Estado nutricional relacionado à vitamina K de pacientes portadores de doença vascular em tratamento anticoagulante oral ambulatorial com varfarina sódica
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Data
2001
Autores
Dôres, Sílvia Maria Custódio das [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
A vitamina K, descoberta em 1929, tem reconhecida função na coagulação sangüínea. Esta vitamina age como co-fator na reação de carboxilação para biossíntese, após tradução, de resíduos de ácido gama carboxi-glutâmico (Gla) em limitado número de proteínas. A reação de carboxilação é passo necessário para a formação de fatores e proteínas da coagulação (fatores II, VII, IX, X, proteínas C e S) e proteínas envolvidas no metabolismo ósseo, como osteocalcina e proteína Gla da matriz. As drogas anticoagulantes orais são usadas na prevenção primária e secundária de fenômenos tromboembólicos e funcionam reduzindo a atividade plasmática das proteínas de coagulação vitamina K-dependentes. As causas da instabilidade da terapia anticoagulante são múltiplas e incluem: baixa adesão ao tratamento, interação droga-droga, resistência herdada à varfarina e alterações dietéticas. O presente trabalho versa sobre a influência do estado nutricional relacionado à vitamina K sobre a terapia de anticoagulação oral, em pacientes portadores de doença vascular. Levantou-se a hipótese de que o consumo de dieta com teor inadequado de vitamina K (elevado ou reduzido), assim como as concentrações plasmáticas da vitamina, podem estar associados a dificuldades na promoção da anticoagulação ou favorecer o estado de hipocoagulabilidade. Objetivou-se ainda a realização de avaliação do estado nutricional relacionado à vitamina K do grupo estudado, identificar as principais fontes dietéticas de vitamina K e investigar o efeito de diversas variáveis (chamadas variáveis descritivas) sobre a ingestão e concentrações plasmáticas de vitamina K. Para atender aos objetivos propostos, o trabalho incluiu dois estudos: transversal e longitudinal. Do estudo transversal, constam a aplicação de protocolo, que contém: os dados...
Vitamin K, which was discovered in the decade of 1930, has a recognized function in blood coagulation. The vitamin acts as a cofactor in posttranslational conversion of specific glutamyl residues to gammacarboxyglutamic acid (GLA) residues in limited numbers of proteins. The carboxylation reaction is a necessary step to synthesis of factors and anticoagulant proteins (factors II , VII, IX, X, proteins C and S) and proteins involved in bone metabolism, such as osteocalcin and matrix GLA-protein. The oral anticoagulant drugs have been used in the primary and secondary prevention of thromboembolic disorders and act reducing the plasmatic activity of blood coagulation proteins. Causes of the unstable anticoagulant therapy are multiple and include poor compliance, drug-drug interaction, inherited warfarin resistance and dietary changes. The present study examined the influence of vitamin K nutritional status on the warfarin anticoagulation therapy in vascular disease patients. We tested the hypothesis that inadequate diet intake of vitamin K (high or low), and the vitamin plasmatic concentrations are related to a disturbances of the coagulation leading to hypercoagulability or favoring hypocoagulability condition. The aim of the study was to assess the vitamin K nutritional status of the group, identify important food sources and investigate the effect of some variables on the dietary vitamin K intake and the vitamin plasmatic concentration. The work included a crosssectional and longitudinal study. The cross-sectional study consisted of clinical history and examination, a 24-hour recall method for assessment of recent food intake of vitamin K and laboratory methods for biochemical assessment, including coagulation test and body composition techniques. For the longitudinal study, a food frequency questionnaire was applied in order to... (Complete abstract click electronic access below)
Vitamin K, which was discovered in the decade of 1930, has a recognized function in blood coagulation. The vitamin acts as a cofactor in posttranslational conversion of specific glutamyl residues to gammacarboxyglutamic acid (GLA) residues in limited numbers of proteins. The carboxylation reaction is a necessary step to synthesis of factors and anticoagulant proteins (factors II , VII, IX, X, proteins C and S) and proteins involved in bone metabolism, such as osteocalcin and matrix GLA-protein. The oral anticoagulant drugs have been used in the primary and secondary prevention of thromboembolic disorders and act reducing the plasmatic activity of blood coagulation proteins. Causes of the unstable anticoagulant therapy are multiple and include poor compliance, drug-drug interaction, inherited warfarin resistance and dietary changes. The present study examined the influence of vitamin K nutritional status on the warfarin anticoagulation therapy in vascular disease patients. We tested the hypothesis that inadequate diet intake of vitamin K (high or low), and the vitamin plasmatic concentrations are related to a disturbances of the coagulation leading to hypercoagulability or favoring hypocoagulability condition. The aim of the study was to assess the vitamin K nutritional status of the group, identify important food sources and investigate the effect of some variables on the dietary vitamin K intake and the vitamin plasmatic concentration. The work included a crosssectional and longitudinal study. The cross-sectional study consisted of clinical history and examination, a 24-hour recall method for assessment of recent food intake of vitamin K and laboratory methods for biochemical assessment, including coagulation test and body composition techniques. For the longitudinal study, a food frequency questionnaire was applied in order to... (Complete abstract click electronic access below)
Descrição
Palavras-chave
Doenças vasculares perifericas - Aspectos nutricionais, Varfarina sódica, Vitamin K, Vascular disease
Como citar
DÔRES, Sílvia Maria Custódio das. Estado nutricional relacionado à vitamina K de pacientes portadores de doença vascular em tratamento anticoagulante oral ambulatorial com varfarina sódica. 2001. 201 f. Tese (doutorado) - Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, 2001.