Niveles de vitamina d y prevalencia de déficit de vitamina d en mujeres postmenopáusicas mayores de 50 años en Bogotá

Objetivo: Describir los niveles de vitamina D y calcular prevalencia de déficit de vitamina D en mujeres postmenopáusicas mayores de 50 años que asisten a consulta de medicina general en una muestra en de la ciudad de Bogotá durante el periodo 2013-2014. Pacientes y métodos: Realizamos un estudio descriptivo para estimar el déficit de VD en mujeres postmenopáusicas entre 50 y 80 años en la ciudad de Bogotá y la prevalencia de hipovitaminosis D. Durante el periodo octubre 2013 a octubre 2014 se analizaron 320 muestras, se identificaron las características socio-demográficas, patológicas y la exposición a radiación ultravioleta de cada participante. Se realizó un análisis descriptivo de las variables, se estableció su asociación con el déficit de vitamina D su aporte estadístico con al mismo. Resultados :El promedio de edad en la muestra fue de 61 años y el promedio de edad en la que reportaron la ultima menstruación fue a los 43 años. Con respecto a las características socio-demográficas 50% de las mujeres pertenecieron a los estratos 3 y 4, únicamente 11% de los pacientes realizaron una carrera universitaria y 73% de la mujeres fueron amas de casa. Con respecto a los niveles de vitamina D, 81% de los pacientes presentaron niveles anormales y el promedio de 25(OH)D en la población estudio fue de 19,81ng/ml. Conclusión: La prevalencia de déficit de vitamina D en mujeres bogotanas postmenopáusicas es significativo. Se requiere incrementar la exposición solar o dar suplencia con vitamina D para disminuir el riesgo de fracturas.

Bone mineral density of tibae and femura of broiler breeders: growth, development and production

The aim of this study was to follow-up the physiological variations in the development of the bone tissue, associating them with the egg production curve. This study was carried out in the facilities of the Faculdade de Medicina Veterinária e Zootecnia of the UNESP, Botucatu, Brazil. Twenty-three families of Ross broiler breeders were used, each family consisting of 13 females and 1 male, distributed in 23 pens of 5.0m² each. The management was that recommended by the genetic company manual (Agroceres Ross, 2003), with daily feeding until 6th week of age; and birds were fed according to a 5:2 schedule (5 days fed, 2 days of fasting) between 7 and 17 weeks of age, returning to daily feeding starting at 18 weeks of age. Birds did not receive afternoon calcium supplementation. on the fourth week of rearing, 84 females were removed for bone analyses of the right tibia and femur, using optical densitometry in radiographic images technique. These analyses were sequentially carried out in 4, 8, 12, 15, 20, 24, 30, 35, 42, 47, and 52 week-old birds. The egg production curve of the birds was followed-up and associated to bone mineral density results. For bone mineral density evaluation (BMD) birds were divided by weight categories as light, intermediate, or heavy within each data age. BMD values of the tibias were not influenced by weight range, but by the age at collection. on the other hand, interactions were found among femur BMD values and weight and age categories. There was no correlation between eggshell quality and femur BMD. A negative correlation (-0.15) was observed between tibia BMD and eggshell percentage. It was possible to conclude that the egg production has little influence on bone mineral density of the birds probably because there was no need of bone mineral mobilization during the production period, since the observed egg production was below that observed under commercial conditions.

Avaliação da densidade mineral óssea em matrizes pesadas por meio da técnica de densitometria óptica em imagens radiográficas

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Comportamento do cálcio e fósforo plasmáticos, em pacientes com hipoparatireoidismo, após administração de carbonato de cálcio em diferentes formas de ingestão

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Glucocorticosteroid-induced spinal osteoporosis: scientific update on pathophysiology and treatment

Glucocorticosteroid-induced spinal osteoporosis (GIOP) is the most frequent of all secondary types of osteoporosis. The understanding of the pathophysiology of glucocorticoid (GC) induced bone loss is of crucial importance for appropriate treatment and prevention of debilitating fractures that occur predominantly in the spine. GIOP results from depressed bone formation due to lower activity and higher death rate of osteoblasts on the one hand, and from increase bone resorption due to prolonged lifespan of osteoclasts on the other. In addition, calcium/phosphate metabolism may be disturbed through GC effects on gut, kidney, parathyroid glands and gonads. Therefore, therapeutic agents aim at restoring balanced bone cell activity by directly decreasing apoptosis rate of osteoblasts (e.g., cyclical parathyroid hormone) or by increasing apoptosis rate of osteoclasts (e.g., bisphosphonates). Other therapeutical efforts aim at maintaining/restoring calcium/phosphate homeostasis: improving intestinal calcium absorption (using calcium supplementation, vitamin D and derivates) and avoiding increased urinary calcium loss (using thiazides) prevent or counteract a secondary hyperparthyroidism. Bisphosphonates, particularly the aminobisphosphonates risedronate and alendronate, have been shown to protect patients on GCs from (further) bone loss to reduce vertebral fracture risk. Calcitonin may be of interest in situation where bisphosphonates are contraindicated or not applicable and in cases where acute pain due to vertebral fracture has to be manage. The intermittent administration of 1-34-parathormone may be an appealing treatment alternative, based on its documented anabolic effects on bone resulting from the reduction of osteoblastic apoptosis. Calcium and vitamin D should be a systematic adjunctive measure to any drug treatment for GIOP. Based on currently available evidence, fluoride, androgens, estrogens (opposed or unopposed) cannot be recommended for the prevention and treatment of GIOP. However, substitution of gonadal hormones may be indicated if GC-induced hypogonadism is present and leads to clinical symptoms. Data using the SERM raloxifene to treat or prevent GIOP are lacking, as are data using the promising bone anabolic agent strontium ranelate. Kyphoplasty performed in appropriately selected osteoporotic patients with painful vertebral fractures is a promising addition to current medical treatment.

Citrate- vs. acetate-based dialysate in bicarbonate haemodialysis: consequences on haemodynamics, coagulation, acid-base status, and electrolytes

BACKGROUND: A concentrate for bicarbonate haemodialysis acidified with citrate instead of acetate has been marketed in recent years. The small amount of citrate used (one-fifth of the concentration adopted in regional anticoagulation) protects against intradialyser clotting while minimally affecting the calcium concentration. The aim of this study was to compare the impact of citrate- and acetate-based dialysates on systemic haemodynamics, coagulation, acid-base status, calcium balance and dialysis efficiency. METHODS: In 25 patients who underwent a total of 375 dialysis sessions, an acetate dialysate (A) was compared with a citrate dialysate with (C+) or without (C) calcium supplementation (0.25 mmol/L) in a randomised single-blind cross-over study. Systemic haemodynamics were evaluated using pulse-wave analysis. Coagulation, acid-base status, calcium balance and dialysis efficiency were assessed using standard biochemical markers. RESULTS: Patients receiving the citrate dialysate had significantly lower systolic blood pressure (BP) (-4.3 mmHg, p < 0.01) and peripheral resistances (PR) (-51 dyne.sec.cm-5, p < 0.001) while stroke volume was not increased. In hypertensive patients there was a substantial reduction in BP (-7.8 mmHg, p < 0.01). With the C+ dialysate the BP gap was less pronounced but the reduction in PR was even greater (-226 dyne.sec.cm-5, p < 0.001). Analyses of the fluctuations in PR and of subjective tolerance suggested improved haemodynamic stability with the citrate dialysate. Furthermore, an increase in pre-dialysis bicarbonate and a decrease in pre-dialysis BUN, post-dialysis phosphate and ionised calcium were noted. Systemic coagulation activation was not influenced by citrate. CONCLUSION: The positive impact on dialysis efficiency, acid-base status and haemodynamics, as well as the subjective tolerance, together indicate that citrate dialysate can significantly contribute to improving haemodialysis in selected patients.

Respuestas fisiológicas a la suplementación con calcio de plántulas de vinal (Prosopis ruscifolia G.) estresadas con NaCl

Vinal (Prosopis ruscifolia G.) es una especie de importancia forestal, nativa de la Región Fitogeográfica del Chaco Occidental, altamente tolerante al estrés salino. El objetivo de este trabajo fue poner a prueba la hipótesis de que la suplementación con CaSO4 disminuye la concentración de iones tóxicos en plántulas de vinal, e incrementa la concentración de prolina, permitiendo un ajuste osmótico. Las plántulas se cultivaron en solución nutritiva de Hoagland al 25%, con o sin la adición de 0,4 mol L-1 de NaCl, y con o sin suplementación de 5 ó 10 mmol L-1 de CaSO4. Se determinó la materia seca, composición mineral, contenido relativo de agua y concentraciones de prolina y azúcares solubles. Se utilizó un diseño experimental completamente aleatorizado con cinco repeticiones, y los resultados se analizaron con ANOVA y test de Tukey. Los resultados obtenidos en este trabajo confirman el rol protector del Ca+2, a través de la manutención de las concentraciones de Ca+2, K+ y Mg+2 en los tejidos, la inhibición de la absorción de Na+ y el ajuste osmótico mediante la síntesis de solutos osmocompatibles.

Transient prenatal vitamin D deficiency is associated with hyperlocomotion in adult rats

Rat experiments have shown that prenatal Vitamin D deficiency leads to altered neonatal brain morphology, cell density and neurotrophin expression. In the current study we examined the hypothesis that Vitamin D deficiency during early development alters adult behaviour even when there is an intervening period in which the animal receives normal Vitamin D in later development. Rats were conceived and born to Vitamin D deficient dams (Birth); conceived, born and weaned from Vitamin D deficient dams (Weaning); or deficient in Vitamin D from conception to 10 weeks of age (Life). Litters were standardized to three males and three females per litter. All rat offspring were rendered normocalcaemic with calcium supplemented water (2 mM) after weaning. Control animals were born to mothers fed a normal diet but subject to similar litter size and calcium supplementation. At 10 weeks all animals were tested on the holeboard test, elevated plus maze test, social interaction observation, acoustic startle response test, prepulse inhibition of the acoustic startle response and a forced swim test. Early Vitamin D deficiency (Birth group) enhanced locomotion in the holeboard test and increased activity in the elevated plus maze. Thus, transient prenatal Vitamin D deficiency induces hyperlocomotion in adulthood, without severe motor abnormalities. (C) 2004 Elsevier B.V. All rights reserved.

Preeclampsia prevention: a case-control study nested in a cohort

Introduction: Preeclampsia is the main complication of pregnancy in developing countries. Calcium starting at 14 weeks of pregnancy is indicated to prevent the disease. Recent advances in prevention of preeclampsia endorse the addition of conjugated linoleic acid. Objective: To estimate the protective effect from calcium alone, compared to calcium plus conjugated linoleic acid in nulliparous women at risk of preeclampsia. Methods: A case-control design nested in the cohort of nulliparous women attending antenatal care from 2010 to 2014. The clinical histories of 387 cases of preeclampsia were compared with 1,054 normotensive controls. The exposure was prescriptions for calcium alone, the first period, or calcium plus conjugated linoleic acid, the second period, from 12 to 16 weeks of gestational age to labor. Confounding variables were controlled, allowing only nulliparous women into the study and stratifying by age, education and ethnic group. Results: The average age was 26.4 yrs old (range= 13-45), 85% from mixed ethnic backgrounds and with high school education. There were no differences between women who received calcium carbonate and those who did not (OR= 0.96; 95% CI= 0.73–1.27). The group of adolescents (13 to 18 yrs old) in the calcium plus conjugated linoleic acid was protected for preeclampsia (OR= 0.00; 95% CI= 0.00–0.44) independent of the confounder variables. Conclusions: 1. Calcium supplementation during pregnancy did not have preventive effects on preeclampsia. 2. Calcium plus Conjugated Linoleic acid provided to adolescents was observed to have preventive effect on Preeclampsia.

Preeclampsia prevention: a case-control study nested in the cohort

Introduction: Preeclampsia is the main complication of pregnancy in developing countries. Calcium starting at 14 weeks of pregnancy is indicated to prevent the disease. Recent advances in prevention of preeclampsia endorse the addition of conjugated linoleic acid. Objective: To estimate the protective effect from calcium alone, compared to calcium plus conjugated linoleic acid in nulliparous women at risk of preeclampsia. Methods: A case-control design nested in the cohort of nulliparous women attending antenatal care from 2010 to 2014. The clinical histories of 387 cases of preeclampsia were compared with 1,054 normotensive controls. The exposure was prescriptions for calcium alone, the first period, or calcium plus conjugated linoleic acid, the second period, from 12 to 16 weeks of gestational age to labor. Confounding variables were controlled, allowing only nulliparous women into the study and stratifying by age, education and ethnic group. Results: The average age was 26.4 yrs old (range= 13-45), 85% from mixed ethnic backgrounds and with high school education. There were no differences between women who received calcium carbonate and those who did not (OR= 0.96; 95% IC= 0.73–1.27). The group of adolescents (13 to 18 yrs old) in the calcium plus conjugated linoleic acid was protected for preeclampsia (OR= 0.00; 95% CI= 0.00–0.44) independent of the confounder variables. Conclusions: 1. Calcium supplementation during pregnancy did not have preventive effects on preeclampsia. 2. Calcium plus Conjugated Linoleic acid provided to adolescents was observed to have preventive effect on Preeclampsia.

Effect of dietary supplementation of vitamins A, D-3, E, and C on yearling rice field eel, Monopterus albus: Serum indices, gonad development, and metabolism of calcium and phosphorus

The objective of this study was to determine the effect of dietary vitamins A, D-3, E, and C on the gonad development, lipid peroxidation, and immune response of yearling rice field eel, Monopterus albus. A 6-wk feeding trial was designed according to an L-16(4(5)) orthogonal design, in which four vitamins, each at four supplementation levels, were arranged. Sixteen diets were mixed with the different vitamin levels and randomly assigned to 16 groups of fish. Increasing dietary vitamin E supplementation level significantly (P <= 0.05) increased the gonadosomatic index and lowered the serum content of malondialdehyde of rice field eel. Increasing dietary vitamin A and C levels also showed similar effect, but the differences were not statistically significant. Serum immunoglobulin M content increased significantly (P <= 0.01) as dietary vitamin C supplementation levels increased. The concentrations of calcium in bones showed significant (P <= 0.05) trend with vitamin D-3 and A supplementation levels, but the bone phosphorus content was not affected by the dietary vitamin levels.

Strategic supplementation of calcium salts of polyunsaturated fatty acids to enhance reproductive performance of Bos indicus beef cows

Five experiments evaluated the effects of supplemental Ca salts of PUFA on reproductive function of Bos indicus beef cows. In Exp. 1, nonlactating and multiparous grazing cows (n = 51) were assigned to receive (as-fed basis) 0.1 kg of a protein-mineral mix + 0.1 kg of ground corn per cow/d, in addition to 0.1 kg per cow/d of 1) Ca salts of PUFA (PF), 2) Ca salts of SFA (SF), or 3) kaolin (control). Treatments were offered from d 0 to 20 of the estrous cycle. No treatment effects were detected on serum progesterone concentrations (P = 0.83), day of luteolysis (P = 0.86), or incidence of short cycles (P = 0.84). In Exp. 2, nonlactating and multiparous grazing cows (n = 43) were assigned to receive PF, SF, or control from d 0 to 8 of the estrous cycle. on d 6, all cows received (intramuscularly) 25 mg of PGF(2 alpha). No treatment effects were detected on serum progesterone concentrations on d 6 (P = 0.37), and incidence (P = 0.67) or estimated time of luteolysis (P = 0.44). In Exp. 3, twenty-seven lactating and multiparous grazing cows, approximately 30 to 40 d postpartum, were assigned to receive PF or control for 10 d beginning at the first postpartum ovulation. No treatment effects were detected (P = 0.85) on incidence of short cycles. In Exp. 4, lactating and multiparous grazing cows (n = 1,454), approximately 40 to 60 d postpartum, were assigned to receive 1 of the 7 treatments for 28 d after timed AI (TAI; d 0): 1) control from d 0 to 28, 2) SF from d 0 to 14 and then control, 3) PF from d 0 to 14 and then control, 4) SF from d 0 to 21 and then control, 5) PF from d 0 to 21 and then control, 6) SF from d 0 to 28, and 7) PF from d 0 to 28. Cows receiving PF for more than 21 d after TAI had greater (P < 0.01) pregnancy to TAI compared with all other treatments combined (50.4 vs. 42.4%, respectively). In Exp. 5, lactating and multiparous grazing cows (n = 501), approximately 40 to 60 d postpartum, were assigned to receive 1 of the 4 treatments for 21 d after TAI (d 0): 1) PF from d 0 to 14 and then control, 2) control from d 0 to 6 and then PF, 3) control from d 0 to 13 and then PF, and 4) PF from d 0 to 21. Cows receiving PF after d 14 of the experiment had greater (P = 0.02) pregnancy to TAI compared with cows not receiving PF during the same period (46.8 vs. 33.1%, respectively). In summary, supplemental Ca salts of PUFA during the expected time of luteolysis increased pregnancy to TAI in beef cows.

Effects of supplementation of calcium salts of polyunsaturated fatty acids on serum concentrations of progesterone and insulin of pregnant dairy cows

Forty-five non-lactating, pregnant Holstein animals (18 heifers and 27 multiparous cows; BW = 561 +/- 114 kg; BCS = 2.9 +/- 0.3; days pregnant = 110 +/- 56 d) were stratified by initial BW and BCS, and randomly assigned to receive daily (as-fed basis) 0.50 kg of ground corn plus 0.22 kg of kaolin (CON), calcium salts of saturated fatty acids (SFA) or polyunsaturated fatty acids (PF) for 14 d. Blood samples were collected on days 0, 7 and 14, immediately prior to (0 h) and 3, 6, 9 and 12 h after feeding, to determine the serum concentrations of P 4 and insulin. No treatment effects were detected for serum concentrations of P 4 (5.52, 6.13 and 5.63 +/- 0.41 ng/mL for CON, SFA and PF, respectively). No treatment effects were detected for serum concentrations of insulin (11.5, 10.5 and 10.1 +/- 1.43 mu IU/mL for CON, SFA and PF, respectively). Heifers had greater serum concentrations of P 4 than multiparous cows (6.35 vs. 5.16 +/- 0.42 ng/mL), but lower serum concentrations of insulin (7.0 vs. 14.4 +/- 1.49 mu IU/mL). Feeding 0.22 kg of calcium salts of polyunsaturated fatty acids is not sufficient to increase the serum concentrations of P 4 and insulin of non-lactating, pregnant dairy cows.

Effects of dietary supplementation with synthetic vitamin D-3 and 25-hydroxycholecalciferol on blood calcium and phosphate levels and performance in laying hens

We investigated the effects of different dietary vitamin D regimen on selected blood parameters in laying hens. Supplementation with vitamin D-3 only was compared with a combination of vitamin D-3 and its metabolite 25-hydroxy-cholecalciferol (25(OH)D-3). Blood concentrations of total calcium, phosphate and 25 (OH)D-3 were determined. Four thousand one-day-old LSL chicks were split in two treatment groups and distributed to eight pens. The control group was given a commercial animal diet containing 2800 IU synthetic vitamin D-3 in the starter feed and 2000 IU synthetic vitamin D-3 in the pullet feed. The experimental group was fed the same commercial diet in which half the synthetic vitamin D-3 content had been substituted with 25(OH)D-3 (Hy center dot D (R)). At 18 weeks of age, pullets were transferred to the layer house. At the ages of 11, 18 and 34 weeks, between 120 and 160 blood samples were collected from both the control and the experimental groups, respectively. The experimental group had higher levels of 25 (OH)D-3 than the control group at all three ages. Serum calcium levels did not differ between the treatment groups at any age. With the onset of laying, calcium levels rose significantly. Whereas blood serum concentration at 18 weeks was 3 mmol/L in both treatment groups, it increased to 8.32 mmol/L in the control group and to 8.66 mmol/L in the experimental group at week 34. At weeks 11 and 34, phosphate was significantly lower in the experimental group. In conclusion, HyD (R) significantly affected serum phosphate and 25(OH)D-3 levels. No effects of (25(OH)D-3 supplementation on performance, shell quality and fractures of keelbones were found.

Effect of disodium monofluorophosphate, calcium and vitamin D supplementation on bone mineral density in patients chronically treated with glucocorticosteroids: a prospective, randomized, double-blind study

To study the effect of fluoride on bone mineral density (BMD) in patients treated chronically with glucocorticosteroids, 15 subjects (renal grafted, n = 12; skin disease, n = 1; broncho pulmonary disorder, n = 1; Crohn's disease, n = 1) were prospectively studied in a double-blinded manner and randomly allocated either to group 1 (n = 8) receiving 13.2 mg/day fluoride given as disodium monofluorophosphate (MFP) supplemented with calcium (1,000 mg/day) and 25-hydroxyvitamin D (calcifediol) (50 micrograms/day), or to group 2 (n = 7) receiving Cas+ calcifediol alone. An additional group of 14 renal transplant patients treated chronically with glucocorticosteroids but exempt of specific therapeutic intervention for bone disease was set up as historical controls. BMD was measured by dual-energy X-ray absorptiometry (DXA, Hologic QDR 1000) performed at months 0, 6 and 12 for groups 1 and 2 (lumbar spine, total upper femur, diaphysis and epiphysis of distal tibia), or 11-31 months apart with calculation of linear yearly changes for the historical cohort. Lumbar BMD tended to rise in groups 1 and 2, and to fall in group 3, the change reaching statistical significance (p < 0.05) in group 1, thus leading to a significant difference between groups 1 and 3 (p < 0.05). At upper femur, tibial diaphysis and tibial epiphysis, no significant change in BMD occurred in any of the groups. In conclusion, lumbar BMD rises more after a mild dosis of fluoride given as MFP and combined to calcium and calcifediol than on Ca+ calcifediol alone, without changes in BMD at the upper femur or distal tibia.