VITAMIN D U SVIM DOBIMA ŽIVOTA
Sažetak
Vitamin D je sekosteroidni hormon sa pleotropnim funkcijama i presudan za pravilan razvoj i zdravlje kroz ceo životni vek. Nedostatak vitamina D ima razmere epidemije širom sveta i ometa važne metaboličke procese. Procene u različitim populacijama različitog etničkog porekla i starosti su od 50% do 100 % u pojedinim grupama. Glavni izvor vitamina D kod ljudi je sinteza u koži pod dejstvom ultraljubičastog B zračenja na 7- dehidrocholesterol. To je vitamin D3 ili holekalciferol. Manje od 20% se dobija iz hrane. Aktivni oblik, 1,25-dihidroksi- vitamin D (kalcitriol) se sintetiše u bubrezima. Sintetički kapaciteta opada sa starenjem. Glavna funkcija vitamina D je homeostaza kalcijuma, zdravlje muskuloskeletnog sistema, urođeni imunitet, integritet arterija, endokrine funkcije, antiinflamatorno dejstvo i različiti lokalni procesi (autokrine i epikrine funkcije) u više od 30 tkiva gde postoje receptori. Vitamin D je takođe važan za kognitivne funkcije, uglavnom egzekutivne u frontalnom režnju. Normalni nivoi vitamina D su iznad 75 nmol/L. Nedostatak vitamina D je uglavnom uzrokovan nedostatkom sunčeve svetlosti, ali i nekih individualnih karakteristika bolesnika. Nedostatak tokom intrauterinog razvoja može da dovede do ranih i kasnih negativnih posledica na rast kostiju, imuni sistem i kogniciju. Ekstremni nedostatak vitamin D izaziva rahitis. Kod odraslih je nedostatak vitamina D faktor rizika za infektivne i autoimune bolest, karcinome (naročito dojke i debelog creva), multiplu sklerozu, padove, osteoporozu, prelome kostiju, kardiovakularna i cerebrovaskularna oboljenja, dijabetes melitus tip I i II, neplodnost, kognitivni pad i demencije. Oralna suplementacija sa normalizacijom nivoa vitamina u serumu može da dovede do smanjenja ovih rizika ali čak i ublažavanje nekih patoloških stanja. Preporučene doze iznose od 400 IU vitamina D kod odojčadi do 2000 IU u starijoj populaciji , ali bi trebalo da se rukovodi individualnim kliničkim okolnostima.
Key words: Vitamin D, kognicija, imunitet, ultravioletna B radijaciju
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