Prevalência da hipovitaminose D em trabalhadores e efeitos da sua suplementação sobre parâmetros metabólicos

Abstract

Vitamin D deficiency is considered a worldwide epidemic with clinical implications for obesity, inflammatory process and oxidative stress. Concomitant with the high prevalence of hypovitaminosis D, there are high rates of overweight and obesity worldwide, and the transformation of working conditions predominantly in indoor environments, which may negatively affect the organic status of vitamin D. This study had the objective of this study was to estimate the prevalence of hypovitaminosis D and the effects of its supplementation on metabolic parameters in workers. This is a cross-sectional epidemiological study and a randomized, double-blind, placebo-controlled clinical trial. In the first stage, 91 workers (31 men and 60 women) from Food and Nutrition Units of the Federal University of Paraíba participated in the study. At baseline, all participants were assessed for sociodemographic and occupational profile, skin phototypes and sun exposure, nutritional status, food intake and blood pressure. Laboratory tests were performed to analyze 25-hydroxyvitamin D [25 (OH) D], parathyroid hormone (PTH), serum calcium, fasting glucose (GJ), C-reactive protein (CRP), alpha-1 acid glycoprotein (AGP), total antioxidant capacity (CAT), malondialdehyde (MDA) and markers of renal and hepatic function. In the clinical trial, 69 workers participated in the screening, of which 39 participants (09 men and 30 women) presented hypovitaminosis D. After the sample calculation, the intervention was performed and included 29 women with vitamin D deficiency / insufficiency and overweight. After randomization, the workers were allocated to the groups: supplementation with 200,000 IU (GS, n=14) or placebo group (GP, n=15). After four weeks, all parameters were reevaluated. The cross-sectional epidemiological study found a prevalence of 61.5% deficiency / insufficiency in serum 25 (OH) D levels (deficient: ≤20 ng/mL; insufficient: 21-29 ng/mL; sufficient: ≥ 30 ng/ml). No differences were confirmed for sample characteristics with vitamin D status by the adjusted Poisson multiple regression. Regarding laboratory parameters, there is an increased prevalence for individuals with type 2 diabetes and hypertriglyceridemia. CAT was significant in relation to 25 (OH) D status, individuals with above-average values showed a reduction in the prevalence of hypovitaminosis D. In the clinical trial, no associations were observed between groups for all variables before supplementation. After the intervention there was an increase of 25(OH)D levels in the GS (p=0.000). No differences were observed for PTH, CAT, PCR, AGP and GJ in either group. There was a significant increase in serum Ca in GS and GP. MDA concentrations increased in GS (p=0.021) and creatinine decreased in GP (p = 0.000). In conclusion, there was a high prevalence of hypovitaminosis D among workers in the units analyzed, and an association of CAT with the reduction of this deficiency / insufficiency. Regarding the clinical trial, supplementation with VD3 megadose significantly increased serum 25 (OH) D concentrations, but had no effect on oxidative and inflammatory stress markers in overweight workers. It can be verified that workers with low serum 25(OH)D levels have lower CAT and therefore higher exposure to oxidative stress.