Concentraciones séricas de vitamina C y retinol en sujetos residentes en instituciones para mayores de 65 años de la ciudad de Lleida (España) / Serum vitamin A and C levels in institutionalized persons aged more than 65 years old in the city of Lleida (Spain)

Fundamentos: Evaluar, en mayores de 65 años, institucionalizados, de la ciudad de Lleida (España), el estado nutricional con respecto a vitamina C y retinol. Métodos: Se incluyó a 46 mujeres y 17 varones, residentes permanentes en dos residencias geriátricas de la ciudad de Lleida. Se registraron edad, peso, historia clínica y consumo promedio semanal de alimentos (junio a septiembre). Se determinó, en sangre extraída en ayunas, método habitual de laboratorio, vitamina C (método de Roe) y retinol mediante un micrométodo de HPLC, de fácil realización, que permite efectuar un diagnóstico bioquímico asequible a los laboratorios de mediana complejidad que no dispongan de cromatógrafos de última generación. Resultados: Para los grupos de mujeres y varones, respectivamente, se obtuvo: índice de masa corporal, mediana (intervalo), 23,5 (16,7-35,6) y 24,5 (18,3-36,5). Vitamina C (mg/ dl), 0,879 (0,273-1,592) y 0,884 (0,37-1,398), con adecuación en el 98% de las mujeres y el 100% de los varones. Retinol (μg/dl), 32 (5-117) y 41 (14-61). Los valores de retinol fueron indicativos de deficiencia ( < 20 μg/dl) en el 24,4% de las mujeres y el 13,3% de los varones. Conclusiones: Estos resultados evidencian: a) adecuación nutricional con respecto a vitamina C en la mayoría de los casos, y b) preocupante deficiencia de vitamina A tanto en la población femenina como en la masculina, pese al predominio de sobrepeso. La metodología utilizada permite realizar fácilmente la detección precoz de la deficiencia de vitamina A e implementar estrategias que corrijan los problemas detectados. Se deberá encarar y corregir esta deficiencia mediante intervenciones a corto y mediano plazo, que redundarán en beneficios en la calidad de vida y en los costes de los sistemas de salud(AU)

Objective: To study vitamin A and C status biochemically in individuals aged more than 65 years old, living in two institutions in Lleida (Spain). Methods: Forty-six women and 17 men, living permanently in two institutions in Lleida city were studied. Age, weight, clinical history, and mean weekly food consumption (between June and September) were recorded. Fasting serum was extracted to determine vitamin C (Roe method) and vitamin A levels, though an easy-to-perform high-performance liquid chromatography (HPLC) micromethod that allows a biochemical diagnosis to be made in medium-complexity laboratories without state-of-the art chromatographic methods. Results. The results (median and ranges) in women and men, respectively, were as follows: BMI (Kg/m2) 23.5 (16.7—35.6) and 24.5 (18.3-36.5); vitamin C (mg/dL): 0.879 (0.273-1.592) and 0.884 (0.370-1.398), with adequate status in 98% of the women and in 100 % of the men; retinol (μg/dL): 32 (5-117) and 41 (14-61), presenting deficiency ... (AU)

Comparative 25-OH-vitamin D level in institutionalized women older than 65 years from two cities in Spain and Argentina having a similar solar radiation index.

OBJECTIVE: The present study evaluated and compared vitamin D nutritional status and calcium-phosphorus metabolism in institutionalized women >65 y from two cities that have a similar sun irradiation index (heliophany). METHODS: The study was carried out in women living in similar social-status institutions from geographic cities having a similar solar radiation index (Lleida, Spain, n=49, and suburban Buenos Aires, Argentina [BA], n=48) at the end of summer. RESULTS: Fish consumption was higher in the Lleida group, as was red-meat consumption in the BA group. In both groups mean calcium intake was 800 mg/d. The daily intake of vitamin D was higher in the BA group (P<0.001). A total of 90% in Lleida and 86% in BA had 25-hydroxyvitamin D (25OHD) levels <20 ng/mL. A significant inverse correlation between individual 25OHD and parathyroid hormone (PTH) levels was observed in the two groups of women (r=-0.329, P=0.035). PTH levels >100 pg/mL were found in 24% and 20% of women in Lleida and BA, respectively. There was a marked increase in carboxy-terminal telopeptide cross-links of type I collagen levels and a decrease in 25OHD with an increase in PTH levels (P<0.05). Conversely, bone alkaline phosphatase increased significantly only when the PTH concentration duplicated the reference range. CONCLUSION: Even at the end of summer, vitamin D deficiency/insufficiency was prevalent in the two studied institutionalized elderly women. In the narrow range of the dietary calcium intake (close to 800 mg/d) of both studied groups, secondary hyperparathyroidism was absent when 25OHD levels were >17 ng/dL, indicating changes in the regulation control of serum PTH and consequently the changes in this threshold. As a result, vitamin D deficiency must be reversed to avoid the increment in bone turnover and to ensure the endocrine and paracrine functions of vitamin D for overall health and well-being.

Folato eritrocitario en un grupo de puérperas del Gran Buenos Aires antes de la ley de enriquecimiento de las harinas / Red blood cell folate levels in a group of puerperial women from Great Buenos Aires before the flour enrichment law

El objetivo del trabajo fue analizar retrospectivamente los valores de folato eritrocitario de un grupo de 50 mujeres puérperas atendidas en un hospital de la zona suburbana del Gran Buenos Aires, en el año 2000. En sangre venosa, extraída en ayunas al día posterior al parto, se determinó: Hematocrito (Htc), Recuento de glóbulos rojos (GR), Hemoglobina (Hb), Volumen corpuscular medio (VCM) y Folato eritrocitario (Folato-E). Se registró el peso materno pregestacional y del recién nacido (PRN) y la edad gestacional (EG). Los resultados fueron (promedio ±DE y rangos): Hto (%): 35(5 (2.51-4.80);GR (x106/(L): 3.87(0.50 (23-47); Hb (g/L): 113(18(65-140);VCM (fL): 90(6(63-99); folato_E (nMol/L): 630±233; (ng/mL): 278(103 (126-564); PRN (g):3341 (435 (2370-4500); (EG) (semanas): 39.1± (34.0-41.0). Los resultados evidenciaron valores de Hb inferiores a 110 ng/ml en 4%, en tanto que si se considera un punto de corte de 192 ng/mL, el 20% de las mujeres estudiadas presentarían un estado nutricional deficiente. No se evidenció diferencia significativa en folato_E entre las mujeres con valores de Hb menores o mayores a 110 g/L. Estos resultados obtenidos antes de la promulgación de la Ley de enriquecimiento de la harina con hierro y ácido fólico, en mujeres que no habían tomado suplementos de vitaminas ni de minerales, indican un adecuado estado nutricional durante el embarazo, con respecto a ácido fólico, en el 96% de las puérperas estudiadas.

The molar ratio of retinol-binding protein to transthyretin in the assessment of vitamin A status in adults. Proposal of a cut-off point.

The molar ratio of retinol-binding protein to transthyretin (RBP:TTR) has been proposed as an indirect method to assess vitamin A status in children with inflammation. Neither reference values nor appropriate cut-off point are available for adults. RBP, TTR and retinol were determined in plasma from 100 healthy adults and 31 low-risk surgical patients with no inflammatory response. RBP:TTR percentile distribution from 99 healthy adults with plasma retinol > or = 0.7 micromol/l was: 2.5th = 0.24; 5th = 0.31; 10th = 0.32; 25th = 0.41; 50th = 0.47; 75th = 0.54; 90th = 0.67; 95th = 0.78 and 97.5th = 0.81. In order to define a cut-off point, receiver operating characteristic (ROC) curve was constructed, using plasma retinol as gold standard. ROC curve was based on data from the 131 studied subjects, 11 of whom (8.4%) were classified as deficient on the basis of plasma retinol < 0.7 pmol/l. According to ROC curve criteria, RBP:TTR ratio was considered a good test, the area under the curve being 0.822, p < 0.001. A cut-off-point of < or = 0.37 is proposed to detect vitamin A deficiency in adults, since it allows reaching high sensitivity (81.8%), specificity (79.2%) and predictive value (79.4%). The proposed cut-off point falls between 13th and 14th percentiles.