Vitamin D nutritional status and its relationship with metabolic changes in adolescents and adults with severe obesity.

INTRODUCTION: increased vitamin D deficiency occurs together with obesity and the association between these conditions has been observed. OBJECTIVE: to assess the nutritional status of vitamin D and metabolic profile in adolescents and adults with obesity, and the relationship between complications arising from severe class of obesity with vitamin D nutritional status, and to compare the differences between these groups. METHODS: observational comparative study. Population comprises adolescents and adults with severe obesity. Waist circumference (WC) and body mass index (BMI) were measured. Analysis of vitamin D (25(OH)D), lipid profile, C-reactive protein (CRP), blood glucose, fasting insulinemia, insulin sensitivity, blood pressure and diagnoses of nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome (MS) were performed. RESULTS: a total of 60 adolescents (G1) and 68 adults (G2) were evaluated. The percentage of vitamin D inadequacy was observed in 90% in G1 and 79.4% in G2. There was a negative and significant correlation of BMI with the values of 25(OH)D in the group of adults (r = -0.244; p = 0.045). Individuals with inadequacy of vitamin D showed higher values of CRP in both groups (p = 0.000). HOMA-IR showed a negative correlation with 25(OH)D in G1 (r = -0.832; p = 0.000) and G2 (r = -0.589; p = 0.000). The inadequacy of this vitamin showed association with high total cholesterol in G1 (p = 0.029) and higher values of LDL-c in G2 (p = 0.003). CONCLUSION: high prevalence of deficiency and insufficiency of vitamin D were observed, associated with metabolic changes both in obese adults and adolescents. It is necessary to develop strategies for the prevention and control of obesity and vitamin D deficiency.

[Anthropometric evaluation of pediatric patients with non-progressive chronic encephalopathy according to different methods of classification]. / Avaliação antropométrica de pacientes pediátricos com encefalopatia crônica não progressiva segundo diferentes métodos de classificação.

OBJECTIVE: To perform anthropometric assessment of patients with quadriplegic, chronic non-progressive encephalopathy, comparing two distinct references of nutritional classification, and to compare the estimated height to the length measured by stadiometer. METHOD: Cross-sectional study including 0-3-year children with quadriplegic, chronic non-progressive encephalopathy in secondary public hospital. Length, weight, arm circumference, triceps skinfold and knee height were measured. The arm muscle circumference and estimated height were calculated. The following relations were evaluated: weight-for-age, length-for-age and weight-for-length, using as reference the charts of the the World Health Organization (WHO) and those proposed by Krick et al. RESULTS: Fourteen children with a mean age of 21 months were evaluated. Assessment of anthropometric indicators showed significant difference between the two classification methods to assess nutritional indicators length/age (p=0.014), weight/age (p=0.014) and weight/length (p=0.001). There was significant correlation between measured length and estimated height (r=0.796, p=0.001). Evaluation of arm circumference and triceps skinfold showed that most patients presented some degree of malnutrition. According to arm muscle circumference, most were eutrophic. CONCLUSIONS: Specific curves for children with chronic non-progressive encephalopathy appear to underestimate malnutrition when one takes into account indicators involving weight. Curves developed for healthy children can be a good option for clinical practice and weight-for-length indicator and body composition measurements should be considered as complementary tools.

Avaliação antropométrica de pacientes pediátricos com encefalopatia crônica não progressiva segundo diferentes métodos de classificação / Anthropometric evaluation of pediatric patients with nonprogressive chronic encephalopathy according to different methods of classification

Objetivo: Realizar a avaliação antropométrica de pacientes com encefalopatia crônica não progressiva quadriplégica, usando referências distintas de classificação do estado nutricional, e comparar a altura estimada com o comprimento mensurado por antropômetro. Métodos: Estudo transversal descritivo, incluindo crianças com encefalopatia crônica não progressiva quadriplégica de 0-3 anos em hospital público secundário. Foram aferido scomprimento, peso, circunferência do braço, prega cutânea tricipital e altura do joelho. Foram calculadas a circunferência muscular do braço e a estimativa da altura. Foram avaliadas as relações peso/idade, comprimento/idade e peso/comprimento, utilizando como referência os gráficos da Organização Mundial de Saúde e os propostos por Krick et al. Resultados: Foram avaliadas 14 crianças com idade média de 21 meses. A avaliação dos indicadores antropométricos mostrou diferença significativa entre os dois métodos de classificação nutricional ao avaliar os indicadores comprimento/idade (p=0,014), peso/idade (p=0,014) e peso/comprimento (p=0,001). Houve correlação significativa entre comprimento mensurado e estatura estimada (r=0,796; p=0,001). A avaliação da circunferência do braço e prega cutânea tricipital mostrou que a maioria dos pacientes apresentava algum grau de desnutrição, mas, de acordo com a medida da circunferência muscular do braço, a maioria estava eutrófica. Conclusões: Curvas específicas para crianças com encefalopatia parecem subestimar a desnutrição, quando se leva em consideração indicadores que envolvem peso. Curvas elaboradas para crianças hígidas podem ser boa opção para prática...

Objective: To perform anthropometric assessment of patients with quadriplegic, chronic non-progressive encephalopathy, comparing two distinct references of nutritional classification and to compare the estimated height to the length measured by stadiometer. Method: Cross-sectional study including 0-3-year children with quadriplegic chronic non-progressive encephalopathy in secondary public hospital. Length, weight, arm circumference, triceps skinfold and knee height were measured. The arm muscle circumference and estimated height were calculated. The following relations were evaluated: weight-for-age, length-for-age and weight-for-length, using as reference the charts of the World Health Organization (WHO) and those proposed by Krick et al. Results: Fourteen children with a mean age of 21 months were evaluated. Assessment of anthropometric indicators showed significant difference between the two classification methods to assess nutritional indicators length/age (p=0.014), weight/age (p=0.014) and weight/length (p=0.001). There was significant correlation between measured length and estimated height (r=0.796, p=0.001). Evaluation of arm circumference and triceps skinfold showed that most patients presented some degree of malnutrition. According to arm muscle circumference, most were eutrophic. Conclusions: Specific curves for children with chronic non-progressive encephalopathy appear to underestimate malnutrition when one takes into account indicators involving weight. Curves developed for healthy children can be a good option for clinical practice and weight-for-length indicator and body composition measurements should be considered as complementary tools...