VITAMIN D LEVELS AND LIPID PROFILE IN PATIENTS UNDERGOING BARIATRIC SURGERY.

BACKGROUND: Vitamin, mineral, and metabolic deficiencies occur in the postoperative period of bariatric surgery, in the short and long term, and are worrisome intercurrences. AIMS: To evaluate the association of serum vitamin D levels with the lipid profile in obese patients undergoing bariatric surgery. METHODS: Case series of patients assisted from 2010 to 2018, in a private hospital of medium and high complexity, who underwent bariatric surgery using sleeve gastrectomy or Roux-en-Y gastric bypass techniques, monitored by the same surgeon. Sociodemographic, clinical, laboratory, and anthropometric data were collected preoperatively and at 6, 12, and 24 months after surgery. RESULTS: A total of 156 individuals, mostly female (75.6%) were monitored. The most frequent comorbidities were hepatic steatosis (76.3%) and hypertension (48.27). Regarding preoperative vitamin D levels, only 18.9% of the population had a satisfactory level (≥30 ng/mL). There was a reduction in weight and an improvement in the lipid profile after surgery. Significant correlations were observed between the lipid profile and vitamin D concentration only in the sample submitted to the Roux-en-Y gastric bypass technique: negative correlation between total cholesterol and vitamin D two years after surgery; positive correlation between triglycerides and vitamin D one year after surgery; and negative correlation between high-density lipoprotein and vitamin D two years post-surgery. CONCLUSIONS: It is essential to routinely monitor vitamin D levels and lipid profile pre- and postoperatively in order to avoid damage associated with this vitamin deficiency.

Vitamin d levels and lipid profile in patients undergoing bariatric surgery / Níveis de vitamina d e perfil lipídico em pacientes submetidos à cirurgia bariátrica

ABSTRACT BACKGROUND: Vitamin, mineral, and metabolic deficiencies occur in the postoperative period of bariatric surgery, in the short and long term, and are worrisome intercurrences. AIMS: To evaluate the association of serum vitamin D levels with the lipid profile in obese patients undergoing bariatric surgery. METHODS: Case series of patients assisted from 2010 to 2018, in a private hospital of medium and high complexity, who underwent bariatric surgery using sleeve gastrectomy or Roux-en-Y gastric bypass techniques, monitored by the same surgeon. Sociodemographic, clinical, laboratory, and anthropometric data were collected preoperatively and at 6, 12, and 24 months after surgery. RESULTS: A total of 156 individuals, mostly female (75.6%) were monitored. The most frequent comorbidities were hepatic steatosis (76.3%) and hypertension (48.27). Regarding preoperative vitamin D levels, only 18.9% of the population had a satisfactory level (≥30 ng/mL). There was a reduction in weight and an improvement in the lipid profile after surgery. Significant correlations were observed between the lipid profile and vitamin D concentration only in the sample submitted to the Roux-en-Y gastric bypass technique: negative correlation between total cholesterol and vitamin D two years after surgery; positive correlation between triglycerides and vitamin D one year after surgery; and negative correlation between high-density lipoprotein and vitamin D two years post-surgery. CONCLUSIONS: It is essential to routinely monitor vitamin D levels and lipid profile pre- and postoperatively in order to avoid damage associated with this vitamin deficiency.

RESUMO RACIONAL: Deficiências vitamínicas, minerais e metabólicas ocorrem no pós-operatório de cirurgia bariátrica, a curto e longo prazo, sendo intercorrências preocupantes. OBJETIVOS: Avaliar a associação dos níveis séricos de vitamina D com o perfil lipídico, em pacientes obesos submetidos à cirurgia bariátrica. MÉTODOS: Série de casos de pacientes atendidos de 2010 até 2018, em hospital privado de média e alta complexidade, submetidos à cirurgia bariátrica pelas técnicas da gastrectomia vertical e derivação gástrica em Y de Roux, acompanhados pelo mesmo cirurgião. Foram coletados dados sociodemográficos, clínicos, dados laboratoriais e antropométricos no pré-operatório, 6 meses, 12 meses e 24 meses após cirurgia. RESULTADOS: Foram acompanhados 156 indivíduos, maioria sexo feminino (75,6%), comorbidades mais frequentes foram esteatose hepática (76,3%) e hipertensão (48,27). Em relação aos níveis de vitamina D pré-operatórios, apenas 18,9% da população apresentaram níveis satisfatórios (=30 ng/mL). Observou-se redução do peso e melhora do perfil lipídico pós-cirúrgico. Sobre as correlações entre o perfil lipídico e concentração de vitamina D foram observadas correlações significativas apenas na amostra que passou pela técnica cirúrgica derivação gástrica em Y de Roux: correlação negativa entre o colesterol total e vitamina D após 2 anos de cirurgia; correlação positiva entre triglicerídeo e vitamina D 1 ano pós-operatório; e correlação negativa entre HDL e vitamina D 2 anos pós-operatório. CONCLUSÕES: é essencial acompanhar os níveis de vitamina D e perfil lipídico no pré e pós-operatório de forma rotineira a fim de evitar danos relacionados a deficiência dessa vitamina.

Ingestão dietética e nível de atividade física como preditoresde mudanças no peso e no índice de massa corporal de universitários / Ingesta dietética y nivel de actividad física como predictores de cambios en el peso y en el índice de masa corporal de universitarios / Dietary intake and level of physical activity as predictors of changes in weight and body mass index among college student

OBJETIVO: O objetivo do presente trabalho foi investigar aingestão dietética e o nível de atividade física como preditores de mudanças no peso e no índice de massa corporal (IMC) de estudantes de uma universidade pública do Nordeste do Brasil. MÉTODOS: Tratou-se de uma coorte, onde 138 estudantes foram avaliados ao início do curso e após 1 ano de vida acadêmica. Foram coletados o peso corporal e a altura, dados sobre o nível de atividade física e sobre o consumo alimentar. O modelo conceitual também considerou variáveis sociodemográficas, comportamentais, de composição corporal e distribuição de gordura corporal. RESULTADOS: A amostra foi 76,1% do sexo feminino, com média de idade de 19,7 ± 3,3 anos no baseline. Ao final do seguimento, 50,7% dos universitários ganharam mais de 0,5Kg de peso, dentre esses, a média de ganho de peso foi 2,87 ± 2,01kg. Nos estudantes que no baseline apresentavam consumo ≤ a uma vez por semana de salada crua e ≤ a uma vez ao dia de frutas e legumes cozidos, a chance de ganho em peso foi de 3,06; 2,57 e 2,49 respectivamente. Houve uma correlação negativa entre a variação anual no peso e a variação no consumo de frutas, salada crua e legumes cozidos. Por outro lado, houve uma correlação positiva com o consumo de embutidos, salgados e doces. Comportamento similar foi observado com a variação no índice de massa corporal (IMC). CONCLUSÃO: Não foi identificado influência da prática de atividade física sobre o ganho de peso. No entanto, o padrão alimentar no baseline e o praticado durante o ano de ingresso na universidade exerceu influência sobre o peso e o IMC dos universitários

OBJETIVO: El objetivo del presente estudio fue investigar la ingesta dietética y el nivel de actividad física como predictores de cambios en el peso y el índice de masa corporal (IMC) de estudiantes de una universidad pública en el noreste de Brasil. MÉTODOS: Se trató de una cohorte, donde se evaluó a 138 estudiantes al inicio del curso y luego de 1 año de vida académica. Se recogieron el peso y la altura corporal, los datos sobre el nivel de actividad física y el consumo de alimentos. El modelo conceptual también consideró variables sociodemográficas, conductuales, de composición corporal y distribución de la grasa corporal. RESULTADOS: La muestra fue 76,1% de mujeres, con una edad media de 19,7 ± 3,3 años al inicio del estudio. Al final del seguimiento, el 50,7% de los estudiantes universitarios ganó más de 0,5 kg de peso, entre ellos, la ganancia de peso promedio fue de 2,87 ± 2,01 kg. En los estudiantes que tenían un consumo inicial ≤ una vez a la semana de ensalada cruda y ≤ una vez al día de frutas y verduras cocidas, la probabilidad de aumento de peso fue de 3,06; 2,57 y 2,49 respectivamente. Hubo una correlación negativa entre la variación anual en peso y la variación en el consumo de frutas, ensalada cruda y verduras cocidas. Por otro lado, hubo una correlación positiva con el consumo de embutidos, snacks y dulces. Se observó un comportamiento similar con la variación en el índice de masa corporal (IMC). CONCLUSIÓN: No se identificó la influencia de la actividad física en el aumento de peso. Sin embargo, el patrón dietético en la línea de base y el practicado durante el año de ingreso a la universidad influyó en el peso y el IMC de los estudiantes

OBJECTIVE: The objective of the present study was to investigate dietary intake and the level of physical activity as predictors of changes in weight and body mass index (BMI) of students at a public university in Northeast Brazil. METHODS: This was a cohort, where 138 students were assessed at the beginning of the course and after 1 year of academic life. Body weight and height, data on the level of physical activity and food consumption were collected. The conceptual model also considered sociodemographic, behavioral, body composition and body fat distribution variables. RESULTS: The sample was 76.1% female, with a mean age of 19.7 ± 3.3 years at baseline. At the end of the follow-up, 50.7% of university students gained more than 0.5 kg of weight, among them, the average weight gain was 2.87 ± 2.01 kg. In students who had a baseline consumption ≤ once a week of raw salad and ≤ once a day of cooked fruits and vegetables, the chance of weight gain was 3.06; 2.57 and 2.49 respectively. There was a negative correlation between the annual variation in weight and the variation in the consumption of fruits, raw salad and cooked vegetables. On the other hand, there was a positive correlation with the consumption of sausages, snacks and sweets. Similar behavior was observed with the variation inbody mass index (BMI). CONCLUSION: The influence of physical activity on weight gain was not identified. However, the dietary pattern in the baseline and that practiced during the year of entry into the university influenced the weight and BMI of the students

Predictive factors of hospitalization in an intensive care unit in patients with COVID-19: A case-control study / Factores predictivos de ingreso a unidad de cuidados intensivos en pacientes con COVID-19: un estudio de casos y controles

OBJECTIVE: The aim of the present study was to evaluate potential predictive factors for the aggravation of COVID-19 in patients hospitalized at a reference hospital in northeastern Brazil. METHODS: A non-paired case-control study was conducted with 235 patients hospitalized at a reference hospital in northeastern Brazil between March and April 2020.The case group was composed of individuals who required hospitalization in the ICU. The control group was composed of patients hospitalized due to COVID-19 who did not meet the criteria established in the institutional protocol for classification as "severe case of the disease" and therefore did not require intensive care. RESULTS: The case group was composed of 84 patients with a median age of 45 years (P25-P75: 36-59); 63.1% weremen; 56.0% were less than 60 years of age; 76.2% had excess weight; 14.3% had a previous heart disease; 46.4% had hypertension; 11.9% had lung disease; and 67.1% took continuous-use medications. The median stay of severe cases in the ICU was positively correlated with weight and BMI only among female patients less than 60 years of age. CONCLUSION: The logistic regression analysis revealed that age older than 60 years and a compromised cardiovascular system were independent predictive factors for the severity of COVID-19

OBJECTIVE: The aim of the present study was to evaluate potential predictive factors for the aggravation of COVID-19 in patients hospitalized at a reference hospital in northeastern Brazil. METHODS: A non-paired case-control study was conducted with 235 patients hospitalized at a reference hospital in northeastern Brazil between March and April 2020. The case group was composed of individuals who required hospitalization in the ICU. The control group was composed of patients hospitalized due to COVID-19 who did not meet the criteria established in the institutional protocol for classification as "severe case of the disease" and therefore did not require intensive care. RESULTS: The case group was composed of 84 patients with a median age of 45 years (P25-P75: 36-59); 63.1% were men; 56.0% were less than 60 years of age; 76.2% had excess weight; 14.3% had a previous heart disease; 46.4% had hypertension; 11.9% had lung disease; and 67.1% took continuous-use medications. The median stay of severe cases in the ICU was positively correlated with weight and BMI only among female patients less than 60 years of age. CONCLUSION: The logistic regression analysis revealed that age older than 60 years and a compromised cardiovascular system were independent predictive factors for the severity of COVID-19