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Витамин А: позиция диетолога

https://doi.org/10.33667/2078-5631-2020-21-49-57

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Аннотация

Витамин А является одним из ключевых элементов для регуляции иммунного ответа и контролирует деление и дифференцировку эпителиальных клеток слизистых оболочек бронхолегочной системы, желудочно-кишечного тракта, мочевыводящих путей, глаз и т.д. Его значение в условиях пандемии COVID‑19 трудно переоценить. Однако ряд проведенных в прошлом исследований связал дополнительный прием витамина А с повышенным риском развития онкологических заболеваний, вследствие чего витамин А был практически исключен из терапевтической практики в развитых странах. Наш обзор освещает роль витамина А в сохранении здоровья человека и сообщает новейшие данные о его влиянии на механизмы развития соматической патологии.

Об авторах

С. В. Орлова
Кафедра диетологии и клинической нутрициологии факультета непрерывного медицинского образования медицинского института ФГАОУ ВО «Российский университет дружбы народов»
Россия

д.м.н., проф., зав. кафедрой

г. Москва



Е. А. Никитина
Кафедра диетологии и клинической нутрициологии факультета непрерывного медицинского образования медицинского института ФГАОУ ВО «Российский университет дружбы народов»
Россия

к.м.н., доцент кафедры

г. Москва



Л. И. Карушина
Кафедра диетологии и клинической нутрициологии факультета непрерывного медицинского образования медицинского института ФГАОУ ВО «Российский университет дружбы народов»
Россия

к.м.н., доцент кафедры

г. Москва



Ю. А. Пигарёва
Кафедра диетологии и клинической нутрициологии факультета непрерывного медицинского образования медицинского института ФГАОУ ВО «Российский университет дружбы народов»; ГБУЗ «Городская клиническая больница имени В.В. Виноградова» Департамента здравоохранения
Россия

к.м.н., ассистент кафедры; зав. отделением клинической диетологии

г. Москва



О. Е. Пронина
Кафедра диетологии и клинической нутрициологии факультета непрерывного медицинского образования медицинского института ФГАОУ ВО «Российский университет дружбы народов»
Россия

ассистент кафедры

г. Москва



Список литературы

1. Tolerable Upper Intake Levels For Vitamins and Minerals. European Food Safety Authority. February 2006.

2. Harrison EH. Mechanisms involved in the intestinal absorption of dietary vitamin A and provitamin A carotenoids. Biochim Biophys Acta. 2012; 1821 (1): 70–77.

3. Christian P, West KP, Jr. Interactions between zinc and vitamin A: an update. Am J Clin Nutr. 1998; 68 (2 Suppl): 435S 441S.

4. Amann PM, Eichmuller SB, Schmidt J, Bazhin AV. Regulation of gene expression by retinoids. Curr Med Chem. 2011; 18 (9): 1405–1412.

5. Timoneda J, Rodríguez-Fernández L, Zaragozá R, et al. Vitamin A Deficiency and the Lung. Nutrients. 2018; 10 (9): 1132.

6. Noy N. Signaling by retinol and its serum binding protein. Prostaglandins Leukot Essent Fatty Acids. 2014; 93: 3–7.

7. Kiefer FW, Orasanu G, Nallamshetty S, et al. Retinaldehyde dehydrogenase 1 coordinates hepatic gluconeogenesis and lipid metabolism. Endocrinology. 2012; 153 (7): 3089–3099.

8. Miller AP, Coronel J, Amengual J. The role of β-carotene and vitamin A in atherogenesis: Evidences from preclinical and clinical studies [published online ahead of print, 2020 Jan 21]. Biochim Biophys Acta Mol Cell Biol Lipids. 2020; 158635.

9. Khan SU, Khan MU, Riaz H, et al. Effects of Nutritional Supplements and Dietary Interventions on Cardiovascular Outcomes: An Umbrella Review and Evidence Map. Ann Intern Med. 2019; 171 (3): 190–198.

10. Ross AC. Vitamin A. In: Ross A, Caballero B, Cousins R, Tucker K, Ziegler T, eds. Modern Nutrition in Health and Disease.

11. th ed: Lippincott Williams & Wilkins; 2014: 260–277. 11. Ребров В. Г., Громова О.А. Витамины и микроэлементы, Москва, 2003.

12. Ross AC. Vitamin A and retinoids. In: Shils M, ed. Nutrition in Health and Disease. 9th ed. Baltimore: Williams & Wilkins; 1999: 305–327.

13. Semba RD. Impact of vitamin A on immunity and infection in developing countries. In: Bendich A, Decklebaum RJ, eds. Preventive Nutrition: The Comprehensive Guide for Health Professionals. 2nd ed. Totowa: Humana Press Inc; 2001: 329–346.

14. McCullough F. et al. The effect of vitamin A on epithelial integrity. Proceedings of the Nutrition Society. 1999; volume 58: pages 289–293.

15. Raverdeau M, Mills KH. Modulation of T cell and innate immune responses by retinoic Acid. J Immunol. 2014; 192 (7): 2953–2958.

16. Field CJ, Johnson IR, Schley PD. Nutrients and their role in host resistance to infection. J Leukoc Biol. 2002; 71 (1): 16–32.

17. Barber T, Esteban-Pretel G, Marin MP, Timoneda J. Vitamin A Deficiency and Alterations in the Extracellular Matrix. Nutrients. 2014; 6 (11): 4984–5017.

18. Витамины и минералы убеременных и кормящих женщин (методическое письмо для врачей). Обучающие программы ЮНЕСКО. Москва. 2007. 142 с.

19. Справочник по диетологии. / Под ред. В.А. Тутельяна, М.А. Самсонова.– 3-е изд. перераб. и доп. М.: Медицина, 2002. 544 с.

20. Dietary reference intakes for vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc: a report of the Panel on Micronutrients… [et al.], Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Food and Nutrition Board, Institute of Medicine. 2001.

21. Методические рекомендации МР 2.3.1.2432–08. Нормы физиологических потребностей в энергии и пищевых веществах для различных групп населения Российской Федерации.

22. Королев А.А. Гигиена питания: руководство для врачей / М.: ГЭОТАР-Медиа, 2016, 624 с.

23. Тутельян В.А. Химический состав и калорийность российских продуктов питания: Справочник. М.: ДеЛи плюс, 2012.– 284 с.

24. Единые санитарно-эпидемиологические и гигиенические требования к товарам, подлежащим санитарно-эпидемиологическому надзору (контролю) (утв. решением комиссии Таможенного союза от 28 мая 2010 года № 299).

25. Ретинол. РЛС. www.rlsnet.ru/tn_index_id_5073. htm#sostav-i-forma-vypuska.

26. Весаноид. РЛС. www.rlsnet.ru/tn_index_id_7582.htm.

27. Никитина Е. А. О нас, витаминах, замолвите слово! (часть 1). Эстетическая медицина. 2009.№ 1. С. 85–94.

28. Semba RD. Vitamin A and human immunodeficiency virus infection. Proc Nutr Soc. 1997; 56 (1B): 459–469.

29. Global prevalence of vitamin A deficiency in populations at risk 1995–2005: WHO global database on vitamin A deficiency. www.who.int/vmnis/ database/vitamina/x/en/

30. Sherwin JC, Reacher MH, Dean WH, Ngondi J. Epidemiology of vitamin A deficiency and xerophthalmia in at-risk populations. Trans R Soc Trop Med Hyg. 2012; 106 (4): 205–214.

31. Colev M, Engel H, Mayers M, Markowitz M, Cahill L. Vegan diet and vitamin A deficiency. Clin Pediatr (Phila). 2004; 43 (1): 107–109.

32. Коденцова В. М., Вржесинская О. А., Никитюк Д. Б., Тутельян В. А. Витаминная обеспеченность взрослого населения Российской Федерации: 1987–2017 гг. // Вопр. питания. 2018. Т. 87, № 4. С. 62–68.

33. Gilbert C, Awan H. Blindness in children. BMJ. 2003; 327 (7418): 760–761.

34. Vitamin A supplementation: A statistical snapshot. Harnessing the power of two life giving drops. United Nations Children’s Fund (UNICEF). February 2016.

35. Benn CS. Combining vitamin A and vaccines:convenience or conflict?. Dan Med J. 2012; 59 (1): B4378.

36. Coutsoudis A, Kiepiela P, Coovadia HM, Broughton M. Vitamin A supplementation enhances specific IgG antibody levels and total lymphocyte numbers while improving morbidity in measles. Pediatr Infect Dis J. 1992; 11 (3): 203–209.

37. Barreto ML, Santos LM, Assis AM, et al. Effect of vitamin A supplementation on diarrhoea and acute lower-respiratory-tract infections in young children in Brazil. Lancet. 1994; 344 (8917): 228–231.

38. Imdad A, Mayo-Wilson E, Herzer K, Bhutta ZA. Vitamin A supplementation for preventing morbidity and mortality in children from six months to five years of age. Cochrane Database Syst Rev. 2017; 3 (3): CD008524. Published 2017 Mar 11.

39. Mathew JL, Patwari AK, Gupta P, et al. Acute respiratory infection and pneumonia in India: a systematic review of literature for advocacy and action: UNICEF-PHFI series on newborn and child health, India. Indian Pediatr. 2011; 48 (3): 191–218.

40. Dibley MJ, Sadjimin T, Kjolhede CL, Moulton LH. Vitamin A supplementation fails to reduce incidence of acute respiratory illness and diarrhea in preschool-age Indonesian children. J Nutr. 1996; 126 (2): 434–442.

41. Zhang, L., and Liu, Y., 2020. Potential interventions for novel coronavirus in China: a systematic review. Journal of medical virology, 92 (5), 479–490.

42. Chen KH, Wang SF, Wang SY, et al. Pharmacological development of the potential adjuvant therapeutic agents against coronavirus disease 2019 [published online ahead of print, 2020 Jun 15]. J Chin Med Assoc. 2020; 10.1097/JCMA.0000000000000375.

43. Beigmohammadi MT, Bitarafan S, Hoseindokht A, et al. Impact of vitamins A, B, C, D, and E supplementation on improvement and mortality rate in ICU patients with coronavirus‑19: a structured summary of a study protocol for a randomized controlled trial. Trials. 2020; 21 (1): 614. Published 2020 Jul 6.

44. Aluisio AR, Perera SM, Yam D, et al. Vitamin A Supplementation Was Associated with Reduced Mortality in Patients with Ebola Virus Disease during the West African Outbreak. J Nutr. 2019; 149 (10): 1757–1765.

45. WHO recommendations on antenatal care for a positive pregnancy experience. World Health Organization 2016.

46. McCauley ME, van den Broek N, Dou L, Othman M. Vitamin A supplementation during pregnancy for maternal and newborn outcomes. Cochrane Database Syst Rev. 2015; 2015 (10): CD 008666. Published 2015 Oct 27.

47. Raghuveer TS, Zackula R. Strategies to Prevent Severe Retinopathy of Prematurity: A 2020 Update and Meta-analysis. Neoreviews. 2020; 21 (4): e249–e263.

48. Garofoli F, Barillà D, Angelini M, et al. Oral vitamin A supplementation for ROP prevention in VLBW preterm infants. Ital J Pediatr. 2020; 46 (1): 77.

49. Garg BD, Bansal A, Kabra NS. Role of vitamin A supplementation in prevention of bronchopulmonary dysplasia in extremely low birth weight neonates: a systematic review of randomized trials. J Matern Fetal Neonatal Med. 2019; 32 (15): 2608–2615.

50. Meyer S, Gortner L; NeoVitaA Trial Investigators. Early postnatal additional high-dose oral vitamin A supplementation versus placebo for 28 days for preventing bronchopulmonary dysplasia or death in extremely low birth weight infants. Neonatology. 2014; 105 (3): 182–188. DOI: 10.1159/000357212.

51. Kahbazi M, Sharafkhah M, Yousefichaijan P, et al. Vitamin A supplementation is effective for improving the clinical symptoms of urinary tract infections and reducing renal scarring in girls with acute pyelonephritis: a randomized, double-blind placebo-controlled, clinical trial study. Complement Ther Med. 2019; 42: 429–437.

52. Zhang GQ, Chen JL, Zhao Y. The effect of vitamin A on renal damage following acute pyelonephritis in children: a meta-analysis of randomized controlled trials. Pediatr Nephrol. 2016; 31 (3): 373–379.

53. Wolf G. The regulation of the thyroid-stimulating hormone of the anterior pituitary gland by thyroid hormone and by 9-cis-retinoic acid. Nutr Rev. 2002; 60 (11): 374–377.

54. Zimmermann MB, Jooste PL, Mabapa NS, et al. Vitamin A supplementation in iodine-deficient African children decreases thyrotropin stimulation of the thyroid and reduces the goiter rate. Am J Clin Nutr. 2007; 86 (4): 1040–1044.

55. Farhangi MA, Keshavarz SA, Eshraghian M, Ostadrahimi A, Saboor-Yaraghi AA. The effect of vitamin A supplementation on thyroid function in premenopausal women. J Am Coll Nutr. 2012; 31 (4): 268–274.

56. Semba RD, Bloem MW. The anemia of vitamin A deficiency: epidemiology and pathogenesis. Eur J Clin Nutr. 2002; 56 (4): 271–281.

57. Lynch SR. Interaction of iron with other nutrients. Nutr Rev. 1997; 55 (4): 102–110.

58. Suharno D, West CE, Muhilal, Karyadi D, Hautvast JG. Supplementation with vitamin A and iron for nutritional anaemia in pregnant women in West Java, Indonesia. Lancet. 1993; 342 (8883): 1325–1328.

59. Tryfonos C, Mantzorou M, Fotiou D, et al. Dietary Supplements on Controlling Multiple Sclerosis Symptoms and Relapses: Current Clinical Evidence and Future Perspectives. Medicines (Basel). 2019; 6 (3): 95. Published 2019 Sep 12.

60. Berson EL, Rosner B, Sandberg MA, et al. A randomized trial of vitamin A and vitamin E supplementation for retinitis pigmentosa. Arch Ophthalmol. 1993; 111 (6): 761–772.

61. Sibulesky L, Hayes KC, Pronczuk A, Weigel-DiFranco C, Rosner B, Berson EL. Safety of <7500 RE (<25000 IU) vitamin A daily in adults with retinitis pigmentosa. Am J Clin Nutr. 1999; 69 (4): 656–663.

62. Lv W, Zhong X, Xu L, Han W. Association between Dietary Vitamin A Intake and the Risk of Glioma: Evidence from a Meta-analysis. Nutrients. 2015; 7 (11): 8897–8904.

63. Zhang X, Dai B, Zhang B, Wang Z. Vitamin A and risk of cervical cancer: a meta-analysis. Gynecol Oncol. 2012; 124 (2): 366–373.

64. Wu Y, Ye Y, Shi Y, et al. Association between vitamin A, retinol intake and blood retinol level and gastric cancer risk: A meta-analysis. Clin Nutr. 2015; 34 (4): 620–626.

65. Yu N, Su X, Wang Z, Dai B, Kang J. Association of Dietary Vitamin A and β-Carotene Intake with the Risk of Lung Cancer: A Meta-Analysis of 19 Publications. Nutrients. 2015; 7 (11): 9309–9324.

66. Tang JE, Wang RJ, Zhong H, Yu B, Chen Y. Vitamin A and risk of bladder cancer: a meta-analysis of epidemiological studies. World J Surg Oncol. 2014; 12: 130.

67. Wang Q, He C. Dietary vitamin A intake and the risk of ovarian cancer: a meta-analysis. Biosci Rep. 2020; 40 (4): BSR20193979.

68. Zhang T, Chen H, Qin S, et al. The association between dietary vitamin A intake and pancreatic cancer risk: a meta-analysis of 11 studies. Biosci Rep. 2016; 36 (6): e00414.

69. Li K, Zhang B. The association of dietary β-carotene and vitamin A intake on the risk of esophageal cancer: a meta-analysis [published online ahead of print, 2020 Jun 16]. Rev Esp Enferm Dig. 2020; 112:10.17235/reed.2020.6699/2019.

70. Zhang YP, Chu RX, Liu H. Vitamin A intake and risk of melanoma: a meta-analysis. PLoS One. 2014; 9 (7): e102527.

71. Omenn GS, Goodman GE, Thornquist MD, Balmes J, Cullen MR, Glass A, Keogh JP, Meyskens FL, Valanis B, Williams JH, Barnhart S, Hammar S. Effects of a combination of beta carotene and vitamin A on lung cancer and cardiovascular disease. N Engl J Med. 1996 May 2; 334 (18): 1150–5.

72. Hennekens CH, Buring JE, Manson JE, et al. Lack of effect of long-term supplementation with beta carotene on the incidence of malignant neoplasms and cardiovascular disease. N Engl J Med. 1996; 334 (18): 1145–1149.

73. Cortés-Jofré M, Rueda JR, Asenjo-Lobos C, Madrid E, Bonfill Cosp X. Drugs for preventing lung cancer in healthy people. Cochrane Database Syst Rev. 2020; 3 (3): CD002141. Published 2020 Mar 4.

74. Bjelakovic G, Nikolova D, Gluud C (2013) Meta-Regression Analyses, Meta-Analyses, and Trial Sequential Analyses of the Effects of Supplementation with Beta-Carotene, Vitamin A, and Vitamin E Singly or in Different Combinations on All-Cause Mortality: Do We Have Evidence for Lack of Harm? PLoS ONE8 (9): e74558.

75. Abdelmalek M, Spencer J. Retinoids and wound healing. Dermatol Surg. 2006; 32 (10): 1219–1230.

76. Kafi R, Kwak HS, Schumacher WE, et al. Improvement of naturally aged skin with vitamin A (retinol). Arch Dermatol. 2007; 143 (5): 606–612.

77. Armstrong WB, Meyskens FL, Jr. Chemoprevention of head and neck cancer. Otolaryngol Head Neck Surg. 2000; 122: 728–735.

78. Tom WL, Peng DH, Allaei A, Hsu D, Hata TR. The effect of short-contact topical tretinoin therapy for foot ulcers in patients with diabetes. Arch Dermatol. 2005; 141 (11): 1373–1377.

79. Zinder R, Cooley R, Vlad LG, Molnar JA. Vitamin A and Wound Healing. Nutr Clin Pract. 2019; 34 (6): 839–849.

80. Polcz ME, Barbul A. The Role of Vitamin A in Wound Healing. Nutr Clin Pract. 2019; 34 (5): 695–700.

81. Г. де-Фер. Плавания Баренца (Diarium Nauticum).1594–1597. Л., 1936.

82. Tan MG, Worley B, Kim WB, Ten Hove M, Beecker J. Drug-Induced Intracranial Hypertension: A Systematic Review and Critical Assessment of Drug-Induced Causes. Am J Clin Dermatol. 2020; 21 (2): 163–172.

83. Michaelsson K, Lithell H, Vessby B, Melhus H. Serum retinol levels and the risk of fracture. N Engl J Med. 2003; 348 (4): 287–294.

84. Promislow JH, Goodman-Gruen D, Slymen DJ, Barrett-Connor E. Retinol intake and bone mineral density in the elderly: the Rancho Bernardo Study. J Bone Miner Res. 2002; 17 (8): 1349–1358.

85. Feskanich D, Singh V, Willett WC, Colditz GA. Vitamin A intake and hip fractures among postmenopausal women. JAMA. 2002; 287 (1): 47–54.

86. Rohde CM, DeLuca H. Bone resorption activity of all-trans retinoic acid is independent of vitamin D in rats. J Nutr. 2003; 133 (3): 777–783.

87. Johansson S, Melhus H. Vitamin A antagonizes calcium response to vitamin D in man. J Bone Miner Res. 2001; 16 (10): 1899–1905.

88. Wu AM, Huang CQ, Lin ZK, et al. The relationship between vitamin A and risk of fracture: meta-analysis of prospective studies. J Bone Miner Res. 2014; 29 (9): 2032–2039.


Для цитирования:


Орлова С.В., Никитина Е.А., Карушина Л.И., Пигарёва Ю.А., Пронина О.Е. Витамин А: позиция диетолога. Медицинский алфавит. 2020;(21):49-57. https://doi.org/10.33667/2078-5631-2020-21-49-57

For citation:


Orlova S.V., Nikitina E.A., Karushina L.I., Pigaryova Yu.A., Pronina O.E. Vitamin A: dietologist’s position. Medical alphabet. 2020;(21):49-57. (In Russ.) https://doi.org/10.33667/2078-5631-2020-21-49-57

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ISSN 2078-5631 (Print)