Ingesta de calcio y vitamina D: relación con exceso de peso en población costarricense / Calcium and vitamin D intake, its relationship with weight excess in Costa Rican population

Introducción: La presencia de sobrepeso y obesidad aumentan la morbimortalidad de la población latinoamericana. La deficiencia de micronutrientes como el calcio y la vitamina D se han relacionado con un aumento del riesgo de obesidad. Objetivo: Determinar la relación entre la ingesta de vitamina D y de calcio con los factores de riesgo para obesidad en la población urbana costarricense incluidas en el Estudio ELANS. Materiales y métodos: Se incluyeron 798 participantes costarricenses del Estudio ELANS. Se determinó la distribución del consumo de calcio y vitamina D según las características socioeconómicas, la actividad física y los datos antropométricos. Se compararon los grupos con las pruebas U de Mann ­ Whitney y Kruskal-Wallis. Se realizaron modelos de regresión lineal y logística. Resultados: El consumo de calcio y vitamina D fue inadecuado en más del 98% de los participantes. Las mujeres, las personas con menor nivel socioeconómico, baja actividad física, de menor edad, con exceso de peso y obesidad abdominal presentaron un consumo menor de calcio y de vitamina D. El consumo de calcio y vitamina D es mayor en los grupos que tienen un menor IMC (p= 0,023 para calcio y p= 0,252 para vitamina D). Las personas con menor circunferencia de la cintura tuvieron más consumo de calcio y vitamina D (p= 0,002 para calcio y p= 0,008 para vitamina D). No hubo asociación del consumo en los modelos de regresión. Conclusiones: El consumo de calcio y vitamina D es deficiente en la población urbana costarricense y, presentó una relación inversa con el IMC(AU)

ntroduction: The presence of overweight and obesity increase the morbimortality of people in Latin America. Micronutrient deficiencies, such as calcium and vitamin D, are associated with an increased risk of obesity. Objective: To determine the relationship between vitamin D and calcium intake with risk factors for obesity in the Costa Rican urban population included in the ELANS Study. Materials and methods: For this analysis we used the 798 Costa Rican participants of the study (ELANS). The distribution of calcium and vitamin D intake was determined according to socioeconomic status, physical activity, and anthropometric measures. The Mann ­ Whitney and Kruskal-Wallis U tests were used, as well as linear and logistic regression models were performed. Results: Calcium and vitamin D intake was inadequate in more than 98% of the participants. Women, individuals with a lower socioeconomic level, low physical activity, younger age and those with excess weight and abdominal obesity presented lower consumptionofcalciumandvitamin D. Theconsumption of calcium and vitamin D was greater in the groups that have a lower BMI (p= 0.023 for calcium and p= 0.252 for vitamin D). The smaller the waist circumference, the greater the consumption of calcium and vitamin D (p= 0.002 for calcium and p= 0.008 for vitamin D). No association of the consumption of calcium and vitamin D was found in the regression models. Conclusions: Consumption of calcium and vitamin D is deficient in the Costa Rican urban population, and more prevalent among those with higher BMI. Arch Latinoam Nutr 2024(AU)

Progress of chronic obstructive pulmonary disease patients with different muscle mass levels / 公共卫生与预防医学

Objective To investigate the difference of the disease progression in patients with chronic obstructive pulmonary disease (COPD) with different muscle mass levels and the influence of related factors on the disease progression. Methods A total of 308 newly diagnosed patients with COPD from February 2021 to February 2022 were selected for this study. All patients were below moderate COPD. The patients were divided into two groups according to their muscle mass levels: sarcopenia group (98 cases) and control group (210 cases). The diagnostic criteria for sarcopenia were based on sarcopenia diagnostic thresholds: RSMI 2 in men and 2 for women. All subjects were followed up for 4 months to observe the progress of the patient's condition. The correlation between the muscle mass level and pulmonary function level, as well as the results of 6-minute walking test and CAT score was evaluated, and the influence of muscle mass level on the patient's disease progress was analyzed. At the same time, the potential influence of related factors (body fat rate, vitamin D level, etc.) on the condition of patients with different muscle mass levels was discussed. SPSS 19.0 software was used to perform statistical analysis. Results Under the same treatment intervention, the baseline and follow-up lung function improvement levels of patients in the sarcopenia group were lower than those in the control group, and the difference was statistically significant (P<0.05). At the same time, the baseline and follow-up 6-minute walk test results of the patients in the sarcopenia group were also worse than those of the control group, and the difference was statistically significant (P<0.05). Further correlation analysis was carried out between the patient's muscle mass level and the post-treatment pulmonary function indicators and 6MWD test level. The results showed that the muscle mass level was positively correlated with several pulmonary function indicators (FEV1, FEV1% predict) and 6MWD (both P<0.05). Considering the possible influence of other factors on the control and progress of the patient's condition, the present study used follow-up CAT score results to distinguish the prognosis of the patient's condition improvement, and used improvement and non-improvement as dependent variables to analyze the influence of various potential influencing factors. The results of regression model analysis showed that lower baseline muscle mass, women, lower body fat percentage, and lower vitamin D level were the main risk factors. Conclusion Under the same treatment condition, COPD patients with different muscle mass levels improve more slowly when complicated with sarcopenia and have poor prognosis. Women, lower body fat percentage and lower vitamin D level are potential risk factors for poor prognosis.

Association of vitamin D receptor gene polymorphisms with type 2 diabetes mellitus in Taif population: a case-control study

Abstract Several reasons may underlie the dramatic increase in type2 diabetes mellitus. One of these reasons is the genetic basis and variations. Vitamin D receptor polymorphisms are associated with different diseases such as rheumatoid arthritis and diabetes. The aim of this study is to investigate the possible association of two identified mutations ApaI (rs7975232) and TaqI (rs731236). Eighty-nine healthy individuals and Fifty-six Type 2 Diabetic (T2D) patients were investigated using RFLP technique for genotyping and haplotyping as well. The distribution of Apal genotypes was not statistically significant among the control (P=0.65) as well as for diabetic patients (P=0.58). For Taql allele frequencies of T allele was 0.61 where of G allele was 0.39. The frequency distribution of Taql genotypes was not statistically significant among the control (P=0.26) as well as diabetic patients (P=0.17). Relative risk of the allele T of Apa1 gene is 1.28 and the odds ratio of the same allele is 1.53, while both estimates were 1.0 of the allele G. Similarly, with the Taq1 gene the relative risk and the odds ratio values for the allele T are 1.09 and 1.27 respectively and both estimates of the allele C were 0.86 for the relative risk and 0.79 for the odds ratio. The pairwise linkage disequilibrium between the two SNPs Taq1/apa1 was statistically significant in control group (D = 0.218, D' = 0.925 and P value 0.001) and similar data in diabetic groups (D = 0.2, D' = 0.875 and P value 0.001). These data suggest that the T allele of both genes Apa1 and Taq1 is associated with the increased risk of type 2 diabetes. We think that we need a larger number of volunteers to reach a more accurate conclusion.

Resumo Várias razões podem estar subjacentes ao aumento dramático da diabetes mellitus tipo 2. Um desses motivos é a base genética e variações. Os polimorfismos do receptor da vitamina D estão associados a diferentes doenças, como artrite reumatoide e diabetes. O objetivo deste estudo é investigar a possível associação de duas mutações identificadas ApaI (rs7975232) e TaqI (rs731236). Oitenta e nove indivíduos saudáveis e 56 pacientes com diabetes tipo 2 (T2D) foram investigados usando a técnica RFLP para genotipagem e haplotipagem também. A distribuição dos genótipos Apal não foi estatisticamente significativa entre o controle (P = 0,65), bem como para os pacientes diabéticos (P = 0,58). Para as frequências do alelo Taql, o alelo T foi de 0,61, onde o alelo G foi de 0,39. A distribuição de frequência dos genótipos Taql não foi estatisticamente significativa entre o controle (P = 0,26), bem como os pacientes diabéticos (P = 0,17). O risco relativo do alelo T do gene Apa1 é 1,28 e a razão de chances do mesmo alelo é 1,53, enquanto ambas as estimativas foram 1,0 do alelo G. Da mesma forma, com o gene Taq1, os valores de risco relativo e razão de chances para o alelo T são 1,09 e 1,27, respectivamente, e ambas as estimativas do alelo C foram de 0,86 para o risco relativo e 0,79 para o odds ratio. O desequilíbrio de ligação par a par entre os dois SNPs Taq1 / apa1 foi estatisticamente significativo no grupo de controle (D = 0,218, D' = 0,925 e valor P 0,001) e dados semelhantes em grupos diabéticos (D = 0,2, D' = 0,875 e valor P 0,001). Esses dados sugerem que o alelo T de ambos os genes Apa1 e Taq1 está associado ao aumento do risco de diabetes tipo 2. Achamos que precisamos de um número maior de voluntários para chegar a uma conclusão mais precisa.

Association of vitamin D receptor gene polymorphisms with type 2 diabetes mellitus in Taif population: a case-control study / Associação de polimorfismos do gene do receptor de vitamina D com diabetes mellitus tipo 2 na população Taif: um estudo de caso-controle

Abstract Several reasons may underlie the dramatic increase in type2 diabetes mellitus. One of these reasons is the genetic basis and variations. Vitamin D receptor polymorphisms are associated with different diseases such as rheumatoid arthritis and diabetes. The aim of this study is to investigate the possible association of two identified mutations ApaI (rs7975232) and TaqI (rs731236). Eighty-nine healthy individuals and Fifty-six Type 2 Diabetic (T2D) patients were investigated using RFLP technique for genotyping and haplotyping as well. The distribution of Apal genotypes was not statistically significant among the control (P=0.65) as well as for diabetic patients (P=0.58). For Taql allele frequencies of T allele was 0.61 where of G allele was 0.39. The frequency distribution of Taql genotypes was not statistically significant among the control (P=0.26) as well as diabetic patients (P=0.17). Relative risk of the allele T of Apa1 gene is 1.28 and the odds ratio of the same allele is 1.53, while both estimates were < 1.0 of the allele G. Similarly, with the Taq1 gene the relative risk and the odds ratio values for the allele T are 1.09 and 1.27 respectively and both estimates of the allele C were 0.86 for the relative risk and 0.79 for the odds ratio. The pairwise linkage disequilibrium between the two SNPs Taq1/apa1 was statistically significant in control group (D = 0.218, D' = 0.925 and P value < 0.001) and similar data in diabetic groups (D = 0.2, D' = 0.875 and P value < 0.001). These data suggest that the T allele of both genes Apa1 and Taq1 is associated with the increased risk of type 2 diabetes. We think that we need a larger number of volunteers to reach a more accurate conclusion.

Resumo Várias razões podem estar subjacentes ao aumento dramático da diabetes mellitus tipo 2. Um desses motivos é a base genética e variações. Os polimorfismos do receptor da vitamina D estão associados a diferentes doenças, como artrite reumatoide e diabetes. O objetivo deste estudo é investigar a possível associação de duas mutações identificadas ApaI (rs7975232) e TaqI (rs731236). Oitenta e nove indivíduos saudáveis ​​e 56 pacientes com diabetes tipo 2 (T2D) foram investigados usando a técnica RFLP para genotipagem e haplotipagem também. A distribuição dos genótipos Apal não foi estatisticamente significativa entre o controle (P = 0,65), bem como para os pacientes diabéticos (P = 0,58). Para as frequências do alelo Taql, o alelo T foi de 0,61, onde o alelo G foi de 0,39. A distribuição de frequência dos genótipos Taql não foi estatisticamente significativa entre o controle (P = 0,26), bem como os pacientes diabéticos (P = 0,17). O risco relativo do alelo T do gene Apa1 é 1,28 e a razão de chances do mesmo alelo é 1,53, enquanto ambas as estimativas foram < 1,0 do alelo G. Da mesma forma, com o gene Taq1, os valores de risco relativo e razão de chances para o alelo T são 1,09 e 1,27, respectivamente, e ambas as estimativas do alelo C foram de 0,86 para o risco relativo e 0,79 para o odds ratio. O desequilíbrio de ligação par a par entre os dois SNPs Taq1 / apa1 foi estatisticamente significativo no grupo de controle (D = 0,218, D' = 0,925 e valor P < 0,001) e dados semelhantes em grupos diabéticos (D = 0,2, D' = 0,875 e valor P < 0,001). Esses dados sugerem que o alelo T de ambos os genes Apa1 e Taq1 está associado ao aumento do risco de diabetes tipo 2. Achamos que precisamos de um número maior de voluntários para chegar a uma conclusão mais precisa.

Efeitos da Suplementação de Vitamina D sobre Parâmetros Hemodinâmicos Centrais e Sistema Nervoso Autônomo em Indivíduos com Obesidade ou Sobrepeso / Effects of Vitamin D Supplementation on Central Hemodynamic Parameters and Autonomic Nervous System in Obese or Overweight Individuals

Resumo Fundamento Estudos prévios têm sido inconsistentes em demonstrar efeitos cardiovasculares benéficos da suplementação de vitamina D. Objetivo Avaliar efeitos da suplementação de vitamina D3 sobre parâmetros hemodinâmicos centrais e atividade autonômica em indivíduos obesos/sobrepeso e baixos níveis de vitamina D (<30ng/dl). Métodos Ensaio clínico prospectivo, randomizado, duplo-cego (NCT 05689632), adultos 40-65 anos com índice de massa corporal ≥25<40 kg/m2. Hemodinâmica central avaliada por método oscilométrico (Mobil-O-Graph®), variabilidade da frequência cardíaca utilizando frequencímetro Polar (software Kubios®). Os pacientes (n=53) receberam placebo no grupo controle (CO, n=25) ou vitamina D3 (VD, n=28) 7000 UI/dia, avaliados antes (S0) e após 8 semanas (S8) com nível de significância de 0,05. Resultados Os grupos foram homogêneos na idade (51±6 vs. 52±6 anos, p=0,509) e níveis de vitamina D (22,8±4,9 vs. 21,7±4,5ng/ml, p=0,590). Na S8, o grupo VD apresentou níveis significativamente maiores de vitamina D (22,5 vs. 35,6ng/ml, p<0,001). Apenas o grupo VD mostrou redução significativa da pressão arterial sistólica (PAS; 123±15 vs. 119±14mmHg, p=0,019) e fosfatase alcalina (213±55 vs. 202±55mg/dl, p=0,012). O grupo CO mostrou elevação da pressão de aumento (AP: 9 vs. 12mmHg, p=0,028) e do índice de incremento (Aix: 26 vs. 35%, p=0,020), o que não foi observado no grupo VD (AP: 8 vs. 8mmHg, Aix: 26 vs. 25%, p>0,05). Grupo VD apresentou aumento no índice do sistema nervoso (iSN) parassimpático (-0,64±0,94 vs. -0,16±1,10, p=0,028) e no intervalo R-R (866±138 vs. 924±161ms, p=0,026). Conclusão Nesta amostra, a suplementação diária de vitamina D durante oito semanas resultou em melhora dos níveis pressóricos, parâmetros hemodinâmicos centrais e do equilíbrio autonômico.

Abstract Background Previous studies have been inconsistent in demonstrating beneficial cardiovascular effects of vitamin D supplementation. Objective To evaluate the effects of vitamin D3 supplementation on central hemodynamic parameters and autonomic activity in obese/overweight individuals with low vitamin D levels (<30ng/dl). Methods Adults 40-65 years old with body mass index ≥25<40 kg/m2 were enrolled in this prospective, randomized, double-blind clinical trial (NCT 05689632). Central hemodynamics was assessed using the oscillometric method (Mobil-O-Graph®), and heart rate variability using a Polar heart rate monitor (Kubios® software). Patients (n=53) received a placebo in the control group (CO, n=25) or vitamin D3 (VD, n=28) 7000 IU/day, and were evaluated before (W0) and after 8 weeks (W8) with a significance level of 0.05. Results The groups were homogeneous regarding age (51±6 vs 52±6 years, p=0.509) and vitamin D levels (22.8±4.9 vs 21.7±4.5ng/ml, p=0.590). At W8, the VD group had significantly higher levels of vitamin D (22.5 vs 35.6ng/ml, p<0.001). Only the VD group showed a significant reduction in systolic blood pressure (SBP; 123±15 vs 119±14mmHg, p=0.019) and alkaline phosphatase (213±55 vs 202±55mg/dl, p=0.012). The CO group showed an increase in augmentation pressure (AP: 9 vs 12 mmHg, p=0.028) and augmentation index (AIx: 26 vs 35%, p=0.020), which was not observed in the VD group (AP: 8 vs 8 mmHg, AIx: 26 vs 25%, p>0.05). VD group showed an increase in the parasympathetic nervous system index (PNSi) (-0.64±0.94 vs -0.16±1.10, p=0.028) and the R-R interval (866±138 vs 924±161 ms, p= 0.026). Conclusion In this sample, eight weeks of daily vitamin D supplementation resulted in an improvement in blood pressure levels and autonomic balance.

Vitamin D status in active and inactive noninfectious uveitis - data from a reference university hospital in Rio de Janeiro, Brazil

ABSTRACT Purpose: This study aimed to investigate the correlation between serum vitamin D levels and disease activity in patients with noninfectious uveitis. Methods: We conducted a prospective case-control study, assessing 51 patients with noninfectious uveitis, categorized into active (n=22) and inactive (n=29) groups, along with 51 healthy controls. Serum 25-hydroxy vitamin D [25(OH)D] levels were measured. The uveitis group also completed a questionnaire regarding sunlight exposure habits and vitamin D supplementation. Results: Patients with inflammation-related uveitis exhibited low serum 25(OH)D levels in 68% of cases. The median 25(OH)D level in patients with active uveitis was 17.8 ng/mL (interquartile range [IQR], 15-21 ng/mL), significantly lower compared to the 31.7 ng/mL (IQR, 25-39 ng/mL) in patients with inactive uveitis (p<0.001) and the 27 ng/mL (IQR, 23-31 ng/mL) in the Control Group (p<0.001). Significantly, nearly all patients with uveitis taking vitamin D supplementation were in the Inactive Group (p<0.005). Moreover, reduced sunlight exposure was associated with active uveitis (p<0.003). Furthermore, patients with 25(OH)D levels below 20 ng/mL had ten times higher odds of developing active uveitis (p=0.001). Conclusions: This study revealed a prevalent 25(OH)D deficiency among patients with noninfectious uveitis and suggested a link between low 25(OH)D levels and disease activity. To prevent future episodes of intraocular inflammation, vitamin D supplementation and controlled sunlight exposure could be viable options.

Implications of Vitamin D Status for Children's Bone Health: A Data Mining Analyses of Observational Studies

ABSTRACT Objective: To investigate associations/correlations between bone alterations and vitamin D status in children through data mining analyses based on observational studies. Material and Methods: Searches in PubMed, Scopus, Web of Science, and Embase databases were performed to recover studies, published until October 2022, with healthy children, which investigated the vitamin D status, related or not to undesirable bone alterations linked to bone quality (bone mineral density and bone mineral content), fracture or anthropometry. Country, study design, area of expertise (medicine, nutrition, dentistry, others), bone outcome, 25-hydroxyvitamin D data (serum or intake levels), the exams for bone diagnosis, and the results were analyzed in the VantagePointTM software. Results: Of 20,583 studies, 27 were included. The USA (n=9; 33.3%) had the highest number of publications. Cross-sectional (n=11; 40.7%), case-control (n=9; 33.3%), and cohort studies (n=7; 25.9%) contemplated the medicine and nutritional areas without any study in dentistry. Studies about bone quality (n=21; 77.8%), analyzed through dual-energy X-ray absorptiometry (DXA; n=14; 51.8%), with association (n=16; 59.2%) between the low serum levels of 25-hydroxyvitamin D and undesirable bone alterations (n=14; 51.8%) were the most prevalent. Conclusion: Most studies were conducted in the medical area and showed an association between low bone quality and low levels of 25-hydroxyvitamin D, verified through DXA.

What is known about the effects of vitamin D in neuropsychiatric lupus?

Abstract Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect several organs and systems. The central and/or peripheral nervous system can suffer from complications known as neuropsychiatric lupus (NPSLE). Studies have associated the manifestations of SLE or NPSLE with vitamin D deficiency. It has been shown that hypovitaminosis D can lead to cognition deficits and cerebral hypoperfusion in patients with NPSLE. In this review article, we will address the main features related to vitamin D supplementation or serum vitamin D levels with neuropsychiatric manifestations, either in patients or in animal models of NPSLE.

Assessment of maternal knowledge of solar exposure and vitamin D in the neonatal period / Avaliação do conhecimento materno sobre exposição solar e vitamina D no período neonatal

ABSTRACT Objective: To assess mothers' knowledge on sun exposure related to serum vitamin D levels in the neonatal period. Methods: Observational, analytical and cross-sectional study, carried out from August 2020 to May 2021 through a questionnaire directed to mothers of newborns, in a maternity hospital in Southern Brazil. Results: From 141 interviewees, 132 (93.6%) believe it is important to expose the neonate to sun, 101 (71.6%) think this exposure can increase vitamin D levels, 86 (61%) received such information from a doctor, 108 (76.6%) believe there are no risks of sun exposure, 88 (62.4%) claim it isn´t necessary to use any kind of protection, 96 (68.1%) said that only exposure to the sun was necessary to maintain adequate levels of vitamin D during the neonatal period. Only two mothers (1.4%) claim that you should not exposure the neonate to the sun, and only one (0.7%) stated that sun expose can cause skin problems. Conclusions: Most mothers lack satisfactory knowledge about sun exposure related to serum vitamin D levels in the neonatal period. The need to inform and clarify the population about sun exposure during this period is remarkable, in addition to disseminating the proper way to maintain serum levels of vitamin D.

RESUMO Objetivo: Avaliar o conhecimento das mães acerca da exposição solar relacionada com níveis séricos de vitamina D no período neonatal. Métodos: Estudo observacional, analítico e transversal, realizado de agosto de 2020 a maio de 2021 por meio de questionário dirigido às mães de recém-nascidos, em uma maternidade no sul do Brasil. Resultados: De 141 entrevistadas, 132 (93,6%) acreditam ser importante expor o lactente ao sol no primeiro mês de vida, 101 (71,6%) acham que essa exposição aumenta os níveis de vitamina D, 86 (61,0%) receberam tal informação de um médico, 108 (76,6%) acreditam que expor o neonato ao sol não causa riscos para a saúde, 88 (62,4%) acham que não é necessário usar proteção contra radiação solar ao expor o neonato ao sol, e 96 (68,1%) afirmaram que apenas a exposição ao sol basta para manter os níveis adequados de vitamina D durante o período neonatal. Apenas duas mães (1,4%) afirmaram que não se deve expor o neonato ao sol e uma (0,7%) que a exposição solar pode causar problemas de pele. Conclusões: A maioria das mães não possui conhecimento satisfatório acerca da exposição solar relacionada aos níveis séricos de vitamina D no período neonatal. É notável a necessidade de informar e esclarecer a população sobre a exposição solar nesse período, além de disseminar a maneira adequada de manter os níveis séricos de vitamina D.

Estrogen deficiency influences SEC23A gene expression in the odontogenic region of incisors ­ a murine model study / A deficiência de estrógeno influencia a expressão gênica de SEC23A na região odontogênica de incisivos ­ um estudo em modelo murino

Recent scientific evidence suggests a close relationship between estrogen deficiency and vitamin D- related genes. Estrogen and vitamin D were involved with alterations in odontogenesis and tooth eruption process. Objective: The aim of the present study was to evaluate the influence of estrogen deficiency on the expression of genes related to the activation and degradation of vitamin D in the odontogenic region of incisors in a murine model. Material and Methods: This is an experimental clinical study that used female Wistar Hannover rats. The animals were randomly divided into two groups according to the intervention received: Hypoestrogenism Group ­ animals submitted to estrogen deficiency by ovariectomy surgery and Control Group ­ animals submitted to sham surgery. Surgical intervention was performed in the prepubertal period; the animals were followed throughout the pubertal period. After euthanasia, the hemimandibles were removed to evaluate the mRNA expression of the vitamin D-related genes AMDHD1, CYP24A1, NADSYN1 and SEC23A in the odontogenic region of incisors through real time PCR. Student's t test was used to compare means. Kruskal-Wallis test and Dunn's posttest were also used. The level of significance was 5%. Results: SEC23A was overexpressed in the estrogen deficiency condition in the odontogenic region (p=0.021). Conclusion: Estrogen deficiency may influence the expression of the SEC23A gene involved in the activation and degradation of vitamin D in the odontogenic region of incisors in a murine model(AU)

Evidências científicas recentes sugerem uma estreita relação entre a deficiência de estrógeno e os genes relacionados à vitamina D. O estrógeno e a vitamina D estão envolvidos com alterações na odontogênese e no processo de erupção dentária. Objetivo: O objetivo do presente estudo foi avaliar a influência da deficiência de estrógeno na expressão de genes relacionados à ativação e degradação da vitamina D na região odontogênica de incisivos em modelo murino. Material e Métodos: Trata-se de um estudo clínico experimental que utilizou ratas Wistar Hannover fêmeas. Os animais foram divididos aleatoriamente em dois grupos de acordo com a intervenção recebida: Grupo Hipoestrogenismo ­ animais submetidos à deficiência de estrógeno pela cirurgia de ovariectomia e Grupo Controle ­ animais submetidos à cirurgia simulada. A intervenção cirúrgica foi realizada no período pré-púbere; os animais foram acompanhados durante todo o período puberal. Após a eutanásia, as hemimandíbulas foram removidas para avaliar a expressão de mRNA dos genes AMDHD1, CYP24A1, NADSYN1 e SEC23A, relacionados à vitamina D, na região odontogênica de incisivos por meio de PCR em tempo real. O teste t de Student foi utilizado para comparar as médias. Também foram utilizados o teste de Kruskal-Wallis e o pós-teste de Dunn. O nível de significância foi de 5%. Resultados: SEC23A foi superexpresso na condição de deficiência de estrógeno na região odontogênica (p=0,021). Conclusão: A deficiência de estrógeno pode influenciar a expressão do gene SEC23A envolvido na ativação e degradação da vitamina D na região odontogênica de incisivos em modelo murino (AU)

Association of vitiligo with ABO/Rh system and its influence on thyroid stimulating hormone and vitamin D

This study was conducted to determine if there is a relationship between vitiligo and ABO blood groups, the Rhesus (Rh) factor, thyroid stimulating hormone (TSH) and vitamin D. For vitiligo analysis, two hundred subjects participated in this study, 100 vitiligo patients and 100 control cases (without vitiligo). ABO blood grouping and Rh typing were tested by a slide method. TSH testing involved 80 vitiligo patients and 80 controls (without vitiligo) and the hormone was analyzed by separating the serum in a centrifuge for two minutes and the results were obtained by Beckman fully automatic analyzer. For vitamin D, 50 vitiligo patients and 50 healthy people (without vitiligo) were included. The data on vitamin D were obtained from private laboratory services. Statistical analysis was performed using IBM SPSS version 26. P< 0.05), while no statistically significant difference in TSH serum levels between vitiligo cases and controls, was found (p-value > 0.05). Furthermore, despite showing that subjects with blood group O are more susceptible to vitiligo as compared to other groups, there was no significant association of vitiligo with ABO blood groups (p-value > 0.05). Similarly, the incidence of Rh positive and Rh negative was not statistically different between the two groups (p-value > 0.05). This study showed that vitiligo patients are often vitamin D deficient. This study highlights the need to evaluate vitamin D status in vitiligo patients to improve the level of skin pigment loss. It remains unknown whether vitamin D deficiency causes vitiligo. However, a collection of larger sample sizes of different ethnicities should be required to achieve a precise conclusion.

Preliminary study of vitamin D deficiency and its associated risk factors in Libya

This study was conducted to investigate levels among the target population and its associated risk factors in Libya. A cross-sectional study was conducted to investigate level and its associated risk factors in Libya during 2022-2023. 192 serum samples were tested in private laboratories. A structured designated questionnaire was filled in containing all the relevant information. Descriptive analyses frequency and percent were measured for numerical data, number, and percent for qualitative data using SPSS version 22. The chi-square test and student t-test were used for the data analysis and to investigate the level of association among variables at the significance level of (p=0.894) The results showed that using supplements for hypovitaminosis did not significantly influence therapeutic outcomes. The mean average level among males was significantly higher than those in females; however, both levels in the two groups are in the deficiency category. Interestingly the group who received treatment of vitamin D, their level was lower than the group who did not receive treatment

Doença falciforme e o efeito modulador da vitamina D em crianças: uma revisão integrativa / Sickle cell disease and the modulating effect of vitamin D in children: an integrative review

INTRODUÇÃO: A deficiência de Vitamina D (VD) é frequente na doença falciforme (DF) em decorrência do status inflamatório crônico, danos renais, endoteliais, hiperhemólise e melanodermia. Atualmente, a suplementação desse nutriente em falcêmicos tem se mostrado importante devido sua ação sistêmica e imunológica. OBJETIVOS: Analisar o impacto da VD em crianças com DF. MÉTODOS: Trata-se de uma revisão integrativa da literatura, onde foram analisados estudos, publicados originalmente em inglês e português, dos últimos dez anos, em humanos, tendo como referência as bases de dados MEDLINE, SciELO e LILACS. A busca foi efetuada mediante a consulta ao MeSH. Os descritores utilizados foram: "children"; "vitamin D"; "sickle cell anemia"; "supplementation". Foram identificados 32 artigos a partir da frase de pesquisa. Ao aplicar os critérios de inclusão, nove artigos foram eleitos para o estudo. RESULTADOS: A partir da análise dos artigos incluídos, 6 avaliaram a prevalência da deficiência de VD em crianças com anemia falciforme e os outros três artigos relataram sobre a suplementação de VD em crianças também com anemia falciforme. Todos os estudos mostraram que as crianças tratadas com reposição de VD tiveram uma diminuição de idas ao pronto-socorro e maior estabilidade hemodinâmica durante os tratamentos. CONCLUSÃO: Outros ensaios clínicos randomizados devem ser realizados para identificar o papel da DV na qualidade de vida e na redução da morbidade falciforme. A contribuição deste artigo é reconhecer que há evidências sobre a vitamina D fora dos ensaios clínicos randomizados.

INTRODUCTION: Vitamin D (VD) deficiency is frequent in sickle cell disease (SCD) due to chronic inflammatory status, kidney and endothelial damage, hyperhemolysis and melanoderma. Currently, the supplementation of this nutrient in sickle cell patients is important due to its systemic and immunological action. Objectives: To analyze the impact of VD in children with SCD. METHODS: This is an integrative literature review, which analyzed studies, originally published in English and Portuguese, in the last ten years, in humans, using the MedLine, SciELO and LILACS databases as References. The search was performed by consulting the MeSH. The descriptors used were: "children"; "vitamin D"; "sickle cell anemia"; "supplementation". 32 articles were identified from the search phrase. When applying the inclusion criteria, nine articles were chosen for the study. RESULTS: Among the included articles, six evaluated the prevalence of VD deficiency in children with sickle cell anemia, and the other three reported on VD supplementation in children with sickle cell anemia. All studies showed that children treated with VD replacement had a decrease in emergency room visits and greater hemodynamic stability during treatments. CONCLUSION: Further randomized controlled trials should be carried out to identify the role of VD in quality of life and in the reduction of sickle cell morbidity. The contribution of this paper is to recognize that there is evidence about vitamin D outside of randomized controlled trials.

Efecto de la suplementación oral con vitamina D sobre la gravedad de la psoriasis: ¿Genera beneficios significativos? / Effect of oral vitamin D supplementation on psoriasis severity: Does it generate significant benefits?

RESUMEN La psoriasis es una enfermedad crónica de la piel mediada por el sistema inmunológico con una base genética y patogénica compleja, que frecuentemente conduce a comorbilidades significativas y una reducción en la calidad de vida. Su prevalencia varía a nivel global y muestra una tendencia creciente con el tiempo. Comorbilidades como la artritis psoriásica, enfermedades cardiovasculares y problemas de salud mental complican aún más la carga de la psoriasis. Las opciones de tratamiento van desde terapias tópicas hasta agentes sistémicos, siendo los agentes biológicos prominentes en los últimos años. Sin embargo, la seguridad y eficacia de estos tratamientos se evalúan continuamente a través de datos del mundo real. La vitamina D ha llamado la atención como un posible objetivo terapéutico debido a su papel en la regulación inmunológica y la función de barrera de la piel. Esta revisión tiene como objetivo evaluar la eficacia de la suplementación oral de vitamina D en mejorar la gravedad de la psoriasis. Después de una búsqueda bibliográfica, se encontró que la psoriasis es una condición multifacética con significativas implicaciones globales. Los agentes biológicos han transformado su manejo, y la suplementación oral de vitamina D es un camino prometedor para una mayor exploración. Un enfoque integral centrado en el paciente que tenga en cuenta las comorbilidades y los resultados a largo plazo es crucial para optimizar el cuidado de la psoriasis. Se necesita más investigación para comprender completamente el papel de la vitamina D en la psoriasis y su potencial como intervención terapéutica.

ABSTRACT Psoriasis is a chronic immune-mediated skin disease with a complex genetic and pathogenic basis, often leading to significant comorbidities and a reduced quality of life. Its prevalence varies globally and exhibits an increasing trend over time. Comorbidities such as psoriatic arthritis, cardiovascular diseases, and mental health issues further compound the burden of psoriasis. Treatment options range from topical therapies to systemic agents, with biologics playing a prominent role in recent years. However, the safety and efficacy of these treatments are continuously assessed through real-world data. Vitamin D has gained attention as a potential therapeutic target due to its role in immune regulation and skin barrier function. This review aims to evaluate the efficacy of oral vitamin D supplementation in ameliorating the severity of psoriasis. After bibliographic search, it was found that psoriasis is a multifaceted condition with significant global implications. Biologics have transformed its management, and oral vitamin D supplementation is a promising avenue for further exploration. A comprehensive, patient-centered approach that considers comorbidities and long-term outcomes is crucial for optimizing psoriasis care. Further research is needed to fully understand the role of vitamin D in psoriasis and its potential as a therapeutic intervention.

Niveles plasmáticos de Vitamina D en adultos mayores de Lima Metropolitana, Perú

Objetivo. Determinar los niveles plasmáticos de vitamina D y su relación con la ocupación, procedencia y los valores de calcio, leucocitos, hemoglobina y plaquetas en adultos mayores de Lima Metropolitana. Método. Estudio observacional descriptivo de corte transversal, participaron 100 adultos mayores de uno u otro sexo de Lima Metropolitana, ellos fueron reclutados durante las estaciones de invierno-primavera del 2022, los niveles de vitamina D se categorizó como suficiente, insuficiente y deficiente, las concentraciones séricas de vitamina D se midieron por radioinmunoensayo. La relación de variables se realizó con el coeficiente de correlación de Spearman y regresión logística. Resultados. La edad media fue 69.6 años, el 71%, fueron del sexo femenino, la concentración media de vitamina D fue 36.56 ng/ml, el 13% tuvieron niveles de deficiente, y el 32% de insuficiente y el 53% suficientes. Según sexo, el 77,7% de los que tuvieron niveles de deficiente/insuficiente fueron mujeres. En el análisis bivariado no hubo correlación entre los valores de vitamina D con calcio, hemoglobina leucocitos y plaquetas, los que procedieron de distritos de menor temperatura tuvieron 2,25 veces más riesgo de tener niveles insuficientes/deficiente de vitamina D. Conclusiones. El 45% de los adultos mayores tuvieron niveles deficientes/insuficiente de vitamina D, siendo más frecuente en las mujeres y de los procedentes de distritos de menor promedio de temperatura.

Objective. To determine the plasmatic levels of vitamin D and its relationship with the occupation, origin and the values of calcium, leukocytes, hemoglobin and platelets in older adults of Metropolitan Lima. Methods Observational descriptive cross-sectional study, 100 older adults of either sex from Metropolitan Lima participated, they were recruited during the winter-spring seasons of 2022, vitamin D levels were categorised as sufficient, insufficient, and deficient, serum vitamin D concentrations were measured by radioimmunoassay. The relationship of variables was established with the Spearman correlation coefficient and logistic regression. Results. The mean age was 69.6 years, 71% were women, the mean vitamin D concentration was 36.56 ng/ml, 13% had deficient levels, 32% were insufficient and 53% sufficient. By sex, 77.7% of those with deficient/insufficient levels were women. In the bivariate analysis, there was no correlation between vitamin D values with calcium, hemoglobin, leukocytes and platelets; those who came from districts with lower temperatures had a 2.25 times greater risk of having insufficient/deficient levels of vitamin D. Conclusions. 45% of older adults had deficient/insufficient levels of vitamin D, more frequent in women and those coming from districts with lower average temperatures.

Prevalencia de niveles bajos de 25(OH)-vitamina D en universitarios costarricenses / Prevalence of low 25 OH-Vitamin D levels in Costa Rican university students

Resumen Objetivo: Describir la prevalencia de hipovitaminosis D3 y sus características clínicas y bioquímicas en una población de universitarios costarricenses. Métodos: Investigación transversal y descriptiva en un total de 118 individuos sanos, de ambos sexos, con edades entre los 18-43 años. Se preguntó sobre historia familiar de enfermedades crónicas, nivel de exposición al sol, uso de protectores solares, presión arterial. En el laboratorio, se analizaron en suero: glucosa, calcio, fosfato, hormona paratiroidea, insulina, 25 OH-Vitamina D e inmunoglobulina E. Se calcularon el índice de masa corporal y el modelo matemático de evaluación para la homeostasis de la resistencia a la insulina. Resultados: La prevalencia de hipovitaminosis D3 (<30 ng/mL) en este estudio fue de 25% sin diferencia significativa por sexo. La concentración promedio de 25 OH-vitamina D fue 36,2 ng/mL, con valores que van desde 14,5 a 59,5 ng/mL. Un total de 26 estudiantes presentaba insuficiencia de 25 OH-vitamina D (21-29 ng/mL) y solamente 4 fueron clasificados con una deficiencia grave (<20 ng/mL). No se encontraron casos de hipervitaminosis D3 (>100 ng/mL) en la muestra de estudio. Al comparar aquellos sujetos con deficiencia de 25 OH-Vitamina D3 contra los que presentaron niveles séricos normales de esta vitamina, se observaron diferencias significativas solamente en dos parámetros bioquímicos: insulina (10,9 ± 7,4 µUI/ mL vs 8,3 ± 4,1 µUI/mL; p=0,017) y el índice HOMA IR (2,48 ± 1,86 vs 1,85 ± 0,3; p=0,002). Cerca de la mitad de los estudiantes relataron antecedentes familiares de diabetes mellitus (49,2%) e hipertensión arterial (52,9%). El 29% de los participantes tenía sobrepeso y obesidad. Conclusiones: El 25% de los sujetos estudiados presentó deficiencia de 25 OH-Vitamina D. Estos sujetos, a su vez, presentaron una mayor prevalencia de hiperinsulinemia y resistencia a la insulina en comparación con personas con concentraciones normales de esta vitamina. También existe una alta prevalencia de factores de riesgo entre los familiares de la población joven, los cuales podrían aumentar el riesgo de estos estudiantes de padecer diabetes mellitus o enfermedades cardiovasculares en un futuro cercano.

Abstract Objective: To determine the prevalence of hypovitaminosis D3 in a population of Costa Rican University students and describe its clinical and biochemical characteristics. Methods: Cross-sectional and descriptive research with a total of 118 healthy individuals of both genders aged between 18-43 years. Questions were asked about family history of chronic diseases, level of sun exposure, use of sunscreens, blood pressure. In the laboratory, glucose, calcium, phosphate, parathyroid hormone, insulin, 25 OH-Vitamin D and immunoglobulin E were analyzed in serum. Body Mass Index and the mathematical assessment model for the homeostasis of insulin resistance were calculated. Results: The prevalence of hypovitaminosis D3 (<30 ng/mL) in this study was 25% with no significant difference by sex. The average concentration of 25 OH-Vitamin D was 36.2 ng/mL, with values ranging from 14.5 to 59.5 ng/mL. A total of 26 students had 25 OH- Vitamin D insufficiency (21-29 ng/mL) and only 4 were classified as severely deficient (<20 ng/mL). No cases of hypervitaminosis D3 (> 100 ng/mL) were found in the study sample. When comparing those subjects with 25 OH-Vitamin D3 deficiency against those with normal serum levels of this vitamin, significant differences were observed only in two biochemical parameters: insulin (10.9 ± 7.4 µIU/mL vs 8.3 ± 4.1 µUI/mL; p=0.017) and the HOMA IR index (2.48 ± 1.86 vs 1.85 ± 0.3; p=0.002). Nearly half of the students reported a family history of Diabetes Mellitus (49.2%) and arterial hypertension (52.9%). Near 29% of the participants were overweight and obese. Conclusions: Around 25% of the subjects studied presented 25 OH-Vitamin D deficiency. These subjects, in turn, presented a higher prevalence of hyperinsulinemia and insulin resistance compared with people with normal concentrations of this vitamin. There is also a high prevalence of risk factors among the relatives of the young population that could increase the risk of these students of suffering from Diabetes Mellitus or cardiovascular diseases in the future.

Relationship of vitamin D with the anthropometric indicators and lifestyle of adults. Medellín. Colombia

Introduction: Serum vitamin D levels depend on sunlight, diet, and other factors. Objective: We aimed to determine serum vitamin D levels and evaluate their relationship with anthropometric indicators and lifestyle habits in apparently healthy volunteers. Materials and Methods: In this cross-sectional study (n=75), socio-demographic, anthropometric, and lifestyle habit-related data were collected. Serum vitamin D levels were determined with high performance liquid chromatography, food intake was measured by semiquantitative frequency and nutritional status was assessed by anthropometry. Chi-square test and also principal component analysis were used to analyze the relationship between some variables and vitamin D status. Spearman's test was used to determine correlations between quantitative variables. Results: 73% were women and 61% belonged to medium socio-economic level. Median vitamin D intake was 137 (83.1­227.3) IU/day. Based on body mass index (BMI), 44% individuals had overweight/obesity. The 68% exhibited deficient/insufficient vitamin D levels (Hypovitaminosis D). BMI classification and waist circumference (CW) were not related with vitamin D status; however, activities with higher sun exposure were highly related (p = 0.013). Sun exposure time explained variation in component 2 (16.60%), where most of the individuals with normal level were grouped. Sun exposure time was positively correlated with vitamin D status (r = 0.263; p = 0.023). Discussion: Excess weight and abdominal obesity are not always associated with hypovitaminosis D. Conclusions: The majority of individuals showed hypovitaminosis D but their status was not related with anthropometric indicators. A Sun exposure time was the only factor positively correlated with vitamin D status.

Introducción: Los niveles séricos de vitamina D dependen de la luz solar, la dieta y otros factores. Objetivo: Nuestro objetivo fue determinar los niveles séricos de vitamina D y evaluar su relación con indicadores antropométricos y estilos de vida en voluntarios aparentemente sanos. Materiales y métodos: En este estudio trasversal (n=75) se recogieron datos sociodemográficos, antropométricos y aquellos relacionados con hábitos y estilos de vida. La vitamina D se determinó por cromatografía liquida de alta eficiencia; la ingesta de alimentos, mediante frecuencia semicuantitativa, y el estado nutricional por antropometría. Para analizar la relación entre algunas variables y el estado de la vitamina D se usó la prueba de Chi cuadrado y también el análisis de componentes principales. Se empleó la prueba de Spearman para determinar la correlación entre variables cuantitativas. Resultados: El 73% eran mujeres y el 61% pertenecían a un estrato socioeconómico medio. La mediana de la ingesta de vitamina D fue de 137 (83,1­227,3) UI/día. Según el índice de masa corporal (IMC), el 44% de los individuos tenían sobrepeso/obesidad. El 68% mostro deficiencia/insuficiencia de vitamina D (hipovitaminosis D). La clasificación del IMC y la circunferencia abdominal no se relacionaron con el estado de la vitamina D; sin embargo, las actividades con una mayor exposición solar estuvieron altamente relacionadas (p=0,013). El tiempo de exposición solar explico la variación en el componente 2 (16,60%) donde se agruparon la mayoría de los individuos con niveles normales. El tiempo de exposición solar tuvo una correlación positiva con el estado de la vitamina D (r = 0,263; p = 0,023). Discusión: El exceso de peso y la obesidad abdominal no siempre se relacionan con la hipovitaminosis D. Conclusiones: La mayoría de los individuos presentaron hipovitaminosis D, pero su estado no se relacionó con los indicadores antropométricos. El tiempo de exposición al sol fue el único factor que se correlaciono positivamente con el estado de la vitamina D.

Introdução: Os níveis séricos de vitamina D dependem da luz solar, da dieta e de outros fatores. Objetivo: Nosso objetivo foi determinar os níveis séricos de vitamina D e avaliar sua relação com indicadores antropométricos e hábitos de vida em voluntários aparentemente saudáveis. Materiais e métodos: Neste estudo transversal (n=75), foram coletados dados sociodemográficos, antropométricos e relacionados a hábitos de vida. Os níveis séricos de vitamina D foram determinados por cromatografia liquida de alto desempenho, a ingestão de alimentos foi medida por frequência semiquantitativa e o estado nutricional foi avaliado por antropometria. O teste do qui-quadrado e a análise de componentes principais foram utilizados para analisar a relação entre algumas variáveis e o estado da vitamina D. O teste de Spearman foi usado para determinar as correlações entre as variáveis quantitativas. Resultados: 73% eram mulheres e 61% pertenciam a um nível socioeconômico médio. A ingestão media de vitamina D foi de 137 (83,1-227,3) UI/dia. Com base no índice de massa corporal (IMC), 44% dos indivíduos tinham sobrepeso/obesidade. Os 68% apresentaram níveis deficientes/insuficientes de vitamina D (hipovitaminose D). A classificação do IMC e a circunferência da cintura (CW) não foram relacionadas ao status da vitamina D; entretanto, as atividades com maior exposição ao sol foram altamente relacionadas (p = 0,013). O tempo de exposição ao sol explicou a variação no componente 2 (16,60%), onde a maioria dos indivíduos com nível normal foi agrupada. O tempo de exposição ao sol foi positivamente correlacionado com o status de vitamina D (r = 0,263; p = 0,023). Discussão: O excesso de peso e a obesidade abdominal nem sempre estão associados com a hipovitaminose D. Conclusões: A maioria dos indivíduos apresentou hipovitaminose D, mas seu status não foi relacionado com indicadores antropométricos. O tempo de exposição ao sol foi o único fator positivamente correlacionado com o status da vitamina D.

Papel inmunomodulador de la vitamina D y los ácidos grasos poliinsaturados omega-3 en trastornos autoinmunes: Revisión de la Literatura / Immunomodulatory role of vitamin D and omega-3 polyunsaturated fatty acids in autoinmune disorders: Literature Review

Los trastornos autoinmunes representan una familia de al menos 80 condiciones diferentes que surgen de una respuesta aberrante del sistema inmunológico resultando finalmente en la destrucción de tejidos y órganos específicos del cuerpo. Es importante destacar que durante las últimas tres décadas los estudios epidemiológicos han proporcionado evidencia de un aumento constante en la incidencia y prevalencia de trastornos autoinmunes. En los últimos años, varios estudios han demostrado que la vitamina D y los ácidos grasos poliinsaturados (AGPs) omega-3 ejercen propiedades inmunomoduladoras y antiinflamatorias sinérgicas que pueden aprovecharse positivamente para la prevención y el tratamiento de trastornos autoinmunes. En este sentido, el reciente ensayo clínico denominado VITAL (ensayo de vitamina D y omega 3); un estudio a gran escala, aleatorizado, doble ciego, controlado con placebo encontró que la suplementación conjunta de vitamina D y AGPs omega-3 (VIDOM) puede reducir la incidencia de enfermedades autoinmunes. En esta revisión de la literatura, resumimos los mecanismos moleculares detrás de las propiedades inmunomoduladoras y antiinflamatorias de la vitamina D y los AGPs omega-3, así como la posible interacción bidireccional entre el metabolismo de la vitamina D y el metabolismo de los AGPs omega-3 que justifica la co- suplementación VIDOM en trastornos autoinmunes(AU)

Autoimmune disorders represent a family of at least 80 different conditions that arise from an aberrant immune system response, which ultimately results in the destruction of specific body tissues and organs. It is important to highlight that during the last three decades epidemiological studies have provided evidence of a steady increase in the incidence and prevalence of autoimmune disorders. In recent years, several studies have shown that vitamin D and omega-3 polyunsaturated fatty acids (PUFAs) exert synergistic immunomodulatory and anti-inflammatory properties that can be positively harnessed for the prevention and treatment of autoimmune disorders. In this sense, the recent clinical trial called VITAL (Vitamin D and Omega 3 trial) - a large, randomized, double-blind, placebo- controlled study - found that co-supplementation of vitamin D and omega-3 PUFAs (VIDOM) can reduce the incidence of autoimmune diseases. In this literature review, we summarize the molecular mechanisms behind the immunomodulatory and anti-inflammatory properties of vitamin D and omega-3 PUFAs, as well as the possible bidirectional interaction between vitamin D metabolism and omega-3 PUFA metabolism that justifies VIDOM co- supplementation in autoimmune disorders(AU)

Vitamin D in pregnant women from extreme areas of latitude: review from midwifery / Vitamina D en gestantes en zonas extremas: revisión desde la matronería

Insufficient vitamin D levels occur in 88.1% of the worlds population, which constitutes a global public health problem. We analyzed vitamin D deficiency and suggested vitamin D supplementation in the perinatal health of pregnant women living in geographical areas higher than 40° south-north latitude according to reviews from the last three decades and identifying midwives role. The methodology used was a qualitative systematic review of full text studies, conducted in geographical areas higher than 40°N and 40°S. Descriptors such as: "deficiency", "vitamin D", "pregnancy", "causes", "perinatal outcomes" and "supplementation", and their respective descriptors in Spanish. The matrices were tabulated according to the modified PRISMA. Eight studies were obtained in English from the Northern Hemisphere only, mostly with good quality evidence and related to the role of midwifing according to the expert round. The results showed risks such as: origin of the pregnant woman, ethnicity, low sun exposure, obesity, socioeconomic status, and perinatal risks. No studies were found in pregnant women from the Southern Hemisphere or related to the role of the midwife in this area. In conclusion, midwifery should considerer the social determinants of vitamin D deficiency in pregnant women, especially those in extreme southern areas where incorporation of supplementation are suggested as a public policy.

Los niveles insuficientes de vitamina D se dan en el 88,1% de la población mundial, lo que constituye un problema de salud pública global. Se analizó la deficiencia y la sugerencia de suplementación de vitamina D en la salud perinatal de las gestantes residentes en áreas geográficas de latitud 40° sur-norte según revisiones de las últimas tres décadas identificando el rol de la matrona. La metodología utilizada fue una revisión sistemática cualitativa de estudios a texto completo, realizados en áreas geográficas mayores al paralelo 40°N y 40°S. Descriptores como: "deficiencia", "vitamina D", "embarazo", "causas", "resultados perinatales" y "suplementación", y sus respectivos descriptores en español. Las matrices se tabularon según el PRISMA modificado. Se obtuvo ocho estudios en inglés pertenecientes sólo al hemisferio norte, la mayoría con buena calidad de evidencia. Los resultados arrojaron factores como origen de la embarazada, etnia, baja exposición al sol, obesidad, nivel socioeconómico y riesgos perinatales. No se encontraron estudios en mujeres embarazadas del hemisferio sur o relacionados con el papel de la matrona. En conclusión, desde el ejercicio de la matronería se deben considerar los determinantes sociales de las mujeres embarazadas especialmente de zonas extremas del sur donde se sugiere investigación experimental e incorporación de la suplementación como política pública.

Asociación entre la vitamina D y las enfermedades inflamatorias intestinales

La vitamina D es una hormona conocida desde larga fecha, por sus efectos sobre la salud ósea y la regulación del metabolismo del fósforo y calcio. Desde el descubrimiento de receptores para esta molécula en un gran número de células del organismo, se ha abierto el campo para el estudio de sus efectos sobre el sistema inmune. Sus relaciones con las células del sistema inmune, genes y microbiota hace que el interés sea grande en relación con enfermedades inmunomediadas. Muchos datos indican que esta vitamina tiene efectos preventivos, moduladores y controladores de los efectos adversos de las Enfermedades Inflamatorias Intestinales (EII) en la salud ósea, aunque es difícil demostrar la causalidad de forma taxativa. En esta revisión intentamos resumir la situación actual y los temas de controversia en este interesante campo, centrándonos en las enfermedades inflamatorias intestinales.

Vitamin D is a hormone known for a long time, for its effects on bone health and the regulation of phosphorus and calcium metabolism. Since the discovery of receptors for this molecule in a large number of cells in the body, the field has been opened for the study of its effects on the immune system. Its relationships with the cells of the immune system, genes, and microbiota cause great interest in relation to immune-mediated diseases. Many data indicates that this vitamin has preventive, modulating and controlling effects of the adverse effects of Inflammatory Bowel Diseases (IBD) on bone health, although it is difficult to definitively demonstrate causality. In this review, we try to summarize the current situation and controversial issues in this interesting field, focusing on inflammatory bowel diseases.