The Effect of Vitamin D Adequacy on Thyroid Hormones and Inflammatory Markers after Bariatric Surgery.

Vitamin D status affects the clinical and corporal outcomes of postoperative patients who undergo a Roux-en-Y gastric bypass (RYGB). The aim of this study was to evaluate the effect of adequate vitamin D serum concentrations on thyroid hormones, body weight, blood cell count, and inflammation after an RYGB. A prospective observational study was conducted with eighty-eight patients from whom we collected blood samples before and 6 months after surgery to evaluate their levels of 25-hydroxyvitamin D 25(OH)D, thyroid hormones, and their blood cell count. Their body weight, body mass index (BMI), total weight loss, and excess weight loss were also evaluated 6 and 12 months after surgery. After 6 months, 58% of the patients achieved an adequate vitamin D nutritional status. Patients in the adequate group showed a decrease in the concentration of thyroid-stimulating hormone (TSH) (3.01 vs. 2.22 µUI/mL, p = 0.017) with lower concentrations than the inadequate group at 6 months (2.22 vs. 2.84 µUI/mL, p = 0.020). Six months after surgery, the group with vitamin D adequacy showed a significantly lower BMI compared with the inadequate group at 12 months (31.51 vs. 35.04 kg/m2, p = 0.018). An adequate vitamin D nutritional status seems to favor a significant improvement in one's thyroid hormone levels, immune inflammatory profile, and weight loss performance after an RYGB.

Vitamin A Deficiency and Its Association with Visceral Adiposity in Women.

Body adiposity is associated with increased metabolic risk, and evidence indicates that vitamin A is important in regulating body fat. The aim of this study was to evaluate serum concentrations of vitamin A and its association with body adiposity in women with the recommended intake of vitamin A. A cross-sectional study was designed with 200 women divided into four groups according to Body Mass Index (BMI): normal weight (NW), overweight (OW), class I obesity (OI), and class 2 obesity (OII). The cut-off points to assess inadequate participants were retinol < 1.05 µmol/L and ß-carotene < 40 µg/dL. Body adiposity was assessed through different parameters and indexes, including waist circumference (WC), waist-to-height ratio (WHtR), hypertriglyceridemic waist (HW), lipid accumulation product (LAP), Visceral Adiposity Index (VAI), and Body Adiposity Index (BAI). It was observed that 55.5% of women had low serum concentrations of ß-carotene (34.9 ± 13.8 µmol/L, p < 0.001) and 43.5% had low concentrations of retinol (0.71 ± 0.3 µmol/L, p < 0.001). Women classified as OI and OII had lower mean values of ß-carotene (OI-35.9 ± 4.3 µg/dL: OII-32.0 ± 0.9 µg/dL [p < 0.001]). IAV showed significant negative correlation with retinol (r = -0.73, p < 0.001). Vitamin A deficiency is associated with excess body adiposity in women with the recommended intake of vitamin. Greater body adiposity, especially visceral, was correlated with reduced serum concentrations of vitamin A.

Evaluation of Liver Metabolism Biomarkers in Metabolic Associated Fatty Liver Disease According to Obesity Phenotype.

OBJECTIVE: To analyze the relationship between the biochemical markers of liver metabolism in different stages of Metabolic Associated Fatty Liver Disease (MAFLD) according to the obesity phenotype. METHODOLOGY: This is a cross-sectional study with individuals with class III obesity classified according to the obesity phenotypes proposed by the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. Biochemical and anthropometric variables were analyzed according to the staging of MAFLD and obesity phenotype. RESULTS: A total of 50 subjects with MAFLD, 62% (n = 31) with steatosis and 38% (n = 19) with steatohepatitis without fibrosis; 36% were classified as metabolically healthy obesity (MHO) and 64% as metabolically unhealthy obesity (MUHO), respectively. Mean values of alkaline phosphatase were 85.44 ± 27.27 vs. 61.92 ± 17.57 (p = 0.006); gamma-glutamyl transpeptidase, 25.77 ± 15.36 vs. 30.63 ± 19.49 (p = 0.025); and albumin, 3.99 ± 0.34 vs. 4.24 ± 0.23 (p = 0.037), were lower and statistically significant in the MHO group with steatosis. The results show when considering individuals with IR, only AP is a predictor of unhealthy phenotype (B-0.934, 0.848- 1.029, p = 0.031). CONCLUSION: MHO individuals with steatosis present lower severe changes related to markers of liver damage and function and AP is considered the predictor of MUHO phenotype.

Impairment of Vitamin D Nutritional Status and Metabolic Profile Are Associated with Worsening of Obesity According to the Edmonton Obesity Staging System.

Obesity is associated with a higher risk of Vitamin D (VD) inadequacy and metabolic diseases. The Edmonton Obesity Staging System (EOSS) is an innovative tool for the evaluation of obesity that goes beyond body weight and considers clinic, functional and menta- health issues. This study aimed to evaluate the nutritional status of VD according to the stages of EOSS and its relationship with the metabolic profile. In the cross-sectional study, we evaluated anthropometric parameters, physical activity, blood pressure, biochemical and metabolic variables, and VD nutritional status. A total of 226 individuals were categorized using EOSS: 1.3%, 22.1%, 62.9%, and 13.7% were in stages 0, 1, 2 and 3, respectively. Regarding the metabolic changes and comorbidities, insulin resistance and hyperuricemia were diagnosed in some individuals in EOSS 1, 2, and 3. EOSS 2 and 3 presented a significant relative-risk for the development of arterial hypertension, metabolic syndrome, and liver disease, compared with EOSS 0. In all stages, there were observed means of 25(OH)D serum concentrations below 30 ng/mL (EOSS 0 24.9 ± 3.3 ng/mL; EOSS 3 15.9 ± 5.4 ng/mL; p = 0.031), and 25(OH)D deficiency was present in all stages. Individuals with obesity classified in more advanced stages of EOSS had lower serum concentrations of 25(OH)D and a worse metabolic profile.

Vitamin D Supplementation and Its Relationship with Loss of Visceral Adiposity.

PURPOSE: An inverse relationship between vitamin D (VD) nutritional status and obesity is frequent, and the distribution of body fat is an important aspect to assess the risks of obesity-related metabolic dysfunction. The purpose of the study was to evaluate the relationship between serum VD concentrations and body fat reduction after 12 months of bariatric surgery, using two different vitamin D3 (VD3) supplementation protocols. MATERIAL AND METHODS: A randomized controlled trial consisted of 41 patients divided into G1 (800 IU/day) and G2 (1800 IU/day) according to the VD3 supplementation. At baseline (T0) and follow-up (T1), 25(OH)D, waist circumference (WC), visceral adiposity index (VAI), body adiposity index (BAI), and waist/height ratio (WHtR) were evaluated. RESULTS: In T0, the mean of 25(OH)D was lower in G2 compared to that in G1 (22.6 vs 23.6 ng/mL; p = 0.000). At T1, it had a significant increase in G2 (32.1 vs 29.9 ng/mL; p = 0.000), with 60% sufficiency. A significant negative correlation was observed between VAI, BAI, and WHtR with 25(OH)D in G2 (r = - 0.746, p = 0.024; r = - 0.411, p = 0.036; r = - 0.441, p = 0.032) after surgery. Higher mean changes from baseline of visceral fat loss, represented by VAI, were observed in G2 (176.2 ± 149.0-75.5 ± 55.0, p = 0.000). CONCLUSION: Patients submitted to the 1800 IU/day protocol, 12 months after the surgical procedure, had a higher percentage of sufficient vitamin D levels compared to those submitted to the 800 IU/day protocol. Additionally, higher dose supplementation promoted a significant improvement in VAI.

Adipose tissue dysfunction and MAFLD in obesity on the scene of COVID-19.

Obesity is a known risk factor for respiratory infection and many other chronic diseases, including metabolic dysfunction-associated fatty liver disease (MAFLD), previously known as nonalcoholic fatty liver disease (NAFLD). Recently, it has been considered an important and independent predictor for coronavirus disease 2019 (COVID-19) complications in adults, especially cardiopulmonary, presenting in a great number of individuals in critical care. In obesity, adipose tissue (AT) undergoes expansion via several processes: expansion of adipocytes and insufficient vascularization lead to hypoxia; adipocyte apoptosis/necrosis; irregular fatty acid flux; and enhanced secretion of inflammatory adipokines, cytokines, and chemokines. In individuals with obesity the liver can also become a target of COVID-19 infection, although major liver damage is uncommon. COVID-19 acute pandemic often develops in patients with major metabolic abnormalities, including fatty liver disease, which is part of a chronic pandemic together with body fat accumulation. During metabolic abnormalities, the expansion of metabolically active fat parallels chronic inflammatory changes, the development of Insulin Resistance (IR), and in the liver, the accumulation of fat, possibly, an underlying fibrosis. SARS-Cov-2 virus might affect the liver by direct or indirect mechanisms. The current epidemic of obesity and related metabolic diseases has extensively contributed to increase the number of severe cases and deaths from COVID-19, resulting in a health, political and economic crisis with long-lasting consequences. In this review, the authors explore the relationship between AT dysfunction and MAFLD in obesity on the scene of COVID-19.

Serum concentration of vitamin A and its relationship with body adiposity, oxidative stress, and cardiovascular risk in women with recommended dietary intake of vitamin A / Concentración sérica de vitamina A y su relación con la adiposidad corporal, el estrés oxidativo y los riesgos cardiovasculares en mujeres con ingesta dietética recomendada de vitamina A

BACKGROUND: evidence indicates a role of vitamin A in the regulation of fat mass influencing obesity and cardiovascular diseases. MATERIAL AND METHODS: a cross-sectional study in 200 women, paired by age and by the recommended dietary intake of vitamin A. Subjects were divided into four groups according to body mass index (BMI): 80 eutrophic (E), 40 overweight (OW), 40 class I obesity (OI) and 40 class II obesity (OII). Lipid and glycemic profiles were measured and oxidative stress was evaluated through serum concentrations of uric acid, glutathione peroxidase (GSH-Px), and thiobarbituric acid reactive substances (TBARS). RESULTS: the cutoff points for deficiency of serum retinol and β-carotene levels were < 1.05 μmol/L and 40 μg/dL, respectively. For the recommended dietary intake of vitamin A it was 700 μg/day. Retinol and β-carotene deficiency was found in the E group at 5 % and 15 %, respectively, reaching 77.5 % and 82.5 % in the OII group. CONCLUSIONS: a correlation was observed between serum concentrations of retinol and β-carotene and glycemic, lipid, and markers of oxidative stress profiles in the groups studied. It was observed that OI and OII subjects who had retinol and β-carotene deficiency presented a risk that was 16 and 20.7 times greater, respectively, of having a diagnosis with DM2 as compared to E subjects with adequate concentrations of vitamin A. Increased demand of vitamin A may be related to increased BMI, body adiposity, and oxidative stress even when a recommended intake of vitamin A is reached

INTRODUCCIÓN: la evidencia indica un papel de la vitamina A en la regulación de la masa grasa que influye en la obesidad y las enfermedades cardiovasculares. MATERIAL Y MÉTODOS: estudio transversal con 200 mujeres emparejadas por edad y por la ingesta dietética de vitamina A recomendada. Se dividieron en cuatro grupos según el índice de masa corporal (IMC): 80 eutróficas (E), 40 con sobrepeso (OW), 40 con obesidad de clase I (OI) y 40 con obesidad de clase II (OII). Se midieron los perfiles lipídicos y glucémicos y se evaluó el estrés oxidativo a través de las concentraciones séricas de ácido úrico, glutatión-peroxidasa (GSH-Px) y sustancias reactivas del ácido tiobarbitúrico (TBARS). RESULTADOS: los puntos de corte para la deficiencia de las concentraciones séricas de retinol y caroteno fueron de 1,05 μmol/L y 40 g/dL, respectivamente. Para la ingesta dietética recomendada de vitamina A fue de 700 g/día. Se encontró deficiencia de retinol y caroteno en el grupo E, del 5 % y 15 %, respectivamente, alcanzando un 77,5 % y 82,5 % en el grupo OII. CONCLUSIONES: se observó correlación entre las concentraciones séricas de retinol y caroteno y los perfiles glucémico, lipídico y de marcadores de perfiles de estrés oxidativo en los grupos estudiados. Se observó que los sujetos con OI y OII que tenían deficiencia de retinol y caroteno presentaban un riesgo 16 y 20,7 veces mayor, respectivamente, de ser diagnosticados de DM2 en comparación con los E con concentraciones adecuadas de vitamina A. El aumento de la demanda de vitamina A puede estar relacionado con el aumento del IMC, la adiposidad corporal y el estrés oxidativo, incluso cuando se alcanza la ingesta recomendada de vitamina A

Serum concentration of vitamin A and its relationship with body adiposity, oxidative stress, and cardiovascular risk in women with recommended dietary intake of vitamin A.

INTRODUCTION: Background: evidence indicates a role of vitamin A in the regulation of fat mass influencing obesity and cardiovascular diseases. Material and methods: a cross-sectional study in 200 women, paired by age and by the recommended dietary intake of vitamin A. Subjects were divided into four groups according to body mass index (BMI): 80 eutrophic (E), 40 overweight (OW), 40 class I obesity (OI) and 40 class II obesity (OII). Lipid and glycemic profiles were measured and oxidative stress was evaluated through serum concentrations of uric acid, glutathione peroxidase (GSH-Px), and thiobarbituric acid reactive substances (TBARS). Results: the cutoff points for deficiency of serum retinol and ß-carotene levels were < 1.05 µmol/L and 40 µg/dL, respectively. For the recommended dietary intake of vitamin A it was 700 µg/day. Retinol and ß-carotene deficiency was found in the E group at 5 % and 15 %, respectively, reaching 77.5 % and 82.5 % in the OII group. Conclusions: a correlation was observed between serum concentrations of retinol and ß-carotene and glycemic, lipid, and markers of oxidative stress profiles in the groups studied. It was observed that OI and OII subjects who had retinol and ß-carotene deficiency presented a risk that was 16 and 20.7 times greater, respectively, of having a diagnosis with DM2 as compared to E subjects with adequate concentrations of vitamin A. Increased demand of vitamin A may be related to increased BMI, body adiposity, and oxidative stress even when a recommended intake of vitamin A is reached.

INTRODUCCIÓN: Introducción: la evidencia indica un papel de la vitamina A en la regulación de la masa grasa que influye en la obesidad y las enfermedades cardiovasculares. Material y métodos: estudio transversal con 200 mujeres emparejadas por edad y por la ingesta dietética de vitamina A recomendada. Se dividieron en cuatro grupos según el índice de masa corporal (IMC): 80 eutróficas (E), 40 con sobrepeso (OW), 40 con obesidad de clase I (OI) y 40 con obesidad de clase II (OII). Se midieron los perfiles lipídicos y glucémicos y se evaluó el estrés oxidativo a través de las concentraciones séricas de ácido úrico, glutatión-peroxidasa (GSH-Px) y sustancias reactivas del ácido tiobarbitúrico (TBARS). Resultados: los puntos de corte para la deficiencia de las concentraciones séricas de retinol y caroteno fueron de 1,05 µmol/L y 40 g/dL, respectivamente. Para la ingesta dietética recomendada de vitamina A fue de 700 g/día. Se encontró deficiencia de retinol y caroteno en el grupo E, del 5 % y 15 %, respectivamente, alcanzando un 77,5 % y 82,5 % en el grupo OII. Conclusiones: se observó correlación entre las concentraciones séricas de retinol y caroteno y los perfiles glucémico, lipídico y de marcadores de perfiles de estrés oxidativo en los grupos estudiados. Se observó que los sujetos con OI y OII que tenían deficiencia de retinol y caroteno presentaban un riesgo 16 y 20,7 veces mayor, respectivamente, de ser diagnosticados de DM2 en comparación con los E con concentraciones adecuadas de vitamina A. El aumento de la demanda de vitamina A puede estar relacionado con el aumento del IMC, la adiposidad corporal y el estrés oxidativo, incluso cuando se alcanza la ingesta recomendada de vitamina A.

Vertical Sleeve Gastrectomy Has Better Weight Evolution and Serum Concentrations of Vitamin D when Compared with Roux-Y Gastric Bypass.

OBJECTIVE: The objective of this study is to compare the weight evolution and serum concentrations of vitamin D in individuals undergoing Roux-en-Y Gastric Bypass (RYGB) and Sleeve after 1 follow-up year. METHODOLOGY: Descriptive, prospective, and longitudinal study, with 108 individuals divided into 2 groups: RYGB (55 patients) and Sleeve (53), evaluated preoperatively, and at 6 and 12 postoperatively months. Anthropometric data, serum concentrations of 25(OH)D, calcium, and parathyroid hormone were analyzed. RESULTS: The Sleeve group showed greater reductions in excess weight and excess body mass index (BMI) when compared with the RYGB group at both times (p < 0.001). Besides, after 12 months, those who had undergone the Sleeve procedure also had higher percentages of surgical success (84.4% versus 65.0%, p = 0.038). The prevalence of preoperative inadequacy of 25(HO)D in both groups was 78.7%. After 6 months, there was an increase in serum concentrations of 25(HO)D in both groups (p < 0.001), but without significant differences between the groups (p = 0.154). In the comparison between 6 and 12 months, there was only a reduction for the RYGB group (p = 0.001). Also, when comparing both groups, the means of vitamin D in patients undergoing RYGB were also lower after 12 months (p = 0.003). There was a negative correlation between vitamin D and parathyroid hormone (r = - 0.235 p = 0.030). The mean serum concentrations of calcium were adequate at all times. CONCLUSION: Patients undergoing the Sleeve procedure had a better evolution in weight loss and are at a lower risk of vitamin D inadequacy than those undergoing RYGB.

Does adipose tissue inflammation drive the development of non-alcoholic fatty liver disease in obesity?

Obesity, an increasingly common problem in modern societies, is associated with acquired metabolic disturbances. In this perspective, the development of insulin resistance is now recognized to be initiated by inflammation of the adipose tissue, but the events that lead to this inflammation are still vague. Furthermore, visceral adipose tissue plays a significant role in obesity pathophysiology and in its clinical effects, such as non-alcoholic fatty liver disease (NAFLD). Among the possible mechanisms linking NAFLD and obesity, we focused on Visfatin/NAMPT, mostly produced by macrophages infiltrated in adipose tissue and a biomarker of the inflammatory cascade affecting hepatic inflammation in NAFLD. We also addressed the signalling pathway triggered by the binding of VEGF-B to its receptor, which mediates lipid fluxes throughout the body, being a promising target to prevent ectopic lipid accumulation. We reviewed the available literature on the topic and we suggest a crosstalk between adipose tissue inflammation and NAFLD in order to provide new insights about the putative mechanisms involved in the development of NAFLD in the obesity context. A better understanding of the pathophysiological processes underlying NAFLD will allow the development of new therapeutic approaches.

Clinic, Anthropometric And Metabolic Changes In Adults With Class III Obesity Classified As Metabolically Healthy And Metabolically Unhealthy.

PURPOSE: To describe clinical, biochemical and anthropometric profiles in adults with class III obesity classified as metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUHO). PATIENTS AND METHODS: This is a cross-sectional study with patients classified as MHO and MUHO according to the NCEP-ATP III. Anthropometric, biochemical and clinical variables were analyzed. RESULTS: A total of 223 subjects were evaluated and 32.73% were classified as MHO and 67.26% as MUHO, respectively. The insulin resistance homeostasis model (HOMA-IR) showed elevation in the MUHO group (p=0.003) and anthropometric variables were correlated with bone markers [body index mass (BMI) vs phosphorus: r=0.31, p<0.001; BMI vs 25(OH)D: r=-0.31, p=0.041]. Visceral adiposity index was lower in MHO (p=0.001). Negative correlations between inflammatory markers and bone markers were observed in the MHO group (calcium vs C-reactive protein: -0.30, p=0.017; parathyroid hormone vs HOMA-IR: r=-0.28, p=0.017. CONCLUSION: MHO individuals showed important metabolic changes, such as those observed in MUHO, despite lower prevalence and severity. Continuous monitoring of these individuals is suggested, given the transient nature of the MHO phenotype.

Bone Metabolism in Adolescents and Adults Undergoing Roux-En-Y Gastric Bypass: a Comparative Study.

OBJECTIVE: To compare the bone metabolism of adolescents and adults with obesity before undergoing a Roux-en-Y gastric bypass (RYGB) and 6 and 12 months after the surgery. MATERIALS AND METHODS: Adolescents (G1) and adults (G2) with obesity assessed before (T0), six (T1), and 12 months after (T2) RYGB. Sun exposure, serum concentrations of 25(OH)D, calcium, phosphorous, magnesium, zinc, alkaline phosphatase, parathyroid hormone (PTH), and bone mineral density (BMD) were evaluated. RESULTS: Sixty adolescents and 60 adults were assessed. At T0, there was no significant difference between the groups' serum 25(OH)D levels (G1 21.87 + 7.52 ng/mL, G2 21.73 + 7.60 ng/mL, p = 0.94) or sun exposure (G1 17 ± 2.0 min/day, G2 13.2 ± 5.2 min/day, p = 0.85). G1 had high levels of inadequacy of calcium (66.7%), phosphorous (80.0%), and zinc (18.3%) at T0 and had a significant fall in their 25(OH)D (p < 0.01) and magnesium (p < 0.01) levels from T1 to T2. G2 saw a significant lowering of their serum zinc levels from T0 to T1 and T2 (T1 p < 0.01; T2 p < 0.01). In both groups, there was a significant rise in PTH from T1 to T2 (G1 p = 0.04, G2 p = 0.02) and from T0 to T2 (G1 and G2 p < 0.01). In G2, 40.4% of individuals with osteopenia and osteoporosis presented inadequacy of 25(OH)D. CONCLUSION: RYGB was found to worsen the inadequacy of micronutrients related to bone metabolism and was associated with secondary hyperparathyroidism and low BMD values, especially among the adolescents. The irreversible damaging effects of obesity on bone metabolism can occur in adolescence.

Vitamin A deficiency is associated with body mass index and body adiposity in women with recommended intake of vitamin A.

INTRODUCTION: evidence indicates that vitamin A is involved in regulating fat mass. A low consumption of vitamin A has been reported in individuals with obesity, as have lower concentrations of this vitamin, than in eutrophic individuals when their dietary intake of vitamin A is not significantly different. OBJECTIVE: to investigate vitamin A nutritional status and its association with body mass index (BMI) and body fat in women who have the recommended dietary intake of vitamin A. METHODS: cross-sectional study with 200 women, paired by age and by the dietary intake of vitamin A recommended. Participants were divided into four groups, according to BMI. Anthropometric data were evaluated (weight, BMI and waist circumference [WC]), as well as the diagnosis of night blindness (NB). Lipid and glycemic profiles were measured. The cut-off points for deficiency of serum concentrations of retinol and ß-carotene were < 1.05 µmol/l and 40 µg/dl, respectively. The recommended dietary intake of vitamin A was 700 µg/day. RESULTS: there was a significant drop in retinol concentrations according to BMI (p < 0.001) and WC (p < 0.001). We found ß-carotene to behave similarly (p = 0.005; p < 0.001). We found NB in 7.5% of overweight (OW) cases and 20.0% of obesity class II (OII), and no functional alteration was found in the eutrophic group (EU). Inadequate levels of retinol and ß-carotene increased the odds ratio for the occurrence of OW, obesity class I (OI) and OII, as well as inadequate WC. CONCLUSION: even with recommended intake of vitamin A, we found a biochemical and functional inadequacy of vitamin A nutritional status,associated with overweight, obesity and body adiposity.

Vitamin A deficiency is associated with body mass index and body adiposity in women with recommended intake of vitamin A / La deficiencia de vitamina A se asocia con el índice de masa corporal y la adiposidad corporal en mujeres con ingesta recomendada de vitamina A

Introduction: evidence indicates that vitamin A is involved in regulating fat mass. A low consumption of vitamin A has been reported in individuals with obesity, as have lower concentrations of this vitamin, than in eutrophic individuals when their dietary intake of vitamin A is not significantly different. Objective: to investigate vitamin A nutritional status and its association with body mass index (BMI) and body fat in women who have the recommended dietary intake of vitamin A. Methods: cross-sectional study with 200 women, paired by age and by the dietary intake of vitamin A recommended. Participants were divided into four groups, according to BMI. Anthropometric data were evaluated (weight, BMI and waist circumference [WC]), as well as the diagnosis of night blindness (NB). Lipid and glycemic profiles were measured. The cut-off points for deficiency of serum concentrations of retinol and β-carotene were < 1.05 μmol/l and 40 μg/dl, respectively. The recommended dietary intake of vitamin A was 700 μg/day. Results: there was a significant drop in retinol concentrations according to BMI (p < 0.001) and WC (p < 0.001). We found β-carotene to behave similarly (p = 0.005; p < 0.001). We found NB in 7.5% of overweight (OW) cases and 20.0% of obesity class II (OII), and no functional alteration was found in the eutrophic group (EU). Inadequate levels of retinol and β-carotene increased the odds ratio for the occurrence of OW, obesity class I (OI) and OII, as well as inadequate WC. Conclusion: even with recommended intake of vitamin A, we found a biochemical and functional inadequacy of vitamin A nutritional status, associated with overweight, obesity and body adiposity

Introducción: la evidencia indica que la vitamina A esta involucrada en la regulación de la masa grasa. Un bajo consumo de vitamina A ha sido reportado en individuos con obesidad, ya que tienen concentraciones mas bajas de esta vitamina que los individuos eutróficos a pesar de que su ingesta dietética de vitamina A no es significativamente diferente. Objetivo: investigar el estado nutricional de la vitamina A y su asociación con el índice de masa corporal (IMC) y la grasa corporal en las mujeres que tienen la ingesta dietética recomendada de vitamina A. Métodos: estudio transversal con 200 mujeres, emparejado por edad y por la ingesta dietética de vitamina A recomendada. Se dividieron en cuatro grupos, de acuerdo con el IMC. Los datos antropométricos fueron evaluados (peso, índice de masa corporal [IMC] y circunferencia de la cintura [CC]), así como el diagnostico de ceguera nocturna (CN). Se midieron los perfiles lipídicos y glicémicos. Los puntos de corte para la deficiencia de las concentraciones séricas de retinol y β-caroteno fueron < 1,05 μmol/l y 40 μg/dl, respectivamente. La ingesta dietética recomendada de vitamina A fue de 700 μg/día. Resultados: hubo una disminución significativa de las concentraciones de retinol según el IMC (p < 0,001) y CC (p < 0,001). Se observo un comportamiento similar del β-caroteno (p = 0,005, p < 0,001). Encontramos NB en el 7,5% de los casos con sobrepeso (OW) y el 20,0% de los casos con obesidad clase II (OII), y no encontramos alteración funcional en la UE. Niveles inadecuados de retinol y (R)-caroteno aumentaron la odds ratio para la ocurrencia de OW, obesidad clase I (OI) y OII, al igual que los niveles insuficientes de CC. Conclusión: incluso con la ingesta recomendada de vitamina A, encontramos una deficiencia bioquímica y funcional del estado nutricional de vitamina A asociada al sobrepeso, la obesidad y la adiposidad corporal

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.

Vitamin d nutritional status and its relationship with metabolic changes in adolescents and adults with severe obesity / El estado nutricional de la vitamina D y su relación con los cambios metabólicos en adolescentes y adultos con obesidad severa

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

Introducción: el aumento de la deficiencia de vitamina D se produce junto con la obesidad y se ha observado la asociación entre estas condiciones. Objetivo: evaluar el estado nutricional de la vitamina D y el perfil metabólico en adolescentes y adultos con obesidad, así como la relación entre las complicaciones derivadas de una clase severa de obesidad con el estado nutricional de vitamina D, y comparar las diferencias entre estos grupos. Métodos: estudio comparativo observacional. La población comprende adolescentes y adultos con obesidad severa. Se midieron la circunferencia de la cintura (CC) y el índice de masa corporal (IMC). Se realizaron análisis de vitamina D (25(OH)D), perfil lipídico, proteína C-reactiva (PCR), glucosa en sangre, insulinemia en ayunas, sensibilidad a la insulina, presión arterial y diagnósticos de enfermedad del hígado graso no alcohólico y síndrome metabólico (MS). Resultados: se evaluaron 60 adolescentes (G1) y 68 adultos (G2). El porcentaje de insuficiencia de vitamina D se observó en un 90% en G1 y un 79,4% en G2. Hubo una correlación negativa y signifi cativa del IMC con los valores de 25(OH)D en el grupo de adultos (r = -0,244, p = 0,045). Las personas con insuficiencia de vitamina D mostraron valores más altos de PCR en ambos grupos (p = 0,000). HOMA-IR mostró una correlación negativa con 25(OH)D en G1 (r = -0,832, p = 0,000) y G2 (r = -0,589, p = 0,000). La insuficiencia de esta vitamina mostró asociación con colesterol total alto en G1 (p = 0,029) y valores más altos de c-LDL en G2 (p = 0,003). Conclusión: se observó alta prevalencia de deficiencia e insuficiencia de vitamina D, asociada a cambios metabólicos tanto en adultos obesos como en adolescentes. Es necesario desarrollar estrategias para la prevención y el control de la obesidad y la deficiencia de vitamina D

Vitamin D metabolism in human adipose tissue: could it explain low vitamin D status in obesity?

Obesity and a low vitamin D (VD) status, as well as a positive association between them, are prevalent worldwide. Additionally, a low VD status has been positively correlated with metabolic dysfunction (although not so convincingly as for obesity). The VD receptor (VDR) mediates VD biological actions in adipose tissue (AT), where VD can be activated or inactivated/degraded through specific hydroxylation steps. Additionally, AT can also store and release VD when needed. A lower VD activation/VD inactivation ratio and an impaired VDR signaling in AT could contribute to metabolic dysfunction besides the aforementioned association between obesity and VD status. However, subcutaneous (SAT) and visceral AT (VAT) are not expected to be similarly accountable as these two fat depots play differential roles in metabolic regulation/dysfunction. To our knowledge, only three articles disclose the evaluation of the expression of VDR and/or VD hydroxylating enzymes in human SAT and VAT. A clear dependence on the subcutaneous and/or the visceral fat depot is missing for the relationships of a) obesity and/or metabolic dysfunction with VD status and b) adipose VDR signaling and adipose VD activation/VD inactivation ratio with VD status, obesity and/or metabolic dysfunction. Further studies are warranted to unravel the influence of adipose VD metabolism on VD status.

Relationship between Nonalcoholic Fatty Liver Disease and Vitamin D Nutritional Status in Extreme Obesity.

AIM: To evaluate the relationship of nonalcoholic fatty liver disease (NAFLD) with nutritional status of vitamin D in extreme obesity. METHODS: Descriptive cross-sectional study in individuals with class III obesity (BMI ≥ 40 kg/m2), aged ≥ 20 years to < 60 years. Data were obtained for weight, height, waist circumference (WC), and serum 25-hydroxyvitamin D (25(OH)D) levels. Vitamin D analysis was performed by high performance liquid chromatography (HPLC) and the cutoff points used for its classification were < 20 ng/mL for deficiency and 20-29.9 ng/ml for insufficiency. NAFLD gradation was conducted through histological evaluation by liver biopsy. RESULTS: The sample is comprised of 50 individuals (86% female). BMI and average weight were 44.1 ± 3.8 kg/m2 and 121.4 ± 21.4 kg, respectively. Sample distribution according to serum 25(OH)D levels showed 42% of deficiency and 48% of insufficiency. The diagnosis of NAFLD was confirmed in 100% of the individuals, of which 70% had steatosis and 30% had steatohepatitis. The highest percentage of 25(OH)D insufficiency was seen in individuals with steatosis (66%/n = 21) and steatohepatitis (93%/n = 16). All individuals with steatohepatitis presented VDD (p < 0.01). CONCLUSION: The results of this study showed high prevalence of serum 25(OH)D inadequacy in individuals with class III obesity, which worsens as the stage of liver disease progresses.