S.V. MALTSEV

 Russian Medical Academy of Continuing Professional Education, Moscow

Contact details:

Maltsev S.V. — MD, Professor, Editor-in-Chief of the “Practical Medicine” scientific and practical journal, Professor of the Department of Pediatrics

The article is devoted to new data on vitamin D metabolism and their role in clinical practice. A number of studies showed that, in addition to the canonical pathway of 25-(OH)D activation into 1,25-(OH)2D, there is an alternative pathway in kidneys — calcitriol synthesis in various organs and tissues. Genetic and epigenetic factors, including a genetic predisposition to low vitamin D levels, were shown to play a decisive role in the vitamin D functions. Several dozen vitamin D metabolites, vitamin D-binding protein, and vitamin D receptors, which are part of the vitamin D hormonal system, are of fundamental and clinical importance. The author describes a view on vitamin D resistance and the use of its high doses. Convincing evidence prove the need for an individual dose of vitamin D preparations in accordance with serum levels and risk factors in each patient.

Key words: vitamin D, metabolism, genetic factors, epigenetics, vitamin D resistance, vitamin D dose.

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