Predictors of 25-hydroxyvitamin D status among individuals with metabolic syndrome: a cross-sectional study.

BACKGROUND: The risk of metabolic syndrome can be influenced by inadequate vitamin D levels, and exposure to sunlight is the main external source of vitamin D. The present study assessed the influence of environmental, biological, and nutritional factors in relation to seasonal 25-hydroxyvitamin D (25OHD) concentration in individuals with metabolic syndrome. METHODS: This cross-sectional study enrolled 180 individuals with metabolic syndrome aged between 18 and 80 years. The 25OHD concentration was considered the dependent variable; independent variables included age, sex, skin color, use of sunscreen, skin type, sun exposure score, ultraviolet radiation index, geographic location, season, body mass index, waist:hip ratio, waist circumference, parathyroid hormone level, total serum calcium level, and calcium and vitamin D intake. RESULTS: The average vitamin D in individuals evaluated in summer 32 ± 10 ng/mL was greater than in the winter 26 ± 8 ng/mL (p < 0.017). HDL-cholesterol was the only component of the MetS that differed significantly between the seasons (p < 0.001), showing higher concentrations in autumn 45 ± 8 mg/dL than in summer 35 ± 8 mg/dL. In the multiple regression model, gender, WHR, sun exposure score, and winter vs. summer explained 10% of the variation in 25OHD concentration (p = 0.004). CONCLUSIONS: Sex, waist:hip ratio, sun exposure, and summer season were predictors of 25OHD status among individuals with metabolic syndrome. HDL-cholesterol was the only component of metabolic syndrome that differed significantly between the seasons.

Avaliação do status de zinco considerando diferentes combinações de componentes na síndrome metabólica / Zinc status assessment considering different combinations of components in metabolic syndrome

Introdução: Fatores cardiometabólicos característicos da síndrome metabólica (SM) influenciam no metabolismo do zinco, de forma isolada ou conjuntamente. Objetivo: Comparar as concentrações de zinco no plasma e na dieta entre os três de grupos de indivíduos com SM, distribuídos conforme número de componentes da SM. Métodos: Estudo transversal incluindo 88 indivíduos com SM, diagnosticados segundo NCEP-ATP III. Definiu-se os grupos, considerando três (n=36), quatro (n=40) e cinco componentes da SM (n=12). O zinco da dieta foi avaliado por dois recordatórios de 24h. Verificou-se a pressão arterial, perímetro da cintura e glicemia de jejum, colesterol da lipoproteína de alta densidade e triglicerídeos. O zinco no plasma foi avaliado por espectrofotometria de absorção atômica. As comparações entre os grupos foram realizadas por meio do teste ANOVA, seguido do teste Tukey. Resultados e discussão: A idade média foi de 50(11) anos, predominando o sexo feminino (72%). Observou-se no grupo com três componentes, dez diferentes fenótipos, destacando- se a combinação: hipertensão arterial ou pressão arterial elevada, diabetes mellitus ou glicemia de jejum elevada e perímetro da cintura aumentado (11,4%). Não foram verificadas diferenças significativas do zinco no plasma entre os grupos com três, quatro e cinco componentes, apresentando médias de 92,62(18,26) μg/dL; 86,24(17,88) μg/dL; 86,94(17,12) μg/dL, respectivamente (p>0,05). Constataramse percentuais de inadequação de ingestão de zinco de 75%, 73,6% e 66,6% nos grupos com três, quatro e cinco componentes, respectivamente. Conclusão: Indivíduos com SM, independentemente do número de componentes, apresentam médias de zinco no plasma dentro da normalidade e baixa ingestão de zinco na dieta

Introduction: Cardiometabolic risk factors characteristic of the metabolic syndrome (MS) influence zinc metabolism, either alone or in combination. Objective: This study aims to compare plasma zinc and zinc intake among the three groups of individuals with MS, distributed according to the number of components of SM. Methods: Cross-sectional study including 88 individuals with MS, diagnosed according to NCEP-ATP III. The groups were defined, considering three (n = 36), four (n = 40) and five components of MS (n = 12). Zinc intake was evaluated by two 24-hour recall. Blood pressure, waist circumference and fasting glycemia, high density lipoprotein cholesterol and triglycerides were measured. Analysis of plasma zinc was performed by atomic absorption spectrophotometry. We used ANOVA, followed by the Tukey test, for comparisons between the groups. Results and discussion: The mean age was 5011 years, predominantly female (72%). We found ten different phenotypes based on the three components of MS, with emphasis on the phenotype: arterial hypertension or high blood pressure, diabetes mellitus or fasting blood glucose and increased waist circumference (11.4%). There were no significant differences in plasma zinc between the groups with three, four and five components, presenting a mean of 92.62 (18.26) μg / dL; 86.24 (17.88) μg / dL; 86.94 (17.12) μg / dL, respectively (p> 0.05). The percentages of zinc intake inadequacy were 75%, 73.6% and 66.6% in the groups with three, four and five components, respectively. Conclusion: Individuals with MS, regardless of the number of components, present mean plasma zinc within normal range and low dietary zinc intake

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Dietary intake and zinc status in amyotrophic lateral sclerosis patients.

BACKGROUND: There is considerable evidence that abnormal zinc homeostasis is related to amyotrophic lateral sclerosis (ALS) pathogenesis, and malnutrition is an independent prognostic factor for worsened survival of ALS patients. OBJECTIVE: To evaluate the dietary intake and zinc status in patients with ALS, treated in a specialized outpatient facility in Natal, Brazil. METHODS: Twenty patients with ALS (case group) and 37 healthy subjects (control group) were included. Clinical and anthropometric assessments were carried out and dietary intake was obtained from two 24-hour recalls. Plasma and urinary zinc concentrations were determined by atomic absorption spectrophotometry. RESULTS: Most of the participants were eutrophic. Mean energy, protein, carbohydrate and fat intake was significantly lower for the case group. There was greater prevalence of inadequate zinc intake in the case group (35%) compared to controls (27%). Mean plasma zinc was significantly lower in the case group than in controls (77.13 ± 22.21 vs 87.84 ± 17.44 µgZn/dl). Urinary zinc did not differ significantly between cases and controls. In the case group, plasma and urinary zinc concentrations were below reference values in 50.0% and 52.6% of patients, respectively. CONCLUSION: A large portion of patients with ALS exhibited poor dietary intake and changes in body zinc status. The zinc deficiency found in half of the ALS patients may contribute to a worsened prognosis and should be the target of nutritional intervention that aims to correct this deficiency.

Dietary intake and zinc status in amyotrophic lateral sclerosis patients / Ingesta dietética y estado de zinc en pacientes con esclerosis lateral amiotrófica

Background: There is considerable evidence that abnormal zinc homeostasis is related to amyotrophic lateral sclerosis (ALS) pathogenesis, and malnutrition is an independent prognostic factor for worsened survival of ALS patients. Objective: To evaluate the dietary intake and zinc status in patients with ALS, treated in a specialized outpatient facility in Natal, Brazil. Methods: Twenty patients with ALS (case group) and 37 healthy subjects (control group) were included. Clinical and anthropometric assessments were carried out and dietary intake was obtained from two 24-hour recalls. Plasma and urinary zinc concentrations were determined by atomic absorption spectrophotometry. Results: Most of the participants were eutrophic. Mean energy, protein, carbohydrate and fat intake was significantly lower for the case group. There was greater prevalence of inadequate zinc intake in the case group (35%) compared to controls (27%). Mean plasma zinc was significantly lower in the case group than in controls (77.13 ± 22.21 vs 87.84 ± 17.44 μgZn/dl). Urinary zinc did not differ significantly between cases and controls. In the case group, plasma and urinary zinc concentrations were below reference values in 50.0% and 52.6% of patients, respectively. Conclusion: A large portion of patients with ALS exhibited poor dietary intake and changes in body zinc status. The zinc deficiency found in half of the ALS patients may contribute to a worsened prognosis and should be the target of nutritional intervention that aims to correct this deficiency (AU)

Introducción: hay pruebas considerables de que los cambios en la homeostasis del zinc están relacionados con la patogénesis de la esclerosis lateral amiotrófica (ELA) y que la malnutrición es un factor pronóstico capaz de reducir la supervivencia de los pacientes con ELA. Objetivo: evaluar la ingesta dietética y el estado de zinc en pacientes con ELA, tratados en un centro de atención ambulatoria especializado en Natal, Brasil. Métodos: se incluyeron 20 pacientes con ELA (grupo de casos) y 37 sujetos sanos (grupo control). Se realizaron evaluaciones clínicas y antropométricas y se obtuvo la ingesta dietética en dos recordatorios de 24 horas. Las concentraciones plasmáticas y urinarias de zinc se determinaron por espectrofotometría de absorción atómica. Resultados: la mayoría de los participantes fueron eutróficos. El consumo medio de energía, proteínas, carbohidratos y grasas fue significativamente menor en el grupo de casos. Hubo una mayor prevalencia de ingesta inadecuada de zinc en el grupo de casos (35%) en comparación con los controles (27%). El zinc plasmático medio fue significativamente menor en el grupo de casos que en los controles (77,13 ± 22,21 frente a 87,84 ± 17,44 μgZn/dl). El zinc urinario no difirió significativamente entre los casos y los controles. En el grupo de casos, las concentraciones de zinc plasmático y urinario fueron inferiores a los valores de referencia en el 50,0% y 52,6% de los pacientes, respectivamente. Conclusión: gran parte de los pacientes con ELA exhibieron una ingesta dietética pobre y modificación en el estatus de zinc corporal. La deficiencia de zinc encontrada en la mitad de los pacientes con ELA puede contribuir a un empeoramiento del pronóstico y debe ser el objetivo de la intervención nutricional que apunta a corregir esta deficiencia (AU)

Association between kidney function and Framingham risk score in an admixed population of Brazil

ABSTRACT Chronic kidney disease (CKD) increases cardiovascular disease (CVD) risk development. However, the mechanisms of reduced kidney function with CVD risk are unclear. This study aimed to investigate the association between kidney function and Framingham risk score (FRS) in participants with traditional cardiovascular risk factors and normal estimated glomerular filtration rate (eGFR) > 60 mL/min/1.73 m² in an admixed population of Brazil. The participants were divided into three groups according to FRS: low risk group with 0% to <10%, moderate risk group with ≥10% to 20% and high risk group with >20%. The eGFR was calculated using Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). Data from participants were collected by questionnaire, and blood and urine samples were collected to analyze biochemical markers. A total of 214 subjects aged 53±10 years old was collected. There were 77 individuals in low risk group, 59 in moderate risk group and 78 in high-risk group. Mean eGFRCKD-EPI was 89.39±15.05 mL/min/1.73 m² and 90.74±16.17 mL/min/1.73 m2 when race adjustment. The results indicated that there is an increasing the cardiovascular risk with a decreased of eGFR, conforming to a significant inverse correlation observed between eGFR and FRS with Spearman correlation (R²=-0.256, p<0.001; R²=-0.224, p=0.001, when adjusted for race). There was a statistically significant difference in eGFRCKD-EPI (p<0.001) and eGFRCKD-EPI with race adjustment (p=0.002) among risk groups. The data suggests that the reduction eGFR is associated with elevated FRS among Brazilian adults without CKD. Furthermore, the results suggest that race adjustment it's not necessary in Brazilian population.