and its ability to enhance the efficacy of new antiviral drugs like molnupiravir and paxlovid against SARS-CoV-2. This review discusses the role of vitamin D sufficiency and VDD in COVID-19 initiation and progression, emphasizing the molecular mechanisms by which vitamin D exerts its actions as a proactive step for the next pandemic. However, there is still no clear evidence of vitamin D's impact on prevention and treatment, leading to contradictory findings. Therefore, large-scale randomized trials are required to reach a definitive conclusion. A bibliometric analysis of publications related to vitamin D, immunity, and COVID-19 revealed a significant increase in research activity in this area, particularly in 2020-2024, underscoring the growing recognition of vitamin D's potential role in the context of the pandemic.
- MeSH
- COVID-19 * imunologie MeSH
- farmakoterapie COVID-19 MeSH
- lidé MeSH
- nedostatek vitaminu D * farmakoterapie imunologie MeSH
- pandemie MeSH
- receptory kalcitriolu metabolismus MeSH
- SARS-CoV-2 imunologie MeSH
- vitamin D * terapeutické užití aplikace a dávkování MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Vitamin D is an important steroid hormone that exerts immunomodulatory actions, controls calcium and phosphate homeostasis, and significantly affects human health. Vitamin D deficiency is a global health problem, affecting approximately 60% of adults worldwide, and has been implicated in a range of different types of diseases, e.g., cancer. Vitamin D is involved in the regulation of cell proliferation, differentiation, energetic metabolism, and different types of cell death (e.g., apoptosis, autophagy, etc.). In physiological conditions, it is also able to modulate immune responses, angiogenesis, etc., which belongs to fundamental cancer-related processes. Vitamin D deficiency has been associated with an increased risk of some types of cancer, e.g., colorectal, breast, ovarian, prostate, pancreatic, etc. The role of vitamin D in cancer prevention, carcinogenesis, and cancer treatment is still under investigation and depends on the type of cancer. This review summarizes the role of vitamin D in all three above-mentioned aspects and discusses the mechanism of action and potential possibilities in cancer treatment.
- MeSH
- lidé MeSH
- nádory * prevence a kontrola farmakoterapie MeSH
- nedostatek vitaminu D komplikace MeSH
- potravní doplňky * MeSH
- vitamin D * terapeutické užití MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
V tomto článku sa venujeme endokrinne sprostredkovanej osteoporóze spôsobenej poruchami sekrécie rastového hormónu (RH); nedostatku rastového hormónu u dospelých a akromegálii. RH a inzulínu podobný rastový faktor-1 (IGF-1) stimulujú lineárny rast kostí prostredníctvom komplexných hormonálnych interakcií a aktivujú epifýzové prechondrocyty. GH prostredníctvom receptorového aktivátora jadrového faktora-kappaB (RANK), jeho ligandu (RANK-L) a osteoprotegerínového systému stimuluje produkciu osteoprotegerínu a jeho akumuláciu v kostnej matrici. Nesprávna funkcia tohto mechanizmu môže viesť k špecifickému poškodeniu kostí. Primárnym problémom kostného postihnutia pri poruchách sekrécie rastového hormónu je riziko osteoporotických fraktúr, preto je dôležité posúdiť kvalitu kosti, ktorá lepšie odráža skutočnú predispozíciu pacienta na fraktúru. Metódou odhadu kvality kostí z DXA skenov bedrovej chrbtice je trabekulárne kostné skóre (TBS). Pri akromegálii TBS lepšie definuje riziko zlomeniny, pretože BMD je normálna alebo dokonca zvýšená. TBS pomáha sledovať efekt liečby rastovým hormónom a vitamínom D. Napriek týmto zisteniam by sa TBS nemal používať samostatne, ale je potrebné komplexné zváženie všetkých rizikových faktorov zlomenín, BMD a markerov kostného obratu.
In this article, we address endocrine-mediated osteoporosis caused by disorders of growth hormone (GH) secretion; growth hormone deficiency in adults and acromegaly. GH and insulin-like growth factor-1 (IGF-1) stimulate linear bone growth through complex hormonal interactions and activate epiphyseal prechondrocytes. GH stimulates the production of osteoprotegerin and its accumulation in the bone matrix through the receptor activator of nuclear factor-kappaB (RANK), its ligand (RANK-L) and the osteoprotegerin system. Incorrect function of this mechanism can lead to specific bone damage. The primary problem of bone involvement in disorders of GH secretion is the risk of osteoporotic fractures, so it is important to assess the quality of the bone, which better reflects the actual predisposition of the patient to fracture. The method for estimating bone quality from DXA scans of the lumbar spine is the trabecular bone score (TBS). In acromegaly, TBS better defines fracture risk because BMD is normal or even elevated. TBS helps to monitor the effect of treatment with growth hormone and vitamin D. Despite these findings, TBS should not be used alone, but a comprehensive consideration of all fracture risk factors, BMD and markers of bone turnover is required.
- Klíčová slova
- trabekulární kostní skóre,
- MeSH
- absorpční fotometrie metody MeSH
- akromegalie diagnóza komplikace MeSH
- insulinu podobný růstový faktor I nedostatek MeSH
- kostní denzita * účinky léků MeSH
- lidé MeSH
- osteoporotické fraktury etiologie prevence a kontrola MeSH
- osteoporóza etiologie MeSH
- růstový hormon * nedostatek terapeutické užití MeSH
- vitamin D terapeutické užití MeSH
- Check Tag
- lidé MeSH
Gestational diabetes mellitus (GDM) is a common disease during pregnancy that has adverse effects on both the mother and fetus. There are currently rare researches on the effect of vitamin supplementation on GDM pregnant mother and their offspring on animal and cell levels systematically. This work supplemented the GDM pregnant mouse model with vitamin D and found that vitamin D can effectively alleviate the hyperglycemia in GDM pregnant mice, increase blood insulin and adiponectin concentrations, and improve GTT and ITT in pregnant mice. In addition, vitamin D can reduce the incidence of death and high birth weight of offspring caused by GDM. The offspring of GDM pregnant mice had higher blood glucose levels in the first 5 weeks after birth compared to the normal group, and then returned to normal levels. Vitamin D can alleviate abnormal glucose metabolism in newborn mice. The therapeutic effect exhibited by vitamin D may be due to their anti-inflammatory effects, as vitamin D supplementation significantly reduces the levels of TFN-?, MCP-1, IL-1? and IL-8 in the blood. Vitamin D also regulates liver lipid metabolism, resulting in a decrease in liver lipid accumulation and a decrease in blood triglycerides (TG) and cholesterol (CHO). The results of this study demonstrate that vitamin D supplementation can serve as an effective treatment strategy for alleviating GDM symptoms. Keywords: Gestational diabetes mellitus, Vitamin D, Glucose metabolism, Anti-inflammatory.
- MeSH
- gestační diabetes * metabolismus prevence a kontrola krev farmakoterapie MeSH
- glukosa metabolismus MeSH
- krevní glukóza * metabolismus účinky léků MeSH
- modely nemocí na zvířatech * MeSH
- myši inbrední C57BL MeSH
- myši MeSH
- potravní doplňky MeSH
- těhotenství MeSH
- vitamin D * farmakologie terapeutické užití MeSH
- zvířata MeSH
- Check Tag
- myši MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- Gravesova nemoc * diagnóza farmakoterapie MeSH
- hmotnostní úbytek MeSH
- hypertyreóza diagnóza farmakoterapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- methimazol aplikace a dávkování terapeutické užití MeSH
- opožděná diagnóza MeSH
- pyridoxin aplikace a dávkování terapeutické užití MeSH
- thyreostatika MeSH
- vitamin B komplex MeSH
- vitamin D aplikace a dávkování terapeutické užití MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
