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1.
Sci Rep ; 14(1): 5073, 2024 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-38429378

RESUMO

Vitamin C played pleiotropic roles in critical illness and vitamin C insufficiency was predictive of the development of multiple organ failure. Currently, the prevalence of vitamin C insufficiency in Chinese critically ill patients is rarely determined and there are no established bedside tools to predict hypovitaminosis C. To develop a nomogram to identify patients with high risk of hypovitaminosis C, we performed a bi-center prospective cohort study at two ICUs of the first and sixth medical center in PLA General Hospital, Beijing, China from May 6th to July 31st, 2021 We identified 322 eligible patients. 62.4% patients were hypovitaminosis C. 7 features, including source of infection, the level of serum albumin, age, male gender, sepsis, vascular disease, and wasting of vitamin C by the kidney, were selected using LASSO algorithm and therefore included in the nomogram. In the testing set, our model showed moderate discrimination ability with areas under the curve of 0.75 [0.64-0.84]. Variable importance evaluated by SHAP value highlighted two novel important predictors, i.e., abdominal infection and the level of serum albumin. In conclusion, we first reported a high burden of vitamin C insufficiency in Chinese adult patient in the ICU. We also constructed a prediction model to timely identify patients with high risk of hypovitaminosis C, which allows the clinicians to choose appropriate candidates for Vitamin C repletion in clinical practice or clinical trials.


Assuntos
Deficiência de Vitaminas , Estado Terminal , Adulto , Humanos , Masculino , Estudos Prospectivos , Vitaminas , Ácido Ascórbico , Algoritmos , Hospitais Gerais , Unidades de Terapia Intensiva , Albumina Sérica , Cuidados Críticos
2.
Clin Nutr ESPEN ; 60: 348-355, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38479934

RESUMO

BACKGROUND & AIMS: Patients receiving oncological esophagectomy or gastrectomy are known to be at high risk for vitamin and micronutrient deficiency before, during and after surgery. However, there are no clear guidelines for these cancer patients regarding postoperative vitamin supplementation. METHODS: We conducted a metanalysis consisting of 10 studies regarding vitamin and micronutrient deficiencies after oncological gastric or esophageal resection. 5 databases were searched. RESULTS: Data was sufficient regarding Vitamins B12 and 25-OH D3 as well as calcium. We were able to show deficiencies in 25-OH Vitamin D3 levels (p < 0.001) and lower levels of Vitamin B12 and calcium (bit p < 0.001) when compared to the healthy population. CONCLUSIONS: Patients from these groups are at risk for vitamin deficiencies. A guideline on postoperative supplementation is needed.


Assuntos
Deficiência de Vitaminas , Neoplasias Esofágicas , Desnutrição , Obesidade Mórbida , Neoplasias Gástricas , Humanos , Neoplasias Esofágicas/cirurgia , Neoplasias Gástricas/cirurgia , Cálcio , Obesidade Mórbida/cirurgia , Vitaminas , Desnutrição/complicações , Vitamina B 12
3.
Sci Rep ; 14(1): 6925, 2024 03 22.
Artigo em Inglês | MEDLINE | ID: mdl-38519539

RESUMO

Mental disorders are intricate and multifaceted and encompass social, economic, environmental, and biological factors. This study aimed to explore the potential association between vitamin D deficiency and anxiety and depression symptoms in adults, considering the role of the vitamin D receptor gene polymorphism FokI (rs2228570). This was a population-based cross-sectional study with stratified and cluster sampling, evaluating anxiety symptoms (AS) and depression symptoms (DS) in 1637 adults. Vitamin D levels were measured using electrochemiluminescence and were considered deficient when < 20 ng/mL in a healthy population or < 30 ng/mL in at-risk groups. Genotyping was performed using real-time polymerase chain reaction with TaqMan probes. The prevalence rates of AS, DS, and vitamin D deficiency were 23.5%, 15.8%, and 30.9%, respectively. No direct association was observed between vitamin D deficiency and AS or DS. However, interaction analysis revealed a combined effect of vitamin D deficiency and FokI for DS but not for AS. Individuals with vitamin deficiency and one or two copies of the altered allele of the FokI exhibited a higher prevalence of DS than individuals homozygous for the wild-type allele and vitamin D sufficiency. The interaction between vitamin D deficiency and the FokI polymorphism was associated with DS.


Assuntos
Deficiência de Vitaminas , Deficiência de Vitamina D , Adulto , Humanos , Estudos Transversais , Receptores de Calcitriol/genética , Polimorfismo Genético , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/epidemiologia , Deficiência de Vitamina D/genética , Transtornos de Ansiedade , Vitamina D/genética , Genótipo , Polimorfismo de Nucleotídeo Único , Predisposição Genética para Doença , Estudos de Casos e Controles
5.
Am J Kidney Dis ; 83(3): 370-385, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37879527

RESUMO

All vitamins play essential roles in various aspects of body function and systems. Patients with chronic kidney disease (CKD), including those receiving dialysis, may be at increased risk of developing vitamin deficiencies due to anorexia, poor dietary intake, protein energy wasting, restricted diet, dialysis loss, or inadequate sun exposure for vitamin D. However, clinical manifestations of most vitamin deficiencies are usually subtle or undetected in this population. Testing for circulating levels is not undertaken for most vitamins except folate, B12, and 25-hydroxyvitamin D because assays may not be available or may be costly to perform and do not always correlate with body stores. The last systematic review through 2016 was performed for the Kidney Disease Outcome Quality Initiative (KDOQI) 2020 Nutrition Guideline update, so this article summarizes the more recent evidence. We review the use of vitamins supplementation in the CKD population. To date there have been no randomized trials to support the benefits of any vitamin supplementation for kidney, cardiovascular, or patient-centered outcomes. The decision to supplement water-soluble vitamins should be individualized, taking account the patient's dietary intake, nutritional status, risk of vitamins deficiency/insufficiency, CKD stage, comorbid status, and dialysis loss. Nutritional vitamin D deficiency should be corrected, but the supplementation dose and formulation need to be personalized, taking into consideration the degree of 25-hydroxyvitamin D deficiency, parathyroid hormone levels, CKD stage, and local formulation. Routine supplementation of vitamins A and E is not supported due to potential toxicity. Although more trial data are required to elucidate the roles of vitamin supplementation, all patients with CKD should undergo periodic assessment of dietary intake and aim to receive various vitamins through natural food sources and a healthy eating pattern that includes vitamin-dense foods.


Assuntos
Deficiência de Vitaminas , Insuficiência Renal Crônica , Deficiência de Vitamina D , Humanos , Vitaminas/uso terapêutico , Vitamina D , Suplementos Nutricionais , Insuficiência Renal Crônica/complicações , Deficiência de Vitamina D/epidemiologia , Deficiência de Vitamina D/etiologia , Vitamina A , Deficiência de Vitaminas/epidemiologia , Deficiência de Vitaminas/complicações , Vitamina K
6.
Nutr Clin Pract ; 39(1): 129-140, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37840401

RESUMO

Chronic pancreatitis (CP) is often associated with exocrine pancreatic insufficiency (EPI), which may increase risk for fat-soluble vitamin depletion. Although vitamin D deficiency is widespread among the general population, vitamins A, E, and K deficiencies may more uniquely present in patients with CP. Yet, it is unclear whether fat-soluble vitamin status should be routinely monitored in all patients with CP or limited to those with EPI. The purpose of this review is to describe the laboratory status of vitamins A, E, and K in adult patients with CP and their association with exocrine pancreatic function. Five primary, observational studies met the inclusion criteria for qualitative synthesis. Biochemical deficiencies in fat-soluble vitamins were observed across trials but results varied with respect to whether EPI increased risk. Challenges related to the diagnosis and treatment of EPI along with potential confounders may contribute to the heterogeneity among study results. Although more studies are needed to determine the influence of pancreatic enzyme replacement therapy on fat-soluble vitamin status as well as effective vitamin repletion strategies, clinicians should consider periodically screening for deficiencies in all patients with CP regardless of EPI to avoid associated health effects of vitamin depletion.


Assuntos
Deficiência de Vitaminas , Insuficiência Pancreática Exócrina , Pancreatite Crônica , Adulto , Humanos , Vitaminas/uso terapêutico , Pancreatite Crônica/complicações , Insuficiência Pancreática Exócrina/etiologia , Insuficiência Pancreática Exócrina/complicações , Pâncreas , Deficiência de Vitaminas/complicações , Deficiência de Vitaminas/diagnóstico , Deficiência de Vitaminas/epidemiologia , Vitamina A , Vitamina K/uso terapêutico
9.
Obes Surg ; 33(12): 3951-3961, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37864735

RESUMO

PURPOSE: The literature on long-term outcomes of duodenal switch (DS) compared to single anastomosis duodenal switch (SADI-S) procedures is lacking. We evaluated the long-term outcomes of SADI-S compared to those after the classic DS procedure. METHODS: This is a follow-up report from a single-institution prospective cohort study comparing long-term outcomes of SADI-S versus DS both as one- and two-stage procedures (ClinicalTrials.gov: NCT02792166). Data is depicted as count (percentage) or median (interquartile range). RESULTS: Forty-two patients underwent SADI-S, of whom 11 had it as a second-stage procedure (26%). Of 20 patients who underwent DS, twelve had it as a second-stage procedure (60%). Both groups were similar at baseline. Median follow-up times for one-stage SADI-S and DS were 57 (24) and 57 (9) months, respectively (p = 0.93). Similar BMI reductions were observed after one-stage SADI-S (16.5 kg/m2 [8.5]) and DS (18.9 kg/m2 [7.2]; p = 0.42). At median follow-up of 51 (21) and 60 (15) months after second-stage SADI-S and DS, respectively (p = 0.60), surgical procedures yielded reductions in BMI of 20.5 kg/m2 (14.0) and 24.0 kg/m2 (13.9), respectively (p = 0.52). Follow-up rates were similar for one-stage (≥ 88%; p = 0.29) and second-stage procedures (≥ 83%; p = 0.16). Similar diabetes and hypertension remissions were found (p = 0.77; P = 0.54, respectively). Despite fat-soluble vitamin deficiencies at baseline, after supplementation, they were either eliminated or less prevalent long-term after SADI-S. Daily bowel movements were also less frequent. CONCLUSIONS: Long-term weight and comorbidity outcomes after SADI-S are similar to those of DS both as one- and two-stage surgeries. SADI-S procedure may allow for similar beneficial outcomes with less burden from gastrointestinal symptoms and fat-soluble vitamin deficiencies.


Assuntos
Deficiência de Vitaminas , Desvio Biliopancreático , Derivação Gástrica , Obesidade Mórbida , Humanos , Obesidade Mórbida/cirurgia , Estudos Prospectivos , Estudos de Coortes , Desvio Biliopancreático/métodos , Gastrectomia/métodos , Anastomose Cirúrgica , Deficiência de Vitaminas/cirurgia , Estudos Retrospectivos , Derivação Gástrica/métodos , Duodeno/cirurgia
10.
BMJ Open ; 13(8): e075924, 2023 08 23.
Artigo em Inglês | MEDLINE | ID: mdl-37612102

RESUMO

INTRODUCTION: Vitamin C is an essential micronutrient playing crucial roles in human biology. Hypovitaminosis C is defined by a plasmatic ascorbemia below 23 µmol/L and is associated with numerous outcomes such as cardiovascular diseases, cancers or neurocognitive disorders. Numerous risk factors are common among older adults making them particularly susceptible to hypovitaminosis C. These risk factors include reduced vitamin intakes, higher vitamin metabolism related to polypathology, and iatrogeny because of polypharmacy. However, the precise prevalence of hypovitaminosis C and its risk factors are poorly documented within the geriatric population.A better knowledge of hypovitaminosis C prevalence and risk factor may lead to improving the vitamin C status among older people and prevent its consequences. METHOD AND ANALYSIS: To answer these questions, we designed a monocentric cross-sectional study in a population of older hospitalised patients in Lyon, France. A sample size of 385 patients was needed to estimate hypovitaminosis C prevalence. The study was proposed to all eligible patient aged more than 75 years old entering the participating acute geriatric unit. The plasmatic vitamin C status was systematically assessed for participating patients, and variables part of the medical and geriatric evaluation were collected. For patients with severe vitamin C depletion, an oral supplementation and a follow-up phone call were organised to ensure treatment completion and tolerance. ETHICS AND DISSEMINATION: The protocol has been approved by an independent national ethics committee and meets the methodological requirements. Final outcomes will be published in a peer-reviewed journal and disseminated through conferences. TRIAL REGISTRATION NUMBER: NCT05668663.


Assuntos
Ácido Ascórbico , Deficiência de Vitaminas , Idoso , Humanos , Estudos Transversais , França/epidemiologia , Prevalência , Fatores de Risco , Vitaminas
11.
Nutrients ; 15(16)2023 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-37630755

RESUMO

BACKGROUND: Hypovitaminosis D is a public health problem due to its implications for various diseases. Vitamin D has numerous functions, such as modulating the metabolism of cellular tissues, and it is expressed through the vitamin D receptor (VDR) gene that may influence gene expression modulation, which plays an important role in vitamin D metabolism. OBJECTIVE: To evaluate the effect of the genotypes of BsmI single nucleotide polymorphism (SNP) of the VDR gene on VDR, SOD2, and CYP24A1 gene expression in individuals with low serum vitamin D levels. METHODS: This was a cross-sectional analytical study. After signing the informed consent form, individuals were invited to participate and answered a structured questionnaire with identification data. Blood was collected for biochemical analysis, and vitamin D was measured by chemiluminescence; BsmI polymorphism was determined using real-time polymerase chain reaction (PCR) assays with TaqMan allelic discrimination, and gene expression was conducted by qRT-PCR using QuantiFast SYBR® Green PCR Master Mix. Data were analyzed using the SPSS 20.0 software, and differences were considered significant at p < 0.05. RESULTS: 98 individuals with vitamin D ≤ 20 ng/dL were evaluated, and the BsmI SNP of the VDR gene showed CYP24A1 overexpression and low SOD2 expression. CONCLUSION: BsmI SNP of the VDR gene can modulate the expression of the genes evaluated without interfering with serum levels.


Assuntos
Deficiência de Vitaminas , Humanos , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Genótipo , Polimorfismo de Nucleotídeo Único , Masculino , Feminino , Deficiência de Vitaminas/genética , Expressão Gênica
12.
J Neurol Neurosurg Psychiatry ; 95(1): 61-72, 2023 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-37536924

RESUMO

Nutritional peripheral neuropathies are a global problem, heavily influenced by geopolitical, cultural and socioeconomic factors. Peripheral neuropathy occurs most frequently secondary to B-vitamin deficiencies, which is suspected to increase in years to come due to the popularity of vegan and vegetarian diets and increased use of bariatric surgery.This review will focus on the common B-vitamins for which a causal link to peripheral neuropathy is more established (vitamins B1, B2, B6, B9 and B12). We will review the historical human and animal data on which much of the clinical descriptions of vitamin deficiencies are based and summarise current available tools for accurately diagnosing a nutritional deficiency. We will also review recently described genetic diseases due to pathogenic variants in genes involved in B-vitamin metabolism that have helped to inform the phenotypes and potential causality of certain B-vitamins in peripheral neuropathy (B2 and B9).Endemic outbreaks of peripheral neuropathy over the last two centuries have been linked to food shortages and nutritional deficiency. These include outbreaks in Jamaican sugar plantation workers in the nineteenth century (Strachan's syndrome), World War two prisoners of war, Cuban endemic neuropathy and also Tanzanian endemic optic neuropathy, which remains a significant public health burden today. An improved understanding of lack of which vitamins cause peripheral neuropathy and how to identify specific deficiencies may lead to prevention of significant and irreversible disability in vulnerable populations.


Assuntos
Deficiência de Vitaminas , Desnutrição , Doenças do Nervo Óptico , Doenças do Sistema Nervoso Periférico , Complexo Vitamínico B , Animais , Humanos , Doenças do Sistema Nervoso Periférico/etiologia , Doenças do Sistema Nervoso Periférico/complicações , Deficiência de Vitaminas/epidemiologia , Deficiência de Vitaminas/complicações , Deficiência de Vitaminas/diagnóstico , Desnutrição/complicações , Tiamina/uso terapêutico , Vitamina A/uso terapêutico
13.
Nutrients ; 15(9)2023 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-37409654

RESUMO

Undernutrition among young women at "Cinderella weight" is socially important in Japan. To determine the nutritional status of Cinderella-weight women, we conducted an exploratory cross-sectional study on the health examination results of employees aged 20 to 39 (n = 1457 and 643 for women and men, respectively). The percentage of underweight women was found to be much higher than that of men (16.8% vs. 4.5%, respectively). In underweight women (n = 245), handgrip strength (22.82 ± 5.55 vs. 25.73 ± 5.81 kg, p < 0.001), cholesterol level (177.8 ± 25.2 vs. 194.7 ± 31.2 mg/dL, p < 0.05), and lymphocyte count (1883 ± 503 vs. 2148 ± 765/µL, p < 0.001) were significantly lower than in overweight women (n = 116). Then, the BMI < 17.5 group (n = 44) was referred to the outpatient nutrition evaluation clinic. Lower prealbumin, cholesterol, and lymphocyte levels were also observed in 34%, 59%, and 32% of the patients, respectively. Regarding dietary characteristics, 32% of the underweight women in this study skipped breakfast, and 50% had low dietary diversity scores. Lower total energy intake, carbohydrate and fiber intake, and Ca and Fe intake were also observed in 90% of the patients. Deficiencies in vitamin B1, B12, D, and folate were diagnosed in 4.6%, 25%, 14%, and 98% of the patients, respectively. Thus, young underweight women may be prone to malnutrition.


Assuntos
Deficiência de Vitaminas , Desnutrição , Estado Nutricional , Feminino , Humanos , Masculino , Deficiência de Vitaminas/epidemiologia , Colesterol , Estudos Transversais , População do Leste Asiático , Força da Mão , Desnutrição/epidemiologia , Magreza/epidemiologia , Adulto Jovem , Adulto
14.
Clin Chim Acta ; 548: 117469, 2023 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-37419302

RESUMO

Fat-soluble vitamins, including vitamins A, D, E, and K, are essential for maintaining normal body function and metabolism. Fat-soluble vitamin deficiency may lead to bone diseases, anemia, bleeding, xerophthalmia, etc. Early detection and timely interventions are significant for preventing vitamin deficiency-related diseases. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) is developing into a potent instrument for the precise detection of fat-soluble vitamins due to its high sensitivity, high specificity, and high resolution.


Assuntos
Deficiência de Vitaminas , Espectrometria de Massas em Tandem , Humanos , Cromatografia Líquida/métodos , Espectrometria de Massas em Tandem/métodos , Vitaminas/análise , Vitaminas/química , Vitamina A , Deficiência de Vitaminas/diagnóstico , Vitamina D
15.
Artigo em Russo | MEDLINE | ID: mdl-37490672

RESUMO

An unbalanced diet and some other factors are the reason for the extreme prevalence of hypovitaminosis among the population of both developing and developed countries. The metabolic relationships of B vitamins determine the more frequent occurrence of poly-, rather than monovitamin deficiency. Since B vitamins play an important role in the processes of energy production and in the functioning of neurotransmitter systems, the first symptoms of such polyhypovitaminosis are signs of brain dysfunction: asthenia, depression, anxiety, cognitive disorders. Correct diagnosis of polyhypovitaminosis based on the identification of risk groups of patients and the determination of their subclinical or early manifesting signs of brain dysfunction is the most important task of a practicing physician. Detection of insufficient intake and vitamin content, as well as verification of the onset of symptoms of brain dysfunction and the appointment of adequate therapy can significantly increase the effectiveness of treatment, as well as prevent asthenic, psycho-emotional and cognitive disorders in patients with polyhypovitaminosis.


Assuntos
Deficiência de Vitaminas , Encefalopatias , Complexo Vitamínico B , Humanos , Complexo Vitamínico B/uso terapêutico , Ansiedade , Encéfalo
16.
Nutrients ; 15(11)2023 May 26.
Artigo em Inglês | MEDLINE | ID: mdl-37299454

RESUMO

BACKGROUND: This review aims to identify the current indications and gaps in the management of fat-soluble vitamins in pediatric patients with cholestasis. METHODS: A comprehensive review of the literature using PubMed, Scopus, Web of Science and Embase was performed. Two authors independently identified the most relevant studies published over the past 20 years up to February 2022, including original papers, narrative reviews, observational studies, clinical trials, systematic reviews and meta-analyses. The literature was screened, and preclinical studies about pathogenetic mechanisms were also included. Keywords searched for each fat-soluble vitamin (A, D, E and K), alone or in combination, were "cholestasis", "chronic liver disease", "biliary atresia", "malnutrition" and "nutritional needs". Studies published prior to the selected time range were searched manually and, when considered relevant, included within the list of references. RESULTS: Eight hundred twenty-six articles were initially screened. From these, 48 studies were selected. A comparison of the recommended methods of supplementation for fat-soluble vitamins was then carried out. The causes of malabsorption were explained and current methods for defining deficiency and monitoring complications were summarized. CONCLUSIONS: According to the literature, children with cholestasis are at a higher risk of fat-soluble vitamin deficiency. Although there are general recommendations, the treatment for vitamin deficiency is not uniformly validated.


Assuntos
Deficiência de Vitaminas , Colestase , Criança , Humanos , Vitaminas/uso terapêutico , Colestase/complicações , Deficiência de Vitaminas/complicações , Deficiência de Vitaminas/tratamento farmacológico
19.
BMC Gastroenterol ; 23(1): 124, 2023 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-37046204

RESUMO

PURPOSE: Chronic pancreatitis (CP) leads to diabetes and pancreatic exocrine insufficiency (PEI). PEI may lead to maldigestion and malnutrition, which may cause fat-soluble vitamin deficiency, sarcopenia and abnormal bone density. We aim to study the prevalence of osteoporosis, sarcopenia and vitamin deficiency among CP patients. METHODS: Long-term (4-5 years) follow-up was implemented on CP patients. We recorded CP duration, BMI, smoking, alcohol consumption and medication. We determined the serum values for A, D and E vitamins, albumin, creatinine, haemoglobin, calcium and magnesium. Bone density measurement was taken from the proximal femur and lumbar spine. CT/MRI scans were used to measure for psoas muscle area. RESULTS: A total of 33 patients (median age 62 [39-81] years, 61% male) were included. None of these patients had earlier diagnosis of osteopathy, and none of them had known vitamin deficiency or were sarcopenic. Nineteen patients (57%) had pancreatic exocrine insufficiency and of these seven patients (37%) had no pancreatic enzyme replacement therapy (PERT) and one (5%) had inadequate enzyme therapy. During the study, osteoporosis was diagnosed in 20% and possible sarcopenia in 48% of patients. PEI and inadequate PERT was associated with low E vitamin levels (75% vs. 0%, p = 0.012), higher risk of osteoporosis (43% vs. 5.6%, p = 0.013) and sarcopenia (80% vs. 36%, p = 0.044). CONCLUSION: This study demonstrates that chronic pancreatitis is associated with osteoporosis, sarcopenia and vitamin deficiency. If untreated, pancreatic exocrine insufficiency is associated with increased risk of these outcomes. This highlights the importance of identifying and treating PEI in CP patients.


Assuntos
Deficiência de Vitaminas , Insuficiência Pancreática Exócrina , Osteoporose , Pancreatite Crônica , Sarcopenia , Humanos , Masculino , Pessoa de Meia-Idade , Feminino , Sarcopenia/epidemiologia , Sarcopenia/complicações , Pancreatite Crônica/complicações , Pancreatite Crônica/epidemiologia , Osteoporose/epidemiologia , Osteoporose/etiologia , Insuficiência Pancreática Exócrina/etiologia , Insuficiência Pancreática Exócrina/complicações , Deficiência de Vitaminas/complicações , Vitaminas
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