Nivel de vitamina D y factores de riesgo cardiometabólicos en una población Pediátrica
Palabras clave:
Vitamina D, enfermedades cardiovasculares, síndrome metabólico, niños.Resumen
Introducción: En los últimos años se ha observado que niveles bajos de vitamina D puede influir en el desarrollo de enfermedad cardiovascular en el futuro. Objetivo: Examinar la asociación entre los niveles séricos de vitamina D y factores de riesgo de enfermedad cardiovascular y síndrome metabólico en una población pediátrica. Material y Método: Estudio observacional, descriptivo con componente analítico, que incluyó 209 pacientes en quienes se midió los niveles séricos de 25 hidroxi-vitaminaD (25[OH]D) y los factores de riesgo cardiovasculares según los criterios del Panel de Tratamiento de Adultos III (APT III) modificado. Se comparó los grupos mediante pruebas T de Student independientes. Se consideró significativo un valor de p<0,05 para las pruebas a dos colas. Resultados: El valor promedio de 25(OH)D fue de 34,9ng/mL. La media de los niveles de 25(OH)D fue inferior en los subgrupos de pacientes con factor de riesgo cardiovascular, es decir: obesidad abdominal, hipertensión arterial, glicemia en ayunas elevada, HDL-colesterolememia baja y trigliceridemia elevada, sin embargo dicha diferencia no fue estadísticamente significativa. Conclusión: Los pacientes con factores de riesgo cardiovascular presentaron niveles más bajos de vitamina D, sin embargo la diferencia no resultó estadísticamente significativa. Se requieren otros estudios para determinar si los niveles bajos de vitamina D durante la infancia y la adolescencia pueden impactar en el desarrollo posterior de enfermedad cardiovascular en la edad adulta.
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5. Outila TA, Karkkainen MU, Lamberg-Allardt CJ. Vitamin D status affects serum parathyroid hormone concentrations during winter in female adolescents: associations with forearm bone mineral density. Am J Clin Nutr. 2001;74(2):206-10. [ Links ]
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14. Knekt P, Laaksonen M, Mattila C, Härkänen T, Marniemi J, Heliövaara M, Rissanen H, Montonen J, Reunanen A. Serum vitamin D and subsequent occurrence of type 2 diabetes. Epidemiology. 2008;19(5):666-71. [ Links ]
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25. Cook S, Weitzman M, Auinger P, Nguyen M, Dietz WH. Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third National Health and Nutrition Examination Survey, 1988-1994. Arch Pediatr Adolesc Med. 2003;157(8):821-27. [ Links ]
26. Fernandez JR, Redden DT, Pietrobelli A, Allison DB. Waist circumference percentiles in nationally representative samples of African-American, European-American, and Mexican-American children and adolescents. J Pediatr. 2004;145(4):439-44. [ Links ]
27. Li C, Ford ES, Mokdad AH, Cook S. Recent trends in waist circumference and waist-height ratio among US children and adolescents. Pediatrics. 2006;118(5): e1390-98. [ Links ]
28. Dobnig H, Pilz S, Scharnagl H, Renner W, Seelhorst U, Wellnitz B, Kinkeldei J, Boehm BO, Weihrauch G, Maerz W. Independent association of low serum 25-hydroxyvitamin d and 1,25-dihydroxyvitamin d levels with all-cause and cardiovascular mortality. Arch Intern Med. 2008;168(12):1340-49. [ Links ]
29. Reis JP, von Muhlen D, Miller ER III. Relation of 25-hydroxyvitamin D and parathyroid hormone levels with metabolic syndrome among US adults. Eur J Endocrinol. 2008;159(1):41-48. [ Links ]
30. Forman JP, Curhan GC, Taylor EN. Plasma 25-hydroxyvitamin d levels and risk of incident hypertension among young women. Hypertension. 2008;52(5):828-32. [ Links ]
31. Forman JP, Bischoff-Ferrari HA, Willett WC, Stampfer MJ, Curhan GC. Vitamin D intake and risk of incident hypertension: results from three large prospective cohort studies. Hypertension. 2005; 46(4):676-82. [ Links ]
32. Krause R, Buhring M, Hopfenmuller W, Holick MF, Sharma AM. Ultraviolet B and blood pressure. Lancet. 1998;352(9129):709-10. [ Links ]
33. Pfeifer M, Begerow B, Minne HW, Nachtigall D, Hansen C. Effects of a short-term vitamin D(3) and calcium supplementation on blood pressure and parathyroid hormone levels in elderly women. J Clin Endocrinol Metab. 2001;86(4):1633-37. [ Links ]
34. Li YC, Kong J, Wei M, Chen ZF, Liu SQ, Cao LP. 1,25-Dihydroxyvitamin D(3) is a negative endocrine regulator of the renin-angiotensin system. J Clin Invest. 2002;110(2):229-38. [ Links ]
35. Eckel RH, Grundy SM, Zimmet PZ. The metabolic syndrome. Lancet. 2005;365(9468):1415-28. [ Links ]
2. Welch TR, Bergstrom WH, Tsang RC. Vitamin D-deficient rickets: the reemergence of a onceconquered disease. J Pediatr. 2000;137(2):143-45. [ Links ]
3. Docio S, Riancho JA, Perez A, Olmos JM, Amado JA, Gonzalez-Macias J. Seasonal deficiency of vitamin D in children: a potential target for osteoporosis-preventing strategies?. J Bone Miner Res. 1998;13(4):544-48. [ Links ]
4. Harkness L, Cromer B. Low levels of 25-hydroxy vitamin D are associated with elevated parathyroid hormone in healthy adolescent females. Osteoporos Int. 2005;16(1):109-113. [ Links ]
5. Outila TA, Karkkainen MU, Lamberg-Allardt CJ. Vitamin D status affects serum parathyroid hormone concentrations during winter in female adolescents: associations with forearm bone mineral density. Am J Clin Nutr. 2001;74(2):206-10. [ Links ]
6. Zittermann A, Schleithoff SS, Koerfer R. Putting cardiovascular disease and vitamin D insufficiency into perspective. Br J Nutr. 2005;94(4):483-92. [ Links ]
7. Cigolini M, Iagulli MP, Miconi V, Galiotto M, Lombardi S, Targher G. Serum 25-hydroxyvitamin D3concentrations and prevalence of cardiovascular disease among type 2 diabetic patients. Diabetes Care. 2006;29(3):722-24. [ Links ]
8. Scragg R, Jackson R, Holdaway IM, Lim T, Beaglehole R. Myocardial infarction is inversely associated with plasma 25-hydroxyvitamin D3 levels: a community-based study. Int J Epidemiol. 1990;19(3):559-63. [ Links ]
9. Poole KE, Loveridge N, Barker PJ, Halsall DJ, Rose C, Reeve J, Warburton EA. Reduced vitamin D in acute stroke. Stroke. 2006;37(1):243-45. [ Links ]
10. Zittermann A, Schleithoff SS, Tenderich G, Berthold HK, Korfer R, Stehle P. Low vitamin D status: a contributing factor in the pathogenesis of congestive heart failure?. J Am Coll Cardiol. 2003;41(1):105-112. [ Links ]
11. Zerwekh JE. Blood biomarkers of vitamin D status. Am J Clin Nutr. 2008;87(4):1087S-91S. [ Links ]
12. Ford ES, Ajani UA, McGuire LC, Liu S. Concentrations of serum vitamin D and the metabolic syndrome among U S adults. Diabetes Care. 2005;28(5):1228-30. [ Links ]
13. Forman JP, Giovannucci E, Holmes MD, Bischoff-Ferrari HA, Tworoger SS, Willett WC, Curhan GC. Plasma 25-hydroxyvitamin D levels and risk of incident hypertension. Hypertension. 2007;49(5):1063-69. [ Links ]
14. Knekt P, Laaksonen M, Mattila C, Härkänen T, Marniemi J, Heliövaara M, Rissanen H, Montonen J, Reunanen A. Serum vitamin D and subsequent occurrence of type 2 diabetes. Epidemiology. 2008;19(5):666-71. [ Links ]
15. Giovannucci E, Liu Y, Hollis BW, Rimm EB. 25-hydroxyvitamin D and risk of myocardial infarction in men: a prospective study. Arch Intern Med. 2008;168(11):1174-80. [ Links ]
16. Reis JP, Michos ED, von Muhlen D, Miller ER III. Differences in vitamin D status as a possible contributor to the racial disparity in peripheral arterial disease. Am J Clin Nutr. 2008;88(6):1469-77. [ Links ]
17. Wang TJ, Pencina MJ, Booth SL, Jacques PF, Ingelsson E, Lanier K, Benjamin EJ, D'Agostino RB, Wolf M, Vasan RS. Vitamin D deficiency and risk of cardiovascular disease. Circulation. 2008;117(4):503-11. [ Links ]
18. Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Research Group. Relationship of atherosclerosis in young men to serum lipoprotein cholesterol concentrations and smoking: a preliminary report from the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Research Group. JAMA. 1990;264(23):3018-24. [ Links ]
19. Berenson GS, Srinivasan SR, Bao W, Newman WP III, Tracy RE, Wattigney WA. Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults: the Bogalusa Heart Study. N Engl J Med. 1998;338(23):1650-56. [ Links ]
20. Klag MJ, Ford DE, Mead LA, He J, Whelton PK, Liang KY, Levine DM. Serum cholesterol in young men and subsequent cardiovascular disease. N Engl J Med. 1993;328(5):313-18. [ Links ]
21. Porkka KV, Viikari JS, Taimela S, Dahl M, Akerblom HK. Tracking and predictiveness of serum lipid and lipoprotein measurements in childhood: a 12-year follow-up-the cardiovascular risk in young finns study. Am J Epidemiol. 1994;140(12):1096-110. [ Links ]
22. Fernández JR, Reeden DT, Petrobielli A, Allison DB. Waist circunference percentiles in nationally representative sample of african-american, european- american and mexican american children and adolescent. J Pediatr. 2004;145:439-44. [ Links ]
23. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004;114(2 suppl):555-76. [ Links ]
24. Cook S, Auinger P, Li C, Ford ES. Metabolic syndrome rates in United States adolescents, from the National Health and Nutrition Examination Survey, 1999-2002. J Pediatr. 2008;152(2):165-70. [ Links ]
25. Cook S, Weitzman M, Auinger P, Nguyen M, Dietz WH. Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third National Health and Nutrition Examination Survey, 1988-1994. Arch Pediatr Adolesc Med. 2003;157(8):821-27. [ Links ]
26. Fernandez JR, Redden DT, Pietrobelli A, Allison DB. Waist circumference percentiles in nationally representative samples of African-American, European-American, and Mexican-American children and adolescents. J Pediatr. 2004;145(4):439-44. [ Links ]
27. Li C, Ford ES, Mokdad AH, Cook S. Recent trends in waist circumference and waist-height ratio among US children and adolescents. Pediatrics. 2006;118(5): e1390-98. [ Links ]
28. Dobnig H, Pilz S, Scharnagl H, Renner W, Seelhorst U, Wellnitz B, Kinkeldei J, Boehm BO, Weihrauch G, Maerz W. Independent association of low serum 25-hydroxyvitamin d and 1,25-dihydroxyvitamin d levels with all-cause and cardiovascular mortality. Arch Intern Med. 2008;168(12):1340-49. [ Links ]
29. Reis JP, von Muhlen D, Miller ER III. Relation of 25-hydroxyvitamin D and parathyroid hormone levels with metabolic syndrome among US adults. Eur J Endocrinol. 2008;159(1):41-48. [ Links ]
30. Forman JP, Curhan GC, Taylor EN. Plasma 25-hydroxyvitamin d levels and risk of incident hypertension among young women. Hypertension. 2008;52(5):828-32. [ Links ]
31. Forman JP, Bischoff-Ferrari HA, Willett WC, Stampfer MJ, Curhan GC. Vitamin D intake and risk of incident hypertension: results from three large prospective cohort studies. Hypertension. 2005; 46(4):676-82. [ Links ]
32. Krause R, Buhring M, Hopfenmuller W, Holick MF, Sharma AM. Ultraviolet B and blood pressure. Lancet. 1998;352(9129):709-10. [ Links ]
33. Pfeifer M, Begerow B, Minne HW, Nachtigall D, Hansen C. Effects of a short-term vitamin D(3) and calcium supplementation on blood pressure and parathyroid hormone levels in elderly women. J Clin Endocrinol Metab. 2001;86(4):1633-37. [ Links ]
34. Li YC, Kong J, Wei M, Chen ZF, Liu SQ, Cao LP. 1,25-Dihydroxyvitamin D(3) is a negative endocrine regulator of the renin-angiotensin system. J Clin Invest. 2002;110(2):229-38. [ Links ]
35. Eckel RH, Grundy SM, Zimmet PZ. The metabolic syndrome. Lancet. 2005;365(9468):1415-28. [ Links ]
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2017-10-21
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Ramírez, L., Riera, J., Vera, N., Pastore, B., & Castaño, L. (2017). Nivel de vitamina D y factores de riesgo cardiometabólicos en una población Pediátrica. Pediatría (Asunción), 42(3), 192-197. Recuperado a partir de https://revistaspp.org/index.php/pediatria/article/view/85
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