Integrative network analysis of differentially methylated regions to study the impact of gestational weight gain on maternal metabolism and fetal-neonatal growth.

Integrative network analysis (INA) is important for identifying gene modules or epigenetically regulated molecular pathways in diseases. This study evaluated the effect of excessive gestational weight gain (EGWG) on INA of differentially methylated regions, maternal metabolism and offspring growth. Brazilian women from "The Araraquara Cohort Study" with adequate pre-pregnancy body mass index were divided into EGWG (n=30) versus adequate gestational weight gain (AGWG, n=45) groups. The methylome analysis was performed on maternal blood using the Illumina MethylationEPIC BeadChip. Fetal-neonatal growth was assessed by ultrasound and anthropometry, respectively. Maternal lipid and glycemic profiles were investigated. Maternal triglycerides-TG (p=0.030) and total cholesterol (p=0.014); fetus occipito-frontal diameter (p=0.005); neonate head circumference-HC (p=0.016) and thoracic perimeter (p=0.020) were greater in the EGWG compared to the AGWG group. Multiple linear regression analysis showed that maternal DNA methylation was associated with maternal TG and fasting insulin, fetal abdominal circumference, and fetal and neonate HC. The DMRs studied were enriched in 142 biological processes, 21 molecular functions,and 17 cellular components with terms directed for the fatty acids metabolism. Three DMGMs were identified:COL3A1, ITGA4 and KLRK1. INA targeted chronic diseases and maternal metabolism contributing to an epigenetic understanding of the involvement of GWG in maternal metabolism and fetal-neonatal growth.

Consumption of ultra-processed products is associated with vitamin D deficiency in Brazilian adults and elderly.

Although studies show that the intake of ultra-processed products (UPP) has a negative impact on health, diet quality and dietary vitamin D, its influence on serum concentrations of this vitamin remains unknown; therefore, it is essential to verify the association between the UPP consumption and vitamin D deficiency. This is a cross-sectional, household, population-based study, carried out with 229 individuals aged 20 years or older, residents of the city of Teresina, Piauí, Brazil. Socio-demographic, lifestyle, food consumption and anthropometric data were collected. Food consumption was obtained using a 24-h food recall, and foods were grouped according to the NOVA classification. Plasma concentrations of calcidiol-25 (OH) D3 were determined by HPLC. Crude and adjusted binary logistic regression was applied to estimate the association between UPP consumption and vitamin D deficiency. Most individuals aged 20-39 years were vitamin D deficient (52·1 %). UPP contributed 19·9 % to the energetic intake of the participant's diet. This contribution was higher for individuals with vitamin D deficiency (22·5 %, P = 0·04). In addition, a high intake of UPP was associated with twice the risk of vitamin D deficiency in comparison with low consumption of UPP (OR: 2·05; CI 1·06, 4·50; P: 0·04). Our results suggest that the consumption of UPP may have a negative impact on serum concentrations of vitamin D; more studies are needed.

Excessive Gestational Weight Gain Alters DNA Methylation and Influences Foetal and Neonatal Body Composition.

BACKGROUND: Changes in body weight are associated with the regulation of DNA methylation (DNAm). In this study, we investigated the associations between maternal gestational weight gain-related DNAm and foetal and neonatal body composition. METHODS: Brazilian pregnant women from the Araraquara Cohort Study were followed up during pregnancy, delivery, and after hospital discharge. Women with normal pre-pregnancy BMI were allocated into two groups: adequate gestational weight gain (AGWG, n = 45) and excessive gestational weight gain (EGWG, n = 30). Foetal and neonatal body composition was evaluated via ultrasound and plethysmography, respectively. DNAm was assessed in maternal blood using Illumina Infinium MethylationEPIC BeadChip arrays. Linear regression models were used to explore the associations between DNAm and foetal and neonatal body composition. RESULTS: Maternal weight, GWG, neonatal weight, and fat mass were higher in the EGWG group. Analysis of DNAm identified 46 differentially methylated positions and 11 differentially methylated regions (DMRs) between the EGWG and AGWG groups. Nine human phenotypes were enriched for these 11 DMRs located in 13 genes (EMILIN1, HOXA5, CPT1B, CLDN9, ZFP57, BRCA1, POU5F1, ANKRD33, HLA-B, RANBP17, ZMYND11, DIP2C, TMEM232), highlighting the terms insulin resistance, and hyperglycaemia. Maternal DNAm was associated with foetal total thigh and arm tissues and subcutaneous thigh and arm fat, as well as with neonatal fat mass percentage and fat mass. CONCLUSION: The methylation pattern in the EGWG group indicated a risk for developing chronic diseases and involvement of maternal DNAm in foetal lean and fat mass and in neonatal fat mass.

Nutritional Global Status and Its Impact in Crohn's Disease.

BACKGROUND: Malnutrition among inflammatory bowel disease (IBD) subjects is well documented in literature and may emerge from factors including inadequate dietary intake, malabsorption and disease activity. The aim of this study was to complete a comprehensive nutrition assessment and explore what possibilities may help bring a better quality of life for IBD subjects. METHODS: Nutritional status based on biochemical tests, body composition and body mass index (BMI). Food intake was assessed by an alternate 3-day food record and the adequacy of intake was evaluated according to national and international references. Clinical disease activity was evaluated by the Harvey-Bradshaw index and CRP levels. RESULTS: The study included 217 patients and 65 controls, where 54.4% of these patients were classified as normal weight with a mean BMI lower than controls (23.8 ± 4.9 versus 26.9 ± 4.8 kg/m2, P = 0.02). Patients with disease activity showed more overweight and obesity than patients with controlled disease. Vitamin B12 deficiency was present in 19% of Crohn's disease (CD), mainly in patients with ileal commitment and small bowel resections. Anemia was present in 21.7% of patients, being more common in patients with active disease (25%) and bowel resection (23%). Regarding calorie intake (EI), CD group ingested more than controls (1986.3 ± 595.9 kcal versus 1701.8 ± 478.9 kcal; P = 0.003). CONCLUSIONS: CD patients presented micronutrient deficiency when compared with controls, explained for other reasons than intake restrictions. Also, fat excess might have contributed to disease burden as continuously reported in the literature.

Nutritional status and vitamin A and zinc levels in patients with kala-azar in Piauí, Brazil.

INTRODUCTION: Malnutrition and kala-azar (or visceral leishmaniasis) are significant public health problems in different parts of the world. Immunity and susceptibility to infectious and parasitic diseases are directly linked to the host's nutritional state, but little is known about the interaction between nutrition and kala-azar. This study aimed to evaluate nutritional status with kala-azar and correlate these findings with the clinical and laboratory manifestations of the disease, and zinc and retinol levels. METHODS: This was a cross-sectional study of 139 patients with kala-azar. Nutritional status classification was performed according to international recommendations. Parametric or nonparametric tests were applied whenever indicated in a two-sided test with a 5% significance level. RESULTS: Weight loss and malnutrition were more frequent in adults. Body mass index-for-age, fat area of the arm, and upper arm muscle area were significantly associated with probability of death. The presence of human immunodeficiency virus, hepatomegaly, and splenomegaly was correlated with nutritional assessment. Blood leukocyte and lymphocyte, serum creatine, and vitamin A levels were significantly higher in adult men. Vitamin A levels were highly associated with the level of hemoglobin and C-reactive protein (CRP) in multivariate analysis. All patients had reduced plasma zinc levels, but this finding had no association with the outcome variables. CONCLUSIONS: Malnutrition was correlated with severe disease and was more prevalent in older people with kala-azar. Vitamin A deficiency was associated with hemoglobin and CRP. Zinc levels were reduced in patients with kala-azar.

Does Vitamin D play a role in the management of Covid-19 in Brazil?

The study discusses the possible role of adequate vitamin D status in plasma or serum for preventing acute respiratory infections during the Covid-19 pandemic. Our arguments respond to an article, published in Italy, that describes the high prevalence of hypovitaminosis D in older Italian women and raises the possible preventive and therapeutic role of optimal vitamin D levels. Based on literature review, we highlight the findings regarding the protective role of vitamin D for infectious diseases of the respiratory system. However, randomized controlled trials are currently lacking. Adequate vitamin D status is obtained from sun exposure and foods rich in vitamin D. Studies in Brazil have shown that hypovitaminosis D is quite common in spite of high insolation. Authors recommend ecological, epidemiological and randomized controlled trials studies to verify this hypothesis.

The Validity of Children's Fruit and Vegetable Intake Using Plasma Vitamins A, C, and E: The SAYCARE Study.

Despite that fruits and vegetables are key elements for health promotion, there are limited studies validating their intake in children. We aimed to validate the SAYCARE (South American Youth/Child Cardiovascular and Environmental) Study Food Frequency Questionnaire (FFQ) and the combination of the FFQ frequency of intake with the 24 h-dietary-recall (24 h-DR) (mean of 3 days), for children's fruit and vegetable intake. The reference methods were plasma dosages of ß-carotene, retinol, ascorbic acid, and α-tocopherol, which were collected in the school environment. It is a validity study in a subsample of 45 children aged 6-10 years participating in the SAYCARE Study, from São Paulo (Brazil). The FFQ was answered by the parents/guardians over the previous 3 months; the 24 h-DR was answered three times (two weekdays by nutritionists, one weekend day by parents/guardians). The mean fruit and vegetable intake (combined with frequency of intake) was calculated using the multiple source method (MSM). Multiple linear regression showed pooled correlation coefficients of 0.29 to 0.35 for the reported fruit and vegetable intake estimated by the FFQ and the MSM, respectively. The SAYCARE FFQ is an accurate and useful tool for ranking fruit and vegetable intake in children between 6-10 years from the SAYCARE Study.

Anthropometric measurements as a potential non-invasive alternative for the diagnosis of metabolic syndrome in adolescents.

OBJECTIVE: To identify which anthropometric measurement would be the best predictor of metabolic syndrome (MetS) in Brazilian adolescents. SUBJECTS AND METHODS: Cross-sectional study conducted on 222 adolescents (15-17 years) from a city in southern Brazil. Anthropometric, physical activity, blood pressure and biochemical parameters were investigated. MetS criteria were transformed into a continuous variable (MetS score). Linear regression analyses were performed to assess the associations of BMI, hip circumference, neck circumference (NC), triceps skinfold, subscapular skinfold and body fat percentage with MetS score. ROC curves were constructed to determine the cutoff for each anthropometric measurement. RESULTS: The prevalence of MetS was 7.2%. Each anthropometric measurement was significantly (p < 0.001) associated with MetS score. After adjusting for potential confounding variables (age, sex, physical activity, and maternal education), the standardized coefficients of NC and body fat percentage appeared to have the strongest association (beta = 0.69 standard deviation) with MetS score. The regression of BMI provided the best model fit (adjusted R2 = 0.31). BMI predicted MetS with high sensitivity (100.0%) and specificity (86.4%). CONCLUSIONS: Our results suggest that BMI and NC are effective screening tools for MetS in adolescents. The early diagnosis of MetS combined with targeted lifestyle interventions in adolescence may help reduce the burden of cardiovascular diseases and diabetes in adulthood.

[Evidence of the impact of vitamin A supplementation on maternal and child health]. / Evidências do impacto da suplementação de vitamina A no grupo materno-infantil.

The aim of this article was to collect the results of systematic reviews and meta-analyses that evaluated the effect of vitamin A supplementation on child growth and maternal, fetal, and child morbidity and mortality. A detailed search was performed in PubMed, Cochrane Library, LILACS, PAHO, CAPES, USP Digital Thesis Library, and UNIFESP Collection Database. A total of 14 studies published from 1993 to 2006 were included in the review. There is evidence that vitamin A supplementation in children is associated with a reduction of 23% to 30% in mortality risk and attenuation in the severity of measles and diarrhea. There is no evidence of the intervention's impact on pneumonia incidence or mortality in children without measles. Vitamin A also appears to be protective in children and pregnant women with HIV/AIDS, with a positive effect on child morbidity and mortality and birth weight. There is no evidence that supplementation in pregnant and lactating women reduces infant morbidity and mortality, but there is an indication that vitamin A protects against maternal morbidity.

The impact of dark chocolate intake on arterial elasticity in individuals with HIV/AIDS undergoing ART: a randomized, double-blind, crossover trial.

An increase in the frequency of cardiovascular diseases has been observed in the HIV/AIDS population. Studies involving healthy subjects or subjects with other diseases have shown benefits of chocolate supplementation on endothelial function and vasodilation. We evaluate the impact of chocolate consumption on arterial elasticity in people living with human immunodeficiency virus - PLHIV. A double-blind, crossover trial including 110 PLHIV (19 to 59 years) on antiretroviral therapy - ART for at least 6 months and with a viral load of <500 copies per mL was conducted. All subjects were randomly assigned to 15-d dietary supplements containing dark chocolate or placebo with a 15-d washout period. Each participant received one of the two sequences: A (dark chocolate, placebo chocolate); B (placebo chocolate, dark chocolate). Arterial elasticity was measured using the HDI/PulseWave™ CR-2000 CardioVascular Profiling System®. Body composition, lipid profile, C-reactive protein, and thiobarbituric acid reactive substances were also assessed. Analysis of variance (ANOVA) for repeated measures using the Stata 11.0® program was used for cross-over analysis. Most subjects were men (59.0%) and Caucasian (46.1%) and the mean age was 44.6 ± 7.1 years. The mean time since diagnosis of HIV infection was 13.7 ± 5.3 years and the mean duration of ART was 12.9 ± 4.2 years. Chocolate consumption resulted in significant alterations in the large artery elasticity index - LAEI (p = 0.049) and the mean concentration of HDL-c was higher after supplementation with dark chocolate (p = 0.045). This is the first study to evaluate the effect of chocolate on arterial elasticity in PLHIV. The results showed that dark chocolate consumption for 15 days improved the elastic properties of the LAEI in PLHIV. These findings, added to the noninvasive method used, may expand the knowledge of CVDs in this population.

[Prevalence and factors associated with vitamin A deficiency in preschool children from Teresina, Piauí, Brazil]. / Prevalência de deficiência de vitamina A e fatores associados em pré-escolares de Teresina, Piauí, Brasil.

Vitamin A deficiency is a public health problem in the Northeast of Brazil. This study aimed to determine the prevalence of vitamin A deficiency and associated factors among preschool children in Teresina, Piauí, Brazil. We studied the serum retinol levels and socioeconomic and demographic characteristics of 631 children from 36 to 83 months of age. The statistical association between each of the above characteristics and serum retinol levels was investigated by univariate and multivariate linear regression analysis. Mean serum retinol was 1.21 mmol/L (95%CI: 1.17-1.25 micromol/L) and was independent of gender (p = 0.259). Prevalence of vitamin A deficiency (retinol < 0.69 micromol/L) was 15.4% (95%CI: 12.7-18.4), with a tendency to decrease with age. Acceptable but not adequate retinol levels (0.70 to 1.04 micromol/L) were observed in 29% of children (95%CI: 25.2-32.4). There were positive associations between retinol levels and age, income, vitamin A supplementation, and maternal schooling. Vitamin A deficiency appeared as a moderately serious public health problem, emphasizing the importance of strategies to combat this problem in the region.

Cardiometabolic risk markers of normal weight and excess body weight in Brazilian adolescents.

Excess body weight leads to a variety of metabolic changes and increases the risk for cardiovascular diseases (CVD) in adulthood. The objective of this study was to investigate the presence of risk markers for CVD among Brazilian adolescents of normal weight and with excess body weight. The markers included blood pressure, C-reactive protein, homocysteine, tumor necrosis factor alpha, fibrinogen, fasting insulin and glucose, homeostasis model assessment of insulin resistance (HOMA-IR), leptin, total cholesterol, low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), and triglycerides. We calculated odds ratios (OR) using logistic regression and adjusted for potential confounders such as age, sex, physical activity, and socioeconomic background. Compared with normal weight subjects, overweight/obese adolescents were more likely to have higher systolic blood pressure (OR = 3.49, p < 0.001), fasting insulin (OR = 8.03, p < 0.001), HOMA-IR (OR = 8.03, p < 0.001), leptin (OR = 5.55, p < 0.001), and LDL-c (OR = 5.50, p < 0.001) and lower serum HDL-c concentrations (OR = 2.76, p = 0.004). After adjustment for confounders, the estimates did not change substantially, except for leptin for which the risk associated with overweight increased to 11.09 (95% CI: 4.05-30.35). In conclusion, excess body weight in adolescents exhibits strong associations with several markers that are established as causes of CVD in adults. This observation stresses the importance of primary prevention and of maintaining a healthy body weight throughout adolescence to reduce the global burden of CVD.

Nutritional status and vitamin A and zinc levels in patients with kala-azar in Piauí, Brazil

Abstract INTRODUCTION: Malnutrition and kala-azar (or visceral leishmaniasis) are significant public health problems in different parts of the world. Immunity and susceptibility to infectious and parasitic diseases are directly linked to the host's nutritional state, but little is known about the interaction between nutrition and kala-azar. This study aimed to evaluate nutritional status with kala-azar and correlate these findings with the clinical and laboratory manifestations of the disease, and zinc and retinol levels. METHODS: This was a cross-sectional study of 139 patients with kala-azar. Nutritional status classification was performed according to international recommendations. Parametric or nonparametric tests were applied whenever indicated in a two-sided test with a 5% significance level. RESULTS: Weight loss and malnutrition were more frequent in adults. Body mass index-for-age, fat area of the arm, and upper arm muscle area were significantly associated with probability of death. The presence of human immunodeficiency virus, hepatomegaly, and splenomegaly was correlated with nutritional assessment. Blood leukocyte and lymphocyte, serum creatine, and vitamin A levels were significantly higher in adult men. Vitamin A levels were highly associated with the level of hemoglobin and C-reactive protein (CRP) in multivariate analysis. All patients had reduced plasma zinc levels, but this finding had no association with the outcome variables. CONCLUSIONS: Malnutrition was correlated with severe disease and was more prevalent in older people with kala-azar. Vitamin A deficiency was associated with hemoglobin and CRP. Zinc levels were reduced in patients with kala-azar.

Beta-carotene concentrations in maternal and cord blood of smokers and non-smokers.

BACKGROUND: Smoking in pregnancy can cause a reduction in the transport of beta-carotene across the placenta, consequently reflecting on the concentrations of this micronutrient in the newborn baby. AIMS: This study determined the concentrations of beta-carotene in maternal blood and umbilical cord blood in a group of smokers and non-smokers. DESIGN AND SUBJECTS: A total of 215 women and respective newborn babies were selected from a hospital in Joinville city, Brazil, between July and November 2002. Women were divided in two groups according to their smoking habits. beta-Carotene concentration was determined by high-performance liquid chromatography (HPLC). The difference between mean concentrations of beta-carotene in maternal blood and cord blood, in smokers and non-smokers, was determined by analysis of variance (ANOVA). The Student's t-test compared mean concentrations of beta-carotene in maternal blood and cord blood, and the mean ingestion of foods rich in beta-carotene by smokers and non-smokers. RESULTS: There was a statistical significant difference between the concentrations of beta-carotene in maternal blood (S=0.271 micromol/L, NS=0.450 micromol/L; P=0.001) and cord blood (S=0.028 micromol/L, NS=0.045 micromol/L; P=0.001) in smokers (S) and non-smokers (NS). The mean concentration of beta-carotene was significantly higher in maternal blood (0.398 micromol/L) than in cord blood (0.041 micromol/L) (P<0.001). The intake of foods rich in beta-carotene was lower in smokers, than in non-smokers (P=0.04). CONCLUSIONS: The concentrations of beta-carotene in maternal blood and cord blood were influenced by the use of tobacco.

Does vitamin D play a role in the management of Covid-19 in Brazil?

ABSTRACT The study discusses the possible role of adequate vitamin D status in plasma or serum for preventing acute respiratory infections during the Covid-19 pandemic. Our arguments respond to an article, published in Italy, that describes the high prevalence of hypovitaminosis D in older Italian women and raises the possible preventive and therapeutic role of optimal vitamin D levels. Based on literature review, we highlight the findings regarding the protective role of vitamin D for infectious diseases of the respiratory system. However, randomized controlled trials are currently lacking. Adequate vitamin D status is obtained from sun exposure and foods rich in vitamin D. Studies in Brazil have shown that hypovitaminosis D is quite common in spite of high insolation. Authors recommend ecological, epidemiological and randomized controlled trials studies to verify this hypothesis.

Concentrations of ascorbic acid in the plasma of pregnant smokers and nonsmokers and their newborns.

A cross-sectional study was carried out to determine the differences in vitamin C status of Brazilian pregnant women smokers and nonsmokers and their respective newborn babies, and to assess the prevalence of hypovitaminosis C among these two groups of women. The study involved 127 pregnant women, 40 pregnant smokers and 87 pregnant nonsmokers, admitted to a maternity hospital in São Paulo, Brazil. Data concerning the pregnant women's socioeconomic, demographic, obstetric, and nutritional characteristics were collected, as well as data concerning the newborns' anthropometry and Apgar scores. A strongly significant correlation (p < 0.001) was found between the concentrations of ascorbic acid (AA) in both pregnant smokers (r = 0.77) and pregnant nonsmokers (r = 0.61) and their respective umbilical cords. The mean umbilical AA concentration was significantly higher than the meanAA concentration in pregnant women (92.05 +/- 41.13 vs. 33.39 +/- 18.25 micromol/L, p < 0.001). It was observed that the mean AA was significantly lower for the newborns (p = 0.03) and pregnant women (p = 0.02) from the smoking group. Forty percent (40%) of the smokers and 27% of the nonsmokers presented hypovitaminosis C. We suggest an increase in the consumption of fruits and vegetables by pregnant women, especially the smokers.

Anthropometric measurements as a potential non-invasive alternative for the diagnosis of metabolic syndrome in adolescents

ABSTRACT Objective: To identify which anthropometric measurement would be the best predictor of metabolic syndrome (MetS) in Brazilian adolescents. Subjects and methods: Cross-sectional study conducted on 222 adolescents (15-17 years) from a city in southern Brazil. Anthropometric, physical activity, blood pressure and biochemical parameters were investigated. MetS criteria were transformed into a continuous variable (MetS score). Linear regression analyses were performed to assess the associations of BMI, hip circumference, neck circumference (NC), triceps skinfold, subscapular skinfold and body fat percentage with MetS score. ROC curves were constructed to determine the cutoff for each anthropometric measurement. Results: The prevalence of MetS was 7.2%. Each anthropometric measurement was significantly (p < 0.001) associated with MetS score. After adjusting for potential confounding variables (age, sex, physical activity, and maternal education), the standardized coefficients of NC and body fat percentage appeared to have the strongest association (beta = 0.69 standard deviation) with MetS score. The regression of BMI provided the best model fit (adjusted R2 = 0.31). BMI predicted MetS with high sensitivity (100.0%) and specificity (86.4%). Conclusions: Our results suggest that BMI and NC are effective screening tools for MetS in adolescents. The early diagnosis of MetS combined with targeted lifestyle interventions in adolescence may help reduce the burden of cardiovascular diseases and diabetes in adulthood.

Selenium inadequacy is not associated with oxidative stress in child and adolescent acute lymphocytic leukemia survivors.

OBJECTIVE: Acute lymphocytic leukemia (ALL) and its subsequent treatment may provoke increased oxidative stress. The aim of this study was to investigate the antioxidant status of children and adolescents who had received ALL therapy, and to test the hypothesis that selenium (Se) inadequacy is correlated with reduced defenses against oxidative stress in this population. METHODS: This case-control study involved 24 patients between ages 5 and 13 y who had been treated successfully for ALL (ALL group) and 60 children of similar age and socioeconomic background with no clinical history of leukemia (control group). Dietary intake of Se was evaluated by the 24-h recall method, and the concentrations of Se in plasma, erythrocytes, and urine determined. Antioxidant status was assessed by analysis of the oxidative stress markers, namely, superoxide dismutase (SOD), glutathione peroxidase (GPx), malondialdehyde (MDA), α-tocopherol, and 8-oxo-deoxyguanosine (8-oxo-dG). RESULTS: There were no between-group differences with respect to plasma (P = 0.122), erythrocyte (P = 0.202), urinary (P = 0.608), or dietary (P = 0.757) levels of Se. GPx activity was significantly (P < 0.001) reduced in the ALL group compared with the control group, whereas SOD activity and MDA concentrations were similar. The concentrations of α-tocopherol and 8-oxo-dG were significantly increased in the ALL group compared with the control group (P < 0.001 and P = 0.031, respectively). CONCLUSION: All participants were Se inadequate, but such inadequacy was not correlated with reduced defenses against oxidative stress. However, individuals of the ALL group were with increased oxidative stress compared with the control group, possibly due to previous disease and to intensive polychemotherapy.

The relationship between serum retinol concentrations and subclinical infection in rural Brazilian children / Relação entre as concentrações séricas de retinol e a infecção subclínica em crianças rurais brasileiras

ABSTRACT Objective To evaluate the relationship between serum retinol concentrations and subclinical infection in children from rural settlements. Methods A cross-sectional population-based study was carried out in nine rural settlements in the northeastern region of Brazil, involving 118 children aged 6 to 59 months. The relationship between serum retinol and C-Reactive Protein levels, an important marker of infectious and inflammatory processes, was investigated by multiple linear regression, controlling for demographic, socioeconomic and nutritional variables. Serum retinol and C-Reactive Protein were measured, respectively, by High Performance Liquid Chromatography and immunoturbidimetric assay in automated equipment. Results Vitamin A deficiency (retinol <0.70μmol/L) was identified in 9.3% of the children. C-Reactive Protein was the only predictor of retinol concentrations in the final regression model, causing a 0.728μmol/L reduction in retinol concentrations in the studied children (p=0.008). Conclusion Vitamin A deficiency is a problem of mild/moderate severity and measures to control infectious diseases in this population are fundamental to prevent and/or combat this problem.

RESUMO Objetivo Esta pesquisa teve por objetivo avaliar a relação entre concentrações séricas de retinol e infecção subclínica, em crianças de assentamentos rurais. Métodos Trata-se de estudo transversal, de base populacional, realizado em nove assentamentos rurais na região nordeste do Brasil, envolvendo 118 crianças de 6 a 59 meses de idade. A relação entre retinol sérico e níveis de proteína C-reativa, importante marcador de processos infecciosos e inflamatórios, foi investigada por análise de regressão linear múltipla, controlando-se variáveis demográficas, socioeconômicas e nutricionais. O retinol sérico e a proteína C-reativa foram medidos, respectivamente, por Cromatografia Líquida de Alta Performance e ensaio imunoturbidimétrico em equipamento automatizado. Resultados A deficiência de vitamina A (retinol <0,70μmll/L) foi identificada em 9,3% das crianças. A proteína C-reativa foi o único preditor de concentrações de retinol no modelo de regressão final, causando uma redução de 0,728μmol/L nas concentrações de retinol nas crianças estudadas (p=0,008). Conclusão A pesquisa concluiu que a deficiência de vitamina A é um problema de severidade leve/moderada, sendo fundamental a adoção de medidas para controlar doenças infecciosas nessa população, bem como para prevenir e/ou combater o problema.

Hepcidin as a biochemical parameter for the assessment of iron deficiency anemia.

Iron deficiency anemia is the most prevalent nutritional disorder in the world. Information on the metabolism of hepcidin and its possible significance as a biochemical parameter in iron deficiency anemia is reported in this review, which was based on a survey of the databases PubMed and LILACS for articles published between 2006 and 2010 on hepcidin as a biomarker for the regulation of iron metabolism. The literature search returned 35 studies published in international journals and one study on the subject in a Brazilian journal. Hepcidin production is homeostatically regulated by anemia and hypoxia. When oxygen delivery is inadequate, hepcidin levels decrease. Consequently, more iron is made available from the diet and from the storage pool in macrophages and hepatocytes. Hepcidin binds to ferroportin, regulating iron release into plasma. When hepcidin concentrations are low, ferroportin molecules are displayed on the plasma membrane and release iron. When hepcidin levels increase, hepcidin binds to ferroportin molecules inducing their internalization and degradation, and iron release is decreased progressively. Apparently, the development of diagnosis and therapy for anemia based on the bioindicator hepcidin may provide a more effective approach. Epidemiological studies are needed to demonstrate the relevance of hepcidin to the differential diagnosis of anemia, including sampling protocols for analysis, with standardization similar to that used in other biochemical assessments, and establishment of cutoff points for urinary and plasma expression of this peptide.