RESUMO
INTRODUCTION: Chagas disease (CD) is an important public health problem in Brazil and worldwide. Aging and obesity are important matters in patients with CD, as is hypovitaminosis D3, which can decrease the quality of life of these patients. Immunomodulation mediated by vitamin D3, especially the production of antimicrobial peptides such as cathelicidin LL-37, might be related to the severity and symptoms of CD. This study aimed to determine the serum levels of vitamin D and LL-37 and VDR gene polymorphisms in patients with chronic CD. METHODS: This study included male patients with cardiac and indeterminate clinical forms of CD. Clinical, anthropometric, and blood parameters were obtained. Serum levels of 25(OH)D3 and LL-37 were determined by chemiluminescence and enzyme-linked immunosorbent assay respectively. Fok (rs731236), Bsm (rs1544410), Apa (rs7975232), and Taq (rs731236) polymorphisms of the VDR gene were investigated by PCR-RFLP. RESULTS: Sixty-four patients were included in the study: 18 of the cardiac form and 46 of the indeterminate form. No differences in age, ethnicity, BMI, arterial hypertension, diabetes mellitus, or dyslipidemias were observed between groups. However, the serum levels of 25(OH)D3, but not of LL-37, were lower in the cardiac form group. The association among polymorphisms, vitamin D, and clinical form was not significant. CONCLUSIONS: Decreased levels of vitamin D suggest an association with the cardiac form of CD. Studies investigating the roles of vitamin D and LL-37 in the immune response and their associations with VDR polymorphisms and disease susceptibility are necessary.
Assuntos
Peptídeos Catiônicos Antimicrobianos/sangue , Doença de Chagas/sangue , Doença de Chagas/genética , Colecalciferol/sangue , Polimorfismo Genético/genética , Receptores de Calcitriol/genética , Biomarcadores/sangue , Humanos , Masculino , Pessoa de Meia-Idade , CatelicidinasRESUMO
BACKGROUND: The aim was to assess the effectiveness of routine administration of calcium +/- vitamin D3 compared with a serum calcium level-based strategy to prevent symptomatic hypocalcaemia after thyroidectomy. METHODS: RCTs comparing routine supplementation of calcium +/- vitamin D3 with treatment based on serum calcium levels measured after total thyroidectomy, published between 1980 and 2017, were identified in MEDLINE, Embase, LILACS and Google Scholar databases. Risk of bias was evaluated using the Cochrane Collaboration tool. Risk differences were calculated by random-effects meta-analysis. Meta-regression and cumulative meta-analysis were used to explore the best therapeutic approach. RESULTS: Fifteen studies with 3037 patients were included, and seven treatment comparisons were made. Routine supplementation with calcium + vitamin D3 offered a lower risk of symptomatic (risk difference (RD) -0·25, 95 per cent c.i. -0·32 to -0·18) and biochemical (RD -0·24, -0·31 to -0·17) hypocalcaemia than treatment based on measurement of calcium levels. The number needed to treat was 4 (95 per cent c.i. 3 to 6) for symptomatic hypocalcaemia. No publication bias was found; although heterogeneity was high for some comparisons, sensitivity analysis did not change the main results. CONCLUSION: Routine postoperative administration of calcium + vitamin D3 is effective in decreasing the rate of symptomatic and biochemical hypocalcaemia.
Assuntos
Cálcio/uso terapêutico , Colecalciferol/uso terapêutico , Suplementos Nutricionais , Hipocalcemia/prevenção & controle , Complicações Pós-Operatórias/prevenção & controle , Tireoidectomia/efeitos adversos , Cálcio/sangue , Colecalciferol/sangue , Humanos , Hipocalcemia/sangue , Hipocalcemia/etiologiaRESUMO
Type 2 diabetes mellitus has undergone a worldwide growth in incidence in the world and has now acquired epidemic status. There is a strong link between type 2 diabetes and vitamin D deficiency. Because vitamin D has beneficial effects on glucose homeostasis, the aim of this study was to evaluate the influence of vitamin D3 supplementation on the modulation of glycaemic control and other metabolic effects, as well as modulation of genomic instability in patients with type 2 diabetes. We evaluated 75 patients with type 2 diabetes, registered in the Integrated Clinics of the University of Southern Santa Catarina. Participants received 4000 IU of vitamin D3 (25(OH)D) supplementation daily for 8 weeks. Blood samples were collected at the beginning and at the end of the supplementation, and 4 weeks after the end of supplementation. The glycidic and lipid profiles [total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein and triglycerides], oxidative stress, DNA damage and 25(OH)D levels were evaluated. Vitamin D3 supplementation for 8 weeks showed enough to significantly increase blood levels of 25(OH)D. A significant difference in lipid profile was observed only in non-HDL cholesterol. Significant changes were observed in glucose homeostasis (fasting glucose and serum insulin) and, in addition, a reduction in the parameters of oxidative stress and DNA damage. There was a significant reduction in the values of 25(OH)D 4 weeks after the end of the supplementation, but levels still remained above baseline. Use of vitamin D supplementation can be an ally in the health modulation of patients with type 2 diabetes mellitus.
Assuntos
Colecalciferol/uso terapêutico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Idoso , Glicemia/efeitos dos fármacos , Colecalciferol/sangue , Colesterol/sangue , Dano ao DNA/efeitos dos fármacos , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/enzimologia , Suplementos Nutricionais , Feminino , Instabilidade Genômica , Glutationa/metabolismo , Humanos , Hipoglicemiantes/sangue , Fígado/enzimologia , Masculino , Malondialdeído/metabolismo , Pessoa de Meia-Idade , Óxido Nítrico/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Triglicerídeos/sangueRESUMO
Abstract INTRODUCTION: Chagas disease (CD) is an important public health problem in Brazil and worldwide. Aging and obesity are important matters in patients with CD, as is hypovitaminosis D3, which can decrease the quality of life of these patients. Immunomodulation mediated by vitamin D3, especially the production of antimicrobial peptides such as cathelicidin LL-37, might be related to the severity and symptoms of CD. This study aimed to determine the serum levels of vitamin D and LL-37 and VDR gene polymorphisms in patients with chronic CD. METHODS: This study included male patients with cardiac and indeterminate clinical forms of CD. Clinical, anthropometric, and blood parameters were obtained. Serum levels of 25(OH)D3 and LL-37 were determined by chemiluminescence and enzyme-linked immunosorbent assay respectively. Fok (rs731236), Bsm (rs1544410), Apa (rs7975232), and Taq (rs731236) polymorphisms of the VDR gene were investigated by PCR-RFLP. RESULTS: Sixty-four patients were included in the study: 18 of the cardiac form and 46 of the indeterminate form. No differences in age, ethnicity, BMI, arterial hypertension, diabetes mellitus, or dyslipidemias were observed between groups. However, the serum levels of 25(OH)D3, but not of LL-37, were lower in the cardiac form group. The association among polymorphisms, vitamin D, and clinical form was not significant. CONCLUSIONS: Decreased levels of vitamin D suggest an association with the cardiac form of CD. Studies investigating the roles of vitamin D and LL-37 in the immune response and their associations with VDR polymorphisms and disease susceptibility are necessary.
Assuntos
Humanos , Masculino , Polimorfismo Genético/genética , Doença de Chagas/genética , Doença de Chagas/sangue , Receptores de Calcitriol/genética , Colecalciferol/sangue , Peptídeos Catiônicos Antimicrobianos/sangue , Biomarcadores/sangue , Pessoa de Meia-IdadeRESUMO
BACKGROUND: An association has been established between low serum values of vitamin D and inflammatory bowel disease. There is a lack of evidence on whether this association is still observed in regions where sun exposure throughout the year is higher. OBJECTIVE: To compare the prevalence of vitamin D deficiency between inflammatory bowel disease patients and healthy controls. METHODS: Inflammatory bowel disease patients were consecutively enrolled as cases. Age and gender-matched healthy subjects who agreed to undertake a determination of serum vitamin D were enrolled as controls. Demographic features, medical treatment, need for hospital admission at diagnosis, steroid treatment, smoking, need for surgical treatment were evaluated as factors associated with vitamin D deficiency. RESULTS: Overall, 59 patients with a diagnosis of either Crohn's disease or ulcerative colitis were enrolled, as well as 56 controls. Median age was 41 years (19-79) and 56% were male. Vitamin D deficiency was observed in 66.1% of inflammatory bowel disease patients versus 21.42% of healthy controls (OR 7.15 (3.1-16.48), P=0.001). Among inflammatory bowel disease patients, male gender, disease duration, moderate-to-severe disease and hospital admission at the moment of diagnosis were found to be associated with vitamin D deficiency. On multivariate analysis, only longer disease duration [(OR 1.01 (1-1.06)] and hospital admission at diagnosis [(OR 5.63 (1.01-31.61)] were found to be significantly associated with the latter. CONCLUSION: Vitamin D deficiency was more frequent among inflammatory bowel disease patients. Longer disease duration and need for hospital admission at diagnosis were associated to vitamin D deficiency among these patients.
Assuntos
Colite Ulcerativa/epidemiologia , Doença de Crohn/epidemiologia , Deficiência de Vitamina D/epidemiologia , Adulto , Idoso , Argentina/epidemiologia , Estudos de Casos e Controles , Colecalciferol/sangue , Colite Ulcerativa/sangue , Colite Ulcerativa/complicações , Doença de Crohn/sangue , Doença de Crohn/complicações , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prevalência , Fatores de Risco , Índice de Gravidade de Doença , Estatísticas não Paramétricas , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/complicações , Adulto JovemRESUMO
Abstract Introduction Allergic rhinitis is one of the most common allergic diseases that cause a decrease in quality of life. Over the last decades, the increase in the number of cases is supposed to be a result of industrialization and lifestyle changes. Vitamin D, which is a steroid hormone, has a significant immunomodulatory and antioxidant role in the human body. Objective The objective of the present study is to investigate the role of 1α-25-dihydroxyvitamin D3 levels in allergic rhinitis patients and to compare them to the levels found in the healthy population. Methods A total of 256 participants were included in the present study. Allergic rhinitis is diagnosed with the help of the Allergic Rhinitis and Its Impact on Asthma (ARIA) guidelines confirmed through skin prick tests. Control subjects were selected among people without allergy history, which was also confirmed through skin prick tests. The levels of 1α-25-dihydroxyvitamin D3, immunoglobulin E (IgE), and eosinophil counts were measured in blood samples from both groups. Results The mean value of serum levels of 1α-25-hydroxyvitamin D3 was 25.5 ± 3.74 in the allergic rhinitis group, and 31.58 ± 3.85 in the control subjects. This difference reveals statistically-decreased levels in the allergic rhinitis group (p< 0.05). The total IgE levels are increased in the allergic rhinitis group (p< 0.05) and negatively correlated with the serum levels of 1α-25-hydroxyvitamin D3 (r = - 0.259, p< 0.05). Conclusion Lower serum levels of 1α-25-hydroxyvitamin D3 were detected in the allergic rhinitis population. This data is also correlated to the IgE response in the study group. A supplement of 1α-25-hydroxyvitamin D3 in deficient patients might be helpful to relieve symptoms and signs of allergic rhinitis, but further studies are needed.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Colecalciferol/sangue , Rinite Alérgica/diagnóstico , Turquia , Vitamina D/sangue , Deficiência de Vitamina D/diagnóstico , Imunoglobulina E/sangue , Testes CutâneosRESUMO
ABSTRACT BACKGROUND: An association has been established between low serum values of vitamin D and inflammatory bowel disease. There is a lack of evidence on whether this association is still observed in regions where sun exposure throughout the year is higher. OBJECTIVE: To compare the prevalence of vitamin D deficiency between inflammatory bowel disease patients and healthy controls. METHODS: Inflammatory bowel disease patients were consecutively enrolled as cases. Age and gender-matched healthy subjects who agreed to undertake a determination of serum vitamin D were enrolled as controls. Demographic features, medical treatment, need for hospital admission at diagnosis, steroid treatment, smoking, need for surgical treatment were evaluated as factors associated with vitamin D deficiency. RESULTS: Overall, 59 patients with a diagnosis of either Crohn's disease or ulcerative colitis were enrolled, as well as 56 controls. Median age was 41 years (19-79) and 56% were male. Vitamin D deficiency was observed in 66.1% of inflammatory bowel disease patients versus 21.42% of healthy controls (OR 7.15 (3.1-16.48), P=0.001). Among inflammatory bowel disease patients, male gender, disease duration, moderate-to-severe disease and hospital admission at the moment of diagnosis were found to be associated with vitamin D deficiency. On multivariate analysis, only longer disease duration [(OR 1.01 (1-1.06)] and hospital admission at diagnosis [(OR 5.63 (1.01-31.61)] were found to be significantly associated with the latter. CONCLUSION: Vitamin D deficiency was more frequent among inflammatory bowel disease patients. Longer disease duration and need for hospital admission at diagnosis were associated to vitamin D deficiency among these patients.
RESUMO CONTEXTO: Uma associação foi estabelecida entre os baixos valores séricos de vitamina D e doença inflamatória intestinal. Falta evidência se esta associação ainda é observada em regiões onde a exposição ao sol durante todo o ano é maior. OBJETIVO: Comparar a prevalência de deficiência de vitamina D entre pacientes com doença inflamatória intestinal e indivíduos controles saudáveis. MÉTODOS: Pacientes com doença inflamatória intestinal foram consecutivamente selecionados. Indivíduos saudáveis combinados da mesma idade e gênero que concordaram em fornecer uma determinação da vitamina D do soro foram considerados como controles. Características demográficas, tratamento médico, necessidade de admissão hospitalar no diagnóstico, tratamento de esteroides, tabagismo, necessidade de tratamento cirúrgico foram avaliados como fatores associados à deficiência de vitamina D. RESULTADOS: No geral, 59 pacientes com diagnóstico de doença de Crohn ou colite ulcerosa foram observados, bem como 56 controles. A idade mediana era de 41 anos (19-79) e 56% eram do sexo masculino. A deficiência de vitamina D foi observada em 66,1% dos pacientes com doença inflamatória intestinal versus 21,42% dos controles saudáveis (OR 7,15 (3.1-16.48), P=0,001). Entre os pacientes com doença inflamatória intestinal, sexo masculino, duração da doença, doença de moderada a severa e admissão hospitalar no momento do diagnóstico foram associados com a deficiência de vitamina D. Na análise multivariada, apenas a duração da doença [(OR 1; 1 (1-1,06)] e a admissão hospitalar no diagnóstico [(OR 5,63 (1,01-31,61)] foram encontradas significativamente associadas ao último. CONCLUSÃO: A deficiência de vitamina D foi mais frequente entre os pacientes com doença inflamatória intestinal. Maior duração da doença e necessidade de admissão hospitalar no diagnóstico foram associadas à deficiência de vitamina D entre esses pacientes.
Assuntos
Humanos , Masculino , Feminino , Adulto , Idoso , Adulto Jovem , Deficiência de Vitamina D/epidemiologia , Colite Ulcerativa/epidemiologia , Doença de Crohn/epidemiologia , Argentina/epidemiologia , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/sangue , Índice de Gravidade de Doença , Colite Ulcerativa/complicações , Colite Ulcerativa/sangue , Doença de Crohn/complicações , Doença de Crohn/sangue , Estudos de Casos e Controles , Prevalência , Estudos Transversais , Análise Multivariada , Fatores de Risco , Colecalciferol/sangue , Estatísticas não Paramétricas , Pessoa de Meia-IdadeRESUMO
Abstract Introduction Benign paroxysmal positional vertigo is the most common cause of dizziness in the general population. It is a condition with potential impact of reduced levels of vitamin D on its recurrent attacks. Objectives The aim of this study was to measure the serum levels of 25-hydroxyvitamin D3 (25-OH D3) in patients with benign paroxysmal positional vertigo and determine whether there is a difference in the serum levels of vitamin D3 between patients with and without recurrence, as well as between the different clinical forms of benign paroxysmal positional vertigo. Methods The study included 40 patients who came to the regular medical examination, diagnosed with posterior canal-benign paroxysmal positional vertigo based on the positive Dix-Hallpike's test. All patients underwent Epley manoeuvre after the diagnosis. Patients were classified according to current guidelines for levels of vitamin D3 in the serum in three groups: the deficiency, insufficiency and adequate level. Results The average serum level of 25-OH D3 among respondents was 20.78 ng/mL, indicating a lack or insufficiency of the aforementioned 25-OH D3. According to the levels of 25-OH D3, most patients suffer from deficiency (47.5%). 7 (17.5%) respondents had adequate blood level of 25-OH D3, and 14 (35%) respondents suffer from insufficiency. A significant difference was not found in the serum level of 25-OH D3 between patients with and without benign paroxysmal positional vertigo recurrence. There was a significant difference in the serum levels of 25-OH D3 in comparison to the clinical form of the disease. Lower 25-OH D3 values were found in patients with canalithiasis compared to those with cupulolithiasis. Conclusions There were no significant differences in the vitamin D3 serum level in patients with and without recurrence. The study showed a low level of serum vitamin D3 in most patients, indicating the need for supplemental therapy.
Resumo Introdução Vertigem posicional paroxística benigna é a causa mais comum de tonturas na população em geral. É uma condição no qual níveis reduzidos de vitamina D podem ter um potencial impacto para o desenvolvimento de crises recorrentes. Objetivos O objetivo desse estudo foi medir os níveis séricos de 25-hidroxivitamina D3 (25-OH D3) em pacientes com vertigem posicional paroxística benigna e determinar se há diferença nos níveis séricos de vitamina D3 entre pacientes com e sem recorrência, bem como entre as diferentes formas clínicas de vertigem posicional paroxística benigna. Método O estudo incluiu 40 pacientes submetidos a exame médico regular, diagnosticados com vertigem posicional paroxística benigna de canal posterior baseado no resultado positivo do teste de Dix-Hallpike. Todos os pacientes foram submetidos à manobra de Epley após o diagnóstico. Os pacientes foram classificados de acordo com as diretrizes atuais para os níveis de vitamina D3 sérica em três grupos: deficiência, insuficiência e nível adequado. Resultados O nível sérico médio de 25-OH D3 entre os indivíduos avaliados foi de 20,78 ng/mL, indicando falta ou insuficiência desta vitamina. De acordo com os níveis de 25-OH D3, a maioria dos pacientes apresentou deficiência (47,5%). Sete indivíduos (17,5%) entrevistados tinham nível sanguíneo adequado de 25-OH D3 e 14 (35%) apresentavam insuficiência. Não foi encontrada diferença significativa no nível sérico de 25-OH D3 entre pacientes com e sem recidiva de vertigem posicional paroxística benigna. Houve uma diferença significativa nos níveis séricos de 25-OH D3 de acordo com a forma clínica da doença. Baixos níveis de 25-OH D3 foram mais encontrados em pacientes com canalitíase em comparação com aqueles com cupulolitíase. Conclusões Não houve diferenças significativas no nível sérico de vitamina D3 em pacientes com e sem recorrência. O estudo mostrou um baixo nível de vitamina D3 sérica na maioria dos pacientes, indicando a necessidade de terapia suplementar.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Calcifediol/sangue , Colecalciferol/sangue , Vertigem Posicional Paroxística Benigna/sangue , Recidiva , Valores de Referência , Deficiência de Vitamina D/sangue , Cálcio/sangue , Estatísticas não Paramétricas , Vertigem Posicional Paroxística Benigna/patologiaRESUMO
INTRODUCTION: Benign paroxysmal positional vertigo is the most common cause of dizziness in the general population. It is a condition with potential impact of reduced levels of vitamin D on its recurrent attacks. OBJECTIVES: The aim of this study was to measure the serum levels of 25-hydroxyvitamin D3 (25-OH D3) in patients with benign paroxysmal positional vertigo and determine whether there is a difference in the serum levels of vitamin D3 between patients with and without recurrence, as well as between the different clinical forms of benign paroxysmal positional vertigo. METHODS: The study included 40 patients who came to the regular medical examination, diagnosed with posterior canal-benign paroxysmal positional vertigo based on the positive Dix-Hallpike's test. All patients underwent Epley manoeuvre after the diagnosis. Patients were classified according to current guidelines for levels of vitamin D3 in the serum in three groups: the deficiency, insufficiency and adequate level. RESULTS: The average serum level of 25-OH D3 among respondents was 20.78ng/mL, indicating a lack or insufficiency of the aforementioned 25-OH D3. According to the levels of 25-OH D3, most patients suffer from deficiency (47.5%). 7 (17.5%) respondents had adequate blood level of 25-OH D3, and 14 (35%) respondents suffer from insufficiency. A significant difference was not found in the serum level of 25-OH D3 between patients with and without benign paroxysmal positional vertigo recurrence. There was a significant difference in the serum levels of 25-OH D3 in comparison to the clinical form of the disease. Lower 25-OH D3 values were found in patients with canalithiasis compared to those with cupulolithiasis. CONCLUSIONS: There were no significant differences in the vitamin D3 serum level in patients with and without recurrence. The study showed a low level of serum vitamin D3 in most patients, indicating the need for supplemental therapy.
Assuntos
Vertigem Posicional Paroxística Benigna/sangue , Calcifediol/sangue , Colecalciferol/sangue , Idoso , Vertigem Posicional Paroxística Benigna/patologia , Cálcio/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Valores de Referência , Estatísticas não Paramétricas , Deficiência de Vitamina D/sangueRESUMO
Vitamin D (25(OH)D3) is an essential nutrient that plays a role in the immune system. Serum 25(OH)D3 is found to be associated with asthma. However, the role of vitamin D in obese asthma remains unclear. Therefore, we investigated the association between vitamin D levels and asthma outcomes in a murine model of obese asthma. We also evaluated NLRP3 inflammasome activity in the pathogenesis of obese asthma. We divided 20 male Balb/c mice (3-4 weeks old) into 4 groups: normal control, asthma, obese, and obese asthma and developed an obese asthma mouse model. Airway hyperreactivity, cytokine concentrations, 25(OH)D3 levels, NLRP3 mRNA and IL-1β mRNA expressions were measured. Lung histology and bronchoalveolar lavage fluid (BALF) cell count were also determined. Obese asthma mice showed a significant increase in airway hyper-responsiveness, airway inflammation, pro-inflammatory cytokine levels and NLRP3 mRNA, IL-1β mRNA expression. Both asthma and obese groups had lower 25(OH)D3 levels. Vitamin D levels in obese asthma were the lowest among all groups. Vitamin D levels correlated negatively with body weight, lung resistance levels at 25 mg/mL of methacholine, total inflammatory cells, and IL-1β and IL-17 concentrations in BALF. These data demonstrated an association between serum vitamin D levels and outcomes of obese asthma, and indicated that NLRP3 inflammasome may play a role in this disorder.