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J. pediatr. (Rio J.) ; 95(5): 575-583, Sept.-Oct. 2019. tab
Article in English | LILACS (Americas) | ID: biblio-1040361


Abstract Objective: Evaluate the association between inflammatory process, adiposity, and vitamins A, D, and E in adolescents, according to gender. Methods: Cross-sectional study with adolescents aged 12-19 years old of both genders attending public schools in Recife. A questionnaire was used to collect data on socioeconomic level, lifestyle, and food intake of adolescents. Then, an anthropometric evaluation and a blood sampling were performed to analyze serum concentrations of α-1-acid glycoprotein, retinol, β-carotene, α-tocopherol, and 25-hydroxy-vitamin D. Results: The levels of α-1-acid glycoprotein were higher for abdominal obesity in both genders. Male adolescents with insufficient serum α-tocopherol levels had low levels of α-1-acid glycoprotein (p = 0.03) and an increased risk of 25-hydroxy-vitamin D and β-carotene deficiency in relation to total and abdominal fat; female adolescents had an increased risk of insufficient β-carotene with abdominal obesity (PR: 1.33; 95% CI: 1.2-1.5). Conclusion: Abdominal adiposity implies a higher risk of inflammation and causes different changes to the levels of fat-soluble vitamins according to gender.

Resumo: Objetivo: Avaliar a associação entre processo inflamatório, adiposidade e as vitaminas A, D e E em adolescentes, segundo o sexo. Métodos: Estudo transversal com adolescentes de 12 a 19 anos de ambos os sexos de escolas públicas de Recife. Foi utilizado um questionário para coleta de dados socioeconômicos, de estilo de vida e de consumo alimentar dos adolescentes. Em seguida, realizou-se a avalição antropométrica e coleta de sangue para análise das concentrações séricas de α-1-glicoproteína ácida, retinol, β-caroteno, α-tocoferol e 25-hidroxivitamina D. Resultados: Os níveis de α-1-glicoproteína ácida foram maiores na obesidade abdominal de ambos os sexos. Os meninos com níveis séricos insuficientes de α-tocoferol expressaram níveis reduzidos de α-1-glicoproteína ácida (p = 0,03) e apresentaram um maior risco de deficiência de 25-hidroxivitamina D e β-caroteno na adiposidade total e abdominal, enquanto as meninas mostraram maior risco de insuficiência de β-caroteno com a obesidade abdominal (RP 1,33; IC 95% 1,2-1,5). Conclusão: A adiposidade abdominal reflete maior risco de inflamação e causa alterações distintas nas concentrações das vitaminas lipossolúveis, de acordo com o sexo.

Humans , Female , Child , Adolescent , Vitamins/metabolism , Adiposity/physiology , Inflammation/metabolism , Obesity/metabolism , Reference Values , Vitamin D/analogs & derivatives , Orosomucoid/analysis , Carotenoids/blood , Anthropometry , Nutritional Status , Cross-Sectional Studies , Inflammation/etiology , Inflammation/physiopathology , Obesity/complications , Obesity/physiopathology
Actual. osteol ; 15(1): 20-33, ene. abr. 2019. ilus., graf., tab.
Article in English | LILACS (Americas) | ID: biblio-1048986


Published evidence reports the existence of two routes for the transformation of 7-dehydrocholecalciferol into previtamin D3: a photochemical route with the participation of UVB photons and another route that occurs in the darkness. Several reports appears to support the presence of these two routes in some mammals, birds, nonvascular plants (e.g.: mosses), vascular plants (e.g.: angiosperms) and lichens. The reviewed evidence suggests that in the darkness, the synthesis of vitamin D3 follows the same scheme of the photochemical pathway, but at a reduced rate respect to the synthesis under UVB radiation. The process of vitamin D synthesis in the dark, then, may be taken as an insurance for survival, at least for mammals and birds. The low rate of the synthesis of vitamin D3 in the absence of light produce low concentrations of vitamin D3 metabolites in plasma. Long term survival under these circumstances might be possible through upregulation of vitamin D receptors (VDRs). In mole rats (South African rodents that live in the dark in underground tunnels), the reduced rate of vitamin D3 synthesis produce low levels of plasma vitamin D3 and their metabolites 25(OH) D3 and 1α,25OH2 D3 . The fact that Kd and ßmax of the complex 1α,25(OH)2 D3 -VDR from the intestinal mucosa, kidneys and the Harderian glands of the mole rat Heterocephalus glaber are significantly different in each one of these tissues, is interpreted as an indicator that the VDRs are, in each tissue, adapted to the maintenance of normal physiological functions. (AU)

Varios trabajos publicados han informado que existen dos mecanismos para la transformación de 7-dehidrocolecalciferol en previtamina D3 : uno iniciado con el auxilio de fotones UVB y un segundo que ocurre en la oscuridad, sin el auxilio de radiación ultravioleta. Una serie de publicaciones contienen información que apoya la presencia de estos dos mecanismos en mamíferos, pájaros, plantas no vasculares (musgos), vasculares (angiospermas) y líquenes. La evidencia revisada sugiere que, en la oscuridad, la síntesis de vitamina D3 sigue el mismo esquema que la ruta fotoquímica y generalmente ocurre a una tasa reducida respecto de la síntesis bajo irradiación ultravioleta. La operación de la síntesis de vitamina D3 en la oscuridad, por lo menos para mamíferos y pájaros, puede tomarse como un reaseguro de sobrevida. La reducida tasa de síntesis de vitamina D en ausencia de luz produce bajas concentraciones en plasma de los metabolitos de la vitamina. La sobrevida saludable en estas condiciones sería posible mediante upregulation de los receptores. En las ratas topo Heterocephalus glaber (roedores sudafricanos que viven en permanente oscuridad, en túneles subterráneos), la reducida tasa de síntesis de vitamina D3 es la causa de los bajos niveles plasmáticos de la vitamina y sus metabolitos: 25(OH)D3 y 1α,25OH2 D3 . El hecho de que el Kd y ßmax del complejo 1α,25(OH)2 D3 -Vitamina-D-Receptor del intestino, riñón y glándulas de Harder de Heterocephalus glaber sean significativamente diferentes entre sí indicaría que los receptores se han modificado para mantener funciones fisiológicas normales en cada tejido. (AU)

Animals , Vitamin D/chemical synthesis , Vitamin D/analogs & derivatives , Vitamin D/biosynthesis , Vitamin D/metabolism , Birds/physiology , Darkness , Bryophyta/chemistry , Tracheophyta/chemistry , Lichens/chemistry , Mammals/physiology
J. bras. pneumol ; 45(1): e20170280, 2019. tab, graf
Article in English | LILACS (Americas) | ID: biblio-990106


ABSTRACT Objective: Bone disease is a common comorbidity in patients with cystic fibrosis (CF). We sought to determine risk factors and identify potential biochemical markers for CF-related bone disease (CFBD) in a unique cohort of CF patients with end-stage lung disease undergoing lung transplantation (LTx) evaluation. Methods: All of the CF patients who were evaluated for LTx at our center between November of 1992 and December of 2010 were included in the study. Clinical data and biochemical markers of bone turnover, as well as bone mineral density (BMD) at the lumbar spine and femoral neck, were evaluated. Spearman's rho and multivariate logistic regression analysis were used. Results: A total of 102 adult CF patients were evaluated. The mean age was 28.1 years (95% CI: 26.7-29.5), and the mean body mass index was 17.5 kg/m2 (95% CI: 17.2-18.2). Mean T-scores were −2.3 and −1.9 at the lumbar spine and femoral neck, respectively, being lower in males than in females (−2.7 vs. −2.0 at the lumbar spine and −2.2 vs. −1.7 at the femoral neck). Overall, 52% had a T-score of < −2.5 at either skeletal site. The homozygous Phe508del genotype was found in 57% of patients without osteoporosis and in 60% of those with low BMD. Mean T-scores were not particularly low in patients with severe CFTR mutations. Although the BMI correlated with T-scores at the femoral neck and lumbar spine, serum 25-hydroxyvitamin D and parathyroid hormone levels did not. Conclusions: CFBD is common in CF patients with end-stage lung disease, particularly in males and patients with a low BMI. It appears that CF mutation status does not correlate with CFBD. In addition, it appears that low BMD does not correlate with other risk factors or biochemical parameters. The prevalence of CFBD appears to have recently decreased, most likely reflecting increased efforts at earlier diagnosis and treatment.

RESUMO Objetivo: A doença óssea é uma comorbidade comum em pacientes com fibrose cística (FC). Nosso objetivo foi determinar os fatores de risco e identificar possíveis marcadores bioquímicos de doença óssea relacionada à FC (DOFC) em uma coorte única de pacientes com FC e doença pulmonar terminal submetidos a avaliação para transplante de pulmão (TxP). Métodos: Todos os pacientes com FC avaliados para TxP em nosso centro entre novembro de 1992 e dezembro de 2010 foram incluídos no estudo. Foram avaliados dados clínicos e marcadores bioquímicos de remodelação óssea, bem como a densidade mineral óssea (DMO) na coluna lombar e colo do fêmur. Foram usados rô de Spearman e análise de regressão logística multivariada. Resultados: Foram avaliados 102 pacientes adultos com FC. A média de idade foi de 28,1 anos (IC95%: 26,7-29,5), e a média do índice de massa corporal foi de 17,5 kg/m2 (IC95%: 17,2-18,2). A média do escore T foi de −2,3 e −1,9 na coluna lombar e colo do fêmur, respectivamente, sendo menor nos homens que nas mulheres (−2,7 vs. −2,0 na coluna lombar e −2,2 vs. −1,7 no colo do fêmur). No geral, 52% apresentaram escore T < −2,5 em um dos dois sítios esqueléticos. O genótipo homozigoto para Phe508del foi encontrado em 57% dos pacientes sem osteoporose e em 60% daqueles com DMO baixa. A média do escore T não foi particularmente baixa em pacientes com mutações graves do gene CFTR. Embora o IMC tenha se correlacionado com o escore T no colo do fêmur e coluna lombar, os níveis séricos de 25-hidroxivitamina D e paratormônio não o fizeram. Conclusões: A DOFC é comum em pacientes com FC e doença pulmonar terminal, particularmente em homens e pacientes com IMC baixo. O estado de mutação da FC aparentemente não se correlaciona com a DOFC. Além disso, aparentemente não há correlação entre DMO baixa e outros fatores de risco ou parâmetros bioquímicos. A prevalência de DOFC parece ter diminuído recentemente, o que provavelmente é reflexo do aumento dos esforços para antecipar o diagnóstico e tratamento.

Humans , Male , Female , Adult , Osteoporosis/etiology , Cystic Fibrosis/complications , Lung Diseases/complications , Osteoporosis/epidemiology , Parathyroid Hormone/blood , Switzerland/epidemiology , Vitamin D/analogs & derivatives , Vitamin D/blood , Body Mass Index , Bone Density , Logistic Models , Multivariate Analysis , Retrospective Studies , Lung Transplantation , Critical Illness , Bone Remodeling , Sex Distribution , Statistics, Nonparametric , Cystic Fibrosis Transmembrane Conductance Regulator/genetics , Cystic Fibrosis/epidemiology , Lung Diseases/epidemiology , Mutation
Braz. j. med. biol. res ; 51(4): e7185, 2018. tab
Article in English | LILACS (Americas) | ID: biblio-889065


Hypovitaminosis D has been identified as a possible new cardiovascular risk factor. However, the results of studies correlating serum vitamin D levels with markers of subclinical atherosclerosis have been conflicting. The aim of this study was to correlate serum levels of 25-hydroxyvitamin D [25(OH)D] with carotid intima-media thickness (C-IMT) and conventional cardiovascular risk factors in Afro-descendants. A cross-sectional analysis was performed on a sample of 382 individuals from a cohort of descendants of African slaves, inhabitants of "Quilombola" communities, with a mean age of 57.79 ±15.3 years, 54.5% of whom were women. Socio-demographic and clinical data were collected and biochemical tests were performed, including serum levels of 25(OH)D by electrochemiluminescence and urinary albumin excretion, evaluated by the albumin/creatinine ratio (ACR) in a spot urine sample. All participants underwent high-resolution ultrasonography for C-IMT measurement. Hypovitaminosis D was defined as serum 25(OH)D levels <30 ng/mL. The mean serum 25(OH)D levels were 50.4±13.5 ng/mL, with a low prevalence of hypovitaminosis D (4.86%). By simple linear correlation, a significant inverse association between 25(OH)D levels and C-IMT (r=-0.174, P=0.001) was observed. However, after multiple linear regression analysis, the significance of the association between serum levels of 25(OH)D and C-IMT measurement was lost (β=-0.039, P=0.318) and only male gender, age, smoking, systolic blood pressure, glucose and low density lipoprotein (LDL)-cholesterol remained significantly associated with C-IMT. Levels of 25(OH)D were independently and positively associated with HDL-cholesterol and inversely associated with age and ACR. In conclusion, no independent association between 25(OH)D levels and C-IMT was observed in this population. On the other hand, there was an inverse association with albuminuria, a marker of endothelial lesion.

Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , African Continental Ancestry Group , Atherosclerosis/blood , Carotid Intima-Media Thickness , Vitamin D Deficiency/epidemiology , Vitamin D/analogs & derivatives , Albuminuria , Atherosclerosis/etiology , Blood Pressure , Brazil/epidemiology , Cross-Sectional Studies , Risk Factors , Socioeconomic Factors , Vitamin D/blood
Arch. argent. pediatr ; 115(4): 336-342, ago. 2017. tab
Article in English, Spanish | LILACS (Americas), BINACIS | ID: biblio-887344


Objetivo. Determinar la concentración de vitamina D en pacientes de entre 6 y 18 años de edad sometidos a un seguimiento por asma y la relación entre la concentración de vitamina D y el control y la gravedad del asma. Materiales y métodos. Se inscribió en el estudio a pacientes con asma y voluntarios sanos de entre 6 y 18 años de edad, asignados al grupo de pacientes y al grupo de referencia, respectivamente. Se registraron las características demográficas y los hallazgos clínicos de los pacientes, y se les realizó una prueba funcional respiratoria. Se estimaron el índice de masa corporal (IMC) y la concentración de 25-hidroxi vitamina D (25(OH)D), calcio, fósforo, fosfatasa alcalina, inmunoglobulina E total y eosinófilos de todos los pacientes. La gravedad del asma y las condiciones de control se determinaron según los criterios de la Iniciativa Global para el Asma (Global Initiative for Asthma, GINA). Resultados. Se incluyó a 72 pacientes con asma y a 66 niños sanos. En comparación con el grupo de referencia, en el grupo de pacientes se detectó una menor concentración de vitamina D. En 38 (52,8%) niños del grupo de pacientes con asma se observó deficiencia de vitamina D; en este grupo, el control del asma era deficiente y la gravedad, significativamente mayor. No se observó una correlación significativa entre la concentración de vitamina D y el sexo, la obesidad, las pruebas funcionales respiratorias, las pruebas cutáneas, la concentración sérica de eosinófilos e inmunoglobulina E (IgE) total. Conclusión. La deficiencia y la insuficiencia de vitamina D fueron más frecuentes en los niños con asma, en comparación con los niños del grupo de referencia. Una menor concentración de vitamina D se asocia con un control deficiente del asma y una mayor gravedad de esta.

Background. The objective was to determine vitamin D levels in patients between the ages 6 and 18 years, followed for asthma, and the relation between vitamin D levels and asthma control and severity. Materials and Methods. Patients with asthma and healthy volunteers between the ages 6 and 18 years were enrolled into the study as patient and control groups, respectively. Patient demographic information and clinical findings were recorded; a respiratory function test was performed. Body mass index (BMI), 25(OH) D,calcium, phosphorus, alkaline phosphatase, total IgE and eosinophil levels were determined for all patients. Asthma severity and control conditions were established based on GINA (Global Initiative for Asthma) criteria. Results. Seventy two patients with asthma and 66 healthy children were included. Compared to the control group, decreased serum vitamin D levels were detected in patient group. Thirty eight (52.8%) patients in asthma patient group had vitamin D defficiency; in this group, asthma control was poor and asthma severity was significantly higher. No significant correlation was found between vitamin D levels and gender, obesity, respiratory functions, skin test, serum eosinophil and total IgE levels. Conclusion. The frequency of vitamin D deficiency and insufficiency was higher in children with asthma, compared to the controls. Lower levels of vitamin D are associated with poor asthma control and increased asthma severity.

Humans , Male , Female , Child , Adolescent , Asthma/complications , Vitamin D/analogs & derivatives , Asthma/blood , Asthma/therapy , Vitamin D/blood , Vitamin D Deficiency/complications , Severity of Illness Index , Cross-Sectional Studies
Clinics ; 72(7): 415-421, July 2017. tab, graf
Article in English | LILACS (Americas) | ID: biblio-890715


OBJECTIVES: Recent studies have shown a high prevalence of hypovitaminosis D, defined as a serum 25-hydroxyvitamin D level less than 30 ng/ml, in both healthy populations and patients with chronic kidney disease. Patients undergoing kidney transplant are at an increased risk of skin cancer and are advised to avoid sunlight exposure. Therefore, these patients might share two major risk factors for hypovitaminosis D: chronic kidney disease and low sunlight exposure. This paper describes the prevalence and clinical characteristics of hypovitaminosis D among patients undergoing kidney transplant. METHODS: We evaluated 25-hydroxyvitamin D serum levels in a representative sample of patients undergoing kidney transplant. We sought to determine the prevalence of hypovitaminosis D, compare these patients with a control group, and identify factors associated with hypovitaminosis D (e.g., sunlight exposure and dietary habits). RESULTS: Hypovitaminosis D was found in 79% of patients undergoing kidney transplant, and the major associated factor was low sunlight exposure. These patients had higher creatinine and intact parathyroid hormone serum levels, with 25-hydroxyvitamin D being inversely correlated with intact parathyroid hormone serum levels. Compared with the control group, patients undergoing kidney transplant presented a higher prevalence of 25-hydroxyvitamin D deficiency and lower serum calcium, phosphate and albumin but higher creatinine and intact parathyroid hormone levels. CONCLUSIONS: Our results confirmed the high prevalence of hypovitaminosis D in patients undergoing kidney transplant. Therapeutic strategies such as moderate sunlight exposure and vitamin D supplementation should be seriously considered for this population.

Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Sunlight , Vitamin D Deficiency/etiology , Kidney Transplantation/adverse effects , Vitamin D/analogs & derivatives , Vitamin D/blood , Vitamin D Deficiency/diagnosis , Case-Control Studies , Risk Factors , Environmental Exposure
Rev. bras. ginecol. obstet ; 39(3): 102-109, Mar. 2017. tab, graf
Article in English | LILACS (Americas) | ID: biblio-843921


Abstract Objectives To assess the prevalence of hypovitaminosis D, altered arterial blood pressure, and serum levels of glucose and lipids in community-dwelling women in the city of Ribeirão Preto, in the southeast of Brazil. Methods Thiswas a cross-sectional studyof women aged40-70years old.Calciumintake and level of sun exposure were assessed by means of a questionnaire. A blood sample was used to determine glucose, lipid profile and 25-hydroxyvitaminD(25[OH]D) concentration. Results Ninety-one women were enrolled (age = 54.2 ± 7.1 years). Themean serum 25(OH)D concentration was 25.7 ± 8.9 ng/mL. A total of 24 (26.4%) women had 25 (OH)D levels < 20 ng/mL. Seventy women (76.9%) had 25(OH)D levels < 30 ng/mL. Seventy-five women (90.4%) had inadequate calcium intake, and 61 women (67%) had appropriate sun exposure, 49 of whom (80.3%) had serum 25(OH)D levels < 30 ng/mL. Conclusion This study indicates that even in community-dwelling women, living in a city with high sun exposure, serum levels of 25(OH)D > 30 ng/ml are hardly reached. Thus, it is probable that other intrinsic factors besides sun exposure may regulate the levels of vitamin D.

Resumo Objetivos Estimar a prevalência de hipovitaminose D, hipertensão arterial, e níveis séricos de glicose e perfil lipídico em uma comunidade de mulheres de Ribeirão Preto, no Sudeste brasileiro. Métodos Estudo transversal com mulheres de 40 a 70 anos de idade, submetidas a um questionário para determinar ingestão diária de cálcio e nível de exposição solar, e coleta de sangue para determinar glicose, perfil lipídico e concentração de 25- hidroxivitamina D (25[OH]D). Resultados Noventa e uma mulheres foram incluídas (idade = 54,2 ± 7,1 anos). O nível sérico médio de 25(OH)D foi 25,7 ± 8,9 ng/mL. Um total de 24 (26,4%) mulheres teve níveis de 25(OH)D < 20 ng/mL. Setenta mulheres (76.9%) tiveram níveis de 25 (OH)D < 30 ng/mL. Setenta e uma mulheres (90.4%) tiveram uma ingesta inadequada de cálcio e 61 mulheres (67%) tiveram exposição solar adequada; 49 das quais (80.3%) tiveram níveis séricos de 25(OH)D < 30 ng/mL. Conclusão Este estudo indica que mesmo morando em uma cidade com exposição solar adequada, níveis séricos de 25(OH)D > 30 ng/mL dificilmente são atingidos por mulheres climatéricas. Logo, é provável que outros fatores intrínsecos podem regular o nível de vitamina D.

Humans , Female , Adult , Middle Aged , Aged , Sunlight , Vitamin D Deficiency/epidemiology , Vitamin D/analogs & derivatives , Brazil/epidemiology , Cross-Sectional Studies , Prevalence , Vitamin D/blood
Clinics ; 72(1): 11-16, Jan. 2017. tab, graf
Article in English | LILACS (Americas) | ID: biblio-840030


OBJECTIVES: In post-menopausal women with osteoporosis, insufficient vitamin D levels decrease calcium fixation in the bones and calcium transport in the sarcoplasmic reticulum, which impairs muscle strength, possibly leading to detrimental consequences for the preservation of functional capacity and postural balance, fall prevention, and fracture risk. The aim of this study was to evaluate the association between vitamin D levels and knee muscle strength, postural balance and functional mobility among postmenopausal women with osteoporosis. METHODS: This cross-sectional study included 63 osteoporotic older women (aged 60.6±3.1 years). The subjects completed the Timed Up and Go Test to measure functional mobility, and postural balance was assessed on the AccuSway Plus portable force platform. Maximal strength was tested using an isokinetic dynamometer for knee flexion and extension. The subjects were assessed as a group and were divided into quartiles according to their vitamin D levels. NCT02771834. RESULTS: Vitamin D status was independently associated with the normalized peak torque of the knee extensors (β=0.59; p=0.04) and Timed Up and Go Test (β=-0.07; p<0.001). No between-group differences were observed in the demographic and clinical variables or postural balance; however, significant differences were observed in the Timed Up and Go Test, and the group with the highest vitamin D levels exhibited better performance than the group with the lowest vitamin D levels (p<0.001). CONCLUSION: The serum vitamin D levels were independently associated with normalized knee extension strength and functional mobility in postmenopausal women with osteoporosis.

Humans , Female , Middle Aged , Aged , Vitamin D/analogs & derivatives , Osteoporosis, Postmenopausal/blood , Postural Balance/physiology , Muscle Strength/physiology , Knee Joint/physiology , Vitamin D/blood , Osteoporosis, Postmenopausal/physiopathology , Cross-Sectional Studies
Article in English | WPRIM (Western Pacific) | ID: wprim-8646


Von Willebrand factor (vWF) is a glycoprotein with a crucial role in the formation of platelet thrombi, and ADAMTS13 is the main enzyme responsible for vWF cleavage. Both are important in the relationship between diabetic nephropathy, hypercoagulability, and cardiovascular disease. This study evaluated a potential relationship between vitamin D (vitD) levels, vWF, ADAMTS13 activity, and inflammation in diabetic patients on chronic hemodialysis (HD). Blood samples from 52 diabetic patients on chronic HD were obtained to determine vitD levels, vWF, and ADAMTS13 activity, and inflammatory markers. HD patients were grouped according to 25-hydroxyvitamin D [25(OH) VitD]25 nmol/L (n=36). vWF antigen and vWF activity were elevated in both groups, with an average of 214.3±82.6% and 175.8±72.6%, respectively. Average ADAMTS13 activity was within the normal range in both groups. Blood samples from the vitD <25 nmol/L group showed a positive correlation between c-reactive protein (CRP) and vWF levels (P=0.023; r=0.564; 95% confidence interval=0.095-0.828), with a negative correlation between HbA1c and 25(OH) VitD (P=0.015; r=-0.337; 95% confidence interval=-0.337-0.19). Diabetic patients on chronic HD had elevated vWF levels and activity with no significant change in ADAMTS13 activity. The correlation between CRP and vWF levels in the 25(OH) VitD<25 nmol/L group suggests inflammatory-related endothelial dysfunction in these patients.

ADAMTS13 Protein/metabolism , Aged , C-Reactive Protein/analysis , Diabetes Mellitus, Type 2/complications , Female , Glycated Hemoglobin A/analysis , Humans , Male , Middle Aged , Renal Dialysis , Renal Insufficiency, Chronic/complications , Vitamin D/analogs & derivatives , von Willebrand Factor/metabolism
Braz. j. med. biol. res ; 50(11): e6527, 2017. graf
Article in English | LILACS (Americas) | ID: biblio-888953


Immunological mechanisms have been proposed to underlie the pathogenesis of recurrent spontaneous abortion (RSA). Vitamin D has a potent immunomodulatory effect, which may affect pregnancy outcome. The objective of this study was to investigate 25-hydroxyvitamin D [25(OH) D] concentration and vitamin D receptor (VDR) expression in the decidual tissues of RSA patients. Thirty women with RSA (RSA group) and thirty women undergoing elective abortion (control group) were recruited during 2016 from gynecology outpatient clinics. We measured 25(OH) D, interleukin (IL)-17, IL-23, transforming growth factor β (TGF-β), VDR and 1-α-hydroxylase (CYP27B1) in decidual tissues collected during the abortion procedure. In the RSA group, 25(OH) D and TGF-β were significantly decreased while IL-17 and IL-23 were significantly increased compared with the control group. VDR expression was significantly decreased in the RSA group compared with the control group. Logistic regression analysis showed a significant negative correlation between 25(OH) D in decidual tissues and RSA. These results indicated that vitamin D concentrations in the decidua are associated with inflammatory cytokine production, suggesting that vitamin D and VDR may play a role in the etiology of RSA.

Humans , Female , Pregnancy , Adult , Young Adult , Vitamin D/analogs & derivatives , Abortion, Habitual/metabolism , Receptors, Calcitriol/analysis , Decidua/chemistry , 25-Hydroxyvitamin D3 1-alpha-Hydroxylase/analysis , Pregnancy Trimester, Third , Vitamin D/analysis , Vitamin D/metabolism , Vitamin D Deficiency/complications , Logistic Models , Risk Factors , Abortion, Habitual/etiology , Transforming Growth Factor beta/analysis , Receptors, Calcitriol/metabolism , Statistics, Nonparametric , Interleukin-17/analysis , Interleukin-23/analysis , 25-Hydroxyvitamin D3 1-alpha-Hydroxylase/metabolism
Braz. j. phys. ther. (Impr.) ; 20(3): 206-212, tab, graf
Article in English | LILACS (Americas) | ID: lil-787642


ABSTRACT Background Nutritional status and daily physical activity (PA) may be an excellent tool for the maintenance of bone health in patients with cystic fibrosis (CF). Objective To evaluate the relationship between nutritional status, daily physical activity and bone turnover in cystic fibrosis patients. Method A cross-sectional study of adolescent and adult patients diagnosed with clinically stable cystic fibrosis was conducted. Total body, femoral neck, and lumbar spine bone mineral density (BMD) were determined by dual energy X-ray absorptiometry and bone metabolism markers ALP, P1NP, PICP, and ß-CrossLaps. PA monitoring was assessed for 5 consecutive days using a portable device. Exercise capacity was also determined. Serum 25-hydroxyvitamin D and vitamin K were also determined in all participants. Results Fifty patients (median age: 24.4 years; range: 16-46) were included. BMI had positive correlation with all BMD parameters, with Spearman’s coefficients ranging from 0.31 to 0.47. Total hip bone mineral density and femoral neck BMD had positive correlation with the daily time spent on moderate PA (>4.8 metabolic equivalent-minutes/day; r=0.74, p<0.001 and r=0.72 p<0.001 respectively), daily time spent on vigorous PA (>7.2 metabolic equivalent-minutes/day; r=0.45 p<0.001), body mass index (r=0.44, p=0.001), and muscle mass in limbs (r=0.41, p=0.004). Levels of carboxy-terminal propeptide of type 1 collagen were positively associated with the daily time spent on moderate (r=0.33 p=0.023) and vigorous PA (r=0.53, p<0.001). Conclusions BMI and the daily time spent on moderate PA were found to be correlated with femoral neck BMD in CF patients. The association between daily PA and biochemical markers of bone formation suggests that the level of daily PA may be linked to bone health in this patient group. Further research is needed to confirm these findings.

Humans , Adult , Vitamin D/analogs & derivatives , Vitamin K/physiology , Biomarkers/blood , Exercise , Bone Density/physiology , Bone Remodeling/physiology , Cystic Fibrosis/physiopathology , Vitamin D/physiology , Vitamin D/metabolism , Vitamin D/chemistry , Vitamin K/metabolism , Vitamin K/chemistry , Absorptiometry, Photon , Nutritional Status , Cross-Sectional Studies
An. bras. dermatol ; 91(1): 34-39, Jan.-Feb. 2016. tab, graf
Article in English | LILACS (Americas) | ID: lil-776418


Abstract BACKGROUND: The role played by vitamin D in atopic dermatitis is controversial and has been the focus of many studies. The ultraviolet index has not been considered in this type of research. OBJECTIVES: The objectives of the study were to assess 25-hydroxy vitamin D [25(OH)D] serum level in atopic dermatitis patients and control group, to investigate the association between atopic dermatitis clinical severity (using the SCORing Atopic Dermatitis index - SCORAD) and 25(OH)D serum levels, and to evaluate the independent predictors, including Ultraviolet index, SCORAD and 25(OH)D. METHODS: We conducted a cross-sectional study of 106 atopic dermatitis patients. A control group was matched with a subsample of 54 participants with atopic dermatitis. SCORAD index, laboratory tests, and local Ultraviolet index were assessed. RESULTS: The atopic dermatitis patients had serum 25(OH)D levels and mean UVI significantly higher than the control group. Immunoglobulin E and Ultraviolet index were associated with the SCORAD index. Skin type, age and Ultraviolet index were independent predictors of 25(OH)D. CONCLUSIONS: Although statistically significant, the different levels of 25(OH)D between the paired groups may be attributed to the higher mean Ultraviolet index in atopic dermatitis patients. Since Ultraviolet index is an independent predictor of SCORAD index and of 25(OH)D level, it may work as a confounding factor in studies involving atopic dermatitis and 25(OH)D and must be considered in this kind of research.

Adolescent , Child , Child, Preschool , Female , Humans , Male , Dermatitis, Atopic/blood , Ultraviolet Rays , Vitamin D Deficiency/epidemiology , Vitamin D/analogs & derivatives , Brazil/epidemiology , Case-Control Studies , Cross-Sectional Studies , Dermatitis, Atopic/etiology , Dermatitis, Atopic/pathology , Immunoglobulin E/blood , Reference Values , Risk Factors , Seasons , Severity of Illness Index , Statistics, Nonparametric , Sunlight/adverse effects , Time Factors , Ultraviolet Rays/adverse effects , Vitamin D Deficiency/complications , Vitamin D/blood
Mem. Inst. Oswaldo Cruz ; 111(2): 128-133, Feb. 2016. tab
Article in English | LILACS (Americas) | ID: lil-772618


The purpose was to determine the prevalence and related factors of vitamin D (VitD) insufficiency in adolescents and young adults with perinatally acquired human immunodeficiency virus. A cohort of 65 patients (17.6 ± 2 years) at the Federal University of Rio de Janeiro, Brazil, were examined for pubertal development, nutrition, serum parathormone and serum 25-hydroxyvitamin D [s25(OH)D]. s25(OH)D levels < 30 ng/mL (< 75 nmol/L) were defined as VitD insufficiency. CD4+ T-cell counts and viral load, history of worst clinical status, immunologic status as nadir, current immunologic status, and antiretroviral (ART) regimen were also evaluated as risk factors for VitD insufficiency. Mean s25(OH)D was 37.7 ± 13.9 ng/mL and 29.2% had VitD insufficiency. There was no difference between VitD status and gender, age, nutritional status, clinical and immunological classification, and type of ART. Only VitD consumption showed tendency of association with s25(OH)D (p = 0.064). Individuals analysed in summer/autumn season had a higher s25(OH)D compared to the ones analysed in winter/spring (42.6 ± 14.9 vs. 34.0 ± 11.9, p = 0.011). Although, the frequency of VitD insufficiency did not differ statistically between the groups (summer/autumn 17.9% vs. winter/spring 37.8%, p = 0.102), we suggest to monitor s25(OH)D in seropositive adolescents and young adults, especially during winter/spring months, even in sunny regions.

Adolescent , Female , Humans , Male , Young Adult , Anti-Retroviral Agents/adverse effects , HIV Seropositivity/congenital , Nutritional Status/physiology , Vitamin D Deficiency/epidemiology , Antiretroviral Therapy, Highly Active/statistics & numerical data , Brazil/epidemiology , Cohort Studies , HIV Seropositivity/drug therapy , Infectious Disease Transmission, Vertical , Prevalence , Parathyroid Hormone/blood , Risk Factors , Seasons , Statistics, Nonparametric , Sunlight , Viral Load , Vitamin D Deficiency/etiology , Vitamin D/analogs & derivatives , Vitamin D/blood
Yonsei Medical Journal ; : 923-927, 2016.
Article in English | WPRIM (Western Pacific) | ID: wprim-63331


PURPOSE: Up to 71% of South Korean postmenopausal women have vitamin D deficiency {serum 25-hydroxyvitamin D [25(OH) D] level <50 nmol/L}. Data on vitamin D supplementation was collected during the screening phase of an efficacy/safety study of denosumab in Korean postmenopausal women with osteoporosis. This report describes the effect of vitamin D supplementation on repletion to 25(OH)D levels ≥50 nmol/L in Korean postmenopausal women with osteoporosis. MATERIALS AND METHODS: Vitamin D levels of Korean postmenopausal women (60-90 years old) were measured by extracting 25(OH)D2 and 25(OH)D3 from serum samples via protein precipitation and using liquid chromatography with tandem mass spectrometry detection. Calibration curves were constructed from the mass chromatograms to obtain total vitamin D levels. Subjects with serum 25(OH)D levels <50 nmol/L were supplemented with 1000 IU of vitamin D tablets during the 2.5-month-long screening period. Dose, frequency, and duration were determined by the investigator. If repletion was achieved (≥50 nmol/L) on retest, subjects were eligible to be rescreened for study entry. RESULTS: Of 371 subjects screened, 191 (52%) required vitamin D supplementation, and 88% (168 of 191) were successfully repleted. More than half of the subjects (58%) who were successfully repleted received doses of 2000 IU daily. The mean time to successful repletion was 31 days (standard deviation 8.4 days; range 11-48 days). CONCLUSION: Supplementation with daily median doses of 2000 IU vitamin D successfully repleted 88% of Korean postmenopausal women with osteoporosis within 48 days to a serum vitamin D level of 50 nmol/L.

Aged , Aged, 80 and over , Asian Continental Ancestry Group , Bone Density Conservation Agents/therapeutic use , Dietary Supplements , Double-Blind Method , Female , Humans , Middle Aged , Osteoporosis, Postmenopausal/complications , Postmenopause/blood , Republic of Korea , Vitamin D/analogs & derivatives , Vitamin D Deficiency/diagnosis
Yonsei Medical Journal ; : 1159-1164, 2016.
Article in English | WPRIM (Western Pacific) | ID: wprim-34048


PURPOSE: Despite new treatment strategies, anemia remains the most prevalent complication in patients with end-stage renal disease (ESRD). We investigated whether 25-hydroxyvitamin D [25(OH)D3] deficiency was associated with anemia in ESRD patients. MATERIALS AND METHODS: We reviewed the medical records of 410 ESRD patients who had undergone renal transplantation (RTx) at Yonsei University Health System and who had 25(OH)D3 levels measured at the time of RTx. Patients were divided into two groups based on baseline 25(OH)D3 concentrations: group 1, 25(OH)D3 levels <10 ng/mL; and group 2, 25(OH)D3 levels ≥10 ng/mL. RESULTS: Using multivariate regression models, 25(OH)D3, age, and erythrocyte-stimulating agent (ESA) dose were found to be significantly associated with hemoglobin (Hb) levels [25(OH)D3: β=0.263, p<0.001; age: β=0.122, p=0.010; ESA dose: β=-0.069, p=0.005]. In addition, logistic regression analysis revealed that patients in group 1 had a significantly higher risk for developing anemia (Hb level <10 g/dL) compared to group 2 patients, even after adjusting for potential risk factors for anemia (odds ratio=3.857; confidence interval=1.091-13.632; p=0.036). CONCLUSION: 25(OH)D3 deficiency was significantly associated with anemia in patients with ESRD. Randomized controlled trials are needed to determine whether vitamin D supplementation can improve anemia in these patients.

Adult , Aged , Anemia/blood , Calcifediol , Cross-Sectional Studies , Female , Hemoglobin A/analysis , Humans , Kidney Failure, Chronic/complications , Kidney Transplantation , Male , Middle Aged , Odds Ratio , Prevalence , Regression Analysis , Risk Factors , Vitamin D/analogs & derivatives , Vitamin D Deficiency/blood
Arq. gastroenterol ; 52(4): 260-265, Oct.-Dec. 2015. tab
Article in English | LILACS (Americas) | ID: lil-771918


Background - Inflammatory bowel disease, comprising Crohn's disease and ulcerative colitis, is a group of debilitating conditions associated with deregulated mucosal immune response. Vitamin D has been implicated in immune response and gastrointestinal function. Objectives - To investigate the correlation between serum vitamin D levels and disease activity and quality of life in patients with inflammatory bowel disease. Methods - This cross-sectional study enrolled ambulatory patients with inflammatory bowel disease and assessed clinical disease activity and quality of life (Short Inflammatory Bowel Disease Questionnaire [SIBDQ]). Vitamin D levels were determined via serum 25-hydroxyvitamin D measurement; deficiency was defined as values <20 ng/mL. Statistical analysis was performed with SPSS vs 20.0. Results - A total of 76 patients were enrolled, 19 with ulcerative colitis (25%) and 57 with Crohn's disease (75%). Overall, mean serum 25-hydroxyvitamin D levels were low (26.0±10.0 ng/mL), while those in patients with Crohn's disease were significantly lower than ulcerative colitis (24.6±8.0 vs 30.0±12.5 ng/mL; P=0.032). Vitamin D deficiency was found in 30% of patients. Patients who were in clinical remission were found to have higher levels of vitamin D than those who were not in remission (28.0±10.3 vs 21.6±6.0 ng/mL, P=0.001). Inflammatory bowel disease patients with SIBDQ scores <50 were found to have significantly lower mean vitamin D levels compared with patients who had SIBDQ scores ≥50 (23.4±6.9 vs 27.9±10.8 ng/mL, P=0.041). Conclusions - A high proportion of patients with inflammatory bowel disease were vitamin D deficient, particularly patients with Crohn's disease. Both clinical disease activity and quality of life correlated significantly with lower levels of vitamin D, illustrating a clear need for supplementation in patients with inflammatory bowel disease.

Contexto - A doença inflamatória intestinal, que compreende a doença de Crohn e a colite ulcerosa, é um grupo de entidades incapacitantes associada a uma resposta imunitária desregulada. A vitamina D tem sido associada à resposta imune e funções gastrointestinais. Objetivo - Investigar a correlação entre os níveis séricos de vitamina D, a atividade clínica da doença e a qualidade de vida em doentes com doença inflamatória intestinal. Método - Estudo transversal que incluiu doentes em ambulatório com doença inflamatória intestinal avaliando a atividade clínica da doença e a qualidade de vida (Short Inflammatory Bowel Disease Questionnaire [SIBDQ]). Os níveis séricos de vitamina D foram determinados através dos níveis de 25-hidroxivitamina D; a deficiência de vitamina D foi definida para valores <20 ng/mL. Resultados - Foram incluídos 76 doentes, 19 com colite ulcerosa (25%) e 57 com doença de Crohn (75%). No global, os valores séricos médios de 25-hidroxivitamina D foram baixos (26,0±10,0 ng/mL), os doentes com doença de Crohn apresentaram níveis mais baixos do que os doentes com colite ulcerosa (24,6±8,0 vs 30,0±12,5 ng/mL; P=0,032). O défice de vitamina D foi identificado em 30% dos doentes. Os doentes em remissão clínica apresentaram níveis mais elevados de vitamina D (28,0±10,3 vs 21,6±6,0 ng/mL, P=0,001). Doentes com SIBDQ <50 apresentaram níveis significativamente inferiores de vitamina D em comparação com doentes com SIBDQ ≥50 (23,4±6,9 vs 27,9±10,8 ng/mL, P=0,041). Conclusão - Uma percentagem elevada de doentes apresentou deficiência de vitamina D, em particular doentes com doença de Crohn. A atividade clínica e a qualidade de vida dos doentes com doença inflamatória intestinal correlacionou-se com níveis mais baixos de vitamina D, ilustrando uma clara necessidade de suplementação desta vitamina em doentes com doença inflamatória intestinal.

Adult , Female , Humans , Male , Colitis, Ulcerative/complications , Crohn Disease/complications , Quality of Life/psychology , Vitamin D Deficiency/etiology , Vitamin D/analogs & derivatives , Cross-Sectional Studies , Colitis, Ulcerative/blood , Colitis, Ulcerative/psychology , Crohn Disease/blood , Crohn Disease/psychology , Severity of Illness Index , Vitamin D Deficiency/blood , Vitamin D/blood
s.l; s.n; nov. 2015.
Non-conventional in Spanish | LILACS (Americas), BRISA | ID: biblio-848331


INTRODUCCIÓN: Antecedentes: El presente informe expone la evaluación del medicamento paricalcitol endovenoso (e.v) y oral, respecto a su uso en pacientes con hiperparatiroidismo secundario a enfermedad renal crónica (ERC) estadío 5 en tratamiento sustitutivo con hemodiálisis o diálisis peritoneal, y resistentes al tratamiento con calcitriol. Aspcetos Generales: El tratamiento del hiprparatiroidismo secundario (HPTs) en la enfermedad rnal crónica se base en el entendimiento de la patogénesis y la clínica de esta condición, y del reconocimiento que la homeostasis aormal del calcio y del fosforo puede incrementar la morbimortalidad. La insuficiencia renal se acompña de una disminución de la absorción del calcio de la excreción de fosfatos. Tecnología Sanitaria de Interés: Paracicalcitol: La reducción de la conversión de la vitamina D a su principal metabolito activo (1,25-hidroxivitamina D) en la Insuficiencia renal conduce a una reducción de la activación del receptor de la vitamina D (VDR), lo cual remueve la supresión inibitoria de la liberación de la hormona paratiroidea (PTH); el incremento sérico de PTH reduce la excreción de calcio e incrementa la resorción del hueso. Paricalcitol es un análogo sintético d ela vitamina D el cual se une y activa al VDR en el riñon, en la glándula paratiroidea, en el intestino y en el hueso; reduciendo así los niveles de PTH y mejorando la momeostasis del calcio y fosforo. METODOLOGÍA: Estrategia de Búsqueda: Se realizó una búsqueda de la literatura con recpecto a la eficacia y seguridad de paricalcitol e.v. y oral para el tratamiento de HPTs en pacientes con enfermedad renal crónica en hemodiálisis o en diálisis peritoneal, y con resistencia al tratamiento con calcitriol, en las bases de datos de OVID MEDLINE y TRIPDATABASE. También se hizo una búsqueda adicional en la página de registro de ensayos clínicos, para poder identificar ensayos en desarrollo o que se hayan realizado y no estén publicados. Adicionalmente, se hizo una búsqueda dentro de la información generada por grupos que realizan revisiones sistemáticas, evaluación de tecnologías sanitarias y guías de práctica clínica, tales como The Cochrane Library, The National Institute for helath and Care Excellence (NICE) y The National Guideline of Clearinghouse. RESULTADOS: Se realizó la búsqueda bibliográfica y de evidencia científica para el sustento del uso de paricalcitol como tratamiento de pacientes con HPTs en hemodiálisis y resistentes al tratamiento con calcitriol. Se presenta la evidencia disponible en guías de práctica clínica, ensayos clínicos no aleatorizados y un estudio registrado en CONCLUSIONES: En la presente evaluación de tecnología sanitaria no se ha encontrado evidencia que muestre ue el paricaclcitorl ofrezca benefícios para los pacientes en hemodiálisis y resistentes al tratamiento con calcitriol en términos de desenlaces clínicamente relevantes para el paciente establecidos en la pregunta PICO, como la mortalidad, la calidad de vida, hospitalizaciones, eventos cardiovasculares y fracturas. Sin embargo, se ha identificado evidencia aunque proveniente de escasos estudios y de baja calidad, que muestra que paricalcitol puede tener un efecto en reducir los niveles séricos de PTH. Los pacientes de interés en en esta evaluaciónya han sido manejados con calcitriol usando dosis máximas tolerables y por un tiempo determinado, no logrando controlar los niveles bioquímicos de PTH. La situación de no mantener los níveles de PTH dentro de rangos recomendados indicaria persistencia de un recambio óseo anormal asociado a la enfermedad de osteodistrofia renal, por lo que requieren ser manejados con otras opciones terapéuticas disponibles. El Instituto de Evaluación de Tecnoglogías en Salud e Investigación_IETSI, aprueba temporalmente el uso de paricalcitol endovenoso y oral para el tratamiento del HPTs en pacientes en hemodiálisis o en diálisis peritonral y resistentes al tratamiento con calcitriol. Dado que la evidencia que respalda este uso de paricalcitol es aún limitada, se establece que el efecto de paricalcitol se evaluará con los datos de los pacientes que hayan recibido paricalcitol por el lapso de un año para determinar el impacto de su uso en varios desenlaces inclyendo los intermedios como los clínicos. Esta inforamción será tomada en cuenta en la re-evaluación de este medicamento para efectos de un nuevo dictamen al terminar la vigencia del presente Dictamen Preliminar.

Humans , Calcitriol/adverse effects , Hyperparathyroidism, Secondary/drug therapy , Peritoneal Dialysis/methods , Renal Dialysis/methods , Renal Insufficiency, Chronic/complications , Vitamin D/administration & dosage , Vitamin D/analogs & derivatives , Drug Resistance/drug effects , Technology Assessment, Biomedical , Treatment Outcome
Arch. endocrinol. metab. (Online) ; 59(5): 448-454, Oct. 2015. tab, graf
Article in English | LILACS (Americas) | ID: lil-764107


ObjectiveTo investigate whether vitamin D deficiency is associated with high mean platelet volume (MPV) in pregnancies diagnosed with gestational diabetes mellitus (GDM) compared to healthy pregnancies.Subjects and methodsThis study included 200 pregnant women. 25-hydroxyvitamin D3(25(OH)D3) and MPV values were monitored between pregnant women with GDM and normal glucose metabolism. Correlation between 25(OH)D3 and MPV was calculated both in GDM and healthy pregnancies. Both 25(OH)D3 level in different MPV percentile (≤ 50, 50-75, 75-90, ≥ 90 percentile) and MPV value in different 25(OH)D3 level (≤ 10, 10-20, ≥ 20 ng/mL) were calculated.ResultsLow 25(OH)D3 level and high MPV were observed both in GDM group (p = 0.007, p = 0.06, respectively) and in glucose metabolism disorders (GMD) group (p = 0.03, p = 0.04, respectively). There was no significant relationship between 25(OH)D3 and MPV in healthy pregnancies. Whereas, it is observed that there is a negative, but statistically insignificant correlation between MPV and 25(OH)D3 pregnant women with GMD (r = 0.1, r = -0.7, respectively). MPV values had significantly higher in vitamin D deficient group than pregnant women with normal 25(OH)D3 level in GMD group (p = 0.04). The optimal 25(OH)D3 cut off point for predicting future cardiovascular risk was 10.4 ng/ mL (area under curve (AUC) = 0.58).ConclusionsVitamin D deficiency may contribute to an increased risk for future cardiovascular diseases and a risk of thrombotic complications in pregnant women with GDM.

Adult , Female , Humans , Pregnancy , Young Adult , Diabetes, Gestational/blood , Mean Platelet Volume , Vitamin D Deficiency/complications , Cardiovascular Diseases/prevention & control , Glucose Tolerance Test , Risk Factors , ROC Curve , Vitamin D Deficiency/blood , Vitamin D/analogs & derivatives , Vitamin D/blood
Salud colect ; 11(3): 351-365, jul.-sep. 2015.
Article in Spanish | LILACS (Americas) | ID: lil-761806


En este artículo se analizan los debates parlamentarios de la Ley 26743 de Identidad de Género y de la Ley 26862 de Fertilización Asistida, desarrollados en el Congreso Nacional argentino entre los años 2011 y 2013. A través de la técnica de análisis de contenido cualitativo se analizan las versiones taquigráficas de los debates parlamentarios con el fin de responder los siguientes interrogantes: ¿cómo fue caracterizado el problema público al cual ambas leyes darían respuesta?, ¿cómo fue conceptualizada la misión de ambas leyes?, ¿en qué medida dicha definición implicó poner en entredicho las nociones de salud y enfermedad con relación a la cobertura de tratamientos de optimización o modificación corporal por parte del sistema público de salud? El proceso de sanción de ambas leyes implicó tensionar los conceptos de salud y enfermedad como categorías morales. En dicho marco emergió una noción ampliada del concepto de salud integral que incluyó los deseos reproductivos y corporales de los ciudadanos y ciudadanas.

In this paper we present an analysis of the parliamentary debates of the Gender Identity Law (No. 26743) and the Assisted Fertilization Law (No. 26862) carried out in the Argentine National Congress between 2011 and 2013. Using a qualitative content analysis technique, the stenographic records of the debates were analyzed to explore the following questions: How was the public problem to which each law responds characterized? How was the mission of each law conceptualized? To what extent did those definitions call into question ideas of health and illness, in including in the public health system coverage for certain medical treatments of body optimization or modification? In the process of sanctioning both laws, the concepts of health and disease were put into dispute as moral categories. In this context, an expanded concept of comprehensive health arose, in which desires regarding reproduction and the body were included.

Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Cholecalciferol/therapeutic use , HIV Infections/complications , Vitamin D Deficiency/drug therapy , Botswana , Cholecalciferol/administration & dosage , Double-Blind Method , HIV Infections/blood , Pilot Projects , Prospective Studies , Treatment Outcome , Viral Load , Vitamin D Deficiency/blood , Vitamin D Deficiency/complications , Vitamin D/analogs & derivatives , Vitamin D/blood
J. pediatr. (Rio J.) ; 91(2): 175-182, Mar-Apr/2015. tab
Article in English | LILACS (Americas) | ID: lil-745947


OBJECTIVE: To analyze the prevalence of excess weight and low height, and identify associated factors among children younger than five years. METHODS: Cross-census study. A total of 1,640 children from two municipalities in Piauí, Brazil were included. RESULTS: The prevalence of low height was 10.9% (95% CI: 9.3 to 12.4), inversely associated with mother's younger age and low level of education, lower socioeconomic status, mothers who had fewer than six prenatal consultations, and households that had more than one child younger than 5 years. Excess weight prevalence was 19.1% (95% CI: 17.2 to 21.0), and remained inversely associated with lower maternal age, low maternal education, and cesarean delivery. Stunting was greater in children aged between 12 and 23 months, while excess weight decreased with age. CONCLUSIONS: It is noteworthy that the stunting rate, although decreasing, is still high, while the prevalence of excess weight, even in this very poor area, already exceeds the expected percentage for a population with better socioeconomic level. .

OBJETIVO: Analisar a prevalência de excesso de peso e déficit de altura e identificar fatores associados entre menores de cinco anos. MÉTODOS: Estudo censitário transversal. Foram incluídas 1.640 crianças de dois municípios do Piauí, Brasil. RESULTADOS: A prevalência de déficit de altura foi 10,9% (IC95%: 9,3-12,4), inversamente associado com menor idade e escolaridade materna, menor condição socioeconômica, mães que fizeram menos de seis consultas pré-natal e se nessas casas havia mais de uma criança menor de cinco anos. O excesso de peso teve prevalência de 19,1% (IC95%: 17,2-21,0) e manteve-se inversamente associado com menor idade da mãe, baixa escolaridade materna e parto cesáreo. O déficit de altura foi maior para crianças entre 12 e 23 meses, enquanto o excesso de peso diminuiu com a idade. CONCLUSÕES: Destaca-se que o déficit de altura, embora esteja diminuindo, ainda é elevado, enquanto a prevalência de excesso de peso, mesmo nessa área muito pobre, já supera o percentual esperado para uma população com melhores condições socioeconômicas. .

Adult , Child , Child, Preschool , Female , Humans , Male , Bone Density , DNA Methylation , Promoter Regions, Genetic , Retinoid X Receptor alpha/genetics , CpG Islands , Electrophoretic Mobility Shift Assay , Prospective Studies , Vitamin D/analogs & derivatives , Vitamin D/blood