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Lima-Silva ML, Torres KCL, Mambrini JVDM, Brot NC, Santos SO, Martins-Filho OA, Teixeira-Carvalho A, Lima-Costa MF, Peixoto SV. A nationwide study on immunosenescence biomarkers profile in older adults: ELSI-Brazil. Exp Gerontol 2024; 191:112433. [PMID: 38621429 DOI: 10.1016/j.exger.2024.112433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 03/19/2024] [Accepted: 04/12/2024] [Indexed: 04/17/2024]
Abstract
Immunosenescence is a phenomenon caused by changes in the immune system, and part of these changes involves an increase in circulating immunological biomarkers, a process known as "Inflammaging." Inflammaging can be associated with many diseases related to older people. As the older population continues to grow, understanding changes in the immune system becomes essential. While prior studies assessing these alterations have been conducted in countries with Caucasian populations, this investigation marks a pioneering effort. The object of the study is to describe for the first time that the distribution of cytokines, chemokines, and growth factors serum levels, assessed by Luminex platform, has been examined in a Brazilian population-based study of older adult females and males by age. Blood samples from 2111 participants (≥50 years old) were analyzed at the baseline (2015/2016) of the ELSI-Brazil study. The exploratory variables considered in the study were age, sex, educational level, residence area, geographic region, alcohol and smoking consumption, physical activity, and self-reported medical diagnoses of hypertension, diabetes, asthma, arthritis, and cancer. The association between serum biomarker levels and age was assessed by a quantile regression model adjusted in the total population and stratified by sex. The significance level considered in the analysis was 0.05. The mean age of the participants was 62.9 years, with a slight majority of female (52.7 %). Differences were found between the sexes in the median circulating levels of the CCL11, CXCL10, and FGF biomarkers. Eight biomarkers showed significant associations with age, including the pro-inflammatory CXCL10, TNF-α, IL-6, IL-17, and IL-2; and type 2/regulatory CCL11 and IL-4, showing positive associations, and anti-inflammatory IL-1Ra showing a negative association. The results suggest similar associations between the sexes, revealing an inflammatory profile characterized by types 1 and 2. Remarkably, these findings reinforce the concept of the Inflammaging process in Brazilian population. These findings add novel insights to about the immunosenescence aspects in middle-income countries and help define biomarkers capable of monitoring inflammation in older adults.
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Affiliation(s)
- Maria Luiza Lima-Silva
- Fundação Oswaldo Cruz, Instituto René Rachou, Núcleo de Estudos em Saúde Pública e Envelhecimento, Belo Horizonte, MG, Brazil; Fundação Oswaldo Cruz, Instituto René Rachou, Grupo Integrado de Pesquisas em Biomarcadores, Belo Horizonte, MG, Brazil; Fundação Oswaldo Cruz, Instituto René Rachou, Programa de Pós-Graduação em Saúde Coletiva, Belo Horizonte, MG, Brazil.
| | - Karen Cecília Lima Torres
- Fundação Oswaldo Cruz, Instituto René Rachou, Grupo Integrado de Pesquisas em Biomarcadores, Belo Horizonte, MG, Brazil; Universidade Edson Antônio Velano - UNIFENAS/MG, Brazil.
| | - Juliana Vaz de Melo Mambrini
- Fundação Oswaldo Cruz, Instituto René Rachou, Núcleo de Estudos em Saúde Pública e Envelhecimento, Belo Horizonte, MG, Brazil; Fundação Oswaldo Cruz, Instituto René Rachou, Programa de Pós-Graduação em Saúde Coletiva, Belo Horizonte, MG, Brazil
| | - Nathalia Coimbra Brot
- Fundação Oswaldo Cruz, Instituto René Rachou, Núcleo de Estudos em Saúde Pública e Envelhecimento, Belo Horizonte, MG, Brazil; Fundação Oswaldo Cruz, Instituto René Rachou, Grupo Integrado de Pesquisas em Biomarcadores, Belo Horizonte, MG, Brazil
| | - Sara Oliveira Santos
- Fundação Oswaldo Cruz, Instituto René Rachou, Núcleo de Estudos em Saúde Pública e Envelhecimento, Belo Horizonte, MG, Brazil
| | - Olindo Assis Martins-Filho
- Fundação Oswaldo Cruz, Instituto René Rachou, Grupo Integrado de Pesquisas em Biomarcadores, Belo Horizonte, MG, Brazil; Universidade do Estado do Amazonas - UEA, Brazil
| | - Andréa Teixeira-Carvalho
- Fundação Oswaldo Cruz, Instituto René Rachou, Grupo Integrado de Pesquisas em Biomarcadores, Belo Horizonte, MG, Brazil; Universidade do Estado do Amazonas - UEA, Brazil
| | - Maria Fernanda Lima-Costa
- Fundação Oswaldo Cruz, Instituto René Rachou, Núcleo de Estudos em Saúde Pública e Envelhecimento, Belo Horizonte, MG, Brazil
| | - Sérgio Viana Peixoto
- Fundação Oswaldo Cruz, Instituto René Rachou, Núcleo de Estudos em Saúde Pública e Envelhecimento, Belo Horizonte, MG, Brazil; Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento de Gestão em Saúde, Belo Horizonte, MG, Brazil.
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de Oliveira LB, de Figueiredo Martins Siqueira MA, de Macedo Gadêlha RB, Garcia J, Bandeira F. Vitamin D Deficiency in Patients Hospitalized for Heart Failure Living in the Tropics. INTERNATIONAL JOURNAL OF HEART FAILURE 2024; 6:84-90. [PMID: 38694929 PMCID: PMC11058433 DOI: 10.36628/ijhf.2023.0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 09/11/2023] [Accepted: 10/23/2023] [Indexed: 05/04/2024]
Abstract
Background and Objectives Vitamin D, as a steroid hormone, has multiple effects on human body and its deficiency has been associated with an increased risk of heart failure (HF) and unfavorable outcomes. The present study investigated the prevalence of vitamin D deficiency (VDD) and its relationship with cardiometabolic parameters in patients hospitalized for HF living in the city of Recife (latitude 8° South). Methods Analytical cross-sectional study, with men and women aged 40-64 years. The HF group was recruited during hospitalization due to decompensation. A matched control group was recruited from the general endocrine clinics. Vitamin D status was assessed by measuring serum 25-hydroxyvitamin D (25OHD), considering deficiency when 25OHD <20 ng/mL (<50 nmol/L). Results A total of 243 patients were evaluated (HF group: 161, control group: 82). Lower serum 25OHD levels were observed in the HF group (25.2±9.4 vs. 30.0±7.7ng/mL; p<0.001), as well as a higher prevalence of VDD (27.3% vs. 9.8%; prevalence ratio, 2.80; 95% confidence interval, 1.38-5.67; p=0.002). In patients with HF, VDD was associated with diabetes mellitus (65.9% vs. 41.0%; p=0.005) and female sex (65.9% vs. 44.4%; p=0.015). In the subgroup with VDD, higher values of hemoglobin A1c (7.9% [6.0-8.9] vs. 6.2% [5.7-7.9]; p=0.006) and dyslipidemia were also observed. Conclusions We found higher rates of VDD in patients hospitalized for HF and this was associated with deleterious laboratory metabolic parameters.
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Affiliation(s)
- Lucian Batista de Oliveira
- Division of Endocrinology and Diabetes, Agamenon Magalhães Hospital, University of Pernambuco (UPE), Faculty of Medical Sciences, Recife, PE, Brazil
| | | | - Rafael Buarque de Macedo Gadêlha
- Division of Cardiology, Agamenon Magalhães Hospital, University of Pernambuco (UPE), Faculty of Medical Sciences, Recife, PE, Brazil
| | - Jessica Garcia
- Division of Cardiology, Agamenon Magalhães Hospital, University of Pernambuco (UPE), Faculty of Medical Sciences, Recife, PE, Brazil
| | - Francisco Bandeira
- Division of Endocrinology and Diabetes, Agamenon Magalhães Hospital, University of Pernambuco (UPE), Faculty of Medical Sciences, Recife, PE, Brazil
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Normando P, de Castro IRR, Bezerra FF, Berti TL, Bertoni N, Lacerda EMDA, Alves-Santos NH, de Freitas MB, Kac G. Prevalence and predictors of vitamin D insufficiency in Brazilian children under 5 years of age: Brazilian National Survey on Child Nutrition (ENANI-2019). Br J Nutr 2024; 131:312-320. [PMID: 37589095 DOI: 10.1017/s0007114523001836] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
To analyse the association of socio-demographic and health factors with vitamin D insufficiency and 25-hydroxyvitamin D (25(OH)D) concentration in Brazilian children aged 6-59 months. Data from 8145 children from the Brazilian National Survey on Child Nutrition (ENANI-2019) were analysed. The serum concentration of 25(OHD)D was measured using a chemiluminescent immunoassay. The prevalence of vitamin D insufficiency (25(OH)D < 50 nmol/l) and 95 % CI was calculated. Logistic and linear regression models were used to identify the variables associated with vitamin D insufficiency and serum 25(OH)D concentrations, respectively. The mean 25(OH)D concentration was 98·6 ± 36·0 nmol/l, and 4·3 % of the children presented vitamin D insufficiency. Children aged 6-23 months (OR = 2·23; 95 % CI 1·52, 3·26); belonging to Southeast (OR = 5·55; 95 % CI 2·34, 13·17) and South (OR = 4·57; 95 % CI 1·77, 11·84) regions; the second tertile of the National Wealth Score (OR = 2·14; 95 % CI 1·16, 3·91) and winter (OR = 5·82; 95 % CI 2·67, 12·71) and spring (OR = 4·84; 95 % CI 2·17, 10·80) seasons of blood collection were associated with a higher chance of vitamin D insufficiency. Female sex (β = -5·66, 95 % CI - 7·81, -3·51), urban location (β = -14·19, 95 % CI -21·0, -7·22) and no vitamin D supplement use (β = -6·01, 95 % CI -9·64, -2·39) were inversely associated with serum 25(OH)D concentration. The age of children and the Brazilian geographical region of household location were the main predictors of vitamin D insufficiency. In Brazil, vitamin D insufficiency among children aged 6-59 months is low and is not a relevant public health problem.
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Affiliation(s)
- Paula Normando
- Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ21941-902, Brazil
| | | | | | - Talita Lelis Berti
- Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ21941-902, Brazil
| | - Neilane Bertoni
- Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ21941-902, Brazil
- Divisão de Pesquisa Populacional, Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, Brazil
| | | | - Nadya Helena Alves-Santos
- Instituto de Estudos em Saúde e Biológicas, Universidade Federal do Sul e Sudeste do Pará, Pará, Brazil
| | - Maiara Brusco de Freitas
- Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ21941-902, Brazil
| | - Gilberto Kac
- Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ21941-902, Brazil
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Ursache A, Lozneanu L, Bujor IE, Mandici CE, Boiculese LV, Bausic AIG, Grigore M, Socolov D, Matasariu DR. Vitamin D-The Iceberg in Endometriosis-Review and Meta-Analysis. J Pers Med 2024; 14:119. [PMID: 38276241 PMCID: PMC10821152 DOI: 10.3390/jpm14010119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/10/2024] [Accepted: 01/15/2024] [Indexed: 01/27/2024] Open
Abstract
(1) Background: Although vitamin D has many known biological effects, very little research has been conducted on how vitamin D may be related or play a role in endometriosis. The aim of our study was to perform an evaluation regarding vitamin D levels and possible implications in endometriosis through a statistical analysis of the data collected from the included studies. (2) Methods: For this review, we searched the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, and PubMed/Internet portal of the National Library of Medicine databases using several keywords related to our topic. (3) Results: Only nine articles were identified as complete or possessing the capacity to compute all available data. We totalized a number of 976 patients with endometriosis and 674 controls. From the nine studies included in our analysis, three of them claim there is no difference between women with and without endometriosis concerning 25(OH) vitamin D levels; however, the other six studies found significant differences regarding this aspect. (4) Conclusions: Our results underscored the complexity of analyzing the role of the vitamin D complex in a challenging condition like endometriosis and suggest that focusing on the tissue level might be essential to obtain accurate answers to our inquiries.
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Affiliation(s)
- Alexandra Ursache
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy ‘Gr. T. Popa’, 700115 Iasi, Romania; (A.U.); (M.G.); (D.S.); (D.R.M.)
- Department of Obstetrics and Gynecology, Cuza Vodă Hospital, 700038 Iasi, Romania
| | - Ludmila Lozneanu
- Department of Morpho-Functional Sciences I—Histology, University of Medicine and Pharmacy ‘Gr. T. Popa’, 700115 Iasi, Romania;
| | - Iuliana Elena Bujor
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy ‘Gr. T. Popa’, 700115 Iasi, Romania; (A.U.); (M.G.); (D.S.); (D.R.M.)
| | - Cristina Elena Mandici
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy ‘Gr. T. Popa’, 700115 Iasi, Romania; (A.U.); (M.G.); (D.S.); (D.R.M.)
| | - Lucian Vasile Boiculese
- Biostatistics, Department of Preventive Medicine and Interdisciplinarity, University of Medicine and Pharmacy ‘Gr. T. Popa’, 700115 Iasi, Romania;
| | | | - Mihaela Grigore
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy ‘Gr. T. Popa’, 700115 Iasi, Romania; (A.U.); (M.G.); (D.S.); (D.R.M.)
- Department of Obstetrics and Gynecology, Cuza Vodă Hospital, 700038 Iasi, Romania
| | - Demetra Socolov
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy ‘Gr. T. Popa’, 700115 Iasi, Romania; (A.U.); (M.G.); (D.S.); (D.R.M.)
- Department of Obstetrics and Gynecology, Cuza Vodă Hospital, 700038 Iasi, Romania
| | - Daniela Roxana Matasariu
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy ‘Gr. T. Popa’, 700115 Iasi, Romania; (A.U.); (M.G.); (D.S.); (D.R.M.)
- Department of Obstetrics and Gynecology, Cuza Vodă Hospital, 700038 Iasi, Romania
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De la Cruz-Góngora V, Palazuelos-González R, Domínguez-Flores O. Micronutrient Deficiencies in Older Adults in Latin-America: A Narrative Review. Food Nutr Bull 2023:3795721231214587. [PMID: 38146136 DOI: 10.1177/03795721231214587] [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: 12/27/2023]
Abstract
BACKGROUND The population in Latin America and Caribbean (LAC) has experienced a major demographic transition with increased numbers of older adults (OA). This change brings opportunities in the public health sector to implement health prevention interventions and delay the onset of geriatric syndromes. Micronutrients play an important role in the maintenance of biological function which contributes to longevity. Micronutrient deficiencies (MD) in OA increase the risk for onset of chronic comorbidities and geriatric syndromes. AIM To review and summarize the existing data on micronutrient status in OA in the LAC region and discuss the gaps and challenges in public health approaches to address deficiencies. METHODS Literature review in Medline for records describing nutritional biomarkers in older adults (≥ 60y) from community dwelling and population-based studies in LAC. RESULTS Few countries (including Chile, Ecuador, Costa Rica, Brazil, and Mexico) have documented one or more nutritional deficiencies for OA in national health surveys, however across the entire region, evidence of micronutrient levels is scarce. Some surveys have documented a high prevalence and large heterogeneity in the prevalence of vitamin D followed by B12 deficiency, being the 2 MDs most studied due their effects on cognition, frailty, and bone mineral density in the OA population. Other MD including C, E, A, copper, zinc, iron, and selenium have also been reported. CONCLUSION Information on the micronutrient status in OA from LAC is poorly documented. Research and capacity building initiatives in the region are crucial to develop tailored strategies that address the specific nutritional needs and challenges faced by the ageing population in Latin-America.
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Affiliation(s)
- Vanessa De la Cruz-Góngora
- Center for Evaluation and Survey Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
- Global Brain Health Institute, Trinity College, Dublin, Ireland
| | | | - Omar Domínguez-Flores
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
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Mendes MM, Gomes APO, Araújo MM, Coelho ASG, Carvalho KMB, Botelho PB. Prevalence of vitamin D deficiency in South America: a systematic review and meta-analysis. Nutr Rev 2023; 81:1290-1309. [PMID: 36882047 DOI: 10.1093/nutrit/nuad010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
CONTEXT Vitamin D deficiency is considered a global public health issue, even in low-latitude countries where there is abundant sunlight radiation. Nevertheless, the prevalence of vitamin D insufficiency and deficiency in the South American continent has not been well characterized. OBJECTIVE The aim of this review was to estimate the prevalence of vitamin D deficiency (25-hydroxy-calciferol < 20 ng/mL) in South American populations. DATA SOURCES Seven electronic databases (MEDLINE, Web of Science, Embase, Biblioteca Virtual de Saúde, SciELO, Scopus, and Google Scholar) were searched systematically for observational studies published before July 1, 2021, and reporting vitamin D status of healthy adults in South America. DATA EXTRACTION Data were extracted using a standardized form. Risk of bias was assessed by the Joanna Briggs Institute Critical Appraisal Instrument for Studies Reporting Prevalence. All steps were conducted independently by two authors. Data were pooled using a random-effects model. Stratified meta-analysis and meta-regression were conducted (R software). DATA ANALYSIS Of 9460 articles identified, 96 studies with a total of 227 758 participants were included. The overall prevalence of vitamin D deficiency was 34.76% (79 studies; 95%CI, 29.68-40.21; I2 = 99%). There were significant differences in prevalence rates related to age, sex, country, latitude, season, and year of publication. CONCLUSION The prevalence of vitamin D deficiency is unexpectedly elevated in South American populations. Public health strategies should include efforts to prevent, detect, and treat vitamin D deficiency. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number CRD42020169439.
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Affiliation(s)
- Marcela M Mendes
- Department of Nutrition, Faculty of Health Sciences, University of Brasília, Brasília, Federal District, Brazil
| | - Anna P O Gomes
- Department of Clinical Nutrition, Faculty of Nutrition, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Maísa M Araújo
- Department of Nutrition, Faculty of Health Sciences, University of Brasília, Brasília, Federal District, Brazil
| | - Alexandre S G Coelho
- Department of Biology, Agronomy School, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Kênia M B Carvalho
- Department of Nutrition, Faculty of Health Sciences, University of Brasília, Brasília, Federal District, Brazil
| | - Patrícia B Botelho
- Department of Nutrition, Faculty of Health Sciences, University of Brasília, Brasília, Federal District, Brazil
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Foroni MZ, Cendoroglo MS, Sakane EN, Marin-Mio RV, Moreira PFDP, Maeda SS, Lazaretti-Castro M. Serum 25 hydroxyvitamin D concentrations in individuals over 80 years old and their correlations with musculoskeletal and health parameters. Endocrine 2023; 79:559-570. [PMID: 36305996 DOI: 10.1007/s12020-022-03231-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 10/09/2022] [Indexed: 01/09/2023]
Abstract
PURPOSE The present study aims to evaluate the serum concentrations of 25 hydroxyvitamin D[25(OH)D] in individuals aged ≥80 years, independent, free-living in Sao Paulo, Brazil (Lat 23.5 oS), and to investigate their associations with musculoskeletal system, physical performance and health markers. METHOD This cross-sectional study included 212 community dwellers aged ≥80 years and evaluated serum 25(OH)D, PTH, calcium, albumin, phosphorus, creatinine, bone markers, and bone mineral density. Physical performance was evaluated with stationary march, Flamingo, and functional reach tests, questionnaires to assess falls and fractures in the previous year, energy expenditure (MET), and Charlson index. Physical activity was evaluated with the International Physical Activity Questionnaire. RESULTS Vitamin D deficiency (<20 ng/mL) was observed in 56% and severe vitamin D deficiency (<10 ng/mL) in 13% of those individuals. Serum concentrations of 25(OH)D were significantly and positively associated with BMD total hip (p = 0.001), femoral neck (p = 0.011) and 33% radius (p = 0.046) BMDs, MET (p = 0.03) and functional reach test (p = 0.037) and negatively with age (p = 0.021), PTH (p = 0.004) and osteoporosis diagnosis (p = 0.012). Long-lived individuals with 25(OH)D ≥ 20 ng/mL had higher total hip and femoral neck BMDs (p = 0.012 and p = 0.014, respectively) and lower PTH (p = 0.030). In multiple linear regression analysis, age and osteoporosis diagnosis remained negatively associated with 25(OH)D levels (p = 0.021 and p = 0.001, respectively), while corrected calcium and cholecalciferol use remained positively associated (p = 0.001 and p = 0.024, respectively). CONCLUSION We observed high vitamin D inadequacy prevalence in those Brazilian community dwellers' oldest old. Serum concentrations of 25(OH)D were positively associated with bone mass and dynamic balance, and negatively with PTH and osteoporosis diagnosis. Additionally, 25(OH)D ≥ 20 ng/mL was associated with better bone mass and lower PTH levels.
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Affiliation(s)
- Mariana Zuccolotto Foroni
- Division of Endocrinology, Escola Paulista de Medicina-Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.
| | - Maysa Seabra Cendoroglo
- Division of Geriatrics, Escola Paulista de Medicina-Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Eliane Naomi Sakane
- Division of Endocrinology, Escola Paulista de Medicina-Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Rosangela Villa Marin-Mio
- Division of Endocrinology, Escola Paulista de Medicina-Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | | | - Sergio Setsuo Maeda
- Division of Endocrinology, Escola Paulista de Medicina-Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Marise Lazaretti-Castro
- Division of Endocrinology, Escola Paulista de Medicina-Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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Adiposity and physical activity are among the main determinants of serum vitamin D concentrations in older adults: the EpiFloripa Aging Cohort Study. Nutr Res 2023; 111:59-72. [PMID: 36827757 DOI: 10.1016/j.nutres.2023.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 01/30/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
The identification of factors associated with 25-hydroxycholecalciferol (25(OH)D) concentration can help suggest more specific interventions for older adults. In this cross-sectional study of older adults from southern Brazil, we hypothesized that some sociodemographic, behavioral, and health factors positively or negatively influence the 25(OH)D concentration in this population. This analysis was performed using data from the second wave of the EpiFloripa Aging Cohort Study (2013-2015). Serum 25(OH)D levels were classified according to the guidelines of the Endocrine Society. Multinomial logistic regression was performed to evaluate the relative risks of sociodemographic, behavioral, and health factors in each 25(OH)D category. A total of 574 older adults (aged 63-93 years) participated in this study. The prevalence of insufficiency (21-29 ng/mL) was 43.7% and that of deficiency (≤20 ng/mL) was 23.5%. In the adjusted analysis, female sex, higher levels of low-density lipoprotein cholesterol (LDL-C ≥160 mg/dL), obesity by adiposity (body fat percentage [%fat], male ≥31%; female ≥43%), and body mass index (BMI, >30 kg/m2) presented higher relative risks for insufficiency than for sufficiency. For those with deficiency, the associated factors were female sex, disability in 4 or more activities of daily living (ADLs), LDL-C ≥100 mg/dL, and obesity by %fat and BMI. A protective factor against insufficiency and deficiency was active leisure-time physical activity (PA, ≥150 min/week). Our results demonstrated that being female and having modifiable factors, such as high levels of LDL-C, obesity, and disability on ADLs, were negatively associated with hypovitaminosis D. On the other hand, leisure-time PA was positively associated with adequate serum vitamin D concentration.
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Leite NP, Alvarez TS, Fonseca FLA, Hix S, Sarni ROS. Vitamin D deficiency in bedridden elderly people at home. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:61-65. [PMID: 36820714 PMCID: PMC9937594 DOI: 10.1590/1806-9282.20220613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 09/30/2022] [Indexed: 02/19/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate serum 25(OH)D concentrations in the homebound elderly people and relate them to level of dementia, nutritional risk, and route of dietary administration. METHODS This is a cross-sectional study involving 207 bedridden elderly people assisted by the Home Care Service in the city of Santo André - SP, from June to December 2016. The following factors were evaluated: dietary intake of vitamin D, arm circumference, triceps skin fold thickness, calf circumference, nutritional risk by Mini-Nutritional Assessment, level of dementia by the adapted Clinical Dementia Rating questionnaire, and laboratory tests such as serum concentrations of 25(OH)D, ultrasensitive C-reactive protein, alkaline phosphatase, serum calcium, and parathormone. RESULTS The mean age of the elderly people was 81.6 (9.2) years. Deficiency of 25(OH)D was observed in 76.3% of the elderly people. There was an inverse correlation between serum concentrations of 25(OH)D: parathormone (r=-0.418, p<0.001) and alkaline phosphatase (r=-0.188, p=0.006) and a direct correlation with serum calcium (r=-0.158, p=0.022). Logistic regression showed that vitamin D deficiency was directly and independently associated with oral feeding (odds ratio 7.71; 95%CI 2.91-20.40). CONCLUSION Bedridden households showed high prevalence of vitamin D deficiency without association with nutritional risk and level of dementia. Oral diet was associated with vitamin D deficiency, possibly due to low consumption of source foods.
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Affiliation(s)
- Narjara Pereira Leite
- Centro Universitário Faculdade de Medicina do ABC – Santo André (SP), Brazil.,Corresponding author:
| | | | - Fernando Luiz Affonso Fonseca
- Centro Universitário Faculdade de Medicina do ABC, Department of Pathology, Discipline of Clinical Analysis – Santo André (SP), Brazil
| | - Sonia Hix
- Centro Universitário Faculdade de Medicina do ABC, Discipline of Clinical Biochemistry – Santo André (SP), Brazil
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Quialheiro A, d´Orsi E, Moreira JD, Xavier AJ, Peres MA. The association between vitamin D and BDNF on cognition in older adults in Southern Brazil. Rev Saude Publica 2022; 56:109. [PMID: 36629701 PMCID: PMC9749663 DOI: 10.11606/s1518-8787.2022056004134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 01/26/2022] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE To estimate the association between vitamin D and the cognitive decline of older adults and evaluate whether this association is mediated by brain-derived neurotrophic factor (BDNF) serum concentration. METHODS Cross-sectional study nested in a population-based cohort. Of the 604 participants in the complementary examination of the EpiFloripa Study, 576 older adults (60 years or older) were eligible for the study. The outcome is cognitive decline evaluated by the Mini-Mental State Examination, the exposure is vitamin D, and BDNF is the mediator. The control variables are age, sex, per capita family income, and educational level. The direct effect of vitamin D and BDNF on cognitive decline and the indirect effect mediated by BDNF was evaluated using path analysis, with the estimation of standardized coefficients. RESULTS Among the participants, we observed a direct and positive effect of vitamin D on cognitive function (Coef: 0.06; 95%CI: 0.02 to 0.11; p < 0.001) and serum BDNF concentration (Coef: 21.55; 95%CI: 9.92 to 33.17; p = 0.002), i.e., the higher the vitamin D, the higher the cognitive function and serum level of BDNF. CONCLUSION There was an association between vitamin D on serum BDNF and on cognitive decline in older adults. Moreover, BDNF did not have an effect on cognitive decline, so BDNF was not a mediator of the vitamin D effect on cognitive decline.
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Affiliation(s)
- Anna Quialheiro
- Universidade Federal de Santa CatarinaPrograma de Pós-Graduação em Saúde ColetivaFlorianópolisSCBrasil Universidade Federal de Santa Catarina. Programa de Pós-Graduação em Saúde Coletiva. Florianópolis, SC, Brasil,Universidade do Minho. Escola de MedicinaInstituto de Investigação em Ciências da Vida e da SaúdeBragaPortugal Universidade do Minho. Escola de Medicina. Instituto de Investigação em Ciências da Vida e da Saúde. Braga, Portugal
| | - Eleonora d´Orsi
- Universidade Federal de Santa CatarinaPrograma de Pós-Graduação em Saúde ColetivaFlorianópolisSCBrasil Universidade Federal de Santa Catarina. Programa de Pós-Graduação em Saúde Coletiva. Florianópolis, SC, Brasil
| | - Júlia Dubois Moreira
- Universidade Federal de Santa CatarinaPrograma de Pós-Graduação em NutriçãoFlorianópolisSCBrasil Universidade Federal de Santa Catarina. Programa de Pós-Graduação em Nutrição. Florianópolis, SC, Brasil
| | - André Junqueira Xavier
- Universidade Federal de Santa CatarinaPrograma de Pós-Graduação em Saúde ColetivaFlorianópolisSCBrasil Universidade Federal de Santa Catarina. Programa de Pós-Graduação em Saúde Coletiva. Florianópolis, SC, Brasil,Universidade do Sul de Santa CatarinaPalhoçaSCBrasil Universidade do Sul de Santa Catarina. Curso de Medicina. Palhoça, SC, Brasil
| | - Marco Aurélio Peres
- National Dental Research Institute SingaporeNational Dental Centre SingaporeSingapore National Dental Research Institute Singapore. National Dental Centre Singapore. Singapore,Duke-NUS Medical SchoolOral Health ACPHealthServices and Systems Research ProgrammeSingapore Duke-NUS Medical School. Oral Health ACP. HealthServices and Systems Research Programme. Singapore
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Lima-Costa MF, de Melo Mambrini JV, Bof de Andrade F, de Souza PRB, de Vasconcellos MTL, Neri AL, Castro-Costa E, Macinko J, de Oliveira C. Cohort Profile: The Brazilian Longitudinal Study of Ageing (ELSI-Brazil). Int J Epidemiol 2022; 52:e57-e65. [PMID: 35748356 PMCID: PMC9908056 DOI: 10.1093/ije/dyac132] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 06/07/2022] [Indexed: 11/12/2022] Open
Affiliation(s)
- Maria Fernanda Lima-Costa
- Corresponding author. Núcleo de Estudos em Saúde Pública e Envelhecimento, Instituto René Rachou, Fundação Oswaldo Cruz, Av. Augusto de Lima 1715, 6º andar, sala 614, Belo Horizonte, 30190-003, Brasil. E-mail:
| | | | | | - Paulo Roberto Borges de Souza
- Instituto de Comunicação e Informação Científica e Tecnológica e Tecnologia em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | | | - Erico Castro-Costa
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - James Macinko
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Cesar de Oliveira
- Department of Epidemiology & Public Health, University College London, London, UK
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12
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Santana KVDSD, Oliver SL, Mendes MM, Lanham-New S, Charlton KE, Ribeiro H. Association between vitamin D status and lifestyle factors in Brazilian women: Implications of Sun Exposure Levels, Diet, and Health. EClinicalMedicine 2022; 47:101400. [PMID: 35497056 PMCID: PMC9043392 DOI: 10.1016/j.eclinm.2022.101400] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 03/21/2022] [Accepted: 03/31/2022] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Vitamin D deficiency has been documented to be prevalent, even in low latitude regions; and this may be related to sun exposure behaviors. The aim of the current study was to assess the association between serum 25-hydroxyvitamin D [25(OH)D] concentrations and lifestyle-related factors in a sample of Brazilian women living at latitude 21º 8' S. METHODS A cross-sectional study was undertaken in 101 women aged 35 years or older in July 2019 to assess the association between 25(OH)D concentration and level of exposure to ultraviolet radiation (UVR), smoking habits, alcohol consumption, and physical activity levels. Age, body mass index (BMI), and postmenopausal status were investigated. FINDINGS According to the slope coefficient for individual daily UVR levels, the concentration of 25(OH)D increased by 5 nmol / L for each extra Standard Erythema Dose of UVR, regardless of age and BMI (p < 0·001). Postmenopausal women had a significantly higher mean concentration of 25(OH)D (p = 0·01), higher UVR exposure (p = 0·01) and lower BMI (p = 0·005) compared with younger women, independent of other confounders including smoking, alcohol, occupation and physical activity. INTERPRETATION Although postmenopausal women from Brazil had higher mean concentrations of 25(OH)D than younger women, more studies are necessary to understand how sun exposure and lifestyle variables interfere with these levels. These findings have important public health implications since they suggest that vitamin D deficiency in older age is not inevitable. FUNDING This study was funded by an award received by Universities Global Partnership Network - UGPN. KVSS and SLO receive scholarship from CAPES, Brazilian Ministry of Education. HR receives a productivity grant from CNPq.
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Affiliation(s)
- Keila Valente de Souza de Santana
- Programa de Pós-Graduação em Saúde Global e Sustentabilidade, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Sofia Lizarralde Oliver
- Departamento de Saúde Ambiental, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Marcela Moraes Mendes
- School of Biosciences and Medicine, Faculty of Health and Medical Sciences, Department of Nutritional Sciences, University of Surrey, Guildford, Surrey, United Kingdom
| | - Susan Lanham-New
- School of Biosciences and Medicine, Faculty of Health and Medical Sciences, Department of Nutritional Sciences, University of Surrey, Guildford, Surrey, United Kingdom
| | - Karen E Charlton
- School of Medicine, University of Wollongong, Wollongong, Australia NSW and Illawarra Health and Medical Research Institute, Wollongong, Australia NSW
| | - Helena Ribeiro
- Departamento de Saúde Ambiental, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brazil
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13
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de Melo Bacha FV, Gomez FLC, Silva ALG, Reis MD, Cabral EDL, de Carvalho LD. Vitamin D: a 14-year retrospective study at a clinical laboratory in Brazil. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2022; 66:19-31. [PMID: 35029851 PMCID: PMC9991022 DOI: 10.20945/2359-3997000000427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE This study aimed to assess vitamin D (25OHD) levels in individuals who underwent an examination at a private laboratory (between latitudes 14° and 22° south) over 14 years, stratified by sex, age, and epidemiological profiles, and determine variations in the number of tests performed over the years. METHODS All records of 25OHD tests performed at a private clinical laboratory in Brazil were analyzed. This retrospective cross-sectional study included patients stratified by sex (female or male), age range (0-17, 18-40, 41-59, and ≥ 60 years), and year of testing. The final sample size was 193,725 patients. Categorical variables are presented as absolute and relative frequencies and numerical variables as means ± standard deviation. Comparisons between groups were performed using the equality of proportions test. RESULTS The number of tests performed steeply increased since 2010. More tests were performed in female individuals (73.3%) and individuals aged 41-59 years (32.2%). Most samples (68.0%) demonstrated sufficient vitamin D status. Women had a higher incidence of vitamin D deficiency than men (33.1% and 26.6%, respectively; p < 0.001). Individuals aged ≥ 60 years had the highest incidence of vitamin D deficiency (68.4%), while individuals aged 0-17 years had the lowest (32.2%) (p < 0.001). CONCLUSION Despite increased testing and attention given to vitamin D in recent years, our study demonstrates high levels of deficiency in a country with geographical conditions favorable to its production.
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Affiliation(s)
| | | | | | - Mariana Didier Reis
- Faculdade Ciências Médicas de Minas Gerais (FCMMG), Belo Horizonte, MG, Brasil
| | - Eliane Dias Lustosa Cabral
- Centro de Desenvolvimento, Inovação, Ciência e Tecnologia/Labtest Diagnóstica S.A., Lagoa Santa, MG, Brasil
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Bezerra FF, Normando P, Fonseca ACP, Zembrzuski V, Campos-Junior M, Cabello-Acero PH, Faerstein E. Genetic, sociodemographic and lifestyle factors associated with serum 25-hydroxyvitamin D concentrations in Brazilian adults: the Pró-Saúde Study. CAD SAUDE PUBLICA 2022; 38:e00287820. [DOI: 10.1590/0102-311x00287820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 05/21/2021] [Indexed: 11/22/2022] Open
Abstract
This study aims to investigate factors associated with serum 25-hydroxyvitamin D [25(OH)D] concentration in Brazilian adults considering sociodemographic and lifestyle factors, as well as vitamin D-related single nucleotide polymorphisms (SNPs). This is a cross-sectional study (n = 491; 34-79y; 251 women), nested within a prospective cohort (Pró-Saúde Study). Associations between serum 25(OH)D and sociodemographic characteristics, diet, use of supplement, physical activity, season of blood collection, body fat, skin type, sun exposure index, and SNPs CYP2R1-rs10741657 and GC-rs2282679 were explored by multiple linear regression. The prevalence of serum 25(OH)D < 50nmol/L was 55%. Serum 25(OH)D was lower among women (β = -4.38; 95%CI: -8.02; -0.74), those with higher visceral fat (β = -4.02; 95%CI: -5.92; -2.12), and those with AC and CC genotypes for GC-rs2282679 (β = -6.84; 95%CI: -10.09; -3.59; β = -10.63; 95%CI: -17.52; -3.74, respectively). Factors directly associated with serum 25(OH)D included summer (β = 20.14; 95%CI: 14.38; 25.90), intermediate skin type (β = 6.16; 95%CI: 2.52; 9.80), higher sun exposure (β = 0.49; 95%CI: 0.22; 0.75), vitamin D intake (β = 0.48; 95%CI: 0.03; 0.93), and physical activity (β = 4.65; 95%CI: 1.54; 7.76). Besides physical activity, diet, and sun exposure, non-modifiable factors, such as GC genotypes must be considered when evaluating vitamin D insufficiency in mixed-race populations. Moreover, high visceral fat in association with poorer vitamin D status deserve attention given that both conditions are unfavorably related with chronic and acute health outcomes.
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