#16
|
|||
|
|||
Íàñ÷åò âèòàìèíà D: â äâîéíûõ ñëåïûõ, ïëàöåáî-êîíòðîëèðîâàííûõ ïðîòîêîëàõ íîðìàëèçàöèÿ åãî óðîâíåé íè íà ãðîø íå èçìåíèëà ãëþêîçó, ãëèêîãåìîãëîáèí è ÷óâñòâèòåëüíîñòü ê èíñóëèíó
DOI: 10.1111/dom.12794 [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ][  ëó÷øåì ñëó÷àå, âëèÿíèå âèòàìèíà D íà äèàáåò “íå äîêàçàíî”, â õóäøåì - “ âûäà÷à æåëàåìîãî çà äåéñòâèòåëüíîå” . A òàê êàê áîëüøèíñòâî ñòàòåé îïèñûâàþò ìåòààíàëèçû ñ âêëþ÷åíèåì ïðèìèòèâíûõ ïðîòîêîëîâ , òî ïîëîæèòåëüíûé ñóììàðíûé ýôôåêò íåèçáåæåí:-)
__________________
Dr.B |
#17
|
||||
|
||||
Íàñ÷åò âèòàìèíà Ä äîêòîðà-åíäîêðèíîëîãè èç ìåä öåíòðà Òàôòñ, Áîñòîí, èíîãî ìíåíèÿ, è ïîêà â ïåðåïèñêå â æóðíàëå èõ íàõîäêè íèêòî íå îñïîðèë:
In adults with prediabetes, vitamin D was effective in decreasing risk for diabetes. Vitamin D and Risk for Type 2 Diabetes in People With Prediabetes A Systematic Review and Meta-analysis of Individual Participant Data From 3 Randomized Clinical Trials Anastassios G. Pittas, MD, MS et al. Ann Intern Med. 2023 Mar;176(3):355-363. doi: 10.7326/M22-3018. ïîëíûé òåêñò ïóáëèêàöèè â ïäô äîñòóïåí íà ÿïîíñêîì ñàéòå ïî ññûëêå íèæå: [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
__________________
Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#18
|
||||
|
||||
È äàæå áåç Õîëèêà ïóáëèêàöèÿ…
Äàâàéòå îòíåñåìñÿ ñî ñäåðæàííûì ñêåïòèöèçìîì
__________________
Ã.À. Ìåëüíè÷åíêî |
#19
|
||||
|
||||
Ãàëèíà Àôàíàñüåâíà, äð. Holick MF ïîñëåäíèé ðàç ïèñàë îá ýòîì áîëåå 15 ëåò íàçàä
Diabetes and the vitamin d connection. Holick MF. Curr Diab Rep. 2008 Oct;8(5):393-8. ïåðâûé àâòîð - ó÷àñòíèê îäíîãî èç êëèí. òðàéëîâ, ãäå öåëåíàïðàâëåííî èçó÷àëñÿ âèòàìèí Ä äëÿ ïðåäóïðåæäåíèÿ äèàáåòà (D2d) äàííàÿ ïóáëèêàöèÿ - èíäèâèäóàëüíûé àíàëèç 3 èñëåäîâàíèé, ðåç-òû êîòîðûõ îïóáëèêîâàíû â ïîñëåäíèå 8 ëåò, ïîýòîìó âñå àâòîðû äàííîãî àíàëèçà - ó÷àñòíèêè âñåõ ýòèõ òðàéëîâ èç 3 ðàçíûõ ñòðàí, ó êîãî åñòü äîñòóï ê áàçàì äàííûõ èíä. ïàöèåíòîâ Pittas AG, Dawson-Hughes B, Sheehan P, et al; D2d Research Group. Vitamin D supplementation and prevention of type 2 diabetes. N Engl J Med. 2019;381:520-30. [PMID: 31173679] Jorde R, Sollid ST, Svartberg J, et al. Vitamin D 20,000 IU per week for five years does not prevent progression from prediabetes to diabetes. J Clin Endocrinol Metab. 2016;101:1647-55. Kawahara T, Suzuki G, Mizuno S, et al. Effect of active vitamin D treatment on development of type 2 diabetes: DPVD randomised controlled trial in Japanese population. BMJ. 2022;377:e066222.
__________________
Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#20
|
||||
|
||||
Àâòîðû îïÿòü æå óêàçûâàþò ÷òî âî âñåõ òðàéëàõ åñòü ýôôåêò ñíèæåíèÿ ðèñêà äèàáåòà, íî òðàéëû íå áûëè äîñòàòî÷íî âåëèêè, ÷òîáû åå óâèäåòü ñî ñòàòèñòè÷åñêîé òî÷êè çðåíèÿ - îòñóòñòâèå ñòàòèñòèêè íå âñåãäà ÍÅÒ ýôôåêòà:
In trials that were specifically designed to test the hypothesis that vitamin D reduces the rate of progression to diabetes in people with prediabetes (2–4), the risk for developing diabetes was consistently lower in the group assigned to vitamin D than in the placebo group; however, the observed differences were not statistically significant, and the reported relative risk reductions (10% to 13%) were smaller than each trial was powered to detect (25% to 36%). PS. Êàê-òî ðàçãîâàðèâàë ñ îäíèì ïðîôåññîðîì ïî ïîâîäó åãî ðåçóëüòàòîâ åãî èññëåäîâàíèÿ, ãäå íå áûë ñòàòèñòè÷åñêèé ýôôåêò îò íàçíà÷åíèÿ òðàíñôóçèé êîìïîíåíòîâ êðîâè íà ñìåðòíîñòü, òàê âîò èäåÿ áûëà ïîêàçàòü ÷òî íîâûé ïîäõîä ñïàñàåò ëþäåé îò ñìåðòè îò êðîâîïîòåðè, íî ðåãóëÿòîðíûå îðãàíû îáÿçàëè ââåñòè ÂÑÞ ñìåðòíîñòü êàê ïåðâè÷íàÿ òî÷êà, è êîíå÷íî âûñòðåë â ãîëîâó íå ñïàñàë îò ñìåðòè, â êàêîé êîìáèíàöèè áû òðàíñôóçèÿ íå ïðîâîäèëàñü: Among patients with severe trauma and major bleeding, early administration of plasma, platelets, and red blood cells in a 1:1:1 ratio compared with a 1:1:2 ratio did not result in significant differences in mortality at 24 hours or at 30 days. However, more patients in the 1:1:1 group achieved hemostasis and fewer experienced death due to exsanguination by 24 hours.
__________________
Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#21
|
||||
|
||||
Ïðèìåíèòåëüíî ê ïîæèëûì ïàöèåíòàì - ðåçóëüòàòû êîíñåíñóñà 2021 ãîäà, îïóáëèêîâàííîãî â 2023-ì:
This paper reports results from the 5th International Conference "Controversies in Vitamin D" that was held in Stresa, Italy, 15-18 September 2021. Regardless of treatment strategies, interventions to restore sufficient vitamin D status will show positive results only in those who are truly deficient. Thus, treatment goals should focus on avoiding 25(OH)D serum levels <30 nmol/l (12 ng/ml), with a goal to reach levels >50 nmol/l (20 ng/dl). The goal for adequate Vitamin D status should be to reach a serum level of 25(OH)D >50 nmol/l (20 ng/dl). It appears that daily low-dose vitamin D regimens reduce the risk of falling, especially in the elderly, compared with infrequent, large bolus doses that may increase it. The role of Vitamin D supplementation on muscle strength remains to be clarified. On the other hand, supplementation decreases the risk of progression to T2D from prediabetes among those who are Vitamin D-deficient. --- Endocrine. 2023 Jan;79(1):31-44. Vitamin D in the older population: a consensus statement
__________________
Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#22
|
||||
|
||||
Íìîëü/ ë íå íã/ ìë
__________________
Ã.À. Ìåëüíè÷åíêî |
|
#23
|
|||
|
|||
Ñïàñèáî, íàñêîëüêî ïîíÿëà ðàçíèöû âëèÿíèÿ íà ïî÷êè ìåæäó ðîçóâîñòàòèíîì è àòîðâîñòàòèíîì íåò. À êàê íàñ÷¸ò âëèÿíèÿ íà ìûøöû?
Ó ìåíÿ õîëåñòåðèí ëó÷øå ñíèæàåòñÿ íà ðîçóâîñòàòèíå, íî ÷åðåç 15 ëåò ñòàëè áîëåòü ìûøöû, ðåøèëà ïîìåíÿòü íà àòîðâîñòàòèí â ñîîòâåòñòâóþùåé äîçå, õîëåñòåðèí ïîäíÿëñÿ. |
#24
|
|||
|
|||
Àòîðâàñòàòèí ñëàáåå è äîçà åãî äîëæíà áûòü áîëüøå â ïîëòîðà-äâà ðàçà
|
#25
|
||||
|
||||
Êñòàòè, ðàçðûâàòü èñòîðèþ è ïèñàòü îòäåëüíî îá óõóäøåíèè ïîñëåäíèõ ìåñÿöåâ â äðóãîé òåìå- çà÷åì?
__________________
Ã.À. Ìåëüíè÷åíêî |
#26
|
|||
|
|||
Ñïàñèáî, íàñêîëüêî ïîíÿëà ðàçíèöû âëèÿíèÿ íà ïî÷êè ìåæäó ðîçóâîñòàòèíîì è àòîðâîñòàòèíîì íåò. À êàê íàñ÷¸ò âëèÿíèÿ íà ìûøöû?
Ó ìåíÿ õîëåñòåðèí ëó÷øå ñíèæàåòñÿ íà ðîçóâîñòàòèíå, íî ÷åðåç 15 ëåò ñòàëè áîëåòü ìûøöû, ðåøèëà ïîìåíÿòü íà àòîðâîñòàòèí â ñîîòâåòñòâóþùåé äîçå, õîëåñòåðèí ïîäíÿëñÿ |
#27
|
||||
|
||||
Åñòü åùå ïèòàâÀñòàòèí (ëèâàçî; âñå ýòè ïðåïàðàòû âÀñòàòèíû, à íå âÎñòàòèíû). Îí ïîñèëüíåé áóäåò è ìåíüøå ïîáî÷íûõ äåéñòâèé.
__________________
Àëåêñàíäð Èâàíîâè÷ ñ ïîæåëàíèÿìè êðåïêîãî çäîðîâüÿ |
#28
|
|||
|
|||
Äóáëü
__________________
Dr.B |
#29
|
|||
|
|||
Öèòàòà:
Íî êàê-òî â ìèîçèò ïîñëå àæ 15 ëåò ïðèåìà ðîçóâàñòàòèíà íå î÷åíü âåðèòñÿ. Áîëè ïðîøëè ïîñëå åãî îòìåíû? Ëèïèäû íà íåì áûëè íîðìàëüíû? Íî ãëàâíàÿ öåëü ñòàòèíîâ ýòî èìåííî íîðìàëèçàöèÿ ëèïèäîâ, à àòîðâàñòàòèí â ðàçû ñëàáåå ðîçóâàñòàòèíà. Òóò íàäî èëè ïîâûñèòü äîçó àòîðâàñòàòèíà, èëè âåðíóòüñÿ íà ðîçóâàñòàòèí â íèçøåé äîçå, ÷òî Âàì óæå è áûëî ïðåäëîæåíî ( ñì. ïîñò Åëåíà_Âëàä).
__________________
Dr.B |
#30
|
|||
|
|||
Ïîñëå îòìåíû ðîçóâîñòàòèíà ìûøå÷íûå áîëè â íîãàõ ïðîøëè, íî, âîçìîæíî, ýòî ñîâïàäåíèå. Ïîñêîëüêó îí íàìíîãî ñèëüíåå è êàê óêàçàíî âûøå íà ïî÷êè íå âëèÿåò, ñîáèðàþñü ñíîâà ïåðåéòè íà íåãî. Íàâåðíîå íåëüçÿ çàäàâàòü òàêîé âîïðîñ, íî âñå òàêè êàêîé ôèðìû ëó÷øå?
|