Evaluation of vitamin D and inflammatory markers in elderly

Abstract Vitamin D is an immune modulator, in addition to being interrelated with calcium homeostasis and bone metabolism. Recent studies have associated vitamin D with inflammatory processes. C-reactive protein (CRP), platelet/lymphocyte ratio (PLR) and neutrophil/lymphocyte ratio (NLR) have been used to determine inflammation. There is no consensus on the use of these markers to determine an association between inflammation and vitamin D levels. The objective of this study was to evaluate the association between inflammatory markers and vitamin D in the elderly. A cross-sectional, descriptive study was performed based on the analysis of vitamin D, CRP (quantitative determination of C-Reactive Protein by the ultra-sensitive method) and blood count of institutionalized elderly. In this study, 64% showed vitamin D deficiency, with mean value of 22 ng/mL. In the vitamin D deficient group, the mean values found were: CRP 4.5 mg/L; NLR 2.35 and PLR 119. In the group without vitamin D deficiency the mean values were: CRP 4 mg/L; NLR 1.87 and PLR 111 without statistical difference between the values of the analyzed parameters. The results point to a predominant profile of vitamin D deficiency in the evaluated individuals. No association was found between vitamin D values and the inflammatory markers analyzed.

Avaliação da relação Triglicerídeo/HDL-C e da razão Neutrófilos/Linfócitos em idosos com e sem dislipidemia / Evaluation of Triglyceride/HDL-C and Neutrophil/Lymphocyte ratio in the elderly with and without dyslipidemia

RESUMO: Introdução: As doenças cardiovasculares(DCV)estão entre as principais causas de mortalidade entre idosos, sendo a dislipidemia um importante fator de risco. Além disso, a relação Triglicerídeo/HDL-C e a razão Neutrófilos/Linfócitos apresentam estreita relação com os fatores de riscos para DCV. Objetivo: Comparar as relações Triglicerídeo/HDL-C e Neutrófilos/Linfócitos na população idosa sem e com dislipidemia. Métodos: Estudo documental, transversal, retrospectivo, com abordagem quantitativa e comparativa. A amostra foi de conveniência e incluiu os 110 idosos residentes em uma Instituição de Longa Permanência de Idosos. Foram coletados dados do perfil lipídico, hemograma, idade e sexo. Os idosos foram divididos em dois grupos: Com Dislipidemia e Sem Dislipidemia. As relações Triglicerídeo/HDL-C e Neutrófilos/Linfócitos foram calculadas e comparadas. Os resultados foram apresentados como mediana e intervalo interquartil e analisados pelo teste de Mann-Whitney. As variáveis categóricas foram representadas como frequência absoluta (n) e relativa (%) e avaliadas pelo teste de Qui-Quadrado (X2). Utilizou-se o programa estatístico SPSS 20.0®e nível de significância < 0,05. Resultados: Foram selecionados 84 idosos com resultados do perfil lipídico e hemograma, sendo 56 (67%) idosos do sexo feminino e 28 (33%) do sexo masculino, com idade mediana de 75 (69-81) anos. O grupo Com Dislipidemia apresentou valores superiores para Triglicerídeo/HDL-C e para a relação Neutrófilos/Linfócitos não houve diferença estatística. Conclusão: A relação Triglicerídeo/HDL-C pode ser utilizada como uma medida preventiva de doenças cardiovasculares nos idosos participantes do estudo. Porém, a relação Neutrófilos/Linfócitos deve ser interpretada com cautela nos idosos que apresentam características particulares quanto ao desenvolvimento das DCV. (AU)

ABSTRACT: Introduction: Cardiovascular diseases (CVD) are the leading causes of mortality among the elderly, and dyslipidemia is an important risk factor. Moreover, the Triglyceride/HDL-C and Neutrophils/Lymphocytes ratios are closely related to CVD risk factors. Objective: Comparing the Triglyceride/HDL-C and Neutrophils/Lymphocytes ratios in elderlies' groups, with and without dyslipidemia. Methods: Documentary, cross-sectional, and retrospective study with a quantitative and comparative approach. The sample was of convenience and included 110 elderlies' residents in a Long-Term Care for Elderlies. Data on lipid profile, full blood count, age, and sex were obtained and the residents divided into two groups, With Dyslipidemia and Without Dyslipidemia. The Triglyceride/HDL-C and Neutrophils/Lymphocytes ratios for both groups were measured and compared. Results were presented as median and interquartile range and analyzed by the Mann-Whitney test. Categorical variables were represented as absolute (n) and relative (%) frequencies and evaluated by the Chi-square (X2). The statistical program SPSS 20.0® was used with a significance level p < 0,05. Results: Eighty-four elderlies with results of lipid profile and blood count were selected, 56 (67%) were female and 28 (33%) male, with a median age of 75 (69-81) years. The group With Dyslipidemia showed higher values for Triglyceride/HDL-C and Neutrophils/Lymphocytes ratios, there was no statistical difference between the groups studied. Conclusion: The Triglyceride/HDL-C ratio can be used as a preventive measure of cardiovascular diseases in the elderlies' participants of the study. However, the Neutrophils/Lymphocytes ratio should be interpreted with caution in the elderly, who have particular characteristics regarding the development of cardiovascular diseases. (AU)

Biomarkers in Non-Complicated Pregnancy: Insights About Serum Myeloperoxidase and Ultrasensitive C-Reactive Protein.

INTRODUCTION: Pregnancy is characterized by increased innate immune response, with low-grade systemic inflammation. The specific role of MPO during normal pregnancy remains not well understood. Therefore, the aim of this study was to evaluate plasma levels of MPO, hs-CRP, total leukocyte, absolute neutrophil and monocyte counts, in all trimesters of normal human pregnancy compared with non-pregnant controls. In addition, possible fluctuations of MPO according to different inflammatory conditions in the normal gestation were studied. MATERIALS AND METHODS: Case-control study (n=84) developed with 63 normal pregnant women and 21 healthy non-pregnant women. Total leukocyte, absolute neutrophils and absolute monocytes count, hs-CRP and MPO were measured in non-pregnant women and normal human pregnancy. They were evaluated according to the 3 trimesters of pregnancy and systemic low grade inflammatory status, which was identified through increased hs-CRP levels. RESULTS: MPO levels in the normal pregnant women were not elevated in every 3 trimesters of pregnancy (P=0.456) or in systemic inflammation (P=0.446). The hs-CRP levels, total leukocyte, absolute neutrophil and monocyte counts are present in higher concentrations in normal pregnant women in relation to non-pregnant women. CONCLUSIONS: The MPO did not show fluctuations in plasma levels during the 3 trimesters of gestation or in relation to different inflammation conditions. Considering MPO and hs-CRP levels are changed in high cardiovascular risk conditions and MPO levels (unlike hs-CRP) didn't increase during non complicated pregnancy, MPO could be a better biomarker than hs-CRP to monitor these patients.

Risco presumido para doenças cardiovasculares em servidores de uma universidade estadual do Paraná, Brasil / Presued risk of cardiovascular diseases of employeesof a paraná staate university, Brazil

Segundo o Ministério da Saúde, há uma carência de informações epidemiológicas relativas a fatores de risco relacionados às doenças crônicas não transmissíveis e que podem ser evitáveis, em sua maioria, com a modificação de estilo de vida, detecção precoce e o controle oportuno, Dentre estas, destacam-se as doenças cardiovasculares, as quais, segundo dados da Secretaria de Saúde do Paraná, apresentam maior impacto sobre a mortalidade, O objetivo deste trabalho foi avaliar a saúde dos servidores da Universidade Estadual de Ponta Grossa por meio do risco total presumido em desenvolver doenças do aparelho circulatório, de acordo com o Escore de Framingham e ocorrência de fatores de risco modificáveis, Para tanto, aplicou-se inquérito epidemiológico e determinaram-se parâmetros antropométricos, parâmetros laboratoriais e pressão arterial, As análises laboratoriais foram realizadas no Laboratório Universitário de Análises Clínicas em rotina automatizada, Os resultados revelaram o risco absoluto de infarto (calculado usando o Escore de Framingham) e morte em 10 anos, Segundo este critério, 78 dos 86 voluntários enquadraram-se em baixo risco no desenvolvimento de doenças cardiovasculares, Entretanto, a ocorrência de fatores de risco modificáveis, como sobrepeso e obesidade, tabagismo e hipertensão, aponta para a necessidade de medidas educativas e preventivas em relação aos fatores de risco observados nos servidores da Universidade, os quais devem ser alvos de um programa de saúde que contemple esses aspectos...

According to the Ministry of Health there is a lack of epidemiological information regarding risk factors related to chronic diseases that may be preventable, mostly, with the modification of lifestyle, early detection and timely control. Among these, there are the cardiovascular diseases, which, according to the Department of Health of Paraná, have greater impact on mortality. The aim of this study was to evaluate the health of servers from the Paraná State University of Ponta Grossa through the assumed total risk in developing cardiovascular diseases, according to the Framingham Score and the occurrence of modifiable risk factors. Therefore, it was applied an epidemiological survey and anthropometric parameters, laboratory parameters and blood pressure were determined. Laboratory analyzes were performed at the University Laboratory of Clinical Analyses in automated routine. The results revealed the absolute risk (calculated using the Framingham Score) of myocardial infarction and death in 10 years. According to this criterion, 78 of the 86 volunteers were classified at low risk of developing cardiovascular disease. However, the occurrence of modifiable risk factors, such as overweight and obesity, smoking and hypertension, points to the need for educational and preventive measures in relation to the risk factors noted in the University’s servers, which should be targeted for a health program that addresses these issues...