Prevalência de hipovitaminose D em um grupo de pacientes com doenças autoimunes
Prevalence of vitamin D deficiency in a group of patients with autoimmune diseases
Saulo Fernando de Carvalho Virgolino, Thays Gianini Siqueira Pacheco, Ana Maria Rampelotti Almeida
Resumo
Introdução: Doenças autoimunes afetam cerca de 7% da população mundial, chegando a ser consideradas um problema de saúde pública. Além do importante papel relacionado à homeostase óssea, estudos atuais têm relacionado a hipovitaminose D com várias doenças autoimunes, pois o calcitriol possui diversas atividades no corpo humano, entre elas imunomoduladores, visto que os linfócitos T e B possuem o receptor de ligação de vitamina D. O objetivo desta pesquisa é avaliar os níveis de vitamina D e realizar a classificação mediante o resultado da avaliação. Método: Estudo do tipo transversal descritivo, por meio de revisão de prontuários, sendo selecionados um grupo de pacientes com doenças autoimunes, avaliando os níveis séricos de 25-OH-Vit.D, 1,25-(OH)2-Vit.D3 e PTH molécula inteira. Resultados: O número de prontuários coletados foi de 384 pacientes, 275 do sexo masculino (71,61%) e 109 do sexo feminino (28,39%), com idade média de 43,9±11,8 anos. A prevalência de hipovitaminose D no grupo avaliado foi de 89,06%, sendo classificados em níveis deficiente e insuficiente cerca de 13,5% e 75,5%, respectivamente. Aproximadamente 82% dos pacientes apresentaram níveis de 1,25-hidroxivitamina2D3 dentro dos valores de referência, porém este não é considerado um bom parâmetro de avaliação, em razão de possuir um curto tempo de meia-vida e sofrer influência dos níveis séricos de cálcio e paratormônio. Em relação aos níveis de paratormônio PTH, foi observado que todos pacientes estão dentro dos valores de referência (15,0 – 65,0 pg/ml). Conclusão: Foi demonstrado que os pacientes com doenças autoimunes analisados apresentam um nível evidente de hipovitaminose D, o que pode ser considerado um agravante à autoimunidade.
Palavras-chave
Abstract
Introduction: Autoimmune diseases affect about 7% of the world, coming to be considered a public health problem. Besides the important role related to bone homeostasis, recent studies have related vitamin D deficiency with several autoimmune diseases because calcitriol has several activities in the human body, including immunomodulators, as the T and B lymphocytes have the vitamin D receptor binding. The objective of this research is to assess the levels of vitamin D and perform the classification by the evaluation result. Methods: Study of descriptive cross-sectional through chart review and selected a group of patients with autoimmune diseases, evaluating serum levels of 25-OH-Vit.D, 1,25- (OH) 2 Vit.D3 and PTH entire molecule. Results: The number of records was collected from 384 patients, 275 were male (71.61%) and 109 females (28.39%) with a mean age of 43.9±11.8 years. The prevalence of vitamin D deficiency in the studied group was of 89.06% when classified as deficient and insufficient levels about 13.5% and 75.5% respectively. Approximately 82% of patients had levels of 1,25-hidroxivitamina2D3 within the reference values, but this is not considered a good parameter to assess, due to have a short half-life and be influenced by serum calcium levels and parathyroid hormone. Related to the levels of parathyroid hormone PTH was observed that all patients are within the reference range (15.0 - 65.0 pg / ml). Conclusion: It has been demonstrated that patients with autoimmune diseases analyzed present one evident level of vitamin D deficiency, which can be regarded as an aggravating autoimmunity
Keywords
Referências
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Submetido em:
05/01/2017
Aceito em:
23/03/2017
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