Associação entre o status de vitamina D e os componentes da síndrome metabólica: estudo Brazuca Natal e estudo Brazuca Natal pós-Covid-19

Abstract

Abdominal obesity, systemic arterial hypertension (SAH), altered blood glucose levels and dyslipidemia, characterized by an increase in triglycerides (TG) and a reduction in high-density lipoprotein (HDL), are criteria that make up metabolic syndrome (MS). Among the environmental factors associated with the components of this syndrome, the dietary intake of micronutrients stands out, the inadequacy of which can compromise metabolic processes and aggravate nutritional deficiencies, including vitamin D deficiency. Furthermore, the COVID19 pandemic has aggravated this scenario by negatively impacting eating habits and reducing exposure to sunlight, with possible prolonged effects. In view of this, this study aims to verify the association between vitamin D status and MS components in the Brazuca Natal Study and Brazuca Natal Post-COVID-19 Study. Both studies have a population-based cross-sectional design. The Brazuca Natal Study was collected from June 2019 to March 2020, interrupted by the COVID-19 pandemic. The Brazuca Natal post-COVID-19 Study began in March 2023 and ended in March 2024, involving adults and elderly people of both sexes living in Natal/RN. The Brazuca Natal Study sample consisted of 411 participants and the subsample of 111 participants (collection of biological material), while the Brazuca Natal post-COVID-19 Study sample consisted of 138 participants and the subsample of 107 participants. Data was collected in three stages: Stage 1: A face-to-face interview was conducted to collect sociodemographic data (age and gender), socioeconomic data (per capita income) and lifestyle data (exposure to sunlight), using an electronic questionnaire (Epicollect5). Anthropometric measurements were taken (weight, height and waist circumference) and blood pressure was measured. Food consumption was collected from the 24hR using the Brazilian version of the Globodiet software. Stage 2: Blood was taken to analyze biomarkers related to MS (glycemia, total cholesterol, HDL, LDL, triglycerides, CRP) and vitamin D status. Stage 3: Food consumption was reassessed via R24h by telephone call. Statistical analysis was carried out using stata software, version 15, and p-values < 0.05 were considered significant. Initially, we assessed the prevalence of inadequate micronutrient intake in the Brazuca Natal Study, stratified by age group and income, in order to see how vitamin D intake was in the study population, then we assessed vitamin D status associated with MS components and exposure to sunlight in both studies. The results indicated a high prevalence of inadequate (>50%) dietary intake of calcium, vitamins B6, D and E in adults and elderly people of both sexes, as well as magnesium in elderly men and selenium and thiamine in adult and elderly women in the Brazuca Natal Study. The highest prevalence of inadequacy (>80%) was observed for vitamins D and E in all groups, with vitamin D inadequacies exceeding 95% regardless of gender and age group. We observed that the prevalence of inadequacy varied according to income level, depending on the specific micronutrient. After the results revealed a high prevalence of inadequate dietary intake of micronutrients, specifically vitamin D, the following results revealed a significant association between lipid profile (total cholesterol, HDL and LDL) and vitamin D deficiency in the Brazuca Natal Study (p<0, 05), however in the Brazuca Natal post-COVID-19 Study only cholesterol showed a statistically significant association with vitamin D deficiency. Fasting glucose showed an association with vitamin D deficiency only in the Brazuca Natal post-COVID-19 Study (p<0.05). While exposure to sunlight showed a marginally significant association with vitamin D deficiency only in the Brazuca Natal study (p=0.53). There was no significant association between triglycerides, high blood pressure, waist circumference and CRP and vitamin D deficiency. We conclude that the population evaluated has a high prevalence of inadequate micronutrients, especially vitamin D, as well as associations between its deficiency and changes in MS components, varying between the Brazuca Natal and Brazuca Natal post-COVID-19 studies.