Сучасні протоколи по застосуванню вітаміну D у дітей з профілактичною та лікувальною метою
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Анотація
В оглядовій статті розглянуто сучасні аспекти профілактичного та лікувального застосування вітаміну D залежно від віку, стану здоров’я та рівня вітаміну D у крові. Багатогранна дія вітаміну D в організмі людини зумовлена наявністю рецепторів до вітаміну D3 (VDR) у більшості органів і тканин організму. Це підтверджує роль вітаміну D як у процесах формування кісткової системи, так і у багатьох його позакісткових ефектах.
Метою роботи було узагальнення даних літератури та аналіз сучасних протоколів застосування вітаміну D у клінічній практиці.
Дефіцит вітаміну D та кальцію пов’язаний з рахітом, остеомаляцією та підвищеним ризиком переломів і остеопорозу. Дані багатьох досліджень свідчать про значення забезпеченості організму вітаміном D y більшocті пацієнтів із ревматоїдними захворюваннями. Bcтанoвленo, що низькі концентрації 25(OH)D у сироватці крові виявляються значно частіше у пацієнтів з ювенільним ідіопатичним артритом (ЮІА). Щодо профілактичної дози вітаміну D, більшість настанов рекомендують щоденне споживання в діапазоні від 400 до 600 М О/день, верхня межа дози вітаміну D знаходиться в діапазоні від 1000 до 4000 МО на день.
Значення вітаміну D у дитячому віці, розуміння його плейотропної дії вимагає напрацювання алгоритму саплементації вітаміном D у клінічній практиці відповідно до оновлених рекомендацій клінічних практичних настанов щодо добавок вітаміну D та кальцію у дітей.
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