clinmedКлиническая медицинаClinical Medicine (Russian Journal)0023-21492412-1339ООО «Медицинское информационное агентство»10.30629/0023-2149-2021-99-9-10-509-520clinmed-297Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESРоль витамина B12 в физиологии и при эндокринопатияхActualization of the role of Vitamin B12 in physiology and endocrine disordershttps://orcid.org/0000-0003-3628-2102ШульпековаН. В.ShulpekovaN. V.

Шульпекова Надежда Владимировна — клинический ординатор 2-го года обучения

117292, Москва

117292, Moscow

https://orcid.org/0000-0002-6674-6441БелаяЖ. Е.BelayaZh. E.

Белая Жанна Евгеньевна — д-р мед. наук, профессор кафедры эндокринологии института высшего и дополнительного образования

117292, Москва

 

Belaya Zhanna E. — MD, PhD, DSc

117292, Moscow

jannabelaya@gmail.comhttps://orcid.org/0000-0001-6581-4521ГалстянГ. Р.GalstyanG. R.

Галстян Гагик Радикович — д-р мед. наук, профессор, и.о. заместителя директора Института диабета, заведующий отделением диабетической стопы, главный научный сотрудник

117292, Москва

117292, Moscow

ФГБУ «Национальный медицинский исследовательский центр эндокринологии» Минздрава РоссииРоссияNational Medical Research Center of EndocrinologyRussian Federation202126012022999-10509520Copyright © Шульпекова Н.В., Белая Ж.Е., Галстян Г.Р., 20222022Шульпекова Н.В., Белая Ж.Е., Галстян Г.Р.Shulpekova N.V., Belaya Z.E., Galstyan G.R.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.clinmedjournal.com/jour/article/view/297

Витамин B12 (кобаламин) — это собирательное название для группы водорастворимых кобальтсодержащих биологически активных соединений, относящихся к группе корриноидов. Витамин B12 необходим для гемопоэза, формирования эпителиальной ткани, в качестве кофермента он участвует в метаболизме жирных кислот, углеводов, нуклеиновых кислот. Дефицит кобаламина ассоциируется с развитием анемии, полинейропатии и снижением когнитивных функций. Ввиду неспецифичности симптомов и возможным развитием тяжелых, в том числе потенциально необратимых осложнений, важно проводить своевременный скрининг среди пациентов из потенциальной группы риска. Среди эндокринопатий дефицит витамина B12 наиболее активно обсуждается у пациентов с сахарным диабетом, ожирением и аутоиммунным поражением щитовидной железы. В частности, у лиц, принимающих метформин, наблюдается снижение уровня витамина B12 и возможно развитие ассоциированной с дефицитом B12 полинейропатии, которую сложно дифференцировать с диабетической полинейропатией. У пациентов с аутоиммунными поражениями щитовидной железы часто наблюдаются и другие аутоиммунные заболевания, в частности атрофический гастрит и пернициозная анемия. Нарушения всасывания B12 могут стать причиной дефицита B12 даже при его адекватном потреблении, что, возможно, объясняет достаточно высокую распространенность дефицита этого витамина у пациентов с аутоиммунным поражением щитовидной железы. В настоящем обзоре литературы суммируются последние сведения о роли метаболизма витамина B12, потенциальных группах риска развития дефицита этого витамина среди распространенных эндокринных заболеваний, а также возможностях его возмещения высокодозными пероральными формами, в частности цианокобаламином 1 мг.

Vitamin B12 (cobalamin) is a collective name for a group of water-soluble cobalt-containing biologically active compounds belonging to corrinoids. Vitamin B12 is essential for hematopoiesis, the formation of epithelial tissue; as a coenzyme, it is involved in the metabolism of fatty acids, carbohydrates, nucleic acids. Cobalamin defi ciency is associated with the development of anemia, polyneuropathy, and decreased cognitive function. Due to the nonspecifi city of symptoms and the possible development of severe and potentially irreversible complications, it is important to conduct timely screening among patients from risk groups. Among endocrine disorders, vitamin B12 defi ciency is found in patients with diabetes mellitus, obesity and autoimmune thyroid disease mostly. In particular, metformin may cause a decrease in vitamin B12 levels and polyneuropathy, which is diffi cult to diff erentiate from diabetic polyneuropathy. In patients with autoimmune thyroid lesions, other autoimmune diseases are often observed, atrophic gastritis and pernicious anemia notably. Vitamin B12 malabsorption can lead to defi ciency even when consumed adequately, which possibly explains the relatively high prevalence of B12 defi ciency in patients with autoimmune thyroid disease. This literature review summarizes recent advances on the role of vitamin B12 metabolism, potential risk groups for vitamin B12 defi ciency among common endocrine diseases, and the benefi t for its replacement with high-dose oral forms, cyanocobalamin 1 mg in particular

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The authors declare that there are no conflicts of interest present.