ABSTRACT
Summary Objective: To evaluate the stature growth rate (GR) and the weight gain of prepubertal asthmatic children. Method: A retrospective cohort study evaluating medical records of 85 children diagnosed with asthma, aged less than 9 years, of both sexes, with at least one year of follow-up in the allergy outpatient clinic. The data on the disease, weights and heights were collected through a standardized questionnaire on two occasions, with an interval of one year. The curves proposed by Tanner were applied for the analysis of the GR, and the Z-score of the GR (ZGR) was calculated. Results: Excess weight (risk for overweight, overweight and obesity) was observed in 31.8% (27/85) of the patients, but there was no association with the severity of asthma. Low GR (ZGR < -2) was found in 13.9% (11/79) of patients, most frequently among children with moderate/severe persistent asthma compared to persistent mild and intermittent forms (7/11 - 63.6% vs. 21/68 - 30.2%, respectively, p=0.047). Use of steroids (dose, type and time of use) was not associated with GR. Conclusion: GR was most affected in children with moderate/severe asthma.
Resumo Objetivo: Avaliar a velocidade de crescimento estatural e o ganho de peso de crianças asmáticas pré-púberes. Método: Estudo de coorte retrospectiva que avaliou 85 prontuários de crianças com diagnóstico de asma, menores de 9 anos, de ambos os sexos, com no mínimo um ano de acompanhamento no ambulatório de alergia. Os dados relativos à doença, aos pesos e às alturas foram coletados por meio de questionário padronizado em dois momentos com intervalo de um ano. Para análise da velocidade de crescimento (VC), foram empregadas as curvas propostas por Tanner e realizado o cálculo do escore Z da VC (ZVC). Resultados: O excesso de peso (risco para sobrepeso, sobrepeso e obesidade) foi observado em 31,8% (27/85) dos pacientes, mas sem associação com a gravidade da asma. Velocidade de crescimento baixa (ZVC < -2) foi encontrada em 13,9% (11/79) dos pacientes, com maior frequência entre as crianças com asma persistente moderada/grave em relação às formas persistente leve e intermitente (7/11 - 63,6% vs. 21/68 - 30,2%, respectivamente; p=0,047). O uso de corticosteroides (dose, tipo e tempo de uso) não mostrou associação com a VC. Conclusão: Foi constatado um maior comprometimento da VC em crianças com asma moderada/grave.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Asthma/physiopathology , Body Height/physiology , Weight Gain/physiology , Child Development/physiology , Asthma/drug therapy , Time Factors , Nutritional Status/physiology , Retrospective Studies , Risk Factors , Analysis of Variance , Age Factors , Adrenal Cortex Hormones/therapeutic use , Statistics, Nonparametric , Overweight/physiopathologyABSTRACT
Some of the recognized actions of vitamin D include immunological effects such as keeping tolerance and to promote protective immunity. These functions are related to the blocking of B cell differentiation and immunoglobulin secretion as well as decreased production of inflammatory cytokines. The aim of this study was to describe the frequency of vitamin D deficiency in patients with primary immunodeficiencies. We studied 31 patients: 14 with Ataxia-telangiectasia (11 male, mean age 13.1±4.9 years) and 17 with Common variable immunodeficiency (8 males, mean age 28.5±11.3 years). Classification of nutritional status and percentage of fat mass were evaluated. 25-hydroxyvitamin D was analyzed by high performance liquid chromatography and deficiency was considered when 25-hydroxyvitamin D< 20 ng/mL. Malnutrition was the most common nutritional disorder: 7/14 (50%) and 4/17 (23.5%) in Ataxia-telangiectasia and Common variable immunodeficiency groups, respectively. We found a high percentage of 25-hydroxyvitamin D deficiency in the Ataxia-telangiectasia group 6/14 (42.8%) and Common variable immunodeficiency group 3/17 (17.6%). There was no association between vitamin D deficiency and high-sensitivity C-reactive protein, lymphocyte count (CD3, CD4 and CD8) and body fat percentage. Considering the frequency of autoimmune diseases and infections in patients with primary immunodeficiencies, strict monitoring of the vitamin levels are recommended with the aim to reduce morbidity.