A carregar...
Publicação
Avaliação dos níveis séricos de 25- hidroxivitamina D em doentes portadores de artrite reumatóide e sua influência na atividade da doença
| Nome: | Descrição: | Tamanho: | Formato: | |
|---|---|---|---|---|
| 855.42 KB | Adobe PDF |
Autores
Orientador(es)
Resumo(s)
A Artrite Reumatóide (AR) é uma doença que afeta cerca de 1% da população mundial, podendo ser grave e deformante, gerando incapacidade e perda de anos de vida produtiva nos doentes em que é diagnosticada. Ainda que já existam várias opções terapêuticas, alguns indivíduos não respondem às medicações disponíveis, o que mantém constante o interesse da comunidade científica em novas opções de tratamento para estes indivíduos. Vários estudos têm associado a vitamina D com a fisiopatologia das doenças autoimunes, inclusivamente com a AR, sugerindo que a deficiência dessa vitamina poderia estar implicada tanto na génese como no agravamento da atividade da doença. Os objetivos principais deste trabalho foram a) analisar os níveis séricos de vitamina D entre doentes com AR atendidos em Vitória da Conquista-Bahia e b) verificar se os níveis de vitamina D influenciam a atividade da AR, usando o DAS 28 como índice. Para este estudo foram selecionados 103 indivíduos portadores de AR de ambos os sexos e com idades compreendidas entre os 18 e os 80 anos, todos em controlo regular, com pelos menos 3 consultas no último ano e com dosagem de vitamina D registada na ficha clínica no período definido para a colheita dos dados. Após a análise estatística verificou-se que 41,7% dos doentes tinham níveis de vitamina D considerados deficientes ou insuficientes e foi encontrada uma correlação estatisticamente significativa entre o DAS28 e a dosagem de vitamina D (p=0,007). A vitamina D correlacionou-se duma forma inversamente proporcional com o DAS28 como índice de atividade de doença na AR, o que confirma os resultados descritos em vários estudos anteriores. Esta relação inversa sugere um papel imunomodulador desta vitamina, apesar da ausência de dados de intervenção a apoiar esta premissa. Para esta observação ter lugar seria necessário efetuar outros estudos, englobando doentes que vivem nesta latitude, numa população maior e num período mais prolongado, nos quais se avaliasse a evolução da atividade da AR perante o suplemento alimentar de vitamina D ou uma intervenção farmacológica com a mesma. Neste momento, a necessidade de determinação laboratorial ou o rastreio dos valores de vitamina D para todos os indivíduos com AR e o melhor método laboratorial a ser usado são ainda discutíveis. No entanto, poder-se-á especular se para os grupos de risco esta não seria uma medida que preveniria complicações futuras, em conjunto com as medidas de reforço e suplementação em doses adequadas a cada défice.
Este estudo foi o primeiro a ser executado numa população do nordeste brasileiro com AR no que diz respeito à análise não só dos níveis de vitamina D, mas também da sua relação com a atividade da doença, medida pelo DAS28, pelo que os seus resultados contribuíram para se conhecer as especificidades desta população no que diz respeito aos parâmetros estudados.
Rheumatoid arthritis (RA) is a disease that affects about 1% of the world's population, which can be severe and deforming, generating disability and loss of productive life years in patients suffering from it. Although there are already several therapeutic options, some individuals do not respond to the medications available, which maintains constant interest of the scientific community in new treatment options for these individuals. Several studies have associated vitamin D with the pathophysiology of autoimmune diseases, including RA, suggesting that the deficiency of this vitamin could be implied both in the genesis and worsening of the disease activity. The main objectives of this work were a) to analyze the serum levels of vitamin D between patients with RA treated in Vitória da Conquista-Bahia and b) to verify if the levels of vitamin D influence the activity of the RA, using DAS28 as index. For this study, 103 RA carriers of both sexes, aged between 18 and 80 years were selected. They were all in regular control with at least 3 consultations in the last year and with vitamin D dosage recorded in the clinical record in the period defined for data collection. After statistical analysis, it was found that 41.7% of these patients had vitamin D levels considered deficient or insufficient and a statistically significant correlation was found between DAS28 and vitamin D dosage (p = 0,007). It was verified that vitamin D correlated in an inversely proportional way with DAS28 as an index of disease activity of the RA, which confirms the results described in several previous studies. This inverse relationship suggests a immunomodulator role of this vitamin, despite the absence of intervention data to support this premise. For this observation to take place it would be necessary to carry out other studies, encompassing patients living in this latitude, in a larger population and in a longer period, in which the evolution of RA activity would be evaluated before the food supplement of vitamin D or a pharmacological intervention with this product. At the moment, the need for laboratory determination or the screening of vitamin D values for all individuals with RA and the best laboratory method to be used are still debatable. However, it could be speculated whether for the risk groups this would be a measure that would prevent future complications, together with the reinforcement and supplementation in appropriate doses for each deficit. This study was the first to be carried out in a Brazilian northeast population with RA with regard to the analysis not only of the levels of vitamin D, but also of its relation with the activity of the disease, measured by the DAS28. Therefore, its results contributed for a better knowledge of the specificities of this population, with regard to the studied parameters.
Rheumatoid arthritis (RA) is a disease that affects about 1% of the world's population, which can be severe and deforming, generating disability and loss of productive life years in patients suffering from it. Although there are already several therapeutic options, some individuals do not respond to the medications available, which maintains constant interest of the scientific community in new treatment options for these individuals. Several studies have associated vitamin D with the pathophysiology of autoimmune diseases, including RA, suggesting that the deficiency of this vitamin could be implied both in the genesis and worsening of the disease activity. The main objectives of this work were a) to analyze the serum levels of vitamin D between patients with RA treated in Vitória da Conquista-Bahia and b) to verify if the levels of vitamin D influence the activity of the RA, using DAS28 as index. For this study, 103 RA carriers of both sexes, aged between 18 and 80 years were selected. They were all in regular control with at least 3 consultations in the last year and with vitamin D dosage recorded in the clinical record in the period defined for data collection. After statistical analysis, it was found that 41.7% of these patients had vitamin D levels considered deficient or insufficient and a statistically significant correlation was found between DAS28 and vitamin D dosage (p = 0,007). It was verified that vitamin D correlated in an inversely proportional way with DAS28 as an index of disease activity of the RA, which confirms the results described in several previous studies. This inverse relationship suggests a immunomodulator role of this vitamin, despite the absence of intervention data to support this premise. For this observation to take place it would be necessary to carry out other studies, encompassing patients living in this latitude, in a larger population and in a longer period, in which the evolution of RA activity would be evaluated before the food supplement of vitamin D or a pharmacological intervention with this product. At the moment, the need for laboratory determination or the screening of vitamin D values for all individuals with RA and the best laboratory method to be used are still debatable. However, it could be speculated whether for the risk groups this would be a measure that would prevent future complications, together with the reinforcement and supplementation in appropriate doses for each deficit. This study was the first to be carried out in a Brazilian northeast population with RA with regard to the analysis not only of the levels of vitamin D, but also of its relation with the activity of the disease, measured by the DAS28. Therefore, its results contributed for a better knowledge of the specificities of this population, with regard to the studied parameters.
Descrição
Palavras-chave
Saúde tropical Doenças tropicais Artrite reumatóide Vitamina D DAS28
Contexto Educativo
Citação
Editora
Instituto de Higiene e Medicina Tropical