Pedrosa Márcia A Carneiro, Castro Marise Lazaretti
Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP.
Arq Bras Endocrinol Metabol. 2005 Aug;49(4):495-502. doi: 10.1590/s0004-27302005000400005. Epub 2005 Oct 19.
Through its action in the kidney, intestines, bone and parathyroid glands vitamin D is a major regulator of calcium homeostasis and for the development of a healthy skeleton. Moreover, receptors for this hormone are present in almost all body tissues and other actions which are not related to the mineral metabolism have been imputed to it. In the skeletal muscle cell, vitamin D acts through the classic mechanism of binding to a nuclear receptor and also by binding to a membrane receptor, carrying out actions that involve calcium transport, protein synthesis and kinetics of muscle contraction. Clinically, vitamin D deficiency, which is very common among the elderly, including the ones in our country, has been related to an increase in the incidence of falls, as well as the reduction of muscle strength and deterioration of body sway, evaluated by the oscillation of the body in the erect position. On the other hand, it has been demonstrated that supplementation of calcium associated to vitamin D in deficient elderly contributes to the improvement of these aspects of the neuro-muscular function. In this review, the mechanisms involved in the association between vitamin D and neuro-muscular function will be discussed, as well as the supplementation of vitamin D and calcium to prevent non-vertebral osteoporotic fractures under the perspective of the neuro-muscular effects.
通过在肾脏、肠道、骨骼和甲状旁腺中的作用，维生素D是钙稳态的主要调节因子，对健康骨骼的发育至关重要。此外，这种激素的受体几乎存在于所有身体组织中，人们还认为它具有与矿物质代谢无关的其他作用。在骨骼肌细胞中，维生素D通过与核受体结合的经典机制发挥作用，也通过与膜受体结合发挥作用，其作用涉及钙转运、蛋白质合成和肌肉收缩动力学。临床上，维生素D缺乏在老年人中非常普遍，包括我国的老年人，这与跌倒发生率增加、肌肉力量下降以及通过直立位身体摆动评估的身体摇摆恶化有关。另一方面，已经证明在缺乏维生素D的老年人中补充钙和维生素D有助于改善神经肌肉功能的这些方面。在这篇综述中，将讨论维生素D与神经肌肉功能之间关联的机制，以及从神经肌肉效应的角度探讨补充维生素D和钙以预防非椎体骨质疏松性骨折的问题。
