Growth, upper arm anthropometry and serum 25-hydroxyvitamin d status of brazilian and nigerian school-aged children with sickle cell disease
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Tipo de documento: | Tese |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=4625817 https://repositorio.unifesp.br/handle/11600/46460 |
Resumo: | BACKGROUND: Sickle cell disease (SCD) phenotype is very variable and many genetic and environmental modulating factors including nutritional status have been implicated. Comparative studies of patients in different socio-geographic and ecological zones afford an opportunity to investigate potential environmental and other factors that influence the phenotype. OBJECTIVES: To assess the growth parameters, upper arm anthropometry, and serum 25-hydroxyvitamin D (25-OHD) of two cohorts of children with SCD at the University Teaching Hospitals in Ile-Ife/Ilesa, Southwest, Nigeria, and Sao Paulo, Brazil. In addition, the study also sought to determine the influence of hydroxyurea (HU) on growth and nutritional status. Relationship between serum 25-OHD and disease phenotypes (rates of pain episodes, biomarkers of intravascular haemolysis and inflammatory cytokines) was also determined. METHODS: Sociodemographic, clinical, growth and upper arm anthropometry of school-aged Brazilian and Nigerian children with SCD as well as age- and sex-matched haemoglobin AA Nigerian controls were assessed. Haematological and biochemical parameters (serum 25-OHD inclusive); and inflammatory cytokines were determined by standard techniques. Relationships between serum 25-OHD, pain rates and cytokines were determined by statistical tests. Nigerian SCA children with suboptimal 25-OHD were given 2,000 IU of vitamin D3 supplemetation daily for three months and its infuence on cytokine profiles was evaluated. RESULTS: A relatively high proportion of the children in both centers (23.5 percent) were underweight. Weight, BMI-Z score, height for age-Z score, upper arm fat area and fat percentage were significantly lower in the Nigerian than Brazilian cohorts. A higher proportion of Nigerian patients (29.5% against 19.3%) were underweight, and of short stature (12.6% vs. 3.7%), while a higher proportion of Brazilian patients were overweight or obese, (9.2% vs. 4.3%) and taller for age, (16.5% vs. 8.4%). None of the Nigerian patients had severe vitamin D deficiency and only 12.6% had suboptimal vitamin D levels, however, 3.7% of the Brazilian patients had severe deficiency and majority, 79.8% had either vitamin D deficiency or insufficiency. Underweight and severe vitamin D deficiency were more prevalent among Brazilian children who were hydroxyurea-naive than those who had used HU for at least 12 months (30.6% vs. 13.7%, p = 0.036; and 11.4% vs 0%, p = 0.008 respectively). Their mean serum 25-OHD was also lower than the HU group, 20.80 ± 7.48 ng/ ml vs. 24.52 ± 8.26 ng/ml, p = 0.021. All Nigerian children with suboptimal vitamin D compared to 69.7% of those with normal vitamin D experienced vasoocclusive pain episodes in the preceding 12 months, p = 0.037, 95% CI = 0.7 ? 0.9. The mean serum vitamin D of those with at least one pain episode (41.25 ± 10.09 ng/mL), was significantly lower than 45.22 ± 7.71 ng/mL for those without pain episode, p = 0.043, 95% CI = 1.3 ? 7.8. After excluding the potential influence of HU, among Brazilian patients, hemoglobin and hematocrit had significant positive correlations with serum 25-OHD (r = 0.40, p = 0.017 and r = 0.45, 0.006 respectively), while reticulocyte percentage, absolute reticulocyte count and serum lactate dehydrogenase (LDH) had significant inverse correlation (r = -0.44, p = 0.008; r = -0.47, p = 0.007 and r = -0.45, p = 0.007 respectively). Also, the mean hemoglobin of those with suboptimal vitamin D was lower (8.1 ± 0.9g/dl vs. 9.4 ± 1.8g/dl, p = 0.014), while the mean reticulocyte count and serum lactate dehydrogenase were significantly higher, p = 0.047 and 0.003 respectively.Compared to those with normal level, Nigerian patients with suboptimal 25-OHD had significantly higher serum pro-inflammatory cytokines IL-6, 8 and 18 (p = 0.003, 0.010 and 0.002 respectively) and lower levels of anti-inflammatory cytokine IL-11 (p = 0.005). Proinflammatory cytokines IL-2, 6, 8, 17 and 18 were reduced significantly while antiinflammatory cytokines IL-11 was significantly higher at the end of 3 months of vitamin D3 supplementation. CONCLUSIONS: Nigerian children with SCD were lighter, shorter and had less fat than their Brazilian counterparts. On the contrary, more Brazilian children had overweight/ obesity, with majority having suboptimal serum 25-OHD levels. HU therapy tends to protect against growth retardation and vitamin D deficiency. A possible association between depressed serum vitamin D level and increased frequency of acute pain episodes supports the role of vitamin D in musculoskeletal health. Also the correlation between serum 25-OHD levels and biomarkers of intravascular haemolysis and inflammation suggest its role in the pathogenesis of haemolytic and inflammatory phenotypes in children with SCD. |
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Adegoke, Samuel Ademola [UNIFESP]Universidade Federal de São Paulo (UNIFESP)Figueiredo, Maria Stella [UNIFESP]2018-07-27T15:50:15Z2018-07-27T15:50:15Z2016-10-27https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=4625817ADEGOKE, Samuel Ademola. Growth, upper arm anthropometry and serum 25-hydroxyvitamin d status of brazilian and nigerian school-aged children with sickle cell disease. 2016. 156 f. Tese (Doutorado) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2016.https://repositorio.unifesp.br/handle/11600/46460SAMUEL ADEMOLA ADEGOKE.pdfBACKGROUND: Sickle cell disease (SCD) phenotype is very variable and many genetic and environmental modulating factors including nutritional status have been implicated. Comparative studies of patients in different socio-geographic and ecological zones afford an opportunity to investigate potential environmental and other factors that influence the phenotype. OBJECTIVES: To assess the growth parameters, upper arm anthropometry, and serum 25-hydroxyvitamin D (25-OHD) of two cohorts of children with SCD at the University Teaching Hospitals in Ile-Ife/Ilesa, Southwest, Nigeria, and Sao Paulo, Brazil. In addition, the study also sought to determine the influence of hydroxyurea (HU) on growth and nutritional status. Relationship between serum 25-OHD and disease phenotypes (rates of pain episodes, biomarkers of intravascular haemolysis and inflammatory cytokines) was also determined. METHODS: Sociodemographic, clinical, growth and upper arm anthropometry of school-aged Brazilian and Nigerian children with SCD as well as age- and sex-matched haemoglobin AA Nigerian controls were assessed. Haematological and biochemical parameters (serum 25-OHD inclusive); and inflammatory cytokines were determined by standard techniques. Relationships between serum 25-OHD, pain rates and cytokines were determined by statistical tests. Nigerian SCA children with suboptimal 25-OHD were given 2,000 IU of vitamin D3 supplemetation daily for three months and its infuence on cytokine profiles was evaluated. RESULTS: A relatively high proportion of the children in both centers (23.5 percent) were underweight. Weight, BMI-Z score, height for age-Z score, upper arm fat area and fat percentage were significantly lower in the Nigerian than Brazilian cohorts. A higher proportion of Nigerian patients (29.5% against 19.3%) were underweight, and of short stature (12.6% vs. 3.7%), while a higher proportion of Brazilian patients were overweight or obese, (9.2% vs. 4.3%) and taller for age, (16.5% vs. 8.4%). None of the Nigerian patients had severe vitamin D deficiency and only 12.6% had suboptimal vitamin D levels, however, 3.7% of the Brazilian patients had severe deficiency and majority, 79.8% had either vitamin D deficiency or insufficiency. Underweight and severe vitamin D deficiency were more prevalent among Brazilian children who were hydroxyurea-naive than those who had used HU for at least 12 months (30.6% vs. 13.7%, p = 0.036; and 11.4% vs 0%, p = 0.008 respectively). Their mean serum 25-OHD was also lower than the HU group, 20.80 ± 7.48 ng/ ml vs. 24.52 ± 8.26 ng/ml, p = 0.021. All Nigerian children with suboptimal vitamin D compared to 69.7% of those with normal vitamin D experienced vasoocclusive pain episodes in the preceding 12 months, p = 0.037, 95% CI = 0.7 ? 0.9. The mean serum vitamin D of those with at least one pain episode (41.25 ± 10.09 ng/mL), was significantly lower than 45.22 ± 7.71 ng/mL for those without pain episode, p = 0.043, 95% CI = 1.3 ? 7.8. After excluding the potential influence of HU, among Brazilian patients, hemoglobin and hematocrit had significant positive correlations with serum 25-OHD (r = 0.40, p = 0.017 and r = 0.45, 0.006 respectively), while reticulocyte percentage, absolute reticulocyte count and serum lactate dehydrogenase (LDH) had significant inverse correlation (r = -0.44, p = 0.008; r = -0.47, p = 0.007 and r = -0.45, p = 0.007 respectively). Also, the mean hemoglobin of those with suboptimal vitamin D was lower (8.1 ± 0.9g/dl vs. 9.4 ± 1.8g/dl, p = 0.014), while the mean reticulocyte count and serum lactate dehydrogenase were significantly higher, p = 0.047 and 0.003 respectively.Compared to those with normal level, Nigerian patients with suboptimal 25-OHD had significantly higher serum pro-inflammatory cytokines IL-6, 8 and 18 (p = 0.003, 0.010 and 0.002 respectively) and lower levels of anti-inflammatory cytokine IL-11 (p = 0.005). Proinflammatory cytokines IL-2, 6, 8, 17 and 18 were reduced significantly while antiinflammatory cytokines IL-11 was significantly higher at the end of 3 months of vitamin D3 supplementation. CONCLUSIONS: Nigerian children with SCD were lighter, shorter and had less fat than their Brazilian counterparts. On the contrary, more Brazilian children had overweight/ obesity, with majority having suboptimal serum 25-OHD levels. HU therapy tends to protect against growth retardation and vitamin D deficiency. A possible association between depressed serum vitamin D level and increased frequency of acute pain episodes supports the role of vitamin D in musculoskeletal health. Also the correlation between serum 25-OHD levels and biomarkers of intravascular haemolysis and inflammation suggest its role in the pathogenesis of haemolytic and inflammatory phenotypes in children with SCD.Dados abertos - Sucupira - Teses e dissertações (2013 a 2016)156 p.engUniversidade Federal de São Paulo (UNIFESP)Childrencytokinesgrowthnutritional statussickle cell anaemiaupper arm anthropometry25-hydroxyvitamin dChildrencytokinesgrowthnutritional statussickle cell anaemiaupper arm anthropometry25-hydroxyvitamin dGrowth, upper arm anthropometry and serum 25-hydroxyvitamin d status of brazilian and nigerian school-aged children with sickle cell diseaseinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESPSão Paulo, Escola Paulista de Medicina (EPM)Medicina (Hematologia)Ciências da saúdeMedicinaORIGINALSAMUEL ADEMOLA ADEGOKE.pdfSAMUEL ADEMOLA ADEGOKE.pdfapplication/pdf3473520${dspace.ui.url}/bitstream/11600/46460/1/SAMUEL%20ADEMOLA%20ADEGOKE.pdf4ca037ac0fc216075441a66ec2db9239MD51open accessTEXTSAMUEL ADEMOLA ADEGOKE.pdf.txtSAMUEL ADEMOLA ADEGOKE.pdf.txtExtracted texttext/plain263256${dspace.ui.url}/bitstream/11600/46460/26/SAMUEL%20ADEMOLA%20ADEGOKE.pdf.txtea2863b1d51623c7bb5213c2ad736008MD526open accessTHUMBNAILSAMUEL ADEMOLA ADEGOKE.pdf.jpgSAMUEL ADEMOLA ADEGOKE.pdf.jpgIM Thumbnailimage/jpeg3887${dspace.ui.url}/bitstream/11600/46460/28/SAMUEL%20ADEMOLA%20ADEGOKE.pdf.jpg75c788ac74b3b9f6e5047a5aef3b77a0MD528open access11600/464602023-06-03 01:37:03.444open accessoai:repositorio.unifesp.br:11600/46460Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestopendoar:34652023-06-03T04:37:03Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.pt.fl_str_mv |
Growth, upper arm anthropometry and serum 25-hydroxyvitamin d status of brazilian and nigerian school-aged children with sickle cell disease |
title |
Growth, upper arm anthropometry and serum 25-hydroxyvitamin d status of brazilian and nigerian school-aged children with sickle cell disease |
spellingShingle |
Growth, upper arm anthropometry and serum 25-hydroxyvitamin d status of brazilian and nigerian school-aged children with sickle cell disease Adegoke, Samuel Ademola [UNIFESP] Children cytokines growth nutritional status sickle cell anaemia upper arm anthropometry 25-hydroxyvitamin d Children cytokines growth nutritional status sickle cell anaemia upper arm anthropometry 25-hydroxyvitamin d |
title_short |
Growth, upper arm anthropometry and serum 25-hydroxyvitamin d status of brazilian and nigerian school-aged children with sickle cell disease |
title_full |
Growth, upper arm anthropometry and serum 25-hydroxyvitamin d status of brazilian and nigerian school-aged children with sickle cell disease |
title_fullStr |
Growth, upper arm anthropometry and serum 25-hydroxyvitamin d status of brazilian and nigerian school-aged children with sickle cell disease |
title_full_unstemmed |
Growth, upper arm anthropometry and serum 25-hydroxyvitamin d status of brazilian and nigerian school-aged children with sickle cell disease |
title_sort |
Growth, upper arm anthropometry and serum 25-hydroxyvitamin d status of brazilian and nigerian school-aged children with sickle cell disease |
author |
Adegoke, Samuel Ademola [UNIFESP] |
author_facet |
Adegoke, Samuel Ademola [UNIFESP] |
author_role |
author |
dc.contributor.institution.pt.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) |
dc.contributor.author.fl_str_mv |
Adegoke, Samuel Ademola [UNIFESP] |
dc.contributor.advisor1.fl_str_mv |
Figueiredo, Maria Stella [UNIFESP] |
contributor_str_mv |
Figueiredo, Maria Stella [UNIFESP] |
dc.subject.por.fl_str_mv |
Children cytokines growth nutritional status sickle cell anaemia upper arm anthropometry 25-hydroxyvitamin d |
topic |
Children cytokines growth nutritional status sickle cell anaemia upper arm anthropometry 25-hydroxyvitamin d Children cytokines growth nutritional status sickle cell anaemia upper arm anthropometry 25-hydroxyvitamin d |
dc.subject.eng.fl_str_mv |
Children cytokines growth nutritional status sickle cell anaemia upper arm anthropometry 25-hydroxyvitamin d |
description |
BACKGROUND: Sickle cell disease (SCD) phenotype is very variable and many genetic and environmental modulating factors including nutritional status have been implicated. Comparative studies of patients in different socio-geographic and ecological zones afford an opportunity to investigate potential environmental and other factors that influence the phenotype. OBJECTIVES: To assess the growth parameters, upper arm anthropometry, and serum 25-hydroxyvitamin D (25-OHD) of two cohorts of children with SCD at the University Teaching Hospitals in Ile-Ife/Ilesa, Southwest, Nigeria, and Sao Paulo, Brazil. In addition, the study also sought to determine the influence of hydroxyurea (HU) on growth and nutritional status. Relationship between serum 25-OHD and disease phenotypes (rates of pain episodes, biomarkers of intravascular haemolysis and inflammatory cytokines) was also determined. METHODS: Sociodemographic, clinical, growth and upper arm anthropometry of school-aged Brazilian and Nigerian children with SCD as well as age- and sex-matched haemoglobin AA Nigerian controls were assessed. Haematological and biochemical parameters (serum 25-OHD inclusive); and inflammatory cytokines were determined by standard techniques. Relationships between serum 25-OHD, pain rates and cytokines were determined by statistical tests. Nigerian SCA children with suboptimal 25-OHD were given 2,000 IU of vitamin D3 supplemetation daily for three months and its infuence on cytokine profiles was evaluated. RESULTS: A relatively high proportion of the children in both centers (23.5 percent) were underweight. Weight, BMI-Z score, height for age-Z score, upper arm fat area and fat percentage were significantly lower in the Nigerian than Brazilian cohorts. A higher proportion of Nigerian patients (29.5% against 19.3%) were underweight, and of short stature (12.6% vs. 3.7%), while a higher proportion of Brazilian patients were overweight or obese, (9.2% vs. 4.3%) and taller for age, (16.5% vs. 8.4%). None of the Nigerian patients had severe vitamin D deficiency and only 12.6% had suboptimal vitamin D levels, however, 3.7% of the Brazilian patients had severe deficiency and majority, 79.8% had either vitamin D deficiency or insufficiency. Underweight and severe vitamin D deficiency were more prevalent among Brazilian children who were hydroxyurea-naive than those who had used HU for at least 12 months (30.6% vs. 13.7%, p = 0.036; and 11.4% vs 0%, p = 0.008 respectively). Their mean serum 25-OHD was also lower than the HU group, 20.80 ± 7.48 ng/ ml vs. 24.52 ± 8.26 ng/ml, p = 0.021. All Nigerian children with suboptimal vitamin D compared to 69.7% of those with normal vitamin D experienced vasoocclusive pain episodes in the preceding 12 months, p = 0.037, 95% CI = 0.7 ? 0.9. The mean serum vitamin D of those with at least one pain episode (41.25 ± 10.09 ng/mL), was significantly lower than 45.22 ± 7.71 ng/mL for those without pain episode, p = 0.043, 95% CI = 1.3 ? 7.8. After excluding the potential influence of HU, among Brazilian patients, hemoglobin and hematocrit had significant positive correlations with serum 25-OHD (r = 0.40, p = 0.017 and r = 0.45, 0.006 respectively), while reticulocyte percentage, absolute reticulocyte count and serum lactate dehydrogenase (LDH) had significant inverse correlation (r = -0.44, p = 0.008; r = -0.47, p = 0.007 and r = -0.45, p = 0.007 respectively). Also, the mean hemoglobin of those with suboptimal vitamin D was lower (8.1 ± 0.9g/dl vs. 9.4 ± 1.8g/dl, p = 0.014), while the mean reticulocyte count and serum lactate dehydrogenase were significantly higher, p = 0.047 and 0.003 respectively.Compared to those with normal level, Nigerian patients with suboptimal 25-OHD had significantly higher serum pro-inflammatory cytokines IL-6, 8 and 18 (p = 0.003, 0.010 and 0.002 respectively) and lower levels of anti-inflammatory cytokine IL-11 (p = 0.005). Proinflammatory cytokines IL-2, 6, 8, 17 and 18 were reduced significantly while antiinflammatory cytokines IL-11 was significantly higher at the end of 3 months of vitamin D3 supplementation. CONCLUSIONS: Nigerian children with SCD were lighter, shorter and had less fat than their Brazilian counterparts. On the contrary, more Brazilian children had overweight/ obesity, with majority having suboptimal serum 25-OHD levels. HU therapy tends to protect against growth retardation and vitamin D deficiency. A possible association between depressed serum vitamin D level and increased frequency of acute pain episodes supports the role of vitamin D in musculoskeletal health. Also the correlation between serum 25-OHD levels and biomarkers of intravascular haemolysis and inflammation suggest its role in the pathogenesis of haemolytic and inflammatory phenotypes in children with SCD. |
publishDate |
2016 |
dc.date.issued.fl_str_mv |
2016-10-27 |
dc.date.accessioned.fl_str_mv |
2018-07-27T15:50:15Z |
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2018-07-27T15:50:15Z |
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https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=4625817 |
dc.identifier.citation.fl_str_mv |
ADEGOKE, Samuel Ademola. Growth, upper arm anthropometry and serum 25-hydroxyvitamin d status of brazilian and nigerian school-aged children with sickle cell disease. 2016. 156 f. Tese (Doutorado) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2016. |
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https://repositorio.unifesp.br/handle/11600/46460 |
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SAMUEL ADEMOLA ADEGOKE.pdf |
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https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=4625817 https://repositorio.unifesp.br/handle/11600/46460 |
identifier_str_mv |
ADEGOKE, Samuel Ademola. Growth, upper arm anthropometry and serum 25-hydroxyvitamin d status of brazilian and nigerian school-aged children with sickle cell disease. 2016. 156 f. Tese (Doutorado) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2016. SAMUEL ADEMOLA ADEGOKE.pdf |
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Universidade Federal de São Paulo (UNIFESP) |
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Universidade Federal de São Paulo (UNIFESP) |
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