diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM9583diaendo-9583Research ArticleОбзорыReviewРоль дефицита витамина D в развитии сахарного диабета 2 типа и диабетической нейропатииRole of vitamin D deficiency in type 2 diabetes mellitus and diabetic neuropathy developmenthttps://orcid.org/0000-0002-8611-7095СтепановаАнна ПавловнаStepanovaAnna P.

аспирант

MD, PhD student

annstepanova12@gmail.comhttps://orcid.org/0000-0002-1547-0123КароноваТатьяна ЛеонидовнаKaronovaTatiana L.

д.м.н.

MD, PhD, Professor

karonova@mail.ruhttps://orcid.org/0000-0002-0904-8575БыстроваАнна АндреевнаBystrovaAnna A.

к.м.н.

MD, PhD

abystrova@inbox.ruhttps://orcid.org/0000-0002-5285-8303БреговскийВадим БорисовичBregovskyVadim B.

д.м.н.

MD, PhD

podiatr@inbox.ru<p>Первый Санкт-Петербургский государственный медицинский университет им. академика И.П. Павлова</p>Россия<p>Academician I.P. Pavlov First St. Petersburg State Medical University</p>Russian Federation<p>Первый Санкт-Петербургский государственный медицинский университет им. академика И.П. Павлова;&nbsp;Национальный медицинский исследовательский центр имени В.А. Алмазова</p>Россия<p>Academician I.P. Pavlov First St. Petersburg State Medical University; Almazov National Medical Research Centre</p>Russian Federation<p>Санкт-Петербургский территориальный диабетологический центр</p>Россия<p>Saint-Petersburg City Diabetes Centre</p>Russian Federation201810102018214301306Copyright &#x00A9; Степанова А.П., Каронова Т.Л., Быстрова А.А., Бреговский В.Б., 20182018Степанова А.П., Каронова Т.Л., Быстрова А.А., Бреговский В.Б.Stepanova A.P., Karonova T.L., Bystrova A.A., Bregovsky V.B.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.dia-endojournals.ru/jour/article/view/9583

Сахарный диабет (СД) 2 типа является глобальной эпидемией и ассоциируется с развитием тяжелых сосудистых осложнений. Диабетическая нейропатия (ДН) относится к частым хроническим осложнениям СД, приводящим к ухудшению прогноза и качества жизни больных. Масштабы проблемы определяют актуальность исследований, направленных на уточнение механизмов развития и прогрессирования СД и ДН. В обзоре обсуждаются современные представления о вкладе витамина D в патофизиологические и биохимические основы метаболизма глюкозы, рассматривается участие в регуляции процессов воспаления. Приведены данные о том, что изменение активности рецептора витамина D или концентрации вне- и внутриклеточного кальция в условиях дефицита витамина D могут оказывать неблагоприятное воздействие на функциональное состояние β-клеток поджелудочной железы и приводить к уменьшению синтеза и секреции инсулина. Также приведены современные представления о роли дефицита витамина D в развитии инсулинорезистентности. Обсуждаются ключевые аспекты патогенеза нейропатии у больных СД. Представлены возможные механизмы, посредством которых витамин D принимает участие в формировании ДН. Приведены результаты исследований, посвященных вопросам терапии препаратами витамина D при СД. Учитывая изложенные в обзоре факты, авторами обосновывается идея о том, что дефицит витамина D может рассматриваться как неклассический фактор риска развития не только СД, но и его осложнений.

Type 2 diabetes mellitus (DM) is a global epidemic associated with severe vascular complications development. Diabetic neuropathy is the most common chronic complication of DM that worsens patients’ life quality and prognosis. Therefore, studies dealing with DM and diabetic neuropathy underlying mechanisms are extremely relevant. The review discusses current views on vitamin D role in glucose metabolism and inflammatory processes. It is reported that vitamin D deficiency can contribute to insulin resistance development, and change in vitamin D receptor activity or extra- and intracellular calcium concentration due to vitamin D deficiency can affect pancreatic β-cells function and lead to decrease in insulin production. Key pathogenic mechanisms of diabetic neuropathy as well as possible relationship between vitamin D deficiency and neuropathy development are in focus of this review. Results of recent clinical trials regarding vitamin D supplementation in patients with DM are also discussed. The presented data suggest that vitamin D deficiency can be considered as a non-classical risk factor for the development of not only DM but its complications as well.

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