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1.
Nutrients ; 13(4)2021 Apr 20.
Artículo en Inglés | MEDLINE | ID: mdl-33923999

RESUMEN

Diet is a modifiable factor that ensures optimal growth, biochemical performance, improved mood and mental functioning. Lack of nutrients, notably vitamin B, has an impact on human health and wellbeing. The United Arab Emirates is facing a serious problem of micronutrient deficiencies because of the growing trend for bariatric surgery, including Roux-en-Y gastric bypass and sleeve gastrectomy. People undergoing bariatric surgery are at high risk of developing neurological, cognitive, and mental disabilities and cardiovascular disease due to deficiency in vitamin B. Vitamin B is involved in neurotransmitter synthesis, including γ-aminobutyric acid, serotonin, dopamine, and noradrenaline. Deficiency of vitamin B increases the risk of depression, anxiety, dementia and Alzheimer's disease. In addition, vitamin B deficiency can disrupt the methylation of homocysteine, leading to hyperhomocysteinemia. Elevated homocysteine levels are detrimental to human health. Vitamin B deficiency also suppresses immune function, increases the production of pro-inflammatory cytokines and upregulates NF-κB. Considering the important functions of vitamin B and the severe consequences associated with its deficiency following bariatric surgery, proper dietary intervention and administration of adequate supplements should be considered to prevent negative clinical outcomes.


Asunto(s)
Cirugía Bariátrica/efectos adversos , Salud Mental , Complejo Vitamínico B/sangre , Deficiencia de Vitamina B/etiología , Suplementos Dietéticos , Humanos , Sistema Inmunológico
2.
Folia Parasitol (Praha) ; 682021 Feb 12.
Artículo en Inglés | MEDLINE | ID: mdl-33762474

RESUMEN

Numerous recent studies show that vitamin D deficiency potentiates various chronic physical and psychiatric disorders and diseases. It has been shown that a similar range of disorders is also associated with latent infection with Toxoplasma gondii (Nicolle et Manceaux, 1908). For instance, among cancer, diabetes and schizophrenia patients, we find a higher prevalence of both toxoplasmosis and vitamin D deficiency. Theoretically, therefore, vitamin D deficiency could be the missing link between toxoplasmosis and these disorders. We tested this hypothesis by searching for decreased vitamin D levels in the serum of subjects infected with T. gondii (furthermore called Toxoplasma-infected subjects) in two cross-sectional and one case-control study. Results of the first cross-sectional study (N = 72) suggest that Toxoplasma-infected neurasthenic patients have non-significantly lower levels of calcidiol than Toxoplasma-free patients (study A: P = 0.26 in women, P = 0.68 in men). However, two other studies (study B: N = 400; study C: N = 191) showed a non-significantly higher concentration of vitamin D in Toxoplasma-infected subjects than in Toxoplasma-free subjects both in men (study B: P = 0.70, study C: P = 0.55) and in women (study B: P = 0.64, study C: P = 0.12). Taken together, our preliminary results thus do not support the hypothesis that toxoplasmosis could be associated with vitamin D decrease.


Asunto(s)
Toxoplasmosis/complicaciones , Deficiencia de Vitamina B/etiología , Vitamina D/sangre , Adulto , Calcifediol/sangre , Estudios de Casos y Controles , Estudios Transversales , Femenino , Humanos , Infección Latente/complicaciones , Masculino , Trastornos Mentales/complicaciones , Persona de Mediana Edad , Esquizofrenia/complicaciones , Toxoplasma
3.
J Laparoendosc Adv Surg Tech A ; 31(3): 296-300, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32762597

RESUMEN

Aim: In this study, we aimed to determine the incidence of hair loss in patients who underwent laparoscopic sleeve gastrectomy (LSG), and to observe whether use of Biotin has an impact on hair loss. Methods: This study included 156 female patients who underwent LSG for obesity and completed a 1-year follow-up. All patients with vitamin deficiency were screened in the pre- and postoperative period. Hair loss was defined as the subjective perception of the women of losing a higher amount of hair when compared with normal situation. Results: Hair loss was observed in 72% of the patients after LSG (n = 112). Seventy-nine percent of the patients reported hair loss between the third and fourth-month interval, and continued for an average of 5.5 ± 2.6 months. Permanent alopecia was not observed in any of the patients. Patients who experienced hair loss and Biotin deficiency after LSG were prescribed 1000 mcg/day of Biotin for 3 months. Of these 22 patients; only 5 (23%) patients reported a remarkable decline in hair loss. In addition, 29 patients were found to take 1000 mcg/day of Biotin for average 2.5 months after onset of hair loss by their own initiative, despite optimal blood Biotin levels. Eleven (38%) patients reported a remarkable decline in hair loss. The effect of biotin use on hair loss in patients with and without biotin deficiency was compared. There was no significant difference (P = .2). Conclusion: Temporary hair loss after LSG is common. It was found that biotin supplementation used to prevent hair loss does provide low efficacy.


Asunto(s)
Alopecia/tratamiento farmacológico , Biotina/uso terapéutico , Gastrectomía/efectos adversos , Obesidad Mórbida/cirugía , Complejo Vitamínico B/uso terapéutico , Deficiencia de Vitamina B/tratamiento farmacológico , Adulto , Alopecia/etiología , Biotina/sangre , Biotina/deficiencia , Suplementos Dietéticos , Femenino , Gastrectomía/métodos , Humanos , Incidencia , Laparoscopía/efectos adversos , Masculino , Persona de Mediana Edad , Periodo Posoperatorio , Deficiencia de Vitamina B/etiología
4.
Am J Clin Nutr ; 106(4): 1032-1040, 2017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-28768650

RESUMEN

Background: Epidemiologic evidence regarding niacin, folate, vitamin B-6, and vitamin B-12 intake in relation to cognitive function is limited, especially in midlife.Objective: We hypothesize that higher intake of these B vitamins in young adulthood is associated with better cognition later in life.Design: This study comprised a community-based multicenter cohort of black and white men and women aged 18-30 y in 1985-1986 (year 0, i.e., baseline) from the Coronary Artery Risk Development in Young Adults (CARDIA) study (n = 3136). We examined participants' CARDIA diet history at years 0, 7, and 20 to assess nutrient intake, including dietary and supplemental B vitamins. We measured cognitive function at year 25 (mean ± SD age: 50 ± 4 y) through the use of the Rey Auditory Verbal Learning Test (RAVLT) for verbal memory, the Digit Symbol Substitution Test (DSST) for psychomotor speed, and a modified Stroop interference test for executive function. Higher RAVLT and DSST scores and a lower Stroop score indicated better cognitive function. We used multivariable-adjusted linear regressions to estimate mean differences in cognitive scores and 95% CIs.Results: Comparing the highest quintile with the lowest (quintile 5 compared with quintile 1), cumulative total intake of niacin was significantly associated with 3.92 more digits on the DSST (95% CI: 2.28, 5.55; P-trend < 0.01) and 1.89 points lower interference score on the Stroop test (95% CI: -3.10, -0.68; P-trend = 0.05). Total folate was associated with 2.56 more digits on the DSST (95% CI: 0.82, 4.31; P-trend = 0.01). We also found that higher intakes of vitamin B-6 (quartile 5 compared with quartile 1: 2.62; 95% CI: 0.97, 4.28; P-trend = 0.02) and vitamin B-12 (quartile 5 compared with quartile 1: 2.08; 95% CI: 0.52, 3.65; P-trend = 0.02) resulted in better psychomotor speed measured by DSST scores.Conclusion: Higher intake of B vitamins throughout young adulthood was associated with better cognitive function in midlife.


Asunto(s)
Trastornos del Conocimiento/prevención & control , Cognición/efectos de los fármacos , Ácido Fólico/administración & dosificación , Niacina/administración & dosificación , Vitamina B 12/administración & dosificación , Vitamina B 6/administración & dosificación , Complejo Vitamínico B/administración & dosificación , Adulto , Factores de Edad , Enfermedad de Alzheimer/etiología , Enfermedad de Alzheimer/prevención & control , Trastornos del Conocimiento/etiología , Estudios de Cohortes , Dieta , Suplementos Dietéticos , Función Ejecutiva , Femenino , Ácido Fólico/farmacología , Humanos , Estudios Longitudinales , Masculino , Memoria , Persona de Mediana Edad , Niacina/farmacología , Desempeño Psicomotor , Aprendizaje Verbal , Vitamina B 12/farmacología , Vitamina B 6/farmacología , Complejo Vitamínico B/farmacología , Deficiencia de Vitamina B/etiología , Deficiencia de Vitamina B/prevención & control , Adulto Joven
5.
Obes Surg ; 27(8): 2079-2082, 2017 08.
Artículo en Inglés | MEDLINE | ID: mdl-28213665

RESUMEN

INTRODUCTION: The aim of this study was to assess the incidence, clinical presentation, and outcomes of neurologic disorders secondary to vitamin B deficiencies following bariatric surgery. METHODS: Patients at a single academic institution who underwent bariatric surgery and developed neurologic complications secondary to low levels of vitamins B1, B2, B6, and B12 between the years 2004 and 2015 were studied. RESULTS: In total, 47 (0.7%) bariatric surgical patients (Roux-en-Y gastric bypass n = 36, sleeve gastrectomy n = 9, and duodenal switch n = 2) developed neurologic manifestations secondary to vitamin B deficiencies. Eleven (23%) patients developed postoperative anatomical complications contributed to poor oral intake. Median duration to onset of neurologic manifestation following surgery was 12 months (IQR, 5-32). Vitamin deficiencies reported in the cohort included B1 (n = 30), B2 (n = 1), B6 (n = 12), and B12 (n = 12) deficiency. The most common manifestations were paresthesia (n = 31), muscle weakness (n = 15), abnormal gait (n = 11), and polyneuropathy (n = 7). Four patients were diagnosed with Wernicke-Korsakoff syndrome (WKS) which was developed after gastric bypass (n = 3) and sleeve gastrectomy (n = 1). Seven patients required readmission for management of severe vitamin B deficiencies. Overall, resolution of neurologic symptoms with nutritional interventions and pharmacotherapy was noted in 40 patients (85%). The WKS was not reversible, and all four patients had residual mild ataxia and nystagmus at the last follow-up time. CONCLUSIONS: Nutritional neurologic disorders secondary to vitamin B deficiency are relatively uncommon after bariatric surgery. While neurologic disorders are reversible in most patients (85%) with vitamin replacements, persistent residual neurologic symptoms are common in patients with WKS.


Asunto(s)
Cirugía Bariátrica/efectos adversos , Cirugía Bariátrica/estadística & datos numéricos , Enfermedades del Sistema Nervioso , Obesidad Mórbida/epidemiología , Obesidad Mórbida/cirugía , Deficiencia de Vitamina B/epidemiología , Deficiencia de Vitamina B/etiología , Adulto , Femenino , Gastrectomía/efectos adversos , Gastrectomía/estadística & datos numéricos , Derivación Gástrica/efectos adversos , Derivación Gástrica/estadística & datos numéricos , Humanos , Incidencia , Masculino , Desnutrición/epidemiología , Desnutrición/etiología , Persona de Mediana Edad , Enfermedades del Sistema Nervioso/epidemiología , Enfermedades del Sistema Nervioso/etiología , Trastornos Nutricionales/epidemiología , Trastornos Nutricionales/etiología , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Deficiencia de Vitamina B/psicología
6.
Obes Surg ; 27(5): 1271-1276, 2017 05.
Artículo en Inglés | MEDLINE | ID: mdl-27889885

RESUMEN

BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) has gained popularity as the leading bariatric procedure for the treatment of morbid obesity. Due to the rising numbers of bariatric surgeries, neurologic complications have become increasingly recognized. Our aim was to examine biochemical and hormonal factors that are associated with neuropathy post-LSG. METHODS: Thirty-two patients were included: 16 patients with neuropathy in the neuropathic group (NG) and 16 patients without neuropathy in the control group (CG). Diagnosis was made by a consultant neurologist, and blood samples were taken to examine vitamin deficiencies and hormones involved in neuropathy. RESULTS: There was no significant difference between the BMI (p = 0.1) in both groups as well as excess weight loss percentages post-LSG at 12 months (p = 0.6). B12 levels were within normal range, but higher in NG (p = 0.005). Vitamin B1 and B2 levels were significantly lower in NG; p values are 0.000 and 0.031, respectively. Vitamin B6 levels were significantly higher in NG (p = 0.02) and copper levels were lower in NG (p = 0.009). There was no significant difference in GLP-1 response in both groups. CONCLUSION: Our data showed post-LSG neuropathy is associated with lower levels of vitamin B1, B2, and copper, plus patients who are older in age. Vitamin B6 was significantly higher in the NG, which is, at toxic levels, associated with neuropathy. No difference in preoperative BMI, excess weight loss percent at 1 year, and GLP-1 levels was found. Larger data is required to validate our results.


Asunto(s)
Cobre/deficiencia , Gastrectomía/efectos adversos , Péptido 1 Similar al Glucagón/deficiencia , Obesidad Mórbida/cirugía , Deficiencia de Vitamina B/sangre , Adulto , Cobre/sangre , Femenino , Péptido 1 Similar al Glucagón/sangre , Humanos , Laparoscopía , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Deficiencia de Vitamina B/etiología , Pérdida de Peso
7.
Ter Arkh ; 88(5): 79-83, 2016.
Artículo en Ruso | MEDLINE | ID: mdl-27239932

RESUMEN

The number of bariatric (weight loss) surgeries have increased steadily in the past decade. Along with the tangible benefit of this treatment, there is a risk for postoperative complications, the main cause of which is impaired absorption of nutrients. The paper describes polyradiculoneuropathy running as a type of Guillain-Barré syndrome.


Asunto(s)
Cirugía Bariátrica/efectos adversos , Síndrome de Guillain-Barré/etiología , Obesidad Mórbida/cirugía , Deficiencia de Vitamina B/complicaciones , Adulto , Humanos , Masculino , Complicaciones Posoperatorias , Deficiencia de Vitamina B/etiología
8.
J Hepatol ; 63(5): 1086-92, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-26143444

RESUMEN

BACKGROUND & AIMS: The relationship between vitamin D levels and chronic hepatitis B (CHB) infection and treatment outcomes are poorly elucidated. We measured pre-treatment serum vitamin D (25-hydroxyvitamin D3; 25[OH]D3) levels and determined their association with clinical parameters and treatment outcomes in active CHB patients without advanced liver disease enrolled in a global clinical trial. METHODS: Patients were randomly assigned to either 48 weeks of tenofovir disoproxil fumarate (TDF) plus peginterferon alfa-2a (PegIFN), TDF plus PegIFN for 16 weeks followed by TDF for 32 weeks, PegIFN for 48 weeks, or TDF for 120 weeks. Univariate and multivariate analyses were conducted to determine associations between vitamin D, baseline factors, and week 48 clinical outcome. RESULTS: Of 737 patients, 35% had insufficient (⩾20 but <31 ng/ml) and 58% had deficient (<20 ng/ml) vitamin D levels. In univariate analysis, lower vitamin D levels were significantly associated with the following baseline parameters: younger age, lower uric acid levels, HBeAg-positive status, lower calcium levels, blood draw in winter or autumn, and HBV genotype D. On multivariate analysis, only HBV genotype, season of blood draw, calcium level, and age retained their association. High baseline level of vitamin D was associated with low HBV DNA, normal ALT and HBsAg at week 48 independent of treatment groups, but the association, with the exception of ALT, became statistically insignificant after adjusting for age, gender, HBeAg and HBV genotype. CONCLUSIONS: Abnormally low vitamin D levels are highly prevalent among untreated, active CHB patients. Baseline vitamin D levels are not associated with treatment outcomes, but were associated with normal ALT.


Asunto(s)
Hepatitis B Crónica/tratamiento farmacológico , Interferón-alfa/uso terapéutico , Polietilenglicoles/uso terapéutico , Tenofovir/uso terapéutico , Deficiencia de Vitamina B/sangre , Vitamina D/farmacocinética , Adolescente , Adulto , Anciano , Antivirales/uso terapéutico , Biomarcadores/sangre , ADN Viral/análisis , Portadores de Fármacos , Quimioterapia Combinada , Femenino , Estudios de Seguimiento , Virus de la Hepatitis B/genética , Hepatitis B Crónica/complicaciones , Hepatitis B Crónica/virología , Humanos , Masculino , Persona de Mediana Edad , Proteínas Recombinantes/uso terapéutico , Factores de Tiempo , Resultado del Tratamiento , Deficiencia de Vitamina B/tratamiento farmacológico , Deficiencia de Vitamina B/etiología , Vitaminas/farmacocinética , Adulto Joven
9.
Nutr Clin Pract ; 30(1): 100-3, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25112945

RESUMEN

An 11-year-old male with autism became less responsive and was hospitalized with hepatomegaly and liver dysfunction, as well as severe lactic acidosis. His diet for several years was self-limited exclusively to a single "fast food"-a particular type of fried chicken-and was deficient in multiple micronutrients, including the B vitamins thiamine and pyridoxine. Lactic acidosis improved rapidly with thiamine; 2 weeks later, status epilepticus-with low serum pyridoxine-resolved rapidly with pyridoxine. Dietary B vitamin deficiencies complicated the care of this critically ill autistic child and should be considered in this setting.


Asunto(s)
Trastorno Autístico/psicología , Enfermedad Crítica/terapia , Piridoxina/uso terapéutico , Tiamina/uso terapéutico , Deficiencia de Vitamina B/etiología , Deficiencia de Vitamina B/terapia , Acidosis Láctica/sangre , Acidosis Láctica/etiología , Acidosis Láctica/terapia , Niño , Dieta/efectos adversos , Comida Rápida/efectos adversos , Conducta Alimentaria/psicología , Hepatomegalia/sangre , Hepatomegalia/etiología , Hepatomegalia/terapia , Humanos , Hepatopatías/sangre , Hepatopatías/etiología , Hepatopatías/terapia , Masculino , Piridoxina/administración & dosificación , Piridoxina/sangre , Piridoxina/deficiencia , Estado Epiléptico/sangre , Estado Epiléptico/etiología , Estado Epiléptico/terapia , Tiamina/administración & dosificación , Tiamina/sangre , Deficiencia de Tiamina/terapia , Deficiencia de Vitamina B/sangre , Deficiencia de Vitamina B/complicaciones
10.
Surg Obes Relat Dis ; 10(5): 944-51, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25264334

RESUMEN

BACKGROUND: Bariatric surgery is considered an effective method for sustained weight loss, but may cause various nutritional complications. The aim of this study was to evaluate the nutritional status of minerals and vitamins, food consumption, and to monitor physiologic parameters in patients with obesity before and 6 months after Roux-en-Y gastric bypass surgery (RYGB). METHODS: Thirty-six patients who had undergone RYGB were prospectively evaluated before and 6 months after surgery. At each phase their weight, height, body mass index (BMI), Electro Sensor Complex (ES Complex) data, food consumption, and total protein serum levels, albumin, prealbumin, parathyroid hormone (PTH), zinc (Zn), B12 vitamin (VitB12), iron (Fe), ferritin, copper (Cu), ionic calcium (CaI), magnesium (Mg), and folic acid were assessed. RESULTS: The mean weight loss from baseline to 6 months after surgery was 35.34±4.82%. Markers of autonomic nervous system balance (P<.01), stiffness index (P<.01), standard deviation of normal-to-normal R-R intervals (SDNN) (P<.01), and insulin resistance (P<.001) were also improved. With regard to the micronutrients measured, 34 patients demonstrated some kind of deficiency. There was a high percentage of Zn deficiency in both pre- (55.55%) and postoperative (61.11%) patients, and 33.33% of the patients were deficient in prealbumin postoperatively. The protein intake after 6 months of surgery was below the recommended intake (<70 g/d) for 88.88% of the patients. Laboratory analyses demonstrated an average decrease in total protein (P<.05), prealbumin (P = .002), and PTH (P = .008) between pre- and postsurgery, and a decrease in the percentage of deficiencies for Mg (P<.05), CaI (P<.05), and Fe (P = .021). CONCLUSION: Despite improvements in the autonomic nervous system balance, stiffness index markers and insulin resistance, we found a high prevalence of hypozincemia at 6 months post-RYGB. Furthermore, protein supplements were needed to maintain an adequate protein intake up to 6 months postsurgery.


Asunto(s)
Enfermedades Carenciales/etiología , Derivación Gástrica/efectos adversos , Micronutrientes/deficiencia , Adulto , Sistema Nervioso Autónomo/fisiología , Biomarcadores/metabolismo , Presión Sanguínea/fisiología , Índice de Masa Corporal , Suplementos Dietéticos , Ingestión de Alimentos/fisiología , Femenino , Frecuencia Cardíaca/fisiología , Humanos , Resistencia a la Insulina/fisiología , Masculino , Minerales/metabolismo , Estado Nutricional , Obesidad/cirugía , Cuidados Posoperatorios/métodos , Cuidados Preoperatorios/métodos , Estudios Prospectivos , Deficiencia de Proteína/etiología , Vitamina B 12/metabolismo , Deficiencia de Vitamina B/etiología , Pérdida de Peso/fisiología , Zinc/deficiencia
11.
Int J Clin Exp Pathol ; 7(4): 1742-7, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24817973

RESUMEN

We report a case of a 49-year-old Japanese man, who was admitted to our hospital because of severe dyspnea. He was found to have severely low serum folate and megaloblastic anemia, which was at first suspected to cause his dyspnea. It was assumed that severely low serum folate might be related to his malnutrition, probably caused by habitual alcohol consumption. He died in several days because of acute respiratory distress syndrome. Autopsy revealed diffuse alveolar damage (DAD) in the lungs and systemic lymph node swelling by EBV-positive diffuse large B-cell lymphoma, in addition to megaloblastic anemia in the bone marrow. Together with histological hemophagocytosis and high level of serum iron and ferritin, DAD was considered to be caused by hypercytokinemia triggered by the presence of EBV-positive diffuse large B-cell lymphoma. On the other hand, pathological findings suggestive of habitual alcohol consumption were not apparent. We considered that low serum folate in this case was not by the low intake but by increased consumption of folate by rapid progression of the lymphoma.


Asunto(s)
Anemia Megaloblástica/etiología , Infecciones por Virus de Epstein-Barr/etiología , Ácido Fólico/sangre , Linfoma de Células B Grandes Difuso/complicaciones , Alveolos Pulmonares/patología , Síndrome de Dificultad Respiratoria/etiología , Deficiencia de Vitamina B/etiología , Anemia Megaloblástica/diagnóstico , Autopsia , Infecciones por Virus de Epstein-Barr/diagnóstico , Resultado Fatal , Humanos , Linfoma de Células B Grandes Difuso/diagnóstico , Masculino , Persona de Mediana Edad , Síndrome de Dificultad Respiratoria/diagnóstico , Síndrome de Dificultad Respiratoria/patología , Deficiencia de Vitamina B/diagnóstico
12.
J Womens Health (Larchmt) ; 23(2): 129-37, 2014 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-24102519

RESUMEN

OBJECTIVE: Bariatric surgery can reduce the risk of obesity-related complications of pregnancy, but may cause essential nutrient deficiencies. To assess adherence to laboratory testing guidelines, we examined frequency of testing for and diagnosis of deficiency during preconception and pregnancy using claims data in women with a delivery and bariatric surgery. METHODS: Retrospective analysis of claims from seven Blue Cross/Blue Shield plans between 2002 and 2008. We included women with a delivery and bariatric surgery within the study period. We used common procedural terminology (CPT) and ICD-9 codes to define laboratory testing and deficiencies for iron, folate, vitamin B12, vitamin D, and thiamine. Using Student's t-test and chi-square testing, we compared frequency of laboratory tests and diagnoses during 12 months preconception and 280 days of pregnancy between women with pregnancy before versus after surgery. We used multivariate logistic regression to evaluate for predictors of laboratory testing. RESULTS: We identified 456 women with pregnancy after bariatric surgery and 338 before surgery. The frequency of testing for any deficiency was low (9%-51%), but higher in those with pregnancy after surgery (p<0.003). The most common deficiency was vitamin B12 (12%-13%) with pregnancy after surgery (p<0.006). Anemia and number of health provider visits were independent predictors of laboratory testing. CONCLUSION: Women with pregnancy after bariatric surgery were tested for and diagnosed with micronutrient deficiencies more frequently than those with pregnancy before surgery. However, most laboratory testing occurred in less than half the women and was triggered by anemia. Increased testing may help identify nutrient deficiencies and prevent consequences for maternal and child health.


Asunto(s)
Cirugía Bariátrica/efectos adversos , Enfermedades Carenciales/etiología , Estado Nutricional , Obesidad/cirugía , Complicaciones Posoperatorias/epidemiología , Complicaciones del Embarazo/etiología , Adulto , Anemia Ferropénica/sangre , Anemia Ferropénica/epidemiología , Anemia Ferropénica/etiología , Enfermedades Carenciales/sangre , Enfermedades Carenciales/epidemiología , Femenino , Ácido Fólico/sangre , Humanos , Hierro/sangre , Deficiencias de Hierro , Modelos Logísticos , Análisis Multivariante , Obesidad/complicaciones , Complicaciones Posoperatorias/sangre , Atención Preconceptiva , Embarazo , Complicaciones del Embarazo/prevención & control , Estudios Retrospectivos , Deficiencia de Vitamina B/sangre , Deficiencia de Vitamina B/epidemiología , Deficiencia de Vitamina B/etiología , Deficiencia de Vitamina D/sangre , Deficiencia de Vitamina D/epidemiología , Deficiencia de Vitamina D/etiología , Adulto Joven
13.
Postepy Hig Med Dosw (Online) ; 67: 548-52, 2013 May 31.
Artículo en Inglés | MEDLINE | ID: mdl-23752606

RESUMEN

BACKGROUND: Carnitine transports fatty acids from the cytoplasm to the mitochondrial matrix, where the fatty acids are oxidized. Chronic alcohol consumption reduces the concentration of carnitine and interferes with oxidative processes occurring in the cell. AIM: The assessment of carnitine concentrations in plasma of chronically intoxicated alcohol dependent persons in a 49-day abstinence period. MATERIAL/METHODS: The study included 31 patients (5 women and 27 men) aged from 26 to 60 years (44.6 ± 8.9) and 32 healthy subjects (15 women and 17 men) aged 22-60 years (39.8 ± 9.4). The patients' alcohol dependence ranged from 2 to 30 years (13.6 ± 7.5). Examined subjects consumed 75-700 g of ethanol/day (226.9 ± 151.5). Plasma concentrations of free and total carnitine were measured three times: at the first (T0), 30th (T30) and 49th (T49) day of hospital detoxification. Free (FC) and total (TC) carnitine were determined by the spectrophotometric method. Plasma acylcarnitine (AC) concentration was calculated from the difference between TC and FC; then the AC/FC ratio was calculated. To determine statistically significant differences for related variables, Student's t-test was used. RESULTS: At T0, alcoholics had significantly lower concentration of FC and TC (p < 0.05) in plasma, as compared to the control group. In comparison to controls, at T30, plasma TC and FC (p < 0.01) as well as AC (p < 0.001) were reduced. The lowest concentration of TC, FC and AC (p < 0.001)was found at T49. The ratio of AC/FC at T0 had a tendency to be higher in alcoholics than in the control group (p = 0.05), whereas at T49 it was significantly lower in alcoholics as compared to the control subjects (p < 0.05). CONCLUSIONS: Chronic alcohol intoxication causes a plasma deficiency of carnitine. Forty-nine days of abstinence showed a significant decrease in the concentration of TC, FC and AC. Further research is necessary to clarify whether a low level of plasma carnitine after chronic alcohol intoxication is caused by the uptake of blood carnitine by tissues such as liver or muscles. In alcoholics the supplementation of carnitine is recommended in the case of a low level of plasma carnitine.


Asunto(s)
Intoxicación Alcohólica/sangre , Intoxicación Alcohólica/complicaciones , Alcoholismo/sangre , Carnitina/sangre , Carnitina/deficiencia , Deficiencia de Vitamina B/etiología , Adulto , Carnitina/análogos & derivados , Femenino , Humanos , Masculino , Persona de Mediana Edad , Plasma/química , Valores de Referencia , Deficiencia de Vitamina B/sangre , Adulto Joven
14.
Blood Coagul Fibrinolysis ; 24(5): 477-83, 2013 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-23406661

RESUMEN

Alcoholism plays a major role in the insufficient utilization or deficiency of the vitamin B-complex molecules, and the pathologies resulting therefrom. Thiamine, pyridoxamine, and folic acid, each contain primary amine functional groups, whereas nicotinamide and vitamin B12 contain amide groups, each of which are potential reactants with acetaldehyde (AcH), the primary intermediate in the metabolism of ethanol. In this current study, it is reported that prothrombin time (PT), which is prolonged in a fraction of the alcoholic population, can be modified (in the laboratory) when several B-complex vitamins and AcH are added successively to human plasma or are premixed prior to the addition to plasma. Particularly, thiamine, pyridoxamine, and folic acid, at 0.01 mol/l, when added successively with 44.7 mmol/l AcH to plasma, or when premixed prior to addition to plasma, produced a marked reduction in the anticoagulant effect of AcH. Nicotinamide had no effect on PT nor did mixtures with AcH effect PT. However, NAD, which contains a primary amine in its AMP moiety, reacted with AcH, lowering the latter's anticoagulant activity upon addition to plasma. Vitamin B12 did not affect PT. Interestingly, successive mixtures of vitamin B12 and AcH to plasma resulted in a small but statistically significant increase (P≤0.05) in the anticoagulant effect of AcH, whereas premixtures had no statistically significant effect (P>0.05). The decrease in anticoagulant activity of AcH in the presence of B-complex vitamins and NAD suggests that the primary amines in these molecules may form Schiff bases with AcH, thereby lowering both the free AcH concentration as well as the ability of the free vitamins/coenzymes to partake in essential physiological reactions.


Asunto(s)
Acetaldehído/farmacología , Tiempo de Protrombina , Complejo Vitamínico B/farmacología , Acetaldehído/sangre , Acetaldehído/metabolismo , Alcoholismo/complicaciones , Aminas/metabolismo , Anticoagulantes/farmacología , Etanol/metabolismo , Humanos , NAD/farmacología , Niacinamida/farmacología , Bases de Schiff/metabolismo , Complejo Vitamínico B/sangre , Deficiencia de Vitamina B/etiología
15.
Am J Clin Nutr ; 97(2): 332-43, 2013 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-23255571

RESUMEN

BACKGROUND: The role of one-carbon metabolism nutrients in colorectal carcinogenesis is not fully understood. Associations might be modified by mandated folic acid (FA) fortification or alcohol intake. OBJECTIVE: We investigated associations between intakes of folate, riboflavin, vitamin B-6, and vitamin B-12 and colorectal cancer (CRC) in the Women's Health Initiative Observational Study, stratified by time exposed to FA fortification and alcohol intake. DESIGN: A total of 88,045 postmenopausal women were recruited during 1993-1998; 1003 incident CRC cases were ascertained as of 2009. Quartiles of dietary intakes were compared; HRs and 95% CIs were estimated by Cox proportional hazards models. RESULTS: Dietary and total intakes of vitamin B-6 in quartile 4 compared with quartile 1 (HR: 0.80; 95% CI: 0.66, 0.97 and HR: 0.80; 95% CI: 0.66, 0.99, respectively) and total intakes of riboflavin (HR: 0.81; 95% CI: 0.66, 0.99) were associated with reduced risk of CRC overall and of regionally spread disease. In current drinkers who consumed <1 drink (13 g alcohol)/wk, B vitamin intakes were inversely associated with CRC risk (P-interaction < 0.05). Dietary folate intake was positively associated with CRC risk among women who had experienced the initiation of FA fortification for 3 to <9 y (P-interaction < 0.01). CONCLUSIONS: Vitamin B-6 and riboflavin intakes from diet and supplements were associated with a decreased risk of CRC in postmenopausal women. Associations of B vitamin intake were particularly strong for regional disease and among women drinkers who consumed alcohol infrequently. Our study provides new evidence that the increased folate intake during the early postfortification period may have been associated with a transient increase in CRC risk.


Asunto(s)
Neoplasias Colorrectales/epidemiología , Complejo Vitamínico B/administración & dosificación , Anciano , Consumo de Bebidas Alcohólicas/efectos adversos , Estudios de Cohortes , Neoplasias Colorrectales/etiología , Neoplasias Colorrectales/prevención & control , Dieta/efectos adversos , Suplementos Dietéticos , Femenino , Ácido Fólico/administración & dosificación , Ácido Fólico/efectos adversos , Ácido Fólico/uso terapéutico , Estudios de Seguimiento , Alimentos Fortificados/efectos adversos , Humanos , Incidencia , Persona de Mediana Edad , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Riboflavina/administración & dosificación , Riboflavina/uso terapéutico , Estados Unidos/epidemiología , Vitamina B 6/administración & dosificación , Vitamina B 6/uso terapéutico , Complejo Vitamínico B/efectos adversos , Complejo Vitamínico B/uso terapéutico , Deficiencia de Vitamina B/etiología , Deficiencia de Vitamina B/fisiopatología
16.
Semin Dial ; 26(1): 11-5, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23173999

RESUMEN

L-Carnitine (LC) administration has been recommended for specific indications in dialysis patients, including epoetin-resistant anemia, intradialytic hypotension, cardiomyopathy, fatigue, muscle weakness, and exercise performance; it may ameliorate insulin resistance, inflammation, and protein wasting. Use of LC for anemia and intradialytic hypotension has been approved for reimbursement by the Centers for Medicare and Medicaid Services. Yet, the data to support these recommendations are inadequate and have not been bolstered over several decades. LC administration continues to appeal to nephrologists because its use in dialysis patients has an attractive rationale, it addresses problems that persist despite dialysis, it is safe, and the existing literature does not refute its use. Nevertheless, definitive trials to justify LC administration have not been conducted and are increasingly unlikely to be funded. In an era of shrinking resources and bundling of dialysis services, the use of LC in dialysis patients will, appropriately, diminish.


Asunto(s)
Carnitina/administración & dosificación , Suplementos Dietéticos , Diálisis Renal/efectos adversos , Deficiencia de Vitamina B/prevención & control , Carnitina/deficiencia , Humanos , Fallo Renal Crónico/terapia , Complejo Vitamínico B/administración & dosificación , Deficiencia de Vitamina B/sangre , Deficiencia de Vitamina B/etiología
17.
Biomédica (Bogotá) ; 32(4): 474-484, oct.-dic. 2012. ilus, tab
Artículo en Español | LILACS | ID: lil-669094

RESUMEN

La cirugía bariátrica es un tratamiento que garantiza una pérdida de peso sustancial y duradera, y beneficios tangibles respecto a condiciones médicas asociadas a la obesidad. El aumento del número de cirugías bariátricas ha llevado también a un aumento de las complicaciones relacionadas con ella, incluyendo la encefalopatía de Wernicke y la polineuropatía por deficiencia de vitaminas del complejo B. En este artículo se reporta un caso de encefalopatía de Wernicke siete semanas después de la cirugía, enfatizando en la importancia de reconocer el espectro de la sintomatología para hacer un diagnóstico temprano, que permita intervenir en la fase reversible de esta enfermedad potencialmente letal.


Bariatric surgery is a treatment that guarantees a substantial and lasting weight loss in addition to the tangible benefits relating to obesity-associated medical conditions. The increasing number of bariatric surgeries has revealed an increasing number of complications related to this procedure, including Wernicke´s encephalopathy and vitamin B deficiency polyneuropathies. Herein, a 7-week post-surgery case of Wernicke´s encephalopathy is presented that emphasizes the importance of an early recognition of these symptoms so as to initiate intervention during the reversible phase of these potentially lethal pathologies.


Asunto(s)
Adulto , Femenino , Humanos , Derivación Gástrica , Polineuropatías/etiología , Complicaciones Posoperatorias/etiología , Deficiencia de Vitamina B/etiología , Encefalopatía de Wernicke/etiología , Trastornos de Ansiedad/diagnóstico , Daño Encefálico Crónico/diagnóstico , Daño Encefálico Crónico/etiología , Coma/diagnóstico , Coma/etiología , Errores Diagnósticos , Trastornos Fingidos/diagnóstico , Hipotiroidismo/complicaciones , Trastornos Mentales/complicaciones , Obesidad Mórbida/complicaciones , Obesidad Mórbida/cirugía , Pronóstico , Polineuropatías/diagnóstico , Complicaciones Posoperatorias/diagnóstico , Náusea y Vómito Posoperatorios/complicaciones , Factores de Riesgo , Infecciones Urinarias/complicaciones , Complejo Vitamínico B/farmacocinética , Deficiencia de Vitamina B/diagnóstico , Encefalopatía de Wernicke/diagnóstico , Encefalopatía de Wernicke/tratamiento farmacológico , Encefalopatía de Wernicke/fisiopatología
18.
Nutr Clin Pract ; 27(1): 65-8, 2012 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-22227728

RESUMEN

Parenteral nutrition (PN) is a relatively recent life-saving development in medicine but brings with it a range of new potential complications. Much of our knowledge about the signs and symptoms of individual micronutrient deficiencies comes from observations of patients receiving PN, and an example of this is the pivotal paper by Velez and colleagues published in Journal of Parenteral and Enteral Nutrition in 1985. This case report was the first published study to identify acute thiamine deficiency with cardiopathy and metabolic acidosis occurring in adult patients receiving vitamin-free PN. Although the importance of thiamine has been recognized since the late 19th century, it is still unclear exactly what dose is required for full repletion of a deficient patient, and further research would be useful to elucidate this question.


Asunto(s)
Acidosis/etiología , Enfermedades Cardiovasculares/etiología , Nutrición Parenteral/efectos adversos , Deficiencia de Tiamina/etiología , Tiamina/sangre , Complejo Vitamínico B/sangre , Deficiencia de Vitamina B/etiología , Acidosis/sangre , Adulto , Enfermedades Cardiovasculares/sangre , Humanos , Deficiencia de Tiamina/sangre , Deficiencia de Tiamina/diagnóstico , Deficiencia de Vitamina B/sangre , Deficiencia de Vitamina B/diagnóstico
19.
Br J Nutr ; 108(6): 1034-41, 2012 Sep 28.
Artículo en Inglés | MEDLINE | ID: mdl-22172166

RESUMEN

Several studies have shown that blood vitamin levels are lower in alcoholic patients than in control subjects. Acute ethanol exposure enhances the release of vitamins from liver cells in vitro. The aim of the present study is to confirm the effects of ethanol consumption on vitamin contents in vivo. We compared the contents of B-group vitamins in the liver, blood and urine between ethanol-fed and control rats fed a diet containing a sufficient- and low-vitamin mixture. The experimental rats were fed a 15 % ethanol solution freely for 28 d, and then 24 h urine samples were collected, after which the animals were killed. The B-group vitamin contents in the liver, blood and urine were measured. No differences in liver, blood and urine contents were observed between the control and ethanol-fed rats fed a diet containing a sufficient-vitamin mixture. On the contrary, in rats fed a diet containing a low-vitamin mixture, consumption of ethanol caused a decrease in the contents of vitamins B1, B2 and pantothenic acid in the liver; however, the contents of the other vitamins did not decrease. In the blood, the contents of vitamins B1, B2, B6 and pantothenic acid were lower in the ethanol-fed rats than in the controls. Urinary excretion of the B-group vitamins, except for niacin, was lower in the ethanol-fed rats. These results show that ethanol consumption affects the absorption, distribution and excretion of each of the vitamins in rats fed a diet containing a low-vitamin mixture.


Asunto(s)
Consumo de Bebidas Alcohólicas/efectos adversos , Hígado/metabolismo , Complejo Vitamínico B/metabolismo , Deficiencia de Vitamina B/etiología , Consumo de Bebidas Alcohólicas/sangre , Consumo de Bebidas Alcohólicas/metabolismo , Consumo de Bebidas Alcohólicas/orina , Animales , Dieta/efectos adversos , Ingestión de Energía , Absorción Intestinal , Hígado/crecimiento & desarrollo , Hígado/patología , Masculino , Tamaño de los Órganos , Ratas , Ratas Wistar , Distribución Tisular , Complejo Vitamínico B/sangre , Complejo Vitamínico B/uso terapéutico , Complejo Vitamínico B/orina , Deficiencia de Vitamina B/patología , Deficiencia de Vitamina B/prevención & control , Aumento de Peso
20.
Biomedica ; 32(4): 474-84, 2012.
Artículo en Español | MEDLINE | ID: mdl-23715222

RESUMEN

Bariatric surgery is a treatment that guarantees a substantial and lasting weight loss in addition to the tangible benefits relating to obesity-associated medical conditions. The increasing number of bariatric surgeries has revealed an increasing number of complications related to this procedure, including Wernicke´s encephalopathy and vitamin B deficiency polyneuropathies. Herein, a 7-week post-surgery case of Wernicke´s encephalopathy is presented that emphasizes the importance of an early recognition of these symptoms so as to initiate intervention during the reversible phase of these potentially lethal pathologies.


Asunto(s)
Derivación Gástrica , Polineuropatías/etiología , Complicaciones Posoperatorias/etiología , Deficiencia de Vitamina B/etiología , Encefalopatía de Wernicke/etiología , Adulto , Trastornos de Ansiedad/diagnóstico , Daño Encefálico Crónico/diagnóstico , Daño Encefálico Crónico/etiología , Coma/diagnóstico , Coma/etiología , Errores Diagnósticos , Trastornos Fingidos/diagnóstico , Femenino , Humanos , Hipotiroidismo/complicaciones , Trastornos Mentales/complicaciones , Obesidad Mórbida/complicaciones , Obesidad Mórbida/cirugía , Polineuropatías/diagnóstico , Complicaciones Posoperatorias/diagnóstico , Náusea y Vómito Posoperatorios/complicaciones , Pronóstico , Factores de Riesgo , Infecciones Urinarias/complicaciones , Complejo Vitamínico B/farmacocinética , Deficiencia de Vitamina B/diagnóstico , Encefalopatía de Wernicke/diagnóstico , Encefalopatía de Wernicke/tratamiento farmacológico , Encefalopatía de Wernicke/fisiopatología
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