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Background. The purpose of the study was to calculate the cost of lowering blood pressure (BP) in the complex antihypertensive therapy of arterial hypertension (AH) with and without Cholecalciferol. Materials and methods. 154 patients with grade II AH were divided into the AH(+)CH group receiving combined antihypertensive therapy plus Cholecalciferol in a dose of 2000 IU / day and into the comparison group — AH(–)CH. Office BP and total Vitamin D levels were measured. The costs of medication were calculated. Results. During the follow-up examination, the blood level of Vtamin D increased; in the AH(+)CH group getting higher (p = 0.0000001) than in the AH(–)CH group. The per capita cost of medication in the AH(+)CH group was higher than in the AH(–)CH group ($ 106.8 and $91.5, respectively); however, the cost of SBP reduction by 1 mmHg in the AH(+) CH group was $ 3.9 lower than in the AH(–)CH group. The Cholecalciferol dose of 2000 IU/day for 3 months results in an optimum level of Vitamin D for 83 % cases, irrespective of antihypertensive therapy. The Cholecalciferol dose of 2000 IU/day from 6.5 to 12 months results in an optimum level of Vitamin D for 100 % cases. The greatest dynamics of increase in the level of 25(OH)D achieved in response to taking cholecalciferol occurs when its initial level is < 20 ng/ml. Conclusions. The economic costs of reducing SBP, with a more frequent achievement of its target values, were the lowest in combination therapy with Cholecalciferol, especially in combination with a diuretic. In addition, with complex therapy, we received not only a correction of blood pressure, but also of the Vitamin D status. [ABSTRACT FROM AUTHOR]

Among elderly people, falls are a serious problem associated with a deterioration in the quality of life, fractures and increased mortality. Today, on the basis of scientific literature, a connection can be clearly traced between the deficiency of serum vitamin D and muscle weakness, cognitive impairment, that is, factors that lead to poorer balance and increase the risk of falling. The review analyzes the features of the effect of vitamin D on the structure and function of muscles, as well as evaluates the effectiveness of calcium and vitamin D intake on muscle strength and reduces the risk of falls in the elderly. Based on the literature data, the role of vitamin D in maintaining normal brain function has been proved, and the incidence of vitamin D deficiency in elderly patients with cognitive impairment has been estimated. It is concluded that data on the therapeutic efficacy of supplemental vitamin D supplementation in cognitive impairment are ambiguous. Issues requiring resolution are noted. First of all, the establishment of threshold values for vitamin D in serum, the need for additional studies to determine the best treatment methods, including the dose of vitamin D and the duration of treatment. The most controversial issue is the use of high doses of vitamin D. Based on the analysis, most researchers consider it unreasonable to use high doses of vitamin D in preventing the frequency and risk of falls, and in general, their negative impact on human health. There is evidence that vitamin D is most effective in combination with calcium. However, despite the growing number of scientific studies on the association of vitamin D with falls, the role and importance of vitamin D in this process has not been conclusively established. [ABSTRACT FROM AUTHOR]

The article presents an analysis of the recent scientific findings on vitamin D status in patients with different etiopathogenetic varieties of nontraumatic transient loss of consciousness. The results of recent researches suggest that vitamin D may play an indirect and, in some cases, direct role in the pathogenesis of nontraumatic transient loss of consciousness. Data on the cause-effect relationship between a low vitamin D status and syncope are mixed, controversial and ambiguous, which is largely due to the use of different doses of vitamin D, its initial concentration, duration of therapy, genetic differences in the vitamin D receptors, different age groups, physical parameters of the surveyed, medications, peculiarities of nutrition with special supplements, differences in physical activity, peculiarities of the climate and season, and others. Until now there is no convincing evidence of the benefits of using vitamin D in the treatment and prevention of syncope. Most studies are observational and relate mainly to adult populations. Therefore, randomized controlled studies focused on children may be a promising field of research. [ABSTRACT FROM AUTHOR]

Background. Today, vitamin D deficiency and insufficiency is a global problem of public health affecting an estimated 1 billion people worldwide. Numerous studies show that the biological effects of vitamin D are not limited to the regulation of calcium-phosphorus metabolism; it also affects other physiological processes in the body. The purpose of the study was to evaluate the efficacy and safety of dietary supplement Olidetrim in the correction of vitamin D deficiency in postmenopausal women, and to study the effects of vitamin D levels on pain severity and quality of life. Materials and methods. The study included 26 postmenopausal women aged 50 to 83 years who had a deficiency or insufficiency of vitamin D. All patients took Olidetrim 1000 IU, 1 capsule 3 times a day for 3 months. At each visit, we examined the level of 25(OH) D using electrochemiluminescent method, severity of low back pain by means of a visual analogue scale, the algo-functional state of large joints was determined using the WOMAC scale (subscales of pain, stiffness, physical functioning), the patient’s quality of life was evaluated on the ECOS-16 scale. Assessment of the condition was carried out after 1 and 3 months. Results. Level of 25(OH)D significantly increased in the examined women after 1 (p = 0.000004) and 3 months (p = 0.000002) of Olidetrim intake. After 3 months of taking Olidetrim, vitamin D deficiency in postmenopausal women was not registered, 69.6 % of patients had vitamin D insufficiency, and the level of vitamin D was optimal in 30.4 % of patients. The maximum level of pain significantly decreased after 1 (p = 0.01) and 3 months (p = 0.01). According to the results of the WOMAC questionnaire, we found a significant increase of daily activity after 1 and 3 months in patients who received Olidetrim. During the observation period, women had no side effects associated with taking a dietary supplement. Conclusions. Olidetrim is an effective and safe dietary supplement for the correction of vitamin D deficiency in postmenopausal women. [ABSTRACT FROM AUTHOR]

Background. The comorbid pathology characteristic of the elderly and senile people may lead to polypharmacy. The leading role in the metabolism of drugs is played by the cytochrome (CY) P450 system. The use of vitamin D in geriatric patients is of particular importance taking into account their age-specific features of metabolism. The purpose of the review was to analyse the international contemporary information content on the interaction of vitamin D with the system of metabolism of the drugs. Materials and methods. Analysis of American and European scientific sources was performed. Results. More than 11,500 proteins of the CYP system are currently described. In the metabolism of medicines, the following six are involved: CYP1A2, CYP2C19, CYP2C9, CYP2D6, CYP2E1, CYP3A4, which provide biotransformation of drugs through oxidation. CYP450 is a he- moprotein that provides binding of the substrate molecules with activation of oxygens, resulting in the formation of oxidation, a more hydrophilic product and water molecule. The insufficiency of hydroxylation capacity of the liver and kidneys can lead to D-hypovitaminosis in the body of patients. CYP11A1, СУР27А1, СУР27В1, СУР24А1 are responsible for vitamin D metabolism. Conducted studies have shown that these cytochromes metabolize a number of other drugs that can act as their inhibitors and inducers. Conclusions. The system of cytochrome P450 influences the formation of vitamin D metabolites. Taking into account the physiological ways of its metabolism, multidirectional results of interaction are formed. [ABSTRACT FROM AUTHOR]

Background. The results of current numerous scientific researches testify to many-sided influence of vitamin D on different organs and systems of human organism. Purpose of the study — to study the effects of the additional cholecalciferol supplementation on the indexes of thyroid peroxidase (TPO) antibodies in patients with autoimmune hypothyroidism. Materials and methods. There were 65 patients with primary hypothyroidism aged 27—59 years, randomized into 2 groups. Cholecalciferol was additionally prescribed to the patients of the first group (n = 36) in a dose of 4000 IU/day (28000 IU/week) during three months on a background of levothyroxine therapy. The patients of the second group (n = 29) received only levothyroxine therapy. Results. Among inspected patients with hypothyroidism, 61 (93.9 %) had deficiency and insufficiency of vitamin D. As for patients with hypothyroidism, a significant negative correlation was detected between the levels of 25(OH)D and TPO antibodies (r = —0.17; р = 0.046). The additional administration of vitamin of D results in a significant decline in the level of TPO antibodies (—46.7 %) in patients with hypothyroidism. On the whole, a decrease in TPO antibody level by 25 % or more was achieved in 80.6 % of patients. Conclusions. Use of vitamin of D resulted in a significant increase of 25(OH)D content in the blood serum with the corresponding reduction of parathyroid hormone concentration, decrease of thyroid peroxidase antibodies level. [ABSTRACT FROM AUTHOR]

Background. Today, the main areas of prevention and therapy of sarcopenia are nutritional correction, physical activity, vitamin D therapy. The purpose of the study was evaluation of the role of vitamin D and exercises in correction of age-related skeletal muscle changes in postmenopausal women. Materials and methods. Thirty eight postmenopausal women aged 53—82 years were examined. They were divided into the following groups: 1 — control group (n = 10); 2 — women received individual targeted vitamin D therapy (n = 11); 3 — women, who took individual targeted vitamin D therapy and OTAGO Exercise Program during 12 months (n = 17). Visits to the center to assess the state of examined women conducted every 3 months. 25(OH)D total level was assessed by electrochemiluminescent method using Elec- sys 2010 analytical system (Roche Diagnostics, Germany). The lean mass was measured by the dual energy X-ray absorptiometry method (Prodigy, GEHC Lunar, Madison, WI, USA). For evaluation of strength and skeletal muscle function, we used hand dynamometry and functional tests. Sta- tistica 6.0 Copyright© StatSoft, Inc. 1984—2001, serial number 31415926535897, was used for data processing. Results. In women of control group, the mean 25(OH)D level significantly increased after 9 months of observation (9 months — р = 0.03) that we explain by seasonal factors. In women of 2nd and 3rd groups, the 25(OH)D level significantly increased after 3, 6, 9 and 12 months of observations (р < 0.05). The lean mass did not change in all groups during 12 months. The muscle strength significantly increased after 9 months (р = 0.01) in women of 3rd group, in women of 1st and 2nd group — did not change. In women of 3rd group, we observed the significant improvement in static balancing (p = 0.01). The fall frequency in women of 1st group significantly increased after 12 months, in women of 2nd group — did not change, in women of 3rd group — significantly decreased. Conclusions. The use of individual targeted vitamin D therapy and OTAGO Exercise Program in postmenopausal women during 12 months significantly improves daily activity, static balancing, muscle strength and decreased the fall frequency. [ABSTRACT FROM AUTHOR]

Background. Vitamin D deficiency is prevalent in all the world countries. Recent studies show the correlation between vitamin D deficiency and musculoskeletal disorders. The purpose of this study is to examine vitamin D deficiency and insufficiency prevalence in patients of various ages, who have musculoskeletal disorders, and to reveal the influence of seasonal factors on these conditions. Materials and methods. 3460 patients of the Ukrainian scientific Medical Center of Osteoporosis Problems, aged 1 to 92 years, who were referred by other specialists to the center for bone state evaluation, were examined. A majority of the patients presented with osteoporosis and its complications, spinal osteochondrosis, knee and hip osteoarthritis (mean age — 52.90 ± 21.10 years). Most of the patients were women (83.5 %). 25(OH)D and parathyroid hormone analyses were performed by means of electrochemiluminescent method (Elecsys 2010 analyzer, Roche Diagnostics, Germany) and cobas test-systems. Statistics 6.0 software package (Copyright StatSoft, Inc., 1984-2001) was also used. Results. Among the patients with musculoskeletal pathology, the highest 25(OH)D level was noted in the age group of 1-9 years and the lowest — in the age group of 80 and over. Age negatively influenced 25(OH)D values. Prevalence of vitamin D deficiency among the patients with musculoskeletal pathology was 37.3 %, vitamin D insufficiency — 30.6 %; 32.1 % of patients had normal vitamin D status. Normal 25(OH)D level was found in 38.0 % of children, 33.2 % of adults and in 29.6 % of elderly patients. Month of blood sampling had a significant influence on 25(OH)D content (F = 7.49; p < 0.001). The highest significant differences in 25(OH)D levels during the summer vs. winter months were observed in the age groups of 10-19 (18.2 %), 40-49 (17.3 %), 30-39 (16.2 %) и 1-9 years (16.1 %). There were no significant seasonal differences observed in the elderly patients (60 years and older) with musculoskeletal pathology. Conclusions. Despite the combined calcium and vitamin D supplementation in most patients with musculoskeletal pathology, only 37.9 % of children, 33.2 % of adults and 29.6 % of the elderly people had normal 25(OH)D values and thus required screening examination of vitamin D level in patients with musculoskeletal disorders and additional vitamin D prescription (Guidelines for the Central and Eastern Europe). [ABSTRACT FROM AUTHOR]

The review represents the results of researches of vitamin D receptor characteristics and its genetic polymorphism, which is variable in different populations, and also depends on age and gender. This polymorphism determines the association of vitamin D different concentration with the probability of bronchial asthma or chronic obstructive pulmonary disease development, and therefore the different efficacy of drug correction of vitamin D deficiency. However, the scientific data are contradictory, the molecular mechanisms of connection between vitamin D and bronchial tonus or allergic reactions remain unclear, which emphasizes the importance of studies to clarify the role of vitamin D in inflammatory, immune disorders in bronchial obstructive syndrome. [ABSTRACT FROM AUTHOR]