Estatus de vitamina D en mujeres adultas hipotiroideas controladas: Relación con el estado nutricional / Vitamin D status in controlled hypothyroid adult women: Relationship with nutritional status

RESUMEN

Introducción: El déficit de vitamina D prevalece a nivel mundial, pudiendo afectar a personas de cualquier edad. Esta hipovitaminosis ha sido vinculada con enfermedades como diabetes mellitus tipo 2, insulinorresistencia, síndrome metabólico, obesidad, enfermedades cardiovasculares, cáncer, alteraciones inmunológicas, musculares y caídas, entre otras. Objetivo: Conocer las concentraciones plasmáticas de vitamina D en mujeres adultas hipotiroideas y su relación con el estado nutricional. Material y métodos: Estudio transversal retrospectivo sobre datos secundarios de vitamina D25OH, peso y talla de 80 mujeres adultas, mayores de 40 años, hipotiroideas controladas con levotiroxina, concurrentes a consultorio privado (Martínez, provincia de Buenos Aires). Variable dependiente estatus de vitamina 25(OH)D3 (ng/ml) estratificado en suficiente (> 30 ng/ml), déficit leve (entre 20 y 30 ng/ml) y déficit grave (< 20 ng/ml). Variable independiente estado nutricional según índice de masa corporal, categorizado en normopeso (18,5 a 24,9 kg/m²) y sobrepeso u obesidad (≥ 25 kg/m²). Datos obtenidos de historia clínica. La 25(OH)D3, fue determinada en laboratorio del centro médico, por radioinmunoanálisis (DiasorinNR) a través de muestra de sangre venosa en ayunas. El peso y la talla, por nutricionista del centro, con metodología estandarizada. Análisis estadístico con software SPSS 19.0, presentando medidas de tendencia central, comparación de medias con ANOVA, X² y correlación de Pearson. Significación de p < de 0,05. Resultados: Edad media ± desviación estándar 57,4 ± 5 años, 57,5% normopeso y 42,5% sobrepeso u obesidad. Valores medios de 25(OH)D3 26,9 (DS 10,5) ng/ml. Estatus suficiente 35%; déficit leve 36,3% y déficit grave 28,7%. Sin diferencias de medias significativas entre D25OH y valores de tirotrofina (TSH) plasmática (p 0,563). Asociación inversa entre D25OH e IMC (r S0,577; p 0,000) y edad (r S0,270; p 0,015). Conclusiones: La mayoría de la muestra presentó disminución de valores plasmáticos de 25(OH)D3. Se observó una disminución del estatus de vitamina D a medida que aumentaron el peso corporal y la edad.

ABSTRACT

Introduction: Vitamin D deficiency is prevalent worldwide. It can affect people of different ages. This vitamin deficiency has been linked with diseases such as type 2 diabetes mellitus, insulin resistance, metabolic syndrome, obesity, cardiovascular disease, cancer, immune disorders, muscle disorders and falls, among others. Objective: To determine the plasma concentrations of vitamin D in hypothyroid adult women and its relationship with nutritional status. Material and methods: A retrospective cross-sectional study limited to 80 hypothyroid adult women, aged over 40 years, controlled with levothyroxine, and for whom weight, height, and 25-hydroxyvitamin D (25OHD) data were available. They attended a private clinic in Martínez (Buenos Aires Province, Argentina). Dependent variable Serum 25(OH)D concentration (ng/ml) stratified as sufficient (> 30 ng/ml), mild deficiency (20 to 30 ng/ml), and severe deficiency (<20 ng/ml). Independent variable nutritional status by BMI, classified as normal weight (18.5 to 24.9 kg/m²) and overweight or obesity (≥ 25 kg/m²). Data were obtained from clinical records. Total serum 25(OH)D concentration was measured using radioimmunoassay (DiasorinNR) in a fasting venous blood specimen by the laboratory of the medical centre. Weight and height were measured by a nutritionist using standardised methodology. Statistical analysis was performed using SPSS 19.0 software, establishing measurements of central tendency. Mean differences were compared using the Student t-test or ANOVA, X², and Pearson correlation, with significance level set at P<.05. Results: The mean age was 57.4 (SD 5) years, with 57.5% being of normal weight and 42.5% overweight or obesity. The mean value of 25(OH)D was 26.9 (SD 10.5) ng/ml. Sufficient vitamin status, was observed in 35%, a mild deficiency in 36.3%, and a severe deficiency in 28.7%. No significant differences were found between the mean 25(OH)D and thyrotropin (TSH) levels (P=.563). There was a significant inverse association between 25(OH)D and BMI (r = -0.577; P=.000) and age (r = -0.270; P=.015). Conclusions: Most of the patient sample showed decreased plasma levels of 25(OH)D. Serum 25(OH)D was shown to decrease as body weight and age increased.