ABSTRACT
RESUMEN La deficiencia de vitamina D en la población general se considera un importante problema en salud pública. Esta vitamina tiene un papel central en el metabolismo cálcico, por lo que el aporte adecuado, a través de la dieta o por síntesis cutánea, es esencial para la salud. Nos propusimos analizar el comportamiento de la vitamina D en mujeres adultas que concurren a la Clínica Tajy de Encamación, Paraguay. Además, determinar la prevalencia de hipovitaminosis, su relación con el metabolismo fosfocálcico y su asociación con factores de riesgo cardiovascular. Se estudiaron 120 mujeres, 61 pre-menopaúsicas y 59 pos-menopaúsicas, que asistieron al Laboratorio Tajy de Encarnación Paraguay desde enero del 2.015 hasta marzo del 2.016. Se tomaron muestras de sangre y datos de peso, talla, circunferencia de cintura y presión arterial. Fueron excluidas mujeres embarazadas, con diabetes, hipertensión, nefropatías, neoplasias, patologías tiroideas, procesos inflamatorios o infecciosos, que se encontraban bajo tratamiento o suplemento de cualquier tipo. El 72% de estas mujeres presentaron hipovitaminosis D (< 30 ng/ml), un 38% eran pre menopáusicas, destacando que dentro de esta población se halló el mayor porcentaje de mujeres con deficiencia severa, y un 39% eran pos-menopáusicas. Se encontró diferencia significativa (p<0,001) entre pre y post menopáusicas en edad, presión arterial sistólica, circunferencia de cintura, glucemia, colesterol-HDL, triglicéridos e índice TG/col-HDL, y concentración de calcio y fosforo (p< 0,001). La concentración de vitamina se correlacionó significativamente con circunferencia de cintura, concentración de calcio y fósforo (p<0.001). 67 mujeres con obesidad abdominal tuvieron hipovitaminosis D, presentando 15 veces más riesgo que aquellas con circunferencia <88 cm. El 72% de las mujeres estudiadas presentaron hipovitaminosis D, un 38% eran mujeres pre menopáusicas y 39% pos-menopáusicas. Esta hipovitaminosis D presentó correlación significativa con las concentraciones de calcio y fosforo, edad, presión arterial sistólica, glucemia y col-HDL y asociación significativa con obesidad abdominal.
ABSTRACT in adult women who attend the Tajy Clinic in Encarnación, Republic of Paraguay. To determine the prevalence of hypovitaminosis and the relationship that exists with phosphocalcic metabolism, as well as to evaluate the association of cardiovascular risk factors to hypovitaminosis D in this population of women. 120 women were studied, 61 pre-menopausal and 59 in post-menopause. With median and 25 and 75 percentiles for age 48 (35-62), who attended the Tajy Laboratory in Encamación Paraguay from January 2015 to March 2016. Blood samples were taken and a survey was carried out in order to collect information on those covariates that may influence the variables of interest and where all have signed a consent. Pregnant women, women with diabetes, with hypertension, nephropathies, neoplastic diseases, thyroid diseases, inflammatory or infectious processes, who are under treatment or supplement of any kind were excluded. We obtained data on weight, height, waist circumference and blood pressure. A blood extraction with fasting of 12 hours was performed for biochemical determinations. All samples were processed with internal and external quality control. It was found that 72% of these women had hypovitaminosis D (< 30 ng/ml) , where 38% were pre-menopausal, highlighting that within this population the highest percentage of women with severe vitamin D deficiency was found and 39% were post-menopausal. A statistically significant difference was found (p <0.001) with age, systolic blood pressure, waist circumference, glycemia, HDL-cholesterol concentration, triglyceride concentration and TG / HDL-col index, as well as calcium and phosphorus (p <0.001). It was found that the concentration of vitamin D had a significant correlation with the measurement of waist circumference, calcium and phosphorus concentration (p <0.001). It was found that 67 women with abdominal obesity had low vitamin D levels (<20 ng / ml), those with abdominal obesity had 15 times more risk of hypovitaminosis D than those with a waist circumference of <88 cm. Through this research, and analyzing the behavior of vitamin D concentration in pre and post menopausal women, we found that 72% of them presented hypovitaminosis D, in which 38% were pre-menopausal women and 39% were menopausal This hypovitaminosis D has a significant correlation with calcium and phosphorus concentrations, as well as with other variables such as age, systolic blood pressure, glycemia and HDL cholesterol concentration. Vitamin D deficiency has a significant association with abdominal obesity in this population of women.