Glycoinsulinemic parameters associated with vitamin D status in patients with chronic kidney disease undergoing dialysis therapy

ABSTRACT Evidence indicates that the physiological role of vitamin D goes beyond regulating classical domains of minerals and hormones. It is reported that the low status of Vitamin D may contribute to the occurrence of metabolic disorders, with emphasis on insulin resistance, atherosclerotic events and metabolic syndrome. In this sense, this study aimed to verify the association between metabolic and anthropometric parameters and vitamin D status in patients with chronic kidney disease undergoing hemodialysis. This was a cross-sectional study conducted with 95 patients with chronic kidney disease treated at clinics in Teresina, Piaui, Brazil. Lipid and inflammatory profile, glycemia, insulin and vitamin D status were determined. Data were analyzed using STATA software, adopting significance level of p<0.05. The results pointed to a significant association between vitamin D concentrations and adiposity of patients. It was observed that the high blood glucose and HOMA-IR values presented statistical association with vitamin D concentrations, and conditioned greater chances of their inadequacy. There was no correlation between nutrient concentrations and cytokines evaluated in the study. Therefore, it was concluded that the increase in levels of glycoinsulinemic parameters (insulin and HOMA-IR) seems to influence vitamin D status in patients with chronic kidney disease.

RESUMEN La evidencia indica que el papel fisiológico de la vitamina D va más allá de regular los dominios clásicos del eje mineral y hormonal. Hay trabajos que muestran que el bajo nivel de vitamina D puede contribuir a la aparición de trastornos metabólicos, con énfasis en la resistencia a la insulina, eventos ateroscleróticos y síndrome metabólico. En este sentido, el objetivo de este estudio fue verificar la asociación entre parámetros metabólicos y antropométricos y el estado de vitamina D en pacientes renales crónicos en hemodiálisis. Se trata de un estudio transversal realizado con 95 pacientes con enfermedad renal crónica atendidos en consultas externas de Teresina, Piauí, Brasil. Se determinó el perfil lipídico e inflamatorio, la glicemia, la insulina y el estado de vitamina D. Los datos se analizaron utilizando programa STATA , con un nivel de significancia de p<0,05. Los resultados apuntaron a una asociación significativa entre las concentraciones de vitamina D y la adiposidad de los pacientes. Se observó que los valores elevados de glucosa en sangre y HOMA-IR se asociaron estadísticamente con las concentraciones de vitamina D y condicionaron mayores posibilidades de su insuficiencia. No hubo correlación entre las concentraciones de nutrientes y las citocinas evaluadas en el estudio. Por tanto, se concluyó que el aumento de los niveles de parámetros glucoinsulinémicos (insulina y HOMA-IR) parece influir en el estado de la vitamina D en pacientes con enfermedad renal crónica.

No Difference in Magnesium Intake between Obese Women and Healthy Controls.

Magnesium is a predominantly intracellular ion and plays an important role in energy metabolism and in the maintenance of energy homeostasis. This study aimed to estimate the dietary intake of magnesium and its association with adiposity parameters in obese women. This cross-sectional study included 125 women, aged between 20 and 50 years, who were divided into two groups: obese group (n = 62) and control group (n = 63). The control group was age-matched. Adiposity parameters determined were weight, body mass index and waist circumference as well as the intake of calories, macronutrients, and magnesium were calculated. The cut-off for obesity was body mass index between 30.0 and 39.9 kg/m2 and for control group was between 18.5 and 24.9 kg/m2 Food intake was calculated using 3-day food records, and energy consumption as well as the intake of macronutrients and magnesium was calculated using the NutWin software version 1.5. The reference values used were the Acceptable Macronutrient Distribution Range for macronutrients and the Estimated Average Requirement (EAR) for magnesium. The average levels of magnesium found in the diet were lower than those recommended (169.1 ± 64.5 mg Mg/day and 158.5 ± 42.9 mg Mg/day, for obese women and control group, respectively) and the differences between the groups were not statistically different (p > 0.05). The correlation analysis indicated that the association between the dietary intake of magnesium and adiposity was not significant. The results of this study indicate that dietary magnesium does not influence the adiposity parameters in obese women.