Impacto da suplementação de vitamina D em adultos com diabetes Mellitus tipo 2.

Detalhes bibliográficos
Ano de defesa: 2015
Autor(a) principal: Correia, Cristiano De Almeida lattes
Orientador(a): Iunes, Denise Hollanda lattes
Banca de defesa: Cisneiros, Ligia Loiola, Azevedo, Luciana
Tipo de documento: Dissertação
Tipo de acesso: Acesso aberto
Idioma: por
Instituição de defesa: Universidade Federal de Alfenas
Programa de Pós-Graduação: Programa de Pós-Graduação em Biociências Aplicada à Saúde
Departamento: Escola de Enfermagem
País: Brasil
Palavras-chave em Português:
Área do conhecimento CNPq:
Link de acesso: https://repositorio.unifal-mg.edu.br/handle/123456789/542
Resumo: The relationship between diabetes mellitus, its complications and vitamin D deficiency has been shown to be increasingly evident in several recent studies. However, many of these studies are observational and the few intervention studies have short duration or utilize small dosages which turns it difficult to define a causal relationship between these factors. This study aims to evaluate the influence of vitamin D replacement on glycemic control and diabetic complications. Type 2 diabetic patients deficient in vitamin D [25 (OH) vitamin D below 30 ng / ml] were evaluated and randomized in a double-blind fashion concerning to replacement of vitamin D into two groups: group 1 (n = 20) and group 2 (n = 13) that were crossed in the middle of the study. In addition to levels of 25 (OH) vitamin D, plasma concentrations of calcium, phosphorus, magnesium, glycated hemoglobin, fasting glucose, fasting insulin, C-peptide, ultrasensitive PCR, lipid profile and plasma creatinine, along with the albumin / creatinine ratio in spot urine sample were analyzed and calculated HOMA-IR and beta indexes (Homeostasis Model Assessment - Insulin resistance and beta) to determine the degree of insulin resistance and secretion, respectively. The neuropathy was assessed by Neuropathy Symptom Score. Such markers were measured at baseline and after 3 and 6 months of follow-up. At 3 months of follow-up patients had intervention changed (vitamin D3 to placebo and vice versa) featuring a cross-over clinical trial. After data collection and statistical analysis correcting for the intervening sequence or carry-over effect, was observed that none of the variables suffered statistically significant interference by the intervention, including 25-hydroxyvitamin D itself, demonstrating that replacement of vitamin D3 in a dose of 5000 IU per day for three months are not able to lead to changes in the concentration of 25- hydroxyvitamin D, glycemic control parameters, systemic inflammation, lipid profile, the renal function parameters, in albuminuria and Neuropathy Symptom Score. It raises issues about the ideal and proper dosage of vitamin D3 to bring forth a real increase in concentrations of 25-hydroxyvitamin D and thus influence glycemic control nephropathy and neuropathy in type 2 diabetic patients.
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spelling Correia, Cristiano De Almeidahttp://lattes.cnpq.br/4799089011745198Cisneiros, Ligia LoiolaAzevedo, LucianaIunes, Denise Hollandahttp://lattes.cnpq.br/29130555359305742015-06-25T18:20:51Z2015-01-29CORREIA, Cristiano de Almeida. Impacto da suplementação de vitamina D em adultos com diabetes Mellitus tipo 2.. 2015. 47 f. Dissertação (Mestrado em Biociências Aplicada à Saúde) - Universidade Federal de Alfenas, Alfenas, MG, 2015.https://repositorio.unifal-mg.edu.br/handle/123456789/542The relationship between diabetes mellitus, its complications and vitamin D deficiency has been shown to be increasingly evident in several recent studies. However, many of these studies are observational and the few intervention studies have short duration or utilize small dosages which turns it difficult to define a causal relationship between these factors. This study aims to evaluate the influence of vitamin D replacement on glycemic control and diabetic complications. Type 2 diabetic patients deficient in vitamin D [25 (OH) vitamin D below 30 ng / ml] were evaluated and randomized in a double-blind fashion concerning to replacement of vitamin D into two groups: group 1 (n = 20) and group 2 (n = 13) that were crossed in the middle of the study. In addition to levels of 25 (OH) vitamin D, plasma concentrations of calcium, phosphorus, magnesium, glycated hemoglobin, fasting glucose, fasting insulin, C-peptide, ultrasensitive PCR, lipid profile and plasma creatinine, along with the albumin / creatinine ratio in spot urine sample were analyzed and calculated HOMA-IR and beta indexes (Homeostasis Model Assessment - Insulin resistance and beta) to determine the degree of insulin resistance and secretion, respectively. The neuropathy was assessed by Neuropathy Symptom Score. Such markers were measured at baseline and after 3 and 6 months of follow-up. At 3 months of follow-up patients had intervention changed (vitamin D3 to placebo and vice versa) featuring a cross-over clinical trial. After data collection and statistical analysis correcting for the intervening sequence or carry-over effect, was observed that none of the variables suffered statistically significant interference by the intervention, including 25-hydroxyvitamin D itself, demonstrating that replacement of vitamin D3 in a dose of 5000 IU per day for three months are not able to lead to changes in the concentration of 25- hydroxyvitamin D, glycemic control parameters, systemic inflammation, lipid profile, the renal function parameters, in albuminuria and Neuropathy Symptom Score. It raises issues about the ideal and proper dosage of vitamin D3 to bring forth a real increase in concentrations of 25-hydroxyvitamin D and thus influence glycemic control nephropathy and neuropathy in type 2 diabetic patients.A relação entre diabetes mellitus e suas complicações e a deficiência de vitamina D tem se mostrado cada vez mais evidente em diversos estudos realizados recentemente. No entanto, muitos destes estudos são observacionais e os poucos estudos de intervenção possuem curto tempo de duração ou utilizam doses que seriam insuficientes, dificultando a definição de uma relação causal entre tais fatores. Este estudo tem como objetivo avaliar a influência da reposição de vitamina D sobre o controle glicêmico e complicações diabéticas. Foram avaliados pacientes diabéticos tipo 2, com deficiência de vitamina D [25(OH)vitamina D abaixo de 30 ng/mL], sendo que tais pacientes foram aleatorizados de forma duplo-cega quanto à reposição de vitamina D3, na dose de 5000 UI diárias durante 3 meses, em dois grupos: grupo1 (n=20) e grupo 2 (n=13), que foram cruzados na metade do estudo. Foram analisadas, além dos níveis de 25(OH) vitamina D, indicadores de controle glicêmico, de inflamação sistêmica, além de outras variáveis secundárias. A neuropatia foi avaliada por meio do Escore de Sintomas Neuropáticos. Tais indicadores foram medidos no início do estudo e após 3 e 6 meses de seguimento dos pacientes. Aos 3 meses do estudo, os pacientes tiveram a intervenção alternada (de placebo para vitamina D3 e vice-versa), caracterizando um ensaio clínico cruzado ou cross-over. Após coleta dos dados e análise estatística, corrigindo-se para o efeito da sequência de intervenção, ou efeito carry-over, observou-se que nenhuma das variáveis analisadas sofreu influência estatisticamente significativa da intervenção, incluindo a própria 25-hidroxivitamina D. Dessa forma, ficou demonstrado que a reposição de vitamina D3 na dose de 5.000 UI diárias por três meses não é capaz de levar a modificações nas concentrações de 25-hidroxivitamina D, nos parâmetros de controle glicêmico, de inflamação sistêmica, no perfil lipídico, na função renal, na albuminúria e no Escore de Sintomas Neuropáticos. Tal fato suscita questões sobre a posologia ideal e dose adequada de vitamina D3 para gerar repercussão, isto é, aumento real nas concentrações de 25-hidroxivitamina D, e, assim, influenciar o controle glicêmico e os indicadores de nefropatia e neuropatia em pacientes portadores de diabetes mellitus tipo 2.application/pdfporUniversidade Federal de AlfenasPrograma de Pós-Graduação em Biociências Aplicada à SaúdeUNIFAL-MGBrasilEscola de Enfermageminfo:eu-repo/semantics/openAccesshttp://creativecommons.org/licenses/by-nc-nd/4.0/Diabetes mellitus tipo 2Vitamina D.Neuropatias DiabéticasCLINICA MEDICA::ENDOCRINOLOGIAImpacto da suplementação de vitamina D em adultos com diabetes Mellitus tipo 2.info:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/publishedVersion-32045805305363604936006001252871826233884142reponame:Repositório Institucional da Universidade Federal de Alfenas - RiUnifalinstname:Universidade Federal de Alfenas (UNIFAL)instacron:UNIFALCorreia, Cristiano De AlmeidaLICENSElicense.txtlicense.txttext/plain; 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dc.title.pt-BR.fl_str_mv Impacto da suplementação de vitamina D em adultos com diabetes Mellitus tipo 2.
title Impacto da suplementação de vitamina D em adultos com diabetes Mellitus tipo 2.
spellingShingle Impacto da suplementação de vitamina D em adultos com diabetes Mellitus tipo 2.
Correia, Cristiano De Almeida
Diabetes mellitus tipo 2
Vitamina D.
Neuropatias Diabéticas
CLINICA MEDICA::ENDOCRINOLOGIA
title_short Impacto da suplementação de vitamina D em adultos com diabetes Mellitus tipo 2.
title_full Impacto da suplementação de vitamina D em adultos com diabetes Mellitus tipo 2.
title_fullStr Impacto da suplementação de vitamina D em adultos com diabetes Mellitus tipo 2.
title_full_unstemmed Impacto da suplementação de vitamina D em adultos com diabetes Mellitus tipo 2.
title_sort Impacto da suplementação de vitamina D em adultos com diabetes Mellitus tipo 2.
author Correia, Cristiano De Almeida
author_facet Correia, Cristiano De Almeida
author_role author
dc.contributor.author.fl_str_mv Correia, Cristiano De Almeida
dc.contributor.advisor1Lattes.fl_str_mv http://lattes.cnpq.br/4799089011745198
dc.contributor.referee1.fl_str_mv Cisneiros, Ligia Loiola
dc.contributor.referee2.fl_str_mv Azevedo, Luciana
dc.contributor.advisor1.fl_str_mv Iunes, Denise Hollanda
dc.contributor.authorLattes.fl_str_mv http://lattes.cnpq.br/2913055535930574
contributor_str_mv Cisneiros, Ligia Loiola
Azevedo, Luciana
Iunes, Denise Hollanda
dc.subject.por.fl_str_mv Diabetes mellitus tipo 2
Vitamina D.
Neuropatias Diabéticas
topic Diabetes mellitus tipo 2
Vitamina D.
Neuropatias Diabéticas
CLINICA MEDICA::ENDOCRINOLOGIA
dc.subject.cnpq.fl_str_mv CLINICA MEDICA::ENDOCRINOLOGIA
description The relationship between diabetes mellitus, its complications and vitamin D deficiency has been shown to be increasingly evident in several recent studies. However, many of these studies are observational and the few intervention studies have short duration or utilize small dosages which turns it difficult to define a causal relationship between these factors. This study aims to evaluate the influence of vitamin D replacement on glycemic control and diabetic complications. Type 2 diabetic patients deficient in vitamin D [25 (OH) vitamin D below 30 ng / ml] were evaluated and randomized in a double-blind fashion concerning to replacement of vitamin D into two groups: group 1 (n = 20) and group 2 (n = 13) that were crossed in the middle of the study. In addition to levels of 25 (OH) vitamin D, plasma concentrations of calcium, phosphorus, magnesium, glycated hemoglobin, fasting glucose, fasting insulin, C-peptide, ultrasensitive PCR, lipid profile and plasma creatinine, along with the albumin / creatinine ratio in spot urine sample were analyzed and calculated HOMA-IR and beta indexes (Homeostasis Model Assessment - Insulin resistance and beta) to determine the degree of insulin resistance and secretion, respectively. The neuropathy was assessed by Neuropathy Symptom Score. Such markers were measured at baseline and after 3 and 6 months of follow-up. At 3 months of follow-up patients had intervention changed (vitamin D3 to placebo and vice versa) featuring a cross-over clinical trial. After data collection and statistical analysis correcting for the intervening sequence or carry-over effect, was observed that none of the variables suffered statistically significant interference by the intervention, including 25-hydroxyvitamin D itself, demonstrating that replacement of vitamin D3 in a dose of 5000 IU per day for three months are not able to lead to changes in the concentration of 25- hydroxyvitamin D, glycemic control parameters, systemic inflammation, lipid profile, the renal function parameters, in albuminuria and Neuropathy Symptom Score. It raises issues about the ideal and proper dosage of vitamin D3 to bring forth a real increase in concentrations of 25-hydroxyvitamin D and thus influence glycemic control nephropathy and neuropathy in type 2 diabetic patients.
publishDate 2015
dc.date.accessioned.fl_str_mv 2015-06-25T18:20:51Z
dc.date.issued.fl_str_mv 2015-01-29
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dc.identifier.citation.fl_str_mv CORREIA, Cristiano de Almeida. Impacto da suplementação de vitamina D em adultos com diabetes Mellitus tipo 2.. 2015. 47 f. Dissertação (Mestrado em Biociências Aplicada à Saúde) - Universidade Federal de Alfenas, Alfenas, MG, 2015.
dc.identifier.uri.fl_str_mv https://repositorio.unifal-mg.edu.br/handle/123456789/542
identifier_str_mv CORREIA, Cristiano de Almeida. Impacto da suplementação de vitamina D em adultos com diabetes Mellitus tipo 2.. 2015. 47 f. Dissertação (Mestrado em Biociências Aplicada à Saúde) - Universidade Federal de Alfenas, Alfenas, MG, 2015.
url https://repositorio.unifal-mg.edu.br/handle/123456789/542
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