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1.
Article in Portuguese | LILACS | ID: biblio-1353115

ABSTRACT

A intoxicação por vitamina D era pouco frequente no Brasil até seu crescente uso na última década. Neste artigo relatamos um caso de intoxicação por vitamina D em que houve a prescrição intencional de dose muito superior ao recomendado pela literatura, com a finalidade de prevenir doenças via "modulação hormonal". A paciente em questão, idosa, previamente hígida, foi submetida a um tratamento não regulamentado e sem respaldo científico, que culminou em sintomas como náuseas e vômitos, além de perda de peso, inapetência, poliúria e astenia ao longo dos meses. Através da história e exames laboratoriais foi diagnosticada intoxicação por vitamina D e lesão renal aguda. Após o tratamento houve remissão completa dos sintomas. A "modulação hormonal" é uma prática condenada pelos Conselhos Federais de Medicina e Odontologia e pela Sociedade Brasileira de Endocrinologia e Metabologia. O ato de prescrever é de grande responsabilidade ética e técnica e deve ser embasado em evidências científicas, oferecendo o melhor tratamento possível aos pacientes, seja ele preventivo ou curativo, minimizando riscos e danos, respeitando as recomendações das autoridades competentes. (AU)


Vitamin D poisoning was not frequent in Brazil until its increasing use in the last decade. In this article, we report a case of intoxication by intentional prescription of vitamin D in a much higher dose than the literature recommends, in order to prevent diseases via "hormonal modulation". The case described in this report was an elderly woman, previously healthy patient that was submitted to an unregulated treatment without scientific support, leading to symptoms such as nausea and vomiting, in addition to weight loss, lack of appetite, polyuria and asthenia over the months. Through the history and laboratory testing, vitamin D intoxication and acute kidney injury were diagnosed. After treatment, there was a complete remission of the symptoms. "Hormonal modulation" is a practice condemned by the Federal Councils of Medicine and Dentistry and by the Brazilian Society of Endocrinology and Metabology. The act of prescribing is of great ethical and technical responsibility and it must be based on scientific evidence. Thus, the patient can receive the best possible treatment, for either preventive or curative nature, by respecting the recommendations of the competent authorities and, therefore, minimizing risks and damages to patients. (AU)


Subject(s)
Humans , Female , Aged , Polyuria , Asthenia , Vitamin D/toxicity , Weight Loss , Anorexia , Ethics, Professional , Acute Kidney Injury
2.
Univ. salud ; 23(3): 248-254, sep.-dic. 2021. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1341771

ABSTRACT

Resumen Introducción: Actualmente la vitamina D ha ganado importancia, por ser considerada una hormona y porque sus bajos niveles están asociados con diferentes patologías, especialmente alteraciones de la masa ósea. Objetivo: Determinar la prevalencia de bajos niveles de vitamina D en pacientes adultos con osteopenia y osteoporosis, atendidos en consulta externa de endocrinología en Popayán Cauca. Materiales y métodos: Estudio descriptivo y retrospectivo que incluyó pacientes con diagnóstico de osteopenia y osteoporosis realizado por densitometría ósea entre los años 2013 y 2016, que tenían reporte de niveles de vitamina D obtenidos por cualquier método. Se describieron características sociodemográficas, resultados de densitometría ósea, niveles vitamina D, hormona paratiroidea y calcio iónico. Resultados: Se incluyeron 300 pacientes con diagnóstico de osteopenia y osteoporosis de los cuales 211 tenían bajos niveles de vitamina D, para una prevalencia del 71,3%, el nivel promedio de 25 hidroxivitamina D fue de 24,35ng/ml. Conclusiones: La alta prevalencia de bajos niveles de vitamina D en pacientes con osteopenia y osteoporosis hace indispensable la medición de 25 hidroxivitamina D en esta población, esto con el fin de realizar una intervención terapéutica apropiada.


Abstract Introduction: Vitamin D has gained interest because it is a hormone whose low levels are associated with different pathologies such as bone mass disorders. Objective: To determine the prevalence of low levels of vitamin D in adult patients with osteopenia and osteoporosis who received care at an outpatient endocrinology clinic in Popayan, Cauca. Materials and methods: A retrospective and descriptive study that included patients diagnosed with osteopenia and osteoporosis through bone densitometry between 2013 and 2016, who also had their vitamin D levels measured by means of any laboratory method. Sociodemographic characteristics, bone densitometry results as well as vitamin D, parathormone and ionic calcium levels were described. Results: A total of 300 patients with osteopenia and osteoporosis were included in the study, of which 211 had low levels of vitamin D, representing a prevalence of 71.3%. Finally, the average level of 25-hydroxyvitamin D was 24.35 ng/ml. Conclusion: The high prevalence of low levels of vitamin D in patients with osteopenia and osteoporosis highlights the importance to measure 25-hydroxyvitamin D levels in this population in order to carry out an appropriate therapeutic intervention.


Subject(s)
Vitamin D , Bone Diseases, Metabolic , Osteoporosis , Prevalence
3.
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
4.
Arq. bras. oftalmol ; 84(3): 241-248, May-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1248966

ABSTRACT

ABSTRACT Purpose: This study aimed to determine the role of vitamin D receptor in the pathogenesis of pterygium. The vitamin D receptor eexpression levels in pterygium tissue, blood vitamin D levels, and frequency of selected vitamin D receptor gene polymorphisms (BsmI, FokI, and TaqI) were compared between patients with pterygium and healthy participants. Methods: The study included patients with pterygiumeee (n=50) and healthy volunteers (n=50). The serum vitamin D levels were measured for both groups. Immunohistochemical staining for vitamin D receptor ewas performed on sections obtained from the pterygium and adjacent healthy conjunctival tissues of the same individuals. The genomic existence of vitamin D receptor epolymorphisms (BsmI, FokI, and TaqI) were analyzed in DNA obtained from venous blood of participants using polymerase chain reaction and restriction fragment length polymorphism methods. Results: There was no difference found between the serum vitamin D levels of patients with pterygium and healthy controls. However, tissue expression of vitamin D receptor was higher in the pterygium endothelial cells of micro-vessels (p=0.002), subepithelial stromal (p=0.04), and intravascular inflammatory cells (p=0.0001), in comparison with the adjacent healthy conjunctival tissue. Moreover, while the BBtt haplotype was 2-fold higher, the bbTt haplotype was 2.5-fold lower, and the BbTT haplotype was 2.25-fold lower in the control group than in the pterygium group (p<0.001). Conclusions: Vitamin D serum levels did not differ between the healthy and pterygium groups. Vitamin D receptor expression was increased in the pterygium tissue versus the adjacent healthy tissue. However, vitamin D receptor polymorphism analysis in patients with pterygium did not reveal any significant difference in BsmI, FokI, or TaqI polymorphisms in comparison with the healthy volunteers.(AU)


RESUMO Objetivo: Determinar o papel do receptor da vitamina D na patogênese do pterígio. Os níveis de expressão do receptor da vitamina D no tecido do pterígio, os níveis sanguíneos de vitamina D e a frequência de alguns polimorfismos do gene do receptor da vitamina D (BsmI, FokI e TaqI) foram comparados entre pacientes com pterígio e participantes saudáveis. Métodos: Foram incluídos pacientes com pterígio (n=50) e voluntários saudáveis (n=50). Os níveis séricos de vitamina D foram medidos em ambos os grupos. Foi feita uma coloração imuno-histoquímica para o receptor da vitamina D em cortes obtidos do pterígio e dos tecidos conjuntivais saudáveis adjacentes dos mesmos indivíduos. A existência de polimorfismos do receptor da vitamina D (BsmI, FokI e TaqI) no genoma foi analisada em DNA obtido do sangue venoso dos participantes, usando métodos de Polymerase chain reaction (PCR) e RFLP. Resultados: Não foi observada nenhuma diferença entre os níveis séricos de vitamina D dos pacientes com pterígio e os dos controles saudáveis. Entretanto, a expressão tissular do receptor da vitamina D foi maior nas células endoteliais dos microvasos do pterígio (p=0,002), nas células estromais sub-epiteliais (p=0,04) e nas células inflamatórias intravasculares (p=0,0001), quando comparada à expressão no tecido conjuntival saudável adjacente. Além disso, embora o haplótipo BBtt tenha sido duas vezes mais frequente, o haplótipo bbTt foi 2,5 vezes menos frequente e o haplótipo BbTT foi 2,25 vezes menos frequente no grupo de controle do que no grupo com pterígio (p<0,001). Conclusões: Os níveis séricos de vitamina D não apresentaram diferenças entre o grupo de pessoas saudáveis e o com pterígio. A expressão do receptor da vitamina D mostrou-se maior no grupo com pterígio do que no tecido saudável adjacente. Entretanto, a análise dos polimorfismos do receptor da vitamina D nos pacientes com pterígio não revelou qualquer diferença significativa nos polimorfismos BsmI, FokI ou TaqI em comparação com os voluntários saudáveis.(AU)


Subject(s)
Humans , Polymorphism, Genetic/drug effects , Vitamin D/therapeutic use , Pterygium/physiopathology , Immunohistochemistry/instrumentation , Cross-Sectional Studies/instrumentation
5.
Goiânia; SES-GO; 14 maio 2021. 1-15 p. fig, ilus, tab.
Non-conventional in Portuguese | LILACS, ColecionaSUS, CONASS, SES-GO | ID: biblio-1224471

ABSTRACT

O termo vitamina D engloba um grupo de moléculas secosteroides derivadas do 7- deidrocolesterol (7-DHC ou provitamina D) interligadas através de uma cascata de reações fotolíticas e enzimáticas que acontecem em células de diferentes tecidos. (CASTRO, 2011). Nos seres humanos, apenas 10% a 20% da vitamina D necessária à adequada função do organismo provém da dieta. (CASTRO, 2011). O restante, cerca de 80%, da vitamina D é produzida na pele após a exposição à radiação ultravioleta B ­ UVB (HOLICK, 2008)


The term vitamin D encompasses a group of secosteroid molecules derived from 7- dehydrocholesterol (7-DHC or provitamin D) interconnected through a cascade of photolytic and enzymatic reactions that occur in cells of different tissues. (CASTRO, 2011). In humans, only 10% to 20% of the vitamin D needed for proper body function comes from the diet. (CASTRO, 2011). The remainder, about 80%, of vitamin D is produced in the skin after exposure to ultraviolet radiation B ­ UVB (HOLICK, 2008)


Subject(s)
Humans , Male , Female , Pregnancy , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Vitamin D/administration & dosage , Vitamin D/biosynthesis
6.
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
7.
Rev. chil. ortop. traumatol ; 62(1): 34-38, mar. 2021. ilus
Article in Spanish | LILACS | ID: biblio-1342663

ABSTRACT

Presentamos el primer reporte de caso en paciente adulto con virus de la inmunodeficiencia humana (VIH + ) con fractura por fragilidad en fémur proximal asociada al uso de terapia antirretroviral (TARV) con fumarato de disoproxilo de tenofovir (FDT) en Chile. Actualmente, los pacientes diagnosticados con VIH inician tratamiento precoz con TARV, lo que implica mayor cantidad de años de exposición a los fármacos de la terapia. El tiempo de exposición acumulado al FDT se ha asociado a disminución de la densidad mineral ósea y falla renal progresiva, pudiendo el paciente desarrollar síndrome de Fanconi adquirido y osteomalacia, con riesgo aumentado de fractura. Presentamos el caso de un hombre de 44 años, VIH+ , evaluado en urgencia tras caída a nivel que resultó en fractura patológica del fémur proximal. Los exámenes de ingreso destacaron hipocalemia, hipocalcemia, hipofosfatemia e hipovitaminosis D. Se realizó manejo multidisciplinario, con suspensión del FDT, un cambio en la TARV, y suplementación con calcio y carga de vitamina D. Se realizó reducción cerrada y fijación con clavo cefalomedular largo, que evolucionó favorablemente con rehabilitación motora precoz; el paciente recuperó su funcionalidad previa, y se observó consolidación ósea a las 12 semanas. La aparición de dolor osteomuscular en pacientes VIH+ en TARV debe levantar alta sospecha clínica de efecto adverso a medicamento; el seguimiento de estos pacientes debe incluir el control seriado de la función renal y de los niveles séricos de calcio y fósforo. La búsqueda y sospecha de estas complicaciones permitiría una intervención precoz, mejorando la condición de los pacientes y previniendo fracturas patológicas.


We present the first case report of a human immunodeficiency virus (HIV)-positive adult patient with a fragility fracture of the proximal femur associated with antiretroviral therapy (ART) with tenofovir disoproxil fumarate (TDF) in Chile. Currently, patients diagnosed with HIV start ART early, resulting in more years of exposure to these drugs. The accumulated exposure time to TDF has been associated with a decreased bone mineral density and progressive renal failure, potentially leading to acquired Fanconi syndrome, osteomalacia, and an increased risk of fracture. We present a case of a 44-year-old, HIV-positive man assessed at the emergency room after a fall from standing height which resulted in a proximal femoral pathological fracture. Laboratory findings at admission revealed hypokalemia, hypocalcemia, hypophosphatemia, and hypovitaminosis D. Multidisciplinary management was performed, with TDF discontinuation, ART change, and supplementation with calcium and vitamin D. Closed reduction and fixation with a long cephalomedullary nail was successful, with early motor rehabilitation, functional recovery, and bone consolidation at 12 weeks. Musculoskeletal pain in HIV-positive patients on ART must raise the clinical suspicion of an adverse drug effect; the follow-up of these subjects must include serial monitoring of renal function and serum calcium and phosphorus levels. Screening and suspicion of such complications would enable an early intervention, improving the patients' condition and preventing pathological fractures.


Subject(s)
Humans , Male , Adult , Anti-HIV Agents/adverse effects , Femoral Fractures/chemically induced , Femoral Fractures/therapy , Tenofovir/adverse effects , Vitamin D/therapeutic use , Bone Nails , Calcium/therapeutic use , Closed Fracture Reduction , Fracture Fixation, Intramedullary/instrumentation
8.
Braz. j. med. biol. res ; 54(8): e11073, 2021. tab, graf
Article in English | LILACS | ID: biblio-1249327

ABSTRACT

The study evaluated the effect of the supernatant of placental explants from preeclamptic (PE) and normotensive (NT) pregnant women after tissue treatment with or without vitamin D (VD) on oxidative stress and nitric oxide (NO) bioavailability in human umbilical vein endothelial cells (HUVEC). Placental explants were prepared from eight NT and eight PE women, and supernatants were obtained after incubation with or without hydrogen peroxide (H2O2) and/or VD. HUVEC were cultured for 24 h with supernatants, and the following parameters were analyzed in HUVEC cultures: NO, nitrate (NO3-), and nitrite (NO2-) levels, lipid peroxidation, and intracellular reactive oxygen species (ROS). Results showed that the production of NO3-, NO2-, malondialdehyde (MDA), and ROS were significantly higher in HUVEC treated with explant supernatant from PE compared to NT pregnant women, while the supernatant of PE explants treated with VD led to a decrease in these parameters. A significantly high production of NO was detected in HUVEC cultured with control supernatant of NT group, and in cultures treated with supernatant of PE explants treated with VD. Taken together, these results demonstrated that cultures of placental explants from PE women with VD treatment generated a supernatant that decreased oxidative stress and increased the bioavailability of NO in endothelial cells.


Subject(s)
Humans , Female , Pregnancy , Pre-Eclampsia/metabolism , Nitric Oxide/metabolism , Placenta/metabolism , Vitamin D/metabolism , Biological Availability , Cells, Cultured , Oxidative Stress , Human Umbilical Vein Endothelial Cells , Hydrogen Peroxide
9.
Braz. j. med. biol. res ; 54(10): e11207, 2021. tab, graf
Article in English | LILACS | ID: biblio-1285643

ABSTRACT

Reactive oxygen species (ROS) are involved in neuropathic pain, a complicated condition after nerve tissue lesion. Vitamin D appears to improve symptoms of pain and exhibits antioxidant properties. We investigated the effects of oral administration of vitamin D3, the active form of vitamin D, on nociception, the sciatic functional index (SFI), and spinal cord pro-oxidant and antioxidant markers in rats with chronic constriction injury (CCI) of the sciatic nerve, a model of neuropathic pain. Vitamin D3 (500 IU/kg per day) attenuated the CCI-induced decrease in mechanical withdrawal threshold and thermal withdrawal latency (indicators of antinociception) and SFI. The vitamin prevented increased lipid hydroperoxide levels in injured sciatic nerve without change to total antioxidant capacity (TAC). Vitamin D3 prevented increased lipid hydroperoxide, superoxide anion generation (SAG), and hydrogen peroxide (H2O2) levels in the spinal cord, which were found in rats without treatment at 7 and 28 days post-CCI. A significant negative correlation was found between mechanical threshold and SAG and between mechanical threshold and H2O2 at day 7. Vitamin D3 also prevented decreased spinal cord total thiols content. There was an increase in TAC in the spinal cord of vitamin-treated CCI rats, compared to CCI rats without treatment only at 28 days. No significant changes were found in body weight and blood parameters of hepatic and renal function. These findings demonstrated, for first time, that vitamin D modulated pro-oxidant and antioxidant markers in the spinal cord. Since antinociception occurred in parallel with oxidative changes in the spinal cord, the oxidative changes may have contributed to vitamin D-induced antinociception.


Subject(s)
Animals , Rats , Neuralgia/drug therapy , Antioxidants , Sciatic Nerve , Spinal Cord , Vitamin D , Vitamins , Reactive Oxygen Species , Rats, Wistar , Nociception , Hydrogen Peroxide , Hyperalgesia/drug therapy
10.
Actual. osteol ; 17(1): 8-17, 2021. graf, tab
Article in English | LILACS, BINACIS, UNISALUD | ID: biblio-1291888

ABSTRACT

Objective: The main purpose of this study was to evaluate serum 25-hydroxyvitamin D (25OHD) levels and its association with in"ammatory markers in patients with rheumatologic diseases (RD). Methods: A cross-sectional study in 154 women with RD (rheumatoid arthritis, spondyloarthritis and other connective tissue diseases) and 112 healthy individuals as a control group (CG) was carried out. Results: No differences in serum and urine calcium, serum phosphate, and urinary deoxypyridinoline were found. RD group had lower 25OHD and higher PTH compared to CG. RD group had higher C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) compared to CG. The overall mean level of 25OHD (ng/ml) was 26.3±12.0 in the CG and 19.4±6.8 in the RD group (p<0.0001). Moreover, CG had lower percentage of individuals with 25OHD de!ciency compared to RD (29.9% vs 53.2%). The femoral neck BMD was signi!cantly lower in postmenopausal RD women compared to CG. 25OHD levels signi!cantly correlated with ESR and CRP as in"ammatory markers. Age, BMI, presence of RD, and CRP were signi!cantly and negatively associated with 25OHD levels through linear regression analysis. According to univariate logistic regression analysis for 25OHD deficiency (<20 ng/ml), a significant and negative association with BMI, presence of RD, ESR and CRP were found. Conclusion: Patients with RD had lower 25OHD levels than controls and the presence of a RD increases by 2.66 the risk of vitamin D de!ciency. In addition, 25OHD has a negative correlation with ESR and CRP as in"ammatory markers. (AU)


Objetivo El objetivo principal de este estudio fue evaluar los niveles séricos de 25-hidroxivitamina D (25OHD) y su asociación con marcadores inflamatorios en enfermedades reumatológicas. Materiales y métodos: Se realizó un estudio transversal en 154 mujeres con enfermedades reumatológicas (artritis reumatoide, espondiloartritis y otras enfermedades del tejido conectivo) y 112 individuos sanos como grupo control (GC). Resultados: No se encontraron diferencias en el calcio sérico y urinario, el fosfato sérico y la desoxipiridinolina urinaria entre el GC y los sujetos con enfermedades reumatológicas. El grupo de pacientes con enfermedades reumatológicas tenía 25OHD más bajo y PTH más alto en comparación con el GC. Asimismo, el grupo de individuos con enfermedades reumatológicas tenía proteína C reactiva (PCR) y velocidad de eritrosedimentación (VES) más altas en comparación con el GC. El nivel de 25OHD (ng/ml) fue 26,3±12,0 en el GC y 19,4±6,8 en el grupo con enfermedades reumatológicas (p<0,0001). Además, el GC presentó un porcentaje menor de deficiencia de 25OHD en comparación con el grupo con enfermedades reumatológicas (29,9% vs 53,2%). La DMO del cuello femoral fue significativamente menor en las mujeres posmenopáusicas con enfermedades reumatológicas en comparación con el GC. La 25OHD correlacionó significativamente con la VES y la PCR como marcadores inflamatorios. El análisis de regresión lineal mostró que la edad, el IMC, la presencia de una enfermedad reumatológica y la PCR se asociaron significativa y negativamente con los niveles de 25OHD. Mientras que el análisis de regresión logística univariada mostró que la deficiencia de 25OHD (<20 ng/ml), se asoció significativa y negativamente con el IMC, la presencia de una enfermedad reumatológica, la VES y los niveles de PCR. Conclusiones: Los pacientes con enfermedades reumatológicas tenían niveles de 25OHD más bajos que los controles y la presencia de una enfermedad reumatológica aumenta en 2.66 el riesgo de deficiencia de vitamina D. Además, la 25OHD mostró correlación negativa con la VES y la PCR como marcadores inflamatorios. (AU)


Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Vitamin D/analogs & derivatives , Vitamin D/blood , Vitamin D Deficiency/etiology , Biomarkers , Rheumatic Diseases/complications , Inflammation/blood , Phosphates/blood , Blood Sedimentation , C-Reactive Protein , Body Mass Index , Bone Density , Logistic Models , Calcium/urine , Calcium/blood , Rheumatic Diseases/blood , Risk , Cross-Sectional Studies , Postmenopause , Amino Acids/urine
11.
Rev. colomb. menopaus ; 27(1): 6-7, 2021.
Article in Spanish | LILACS, COLNAL | ID: biblio-1283525

ABSTRACT

Hoy en día se enseña a los médicos jóvenes a formular calcio en las diversas etapas de la vida desde la mujer embarazada para prevenir la aparición de preeclampsia, en los jóvenes, en la mujer que busca un embarazo y en la transición a la menopausia y menopausia. Se habla de los efectos pleiotrópicos que tiene la vitamina D y su deficiencia se ha asociado con algunas enfermedades como la diabetes tipo 2, las enfermedades autoinmunes, la enfermedad hepática no alcohólica, la enfermedad cardiovascular y el cáncer. Se han descrito los efectos de esta vitamina sobre la respuesta inmune implicándola tanto en inmunidad celular como humoral y mediando procesos inflamatorios. Es por ello que recientemente se publicó que la población con niveles deficientes tenía peor desenlace con la infección por Covid-19. Hay que ser cautos y críticos con la administración masiva de fármacos.


Today young physicians are taught to prescribe calcium in different stages of life from pregnant women to prevent preeclampsia, in young people, in women seeking pregnant and in those in menopausal transition or menopause. It is spoken of the pleiotropic effects of vitamin D and its deficiency has been associated with some diseases such as type 2 diabetes, autoimmune diseases, non-alcoholic hepatic disease, cardiovascular disease and cancer. The effects of this vitamin over immune answer have been described, implicating it in celular and humoral immunity and mediating inflammatory processes. That is why recently was published that the population with deficient levels had worst outcomes with Covid-19 infection. We mast be careful and critic with massive administration of pharmaceuticals.


Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Aged , Vitamin D , Calcium , Immunity
12.
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
13.
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
14.
Rev. chil. endocrinol. diabetes ; 14(4): 159-165, 2021. tab, ilus
Article in Spanish | LILACS | ID: biblio-1344801

ABSTRACT

La diabetes Tipo 1 (DT1) es una compleja enfermedad autoinmune con una etiología aún desconocida. La vitamina D ha sido ampliamente estudiada debido a su potencial terapéutico en los potenciales nuevos casos de DT1. Por otra parte, los microARNs (miRs) han sido propuestos como posibles biomarcadores en diversos procesos biológicos como en la apoptosis e inflamación. El objetivo de este estudio fue evaluar el efecto de la suplementación con vitamina D sobre el perfil de expresión del miR-21 y marcadores de apoptosis tales como: BCL2, STAT3, TIPE2 y DAXX, en células mononucleares periféricas provenientes de pacientes con DT1 y sujetos controles. RESULTADOS: El perfil de expresión de miR-21 se encontró disminuido en los pacientes con DT1 en comparación con los controles. La expresión relativa de BCL2 se encontró aumentada en controles al comparar con pacientes DT1 en todas las condiciones experimentales. La expresión relativa de DAXX mostró un perfil de expresión diferencial al comparar pacientes con DT1 versus controles (p=0.006). CONCLUSIÓN: El estímulo con vitamina D parece tener un posible efecto regulador sobre los genes BCL2 y DAXX.


Type 1 diabetes (T1D) is a complex chronic autoimmune disease. Vitamin D has been one of the most studied therapeutic potential outbreaks related to T1D. Specific miRNAs have been proposed as potential biomarkers in several biological processes as apoptosis and inflammation. The aim of this study was to evaluate the effect of vitamin D on the expression profiles of miR-21 and apoptotic markers BCL2, STAT3, TIPE2 and DAXX, in PBMCs from T1D patients and control subjects. RESULTS: miR-21 expression was increased in controls regarding T1D patients. BCL2 was increased in controls compared to T1D patients in all experimental conditions. DAXX showed different expression patterns between T1D patients and controls (p=0.006). CONCLUSION: Vitamin D showed a possible regulation effect on apoptosis markers mainly through the regulation of BCL2 and DAXX


Subject(s)
Humans , Child , Adolescent , Vitamin D/administration & dosage , Apoptosis , Diabetes Mellitus, Type 1/metabolism , Vitamin D/metabolism , Biomarkers , Molecular Chaperones/drug effects , Molecular Chaperones/genetics , Molecular Chaperones/metabolism , Proto-Oncogene Proteins c-bcl-2/drug effects , Proto-Oncogene Proteins c-bcl-2/genetics , Proto-Oncogene Proteins c-bcl-2/metabolism , MicroRNAs/drug effects , MicroRNAs/genetics , MicroRNAs/metabolism , STAT3 Transcription Factor/drug effects , STAT3 Transcription Factor/genetics , STAT3 Transcription Factor/metabolism , Co-Repressor Proteins/drug effects , Co-Repressor Proteins/genetics , Co-Repressor Proteins/metabolism , Glucose/administration & dosage
15.
Rev. chil. endocrinol. diabetes ; 14(4): 166-170, 2021. tab, ilus
Article in Spanish | LILACS | ID: biblio-1344802

ABSTRACT

La epilepsia es una enfermedad neurológica frecuente que afecta a cerca de 50.000 millones de personas en el mundo. En Chile, la prevalencia estimada es de 10.8 a 17 por 1.000 habitantes. La primera opción para su tratamiento son los fármacos antiepilépticos (FAE) los cuales logran un aceptable control de enfermedad en la mayoría de los casos, sin embargo, tienen la potencialidad de desencadenar una serie de efectos adversos destacando entre ellos el desarrollo de hipocalcemia (HC) secundaria a hipovitaminosis D (HD), alteración que por lo general es leve y asintomática. Presentamos el caso de una mujer perimenopausica con antecedente de epilepsia en tratamiento con anticonvulsivante que desarrolla hipocalcemia severa. Además revisamos los mecanismos descritos a través de los cuales los FAE afectan el metabolismo de esta vitamina.


Epilepsy is a common neurological disease that affects about 50,000 million people in the world. The estimated prevalence is 10.8 to 17 per 1.000 inhabitants in Chile. The first option for its treatment are antiepileptic drugs (AEDs) which achieve an acceptable control of the disease in most cases, however, they have the potential to trigger a series of adverse effects (AE) highlighting among them the development of hypocalcemia (HC) secondary to hypovitaminosis D (HD), an alteration that is generally mild and asymptomatic. We present the case of a perimenopausal woman with a history of epilepsy under treatment with an anticonvulsant who develops severe hypocalcemia. We also review the mechanisms described through which AEDs affect the metabolism of this vitamin.


Subject(s)
Humans , Female , Middle Aged , Vitamin D Deficiency/complications , Vitamin D Deficiency/chemically induced , Epilepsy/drug therapy , Anticonvulsants/adverse effects , Vitamin D/metabolism , Epilepsy/metabolism , Hypercalcemia/etiology
16.
Adv Rheumatol ; 61: 16, 2021. tab, graf
Article in English | LILACS | ID: biblio-1152746

ABSTRACT

Abstract Backgrounds: It is important to improve our understanding of the roles of calcium and vitamin D in bone health for preventing osteoporosis. We aimed at exploring the associations between serum calcium, vitamin D level, and bone mineral density (BMD) in adolescents included in the National Health and Nutrition Examination Survey (NHANES) 2001 - 2006. Methods: Weighted multivariate linear regression models were used to estimate the associations of serum calcium, 25(OH)D level with total BMD. Smooth curve fitting was used to explore the potential non-linear relationship. Results: A total of 5990 individuals aged between 12 and 19 years were included in this study. The fully-adjusted model showed serum calcium positively correlated with total BMD. However, an inverted U-shaped relationship was found when we performed the smooth curve fitting method, and the inflection point was calculated at 9.6 mg/dL using the two-piecewise linear regression model. In contrast, there was a positive correlation between serum 25(OH)D and total BMD after adjusting for potential confounders. Conclusions: The present study revealed a positive correlation between serum 25(OH)D level and total BMD, and an inverted U-shaped relationship between serum calcium and total BMD.(AU)


Subject(s)
Humans , Adolescent , Vitamin D/analysis , Bone Density , Calcium/analysis , Linear Models , Nutrition Surveys , Multivariate Analysis
17.
Article in Chinese | WPRIM | ID: wpr-879894

ABSTRACT

OBJECTIVE@#To study the association of neonatal blood calcium levels with perinatal factors and neonatal urinary calcium levels measured by an intelligent urine test system.@*METHODS@#The medical data of 96 full-term singleton neonates with mild diseases were collected by a cross-sectional survey, who were hospitalized in the Department of Neonatology, The First Affiliated Hospital of Xi'an Jiaotong University, from June to August 2018. Urinary calcium levels measured by an intelligent urine test system, total blood calcium levels, ionized calcium levels, and the mother's calcium and vitamin D supplementation during pregnancy were recorded.@*RESULTS@#Compared with the group without vitamin D supplementation for the mother (17 neonates), the group with vitamin D supplementation for the mother (79 neonates) had significantly higher levels of total blood calcium and ionized calcium (@*CONCLUSIONS@#Vitamin D supplementation during pregnancy can increase the blood levels of total calcium and ionized calcium in neonates, and calcium supplementation alone cannot increase the blood levels of total calcium or ionized calcium in neonates. Hypothermia in neonates might cause the reduction in blood calcium levels. The urinary calcium level measured by the intelligent urine test system is positively correlated with the blood level of ionized calcium.


Subject(s)
Calcium , Calcium, Dietary , Cross-Sectional Studies , Female , Humans , Infant, Newborn , Pregnancy , Vitamin D , Vitamin D Deficiency
18.
Article in Chinese | WPRIM | ID: wpr-879852

ABSTRACT

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disease in children and has the clinical manifestations of recurrent abdominal pain with the changes in defecation frequency or stool form. Many studies have shown that children with IBS have a significantly lower vitamin D level than the healthy population, and vitamin D supplementation can significantly improve the clinical symptoms and quality of life of the children, suggesting that vitamin D supplementation may play a role in the treatment of IBS. This article reviews the association between vitamin D and IBS in children and elaborates on the possible mechanism of action of vitamin D.


Subject(s)
Abdominal Pain , Child , Diarrhea , Humans , Irritable Bowel Syndrome/drug therapy , Quality of Life , Vitamin D , Vitamin D Deficiency
19.
Article in Chinese | WPRIM | ID: wpr-878728

ABSTRACT

Gestational diabetes mellitus(GDM)can cause blood glucose disorders in pregnant women and result in adverse maternal-neonatal outcomes.Vitamin D(VD)can improve glucose tolerance and insulin sensitivity,and thus theoretically,VD supplementation during pregnancy could improve glycemic control as well as maternal-neonatal outcomes in GDM patients.Although studies have shown that VD deficiency is associated with poor maternal-neonatal outcomes in GDM patients,no solid conclusion has been drawn with regard to the effects of VD supplementation on these patients.Therefore,here we summarized the research progress of the effects of VD supplementation on glycemic control and adverse maternal-neonatal outcomes in GDM patients,in an effort to guide the clinical VD supplementation during pregnancy.


Subject(s)
Blood Glucose , Diabetes, Gestational/drug therapy , Dietary Supplements , Female , Glycemic Control , Humans , Infant, Newborn , Pregnancy , Pregnancy Outcome , Vitamin D
20.
Article in Chinese | WPRIM | ID: wpr-878703

ABSTRACT

Objective To evaluate the effects of vitamin D supplementation on serum lipid profiles and neonatal prognosis in gestational diabetes mellitus(GDM)patients.Methods The electronic databases including PubMed,Web of Science,Embase,CNKI,and Wanfang Data were searched from inception to February 1,2020.All randomized controlled trials that compared vitamin D supplementation with placebo or without supplementation for GDM women were included.Paper selection,data extraction,meta-analysis and sensitivity analysis were conducted independently by two authors.Risk of bias was assessed using the Cochrane Risk of Bias Tool.The data were analyzed in RevMan 5.3 software and Stata 12.0.Results Totally 17 randomized controlled trials involving 1432 patients(704 in the intervention group and 728 in the control group)were included in the meta-analysis.The results showed that vitamin D supplementation significantly reduced serum total cholesterol [MD=-6.11,95% CI=(-7.17,-5.04)],low-density lipoprotein cholesterol [MD=-10.80,95% CI=(-14.72,-6.89)],and triglyceride [MD=-8.11,95% CI=(-10.09,-6.13)],while significantly increased serum 25-hydroxyvitamin D3 level [MD=45.45,95% CI=(41.98,48.92)] and high-density lipoprotein cholesterol [MD=2.77,95% CI=(1.59,3.96)].In addition,vitamin D supplementation significantly reduced the incidence rate of hyperbilirubinemia [RR=0.49,95% CI=(0.35,0.68)],premature birth [RR=0.44,95% CI=(0.27,0.72)],and neonatal hospitalization [RR=0.44,95% CI=(0.29,0.67)].Conclusions Vitamin D supplementation may regulate the serum lipid profiles in patients with GDM and reduce the incidence of adverse neonatal outcomes.More high-quality RCTs are needed to confirm the findings in our study.


Subject(s)
Diabetes, Gestational/drug therapy , Dietary Supplements , Female , Humans , Infant, Newborn , Pregnancy , Premature Birth , Randomized Controlled Trials as Topic , Vitamin D , Vitamins
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