D Vitamininin kardiyovasküler ve metabolik etkileri

İnsanlarda D vitamini ihtiyacının %95 kadarı güneş ışınlarının etkisiyle deride sentezlenmektedir. Böbrek dışı dokularda da 1-alfa hidroksilaz enzimi aracılığıyla 25(OH)D'den aktif D vitamini sentezi gerçekleşmektedir. D vitamininin reseptör düzeyindeki etkisi aktif D vitamini sayesinde olur. D vitamini reseptörleri 30'dan fazla dokuda gösterilmiştir. Vitamin D'nin klasik olmayan etkileri 3 ana başlık altında toplanmaktadır: Hormon sekresyonunun regülasyonu, immün fonksiyonların regülasyonu, hücre proliferasyon ve farklılaşmasının düzenlenmesi. Kardiyovasküler hastalıklar, böbrek hastalıkları, diyabet, obezite, metabolik sendrom vitamin D ile ilişkisi en çok araştırılan hastalıklardır. Vitamin D düzeylerinin hipertansiyon, obezite, diyabet, hipertrigliseridemi ile ters ilişkili olduğu gösterilmiştir. İnvitro çalışmalarda aktif D vitamininin kardiyomiyositlerin relaksasyonunu hızlandırdığı ve kalbin diyastolik fonksiyonlarını iyileştirdiği gösterilmiştir. Kronik böbrek hastalığı olan hastalarda yapılan klinik çalışmalarda kötü vitamin D durumunun koroner vasküler kalsifikasyon, kalp yetmezliğini içeren kalp hastalıkları ve kardiyovasküler mortalite için bağımsız bir risk faktörü olduğu gösterilmiştir. Bu derlemede vitamin D'nin kardiyovasküler ve metabolik etkileri güncel bilgiler ışığında gözden geçirilmiştir

Cardiovascular and metabolic effects of vitamin D

In humans, approximately 95% of the total requirement for vitamin D is synthesized in the skin by the effects of sunlight. The active vitamin D synthesis from 25 (OH) D takes place via the 1-alpha hydroxylase enzyme both in renal and non-renal tissues. The effect of vitamin D on the receptor level is through active vitamin D. Vitamin D receptors are shown in more than 30 tissues. Non-classical effects of vitamin D are grouped under three main headings: Regulation of hormone secretion, regulation of immune function, regulation of cell proliferation and differentiation. Cardiovascular diseases, renal diseases, diabetes, obesity, metabolic syndrome are mostly researched diseases related with vitamin D. Vitamin D levels were shown inversely to be related with hypertension, obesity, diabetes and hypertriglyceridemia. In vitro studies have shown that vitamin D accelerates relaxation in cardiomyocytes and improves diastolic function of the heart. In clinical studies done in patients with chronic kidney disease, poor vitamin D status was shown to be an independent risk factor for coronary vascular calcification, other heart diseases such as heart failure, and cardiovascular mortality. In this review, the cardiovascular and metabolic effects of vitamin D have been reviewed in the light of current knowledge. J Clin Exp Invest 2013; 4 (3): 398-404

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