КАРДИОПРОТЕКТИВНЫЕ ЭФФЕКТЫ D-ГОРМОНА У БОЛЬНЫХ С ХРОНИЧЕСКОЙ БОЛЕЗНЬЮ ПОЧЕК: ОБЗОР ЛИТЕРАТУРЫ И СОБСТВЕННЫЕ ДАННЫЕ
https://doi.org/10.24884/1561-6274-2009-13-1-30-38
Аннотация
Основной причиной смерти у пациентов с хронической болезнью почек являются сердечно-сосудистые болезни, риск развития которых повышается уже при незначительном снижении скорости клубочковой фильтрации. Причиной этого могут быть нарушения неэкскреторных функций почек, важное место среди которых занимает снижение синтеза в канальцах активной формы витамина D (ВД) – 1,25(OH)₂ витамина D – кальцитриола, который помимо регулирования фосфорно-кальциевого обмена оказывает важные эффекты на многие органы и ткани, включая сердечно-сосудистую систему. В обзоре рассмотрены результаты экспериментальных и клинических исследований, доказавших, что ВД тормозит активность ренин-ангиотензиновой системы, модулирует иммунную систему, что, в свою очередь, вызывает уменьшение системной воспалительной реакции, ингибирует пролиферацию и способствует дифференциации клеток. Эти механизмы приводят к торможению прогрессирования атеросклероза, гипертрофии левого желудочка, артериальной гипертензии, сердечной недостаточности и лежат в основе улучшения выживаемости пациентов, получающих лечение витамином D.
Об авторах
А. В. Смирнов
Санкт-Петербургский государственный медицинский университет имени академика И.П. Павлова
Россия
Россия
кафедра пропедевтики внутренних болезней;
Научно-исследовательский институт нефрологии
197022 Санкт-Петербург, ул. Толстого 17, СПбГМУ им. акад. И.П.Павлова, тел.: 8-812-234-01-65
М. М. Волков
Санкт-Петербургский государственный медицинский университет имени академика И.П. Павлова
Россия
Россия
кафедра пропедевтики внутренних болезней
197022 Санкт-Петербург, ул. Толстого 17, СПбГМУ им. акад. И.П.Павлова
В. А. Добронравов
Санкт-Петербургский государственный медицинский университет имени академика И.П. Павлова
Россия
Россия
кафедра пропедевтики внутренних болезней;
Научно-исследовательский институт нефрологии
197022 Санкт-Петербург, ул. Толстого 17, СПбГМУ им. акад. И.П.Павлова
Список литературы
1. Foley RN, Parfrey PS, Sarnak MJ. Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis 1998; 32(5 Suppl 3): S112-119
2. Vanholder R, Massy Z, Argiles A et al. Chronic kidney disease as cause of cardiovascular morbidity and mortality. Nephrol Dial Transplant 2005; 20(6): 1048-1056
3. Haussler MR, Whitfield GK, Haussler CA et al. The nuclear vitamin D receptor: biological and molecular regulatory properties revealed. J Bone Miner Res 1998;13(3):325-349
4. O’Connell TD, Simpson RU. Immunochemical identification of the 1,25-dihydroxyvitamin D3 receptor protein in human heart. Cell Biol Int 1996;20(9):621-624
5. Sandgren ME, Bronnegard M, DeLuca HF. Tissue distribution of the 1,25-dihydroxyvitamin D3 receptor in the male rat. Biochem Biophys Res Commun 1991; 181(2): 611-616
6. Levin A, Li YC. Vitamin D and its analogues: do they protect against cardiovascular disease in patients with kidney disease? Kidney Int2005; 68(5): 1973-1981
7. Blacher J, Guerin AP, Pannier B et al. Arterial calcifications, arterial stiffness, and cardiovascular risk in end-stage renal disease. Hypertension 2001;38(4):938-942
8. Adragao T, Pires A, Lucas C et al. A simple vascular calcification score predicts cardiovascular risk in haemodialysis patients. Nephrol Dial Transplant 2004; 19(6): 1480-1488
9. Goldsmith DJ, Covic A, Sambrook PA, Ackrill P. Vascular calcification in long-term hemodialysis patients in a single unit: a retrospective analysis. Nephron 1997;77(1):37-43
10. Milliner DS, Zinsmeister AR, Lieberman E, Landing B. Soft tissue calcification in pediatric patients with end-stage renal disease. Kidney Int 1990; 38(5):931-936
11. Teng M, Wolf M, Ofsthun MN et al. Activated injectable vitamin D and hemodialysis survival: a historical cohort study. J Am Soc Nephrol 2005;16(4): 1115-1125
12. Tentori F, Hunt WC, Stidley CA et al. Mortality risk among hemodialysis patients receiving different vitamin D analogs. Kidney Int 2006; 70(10): 1858-1865
13. Shoji T, Shinohara K, Kimoto E et al. Lower risk for cardiovascular mortality in oral 1alpha-hydroxy vitamin D3 users in a haemodialysis population. Nephrol Dial Transplant 2004;19(1):179-184
14. Kovesdy CP, Ahmadzadeh S, Anderson JE, Kalantar-Zadeh K. Association of activated vitamin D treatment and mortality in chronic kidney disease. Arch Intern Med 2008;168(4):397-403
15. Ravani P, Malberti F, Tripepi G et al. Vitamin D levels and patient outcome in chronic kidney disease. Kidney Int 2009;75(1):88-95
16. Wang TJ, Pencina MJ, Booth SL et al. Vitamin D deficiency and risk of cardiovascular disease. Circulation 2008;117(4):503-511
17. Dobnig H, Pilz S, Scharnagl H et al. Independent association of low serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels with all-cause and cardiovascular mortality. Arch Intern Med 2008;168(12):1340-1349
18. McCarron DA, Morris CD. The calcium deficiency hypothesis of hypertension. Ann Intern Med 1987;107(6):919-922
19. Jorde R, Svartberg J, Sundsfjord J. Serum parathyroid hormone as a predictor of increase in systolic blood pressure in men. J Hypertens 2005;23(9):1639-1644
20. Resnick LM, Muller FB, Laragh JH. Calcium-regulating hormones in essential hypertension. Relation to plasma renin activity and sodium metabolism. Ann Intern Med 1986; 105(5): 649-654
21. Burgess ED, Hawkins RG, Watanabe M. Interaction of 1,25-dihydroxyvitamin D and plasma renin activity in high renin essential hypertension. Am J Hypertens1990; 3(12 Pt 1):903-905
22. Park CW, Oh YS, Shin YS et al. Intravenous calcitriol regresses myocardial hypertrophy in hemodialysis patients with secondary hyperparathyroidism. Am J Kidney Dis 1999;33(1):73-81
23. Kristal-Bohen E, Froom P, Harari G et al. Association of calcitriol and blood pressure in normotensive men. Hypertension 1997; 30:1289-1294
24. Lind L, Hanni A, Lithell H et al. Vitamin D is related to blood pressure and other cardiovascular risk factors in middle-aged men. Am J Hypertens 1995;8(9):894-901
25. Pfeifer M, Begerow B, Minne HW et al. Effects of a short-term vitamin D(3) and calcium supplementation on blood pressure and parathyroid hormone levels in elderly women. J Clin Endocrinol Metab 2001;86(4): 1633-1637
26. Lind L, Wengle B, Wide L, Ljunghall S. Reduction of blood pressure during long-term treatment with active vitamin D (alphacalcidol) is dependent on plasma renin activity and calcium status. A double-blind, placebo-controlled study. Am J Hypertens 1989;2(1):20-25
27. Krause R, Buhring M, Hopfenmuller W et al. Ultraviolet B and blood pressure. Lancet 1998;352(9129):709-710
28. Li YC, Kong J, Wei M et al. 1,25-Dihydroxyvitamin D3 is a negative endocrine regulator of the renin-angiotensin system. J Clin Invest2002;110:229–238
29. Li YC. Vitamin D regulation of the renin-angiotensin system. J Cell Biochem 2003 1;88(2):327-331
30. Kong J, Qiao G, Zhang Z et al. Targeted vitamin D receptor expression in juxtaglomerular cells suppresses renin expression independent of parathyroid hormone and calcium. Kidney Int2008;74(12):1577-1581
31. Xiang W, Kong J, Chen S et al. Cardiac hypertrophy in vitamin D receptor knockout mice: role of the systemic and cardiac renin-angiotensin systems. Am J Physiol Endocrinol Metab 2005; 288(1):E125-132
32. Kong J, Li YC. Effect of ANG II type I receptor antagonist and ACE inhibitor on vitamin D receptor-null mice. Am J Physiol Regul Integr Comp Physiol 2003;285(1):R255-261
33. Freundlich M, Quiroz Y, Zhang Z et al. Suppression of renin-angiotensin gene expression in the kidney by paricalcitol. Kidney Int 2008;74(11):1394-1402
34. McGonigle RJ, Fowler MB, Timmis AB et al. Uremic cardiomyopathy: potential role of vitamin D and parathyroid hormone. Nephron 1984;36(2):94-100
35. Kim HW, Park CW, Shin YS et al. Calcitriol regresses cardiac hypertrophy and QT dispersion in secondary hyperparathyroidism on hemodialysis. Nephron Clin Pract 2006;102(1):c21-29
36. Bodyak N, Ayus JC, Achinger S et al. Activated vitamin D attenuates left ventricular abnormalities induced by dietary sodium in Dahl salt-sensitive animals. Proc Natl Acad Sci USA 2007;104(43):16810-16815
37. Mancuso P, Rahman A, Hershey SD et al. 1,25-Dihydroxyvitamin-D3 treatment reduces cardiac hypertrophy and left ventricular diameter in spontaneously hypertensive heart failure-prone (cp/+) rats independent of changes in serum leptin. J Cardiovasc Pharmacol 2008;51(6):559-564
38. Weishaar RE, Simpson RU. The involvement of the endocrine system in regulating cardiovascular function: emphasis on vitamin D3. Endocr Rev 1989;10(3):351-365
39. Weishaar RE, Kim SN, Saunders DE, Simpson RU. Involvement of vitamin D3 with cardiovascular function. III. Effects on physical and morphological properties. Am J Physiol 1990; 258(1 Pt 1):E134-142
40. O’Connell TD, Berry JE, Jarvis AK et al. 1,25-Dihydroxyvitamin D3 regulation of cardiac myocyte proliferation and hypertrophy. Am J Physiol 1997;272(4 Pt 2):H1751-1758.
41. Wu J, Garami M, Cheng T, Gardner DG. 1,25(OH)2 vitamin D3, and retinoic acid antagonize endothelin-stimulated hypertrophy of neonatal rat cardiac myocytes. J Clin Invest 1996; 97(7):1577-1588
42. Li Q, Gardner DG. Negative regulation of the human atrial natriuretic peptide gene by 1,25-dihydroxyvitamin D3. J Biol Chem 1994;269(7):4934-4939
43. Smeets PJ, Teunissen BE, Willemsen PH et al. Cardiac hypertrophy is enhanced in PPAR alpha-/-mice in response to chronic pressure overload. Cardiovasc Res 2008; 78(1):79-89
44. Ouzounian M, Lee DS, Liu PP. Diastolic heart failure: mechanisms and controversies. Nat Clin Pract Cardiovasc Med 2008;5(7):375-386
45. Zittermann A, Schleithoff SS, Tenderich G et al. Low vitamin D status: a contributing factor in the pathogenesis of congestive heart failure? J Am Coll Cardiol 2003;41(1):105-112
46. Zittermann A, Schleithoff SS, Gotting C et al. Poor outcome in end-stage heart failure patients with low circulating calcitriol levels. Eur J Heart Fail 2008;10(3):321-327
47. Boxer RS, Dauser DA, Walsh SJ et al. The association between vitamin D and inflammation with the 6-minute walk and frailty in patients with heart failure. J Am Geriatr Soc 2008; 56(3):454-461
48. Walters MR, Ilenchuk TT, Claycomb WC. 1,25-Dihydroxyvitamin D3 stimulates 45Ca2+ uptake by cultured adult rat ventricular cardiac muscle cells. J Biol Chem 1987;262(6):2536-2541
49. O’Connell TD, Berry JE, Jarvis AK et al. 1,25-Dihydroxyvitamin D3 regulation of cardiac myocyte proliferation and hypertrophy. Am J Physiol 1997;272(4 Pt 2): H1751-H1758
50. O’Connell TD, Giacherio DA, Jarvis AK, Simpson RU. Inhibition of cardiac myocyte maturation by 1,25-dihydroxyvitamin D3. Endocrinology 1995;136(2):482-488.
51. Green JJ, Robinson DA, Wilson GE et al. Calcitriol modulation of cardiac contractile performance via protein kinase C. J Mol Cell Cardiol 2006;41(2):350-359
52. Marniemi J, Alanen E, Impivaara O et al. Dietary and serum vitamins and minerals as predictors of myocardial infarction and stroke in elderly subjects. Nutr Metab Cardiovasc Dis 2005;15(3):188-197
53. Pearson TA, Mensah GA, Alexander RW et al. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: A statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation 2003; 107(3):499-511
54. Ross R. Atherosclerosis – an inflammatory disease. N Engl J Med1 999; 340: 115-126
55. Glass CK, Witztum JL. Atherosclerosis: the road ahead. Cell 2001;104(4):503-516
56. Mathieu C, Adorini L. The coming of age of 1,25-dihydroxyvitamin D(3) analogs as immunomodulatory agents. Trends Mol Med 2002;8(4):174-179
57. Xing N, L Maldonado ML, Bachman LA et. Distinctive dendritic cell modulation by vitamin D(3) and glucocorticoid pathways. Biochem Biophys Res Commun 2002;297(3):645-652
58. Carthy EP, Yamashita W, Hsu A, Ooi BS. 1,25- Dihydroxyvitamin D3 and rat vascular smooth muscle cell growth. Hypertension 1989;13(6 Pt 2):954-959
59. Timms PM, Mannan N, Hitman GA et al. Circulating MMP9, vitamin D and variation in the TIMP-1 response with VDR genotype: mechanisms for inflammatory damage in chronic disorders? QJM 2002;95(12):787-796
60. Goldsmith DJ, Covic A, Sambrook PA, Ackrill P. Vascular calcification in long-term haemodialysis patients in a single unit: a retrospective analysis. Nephron 1997;77(1):37-43
61. Milliner DS, Zinsmeister AR, Lieberman E, Landing B. Soft tissue calcification in pediatric patients with end-stage renal disease. Kidney Int 1990;38(5):931-936
62. Mathew S, Lund RJ, Chaudhary LR et al. Vitamin D Receptor Activators Can Protect against Vascular Calcification. J Am Soc Nephrol 2008;19(8):1509-1519
63. Watson KE, Abrolat ML, Malone LL et al. Active serum vitamin D levels are inversely correlated with coronary calcification. Circulation 1997;96(6):1755-1760
64. Zittermann A, Schleithoff SS, Koerfer R. Vitamin D and vascular calcification. Curr Opin Lipidol 2007; 18(1): 41-46
65. Li H, Cybulsky MI, Gimbrone MA Jr, Libby P. An atherogenic diet rapidly induces VCAM-1, a cytokine-regulatable mononuclear leukocyte adhesion molecule, in rabbit aortic endothelium. Arterioscler Thromb 1993;13(2):197-204
66. Martinesi M, Bruni S, Stio M, Treves C. 1,25-Dihydroxyvitamin D3 inhibits tumor necrosis factor-alpha-induced adhesion molecule expression in endothelial cells. Cell Biol Int 2006; 30(4):365-375
67. Weinreich T, Wuthrich RP, Booy C, Binswanger U. Suppression of ICAM-1 expression in renal proximal tubular cells by 1,25-dihydroxyvitamin D3. Kidney Blood Press Res2001; 24(2):92-98
68. Kaneko A, Suzuki S, Hara M et al. 1,25-Dihydroxyvitamin D3 suppresses the expression of the VCAM-1 receptor, VLA-4 in human leukemic HL-60 cells. Biochem Biophys Res Commun 1999;255(2):371-376
69. Dobnig H, Pilz S, Scharnagl H et al. Independent association of low serum 25-hydroxyvitamin d and 1,25-dihydroxyvitamin D levels with all-cause and cardiovascular mortality. Arch Intern Med 2008;168(12):1340-1349
70. Jorde R, Haug E, Figenschau Y, Hansen JB. Serum levels of vitamin D and haemostatic factors in healthy subjects: the Tromso study. Acta Haematol 2007;117(2):91-97
71. Boucher BJ. Inadequate vitamin D status: does it contribute to the disorders comprising syndrome ‘X’? Br J Nutr 1998;79(4):315-327
72. Harris MI, Flegal KM, Cowie CC et al. Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in U.S. adults. The Third National Health and Nutrition Examination Survey, 1988-1994. Diabetes Care 1998;21(4):518-524
73. McKenna MJ. Differences in vitamin D status between countries in young adults and the elderly. Am J Med 1992;93(1):69-77
74. McKeigue PM, Marmot MG, Syndercombe Court YD et al. Diabetes, hyperinsulinaemia, and coronary risk factors in Bangladeshis in east London. Br Heart J 1988;60(5):390-396
75. Need AG, O’Loughlin PD, Horowitz M, Nordin BE. Relationship between fasting serum glucose, age, body mass index and serum 25 hydroxyvitamin D in postmenopausal women. Clin Endocrinol (Oxf) 2005;62(6):738-741
76. Baynes KC, Boucher BJ, Feskens EJ, Kromhout D. Vitamin D, glucose tolerance and insulinaemia in elderly men. Diabetologia 1997;40(3):344-347
77. Chiu KC, Chu A, Go VL, Saad MF. Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction. Am J Clin Nutr 2004;79(5):820-825
78. De Fronzo RA, Alvestrand A, Smith D et al. Insulin resistance in uremia. J Clin Invest 1981;67(2):563-568
79. Chen J, Muntner P, Hamm LL et al. Insulin resistance and risk of chronic kidney disease in nondiabetic US adults. J Am Soc Nephrol 2003;14(2):469-477
80. Feneberg R, Sparber M, Veldhuis JD et al. Altered temporal organization of plasma insulin oscillations in chronic renal failure. J Clin Endocrinol Metab 2002;87(5):1965-1973
81. Levin A, Bakris GL, Molitch M et al. Prevalence of abnormal serum vitamin D, PTH, calcium, and phosphorus in patients with chronic kidney disease: results of the study to evaluate early kidney disease. Kidney Int 2007;71(1):31-38
82. Chonchol M, Scragg R. 25-Hydroxyvitamin D, insulin resistance, and kidney function in the Third National Health and Nutrition Examination Survey. Kidney Int 2007;71(2):134-139
Рецензия
Для цитирования:
Смирнов А.В., Волков М.М., Добронравов В.А. КАРДИОПРОТЕКТИВНЫЕ ЭФФЕКТЫ D-ГОРМОНА У БОЛЬНЫХ С ХРОНИЧЕСКОЙ БОЛЕЗНЬЮ ПОЧЕК: ОБЗОР ЛИТЕРАТУРЫ И СОБСТВЕННЫЕ ДАННЫЕ. Нефрология. 2009;13(1):30-38. https://doi.org/10.24884/1561-6274-2009-13-1-30-38
For citation:
Smirnov A.V., Volkov M.M., Dobronravov V.A. CARDIOPROTECTIVE EFFECTS OF D-HORMONE IN PATIENTS WITH CHRONIC KIDNEY DISEASE: LITERATURE REVIEW AND PERSONAL DATA. Nephrology (Saint-Petersburg). 2009;13(1):30-38. (In Russ.) https://doi.org/10.24884/1561-6274-2009-13-1-30-38
Просмотров: 175
Послать статью по эл. почте 