Original Article Opportunities and perspectives of the use of colecalciferol in therapy of climacteric syndrome in patients on the background of vitamin D deficiency

Relevance. An insufficient level of vitamin D3 in the blood serum changes the function of metabolites, causes insulin resistance, and contributes to the development of metabolic syndrome, depression, etc. Vitamin D, being an inducer of nerve growth factor, modulates the neurotrophic factor of the brain in neurons, and its insufficiency can lead to the development of dementia, including Alzheimer's disease, and cognitive impairment Aim. To substantiate the feasibility of determining the level of 25(OH)D in the blood serum and to clarify the effectiveness of treatment of climacteric syndrome (CS) against the background of correction of vitamin D deficiency with colecalciferol. Materials and methods. The method of continuous sampling was used to determine the level of 25(OH)D in the blood serum of 307 patients aged 45-48 years, with neurovegetative and psychoemotional manifestations of menopausal syndrome in the period of early postmenopause. All patients underwent a comprehensive clinical and laboratory examination, including an assessment of the severity of menopausal syndrome based on the results of determining the modified menopausal index. Determination of the level of 25(OH)D vitamin D was carried out by the enzyme immunoassay "25(OH) Vitamin D Elisa". A personalized analysis of the results of the examination was carried out before and after the use of menopausal hormone therapy with and without colecalciferol. Results. Our results indicate that in 73.29% of cases in patients with neurovegetative and psychoemotional manifestations of CS in the early postmenopausal period, serum level 25(OH)D corresponds to hypovitaminosis D. The severity of CS with neurovegetative and psychoemotional manifestations in women in the early postmenopausal period is significantly higher (p<0.001) at a level of 25(OH)D in the blood serum of less than 20 ng/ml (modified menopausal index 49.17±1.57) compared with patients whose level 25(OH)D is in the range from 20 ng/ml to 30 ng/ml (modified menopausal index 34.27±1.79). According to our data, the use of colecalciferol in combination with menopausal hormone therapy significantly reliably reduces the main neurovegetative and psychoemotional manifestations of menopause in the early postmenopausal period, against the background of vitamin D deficiency, compared with the use of menopausal hormone therapy alone. Conclusions. Determination of the level of 25(OH)D in the blood serum of patients in the early postmenopausal period with the presence of neurovegetative and psychoemotional manifestations of menopause syndrome, as well as the correction of the revealed vitamin D deficiency with colecalciferol preparations, is promising and increases the efficiency of the correction of clinical manifestations of menopause syndrome. Key words: menopausal syndrome, menopausal hormone therapy, vitamin D deficiency, colecalciferol. For citation: Pestrikova T.Yu., Yachinskaya T.V. Opportunities and perspectives of the use of colecalciferol in therapy of climacteric syndrome in patients on the background of vitamin D deficiency. Consilium Medicum. 2020 (22); 6: 38-44. DOI: 10.26442/20751753.2020.6.200333

menopausal syndrome, menopausal hormone therapy, vitamin D deficiency, colecalciferol