mrjСовременная ревматологияModern Rheumatology Journal1996-70122310-158XIMA-PRESS, LLC10.14412/1996-7012-2009-546mrj-231Research ArticleСтатьиArticlesРоль витамина D в эффективности антирезорбтивной терапииROLE OF VITAMIN D IN THE EFFICIENCY OF ANTIRESORPTIVE THERAPYТоропцоваН. В.ToroptsovaN Vepid@irramn.ru20091306200932№2 (2009)7881Copyright © Торопцова Н.В., 20092009Торопцова Н.В.Toroptsova N.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://mrj.ima-press.net/mrj/article/view/231

Дефицит витамина D - один из обоснованных факторов риска развития остеопороза. Этот витамин необходим для обеспечения абсорбции кальция в кишечнике и регуляции обменных процессов в костной ткани, а также для обеспечения нейромышечных функций в организме. Недостаточность витамина D приводит к повышению костного метаболизма, в результате чего прогрессирует потеря костной массы и увеличивается риск возникновения переломов. Кроме того, у пациентов с дефицитом витамина D существует более высокая вероятность падений и потери мышечной массы, что в свою очередь повышает риск возникновения переломов. Комбинированная таблетированная форма алендроната и витамина D так же эффективна, как и моноформа алендроната, но, кроме того, обладает дополнительным преимуществом, связанным с гарантированным поступлением в организм витамина D. При этом биодоступность каждого из компонентов не отличается от аналогичного показателя при индивидуальном их использовании.

Vitamin D deficiency is one of the substantiated risk factors of osteoporosis. This vitamin is required to provide intestinal calcium absorption, bone metabolism regulation, and neuromuscular functions in the body. Vitamin D deficiency results in increased bone metabolism, causing bone loss progression and increasing the risk of fractures. Moreover, patients with vitamin D deficiency have a higher probability of fallings and loss of muscle mass, increasing in turn the risk of fractures. The combined formulation of alendronate and vitamin D as tablets is as effective as the mono-formulation of alendronate, but, furthermore, it has an additional advantage associated with the guaranteed vitamin D intake. At the same time the bioavailability of each component does not differ from the similar index when these agents are used alone.

остеопорозхолекальциферолалендронатosteoporosischolecalciferolalendronateReferences<div><p>Клинические рекомендации. Остеопороз. Диагностика, профилактика и лечение. Под ред. Л.И. Беневоленской, О.М. Лесняк. М.: ГЭОТАР-Медиа, 2009.</p><p>Holick M.F. Vitamin D: a millennium perspective. J Cell Biochem 2003:88;296-307.</p><p>Lips P., Hosking D., Lippuner K. et al. The prevalence of vitamin D inadequacy amongst women with osteoporosis an international epidemiological investigation. J Inter Med 2006; 260:245-54.</p><p>Van der Wielen R.P.J., Lowik M.R.H., van den Berg H. et al. Serum vitamin D concentrations among elderly people in Europe. Lancet 1995;346:207-10.</p><p>Chapuy M.-C., Preziosi P., Maamer M. et al. Prevalence of vitamin D insufficiency in an adult normal population. Osteoporosis Int 1997;7:439-43.</p><p>Krall E.A., Sahyoun N., Tannenbaum S. et al. Effect of vitamin D intake on seasonal variations in parathyroid hormone secretion in postmenopausal women. N Engl J Med 1989;321:1777-83.</p><p>Lips P. Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Edocr Rev 2001;22:477-501.</p><p>Janssen H.C., Samson M.M., Verhaar H.J. Vitamin D deficiency, muscle function, and falls in elderly people. Am J Clin Nutr 2002;75:611-5.</p><p>Chapuy M.-C., Arlot M.E., Delmas P.D., Meunier P.J. Effect of calcium and cholecalciferol treatment for three years on hip fractures in elderly women. Brit Med J 1994;308:1081-2.</p><p>Бахтиярова С.А, Лесняк О.М. Дефицит витамина D среди пожилых людей. Общ врачебн практ 2004;1:26-32.</p><p>Black D.M., Thompson D.E., Bauer D.C. and FIT research group. Fracture risk reduction in women with osteoporosis: the Fracture Intervention Trial. J Clin Endocrinol Metab 2000;85:4118-24.</p><p>Liberman U.A.,Weiss S.R., Broll J. et al. Effect of oral alendronate on bone mineral density and the incidence of fractures in post-menopausal osteoporosis. N Engl J Med 1995;333:1437-43.</p><p>World Health Organization. Adherence to long-term therapies: evidence for action. Geneva: WHO, 2003.</p><p>Baroutsou B., Babiolakis D., Stamatiadou A. et al. Patient compliance and preference of alendronate once weekly administration in comparison with daily regimens for osteo-porotic postmenopausal women. Ann Rheum Dis 2004;63(Suppl 1):455(SATO240).</p><p>Kendler D., Kung A.W., Fuleihan Gel H. et al. Patients with osteoporosis prefer once weekly to once daily dosing with alendronate. Maturitas 2004;48:243-51.</p><p>Simon J.A., Lewiecki E.M., Smith M.E. et al. Patient preference for once-weekly alendronate 70 mg versus once-daily alendronate 10 mg: a multicenter, randomized, open-label, cross-over study. Clin Ther 2002;24:1871-86.</p><p>Cramer J., Amonkar M.M., Hebborn A. et al. Compliance and persistence with bis-phosphonate dosing regimens among women with postmenopausal osteoporosis. Curr Med Res Opin 2005;21:1453-60.</p><p>Schnitzer T., Bone H.G., Crepaldi G. et al. Therapeutic equivalence of alendronate 70 mg once-weekly and alendronate 10 mg daily in the treatment of osteoporosis. Aging Clin Exp Res 2000;12:1-12.</p><p>Rizzoli R., Greenspan S.L., Bone G. 3rd et al. Two-year results of once-weekly administration of alendronate 70 mg for the Treatment of Postmenopausal Osteoporosis. J Bone Mineral Research 2002;17(11):1988-96.</p><p>Greenspan S., Field-Munves E., Tonino R., et al. Tolerability of once-weekly alendronate in patients with osteoporosis: a randomized, double-blind, placebo-controlled study. Mayo Clin Proc 2002;77(10):1044-52.</p><p>Lanza F., Sahba B., Schwartz H. et al. The upper GI safety and tolerability of oral alendronate at a dose of 70 milligrams once weekly: a placebo-controlled endoscopy study. Am J Gastroenterol 2002;97(1):58-64.</p><p>Recker R., Lips P., Felsenberg D. et al. Alendronate with and without cholecalciferol for osteoporosis: results of a 15-week randomized controlled trial. Curr Med Res Opin 2006;22(9):1745-55.</p></div><br /><div><p>Клинические рекомендации. Остеопороз. Диагностика, профилактика и лечение. Под ред. Л.И. Беневоленской, О.М. Лесняк. М.: ГЭОТАР-Медиа, 2009.</p><p>Holick M.F. Vitamin D: a millennium perspective. J Cell Biochem 2003:88;296-307.</p><p>Lips P., Hosking D., Lippuner K. et al. The prevalence of vitamin D inadequacy amongst women with osteoporosis an international epidemiological investigation. J Inter Med 2006; 260:245-54.</p><p>Van der Wielen R.P.J., Lowik M.R.H., van den Berg H. et al. Serum vitamin D concentrations among elderly people in Europe. Lancet 1995;346:207-10.</p><p>Chapuy M.-C., Preziosi P., Maamer M. et al. Prevalence of vitamin D insufficiency in an adult normal population. Osteoporosis Int 1997;7:439-43.</p><p>Krall E.A., Sahyoun N., Tannenbaum S. et al. Effect of vitamin D intake on seasonal variations in parathyroid hormone secretion in postmenopausal women. N Engl J Med 1989;321:1777-83.</p><p>Lips P. Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Edocr Rev 2001;22:477-501.</p><p>Janssen H.C., Samson M.M., Verhaar H.J. Vitamin D deficiency, muscle function, and falls in elderly people. Am J Clin Nutr 2002;75:611-5.</p><p>Chapuy M.-C., Arlot M.E., Delmas P.D., Meunier P.J. Effect of calcium and cholecalciferol treatment for three years on hip fractures in elderly women. Brit Med J 1994;308:1081-2.</p><p>Бахтиярова С.А, Лесняк О.М. Дефицит витамина D среди пожилых людей. Общ врачебн практ 2004;1:26-32.</p><p>Black D.M., Thompson D.E., Bauer D.C. and FIT research group. Fracture risk reduction in women with osteoporosis: the Fracture Intervention Trial. J Clin Endocrinol Metab 2000;85:4118-24.</p><p>Liberman U.A.,Weiss S.R., Broll J. et al. Effect of oral alendronate on bone mineral density and the incidence of fractures in post-menopausal osteoporosis. N Engl J Med 1995;333:1437-43.</p><p>World Health Organization. Adherence to long-term therapies: evidence for action. Geneva: WHO, 2003.</p><p>Baroutsou B., Babiolakis D., Stamatiadou A. et al. Patient compliance and preference of alendronate once weekly administration in comparison with daily regimens for osteo-porotic postmenopausal women. Ann Rheum Dis 2004;63(Suppl 1):455(SATO240).</p><p>Kendler D., Kung A.W., Fuleihan Gel H. et al. Patients with osteoporosis prefer once weekly to once daily dosing with alendronate. Maturitas 2004;48:243-51.</p><p>Simon J.A., Lewiecki E.M., Smith M.E. et al. Patient preference for once-weekly alendronate 70 mg versus once-daily alendronate 10 mg: a multicenter, randomized, open-label, cross-over study. Clin Ther 2002;24:1871-86.</p><p>Cramer J., Amonkar M.M., Hebborn A. et al. Compliance and persistence with bis-phosphonate dosing regimens among women with postmenopausal osteoporosis. Curr Med Res Opin 2005;21:1453-60.</p><p>Schnitzer T., Bone H.G., Crepaldi G. et al. Therapeutic equivalence of alendronate 70 mg once-weekly and alendronate 10 mg daily in the treatment of osteoporosis. Aging Clin Exp Res 2000;12:1-12.</p><p>Rizzoli R., Greenspan S.L., Bone G. 3rd et al. Two-year results of once-weekly administration of alendronate 70 mg for the Treatment of Postmenopausal Osteoporosis. J Bone Mineral Research 2002;17(11):1988-96.</p><p>Greenspan S., Field-Munves E., Tonino R., et al. Tolerability of once-weekly alendronate in patients with osteoporosis: a randomized, double-blind, placebo-controlled study. Mayo Clin Proc 2002;77(10):1044-52.</p><p>Lanza F., Sahba B., Schwartz H. et al. The upper GI safety and tolerability of oral alendronate at a dose of 70 milligrams once weekly: a placebo-controlled endoscopy study. Am J Gastroenterol 2002;97(1):58-64.</p><p>Recker R., Lips P., Felsenberg D. et al. Alendronate with and without cholecalciferol for osteoporosis: results of a 15-week randomized controlled trial. Curr Med Res Opin 2006;22(9):1745-55.</p></div><br />

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