RESUMO
BACKGROUND: Vitamin D deficiency has reached epidemic proportions globally. Observational data link low vitamin D status to diabetes, dyslipidemia, and metabolic syndrome, but interventional trials on the effects of supplementation are limited. OBJECTIVE: We investigated associations between serum 25-hydroxyvitamin D (25(OH)D) levels and metabolic markers in Saudi adults. METHODS: This retrospective cross-sectional study analyzed the clinical records of 476 patients from Saudi Arabia, aged 15-78 years. According to 25(OH)D levels, participants were stratified as vitamin D-sufficient (≥30 ng/mL), -insufficient (21-29 ng/mL), or -deficient (≤20 ng/mL). The outcomes were diabetic status (fasting glucose, HbA1c) and lipid panel results. RESULTS: Higher diabetes prevalence was significantly associated with lower 25(OH)D levels (10.1% in the sufficient group, 11.6% in the insufficient group, and 18.3% in the deficient group). Similarly, worse lipid profiles were associated with more severe hypovitaminosis D, including a total cholesterol level of ≥240 mg/dL (5.3% in participants with normal vitamin D levels vs. 18.9% in those with deficient levels) and LDL ≥ 160 mg/dL (6.9% in participants with normal vitamin D levels vs. 13.2% in those with deficient levels). Vitamin D deficiency disproportionately affected women and adults > 45 years old. CONCLUSIONS: Vitamin D deficiency is endemic in Saudi Arabia and strongly linked to worsened metabolic markers. Optimizing vitamin D status through screening and correcting the deficiency may provide a cost-effective approach to confronting the regional diabetes epidemic and reducing cardiovascular disease risk.
RESUMO
Background: Beta-thalassemia major is the most common chronic hemolytic anemia among children and adolescents across the world. Several studies have demonstrated that thalassemic patients who have preserved left ventricle systolic function could still have subtle systolic dysfunction. Among patients with beta-thalassemia, early detection of transfusion-induced myocardial iron loading and its intervention with aggressive chelation therapy may delay or reverse heart failure. Two-dimensional speckle-tracking echocardiography (2D-STE) is a novel tool that may detect early myocardial dysfunction in these patients. Objective: The aim of this study was to investigate whether longitudinal strain based on speckle tracking can detect subtle right or left ventricular dysfunction. Patients and Methods: Fifty thalassemic patients with preserved left ventricular ejection fraction (>55%), mean age of 14.75 ± 4.73 years, and thirty age-matched healthy control subjects have been included in the study. Conventional echo Doppler, tissue Doppler echocardiography, and 2D-STE were performed in all patients and control subjects. Results: The right ventricular and left ventricular longitudinal strains were significantly lower in patients than in controls (21.67 ± 5.59 vs. 25.32 ± 2.29, P = 0.001 for right ventricular and 21.29 ± 3.49 vs. 24.90 ± 0.97, P = 0.001 for left ventricular). Conclusions: The 2D-STE can detect early ventricular (left and right) systolic dysfunction in thalassemic patients in the presence of normal systolic function by conventional methods. It may be suggested that the assessment of global longitudinal strain (GLS) can be used as a useful and less expensive tool for screening myocardial iron overload, especially in countries with a limited magnetic resonance imaging (MRI) availability for logistic and economic reasons. Hence, we can refer positive cases with GLS to a higher center to do MRI and start intensive iron chelation treatment.