Proposal to Screen for Zinc and Selenium in Patients with IgA Deficiency.

The increase in life expectancy can be a consequence of the world's socioeconomic, sanitary and nutritional conditions. Some studies have demonstrated that individuals with a satisfactory diet variety score present a lower risk of malnutrition and better health status. Zinc and selenium are important micronutrients that play a role in many biochemical and physiological processes of the immune system. Deficient individuals can present both innate and adaptive immunity abnormalities and increased susceptibility to infections. Primary immunodeficiency diseases, also known as inborn errors of immunity, are genetic disorders classically characterized by an increased susceptibility to infection and/or dysregulation of a specific immunologic pathway. IgA deficiency (IgAD) is the most common primary antibody deficiency. This disease is defined as serum IgA levels lower than 7 mg/dL and normal IgG and IgM levels in individuals older than four years. Although many patients are asymptomatic, selected patients suffer from different clinical complications, such as pulmonary infections, allergies, autoimmune diseases, gastrointestinal disorders and malignancy. Knowing the nutritional status as well as the risk of zinc and selenium deficiency could be helpful for the management of IgAD patients. OBJECTIVES: to investigate the anthropometric, biochemical, and nutritional profiles and the status of zinc and selenium in patients with IgAD. METHODS: in this descriptive study, we screened 16 IgAD patients for anthropometric and dietary data, biochemical evaluation and determination of plasma and erythrocyte levels of zinc and selenium. RESULTS: dietary intake of zinc and selenium was adequate in 75% and 86% of the patients, respectively. These results were consistent with the plasma levels (adequate levels of zinc in all patients and selenium in 50% of children, 25% of adolescents and 100% of adults). However, erythrocyte levels were low for both micronutrients (deficiency for both in 100% of children, 75% of adolescents and 25% of adults). CONCLUSION: our results highlight the elevated prevalence of erythrocyte zinc and selenium deficiency in patients with IgAD, and the need for investigation of these micronutrients in their follow-up.

Appendicular Skeletal Muscle Mass Prediction in People Living With HIV: A Cross-sectional Study.

ABSTRACT: People living with HIV (PWH) experience an accelerated aging process. There is no anthropometric predictive model for appendicular skeletal muscle mass (ASM) in PWH. This study develops anthropometric models to predict and validate ASM measured by dual energy x-ray absorptiometry (DXA) in PWH; DXA scans were obtained for 125 PWH (male = 74; age >18 years) on antiretroviral therapy. Fat mass ratio was used for lipodystrophy diagnosis. A multiple stepwise linear regression considered ASM DXA as the dependent variable and validated by PRESS method. A high power of determination and low standard estimate error were found for ASM DXA -predicted (adjusted r2 = 0.84 to 0.87, standard estimate error = 1.7-1.6 kg) and high PRESS validation coefficients (Q 2PRESS = 0.84-0.86, S PRESS = 1.7-1.6 kg). The variables included were lipodystrophy diagnosis, medial calf circumference, sex, and total body weight. We present novel, reliable, and validated anthropometric models to predict ASM DXA in PWH.

Household Salt Storage and Seasoning Consumption Are Predictors of Insufficient Iodine Status Among Pregnant Women in Southeastern Brazil.

Iodine deficiency in pregnancy may lead to adverse maternal and fetal outcomes, including impaired child development. Sociodemographic factors and different dietary habits may be related to iodine status in pregnant women. The aim of this study was to evaluate the iodine status and its predictors among pregnant women in a city of Southeastern Brazil. This cross-sectional study was conducted with 266 pregnant women receiving prenatal care in 8 primary health care units. Sociodemographic, obstetric and health, habits of acquisition, storage and consumption of iodized salt, and dietary iodine intake data were collected through a questionnaire. The iodine content was evaluated in urinary iodine concentration (UIC), household salt and seasonings, and drinking water samples. Pregnant women were categorized into three groups according to the UIC, determined by iodine coupled plasma-mass spectrometry (ICP-MS): insufficient (< 150 µg/L), adequate (150-249 µg/L), and more than adequate iodine nutrition (≥ 250 µg/L). The median (p25-p75) UIC was 180.2 µg/L (112.8-262.7). It was found 38% and 27.8% of insufficient and more than adequate iodine nutrition, respectively. Number of gestations, KI content of supplement, alcohol consumption, salt storage, and frequency of using industrialized seasoning were associated to iodine status. Alcohol consumption (OR = 6.59; 95%CI 1.24-34.87), pack the salt in opened container (OR = 0.22; 95%CI 0.08-0.57), and use industrialized seasoning weekly (OR = 3.68; 95% CI 1.12-12.11) were predictors of iodine insufficiency. The pregnant women evaluated have adequate iodine nutrition. Household salt storage and seasoning consumption were risk factors for insufficient iodine status.

Bone Mineral Content Estimation in People Living with HIV: Prediction and Validation of Sex-Specific Anthropometric Models.

People living with HIV (PWH) experience an accelerated reduction in bone mineral content (BMC), and a high risk of osteopenia and osteoporosis. Anthropometry is an accurate and low-cost method that can be used to monitor changes in body composition in PWH. To date, no studies have used anthropometry to estimate BMC in PWH. To propose and validate sex-specific anthropometric models to predict BMC in PWH. This cross-sectional study enrolled 104 PWH (64 males) aged >18 years at a local university hospital. BMC was measured using dual energy X-ray absorptiometry (DXA). Anthropometric measures were collected. We used linear regression analysis to generate the models. Cross-validations were conducted using the "leave one out", from the predicted residual error sum of squares (PRESS) method. Bland-Altman plots were used to explore distributions of errors. We proposed models with high coefficient of determination and reduced standard error of estimate for males (r2 = 0.70; SEE = 199.97 g; Q2PRESS = 0.67; SEEPRESS = 208.65 g) and females (r2 = 0.65; SEE = 220.96 g; Q2PRESS = 0.62; SEEPRESS = 221.90 g). Our anthropometric predictive models for BMC are valid, practical, and a low-cost alternative to monitoring bone health in PWH.

Bone loss in hepatitis B virus-infected patients can be associated with greater osteoclastic activity independently of the retroviral use.

Nucleoside/nucleotide analogs such as tenofovir, have been used as long-term therapy for the treatment of hepatitis B and side effects such as the reduction in bone mineral density have been associated with their use. To determine the relationships between bone, hormonal, biochemical, and mineral parameters in patients with hepatitis B treated with nucleoside/nucleotide antiviral. A cross-sectional study was conducted with 81 adult patients with chronic hepatitis B infection. Dual-energy X-ray absorptiometry (DXA) was performed to assess bone mineral density. Biochemical analyses were performed for osteocalcin, deoxypyridinoline, parathyroid hormone, vitamin D, IGF-1, TSH, testosterone, estradiol, FSH, transaminases, urea, creatinine, calcium, serum and urinary phosphorus, magnesium, and FGF-23, body composition was performed by DXA. Participants, both gender, were divided according to the use of antiretrovirals: Group1: 27 inactive virus carriers without medication; Group2: 27 patients using tenofovir; and Group3: 27 patients using lamivudine or entecavir. DXA readings diagnosed osteopenia in the lumbar spine for 7.4% of individuals in Group1, 15% in Group2, and 3.7% in Group3. For all groups, we observed normal values in bone formation markers, osteocalcin levels as well as parathyroid hormone, insulin growth factor 1, and FGF-23. In all groups, we found increased levels of urinary deoxypyridinoline, a bone resorption marker. Increased levels in the bone resorption markers indicated a high resorptive activity of bone tissue. These data suggested high resorption activity of bone tissue in hepatitis B virus-infected patients independent of the use of antiretrovirals.

High intestinal hydrogen production in runners after intake of fructose solution.

Fructose intake is associated with increased consumption of processed foods, specifically in the context of nutritional supplements. To assess gastrointestinal symptoms and hydrogen production after the ingestion of a fructose solution in runners, healthy and sick persons. Hydrogen test (H2 test) was performed after the intake a solution with 50 g fructose along with the application of a questionnaire to evaluate the gastrointestinal symptoms during the H2 test in three groups: Athletes group (AG); control group (CG) with healthy subjects; and non-alcoholic fatty liver disease group (NAFLDG). Statistical analysis was performed with analysis of variance at a p < 0.05 significance level. The AG was the largest H2 producer followed by the CG with significant difference between the AG and NAFLDG (p ≤ 0.05). Most participants remained asymptomatic, but the strongest correlation was the symptom of bloating GC (R = 0.625), eructation in NAFLD (R = 0.481) and diarrhea in CG (R = 0.345) and AG (R = 0.338) The result of the present study suggests the production of hydrogen by the colon following the administration of fructose is higher in athletes compared with healthy individuals and persons with NAFLD, showing that fructose intake may be an interesting point of dietary management, especially in elite professionals.

Anthropometric cutoff points to identify lipodystrophy characteristics in people living with HIV/AIDS: an observational study / Puntos de corte antropométricos para identificar las características de la lipodistrofia en personas que viven con VIH/SIDA: un estudio observacional

Introduction: currently, there is no consensus regarding accurate and low-cost methods for diagnosing lipodystrophy in people living with HIV/ AIDS (PLWHA). The aim of this study was to propose anthropometric cutoff points for the diagnosis of lipodystrophy among PLWHA. Methods: we included 106 PLWHA (men = 65, women = 41) who are under antiretroviral therapy and have been clinically classified into either a "lipodystrophy" or "non-lipodystrophy" group. Anthropometric measurements included 19 regions of body perimeters and 6 skinfold thickness measures. The Youden index was used to establish anthropometric cutoff points for the diagnosis of lipodystrophy, using the mean values of the anthropometric data (referred to as "original") along with the "Z index" (ZI) values, which were adjusted by the "Phantom Strategy." The cutoff points were proposed when "original" anthropometric measurements and ZI values had a statistical significance of p < 0.01 and an area under the curve (AUC) higher than 70%. The size effect was assessed to verify the influence of lipodystrophy on each anthropometric measure. Results: our data analysis proposes sex-specific cutoff points for the diagnosis of lipodystrophy in PLWHA - 17 points using the "original" anthropometric measurements, and 20 using the ZI values (average effect size between 1.0 and 1.1, and AUC = 76.7% and 78%). Conclusions: our study proposes accurate cutoff points for the diagnosis of lipodystrophy using "original" anthropometric measurements and ZI values adjusted by the "Phantom Strategy." Our findings support the use of anthropometric measurements as a simplified method for diagnosing lipodystrophy and monitoring body composition alterations in people living with HIV/AIDS

Introducción: no existe consenso con respecto a métodos precisos y de bajo coste para diagnosticar la lipodistrofia en personas que viven con VIH/SIDA (PVVS). El objetivo de este estudio es proponer puntos de corte antropométricos para el diagnóstico de lipodistrofia entre las PVVS. Métodos: se incluyeron 106 PVVS (hombres = 65, mujeres = 41) en tratamiento antirretroviral que se clasificaron clínicamente en dos grupos de "lipodistrofia" o "no lipodistrofia". Las mediciones antropométricas incluyeron 19 regiones de parámetros corporales y 6 medidas de pliegues cutáneos. El índice de Youden se utilizó para establecer puntos de corte antropométricos para el diagnóstico de lipodistrofia utilizando la media de los datos antropométricos (denominados "originales") junto con los valores del "índice Z" (IZ), que fueron ajustados por la "estrategia Phantom". Los puntos de corte se propusieron cuando las mediciones antropométricas "originales" y los valores de IZ fueron estadísticamente significativos con un valor p < 0,01 y un área bajo la curva (AUC) superior al 70%. Se evaluó el tamaño del efecto para verificar la influencia de la lipodistrofia en cada medida antropométrica. Resultados: se propusieron puntos de corte específicos según el sexo para el diagnóstico de lipodistrofia en PVVS: 17 puntos usando las medidas antropométricas "originales" y 20 usando los valores de IZ (tamaño del efecto promedio entre 1.0 y 1.1, y AUC = 76.7% y 78%). Conclusiones: se propusieron puntos de corte antropométricos para el diagnóstico de lipodistrofia. Las mediciones antropométricas son un método simplificado para diagnosticar y monitorear los cambios de composición corporal en las PVVS

Anthropometric cutoff points to identify lipodystrophy characteristics in people living with HIV/AIDS: an observational study.

INTRODUCTION: Introduction: currently, there is no consensus regarding accurate and low-cost methods for diagnosing lipodystrophy in people living with HIV/AIDS (PLWHA). The aim of this study was to propose anthropometric cutoff points for the diagnosis of lipodystrophy among PLWHA. Methods: we included 106 PLWHA (men = 65, women = 41) who are under antiretroviral therapy and have been clinically classified into either a "lipodystrophy" or "non-lipodystrophy" group. Anthropometric measurements included 19 regions of body perimeters and 6 skinfold thickness measures. The Youden index was used to establish anthropometric cutoff points for the diagnosis of lipodystrophy, using the mean values of the anthropometric data (referred to as "original") along with the "Z index" (ZI) values, which were adjusted by the "Phantom Strategy." The cutoff points were proposed when "original" anthropometric measurements and ZI values had a statistical significance of p < 0.01 and an area under the curve (AUC) higher than 70%. The size effect was assessed to verify the influence of lipodystrophy on each anthropometric measure. Results: our data analysis proposes sex-specific cutoff points for the diagnosis of lipodystrophy in PLWHA - 17 points using the "original" anthropometric measurements, and 20 using the ZI values (average effect size between 1.0 and 1.1, and AUC = 76.7% and 78%). Conclusions: our study proposes accurate cutoff points for the diagnosis of lipodystrophy using "original" anthropometric measurements and ZI values adjusted by the "Phantom Strategy." Our findings support the use of anthropometric measurements as a simplified method for diagnosing lipodystrophy and monitoring body composition alterations in people living with HIV/AIDS.

INTRODUCCIÓN: Introducción: no existe consenso con respecto a métodos precisos y de bajo coste para diagnosticar la lipodistrofia en personas que viven con VIH/SIDA (PVVS). El objetivo de este estudio es proponer puntos de corte antropométricos para el diagnóstico de lipodistrofia entre las PVVS. Métodos: se incluyeron 106 PVVS (hombres = 65, mujeres = 41) en tratamiento antirretroviral que se clasificaron clínicamente en dos grupos de "lipodistrofia" o "no lipodistrofia". Las mediciones antropométricas incluyeron 19 regiones de parámetros corporales y 6 medidas de pliegues cutáneos. El índice de Youden se utilizó para establecer puntos de corte antropométricos para el diagnóstico de lipodistrofia utilizando la media de los datos antropométricos (denominados "originales") junto con los valores del "índice Z" (IZ), que fueron ajustados por la "estrategia Phantom". Los puntos de corte se propusieron cuando las mediciones antropométricas "originales" y los valores de IZ fueron estadísticamente significativos con un valor p < 0,01 y un área bajo la curva (AUC) superior al 70%. Se evaluó el tamaño del efecto para verificar la influencia de la lipodistrofia en cada medida antropométrica. Resultados: se propusieron puntos de corte específicos según el sexo para el diagnóstico de lipodistrofia en PVVS: 17 puntos usando las medidas antropométricas "originales" y 20 usando los valores de IZ (tamaño del efecto promedio entre 1.0 y 1.1, y AUC = 76.7% y 78%). Conclusiones: se propusieron puntos de corte antropométricos para el diagnóstico de lipodistrofia. Las mediciones antropométricas son un método simplificado para diagnosticar y monitorear los cambios de composición corporal en las PVVS.

Influence of antiretroviral therapy on bone metabolism of patients with chronic hepatitis B: a review.

Hepatitis B is a major public health problem worldwide and associated with significant mortality. To prevent or delay the deleterious effects of chronic infection by the hepatitis B virus, patients should be carefully followed, and antiviral therapy indicated according to specific recommendations. Currently, available drugs inhibit viral replication and slow or stop the progression of inflammation and fibrosis of the liver. However, the drugs for oral use in the treatment of hepatitis B, jointly referred to as nucleoside/nucleotide analogs, are indicated for prolonged use and have potential side effects. The reduction in bone mineral density was associated with the use of tenofovir, already evaluated in patients infected with HIV because the drug is also part of the therapeutic arsenal for this viral infection. There are few studies on the effects of tenofovir in patients with mono hepatitis B. Therefore, this literature review proposes to examine how hepatitis B acts in the body and the mechanisms by which antiretroviral drugs (especially tenofovir) can affect bone metabolism.

Baru Almonds Increase the Activity of Glutathione Peroxidase in Overweight and Obese Women: A Randomized, Placebo-Controlled Trial.

BACKGROUND: Obesity-induced inflammation is frequently associated with higher oxidative stress. In vitro and experimental studies have considered baru almonds (Dipteryx alata Vog) as a legume seed with high antioxidant capacity. The aim of this study was to evaluate whether baru almonds are capable of improving the inflammatory and antioxidant status in overweight and obese women. METHODS: In a parallel-arm, randomized placebo-controlled trial, 46 overweight and obese women (age: 40 ± 11 years; body mass index: 33.3 ± 4.3) were randomly assigned to receive advice to follow a normocaloric and isoenergetic diet with placebo (PLA, n = 22) or similar advice plus 20 g baru almonds (BARU, n = 24) for 8 wk. Malondialdehyde (MDA), adiponectin, tumor necrosis factor-α, interleukin-6, interleukin-10, antioxidant enzymes activities (catalase-CAT; glutathione peroxidase-GPx; superoxide dismutase-SOD), and minerals were analyzed in plasma samples. RESULTS: At baseline, groups were similar regarding the body composition, oxidative, and inflammatory parameters. The BARU group increased the activity of GPx (+0.08 U/mg, 95%CI + 0.05 to +0.12 vs. -0.07, 95%CI -0.12 to -0.03, p < 0.01) and plasma copper concentration (p = 0.037) when compared to the PLA group. No differences were observed between groups in CAT and SOD activity or MDA and cytokines concentrations. CONCLUSIONS: Baru almond supplementation increased the GPx activity in overweight and obese women.

Heart failure, micronutrient profile, and its connection with thyroid dysfunction and nutritional status.

INTRODUCTION: Heart failure (HF) is a growing public health issue; its risk factors include inappropriate dietary intake of microelements such as iodine, selenium, zinc and iron, which may lead to thyroid dysfunction. OBJECTIVE: This study aimed to assess the correlation among the functional class stages of patients with HF, iodine, selenium, iron and zinc levels with the presence of thyroid dysfunction. METHODOLOGY: One hundred nine patients from the HF outpatient clinic of the Clinics Hospital of Ribeirão Preto whose blood and urine were collected for micronutrient analysis and laboratory tests were selected. The subjects' weight and height were also measured to calculate their BMI. First, a descriptive analysis of the data was made into tables, and then statistical analyses were done at a 5% significance level (p < 0.05). RESULTS: Most patients whose data was analysed were elderly and overweight. Excess ioduria, serum selenium and zinc, erythrocyte zinc and deficiency in serum iron and erythrocyte selenium were observed. The prevalence of thyroid dysfunction was 8.3%. Multivariate logistic regression verified that thyroid dysfunction increases the chance of classification in functional class III or IV (p = 0.015; OR = 8.72) by 8.7 times; each year of age increases the chance by 4.6% of classification in functional class III or IV (p = 0.008; odds ratio [OR] = 1.05), and each unit of BMI increases the chance of classification in functional class III or IV by 9.2% (p = 0.028; OR = 1.09). CONCLUSION: Patients with HF were deficient in serum iron and erythrocyte selenium. No connection was found between hypothyroidism and mineral deficiency, which seems to be related more to the severity of the disease than to the micronutrient nutritional profile.

Influence of antiretroviral therapy on bone metabolism of patients with chronic hepatitis B: a review

Abstract Hepatitis B is a major public health problem worldwide and associated with significant mortality. To prevent or delay the deleterious effects of chronic infection by the hepatitis B virus, patients should be carefully followed, and antiviral therapy indicated according to specific recommendations. Currently, available drugs inhibit viral replication and slow or stop the progression of inflammation and fibrosis of the liver. However, the drugs for oral use in the treatment of hepatitis B, jointly referred to as nucleoside/nucleotide analogs, are indicated for prolonged use and have potential side effects. The reduction in bone mineral density was associated with the use of tenofovir, already evaluated in patients infected with HIV because the drug is also part of the therapeutic arsenal for this viral infection. There are few studies on the effects of tenofovir in patients with mono hepatitis B. Therefore, this literature review proposes to examine how hepatitis B acts in the body and the mechanisms by which antiretroviral drugs (especially tenofovir) can affect bone metabolism.

Assessment of thyroid function, ioduria and oxidative stress in women in the first trimester of pregnancy.

INTRODUCTION: adequate iodine intake during pregnancy is essential for the synthesis of thyroid hormones, which are important for the physiological functions of the mother and appropriate maturation of the central nervous system of the fetus. OBJECTIVE: the objective of the present study was to determine the levels of urinary iodine excretion and thyroid function, antioxidants and oxidative stress markers in pregnant women. METHODS: the study was conducted on 191 pregnant women and 62 non-pregnant women who were evaluated regarding nutritional status. Analyses of urinary iodine, of oxidative stress markers and thyroid function were performed, revealing iodine insufficiency in 81 pregnant women. RESULTS: there was no change in the thyroid stimulating hormone concentration in 89% of the pregnant women. Antithyroperoxidase antibody values were higher in the control group compared to the pregnant women's group (64.5% and 12.6%, respectively) and antithyroglobulin antibody values were also higher in the control group (11.6%). Assessment of oxidative stress revealed higher levels of advanced oxidation protein products, of total antioxidant capacity and of superoxide dismutase antioxidants in pregnant women. Classification of ioduria with respect to oxidative stress markers revealed lower α-tocopherol levels for the pregnant women with iodine insufficiency. CONCLUSION: on this basis, the results suggest that iodine insufficiency did not induce changes in thyroid stimulating hormone levels or antibodies and those pregnant women with adequate urinary iodine excretion had a better profile of the α-tocopherol antioxidant, indicating that iodine may play a significant role in antioxidant capacity during gestation.

Influence of the duration of antiretroviral use on insulin resistance among people living with HIV with lipodystrophy / Influência do tempo de uso de Antirretrovirais na resistência insulínica entre pessoas vivendo com HIV com síndrome lipodistrófica

Objective: The present study evaluated the influence of the duration of antiretroviral therapy on insulin resistance among people living with HIV with lipodystrophic syndrome. Methods: The study assessed 36 subjects of both sexes between 22 and 60 years old split into three groups: 1) HIV-positive using antiretroviral with lipodystrophy syndrome (HIV+LIPO+); 2) HIV-positive using antiretroviral therapy with no lipodystrophy syndrome (HIV+LIPO-); and 3) HIV-negative and healthy (Control). The data were collected at the Special Unit for the Treatment of Infectious Diseases (Unidade Especial de Tratamento para Doenças Infecciosas - UETDI) of the Dyslipidemia Outpatient Clinic (Ambulatório de Dislipidemia - ADIS) of the General Hospital of the Medical School of Ribeirão Preto (HC-FMRP). The biochemical assessment used laboratory kits when the results were not available in the volunteer's records. Results: Higher HOMA-IR values were observed for the group 1: HIV+LIPO+ (1,61 ± 1,17 ) compared to group 2: HIV+LIPO- (0,79 ± 0,87) and group 3: Control (0,46 ± 0,72 ) and such values were positively correlated with the time of antiretroviral medication use (r=0,41). Conclusions: The time of infection by HIV and the use of antiretrovirals impact the glucose metabolism with changes in serum insulin levels and consequent insulin resistance and increased risk for the development of diabetes and diseases related to carbohydrate metabolism. (AU)

Métodos: Foram avaliados 36 indivíduos de ambos os sexos, com idade entre 22 e 60 anos, divididos em três grupos: 1) Soropositivo para HIV em uso de TARV com síndrome de lipodistrofia (VIH + LIPO +); 2) Soropositivo para HIV em uso de TARV sem síndrome de lipodistrofia (VIH + LIPO-); 3) Soronegativo para HIV (Controle). Os dados foram coletados na Unidade Especial de Tratamento para Doenças Infecciosas (UETDI), no Ambulatório de Dislipidemia (ADIS) do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto (HC-FMRP). Para a análise bioquímica foram utilizados kits de laboratório, quando os mesmos não estavam disponíveis nos prontuário eletrônico. Resultados: Foram observados maiores valores de HOMA-IR para o grupo GRUPO 1: HIV+LIPO+ (1,61 ± 1,17), comparado aos grupos GRUPO 2: HIV+LIPO- (0,79 ± 0,87) e GRUPO 3: Controle (0,46 ± 0,72), sendo que o HOMA-IR apresentou correlação positiva com o tempo de uso dos antirretrovirais (r=0,41). Conclusão: O tempo de infecção por HIV e o uso de antirretrovirais influenciam o metabolismo glicídico, com modificações nos níveis séricos de insulina e consequentemente resistência à insulina e maior risco para desenvolver diabetes e enfermidades relacionadas ao metabolismo de carboidratos. (AU)

Assessment of thyroid function, ioduria and oxidative stress in women in the first trimester of pregnancy / Evaluación de la función tiroidea, yoduria y estrés oxidativo en mujeres en el primer trimestre de embarazo

Introduction: adequate iodine intake during pregnancy is essential for the synthesis of thyroid hormones, which are important for the physiological functions of the mother and appropriate maturation of the central nervous system of the fetus. Objective: the objective of the present study was to determine the levels of urinary iodine excretion and thyroid function, antioxidants and oxidative stress markers in pregnant women. Methods: the study was conducted on 191 pregnant women and 62 non-pregnant women who were evaluated regarding nutritional status. Analyses of urinary iodine, of oxidative stress markers and thyroid function were performed, revealing iodine insufficiency in 81 pregnant women. Results: there was no change in the thyroid stimulating hormone concentration in 89% of the pregnant women. Antithyroperoxidase antibody values were higher in the control group compared to the pregnant women's group (64.5% and 12.6%, respectively) and antithyroglobulin antibody values were also higher in the control group (11.6%). Assessment of oxidative stress revealed higher levels of advanced oxidation protein products, of total antioxidant capacity and of superoxide dismutase antioxidants in pregnant women. Classification of ioduria with respect to oxidative stress markers revealed lower α-tocopherol levels for the pregnant women with iodine insufficiency. Conclusion: on this basis, the results suggest that iodine insufficiency did not induce changes in thyroid stimulating hormone levels or antibodies and those pregnant women with adequate urinary iodine excretion had a better profile of the α-tocopherol antioxidant, indicating that iodine may play a significant role in antioxidant capacity during gestation

Introducción: la ingesta adecuada de yodo durante el embarazo es esencial para la síntesis de las hormonas tiroideas, que son importantes para las funciones fisiológicas de la madre y la maduración apropiada del sistema nervioso central del feto. Objetivo: el objetivo del presente estudio fue determinar los niveles de excreción de yodo urinario y función tiroidea, antioxidantes y marcadores de estrés oxidativo en mujeres embarazadas. Métodos: el estudio se realizó en 191 mujeres embarazadas y 62 mujeres no embarazadas que fueron evaluadas con respecto al estado nutricional. Se realizaron análisis de yodo urinario, marcadores de estrés oxidativo y función tiroidea, que revelaron insuficiencia de yodo en 81 embarazadas. Resultados: no hubo cambios en la concentración de hormona estimulante tiroidea en el 89% de las mujeres embarazadas. Los valores de anticuerpos antitiroperoxidasa fueron mayores en el grupo control en comparación con el grupo de mujeres embarazadas (64,5% y 12,6%, respectivamente) y los de anticuerpos antitiroglobulina fueron también mayores en el grupo control (11,6%). La evaluación del estrés oxidativo reveló niveles más altos de productos avanzados de proteína de oxidación, de capacidad antioxidante total y de antioxidantes de superóxido dismutasa en mujeres embarazadas. La clasificación de la yoduria con respecto a marcadores de estrés oxidativo reveló menores niveles de α-tocoferol para las mujeres embarazadas con insuficiencia de yodo. Conclusión: sobre esta base, los resultados sugieren que la insuficiencia de yodo no indujo cambios en los niveles de hormona estimulante de la tiroides o anticuerpos y las mujeres embarazadas con excreción urinaria adecuada de yodo tuvieron un mejor perfil del antioxidante α-tocoferol, lo que indica que el yodo puede desempeñar un papel significativo en la capacidad antioxidante durante la gestación

Comparison of Iodine Concentrations in Kitchen Salt and Urine with the Thyroid Volume of Schoolchildren from Ribeirão Preto, São Paulo, Brazil: Warning of Worsening After 10 Years of Study.

Background: In 2007 and 2015, two studies were conducted in Ribeirão Preto, São Paulo, Brazil, on schoolchildren of both sexes attending schools of three different socioeconomic levels (school 1: low; school 2: middle; school 3: high). Methods: Iodine concentrations were measured in samples of kitchen salt from the home provided by the schoolchildren and in urine samples, and these levels were compared to the thyroid volume by clinical assessment. Results: In 2007, a marked discrepancy in iodine concentrations was found in salt samples in 300 schoolchildren of both sexes (age range 8-10 years). Urinary iodine excretion >100 µg/L was detected in all cases, and 55.2% had concentrations of >300 µg/L (considered to be the upper limit by the World Health Organization). There was no increase in thyroid volume among the schoolchildren. In 2015, after a change in the norms for salt iodination from 20-60 to 15-45 mg/kg, the study was repeated in 295 schoolchildren (age range 8-10 years) from the same three schools studied previously. An improved standardization of iodine concentration was observed in the salt samples provided by the children, as well as a significant reduction in ioduria, with 10.9% of the samples showing an iodine concentration of <100 µg/L and with a reduction to 30.5% of samples with >300 µg/L. An increase in thyroid volume was also observed in a greater proportion of children from school 1, with a 7.92%, 5.19%, and 0.85% prevalence of goiter at schools 1, 2, and 3, respectively. Conclusions: Despite the limitations of the present study, which include sample size and thyroid evaluation by palpation, it is inferred that the iodination of the Ribeirão Preto schoolchildren studied is adequate. However, the individual iodine intake of some students was <100 µg/L, and some students also had an increased thyroid volume, raising the possibility of a deterioration of iodine intake in 2015 compared to 2007.