Vitamin D3 supplementation had no benefits in patients with metabolic syndrome and vitamin D deficiency: A pilot study.

BACKGROUND: Vitamin D deficiency has been observed in individuals with metabolic syndrome (MetS). This study evaluated the effects of vitamin D supplementation in patients with MetS and vitamin D deficiency. METHODS: Vitamin D3 supplementation was performed in patients with MetS and 25(OH)D levels ≤20 ng/mL arranged in two phases. The first phase corresponded to 50,000 IU/week for eight weeks, and the second phase was 7000 IU/week for twelve weeks. RESULTS: The 20-week intervention resulted in an increment of 14.3 ng/mL of 25(OH)D. HbA1c showed a reduction of 0.69% (95% CI [-1.16, -0.21], p = 0.005); however, the triglycerides, HDL-cholesterol, fasting blood glucose, blood pressure, and waist circumference were not responsive to supplementation. CONCLUSION: Vitamin D3 supplementation did not favor the MetS components.

Nutritional risk of vitamin D, vitamin C, zinc, and selenium deficiency on risk and clinical outcomes of COVID-19: A narrative review.

The pathogenicity of the current coronavirus disease (COVID-19) shows postulates that optimal status of essential nutrients is crucial in supporting both the early viraemic and later hyperinflammatory phases of COVID-19. Micronutrients such as vitamin C, D, zinc, and selenium play roles in antioxidant, anti-inflammatory, antithrombotic, antiviral, and immuno-modulatory functions and are useful in both innate and adaptive immunity. The purpose of this review is to provide a high-level summary of evidence on clinical outcomes associated with nutritional risk of these micronutrients observed in patients with COVID-19. A literature search was performed on PubMed and Google Scholar to obtain findings of cross-sectional and experimental studies in humans. The search resulted in a total of 1212 reports including all nutrients, but only 85 were included according to the eligibility criteria. Despite the diversity of studies and the lack of randomized clinical trials and prospective cohorts, there is evidence of the potential protective and therapeutic roles of vitamin C, D, zinc, and selenium in COVID-19. The findings summarized in this review will contribute to guide interventions in clinical practice or in future clinical studies.

High Prevalence of Hypovitaminosis D in Institutionalized Elderly Individuals is Associated with Summer in a Region with High Ultraviolet Radiation Levels.

Vitamin D may play a significant role in regulating the rate of aging. The objective of the study was to assess vitamin D status and its associated factors in institutionalized elderly individuals. A total of 153 elderly individuals living in Nursing Homes (NH) were recruited into the study. Serum 25-hydroxyvitamin D [25(OH)D] concentration was used as the biomarker of vitamin D status, and it was considered as the dependent variable in the model. The independent variables were the type of NH, age-adjusted time of institutionalization, age, sex, skin color, body mass index, waist and calf circumference, physical activity practice, mobility, dietary intake of vitamin D and calcium, vitamin D supplementation, use of antiepileptics, and season of the year. Serum 25(OH)D concentrations less than or equal to 29 ng/mL were classified as insufficient vitamin D status. The prevalences of inadequate dietary intake of vitamin D and calcium were 95.4% and 79.7%, respectively. The prevalence of hypovitaminosis D was 71.2%, and the mean serum concentration of 25(OH)D was 23.9 ng/mL (95% confidence interval [CI]: 22.8-26.1). Serum 25(OH)D concentration was associated with the season of summer (p = 0.046). There were no associations with other independent variables (all p > 0.05). The present results showed that a high prevalence of hypovitaminosis D was significantly associated with summer in institutionalized elderly individuals.

Zinc supplementation reduces RANKL/OPG ratio and prevents bone architecture alterations in ovariectomized and type 1 diabetic rats.

Type 1 diabetes mellitus (T1DM) and estrogen deficiency are associated with several alterations in bone turnover. Zinc (Zn) is required for growth, development, and overall health. Zinc has been used in complementary therapy against bone loss in several diseases. We hypothesized that Zn supplementation represents a potential therapy against severe bone loss induced by the combined effect of estrogen deficiency and T1DM. We evaluated the protective effect of Zn against bone alterations in a chronic model of these disorders. Female Wistar rats were ramdomized into 3 groups (5 rats each): control, OVX/T1DM (ovariectomized rats with streptozotocin-induced T1DM), and OVX/T1DM+Zn (OVX/T1DM plus daily Zn supplementation). Serum biochemical, bone histomorphometric, and molecular analyses were performed. Histomorphometric parameters were similar between the control and OVX/T1DM+Zn groups, suggesting that Zn prevents bone architecture alterations. In contrast, the OVX/T1DM group showed significantly lower trabecular width and bone area as well as greater trabecular separation than the control. The OVX/T1DM and OVX/T1DM+Zn groups had significantly higher serum alkaline phosphatase activity than the control. The supplemented group had higher levels of serum-ionized calcium and phosphorus than the nonsupplemented group. The RANKL/OPG ratio was similar between the control and OVX/T1DM+Zn groups, whereas it was higher in the OVX/T1DM group. In conclusion, Zn supplementation prevents bone alteration in chronic OVX/T1DM rats, as demonstrated by the reduced RANKL/OPG ratio and preservation of bone architecture. The findings may represent a novel therapeutic approach to preventing OVX/T1DM-induced bone alterations.

Zinc Status Biomarkers and Cardiometabolic Risk Factors in Metabolic Syndrome: A Case Control Study.

Metabolic syndrome (MS) involves pathophysiological alterations that might compromise zinc status. The aim of this study was to evaluate zinc status biomarkers and their associations with cardiometabolic factors in patients with MS. Our case control study included 88 patients with MS and 37 controls. We performed clinical and anthropometric assessments and obtained lipid, glycemic, and inflammatory profiles. We also evaluated zinc intake, plasma zinc, erythrocyte zinc, and 24-h urinary zinc excretion. The average zinc intake was significantly lower in the MS group (p < 0.001). Regression models indicated no significant differences in plasma zinc concentration (all p > 0.05) between the two groups. We found significantly higher erythrocyte zinc concentration in the MS group (p < 0.001) independent from co-variable adjustments. Twenty-four hour urinary zinc excretion was significantly higher in the MS group (p = 0.008), and adjustments for age and sex explained 21% of the difference (R² = 0.21, p < 0.001). There were significant associations between zincuria and fasting blood glucose concentration (r = 0.479), waist circumference (r = 0.253), triglyceride concentration (r = 0.360), glycated hemoglobin concentration (r = 0.250), homeostatic model assessment-insulin resistance (r = 0.223), and high-sensitivity C-reactive protein concentration (r = 0.427) (all p < 0.05) in the MS group. Patients with MS had alterations in zinc metabolism mainly characterized by an increase in erythrocyte zinc and higher zincuria.

Zinc supplementation reduces RANKL/OPG ratio and prevents bone architecture alterations in ovariectomized and type 1 diabetic rats

Type 1 diabetes mellitus (T1DM) and estrogen deficiency are associated with several alterations in bone turnover. Zinc (Zn) is required for growth, development, and overall health. Zinc has been used in complementary therapy against bone loss in several diseases. We hypothesized that Zn supplementation represents a potential therapy against severe bone loss induced by the combined effect of estrogen deficiency and T1DM. We evaluated the protective effect of Zn against bone alterations in a chronic model of these disorders. Female Wistar rats were ramdomized into 3 groups (5 rats each): control, OVX/T1DM (ovariectomized rats with streptozotocin-induced T1DM), and OVX/T1DM+Zn (OVX/T1DM plus daily Zn supplementation). Serum biochemical, bone histomorphometric, and molecular analyses were performed. Histomorphometric parameters were similar between the control and OVX/T1DM+Zn groups, suggesting that Zn prevents bone architecture alterations. In contrast, the OVX/T1DM group showed significantly lower trabecular width and bone area as well as greater trabecular separation than the control...

Fecal selenium excretion is regulated by dietary selenium intake.

Whole-body selenium is regulated by excretion of the element. Reports of studies carried out using isotopic tracers have led to the conclusion that urinary selenium excretion is regulated by selenium intake but that fecal excretion is not. Because of the limitations of tracer studies, we measured urinary and fecal selenium excretion by mice with selenium intakes in the form of sodium selenite ranging from deficient to almost toxic. Tissue and whole-body selenium concentrations increased sharply between deficient and adequate selenium intakes, reflecting tissue accumulation of selenium in the form of selenoproteins. Once the requirement for selenium had been satisfied, a 31-fold further increase in intake resulted in less than doubling of tissue and whole-body selenium, demonstrating the effectiveness of selenium excretion by the mouse. Urinary selenium excretion increased with increases in dietary selenium intake. Fecal selenium excretion, which was 20 to 30 % of the selenium excreted in the physiological range, responded to moderately high selenium intake but did not increase further when selenium intake was increased to even higher levels. Thus, fecal selenium excretion contributes to regulation of whole-body selenium at physiological selenium intakes. The pattern of its response to the full spectrum of selenium intakes was different from the urinary excretion response, suggesting that the mechanisms of fecal and urinary routes of excretion are different.

Comparison between objective assessment and self-assessment of sexual maturation in children and adolescents / Comparação entre avaliação objetiva e autoavaliação da maturação sexual em crianças e adolescentes

OBJETIVO: Avaliar as correlações entre avaliação objetiva e autoavaliação em ambientes diferentes (ambulatorial e escolar). MÉTODOS: Trezentos e dezenove indivíduos, 178 ambulatoriais (96 meninos e 82 meninas) e 141 (73 meninos e 68 meninas) de escolas públicas (8,3-18,7 anos), com 73 indivíduos (39 meninas e 34 meninos) apresentando índice de massa corporal acima do percentil 85 do Centers for Disease Control and Prevention, de 2000. Todos foram examinados, após consentimento informado, em sequência e individualmente, por dois médicos treinados, e então submetidos a autoavaliação, utilizando fotogramas (Tanner). Dos dados obtidos foram calculados os coeficientes de correlação de kappa entre examinadores e a autoavaliação. Para os testes foi adotado p < 5%. RESULTADOS: Não houve diferença significante entre as correlações obtidas no ambulatório e nas escolas e os dois grupos foram analisados em conjunto. As correlações obtidas entre os examinadores foram significantemente maiores que as da autoavaliação, com kappa (e intervalo de confiança) de 0,75 (0,8-0,69) para mamas/genitália entre examinadores contra 0,27 (0,34-0,20) e 0,29 (0,36-0,22) entre os dois examinadores e a autoavaliação (p < 0,0001). CONCLUSÕES: Na amostra estudada, a autoavaliação do estádio puberal não deve substituir a avaliação objetiva feita por profissionais treinados. Um aperfeiçoamento do método de autoavaliação poderia permitir seu uso em estudos populacionais.

OBJECTIVE: To assess the correlations between objective assessment and self-assessment of sexual maturation in the outpatient and school settings. METHODS: Three hundred and nineteen individuals, 178 (96 boys and 82 girls) from an outpatient clinic and 141 (73 boys and 68 girls) from public schools (8.3-18.7 years), of whom 73 individuals (39 girls an d 34 boys) had a body mass index above the 85th percentile, according to 2000 CDC Growth Chart, were analyzed. All of them were examined sequentially and individually by two trained physicians after a written consent form was signed by parents or surrogates, and then submitted to self-assessment using pictures (Tanner stages). Kappa coefficients between examiners and the self-assessment were calculated based on the collected data. A p value < 5% was established as statistically significant. RESULTS: No significant difference was observed between correlations obtained from the outpatient clinic and schools, and both groups were combined for analysis. The correlations obtained by examiners were significantly higher than those from self-assessment, with a kappa coefficient (and confidence interval) of 0.75 (0.8-0.69) for breasts/genitals across examiners against 0.27 (0.34-0.20) and 0.29 (0.36-0.22) between the two examiners and the self-assessment (p < 0.0001). CONCLUSIONS: In the studied sample, self-assessment of the pubertal stage should not replace the objective assessment made by trained professionals. Improvement of the self-assessment method may validate its use in population-based studies.

Comparison between objective assessment and self-assessment of sexual maturation in children and adolescents.

OBJECTIVE: To assess the correlations between objective assessment and self-assessment of sexual maturation in the outpatient and school settings. METHODS: Three hundred and nineteen individuals, 178 (96 boys and 82 girls) from an outpatient clinic and 141 (73 boys and 68 girls) from public schools (8.3-18.7 years), of whom 73 individuals (39 girls an d 34 boys) had a body mass index above the 85th percentile, according to 2000 CDC Growth Chart, were analyzed. All of them were examined sequentially and individually by two trained physicians after a written consent form was signed by parents or surrogates, and then submitted to self-assessment using pictures (Tanner stages). Kappa coefficients between examiners and the self-assessment were calculated based on the collected data. A p value <5%was established as statistically significant. RESULTS: No significant difference was observed between correlations obtained from the outpatient clinic and schools, and both groups were combined for analysis. The correlations obtained by examiners were significantly higher than those from self-assessment, with a kappa coefficient (and confidence interval) of 0.75 (0.8-0.69) for breasts/genitals across examiners against 0.27 (0.34-0.20) and 0.29 (0.36-0.22) between the two examiners and the self-assessment (p < 0.0001). CONCLUSIONS: In the studied sample, self-assessment of the pubertal stage should not replace the objective assessment made by trained professionals. Improvement of the self-assessment method may validate its use in population-based studies.

Association of nutritional status with the response to infection with Leishmania chagasi.

Outcomes of infection with Leishmania chagasi range from self-resolving infection to visceral leishmaniasis (VL). Risk factors determining development of disease are not totally understood, but probably include environmental influences and host genetics. We assessed whether nutrition influenced the outcome of Leishmania infection by comparing relatives of children with VL with either self-resolving Leishmania spp. infection or apparently uninfected households. We observed a decrease in body mass index (P < 0.0005) and mid-upper arm circumference for age (P = 0.022) z-scores for children with VL. Levels of vitamin A were lower in active children with VL as measured by serum retinol (P = 0.035) and the modified-relative-dose-response test (P = 0.009). Higher birth weight (P = 0.047) and albumin concentrations (P = 0.040) protected against disease. Increased breastfeeding time (P = 0.036) was associated with asymptomatic infection. The results indicate that modifiable nutritional aspects are associated with the outcome of Leishmania spp. infection in humans.

[Plasma lipid profile and lipid peroxidation in overweight or obese children and adolescents]. / Perfil lipídico e peroxidação de lipídeos no plasma em crianças e adolescentes com sobrepeso e obesidade.

OBJECTIVE: To study the plasma lipid profile and lipid peroxidation in overweight or obese children and adolescents receiving care at the pediatric endocrinology clinic in HOSPED/UFRN, a university hospital. METHODS: Three groups were studied: overweight (n = 15), obese (n = 30) and control (n = 21) children and adolescents. To evaluate plasma lipid profile, total cholesterol, LDL-cholesterol, HDL-cholesterol and triglyceride levels were measured. Lipid peroxidation was determined by measuring malondialdehyde concentration. Data were analyzed using Student's t test, Tukey test, ANOVA and Pearson's correlation. RESULTS: Altered levels of total and LDL-cholesterol were observed mainly in overweight or obese males. HDL-cholesterol was borderline in the overweight and obese groups of both sexes. Obese females had the highest levels of triglycerides. Increased plasma lipid peroxidation was observed mainly in obese males. CONCLUSION: In the present population, the greatest alterations in lipid profile were observed in obese and overweight males. Plasma lipid peroxidation was more evident in obese males and females.

Perfil lipídico e peroxidação de lipídeos no plasma em crianças e adolescentes com sobrepeso e obesidade / Plasma lipid profile and lipid peroxidation in overweight or obese children and adolescents

OBJETIVO: Identificar o perfil lipídico e a peroxidação de lipídeos no plasma de crianças e adolescentes com sobrepeso e obesidade atendidos no Ambulatório de Endocrinologia Pediátrica do HOSPED/UFRN. MÉTODOS: Foram constituídos grupos com crianças e adolescentes com sobrepeso (n = 15), obesidade (n = 30) e controle (n = 21). O perfil lipídico foi avaliado por meio do colesterol total, LDL-colesterol, HDL-colesterol e triglicerídeos. A peroxidação de lipídeos no plasma foi medida pelo marcador malonildialdeído (MDA). A análise estatística foi realizada através do teste t de Student, teste de Tukey, ANOVA e correlação de Pearson. RESULTADOS: As alterações de colesterol total e LDL-colesterol estavam mais presentes nos grupos sobrepeso e obesidade masculinos. O HDL-colesterol mostrou-se em condições limítrofes nos grupos sobrepeso e obesidade em ambos sexos. As maiores concentrações de triglicerídeos foram registradas no grupo obesidade feminino. Identificou-se elevada peroxidação de lipídeos no plasma no grupo obesidade, principalmente no sexo masculino. CONCLUSÕES: Na amostra estudada, maiores alterações do perfil lipídico foram observadas no sexo masculino nos grupos sobrepeso e obesidade, e a peroxidação de lipídeos estava mais evidente no grupo obesidade em ambos sexos.

Efeito da suplementaçäo com zinco sobre a zincúria de pacientes com diabetes tipo 1 / Effect of zinc supplementation on urinary zinc excretion of patients with type 1 diabetes

Neste estudo foi investigado o efeito da suplementaçäo oral de zinco (Zn) em crianças e adolescentes com diabetes (DM), avaliando o controle metabólico da doença e concentrações de Zn na urina. A amostra foi constituída por 20 pacientes com DM tipo 1, os quais foram comparados com um grupo controle (n=17). O controle metabólico foi avaliado pela glicemia de jejum, glicosúria 24h e HbA1c. As concentrações de Zn foram investigadas na urina de 24h antes (T1) e após a suplementaçäo (T2). Após a 1a coleta de dados dos pacientes com DM1 (T1), teve início a suplementaçäo oral com Zn bis-glicina quelato sem sabor, por um período de 4 meses. As doses foram estabelecidas baseadas nas Dietary Reference Intakes. Os resultados evidenciaram um controle metabólico insatisfatório da doença, devido ao aumento da HbA1c de alguns pacientes, após a suplementaçäo. A excreçäo urinária de Zn foi maior nos pacientes com DM1 e esteve correlacionado positivamente com o tempo de doença e HbA1c. A suplementaçäo com Zn näo corrigiu a heterogeneidade na variaçäo circadiana da zincúria nos pacientes estudados, sugerindo que o controle metabólico inadequado no DM predispöe a distúrbios no metabolismo do Zn, independente da fonte, alimentar ou medicamentosa

Efeito da suplementaçäo com ferro na biodisponibilidade de zinco em uma dieta regional do nordeste do Brasil / Effects of supplementation with iron on the bioavailability of zinc in the regional diet of northeastern Brazil

Foram investigados os efeitos da suplementaçào com ferro na biodisponibilidade de zinco de uma dieta regional do Nordeste (DRNE), em ratos albinos Wistar, consumindo raçöes à base da referida dieta (DRNE) e raçöes controle. As raçöes DRNE continham 16 mg de Zn/Kg e níveis de 35 mg, 70 mg e 140 mg Fe/Kg. As raçöes controle foram elaboradas segundo o "Committee on Laboratory Animal Diets", contendo níveis de proteína, ferro e zinco ajustados aos das raçöes experimentais DRNE. Os parâmetros utilizados para medir a biodisponibilidade do zinco foram: índice de absorçäo aparente do Zn e nível total de Zn nos fêmures. Os resultados obtidos demonstraram que a suplementaçäo com ferro diminuiu a biodisponibilidade do Zn, e os efeitos dessa interferência foram influenciados pela qualidade da dieta e pelas proporçöes Fe:Zn. Tal fato deve ser considerado nas práticas que envolvem fortificaçäo de alimentos e/ou suplementos medicamentosos, comuns nas populaçöes com carências nutricionais