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2020, vol. 77, br. 6, str. 582-589
Efekat vitamina D na proteinuriju, lipidni status, glikoregulaciju i C-reaktivni protein kod bolesnika sa dijabetes melitusom tip 2
aVojnomedicinska akademija, Klinika za nefrologiju, Beograd + Univerzitet odbrane, Medicinski fakultet Vojnomedicinske akademije, Beograd
bUniverzitet odbrane, Medicinski fakultet Vojnomedicinske akademije, Beograd + Vojnomedicinska akademija, Klinika za endokrinologiju, Beograd
cUniverzitet odbrane, Medicinski fakultet Vojnomedicinske akademije, Beograd + Vojnomedicinska akademija, Klinika za gastroenterologiju i hepatologiju, Beograd
dVojnomedicinska akademija, Klinika za nefrologiju, Beograd
eVojnomedicinska akademija, Klinika za endokrinologiju, Beograd + Vojnomedicinska akademija, Centar za kliničku farmakologiju, Beograd
fVojnomedicinska akademija, Institut za medicinsku biohemiju, Beograd
gKlinički centar Kragujevac, Klinika za internu medicinu + Univerzitet u Kragujevcu, Medicinski fakultet
hVojnomedicinska akademija, Klinika za endokrinologiju, Beograd

e-adresamakystan@yahoo.com
Sažetak
Uvod/Cilj. Nedostatak vitamina D je često prisutan kod bolesnika sa dijabetes melitusom (DM) tip 2 i može biti faktor rizika od brže progresije dijabetesne nefropatije i veće incidencije kardiovaskularnih događaja. Cilj studije bio je da se ispita uticaj supstitucije vitamina D na proteinuriju, holesterol, trigliceride, C-reaktivni protein (CRP) i hemoglobin A1c kod bolesnika sa DM tip 2 i nedostatkom vitamina D. Metode. Prospektivnom, kohortnom studijom obuhvaćeno je 90 bolesnika sa DM tip 2 i nedostatkom (insuficijencija/deficijencija) vitamina D svrstanih u tri grupe po 30 bolesnika: I - sa normalnom proteinurijom, II - sa mikroproteinurijom i III - sa makroproteinurijom. Sprovedena je šestomesečna nadoknada vitamina D holekalciferol kapima: tokom prva dva meseca sa 20 000 i.j. dva puta nedeljno, a zatim, je kod bolesnika kod kojih je nivo vitamina D ostao snižen nastavljeno sa istom dozom još četiri meseca. Kod bolesnika kod kojih se nivo vitamina D normalizovao, nastavljeno je sa 5 000 i.j. dva puta nedeljno. Na početku i na kraju ispitivanja meren je nivo uree, kreatinina, jutarnje glikemije, kalcijuma, fosfora, holesterola, triglicerida, CRP, hemoglobina A1c, intaktnog paratireoidnog hormona, 24časovne proteinurije i klirensa kreatinina. Zbog eventualne korekcije doze holekalciferola vrednosti kalcijuma, fosfora i vitamina D proverene su i dva meseca posle započinjanja supstitucije. Rezultati. Najniži nivo vitamina D pre terapije imali su bolesnici u grupi sa makroproteinurijom, dok je na kraju ispitivanja utvrđen statistički značajno povišen nivo vitamina D, u sve tri grupe. Nakon šestomesečne primene vitamina D, postignuto je statistički značajno sniženje nivoa 24-časovne proteinurije, holesterola, triglicerida i hemoglobin A1c u sve tri ispitivane grupe, a CRP u grupi sa normalnom proteinurijom i mikroproteinurijom. Statistički značajna negativna korelacija između vitamina D i 24-časovne proteinurije, holesterola i CRP dokazana je u grupi sa makroproteinurijom. Statistički značajna negativna korelacija dokazana je između vitamina D i HBA1c u grupi sa normalnom proteinurijom i vitamina D i CRP u grupi sa miroproteinurijom. Zaključak. Supstitucija vitamina D visokim dozama holekalciferola i njegova preventivna primena kod bolesnika sa DM tip 2 (sa ili bez proteinurije) snižava holesterol, trigliceride, proteinuriju, CRP i hemoglobin A1c.
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O članku

jezik rada: engleski
vrsta rada: izvorni naučni članak
DOI: 10.2298/VSP180525113P
objavljen u SCIndeksu: 14.07.2020.
metod recenzije: dvostruko anoniman
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