O efeito da suplementação isolada de vitamina D sobre os marcadores cardiometabólicos em mulheres na pós-menopausa
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Data
2018-05-03
Autores
Poloni, Priscila Ferreira
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Universidade Estadual Paulista (Unesp)
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Objetivo: Avaliar o efeito da suplementação isolada de vitamina D (VD) sobre os marcadores cardiometabólicos em mulheres na pós-menopausa. Métodos: Foi conduzido ensaio clínico, duplo-cego, placebo-controlado envolvendo 160 mulheres com idade entre 50-65 anos e amenorréia ≥ 12 meses. Foram excluídas mulheres com histórico de doença cardiovascular, diabetes insulino dependente, doença renal crônica, doença hepática, disfunção da paratireóide e usuárias de suplementação de VD. As participantes foram randomizadas em dois grupos: grupo VD, ingestão de colicalciferol 1.000 UI/dia via oral (n=80) ou grupo placebo (n=80). O tempo de intervenção foi de nove meses, com avaliações nos momentos inicial e final. Foram consideradas com síndrome metabólica (SM) as mulheres que apresentaram três ou mais critérios diagnósticos: circunferência da cintura (CC) > 88 cm; TG 150 mg/dL; HDL colesterol < 50 mg/dL; pressão arterial 130/85 mmHg; glicose 100 mg/dL. Foram coletados dados clínicos, antropométricos e bioquímicos (colesterol total, HDL, LDL, triglicerídeos, glicose e insulina. Os valores séricos de 25-hidroxivitamina D [25(OH)D] foram mensurados por cromatografia líquida de alta eficiência (HPLC). A análise estatística foi por Intenção de Tratamento (ITT), empregando-se o Teste t-student, a Distribuição Gama (variáveis assimétricas), teste do Qui-quadrado, ANOVA e a regressão logística (odds ratio-OR). Resultados: Após nove meses, valores médios de 25(OH)D aumentaram de 15,0 ± 7,5 ng/ml para 27,5 ± 10,4 ng/ml (+45,4%, p<.001) no grupo VD, e diminuíram de 16,9 ± 6,7 ng/ml para 13,8 ± 6,0 ng/ml (-18,5%, p=0.049) no placebo. No grupo VD, observou-se redução significativa nos triglicerídeos (-12,2%, p=0,001), insulina (-13,7%, p=0,008) e HOMA-IR (-17,9%, p=0,007). No grupo placebo, houve aumento nos valores séricos de glicose (+6,2%, p=0,009). Não foram observadas diferenças significativas nos parâmetros antropométricos entre os grupos (p> 0,05). Na análise de risco ajustado para idade, tempo de menopausa e índice de massa corpórea, as mulheres suplementadas com VD apresentaram menor risco para SM (OR 0,42; IC 95%: 0,21-0,83), hipertrigliceridemia (OR 0,43; IC 95%: 0,22-0,85) e hiperglicemia (OR 0,23; IC 95%: 0,10-0,52) em comparação com ao grupo placebo (p <0,05). Conclusões: Em mulheres na pós-menopausa, a suplementação isolada de 1.000 UI de vitamina D3 por nove meses associou-se a menor risco cardiometabólico. As mulheres submetidas à suplementação de VD apresentaram menor risco de síndrome metabólica, hipertrigliceridemia e hiperglicemia que as mulheres no grupo placebo.
Objective: To evaluate the effect of isolated vitamin D (VD) supplementation on cardiometabolic markers in postmenopausal women. Methods: This is a double-blind, placebo-controlled trial. A total of 160 postmenopausal women with amenorrhea ≥ 12 months and age 50-65 years were included. Those with established cardiovascular disease, insulin dependent diabetes, primary hyperparathyroidism, cronic renal failure, liver disorders, and previous use of VD supplementation were excluded. The participants were randomized into two groups: VD group, vitamin D3 supplementation 1,000 IU / day/ orally (n=80) or placebo group (n=80). The intervention time was 9 months, with assessments at baseline and endpoint. Clinical and anthropometric data were collected. Diagnostic criteria for metabolic syndrome (MetS): waist circumference > 88cm; triglycerides ≥ 150mg/dL; HDL < 50mg/dL; blood pressure ≥ 130/85mmHg; glucose ≥ 100mg/dL. The plasma concentration of 25-hydroxyvitamin D [25(OH) D] was measured by HPLC. Biochemical parameters, including total cholesterol, HDL, LDL, triglycerides, glucose, and insulin were measured. Statistical analysis was by intention-to-treat (ITT), using the Student’s t test, the Gamma distribution (asymmetric), the chi-square test, ANOVA and the logistic regression (OR-odds ratio). Results: After 9 months, there was a significant increase in the plasma 25(OH)D levels for VD group (+45.4%, p<.001), and a decrease (-18.5%, p=0.049) in the placebo group. In the VD group, a significant reduction was observed in triglycerides (-12.2%, p=0.001), insulin (-13.7%, p=0.008) and HOMA-IR (-17.9%, p=0.007). In the placebo group, there was an increase in glucose (+6.2%, p=0.009). No significant differences were observed 11 in anthropometric parameters between groups (p>0.05). Analysis of the risk adjusted for age, time since menopause, and BMI showed that women supplemented with VD had a lower risk of MetS (OR 0.42; 95% CI 0.21-0.83), hypertriglyceridemia (OR 0.43; 95% CI 0.22-0.85) and impaired glucose (OR 0.23; 95% CI 0.10-0.52) compared to the placebo group (p<0.05). Conclusions: In postmenopausal women, isolated supplementation with 1,000 IU of vitamin D3 for 9 months was associated with lower cardiometabolic risk. Women undergoing VD supplementation had a lower risk of MetS, hypertriglyceridemia and dysglicemia than women in the placebo group.
Objective: To evaluate the effect of isolated vitamin D (VD) supplementation on cardiometabolic markers in postmenopausal women. Methods: This is a double-blind, placebo-controlled trial. A total of 160 postmenopausal women with amenorrhea ≥ 12 months and age 50-65 years were included. Those with established cardiovascular disease, insulin dependent diabetes, primary hyperparathyroidism, cronic renal failure, liver disorders, and previous use of VD supplementation were excluded. The participants were randomized into two groups: VD group, vitamin D3 supplementation 1,000 IU / day/ orally (n=80) or placebo group (n=80). The intervention time was 9 months, with assessments at baseline and endpoint. Clinical and anthropometric data were collected. Diagnostic criteria for metabolic syndrome (MetS): waist circumference > 88cm; triglycerides ≥ 150mg/dL; HDL < 50mg/dL; blood pressure ≥ 130/85mmHg; glucose ≥ 100mg/dL. The plasma concentration of 25-hydroxyvitamin D [25(OH) D] was measured by HPLC. Biochemical parameters, including total cholesterol, HDL, LDL, triglycerides, glucose, and insulin were measured. Statistical analysis was by intention-to-treat (ITT), using the Student’s t test, the Gamma distribution (asymmetric), the chi-square test, ANOVA and the logistic regression (OR-odds ratio). Results: After 9 months, there was a significant increase in the plasma 25(OH)D levels for VD group (+45.4%, p<.001), and a decrease (-18.5%, p=0.049) in the placebo group. In the VD group, a significant reduction was observed in triglycerides (-12.2%, p=0.001), insulin (-13.7%, p=0.008) and HOMA-IR (-17.9%, p=0.007). In the placebo group, there was an increase in glucose (+6.2%, p=0.009). No significant differences were observed 11 in anthropometric parameters between groups (p>0.05). Analysis of the risk adjusted for age, time since menopause, and BMI showed that women supplemented with VD had a lower risk of MetS (OR 0.42; 95% CI 0.21-0.83), hypertriglyceridemia (OR 0.43; 95% CI 0.22-0.85) and impaired glucose (OR 0.23; 95% CI 0.10-0.52) compared to the placebo group (p<0.05). Conclusions: In postmenopausal women, isolated supplementation with 1,000 IU of vitamin D3 for 9 months was associated with lower cardiometabolic risk. Women undergoing VD supplementation had a lower risk of MetS, hypertriglyceridemia and dysglicemia than women in the placebo group.
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Palavras-chave
vitamina D, mulheres na pós menopausa, sindrome metabolica