Vitamina D - Aspectos Fisiológicos, Nutricionais, Imunológicos, Genéticos. Ações em doenças autoimunes, tumorais, infecciosas. Funções musculoesqueléticas e cognitivas
DOI:
https://doi.org/10.11606/issn.1679-9836.v102i3e-210547Palavras-chave:
Vitamina D, COVID-19, NutriçãoResumo
Vitamina D representa de fato, um hormônio esteroide lipossolúvel com funções endócrinas, parácrinas e autócrinas. Este artigo buscou realizar revisão de aspectos fisiológicos, ambientais, nutricionais e genéticos relacionados a esta vitamina, classificação dos níveis séricos da forma circulante representativa do status, bem locais de armazenamento em tecidos. Sugestões são apresentadas, de acordo com literatura consultada, quanto a hábitos alimentares, exposição solar adequada, suplementação oral e/ou necessidade de doses de manutenção, riscos de toxicidade. Funções imunológicas, imunomoduladoras, participação a nível celular e tecidual em doenças autoimunes, tumorais, infecto-contagiosas, com ênfase ao SARS-CoV-2 também foram abordadas. Entre as inúmeras ações da vitamina D, houve destaque à participação no metabolismo musculoesquelético, ocorrência de quedas, particularmente entre os idosos, sistema nervoso central, com ênfase à cognição, demência, doença de Alzheimer. Aspectos consensuais ou controversos também foram abordados, bem como sugestões de novos estudos a nível mundial para esclarecimento de resultados questionáveis.
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Demer LL, Hsu JJ, Tintut Y. Steroid hormone vitamin D: Implications for cardiovascular disease. Circ Res. 2018;122(11):1576-85. doi:10.1161/CIRCRESAHA.118.311585.
Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, et al. Evaluation, of treatment, and prevention vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2011;96(7):1911-30. doi.org/10.1210/jc.2011-0385.
DeLuca HF. Overview of general physiologic features and functions of vitamin D. Am J Clin Nutr. 2004;80(6 Suppl):1689S-96S.
Borel P, Caillaud D, Cano NJ. Vitamin D bioavailability: state of the art. Crit Rev Food Sci Nutr. 2015;55(9):1193-2205. doi: 10.1080/10408398.2012.688897.
Galvão LO, Galvão MF, Reis CMS, Batista CMA, Casulari LA. Current considerations about vitamin D. BSBM. Brasília Med. 2013;50(4):324-32.
Mostafa WZ, Hegazy RA. Vitamin D and the skin: Focus on a complex relationship: A review. J Adv Res. 2015;6:793-804. doi.org/10.1016/j.jare.2014.01.011
Lanham-New SA. Nutritional Influences on bone health: an update on current research and clinical implications. Medscape Ob/Gyn & Women's Health, Feb 2006. https://www.medscape.org/viewarticle/522589_10
Maeda SS, Borba VZC, Camargo MBR, Silva DMW, Borges JLC, et al. Recommendations of the Brazilian Society of Endocrinology and Metabology (SBEM) for the diagnosis and treatment of hypovitaminosis D. Arq Bras Endocrinol Metab. 2014;58(5):411-33. doi.org/10.1590/0004-2730000003388
Maeda SS, Kunii IS, Hayashi L, Lazaretti-Castro M. The effect of sun exposure on 25- hydroxyvitamin D concentrations in young healthy subjects living in the city of São Paulo, Brazil. Braz J Med Biol Res. 2007;40(12): 1653-1659. doi.org/10.1590/S0100-879X2006005000162
Unger MD, Cuppari L, Titan SM, Magalhães MCT, Sassaki AL, et al. Vitamin D status in a sunny country: where has the sun gone? Clin Nutr. 2010;29:784-8. DOI: 10.1016/j.clnu.2010.06.009
Rostand SG, Warnock DG. Introduction to Vitamin D Symposium. Clin J Am Soc Nephrol. 2008;3:1534. doi: 10.2215/CJN.01130308
Lavelli V, D’Incecco P, Pellegrino L. Vitamin D Incorporation in foods: formulation strategies, stability, and bioaccessibility as affected by the food matrix Foods. 2021;10(9):1989. doi:10.3390/foods10091989
Adebayo FA, Itkonen ST, Öhman T, Kiely M, Cashman KD, et al Safety of vitamin D food fortification and supplementation: evidence from randomized controlled trials and observational studies. Foods. 2021;10(12):3065. doi:10.3390/foods10123065
Robien K, Butler LM, Wang R, Beckman KB, Walek D, et al. Genetic and environmental predictors of serum 25(OH)D concentrations among middle-aged and elderly Chinese in Singapore. Br J Nutr. 2013;109(3):493-502. doi: 10.1017/S0007114512001675.
Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357(3):266–281. doi: 10.1056/NEJMra070553.
Zittermann A, Trummer C, Theiler-Schwetz V, Lerchbaum E, März W, et al. Vitamin D and cardiovascular disease: an updated narrative review. Int J Mol Sci. 2021;22(6):2896. doi:10.3390/ijms22062896
Borel P, Caillaud D, Cano NJ. Vitamin D bioavailability: state of the art. Crit Rev Food Sci Nutr. 2015;55(9):1193-2205. doi: 10.1080/10408398.2012.688897.
Weaver CM, Fleet JC. Vitamin D requirements: current and future. Am J Clin Nutr. 2004;80(6 Suppl):1735S-9S. doi.org/10.1093/ajcn/80.6.1735S
Ohyama Y. Eight Cytochrome P450S Catalyze Vitamin D Metabolism. Front Biosci.2004;9:3007-8. DOI: 10.2741/1455
Braz CL, Figueiredo TP, Barroso SCC, AMM Reis. Medicamentos com atividade sobre o citocromo P450 utilizados por idosos em domicílio. drugs with activity on the cytochrome P450 used by elderly at home. Rev Med Minas Gerais. 2018;28:e-1927. doi.10.5935/2238-3182.20180069.
Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, et al. Guidelines for preventing and treating vitamin D deficiency and insufficiency revisited. J Clin Endocrinol Metab. 2012;97(4):1153-8. doi.org/10.1210/jc.2011-2601
Priemel M, von Domarus C, Klatte TO, Kessler S, Schlie J, et al. Bone mineralization defects and vitamin D deficiency: histomorphometric analysis of iliac crest bone biopsies and circulating 25-hydroxyvitamin D in 675 patients. J Bone Miner Res. 2010;25:305-12. DOI: 10.1359/jbmr.090728
Manson JE, Cook NR, Lee IM, et al; VITAL Research Group. Vitamin D supplements and prevention of cancer and cardiovascular disease. N Engl J Med. 2019;380(1):33-44. doi:10.1056/NEJMoa18099441
Tobias DK, Luttmann-Gibson H, Mora S, Danik J, Bubes V, Copeland T, et al. Association of Body Weight With Response to Vitamin D sSupplementation and metabolism. JAMA Network Open. 2023;6(1):e2250681. doi:10.1001/jamanetworkopen.2022.506811
Bachmann KN. Responses to Vitamin D supplementation in individuals with overweight and obesity. JAMA Network Open. 2023;6(1):e2250695. doi:10.1001/jamanetworkopen.2022.50695 (R 1
Marins TA, Galvão TFG, Korkes F, Malerbi DAC, Ganc AJ, et al. Vitamin D intoxication: case report. Einstein. 2014;12(2):242-4. doi: 10.1590/S1679-45082014RC28601444
Aranow C. Vitamin D and the immune system. J Investig Med. 2011;59(6):881-6. doi:10.231/JIM.0b013e31821b8755.
Aguilera O, Peña C, García JM, Larriba MJ, Ordóñez-Morán P, et al. The Wnt antagonist DICKKOPF-1 gene is induced by 1,25-dihydroxyvitamin D3 associated to the di erentiation of human colon cancer cells. Carcinogenesis. 2007;28:1877-84. doi. org/10.1093/carcin/bgm094.
Bueno AC, Stecchini MF, Marrero-Gutiérrez J, More CB, Leal LF, et al. Vitamin D receptor hypermethylation as a biomarker for pediatric adrenocortical tumors. Eur J Endocrinol. 2022;186:573-85. doi.org/10.1530/EJE-21-0879
Bueno AC, Silva RMP, Stecchini MF, Marrero-Gutiérrez J, Silva DCAE, et al. DNA methylation is a comprehensive marker for pediatric adrenocortical tumors. Endocr Relat Cancer. 2022;29(11):599-613. doi: 10.1530/ERC-22-0145.
Bueno AC, More CB, Marrero-Gutiérrez J, Silva DCA, Leal LF, et al. Vitamin D receptor activation is a feasible therapeutic target to impair adrenocortical tumorigenesis. Mol Cell Endocrinol. 2022;558:111757. doi.org/10.1016/j.mce.2022.111757
Rodriguez-Galindo C, Figueiredo BC, Zambetti GP, Ribeiro RC. Biology, clinical characteristics, and management of adrenocortical tumors in children. Pediatr Blood Cancer. 2005;45(3):265-73. doi: 10.1002/pbc.20318
Ilie PC, Stefanescu S, Smith L. The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality. Aging Clin Exp Res. 2020;32(7):1195-8. doi:10.1007/s40520-020-01570-8.
Grant WB, Lahore H, McDonnell SL, Baggerly CA, French CB, et al. Evidence that Vitamin D supplementation could reduce risk of influenza and COVID-19 infections and deaths. Nutrients. 2020;12(4):988. doi: 10.3390/nu12040988.
Hu J, Luo Z, Zhao X, Chen Q, Chen Z, et al. Changes in the calcium-parathyroid hormone-vitamin d axis and prognosis for critically ill patients: a prospective observational study. PLoS ONE. 2013;8(9):e75441. doi.org/10.1371/journal.pone.0075441
Ginde AA, Camargo Junior CA, Shapiro, NI. Vitamin D insufficiency and sepsis severity in emergency department patients with suspected infection. Acad Emerg Med. 2011;18(5):551-4. doi.org/10.1111/j.1553-2712.2011.01047.x
Mckinney JD, Bailey BA, Garrett LH, Peiris P, Manning T, et al. Relationship between vitamin D status and ICU outcomes in veterans. J Am Med Dir Assoc. 2011;12(3):208-11. doi: 10.1016/j.jamda.2010.04.004
Higgins DM, Wischmeyer PE, Queensland KM, Sillau SH, Sufit AJ, et al. Relationship of vitamin D deficiency to clinical outcomes in critically ill patients. JPEN J Parenter Enteral Nutr. 2012;36(6):713-20. doi.org/10.1177/0148607112444449
Moraes RB, Friedman G, Wawrzeniak IC, Marques LS, Nagel FM, et al. Vitamin D deficiency is independently associated with mortality among critically ill patients. Clinics. 2015;70(5):326-32. Doi.org/10.6061/clinics/2015(05)04.
Turrubiates-Hernández FJ, Athziri Sánchez-Zuno GA, González-Estevez G, Hernández-Bello J, et al. Potential immunomodulatory effects of vitamin D in the prevention of severe coronavirus disease 2019: an ally for Latin America (Review). Int J Mol Med. 2021;47(4):32. doi:10.3892/ijmm.2021.4865
Maghbooli Z, Sahraian MA, Ebrahimi M, Pazoki M, Kafan S, et al. Vitamin D sufficiency, a serum 25-hydroxyvitamin D at least 30 ng/mL reduced risk for adverse clinical outcomes in patients with COVID-19 infection. PLoS ONE. 2020;15(9):e0239799. doi.org/10.1371/journal.pone.0239799
Kaufman HW, Niles JK, Kroll MH, Bi C, Holick MF. SARS-CoV-2 positivity rates associated with circulating 25-hydroxyvitamin D levels. PLoS ONE. 2020;15 (9):e0239252. doi.org/10.1371/journal.pone.0239252
Charoenngam N, Shirvani A, Reddy N, Vodopivec DM, Apovian CM, et al. Association of Vitamin D status with hospital morbidity and mortality in adult hospitalized patients with COVID-19. Endocr Pract. 2021;27(4):271-8. doi: 10.1016/j.eprac.2021.02.013.
Borsche L, Glauner B, von Mendel J. COVID-19 Mortality risk correlates inversely with vitamin d3 status, and a mortality rate close to zero could theoretically be achieved at 50 ng/mL 25(OH)D3: results of a systematic review and meta-analysis. Nutrients. 2021;13(10):3596. doi: 10.3390/nu13103596
Kaufman HW, Niles JK, Kroll MH, Bi C, Holick, M.F. SARS-CoV-2 positivity rates associated with circulating 25- hydroxyvitamin D levels. PLoS ONE. 2020;15:1252. doi: 10.1371/journal.pone.0239252
Pereira M, Dantas Damascena A, Galvão Azevedo LM, Almeida Oliveira T, Mota Santana J, et al. Vitamin D deficiency aggravates COVID-19: systematic review and meta-analysis. Crit Rev Food Sci Nutr. 2022;62(5):1308-16. doi: 10.1080/10408398.2020.1841090.
Grant WB. Does vitamin D reduce the risk of dementia? J Alzheimers Dis. 2009;17(1):151-9. doi.org/10.1002/dad2.12404
Pogge E. Vitamin D and Alzheimer's disease: is there a link? Consult Pharm. 2010;25(7):440-50. DOI: 10.4140/TCP.n.2010.440
Buell JS, Scott TM, Dawson-Hughes B, Dallal GE, Rosenberg IH, et al. Vitamin D is associated with cognitive function in elders receiving home health services. J Gerontol A Biol Sci Med Sci. 2009;64(8):888-95. DOI: 10.1093/gerona/glp032
Fernandes Abreu DA, Eyles D, Féron F. Vitamin D, a neuro-immunomodulator: implications for neurodegenerative and autoimmune diseases. Psychoneuroendocrinology. 2009;34(Suppl 1):S265-77. doi.org/10.1016/j.psyneuen.2009.05.023
Dickens AP, Lang IA, Langa KM, Kos, K, Llewellyn DJ. Vitamin D, cognitive dysfunction and dementia in older adults. CNS Drugs. 2011;25(8):629-39. doi: 10.2165/11593080-000000000-00000
Kuningas M, Mooijaart SP, Jolles J, Slagboom PE, Westendorp RG, et al. VDR gene variants associate with cognitive function and depressive symptoms in old age. Neurobiol Aging. 2009;30(3):466-73. DOI: 10.1016/j.neurobiolaging.2007.07.001
Llewellyn DJ, Lang IA, Langa KM, Muniz-Terrera G, Phillips CL, et al. Vitamin D and risk of cognitive decline in elderly persons. Arch Intern Med. 2010;170(13):1135-41. doi: 10.1001/archinternmed.2010.173
Slinin Y, Paudel ML, Taylor BC, Fink HA, Ishani A, et al. 25-Hydroxyvitamin D levels and cognitive performance and decline in elderly men. Neurology. 2010;74 (1):33-41. doi.org/10.1212/WNL.0b013e3181c7197b
Gómez-Oliva R, Geribaldi-Doldán N, Domínguez-García S, Carrascal L, Verástegui C, et al. Vitamin D deficiency as a potential risk factor for accelerated aging, impaired hippocampal neurogenesis and cognitive decline: a role for Wnt/β-catenin signaling. Aging (Albany NY). 2020;12(13):13824-44. doi: 10.18632/aging.103510. doi: 10.18632/aging.103510.
Tang Y, Chen Y, Liu R, Li W, Hua B, et al. Signaling Pathways: a role in pain processing NeuroMolecular Medicine. 2022;24:233-49. doi.org/10.1007/s12017-021-08700-z
Arosio B, Rossi PD, Ferri E, Cesari M, Vitale G. Characterization of Vitamin D status in older persons with cognitive impairment. Nutrients. 2022;14:1142. doi.org/10.3390/nu14061142
Duchaine CS, Talbot D, Nafti M, Giguère Y, Dodin S, et al. Vitamin D status, cognitive decline and incident dementia: the Canadian study of health and aging. Can J Public Health. 2020;111:312-21. doi.org/10.17269/s41997-019-00290-5
Kang JH, Vyas CM, Okereke OI, Ogata S, Albert M, et al. Effect of vitamin D on cognitive decline: results from two ancillary studies of the VITAL randomized Trial. Sci Rep. 2021;11:23253. doi: 10.1038/s41598-021-02485-8
Aspell N, Brian Lawlor B, O’Sullivan M. Is there a role for vitamin D in supporting cognitive function as we age? Proc Nutr Soc. 2018;77:124-34. doi:10.1017/S0029665117004153
Lai RH., Hsu YY, Shie FS, Huang CC, Chen MH, et al. Non-genomic rewiring of vitamin D receptor to p53 as a key to Alzheimer's disease. Aging Cell. 2021;20(12), e13509. doi.org/10.1111/acel.13509
Lai RH, Hsu CC, Yu BH, Lo YR, Hsu YY, et al. Vitamin D supplementation worsens Alzheimer's progression: animal model and human cohort studies. Aging Cell. 2022;21(8):e13670. doi: 10.1111/acel.13670.
Hooper C, Meimaridou E, Tavassoli M, Melino G, et al. P53 is upregulated in Alzheimer's disease and induces tau phosphorylation in HEK293a cells. Neurosci Lett. 2007;418(1):34-7. doi:10.1016/j.neulet.2007.03.026
Martínez VG, Salas AA, Ballestín SS.
Vitamin supplementation and dementia: a systematic review. Nutrients. 2022; 14(5):1033. doi: 10.3390/nu14051033
Annweiler C, Fantino B. Gautier J, Beaudenon M, Thiery S, et al. Cognitive effects of vitamin D supplementation in older outpatients visiting a memory clinic: a pre-post study. J Am Geriatr Soc. 2012;60:793-5. DOI: 10.1111/j.1532-5415.2011.03877.x
Pfeifer M, Begerow B, Minne HW. Vitamin D and muscle function. Osteoporos Int 2002;13(3):187-94. doi.org/10.1007/s001980200012
Ontario Health. Prevention of falls and fall-related injuries in community-dwelling seniors: an evidence-based analysis. Ont Health Technol Assess Ser. 2008;8(2):1-78. PMCID: PMC3377567
Al Snih S, Markides KS, Ray L, Ostir GV, Goodwin JS. Handgrip strength and mortality in older Mexican Americans. J Am Geriatr Soc. 2002;50(7):1250-6. DOI: 10.1046/j.1532-5415.2002.50312.x
Shobha S R. Prevention of falls in older patients. Am Fam Phisician. 2005;72 (1):81-8. PMID:16035686
Tinetti M E. Preventing falls in elderly persons. N Engl J Med. 2003;348(1):42-9. DOI: 10.1056/NEJMcp020719
Bischoff-Ferrari HA, Dawson-Hughes B, Willett WC, Staehelin HB, Bazemore MG, et a.. Effect of vitamin D on falls: a meta-analysis. JAMA. 2004;291(16): 1999-2006. doi: 10.1001/jama.291.16.1999
Bischoff-Ferrari HA, Dietrich T, Orav EJ, Hu FB et al. Higher 25-hydroxyvitamin D concentrations are associated with better lower-extremity function in both active and inactive persons aged >or=60y. Am J Clin Nutr. 2004; 80 (3):752-8. DOI: 10.1093/ajcn/80.3.752
Flicker L, Macinnis RJ, Stein MS, Scherer SC, Mead KE, et al. Should older people in residential care receive vitamin d to prevent falls? results of a randomized trial. J Am Geriatr Soc. 2005; 53:1881-8. DOI:10.1111/j.1532-5415.2012.04190.x
Kong SH, Jang HN, Kim JH, Kim SW, Shin CS. Effect of vitamin D supplementation on risk of fractures and falls according to dosage and interval: a meta-analysis. Endocrinol Metab (Seoul). 2022;37(2):344-58. doi: 10.3803/EnM.2021.1374
Waterhouse M, Sanguineti E, Baxter C, Romero BD, McLeod DSA, et al. Vitamin D supplementation and risk of falling: outcomes from the randomized, placebo controlled D-Health trial. J Cachexia Sarcopenia Muscle. 2021;12(6):1428-39. doi:10.1002/jcsm.12759
LeBoff MS, Murata EM, Cook NR, Cawthon P, Chou SH, et al. VITamin D and OmegA-3 TriaL (VITAL): Effects of vitamin D supplements on risk of falls in the US population. J Clin Endocrinol Metab. 2020;105(9):2929-38. doi: 10.1210/clinem/dgaa311.
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