RESUMO
OBJECTIVE: To evaluate the relationship between vitamin D status and hypertriglyceridemic-waist (HTW) phenotype and cardiometabolic markers in individuals with type 2 diabetes mellitus (T2DM) living in regions with high solar incidence (10° south). METHODS: An observational, cross-sectional study, with 122 individuals with T2DM, of both sexes, aged between 19 and 59 years, residing in Sergipe/Brazil. Measurements included serum 25-hydroxyvitamin D (25[OH]D), glucose, insulin, total cholesterol, LDL-c, HDL-c, triacylglycerols, blood pressure, body mass index, %body fat, and waist circumference. Participants were classified by the presence or absence of the HTW phenotype, according to increased waist circumference and triacylglycerols concentrations. Logistic and linear regression models were applied to verify the association among the concentration of 25(OH)D, HTW phenotype, and lipid profile variables. RESULTS: Triacylglycerols concentrations (p = .013) and %body fat (p = .011) were higher in women with serum 25(OH)D insufficient/deficient than in those with adequate 25(OH)D levels. Individuals with serum 25(OH)D insufficiency/deficiency were 2.595 times more likely to present the HTW phenotype than those with adequate 25(OH)D levels (p = .021). Additionally, a negative association was observed between the concentration of 25(OH)D and total cholesterol (Beta = -0.204, p = .049). CONCLUSION: Insufficiency/deficiency of serum 25(OH)D in individuals with T2DM increases the chances of developing the HTW phenotype.
Assuntos
Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Deficiência de Vitamina D , Masculino , Humanos , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Diabetes Mellitus Tipo 2/epidemiologia , Estudos Transversais , Incidência , Vitamina D , Triglicerídeos , Calcifediol , Fenótipo , Índice de Massa Corporal , Doenças Cardiovasculares/etiologia , Deficiência de Vitamina D/epidemiologiaRESUMO
Menopause and vitamin D deficiency increase bone reabsorption and bone fracture risk in women in postmenopause, and vitamin D supplementation may improve bone health and decrease bone fracture risk. This study aims to discuss the effect of vitamin D supplementation, isolated or calcium-associated, on remodeling and fracture risk bone in women in postmenopause without osteoporosis. This study was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO database registration: CRD42022359796). A search was conducted in four databases and gray literature using MeSH and similar terms related to supplements, vitamin D, calcium, remodeling, and fracture bone, without the restriction of language and year of publication. A total of 3460 studies were identified, and nine were selected. Vitamin D supplementation increased 25-hydroxyvitamin D levels ≥10 ng/mL and decreased parathyroid hormone secretion dependent on baseline levels. The doses of 400 IU of vitamin D improved the percentage of carboxylated osteocalcin, whereas 800 to 1000 IU combined with calcium resulted in reduced, improved, or maintained bone mineral density and reduced alkaline phosphatase levels. However, 4000 IU alone or combined with calcium for 6 mo did not improve C-telopeptide and procollagen type 1 peptide levels. Additionally, 15 000 IU/wk increased the cortical area of metacarpal bone, whereas 500 000 IU of vitamin D annually for 5 y did not contribute to reducing the fracture risk and falls. Only one study found a reduction in fracture risk (dose of 800 IU of vitamin D plus 1200 mg of calcium). Thus, the vitamin D supplementation, alone or calcium-associated, improved the status of 25-hydroxyvitamin D and bone remodeling, but it was not possible to assert that it reduced fracture bone risk in postmenopausal women.
Assuntos
Fraturas Ósseas , Osteoporose , Humanos , Feminino , Cálcio , Pós-Menopausa , Ensaios Clínicos Controlados Aleatórios como Assunto , Vitamina D/uso terapêutico , Vitaminas/uso terapêutico , Fraturas Ósseas/etiologia , Fraturas Ósseas/prevenção & controle , Fraturas Ósseas/tratamento farmacológico , Cálcio da Dieta , Calcifediol , Suplementos Nutricionais , Remodelação ÓsseaRESUMO
Hypomagnesemia and unhealthy eating patterns are associated with poor glycemic control in individuals with type 2 diabetes mellitus (T2DM). This study aimed to associate magnesium status and dietary patterns with glycemic control in T2DM individuals. This cross-sectional study included 147 individuals with T2DM, aged between 19 and 59 years, of both sexes, residents in Sergipe/Brazil. The BMI, waist circumference, %body fat, plasma magnesium, serum glucose, insulin, %HbA1c, triacylglycerol, total cholesterol, LDL-c, and HDL-c were analyzed. Eating patterns were identified using a 24-h recall method. Logistic regression models were used to verify the association of magnesium status and dietary patterns with markers of glycemic control by adjusting for sex, age, time of T2DM diagnosis, and BMI. A P value < 0.05 was considered significant. Magnesium deficiency increased the chance of elevated %HbA1c by 5.893-fold (P = 0.041). Three main dietary patterns were identified: mixed (MDP), unhealthy (UDP), and healthy (HDP). UDP also increased the chance of elevated %HbA1c levels (P = 0.034). T2DM individuals' who presented magnesium deficiency had a higher chance of elevated %HbA1c levels (8.312-fold) and those in the lowest quartile (Q) of the UDP (Q1: P = 0.007; Q2: P = 0.043) had a lower chance of elevated %HbA1c levels. However, the lower quartiles of the HDP were associated with a greater chance of alterations in the %HbA1c level (Q1: P = 0.050; Q2: P = 0.044). No association was observed between MDP and the variables studied. Magnesium deficiency and UDP were associated with a higher chance of inadequate glycemic control in T2DM individuals.
Assuntos
Diabetes Mellitus Tipo 2 , Deficiência de Magnésio , Masculino , Feminino , Humanos , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Magnésio , Hemoglobinas Glicadas , Glicemia , Estudos Transversais , Controle Glicêmico , Difosfato de UridinaRESUMO
CONTEXT: Foods containing vitamin D reduce the deficiency of this vitamin and improve bone turnover. OBJECTIVE: To discuss effects of the intake of vitamin D-fortified foods in isolated form or associated with calcium on bone remodeling in postmenopausal women. DATA SOURCES: PubMed, Lilacs, Scopus, and Bireme databases. OpenThesis and Google Scholar were searched as "grey literature". Medical subject headings or similar terms related to food fortified with vitamin D and bone in postmenopausal women were used. DATA EXTRACTION: Information was collected on study methodology and characteristics of studied populations; dosage; the food matrix used as the fortification vehicle; duration of intervention; dietary intake; 25-hydroxyvitamin D [25(OH)D] levels; serum parathyroid hormone (PTH) concentrations; bone resorption and/or formation markers (ie, carboxy terminal cross-linked telopeptide of type I collagen [CTX], tartrate-resistant acid phosphatase isoform 5b [TRAP5b], and procollagen type 1 N-terminal propeptide [P1NP]); main results; and study limitations. DATA ANALYSIS: Five randomized controlled trials involving postmenopausal women were included. The mean ages of participants ranged from 56.1 to 86.9 years. Daily consumption of soft plain cheese fortified with 2.5 µg of vitamin D3 and 302 mg of calcium for 4 weeks resulted in a mean increase of 0.8 ng/mL in 25(OH)D and 15.9 ng/mL in P1NP levels compared with baseline, and decreased CTX, TRAP5b, and PTH values. A similar intervention for 6 weeks, using fortified cheese, showed a reduction only in TRAP5b values (-0.64 U/L). Yogurt fortified with 10 µg of vitamin D3 and 800 mg of calcium did not change P1NP values after 8 weeks of intervention, but was associated with decreases of 0.0286 ng/mL and 1.06 U/L in PTH and TRAP5b, respectively. After 12 weeks of eating the fortified yogurt, 25(OH)D levels increased by a mean of 8.8 ng/mL and PTH levels decreased in by a mean of 0.0167 ng/mL. CONCLUSIONS: The interventions contributed toward the improvement of the bone resorption process but not to the bone formation process in postmenopausal women. PROSPERO REGISTRATION NUMBER: CRD42019131976.
Assuntos
Cálcio , Alimentos Fortificados , Idoso , Idoso de 80 Anos ou mais , Biomarcadores , Remodelação Óssea , Cálcio/farmacologia , Feminino , Humanos , Pessoa de Meia-Idade , Pós-Menopausa , Ensaios Clínicos Controlados Aleatórios como Assunto , Vitamina D , VitaminasRESUMO
Different dietary patterns have been positively related to the glycemic control of individuals with type 2 diabetes mellitus. However, consensual dietary pattern for these individuals is not established. We aimed to evaluate the effects of adopting different dietary patterns on glycemic control markers of individuals with type 2 diabetes mellitus. PubMed, Scopus, MEDLINE, Lilacs, Open Thesis and Google Scholar databases were searched using the Medical Subject Headings and terms related to dietary pattern and glycemic control in individuals with type 2 diabetes mellitus. Interventional studies with adults of this population without diabetes-related complications, presenting data on percentage of glycated hemoglobin, and dietary patterns were included. In vitro, animal, reviews, observational, and studies with children, adolescents, pregnant and breastfeeding women were excluded. The time of adoption dietary patterns ranged from eight weeks to four years in randomized clinical trials, and six months in the cohort study. Vegetarian, vegan, Mediterranean, and Dietary Approaches to Stop Hypertension dietary patterns reduced 0.8% on average of percentage of glycated hemoglobin, considering all included studies. It was also observed reduction in fasting glycemia and improvement in Homeostasis Model Assessment of Insulin Sensitivity. However, more randomized clinical trials are required for a full elucidation of these questions.
Assuntos
Glicemia/efeitos dos fármacos , Glicemia/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Dieta , Diabetes Mellitus Tipo 2/dietoterapia , Dieta/efeitos adversos , Hemoglobinas Glicadas/metabolismo , Humanos , Resistência à InsulinaRESUMO
Past research has shown the importance of zinc in several metabolic processes, such as the glucidic metabolism. The present systematic review aims to discuss zinc's participation in the glycemic control of type 2 diabetes mellitus (DM2) patients. In order to accomplish that, a systematic search was performed in the Pubmed database using the following indexed and theme-related descriptors: "zinc" AND "type 2 diabetes mellitus", AND MeSH terms related to glycemic control combined with the boolean operator OR. In total, 1078 articles were retrieved from the research, of which 15 articles of original studies conducted with DM2 patients were included, with three being about the effect of mineral supplementation and 12 reporting observational studies. The main findings of these studies consisted of low body contents of zinc and high excretion of zinc in urine. Hyperglycemia was one of the mechanisms that caused these alterations owing to its interference in zinc reabsorption via renal cells. Another evidence was the negative correlation between the glycated hemoglobin percentage (%HbA1c) and the plasma zinc levels. Additionally, it has been observed that zinc supplementation in DM2 patients has improved glycemic control, since the %HbA1c significantly reduced in these individuals. This present review shows the positive effect of adequate zinc levels on glycemic control, whether it is through dietetic ingestion or supplementation, since its role in insulin homeostasis is clear.