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1.
J Steroid Biochem Mol Biol ; 225: 106198, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36181990

RESUMO

To evaluate the effects of long-term vitamin D supplementation on metabolic profiles in middle-aged to elderly patients with type 2 diabetes (T2D), a randomized controlled trial was conducted among patients with T2D aged 50-70 years. A total of 270 patients underwent randomization with 135 being allocated to the vitamin D group and 135 to the control group, and participants in the vitamin D group received oral vitamin D3 (800 IU/day) for 30 months. Serum 25(OH)D and metabolic variables were measured at baseline, and after 6, 12, 18, and 30 months of intervention. After 30 months, the vitamin D group showed a greater increase in serum 25(OH)D than the control group (12.39 ± 6.99 vs 5.35 ± 5.29 ng/ml, P < 0.001). Meanwhile, changes in the levels of fasting insulin, HOMA-IR, non-high-density-lipoprotein cholesterol (non-HDL-C), high-sensitivity C-reactive protein (hs-CRP), and uric acid differed significantly between the two groups (all P < 0.05). Stratified analysis indicated that change in uric acid differed significantly between the two groups in subgroup with baseline 25(OH)D ≥ 20 ng/ml (P = 0.042) or subgroup with female patients (P = 0.034). And the change in fasting blood glucose (FBG) differed significantly between the vitamin D group (-0.30 ± 2.52 mmol/L) and the control group (0.49 ± 1.78 mmol/L, P = 0.049) among patients achieving 25(OH)D concentrations of 30 ng/ml at the end of this trial. A significant difference in the change of triglyceride was observed between the two groups among patients with obesity at baseline [0.05(-0.59, 0.23) vs 0.41(-0.01, 0.80) mmol/L, P = 0.023]. These findings suggested that long-term vitamin D supplementation significantly reduced fasting insulin, HOMA-IR, and serum concentrations of non-HDL-C, hs-CRP, and uric acid among middle-aged to elderly patients with T2D. And vitamin D status, gender, and baseline obesity may modify the effects of vitamin D supplementation.


Assuntos
Diabetes Mellitus Tipo 2 , Resistência à Insulina , Pessoa de Meia-Idade , Idoso , Humanos , Feminino , Vitamina D/uso terapêutico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/metabolismo , Proteína C-Reativa/metabolismo , Ácido Úrico , Glicemia/metabolismo , Suplementos Nutricionais , Vitaminas/uso terapêutico , Insulina/metabolismo , Obesidade , Metaboloma , Método Duplo-Cego
2.
J Steroid Biochem Mol Biol ; 225: 106201, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36210028

RESUMO

Higher 25-hydroxyvitamin D is associated with lower colorectal cancer (CRC) risk, with limited data from African Americans (AAs), who have greater risk for CRC and 25-hydroxyvitamin D deficiency. In a predominantly AA sample of CRC cases from the Southern Community Cohort Study (SCCS), we report associations between vitamin D biomarkers and tumor expression of proteins implicated in vitamin D's anti-tumorigenic pathways (e.g. proliferation and inflammation) and CRC prognosis. SCCS participants with incident CRC were identified via state cancer registries. Serum 25-hydroxyvitamin D and vitamin D binding protein (VDBP) were measured at enrollment. 'Free' 25-hydroxyvitamin D was calculated via standard equation. Cellular Ki67, p53, and COX-2 were measured from tumor samples and categorized using literature-defined cut-points related to survival. Generalized linear models were used to measure associations between vitamin D exposures, tumor biomarkers, and stage. In total, 104 cases (40-79 years) were analyzed. 25-hydroxyvitamin D was not associated with high Ki67 (odds ratio (OR) per 1-standard deviation (SD) increase [95% confidence interval] 1.35[0.86-2.11]), p53 (0.75[0.47-1.20]), or COX-2 expression (1.25[0.78-2.01]), or metastatic disease (1.04[0.59-1.81]). Mean biomarker expression was unrelated to 25-hydroxyvitamin D (p-trend ≥.09). Null associations were observed for VDBP and free 25-hydroxyvitamin D. In AAs (n = 70), higher VDBP was associated with lower odds of high Ki67 expression (0.53[0.28-0.98], p-trend =.04). In conclusion, we observed no associations between 25-hydroxyvitamin D and prognostic marker expression in CRC. An inverse association between VDBP and tumor Ki67 in AAs is consistent with reports showing relationships with reduced CRC mortality.


Assuntos
Neoplasias Colorretais , Proteína Supressora de Tumor p53 , Humanos , Ciclo-Oxigenase 2/genética , Estudos de Coortes , Antígeno Ki-67/genética , Proteína de Ligação a Vitamina D , Calcifediol , Vitaminas , Biomarcadores
3.
Food Chem ; 402: 133922, 2023 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-36162171

RESUMO

In vitro experiments showed that i) phytates, tannins and saponins from pulses can alter vitamin D and K bioavailability and ii) meat decreased vitamin D bioaccessibility by impairing its stability during digestion. We aimed to confirm these results in vivo by force-feeding mice with emulsions containing either potatoes or semolina or chickpeas or meat. Vitamin D and K plasma responses decreased after a gavage with chickpeas or meat compared with potatoes (-62 % and -67 %, respectively for vitamin D, -40 % and -64 %, respectively for vitamin K; p < 0.05). Vitamin D and K intestinal contents were also reduced in mice force-fed with chickpeas or meat compared with potatoes (from -64 to -83 % and from -76 to -84 %, respectively for vitamin D and from -7 to -59 % and from -7 to -90 %, respectively for vitamin K; p < 0.05). The results confirm that chickpea and meat compounds can decrease vitamin D and K bioavailability.


Assuntos
Saponinas , Vitamina D , Camundongos , Animais , Emulsões , Vitaminas , Carne/análise , Amido , Vitamina K , Taninos
4.
Talanta ; 252: 123836, 2023 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-35985191

RESUMO

A glassy carbon electrode was modified with nitrogen and sulfur co-doped graphene quantum dots immobilized in chitosan for the monitoring of multivitamins. The graphene quantum dots were synthesized using a simple citric acid/l-cysteine pyrolysis procedure. The co-doping with nitrogen and sulfur in the graphene matrix was confirmed by spectroscopic techniques. Electron microscopy results showed that the synthesized quantum dots had a diameter of 3.4 ± 1.4 nm. Electrochemical techniques showed excellent current responses to vitamin oxidation provided by the modified electrode compared to the bare electrode. The parameters of square wave voltammetry were optimized in order to obtain the best current responses and to study the electrochemical oxidation of vitamins. The calibration plots for vitamins B2, B6 and B12 were constructed in 0.1 mol L-1 sodium acetate buffer (pH 5.0) with limits of detection of 0.30, 30.1 and 0.32 nmol L-1, respectively. Lastly, the modified electrode was effectively implemented in the quantification of vitamins in classic and fruit-based energy drink samples.


Assuntos
Bebidas Energéticas , Grafite , Pontos Quânticos , Grafite/química , Pontos Quânticos/química , Nitrogênio/química , Eletrodos , Técnicas Eletroquímicas/métodos , Vitaminas , Enxofre , Limite de Detecção
5.
Spectrochim Acta A Mol Biomol Spectrosc ; 286: 122040, 2023 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-36323094

RESUMO

2,4-Dinitroaniline is a multifunctional product and has been applicated in various fields. It has absorbed much concerns due to its large consumption and occurrence in many environmental matrices. It is urgent to explore reliable and sensitive measurement technology. Present study described an outstanding fluorescence sensor constructed with carbon dots (CDs) derived from vitamin B1. The CDs were fabricated by dealing with a facile hydrothermal process, and exhibited good water solubility, fluorescence stability and highly fluorescence quenching characteristics in presence of 2,4-dinitroaniline. The excitation and emission wavelengths of the obtained CDs were 305 and 378 nm, respectively. The sensor displayed good selectivity and sensitivity for 2,4-dinitroaniline. Good linearity can be achieved in two-stage of 0.2-3 µmol L-1 and 3-20 µmol L-1. The sensor earned low detection limit for 2,4-dinitroaniline down to 0.05 µmol L-1. The sensor has been commendably employed for analysis of 2,4-dinitroaniline in real aqueous samples with spiked recoveries in the range of 95.0-99.6%. The proposed sensor provided a promising alternative for analysis of environmental pollutants or other meaningful employment.


Assuntos
Carbono , Pontos Quânticos , Espectrometria de Fluorescência , Corantes Fluorescentes , Tiamina , Limite de Detecção , Vitaminas
6.
Food Chem ; 404(Pt A): 134613, 2023 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-36444022

RESUMO

Acerola is a tropical fruit rich in vitamins, carotenoids, anthocyanins, and bioactive compounds such as ascorbic acid. The production of this fruit has increased over the last few years due to its physiochemical, organoleptic, and nutritional qualities, and has gained importance in the food, pharmaceutical, and chemical industries. The change in the current world scenario, with focus on sustainable development and sustainable use of resources, has powered the search for new techniques that reduce the impact caused on the environment and promote efficient use of resources. In addition, several studies have proven that the by-products of fruit and vegetable processing contain highly nutritious components. Therefore, the objective of this review is to provide information regarding recent studies related to the use and application of the by-products obtained from acerola processing.


Assuntos
Antocianinas , Malpighiaceae , Ácido Ascórbico , Rutina , Vitaminas , Cálcio
7.
J Ethnopharmacol ; 300: 115740, 2023 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-36162549

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Antrodia camphorata is a genus of wood-rot basidiomycete in the family Fomitopsidaceae. It is a valuable medicinal fungus in China that contains more than 78 kinds of active compounds. A. camphorata has good protection effects on the liver, especially on alcoholic liver injury (ALI). AIM: This paper summarizes the complex occurrence and development of alcoholic liver disease (ALD). In addition, the effect of ALD on the intestine through the gut-liver axis is summarized. The protective mechanism of A. camphorata on ALI is reviewed to reveal its therapeutic potential, offering insights into future research. MATERIALS AND METHODS: A comprehensive search in the literature was obtained from books and online databases such as Web of Science, Google Scholar, PubMed, Scopus, Science direct, ACS Publications and Baidu Scholar. RESULTS: The pathogenesis of ALD mainly includes oxidative stress injury, intestinal microflora imbalance, inflammatory mediator injury and nutritional imbalance. A. camphorata contains rich active components (e.g. polysaccharides, triterpenoids, maleic and succinic acid derivatives, amino acids, superoxide dismutase, vitamins, lignin and sterols). These components have good antioxidant, anti-inflammatory and intestinal protection activities. Therefore, A. camphorata has a wide application in the prevention and treatment of ALI. CONCLUSIONS: ALD develops from a mild disease to alcoholic hepatitis and cirrhosis, which is the main reason of global morbidity and mortality. At present, there is no effective drug for the treatment of ALD. A. camphorata, as a valuable medicinal fungus unique to Taiwan, has a great protective effect on the liver. It is expected to be an effective drug for ALI treatment. Although many studies have performed the protective effects of A. camphorata on ALI, its regulatory effects on the gut-liver axis of ALD patients need to be further explored.


Assuntos
Antrodia , Hepatopatias Alcoólicas , Triterpenos , Aminoácidos/metabolismo , Anti-Inflamatórios/farmacologia , Antioxidantes/metabolismo , Antioxidantes/farmacologia , Antioxidantes/uso terapêutico , Antrodia/química , Humanos , Mediadores da Inflamação/metabolismo , Lignina , Hepatopatias Alcoólicas/tratamento farmacológico , Hepatopatias Alcoólicas/prevenção & controle , Polyporales , Esteróis , Succinatos , Superóxido Dismutase/metabolismo , Triterpenos/uso terapêutico , Vitaminas/metabolismo
8.
J Affect Disord ; 320: 390-396, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36183827

RESUMO

BACKGROUND: Evidence suggests that low individual vitamin D levels enhance adverse effects associated with air pollution on mental health conditions. The aim of this study was to identify associations between ambient air pollution exposure, mental health, and serum vitamin D status in the general population of South Korea. METHODS: We included national representative data for 29,373 adults in the final analysis. We measured serum 25-hydroxyvitamin D concentrations to assess vitamin D status for each participant. We assessed mental health factors (i.e., perceived stress, depressive symptoms, and suicidal ideation), and analyzed associations between these factors and individuals' annual average exposures to air pollutants, including particulate matter with an aerodynamic diameter ≤ 10 µm (PM10), nitrogen dioxide (NO2), sulfur dioxide, and carbon monoxide (CO). RESULTS: Using an adjusted model, we found PM10 affected mental health outcomes, such as perceived stress (odds ratio [OR] = 1.04; 95 % confidence interval [CI] = 1.00-1.09), depression symptoms (OR = 1.12; 95 % CI = 1.06-1.18), and suicidal ideation (OR = 1.11; 95 % CI = 1.05-1.17). Effects of the pollutants NO2 and CO were significant only in the group with perceived stress and depressive symptoms. PM10 and NO2 exposures were significantly associated with increased odds of adverse mental health in participants with vitamin D deficiency. LIMITATIONS: Since the cross-sectional design of KNHANES data, it is not possible to evaluate the causal relationship between air pollution exposure, vitamin D status and mental health. CONCLUSIONS: This study results suggest that associations between ambient air pollution and mental health outcomes were stronger in participants with vitamin D deficiency.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Deficiência de Vitamina D , Humanos , Adulto , Dióxido de Nitrogênio/análise , Inquéritos Nutricionais , Estudos Transversais , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Material Particulado/efeitos adversos , Material Particulado/análise , Vitamina D , Vitaminas , Deficiência de Vitamina D/epidemiologia , Avaliação de Resultados em Cuidados de Saúde , Exposição Ambiental/efeitos adversos
9.
Food Chem ; 400: 134069, 2023 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-36108445

RESUMO

This study aimed to examine the impact of sucrose treatment on the growth conditions, dietary nutritional quality, and biological activities of mung bean sprouts. Mung bean seeds were sprouted with solutions containing different sucrose concentrations (10, 20, and 30 g/L). The application of exogenous sucrose significantly decreased the height and fresh weight of mung bean sprouts. However, the sucrose-treated sprouts contained more polyphenols, flavonoids, γ-aminobutyric acid, phytosterols, and vitamins. The antioxidant capacities were also significantly higher in the sucrose-treated sprouts than in the control sprouts. The sprouts treated with 2-3 % sucrose showed markedly improved FFA-induced insulin resistance and alcohol-induced oxidative injury in HepG2 cells. Taken together, the elicitor application of sucrose at 3 % during mung bean sprouting could be an effective strategy to improve the dietary phytochemical composition and provide potential health benefits.


Assuntos
Fitosteróis , Vigna , Antioxidantes/farmacologia , Flavonoides , Compostos Fitoquímicos/farmacologia , Polifenóis , Estresse Fisiológico , Sacarose , Vitaminas , Ácido gama-Aminobutírico
10.
Food Chem ; 398: 133860, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-35964563

RESUMO

Although prime compounds in yeast metabolism, vitamins in oenology have remained mostly unexplored for decades. Here, a premier characterization of the vitamers in white grape musts has been drawn. A RP-HPLC method has therefore been developed for their direct analysis in musts, allowing for the determination of 19 different vitamers from 8 water-soluble vitaminic groups, including thiamine forms T, TMP and TPP, with LODs between 0.1 and 45.9 µg.L-1 and LOQs between 0.4 and 137.8 µg.L-1. A resulting characterization of 85 grape musts has been drawn from their vitaminic composition. Plus, the use of neither sulfites nor filtration affects the must vitamin content. The method stands as a useful tool for the later determination of yeast requirements, or impact of winemaking products on vitamins. The method has, overall, proven as practical and sensitive, for rapid identification of vitamins and vitamers in musts.


Assuntos
Vitaminas , Vitis , Cromatografia Líquida de Alta Pressão/métodos , Saccharomyces cerevisiae , Tiamina/análise , Vitamina A/análise , Vitamina K/análise , Vitaminas/análise
11.
Food Chem ; 398: 133917, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-35987007

RESUMO

The effect of dried and UV-C-irradiated mushroom powder on lipid oxidation and vitamin D content in fish meat was investigated. To this end, Flammulina velutipes, Grifola frondosa, Hypsizygus marmoreus, Lentinula edodes, Pleurotus eryngii, Pleurotus ostreatus were dried by hot air and irradiated by UV-C and evaluated the effect of these treatments on the components. In general, the ergothioneine content did not change substantially, the total phenolic compound content decreased by hot-air drying, and the ergocalciferol content increased by UV-C irradiation. To the evaluate effect of mushroom powder on lipid oxidation and vitamin D content in fish meat, 5% of the hot air dried and UV-C-irradiated mushroom powder was added to fish meat and oxidized. Consequently, all six mushrooms prevented lipid oxidation, and ergocalciferol content in each mushroom powder remained between 58.2% and 69.7%. Overall, P. eryngii, L. edodes, and P. ostreatus strongly prevented the generation of lipid peroxide and aldehyde.


Assuntos
Agaricales , Vitamina D , Agaricales/efeitos da radiação , Animais , Ergocalciferóis , Peixes , Lipídeos , Carne , Pós , Vitaminas
12.
Afr J Prim Health Care Fam Med ; 14(1): e1-e8, 2022 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-36453805

RESUMO

BACKGROUND: Dietary patterns provide comprehensive information about the food consumption habits within a population and how an individual's dietary pattern may change with age. AIM: To evaluate the nutritional status and dietary patterns of the elderly in Thulamela municipality of Vhembe district, Limpopo province. SETTING: Study was conducted in Thulamela municipality of Vhembe district, Limpopo province. METHODS: This study included 300 elderly people recruited from Thulamela municipality of Vhembe district, Limpopo province. The municipality was randomly selected, and convenience sampling was used to choose elderly people. Body weight and height were measured using standard techniques. Body mass index (BMI) was determined and classified using BMI categories. Data on dietary patterns and dietary intake were collected using a food frequency questionnaire. RESULTS: A total of 300 elderly people from villages participated in the study. About 38.6% of elderly people had a primary education, while 28.1% had a secondary education. The prevalence of underweight, overweight and obesity was 2.0%, 34.0% and 17.0%, respectively. Less than half of the elderly people did not meet the reference intake of energy (p = 0.023). More than half of the elderly people did not meet the reference intake of protein, iron, zinc, potassium, calcium and vitamins B1, B12 and C. It was found that 13.7% of the elderly skipped breakfast every day. About 19.6% of the elderly ate supper sometimes, while 13.7% did not eat supper. CONCLUSION: The findings of the study revealed that most of the participants ate three main meals a day, with a minority skipping either breakfast or dinner or eating in between meals. The prevalence of underweight was low and that of overweight and obesity was high.Contribution: Poor food choices and physiological changes may reduce the inclusion of food rich in minerals and vitamins in the elderly's diets and prompt the prevalence of malnutrition.


Assuntos
Estado Nutricional , Magreza , Idoso , Humanos , Magreza/epidemiologia , Sobrepeso/epidemiologia , Dieta , Obesidade/epidemiologia , Vitaminas
13.
Cochrane Database Syst Rev ; 2(2022)2022 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-36321557

RESUMO

BACKGROUND: Description of the condition Malaria, an infectious disease transmitted by the bite of female mosquitoes from several Anopheles species, occurs in 87 countries with ongoing transmission (WHO 2020). The World Health Organization (WHO) estimated that, in 2019, approximately 229 million cases of malaria occurred worldwide, with 94% occurring in the WHO's African region (WHO 2020). Of these malaria cases, an estimated 409,000 deaths occurred globally, with 67% occurring in children under five years of age (WHO 2020). Malaria also negatively impacts the health of women during pregnancy, childbirth, and the postnatal period (WHO 2020). Sulfadoxine/pyrimethamine (SP), an antifolate antimalarial, has been widely used across sub-Saharan Africa as the first-line treatment for uncomplicated malaria sTo examine the effects of folic acid supplementation, at various doses, on malaria susceptibility (risk of infection) and severity among people living in areas with various degrees of malaria endemicity. We will examine the interaction between folic acid supplements and antifolate antimalarial drugs. Specifically, we will aim to answer the following. Among uninfected people living in malaria endemic areas, who are taking or not taking antifolate antimalarials for malaria prophylaxis, does taking a folic acid-containing supplement increase susceptibility to or severity of malaria infection? Among people with malaria infection who are being treated with antifolate antimalarials, does folic acid supplementation increase the risk of treatment failure?Criteria for considering studies for this review Types of studies Inclusion criteria Randomized controlled trials (RCTs) Quasi-RCTs with randomization at the individual or cluster level conducted in malaria-endemic areas (areas with ongoing, local malaria transmission, including areas approaching elimination, as listed in the World Malaria Report 2020) (WHO 2020) Exclusion criteria Ecological studies Observational studies In vivo/in vitro studies Economic studies Systematic literature reviews and meta-analyses (relevant systematic literature reviews and meta-analyses will be excluded but flagged for grey literature screening) Types of participants Inclusion criteria Individuals of any age or gender, living in a malaria endemic area, who are taking antifolate antimalarial medications (inclu


Assuntos
Anemia , Antimaláricos , Antagonistas do Ácido Fólico , Defeitos do Tubo Neural , Criança , Lactente , Gravidez , Recém-Nascido , Feminino , Humanos , Pré-Escolar , Antimaláricos/uso terapêutico , Sulfadoxina/uso terapêutico , Pirimetamina/uso terapêutico , Antagonistas do Ácido Fólico/uso terapêutico , Peso ao Nascer , Parasitemia/tratamento farmacológico , Vitaminas , Ácido Fólico/uso terapêutico , Anemia/tratamento farmacológico , Suplementos Nutricionais , Ferro/uso terapêutico , Recidiva
14.
Medicine (Baltimore) ; 101(43): e31518, 2022 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-36316853

RESUMO

BACKGROUND: Persistent kidney illness in children and those on dialysis therapy, risk of vitamin and mineral deficiencies due to abnormal renal metabolism, anorexia, inadequate intake, poor gastrointestinal absorption, drug-nutrient interaction, and dialysis-related losses. Adequate nutritional management is essential to achieve and maintain an optimal nutritional status for the usual pattern of growth, sexual and neurocognitive development, metabolic abnormalities, and ultimately reducing the risk of chronic mortality and morbidity in adulthood. The purpose of this paper is to describe a protocol for a systematic review to assess the effects of vitamin and mineral supplementation in children with chronic renal disease. METHODS: This systematic review protocol is developed according to the Preferred Reporting Item for Systematic Review and Meta-Analysis Protocols (PRISMA-P) as well as the Cochrane group guidelines. Comprehensive searching for all possible relevant works of literature- such as PubMed, Google Scholar, MEDLINE, Embase, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), Science-Direct, Scopus, Research-Gate, Clinical Trials for all randomized controlled studies, full paper articles, and articles written in English will be considered. The primary outcome of this review will be measuring any changes (such as changes in body mass, BMI, and overall Z-score) in the nutritional status of the children (age < 18 years) with chronic kidney disease following vitamin and mineral supplementations. This review will help better understand the effects of vitamin and mineral supplementation to improve nutritional status in CKD children and will create a guideline to determine the applicability of these interventions in different feasible settings. CONCLUSION: The systematic review protocol has been evaluated and approved by the institutional review board of North South University. Finding will be shared using traditional approaches, including scientific presentations, open-access peer-reviewed platforms. PROSPERO REGISTERED NUMBER: CRD42022341339.


Assuntos
Insuficiência Renal Crônica , Vitaminas , Criança , Humanos , Adulto , Adolescente , Vitaminas/uso terapêutico , Estado Nutricional , Diálise Renal , Revisões Sistemáticas como Assunto , Metanálise como Assunto , Insuficiência Renal Crônica/terapia , Insuficiência Renal Crônica/tratamento farmacológico , Suplementos Nutricionais , Minerais , Literatura de Revisão como Assunto
17.
Arch Endocrinol Metab ; 66(5): 748-755, 2022 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-36382764

RESUMO

Vitamin D deficiency is a general health problem affecting individuals at all stages of life and on different continents. The musculoskeletal effects of vitamin D are well known. Its deficiency causes rickets, osteomalacia, and secondary hyperparathyroidism and increases the risk of fractures. Clinical and experimental evidence suggests that vitamin D performs multiple extraskeletal functions. Several tissues unrelated to calcium and phosphate metabolism express vitamin D receptor (VDR) and are directly or indirectly influenced by 1,25(OH)2D (calcitriol). Some also express the enzyme 1 alpha-hydroxylase (CYP27B1) and produce 1,25(OH)2D, inducing autocrine or paracrine effects. Among the pleiotropic effects of vitamin D are the regulation of cell proliferation and differentiation, hormone secretion, and immune function. In this review, we outline vitamin D physiology and the outcomes of recent large RCTs on its potential extraskeletal effects. Those studies exhibit a need for continued clinical analysis to elucidate whether vitamin D status can influence extraskeletal health. Longer longitudinal follow-up and standardized assays are crucial to better assess potential outcomes.


Assuntos
Raquitismo , Deficiência de Vitamina D , Humanos , Vitamina D/metabolismo , Deficiência de Vitamina D/complicações , Calcitriol , Vitaminas
18.
BMC Nephrol ; 23(1): 362, 2022 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-36368937

RESUMO

INTRODUCTION: Extended-release calcifediol (ERC), active vitamin D hormones and analogs (AVD) and nutritional vitamin D (NVD) are commonly used therapies for treating secondary hyperparathyroidism (SHPT) in adults with stage 3-4 chronic kidney disease (CKD) and vitamin D insufficiency (VDI). Their effectiveness for increasing serum total 25-hydroxyvitamin D (25D) and reducing elevated plasma parathyroid hormone (PTH), the latter of which is associated with increased morbidity and mortality, has varied across controlled clinical trials. This study aimed to assess real-world experience of ERC and other vitamin D therapies in reducing PTH and increasing 25D. METHODS: Medical records of 376 adult patients with stage 3-4 CKD and a history of SHPT and VDI from 15 United States (US) nephrology clinics were reviewed for up to 1 year pre- and post-ERC, NVD or AVD initiation. Key study variables included patient demographics, concomitant usage of medications and laboratory data. The mean age of the study population was 69.5 years, with gender and racial distributions representative of the US CKD population. Enrolled patients were grouped by treatment into three cohorts: ERC (n = 174), AVD (n = 55) and NVD (n = 147), and mean baseline levels were similar for serum 25D (18.8-23.5 ng/mL), calcium (Ca: 9.1-9.3 mg/dL), phosphorus (P: 3.7-3.8 mg/dL) and estimated glomerular filtration rate (eGFR: 30.3-35.7 mL/min/1.73m2). Mean baseline PTH was 181.4 pg/mL for the ERC cohort versus 156.9 for the AVD cohort and 134.8 pg/mL (p < 0.001) for the NVD cohort. Mean follow-up during treatment ranged from 20.0 to 28.8 weeks. RESULTS: Serum 25D rose in all cohorts (p < 0.001) during treatment. ERC yielded the highest increase (p < 0.001) of 23.7 ± 1.6 ng/mL versus 9.7 ± 1.5 and 5.5 ± 1.3 ng/mL for NVD and AVD, respectively. PTH declined with ERC treatment by 34.1 ± 6.6 pg/mL (p < 0.001) but remained unchanged in the other two cohorts. Serum Ca increased 0.2 ± 0.1 pg/mL (p < 0.001) with AVD but remained otherwise stable. Serum alkaline phosphatase remained unchanged. CONCLUSIONS: Real-world clinical effectiveness and safety varied across the therapies under investigation, but only ERC effectively raised mean 25D (to well above 30 ng/mL) and reduced mean PTH levels without causing hypercalcemia.


Assuntos
Hiperparatireoidismo Secundário , Insuficiência Renal Crônica , Adulto , Humanos , Idoso , Calcifediol/uso terapêutico , Vitamina D , Hiperparatireoidismo Secundário/tratamento farmacológico , Hiperparatireoidismo Secundário/etiologia , Vitaminas/uso terapêutico , Hormônio Paratireóideo , Insuficiência Renal Crônica/tratamento farmacológico , Insuficiência Renal Crônica/epidemiologia , Cálcio
19.
Sci Rep ; 12(1): 19397, 2022 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-36371591

RESUMO

Vitamin D deficiency has long been associated with reduced immune function that can lead to viral infection. Several studies have shown that Vitamin D deficiency is associated with increases the risk of infection with COVID-19. However, it is unknown if treatment with Vitamin D can reduce the associated risk of COVID-19 infection, which is the focus of this study. In the population of US veterans, we show that Vitamin D2 and D3 fills were associated with reductions in COVID-19 infection of 28% and 20%, respectively [(D3 Hazard Ratio (HR) = 0.80, [95% CI 0.77, 0.83]), D2 HR = 0.72, [95% CI 0.65, 0.79]]. Mortality within 30-days of COVID-19 infection was similarly 33% lower with Vitamin D3 and 25% lower with D2 (D3 HR = 0.67, [95% CI 0.59, 0.75]; D2 HR = 0.75, [95% CI 0.55, 1.04]). We also find that after controlling for vitamin D blood levels, veterans receiving higher dosages of Vitamin D obtained greater benefits from supplementation than veterans receiving lower dosages. Veterans with Vitamin D blood levels between 0 and 19 ng/ml exhibited the largest decrease in COVID-19 infection following supplementation. Black veterans received greater associated COVID-19 risk reductions with supplementation than White veterans. As a safe, widely available, and affordable treatment, Vitamin D may help to reduce the severity of the COVID-19 pandemic.


Assuntos
COVID-19 , Deficiência de Vitamina D , Humanos , Pandemias , Suplementos Nutricionais , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/tratamento farmacológico , Deficiência de Vitamina D/epidemiologia , Colecalciferol , Vitamina D/uso terapêutico , Vitaminas/uso terapêutico
20.
Cochrane Database Syst Rev ; 11: CD013521, 2022 11 14.
Artigo em Inglês | MEDLINE | ID: mdl-36373961

RESUMO

BACKGROUND: Smith-Lemli-Opitz syndrome (SLOS) is a multiple congenital malformations syndrome caused by defective cholesterol biosynthesis. Affected individuals show cholesterol deficiency and accumulation of various precursor molecules, mainly 7-dehydrocholesterol and 8-dehydrocholesterol. There is currently no cure for SLOS, with cholesterol supplementation being primarily a biochemical therapy of limited evidence. However, several anecdotal reports and preclinical studies have highlighted statins as a potential therapy for SLOS. OBJECTIVES: To evaluate the effects of statins, either alone or in combination with other non-statin therapies (e.g. cholesterol, bile acid, or vitamin co-supplementation), compared to cholesterol supplementation alone or in combination with other non-statin therapies (e.g. bile acid or vitamin supplementation) on several important outcomes including overall survival, neurobehavioral features, and adverse effects in individuals with SLOS. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, five other databases and three trials registers on 15 February 2022, together with reference checking, citation searching and contact with study authors to identify additional studies. SELECTION CRITERIA: Randomized controlled trials (RCTs) and quasi-RCTs with parallel or cross-over designs, and non-randomized studies of interventions (NRSIs) including non-randomized trials, cohort studies, and controlled before-and-after studies, were eligible for inclusion in this review if they met our prespecified inclusion criteria, i.e. involved human participants with biochemically or genetically diagnosed SLOS receiving statin therapy or cholesterol supplementation, or both. DATA COLLECTION AND ANALYSIS: Two authors screened titles and abstracts and subsequently full-texts for all potentially-relevant references. Both authors independently extracted relevant data from included studies and assessed the risks of bias. We analyzed the data extracted from the included NRSIs and cohort studies separately from the data extracted from the single included RCT. We used a random-effects model to account for the inherent heterogeneity and methodological variation between these different study designs. We used GRADE to assess the certainty of evidence. MAIN RESULTS: We included six studies (61 participants with SLOS); one RCT (N = 18), three prospective NRSIs (N = 20), and two retrospective NRSIs (N = 22). Five studies included only children, and two limited their participant inclusion by disease severity. Overall, there were nearly twice as many males as females. All six studies compared add-on statin therapy to cholesterol supplementation alone. However, the dosages, formulations, and durations of treatment were highly variable across studies. We judged the RCT as having a high risk of bias due to missing data and selective reporting. All included NRSIs had a serious or critical overall risk of bias assessed by the Risk Of Bias In Non-randomized Studies of Interventions tool (ROBINS-I). None of the included studies evaluated survival or reported quality of life (QoL). Only the included RCT formally assessed changes in the neurobehavioral manifestations of SLOS, and we are uncertain whether statin therapy improves this outcome (very low-certainty evidence). We are also uncertain whether the adverse events reported in the RCT were statin-related (very low-certainty evidence). In contrast, the adverse events reported in the NRSIs seem to be possibly due to statin therapy (risk ratio 13.00, 95% confidence interval 1.85 to 91.49; P = 0.01; low-certainty evidence), with only one of the NRSIs retrospectively mentioning changes in the irritability of two of their participants. We are uncertain whether statins affect growth based on the RCT or NRSI results (very low-certainty evidence). The RCT showed that statins may make little or no difference to plasma biomarker levels (low-certainty evidence), while we are uncertain of their effects on such parameters in the NRSIs (very low-certainty evidence). AUTHORS' CONCLUSIONS: Currently, there is no evidence on the potential effects of statin therapy in people with SLOS regarding survival or QoL, and very limited evidence on the effects on neurobehavioral manifestations. Likewise, current evidence is insufficient and of very low certainty regarding the effects of statins on growth parameters in children with SLOS and plasma or cerebrospinal fluid (CSF) levels of various disease biomarkers. Despite these limitations, current evidence seemingly suggests that statins may increase the risk of adverse reactions in individuals with SLOS receiving statins compared to those who are not. Given the insufficient evidence on potential benefits of statins in individuals with SLOS, and their potential for causing adverse reactions, anyone considering this therapy should take these findings into consideration. Future studies should address the highlighted gaps in evidence on the use of statins in individuals with SLOS by collecting prospective data on survival and performing serial standardized assessments of neurobehavioral features, QoL, anthropometric measures, and plasma and CSF biomarker levels after statin introduction. Future studies should also attempt to use consistent dosages, formulations and durations of cholesterol and statin therapy.


Assuntos
Inibidores de Hidroximetilglutaril-CoA Redutases , Síndrome de Smith-Lemli-Opitz , Criança , Feminino , Humanos , Masculino , Ácidos e Sais Biliares , Colesterol , Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Síndrome de Smith-Lemli-Opitz/tratamento farmacológico , Vitaminas , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Cross-Over
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