Витамин D в профилактике и терапии коморбидных состояний при мышечной дистрофии Дюшенна

Мышечная дистрофия Дюшенна (МДД) представляет собой Х-сцепленное рецессивное дегенеративное нервно-мышечное расстройство, характеризующееся нарушением синтеза белка дистрофина. Больные МДД имеют повышенный риск развития остеопороза, переломов трубчатых костей и позвонков, зачастую возникают поведенческие и когнитивные расстройства. Витамин D (ВД) рекомендуют принимать при МДД, т.к. в ряде исследований показан его дефицит. 

Цель данной работы — консолидация данных опубликованных исследований о дефиците ВД у больных МДД, его влиянии на развитие сопутствующих МДД коморбидных состояний костно-мышечной, эндокринной и нервной систем. Поддержание оптимального уровня ВД при МДД положительно влияет на течение заболевания и качество жизни больных. Основные клинические результаты устранения дефицита ВД — предупреждение развития остеопороза (особенно после начала приема глюкокортикоидов), переломов трубчатых костей и позвонков, продление способности ходить, бóльшая эффективность терапии бисфосфонатами, включая уменьшение количества осложнений при первичном применении и некрозов нижней челюсти, положительное влияние на выраженность симптомов аутистического спектра. Для больных с многолетней терапией глюкокортикоидами, нарушением метаболизма и вовлечением печени в патологический процесс возможна замена D2 и D3 на кальцидиол для более эффективного восполнения дефицита ВД.

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