51
|
Gonçalves TJM, Gonçalves SEAB, Guarnieri A, Risegato RC, Guimarães MP, de Freitas DC, Razuk-Filho A, Benedito Junior PB, Parrillo EF. Prevalence of obesity and hypovitaminosis D in elderly with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Clin Nutr ESPEN 2020; 40:110-114. [PMID: 33183522 PMCID: PMC7552968 DOI: 10.1016/j.clnesp.2020.10.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 09/19/2020] [Accepted: 10/07/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND & AIM Verify the prevalence of hypovitaminosis D and obesity in elderly patients infected by new coronavirus. The patients developed severe symptoms and were admitted in intensive care unit (ICU) to receive invasive ventilation due to diagnosis of acute respiratory distress syndrome (ARDS). METHODS A cross-sectional descriptive study composed of elderly (age ≥ 60 years) admitted to the ICU. Were collected demographic (sex, age), anthropometric data, presence of comorbidities (hypertension, diabetes, heart disease, lung, neurological and oncological diseases), severity score in ICU (SAPS III), PaO2/FiO2 ratio, analysis of C-reactive protein (CRP) and serum dosage of 25-hydroxy vitamin D (25 OHD) in the first day of hospitalization to identify elderly with hypovitaminosis D (low values < 30 ng/mL). The diagnosis of obesity in elderly was determined by calculating the body mass index (BMI) ≥ 30 kg/m2. RESULTS A total of 176 elderly met the inclusion criteria. 54% were elderly men and mean age of 72.9 ± 9.1 years. The median BMI was 30.5 (28.1-33) kg/m2 with 68.7% having a nutritional diagnosis of obesity and 15.3% had BMI ≥ 35 kg/m2. The most prevalent comorbidities were hypertension (72.2%) and diabetes (40.9%). Prevalence of hypovitaminosis D with values of 25 OHD <30 ng/mL, < 20 ng/mL and <10 ng/mL was 93.8%, 65.9% and 21% respectively. The prevalence of hypovitaminosis D (<30 ng/mL) in obese elderly was 94.2%. There was a negative and significant bivariate correlation between BMI and levels of 25 OHD (r = - 0.15; p = 0.04). CONCLUSION Hypovitaminosis D and obesity in elderly have a high prevalence in critically ill patients in ICU infected by the new coronavirus. Laboratory investigation of vitamin D becomes important, especially in obese elderly patients.
Collapse
Affiliation(s)
| | | | - Andreia Guarnieri
- Sancta Maggiore Hospital, Prevent Senior Private Health Operator, São Paulo, Brazil
| | | | | | | | - Alvaro Razuk-Filho
- Sancta Maggiore Hospital, Prevent Senior Private Health Operator, São Paulo, Brazil
| | | | | |
Collapse
|
52
|
Ferraz GC, Andrade RRD, Reis FMP, Oliveira Neto OBD, Omena COD, Jucá MJ, Sousa-Rodrigues CFD, Barbosa FT. Association between vitamin D and cardioprotection in adult patients. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2020; 66:1444-1448. [PMID: 33174941 DOI: 10.1590/1806-9282.66.10.1444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 07/24/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To conduct a review of articles which have evaluated the relationship between vitamin D and cardioprotection in adult. METHODS A literature search was performed in the Pubmed and Scielo databases. The results were extracted from primary and secondary sources and will be presented in the form of a bibliographic review. RESULTS Twenty-three articles were identified from the electronic search that reported on physiological mechanisms relating the vitamin D axis and the cardiovascular system through receptors. Of the ten studies that evaluated the therapeutic effect of vitamin D in cardiovascular diseases, none reported significant results. CONCLUSION The articles assessed in this review did not demonstrate a cardioprotective effect of vitamin D, despite the epidemiological correlation of vitamin D deficiency with a higher prevalence of cardiovascular diseases.
Collapse
Affiliation(s)
| | | | | | | | | | - Mario Jorge Jucá
- Médico e Professor do Centro Universitário CESMAC, Maceió, AL, Brasil
| | | | | |
Collapse
|
53
|
Amorim CLCGD, Oliveira JMD, Rodrigues A, Furlanetto KC, Pitta F. Vitamin D: association with eosinophil counts and IgE levels in children with asthma. ACTA ACUST UNITED AC 2020; 47:e20200279. [PMID: 33174974 PMCID: PMC7889310 DOI: 10.36416/1806-3756/e20200279] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 07/06/2020] [Indexed: 11/19/2022]
Abstract
In this cross-sectional study, we investigated the relationship that levels of vitamin D had with eosinophil counts and IgE levels in 26 children with asthma (6-12 years of age) in the city of Londrina, Brazil. Vitamin D levels were found to correlate significantly, albeit moderately, with age (r = −0.51) and eosinophilia (r = −0.49), although not with IgE levels (r = −0.12). When we stratified the sample into two groups by the median vitamin D level (< or ≥ 24 ng/mL), we found that those in the < 24 ng/mL group were older, had higher eosinophil counts, and had higher IgE levels. To our knowledge, this is the first study to show an association between low levels of vitamin D and more pronounced eosinophilia in children with asthma in Brazil.
Collapse
Affiliation(s)
- Claudio Luiz Castro Gomes de Amorim
- . Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Londrina, Londrina (PR) Brasil.,. Laboratório de Pesquisa em Fisioterapia Pulmonar, Departamento de Fisioterapia, Universidade Estadual de Londrina, Londrina (PR) Brasil
| | - Joice Mara de Oliveira
- . Laboratório de Pesquisa em Fisioterapia Pulmonar, Departamento de Fisioterapia, Universidade Estadual de Londrina, Londrina (PR) Brasil.,. Centro de Pesquisa e Pós-Graduação, Universidade Pitágoras-Universidade Norte do Paraná - UNOPAR - Londrina (PR) Brasil
| | - Antenor Rodrigues
- . Laboratório de Pesquisa em Fisioterapia Pulmonar, Departamento de Fisioterapia, Universidade Estadual de Londrina, Londrina (PR) Brasil.,. Rehabilitation Aimed at Muscle Performance-RAMP-University of Toronto, Toronto, ON, Canada
| | - Karina Couto Furlanetto
- . Laboratório de Pesquisa em Fisioterapia Pulmonar, Departamento de Fisioterapia, Universidade Estadual de Londrina, Londrina (PR) Brasil.,. Centro de Pesquisa e Pós-Graduação, Universidade Pitágoras-Universidade Norte do Paraná - UNOPAR - Londrina (PR) Brasil
| | - Fabio Pitta
- . Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Londrina, Londrina (PR) Brasil.,. Laboratório de Pesquisa em Fisioterapia Pulmonar, Departamento de Fisioterapia, Universidade Estadual de Londrina, Londrina (PR) Brasil
| |
Collapse
|
54
|
da Silva Canhos MM, de Oliveira RC, Modelli de Andrade LG, Caramori JCT, Barretti P, Martin LC. Association between vitamin D levels and mortality in hemodialysis patients: a cohort study. Ren Fail 2020; 42:225-233. [PMID: 32126885 PMCID: PMC7067165 DOI: 10.1080/0886022x.2020.1735415] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 02/12/2020] [Accepted: 02/17/2020] [Indexed: 12/28/2022] Open
Abstract
Introduction: Low vitamin D levels are associated with mortality in hemodialysis (HD) patients; however, the serum vitamin D thresholds are unclear. This study aimed to identify the vitamin D level below which mortality increases in HD patients.Methods: A cohort of HD patients enrolled from January 2014 to January 2017 was evaluated. The variables were analyzed according to the season, namely, summer, winter, and annual average, mortality was the primary outcome. The patients were assigned to vitamin D quintiles, and multivariate Cox regression analysis adjusted for age, ethnicity, gender, body mass index (BMI), inhibitors of the renin-angiotensin system, statin, calcitriol, and antiplatelet drugs use, hemodialysis vintage, hypertension, diabetes mellitus, atherosclerotic disease, and C-reactive protein was performed.Results: There were studied 306 patients. Vitamin D levels of 18.0-23.6 ng/mL (hazard ratio [HR] = 4.30; 95% confidence interval [CI] 1.60-11.54, p = 0.004) and <18.0 ng/mL (HR = 3.83; 95% CI: 1.42-10.35, p = 0.008) in summer and vitamin D levels of 21.5-27.1 ng/mL (HR = 3.70; 95% CI: 1.50-9.11, p = 0.004) and ≤17.5 ng/mL (HR = 2.84; 95% CI: 1.13-7.13, p = 0.026) in winter were associated with mortality. The average annual values of vitamin D associated with all-cause mortality were <17.7 ng/dL (adjusted HR = 4.25, 95% CI: 1.57-11.48, p = 0.004), and between >17.7 ng/dL and ≤23.1 ng/dL (adjusted HR = 3.91, 95% CI: 1.47-10.42, p = 0.006).Conclusions: Annual average vitamin D levels <23.1 ng/mL were associated with higher all-cause mortality, regardless of the confounding variables evaluated.
Collapse
Affiliation(s)
- Maryanne Machado da Silva Canhos
- Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Rogério Carvalho de Oliveira
- Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Luis Gustavo Modelli de Andrade
- Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Jacqueline Costa Teixeira Caramori
- Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Pasqual Barretti
- Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Luis Cuadrado Martin
- Division of Nephrology, Department of Internal Medicine, Botucatu Medical School, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| |
Collapse
|
55
|
Zhang Y, Lun X, Guo W. Expression of TRPC1 and SBEM protein in breast cancer tissue and its relationship with clinicopathological features and prognosis of patients. Oncol Lett 2020; 20:392. [PMID: 33193852 DOI: 10.3892/ol.2020.12255] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 07/22/2020] [Indexed: 12/23/2022] Open
Abstract
This study investigated the relationship of the expression of transient receptor potential channel 1 (TRPC1), small breast epithelial mucin (SBEM) in breast cancer tissues with clinical pathological features and prognosis of patients. Altogether 50 patients with breast cancer who were treated in Weifang People's hospital from April 2017 to November 2018 were selected, and the mRNA and protein differences of TRPC1 and SBEM in breast cancer patients and normal breast cancer tissues were detected by qRT-PCR and Western blot. Spearman test was used for correlation analysis. Logistic univariate and multivariate analysis were performed on the risk factors related to breast cancer metastasis in breast cancer patients. The expression of TRPC1 and SBEM in breast cancer tissues was significantly higher than that in normal breast tissues (P<0.001). The mRNA expression of TRPC1, SBEM and protein was not related to age, tumor size and tissue grade of breast cancer patients, but related to TNM stage, clinical stage and lymph node metastasis (P<0.001). The relative expression of TRPC1 was positively correlated with clinical stage of breast cancer (r=0.992, P<0.001). The relative expression of SBEM was positively correlated with the clinical stage of breast cancer (r=0.853, P<0.001). The relative expression of TRPC1 was positively correlated with TNM staging of breast cancer (r=0.860, P<0.001). The relative expression of SBEM was positively correlated with TNM staging of breast cancer (r=0.880, P<0.001). Multivariate conditional Logistic regression analysis showed that TNM staging, TRPC1, SBEM were independent risk factors for malignant breast cancer metastasis. On the contrary, expression of TRPC1 and SBEM in breast cancer tissues was up-regulated. TRPC1 and SBEM may be involved in the process of breast cancer occurrence, development and metastasis, and can be used as potential tissue biomarkers in diagnosis of breast cancer metastasis and disease assessment.
Collapse
Affiliation(s)
- Yongqing Zhang
- Department of General Surgery, Weifang People's Hospital, Weifang, Shandong 261041, P.R. China
| | - Xiaoqin Lun
- Department of General Surgery, Weifang People's Hospital, Weifang, Shandong 261041, P.R. China
| | - Weiling Guo
- Department of General Surgery, Weifang People's Hospital, Weifang, Shandong 261041, P.R. China
| |
Collapse
|
56
|
Kellen de Souza Cardoso C, Gondim Peixoto MDR, dos Santos Rodrigues AP, Rodrigues Mendonça C, de Oliveira C, Aparecida Silveira E. Bone Mineral Density in Severely Obese Women: Health Risk and Health Protective Risk Factors in Three Different Bone Sites. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7017. [PMID: 32992832 PMCID: PMC7579229 DOI: 10.3390/ijerph17197017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/05/2020] [Accepted: 08/06/2020] [Indexed: 11/21/2022]
Abstract
Factors associated with bone mineral density (BMD) are poorly known in severely obese individuals i.e., a body mass index (BMI) > 35 kg/m2. The objectives of this study were to describe the bone health profile of severely obese Brazilian women, to identify the health risk and health protective factors for BMD in this group and to assess whether these factors vary according to three different bone sites. BMD was assessed using dual-energy X-ray absorptiometry (DXA). This study analyzed baseline data from 104 women who had an average BMI of 43.7 ± 4.5 kg/m2 and presented the following BMD status: 1.283 ± 0.094 g/cm2 for total body, 1.062 ± 0.159 g/cm2 for vertebral column and 1.195 ± 0.134 g/cm2 for hip. They took part in the "Effect of nutritional intervention and olive oil in severe obesity" randomized clinical trial (DieTBra Trial). The risk factors negatively associated with lower BMD were age ≥50 years for the three bone sites i.e., total body, vertebral column and hip. Smoking for total body BMD (p = 0.045); BMI ≥ 50kg/m2 for vertebral column and hip; menopause for hip; high C-reactive protein (CRP) levels (p = 0.049), insufficient zinc (p = 0.010) and previous fracture for vertebral column (p = 0.007). The protective factors positively associated with BMD were physical activity (≥150 min/week (p = 0.001)) for hip; type 2 diabetes mellitus (DM2) (p < 0.0001) total body and adequate vitamin D levels from food consumption (p = 0.039) for vertebral column. A BMI ≥ 50 kg/m2 was a risk factor for lower BMD. The findings showed that protective and risk factors varied by bone site. The original study is registered with ClinicalTrials.gov. (protocol number: NCT02463435).
Collapse
Affiliation(s)
| | - Maria do Rosário Gondim Peixoto
- Postgraduate Program in Nutrition and Health, Faculty of Nutrition, Federal University of Goias, Goiânia 74605-220, Goiás, Brazil;
| | - Ana Paula dos Santos Rodrigues
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiânia 74605-220, Goiás, Brazil; (A.P.d.S.R.); (C.R.M.)
| | - Carolina Rodrigues Mendonça
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiânia 74605-220, Goiás, Brazil; (A.P.d.S.R.); (C.R.M.)
| | - Cesar de Oliveira
- Department of Epidemiology & Public Health, Institute of Epidemiology & Health Care, University College London, London WC1E 6BT, UK;
| | - Erika Aparecida Silveira
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiânia 74605-220, Goiás, Brazil; (A.P.d.S.R.); (C.R.M.)
- Department of Epidemiology & Public Health, Institute of Epidemiology & Health Care, University College London, London WC1E 6BT, UK;
| |
Collapse
|
57
|
Silveira EA, Souza JDD, Santos ASEADC, Canheta ABDS, Pagotto V, Noll M. What are the factors associated with sarcopenia-related variables in adult women with severe obesity? Arch Public Health 2020; 78:71. [PMID: 32774854 PMCID: PMC7398193 DOI: 10.1186/s13690-020-00454-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 07/28/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Understanding the association between sarcopenia-related variables and several risk factors may help to implement interventions aimed at preventing its occurrence by reducing or controlling the identified risk factors. Although changes in body composition occur in both sexes, in women, muscle loss is accentuated due to decreased estrogen levels following menopause. This study aims to determine the factors associated with sarcopenia-related parameters in middle-aged women identified with class II/III obesity (body mass index [BMI] ≥ 35 kg/m2). METHODS The study included 104 women with severe obesity (40.23 ± 8.49 years) with an average body fat percentage of 52.45 ± 4.14%. Sarcopenia was assessed using total appendicular skeletal muscle mass (ASMM), appendicular skeletal muscle mass index (ASMMI), and appendicular skeletal muscle mass adjusted by BMI (ASMM/BMI) as evaluated using dual energy X-ray absorptiometry (DXA). Hand grip strength (HGS) and HGS adjusted by BMI (HGS/BMI) were evaluated using dynamometry. Functional performance was assessed using the walking speed test (WS). The explanatory variables were age, lifestyle, comorbidities, food consumption, and metabolic parameters. A multivariate linear regression was performed. RESULTS Factors associated with sarcopenia-related variables in 104 severely obese women with a mean BMI of 43.85 kg/m2 were as follows: ASMMI negatively correlated with serum levels of tetraiodothyronine (T4) and tobacco use; ASMM/BMI negatively correlated with age, serum T4 levels, and diabetes; ASMM negatively correlated with T4 serum levels and diabetes; HGS negatively correlated with age and hypercholesterolemia, and positively correlated with low-density lipoprotein cholesterol (LDL-c); HGS/BMI negatively correlated with age and hypercholesterolemia and positively correlated with LDL-c; and WS negatively correlated with hypothyroidism and diabetes. CONCLUSION In severely obese women, muscle mass and function were inversely associated with age, smoking status, endocrine parameters, hypercholesterolemia, and comorbidities such as diabetes. Thus, the results of this investigation are relevant in supporting the development of clinical interventions to aid in the prevention of sarcopenia in adult women with severe obesity.
Collapse
Affiliation(s)
- Erika Aparecida Silveira
- Health Science Post-Graduation Program, Faculty of Medicine, Universidade Federal de Goiás, 1a. s/n - Setor Leste Universitário, Goiânia, Goiás CEP 74605-020 Brazil
| | - Jacqueline Danesio de Souza
- University North of Paraná, Londrina, Brazil
- Faculty of Nursing, Universidade Federal de Goiás, Goiânia, Brazil
| | - Annelisa Silva e Alves de Carvalho Santos
- Health Science Post-Graduation Program, Faculty of Medicine, Universidade Federal de Goiás, 1a. s/n - Setor Leste Universitário, Goiânia, Goiás CEP 74605-020 Brazil
| | - Andrea Batista de Souza Canheta
- Health Science Post-Graduation Program, Faculty of Medicine, Universidade Federal de Goiás, 1a. s/n - Setor Leste Universitário, Goiânia, Goiás CEP 74605-020 Brazil
| | - Valéria Pagotto
- Health Science Post-Graduation Program, Faculty of Medicine, Universidade Federal de Goiás, 1a. s/n - Setor Leste Universitário, Goiânia, Goiás CEP 74605-020 Brazil
| | - Matias Noll
- Health Science Post-Graduation Program, Faculty of Medicine, Universidade Federal de Goiás, 1a. s/n - Setor Leste Universitário, Goiânia, Goiás CEP 74605-020 Brazil
- Instituto Federal Goiano, Goiânia, Brazil
| |
Collapse
|
58
|
Moreira CA, Ferreira CEDS, Madeira M, Silva BCC, Maeda SS, Batista MC, Bandeira F, Borba VZC, Lazaretti-Castro M. Reference values of 25-hydroxyvitamin D revisited: a position statement from the Brazilian Society of Endocrinology and Metabolism (SBEM) and the Brazilian Society of Clinical Pathology/Laboratory Medicine (SBPC). ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2020; 64:462-478. [PMID: 32813765 PMCID: PMC10522078 DOI: 10.20945/2359-3997000000258] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 03/01/2020] [Indexed: 11/23/2022]
Abstract
Hypovitaminosis D is a common condition with a negative impact on health. This statement, prepared by experts from the Brazilian Society of Endocrinology and Metabolism and the Brazilian Society of Clinical Pathology/Laboratory Medicine, includes methodological aspects and limitations of the measurement of 25-hydroxyvitamin D [25(OH)D] for identification of vitamin D status, and identifies individuals at increased risk for deficiency of this vitamin in whom 25(OH)D measurement is recommended. For the general population, 25(OH)D levels between 20 and 60 ng/mL are considered normal, while individuals with levels below 20 ng/mL are considered to be vitamin D deficient. This statement identifies potential benefits of maintaining 25(OH)D levels > 30 ng/mL in specific conditions, including patients aged > 65 years or pregnant, those with recurrent falls, fragility fractures, osteoporosis, secondary hyperparathyroidism, chronic kidney disease, or cancer, and individuals using drugs with the potential to affect the vitamin D metabolism. This statement also calls attention to the risk of vitamin D intoxication, a life-threatening condition that occurs at 25(OH)D levels above 100 ng/mL.
Collapse
Affiliation(s)
- Carolina Aguiar Moreira
- Departamento de Metabolismo Ósseo, Sociedade Brasileira de Endocrinologia e Metabologia, Brasil
| | | | - Miguel Madeira
- Departamento de Metabolismo Ósseo, Sociedade Brasileira de Endocrinologia e Metabologia, Brasil
| | | | - Sergio Setsuo Maeda
- Departamento de Metabolismo Ósseo, Sociedade Brasileira de Endocrinologia e Metabologia, Brasil
| | | | - Francisco Bandeira
- Departamento de Metabolismo Ósseo, Sociedade Brasileira de Endocrinologia e Metabologia, Brasil
| | | | - Marise Lazaretti-Castro
- Departamento de Metabolismo Ósseo, Sociedade Brasileira de Endocrinologia e Metabologia, Brasil
| |
Collapse
|
59
|
Dutra JDM, Lisboa QC, Ferolla SM, Carvalho CMML, Mendes CCM, Ferrari TCA, Couto CA. Vitamin D levels are not associated with non-alcoholic fatty liver disease severity in a Brazilian population. INT J VITAM NUTR RES 2020; 91:411-418. [PMID: 32639223 DOI: 10.1024/0300-9831/a000667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Some epidemiological evidence suggests an inverse correlation between non-alcoholic fatty liver disease (NAFLD) frequency and vitamin D levels. Likewise, a beneficial effect of vitamin D on diabetes mellitus (DM) and insulin resistance has been observed, but this is an unsolved issue. Thus, we aimed to investigate the prevalence of hypovitaminosis D in a NAFLD Brazilian population and its association with disease severity and presence of comorbidities. In a cross-sectional study, the clinical, biochemical and histological parameters of 139 NAFLD patients were evaluated according to two different cut-off points of serum 25-hydroxyvitamin D levels (20 ng/mL and 30 ng/mL). The mean age of the population was 56 ± 16 years, most patients were female (83%), 72% had hypertension, 88% dyslipidemia, 46% DM, 98% central obesity, and 82% metabolic syndrome. Serum vitamin D levels were < 30 ng/mL in 78% of the patients, and < 20 ng/mL in 35%. The mean vitamin D level was 24.3 ± 6.8 ng/mL. The comparison between the clinical, biochemical and histological characteristics of the patients according to the levels of vitamin D showed no significant difference. Most patients with NAFLD had hypovitaminosis D, but low vitamin D levels were not related to disease severity and the presence of comorbidities.
Collapse
Affiliation(s)
- Jeniffer Danielle M Dutra
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Quelson Coelho Lisboa
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Silvia Marinho Ferolla
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Carolina Martinelli M L Carvalho
- Instituto Alfa de Gastroenterologia do Hospital das Clínicas, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Camila Costa M Mendes
- Instituto Alfa de Gastroenterologia do Hospital das Clínicas, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Teresa Cristina A Ferrari
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.,Instituto Alfa de Gastroenterologia do Hospital das Clínicas, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Cláudia Alves Couto
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.,Instituto Alfa de Gastroenterologia do Hospital das Clínicas, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| |
Collapse
|
60
|
Neves Marques de Queiroz N, Trindade Cunha de Melo F, de Souza Resende F, Corrêa Janaú L, Jorge Kzan de Souza Neto N, Nascimento de Lemos M, Lobato Virgolino AC, Neres Iunes de Oliveira MC, Leite de Alcântara A, Vilhena de Moraes L, Franco David T, Maia da Silva W, Souza Reis S, Costa dos Santos M, Contente Braga de Souza AC, Freire Piani PP, Arroyo Lara Mourão N, Mileo Felício K, Felício Abrahão Neto J, Felício JS. Vitamin D and PTH: data from a cross-sectional study in an equatorial population. Endocr Connect 2020; 9:667-675. [PMID: 32567548 PMCID: PMC7424356 DOI: 10.1530/ec-20-0206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 06/18/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Investigate the prevalence of vitamin D deficiency in an equatorial population through a large-sample study. METHODS Cross-sectional study with 30,224 healthy individuals from the North Region, in Brazil (Amazônia - state of Pará), who had 25-hydroxy-vitamin D (25(OH)D) and intact parathyroid hormone (PTH) serum levels measured by immunoassay method. Those with history of acute or chronic diseases were excluded. Abnormal levels of calcium, creatinine, glycemia and albumin were also exclusion criteria. RESULTS 25(OH)D levels were 29.1 ± 8.2 ng/mL and values <12.7 ng/mL were equal to < -2 s.d. below average. Hypovitaminosis D was present in 10% of subjects according to the Institute of Medicine (values <20 ng/mL) and in 59%, in consonance with Endocrine Society (values 20-30 ng/mL as insufficiency and <20 ng/mL as deficiency) criteria. Individuals were divided according to four age brackets: children, adolescents, adults and elderly, and their 25(OH)D levels were: 33 ± 9; 28.5 ± 7.4; 28.3 ± 7.7; 29.3 ± 8.5 ng/mL, respectively. All groups differed in 25(OH)D, except adolescents vs adults. Regression model showed BMI, sex, living zone (urban or rural) and age as independent variables to 25(OH)D levels. Comparing subjects with vitamin D deficiency (<20 ng/mL) to those with vitamin D insufficiency (20-30 ng/mL), a difference between PTH levels in these two groups was observed (95.9 ± 24.7 pg/mL vs 44.2 ± 64.5 pg/mL; P < 0.01). Additionally, the most accurate predictive vitamin D level for subclinical hyperparathyroidism in ROC curve was 26 ng/mL. CONCLUSION Our equatorial population showed low prevalence of vitamin D hypovitaminosis ranging with age bracket. The insufficient category by Endocrine Society was corroborated by our PTH data.
Collapse
|
61
|
Confortin S, Ono L, Marques L, Ceolin G, d’Orsi E, Barbosa A. Osteopenia/Osteoporosis and Its Association with Sarcopenia: EpiFloripa Aging Study 2013/2014. PORTUGUESE JOURNAL OF PUBLIC HEALTH 2020. [DOI: 10.1159/000508924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
|
62
|
Curvello-Silva KL, Oliveira NA, Silva TSS, Sousa CD, Daltro C. Association Between Cardiovascular Risk Factors and 25(OH)D Levels in Obese Patients. Metab Syndr Relat Disord 2020; 18:328-332. [PMID: 32513042 DOI: 10.1089/met.2020.0023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Obesity is associated with lower levels of 25-hydroxyvitamin D [25(OH)D] and higher cardiovascular risk related to metabolic syndrome (MetS). Our purpose was to investigate if there is an association between levels of 25(OH)D and the components of MetS in an obese sample. Methods: This cross-sectional study enrolled obese patients referred for bariatric surgery in a specialized clinic. Secondary data were gathered as follows: glycemic and lipid profiles, 25(OH)D, anthropometric parameters, and clinical and sociodemographic information. The results were presented as means (standard deviations) or medians and interquartile intervals or absolute and relative frequencies. The patients were divided into three groups based on 25(OH)D terciles for analysis and were compared using ANOVA, Kruskal-Wallis or chi-squared tests. The correlations were calculated by Spearman's or Pearson's correlation tests. Results: We studied 299 patients, with the majority being women (74.9%). The patients' average (SD) age and 25(OH)D level were 36 (9) years and 25.8 (7.5) ng/mL, respectively. There was no association between vitamin D and MetS or its components. A progressive decrease in total cholesterol, low-density lipoprotein cholesterol (LDL-c), and nonhigh-density lipoprotein cholesterol (HDL-c) was observed as the serum vitamin D level increased, although only the latter reached statistical significance (P = 0.033). The correlation analysis showed a negative linear association between 25(OH)D and total cholesterol (r = -0.157; P = 0.047), 25(OH)D and LDL-c (r = -0.164; P = 0.038), and 25(OH)D and non-HDL-c (r = -0.176; P = 0.026). Conclusions: There was a negative correlation between 25(OH)D levels and the atherogenic profile but none with the MetS.
Collapse
Affiliation(s)
| | | | - Thalane S S Silva
- Nutrition School, Federal University of Bahia, Salvador, Brazil.,Nutrition Bachelor's Course, School of Technology and Science, Jequié, Bahia, Brazil
| | - Cláudia D Sousa
- Nutrition Department, Núcleo de Tratamento e Cirurgia da Obesidade, Salvador, Brazil
| | - Carla Daltro
- Nutrition School, Federal University of Bahia, Salvador, Brazil.,Nutrition Department, Núcleo de Tratamento e Cirurgia da Obesidade, Salvador, Brazil.,Medicine School, Federal University of Bahia, Salvador, Brazil
| |
Collapse
|
63
|
Segheto KJ, Pereira M, Silva DCGD, Carvalho CJD, Massardi FR, Kakehasi AM, Juvanhol LL, Longo GZ. Vitamin D and bone health in adults: a systematic review and meta-analysis. CIENCIA & SAUDE COLETIVA 2020; 26:3221-3244. [PMID: 34378711 DOI: 10.1590/1413-81232021268.15012020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 05/26/2020] [Indexed: 11/22/2022] Open
Abstract
Low bone health is associated with vitamin D deficiency in older individuals; however, this association is not well established in adults. The aim of the study was to analyze the association between serum concentrations of 25-hydroxyvitamin D and bone health in adults by systematic review and meta-analysis. The search was carried out in the LILACS, PubMed, Scopus, Web of Science, ScienceDirect databases from March 2017 to October 2018 with adult individuals (20-59 years). Bone health was evaluation performed through dual X-ray absorptiometry and serum concentrations of 25(OH)D. The random effect model was used to analyze data from bone mineral content and bone mineral. Random effects models were used and the sources of heterogeneity were explored by means of meta-regression. Thirty-five articles were selected. There was positive correlation between vitamin D and bone health in most of the evaluated sites. Correlation was observed in the analysis of subgroups for lumbar spine among men. When stratified, the studies presented high heterogeneity, which was explained by the sample size, mean serum vitamin D levels and risk of bias. Vitamin D is positively correlated to bone health in adult individuals.
Collapse
Affiliation(s)
- Kátia Josiany Segheto
- Departamento de Nutrição e Saúde, Universidade Federal de Viçosa (UFV). Ed. Centro de Ciências Biológicas II s/n, Campus Universitário. 36570-900 Viçosa MG Brasil.
| | - Marcos Pereira
- Instituto de Saúde Coletiva, Universidade Federal da Bahia. Salvador BA Brasil
| | | | | | | | | | - Leidjaira Lopes Juvanhol
- Departamento de Nutrição e Saúde, Universidade Federal de Viçosa (UFV). Ed. Centro de Ciências Biológicas II s/n, Campus Universitário. 36570-900 Viçosa MG Brasil.
| | - Giana Zarbato Longo
- Departamento de Nutrição, Universidade Federal de Santa Catarina. Florianópolis SC Brasil
| |
Collapse
|
64
|
Milagres LC, Filgueiras MDS, Rocha NP, Suhett LG, de Albuquerque FM, Juvanhol LL, Franceschini SDCC, de Novaes JF. Cutoff point estimation for serum vitamin D concentrations to predict cardiometabolic risk in Brazilian children. Eur J Clin Nutr 2020; 74:1698-1706. [PMID: 32341487 DOI: 10.1038/s41430-020-0624-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 03/20/2020] [Accepted: 03/25/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND/OBJECTIVES To evaluate serum 25(OH)D concentrations and determine a cutoff point for cardiometabolic risk in children. SUBJECT/METHODS This is a cross-sectional study with a representative sample of 378 8-9-year-old children from all urban schools in the city of Viçosa, MG, Brazil. Sociodemographic data and information on lifestyle, and food consumption were collected. Biochemical evaluation included glucose, triglycerides, leptin, calcidiol [25(OH)D], and parathormone. Body composition was assessed by dual energy X-ray absorptiometry. Cardiometabolic risk was considered when nontraditional risk markers were detected, including triglyceride × glycemia index (TyG index), hyperleptinemia, and hypertriglyceridemic waist phenotype (HWP). The receiver operating characteristic curve (ROC) was used to define the cutoff point for serum 25(OH)D to predict cardiometabolic risk. RESULTS 25(OH)D showed better predictive capacity for grouping of cardiometabolic risk markers than for either single or paired markers. The area under the curve for grouping of risk markers was 0.636 (95% CI: 0.585, 0.685, P < 0.001). The cutoff point to predict cardiometabolic risk was defined as 32.0 ng/mL. CONCLUSION 25(OH)D presented good predictive capacity for cardiometabolic risk and 25(OH)D concentration higher than 32 ng/mL was associated with a 49% reduction of cardiometabolic risk prevalence in prepubertal Brazilian children.
Collapse
Affiliation(s)
- Luana Cupertino Milagres
- Department of Nutrition and Health, Biological Sciences Center, Federal University of Viçosa, Viçosa, Minas Gerais, 36570-900, Brazil.
| | - Mariana De Santis Filgueiras
- Department of Nutrition and Health, Biological Sciences Center, Federal University of Viçosa, Viçosa, Minas Gerais, 36570-900, Brazil
| | - Naruna Pereira Rocha
- Department of Nutrition and Health, Biological Sciences Center, Federal University of Viçosa, Viçosa, Minas Gerais, 36570-900, Brazil
| | - Lara Gomes Suhett
- Department of Nutrition and Health, Biological Sciences Center, Federal University of Viçosa, Viçosa, Minas Gerais, 36570-900, Brazil
| | - Fernanda Martins de Albuquerque
- Department of Nutrition and Health, Biological Sciences Center, Federal University of Viçosa, Viçosa, Minas Gerais, 36570-900, Brazil
| | - Leidjaira Lopes Juvanhol
- Department of Nutrition and Health, Biological Sciences Center, Federal University of Viçosa, Viçosa, Minas Gerais, 36570-900, Brazil
| | | | - Juliana Farias de Novaes
- Department of Nutrition and Health, Biological Sciences Center, Federal University of Viçosa, Viçosa, Minas Gerais, 36570-900, Brazil
| |
Collapse
|
65
|
Santos D, Lopes T, Jesus P, Cruz S, Cordeiro A, Pereira S, Saboya C, Ramalho A. Bone Metabolism in Adolescents and Adults Undergoing Roux-En-Y Gastric Bypass: a Comparative Study. Obes Surg 2020; 29:2144-2150. [PMID: 30820885 DOI: 10.1007/s11695-019-03797-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To compare the bone metabolism of adolescents and adults with obesity before undergoing a Roux-en-Y gastric bypass (RYGB) and 6 and 12 months after the surgery. MATERIALS AND METHODS Adolescents (G1) and adults (G2) with obesity assessed before (T0), six (T1), and 12 months after (T2) RYGB. Sun exposure, serum concentrations of 25(OH)D, calcium, phosphorous, magnesium, zinc, alkaline phosphatase, parathyroid hormone (PTH), and bone mineral density (BMD) were evaluated. RESULTS Sixty adolescents and 60 adults were assessed. At T0, there was no significant difference between the groups' serum 25(OH)D levels (G1 21.87 + 7.52 ng/mL, G2 21.73 + 7.60 ng/mL, p = 0.94) or sun exposure (G1 17 ± 2.0 min/day, G2 13.2 ± 5.2 min/day, p = 0.85). G1 had high levels of inadequacy of calcium (66.7%), phosphorous (80.0%), and zinc (18.3%) at T0 and had a significant fall in their 25(OH)D (p < 0.01) and magnesium (p < 0.01) levels from T1 to T2. G2 saw a significant lowering of their serum zinc levels from T0 to T1 and T2 (T1 p < 0.01; T2 p < 0.01). In both groups, there was a significant rise in PTH from T1 to T2 (G1 p = 0.04, G2 p = 0.02) and from T0 to T2 (G1 and G2 p < 0.01). In G2, 40.4% of individuals with osteopenia and osteoporosis presented inadequacy of 25(OH)D. CONCLUSION RYGB was found to worsen the inadequacy of micronutrients related to bone metabolism and was associated with secondary hyperparathyroidism and low BMD values, especially among the adolescents. The irreversible damaging effects of obesity on bone metabolism can occur in adolescence.
Collapse
Affiliation(s)
- Débora Santos
- Researcher of the Center for Research on Micronutrients (NPqM) of the Institute of Nutrition Josué de Castro of Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, 21.941-902, Brazil
| | - Tais Lopes
- Researcher of the Center for Research on Micronutrients (NPqM) of the Institute of Nutrition Josué de Castro of Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, 21.941-902, Brazil
| | - Patrícia Jesus
- Researcher of the Center for Research on Micronutrients (NPqM) of the Institute of Nutrition Josué de Castro of Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, 21.941-902, Brazil.,School of Medicine at Federal University of Rio de Janeiro (UFRJ), Carlos Chagas avenue, 373. Edifício do Centro de Ciências da Saúde, 2° floor, room 49. Cidade Universitária - Ilha do Fundão, Rio de Janeiro, 21.941-902, Brazil
| | - Sabrina Cruz
- Researcher of the Center for Research on Micronutrients (NPqM) of the Institute of Nutrition Josué de Castro of Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, 21.941-902, Brazil. .,School of Medicine at Federal University of Rio de Janeiro (UFRJ), Carlos Chagas avenue, 373. Edifício do Centro de Ciências da Saúde, 2° floor, room 49. Cidade Universitária - Ilha do Fundão, Rio de Janeiro, 21.941-902, Brazil.
| | - Adryana Cordeiro
- Researcher of the Center for Research on Micronutrients (NPqM) of the Institute of Nutrition Josué de Castro of Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, 21.941-902, Brazil.,School of Medicine at Federal University of Rio de Janeiro (UFRJ), Carlos Chagas avenue, 373. Edifício do Centro de Ciências da Saúde, 2° floor, room 49. Cidade Universitária - Ilha do Fundão, Rio de Janeiro, 21.941-902, Brazil
| | - Silvia Pereira
- Multidisciplinary Center for Bariatric and Metabolic Surgery, School of Medicine of Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.,Researcher of the NPqM at Federal University of Rio de Janeiro, (UFRJ), Rio de Janeiro, Brazil
| | - Carlos Saboya
- Multidisciplinary Center for Bariatric and Metabolic Surgery, School of Medicine of Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.,Researcher of the NPqM at Federal University of Rio de Janeiro, (UFRJ), Rio de Janeiro, Brazil.,Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Andréa Ramalho
- Researcher of the NPqM at Federal University of Rio de Janeiro, (UFRJ), Rio de Janeiro, Brazil.,Department of Social and Applied Nutrition of the Institute of Nutrition at UFRJ. Coordinator of the Center for Research on Micronutrients (NPqM) of the Institute of Nutrition Josué de Castro of UFRJ, Rio de Janeiro, Brazil
| |
Collapse
|
66
|
Association of seasonality and serum albumin concentration with vitamin D deficiency in subjects with chronic hepatitis C infection living in a sunny country. Public Health Nutr 2020; 23:1247-1253. [PMID: 32148208 DOI: 10.1017/s1368980019004178] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study aimed to analyse the relationship between vitamin D deficiency and the season when the blood sample was obtained from subjects with chronic hepatitis C (CHC) infection. DESIGN A cross-sectional study was conducted on a representative sample. Vitamin D deficiency was defined as a serum 25-hydroxyvitamin D [25(OH)D] concentration <50 nmol/l, based on the values set forth by the Endocrine Society guideline for higher-risk populations. Seasonality was defined according to solstices and equinoxes. The association of seasonality and clinical/laboratory characteristics with vitamin D deficiency was assessed using a multivariate logistic regression analysis. SETTING NUPAIG Viral Hepatitis Outpatient Clinic of the Universidade Federal de São Paulo - Brazil. PARTICIPANTS Adult subjects with CHC infection (n 306). RESULTS The prevalence of vitamin D deficiency was 16 %, whereas the median serum 25(OH)D concentration was 87 (interquartile range, 59; third quartile = 118) nmol/l. Serum concentration was consistently lower in samples collected in spring and winter than in other seasons. In multivariate analysis, vitamin D deficiency was found to be independently associated with male gender, serum albumin concentration and with samples drawn in winter and spring. CONCLUSIONS The findings show not only the relevance to consider season as a factor influencing 25(OH)D concentration but also the need to actively screen for hypovitaminosis D in all patients with CHC infection, especially in females and those with low albumin concentration.
Collapse
|
67
|
Non-pregnant Women Have a Lower Vitamin D than Pregnant Women After Gastric Bypass. Obes Surg 2020; 30:2558-2565. [DOI: 10.1007/s11695-020-04512-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
68
|
Confortin SC, Ono LM, Marques LP, Figueiró TH, Ceolin G, Barbosa AR, d’Orsi E. Sarcopenia, bone mineral density, and vitamin D: EpiFloripa aging study 2013/2014. GERIATRICS, GERONTOLOGY AND AGING 2020. [DOI: 10.5327/z2447-212320202000079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE: To verify associations between osteopenia/osteoporosis and vitamin D and sarcopenia in the older adult population of Florianopolis, Brazil. METHODS: A cross-sectional population-based study, with 604 older adults (60 years and over). The appendicular muscle mass index (AMMI) was used to identify sarcopenia, with cutoffs of AMMI (Kg/m2) < 7.26 kg/m2 for men and < 5.50 kg/m2 for women indicating inadequate values (sarcopenia). The independent variable osteopenia/osteoporosis was measured using bone mineral density (BMD, g/cm2): T-Scores for whole body BMD, lumbar spine BMD, and femoral neck BMD, categorized as normal (BMD ≥ -1 SD) or osteopenia/osteoporosis (BMD < -1 SD from the mean of the young adult reference population). Fasting serum samples were collected and assayed using the microparticle chemiluminescence (CMIA)/Liaison method. Vitamin D concentrations of < 30 ng/mL were defined as hypovitaminosis. Crude and adjusted logistic regression analyses were performed. RESULTS: Osteopenia/osteoporosis in the lumbar spine and femoral neck were associated with higher odds of sarcopenia in women and men. Osteopenia/osteoporosis in the whole body was associated with sarcopenia in women only. Vitamin D was not associated with sarcopenia in either sex. CONCLUSIONS: Having osteopenia/osteoporosis is associated with sarcopenia in the older adult population.
Collapse
|
69
|
Champs APS, Maia GAG, Oliveira FG, de Melo GCN, Soares MMS. Osteoporosis-related fractures after spinal cord injury: a retrospective study from Brazil. Spinal Cord 2019; 58:484-489. [DOI: 10.1038/s41393-019-0387-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 10/31/2019] [Accepted: 11/15/2019] [Indexed: 12/12/2022]
|
70
|
Fonseca Valle D, Giannini DT. Correlation between vitamin D and blood pressure in adolescents. Int J Adolesc Med Health 2019; 32:/j/ijamh.ahead-of-print/ijamh-2017-0165/ijamh-2017-0165.xml. [PMID: 31562802 DOI: 10.1515/ijamh-2017-0165] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 01/28/2018] [Indexed: 11/15/2022]
Abstract
Introduction Low serum levels of vitamin D have been associated with hypertension worldwide. Hypovitaminosis D has been observed even in countries with high incidence of sunlight all year round. Several studies demonstrated a high prevalence of deficiency/insufficiency of vitamin D in adolescents. Objective To investigate the association between the nutritional status of vitamin D with anthropometric measures and blood pressure in overweight adolescents. Methods This a descriptive and cross-sectional study with overweight adolescents of both sexes aged 12-19 years. The anthropometric data, biochemical profile, blood pressure and serum vitamin D dosage were analyzed. The chi-squared test for verification of association and Student's t-test to compare medians between variables were used. Results There were high frequencies of hypovitaminosis D (34%) and hypertension (43.3%) in overweight adolescents. We observed an inverse correlation between serum vitamin D levels and BP (r = -0.28, p = 0.005). Patients with desirable serum vitamin D had lower body mass index values (31.3 kg/m2 vs. 33.9 kg/m2; p < 0.02), waist circumference (95.2 cm vs. 101.1 cm; p < 0.03), waist-to-height ratio (0.58 vs. 0.61; p < 0.03) and systolic blood pressure (120 mm Hg vs. 127.6 mm Hg; p = 0.007). Conclusions High frequency of vitamin D deficiency is associated with increased BP and adiposity in overweight adolescents.
Collapse
Affiliation(s)
- Débora Fonseca Valle
- Universidade do Estado do Rio de Janeiro, Núcleo de Estudo da Saúde do Adolescente, Boulevard 28 de Setembro, 109 - Vila Isabe, Rio de Janeiro, Brazil
| | - Denise Tavares Giannini
- Universidade do Estado do Rio de Janeiro, Núcleo de Estudo da Saúde do Adolescente, Boulevard 28 de Setembro, 109 - Vila Isabel Rio de Janeiro, Brazil
| |
Collapse
|
71
|
Gandolfi NRS, Corrente JE, De Vitta A, Gollino L, Mazeto GMFDS. The influence of the Pilates method on quality of life and bone remodelling in older women: a controlled study. Qual Life Res 2019; 29:381-389. [PMID: 31512157 DOI: 10.1007/s11136-019-02293-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE The objective of this study was to evaluate the effects of the Pilates method on quality of life and bone remodeling markers in a group of older women. METHODS A longitudinal prospective study with intervention was performed on 40 women aged over 60 years; they were divided into two groups: one submitted to a 50-min Pilates exercise session once a week for 20 weeks (Pilates), and the other was not (Control). Both groups were compared for quality of life using the Medical Outcomes Study 36, and for bone-specific alkaline phosphatase (BSAP) and Type 1 collagen C-telopeptide (CTx) bone remodeling markers. RESULTS The Pilates group presented improvement in the quality of life evaluation scores: physical functioning (67.50 ± 18.88 × 86.25 ± 9.58; p = 0.0232), and physical component summary (65.00 ± 14.39 × 79.70 ± 3.83; p = 0.0220). The Pilates group also presented higher scores than that of Controls after the exercise program: physical functioning (86.25 ± 9.58 × 55.50 ± 20.83, p = 0.0003), physical role (100.00 ± 0.00 × 41.25 ± 46.79, p = 0.0009), emotional role (100.00 ± 0.00 × 48.33 ± 50.12, p = 0.0046), vitality (82.50 ± 14.28 × 60.25 ± 21.43, p = 0.011), physical component summary (79.70 ± 3.83 × 54.90 ± 15.05, p < 0.0001), and emotional component summary (74.10 ± 8.37 × 54.18 ± 22.55, p = 0.0111). No changes were noted in bone remodeling markers [CTx (0.39 ± 0.26 × 0.38 ± 0.22 ng/mL) and BSAP (10.73 ± 2.40 × 11.01 ± 3.56 μg/L)] and did not differ from the Control group both before (CTx: 0.39 ± 0.26 × 0.37 ± 0.17 ng/mL; BSAP: 10.73 ± 2.40 × 10.58 ± 3.49 μg/L; p > 0.05) and after exercise (CTx: 0.38 ± 0.22 × 0.38 ± 0.22 ng/mL; BSAP: 11.01 ± 3.56 × 9.85 ± 3.12 μg/L; p > 0.05). CONCLUSION The group of women submitted to Pilates presented improved quality of life but without changes in bone remodeling.
Collapse
Affiliation(s)
| | - Jose Eduardo Corrente
- Biostatistics Department, Institute of Biosciences, Sao Paulo State University - Unesp, Botucatu, Sao Paulo, 18618-687, Brazil
| | - Alberto De Vitta
- Universidade Anhanguera - UNIDERP, Campo Grande, Mato Grosso do Sul, 79037-280, Brazil
| | - Loraine Gollino
- Internal Medicine Department, Botucatu Medical School, Sao Paulo State University - Unesp, Botucatu, Sao Paulo, 18618-687, Brazil
| | | |
Collapse
|
72
|
Soares CSP, Tagliarini JV, Mazeto GMFS. Preoperative vitamin D level as a post-total thyroidectomy hypocalcemia predictor: a prospective study. Braz J Otorhinolaryngol 2019; 87:85-89. [PMID: 31492617 PMCID: PMC9422554 DOI: 10.1016/j.bjorl.2019.07.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 07/01/2019] [Accepted: 07/03/2019] [Indexed: 01/14/2023] Open
Abstract
Introduction Hypocalcemia is one of the most common complications after total thyroidectomy. Preoperative serum vitamin D concentration has been postulated as a risk factor for this complication. However, the subject is still controversial and the role of vitamin D in the occurrence of hypocalcemia remains uncertain. Objective To evaluate the capability of preoperative vitamin D concentrations in predicting post-total thyroidectomy hypocalcemia. Methods Forty-seven total thyroidectomy patients were prospectively evaluated for serum 25(OH) vitamin D, calcium and parathyroid hormone before surgery, Calcium every 6 hours, and parathyroid hormone 8 hours post-operatively. Patients were divided according to postoperative corrected calcium into groups without (corrected calcium ≥8.5 mg/dL) and with hypocalcemia (corrected calcium <8.5 mg/dL), who were then evaluated for preoperative 25(OH) vitamin D values. Results A total of 72.3% of cases presented altered 25(OH) vitamin D preoperative serum concentrations and 51% evolved with postoperative hypocalcemia. The with and without hypocalcemia groups did not differ for preoperative 25(OH) vitamin D (p = 0.62). Univariate analysis showed that age (p = 0.03), postoperative PTH concentration (p = 0.02), and anatomopathological diagnosis of malignancy (p = 0.002) were predictors of postoperative hypocalcemia. In multivariate analysis only parathyroid hormone in postoperative (p = 0.02) was associated with post-total thyroidectomy hypocalcemia. Conclusion Preoperative serum concentrations of 25(OH) vitamin D were not predictors for post-total thyroidectomy hypocalcemia, whereas postoperative parathyroid hormone influenced the occurrence of this complication.
Collapse
Affiliation(s)
- Carlos Segundo Paiva Soares
- Universidade Estadual Paulista (Unesp), Faculdade de Medicina de Botucatu, Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Botucatu, SP, Brazil
| | - José Vicente Tagliarini
- Universidade Estadual Paulista (Unesp), Faculdade de Medicina de Botucatu, Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Botucatu, SP, Brazil
| | - Gláucia M F S Mazeto
- Universidade Estadual Paulista (Unesp), Faculdade de Medicina de Botucatu, Departamento de Medicina Interna, Botucatu, SP, Brazil.
| |
Collapse
|
73
|
Coutinho RCS, dos Santos AF, da Costa JG, Vanderlei AD. Sun exposure, skin lesions and vitamin D production: evaluation in a population of fishermen. An Bras Dermatol 2019; 94:279-286. [PMID: 31365655 PMCID: PMC6668935 DOI: 10.1590/abd1806-4841.20197201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 01/07/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Exposure to UVR provides benefits related to vitamin D synthesis, but also causes harms, since UVB is considered a complete carcinogen. There is no definition of the level of sun exposure and the proportion of exposed body required for proper synthesis of vitamin D in the skin without causing it damage. OBJECTIVES This study aims to analyze the sun exposure index, vitamin D levels and clinical changes in the skin caused by constant sun exposure in the fishermen population. METHODS It is a cross-sectional, observational and analytical study. The sample consisted of fishermen and was calculated in 174 individuals. The questionnaire was applied, the dermatological examination was carried out and the examinations of calcidiol, parathyroid hormone, calcium and phosphorus were requested. Data were expressed as percentages. The comparative analysis was done through the Chi-square test, and the correlations were established through the Pearson's linear coefficient. Results: We observed that there was vitamin D deficiency in a small part of the cases (11.46%), and the frequency of diagnosis of skin cancer was 2.7% of the cases surveyed. STUDY LIMITATIONS The difficulty in categorizing the sun exposure index. CONCLUSION The fact that fishermen expose themselves to the sun chronically and have been exposed to the sun for more than 15 years, between 21 and 28 hours a week, and without photoprotection, were indicative factors for protection against vitamin D deficiency. Chronic exposure to sun and high vitamin levels D may be indicative of protection of this population against skin cancer.
Collapse
Affiliation(s)
- Roberta Cavalcanti Soriano Coutinho
- Discipline of Dermatology, Centro Universitário CESMAC,
Maceió (AL), Brazil
- Program of Post-Graduation, Professional Master’s Degree in Health
Research, Centro Universitário CESMAC, Maceió (AL), Brazil
| | - Aldenir Feitosa dos Santos
- Program of Post-Graduation, Professional Master’s Degree in Health
Research, Centro Universitário CESMAC, Maceió (AL), Brazil
- Program of Post-Graduation, Professional Master’s Degree in
Analysis of Environmental Systems, Centro Universitário CESMAC, Maceió
(AL), Brazil
- Discipline de Biochemistry, Universidade Estadual de Alagoas,
Arapiraca (AL), Brazil
| | - João Gomes da Costa
- Program of Post-Graduation, Professional Master’s Degree in
Analysis of Environmental Systems, Centro Universitário CESMAC, Maceió
(AL), Brazil
- Program of Post-Graduation in Agriculture and Environment,
Universidade Federal de Alagoas, Maceió (AL), Brazil
| | - Aleska Dias Vanderlei
- Program of Post-Graduation, Professional Master’s Degree in Health
Research, Centro Universitário CESMAC, Maceió (AL), Brazil
- Discipline of Dentistry, Centro Universitário CESMAC,
Maceió (AL), Brazil
| |
Collapse
|
74
|
de Carvalho GB, Giraldo LR, Lira RB, Macambira IBM, Tapia MA, Kohler HF, Novoa JA, Kowalski LP. Preoperative vitamin D deficiency is a risk factor for postoperative hypocalcemia in patients undergoing total thyroidectomy: retrospective cohort study. SAO PAULO MED J 2019; 137:241-247. [PMID: 31340251 PMCID: PMC9744000 DOI: 10.1590/1516-3180.2018.0336140319] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 03/14/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The relationship between preoperative vitamin D deficiency and postoperative hypocalcemia in cases of total thyroidectomy (TT) is a matter of controversy and may vary according to geographical scenarios and populations. OBJECTIVE The objective here was to evaluate whether preoperative vitamin D deficiency was associated with postoperative symptomatic hypocalcemia in a population in South America. DESIGN AND SETTING Retrospective cohort study on data from all patients undergoing total thyroidectomy, with or without central compartment lymph node dissection, from January 2014 to December 2017, at the A. C. Camargo Cancer Center. METHODS Patients with benign thyroid disease (Graves' disease, multinodular goiter or hyperthyroidism) or thyroid cancer who underwent primary total thyroidectomy with or without central compartment lymph node dissection were included. The exclusion criteria were simultaneous parathyroidectomy and conditions that could affect serum calcium levels. The data collected included patient demographics, thyroid pathology, extent of the surgical procedure and complications. Information on preoperative and postoperative calcium, parathyroid hormone (PTH) and vitamin D levels were retrieved from the medical records. RESULTS 1,347 patients were assessed and postoperative hypocalcemia was diagnosed in 284 patients (21%). The vitamin D levels were considered deficient in 243 patients (18%). Postoperative hypocalcemia was diagnosed in 357 patients (31.5%). Multivariate analysis showed that central compartment dissection and preoperative total calcium and deficient vitamin D levels were significant risk factors for postoperative hypocalcemia. CONCLUSION Deficient preoperative vitamin D levels were a significant risk factor for postoperative hypocalcemia. Preoperative oral supplementation should be considered, to minimize this risk.
Collapse
Affiliation(s)
- Genival Barbosa de Carvalho
- MD, MSc. Attending Physician of Head and Neck Surgery, Department of Otorhinolaryngology, A.C. Camargo Cancer Center, and Head and Neck Surgery Sector, Department of Otorhinolaryngology, A.C. Camargo Cancer Center, São Paulo (SP), Brazil.
| | - Lina Restrepo Giraldo
- MD. Master’s Student of Head and Neck Surgery, Department of Otorhinolaryngology, A.C. Camargo Cancer Center, São Paulo (SP), Brazil.
| | - Renan Bezerra Lira
- MD, PhD. Attending Physician of Head and Neck Surgery, Department of Otorhinolaryngology, A.C. Camargo Cancer Center, São Palo (SP), Brazil.
| | - Isabela Bergh Martins Macambira
- MD. Resident of Head and Neck Surgery, Department of Otorhinolaryngology, A.C. Camargo Cancer Center, São Paulo (SP), Brazil.
| | - Marcel Adalid Tapia
- MD. Resident of Head and Neck Surgery, Department of Otorhinolaryngology, A.C. Camargo Cancer Center, São Paulo (SP), Brazil.
| | - Hugo Fontan Kohler
- MD. Attending Physician of Head and Neck Surgery, Department of Otorhinolaryngology, A.C. Camargo Cancer Center, São Paulo (SP), Brazil.
| | - Joel Arévalo Novoa
- MD. Resident of Head and Neck Surgery, Department of Otorhinolaryngology, A.C. Camargo Cancer Center, São Paulo (SP), Brazil.
| | - Luiz Paulo Kowalski
- MD, PhD. Director of Head and Neck Surgery, Department of Otorhinolaryngology, A.C. Camargo Cancer Center, São Paulo (SP), Brazil.
| |
Collapse
|
75
|
Neves CDM, Nascimento MMGD, Silva DÁM, Ramalho-de-Oliveira D. Clinical Results of Comprehensive Medication Management Services in Primary Care in Belo Horizonte. PHARMACY 2019; 7:pharmacy7020058. [PMID: 31212741 PMCID: PMC6631671 DOI: 10.3390/pharmacy7020058] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 05/28/2019] [Accepted: 06/06/2019] [Indexed: 12/21/2022] Open
Abstract
The high prevalence of chronic diseases and use of multiple medications identified in Primary Health Care (PHC) suggest the need for the implementation of Comprehensive Medication Management (CMM) services. This study aimed to evaluate the clinical results of CMM services in a Brazilian PHC setting. A quasi-experimental study was performed with patients followed-up for two years (n = 90). Factors associated with the detection of four drug therapy problems (DTP) or more in the initial assessment were evaluated (univariate and multivariate analyses), as well as the clinical impact observed in laboratory parameters (HbA1c, Blood Pressure, LDL- and HDL-covariance analysis). A predominance of women (61.1%), a mean age of 65.5 years, and a prevalence of polypharmacy (87.8%)—use of five or more drugs—were observed. A total of 441 DTP was identified, 252 required interventions with the prescriber, 67.9% of which were accepted and 59.6% were solved. The main DTP were ‘non-adherence’ (28.1%), ‘need for additional drug therapy’ (21.8%), and ‘low dose’ (19.5%). Hypertension was positively associated with the identification of four DTP or more. A statistically significant reduction was detected in all assessed laboratory parameters (p < 0.05). CMM services contributed to the resolution of DTP and improved clinical outcomes.
Collapse
Affiliation(s)
- Carina de Morais Neves
- Center for Pharmaceutical Care Studies, College of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte, MG 31270-901, Brazil.
| | | | - Daniela Álvares Machado Silva
- Center for Pharmaceutical Care Studies, College of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte, MG 31270-901, Brazil.
| | - Djenane Ramalho-de-Oliveira
- Center for Pharmaceutical Care Studies, College of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte, MG 31270-901, Brazil.
| |
Collapse
|
76
|
Valladares T, Simões R, Bernardo W, Schmitt ACB, Cardoso MRA, Aldrighi JM. Prevalence of hypovitaminosis D in postmenopausal women: a systematic review. ACTA ACUST UNITED AC 2019; 65:691-698. [PMID: 31166447 DOI: 10.1590/1806-9282.65.5.691] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 10/29/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Hypovitaminosis D is considered a global public health issue. Knowledge of its true dimensions will allow us to design interventions and plan preventive measures that can have a significant impact on human health. OBJECTIVES The aim of this study was to evaluate the prevalence of hypovitaminosis D, defined as a serum 25-hydroxyvitamin D concentration < 30 ng/ml, in postmenopausal women around the world, as well as to identify the potential associated factors. METHODS A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses recommendations. Specific search terms were consulted in Medline, Excerpta Medica, and Latin-American and Caribbean Health Sciences Literature databases, with no restriction for the year or language of publication. RESULTS Of 451 studies initially identified, 32 were selected for analysis. Collectively, those 32 studies evaluated 21,236 postmenopausal women, of whom 16,440 (77.4%) had serum 25-hydroxyvitamin D concentrations < 30 ng/ml. The reported prevalence of hypovitaminosis D ranged from 29% (in the United States) to 99.4% (in China). In six of the studies, the prevalence was above 90%. CONCLUSIONS If the criterion is the 30 ng/ml cut-off point, the majority of postmenopausal women in the world could be classified as having hypovitaminosis D. Among the studies evaluated, the lowest prevalence reported was nearly 30%. Neither latitude, region of the world, nor laboratory methodology were found to be associated with the prevalence of hypovitaminosis D.
Collapse
Affiliation(s)
- Tania Valladares
- Women's Health Clinic, Barra Funda College Health Care Center, Santa Casa Sisters of Mercy Hospital of São Paulo, São Paulo, Brasil.,University of São Paulo School of Public Health, São Paulo, Brasil
| | - Ricardo Simões
- Department of Obstetrics and Gynecology, University of São Paulo School of Medicine Hospital das Clínicas, São Paulo, Brasil
| | - Wanderley Bernardo
- Department of General Surgery, University of São Paulo School of Medicine, São Paulo, Brasil
| | | | - Maria Regina A Cardoso
- Department of Epidemiology, University of São Paulo School of Medicine, São Paulo, Brasil
| | - José Mendes Aldrighi
- University of São Paulo School of Public Health, São Paulo, Brasil.,Department of Obstetrics and Gynecology, Santa Casa of São Paulo School of Medical Sciences, São Paulo, Brasil
| |
Collapse
|
77
|
Vivan MA, Kops NL, Fülber ER, de Souza AC, Fleuri MASB, Friedman R. Prevalence of Vitamin D Depletion, and Associated Factors, among Patients Undergoing Bariatric Surgery in Southern Brazil. Obes Surg 2019; 29:3179-3187. [DOI: 10.1007/s11695-019-03963-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
|
78
|
Branco JMCR, Smoraog DC, Bentes CM, Netto CC, Marinheiro LPF. Association between vitamin D status and glycemic profile in postmenopausal women with type 2 diabetes. Diabetes Metab Syndr 2019; 13:1685-1688. [PMID: 31235079 DOI: 10.1016/j.dsx.2019.03.040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 03/21/2019] [Indexed: 01/04/2023]
Abstract
The aim of this study is to evaluate the association between vitamin D status and glycemic profile in postmenopausal women with type 2 diabetes. A cross-sectional study was carried out with 70 (59.47 ± 6.47 years; 1.56 ± 0.05 m; 73.56 ± 13.01 kg; 30.30 ± 5.00 BMI kg/m2) postmenopausal women with type 2 diabetes (T2D). The blood samples were collected after fasting for 12 h and the main outcome parameters were serum follicle-stimulating hormone (FSH), estradiol; 25-OH vitamin D; insulin; C-Reactive Protein; cholesterol total (CT), triglycerides (TG), high density lipoprotein (HDL-cholesterol), glucose; calcium, HDL-cholesterol. The average serum 25(OH)D level in this study was 28.45 ± 8.26 ng/mL. The prevalence of hypovitaminosis D was 60%. Table 1 displays mean and standard deviation values for participants' characteristics. The postmenopause status of the women studied was confirmed by FSH and estradiol measurement. All the clinical and anthropometric characteristics did not show difference (p > 0.05) between the groups (Table 2). Triglycerides level was highest (p < 0.0391) in the hypovitaminosis D group. The other serum markers did not show statistical differences (p > 0.05) between the groups. In conclusion, our results suggest that only TG level shows a negative correlation with vitamin D status in postmenopausal women with type 2 diabetes.
Collapse
Affiliation(s)
- Jéssica M C R Branco
- Department of Biochemistry, Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, RJ, Brazil
| | - Dyego C Smoraog
- Department of Biochemistry, Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, RJ, Brazil
| | - Claudio Melibeu Bentes
- Oswaldo Cruz Foundation, Fernandes Figueira Institute, Gynecologic and Obstetrics Department, Rio de Janeiro, RJ, Brazil; Academic Coordination of Health at UNISUAM (Centro Universitário Augusto Motta), Rio de Janeiro, RJ, Brazil.
| | - Claudia C Netto
- Department of Biochemistry, Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, RJ, Brazil
| | - Lizanka P F Marinheiro
- Oswaldo Cruz Foundation, Fernandes Figueira Institute, Gynecologic and Obstetrics Department, Rio de Janeiro, RJ, Brazil
| |
Collapse
|
79
|
Simas LAW, Zanatta LCB, Moreira CA, Borba VZC, Boguszewski CL. Body composition and nutritional and metabolic parameters in postmenopausal women sufficient, insufficient and deficient in vitamin D. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2019; 63:265-271. [PMID: 31038588 PMCID: PMC10522206 DOI: 10.20945/2359-3997000000121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 02/09/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVE We investigated changes in body composition and nutritional and metabolic parameters in a group of postmenopausal women who were classified as sufficient, insufficient and deficient in vitamin D. SUBJECTS AND METHODS A total of 106 postmenopausal women were included in this cross-sectional study and classified according to their serum levels of 25-OH-vitamin D as sufficient (≥ 30 ng/mL; group S), insufficient (20.1 and 29.9 ng/mL; group I) or deficient (≤ 20 ng/mL; group D) in vitamin D. Body composition was measured by dual-energy X-ray absorptiometry (DXA); dietary recall questionnaires were completed; and blood samples were analysed to compare the metabolic and nutritional status of the study groups. RESULTS Eleven (10.4%) of the women were classified in group S, 50 (47.2%) in group I and 45 (42.4%) in group D, with a mean serum level for 25-OH-D of 21.1 ± 7.0 ng/mL in all participants. Body composition did not differ among the groups. Serum levels of 25-OH-D were negatively correlated with serum levels of triglycerides, total cholesterol and LDL cholesterol. CONCLUSIONS Vitamin D insufficiency and deficiency were highly prevalent in our group of postmenopausal women, showing an association with an unfavourable lipid profile.
Collapse
Affiliation(s)
- Luisa Amábile Wolpe Simas
- Universidade Federal do ParanáServiço de Endocrinologia e MetabologiaDepartamento de Medicina InternaUniversidade Federal do ParanáCuritibaPRBrasil Serviço de Endocrinologia e Metabologia (SEMPR), Departamento de Medicina Interna , Universidade Federal do Paraná , Curitiba , PR , Brasil
| | - Leila Caroline Bianchet Zanatta
- Universidade Federal do ParanáServiço de Endocrinologia e MetabologiaDepartamento de Medicina InternaUniversidade Federal do ParanáCuritibaPRBrasil Serviço de Endocrinologia e Metabologia (SEMPR), Departamento de Medicina Interna , Universidade Federal do Paraná , Curitiba , PR , Brasil
| | - Carolina Aguiar Moreira
- Universidade Federal do ParanáServiço de Endocrinologia e MetabologiaDepartamento de Medicina InternaUniversidade Federal do ParanáCuritibaPRBrasil Serviço de Endocrinologia e Metabologia (SEMPR), Departamento de Medicina Interna , Universidade Federal do Paraná , Curitiba , PR , Brasil
| | - Victoria Zeghbi Cochenski Borba
- Universidade Federal do ParanáServiço de Endocrinologia e MetabologiaDepartamento de Medicina InternaUniversidade Federal do ParanáCuritibaPRBrasil Serviço de Endocrinologia e Metabologia (SEMPR), Departamento de Medicina Interna , Universidade Federal do Paraná , Curitiba , PR , Brasil
| | - Cesar Luiz Boguszewski
- Universidade Federal do ParanáServiço de Endocrinologia e MetabologiaDepartamento de Medicina InternaUniversidade Federal do ParanáCuritibaPRBrasil Serviço de Endocrinologia e Metabologia (SEMPR), Departamento de Medicina Interna , Universidade Federal do Paraná , Curitiba , PR , Brasil
| |
Collapse
|
80
|
Fajardo VC, de Oliveira FLP, Machado-Coelho GLL, Pimenta FAP, de Freitas SN, Ribeiro ALP, Soares MMS, Lauria MW, Farias RDC, França IB, do Nascimento Neto RM. Effects of vitamin D supplementation on cardiovascular risk factors in shift workers: Study protocol for randomized, double-blind, placebo-controlled clinical trial. Medicine (Baltimore) 2019; 98:e15417. [PMID: 31045798 PMCID: PMC6504534 DOI: 10.1097/md.0000000000015417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE The present clinical study aims to describe protocol to evaluate the effects of vitamin D3 supplementation on the cardiovascular risk factors in a population of rotating shift workers. DESIGN A randomized, double-blind, placebo-controlled, parallel group clinical trial testing 2 oral dosages of cholecalciferol (14,000 IU and 28,000 IU per week) for 12 months. SETTING The primary outcome for evaluation is an 18% reduction in hypertriglyceridemia (≥150 mg/dL) between pre and postintervention measurements. Baseline characteristics of the study population will be summarized separately within each randomized group, and will use tests for continuous and categorical variables. For all tests, a P < .05 will be considered significant. The analysis of primary and secondary outcomes will use an intention-to-treat population and a per-protocol population. The primary and secondary outcomes will be compared separately between each treatment group and placebo, using binary logistic regression or regressão de Poisson for proportions (for binary outcomes) and using linear regression for differences in means (for continuous endpoints), with 95% confidence intervals. PARTICIPANTS Rotating shift workers, adults aged between 18 and 60 years, with hypovitaminosis D and alterations in at least 1 of the following parameters: fasting glucose, high-density lipoprotein cholesterol, triglycerides, low-density lipoprotein cholesterol, blood pressure, and waist circumference. CONCLUSION This clinical trial aims to contribute to the gap in knowledge about the potential, dose, and time of vitamin D supplementation to generate beneficial effects on triglycerides in a population at increased risk for hypertriglyceridemia and vitamin D deficiency.
Collapse
Affiliation(s)
- Virginia Capistrano Fajardo
- Applied Science to Adult Health Postgraduate Program, School of Medicine, Federal University of Minas Gerais, Belo Horizonte
| | | | | | | | | | | | | | - Marcio Weissheimer Lauria
- Department of Clinical Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte
| | - Rosielle da Costa Farias
- Applied Statistics and Biometrics Postgraduate Program, Department of Statistics, Federal University of Viçosa, Viçosa, MG
| | - Ive Bahia França
- School of Medicine, University Center of Espirito Santo. Colatina, ES, Brazil
| | | |
Collapse
|
81
|
da Rosa MI, Beck WO, Colonetti T, Budni J, Falchetti ACB, Colonetti L, Coral AS, Meller FO. Association of vitamin D and vitamin B 12 with cognitive impairment in elderly aged 80 years or older: a cross-sectional study. J Hum Nutr Diet 2019; 32:518-524. [PMID: 30821057 DOI: 10.1111/jhn.12636] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND The present study aimed to assess the association of vitamin D and vitamin B12 with cognitive impairment in elderly people. METHODS The data were obtained from a cross-sectional study that included individuals aged 80 years or older living in the urban and rural areas of the cities of Siderópolis and Treviso in the state of Santa Catarina, Brazil. In total, 165 elderly people were included in the analysis. The outcome of cognitive decline was assessed by the Mini-Mental State Examination. Vitamin D and vitamin B12 levels were measured from blood samples. The socio-demographic, anthropometric and health variables used in the analysis were collected from a questionnaire. Crude and adjusted analyses of the relationship between vitamins D and B12 and cognitive decline were performed using a Poisson regression model. RESULTS The prevalence of cognitive decline was 35.2%. In the adjusted model, individuals who had vitamin D levels >19 ng mL-1 showed a lower prevalence of cognitive decline (prevalence ratio = 0.59; 95% confidence interval = 0.39-0.87). Those participants who had vitamin B12 levels of ≥496 pg mL-1 had a higher prevalence of cognitive decline (prevalence ratio = 1.90; 95% confidence interval = 1.08-3.36). CONCLUSIONS The present study showed that individuals aged ≥80 years who had vitamin D levels of ≤18 ng mL-1 had a higher prevalence of cognitive decline even after adjustment for potential confounders. In addition, the study demonstrated that vitamin B12 levels of ≥496 pg mL-1 in this population were also a risk factor for cognitive decline. A cross-sectional analysis does not enable the inference of a cause-effect relationship and additional studies are needed to understand these relationships.
Collapse
Affiliation(s)
- M I da Rosa
- Laboratory of Translational Biomedicine, Graduate Program in Health Sciences, University of Extreme South Catarinense, Criciuma, Brazil.,Graduate Program in Public Health, University of Extreme South Catarinense, Criciuma, Brazil
| | - W O Beck
- Graduate Program in Public Health, University of Extreme South Catarinense, Criciuma, Brazil
| | - T Colonetti
- Laboratory of Translational Biomedicine, Graduate Program in Health Sciences, University of Extreme South Catarinense, Criciuma, Brazil
| | - J Budni
- Laboratory of Experimental Neurology, Graduate Program in Health Sciences, University of Extreme South Catarinense, Criciuma, Brazil
| | - A C B Falchetti
- Laboratory of Experimental Neurology, Graduate Program in Health Sciences, University of Extreme South Catarinense, Criciuma, Brazil
| | - L Colonetti
- Laboratory of Translational Biomedicine, Graduate Program in Health Sciences, University of Extreme South Catarinense, Criciuma, Brazil
| | - A S Coral
- Laboratory of Translational Biomedicine, Graduate Program in Health Sciences, University of Extreme South Catarinense, Criciuma, Brazil
| | - F O Meller
- Graduate Program in Public Health, University of Extreme South Catarinense, Criciuma, Brazil
| |
Collapse
|
82
|
Souza JRDJLD, Silva TSDA, Figueredo ED. Hypovitaminosis D in pregnancy: Is it a public health issue? REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2019. [DOI: 10.1590/1806-93042019000100011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Abstract Objectives: to measure the prevalence of hypovitaminosis D in healthy pregnant women and to analyze the association among some variables and the levels of vitamin D. Methods: an analytical cross-sectional study. 174 healthy pregnant women were selected from four basic health units in São Luís, Brazil, from January to February 2017. The participants answered a questionnaire about sociodemographic and obstetric data. A blood sample was collected to evaluate the plasmatic level of vitamin D. The association between independent variables and the outcome was evaluated by using the Student’s t-test and Chisquare test. Results: the mean of vitamin D concentration was 24.9±6.6ng/ml. Forty women (23.0%) presented vitamin D sufficiency, 93 (53.4%) insufficient, and 41 (23.6%) with deficiency. There was a difference in the vitamin D concentration between evangelical (23.1 ng/ml) and non-evangelical (25.5 ng/ml) (p=0.02) and between primigravida (23.8 ng/ml) and non-primigravida (25.7 ng/ml) (p=0.03). There was a difference in the hypovitaminosis D between adolescents (89.7%) and non-adolescents (72.6%) (p=0.02) and between primigravida (85.0%) and non-primigravida (69.2%) (p=0.01). Low monthly income per capita was associated with a higher frequency of vitamin D sufficiency. Conclusions: Due to the impact of inadequate levels of vitamin D in pregnant women and their babies’ health, even in an equatorial city, hypovitaminosis D in pregnant women is an important public health issue.
Collapse
|
83
|
Zamboni C, Carvalho MS, Pires EA, Durigan JR, Fucs PMDMB, Mercadante MT. ARE TRAUMATOLOGISTS TREATING OSTEOPOROSIS TO PREVENT NEW FRACTURES IN BRAZIL? ACTA ORTOPEDICA BRASILEIRA 2019; 26:384-387. [PMID: 30774511 PMCID: PMC6362685 DOI: 10.1590/1413-785220182606202125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objectives: To determine the proportion of traumatologists who investigate osteoporosis in elderly patients with fractures and recommend secondary prevention of osteoporotic fractures. Methods: We distributed questionnaires to 244 physicians attending the 2015 Brazilian Congress of Orthopedic Trauma. We determined the respondents’ profiles and assessed how they investigated and treated osteoporosis in elderly patients with fractures. Results: Overall, 32% of the respondents reported that their knowledge level regarding osteoporosis ranged from 0-5 (out of 0-10). In total, 42% of the participants reported that they usually requested DXA for elderly patients with fractures and less than 30% reported prescribing supplemental calcium and/or vitamin D. We considered physicians conducting a complete treatment for the patient as those who in addition to requesting DXA prescribed supplemental calcium, vitamin D, and specific medications for their elderly patients, and recommended non-pharmacological measures. Only 0.8% of the participants fulfilled all these criteria. In addition, 47% of the traumatologists reported that they did not treat osteoporosis directly but instead, referred osteoporotic patients to a qualified physician. Conclusion: Less than 50% of the surveyed traumatologists investigated and performed secondary prevention against osteoporotic fractures after treating an elderly patient with a fracture. Level of evidence III, Economic and Decision Analyses - Developing an Economic or Decisions Model.
Collapse
Affiliation(s)
- Caio Zamboni
- Department of Orthopedics and Traumatology, Santa Casa de Sao Paulo, SP, Brazil
| | | | | | | | | | | |
Collapse
|
84
|
Peçanha MB, Freitas RDB, Moreira TR, Silva LS, Oliveira LLD, Cardoso SA. Prevalence of vitamin D deficiency and its relationship with factors associated with recurrent wheezing. ACTA ACUST UNITED AC 2019; 45:e20170431. [PMID: 30758429 PMCID: PMC6534403 DOI: 10.1590/1806-3713/e20170431] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 03/26/2018] [Indexed: 01/16/2023]
Abstract
Objective: To determine the prevalence of vitamin D deficiency/insufficiency in children 0-18 years of age with recurrent wheezing and/or asthma residing in the microregion of Viçosa, Minas Gerais, Brazil, and treated at a referral center, and to determine its association with major risk factors for wheezing. Methods: A cross-sectional study was performed using a semi-structured questionnaire, which was administered by trained interviewers to the legal guardians of the study participants. Data were obtained regarding general characteristics of recurrent wheezing; general sociodemographic, environmental, and biologic factors; and atopy-related factors. The magnitude of the statistical association was assessed by calculating ORs and their corresponding 95% CIs by using multiple logistic regression. Results: We included 124 children in the study. The prevalence of vitamin D deficiency/insufficiency in the sample was 57.3%. Vitamin D deficiency/insufficiency was found to be associated with wheezing in the first year of life, personal history of atopic dermatitis, environmental pollution, and vitamin D supplementation until 2 years of age. Conclusions: The prevalence of vitamin D deficiency/insufficiency was high in our sample. Vitamin D concentrations were directly associated with vitamin D supplementation until 2 years of age and were inversely associated with wheezing events in the first year of life, personal history of atopic dermatitis, and environmental pollution.
Collapse
Affiliation(s)
- Mirna Brito Peçanha
- . Departamento de Medicina e Enfermagem, Universidade Federal de Viçosa, Viçosa (MG) Brasil.,. Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Viçosa, Viçosa (MG) Brasil
| | | | - Tiago Ricardo Moreira
- . Departamento de Medicina e Enfermagem, Universidade Federal de Viçosa, Viçosa (MG) Brasil
| | - Luiz Sérgio Silva
- . Departamento de Medicina e Enfermagem, Universidade Federal de Viçosa, Viçosa (MG) Brasil.,. Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Viçosa, Viçosa (MG) Brasil
| | - Leandro Licursi de Oliveira
- . Departamento de Biologia Geral, Universidade Federal de Viçosa, Viçosa (MG) Brasil.,. Programa de Pós-Graduação em Biologia Celular e Estrutural, Universidade Federal de Viçosa, Viçosa (MG) Brasil
| | - Silvia Almeida Cardoso
- . Departamento de Medicina e Enfermagem, Universidade Federal de Viçosa, Viçosa (MG) Brasil.,. Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Viçosa, Viçosa (MG) Brasil
| |
Collapse
|
85
|
Pereira LA, Luz FB, Carneiro CMMDO, Xavier ALR, Kanaan S, Miot HA. Evaluation of vitamin D plasma levels after mild exposure to the sun with photoprotection. An Bras Dermatol 2019; 94:56-61. [PMID: 30726465 PMCID: PMC6360984 DOI: 10.1590/abd1806-4841.20198070] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 04/28/2018] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Most of the organism's vitamin D (VD) is obtained through the cutaneous synthesis after exposure to the sun's UVB radiation. Sunscreens are indicated for the prevention of actinic damage to the skin, however, there are few clinical trials assessing the synthesis of cutaneous VD in real-life situations of sun exposure with ordinary clothing and usual photoprotection. OBJECTIVES To evaluate the synthesis of VD with suberythemal sun exposure in healthy adults using topical photoprotection (SPF 30). METHODS Quasi-experimental study, conducted at Rio de Janeiro (Brazil), during winter, with 95 healthy adults who had 25-OH-VD checked twice, 24 hours apart, and were exposed to the sun (UVB=20 mJ/cm2), according to a randomized grouping: SC - use of SPF 30 on the face, neck and chest (n=64), NO - no sunscreens (n=10), CO - confined from sun exposure for 24h (n=21). The groups were matched according to the propensity score related to gender, age, phototype, body mass index, glycosylated hemoglobin and baseline levels of VD. The outcome evaluated was the variation (ΔVD) in serum level of 25-OH-VD (ng/ml) between the groups. RESULTS A statistically significant difference was identified between CO and SC groups [median (p25-p75)]: ΔVD =1.4 (-0.3-3.6) vs. 5.5 (4.8-6.6); p<0.01. There was no difference between SC and NO groups: 5.4 (3.1-6.1) vs. 4.1 (2.5-6.0); p=0.17. STUDY LIMITATIONS Laboratory analysis technique (chemiluminescence) with great variability, loss of food intake standardatization, unbalanced groups. CONCLUSIONS Suberythemal sun exposure with sunscreen (SPF 30) provides similar vitamin D serum variation than without photoprotection in healthy adults.
Collapse
Affiliation(s)
- Luiza Alonso Pereira
- Department of Dermatology, Universidade Federal Fluminense,
Niterói (RJ), Brasil
| | - Flávio Barbosa Luz
- Discipline of Dermatology, Department of Dermatology, Universidade
Federal Fluminense, Niterói (RJ), Brasil
| | | | - Ana Lucia Rampazzo Xavier
- Discipline of Pathology, Department of Pathology-Clinical
Biochemistry, Universidade Federal Fluminenese, Niterói (RJ), Brasil
| | - Salim Kanaan
- Discipline of Pathology, Department of Pathology-Clinical
Biochemistry, Universidade Federal Fluminenese, Niterói (RJ), Brasil
| | - Hélio Amante Miot
- Discipline of Dermatology, Department of Dermatology and
Radiotherapy, Universidade Estadual Paulista, Botucatu (SP), Brasil
| |
Collapse
|
86
|
Longitudinal association of 25-hydroxyvitamin D with adipokines and markers of glucose metabolism among Brazilian pregnant women. Br J Nutr 2018; 121:42-54. [DOI: 10.1017/s0007114518003057] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
AbstractThis study aimed to evaluate the longitudinal association of vitamin D status with glycaemia, insulin, homoeostatic model assessment of insulin resistance, adiponectin and leptin. A prospective cohort with 181 healthy, pregnant Brazilian women was followed at the 5th–13th, 20th–26th and 30th–36th gestational weeks. In this cohort, 25-hydroxyvitamin D (25(OH)D) plasma concentrations were analysed using liquid chromatography–tandem MS. Vitamin D status was categorised as sufficient or insufficient using the Endocrine Society Practice Guidelines (≥75/<75 nmol/l) and the Institute of Medicine (≥50/<50 nmol/l) thresholds. Linear mixed-effect regression models were employed to evaluate the association between vitamin D status and each outcome, considering interaction terms between vitamin D status and gestational age (P<0·1). At baseline, 70·7 % of pregnant women had 25(OH)D levels <75 nmol/l and 16 % had levels <50 nmol/l. Women with sufficient vitamin D status at baseline, using both thresholds, presented lower glycaemia than those with insufficient 25(OH)D. Pregnant women with 25(OH)D concentrations <75 nmol/l showed lower insulin (β=−0·12; 95 % CI −0·251, 0·009;P=0·069) and adiponectin (β=−0·070; 95 % CI −0·150, 0·010;P=0·085) concentrations throughout pregnancy than those with 25(OH)D levels ≥75 nmol/l. Pregnant women with 25(OH)D <50 nmol/l at baseline presented significantly higher leptin concentrations than those with 25(OH)D levels ≥50 nmol/l (β=−0·253; 95 % CI −0·044, 0·550;P=0·095). The baseline status of vitamin D influences the biomarkers involved in glucose metabolism. Vitamin D-sufficient women at baseline had higher increases in insulin and adiponectin changes throughout gestation than those who were insufficient.
Collapse
|
87
|
Sale JEM, Gray M, Mancuso D, Inrig T, Boire G, Beaulieu MC, Funnell L, Bogoch E. Treatment recommendations based on fracture risk status are not consistently provided in osteoporosis guidelines. Rheumatol Int 2018; 38:2193-2208. [PMID: 30367203 DOI: 10.1007/s00296-018-4181-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 10/19/2018] [Indexed: 11/25/2022]
Abstract
We examined international osteoporosis guidelines to determine the tools used to assess fracture risk, the classification of fracture risk presented, and the recommendations based on fracture risk status. We conducted a document analysis of guidelines from the International Osteoporosis Foundation (IOF) website retrieved as of May 10, 2018, focusing on guidelines written in English only. Two reviewers independently reviewed each document and the following data were extracted: (1) fracture risk tool(s) endorsed; (2) classification system used to describe fracture risk status (e.g., low, moderate, high); and (3) recommendations based on risk status (e.g., pharmacological treatment). Two additional reviewers verified all data extraction. A total of 112 guidelines were listed on the IOF website, of which 94 were located either through the provided link or through a PubMed search. Of 70 guidelines written in English, 63 guidelines discussed the concept of fracture risk of which, 39 endorsed FRAX. Twenty-eight guidelines defined fracture risk categories or thresholds which determined recommendations. In total, 26 provided a risk category or threshold which constituted an indication for pharmacotherapy. Twelve guidelines reported a moderate, medium, or intermediate risk category which was associated with variable recommendations for testing and treatment. Despite the generally accepted international shift to fracture risk as a basis for treatment decisions, the majority of guidelines in English did not provide treatment recommendations based on fracture risk status. In guidelines with recommendations based on fracture risk status, thresholds and recommendations varied making international comparisons of treatment difficult.
Collapse
Affiliation(s)
- Joanna E M Sale
- Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada.
- Institute of Health Policy, Management and Evaluation, University of Toronto, Health Sciences Building, 155 College Street, Suite 425, Toronto, Ontario, M5T 3M6, Canada.
| | - Matthew Gray
- Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada
| | - Daniel Mancuso
- Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada
| | - Taucha Inrig
- Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada
| | - Gilles Boire
- Department of Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001, 12th Avenue North, Room 3853, Sherbrooke, QC, J1H 5N4, Canada
| | - Marie-Claude Beaulieu
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001, 12e Avenue North, Sherbrooke, QC, J1H 5N4, Canada
| | - Larry Funnell
- Osteoporosis Canada, 1200 Eglinton Avenue East, Suite 500, Toronto, ON, M3C 1H9, Canada
| | - Earl Bogoch
- Department of Surgery, University of Toronto, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada
| |
Collapse
|
88
|
Mendes MM, Hart KH, Botelho PB, Lanham-New SA. Vitamin D status in the tropics: Is sunlight exposure the main determinant? NUTR BULL 2018. [DOI: 10.1111/nbu.12349] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- M. M. Mendes
- Department of Nutritional Sciences; University of Surrey; Guildford UK
| | - K. H. Hart
- Department of Nutritional Sciences; University of Surrey; Guildford UK
| | - P. B. Botelho
- Faculty of Health Science; University of Brasília; Brasília Brazil
| | - S. A. Lanham-New
- Department of Nutritional Sciences; University of Surrey; Guildford UK
| |
Collapse
|
89
|
Siebert C, Bertó CG, Ferreira FS, Moreira DDS, Santos TM, Wyse AT. Vitamin D partially reverses the increase in p‐NF‐κB/p65 immunocontent and interleukin‐6 levels, but not in acetylcholinesterase activity in hippocampus of adult female ovariectomized rats. Int J Dev Neurosci 2018; 71:122-129. [DOI: 10.1016/j.ijdevneu.2018.08.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 07/19/2018] [Accepted: 08/27/2018] [Indexed: 12/22/2022] Open
Affiliation(s)
- Cassiana Siebert
- Laboratório de Neuroproteção e Doenças NeurometabólicasDepartamento de BioquímicaICBS, Universidade Federal do Rio Grande do SulRua Ramiro Barcelos, 2600‐AnexoCEP 90035‐003Porto AlegreRSBrazil
| | - Carolina Gessinger Bertó
- Laboratório de Neuroproteção e Doenças NeurometabólicasDepartamento de BioquímicaICBS, Universidade Federal do Rio Grande do SulRua Ramiro Barcelos, 2600‐AnexoCEP 90035‐003Porto AlegreRSBrazil
| | - Fernanda Silva Ferreira
- Laboratório de Neuroproteção e Doenças NeurometabólicasDepartamento de BioquímicaICBS, Universidade Federal do Rio Grande do SulRua Ramiro Barcelos, 2600‐AnexoCEP 90035‐003Porto AlegreRSBrazil
| | - Daniella de S. Moreira
- Laboratório de Neuroproteção e Doenças NeurometabólicasDepartamento de BioquímicaICBS, Universidade Federal do Rio Grande do SulRua Ramiro Barcelos, 2600‐AnexoCEP 90035‐003Porto AlegreRSBrazil
| | - Tiago Marcon Santos
- Laboratório de Neuroproteção e Doenças NeurometabólicasDepartamento de BioquímicaICBS, Universidade Federal do Rio Grande do SulRua Ramiro Barcelos, 2600‐AnexoCEP 90035‐003Porto AlegreRSBrazil
| | - Angela T.S. Wyse
- Laboratório de Neuroproteção e Doenças NeurometabólicasDepartamento de BioquímicaICBS, Universidade Federal do Rio Grande do SulRua Ramiro Barcelos, 2600‐AnexoCEP 90035‐003Porto AlegreRSBrazil
| |
Collapse
|
90
|
Carvalho VA, Ferreira do Prado Moreira P, Périgo Nascimento NA, Bertolini AA, Aragão L, Cendoroglo MS. The influence of 25-hydroxyvitamin D and High-Density Lipoprotein Cholesterol on BIA Resistance results and aging on BIA Reactance results in elderly people. Clin Nutr ESPEN 2018; 27:92-95. [PMID: 30144899 DOI: 10.1016/j.clnesp.2018.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 05/15/2018] [Accepted: 06/13/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND & AIMS The use of Bioimpedance (BIA) as a bedside method of evaluation of body composition increased in the last years. However there are still some questions about correct interpretation of the raw data, reactance and resistance, as measures of body composition. This study investigated the relationship of age, physical activity practice, Body Mass Index (BMI), 25-hydroxyvitamin D and serum lipoproteins in BIA data of resistance and reactance. METHODS A transversal study was performed with elderly women who practiced regular physical activity (Group 1) and community dwelling elderly women (Group 2). Blood test, antrophometric measures and BIA exam were performed. As some studies had suggested, the ones with a BMI superior to 34 Kg/m2 were excluded. Students T-test was applied to assess differences between both groups, and due to its results, it was performed a stepwise multiple regression analysis. RESULTS The results of 320 elderly women with a BMI ≤34 Kg/m2 (Group 1 = 225; Group 2 = 95) were analyzed. At the blood test, there was a statistically significant difference for total-cholesterol, LDL-cholesterol, High-Density Lipoprotein Cholesterol and 25-hydroxyvitamin D. We observed an increase of 0.42 OHMS in BIA Resistance for each increment of 1 nmol/dL of 25-hydroxyvitamin D (p < 0.005), and an increase of 1 mg/dL of High-Density Lipoprotein Cholesterol led to an increase of 0.655 OHMS in BIA Resistance (p < 0.005). Also, it was observed that an increment of 1 year old have showed a reduction of 0.038 OHMS in BIA Reactance (p < 0.1). CONCLUSIONS BIA Reactance was influenced by aging and BIA Resistance was influenced by High-Density Lipoprotein Cholesterol and 25-hydroxyvitamin D.
Collapse
|
91
|
Bittar FB, Castro CHM, Szejnfeld VL. Screening for vitamin D deficiency in a tropical area: results of a sun exposure questionnaire. BMC Endocr Disord 2018; 18:44. [PMID: 29970080 PMCID: PMC6029128 DOI: 10.1186/s12902-018-0272-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 06/25/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Vitamin D deficiency is pandemic while resources available to measure 25-hydroxyvitamin D (25OHD) are limited. The present study aimed to verify whether sun exposure measured by a structured questionnaire could predict serum 25OHD concentrations in healthy Caucasian individuals living in a tropical area. METHODS A cross-sectional study was carried out in subjects living in the greater São Paulo area, Brazil. Two groups of 50 young (20 to 40 years old) and 50 older (60 to 80 years old) subjects (N = 200) answered a structured questionnaire on sun exposure and had blood samples drawn for serum 25OHD concentration measurement during both summer and winter. Anthropometric data were also recorded. Correlation between the questionnaire variables (duration of sun exposure, amount of exposed skin, total sun exposure score - TSES and other data) and serum 25OHD concentration was evaluated. RESULTS Mean serum 25OHD concentration was 17.60 ± 7.3 ng/mL with no difference between age groups (p = 0.293). TSES weakly correlated with serum 25OHD levels (r = 0.264; p < 0.001). Separate analyzes by age groups demonstrated that TSES correlated significantly with serum 25OHD concentration only in the older subjects during summer (r = 0.322; p = 0.023). Using linear regression analyses, TSES and body mass index (BMI) were significantly associated with serum 25OHD levels. On the other hand, Receiver operating characteristic (ROC) analysis for TSES showed no significance as a screening tool for vitamin D deficiency (p = 0.172). CONCLUSION Sun exposure questionnaire associated with BMI correlates with serum 25OHD concentration with very low accuracy. The use of the questionnaire does not discriminate between vitamin D sufficient and deficient individuals.
Collapse
Affiliation(s)
- Fernanda Barros Bittar
- Rheumatology Division, Universidade Federal de São Paulo - Escola Paulista de Medicina (UNIFESP-EPM), Rua Botucatu, 740 – 3° andar – Vila Clementino, CEP, São Paulo, SP 04023-900 Brazil
| | - Charlles H. M. Castro
- Rheumatology Division, Universidade Federal de São Paulo - Escola Paulista de Medicina (UNIFESP-EPM), Rua Botucatu, 740 – 3° andar – Vila Clementino, CEP, São Paulo, SP 04023-900 Brazil
| | - Vera Lúcia Szejnfeld
- Rheumatology Division, Universidade Federal de São Paulo - Escola Paulista de Medicina (UNIFESP-EPM), Rua Botucatu, 740 – 3° andar – Vila Clementino, CEP, São Paulo, SP 04023-900 Brazil
| |
Collapse
|
92
|
Borges JLC, Miranda ISDM, Sarquis MMS, Borba V, Maeda SS, Lazaretti-Castro M, Blinkey N. Obesity, Bariatric Surgery, and Vitamin D. J Clin Densitom 2018; 21:157-162. [PMID: 28427988 DOI: 10.1016/j.jocd.2017.03.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Revised: 02/02/2017] [Accepted: 03/14/2017] [Indexed: 02/07/2023]
Abstract
The high prevalence of obesity is a worldwide problem associated with multiple comorbidities, including cardiovascular diseases. Vitamin D deficiency with secondary hyperparathyroidism is common in obese individuals and can be aggravated after bariatric surgery. Moreover, there is no consensus on the optimal supplementation dose of vitamin D in postbariatric surgical patients. We present new data on the variability of 25(OH)D response to supplementation in postmenopausal obese women. It is important to recognize and treat vitamin D deficiency before bariatric surgery to avoid postoperative complications, such as metabolic bone disease with associated high fracture risk. The objective of this article is to discuss the bone metabolism consequences of vitamin D deficiency after bariatric surgery.
Collapse
Affiliation(s)
| | | | | | - Victoria Borba
- Disciplina de Endocrinologia, Universidade Federal do Paraná, Brazil
| | - Sergio Setsuo Maeda
- Disciplina de Endocrinologia, Universidade Federal de Sao Paulo-Escola Paulista de Medicina, Brazil
| | - Marise Lazaretti-Castro
- Disciplina de Endocrinologia, Universidade Federal de Sao Paulo-Escola Paulista de Medicina, Brazil
| | | |
Collapse
|
93
|
Pereira-Santos M, Santos JYGD, Carvalho GQ, Santos DBD, Oliveira AM. Epidemiology of vitamin D insufficiency and deficiency in a population in a sunny country: Geospatial meta-analysis in Brazil. Crit Rev Food Sci Nutr 2018; 59:2102-2109. [PMID: 29420062 DOI: 10.1080/10408398.2018.1437711] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Studies conducted among populations of tropical countries have reported high prevalences of vitamin D deficiency and insufficiency. Information resulting from meta-analyses on the spatial distribution of vitamin D deficiency and insufficiency in tropical countries is still rare. The aim of this review was investigated the prevalence of vitamin D deficiency and insufficiency among the Brazilian population. Observational studies were searched in eight electronically databases. Additionally, theses and dissertations and abstracts were screened. Details on study design, methods, population, mean and data on serum concentrations of vitamin D in different age groups in Brazil were extracted. Data were pooled using a random-effects model and choropleth maps were created based on the geopolitical regions of the country. 72 published paper met the inclusion criteria. The mean vitamin D concentration among the Brazilian population between 2000 and 2017 of 67.65 nmol/L (95% CI: 65.91, 69.38 nmol/L).The prevalences of vitamin D deficiency and insufficiency were 28.16% (95% CI: 23.90, 32.40) and 45.26% (95% CI: 35.82, 54.71), respectively, for the Brazilian population. The highest prevalence of deficiency were observed in the southern and southeastern regions and the highest occurrence of vitamin D insufficiency was among the populations of the southeastern and northeastern regions. Finally, there are high prevalence of inadequate vitamin D concentrations among the population, regardless of age group in Brazil. The development of vitamin D food fortification policies in needs to be cautious and carefully planned.
Collapse
Affiliation(s)
- Marcos Pereira-Santos
- a Center of Biological and Health Sciences , Universidade Federal do Oeste da Bahia, Barreiras; Instituto de Saúde Coletiva, Universidade Federal da Bahia , Salvador , Brazil
| | | | - Gisele Queiroz Carvalho
- c Campus Avan¸ado de Governador Valadares , Universidade Federal de Juiz de Fora , Minas Gerais , Brazil
| | | | | |
Collapse
|
94
|
Lower vitamin D intake is associated with low HDL cholesterol and vitamin D insufficiency/deficiency in Brazilian children. Public Health Nutr 2018; 21:2004-2012. [PMID: 29478422 DOI: 10.1017/s1368980018000204] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To evaluate the association of vitamin D intake with dyslipidaemia and vitamin D insufficiency/deficiency in Brazilian children and identify the main food group sources of this nutrient in the sample. DESIGN A cross-sectional study carried out with a representative sample. Blood was collected after 12 h of fasting. Laboratory tests were performed to determine total cholesterol, HDL cholesterol (HDL-C), LDL cholesterol, TAG, apoB, apoA1, 25-hydroxyvitamin D and parathyroid hormone. Dietary intake was evaluated by a 24 h recall. SETTING Viçosa, Minas Gerais, Brazil. SUBJECTS Children between 8 and 9 years old enrolled in urban schools (n 378). RESULTS We found an elevated prevalence of inadequate vitamin D intake (91·3 %), dyslipidaemia (72·8 %) and vitamin D insufficiency/deficiency (56·2 %). The food groups that contributed the most to vitamin D intake were dairy products and fish. Lower vitamin D intake was associated with increased prevalence of both low HDL-C (prevalence ratio=2·51; 95 % CI 1·02, 6·18; P<0·05) and vitamin D insufficiency/deficiency (prevalence ratio=1·61; 95 % CI 1·01, 2·58; P<0·05). CONCLUSIONS Given the elevated prevalence of inadequate vitamin D intake and its association with low HDL-C and vitamin D insufficiency/deficiency, it is important to develop specific actions in food and nutritional education as well as programmes that stimulate and facilitate access to vitamin D food sources, such as dairy products and fish.
Collapse
|
95
|
Furuie IN, Mauro MJJ, Petruzziello S, Riechi SC, Petterle RR, Boguszewski CL, Borba VZC. Two threshold levels of vitamin D and the prevalence of comorbidities in outpatients of a tertiary hospital. Osteoporos Int 2018; 29:433-440. [PMID: 29143130 DOI: 10.1007/s00198-017-4299-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 11/02/2017] [Indexed: 10/18/2022]
Abstract
UNLABELLED This study evaluated the number of comorbidities between two normal values of 25OHD in outpatients during 1 year of 25OHD measurements. Five hundred twenty-nine outpatients were included, patients with 25OHD ≥ 20 and < 30 ng/mL had the higher number of comorbidities, suggesting that for this specific population, 25OHD ≥ 30 ng/mL would be more appropriate. INTRODUCTION : This study evaluated the comorbidities between two values of 25OHD in outpatients of a tertiary hospital. METHODS This is a cross-sectional study with measures of 25OHD in 1-year period, excluding 25OHD < 20 and > 50 ng/mL, clinical research participants, and liver disease and chronic renal failure patients. Patients were divided into two groups: group 1 (G1), 25OHD ≥ 20 and < 30 ng/mL; and group 2 (G2), 250HD ≥ 30 and ≤ 50 ng/mL. Medical records were reviewed for demographic, laboratory, and comorbidity data. RESULTS From 529 outpatients included, 319 were in G1 (53.3 ± 15.8 years, 85% women), mean 25OHD 24.8 ± 2.8 ng/mL; and 210 outpatients in G2 (56.7 ± 16.0 years, 83% women), mean 25OHD was 36.8 ± 4.8 ng/mL. G1 had the higher number of comorbidities, including altered glycemia, dyslipidemia, hypothyroidism, urinary tract diseases, arthropathy, secondary hyperparathyroidism, anemia, and neurological and psychiatric disorders. Osteoporosis and hypothyroidism were more prevalent in G2. After binary logistic regression, the variables age (OR 0.988, CI 0.97-1.00, p = 0.048), osteoporosis (OR 0.54, CI 0.36-0.80, p = 0.003), dyslipidemia (OR 1.61, CI 1.10-2.39, p = 0.015), arthropathy (OR 2.60, CI 1.40-5.10, p = 0.003), anemia (OR 15.41, CI 3.09-280.08, p = 0.008), and neurological and psychiatric diseases (OR 3.78, CI 1.98-7.88, p = 0.001) maintained significance. CONCLUSION Patients with serum 25OHD ≥ 20 and < 30 ng/mL had higher prevalence of comorbidities compared to ≥ 30 ng/mL.
Collapse
Affiliation(s)
- I N Furuie
- Universidade Federal do Paraná, Curitiba, Brazil
| | - M J J Mauro
- Universidade Federal do Paraná, Curitiba, Brazil
| | | | - S C Riechi
- Clinical Laboratory Unit, Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Brazil
| | - R R Petterle
- Statistics Department, Universidade Federal do Paraná, Curitiba, Brazil
| | - C L Boguszewski
- Serviço de Endocrinologia e Metabologia do Hospital de Clínicas, da Universidade Federal do Paraná (SEMPR), Curitiba, PR, Brazil
| | - V Z C Borba
- Serviço de Endocrinologia e Metabologia do Hospital de Clínicas, da Universidade Federal do Paraná (SEMPR), Curitiba, PR, Brazil.
| |
Collapse
|
96
|
Maceda EB, Gonçalves CCM, Andrews JR, Ko AI, Yeckel CW, Croda J. Serum vitamin D levels and risk of prevalent tuberculosis, incident tuberculosis and tuberculin skin test conversion among prisoners. Sci Rep 2018; 8:997. [PMID: 29343733 PMCID: PMC5772514 DOI: 10.1038/s41598-018-19589-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 01/03/2018] [Indexed: 01/09/2023] Open
Abstract
Poor vitamin D status has been associated with tuberculosis (TB); whether poor status is cause or consequence of disease is uncertain. We conducted a case-control study and two nested case-control studies to determine whether vitamin D levels were associated with active TB, tuberculin skin test (TST) conversion, and risk of progression to the active TB in prisoners in Brazil. In multivariable conditional logistic regression, subnormal vitamin D levels (OR, 3.77; 95% CI, 1.04–13.64) were more likely in prisoners with active TB. In contrast, vitamin D was not found to be a risk factor for either TST conversion (OR, 2.49; 95% CI, 0.64–9.66) or progression to active disease (OR, 0.59; 95% CI, 0.13–2.62). Black race (OR, 11.52; 95% CI, 2.01–63.36), less than 4 years of schooling (OR, 2.70; 95% CI, 0.90–8.16), cigarette smoking (OR, 0.23; 95% CI, 0.06–0.79) were identified as risk factors for TST conversion. Risk of progression to active TB was found to be associated with cigarette smoking (OR, 7.42; 95% CI, 1.23–44.70). Our findings in the prison population show that poor vitamin D status is more common in individuals with active TB, but is not a risk factor for acquisition of latent TB or progression to active TB.
Collapse
Affiliation(s)
- Elisangela B Maceda
- Faculty of Health Sciences, Federal University of Grande Dourados, Dourados, Brazil
| | | | - Jason R Andrews
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Albert I Ko
- Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, CT, USA.,Oswaldo Cruz Foundation, Salvador, Brazil
| | - Catherine W Yeckel
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Julio Croda
- Faculty of Health Sciences, Federal University of Grande Dourados, Dourados, Brazil. .,School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Brazil. .,Oswaldo Cruz Foundation, Campo Grande, Brazil.
| |
Collapse
|
97
|
Association of vitamin D deficiency and type 1 diabetes mellitus: a systematic review and meta-analysis. Int J Diabetes Dev Ctries 2018. [DOI: 10.1007/s13410-018-0607-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
|
98
|
Maeda SS, Moreira CA, Borba VZC, Bandeira F, Farias MLFD, Borges JLC, Paula FJAD, Vanderlei FAB, Montenegro FLDM, Santos RO, Ferraz-de-Souza B, Lazaretti-Castro M. Diagnosis and treatment of hypoparathyroidism: a position statement from the Brazilian Society of Endocrinology and Metabolism. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2018; 62:106-124. [PMID: 29694629 PMCID: PMC10118685 DOI: 10.20945/2359-3997000000015] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 11/14/2017] [Indexed: 11/23/2022]
Abstract
Objective To present an update on the diagnosis and treatment of hypoparathyroidism based on the most recent scientific evidence. Materials and methods The Department of Bone and Mineral Metabolism of the Sociedade Brasileira de Endocrinologia e Metabologia (SBEM; Brazilian Society of Endocrinology and Metabolism) was invited to prepare a document following the rules set by the Guidelines Program of the Associação Médica Brasileira (AMB; Brazilian Medical Association). Relevant papers were retrieved from the databases MEDLINE/PubMed, LILACS, and SciELO, and the evidence derived from each article was classified into recommendation levels according to scientific strength and study type. Conclusion An update on the recent scientific literature addressing hypoparathyroidism is presented to serve as a basis for the diagnosis and treatment of this condition in Brazil.
Collapse
|
99
|
Reginatto MW, Pizarro BM, Antunes RA, Mancebo ACA, Hoffmann L, Fernandes P, Areas P, Chiamolera MI, Silva R, de Souza MDCB, Bloise E, Ortiga-Carvalho TM. Vitamin D Receptor TaqI Polymorphism Is Associated With Reduced Follicle Number in Women Utilizing Assisted Reproductive Technologies. Front Endocrinol (Lausanne) 2018; 9:252. [PMID: 29892263 PMCID: PMC5985330 DOI: 10.3389/fendo.2018.00252] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Accepted: 05/02/2018] [Indexed: 02/05/2023] Open
Abstract
PURPOSE Calcitriol, or 1,25-hydroxycholecalciferol, is the active form of vitamin D. It binds and activates vitamin D receptor (VDR). Infertility and defective folliculogenesis have been observed in female vdr-knockout mice; however, whether VDR polymorphisms affect human ovarian responses to controlled ovarian stimulation (COS) remains unclear. We hypothesized that VDR polymorphisms are associated with infertility and COS responses. Thus, we evaluated the association between the TaqI, BsmI, and FokI VDR polymorphisms and ovarian responses in women undergoing COS. METHODS In this study, we recruited a control group (n = 121) comprising volunteers with a history of natural conception and a second group of women undergoing COS (n = 70). TaqI, BsmI, and FokI genotyping was performed via restriction fragment length polymorphism analysis or TaqMan qPCR and Sanger sequencing. Intrafollicular 25(OH)D contents were measured in follicular fluid collected from COS patients during oocyte retrieval. Ovarian response parameters were obtained from patient medical records. RESULTS There were no significant differences in the genotype frequencies of VDR polymorphisms (TaqI, BsmI and FokI) between the control and COS groups. However, the allele frequency of TaqI (C allele) was significantly lower in the COS group than in the control group (p = 0.02). Follicle number but not oocyte number was lower in patients with TaqI polymorphic (TC/CC) genotypes (p = 0.03). Importantly, the ratio between the number of follicles retrieved and intrafollicular estradiol concentrations was higher in patients with the TC/CC TaqI genotypes (p < 0.02). CONCLUSION We identified an association between the VDR TaqI polymorphism and reduced follicle number in women undergoing COS, suggesting that VDR signaling affects the ovarian response to stimulation via unknown mechanisms.
Collapse
Affiliation(s)
- Mila W. Reginatto
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bartira M. Pizarro
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Roberto A. Antunes
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Fertipraxis – Centro de Reprodução Humana, Rio de Janeiro, Brazil
- Maternidade Escola, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Luísa Hoffmann
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Pâmela Fernandes
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Patrícia Areas
- Fertipraxis – Centro de Reprodução Humana, Rio de Janeiro, Brazil
| | - Maria I. Chiamolera
- Departmento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Rosane Silva
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Enrrico Bloise
- Departamento de Morfologia, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | - Tânia M. Ortiga-Carvalho
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- *Correspondence: Tânia M. Ortiga-Carvalho,
| |
Collapse
|
100
|
Silva ECD, Taminato M, Fonseca CDD, Moraes GMD, Longo MCB, Grothe CE, Belasco AGS, Barbosa DA. Use of vitamin D and infection in patients with chronic kidney disease. Rev Bras Enferm 2018; 71:2792-2799. [DOI: 10.1590/0034-7167-2018-0640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 08/07/2018] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: To evaluate the effectiveness of vitamin D supplementation as protection factor against infection of patients with chronic kidney disease on conservative treatment. Method: Retrospective cohort study carried out between 2013 and 2016 in the Conservative Treatment Outpatient Clinics (Ambulatório de Tratamento Conservador) of the Hypertension and Kidney Hospital (Hospital do Rim e Hipertensão) of the Universidade Federal de São Paulo. Data on sociodemographic factors, comorbidity, infection episodes and use or nonuse of vitamin D supplementation for at least 6 months were collected from medical records. The primary outcomes considered in both groups were: presence or absence of infection anywhere on the body (bloodstream, urinary, respiratory and surgical sites). Results: A total of 263 patients were included and those who received (n=43) vitamin D had 59% less chance of developing infections (OR=0.41; 95%CI; 0.15-0.99), when compared to those who did not receive. Conclusion: Vitamin D supplementation was a protective factor against infections of all causes.
Collapse
|