Avaliação da frequência de deficiência de vitamina D em pacientes com obesidade

  • Raquel Coronato Nunes Pontifícia Universidade Católica do Rio de Janeiro (PUC-RJ), Rio de Janeiro, RJ
  • Ana Luiza Gomes Moura Faculdade de Medicina da Universidade Presidente Antônio Carlos (FAME/UNIPAC), Juiz de Fora, MG.
  • Arthur Lawall Silva Faculdade de Medicina da Universidade Presidente Antônio Carlos (FAME/UNIPAC), Juiz de Fora, MG.
  • Gustavo Gusman Oliveira Faculdade de Medicina da Universidade Presidente Antônio Carlos (FAME/UNIPAC), Juiz de Fora, MG.
  • Luisa Artiaga Malta Faculdade de Medicina da Universidade Presidente Antônio Carlos (FAME/UNIPAC), Juiz de Fora, MG.
  • Rodrigo Oliveira Moreira Instituto Estadual de Diabetes e Endocrinologia (IEDE), Rio de Janeiro, RJ
Palavras-chave: Obesidade, Metabolismo, Vitamina D, Síndrome metabólica

Resumo

Introdução: A obesidade é um problema de saúde pública mundial. Além das diversas alterações metabólicas encontradas em indivíduos obesos, há evidências de alterações no sistema endócrino, como observado no metabolismo da vitamina D.

Objetivos:Avaliar a frequência de deficiência de vitamina D em uma amostra de pacientes adultos com obesidade.

Materiais e métodos: Foi realizado um estudo transversal retrospectivo analisando 183 prontuários dos pacientes atendidos pela primeira vez buscando tratamento para obesidade. Após os fatores de exclusão, restaram 113 prontuários válidos.

Resultados: O IMC variou de 30.1 a 77.1, com uma mediana de 44.5 kg/m2. Trinta pacientes (26,55 %) tinham a Vitamina D abaixo de 20 ng/ml, sendo considerados com diagnóstico de Deficiência de Vitamina D. Nenhum correlação foi encontrada entre os níveis de Vitamina D e os parâmetros antropométricos. Houve associação significativa estatística dos níveis de Vitamina D com colesterol total (r=-0.26; p=0.0053), LDL-colesterol (r=-0.25; p=0.0071), além de uma tendência à significância com os níveis de TGP (r=0.16; p=0.088).

Conclusão: Houve uma elevada frequência de deficiência de vitamina D em pacientes obesos. Não houve correlação entre os níveis de vitamina D e os marcadores antropométricos, porém foi encontrada uma correlação inversa de vitamina D com níveis de colesterol total e LDL-colesterol, mostrando a relação com a dislipidemia. Também, houve uma tendência à significância com os níveis de TGP, o que provavelmente remete à esteatose hepática, comum em obesos.

Referências

AL-DAGHRI, N. M. et al. Intermediate and low abundant protein analysis of vitamin D deficient obese and non-obese subjects by MALDI-profiling. Scientific Reports, 7(1), 1–10, 2017.

AL-DAGHRI, N. M. et al.Sex-specific correlation of IGFBP-2 and IGFBP-3 with vitamin D status in adults with obesity: a cross-sectional serum proteomics study. Nutrition & Diabetes, 8(1), 54, 2018.

AL-KHALIDI, B. et al. Standardized serum 25-hydroxyvitamin D concentrations are inversely associated with cardiometabolic disease in U.S. adults: a cross-sectional analysis of NHANES, 2001-2010. Nutrition Journal, 16(1), 16, 2017.

ALKHATATBEH, M. J. et al. High prevalence of vitamin D deficiency and correlation of serum vitamin D with cardiovascular risk in patients with metabolic syndrome. Metabolic Syndrome and Related Disorders, 15(5), 213–219, 2017.

ARSLAN, N. Obesity, fatty liver disease and intestinal microbiota. World Journal of Gastroenterology, 20(44): 16452-16463, 2014.

BOTELLA-CARRETERO, J.I. et al. Vitamin D deficiency is associated with the metabolic syndrome in morbid obesity. Clinical Nutrition, 26(5): 573–580, 2007.

BURKE, G.L. et al. The impact of obesity on cardiovascular disease risk factors and subclinical vascular disease: the multi-ethnic study of atherosclerosis. Archives of Internal Medicine, 168(9):928-935, 2008.

CASTRO, L.C.G. O sistema endocrinológico vitamina D. Arquivos Brasileiros de Endocrinologia & Metabologia, 55-58, 2011.

CEFALO, C. M. A. et al. Effect of vitamin D supplementation on obesity-induced insulin resistance: adouble-blind, randomized, placebo-controlled trial. Obesity, 26(4), 651–657, 2018.

CHAUDHURI, J.R. et al. Deficiency of 25 - hydroxyvitamin D and dyslipidemia in indian subjects. Journal of Lipids, ID 623420, 2013.

EARTHMAN, C.P. et al. The link between obesity and low circulating 25-hydroxyvitamin D concentrations: considerations and implications. International Journal of Obesity, 36(3):387-396, 2012.

ERNST, B. et al. Evidence for the necessity to systematically assess micronutrient status prior to bariatric surgery. Obesity Surgery, 19(1):66-73, 2009.

FU, J. et al. Vitamin D levels are associated with metabolic syndrome in adolescents and young adults: The BCAMS study. Clinical Nutrition, sep. 1–7, 2018.

FU, J. et al. Vitamin D modifies the associations between circulating betatrophin and cardiometabolic risk factors among youths at risk for metabolic syndrome. Cardiovascular Diabetology, 15(1), 1–12, 2016.

GEMMEL, K. et al. Vitamin D deficiency in preoperative bariatric surgery patients. Surgery for Obesity and Related Diseases, 5(1): 54–59, 2009.

GHADIEH, R. et al. The relationship between hypovitaminosis D and metabolic syndrome : a cross sectional study among employees of a private university in Lebanon. BMC Nutrition, 1–12, 2018.

GOLDNER, W.S.et al. Prevalence of vitamin D insufficiency and deficiency in morbidly obese patients: comparison with non-obese controls. Obesity Surgery 18:145-150, 2008.

GOODPASTER, B.H.etal. Obesity, regional body fat distribution and the metabolic syndrome in older men and women. Archives of Internal Medicine, 165: 777-783, 2005.

HOLICK, M.F. Vitamin D: D-lightful health perspective. Nutrition Reviews, 66 (supl.2): 182-194, 2008.

JOOB, B.; WIWANITKIT, V. Mosquito net and snakebite. International Journal of Preventive Medicine, 8, 1–7, 2017.

KARHAPAA, P. et al. Diverse associationsof 25-hydroxyvitamin D and 1,25-dihydroxy-vitamin D withdyslipidaemias. Journal of Internal Medicine, 268 (6): 604–610, 2010.

KHOSRAVI, Z. S. et al. Effect of vitamin D supplementation on weight loss, glycemic indices, and lipid profile in obese and overweight women: a clinical trial study. International Journal of Preventive Medicine, 20;9:63, 2018.

KIM, D.H. et al. Prevalence of hypovitaminosis D in cardiovascular diseases (from the National Health and Nutrition Examination Survey 2001 to 2004). American Journal of Cardiology, 102(11):1540–1544, 2008.

KLOP, B.; ELTE, J.W.; CABEZAS, M.C. Dyslipidemia in obesity: mechanisms and potential targets. Nutrients,5(4):1218-40, 2013.

LUNG, K.V.Q.; NGUYEN, L.T.H. The beneficial role of vitamin D in obesity: possible genetic and cell signaling mechanisms.Nutrition Journal, 12:89, 2013.

MIÑAMBRES, I. et al. The association of hypovitaminosis D with the metabolic syndrome is independent of the degree of obesity. International scholarly research network .International Scholary Research Notices: Endocrinology. ID 691803.2012;1-5, 2012.

Ministério da Saúde. Pesquisa de orçamentos familiares. Antropometria e estado nutricional de crianças, adolescentes e adultos no Brasil. 2008-2009.

Ministério da saúde: Portal. Em 10 anos, obesidade cresce 60% no Brasil e colabora para maior prevalência de hipertensão e diabetes. Disponível em: http://portalms.saude.gov.br, 2017.

MOKDAD, A.H.et al. The continuing epidemic of obesity in the United States. JAMA, 284:1650–1651, 2000.

NORMAN, A.W. From vitamin D to hormone D: fundamentals of the vitamin D endocrine system essential for good health. The American Journal of Clinical Nutrition, 88(suppl)491-499S, 2008.

OLMOS, J. M. et al.Serum 25-hydroxyvitamin D in obese spanishadults: the camargocohort study. Obesity Surgery, 2018.

PARIKH, S.Jet al. The relationship between obesity and serum 1,25-dihydroxy vitamin D concentrations in healthy adults. The Journal of Clinical Endocrinology and Metabolism 89(3):1196-1199, 2004.

RAFIQ, S.; JEPPESEN, P. B. Body mass index, vitamin d, and type 2 diabetes: a systematic review and meta-analysis. Nutrients, 10(9), 2018.

RHEE, E.J. et al. High serum vitamin D levels reduce the risk for nonalcoholic fatty liver disease in healthy men independent of metabolic syndrome. Endocrine Journal, 60(6):743-752, 2013.

SOUSA-SANTOS, A. R. et al. The association between 25(OH)D levels, frailty status and obesity indices in older adults. PLoS ONE, 13(8), 1–16, 2018.

SWINBURN, B.A. et al. The global obesity pandemic: shaped by global drivers and local environments. The Lancet, 378:804-14, 2011.

TARANTINO, G.; FINELLI, C. What about non-alcoholic fatty liver disease as a new criterion to define metabolic syndrome? World Journal of Gastroenterology,19(22): 3375-3384, 2013.

VANLINT, S. Vitamin D and obesity. Review. Nutrients, 5: 949-956, 2013.

VIMALESWARAN, K.S.et al. Causal relationship between obesity and vitamin D status: bi-directional mendelian randomization analysis of multiple cohorts. PLOS Medicine, 10(2), 2013.

WAMBERG, L. Expression of vitamin D-metabolizing enzymes in human adipose-tissue the effect of obesity and diet-induced weight loss. International Journal of Obesity, 37:651–657, 2013

Publicado
2019-04-04
Como Citar
Nunes, R. C., Moura, A. L. G., Silva, A. L., Oliveira, G. G., Malta, L. A., & Moreira, R. O. (2019). Avaliação da frequência de deficiência de vitamina D em pacientes com obesidade. HU Revista, 44(2), 175 - 181. https://doi.org/10.34019/1982-8047.2018.v44.13966

Artigos mais lidos pelo mesmo (s) autor (es)