The impact of co/polymorbidity on the therapeutic response to vitamin D in patients with osteoporosis and vitamin D hypovitaminosis in primary health care

Introduction: Vitamin D, its active metabolites and analogs, represent a group of compounds with numerous functions in the body. The activated receptor for vitamin D in the intestines stimulates the synthesis of the binding protein for calcium, bone stimulates the production of osteocalcin, osteoponin, alkaline phosphatase, increases the transport of calcium from vancellular to intracellular cells, can mobilize calcium from the intracellular calcium reservoir and enhance the metabolism of phosphatidylinositol. Objective: The aim of this paper is to examine the possible cause-and-effect linkages between the therapeutic response and the use of vitamin D and additional diseases and therapies in primary health care patients with vitamin D deficiency and osteoporosis. Material and method: Epidemiological survey of osteoporosis and hypovitaminosis D vitamins, was conducted as a retrospective study in patients in primary health care of the Health Kragujevac, after receiving the decision of the Ethics Committee of the Health Center Kragujevac. In the period from 01. 02. 2018. to 22. 10. 2019. an study was conducted, in which patients with various diseases, ages 30 to 65, were administered vitamin D (Detrical® 1000), and levels of serum D vitamins were measured before and after therapy. Results: Statistically significant differences in the response to vitamin D (Detrical®1000) were observed in patients with hypertension, diabetes and thyroid disorders (p < 0.05). The results obtained also indicate, that there are statistically significant differences in patients with hypertension treated with combination therapy with ACE inhibitor and diuretic (p < 0.05). T-assay of samples showed a statistically significant increase in the level of vitamin D in the subjects after treatment with Detrical® (p < 0.0001). Conclusion: Ensuring adequate vitamin D intake is a key ingredient in the treatment of osteoporosis. People at high risk of developing fractures benefit from taking vitamin D supplementation, at least 800 IJ per day. By entering one tablet daily, Detrical®1000, a better neuromuscular function is achieved.