Hipovitaminose D em pacientes com fibrose cística: prevalência e influência do polimorfismo BsmI (rs 1544410) do gene VDR na suplementação com vitamina D sobre marcadores de processo inflamatório e estresse oxidativo
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da UFPB |
Texto Completo: | https://repositorio.ufpb.br/jspui/handle/123456789/22362 |
Resumo: | Patients with Cystic Fibrosis are at risk for vitamin deficiency due to pancreatic insufficiency. Vitamin deficiency is possibly associated with an inflammatory state and oxidative stress. The presence of genetic polymorphisms in the VDR appears to play a role in supplementation response and clinical effects. The aim of the present study was to evaluate the prevalence of hypovitaminosis D and the influence of the VDR gene’s BsmI polymorphism (rs 1544410) on vitamin D megadose supplementation on inflammatory process and oxidative stress markers in patients with Cystic Fibrosis. A multicenter cross-sectional study was performed, followed by a single-arm nonrandomized pre and post-study with patients who had 25(OH)D insufficiency or deficiency. Patients with Cystic Fibrosis were > 5 years old, both genders. In the first stage of the study, 48 patients with Cystic Fibrosis participated, who were interviewed regarding sociodemographic profile, skin type photo and sun exposure, anthropometric data (weight, height, Body Mass Index), food consumption, biochemical evaluation for analysis of renal function and liver, calcium, parathyroid hormone (PTH), inflammatory process (C-reactive protein (CRP) and alpha-1-acid glycoprotein- A1GPA) and oxidative stress (malondialdehyde- MDA and total antioxidant capacity- CAOT) and genotypic determination of the BsmI polymorphism (rs 1544410). Patients diagnosed with insufficiency and/or vitamin D deficiency, were supplemented with vitamin D, 4000 IU/day for children aged 5 to 10 years and 10,000 IU/day for children over 10 years, adolescents and adults, for 8 weeks. Statistical analysis was performed using the “Statistical Pacage for the Social Sciences” and Prism 6, adopting a significance level of p<0.05. It was observed that the majority of the population had Vitamin D insufficiency and/or deficiency (64.6%). There was no association between vitamin D levels and gender, sun exposure, photo skin type, nutritional status and genotypic variation of the BsmI polymorphism. After multivariate linear regression analysis, the MDA showed an inverse association with the blood values of 25- Hydroxyvitamin D (p= 0.01), but conditioned by markers of the inflammatory process. When only oxidative stress is evaluated, this association disappears. Individuals with the BB and Bb genotypes showed increased serum levels of 25(OH)D, but not those with the bb genotype of the BsmI polymorphism of the VDR gene. The analysis paired with the BB genotype showed a reduction in A1GPA. The bb genotype showed high levels of MDA compared to the pre intervention period. In conclusion, there was a high prevalence of hypovitaminosis D in patients with Cystic Fibrosis, presenting an inverse relationship with oxidative stress when associated with markers of the inflammatory process. As for the BsmI polymorphism of the VDR gene, genotype variation seems to influence vitamin D levels and markers of inflammatory process and oxidative stress. The presence of polymorphism appears to influence the effect of supplementation and clinical response in patients with Cystic Fibrosis. We suggest that our studies take longer and more patients to understand ideal levels for vitamin D correction and the relationship with genetic polymorphisms in the VDR gene. |
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Hipovitaminose D em pacientes com fibrose cística: prevalência e influência do polimorfismo BsmI (rs 1544410) do gene VDR na suplementação com vitamina D sobre marcadores de processo inflamatório e estresse oxidativoHipovitaminose DPolimorfismo genéticoFibrose císticaInflamaçãoHypovitaminosis DGenetic polymorphismCystic fibrosisInflammationCNPQ::CIENCIAS DA SAUDE::NUTRICAOPatients with Cystic Fibrosis are at risk for vitamin deficiency due to pancreatic insufficiency. Vitamin deficiency is possibly associated with an inflammatory state and oxidative stress. The presence of genetic polymorphisms in the VDR appears to play a role in supplementation response and clinical effects. The aim of the present study was to evaluate the prevalence of hypovitaminosis D and the influence of the VDR gene’s BsmI polymorphism (rs 1544410) on vitamin D megadose supplementation on inflammatory process and oxidative stress markers in patients with Cystic Fibrosis. A multicenter cross-sectional study was performed, followed by a single-arm nonrandomized pre and post-study with patients who had 25(OH)D insufficiency or deficiency. Patients with Cystic Fibrosis were > 5 years old, both genders. In the first stage of the study, 48 patients with Cystic Fibrosis participated, who were interviewed regarding sociodemographic profile, skin type photo and sun exposure, anthropometric data (weight, height, Body Mass Index), food consumption, biochemical evaluation for analysis of renal function and liver, calcium, parathyroid hormone (PTH), inflammatory process (C-reactive protein (CRP) and alpha-1-acid glycoprotein- A1GPA) and oxidative stress (malondialdehyde- MDA and total antioxidant capacity- CAOT) and genotypic determination of the BsmI polymorphism (rs 1544410). Patients diagnosed with insufficiency and/or vitamin D deficiency, were supplemented with vitamin D, 4000 IU/day for children aged 5 to 10 years and 10,000 IU/day for children over 10 years, adolescents and adults, for 8 weeks. Statistical analysis was performed using the “Statistical Pacage for the Social Sciences” and Prism 6, adopting a significance level of p<0.05. It was observed that the majority of the population had Vitamin D insufficiency and/or deficiency (64.6%). There was no association between vitamin D levels and gender, sun exposure, photo skin type, nutritional status and genotypic variation of the BsmI polymorphism. After multivariate linear regression analysis, the MDA showed an inverse association with the blood values of 25- Hydroxyvitamin D (p= 0.01), but conditioned by markers of the inflammatory process. When only oxidative stress is evaluated, this association disappears. Individuals with the BB and Bb genotypes showed increased serum levels of 25(OH)D, but not those with the bb genotype of the BsmI polymorphism of the VDR gene. The analysis paired with the BB genotype showed a reduction in A1GPA. The bb genotype showed high levels of MDA compared to the pre intervention period. In conclusion, there was a high prevalence of hypovitaminosis D in patients with Cystic Fibrosis, presenting an inverse relationship with oxidative stress when associated with markers of the inflammatory process. As for the BsmI polymorphism of the VDR gene, genotype variation seems to influence vitamin D levels and markers of inflammatory process and oxidative stress. The presence of polymorphism appears to influence the effect of supplementation and clinical response in patients with Cystic Fibrosis. We suggest that our studies take longer and more patients to understand ideal levels for vitamin D correction and the relationship with genetic polymorphisms in the VDR gene.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPESPacientes com Fibrose Cística possuem risco de deficiência de vitamina devido à insuficiência pancreática. A vitamina tem sua deficiência possivelmente associada com estado inflamatório e estresse oxidativo. A presença de polimorfismo genéticos no VDR parece ter papel na reposta da suplementação da vitamina D e efeitos clínicos como atuação na redução do processo inflamatório e estresse oxidativo. O objetivo do presente estudo foi avaliar a prevalência da hipovitaminose D e influência do polimorfismo BsmI (rs 1544410) do gene VDR na suplementação de megadose de vitamina D sobre marcadores de processo inflamatório e estresse oxidativo em pacientes com Fibrose Cística. Foi realizado um estudo transversal multicêntrico, seguido de estudo pré e pós não randomizado de braço único com pacientes que apresentaram insuficiência ou deficiência de 25(OH)D. Os pacientes com Fibrose Cística tinham idade > 5 anos de ambos os sexos. Na primeira etapa do estudo participaram 48 pacientes com Fibrose Cística que foram entrevistados quanto ao perfil sociodemográfico, foto tipo de pele e exposição solar, dados antropométricos (peso, altura, Índice de Massa Corporal), consumo alimentar, avaliação bioquímica para análise de função renal e hepática, cálcio, paratormônio (PTH), processo inflamatório (proteína C reativa (PCR) e alfa-1-glicoproteína ácida - A1GPA) e estresse oxidativo (malondialdeido - MDA e capacidade antioxidante total - CAOT) e determinação genotípica do polimorfismo BsmI (rs 1544410).Os pacientes diagnosticados com insuficiência e/ou deficiência de vitamina D, foram suplementados vitamina D, 4000 UI/dia para crianças de 5 a 10 anos e 10.000 UI/dia para crianças maiores de 10 anos, adolescentes e adultos, durante 8 semanas. A Análise estatística foi realizada através do “Statistical Pac age for the Social Sciences” e Prism 6, adotando-se significância de p<0,05. Observou-se que a maioria da população tinha Insuficiência e/ou deficiência de vitamina D (64,6 %). Não houve associação entre os níveis de vitamina D com sexo, exposição solar, foto tipo de pele, estado nutricional e variação genotípica do polimorfismo BsmI. Após análise de regressão linear multivariada, o MDA apresentou associação inversa aos valores sanguíneos de 25- Hidroxivitamina D (p= 0,01), porém condicionada aos marcadores de processo inflamatório. Quando avaliado somente o estresse oxidativo, essa relação essa associação desaparece. Os indivíduos com os genótipos BB e Bb apresentaram aumento dos níveis séricos de 25(OH)D, mas não os com genótipo bb do polimorfismo BsmI do gene VDR. O Analise pareada o genótipo BB apresentaram redução do A1GPA. Já o genótipo bb apresentaram níveis elevados de MDA comparado ao momento pré intervenção. Em conclusão, verificou-se uma alta prevalência de hipovitaminose D nos pacientes com Fibrose Cística, apresentando uma relação inversa estresse oxidativo quando associado aos marcadores de processo inflamatório. Quanto do polimorfismo BsmI do gene VDR, houve um efeito da variação dos genótipos com os níveis de vitamina D e marcadores de processo inflamatório e estresse oxidativo. Sugerimos que nossos estudos com maior tempo e maior número de pacientes para compreender níveis ideais para correção da vitamina D e a relação com polimorfismos genéticos no gene VDR.Universidade Federal da ParaíbaBrasilCiências da NutriçãoPrograma de Pós-Graduação em Ciências da NutriçãoUFPBGonçalves, Maria da Conceição Rodrigueshttp://lattes.cnpq.br/0107894093263204Queiroz, Dayanna Joyce Marques2022-03-11T19:13:15Z2021-12-132022-03-11T19:13:15Z2021-08-28info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesishttps://repositorio.ufpb.br/jspui/handle/123456789/22362porAttribution-NoDerivs 3.0 Brazilhttp://creativecommons.org/licenses/by-nd/3.0/br/info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UFPBinstname:Universidade Federal da Paraíba (UFPB)instacron:UFPB2022-04-13T12:22:28Zoai:repositorio.ufpb.br:123456789/22362Biblioteca Digital de Teses e Dissertaçõeshttps://repositorio.ufpb.br/PUBhttp://tede.biblioteca.ufpb.br:8080/oai/requestdiretoria@ufpb.br|| diretoria@ufpb.bropendoar:2022-04-13T12:22:28Biblioteca Digital de Teses e Dissertações da UFPB - Universidade Federal da Paraíba (UFPB)false |
dc.title.none.fl_str_mv |
Hipovitaminose D em pacientes com fibrose cística: prevalência e influência do polimorfismo BsmI (rs 1544410) do gene VDR na suplementação com vitamina D sobre marcadores de processo inflamatório e estresse oxidativo |
title |
Hipovitaminose D em pacientes com fibrose cística: prevalência e influência do polimorfismo BsmI (rs 1544410) do gene VDR na suplementação com vitamina D sobre marcadores de processo inflamatório e estresse oxidativo |
spellingShingle |
Hipovitaminose D em pacientes com fibrose cística: prevalência e influência do polimorfismo BsmI (rs 1544410) do gene VDR na suplementação com vitamina D sobre marcadores de processo inflamatório e estresse oxidativo Queiroz, Dayanna Joyce Marques Hipovitaminose D Polimorfismo genético Fibrose cística Inflamação Hypovitaminosis D Genetic polymorphism Cystic fibrosis Inflammation CNPQ::CIENCIAS DA SAUDE::NUTRICAO |
title_short |
Hipovitaminose D em pacientes com fibrose cística: prevalência e influência do polimorfismo BsmI (rs 1544410) do gene VDR na suplementação com vitamina D sobre marcadores de processo inflamatório e estresse oxidativo |
title_full |
Hipovitaminose D em pacientes com fibrose cística: prevalência e influência do polimorfismo BsmI (rs 1544410) do gene VDR na suplementação com vitamina D sobre marcadores de processo inflamatório e estresse oxidativo |
title_fullStr |
Hipovitaminose D em pacientes com fibrose cística: prevalência e influência do polimorfismo BsmI (rs 1544410) do gene VDR na suplementação com vitamina D sobre marcadores de processo inflamatório e estresse oxidativo |
title_full_unstemmed |
Hipovitaminose D em pacientes com fibrose cística: prevalência e influência do polimorfismo BsmI (rs 1544410) do gene VDR na suplementação com vitamina D sobre marcadores de processo inflamatório e estresse oxidativo |
title_sort |
Hipovitaminose D em pacientes com fibrose cística: prevalência e influência do polimorfismo BsmI (rs 1544410) do gene VDR na suplementação com vitamina D sobre marcadores de processo inflamatório e estresse oxidativo |
author |
Queiroz, Dayanna Joyce Marques |
author_facet |
Queiroz, Dayanna Joyce Marques |
author_role |
author |
dc.contributor.none.fl_str_mv |
Gonçalves, Maria da Conceição Rodrigues http://lattes.cnpq.br/0107894093263204 |
dc.contributor.author.fl_str_mv |
Queiroz, Dayanna Joyce Marques |
dc.subject.por.fl_str_mv |
Hipovitaminose D Polimorfismo genético Fibrose cística Inflamação Hypovitaminosis D Genetic polymorphism Cystic fibrosis Inflammation CNPQ::CIENCIAS DA SAUDE::NUTRICAO |
topic |
Hipovitaminose D Polimorfismo genético Fibrose cística Inflamação Hypovitaminosis D Genetic polymorphism Cystic fibrosis Inflammation CNPQ::CIENCIAS DA SAUDE::NUTRICAO |
description |
Patients with Cystic Fibrosis are at risk for vitamin deficiency due to pancreatic insufficiency. Vitamin deficiency is possibly associated with an inflammatory state and oxidative stress. The presence of genetic polymorphisms in the VDR appears to play a role in supplementation response and clinical effects. The aim of the present study was to evaluate the prevalence of hypovitaminosis D and the influence of the VDR gene’s BsmI polymorphism (rs 1544410) on vitamin D megadose supplementation on inflammatory process and oxidative stress markers in patients with Cystic Fibrosis. A multicenter cross-sectional study was performed, followed by a single-arm nonrandomized pre and post-study with patients who had 25(OH)D insufficiency or deficiency. Patients with Cystic Fibrosis were > 5 years old, both genders. In the first stage of the study, 48 patients with Cystic Fibrosis participated, who were interviewed regarding sociodemographic profile, skin type photo and sun exposure, anthropometric data (weight, height, Body Mass Index), food consumption, biochemical evaluation for analysis of renal function and liver, calcium, parathyroid hormone (PTH), inflammatory process (C-reactive protein (CRP) and alpha-1-acid glycoprotein- A1GPA) and oxidative stress (malondialdehyde- MDA and total antioxidant capacity- CAOT) and genotypic determination of the BsmI polymorphism (rs 1544410). Patients diagnosed with insufficiency and/or vitamin D deficiency, were supplemented with vitamin D, 4000 IU/day for children aged 5 to 10 years and 10,000 IU/day for children over 10 years, adolescents and adults, for 8 weeks. Statistical analysis was performed using the “Statistical Pacage for the Social Sciences” and Prism 6, adopting a significance level of p<0.05. It was observed that the majority of the population had Vitamin D insufficiency and/or deficiency (64.6%). There was no association between vitamin D levels and gender, sun exposure, photo skin type, nutritional status and genotypic variation of the BsmI polymorphism. After multivariate linear regression analysis, the MDA showed an inverse association with the blood values of 25- Hydroxyvitamin D (p= 0.01), but conditioned by markers of the inflammatory process. When only oxidative stress is evaluated, this association disappears. Individuals with the BB and Bb genotypes showed increased serum levels of 25(OH)D, but not those with the bb genotype of the BsmI polymorphism of the VDR gene. The analysis paired with the BB genotype showed a reduction in A1GPA. The bb genotype showed high levels of MDA compared to the pre intervention period. In conclusion, there was a high prevalence of hypovitaminosis D in patients with Cystic Fibrosis, presenting an inverse relationship with oxidative stress when associated with markers of the inflammatory process. As for the BsmI polymorphism of the VDR gene, genotype variation seems to influence vitamin D levels and markers of inflammatory process and oxidative stress. The presence of polymorphism appears to influence the effect of supplementation and clinical response in patients with Cystic Fibrosis. We suggest that our studies take longer and more patients to understand ideal levels for vitamin D correction and the relationship with genetic polymorphisms in the VDR gene. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-12-13 2021-08-28 2022-03-11T19:13:15Z 2022-03-11T19:13:15Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
format |
doctoralThesis |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://repositorio.ufpb.br/jspui/handle/123456789/22362 |
url |
https://repositorio.ufpb.br/jspui/handle/123456789/22362 |
dc.language.iso.fl_str_mv |
por |
language |
por |
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Attribution-NoDerivs 3.0 Brazil http://creativecommons.org/licenses/by-nd/3.0/br/ info:eu-repo/semantics/openAccess |
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Attribution-NoDerivs 3.0 Brazil http://creativecommons.org/licenses/by-nd/3.0/br/ |
eu_rights_str_mv |
openAccess |
dc.publisher.none.fl_str_mv |
Universidade Federal da Paraíba Brasil Ciências da Nutrição Programa de Pós-Graduação em Ciências da Nutrição UFPB |
publisher.none.fl_str_mv |
Universidade Federal da Paraíba Brasil Ciências da Nutrição Programa de Pós-Graduação em Ciências da Nutrição UFPB |
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reponame:Biblioteca Digital de Teses e Dissertações da UFPB instname:Universidade Federal da Paraíba (UFPB) instacron:UFPB |
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Universidade Federal da Paraíba (UFPB) |
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UFPB |
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UFPB |
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Biblioteca Digital de Teses e Dissertações da UFPB |
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Biblioteca Digital de Teses e Dissertações da UFPB |
repository.name.fl_str_mv |
Biblioteca Digital de Teses e Dissertações da UFPB - Universidade Federal da Paraíba (UFPB) |
repository.mail.fl_str_mv |
diretoria@ufpb.br|| diretoria@ufpb.br |
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1801842989593526272 |