Efeito de suplementação de vitamina D sobre o perfil de adipocinas em mulheres na pós-menopausa.
Carregando...
Data
2022-03-09
Autores
Schmitt, Eneida Maria Boteon [UNESP]
Título da Revista
ISSN da Revista
Título de Volume
Editor
Universidade Estadual Paulista (Unesp)
Resumo
Objetivo: Avaliar o efeito da suplementação isolada de vitamina D (VD) sobre o perfil de adipocinas em mulheres na pós-menopausa. Métodos: Foi conduzido ensaio clínico, duplo-cego, placebo-controlado envolvendo 160 mulheres com idade entre 50-65 anos e amenorreia ≥ 12 meses. Foram excluídas mulheres com histórico de doença cardiovascular, diabetes insulino dependente, doença renal crônica, doença hepática, doença autoimune, disfunção da paratireoide e usuárias de terapia hormonal da menopausa e de VD. As participantes foram randomizadas em dois grupos: VD, ingestão de colicalciferol 1.000 UI/dia via oral (n=80) ou placebo (n=80). O tempo de intervenção foi de 9 meses, com avaliações nos momentos inicial e final. Para avaliação do perfil de adipocinas foram dosadas adiponectina, resistina, adipsina e PAI-1 (Inibidor do ativador de plasminogênio tipo 1). Os valores séricos de 25-hidroxivitamina D [25(OH)D] foram mensurados por cromatografia líquida de alta eficiência (HPLC). A análise estatística foi per protocol, empregando-se ANOVA e medidas repetidas por meio da Distribuição Gama seguido do teste de comparação múltipla de Wald. Resultados: Os grupos foram similares nos parâmetros iniciais clínicos, bioquímicos e no perfil de adipocinas. A média de idade foi de 58,8 ± 6,6 anos no grupo VD e de 59,3 ± 6,7 anos no grupo placebo, com tempo de menopausa de 12,0 ± 8,8 anos e 12,3 ± 8,4 anos, respectivamente (p>0.05). Após 9 meses, valores médios de 25(OH)D aumentaram de 15,0 ± 7,5 ng/ml para 27,5 ± 10,4 ng/ml (+45,4%) no grupo VD, e diminuíram de 16,9 ± 6,7 ng/ml para 13,8 ± 6,0 ng/ml (-18,5%) no placebo (p<0.001). No grupo VD, na comparação entre momentos, observou-se aumento nos valores médios de adiponectina (18.6%) e redução de resistina (-32.4%) e PAI-1 (-39.3%), (p<0.05). E no grupo placebo houve redução no PAI-1 (-25.5%) (p<0.05). Na comparação entre os grupos no momento final, foi observada diferença significativa entre os grupos placebo e VD nos valores médios de adiponectina e resistina (11.5 ± 5.5 ng/mL vs 18.5 ± 21.8 ng/mL, p=0.047, e 16.5 ± 3.5 ng/mL vs 11.7 ± 3.3 ng/mL, p=0.027, respectivamente). Não foram observadas diferenças entre grupos e entre momentos nos valores de adipsina e PAI-1. Conclusões: A suplementação diária e isolada de 1.000 UI de VD por 9 meses associou-se com aumento no valor de adiponectina e redução da resistina quando comparada ao placebo, sugerindo efeito benéfico sobre o perfil de adipocinas em mulheres na pós-menopausa com deficiência de VD.
Objective: To evaluate the effect of supplementation of vitamin D (VD) alone on adipokines profile in postmenopausal women. Methods: In this double-blind, placebo-controlled trial, 160 postmenopausal women were randomized into two groups: VD group, vitamin D3 supplementation 1,000 IU/day orally (n=80) or placebo group (n=80). Women with amenorrhea ≥ 12 months and age 50-65 years were included. Those with established cardiovascular disease, insulin dependent diabetes, primary hyperparathyroidism, renal failure (or creatinine >1.4 mg/dL), liver disorders, autoimmune diseases, and previous use of menopausal hormone therapy and VD were excluded. The intervention time was 9 months, with assessments at the start and end of treatment. Serum levels of adiponectin, resistin, adipsin and PAI-1 (Inhibitor of plasminogen activator type 1) were determined. The plasma concentrations of 25-hydroxyvitamin D [25(OH)D] were measured by HPLC (high-performance liquid chromatography). Statistical analysis was by intention-to-treat (ITT), using ANOVA and Gamma distribution in repeated measures design followed by multiple comparison Wald’s test. Results: The two groups were similar at baseline in terms of clinical and laboratory parameters. The mean age of the patients included was 58.8 ± 6.6 years in the VD group and 59.3 ± 6.7 years in the placebo group, with time since menopause of 12.0 ± 8.8 years and 12.3 ± 8.4 years, respectively (p>0.05). After 10 months, there was increase in the 25(OH)D concentrations from 15.0 ± 7.5 ng/ml to 27.5 ± 10.4 ng/ml (+45.4%) in VD group, and decrease from 16.9 ± 6.7 ng/ml to 13.8 ± 6.0 ng/ml (-18.5%) in placebo group (p<0.001). In the VD group, in the comparison between moments, there was significant increase in adiponectin (+18.6%) and decrease in resistin (-32.4%) and PAI-1 (-39.3%) (p<0.05). And in the placebo group, there was decrease in PAI-1 (-25.5%) (p<0.05). In the comparison between groups at the end point, a significant difference was observed between the PL and VD groups in the mean values of adiponectin and resistin (11.5 ± 5.5 ng/mL vs 18.5 ± 21.8 ng/mL, p=0.047, and 16.5 ± 3.5 ng /mL vs 11.7 ± 3.3 ng/mL, p=0.027, respectively). There were no significant intervention effects on serum levels of adipsin and PAI-1. Conclusion: In postmenopausal women with vitamin D deficiency, daily isolated supplementation of 1,000 IU of vitamin D3 for 9 months was associated with an increase in adiponectin value and a decrease in resistin when compared to placebo, suggesting a beneficial effect on the adipokine profile.
Objective: To evaluate the effect of supplementation of vitamin D (VD) alone on adipokines profile in postmenopausal women. Methods: In this double-blind, placebo-controlled trial, 160 postmenopausal women were randomized into two groups: VD group, vitamin D3 supplementation 1,000 IU/day orally (n=80) or placebo group (n=80). Women with amenorrhea ≥ 12 months and age 50-65 years were included. Those with established cardiovascular disease, insulin dependent diabetes, primary hyperparathyroidism, renal failure (or creatinine >1.4 mg/dL), liver disorders, autoimmune diseases, and previous use of menopausal hormone therapy and VD were excluded. The intervention time was 9 months, with assessments at the start and end of treatment. Serum levels of adiponectin, resistin, adipsin and PAI-1 (Inhibitor of plasminogen activator type 1) were determined. The plasma concentrations of 25-hydroxyvitamin D [25(OH)D] were measured by HPLC (high-performance liquid chromatography). Statistical analysis was by intention-to-treat (ITT), using ANOVA and Gamma distribution in repeated measures design followed by multiple comparison Wald’s test. Results: The two groups were similar at baseline in terms of clinical and laboratory parameters. The mean age of the patients included was 58.8 ± 6.6 years in the VD group and 59.3 ± 6.7 years in the placebo group, with time since menopause of 12.0 ± 8.8 years and 12.3 ± 8.4 years, respectively (p>0.05). After 10 months, there was increase in the 25(OH)D concentrations from 15.0 ± 7.5 ng/ml to 27.5 ± 10.4 ng/ml (+45.4%) in VD group, and decrease from 16.9 ± 6.7 ng/ml to 13.8 ± 6.0 ng/ml (-18.5%) in placebo group (p<0.001). In the VD group, in the comparison between moments, there was significant increase in adiponectin (+18.6%) and decrease in resistin (-32.4%) and PAI-1 (-39.3%) (p<0.05). And in the placebo group, there was decrease in PAI-1 (-25.5%) (p<0.05). In the comparison between groups at the end point, a significant difference was observed between the PL and VD groups in the mean values of adiponectin and resistin (11.5 ± 5.5 ng/mL vs 18.5 ± 21.8 ng/mL, p=0.047, and 16.5 ± 3.5 ng /mL vs 11.7 ± 3.3 ng/mL, p=0.027, respectively). There were no significant intervention effects on serum levels of adipsin and PAI-1. Conclusion: In postmenopausal women with vitamin D deficiency, daily isolated supplementation of 1,000 IU of vitamin D3 for 9 months was associated with an increase in adiponectin value and a decrease in resistin when compared to placebo, suggesting a beneficial effect on the adipokine profile.
Descrição
Palavras-chave
Vitamina D, Menopausa, Adipocinas