{"id":33866,"date":"2023-09-12T16:49:54","date_gmt":"2023-09-12T14:49:54","guid":{"rendered":"https:\/\/www.oafifoundation.com\/?p=33866"},"modified":"2023-09-14T11:59:32","modified_gmt":"2023-09-14T09:59:32","slug":"salud-osea-vitamina-d-por-que-es-importante","status":"publish","type":"post","link":"https:\/\/www.oafifoundation.com\/ca\/salud-osea-vitamina-d-por-que-es-importante\/","title":{"rendered":"CAP\u00cdTOL 1: Salut \u00f2ssia i Vitamina D. Qu\u00e8 \u00e9s i per qu\u00e8 \u00e9s tan important?"},"content":{"rendered":"\n<ul class=\"wp-block-list\">\n<li><strong>La mal anomenada Vitamina D \u00e9s en realitat una hormona imprescindible per al bon funcionament de m\u00faltiples teixits i \u00f2rgans en el cos hum\u00e0.<\/strong><\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>La Vitamina D (VD)&nbsp;\u00e9s ben coneguda per les seves accions a nivell m\u00fascul-esquel\u00e8tic, per\u00f2 t\u00e9 tamb\u00e9 m\u00faltiples funcions, anomenades&nbsp;pleiotr\u00f3picas, en altres \u00f2rgans i sistemes com el sistema immune, el sistema nervi\u00f3s central o el sistema endocr\u00ed entre altres.<\/strong><\/li>\n<\/ul>\n\n\n\n<p><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Paper al sistema nervi\u00f3s central:<\/h3>\n\n\n\n<p>La VD t\u00e9 efectes neuroprotectors i antiinflamatoris a nivell del cervell sent capa\u00e7 de protegir-lo davant de toxines, la protecci\u00f3 de la superviv\u00e8ncia de neurones, implicaci\u00f3 en l&#8217;alliberament de neurotransmissors com la dopamina, GABA, serotonina[i][ii]54, i ajudant a reduir la inflamaci\u00f3 del sistema nervi\u00f3s gr\u00e0cies al seu paper en l&#8217;alliberament d&#8217;unes subst\u00e0ncies anomenades citocines antiinflamat\u00f2ries. Hi ha ja abundant evid\u00e8ncia del paper rellevant de la VD en malalties com l&#8217;esclerosi m\u00faltiple, l&#8217;Alzheimer, el P\u00e0rkinson o els pacients amb epil\u00e8psia en tractament amb f\u00e0rmacs antiepil\u00e8ptics, entre d&#8217;altres. Aix\u00f2 ens indica que el paper de la Vitamina D \u00e9s molt m\u00e9s ampli i rellevant del que en principi podr\u00edem esperar.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Paper al sistema immune:<\/h3>\n\n\n\n<p>L&#8217;activitat de la VD a nivell del sistema immune tamb\u00e9 est\u00e0 molt estudiada. La VD actua com a immunomodulador de manera que ajuda el sistema immune innat (aquell que presenta la resposta immediata davant les infeccions) i alhora participa en la regulaci\u00f3 de la resposta immune adaptativa (la que est\u00e0 associada a les malalties autoimmunes com l&#8217;esclerosi m\u00faltiple). At\u00e8s el paper tan rellevant que t\u00e9 la VD sobre el sistema immune, s&#8217;han realitzat una gran quantitat d&#8217;estudis cl\u00ednics durant l&#8217;epid\u00e8mia de COVID-19[i] on s&#8217;ha vist que la VD podria millorar la resposta immune davant d&#8217;infeccions, reduir el temps de recuperaci\u00f3, reduir la taxa d&#8217;hospitalitzaci\u00f3, reduir la taxa d&#8217;ingressos a UCI i fins i tot la mortalitat. El paper de la VD en altres tipus d&#8217;infeccions com les infeccions respirat\u00f2ries agudes t\u00edpiques de l&#8217;hivern (refredats, grips\u2026) tamb\u00e9 han estat demostrats en altres estudis cl\u00ednics.<\/p>\n\n\n\n<p>En el cas del <strong>COVID-19<\/strong> s\u00f3n m\u00faltiples els estudis realitzats en els darrers anys. Aquests estudis han suggerit que nivells baixos de VD (&lt;20 ng\/ml) augmenten significativament el <strong>risc d&#8217;infecci\u00f3<\/strong> per COVID-19 en adults[ii] [iii] [iv]. De fet es va demostrar el 2021 en un estudi amb 1 mili\u00f3 d&#8217;adults, que la defici\u00e8ncia de VD s&#8217;associava a m\u00e9s severitat de COVID ia 3 vegades m\u00e9s de probabilitat de mort[v].<\/p>\n\n\n\n<p>Un altre estudi m\u00e9s recent va mostrar un 80% m\u00e9s de risc d&#8217;infecci\u00f3 en persones amb nivells baixos de VD[vi]. Altres estudis observacionals suggereixen a m\u00e9s que la defici\u00e8ncia de VD s&#8217;associa en duplicar la r\u00e0tio d&#8217;hospitalitzaci\u00f3 i triplicar la r\u00e0tio d&#8217;ingr\u00e9s a UCI i la r\u00e0tio de mortalitat[vii] [viii] [ix].&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Paper de la VD al sistema musculoesquel\u00e8tic:<\/h3>\n\n\n\n<p>La import\u00e0ncia de la s\u00edntesi interna de la VD \u00e9s tan gran que ha provocat una pressi\u00f3 evolutiva en l&#8217;home per reduir la pigmentaci\u00f3 de la pell a mesura que els humans migraven des d&#8217;\u00c0frica a Europa i pa\u00efsos del nord[i] i es considera un important factor evolutiu de l&#8217;esp\u00e8cie de manera que la defici\u00e8ncia de VD que es produ\u00efa a latituds nord resultava en una p\u00e8rdua de for\u00e7a \u00f2ssia i d&#8217;un pitjor sistema immune.<\/p>\n\n\n\n<p>L&#8217;esquelet \u00e9s un \u00f2rgan din\u00e0mic, metab\u00f2licament actiu i funcionalment divers que est\u00e0 cont\u00ednuament en remodelaci\u00f3 a trav\u00e9s de 2 processos coordinats: resorci\u00f3 \u00f2ssia (destrucci\u00f3 de pinyol) i formaci\u00f3 de pinyol[ii] [iii]. El desequilibri daquests processos pot causar malalties com el raquitisme, osteomal\u00e0cia, osteoclerosi i osteoporosi[iv] [v].<\/p>\n\n\n\n<p>Al llarg de la vida, l&#8217;esquelet ossi est\u00e0 sotm\u00e8s a un proc\u00e9s continu i din\u00e0mic de construcci\u00f3-deconstrucci\u00f3 (en el que s&#8217;anomena modelat i remodelat ossi) que t\u00e9 com a objectiu reparar els danys ossis, prevenir acumulaci\u00f3 d&#8217;hiper mineralitzacions i mantenir el equilibri als dip\u00f2sits de calci i fosfat. Aquests processos s\u00f3n tan din\u00e0mics que s&#8217;estima que fins a un 10% de l&#8217;esquelet ossi es renova cada any[vi].<\/p>\n\n\n\n<p>Tant la for\u00e7a i massa muscular adequada com la correcta formaci\u00f3 de l&#8217;os s\u00f3n essencials per evitar les temudes caigudes i fractures, de manera que mantenir una adequada salut osteomuscular \u00e9s important, especialment per a les persones amb osteoporosi o en persones grans.<\/p>\n\n\n\n<p>Mantenir uns nivells \u00f2ptims de VD \u00e9s important ja que se sap que la VD t\u00e9 un paper important en tots aquests processos de remodelaci\u00f3 \u00f2ssia ja que participa a:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Els processos de formaci\u00f3 d&#8217;\u00f2s nou<\/li>\n\n\n\n<li>Al cicle de remodelaci\u00f3 \u00f2ssia ja que assegura la disponibilitat de calci[vii] i fosfat[viii] per mineralitzar l&#8217;os nou<\/li>\n\n\n\n<li>Ajuda que hi hagi suficients les c\u00e8l\u00b7lules formadores d&#8217;os (anomenades osteoblasts) [ix] [x].<\/li>\n\n\n\n<li>Reducci\u00f3 de fractures \u00f2ssies<\/li>\n\n\n\n<li>Millorar la densitat \u00f2ssia per evitar o reduir l&#8217;osteoporosi<\/li>\n\n\n\n<li>Ajuda a la reparaci\u00f3 de l&#8217;os despr\u00e9s d&#8217;una fractura[xi]<\/li>\n<\/ul>\n\n\n\n<p>S&#8217;ha vist tamb\u00e9 que la VD \u00e9s essencial per a la funci\u00f3 muscular ja que afavoreix[xii] [xiii]:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>La proliferaci\u00f3 i diferenciaci\u00f3 de c\u00e8l\u00b7lules musculoesquel\u00e8tiques<\/li>\n\n\n\n<li>El metabolisme de les c\u00e8l\u00b7lules musculoesquel\u00e8tiques.<\/li>\n\n\n\n<li>La funci\u00f3, massa i for\u00e7a muscular.<\/li>\n\n\n\n<li>El desenvolupament i la reparaci\u00f3 muscular.<\/li>\n\n\n\n<li>Tamb\u00e9 hi juga paper en la resposta inflamat\u00f2ria del m\u00fascul.<\/li>\n<\/ul>\n\n\n\n<p>Article per cortesia de la <a href=\"https:\/\/www.linkedin.com\/in\/dr-esperanza-regueras-2728b71\/?originalSubdomain=es\" data-type=\"link\" data-id=\"https:\/\/www.linkedin.com\/in\/dr-esperanza-regueras-2728b71\/?originalSubdomain=es\" target=\"_blank\" rel=\"noopener\">Dra. Esperanza Regueras<\/a>. Farmac\u00e8utica i Doctora a Farm\u00e0cia. CEO i directora cient\u00edfica d&#8217;<a href=\"https:\/\/www.advantalpharma.com\/\" data-type=\"link\" data-id=\"https:\/\/www.advantalpharma.com\/\" target=\"_blank\" rel=\"noopener\">Advantal Pharma<\/a>.<\/p>\n\n\n\n<p><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Bibliografia<\/h3>\n\n\n\n<p>[1] Seyedi M, Gholami F, Samadi M, Djalali M, Effatpanah M, Yekaninejad MS, Hashemi R, Abdolahi M, Chamari M, Honarvar NM. The Effect of Vitamin D3 Supplementation on Serum BDNF, Dopamine, and Serotonin in Children with Attention-Deficit\/Hyperactivity Disorder. CNS Neurol Disord Drug Targets. 2019;18(6):496-501. doi: 10.2174\/1871527318666190703103709. PMID: 31269890.<\/p>\n\n\n\n<p>[2] Murthi P, Davies-Tuck M, Lappas M, Singh H, Mockler J, Rahman R, Lim R, Leaw B, Doery J, Wallace EM, Ebeling PR. Maternal 25-hydroxyvitamin D is inversely correlated with foetal serotonin. Clin Endocrinol (Oxf). 2017 Mar;86(3):401-409. doi: 10.1111\/cen.13281. Epub 2016 Dec 19. PMID: 27862146.<\/p>\n\n\n\n<p>[3] Entrenas Castillo M, Entrenas Costa LM, Vaquero Barrios JM, et al. Effect of calcifediol treatment and best available therapy versus best available therapy on intensive care unit admission and mortal- ity among patients hospitalized for COVID-19: a pilot randomized clinical study. J Steroid Biochem Mol Biol. 2020;203:105751.<\/p>\n\n\n\n<p>[4] KaufmanHW,NilesJK,KrollMH,BiC,HolickMF.SARS-CoV-2positiv- ity rates associated with circulating 25-hydroxyvitamin D levels. PLoS One. 2020;15(9):e0239252.<\/p>\n\n\n\n<p>[5] Merzon E, Tworowski D, Gorohovski A, et al. Low plasma 25(OH) vitamin D level is associated with increased risk of COVID- 19 infection: an Israeli population-based study. FEBS J. 2020; 287(17):3693-3702.<\/p>\n\n\n\n<p>[6] Brenner H. Vitamin D supplementation to prevent COVID-19 infec- tions and deaths\u2014accumulating evidence from epidemiological and intervention studies calls for immediate action. Nutrients. 2021;13(2):411.<\/p>\n\n\n\n<p>[7] Akbar MR, Wibowo A, Pranata R, Setiabudiawan B. Low serum 25- hydroxyvitamin D (Vitamin D) Level is associated with susceptibility to COVID-19, severity, and mortality: a systematic review and meta- analysis. Front Nutr. 2021;8:660420.<\/p>\n\n\n\n<p>[8] TeshomeA,AdaneA,GirmaB,MekonnenZA.Theimpactofvitamin D level on COVID-19 infection: systematic review and meta-analysis. Front Public Health. 2021;9:624559.<\/p>\n\n\n\n<p>[9] Charoenngam N, Ponvilawan B, Rujirachun P, Wattanachayakul P. Association of vitamin D Status with hospital morbidity and mortal- ity in adult hospitalized patients with COVID-19. Endocr Pract. 2021; 27(4):271-278.<\/p>\n\n\n\n<p>[10] Angelidi AM, Belanger MJ, Lorinsky MK, et al. Vitamin D status is associated with in-hospital mortality and mechanical ventilation: a cohort of COVID-19 hospitalized patients. Mayo Clin Proc. 2021; 96(4):875-886.<\/p>\n\n\n\n<p>[11] PetrelliF,LucianiA,PeregoG,etal.Therapeuticandprognosticrole of vitamin D for COVID-19 infection: a systematic review and meta- analysis of 43 observational studies. J Steroid Biochem Mol Biol. 2021; 211:105883.<\/p>\n\n\n\n<p>[12] Carlberg C. Nutrigenomics of Vitamin D. Nutrients. 2019 Mar 21;11(3):676. doi: 10.3390\/nu11030676. PMID: 30901909; PMCID: PMC6470874 <\/p>\n\n\n\n<p>[13] N.A. Sims, T.J. Martin, Coupling the activities of bone formation and resorption: a multitude of signals within the basic multicellular unit, Bonekey. Rep. 3 (2014) 481.<\/p>\n\n\n\n<p><\/p>\n\n\n\n<p><strong>* Des d&#8217;<a href=\"https:\/\/www.oafifoundation.com\/ca\/\" data-type=\"link\" data-id=\"https:\/\/www.oafifoundation.com\/ca\/\">OAFI <\/a>recomanem seguir els consells, sempre sota supervisi\u00f3 del vostre metge de confian\u00e7a.<\/strong><\/p>\n\n\n\n<p>*Imatge que il\u00b7lustra l&#8217;article de <a href=\"https:\/\/unsplash.com\/@mab_studio\" data-type=\"link\" data-id=\"https:\/\/unsplash.com\/@mab_studio\" target=\"_blank\" rel=\"noopener\">Michele Blackwell<\/a><\/p>\n\n\n\n<p><\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Vitamina D y Salud Articular<\/p>\n","protected":false},"author":1,"featured_media":33875,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1362,549,962,1286,814,959,531,1282,552,728],"tags":[1302,1288,1255,1367,1278,1257,1369,1336,1258,1279,1368,1280,1335,1281,1301,1363,1370,1364],"class_list":["post-33866","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-aecosar-ca","category-amics-oafi","category-area-pacients","category-blog-ca","category-consells-sobre-salut-articular","category-dolor-ca","category-osteoartritis-ca","category-osteoporosi","category-recerca","category-sense-categoria","tag-artrosi","tag-artrosis-ca","tag-calidad-de-vida-ca","tag-fundacio-oafi","tag-fundacion-internacional-de-la-artrosis-ca","tag-fundacion-oafi-ca","tag-id","tag-investigacio","tag-investigacion-ca","tag-oafi-ca","tag-prevencio","tag-prevencion-ca","tag-qualitat-de-vida","tag-salud-articular-ca","tag-salut-articular","tag-vitamina-d-ca","tag-vitamina-d-i-salut-articular","tag-vitamina-d-y-salud-articular-ca"],"_links":{"self":[{"href":"https:\/\/www.oafifoundation.com\/ca\/wp-json\/wp\/v2\/posts\/33866","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.oafifoundation.com\/ca\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.oafifoundation.com\/ca\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.oafifoundation.com\/ca\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.oafifoundation.com\/ca\/wp-json\/wp\/v2\/comments?post=33866"}],"version-history":[{"count":14,"href":"https:\/\/www.oafifoundation.com\/ca\/wp-json\/wp\/v2\/posts\/33866\/revisions"}],"predecessor-version":[{"id":33963,"href":"https:\/\/www.oafifoundation.com\/ca\/wp-json\/wp\/v2\/posts\/33866\/revisions\/33963"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.oafifoundation.com\/ca\/wp-json\/wp\/v2\/media\/33875"}],"wp:attachment":[{"href":"https:\/\/www.oafifoundation.com\/ca\/wp-json\/wp\/v2\/media?parent=33866"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.oafifoundation.com\/ca\/wp-json\/wp\/v2\/categories?post=33866"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.oafifoundation.com\/ca\/wp-json\/wp\/v2\/tags?post=33866"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}