RESUMEN
OBJECTIVES: Studies in children and pregnant women consistently showed pandemic proportions of micronutrient deficiencies in the Indian subcontinent. However, vitamin deficiencies in apparently healthy adults are seldom recognized, hence the aim of this exploratory study was to assess their subclinical vitamin status and dietary intakes. METHODS: In all, 270 apparently healthy urban adults 30 to 70 y of age, from Hyderabad city, India participated in this study. Blood levels of vitamins (A, B1, B2, B6, total and active B12, D, and folate) and homocysteine were assessed. Anthropometric parameters were measured; dietary intake was obtained by food frequency questionnaire, and probability of adequacy (PA) was calculated by the estimated average requirement. RESULTS: Among the study population, the overall prevalence of deficiency of vitamin B2 was strikingly high (50%) followed by the vitamins B6 (46%), active B12 (46%), total B12 (37%), folate (32%), D (29%), B1 (11%), and A (6%). Hyperhomocysteinemia (HHcys) was widely prevalent (52%) in the study participants. In case of dietary intakes, PA was lowest for vitamin B12 (4%) and folate (9%) followed by vitamins A (22%), B2 (33%), B6 (30%), and B1 (59%). The mean PA of these vitamins was noticeably low (28%). The unadjusted logistic regression analysis found men and those with a deficiency of folate and total and active B12 to be at higher risk for HHcys. In the adjusted model, the risk for active B12 deficiency almost doubled. CONCLUSION: The study demonstrated a high prevalence of multiple subclinical vitamin deficiencies, dietary inadequacies, and HHcys, which are possible risk factors for disease burden among apparently healthy adults.
Asunto(s)
Avitaminosis/epidemiología , Dieta/efectos adversos , Población Urbana/estadística & datos numéricos , Adulto , Anciano , Avitaminosis/etiología , Dieta/estadística & datos numéricos , Encuestas sobre Dietas , Ingestión de Alimentos , Femenino , Homocisteína/sangre , Humanos , India/epidemiología , Modelos Logísticos , Masculino , Persona de Mediana Edad , Estado Nutricional , Prevalencia , Factores de Riesgo , Vitaminas/sangreRESUMEN
OBJECTIVE: Diabetic retinopathy (DR) is a common cause of blindness. Although an association between hypovitaminosis D and type 1 diabetes is known, the association between vitamin D (VD) and type 2 diabetes (T2D) and its complications such as DR has been unclear. The aim of this study was to investigate the status of VD in T2D patients with and without DR. METHODS: A cross-sectional case-control study was conducted with 99 normal control (CN) participants and 164 patients with T2D, of which 82 had retinopathy (DR) and 82 did not (DNR). After a complete ophthalmic examination, inclusive of fundus fluorescein angiography, the clinical profile and the plasma levels of VD and calcium were analyzed. RESULTS: Although the mean plasma VD levels were significantly lower in the DNR and DR groups compared with the CN group, no significant differences were observed between the groups with diabetes. Although the mean levels of VD in all three groups were below the normal range, the prevalence of VD deficiency (VDD) was higher in the DNR and DR groups (66% and 63%) than in the CN group (45%), suggesting that the prevalence of VDD was higher in individuals with diabetes, regardless of the presence or absence of retinopathy. However, there were no group differences in the plasma levels of calcium. Additionally, VDD did not seem to be related to patient's age or body mass index, but was related to the duration of diabetes. CONCLUSION: Results from this study suggest a possible association between VDD and T2D, but not specifically with DR. Further investigations are warranted.
Asunto(s)
Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/metabolismo , Retinopatía Diabética/epidemiología , Retinopatía Diabética/metabolismo , Deficiencia de Vitamina D/epidemiología , Vitamina D/sangre , Adulto , Factores de Edad , Anciano , Índice de Masa Corporal , Calcio/sangre , Estudios de Casos y Controles , Estudios Transversales , Retinopatía Diabética/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Factores de Tiempo , Deficiencia de Vitamina D/sangreRESUMEN
Regulatory T cells and IgE receptors (CD23 and CD21) on B cells were assessed in vitamin D deficient pregnant women. For this, 153 pregnant women were recruited from a government hospital and were categorized into three groups based on 25-hydroxyvitamin D3 (25(OH)D3) status. Regulatory T cell population (Treg cells) and CD23/CD21 expression on B cells were quantified by FACS ARIA II in maternal blood at third trimester; and the same parameters were evaluated in cord blood soon after delivery. In addition, TGF ß and IL-10 were quantified in maternal and cord blood by using Milliplex kits. In a representative sample of eight women from each group (vitamin D sufficient, insufficient and deficient), placental tissues were processed for mRNA expressions of vitamin D receptor (VDR), retinoic acid receptor (RXR), vitamin D binding protein (VDBP) and vitamin D regulating enzymes. Of the 153 pregnant women, 18 were sufficient (≥30ng/mL), 55 were insufficient (20-29ng/mL) and 80 were deficient (≤19ng/mL) for 25(OH)D3 status. The maternal blood Treg cell population (mean (%)±SE) was lower (p<0.05) in 25(OH)D3 deficient (0.2±0.01) pregnant women compared to insufficient (0.34±0.01) and sufficient (0.45±0.02) pregnant women. Similarly, cord blood Treg cell population (mean (%)±SE) was also lower (p<0.05) in 25(OH)D3 deficient (0.63±0.03) pregnant women when compared to insufficient (1.05±0.04) and sufficient (1.75±0.02) pregnant women. Mean (%)±SE of B cells with CD23 and CD21 in maternal blood was higher (p<0.05) in 25(OH)D3 deficient pregnant women (0.35±0.02; 1.65±0.04) when compared to insufficient (0.22±0.02; 0.55±0.05) and sufficient (0.15±0.02; 0.21±0.01) pregnant women. Similarly, mean (%)±SE of B cell population with CD23 and CD21 in cord blood was also higher (p<0.05) in 25(OH)D3 deficient (0.41±0.02; 1.2±0.03) when compared to insufficient (0.32±0.01; 0.6±0.05) and sufficient (0.2±0.01; 0.4±0.02) pregnant women. Regulatory cytokines, TGF ß and IL-10 were lower (p<0.05) in 25(OH)D3 insufficient and deficient subjects. In the placenta tissue of women with 25(OH)D3 deficiency, the regulatory T cell transcription factor FOXP3, vitamin D receptor (VDR) and retinoic acid receptor (RXR) expressions were downregulated. In contrast, CD23, CD21 and VDBP expressions were upregulated in 25(OH)D3 deficient and insufficient women. Vitamin D regulating enzymes (CYP24A1, CYP2R1 and CYP27B1) expression were also altered in women with 25(OH)D3 deficiency. The current study shows that impaired maternal 25(OH)D3 during pregnancy influences the spectrum of immune cells such as regulatory T cells and B cells with IgE receptors and this in turn may be linked to allergy and asthma in neonates.
Asunto(s)
Biomarcadores/metabolismo , Sangre Fetal/metabolismo , Linfocitos T Reguladores/inmunología , Deficiencia de Vitamina D/inmunología , 25-Hidroxivitamina D3 1-alfa-Hidroxilasa/genética , Adulto , Western Blotting , Células Cultivadas , Colestanotriol 26-Monooxigenasa/genética , Familia 2 del Citocromo P450 , Citocinas/metabolismo , Femenino , Sangre Fetal/citología , Humanos , Recién Nacido , Interleucina-10/metabolismo , Embarazo , ARN Mensajero/genética , Reacción en Cadena en Tiempo Real de la Polimerasa , Receptores de Calcitriol/genética , Receptores de Complemento 3d/genética , Receptores de IgE/genética , Receptores X Retinoide/genética , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Linfocitos T Reguladores/metabolismo , Linfocitos T Reguladores/patología , Factor de Crecimiento Transformador beta/genética , Vitamina D/farmacología , Deficiencia de Vitamina D/metabolismo , Deficiencia de Vitamina D/patología , Proteína de Unión a Vitamina D/genética , Vitamina D3 24-Hidroxilasa/genética , Vitaminas/farmacología , Adulto JovenRESUMEN
Regulatory T cells and IgE receptors (CD23 and CD21) on B cells were assessed in vitamin D deficient pregnant women. For this, 153 pregnant women were recruited from a government hospital and were categorized into three groups based on 25-hydroxyvitamin D3 (25(OH)D3) status. Regulatory T cell population (Treg cells) and CD23/CD21 expression on B cells were quantified by FACS ARIA II in maternal blood at third trimester; and the same parameters were evaluated in cord blood soon after delivery. In addition, TGF ß and IL-10 were quantified in maternal and cord blood by using Milliplex kits. In a representative sample of eight women from each group (vitamin D sufficient, insufficient and deficient), placental tissues were processed for mRNA expressions of vitamin D receptor (VDR), retinoic acid receptor (RXR), vitamin D binding protein (VDBP) and vitamin D regulating enzymes. Of the 153 pregnant women, 18 were sufficient (≥30 ng/mL), 55 were insufficient (20-29 ng/mL) and 80 were deficient (≤19 ng/mL) for 25(OH)D3 status. The maternal blood Treg cell population (mean (%)± SE) was lower (p<0.05) in 25(OH)D3 deficient (0.2 ± 0.01) pregnant women compared to insufficient (0.34 ± 0.01) and sufficient (0.45 ± 0.02) pregnant women. Similarly, cord blood Treg cell population (mean (%)± SE) was also lower (p<0.05) in 25(OH)D3 deficient (0.63 ± 0.03) pregnant women when compared to insufficient (1.05 ± 0.04) and sufficient (1.75 ± 0.02) pregnant women. Mean (%) ± SE of B cells with CD23 and CD21 in maternal blood was higher (p<0.05) in 25(OH)D3 deficient pregnant women (0.35 ± 0.02; 1.65 ± 0.04) when compared to insufficient (0.22 ± 0.02; 0.55 ± 0.05) and sufficient (0.15 ± 0.02; 0.21 ± 0.01) pregnant women. Similarly, mean (%)± SE of B cell population with CD23 and CD21 in cord blood was also higher (p<0.05) in 25(OH)D3 deficient (0.41 ± 0.02; 1.2 ± 0.03) when compared to insufficient (0.32 ± 0.01; 0.6 ± 0.05) and sufficient (0.2 ± 0.01; 0.4 ± 0.02) pregnant women. Regulatory cytokines, TGF ß and IL-10 were lower (p<0.05) in 25(OH)D3 insufficient and deficient subjects. In the placenta tissue of women with 25(OH)D3 deficiency, the regulatory T cell transcription factor FOXP3, vitamin D receptor (VDR) and retinoic acid receptor (RXR) expressions were downregulated. In contrast, CD23, CD21 and VDBP expressions were upregulated in 25(OH)D3 deficient and insufficient women. Vitamin D regulating enzymes (CYP24A1, CYP2R1 and CYP27B1) expression were also altered in women with 25(OH)D3 deficiency. The current study shows that impaired maternal 25(OH)D3 during pregnancy influences the spectrum of immune cells such as regulatory T cells and B cells with IgE receptors and this in turn may be linked to allergy and asthma in neonates.
Asunto(s)
Complicaciones del Embarazo/inmunología , Linfocitos T Reguladores/inmunología , Deficiencia de Vitamina D/complicaciones , Deficiencia de Vitamina D/inmunología , Vitamina D/inmunología , Adulto , Femenino , Factores de Transcripción Forkhead/genética , Factores de Transcripción Forkhead/inmunología , Expresión Génica , Humanos , Interleucina-10/sangre , Embarazo , Complicaciones del Embarazo/sangre , Complicaciones del Embarazo/genética , ARN Mensajero/genética , Receptores de Calcitriol/genética , Receptores de Calcitriol/inmunología , Receptores de Complemento 3d/sangre , Receptores de Complemento 3d/genética , Receptores de Complemento 3d/inmunología , Receptores de IgE/sangre , Receptores de IgE/genética , Receptores de IgE/inmunología , Factor de Crecimiento Transformador beta/sangre , Vitamina D/sangre , Deficiencia de Vitamina D/sangre , Deficiencia de Vitamina D/genéticaRESUMEN
OBJECTIVE: To study the nutritional status of children with Respiratory Syncitial virus infection. METHODS: One hundred and twenty six children with acute respiratory infection, between the age of 4-24 months, were investigated for RSV infection with bronchiolitis, pneumonia and upper respiratory tract infection. Nasopharyngeal aspirates were collected and cytokine responses were determined by ELISA. Upper respiratory tract infections were detected in 16.66%, bronchiolitis in 30.15% and Pneumonia in 53.17% children. RESULTS: Of the 126 patients, 46.66% children were positive for RSV while 58.33% were negative for RSV. Children with bronchiolitis were more commonly positive for RSV compared to URTI and pneumonia. RSV was almost equally distributed among boys (42.5%) and girls (48.7%). More children were RSV positive when the mean age lesser (8.4 mo) was compared to RSV negative (9.93 mo). Well nourished children and children with normal birth weight had more RSV positives, though not statistically significant. In a sub sample analysis of cytokines done (n=25), Interleukin-2 and Interleukin-8 levels were higher in the RSV positive children and these levels declined after 5 days of illness. CONCLUSIONS: RSV is more commonly associated with bronchiolitis in younger infants with normal birth weight or more weight for age (WFA). Proinflammatory cytokine IL-8 was secreted at high concentrations in the nasopharyngeal aspirate in all the children.