Медицинский совет (Jan 2021)
Effects of the inclusion of alfacalcidol in complex rehabilitation programs for patients with age-related facial ptosis
Abstract
Introduction. The sufficiency of vitamin D is important for slowing down the aging of the skin, maintaining its hydration, elasticity and the ability to regenerate. Biologically active forms of vitamin D (including alfacalcidol) promote the activation of genes whose function is directly related to the maintenance of the structure of the skin, subcutaneous tissue, fascia and muscle fibers.The aim of the work was to assess the prospects for the inclusion of alfacalcidol (“Alpha D3”, 0.25 μg, 1 caps/day) in the rehabilitation programs of patients with age-related ptosis of the face (n = 40, age 47 ± 5 years).Materials and methods. 4 groups of patients with age-related facial ptosis (n = 40, average age 47 ± 5 years) were observed for 60 days; measurements were made before and after clinical trials. Group 1A (first treatment, n = 12) received the daily dose of Alpha D3, 0.25 mg, in the morning, for 60 days, during this period the patients received 4 cosmetic procedures (2 plastic face massages and 2 stimulation current therapies). Group 1B (first control, n = 8) received only 4 cosmetic procedures over 60 days (2 plastic face massages and 2 stimulation current therapies). Group 2A (second treatment, n = 12) received the daily dose of ALFA D3, 0.25 mg, for 60 days, during this period the patients received 4 DMAE (diethylaminoethanol) mesotherapy procedures. Group 2B (second control, n = 8) only received 4 DMAE (diethylaminoethanol) mesotherapy procedures.Results. Alfacalcidol intake significantly increased the concentrations of 25 (OH) D (from 17 ± 5 ng/ml to 27 ± 8 ng/ml, P = 0.001) and calcium (from 86 ± 10 mg/L to 96 ± 6 mg/L, P = 0.01) in serum. The positive dynamics of the concentrations of 25 (OH) D and calcium when taking alfacalcidol corresponded to an increase in the total bone mineral density (+ 0.03 ± 0.03 g/cm3, control: + 0.006 ± 0.03, P = 0.016) and T-criterion (+0.4 ± 0.5, control: -0.07 ± 0.2, P = 0.0002), which indicates compensation for vitamin D deficiency and an improvement in bone metabolism. An increase in the levels of 25 (OH) D and calcium when taking alfacalcidol was accompanied by a positive trend in skin condition according to bioimpedance measurements. Taking the drug significantly increased the moisture content of the facial skin (from 17 ± 14 points to 29 ± 14 points, P = 0.055, without changes in the control) and increased the amplitude of the muscle motor response to the stimulus (+ 0.24 ± 0.22, P < 0.02).Conclusions. Within the framework of a randomized design, it was shown that the addition of massage, microcurrent therapy, mesotherapy with alfacalcidol led to a significant increase in serum 25 (OH) D levels, an increase in skin elasticity and hydration, a decrease in visceral fat according to bioimpedance measurements, and an improvement in indicators of muscle contractility and neuromuscular signal transmission according to electromyography data and an increase in bone mineral density.
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