Effects of vitamin D supplementation on the glycemic control of pre-diabetic individuals: a systematic review / Efectos de la suplementación con vitamina D sobre el control glucémico en pacientes prediabéticos: una revisión sistemática

INTRODUCTION: research shows the potential effect of vitamin D supplementation with an improvement in the glycemic profile of pre-diabetic patients. OBJECTIVE: this study evaluates the effects of vitamin D supplementation on glycemic control markers in pre-diabetic individuals. METHODS: we analyzed studies published over the last ten years, and indexed in the Science Direct, PubMed, and LILACS databases. We searched studies using health descriptors related to vitamin D, pre-diabetes, and glycemic control markers. We considered randomized controlled trials eligible for inclusion. All phases of selection, data extraction, and risk of bias assessment were carried out by two independent evaluators. RESULTS: we identified 309 articles, of which 4 met the inclusion criteria. Of these, 3 studies have shown that vitamin D supplementation does not alter glycemic control markers in pre-diabetic individuals. Only one study showed a positive effect after supplementation with 60,000 IU/month of vitamin D3 for 12 months, with a significant reduction in the concentrations of glycated hemoglobin, fasting glucose, and two-hour postprandial glucose. CONCLUSION: there is insufficient scientific evidence to confirm the beneficial effects of vitamin D supplementation on glycemic control markers in pre-diabetic individuals

INTRODUCCIÓN: las investigaciones muestran el efecto potencial de la suplementación con vitamina D con una mejora del perfil glucémico de los pacientes prediabéticos. OBJETIVO: este estudio evalúa los efectos de la suplementación con vitamina D sobre los marcadores de control glucémico en personas prediabéticas. MÉTODOS: analizamos los estudios publicados en los últimos diez años e indexados en las bases de datos Science Direct, PubMed y LILACS. Se realizaron búsquedas de estudios mediante descriptores de salud relacionados con la vitamina D, la prediabetes y los marcadores de control glucémico. Los ensayos controlados y aleatorizados se consideraron elegibles para su inclusión. Todas las fases de selección, extracción de datos y evaluación del riesgo de sesgos fueron realizadas por dos evaluadores independientes. RESULTADOS: identificamos 309 artículos, de los que 4 cumplieron los criterios de inclusión. De estos, 3 estudios demostraron que la suplementación con vitamina D no altera los marcadores de control glucémico en las personas prediabéticas. Solo un estudio mostró un efecto positivo después de la suplementación de 60.000 UI/mes de vitamina D3 durante 12 meses, con una reducción significativa de las concentraciones de hemoglobina glucosilada, glucosa en ayunas y glucosa posprandial a las dos horas. CONCLUSIÓN: no hay evidencia científica suficiente para confirmar los efectos beneficiosos de la suplementación de vitamina D sobre los marcadores de control glucémico en las personas prediabéticas

Effects of vitamin D supplementation on the glycemic control of pre-diabetic individuals: a systematic review.

INTRODUCTION: Introduction: research shows the potential effect of vitamin D supplementation with an improvement in the glycemic profile of pre-diabetic patients. Objective: this study evaluates the effects of vitamin D supplementation on glycemic control markers in pre-diabetic individuals. Methods: we analyzed studies published over the last ten years, and indexed in the Science Direct, PubMed, and LILACS databases. We searched studies using health descriptors related to vitamin D, pre-diabetes, and glycemic control markers. We considered randomized controlled trials eligible for inclusion. All phases of selection, data extraction, and risk of bias assessment were carried out by two independent evaluators. Results: we identified 309 articles, of which 4 met the inclusion criteria. Of these, 3 studies have shown that vitamin D supplementation does not alter glycemic control markers in pre-diabetic individuals. Only one study showed a positive effect after supplementation with 60,000 IU/month of vitamin D3 for 12 months, with a significant reduction in the concentrations of glycated hemoglobin, fasting glucose, and two-hour postprandial glucose. Conclusion: there is insufficient scientific evidence to confirm the beneficial effects of vitamin D supplementation on glycemic control markers in pre-diabetic individuals.

INTRODUCCIÓN: Introducción: las investigaciones muestran el efecto potencial de la suplementación con vitamina D con una mejora del perfil glucémico de los pacientes prediabéticos. Objetivo: este estudio evalúa los efectos de la suplementación con vitamina D sobre los marcadores de control glucémico en personas prediabéticas. Métodos: analizamos los estudios publicados en los últimos diez años e indexados en las bases de datos Science Direct, PubMed y LILACS. Se realizaron búsquedas de estudios mediante descriptores de salud relacionados con la vitamina D, la prediabetes y los marcadores de control glucémico. Los ensayos controlados y aleatorizados se consideraron elegibles para su inclusión. Todas las fases de selección, extracción de datos y evaluación del riesgo de sesgos fueron realizadas por dos evaluadores independientes. Resultados: identificamos 309 artículos, de los que 4 cumplieron los criterios de inclusión. De estos, 3 estudios demostraron que la suplementación con vitamina D no altera los marcadores de control glucémico en las personas prediabéticas. Solo un estudio mostró un efecto positivo después de la suplementación de 60.000 UI/mes de vitamina D3 durante 12 meses, con una reducción significativa de las concentraciones de hemoglobina glucosilada, glucosa en ayunas y glucosa posprandial a las dos horas. Conclusión: no hay evidencia científica suficiente para confirmar los efectos beneficiosos de la suplementación de vitamina D sobre los marcadores de control glucémico en las personas prediabéticas.

Association between matrix metalloproteinase-9 gene polymorphism and breast cancer in Brazilian women.

OBJECTIVE: This study aimed to determine the relationship between rs17576 (MMP-9) polymorphism and increased cancer risk in a Brazilian breast cancer cohort. METHODS: This study included 141 women (71 breast cancer patients and 70 controls without breast cancer) who donated 3 mL of their peripheral blood for genomic DNA extraction. This DNA was then genotyped using a real-time polymerase chain reaction. RESULTS: The AG (rs17576) genotype was identified in 26 (18.43%) participants in the case group and in 22 (15.60%) participants in the control group (p=0.274), while the GG genotype was identified in ten (7.09%) participants in the case group and in one (0.70%) participant in the control group (p<0.003 - OR (95% CI) 13.13 (1.73, 593.08). No significant difference in the incidence rates was observed for AG or GG rs17576 genotypes in premenopausal women, p=0.813 and p=0.556, respectively. However, in postmenopausal women, the AG genotype was shown to occur in 14 (22.5%) participants in the case group and in 4 (6.45%) participants in the control (p<0.043), while GG genotype occurred in eight (12.90%) of the individuals in the case group and in none of the individuals in the control group (p<0.006). CONCLUSION: In this study, the MMP-9 rs17576 GG polymorphic variant was shown to be significantly associated with breast cancer risk in premenopausal women, while the AG and GG genotypes were associated with increased cancer risk in postmenopausal women.

Association between matrix metalloproteinase-9 gene polymorphism and breast cancer in Brazilian women

OBJECTIVE: This study aimed to determine the relationship between rs17576 (MMP-9) polymorphism and increased cancer risk in a Brazilian breast cancer cohort. METHODS: This study included 141 women (71 breast cancer patients and 70 controls without breast cancer) who donated 3 mL of their peripheral blood for genomic DNA extraction. This DNA was then genotyped using a real-time polymerase chain reaction. RESULTS: The AG (rs17576) genotype was identified in 26 (18.43%) participants in the case group and in 22 (15.60%) participants in the control group (p=0.274), while the GG genotype was identified in ten (7.09%) participants in the case group and in one (0.70%) participant in the control group (p<0.003 - OR (95% CI) 13.13 (1.73, 593.08). No significant difference in the incidence rates was observed for AG or GG rs17576 genotypes in premenopausal women, p=0.813 and p=0.556, respectively. However, in postmenopausal women, the AG genotype was shown to occur in 14 (22.5%) participants in the case group and in 4 (6.45%) participants in the control (p<0.043), while GG genotype occurred in eight (12.90%) of the individuals in the case group and in none of the individuals in the control group (p<0.006). CONCLUSION: In this study, the MMP-9 rs17576 GG polymorphic variant was shown to be significantly associated with breast cancer risk in premenopausal women, while the AG and GG genotypes were associated with increased cancer risk in postmenopausal women.

Expression of matrix metalloproteinase 2 and 9 in breast cancer and breast fibroadenoma: a randomized, double-blind study.

BACKGROUND: Matrix metalloproteinases (MMPs) 2 and 9 may play an important role in cell proliferation and dissemination of cancer. However, few studies have compared the expression of these proteins between breast cancer and fibroadenoma. MATERIAL AND METHODS: A randomized, double-blind study was carried out in 66 premenopausal women, aged 20-49 years, who had been diagnosed with fibroadenoma or breast cancer. The patients were divided into two groups: Group A, control (fibroadenoma, n=36) and Group B, study (cancer, n=30). Immunohistochemical analysis was performed using tissue samples of fibroadenoma and breast cancer to assess MMP-2 and MMP-9 antigen expression. Cells were considered positive if exhibiting brown cytoplasmic staining. Fisher's exact test was used to compare the percentage of cases with cells expressing MMP-2 and MMP-9 in control and study groups (p < 0.05). RESULTS: Light microscopy showed a higher concentration of cells with positive cytoplasmic staining for MMP-2 and MMP-9 expression in breast cancer than in fibroadenoma. The percentage of cases with cells expressing MMP-2 in the control and study groups was 41.67% and 86.11%, respectively (p < 0.0009), whereas the percentage of cases with cells expressing MMP-9 in groups A and B was 66.67% and 93.33%, respectively (p<0.0138). MMP-2 and MMP-9 positive expression was significantly higher in moderately differentiated tumors compared to well and poorly differentiated tumors, p <0.005 and p<0.001, respectively. CONCLUSIONS: The current study shows that MMP-2 and MMP-9 protein expression was significantly higher in the breast cancer than in the fibroadenoma and also in moderately differentiated breast cancer.

Influência do Tratamento Quimioterápico no Comportamento Alimentar e Qualidade de Vida de Pacientes Oncológicos / Influence of Chemotherapy Treatment on Eating Behavior and Quality of Life of Oncologic Patients / Influencia del Tratamiento de Quimioterapia en el Comportamento Alimentario y Calidad de Vida de los Pacientes con Cáncer

Introdução: O câncer é uma doença de origem multifatorial, com crescimento irregular e descontrolado de células, cujo tratamento pode desencadear aversões alimentares e mudanças na qualidade de vida. Objetivo: Avaliar a influência do tratamento quimioterápico no comportamento alimentar e na qualidade vida de pacientes oncológicos. Método: Estudo longitudinal e observacional, realizado de junho a outubro de 2018, no Hospital Universitário da Universidade Federal do Piauí. Os dados foram obtidos em dois momentos: T0, socioeconômicos, demográficos, clínicos, de comportamento alimentar e qualidade de vida; e T1, de comportamento alimentar e qualidade de vida. Foram utilizados os testes Shapiro-Wilk, t-Student e Wilcoxon; Pearson e Spearman com p< 0,05. Resultados: Dos 17 pacientes, a maioria era do sexo feminino (82,4%), média de 54,2 anos, renda familiar de um a dois salários mínimos (64,7%) e de etnia parda (76,5%). O câncer mais frequente foi o de mama (52,9%). Houve aversões alimentares em T1 para: "sopas e massas" (p=0,001), "carnes e peixes" (p=0,016), e "doces, sobremesas e aperitivos" (p=0,001). Houve diferença significativa na qualidade de vida quanto à medida global de saúde (p=0,001) e dificuldade financeira (p=0,026), assim também como nas correlações entre qualidade de vida e comportamento alimentar. Conclusão: Os resultados reforçam a necessidade de constante monitoramento nutricional desde o início do tratamento quimioterápico com o intuito de evitar e/ou reduzir suas repercussões negativas no estado nutricional e, consequentemente, na qualidade de vida. Além disso, a realização de mais estudos, com amostra e intervalo de tempo maiores, é necessária.

Introduction: Cancer is a multifactorial disease with uncontrolled cells growth, whose treatment can trigger food aversions and changes in quality of life. Objective: To evaluate the influence of chemotherapy treatment on eating behavior and quality of life of oncologic patients. Method: A longitudinal and observational study, carried out from June to October of 2018, at the University Hospital of the Federal University of Piauí. The data were obtained in two moments: T0, socioeconomic, demographic, clinical, food behavior and quality of life, and T1, food behavior and quality of life. The following tests were used: Shapiro-Wilk, t-Student and Wilcoxon; Pearson and Spearman, with p <0.05. Results: Of the 17 patients, the majority were females (82.4%), medium age of 54.2 years, family income of 1 to 2 minimum wages (64.7%) and ethnics, brown (76.5%). Breast cancer was the most frequent (52.9%). There were food aversions in T1, for "soups and pastas" (p=0.001), "meats and fish" (p=0.016), and "sweets, desserts and appetizers (p=0.001). There was a significant difference in quality of life regarding the general health status (p=0.001) and financial difficulty (p=0.026), as well as in correlations between quality of life and food behavior. Conclusion: The results reinforce the need of constant nutritional monitoring since the beginning of the chemotherapy in order to avoid and/or reduce the negative repercussions on the nutritional status and, consequently, on the quality of life. In addition, more studies with longer time ranges and larger samples are required.

Introducción: El cáncer es una enfermedad de origen multifactorial, con crecimiento descontrolado de células, cuyo tratamiento puede desencadenar aversiones alimenticias y cambios en la calidad de vida. Objetivo: Evaluar la influencia del tratamiento quimioterápico en el comportamiento alimentario y en la calidad de vida de pacientes oncológicos. Método: Estudio longitudinal y observacional, realizado de junio a octubre de 2018, en el Hospital Universitario de la Universidad Federal de Piauí. Los datos fueron obtenidos en dos momentos: T0, socioeconómicos, demográficos, clínicos, de comportamiento alimentario y calidad de vida y T1, de comportamiento alimentario y calidad de vida. Se utilizaron las pruebas: Shapiro-Wilk, t-Student y Wilcoxon; Pearson y Spearman, con p <0,05. Resultados: De los 17 pacientes, la mayoría eran mujeres (82,4%), promedio de 54,2 años, ingreso familiar de 1 a 2 salarios mínimos (64,7%) y de etnia parda (76,5%). El cáncer más frecuente fue el de mama (52,9%). Se observaron aversiones alimentarias en T1, para algunos grupos de alimentos. Se observó una diferencia significativa em la calidad de vida en cuanto a la medida global de salud (p=0,001) y dificultad financiera (p=0,026), así como las correlaciones entre calidad de vida y comportamiento alimentario. Conclusión: Los resultados refuerzan la necesidad de constante monitoreo nutricional desde el inicio del tratamiento quimioterápico con el fin de evitar y/o reducir lãs repercusiones negativas de este en el estado nutricional y en calidad de vida. Además, la realización de más estúdios com muestra e intervalo de tempo mayor, son necesarios.

Mineral status and superoxide dismutase enzyme activity in Alzheimer's disease.

The study evaluated the dietary intake of zinc and copper, as measured by plasma and erythrocyte concentrations, the Cu/Zn ratio and measure the erythrocyte superoxide dismutase enzyme (eSOD) activity and the relationship between these markers and the degree of dementia in elderly individuals with and without Alzheimer's Disease (AD). A total of 93 elderly people aged 60-94 years were divided into two groups: with AD (n=44) and without AD (n=49). The NINCDS-ADRDA criteria were used for diagnosing AD, and dementia staging was determined using the Clinical Dementia Rating (CDR) scale. The dietary intake of Zn and Cu was obtained from a standard 3-day food record. Plasma and erythrocyte concentrations of the minerals were determined by flame atomic absorption spectrophotometry and by measuring eSOD activity in an automatic biochemical analyzer. The results showed dietary intake of Zn and Cu above the reference values with no differences observed between the two groups (p>0.05). Plasma and erythrocyte normocupremia as well as alteration in the Zn pool, with its reduced plasma concentrations and high in the erythrocytes, were observed in both groups (p>0.05). The plasma Cu/Zn ratio were not significantly different in patients with and without AD (p>0.05). The eSOD activity was high in both patient groups (p>0.05). However, among elderly patients with AD there was a positive correlation between this marker and dementia severity. According to our study results, we conclude that plasma and erythrocyte concentrations of Cu and Zn, as well as Cu/Zn ratio among elderly individuals is not related to Alzheimer's Disease. However, antioxidant activity of eSOD is associated with dementia severity.

Immunonutrition effects in the treatment of cancer patients and itscomplications - a review / Efeitos da imunonutrição no tratamento de pacientes com câncer esuas complicações – uma revisão

The aim of this study was to review and summarize the data from the literature regarding the effects ofpre- and postoperative immunonutrition in the outcome of cancer patients. The review was conductedthrough literature searches in databases such as Medline/Pubmed, Scielo and Lilacs, from July toSeptember 2014, for articles investigating the effects of immunonutrition related to nutritional recoveryand pre- and post-operative procedures in cancer patients. We found 32 articles, 27 of which met theinclusion criteria, including review articles, case-control studies, epidemiological studies and crosssectionalstudies. From this literature review it was possible to see the benefits of using preoperativeimmunomodulating diet in cancer patients undergoing major abdominal surgery, including reduction ofseptic and inflammatory complications during postoperative period and hence the hospital length of stay.Thus, the use of immunonutrition has been shown to be capable to reverse organic and immunologicalchanges caused by both malnutrition and the tumor itself in cancer patients.

O objetivou deste trabalho foi revisar, de forma sucinta e objetiva, as evidências disponíveis nos bancos de dados digitais, sobre os efeitos da imunonutrição para a resposta ao tratamento de pacientes com câncer em pré e pós-operatório. Foi realizada uma revisão de literatura, por meio de buscas bibliográficas nos bancos de dados informatizados Medline/Pubmed, Scielo e Lilacs, no período de julho a setembro de 2014, de artigos que investigaram os efeitos da imunonutrição na recuperação do estado nutricional e em procedimentos pré e pós-operatório de pacientes com câncer. Foram encontrados 32 artigos, dos quais 27 atenderam aos critérios de inclusão do estudo, compreendendo artigos de revisão, caso-controle,epidemiológicos e transversais. A partir desta revisão de literatura foi possível verificar o benefício do uso da dieta imunomoduladora em pacientes oncológicos submetidos ao tratamento no pré-operatório de cirurgias de grande porte abdominal, diminuindo complicações sépticas e inflamatórias no período pós operatório e consequentemente o tempo de internação hospitalar. Dessa forma, o uso da imunonutrição mostra-se com capacidade de reverter alterações orgânicas e imunológicas causadas tanto pela desnutrição como pelo próprio tumor em pacientes com câncer.