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Background & aims: Vitamin D supplementation as animmunomodulator has been identified as a potential strategy to prevent and treat Coronavirus disease 2019 (COVID-19). We aimed to analyze the effect of 10,000 IU vitamin D3supplementation on 25(OH)D levels on primary clinical outcomes (conversion length), inflammatory markers (TotalLymphocyte Count (TLC), Neutrophil-to-Lymphocyte Ratio(NLR), Platelet-to-Lymphocyte Ratio (PLR)) and coagulationmarker (D-Dimer) in moderate COVID-19 patients atWahidin Sudirohusodo Hospital, Makassar, Indonesia.Methods: We conducted a singleblind randomized-controlled trial on the confirmed moderate COVID-19 patientsabove 18 years old and low vitamin D status. Each of inter-vention and control groups were supplemented of 10,000 IUand 1000 IU cholecalciferol that taken daily for 2 weeks.Levels of 25(OH)D were analyzed for the primary endpoint(conversion length), then correlated to secondary endpoints(Length of Stay (LOS)), clinical manifestations improvement,and markers TLC, NLR, PLR, and D-Dimer serum, handgripstrength (HGS) as functional capacity measurement, after ad-justed to age, sex, nutritional status based on body mass in-dex (BMI) and Subjective Global Assessment (SGA) tool, co-morbidities, and anticoagulant administration. Medical nutri-tional therapy was given and presented as energy, protein,carbohydrate, and fat achievement, and vitamin D intake wasalso calculated.Results: A significant effects was found in 60 samples withpre-intervention vitamin D deficiency (61.7%) and insuffi-ciency (38.3%) status, and 10,000 IU of vitamin D3 supplementation could increase 25(OH)D levels within 2 weeks toreach sufficiency status (16.7%). The Vitamin D3 supplementation of 10,000 IU and 1000 IU could significantly increase25(OH)D levels compared to the control group of 1000 IU(4.61±5.43 vs. -0.29±2.72; P <0.0001) and it was correlatedto primary clinical outcome, which is length of conversion...(AU)
Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Pandemias , Infecções por Coronavirus/epidemiologia , Transtornos da Coagulação Sanguínea , Vitamina D , Estado Nutricional , Índice de Massa Corporal , Indonésia , 52503RESUMO
Background: This study aims to evaluate the association and dose-response between triglyceride-glucose (TyG) index and breast cancer. Method: This is a multicenter case-control study conducted in six public referral hospitals in Indonesia. Cases are individuals aged 19 years or above who were diagnosed with breast cancer within 1 year of diagnosis, based on histopathology and immunohistochemistry. Controls were recruited from corresponding hospitals. TyG index was determined by the formula: ln (fasting TG [mg/dl] × fasting glucose [mg/dl]). Results: There were 212 participants in the breast cancer group and 212 participants in the control group. TyG index was higher in patients with breast cancer (median 8.65 [7.38, 10.9] vs. 8.30 [7.09, 10.84], p < 0.001). When compared with TyG quartile of Q1, Q4 was associated with an OR of 2.42 (1.77, 3.31), p < 0.001, Q3 was associated with an OR of 1.53 (1.21, 1.93), p < 0.001, Q2 was associated with an OR of 1.39 (1.12, 1.73), p = 0.002 for the risk of breast cancer. The dose-response relationship was nonlinear (p < 0.001). On univariate analysis, smoking (OR 2.15 [1.44, 3.22], p < 0.001), use of contraception (1.73 [1.15, 2.60], p = 0.008), alcohol consumption (OR 2.04 [0.96, 4.35], p = 0.064), and TyG Index >8.87 (OR 3.08 [1.93, 4.93], p < 0.001) were associated with risk of breast cancer. Independently associated with increased risk of breast cancer included smoking (OR 1.93 [1.23, 3.01], p = 0.004), use of contraception (OR 1.59 [1.02, 2.48], p = 0.039), and TyG Index >8.87 (OR 2.93 [1.72, 4.98], p < 0.001). Conclusion: TyG index was associated with breast cancer in a nonlinear dose-response fashion.