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2.
Int. braz. j. urol ; 48(2): 316-325, March-Apr. 2022. tab, graf
Article in English | LILACS | ID: biblio-1364940

ABSTRACT

ABSTRACT Purpose: Overactive bladder (OAB) is a common syndrome associated with lower urinary tract symptoms (LUTS), especially urinary incontinence in children, which may affect the patient's quality of life (QoL). Vitamin D deficiency has been shown to be associated with OAB syndrome. This study evaluated the relationship between vitamin D status and OAB-related symptoms and QoL in children. Materials and Methods: The study included 52 pediatric patients with OAB-related urinary incontinence and 41 healthy children. LUTS were assessed using the Dysfunctional Voiding and Incontinence Symptoms Score (DVISS) questionnaire, and QoL was assessed using the Pediatric Incontinence Questionnaire (PINQ). Oral vitamin D supplementation was given to patients with OAB with vitamin D deficiency. Urinary symptoms and QoL were evaluated before and after vitamin D supplementation. Results: Vitamin D deficiency was more common in the OAB group (75%) than in the control group (36.6%). Logistic regression analysis revealed that vitamin D status (<20ng/mL) was a significant predictor of OAB. Both pre-treatment and post-treatment DVISS and PINQ scores showed a positive correlation. After vitamin D supplementation, 8 (23.5%) patients had a complete response and 19 (55.9%) patients had a partial response. Significant improvement in QoL was also achieved. Conclusions: Vitamin D deficiency is more common in children with urinary incontinence and OAB than in healthy children. Although vitamin D deficiency is not routinely evaluated for every patient, it should be evaluated in treatment-resistant OAB cases. Vitamin D supplementation may improve urinary symptoms and QoL in patients with OAB.


Subject(s)
Humans , Child , Urinary Incontinence/complications , Vitamin D Deficiency/complications , Urinary Bladder, Overactive/complications , Urinary Bladder, Overactive/etiology , Quality of Life , Surveys and Questionnaires
3.
Mediterr J Pharm Pharm Sci ; 2(1): 55-64, 2022.
Article in English | AIM, AIM | ID: biblio-1366191

ABSTRACT

Aging seldom comes alone and it is considered to be the major factor for many diseases and comorbidities and disabilities. The objectives of the study are to examine demographic characteristics and prevalence of comorbidities and polypharmacy of elderly patients who were admitted at Sebha Medical Center according to the selected period. This study is descriptive and retrospective cross-sectional study conducted in Sebha during 2021. From 195 participants of the study, the highest rate of patients was from the age group of 65 - 74 years which accounted for 86 participants (44%) and followed by those age group of 75 - 84 years which was reported by 65 participants (33%). The majority of elderly patients have hypertension, (n = 116, 59%) and over one-third of the patients (n = 73, 37%) have diabetes mellitus while nearly one-quarter of patients have both diseases at the same time (n = 47, 24%). Nearly, three-quarters of patients have electrolytes imbalance (n = 142,72%). Nearly, two-thirds of the patients had three to five comorbidity diseases (n = 122, 63%). Whereas, over one-third of the patients had just one or two comorbidities (n = 70, 36%). Almost all the participants have polypharmacy (n = 187, 96%). Just above half of the patients have five - ten medications (n = 100, 51%) compared with 45% of the patients from those who have more than ten medications (n = 87). This study showed that there is a strong relationship between the prevalence of polypharmacy and the number of comorbidities. A Spearman correlation test indicated that rate of comorbidities was related to polypharmacy with a significant correlation (P < 0.01). The present study found high prevalence of comorbidities and polypharmacy among elderly inpatients. Based on this high prevalence, practicing pharmaceutical care could play an effective role to reduce the risk of inappropriate polypharmacy among hospitalized elderly patients through encouraging clinical pharmacist to engage in clinical activities in hospitals


Subject(s)
Students, Medical , Vitamin D Deficiency , Prevalence , Vitamin D
4.
Article in English | AIM, AIM | ID: biblio-1367376

ABSTRACT

Background: Age, body mass index (BMI) and pre-existing comorbidities are known risk factors of severe coronavirus disease 2019 (COVID-19). In this study we explore the relationship between vitamin D status and COVID-19 severity. Methods: We conducted a prospective, cross-sectional descriptive study. We enrolled 100 COVID-19 positive patients admitted to a tertiary level hospital in Johannesburg, South Africa. Fifty had symptomatic disease (COVID-19 pneumonia) and 50 who were asymptomatic (incidental diagnosis). Following written informed consent, patients were interviewed regarding age, gender and sunlight exposure during the past week, disease severity, BMI, calcium, albumin, magnesium and alkaline phosphatase levels. Finally, blood was collected for vitamin D measurement. Results: We found an 82% prevalence rate of vitamin D deficiency or insufficiency among COVID-19 patients. Vitamin D levels were lower in the symptomatic group (18.1 ng/mL ± 8.1 ng/mL) than the asymptomatic group (25.9 ng/mL ± 7.1 ng/mL) with a p-value of 0.000. The relative risk of symptomatic COVID-19 was 2.5-fold higher among vitamin D deficient patients than vitamin D non-deficient patients (confidence interval [CI]: 1.14­3.26). Additional predictors of symptomatic disease were older age, hypocalcaemia and hypoalbuminaemia. Using multiple regression, the only independent predictors of COVID-19 severity were age and vitamin D levels. The patients exposed to less sunlight had a 2.39-fold increased risk for symptomatic disease compared to those with more sunlight exposure (CI: 1.32­4.33). Conclusion: We found a high prevalence of vitamin D deficiency and insufficiency among patients admitted to hospital with COVID-19 and an increased risk for symptomatic disease in vitamin D deficient patients.


Subject(s)
Vitamin D Deficiency , Comorbidity , COVID-19 Serological Testing , SARS-CoV-2 , COVID-19 , Diagnosis , Asymptomatic Infections
5.
Ciênc. Saúde Colet ; 27(2): 653-663, Fev. 2022. tab
Article in English, Portuguese | LILACS | ID: biblio-1356077

ABSTRACT

Resumo O objetivo deste artigo é analisar a insuficiência de vitamina D e fatores associados em idosos assistidos na atenção primária à saúde. Trata-se de um estudo transversal que avaliou 533 idosos (≥ 60 anos) em três cidades do estado de São Paulo, Brasil. Foi avaliada a 25-hidroxivitamina D (25 OH D) sérica por quimioluminescência. Os fatores avaliados foram condições sociodemográficas (sexo, faixa etária, etnia, escolaridade, renda, estado civil), de saúde (doenças referidas), composição corporal (IMC, circunferência da cintura), estilo de vida (atividade física e tabagismo) e exposição solar (finalidade, duração, frequência e horário de exposição, partes expostas, uso de protetor solar, tipo de pele). A prevalência de insuficiência foi de 64,5%, com associação para sexo feminino, etnia não brancos/não declarados, baixo peso, circunferência da cintura elevada (risco para DCV) e inatividade física. Houve associação negativa para exposição solar habitual de mãos, braços e pernas, durante atividade de lazer, deslocamentos diários e atividade física e entre as 9h e 15h. Os achados mostram a relevância de fatores como sexo, etnia, composição corporal, atividade física e hábitos de exposição solar na alta prevalência de níveis inadequados de vitamina D em idosos.


Abstract This article aims to analyze vitamin D insufficiency and factors associated among older adults using primary health care services. This is a cross-sectional study that evaluated 533 older adults individuals (≥ 60 years old) in three cities in the state of São Paulo, Brazil. Serum level of 25-hydroxyvitamin D (25-OHD) was evaluated by chemiluminescence. The factors evaluated were sociodemographic information (sex, age group, ethnicity, education, income, marital status), health conditions (reported diseases), body composition (BMI, waist circumference), lifestyle (physical activity and smoking), and sun exposure (purpose, duration, frequency, time of exposure, exposed body parts, use of sunscreen, skin type). The prevalence of vitamin D insufficiency was 64.5%, presenting association with female participants, non-white/unreported ethnicity, low weight, high waist circumference (risk for CVD - cardiovascular disease), and physical inactivity. Negative association was observed with habitual sun exposure of hands, arms and legs, during leisure activities, daily commuting and physical activity, and between 9 am and 3 pm. The findings show the relevance of factors such as sex, ethnicity, body composition, physical activity, and sun exposure habits in the high prevalence of inadequate levels of vitamin D among older adults.


Subject(s)
Humans , Female , Aged , Vitamin D Deficiency/epidemiology , Primary Health Care , Vitamin D , Brazil/epidemiology , Cross-Sectional Studies , Middle Aged
6.
Rev. Col. Bras. Cir ; 49: e20223054, 2022. tab, graf
Article in English | LILACS | ID: biblio-1365396

ABSTRACT

ABSTRACT Objective: to evaluate the relationship between 25(OH)D3 levels and fatal outcome in patients over 60 years of age undergoing surgical repair of hip fractures. Methods: prospective cohort of patients undergoing surgical repair of hip fractures. At admission, 25(OH)D3 levels were measured, among other parameters. Patients were followed for at least 1 year, and incident mortality was recorded. Results: 209 patients were included in the study, with a mean age of 79.5 ± 7.6 years among survivors and 80.7 ± 8.2 years among those who died in the first postoperative year (p=0.346). The 25(OH)D3 levels of survivors were significantly higher than those of patients who died (p=0.003). After adjusting for confounding variables, 25(OH)D3 levels below 12.5ng/mL were significant risk factors regardless of mortality (adjusted OR: 7.6; 95% CI: 2.35 to 24.56). Conclusions: our data show that serum 25(OH)D3 levels below 12.5ng/mL significantly and independently increased the risk of mortality in the first year after surgical repair of low-energy hip fracture in patients over 60 years of age in the geographic region where this study was conducted. Low albumin also showed a significant association with mortality in these patients. All other factors had no significant associations.


RESUMO Objetivo: avaliar a relação entre os níveis de 25(OH)D3 e o desfecho fatal em pacientes acima de 60 anos submetidos a correção cirúrgica de fratura de quadril. Métodos: coorte prospectiva de pacientes submetidos a correção cirúrgica de fraturas de quadril. À admissão, foram medidos os níveis de 25(OH)D3, entre outros parâmetros. Os pacientes foram acompanhados por, pelo menos, um ano e a mortalidade foi registrada. Resultados: foram incluídos 209 pacientes no estudo, com média de idade de 79,5 ± 7,6 anos entre os sobreviventes e 80,7 ± 8,2 anos entre os que morreram no primeiro ano de pós-operatório (p=0,346). Os níveis de 25(OH)D3 dos sobreviventes foram significativamente maiores do que os dos pacientes que morreram (p=0,003). Após o ajuste para variáveis de confusão, níveis de 25(OH)D3 abaixo de 12,5ng/mL foram fator de risco significativo, independentemente da mortalidade (OR ajustado 7,6; IC 95% 2,35 24,56). Conclusões: níveis séricos de 25(OH)D3 abaixo de 12,5ng/mL aumentaram significativa e independentemente o risco de morte no primeiro ano após o reparo cirúrgico de fratura de quadril de baixa energia em pacientes com mais de 60 anos de idade na região geográfica onde este estudo foi realizado. A albumina baixa também teve associação significativa com a mortalidade nesses pacientes. Todos os outros fatores não tiveram associações significativas.


Subject(s)
Humans , Aged , Aged, 80 and over , Vitamin D Deficiency/complications , Hip Fractures/surgery , Vitamin D , Prospective Studies , Risk Factors , Cohort Studies , Middle Aged
7.
Cad. Saúde Pública (Online) ; 38(1): e00287820, 2022. tab
Article in English | LILACS | ID: biblio-1355982

ABSTRACT

This study aims to investigate factors associated with serum 25-hydroxyvitamin D [25(OH)D] concentration in Brazilian adults considering sociodemographic and lifestyle factors, as well as vitamin D-related single nucleotide polymorphisms (SNPs). This is a cross-sectional study (n = 491; 34-79y; 251 women), nested within a prospective cohort (Pró-Saúde Study). Associations between serum 25(OH)D and sociodemographic characteristics, diet, use of supplement, physical activity, season of blood collection, body fat, skin type, sun exposure index, and SNPs CYP2R1-rs10741657 and GC-rs2282679 were explored by multiple linear regression. The prevalence of serum 25(OH)D < 50nmol/L was 55%. Serum 25(OH)D was lower among women (β = -4.38; 95%CI: -8.02; -0.74), those with higher visceral fat (β = -4.02; 95%CI: -5.92; -2.12), and those with AC and CC genotypes for GC-rs2282679 (β = -6.84; 95%CI: -10.09; -3.59; β = -10.63; 95%CI: -17.52; -3.74, respectively). Factors directly associated with serum 25(OH)D included summer (β = 20.14; 95%CI: 14.38; 25.90), intermediate skin type (β = 6.16; 95%CI: 2.52; 9.80), higher sun exposure (β = 0.49; 95%CI: 0.22; 0.75), vitamin D intake (β = 0.48; 95%CI: 0.03; 0.93), and physical activity (β = 4.65; 95%CI: 1.54; 7.76). Besides physical activity, diet, and sun exposure, non-modifiable factors, such as GC genotypes must be considered when evaluating vitamin D insufficiency in mixed-race populations. Moreover, high visceral fat in association with poorer vitamin D status deserve attention given that both conditions are unfavorably related with chronic and acute health outcomes.


Este estudo teve como objetivo investigar fatores associados com as concentrações séricas de 25-hidroxivitamina [25(OH)D] em adultos brasileiros de acordo com fatores sociodemográficos e de estilo de vida, assim como de polimorfismos de nucleotídeo único (SNPs) relacionados à vitamina D. Este é um estudo transversal (n = 491; 34-79 anos; 251 mulheres) aninhado em uma coorte prospectiva (Estudo Pró-Saúde). Associações entre a 25(OH)D sérica e características sociodemográficas, consumo alimentar, uso de suplementos, atividade física, estação do ano na coleta da amostra de sangue, gordura corporal, fototipo de pele, índice de exposição solar e SNPs CYP2R1-rs10741657 e GC-rs2282679, explorados por regressão multilinear. A prevalência de 25(OH)D sérica < 50nmol/L foi 55%. A concentração sérica de 25(OH)D foi menor entre mulheres (β = -4,38; IC95%: -8,02; -0,74), indivíduos com mais gordura visceral (β = -4,02; IC95%: -5,92; -2,12) e genótipos AC e CC para GC-rs2282679 (β = -6,84; IC95%: -10,09; -3,59 e β = -10,63; IC95%: -17,52; -3,74, respectivamente). Os fatores associados diretamente à 25(OH)D sérica incluíram os meses de verão (β = 20,14; IC95%: 14,38; 25,90), fototipo intermediário (β = 6,16; IC95%: 2,52; 9,80), maior exposição solar (β = 0,49; IC95%: 0,22; 0,75), ingestão de vitamina D (β = 0,48; IC95%: 0,03; 0,93) e atividade física (β = 4,65; IC95%: 1,54; 7,76). Além de atividade física, dieta e exposição solar, fatores não modificáveis, tais como variantes do gene GC devem ser considerados na avaliação da deficiência de vitamina D em populações miscigenadas. Além disso, merece atenção a associação entre a gordura visceral elevada e o pior estado de vitamina D, uma vez que ambas as condições implicam em desfechos de saúde desfavoráveis, tanto crônicos quanto agudos.


Nuestro objetivo fue investigar factores asociados con la concentración sérica 25-hidroxivitamina D [25(OH)D] en adultos brasileños, considerando factores sociodemográficos y de vida, así como también los polimorfismos de nucleótido único relacionados con la vitamina D (SNPs). Se trata de un estudio transversal (n = 491; 34-79 años; 251 mujeres), anidado dentro de una cohorte prospectiva (Estudio Pro-Salud). Se investigaron las asociaciones entre concentración sérica 25(OH)D y características sociodemográficas, ingesta alimentaria, uso de suplementos, actividad física, estación del año de recogida de muestras de sangre, grasa corporal, tipo de piel, índice de exposición al sol, y SNPs CYP2R1-rs10741657 y GC-rs2282679 mediante una regresión múltiple lineal. La prevalencia sérica 25(OH)D < 50nmol/L fue 55%. La 25(OH)D sérica fue menor entre las mujeres (β = -4,38; IC95%: -8,02; -0,74), quienes tenían alta grasa visceral (β = -4,02; IC95%: -5,92; -2,12), genotipos AC y CC para GC-rs2282679 (β = -6,84; IC95%: -10,09; -3,59 y β = -10,63; IC95%: -17,52; -3,74, respectivamente). Los factores directamente asociados con la concentración sérica 25(OH)D incluyeron verano (β = 20,14; IC95%: 14,38; 25,90), tipo de piel intermedia (β = 6,16; IC95%: 2,52; 9,80), más alta exposición al sol (β = 0,49; IC95%: 0,22; 0,75), toma de vitamina D (β = 0,48; IC95%: 0,03; 0,93) y actividad física (β = 4,65; IC95%: 1,54; 7,76). Además de la actividad física, dieta y exposición al sol, los factores no modificables, tales como genotipos GC, necesitan tenerse en cuenta cuando se está evaluando la insuficiencia de vitamina D en poblaciones mestizas. Asimismo, las implicaciones de la asociación de una alta grasa visceral con un estatus más pobre de vitamina D merece que se le preste atención, puesto que ambas condiciones de salud están relacionadas desfavorablemente con resultados de salud graves y crónicos.


Subject(s)
Humans , Female , Adult , Vitamin D-Binding Protein/genetics , Vitamin D Deficiency/genetics , Vitamin D Deficiency/epidemiology , Seasons , Vitamin D/analogs & derivatives , Brazil , Cross-Sectional Studies , Prospective Studies , Life Style
8.
Rev. bras. ortop ; 56(6): 784-789, Nov.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1357136

ABSTRACT

Abstract Objective To measure the levels of vitamin D in patients hospitalized for fractures and to evaluate its relationship with fractures. Methods A primary, analytical, cross-sectional, non-interventional, observational, controlled study was conducted in humans. The serum measurement of: vitamin D, parathyroid hormone (PTH), calcium, phosphorus, magnesium and albumin was performed in 49 patients who were consecutively hospitalized for surgery due to fracture(s) (study group), and in 50 patients without fractures, from the various outpatient clinics, and who underwent routine tests (control group). Results The mean level of 25-hydroxyvitaminD (25[OH]D) in patients with fractures was of 23.78 ± 8.01 ng/mL (61.22% of patients with fractures had hypovitaminosis D). The mean 25(OH)D of the control group was of 37.52 ± 9.21 ng/mL (10% of the patients had hypovitaminosis D). Most cases of hypovitaminosis (96%) did not course with secondary hyperparathyroidism (mean PTH = 41.80 ± 22.75 pg/mL). Conclusion Hypovitaminosis D was found in a significant percentage (61.22%) of the patients who suffered fractures. Further studies on the subject are needed to better understand the influence of hypovitaminosis D on the occurrence of fractures, as well as the benefits of vitamin D supplementation in these patients.


Resumo Objetivo Dosar a vitamina D nos pacientes internados por fratura e avaliar sua relação com as fraturas. Métodos Realizou-se estudo primário, analítico, transversal, não intervencional, observacional, controlado, em seres humanos. Fez-se a dosagem sérica de: vitamina D, paratormônio(PTH), cálcio, fósforo, magnésio e albumina em 49 pacientes que foram internados consecutivamente para cirurgia devido a fratura(s) (grupo de estudo), e em 50 pacientes, dos diversos ambulatórios, sem fraturas, e que realizaram exames de rotina (grupo de controle). Resultados A média de 25-hidroxivitamina D (25[OH]D) nos pacientes com fraturas foi de 23,78 ± 8,01 ng/mL (61,22% dos pacientes com fraturas apresentaram hipovitaminose D). A média de 25(OH)D do grupo de controle foi de 37,52 ± 9,21 ng/mL (10% dos pacientes apresentaram hipovitaminose D). A maioria dos casos de hipovitaminose (96%) não cursou com hiperparatireoidismo secundário (média do PTH = 41,80 ± 22,75 pg/mL). Conclusão A hipovitaminose D foi encontrada em um percentual expressivo (61,22%) dos pacientes que sofreram fraturas. Mais estudos sobre o assunto são necessários para se compreender melhor a influência da hipovitaminose D na ocorrência das fraturas e os benefícios da suplementação com vitamina D nesses pacientes.


Subject(s)
Humans , Osteoporosis , Avitaminosis , Vitamin D , Vitamin D Deficiency , Fracture Healing , Fractures, Bone , Hip Fractures
9.
Ciênc. Saúde Colet ; 26(8): 3221-3244, ago. 2021. tab, graf
Article in English | LILACS | ID: biblio-1285943

ABSTRACT

Abstract Low bone health is associated with vitamin D deficiency in older individuals; however, this association is not well established in adults. The aim of the study was to analyze the association between serum concentrations of 25-hydroxyvitamin D and bone health in adults by systematic review and meta-analysis. The search was carried out in the LILACS, PubMed, Scopus, Web of Science, ScienceDirect databases from March 2017 to October 2018 with adult individuals (20-59 years). Bone health was evaluation performed through dual X-ray absorptiometry and serum concentrations of 25(OH)D. The random effect model was used to analyze data from bone mineral content and bone mineral. Random effects models were used and the sources of heterogeneity were explored by means of meta-regression. Thirty-five articles were selected. There was positive correlation between vitamin D and bone health in most of the evaluated sites. Correlation was observed in the analysis of subgroups for lumbar spine among men. When stratified, the studies presented high heterogeneity, which was explained by the sample size, mean serum vitamin D levels and risk of bias. Vitamin D is positively correlated to bone health in adult individuals.


Resumo A baixa saúde óssea está associada à deficiência de vitamina D em indivíduos mais velhos; no entanto, isso não está bem estabelecido em adultos. O estudo objetivou-se analisar a associação entre concentrações séricas de 25-hidroxivitamina D e baixa saúde óssea em adultos por revisão sistemática e metanálise. A pesquisa foi realizada nas bases LILACS, PubMed, Scopus, Web of Science, ScienceDirect de março de 2017 a outubro de 2018 com indivíduos adultos (20-59 anos). A avaliação da saúde óssea foi realizada através da absorciometria dupla de raios X e concentrações séricas de 25(OH)D. O modelo de efeito aleatório foi utilizado para analisar dados do conteúdo mineral ósseo e densidade mineral óssea. Modelos de efeitos aleatórios foram utilizados e a heterogeneidade foi explorada por meio de meta-regressão. Trinta e cinco artigos foram selecionados. Houve correlação positiva entre a vitamina D e a saúde óssea na maioria dos locais avaliados. Observou-se correlação na análise de subgrupos da coluna lombar entre homens. Quando estratificados, os estudos apresentaram alta heterogeneidade, explicada pelo tamanho da amostra, pelos níveis séricos médios da vitamina e pelo risco de viés. A vitamina D está positivamente correlacionada com a saúde óssea em indivíduos adultos.


Subject(s)
Humans , Male , Adult , Aged , Vitamin D Deficiency/epidemiology , Bone Density , Vitamin D , Vitamins , Absorptiometry, Photon
10.
An. bras. dermatol ; 96(3): 284-294, May-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1355616

ABSTRACT

Abstract Background: The serum Vitamin D status in patients with vitiligo is ambiguous when compared to controls. A systematic review and updated meta-analysis were conducted to evaluate the association between Vitamin D and vitiligo. Methods: Relevant studies were identified by searching PubMed and other databases. The random effects model was used to obtain standardized mean differences and pooled correlation coefficients. Meta-regression and sub-group analyses were conducted to explore heterogeneity. The presence of publication bias and the study robustness were tested using funnel plot and sensitivity analyses, respectively. Results: This meta-analysis finally included 31 studies. Compared with controls, vitiligo patients showed significantly decreased serum Vitamin D levels (standardized mean difference = −1.03; p < 0.0001). The sub-group analysis showed that vitiligo patients with indoor/urban work had a significantly lower Vitamin D level when compared to their outdoor/rural counterparts (standardized mean differences = −0.45; p = 0.03). The sensitivity analysis indicated that no single study had a significant influence on the overall outcome, suggesting the robustness of this meta-analysis. Study limitations: Varied sample sizes and heterogeneous study populations from different countries are the limitations of this study. However, the between-study heterogeneity has been addressed by the random-effects model with meta-regression and sensitivity analyses. Conclusions: This meta-analysis showed significantly decreased Vitamin D level in vitiligo, and its association with indoor/outdoor type of work of vitiligo patients. This study highlights the need to assess Vitamin D status for improving its level in vitiligo.


Subject(s)
Humans , Vitamin D Deficiency/complications , Vitiligo , Vitamin D , Sample Size
11.
An. bras. dermatol ; 96(3): 284-294, May-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1285081

ABSTRACT

Abstract Background: The serum Vitamin D status in patients with vitiligo is ambiguous when compared to controls. A systematic review and updated meta-analysis were conducted to evaluate the association between Vitamin D and vitiligo. Methods: Relevant studies were identified by searching PubMed and other databases. The random effects model was used to obtain standardized mean differences and pooled correlation coefficients. Meta-regression and sub-group analyses were conducted to explore heterogeneity. The presence of publication bias and the study robustness were tested using funnel plot and sensitivity analyses, respectively. Results: This meta-analysis finally included 31 studies. Compared with controls, vitiligo patients showed significantly decreased serum Vitamin D levels (standardized mean difference = −1.03; p < 0.0001). The sub-group analysis showed that vitiligo patients with indoor/urban work had a significantly lower Vitamin D level when compared to their outdoor/rural counterparts (standardized mean differences = −0.45; p = 0.03). The sensitivity analysis indicated that no single study had a significant influence on the overall outcome, suggesting the robustness of this meta-analysis. Study limitations: Varied sample sizes and heterogeneous study populations from different countries are the limitations of this study. However, the between-study heterogeneity has been addressed by the random-effects model with meta-regression and sensitivity analyses. Conclusions: This meta-analysis showed significantly decreased Vitamin D level in vitiligo, and its association with indoor/outdoor type of work of vitiligo patients. This study highlights the need to assess Vitamin D status for improving its level in vitiligo.


Subject(s)
Humans , Vitamin D Deficiency/complications , Vitiligo , Vitamin D , Sample Size
12.
Säo Paulo med. j ; 139(3): 279-284, May-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1252247

ABSTRACT

ABSTRACT BACKGROUND: Vitamin D has relationships with pathogenesis and inflammation pathways in many diseases. Its deficiency may make clinicians think not only of supplementation but also of presence of other diseases. OBJECTIVE: To investigate the relationship between vitamin D levels and deep vein thrombosis (DVT), given that reduced levels are related to increased risk of cardiovascular diseases. DESIGN AND SETTING: Case-control study conducted in the cardiovascular surgery and family medicine departments of a hospital in Turkey. METHODS: A total of 280 participants were included: 140 each in the DVT and control groups. Basic clinical characteristics, comorbidities and serum 25-hydroxyvitamin D (25(OH)D) levels were recorded and then compared between the groups. Serum 25(OH)D levels were also evaluated separately in three subgroups (sufficient, insufficient and deficient). RESULTS: Serum 25(OH)D levels were significantly lower in the DVT group than in the controls (P < 0.001). Females in the DVT group had lower 25(OH)D levels than those in the control group (P = 0.002). Nonetheless, the median 25(OH)D level (16.41 ng/ml) of the control group was still below the reference value. Logistic regression analysis showed that 25(OH)D was a significant predictor of DVT. Weight, height and body mass index, which all presented interaction, were significant in the logistic regression analysis but not in individual analyses. CONCLUSION: The serum vitamin D levels of DVT patients were lower than those of controls. If the results obtained from our study are supported by further large-scale randomized controlled trials, vitamin D replacement may be brought into the agenda for protection against DVT.


Subject(s)
Humans , Male , Female , Vitamin D/blood , Vitamin D Deficiency/complications , Venous Thrombosis/etiology , Turkey , Case-Control Studies , Extremities
13.
Rev. bras. ortop ; 56(3): 351-355, May-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1288681

ABSTRACT

Abstract Objective To compare the serum levels of vitamin D and minerals in children with or without isolated distal radius fractures. Methods The present prospective clinical study included 50 children (aged between 5 and 15 years) with isolated distal radius fractures who were admitted to our emergency unit between February and May 2018 as the study group (group A), and 50 healthy children with no history of fracture as the control group (group B). Peripheral venous blood samples were obtained and analyzed for measurements of 25-hydroxyvitamin D (25(OH)D), calcium (Ca), magnesium (Mg), phosphorus (P), alkaline phosphatase (ALP), and parathyroid hormone (PTH) in both groups. Patient characteristics and peripheral venous blood samples were compared between the groups. Results The mean age, height, weight, body mass index (BMI) and gender distribution were similar in both groups. There were no statistical differences in the blood analyses, including Ca, Mg, P, ALP, and PTH. However, the serum levels of 25(OH)D were statistically lower in group A when compared to group B (p < 0.001), and the number of patients with 25(OH)D insufficiency was statistically higher in group A than in group B (p = 0.012). Conclusion Children with isolated distal radius fracture should be informed about vitamin D deficiency, and, in children with low levels of vitamin D, supplementation may be considered.


Resumo Objetivo Comparar os níveis séricos de vitamina D e minerais de crianças com ou sem fraturas isoladas da extremidade distal do rádio. Métodos Este estudo clínico prospectivo incluiu 50 crianças (com idade entre 5 e 15 anos) com fratura isolada distal do rádio que deram entrada em nossa unidade de emergência entre fevereiro e maio de 2018 como grupo de estudo (grupo A), e 50 crianças saudáveis sem histórico de fratura como grupo controle (grupo B). Foram obtidas e analisadas amostras de sangue venoso periférico para medições de 25-hidroxivitamina D (25(OH)D), Cálcio (Ca), Magnésio (Mg), Fósforo (P), fosfatase alcalina (FA) e hormônio da paratireoide (HPT) em ambos os grupos. As características dos pacientes e as amostras de sangue venoso periférico foram comparadas entre os grupos. Resultados A média de idade, altura, peso, índice de massa corporal (IMC) e distribuição de gênero foram semelhantes em ambos os grupos. Não houve diferenças estatísticas nas análises sanguíneas, incluindo Ca, Mg, P, FA e HPT. No entanto, os níveis séricos de 25(OH)D foram estatisticamente menores no grupo A do que no grupo B (p < 0,001), e o número de pacientes com insuficiência de 25(OH)D foi estatisticamente maior no grupo A do que no grupo B (p = 0,012). Conclusão Crianças com fratura isolada distal do rádio devem ser informadas sobre deficiência de vitamina D, e, em crianças com baixos níveis de vitamina D, a suplementação pode ser considerada.


Subject(s)
Humans , Child , Parathyroid Hormone , Radius Fractures , Vitamin D , Vitamin D Deficiency , Body Weight , Body Mass Index , Calcium , Alkaline Phosphatase
14.
Arch. latinoam. nutr ; 71(1): 5-12, mar. 2021. tab, graf
Article in Spanish | LILACS, LIVECS | ID: biblio-1283237

ABSTRACT

La vitamina D es esencial para el funcionamiento del organismo. Su deficiencia puede estar asociada tanto a patologías óseas, como a otras afecciones sistémicas. La prevalencia de la hipovitaminosis está aumentando, en todas las edades, incluidos niños y adolescentes. El objetivo del presente estudio fue evaluar los niveles sanguíneos de vitamina D en niñas colombianas, analizando también la dieta, la actividad física y la exposición solar. Se realizó un estudio descriptivo transversal con 52 niñas sanas prepúberes de Pasto (Colombia), entre 7 y 10 años. Se analizaron los niveles de albúmina, calcio, fósforo, magnesio, calcitriol (1,25 dihidroxicolecalciferol) y calcidiol (25 hidroxicolecalciferol). Se realizaron encuestas sobre hábitos alimentarios, actividad física y exposición solar. El 51,1% de las niñas evaluadas presentó insuficiencia de 25-OH-VITD y el 40% presentó deficiencia (< 20 ng/mL). Ninguna niña se encontraba en desnutrición u obesidad, el 10% se encontraba en riesgo de bajo peso (IMC ≤ -1DE y > -2DE), el 4 % presentaba sobrepeso (≥ +1DE y < +2DE), y el 34 % se encontraban en riesgo de talla baja (T/E: -1 y -2 DE). La ingesta media de calorías/día fue inferior a las recomendadas. Se observó una ingesta deficiente de vitamina D, calcio y magnesio (p > 0,05), así como de fibra (p > 0,05). Se pone de manifiesto una deficiencia de vitamina D en las niñas evaluadas a pesar de tener una actividad física y una exposición solar adecuadas. Además, se observan ingestas deficientes de fibra, calcio, magnesio y vitamina D. Habría por tanto que asegurar la ingesta e incluso suplementar para evitar problemas de salud en la edad adulta(AU)


Vitamin D is essential for the body to function. Its deficiency can be associated with bone pathologies as well as other systemic conditions. The prevalence of hypovitaminosisis increasing, in all ages, including children and adolescents. The objective of this study was to evaluate blood levels of vitamin D in Colombian girls, also analyzing diet, physical activity and sun exposure. A descriptive cross-sectional study was carried out with 52 healthy prepubertal girls from Pasto (Colombia), between 7 and 10 yearsold. The levels of albumin, calcium, phosphorus, magnesium, calcitriol (1.25 dihydroxycholecalciferol) and calcidiol (25 hydroxycholecalciferol) were analyzed. Surveys were conducted one a ting habits, physicalactivity and sun exposure. 51.1% of the girls evaluated presented 25-OH-VITD insufficiency and 40% presented deficiency (<20 ng / mL). None of the girls were under nourished or obese, 10% were at risk of low weight (BMI ≤ -1SD and> -2SD), 4% were overweight (≥ + 1DE and <+ 2DE), and 34% were they were at risk of short stature (T / E: -1 and -2 SD). The average calorie intake / day was lower than recommended. A deficient intake of vitamin D, calcium and magnesium (p> 0.05), as well as fiber (p> 0.05) was observed. A vitamin D deficiency is evident in the girls evaluated despite adequate physical activity and sun exposure. In addition, deficient intakes of fiber, calcium, magnesium and vitamin D are observed. Therefore, it would be necessary to ensure the intake and even supplement to avoid health problems in adulthood(AU)


Subject(s)
Humans , Female , Child , Sunlight , Vitamin D Deficiency/blood , Exercise , Diet , Vitamin D Deficiency/epidemiology , Cross-Sectional Studies , Colombia/epidemiology , Eating
15.
Arch. argent. pediatr ; 119(1): e49-e53, feb. 2021. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1147262

ABSTRACT

El raquitismo afecta la diferenciación y mineralización del cartílago de crecimiento como consecuencia, en última instancia, de una alteración en los niveles de fósforo y/o calcio. El secundario a la deficiencia de vitamina D es la forma más frecuente (raquitismo carencial). Las manifestaciones clínicas durante los primeros años de vida suelen comprometer en forma más marcada las epífisis de los huesos.Se describe el caso de un lactante de 8 meses con diagnóstico de alergia a la proteína de la leche de vaca que presentó múltiples fracturas patológicas mientras se encontraba bajo tratamiento con fórmulas lácteas a base de aminoácidos. Se efectuó el diagnóstico de raquitismo hipofosfatémico por deficiencia de fósforo y, tras 3 meses de tratamiento con sales de fosfato, calcio, calcitriol, el abandono paulatino de la leche elemental y el descenso gradual de la medicación antiácida, el paciente evolucionó con curación clínico-radiológica del cuadro


The rickets is a disease that affects the differentiation and mineralization of the growth cartilage, as an ultimate consequence of a balance loss in calcium and phosphate levels. Vitamin D deficiency is the most common cause of the rickets (nutritional rickets). Its clinical manifestation during the first years of life involves long bones epiphysis in a more severe way.We report an 8-month-old infant who was diagnosed with cow ́s milk protein allergy and suffered from multiple fractures while receiving elemental formula as part of his treatment. The final etiology was hypophosphatemic rickets secondary to phosphate deficiency, and after 3 months of phosphate, calcium and calcitriol supplementation, in addition to the gradually reduction of the proportion of elemental formula intake and the decline of the antacid doses, clinical and radiological heal was achieved.


Subject(s)
Humans , Male , Infant , Rickets, Hypophosphatemic/diagnostic imaging , Vitamin D Deficiency , Milk Hypersensitivity , Infant Formula , Rickets, Hypophosphatemic/therapy , Amino Acids
16.
Rev. Assoc. Med. Bras. (1992) ; 67(1): 88-93, Jan. 2021. tab, graf
Article in English | LILACS | ID: biblio-1287778

ABSTRACT

SUMMARY OBJECTIVE: To evaluated calcification of the coronary arteries and its association with visceral fat and 25-hydroxyvitamin D (25(OH)D) serum levels. METHODS: A cross sectional study involving 140 individuals without any previous diagnosis of cardiovascular disease. A biochemical analysis of vitamin D serum levels was carried out, as well as computed tomography to measure coronary artery calcium score and visceral adipose tissue. RESULTS: The mean age of the individuals was 55.9 (±12.4). Coronary artery calcium was observed in 40.7% of the population. Vitamin D presented median serum levels of 30.4 ng/ml (IQ24.5-39.1), with 14,1 and 33.7% of the individuals presenting deficiency and insufficiency, respectively. In the univariate analysis, the calcium score was more prevalent in aged patients (p<0.01), in hypertensive individuals (p<0.01), in diabetics (p=0.02), and in those with a higher concentration of VAT (p=0.02). In the adjusted analysis, it was found that the highest concentration of VAT (OR: 4.0; 95%CI 1.4-11.7), hypertension (OR: 4.8; 95%CI 1.5-15.3), and age (OR: 10.4; 95%CI 3.9-27.6) were predictors of subclinical atherosclerosis, regardless of body mass index, diabetes, and 25OHD. CONCLUSIONS: Excess visceral fat was associated with subclinical atherosclerosis, regardless of other risk factors for cardiovascular disease. Serum levels of 25OHD were not associated with CAD in its early stages.


Subject(s)
Humans , Aged , Vitamin D Deficiency/complications , Coronary Artery Disease/diagnostic imaging , Vitamin D , Cross-Sectional Studies , Intra-Abdominal Fat/diagnostic imaging
17.
Femina ; 49(1): 44-51, 20210131. ilus
Article in Portuguese | LILACS | ID: biblio-1146937

ABSTRACT

O estudo objetiva avaliar a relação dos níveis de vitamina D em gestantes com as principais complicações gestacionais. A pesquisa foi realizada nas bases de dados PubMed, LILACS e BIREME, sendo selecionados artigos relevantes publicados de 2013 a 2018, usando os descritores: "vitamin D" AND "maternity" OR "pregnancy". Foram revisados 14 estudos observacionais incluindo casos-controles e coortes que investigaram a relação dos níveis de vitamina D maternos com pré-eclâmpsia, diabetes mellitus gestacional e prematuridade, sendo excluídos os estudos que utilizaram suplementação de vitamina D. Os dados foram extraídos por meio de uma tabulação com as seguintes informações: autor, ano da publicação, país do estudo, score obtido no downs and black, ano da coleta da amostra, tipo do estudo, número de participantes, método de obtenção da amostra de 25(OH)D, tempo da gestação na obtenção da amostra, complicação obstétrica, fatores de confusão ajustados e os principais desfechos. Foi obtido um total de 32.505 pacientes após a soma das amostras de todos os artigos analisados. O principal resultado encontrado, abrangendo as três comorbidades analisadas, relaciona níveis menores que 30 nmol/L de vitamina D como potencial fator de risco para pré-eclâmpsia, diabetes mellitus gestacional e prematuridade.(AU)


The study aims to assess the relationship between vitamin D levels in pregnant women and the main gestational complications. The research was carried out in the PubMed, LILACS and BIREME databases, with the selection of relevant articles published from 2013 to 2018, using the descriptors: "vitamin D" AND "maternity" OR "pregnancy". 14 observational studies were reviewed including control cases and cohorts that investigated the relationship between maternal vitamin D levels and pre-eclampsia, gestational diabetes mellitus and prematurity, and studies that used vitamin D supplementation were excluded. Data were extracted using a tabulation with the following information: author, year of publication, country of study, score obtained in downs and black, year of sample collection, type of study, number of participants, method of obtaining the sample of 25(OH)D, time of pregnancy in obtaining the sample, obstetric complication, adjusted confounding factors and the main outcomes. A total of 32,505 patients were obtained after adding the samples of all analyzed articles. The main result found, covering the three comorbidities analyzed, lists levels below 30 nmol/L of vitamin D as a potential risk factor for pre-eclampsia, gestational diabetes mellitus and prematurity.(AU)


Subject(s)
Humans , Female , Pregnancy , Pre-Eclampsia/physiopathology , Pregnancy Complications , Vitamin D Deficiency/complications , Diabetes, Gestational/physiopathology , Premature Birth/physiopathology , Risk Factors , Databases, Bibliographic
18.
Evid. actual. práct. ambul ; 24(2): e002135, 2021.
Article in Spanish | LILACS | ID: biblio-1254959

ABSTRACT

La Vitamina D es un micronutriente esencial que obtenemos a partir de la síntesis dérmica tras la radiación solar ultravioleta. Diferentes estudios han evidenciado que la vitamina D tiene diversos efectos a nivel del sistema inmune, y cumple un rol esencial en la respuesta ante infecciones virales respiratorias. A partir de un caso clínico real, en contexto de la actual pandemia de COVID-19, revisamos la evidencia disponible y encontramos que no existen pruebas que respaldan la suplementación con vitamina D para prevenir la infección o los desenlaces adversos de esta enfermedad. (AU)


Vitamin D is an essential micronutrient that we obtain from dermal synthesis following solar ultraviolet radiation. Different studies have shown that vitamin D has various effects on the immune system and plays an essential role in the response to respiratory viral infections. Based on a real clinical case, in the context of the current COVID-19 pandemic, we reviewed the available evidence and found that there is no proof to support vitamin D supplementation to prevent the infection or the adverse outcomes of this disease. (AU)


Subject(s)
Humans , Female , Aged , Vitamin D , COVID-19 , Primary Health Care , Vitamin D Deficiency , Dietary Supplements , Pandemics , Systematic Reviews as Topic , SARS-CoV-2
19.
Clinics ; 76: e1821, 2021. tab, graf
Article in English | LILACS | ID: biblio-1153986

ABSTRACT

OBJECTIVES: This study aimed to evaluate the potential anti-inflammatory effects of vitamin D supplementation under uremic conditions, both in vivo and in vitro, and its effects on the parameters of mineral metabolism. METHODS: Thirty-two hemodialysis patients were randomly assigned to receive placebo (N=14) or cholecalciferol (N=18) for six months. Serum levels of calcium, phosphate, total alkaline phosphatase, intact parathyroid hormone (iPTH), and vitamin D were measured at baseline and after three and six months. The levels of fibroblast growth factor-23 (FGF-23), interleukin-1β (IL-1β), and high-sensitivity C-reactive protein (hs-CRP) were also measured at baseline and at six months. Human monocytes were used for in vitro experiments and treated with cholecalciferol (150 nM) and uremic serum. Cell viability, reactive oxygen species (ROS) production, and cathelicidin (CAMP) expression were evaluated using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, dichloro-dihydro-fluorescein diacetate assay, and real time-quantitative polymerase chain reaction, respectively. RESULTS: Both patient groups were clinically and biochemically similar at baseline. After six months, the levels of vitamin D and iPTH were higher and lower, respectively, in the cholecalciferol group than in the placebo group (p<0.05). There was no significant difference between the parameters of mineral metabolism, such as IL-1β and hs-CRP levels, in both groups. Treatment with uremic serum lowered the monocyte viability (p<0.0001) and increased ROS production (p<0.01) and CAMP expression (p<0.05); these effects were counterbalanced by cholecalciferol treatment (p<0.05). CONCLUSIONS: Thus, cholecalciferol supplementation is an efficient strategy to ameliorate hypovitaminosis D in hemodialysis patients, but its beneficial effects on the control of secondary hyperparathyroidism are relatively unclear. Even though cholecalciferol exhibited anti-inflammatory effects in vitro, its short-term supplementation was not effective in improving the inflammatory profile of patients on hemodialysis, as indicated by the IL-1β and hs-CRP levels.


Subject(s)
Humans , Vitamin D Deficiency , Cholecalciferol/therapeutic use , Parathyroid Hormone/therapeutic use , Vitamin D , Renal Dialysis , Dietary Supplements , Anti-Inflammatory Agents
20.
Article in English | WPRIM | ID: wpr-922395

ABSTRACT

OBJECTIVES@#To investigate vitamin D nutritional status in children after outbreak of coronavirus disease 2019 (COVID-19), as well as the effect of strict epidemic prevention and control measures for the COVID-19 epidemic on vitamin D nutritional status in children.@*METHODS@#A total of 7 460 children who underwent routine physical examinations from February to August, 2020 and had normal results were retrospectively enrolled as the observation group, and 10 102 children who underwent routine physical examinations from February to August, 2019 (no epidemic of COVID-19) and had normal results were enrolled as the control group. The serum level of 25-hydroxy vitamin D [25(OH)D] was compared between the two groups. The children in the observation and control groups who underwent physical examinations in March and April were selected as the epidemic prevention subgroup (@*RESULTS@#The observation group had a lower serum level of 25(OH)D than the control group in March and April (@*CONCLUSIONS@#Strict prevention and control measures for the COVID-19 epidemic may lead to a significant reduction in vitamin D level in children, especially school-aged and adolescent children. It is recommended to timely monitor vitamin D level in children, take vitamin D supplements, and increase the time of outdoor sunshine as far as possible under the premise of adherence to epidemic prevention regulations.


Subject(s)
Adolescent , COVID-19 , Child , Child, Preschool , Disease Outbreaks , Humans , Nutritional Status , Retrospective Studies , SARS-CoV-2 , Vitamin D , Vitamin D Deficiency/epidemiology
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