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Influ?ncia da varia??o sazonal no status de 25-hidroxivitamina D de adultos com s?ndrome metab?lica de uma regi?o do Brasil com elevados ?ndices de radia??o ultravioletaAquino, S?phora Louyse Silva de 22 November 2016 (has links)
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Previous issue date: 2016-11-22 / O risco de s?ndrome metab?lica pode ser influenciado pelo status inadequado de vitamina D, sendo a exposi??o ? luz solar a principal fonte externa desta vitamina. O objetivo do estudo foi avaliar a influ?ncia dos fatores ambientais, biol?gicos e nutricionais em fun??o das esta??es do ano no status de 25OHD em pacientes com s?ndrome metab?lica. Estudo transversal desenvolvido com 180 indiv?duos adultos e idosos com idade entre 18-80 anos, ambos os sexos, com diagn?stico de s?ndrome metab?lica, segundo os crit?rios do National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III). Foi considerada como vari?vel dependente a concentra??o de 25OHD; e como vari?veis independentes: idade, sexo, cor da pele, uso de filtro solar, fototipo de pele, escore de exposi??o solar, ?ndice de radia??o ultravioleta (IRUV), localiza??o geogr?fica, esta??es do ano, ?ndice de massa corporal (IMC), rela??o cintura-quadril (RCQ), circunfer?ncia da cintura (CC), paratorm?nio (PTH), c?lcio total s?rico, al?m do c?lcio e vitamina D da dieta. Potenciais preditores para a magnitude do status de 25OHD foram investigados por meio de 16 modelos de regress?o linear univariado, e sete modelos de regress?o m?ltipla. Foram estabelecidas medidas de associa??o e correla??o. O n?vel de signific?ncia adotado foi 5%. O status de 25OHD foi significativamente diferente entre inverno e ver?o (P=0,017). A m?dia de 25OHD indicou insufici?ncia no inverno (25,89ng/mL+7,61) e sufici?ncia no ver?o (31,81ng/mL+10,22), com aumento de 5,59ng/mL no ver?o. No modelo de regress?o linear simples, a concentra??o de 25OHD associou-se significativamente com o ver?o (P=0,003), de modo que a vari?vel esta??o do ano explicou 4,2% da variabilidade do status de 25OHD. O escore de exposi??o solar foi significativamente associado com a concentra??o de 25OHD (P=0,008), explicando 3,4% da variabilidade. No modelo de regress?o m?ltipla, sexo (P=0,027), RCQ (P=0,027), escore de exposi??o solar (P=0,006) e inverno vs. ver?o (P=0,004), explicaram 10,4% da varia??o da concentra??o de 25OHD. Os homens tiveram a concentra??o de 25OHD 3,71ng/mL maior do que as mulheres. O aumento de 1,0 unidade no escore de exposi??o solar, resultou no acr?scimo de aproximadamente 0,16ng/mL na concentra??o de 25OHD. A RCQ teve associa??o inversa com a concentra??o de 25OHD. A esta??o do ano ver?o e a exposi??o solar influenciaram no status de 25OHD dos indiv?duos com s?ndrome metab?lica residentes de uma regi?o do Brasil com elevados ?ndices de radia??o ultravioleta. / The risk of metabolic syndrome can be influenced by inadequate vitamin D levels, and exposure to sunlight is the main external source of vitamin D. This study assessed the influence of environmental, biological and nutritional factors as a function of seasons on the 25OHD status among individuals with metabolic syndrome. A cross-sectional study was developed with 180 adult and elderly individuals of both genders, between 18-80 years of age, with metabolic syndrome according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria. The 25OHD concentration was considered dependent variable; the independent variables were age, gender, skin color, use of sunscreen, skin type, sun exposure score, ultraviolet index (UVI), geographic location, season, body mass index (BMI), waist-hip ratio (WHR), waist circumference (WC), parathyroid hormone (PTH) level, total serum calcium level, and diet levels of calcium and vitamin D. The potential predictors for the 25OHD levels were investigated using 16 univariate linear regression models and seven multiple regression models. Measures of association and correlation were established and statistical significance was assumed for P < 0.05 (5%). The 25OHD status differed significantly between winter and summer (P = 0.017). The average 25OHD level was insufficient during the winter (25.89 ? 7.61 ng/mL) and sufficient during the summer (31.81 ? 10.22 ng/mL), with an increase of 5.59 ng/mL in the summer. In the simple linear regression model, 25OHD concentration was significantly associated with the summer season (P = 0.003); the season variable explained 4.2% of the variability in 25OHD concentration. The sun exposure score was significantly associated with 25OHD concentration (P = 0.008), explaining 3.4% of the variability. In the multiple regression model, gender (P = 0.27), WHR (P = 0.27), sun exposure score (P = 0.006), and winter vs. summer (P = 0.004) explained 10.4% of the variation in 25OHD concentration. Men had a 25OHD concentration 3.71 ng/mL higher than that of women. An increase of 1.0 unit in the sun exposure score resulted in an increase of approximately 0.16 ng/mL on 25OHD concentration. WHR showed an inverse association with the 25OHD concentration. The summer season and sun exposure influenced the 25OHD status in individuals with metabolic syndrome living in a region of Brazil with a high ultraviolet radiation index.
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