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Obesity is associated with a higher risk of Vitamin D (VD) inadequacy and metabolic diseases. The Edmonton Obesity Staging System (EOSS) is an innovative tool for the evaluation of obesity that goes beyond body weight and considers clinic, functional and menta- health issues. This study aimed to evaluate the nutritional status of VD according to the stages of EOSS and its relationship with the metabolic profile. In the cross-sectional study, we evaluated anthropometric parameters, physical activity, blood pressure, biochemical and metabolic variables, and VD nutritional status. A total of 226 individuals were categorized using EOSS: 1.3%, 22.1%, 62.9%, and 13.7% were in stages 0, 1, 2 and 3, respectively. Regarding the metabolic changes and comorbidities, insulin resistance and hyperuricemia were diagnosed in some individuals in EOSS 1, 2, and 3. EOSS 2 and 3 presented a significant relative-risk for the development of arterial hypertension, metabolic syndrome, and liver disease, compared with EOSS 0. In all stages, there were observed means of 25(OH)D serum concentrations below 30 ng/mL (EOSS 0 24.9 ± 3.3 ng/mL; EOSS 3 15.9 ± 5.4 ng/mL; p = 0.031), and 25(OH)D deficiency was present in all stages. Individuals with obesity classified in more advanced stages of EOSS had lower serum concentrations of 25(OH)D and a worse metabolic profile.
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Deficiência de Vitamina D , Vitamina D , Humanos , Índice de Massa Corporal , Estado Nutricional , Estudos Transversais , Obesidade , Vitaminas , Metaboloma , Deficiência de Vitamina D/complicaçõesRESUMO
BACKGROUND: To assess the influence of the time interval between pregnancy and the Roux-en-Y gastric bypass (RYGB) on maternal-infant complications. METHODS: This is an analytical, longitudinal and retrospective study comprising 42 pregnant women who had previously undergone RYGB, subdivided according to the time interval between pregnancy and bariatric surgery: ≤12 months (G1), >12 and <24 months (G2) and ≥24 months (G3). Anthropometric variables of mothers, newborns and information on pregnancy complications were collected. RESULTS: G1 was the group more likely to develop urinary tract infection, dumping syndrome and inadequacy of birth weight than G2. Pregnancy complications were similar and >80.0% both in the first 12 months and after 24 months of the RYGB and the smallest percentages occurred in the time interval of 12-24 months after it. In addition, the percentage of neonatal complications was the highest in G1 when compared to the other times studied. CONCLUSION: Our findings indicate less predisposition to maternal-infant complications in pregnancies occurring in the time interval of >12 and <24 months and suggest that pregnancy after 24 months can be as harmful as pregnancies occurring before the first 12 postoperative months, since a great catabolism occurs at this time as it has been shown in the literature.
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Derivação Gástrica/efeitos adversos , Período Pós-Operatório , Complicações na Gravidez/epidemiologia , Adulto , Antropometria , Peso ao Nascer , Índice de Massa Corporal , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Estudos Longitudinais , Gravidez , Estudos Retrospectivos , Fatores de Tempo , Aumento de PesoRESUMO
BACKGROUND: The aim of this review was to evaluate the impact of vitamin A supplementation on adult pregnant women and women who have just given birth in studies examining serum concentrations of vitamin A in breast milk and in maternal/child morbidity and mortality. METHODS: This review followed the recommendations in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). In November 2014, an electronic search was independently performed by two authors on the Medline, Scopus, Web of Science, and LILACS databases on studies published from January 2004 to November 2014. The methodological quality of the studies was assessed in accordance with the Jadad scale, which determines the exclusion of studies with scores lower than 3. RESULTS: It was observed that when supplementation was provided only in the immediate postpartum period, it increased the liver stores of vitamin A. On the other hand, when supplementation was provided during pregnancy and puerperium5, the propensity for depleting the stores of vitamin A at the end of pregnancy decreased, the immune system improved, and cases of gestational night blindness decreased, but there were no changes in the outcomes at childbirth or in maternal, fetal, and child mortality. When supplementation was provided before and during pregnancy and in the immediate postpartum period, an additional improvement of lung function evaluated in preschool-aged children was found, but no significant changes in cognitive and motor development were noted. CONCLUSIONS: Studies show the benefits of vitamin A supplementation, not just in the immediate postpartum period but, above all, when it is provided before and/or during pregnancy. Considering the positive repercussions observed, we suggest supplementation both in the gestational period and in the immediate postpartum period as a way to enhance the safety of mother-child care.
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Suplementos Nutricionais , Vitamina A/uso terapêutico , Feminino , Humanos , Leite Humano , Período Pós-Parto , Gravidez , Complicações na Gravidez/tratamento farmacológico , Deficiência de Vitamina A/tratamento farmacológicoRESUMO
PURPOSE: The objective of this study was to evaluate vitamin D nutritional status and its relation with ionic calcium, parathyroid hormone (PTH), maternal anthropometry and perinatal outcomes in pregnant women who previously underwent Roux-en-Y gastric bypass (RYGB) surgery. METHODS: In a clinic specialized in obesity control located in the city of Rio de Janeiro (Brazil), the following information were collected for adult women who underwent RYGB before pregnancy: serum concentrations of vitamin D [25(OH)D], calcium and PTH per gestational trimester and data on maternal anthropometry, gestational intercurrences and perinatal outcomes. RESULTS: The present study included 46 post-RYGB pregnant women. The prevalence of pregnant women with deficiency (≤20 ng/mL) or insufficiency (≥21 and 29 ng/mL) of vitamin D was above 70% in all trimesters. The prevalence of calcium deficiency was 15.2% in the first and in the second trimesters and 20% in the third trimester, while the prevalence of excess PTH was 19.6, 30.4 and 32.6% in the first, the second and the third trimesters, respectively. In the second and the third trimesters, a significant difference was observed between concentrations of 25(OH)D, and a negative correlation was observed between concentrations of calcium and PTH. Association of 25(OH)D with urinary tract infection (UTI) was found, but there was no association with calcium, PTH, maternal anthropometry, type of delivery and weight and gestational age at birth CONCLUSIONS: The post-RYGB pregnant women showed an elevated serum inadequacy (deficiency or insufficiency) of 25(OH)D during pregnancy. Maternal vitamin D status showed no association with maternal variables, except UTI, and the neonatal variables analyzed.
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Cálcio/metabolismo , Derivação Gástrica/métodos , Obesidade/cirurgia , Hormônio Paratireóideo/sangue , Vitamina D/metabolismo , Adulto , Brasil , Cálcio/sangue , Feminino , Derivação Gástrica/efeitos adversos , Humanos , Estado Nutricional , Obesidade/complicações , Gravidez , Segundo Trimestre da Gravidez , Terceiro Trimestre da Gravidez , Trimestres da Gravidez , Prevalência , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/metabolismo , Redução de Peso , Adulto JovemRESUMO
PURPOSE: To evaluate vitamin A concentration in mature breast milk of nursing mothers aiming to meet the daily needs and the formation of liver reserve in pre-term (PT) and term infants (T) in comparison with the recommended intake for this nutrient in this group. METHODS: We analyzed the retinol concentration in the milk of 120 nursing mothers (40 of PT infants and 80 of T infants) by collecting 10 mL of mature breast milk, held by a hand spray of one of the breasts 2 h after the last feeding in the morning. The cutoff points adopted for identification of vitamin A deficiency (VAD) and the liver reserve were <1.05 and >2.3 µmol/L, respectively. RESULTS: The concentrations of retinol in the human milk of T infants were superior to concentrations in the milk of PT infants (1.87 + 0.81 > 1.38 + 0.67 µmol/L, p < 0.0001). They were higher in T compared to PT (352.64 + 152.72 > 217.65 + 105.65 µg, p < 0.0001), but both were below the recommendation. VAD was 20.0 % (T) and 27.5 % (PT). Only 40.0 % (T) and 22.5 % (PT) of the mothers had retinol concentrations in milk above 2.3 mmol/L. CONCLUSION: The milk of the nursing mothers studied did not have enough retinol to meet the daily needs and to form liver reserve in both groups, especially in PT newborns. This finding reinforces the idea that supplementation with massive doses of vitamin A in the immediate postpartum period can be used as a protective device of the infant against VAD.
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Aleitamento Materno , Leite Humano/química , Deficiência de Vitamina A/epidemiologia , Vitamina A/análise , Adulto , Suplementos Nutricionais , Feminino , Humanos , Lactente , Recém-Nascido , Fígado/química , Masculino , Mães , Período Pós-Parto , Recomendações Nutricionais , Nascimento a Termo , Adulto JovemRESUMO
To assess the correlation between vitamin D status and body composition variables in adult women of childbearing age, a cross-sectional study was conducted involving women aged 20-49 years. The participants were categorized based on their vitamin D status and further divided according to body mass index (BMI). Anthropometric and biochemical data were collected to compute body composition indices, specifically body fat and muscle mass. The sample included 124 women, with 63.70% exhibiting vitamin D inadequacy. Women with inadequate vitamin D status demonstrated a higher waist-to-height ratio (WHtR) and body adiposity index (BAI), along with a lower BMI-adjusted muscle mass index (SMI BMI), compared to those with adequate levels of vitamin D (p = 0.021; p = 0.019; and p = 0.039, respectively). A positive correlation was observed between circulating concentrations of 25(OH)D and SMI BMI, while a negative correlation existed between circulating concentrations of 25(OH)D and waist circumference (WC), WHtR, conicity index (CI), fat mass index (FMI), body fat percentage (% BF), and fat-to-muscle ratio (FMR). These findings suggest that inadequate vitamin D status may impact muscle tissue and contribute to higher body adiposity, including visceral adiposity. It is recommended that these variables be incorporated into clinical practice, with a particular emphasis on WHtR and SMI BMI, to mitigate potential metabolic consequences associated with vitamin D inadequacy.
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Tecido Adiposo , Adiposidade , Composição Corporal , Índice de Massa Corporal , Músculo Esquelético , Deficiência de Vitamina D , Vitamina D , Humanos , Feminino , Adulto , Estudos Transversais , Pessoa de Meia-Idade , Vitamina D/sangue , Vitamina D/análogos & derivados , Adulto Jovem , Deficiência de Vitamina D/sangue , Tecido Adiposo/metabolismo , Músculo Esquelético/metabolismo , Circunferência da Cintura , Estado NutricionalRESUMO
PURPOSE: To evaluate the influence of vitamin D (VD) concentrations coupled with metabolic phenotypes preoperatively and 6 months after Roux-en-Y gastric bypass (RYGB) on body variables and weight loss. MATERIALS AND METHODS: A longitudinal, retrospective, analytical study comprising 30 adult individuals assessed preoperatively (T0) and 6 months (T1) after undergoing Roux-en-Y gastric bypass. The participants were distributed preoperatively into metabolically healthy obese (MHO) and metabolically unhealthy obese individuals (MUHO) according to the HOMA-IR classification, as well as the adequacy and inadequacy of vitamin D concentrations in the form of 25(OH)D. All participants were assessed for weight, height, body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), visceral adiposity index (VAI), body circularity index (BCI), body adiposity index (BAI), weight loss, and assessment of 25(OH)D and 1,25(OH)2D concentrations using high-performance liquid chromatography with an ultraviolet detector (HPLC-UV). The statistical program used was SPSS version 21. RESULTS: VD adequacy and a healthy phenotype in the preoperative period may play an important role concerning body fat distribution, as the body averages for WHtR (0.020*) and BCI (0.020*) were lower in MHO participants. In comparison, those with VD inadequacy and MUHOs had higher BAI averages (0.000*) in the postoperative period. Furthermore, it is possible that VD inadequacy before and after RYGB, even in the presence of an unhealthy phenotype, may contribute to the increase in VAI values (0.029*) after this surgery. Only those with inadequate VD and MUHOs had higher 25(OH)D concentrations. Besides, this unhealthy phenotype had a greater reduction in BMI in the early postoperative period (p < 0.001). CONCLUSION: This study suggests that VD adequacy and the presence of a healthy phenotype appear to have a positive impact on the reduction of visceral fat in the context of pre- and postoperative obesity. In addition, there was a greater weight reduction in those with VD inadequacy and in MUHO, which suggests that the volumetric dilution effect of VD and catabolism after bariatric surgery is more pronounced in this specific metabolic phenotype.
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Derivação Gástrica , Obesidade Mórbida , Adulto , Humanos , Vitamina D , Estudos Longitudinais , Obesidade Mórbida/cirurgia , Estudos Retrospectivos , Obesidade/cirurgia , Vitaminas , Índice de Massa Corporal , Redução de Peso , Fenótipo , Obesidade AbdominalRESUMO
Body adiposity is associated with increased metabolic risk, and evidence indicates that vitamin A is important in regulating body fat. The aim of this study was to evaluate serum concentrations of vitamin A and its association with body adiposity in women with the recommended intake of vitamin A. A cross-sectional study was designed with 200 women divided into four groups according to Body Mass Index (BMI): normal weight (NW), overweight (OW), class I obesity (OI), and class 2 obesity (OII). The cut-off points to assess inadequate participants were retinol < 1.05 µmol/L and ß-carotene < 40 µg/dL. Body adiposity was assessed through different parameters and indexes, including waist circumference (WC), waist-to-height ratio (WHtR), hypertriglyceridemic waist (HW), lipid accumulation product (LAP), Visceral Adiposity Index (VAI), and Body Adiposity Index (BAI). It was observed that 55.5% of women had low serum concentrations of ß-carotene (34.9 ± 13.8 µmol/L, p < 0.001) and 43.5% had low concentrations of retinol (0.71 ± 0.3 µmol/L, p < 0.001). Women classified as OI and OII had lower mean values of ß-carotene (OI-35.9 ± 4.3 µg/dL: OII-32.0 ± 0.9 µg/dL [p < 0.001]). IAV showed significant negative correlation with retinol (r = -0.73, p < 0.001). Vitamin A deficiency is associated with excess body adiposity in women with the recommended intake of vitamin. Greater body adiposity, especially visceral, was correlated with reduced serum concentrations of vitamin A.
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Vitamin D status affects the clinical and corporal outcomes of postoperative patients who undergo a Roux-en-Y gastric bypass (RYGB). The aim of this study was to evaluate the effect of adequate vitamin D serum concentrations on thyroid hormones, body weight, blood cell count, and inflammation after an RYGB. A prospective observational study was conducted with eighty-eight patients from whom we collected blood samples before and 6 months after surgery to evaluate their levels of 25-hydroxyvitamin D 25(OH)D, thyroid hormones, and their blood cell count. Their body weight, body mass index (BMI), total weight loss, and excess weight loss were also evaluated 6 and 12 months after surgery. After 6 months, 58% of the patients achieved an adequate vitamin D nutritional status. Patients in the adequate group showed a decrease in the concentration of thyroid-stimulating hormone (TSH) (3.01 vs. 2.22 µUI/mL, p = 0.017) with lower concentrations than the inadequate group at 6 months (2.22 vs. 2.84 µUI/mL, p = 0.020). Six months after surgery, the group with vitamin D adequacy showed a significantly lower BMI compared with the inadequate group at 12 months (31.51 vs. 35.04 kg/m2, p = 0.018). An adequate vitamin D nutritional status seems to favor a significant improvement in one's thyroid hormone levels, immune inflammatory profile, and weight loss performance after an RYGB.
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OBJECTIVE: To analyze the relationship between the biochemical markers of liver metabolism in different stages of Metabolic Associated Fatty Liver Disease (MAFLD) according to the obesity phenotype. METHODOLOGY: This is a cross-sectional study with individuals with class III obesity classified according to the obesity phenotypes proposed by the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. Biochemical and anthropometric variables were analyzed according to the staging of MAFLD and obesity phenotype. RESULTS: A total of 50 subjects with MAFLD, 62% (n = 31) with steatosis and 38% (n = 19) with steatohepatitis without fibrosis; 36% were classified as metabolically healthy obesity (MHO) and 64% as metabolically unhealthy obesity (MUHO), respectively. Mean values of alkaline phosphatase were 85.44 ± 27.27 vs. 61.92 ± 17.57 (p = 0.006); gamma-glutamyl transpeptidase, 25.77 ± 15.36 vs. 30.63 ± 19.49 (p = 0.025); and albumin, 3.99 ± 0.34 vs. 4.24 ± 0.23 (p = 0.037), were lower and statistically significant in the MHO group with steatosis. The results show when considering individuals with IR, only AP is a predictor of unhealthy phenotype (B-0.934, 0.848- 1.029, p = 0.031). CONCLUSION: MHO individuals with steatosis present lower severe changes related to markers of liver damage and function and AP is considered the predictor of MUHO phenotype.
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Hepatopatia Gordurosa não Alcoólica , Obesidade Metabolicamente Benigna , Humanos , Estudos Transversais , Obesidade/metabolismo , Biomarcadores , FenótipoRESUMO
Introduction: Objective: to evaluate clinical, metabolic and body characteristics related to the metabolically unhealthy phenotype (MUH) in menopausal women who practice resistance training (RT). Methods: cross-sectional study with a sample of 31 women. Clinical and metabolic variables were measured. Body adiposity was assessed by body mass index, waist circumference, visceral adiposity index (VAI) and lipid accumulation product (LAP). Body composition analysis was performed by DEXA. Results: the prevalence of the MH phenotype was 74.2 %. Metabolically healthy (MH) women were younger, had more years of RT practice, higher HDL-c levels and lower VAI and android/gynoid ratio (A/G) than the MUH women. Women with inadequacy of HDL-c, TG, A/G and VAI had 12.50 (95 % CI: 3.30-47.23), 4.83 (95 % CI: 2.37-9.85), 5.20 (95 % CI: 1.90-14.16) and 3.12 (95 % CI: 1.07-9.04) times greater prevalence of the MUH phenotype, respectively, than those with adequacy of these parameters. Binary logistic regression analysis demonstrated that age is a predictor of the MUH phenotype (OR = 1.254; 95 % CI: 1.00-1.56) and this variable showed correlation with TG, VAI and A/G. There was no association between thyrotropin and MUH phenotype in the present sample. Conclusion: age and visceral adiposity are predictors for the MUH phenotype in RT practitioners in menopause, which may initially be characterized by alterations in serum lipid profile.
Introducción: Objetivo: evaluar las características clínicas, metabólicas y corporales relacionadas con el fenotipo metabólicamente no saludable (MNS) en mujeres menopáusicas que practican entrenamiento de resistencia (ER). Métodos: estudio transversal con 31 mujeres. Se midieron variables clínicas y metabólicas. La adiposidad corporal se evaluó mediante el índice de masa corporal, la circunferencia de la cintura, el índice de adiposidad visceral (IAV) y el producto de acumulación de lípidos (PAL). El análisis de composición corporal fue realizado por DEXA. Resultados: la prevalencia del fenotipo metabólicamente saludable (MS) fue del 74,2 %. Las mujeres metabólicamente saludables (MS) eran más jóvenes, tenían más años de práctica de ER, niveles más altos de HDL-c y menor IAV y relación androide/ginoide (A/G) que las mujeres MNS. Hubo asociación del fenotipo MNS con los niveles de HDL-c y A/G. Las mujeres con insuficiencia de HDL-c, TG, A/G y IAV tuvieron 12,50 (IC 95 %: 3,30-47,23), 4,83 (IC 95 %: 2,37-9,85), 5,20 (IC 95 %: 1,90-14,16) y 3,12 (IC 95 %: 1,07-9,04) veces mayor prevalencia del fenotipo MNS, respectivamente, que aquellas con adecuación de estos parámetros. El análisis de regresión logística binaria demostró que la edad es un predictor del fenotipo MUH (OR = 1,254; IC 95 %: 1,00-1,56) y esta variable mostró correlación con TG, VAI and A/G. No hubo asociación entre la tirotropina y el fenotipo MUH en la presente muestra. Conclusión: la edad y la adiposidad visceral son predictores del fenotipo MUH en practicantes de ER en la menopausia, que puede caracterizarse inicialmente alteraciones en el perfil plasmático de insípidos.
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Vitamin A (VA) has a negative association with body mass index (BMI) since it is involved in the regulation of body adiposity via nuclear receptors. However, few studies have investigated the relationship between VA nutritional status and the way body adipose is stored, which is the aim of this cross-sectional analytical study with Brazilian adult women in different BMI classes with the intake of VA recommended. VA nutritional status was assessed by serum retinol and ß-carotene measurements, dietary intake, and diagnosis of night blindness (NB). Results: 268 women with mean age of 38.00±5.80 years. According to the BMI, 30.97% were normal weight, 14.18% overweight, 25.37% class I obesity, 14.55% class II, and 14.93% class III.The prevalence of low serum of ß-carotene, retinol, and presence of NB in the total sample was 73.5%, 45.9%, and 20.1%, respectively. A total of 86.7% of normal weight women had inadequate visceral adiposity index (VAI) and 41.0% had inadequate body adiposity index (BAI).VAI was the body adiposity marker with the highest association with low serum retinol and b-carotene concentrations (P<.001). There was presence of NB in 100% of cases of inadequacy of BAI (P<.001). High visceral and body adiposity were associated with compromised VA nutritional status regardless of BMI and the recommended intake of VA. Additional measures to assess body adiposity, and especially its distribution, may collaborate in clinical practice to identify women at risk of compromising their VA nutritional status even when they are classified as normal weight according to their BMI.
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Adiposidade , Vitamina A , Adulto , Índice de Massa Corporal , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Estado Nutricional , Obesidade/complicações , beta CarotenoRESUMO
Obesity is a known risk factor for respiratory infection and many other chronic diseases, including metabolic dysfunction-associated fatty liver disease (MAFLD), previously known as nonalcoholic fatty liver disease (NAFLD). Recently, it has been considered an important and independent predictor for coronavirus disease 2019 (COVID-19) complications in adults, especially cardiopulmonary, presenting in a great number of individuals in critical care. In obesity, adipose tissue (AT) undergoes expansion via several processes: expansion of adipocytes and insufficient vascularization lead to hypoxia; adipocyte apoptosis/necrosis; irregular fatty acid flux; and enhanced secretion of inflammatory adipokines, cytokines, and chemokines. In individuals with obesity the liver can also become a target of COVID-19 infection, although major liver damage is uncommon. COVID-19 acute pandemic often develops in patients with major metabolic abnormalities, including fatty liver disease, which is part of a chronic pandemic together with body fat accumulation. During metabolic abnormalities, the expansion of metabolically active fat parallels chronic inflammatory changes, the development of Insulin Resistance (IR), and in the liver, the accumulation of fat, possibly, an underlying fibrosis. SARS-Cov-2 virus might affect the liver by direct or indirect mechanisms. The current epidemic of obesity and related metabolic diseases has extensively contributed to increase the number of severe cases and deaths from COVID-19, resulting in a health, political and economic crisis with long-lasting consequences. In this review, the authors explore the relationship between AT dysfunction and MAFLD in obesity on the scene of COVID-19.
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COVID-19 , Hepatopatia Gordurosa não Alcoólica , Tecido Adiposo , Adulto , COVID-19/complicações , Humanos , Hepatopatia Gordurosa não Alcoólica/complicações , Obesidade/complicações , Obesidade/epidemiologia , SARS-CoV-2RESUMO
PURPOSE: An inverse relationship between vitamin D (VD) nutritional status and obesity is frequent, and the distribution of body fat is an important aspect to assess the risks of obesity-related metabolic dysfunction. The purpose of the study was to evaluate the relationship between serum VD concentrations and body fat reduction after 12 months of bariatric surgery, using two different vitamin D3 (VD3) supplementation protocols. MATERIAL AND METHODS: A randomized controlled trial consisted of 41 patients divided into G1 (800 IU/day) and G2 (1800 IU/day) according to the VD3 supplementation. At baseline (T0) and follow-up (T1), 25(OH)D, waist circumference (WC), visceral adiposity index (VAI), body adiposity index (BAI), and waist/height ratio (WHtR) were evaluated. RESULTS: In T0, the mean of 25(OH)D was lower in G2 compared to that in G1 (22.6 vs 23.6 ng/mL; p = 0.000). At T1, it had a significant increase in G2 (32.1 vs 29.9 ng/mL; p = 0.000), with 60% sufficiency. A significant negative correlation was observed between VAI, BAI, and WHtR with 25(OH)D in G2 (r = - 0.746, p = 0.024; r = - 0.411, p = 0.036; r = - 0.441, p = 0.032) after surgery. Higher mean changes from baseline of visceral fat loss, represented by VAI, were observed in G2 (176.2 ± 149.0-75.5 ± 55.0, p = 0.000). CONCLUSION: Patients submitted to the 1800 IU/day protocol, 12 months after the surgical procedure, had a higher percentage of sufficient vitamin D levels compared to those submitted to the 800 IU/day protocol. Additionally, higher dose supplementation promoted a significant improvement in VAI.
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Adiposidade , Obesidade Mórbida , Índice de Massa Corporal , Colecalciferol/uso terapêutico , Suplementos Nutricionais , Humanos , Obesidade , Obesidade Abdominal/cirurgia , Obesidade Mórbida/cirurgia , Vitamina D , Vitaminas/uso terapêuticoRESUMO
PURPOSE: The purpose of this study is to evaluate the relationship between body composition, basal metabolic rate (BMR), and serum concentrations of leptin with long-term weight regain after Roux-en-Y gastric bypass (RYGB) and compare it with obesity before surgery. MATERIALS AND METHODS: Prospective longitudinal analytical study. Three groups were formed: individuals 60 months post RYGB, with weight regain (G1) and without it (G2), and individuals with obesity who had not undergone bariatric surgery (G3). Body fat (BF), body fat mass (BFM), visceral fat (VF), fat-free mass (FFM), skeletal muscle mass (SMM), and BMR were assessed by octapolar and multi-frequency electrical bioimpedance. Fasting serum concentrations of leptin were measured. RESULTS: Seventy-two individuals were included, 24 in each group. Higher means of BF, BFM, VF, and leptin levels were observed in G1, when compared to G2 (BF: 47.5 ± 5.6 vs. 32.0 ± 8.0, p < 0.05; FBM: 47.8 ± 11.6 vs. 23.9 ± 7.0, p < 0.05; VF: 156.8 ± 30.2 vs. 96.1 ± 23.8, p < 0.05; leptin: 45,251.2 pg/mL ± 20,071.8 vs. 11,525.7 pg/mL ± 9177.5, p < 0.000). G1 and G2 did not differ in FFM, SMM, and BMR. G1 and G3 were similar according to BF, FFM, BMR, and leptin levels. Body composition, but not leptin, was correlated with %weight regain in G1 (FBM: r = 0.666, p < 0.000; BF: r = 0.428, p = 0.037; VF: r = 0.544, p = 0.006). CONCLUSION: Long-term weight regain after RYGB is similar to pre-surgical obesity in body composition, BMR, and leptin concentrations, indicating relapse of metabolic and hormonal impairments associated with excessive body fat.
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Derivação Gástrica , Obesidade Mórbida , Metabolismo Basal , Composição Corporal/fisiologia , Humanos , Leptina , Obesidade/metabolismo , Obesidade/cirurgia , Obesidade Mórbida/cirurgia , Estudos Prospectivos , Aumento de Peso/fisiologiaRESUMO
Objective: To assess the influence of vitamin D on body weight loss in women who had previously undergone Roux-en-Y gastric bypass (RYGB). Methodology: This is an analytical, longitudinal and retrospective study comprising 40 women of reproductive age who had previously undergone RYGB. To investigate the influence of the serum concentrations of vitamin D on body weight reduction, the variables were analyzed in the pre-operative period (T0), in the first (T1) and in the second postoperative year (T2) and were stratified according to the BMI measured in T1 and T2. In addition, in the pre-operative period, participants were subdivided into groups based on adequacy (G1), deficiency (G2) and insufficiency (G3), according to their serum concentrations of vitamin D. Results: Although weight loss occurred in a substantial way in T1, it continued to decrease in T2 (p = 0.017). The women who reached normal weight within two years of surgery showed the lowest vitamin D concentrations preoperatively when compared to those who were overweight (p = 0.011). Women with preoperative vitamin D deficiency showed increased concentrations in the assessed times (p < 0.001), while the opposite (p = 0.001) occurred in women with adequacy. Conclusion: The study showed that inadequacy of vitamin D does not interfere with weight loss in the two-year-follow-up after RYGB and highlights that vitamin D can present a differentiated response postoperatively, to the detriment of the pre-operative period.
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The relationship between volume training of resistance training (RT), body composition and cardiometabolic profile in menopausal women is poorly understand. This study aimed to evaluate the dose−response relationship of RT on lipid profile, body composition and metabolic phenotypes in menopausal women. A total of 31 women were categorized according to different volume of RT. Body composition was evaluated by DEXA and the cardiometabolic risk by metabolic phenotypes and lipid profile. There was a higher frequency of metabolically unhealthy phenotype in women who practiced RT for less than two years and had a weekly frequency lower than three days a week (p > 0.05). Women with more than two years and a higher weekly frequency of RT had lower trunk fat mass than their counterparties (15.33 ± 7.56 versus 10.57 ± 4.87, p = 0.04; 16.31 ± 7.46 versus 10.98 ± 5.49, p = 0.03, respectively). There was an association between HDL-c and time of RT in years. A moderate correlation was identified between variables of body adiposity, time in years and weekly frequency of RT. The present study concludes that more time in years and weekly frequency of RT practice are associated with lower body adiposity in menopausal women, the first also being associated with HDL-c.
Assuntos
Doenças Cardiovasculares , Treinamento Resistido , Composição Corporal , Índice de Massa Corporal , Doenças Cardiovasculares/metabolismo , Feminino , Humanos , Lipídeos , Menopausa , Obesidade , FenótipoRESUMO
Evaluating the influence of vitamin D concentrations together with preoperative metabolic phenotypes on remission of chronic noncommunicable diseases (CNCDs) after 6 months of Roux-en-Y gastric bypass (RYGB). Cross-sectional analytical study comprising 30 adult individuals who were assessed preoperatively (T0) and 6 months (T1) after undergoing RYGB. Participants were distributed preoperatively into metabolically healthy obese (MHO) and metabolically unhealthy obese (MUHO) individuals according to HOMA-IR classification and to the adequacy and inadequacy of vitamin D concentrations in the form of 25(OH)D. All participants were assessed for anthropometric characteristics, biochemical variables, and presence of CNCDs. The statistical program used was the SPSS version 21. In face of vitamin D adequacy and regardless of the metabolic phenotype classification in the preoperative period, the means found for HOMA-IR allowed us to define them as metabolically healthy 6 months after RYGB. Only those with vitamin D inadequacy with the MUHO phenotype showed better results regarding the reduction of glucose that accompanied the shift in serum 25(OH)D concentrations from deficient to insufficient. It is possible that preoperative vitamin D adequacy, even in the presence of an unhealthy phenotype, may contribute to the reduction of dyslipidemia and improvement in cholesterol. It is suggested that preoperative vitamin D adequacy in both phenotypes may have a protective effect on metabolic health.
Assuntos
Derivação Gástrica , Estudos Transversais , Humanos , Período Pré-Operatório , Vitamina D , VitaminasRESUMO
INTRODUCTION: Objective: to analyze the relationship of age at menarche and leptin with the metabolically healthy (MH) and metabolically unhealthy (MUH) phenotypes in adolescent girls in different body mass index (BMI) categories. Method: an observational and cross-sectional study consisting of 139 female adolescents attended to at the Adolescent Reference Center in Macaé, Rio de Janeiro. Menarche was classified as early (EM) when the first menstruation occurred at or before 11 years of age; normal menarche (NM) was categorized at ages 12 to 14; menarche was considered late (LM) when it occurred at age 15 or older. The factors required to ascertain the subjects' phenotype, as well as their leptin levels, weight, and height, were measured and their BMIs were calculated. The girls were classified as MH or MUH based on the NCEP-ATP III criteria as adapted for children and adolescents. Results: 82 % (n = 114) of the girls were classified as MH and 18 % (n = 25) as MUH. Mean age at menarche was 11.79 ± 1.39 years. There was a higher prevalence of MUH amongst the girls who had EM (p = 0.04). A higher inadequacy of serum leptin concentrations was found in girls who had EM (p = 0.05) and in those classified as MUH (p = 0.01). The adolescents who were severely obese exhibited inadequate leptin levels (p < 0.01) and had gone through EM (p = 0.02). A total of 8.1 % (n = 7) of the normal-weight girls were classified as MUH, and 29.4 % (n = 5) of those who were severely obese were classified as MH (p < 0.01). Conclusion: early menarche and high serum leptin concentrations are related with the MUH phenotype in adolescent girls in different BMI categories.
INTRODUCCIÓN: Objetivo: analizar la relación de la edad de la menarquia y los niveles de leptina con los fenotipos metabólicamente saludables (MS) y metabólicamente no saludables (MNS) en adolescentes de diferentes categorías de índice de masa corporal (IMC). Método: estudio observacional y transversal compuesto por 139 adolescentes de sexo feminino, atendidas en el Centro de Referencia para Adolescentes de Macaé, Río de Janeiro. La menarquia se clasificó como precoz (MP) cuando se produjo la primera menstruación a o antes de los 11 años de edad; la menarquia normal (MN) se clasificó como aquella sucedida a la edad de 12 a 14 años; la menarquia se consideró tardía (MT) cuando ocurrió a los 15 años o más. Se midieron los factores necesarios para determinar el fenotipo de los sujetos, y se midieron sus niveles de leptina, peso y altura, y se calculó su IMC. Las adolescentes se clasificaron como MS y MNS según los criterios de NCEP-ATP III, adaptados para niños y adolescentes. Resultados: el 82 % (n = 114) de las adolescentes se clasificaron como MH y el 18 % (n = 25) como MUH. La edad media de la menarquia fue de 11,79 ± 1,39 años. Hubo una mayor prevalencia de MUH entre las adolescentes que tenían MP (p = 0,04). Se encontró una mayor insuficiencia de las concentraciones séricas de leptina en las adolescentes que tenían MP (p = 0,05) y en aquellas clasificadas como MNS (p = 0,01). Las adolescentes que eran severamente obesas exhibieron niveles inadecuados de leptina (p < 0,01) y habían pasado por una MP (p = 0,02). El 8,1 % (n = 7) de las adolescentes de peso normal se clasificaron como MNS y el 29,4 % (n = 5) de las que eran severamente obesas se clasificaron como MS (p < 0,01). Conclusión: la menarquia temprana y las altas concentraciones séricas de leptina están relacionadas con el fenotipo MNS en las adolescentes de diferentes categorías de IMC.
Assuntos
Índice de Massa Corporal , Leptina/sangue , Menarca/sangue , Obesidade Infantil/sangue , Adolescente , Fatores Etários , Estatura , Peso Corporal , Brasil , Criança , Estudos Transversais , Feminino , Humanos , Menarca/fisiologia , Obesidade Infantil/classificação , Fenótipo , Puberdade/sangue , Puberdade/fisiologia , Maturidade SexualRESUMO
The objective of the present study is to assess the association between vitamin A deficiency (VAD) evaluated by serum retinol concentration from the mother and umbilical cord and placental concentration of retinol and carotenoids to propose placental values representative of deficiency. Two hundred and sixty-two puerperal women and their newborns were assessed. Concentration of serum and placental retinol and carotenoids was determined by the spectrophotometric method. Receiver operating characteristic (ROC) curve analysis was performed according to two cut-off points (0.70 and 1.05 mumol/l) to represent deficiency in the placental concentration. No difference between averages of placental retinol and carotenoids was observed in the puerperal women regardless of the cut-off point used to define VAD. In relation to the newborns, a decrease (P = 0.012) in placental retinol averages in individuals with VAD was observed when the 1.05 mumol/l cut-off point was adopted. In respect to the placental carotenoid averages, a decrease is observed for both the cut-off points (P = 0.013 and 0.019 for 1.05 and 0.7 mumol/l, respectively). The ROC curve results point to the value of 0.80 mumol/l as representing deficiency with greater values found for sensitivity (66.7 %), specificity (41.7 %) and accuracy (65 %) when the 0.70 mumol/l cut-off point was adopted. The results of the present study show an association between the placental concentration of retinol and carotenoids with clinical VAD, suggesting the need for further studies on more severe cases of deficiency.