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1.
PLoS One ; 15(7): e0235135, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32628733

RESUMO

BACKGROUND: In patients on hemodialysis (HD), the various chemical elements in the dialysate may influence survival rates. In particular, calcium modifies mineral and bone metabolism and the vascular calcification rate. We studied the influence of the dialysate calcium concentration and the treatments prescribed for mineral bone disease (MBD) on survival. METHODS: All patients in REIN having initiated HD from 2010 to 2013 were classified according to their exposure to the different dialysate calcium concentrations in their dialysis unit. Data on the individual patients' treatments for MBD were extracted from the French national health database. Cox proportional hazard models were used to estimate mortality hazard ratios (HR) associated with time-dependent exposure to dialysate calcium concentrations and MBD therapies, adjusted for comorbidities, laboratory and technical data. RESULTS: Dialysate calcium concentration of 1.5 mmol/L was used by 81% of the dialysis centers in 2010 and in 83% in 2014. Most centers were using several formulas in up to 78% for 3 formulas in 2010 to 86% in 2014. In full adjusted Cox survival analyses, the percentage of calcium >1.5 mmol/L and <1.5 mmol/l by center and the number of formula used per center were not associated with survival. Depending on the daily dose used, the MBD therapies were associated with survival improvement for calcium, native vitamin D, active vitamin D, sevelamer, lanthanum and cinacalcet in the second and third tertiles of dose. CONCLUSION: No influence of the dialysate calcium concentration was evidenced on survival whereas all MBD therapies were associated with a survival improvement depending on the daily dose used.


Assuntos
Osso e Ossos/efeitos dos fármacos , Cálcio/análise , Soluções para Hemodiálise/análise , Sistema de Registros , Diálise Renal , Insuficiência Renal Crônica/terapia , Idoso , Vasos Sanguíneos/efeitos dos fármacos , Vasos Sanguíneos/metabolismo , Vasos Sanguíneos/fisiopatologia , Osso e Ossos/metabolismo , Osso e Ossos/fisiopatologia , Calcinose/epidemiologia , Calcinose/metabolismo , Calcinose/fisiopatologia , Cálcio/administração & dosagem , Cálcio/metabolismo , Cinacalcete/análise , Feminino , França/epidemiologia , Soluções para Hemodiálise/administração & dosagem , Soluções para Hemodiálise/química , Humanos , Lantânio/análise , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/mortalidade , Insuficiência Renal Crônica/fisiopatologia , Sevelamer/análise , Vitamina D/análise , Vitamina D/metabolismo
2.
Medicine (Baltimore) ; 99(21): e20416, 2020 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-32481343

RESUMO

BACKGROUND: In recent decades, many researches manifested that the perimenopause is a window of vulnerability for the development of both depressive symptoms and major depressive episodes. Some scholar thought that those women diagnosed with depression may be particularly sensitive to changes in the hormonal milieu experienced premenstrual, during the postpartum period or during the menopause transition in. Risk factors for depressive symptoms during the perimenopause include prior standardized mean difference (MDD), psychosocial factors, anxiety symptoms, and reproductive-related mood disturbance. However, active vitamin D (VD), exerts protective and regulatory effects on the brain dopamine system and suggests that similar to the antidepressant. Therefore, serum 25(OH)D level may be negatively correlated with the perimenopausal depression. METHODS: The study only selects clinical randomized controlled trials of depression in perimenopausal women. We will search each database from the built-in until October 2020. The English literature mainly searches Cochrane Library, PubMed, EMBASE, and Web of Science. While the Chinese literature comes from CNKI, CBM, VIP, and Wangfang database. Meanwhile, we will retrieve clinical trial registries and grey literature. Two researchers worked independently on literature selection, data extraction, and quality assessment. The dichotomous data is represented by relative risk, and the continuous is expressed by mean difference or standard mean difference, eventually the data is synthesized using a fixed effect model or a random effect model depending on the heterogeneity. The serum vitamin D level, Hamilton Depression Scale, or Beck Depression Inventory or Zung self-rating depression scale or patient health questionnare-9 were evaluated as the main outcomes. While several secondary outcomes were also evaluated in this study. The statistical analysis of this Meta-analysis was conducted by RevMan software version 5.3. RESULTS: This meta-analysis will further determine the association analysis between VD level and depression in women perimenopause. CONCLUSION: This study determines the VD level is related to the occurrence of depression in perimenopausal women.


Assuntos
Depressão/sangue , Perimenopausa/sangue , Vitamina D/análise , Adulto , Protocolos Clínicos , Depressão/psicologia , Feminino , Humanos , Metanálise como Assunto , Pessoa de Meia-Idade , Perimenopausa/metabolismo , Psicometria/instrumentação , Psicometria/métodos , Revisões Sistemáticas como Assunto , Vitamina D/sangue
3.
BMJ Open Qual ; 9(1)2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32098778

RESUMO

INTRODUCTION: Testing of 25-hydroxy (25-OH) vitamin D serum levels has increased drastically in recent years and much of it is considered inappropriate based on current guidelines. METHODS: In consultation with our physician groups (experts and frequent orderers), we modified existing guidelines and implemented a rational policy for 25-OH vitamin D testing and 1,25 dihydroxy (1,25 di-OH) vitamin D testing at a tertiary care centre. A computer decision support tool requiring selection of one of five acceptable testing indications was created for each test as part of a computerised physician order entry system. RESULTS: As a result of our intervention, we observed a 27% decrease in the average monthly test volume for 25-OH vitamin D from 504±62 (mean±SD) tests per month to 370±33 (p<0.001). 1,25 di-OH vitamin D testing decreased 58% from 71±18 to 30±10 (p<0.001). The departments ordering the tests were similar during the preintervention and postintervention periods, and further audits, patient chart reviews and individualised physician feedback were required to ensure appropriate ordering of 1,25 di-OH vitamin D. The most common ordering reasons selected were malabsorption/dietary concerns (46%) for 25-OH vitamin D and renal failure (42%) for 1,25 di-OH vitamin D. CONCLUSIONS: Limitations of our computer decision support tool include a dependence on an honour system in selecting the testing indication and an inability to limit ordering frequency. Periodic monitoring of test volumes will be required to ensure adherence to guidelines. Despite these limitations, we have improved appropriate utilisation of these tests and reduced costs by approximately $C60 375 per year.


Assuntos
Sobremedicalização/prevenção & controle , Vitamina D/análise , Canadá , Humanos , Sobremedicalização/estatística & dados numéricos , Centros de Atenção Terciária/organização & administração , Centros de Atenção Terciária/estatística & dados numéricos , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/diagnóstico
4.
Crit Rev Food Sci Nutr ; 60(4): 660-669, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30596263

RESUMO

Vitamin D deficiency is considered a global public health problem with high prevalence in children and adolescents. The majority of the studies in the literature have identified a relationship between vitamin D insufficiency/deficiency and obesity, as well as other traditional cardiometabolic risk factors in children and adolescents. Scarce studies address vitamin D status with oxidative stress and inflammation in the young population. The aim of this systematic review was to evaluate the evidence of the association of vitamin D status with oxidative stress and inflammation in children and adolescents. This is a systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guideline on reporting systematic reviews. Eight studies were selected for this review. All included studies evaluated inflammatory biomarkers and two out of eight evaluated biomarkers of oxidative stress. The majority of the studies (five out of eight) found association of vitamin D status with biomarkers of oxidative stress and inflammation such as C-reactive protein (CRP), interleukin-6 (IL-6), cathepsin S, vascular cell adhesion molecule-1 (VCAM-1), malondialdehyde (MDA), myeloperoxidase, 3-nitrotyrosine, and superoxide dismutase (SOD). Vitamin D status is associated with oxidative stress and inflammation in the majority of the studies with children and adolescents. Thus, the assessment of vitamin D status is important because it is associated with nontraditional cardiometabolic markers in the pediatric population (review registration: PROSPERO CRD42018109307).


Assuntos
Inflamação/sangue , Inflamação/metabolismo , Estresse Oxidativo , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/metabolismo , Vitamina D/análise , Vitamina D/metabolismo , Adolescente , Biomarcadores/sangue , Biomarcadores/metabolismo , Criança , Humanos , Vitaminas/sangue , Vitaminas/metabolismo
5.
Ann Biol Clin (Paris) ; 77(6): 693-696, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-31859648

RESUMO

Several hyperthyroidism misdiagnoses cases have been recently described due to biotin intake. Biotin used in immuno-analysis assays which rely on biotin/streptavidin binding properties. In these assays, high plasmatic biotin levels can lead to major analytical interferences resulting in falsely higher (competition tests) or falsely reduced determinations (for sandwiches assays). We performed a simulation test of biotin intake with patient's samples. We studied the effect of biotin on cardiac troponin I and total vitamin D (D2+D3) assays that are using biotin-streptavidin binding on Dimension EXL®. Increasing doses of biotin were added (28 samples for each parameter) before the assays. The results evidenced a significant negative interference of biotin on cardiac troponin I determinations for concentrations of 100 ng/mL and above, with a total loss of signal for higher biotin additions. Such interference may lead to inappropriate therapeutic decisions. Positive interferences were observed on total vitamin D (D2+D3) with less impact for therapeutic decisions.


Assuntos
Ligação Competitiva , Biotina/metabolismo , Testes Diagnósticos de Rotina , Hipertireoidismo/diagnóstico , Estreptavidina/metabolismo , Troponina I/análise , Vitamina D/análise , Adulto , Artefatos , Biotina/administração & dosagem , Biotina/efeitos adversos , Colecalciferol/análise , Colecalciferol/sangue , Doença das Coronárias/sangue , Doença das Coronárias/diagnóstico , Erros de Diagnóstico , Testes Diagnósticos de Rotina/instrumentação , Testes Diagnósticos de Rotina/métodos , Testes Diagnósticos de Rotina/normas , Ergocalciferóis/análise , Ergocalciferóis/sangue , Humanos , Hipertireoidismo/sangue , Imunoensaio/instrumentação , Imunoensaio/métodos , Miocárdio/química , Miocárdio/metabolismo , Troponina I/sangue , Troponina I/metabolismo , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/diagnóstico
6.
Actual. osteol ; 15(3): 214-224, Sept-Dic. 2019. graf, tab
Artigo em Espanhol | LILACS | ID: biblio-1116039

RESUMO

En la Argentina, las embarazadas presentan alta prevalencia (80%) de hipovitaminosis D y de sobrepeso u obesidad (27,4%). Ambas condiciones pueden aumentar la morbimortalidad materno-fetal. Bajos niveles de vitamina D se han relacionado con aumento del colesterol total, LDL, triglicéridos (Tg) y descenso de HDL. Objetivo: evaluar los niveles de 25-hidroxivitamina D (25OHD) y su relación con el perfil lipídico en pacientes embarazadas de alto riesgo. Materiales y métodos: estudio de corte transversal entre septiembre de 2016 y abril de 2017. Se excluyeron pacientes que recibieron suplementos de vitamina D, con disfunción tiroidea no compensada, malabsorción, insuficiencia cardíaca, renal o hepática y dislipidemia familiar. Niveles circulantes de 25OHD < 30 ng/ml se consideraron hipovitaminosis. Resultados: se evaluaron 86 embarazadas de 29,3 ± 7,1 años durante la semana 28 ± 6,5. El IMC pregestacional fue 28,3 ± 6,5 kg/m2 y la ganancia de peso 7 ± 4,3 kg. Perfil lipídico: colesterol total 240 ± 54 mg/dl; LDL 156 ± 54 mg/dl; HDL 66 ± 15 mg/dl; Tg 204 ± 80 mg/dl. La media de 25OHD fue de 23,8 ± 9 ng/ml, con una prevalencia de hipovitaminosis D de 77,9 %. Las pacientes con hipovitaminosis D presentaron mayores valores de colesterol total y LDL (p < 0,05), con tendencia no significativa a presentar mayores valores de Tg. Conclusión: en embarazadas de alto riesgo se observó una alta prevalencia de hipovitaminosis D, asociada con mayores concentraciones de colesterol total y LDL. (AU)


In Argentina, pregnant women have a high prevalence (80 %) of hypovitaminosis D and verweight/obesity (27.4%), conditions that can increase maternal-fetal morbidity and mortality. Low levels of 25-hydroxyvitamin D (25OHD) have been linked to an increase in total cholesterol, LDL cholesterol, triglycerides (TG) and a decrease in HDL cholesterol. Objective: to evaluate the levels of vitamin D and its relationship with the lipid profile in high risk pregnant patients. Materials and methods: cross-sectional study between September 2016 and April 2017. Patients who received vitamin D supplements or had non-compensated thyroid dysfunction, malabsorption, heart failure, renal or hepatic failure, or familial dyslipidemia were excluded. Hypovitaminosis D was defined as a circulating level of 25OHD < 30 ng/ml. Results: We assessed 86 women of 29.3 ± 7.1 years during pregnancy week 28 ± 6.5. Pre-gestational BMI was 28.3 ± 6.5 kg/m2. Their weight gain was 7 ± 4.3 kg. Lipid profile: total cholesterol 240 ± 54 mg/dl; LDL cholesterol 156 ± 54 mg/dl; HDL cholesterol 66 ± 15 mg/dL; TG 204 ± 80 mg/dl. The mean 25OHD level was 23.8 ± 9 ng/ml, with a 77.9 % prevalence of hypovitaminosis D. Patients with hypovitaminosis D had higher values of total cholesterol and LDL cholesterol (p<0.05), and a non-significant trend toward higher triglyceridemia. Conclusion: A high prevalence of hypovitaminosis D, associated with high total and LDL cholesterol was found in high risk pregnant women. (AU)


Assuntos
Humanos , Feminino , Gravidez , Adulto , Adulto Jovem , Deficiência de Vitaminas/metabolismo , Vitamina D/metabolismo , Gravidez de Alto Risco/metabolismo , Argentina/epidemiologia , Deficiência de Vitaminas/sangue , Deficiência de Vitaminas/epidemiologia , Vitamina D/análise , Vitamina D/sangue , Estudos Epidemiológicos , Índice de Massa Corporal , Colesterol/análise , Colesterol/sangue , Indicadores de Morbimortalidade , Saúde Pública/estatística & dados numéricos , Estudos Transversais/estatística & dados numéricos , Diabetes Gestacional/metabolismo , Gravidez de Alto Risco/sangue , Dislipidemias/metabolismo , Sobrepeso/metabolismo , Trabalho de Parto Prematuro/metabolismo , LDL-Colesterol/análise , LDL-Colesterol/sangue , Obesidade/metabolismo
7.
BMC Public Health ; 19(1): 1119, 2019 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-31416429

RESUMO

BACKGROUND: Vitamin D deficiency has been highlighted as a serious public health problem in the United Kingdom. One in four toddlers are not achieving the recommended intake for their healthy development. This study uses quantitative and qualitative methods to explore parents' perceptions, awareness and behaviours around vitamin D intake, and the acceptability of and factors affecting purchasing of food and drink fortified with Vitamin D in children aged 0-2 years old. METHODS: One hundred and ninety-four parents completed an online questionnaire, advertised to parents with one child aged up to 2 years on popular social media websites. The majority of participants were mothers, White-British ethnic background, aged 25-44 years. Participants provided an email address if they wanted to be contacted about the focus groups. Recruitment posters advertising the focus groups were placed in community centres. Eighteen participated in 5 focus groups (13 parents), and 5 individual interviews. A thematic analysis methodology was applied. RESULTS: Fifty-seven percent (n = 110) of parents reported receiving information about vitamin D during pregnancy and 52% (n = 100) after the birth of their child. Parents reported a low level of satisfaction with vitamin D information: many thought it was limited and recommendations on supplements were unclear. Parents wanted more information about vitamin D requirements for their child (80%, n = 153 out of 192 respondents, 2 non-response), about vitamin D and breastfeeding (56%, n = 108) and vitamin D and pregnancy (49%, n = 94). The recommendations were for simpler, easier to read, with specific and clearer guidelines; delivered regularly during routine appointments, at timely stages throughout pregnancy and after the birth. 23% (n = 45, out of 194 respondents) of parents did not know why vitamin D is important for health. Only 26% (n = 49, out of 192 respondents) of parents reported giving their youngest child a vitamin D supplement on most days of the week. The majority of parents (interview/focus group) wanted more information about foods/drinks fortified with vitamin D. CONCLUSION: Parents were generally not aware of the importance of vitamin D, dietary requirements including supplementation and the availability of vitamin D fortified foods. Major improvements are required for the effective promotion of vitamin D information to parents.


Assuntos
Dieta/psicologia , Pais/psicologia , Deficiência de Vitamina D/psicologia , Vitamina D/análise , Vitaminas/análise , Adulto , Pré-Escolar , Suplementos Nutricionais/estatística & dados numéricos , Feminino , Alimentos Fortificados/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Lactente , Recém-Nascido , Masculino , Necessidades Nutricionais , Gravidez , Pesquisa Qualitativa , Inquéritos e Questionários , Reino Unido
8.
Clin Chim Acta ; 498: 84-89, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31421120

RESUMO

INTRODUCTION: Mass spectrometry-based assays have increasingly been implemented in clinical laboratories for their multiplexing capacity and high specificity and sensitivity. However, these methods are often associated with labor-intensive and error-prone data-related workflows, due to the volume of data generated that is often manually reviewed and resulted. We aimed to establish a system within our clinical mass spectrometry laboratory to facilitate data 'flow' from electronic medical record order to result and to automate processes for chromatogram peak review. The processes and validation are described for a 25-hydroxyvitamin D assay. METHODS: Automating chromatogram review and order to result data transfer required flat file interfacing, file transfers of standardized data formats, barcode scanning, and software for peak processing and review. Validation of the automated workflow involved (1) correlation of quantified results generated by two chromatogram analysis methods: Waters TargetLynx and Indigo Bioautomation ASCENT, (2) manual verification of quality assurance flags applied in ASCENT, and (3) testing data flow and integrity across all the systems from order to result. Efficiency and quality improvements were assessed through calculation of batch review times and rates for autoverification and manual manipulations. RESULTS: The correlation of TargetLynx and ASCENT quantitation methods for 25-hydroxyvitamin D2 in patient samples yielded slope of 0.99 (95% CI: 0.989 to 0.996), intercept of 0.46 (95% CI: 0.363 to 0.565), with r = 0.999. The correlation for the D3 fraction showed Deming regression slope of 0.98 (95% CI: 0.969 to 0.989), intercept of 0.06 (95% CI: -0.115 to 0.313), and r = 0.995. Results from both quantitation approaches were also compared to the assigned value in CDC reference samples. The mean bias relative to the CDC was 4.6% for ASCENT and 2.5% for TargetLynx. The median time for chromatogram review of a full 96-well plate of vitamin D results is reduced from approximately 2 h to 14 min and 80% of batches were reviewed within 30 min. Instead of 100% peak review, technologists review only the peaks that have been flagged by the system based on applied rules. Analysis of full plate batches showed that 2-20% of peaks per batch were flagged for manual review. Manipulations made by technologists during chromatogram review were reduced by 75% when using the automated versus manual system. CONCLUSIONS: We describe a system to facilitate data 'flow' from electronic order to result and to automate chromatogram peak review in a clinical liquid chromatography mass spectrometry assay for 25-hydroxyvitamin D. This eliminated manual result entry, repetitive transcription, and unnecessary review of high quality data while enabling systematic evaluation of data quality indicators. The new processes were accurate, improved the data review and processing times, and helped to reduce manual manipulations during chromatogram review.


Assuntos
Cromatografia Líquida/métodos , Laboratórios , Espectrometria de Massas/métodos , Fluxo de Trabalho , Animais , Automação , Humanos , Fatores de Tempo , Vitamina D/análogos & derivados , Vitamina D/análise
9.
J Steroid Biochem Mol Biol ; 194: 105437, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31352025

RESUMO

Accurately detecting vitamin D deficiency (defined as concentration in blood of 25-hydroxyvitamin D (25(OH)D), <20 ng/mL) is important for both clinicians and researchers. Drawing blood may be difficult in some populations, such as infants and children. We thus explored the development of a method to measure 25(OH)D concentrations in saliva, using a liquid chromatography tandem mass spectrometry (LC-MS/MS) assay. Using 25(OH)D3 standards spiked into synthetic saliva, we generated a standard curve with high correlation (r = 0.999, Pearson's); the intra-assay and inter-assay variation were ≤3.2% and ≤13.2% (CV%), respectively. Passive collection of saliva via drooling into glass or polypropylene tubes yielded higher levels of 25(OH)D3 than chewing on a synthetic swab. Chewing gum for at least 4 min reduced saliva levels of 25(OH)D3. Differences in the levels of 25(OH)D3 in saliva between the passive drooling and stimulated swab-chewing methods were normalised by adjusting for measured levels of vitamin D binding protein in saliva. Freezing samples immediately, or after 24 h of refrigeration did not affect 25(OH)D3 levels. When saliva levels of 25(OH)D3 were averaged from samples collected daily for three consecutive days, for which an additional centrifugation step was performed after samples were defrosted (to remove mucin), there was a positive (but non-significant) correlation between 25(OH)D3 levels in saliva and serum (r = 0.57, p = 0.24, Pearson's) with significant correlations (r ≥ 0.88, p < 0.05) observed after further adjusting for saliva flow rate. The time of day of the collection made little difference to 25(OH)D3 levels measured in saliva. In conclusion, we have developed an LC-MS/MS assay that accurately measures saliva 25(OH)D3 levels, which correlated with serum levels. However, for a measurement that correlates with serum 25(OH)D it may be necessary to average results from saliva collected on three consecutive days, and adjust for differences in saliva flow rate. This would increase costs, and combined with the processing requirements for samples, could limit the applicability of this assay to large cohort and field studies.


Assuntos
Bioensaio , Saliva/química , Vitamina D/análogos & derivados , Adulto , Criança , Cromatografia Líquida , Humanos , Mucinas/química , Espectrometria de Massas em Tandem , Vitamina D/análise , Vitamina D/sangue
10.
Medicina (Kaunas) ; 55(7)2019 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-31277328

RESUMO

Background and objective: Often micronutrient deficiencies cannot be detected when patient is already following a long-term gluten-free diet with good compliance (LTGFDWGC). The aim of this narrative review is to evaluate the most recent literature that considers blood micronutrient deficiencies in LTGFDWGC subjects, in order to prepare dietary supplementation advice (DSA). Materials and methods: A research strategy was planned on PubMed by defining the following keywords: celiac disease, vitamin B12, iron, folic acid, and vitamin D. Results: This review included 73 studies. The few studies on micronutrient circulating levels in long-term gluten-free diet (LTGFD) patients over 2 years with good compliance demonstrated that deficiency was detected in up to: 30% of subjects for vitamin B12 (DSA: 1000 mcg/day until level is normal, then 500 mcg), 40% for iron (325 mg/day), 20% for folic acid (1 mg/day for 3 months, followed by 400-800 mcg/day), 25% for vitamin D (1000 UI/day or more-based serum level or 50,000 UI/week if level is <20 ng/mL), 40% for zinc (25-40 mg/day), 3.6% of children for calcium (1000-1500 mg/day), 20% for magnesium (200-300 mg/day); no data is available in adults for magnesium. Conclusions: If integration with diet is not enough, starting with supplements may be the correct way, after evaluating the initial blood level to determine the right dosage of supplementation.


Assuntos
Doença Celíaca/dietoterapia , Dieta Livre de Glúten/efeitos adversos , Micronutrientes/análise , Adolescente , Adulto , Cálcio/análise , Cálcio/sangue , Doença Celíaca/sangue , Doença Celíaca/tratamento farmacológico , Criança , Dieta Livre de Glúten/métodos , Suplementos Nutricionais/normas , Feminino , Ácido Fólico/análise , Ácido Fólico/sangue , Humanos , Ferro/análise , Ferro/sangue , Masculino , Micronutrientes/sangue , Cooperação do Paciente/psicologia , Vitamina B 12/análise , Vitamina B 12/sangue , Vitamina D/análise , Vitamina D/sangue , Zinco/análise , Zinco/sangue
11.
Medicina (Kaunas) ; 55(7)2019 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-31261815

RESUMO

BACKGROUND AND OBJECTIVES: Vitamin D deficiency and insufficiency are related with many neurological diseases such as migraine. The aim of this study was to investigate whether pediatric migraine is associated with vitamin D deficiency and the effect of vitamin D therapy on the frequency, duration, severity of migraine attacks, and Pediatric Migraine Disability Assessment (PedMIDAS). MATERIALS AND METHODS: We retrospectively examined the patients' levels of calcium, phosphorus, parathyroid hormone, alkaline phosphatase, and 25-OH vitamin D of 92 pediatric migraine patients. The patients were divided into two groups: Group 1, which had low vitamin D levels and received vitamin D therapy, and group 2, which had normal vitamin D levels and did not receive vitamin D therapy. Migraine severity measured by the visual analog scale (VAS), migraine frequency, and duration as well as scores on the PedMIDAS questionnaire were compared with regard to the 25-OH vitamin D levels. In addition, pre- and posttreatment pedMIDAS scores, VAS, migraine frequency, and duration were compared with baseline values. RESULTS: A total of 34.7% patients had vitamin D insufficiency (vitamin D levels between 10 and 20 ng/mL), whereas 10.8% had vitamin D deficiency (vitamin D levels < 10 ng/mL). Migraine frequency, migraine duration, and PedMIDAS scores were significantly higher in the group 1 than group 2 (p = 0.004, p = 0.008, and p = 0.001). After vitamin D therapy at sixth months of supplementation, migraine duration was reported statistically significant shorter (p < 0.001) and the migraine frequency, VAS scores, and pedMIDAS scores were statistically significant lower compared with baseline values in group 1 (p < 0.001). CONCLUSION: We found a marked correlation between pediatric migraine and vitamin D levels. Vitamin D therapy was beneficial in migraine pediatric patients.


Assuntos
Transtornos de Enxaqueca/sangue , Transtornos de Enxaqueca/tratamento farmacológico , Deficiência de Vitamina D/diagnóstico , Adolescente , Criança , Feminino , Humanos , Masculino , Pediatria/métodos , Estudos Retrospectivos , Estatísticas não Paramétricas , Inquéritos e Questionários , Resultado do Tratamento , Vitamina D/análise , Vitamina D/sangue , Vitamina D/uso terapêutico , Deficiência de Vitamina D/sangue
12.
Cell Biochem Funct ; 37(6): 408-423, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31328813

RESUMO

Current understanding of vitamin D tends to be focussed on the measurement of the major circulating form 25-hydroxyvitamin D3 (25OHD3) and its conversion to the active hormonal form, 1α,25-dihydroxyvitamin D3 (1α,25(OH)2 D3) via the enzyme 25-hydroxyvitamin D-1α-hydroxylase (CYP27B1). However, whilst these metabolites form the endocrine backbone of vitamin D physiology, it is important to recognise that there are other metabolic and catabolic pathways that are now recognised as being crucially important to vitamin D function. These pathways include C3-epimerization, CYP24A1 hydroxylase, CYP11A1 alternative metabolism of vitamin D3, and phase II metabolism. Endogenous metabolites beyond 25OHD3 are usually present at low endogenous levels and may only be functional in specific target tissues rather than in the general circulation. However, the technologies available to measure these metabolites have also improved, so that measurement of alternative vitamin D metabolic pathways may become more routine in the near future. The aim of this review is to provide a comprehensive overview of the various pathways of vitamin D metabolism, as well as describe the analytical techniques currently available to measure these vitamin D metabolites.


Assuntos
Metaboloma/fisiologia , Vitamina D/análise , Vitamina D/metabolismo , Animais , Humanos
13.
Adv Exp Med Biol ; 1140: 299-316, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31347055

RESUMO

The pharmaceutical and clinical industries are imperative for the maintenance of global health and welfare and require accurate, reproducible, and high throughput analyses. Technological advancements, such as the development and implementation of liquid chromatography-tandem mass spectrometry (LC-MS), have allowed for improvements in these areas, however there is still room for development. One way in which current analyses may be improved is by the implementation of ion mobility technology. Ion mobility has the capability to produce much more comprehensive data sets, by providing separation of isomers, as well as improving throughput, with separations being performed as fast as 60 ms. Here we will discuss the potential for ion mobility to assist in the two specific areas of glycosylation monitoring of biological drugs, and vitamin D analysis, as representatives of ion mobility's potential in both the pharmaceutical and clinical industries, respectively, as well as the current hurdles of ion mobility adoption in both fields.


Assuntos
Química Farmacêutica/métodos , Cromatografia Líquida , Espectrometria de Massas em Tandem , Glicosilação , Isomerismo , Preparações Farmacêuticas/análise , Vitamina D/análise
14.
Med Sci Monit ; 25: 4759-4765, 2019 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-31243261

RESUMO

BACKGROUND Dry eye disease (DED) is a chronic dysfunction of the ocular surface and has become an important public problem. Vitamin D receptor (VDR) gene polymorphism has been found to be associated with different kinds of diseases. The relationship between single nucleotide polymorphisms (SNPs) in the VDR gene should be studied. MATERIAL AND METHODS In the present case-control study, we investigated the association of VDR gene polymorphism with DED risk. Clinical data including age, gender, body mass index (BMI, kg/m²), smoking history, diabetes, and blood pressure were recorded. Serum 25-hydroxy vitamin D (25[OH]D) was chosen as the main parameter that reflected the level of vitamin D. We identified SNPs of VDR gene Apa-1, Bsm-1, Fok-1, and Taq-1 in both DED cases and healthy controls. RESULTS A total of 124 DED cases and 135 healthy controls were included in this study. It was reported that aa in Apa-1 (OR=2.803, 95% CI, 1.350-5.820) and tt in Taq-1 (OR=0.362, 95% CI, 0.141-0.930) were associated with increased the risk of DED. Analysis of the allele frequencies of VDR gene polymorphisms among DED patients and healthy controls showed that allele differences in Apa-1 were significantly associated with higher risk. CONCLUSIONS SNPs of VDR gene (Apa-1 and Taq-1) were associated with the risk of DED. No significant association of Bsm-1 and Fok-1 in VDR gene demonstrated significant effect in the incidence of DED. Thus, we found that several SNPs of VDR gene could provide significant pathogenic effects in the risk of DED.


Assuntos
Síndromes do Olho Seco/genética , Receptores de Calcitriol/genética , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático/genética , Índice de Massa Corporal , Estudos de Casos e Controles , China , Síndromes do Olho Seco/metabolismo , Grupos Étnicos/genética , Feminino , Frequência do Gene , Predisposição Genética para Doença , Genótipo , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Vitamina D/análogos & derivados , Vitamina D/análise , Vitamina D/sangue
15.
An Bras Dermatol ; 94(2 Suppl 1): 76-107, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31166402

RESUMO

Psoriasis is a chronic inflammatory disease that affects 1.3% of the Brazilian population. The most common clinical manifestations are erythematous, scaling lesions that affect both genders and can occur on any anatomical site, preferentially involving the knees, elbows, scalp and genitals. Besides the impact on the quality of life, the systemic nature of the disease makes psoriasis an independent risk factor for cardiovascular disease, especially in young patients with severe disease. By an initiative of the Brazilian Society of Dermatology, dermatologists with renowned clinical experience in the management of psoriasis were invited to form a work group that, in a partnership with the Brazilian Medical Association, dedicated themselves to create the Plaque Psoriasis Diagnostic and Treatment Guidelines. The relevant issues for the diagnosis (evaluation of severity and comorbidities) and treatment of plaque psoriasis were defined. The issues generated a search strategy in the Medline-PubMed database up to July 2018. Subsequently, the answers to the questions of the recommendations were devised, and each reference selected presented the respective level of recommendation and strength of scientific evidence. The final recommendations for making up the final text were worded by the coordinators.


Assuntos
Psoríase/diagnóstico , Psoríase/terapia , Corticosteroides/uso terapêutico , Antralina/uso terapêutico , Anticorpos Monoclonais/uso terapêutico , Brasil , Inibidores de Calcineurina/uso terapêutico , Comorbidade , Ciclosporina/uso terapêutico , Fármacos Dermatológicos/uso terapêutico , Dermatologia , Combinação de Medicamentos , Feminino , Humanos , Masculino , Metotrexato/uso terapêutico , Fototerapia/métodos , Psoríase/epidemiologia , Índice de Gravidade de Doença , Sociedades Médicas , Fatores de Tempo , Vitamina D/análise
16.
Medicina (Kaunas) ; 55(6)2019 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-31174403

RESUMO

Background and objectives: Vitamin D is an essential vitamin that plays a key role in maintaining physiological calcium balance, and is also a pivotal element in the formation of bone structure. Vitamin D deficiency is associated with a wide array of clinical symptoms. Vitamin and mineral deficiencies are quite common prior to and after bariatric surgery, and therefore we have evaluated the effects of two different cholecalciferol supplementation regimes on serum calcium, 25(OH) cholecalciferol, and parathyroid hormone (PTH). Materials and Methods: In this retrospective matched cohort study, two different cholecalciferol supplementation regimes were compared. Group A consisted of 50 patients who had 1000 mg calcium and 800 IU cholecalciferol. In Group B, 50 patients had 1000 mg calcium and 800 IU cholecalciferol with an additional 1 ml liquid cholecalciferol (50,000 IU) monthly. The primary outcome was the effects on blood serum levels of calcium, 25(OH) cholecalciferol, and PTH. Results: In group A and group B, there were significant increases in 25(OH) cholecalciferol, with a higher delta in favor of group B (for all three p < 0.001). A decrease was seen in PTH (p < 0.001), and no differences were measured in calcium levels in both groups. Conclusion: Our study suggests that an additional 1 ml cholecalciferol (50,000 IU) monthly can result in less biochemically 25(OH) cholecalciferol deficient patients after bariatric surgery. No effects were seen on the calcium balance. However, larger randomized clinical trials need to be done to assess the effects on clinical outcomes like bone health and fracture risk.


Assuntos
Cirurgia Bariátrica/reabilitação , Cálcio/análise , Colecalciferol/uso terapêutico , Hormônio Paratireóideo/análise , Adulto , Análise de Variância , Cirurgia Bariátrica/métodos , Cálcio/sangue , Colecalciferol/farmacologia , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos , Hormônio Paratireóideo/sangue , Projetos Piloto , Período Pós-Operatório , Estudos Retrospectivos , Vitamina D/análise , Vitamina D/sangue
17.
Medicina (Kaunas) ; 55(6)2019 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-31185696

RESUMO

Background and Objectives: The major cause of vitamin D deficiency is inadequate exposure to sunlight. It is difficult to supplement it with food because sufficient concentrations of vitamin D naturally occur only in a handful of food products. Thereby, deficiency of this vitamin is commonly corrected with oral supplements. Different supplement delivery systems for improved vitamin D stability and bioavailability are proposed. In this study, we compared efficiency of three vitamin D delivery systems: microencapsulated, micellized, and oil-based. Materials and Methods: As a model in this medical testing, laboratory rats were used for the evaluation of bioavailability of different vitamin D vehicles. Animals were divided into three groups: the first one was given microencapsulated vitamin D3, the second-oil-based vitamin D3, and the third-micellized vitamin D3. Test substances were given per os to each animal for 7 days, and vitamin D concentration in a form of 25-hydroxyvitamin D (25(OH)D) in the blood was checked both during the vitamin delivery period and later, up to the 24th day. Results: Comparison of all three tested products showed that the microencapsulated and oil-based vitamin D3 vehicles were the most bioavailable in comparison to micellized vitamin D3. Even more, the effect of the microencapsulated form of vitamin D3 remained constant for the longest period (up to 14 days). Conclusions: The results of this study suggest that the oral vitamin D supplement vehicle has an impact on its bioavailability, thus it is important to take into account how much of the suppled vitamin D will be absorbed. To maximize the full exploit of supplement, the best delivery strategy should be employed. In our study, the microencapsulated form of vitamin D was the most bioavailable.


Assuntos
Disponibilidade Biológica , Deficiência de Vitamina D/tratamento farmacológico , Vitamina D/uso terapêutico , Animais , Suplementos Nutricionais/normas , Modelos Animais de Doenças , Ratos , Ratos Wistar/sangue , Vitamina D/análise , Vitamina D/sangue , Deficiência de Vitamina D/sangue
18.
Nutr. hosp ; 36(3): 571-577, mayo-jun. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-184553

RESUMO

Background: older adults are at increased risk of vitamin D deficiency as a result of limited sun exposure and inadequate vitamin D intake. Despite this evidence, there are scarce data regarding the concentration of 25(OH)D and its metabolites among older adults with physical disability. Methods: the National Health and Nutrition Examination Survey 2007-2014 data were collected to compare 25(OH)D3, 25(H)D2, and total 25(OH)D concentrations among adults aged 60 years and older with and without physical disability. Moreover, general linear models adjusted for potential confounders were used to examine the independent effect of vitamin D intake, physical activity status and body mass index (BMI) categories on 25(OH)D concentrations by disability status. Results: of 6,250 older adults, 17.9% were defined as physically disabled. 25(OH)D concentrations were 71.3 and 78.2 nmol/l in subjects with and without disability, respectively. However, after adjustment for potential confounders, similar 25(OH)D concentrations were seen between disabled subjects and their non-disabled counterparts (75.6 vs 77.5 nmol/l; p = 1.17). In contrast, older adults with disability had significantly increased 25(OH)D2 concentrations (8.3 vs 6.1 nmol/l; p < 0.05). Notably, older adults with a daily vitamin D intake of = 15 mcg achieved sufficient 25(OH)D concentrations, regardless of their disability status. Conclusion: 25(OH)D concentrations did not significantly differ among older adults by disability status. This finding was attributed to increased 25(OH)D2 concentrations among those with physical disability. Thus, adequate vitamin D intake is an effective strategy to maintain sufficient 25(OH)D concentrations, particularly among disabled older adults


Antecedentes: los adultos mayores tienen mayor riesgo de deficiencia de vitamina D debido a una limitada exposición al sol e ingesta inadecuada de vitamina D. A pesar de esto, existen escasos datos sobre la concentración de 25(OH)D y sus metabolitos en adultos mayores con discapacidad física. Métodos: la Encuesta Nacional de Salud y Nutrición de 2007-2014 se analizó para comparar las concentraciones de 25(OH)D3, 25(OH)D2 y 25(OH)D total entre los adultos mayores con y sin discapacidad física. Se usaron modelos generalizados lineales ajustados por cofactores para examinar el efecto independiente de la ingesta de vitamina D, los niveles de actividad física y las categorías del índice de masa corporal (IMC) sobre las concentraciones de 25(OH)D por condición de discapacidad. Resultados: de un total de 6.250 adultos mayores, el 17,9% tenía discapacidad física. Las concentraciones de 25(OH)D fueron 71,3 y 78,2 nmol/l en sujetos con y sin discapacidad, respectivamente. Sin embargo, después del ajuste por covariables, niveles similares de 25(OH)D fueron observados entre los sujetos con discapacidad y sus homólogos sin discapacidad (75,6 vs. 77,5 nmol/l; p = 1,17). En contraste, las concentraciones de 25(OH)D2 fueron significativamente mayores en los sujetos con discapacidad física (8,3 vs. 6,1 nmol/l; p < 0,05). En particular, los sujetos con una ingesta diaria de vitamina D de = 15 mcg alcanzaron niveles adecuados de 25(OH)D, a pesar de su condición de discapacidad. Conclusión: las concentraciones de 25(OH)D fueron similares entre los adultos mayores por condición de discapacidad. Este hallazgo fue atribuido al aumento de la concentración de 25(OH)D2 entre las personas con discapacidad física. Así, la ingesta adecuada de vitamina D es una estrategia efectiva para mantener niveles óptimos de 25(OH)D, particularmente entre los adultos mayores con discapacidad


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Vitamina D/administração & dosagem , Vitamina D/análise , Idoso Fragilizado , Pessoas com Deficiência , Saúde da Pessoa com Deficiência , Atividade Motora , Inquéritos Nutricionais/estatística & dados numéricos , Inquéritos Epidemiológicos , Índice de Massa Corporal
19.
Medicina (Kaunas) ; 55(5)2019 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-31137600

RESUMO

Background and objectives: Obstructive sleep apnea syndrome (OSAS) is associated with cardiovascular and metabolic risk factors, such as insulin resistance. Furthermore, OSAS has been associated with decreased levels of vitamin D (Vit D). The aim of the study was to assess the association between Vit D levels (expressed as 25(OH)D serum levels) and insulin resistance in patients with OSAS. Materials and Methods: Serum 25(OH)D levels were measured in consecutive subjects who had undergone polysomnography and pulmonary function testing. OSAS patients were divided into those with (homeostatic model assessment [HOMA-IR] ≥ 2) and without insulin resistance (HOMA-IR < 2). Results: Overall, 92 patients (81 males) were included in the study. OSAS patients with insulin resistance significantly differed from those without insulin resistance in terms of the body-mass index (BMI) (36.3 ± 5.8 compared to 32 ± 5.6 kg/m2, respectively, p = 0.001), apnoea-hypopnoea index (AHI) (57.4 ± 28.9 compared to 40.9 ± 27.9 events/h, respectively, p = 0.009) and indices of hypoxia during sleep. Patients with OSAS and insulin resistance had lower levels of serum 25 (OH) D compared with OSAS but without insulin resistance (19.3 ± 11.5 vs 26.7 ± 12.2 ng/mL, respectively, p = 0.005). Regression analysis demonstrated a negative association of 25(OH)D levels (ß = -0.048, odds ratio [OR]: 0.953, 95% confidence interval [CI]: 0.913-0.995, p = 0.030) and a positive association of BMI (ß = 0.110, OR: 1.116, 95% CI: 1.007-1.237, p = 0.036) with insulin resistance. Conclusions: Vit D insufficiency was significantly more frequent among OSAS patients with insulin resistance. Both low 25(OH)D levels and high BMI were associated with the risk of insulin resistance in this population.


Assuntos
Resistência à Insulina/fisiologia , Apneia Obstrutiva do Sono/sangue , Deficiência de Vitamina D/complicações , Vitamina D/análise , Adulto , Distribuição de Qui-Quadrado , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polissonografia/métodos , Fatores de Risco , Sono/fisiologia , Apneia Obstrutiva do Sono/complicações , Estatísticas não Paramétricas , Vitamina D/sangue , Deficiência de Vitamina D/sangue
20.
Medicina (Kaunas) ; 55(5)2019 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-31121922

RESUMO

Background and Objectives: Vitamin D levels have been associated with a diversity of diseases, including obesity. Vitamin D presents a pleiotropic action, and can regulate insulin secretion and inflammatory responses. Vitamin D receptor (VDR) gene polymorphisms are involved in the gene expression regulation and have been associated with type 2 diabetes mellitus (T2DM). This study aimed to evaluate the association between the polymorphisms ApaI (rs7975232), BsmI (rs1544410), FokI (rs10735810), and TaqI (rs731236) in the VDR gene in people diagnosed with T2DM, and plasma 25-hydroxivitamin D levels [25(OH)D]. Materials and Methods: A total of 101 T2DM patients and 62 gender, age, and body mass index (BMI) matched non-diabetic controls were included in this study. Molecular analyzes were performed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The plasma 25(OH)D levels were measured by high performance liquid chromatography. Results: The plasma 25(OH)D levels were lower in T2DM patients (17.2 (16.6) ng/mL) when compared with the control subjects (30.8 (16.2) ng/mL, p < 0.0001), independently of obesity status. We found no difference between genotypic and allelic frequencies of the VDR polymorphisms when comparing the T2DM group and control group (p > 0.05 for all), and did not show any association with plasma 25(OH)D levels. Conclusions: These results suggest that T2DM is associated with lower plasma 25(OH)D levels, which are not related to BMI and VDR gene polymorphisms.


Assuntos
Diabetes Mellitus Tipo 2/sangue , Polimorfismo Genético/fisiologia , Receptores de Calcitriol/genética , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/genética , Adulto , Idoso , Glicemia/análise , Brasil , Estudos de Casos e Controles , Diabetes Mellitus Tipo 2/metabolismo , Jejum/sangue , Feminino , Humanos , Resistência à Insulina/fisiologia , Masculino , Pessoa de Meia-Idade , Receptores de Calcitriol/análise , Receptores de Calcitriol/sangue , Estatísticas não Paramétricas , Vitamina D/análise , Vitamina D/sangue , Deficiência de Vitamina D/sangue
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