Plasma Levels Of Vitamin Research Articles

A Nested Case–Control Study on Plasma Vitamin E and Risk of Cancer: Evidence of Effect Modification by Selenium

BackgroundEvidence from epidemiologic studies has been inconsistent regarding the role of vitamin E in cancer incidence risk. ObjectiveThe aim of this study was to evaluate the prospective association between baseline plasma vitamin E levels and subsequent cancer risk in Chinese adults with hypertension, and to identify effect modifiers. DesignA nested, case–control study was conducted from 20,702 hypertensive participants in the China Stroke Primary Prevention Trial, a randomized, double-blind, controlled trial, conducted from May 2008 to August 2013. ParticipantsThe current study included 229 new cancer cases and 229 controls matched for age (±1 year), sex, treatment group, and study site. Main outcome measuresPlasma vitamin E was measured by liquid chromatography with tandem quadrupole mass spectrometers and plasma selenium was measured by inductively coupled plasma mass spectrometry using Thermo Fisher iCAP Q ICP-MS. Statistical analysesOdds ratios (OR) of cancer in relation to plasma concentrations of vitamin E were calculated using conditional logistic regression models. ResultsMedian follow-up duration was 4.5 years. Overall, vitamin E was not associated with subsequent risk of total cancer (per 1-mg/L [2.3 μmol/L] increase: OR 1.01, 95% CI 0.93 to 1.09) and non-gastrointestinal cancer (OR 1.10, 95% CI 0.98 to 1.24). However, there was a significant, inverse association between vitamin E and gastrointestinal cancer (OR 0.86, 95% CI 0.75 to 0.99), particularly esophageal cancer (OR 0.67, 95% CI 0.48 to 0.95). Moreover, high vitamin E decreased the risk of total cancer (OR 0.91, 95% CI 0.84 to 0.99) and gastrointestinal cancer (OR 0.83, 95% CI 0.73 to 0.95) among patients with high selenium levels (median≥83.7 μg/L [1.1 μmol/L]), and increased the risk of total cancer (OR 1.13, 95% CI 1.00 to 1.26) and non-gastrointestinal cancer (OR 1.25, 95% CI 1.03 to 1.50) among those with low selenium levels (<83.7 μg/L [1.1 μmol/L]). ConclusionsThis study suggests that higher levels of plasma vitamin E are associated with reduced risk of gastrointestinal cancer. High vitamin E decreased the risk of total cancer among patients with high selenium levels, but increased the risk of total cancer among those with low selenium levels.

The Effect of a High-intensity Interval Training on Plasma Vitamin D Level in Obese Male Adolescents.

Background:The worldwide increasing vitamin D deficiency in adolescents is alarming. The effect of high-intensity trainings on adolescent health is not clear.Object:This study aimed to examine the effect of a high-intensity interval training (HIIT) on plasma level of vitamin D in overweight male adolescents.Materials and Methods:About 96 overweight students aged 12–16 years from two high schools participated in the study. The schools were randomly assigned to the intervention group (n = 52) and the control group (n = 44). For the intervention group, HIIT was performed 3 days per week for 8 weeks, while the control group was asked to walk outdoors at the same time.Results:At the end of the study, the vitamin D level was increased to 1.21 ng/dl in the intervention group, whereas it decreased to 1.94 ng/dl in the control group (P = 0.003).Conclusion:About 8 weeks of HIIT improved plasma level of vitamin D in overweight male adolescents. More prolonged interventions consisted of both the sex and broader age ranges are warranted.

Surgery-Induced Changes in Erythrocyte and Plasma Lipid Peroxidation, Enzymatic and Non-Enzymatic Antioxidants of Female Rats: Protective Role of Heparin and Pentoxifylline

Background: Intra abdominal adhesions are a complication that occurs after many abdominal surgical procedures, especially gynecological operations. These complications occur by irritating the peritoneum due to such circumstances as infection or surgical trauma, and are considered a pathological part of the healing process of peritoneal injury. It manifests itself with symptoms such as pain, intestinal or urethral obstruction and abdominal abscesses. Oxidative stress due to adhesions plays an important role on adhesion formation. In addition to many researches done at the point of prevention of adhesion and decreasing stress parameters, in this study, it was planned to determine the effect of Heparin (H) and Pentoxifylline (PTX) on malondialdehyde (MDA) and some antioxidant values.Materials, Methods &amp; Results: This study was performed on rats and thirty-seven female Sprague-Dawley rats were randomized into four groups. The first group was sham (Sh) group (n = 7) and laparotomy was performed and 2 mL of 0.9 % NaCl was applied. For all other rats (n = 30) the small intestine was withdrawn and the uterus was uncovered and the anti mesenteric surfaces of the left uterine horn and left abdominal wall were superficially tilted until slight bleeding was seen. Lesion areas have been covered. Two mL 0.9 % NaCl to control (C) group (n = 10), 500 IU heparin to group H, and 25 mg / kg Pentoxifylline to group PTX (n = 10) have been given and then the abdominal incision was closed. The adhesion score of group Sh was found to be more important than C and PTX groups (P &lt; 0.05). The adhesion score of group C was determined to be more significant than group H (P &lt; 0.05). In group Sh, erythrocyte reduced glutathione (GSH) levels were found to be more significant (P &lt; 0.01) than C, H and PTX groups whereas it was found that group C was more significant than group H (P &lt; 0.01). In group Sh, glutathione peroxidase (GSH-Px) activity was found to be more significant (P &lt; 0.05) than H and PTX groups, while MDA level was found to be lower and more significant (P &lt; 0.01) than group C. In addition, group C was found to be higher and more significant (P &lt; 0.01) than group H. Plasma vitamin E levels in Sh, H and PTX groups were found to be higher and more significant (P &lt; 0.01) than group C. It is also observed that MDA levels in group C are higher and more significant (P &lt; 0.01) than all groups. Nitric oxide (NO) level in Sh group was found to be lower and more significant (P &lt; 0.05) than the other groups whereas it is determined that NO level in H group is higher and more significant (P &lt; 0.05) than group C. Activites of erythrocyte catalase (CAT) and superoxide dismutase (SOD), the levels of plasma vitamin A and β-carotene were not important in all groups.Discussion: Intra abdominal adhesions that occur due to operations performed in the abdominal region still remain as a major problem. This adhesion brings certain problems with itself. Various applications have been made to reduce these problems. In this study, it was observed that inhibition of heparin and pentoxifylline adhesions contributed to the reduction of MDA levels and the reduction of oxidative damage due to the increase in levels of Vitamin E, GSH, GSH-Px and NO levels. In conclusion, it is suggested that heparin and pentoxifylline should be used to prevent adhesions due to abdominal operations and to reduce oxidative damage.

Investigating Nutrition-Related Complications and Quality of Life in Patients With Gastroenteropancreatic Neuroendocrine Tumors: Protocol for a Mixed-Methods Prospective Study.

BackgroundGastroenteropancreatic neuroendocrine tumors (GEP NETs) are a heterogeneous group of tumors with distinct effects on the body due to their potential to secrete hormones and peptides. The incidence and prevalence of GEP NETs in Australia are rising. During 2000-2006, the annual incidence was approximately 3.3 per 100,000 population. To date, there has been development of clinical practice and consensus guidelines for NETs covering best practice for diagnosis, treatment, and medical management; however, the supportive care needs and optimal nutritional management of patients affected by NETs remains underresearched, and evidence to guide clinical practice is lacking. While there is emerging research describing the extent of morbidity in different types of GEP NET patients, little is known about the experience of people affected by these tumors and how nutritional status is impacted by either diagnosis or treatment.ObjectiveThe objective of this study was to explore nutrition-related complications and quality of life of patients diagnosed with a GEP NET and to generate evidence to inform future research and development of nutrition screening and management practices.MethodsPatients diagnosed with a GEP NET at two metropolitan recruitment sites will be invited to participate in a 6-month, mixed-methods longitudinal study. Participants recruited to the study will receive usual care and participate in data collection for the study at 4 time points (at recruitment and 2, 4, and 6 months postrecruitment). Study data will include nutritional status, body weight, fat-free mass, and patient-reported outcome measures (dietitian contact, disease-related symptom presence and severity, dietary habits, health-related quality of life, psychological morbidity, and financial impact). At recruitment and 6 months postrecruitment, complete nutrient testing, including relevant plasma vitamin levels, will also be undertaken. A purposive sample of participants will be invited to take part in semistructured interviews to explore the experience of living with a GEP NET and associated nutrition complications.ResultsEthics approval has been obtained, and study recruitment and data collection are underway.ConclusionsThis study will provide the first in-depth, comprehensive description of nutritional issues in patients with GEP NETs. Results will advance the knowledge of nutritional issues faced by patients with GEP NETs and help inform the development of screening tools and clinical practice guidelines.International Registered Report Identifier (IRRID)DERR1-10.2196/11228

Poor Vitamin Status is Associated with Skeletal Muscle Loss and Mucositis in Head and Neck Cancer Patients.

Mucositis and muscle wasting are two common toxicity effects of cancer treatment in head and neck cancer (HNC). There is limited data evaluating cancer treatment toxicities in relation to vitamin status. This study aimed to assess changes in vitamin status during HNC treatment in relation to body composition, inflammation and mucositis. In this prospective cohort study, dietary intakes (3-day food record), plasma levels of vitamins and C-reactive protein (CRP) were assessed at baseline (at diagnosis) and post-treatment (after 6–8 weeks of radiation therapy with or without chemotherapy). Computed tomography images were used to quantify body composition. Mucositis information was collected from health records of patients. Twenty-eight HNC patients (age 60 ± 10 years) completed both study time points. Patients who developed mucositis had significantly lower dietary intake of vitamins and plasma 25-hydroxy vitamin D (25-OHD) and all-trans retinol levels (p < 0.02). Patients lost a considerable amount of muscle mass (3.4 kg) and fat mass (3.6 kg) over the course of treatment. There was a trend toward greater muscle loss in patients with 25-OHD < 50 nmol/L compared to patients with 25-OHD ≥ 50 nmol/L (p = 0.07). A significant negative correlation was found between plasma all-trans retinol and CRP level at the end of treatment (p = 0.03). Poor vitamin status could be a contributing factor in developing treatment-induced toxicities.

Prevalence and Factors Associated with Helicobacter Pylori in Patients Undergoing Bariatric Surgery: the SOON Cohort.

Helicobacter Pylori (HP) infection is systematically screened for before carrying out bariatric surgery. Criteria to determine "at risk" patients and avoid systematic screening are lacking. We evaluated the prevalence of HP infection and associated predictive factors in a population of patients with class II and III obesity volunteering for bariatric surgery. Observational, cross-sectional study of patients included in the severe obesity outcome network (SOON) cohort. All patients underwent HP screening. The relationship between plasma metabolic parameters and vitamin levels, medical history and socio-economic parameters, and HP infection was analyzed. Data from 201 patients, median age 43years [IQR 35; 52] (81% female) were analyzed. Forty-four patients (22%) were infected with HP and successfully treated, most with a single course of treatment, either combined antibiotics or Pylera®. HP infection was associated with social precariousness as defined by the French "Evaluation de la Précarité et des Inégalités de santé dans les Centres d'Examens de Santé" (EPICES) score (Evaluation of Poverty and Health Inequalities in Health-Assessment Centers) (OR, 1.027; 95% CI, 1.008-1.046; p < 0.004) and with higher levels of vitamin B12 (OR, 1.004; 95% CI, 1.001-1.007; p < 0.007). The prevalence of HP infection was 22% and was associated with social precariousness. Plasma glucose/insulin and lipid/lipoprotein profiles, liver enzymes or vitamin deficiencies were not associated with HP infection. The number of characteristics associated with HP infection was insufficient to define patients who do not require HP screening before bariatric surgery.

PERBANDINGAN ANTARA KADAR VITAMIN C PLASMA DARAH HAMIL ATERM PADA KETUBAN PECAH DINI DENGAN HAMIL ATERM TANPA KETUBAN PECAH DINI

Premature rupture of membranes is the most common complication of pregnancy. The incidence of premature rupture of membranes in pregnancy ranged from 6% to 10%, and 20% of these cases occur before 37 weeks gestation. The incidence of premature rupture of membranes in Indonesia ranges from 4.5% to 7.6% of all pregnancies. This research was conducted to determine the cross-sectional differences in the blood plasma levels of vitamin C in term pregnancy premature rupture of membranes with blood plasma levels of vitamin C in term pregnancy without premature rupture of membranes in M. Jam- il Padang hospital, Achmad Muchtar Bukittinggi hospital, and Pariaman Hospital. There are significant differences in vitamin C blood plasma levels in term pregnancy with premature rupture of membranes and term pregnancy without premature rupture of membranes ( P &lt; 0.05). Mean levels of vitamin C in blood plasma at term pregnancy with premature rupture of membranes lower than in the blood plasma levels of vitamin C in term pregnancy without premature rupture of membranes.Keywords: Premature rupture of membrane in aterm, blood plasma levels of vitamin C

Vitamin D Supplementation is a Promising Therapy for Pancreatic Ductal Adenocarcinoma in Conjunction with Current Chemoradiation Therapy.

The cancer-associated fibroblasts (CAFs) in pancreatic ductal adenocarcinoma (PDAC) are well known to play a dominant role in distant metastasis. Nevertheless, the effect on CAFs with current chemoradiation therapies remains uncertain. This study aimed to reveal the role of CAFs under current chemoradiation therapy (CRT) and investigate the factors regulating CAFs. α-SMA-positive cells in 86 resected PDAC specimens with/without preoperative CRT were evaluated by immunohistochemistry. Various factors, including the plasma levels of vitamin D, were investigated for association with the number of CAFs or distant metastasis-free survival (DMFS). Human pancreatic satellite cells (hPSCs) extracted from clinical specimens were used to validate the factors. All PDAC samples contained CAFs but the number varied widely. Multivariate analysis for DMFS indicated a larger number of CAFs was a significant risk factor. Univariate analysis for the number of CAFs identified two clinical factors: preoperative CRT and lower plasma levels of vitamin D. In subgroup analysis, the higher plasma level of vitamin D was a dominant factor for longer DMFS in PDAC patients after preoperative CRT. These results were validated by using extracted hPSCs. Irradiation activated stromal cells into CAFs facilitating malignant characteristics of PDAC and the change was inhibited by vitamin D supplementation in vitro. In conjunction with established current therapies, vitamin D supplementation may be an effective treatment for PDAC patients by inactivating CAFs.

OP-38 - Effect of Plasma Level of Vitamin D on Postoperative Atrial Fibrillation in Patients Undergoing Isolated Coronary Artery Bypass Grafting

Objective: Postoperative atrial fibrillation (PoAF) is a common complication after coronary artery bypass grafting (CABG). The aim of this study was to evaluate the relationship between development of PoAF and vitamin D levels in patients undergoing isolated CABG.

Reduced vitamin D receptor (VDR) expression and plasma vitamin D levels are associated with aging-related prostate lesions.

Protective roles have been proposed for vitamin D in prostate cancer, which has the advanced age as the major risk factor. However, little is known about the expression of the vitamin D receptor (VDR) in the aging prostate and its association with the development of epithelial lesions that affect tissue homeostasis and may precede prostate tumors. VDR expression in the prostatic complex of young adults to senile Wistar rats, a natural model to study age-related prostatic disorders, was evaluated by immunohistochemical, Western blotting, and image-assisted analyzes. Results were correlated with the plasma levels of vitamin D and testosterone, the occurrence of punctual histopathological changes in the aging prostate, and the expression of retinoid X receptors (RXR). VDR was widely distributed in the prostatic complex at all ages analyzed, with the highest immunoexpression found in basal epithelial cells. As the animals aged, VDR levels increased, except in punctual areas with intraepithelial proliferation, metaplasia, or proliferative inflammatory atrophy, which had reduced expression of this receptor concomitantly with increased cell proliferation. Interestingly, RXR expression in the aging prostate was similar to that found for its partner VDR, indicating that components of the VDR/RXR complex required for vitamin D signaling are affected in aging-related prostatic lesions. Moreover, plasma vitamin D levels declined at the same ages when prostatic alterations appeared. Although circulating levels of testosterone also decreased with aging, the changes observed in the components of the vitamin D system were not correlated with androgens. Our data indicate that the aging prostate suffers from an imbalance on the intricate mechanism of tissue regulation by the vitamin D responsive system. We argue that the status of VDR expression might be determinant for the development of histopathological alterations in the aging prostate, which include premalignant lesions.

A Randomized Trial of a Novel Chewable Multivitamin and Mineral Supplement Following Roux-en-Y Gastric Bypass.

Vitamin and mineral deficiencies are common following Roux-en-Y gastric bypass (RYGB) and can lead to significant morbidity, but little research on the efficacy of vitamin supplementation regimens exists. We compared the efficacy and tolerability of an investigational versus a standard multivitamin regimen in patients undergoing RYGB. Fifty-six patients, aged 18 to 65, were randomized to an investigational versus a standard multivitamin. Plasma levels of vitamins A, B-12, D, E-α, E-β/γ, thiamine, folate, iron, iron-binding capacity, iron saturation, prealbumin, and parathyroid hormone (PTH) were measured at 3 and 6months postoperatively. Proteins induced by vitamin K absence (PIVKA), beta-carotene, coenzyme Q10, and mixed tocopherols were measured at 3months postoperatively. Primary outcomes were differences in plasma levels at 3 and 6months. Secondary outcomes were palatability, ease of use, and adherence. Twenty-one patients were randomized to the standard regimen and 26 to the investigational multivitamin. Nine were lost to follow-up. At 3months, plasma levels of PTHwere lower (p = 0.042), and levels of vitamin D (p = 0.033), thiamine (p = 0.009), and beta-carotene (p = 0.033) were higher in the investigational multivitamin arm compared to those in the standard regimen arm. Patients receiving the investigational multivitamin reported higher taste satisfaction than those receiving the standard regimen (p = 0.035). The investigational multivitamin appears to be more effective than a standard multivitamin in maintaining therapeutic levels of clinically relevant vitamins and minerals, and was more palatable. Additional studies should be conducted to confirm these findings and refine the optimal dosing regimen. www.clinicaltrials.gov under identifier NCT01475617.

Effects of glutathione s-transferase (GST) M1 and T1 polymorphisms on antioxidant vitamins and oxidative stress-related parameters in Korean subclinical hypertensive subjects after kale juice (Brassica oleracea acephala) supplementation.

BACKGROUND/OBJECTIVESGlutathione s-transferase (GST) is involved in the formation of a multigene family comprising phase II detoxification enzymes, involved in the detoxification of reactive oxygen species. This study evaluated whether daily supplementation with kale juice could modulate levels of plasma antioxidant vitamins and oxidative stress-related parameters. We further examined whether this modulation was affected by combined GSTM1 and T1 polymorphisms.SUBJECTS/METHODSTotally, 84 subclinical hypertensive patients having systolic blood pressure (BP) over 130 mmHg or diastolic BP over 85 mmHg, received 300 mL of kale juice daily for 6 weeks. Blood samples were drawn before start of study and after completion of 6 weeks.RESULTSAfter supplementation, we observed significant decrease in DNA damage and increase in erythrocyte catalase activity in all genotypes. Plasma level of vitamin C was significantly increased in the wild/null and double null genotypes. The plasma levels of β-carotene, erythrocyte glutathione peroxidase activity, and nitric oxide were increased only in the wild/null genotype after kale juice supplementation.CONCLUSIONSThe effect of kale juice was significantly greater in the GSTM1 null genotype and wild/null genotype groups, suggesting possibility of personalized nutritional prescriptions based on personal genetics.

Effect of Plasma Level of Vitamin D on Postoperative Atrial Fibrillation in Patients Undergoing Isolated Coronary Artery Bypass Grafting.

ObjectivePostoperative atrial fibrillation (PoAF) is a common complication after coronary artery bypass grafting (CABG). The aim of the present study was to evaluate the association between development of PoAF and vitamin D levels in patients undergoing isolated CABG.MethodsThis prospective randomized clinical trial was conducted on the patients with isolated CABG. The study was terminated when 50 patients in both PoAF(+) group and PoAF(-) group were reached. Development of AF until discharge period was assessed. Vitamin D level was measured immediately after AF; it was measured on the discharge day for the patients without PoAF. Predictive values of the independent variables were measured for the development of PoAF.ResultsThe groups were separated as PoAF(-) group (66% male, mean age 58.18±10.98 years) and PoAF(+) group (74% male, mean age 61.94±10.88 years). 25(OH) vitamin D level (OR=0.855, 95% CI: 0.780-0.938, P=0.001) and > 65 years (OR=3.525, 95% CI: 1.310-9.483, P=0.013) were identified as an independent predictor of postoperative AF after CABG surgery in multivariate analysis. The cut-off level for 25(OH) vitamin D level in receiver-operating characteristic curve analysis was determined as 7.65 with sensitivity of 60% and specificity of 64% for predicting PoAF (area under the curve: 0.679, P=0.002).ConclusionVitamin D level is considered an independent predictor for development of PoAF. Lower vitamin D levels may be one of the reasons for PoAF.

Vitamin C supplementation in the critically ill: A systematic review and meta-analysis.

Background:Low plasma levels of vitamin C are associated with adverse outcomes, including increased mortality, in critically ill patients. Several trials have suggested that the administration of intravenous vitamin C in this setting may have beneficial effects, such as reducing the incidence of organ failure and improving survival. However, these studies have generally involved combination therapies consisting of vitamin C along with other antioxidants, confounding the effects of vitamin C alone. The primary objective of this meta-analysis is to investigate the effects of isolated intravenous supplementation of vitamin C in adults with critical illness.Methods:A database search was conducted for studies on the use of intravenous vitamin C in adult patients with critical illness. The primary outcome assessed was mortality at the longest follow-up time available. Secondary outcomes were the duration of mechanical ventilation, duration of vasopressor support, fluid requirements, and urine output in the first 24 h of intensive care unit admission.Results:Five studies (four randomized controlled trials and one retrospective review) enrolling a total of 142 patients were included in this meta-analysis. Compared with controls, the administration of intravenous vitamin C was associated with a decreased need for vasopressor support (standardized mean difference −0.71; 95% confidence interval (−1.16 to −0.26); p = 0.002) and decreased duration of mechanical ventilation (standardized mean difference −0.5; 95% confidence interval (−0.93 to −0.06); p = 0.03), but no difference was found in mortality (odds ratio 0.76; 95% confidence interval (0.27 to 2.16); p = 0.6). Trends were also noted toward decreased fluid requirements and increased urine output. No adverse effects were reported.Conclusion:The administration of intravenous vitamin C may lead to vasopressor sparing effects and a reduced need for mechanical ventilation in the critically ill, without affecting overall mortality. However, these results should be interpreted in light of the limitations of the primary literature and should serve as a preview of upcoming trials in this area.

Dietary patterns, plasma vitamins and Trans fatty acids are associated with peripheral artery disease

BackgroundTo investigate the association between dietary patterns (DP), plasma vitamins and trans fatty acids (TFAs) with the likelihood of peripheral artery disease (PAD).MethodsNational Health and Nutrition Examination Survey (NHANES) data for the years 1999–2002 were used. PAD was diagnosed by ankle brachial index assessment. Plasma concentrations of vitamins were measured using high performance liquid chromatography. Vitamin D levels were measured by radioimmunoassay. Analysis of covariance, principal components analysis (PCA) and adjusted logistic regression were applied, accounting for the survey design and sample weights.ResultsOf the 4864 eligible participants, 2482 (51.0%) were men and 269 (5.5%) had prevalent PAD. PCA uncovered three DPs which accounted for 56.8% of the variance in dietary nutrients consumption including DP1 (fatty acids and cholesterol), DP2 (minerals, vitamins and fiber), and DP3 (polyunsaturated fatty acids [PUFA]). PAD patients had a significantly higher serum concentrations of trans 9-octadecenoic acid and trans 9, trans 12-octadienoic acid as well as lower plasma levels of vitamin D, retinol, retinyl stearate and retinyl palmitate (p < 0.001 for all comparisons). In models adjusted for age, race, diabetes, cholesterol, hypertension, smoking and energy intake, individuals in the highest quartile of the DP1 had higher odds for PAD compared with those in the lowest quartile [(odds ratio (OR): 6.43, 95% confidence interval (CI): 2.00–20.63 p < 0.001], while those in the highest quartile of DP2 and DP3 had lower odds of PAD relative to those in the lowest quartile (OR:0.28, OR:0.44, respectively; p < 0.001 for both comparisons).ConclusionWe found that quality of diet, plasma vitamins and TFAs are associated with the likelihood of PAD. If confirmed in prospective studies, the possibility that dietary factors, plasma vitamins and TFAs might be valuable for preventing or delaying the clinical progression of PAD, should be investigated in intervention trials.

Clinical and Electrophysiological Characteristics of Vincristine Induced Peripheral Neuropathy in Children

ABSTRACTBackground: Vincristine is a chemotherapeutic agent frequently used in the treatment of childhood cancer. Peripheral neuropathy is an important side effect of Vincristine. We assessed the incidence, severity and type of peripheral neuropathy in children on Vincristine using clinical parameters and nerve conduction studies. Methods: Children with cancer treated with Vincristine were enrolled. Symptoms and signs of motor, sensory and autonomic peripheral neuropathy at baseline and at 3, 6 and 12 month follow up were documented. A modified total neuropathy score grading was undertaken. Nerve conduction studies (NCS) were undertaken and vitamin E levels measured at the time of these assessments.Results: 28 patients were enrolled over 12 months. 93% had evidence of neuropathy clinically and/or electrophysiologically. Weakness, pain and constipation were the most common symptoms and the most common sign was loss of ankle reflexes. The peripheral neuropathy was mild in most cases. Plasma levels of vitamin E remained in the normal range, however they dropped significantly from the baseline value.Conclusions: Peripheral neuropathy assessed clinically and electrophysiologically, occurs in the majority of children on Vincristine treatment. The neuropathy is sensory-motor and generally mild. There was a statistically significant drop in average vitamin E levels during treatment. Keywords: Vincristine, peripheral neuropathy, vitamin E

Abstract P520: Low Plasma Levels of Vitamin D are Not Associated With Carotid Artery Stiffness in Hypertension

Objectives: Recent studies suggest an association between vitamin D deficiency and prevalence of cardiovascular disease in the general population. However, the evidence of a relationship between vitamin D status and vascular functional changes in hypertension is currently controversial. We aimed to investigate if the presence of low serum vitamin D levels is associated with an increased arterial stiffness in essential hypertension. Design and Method: In 151 essential hypertensive patients (53±13 y, 71 males) we measured serum 25(OH)-vitamin D levels and performed a carotid ultrasound examination to determine variables of carotid stiffness, such as distensibility, compliance, Young elastic modulus and beta-stiffness. Furthermore, in a subgroup of 86 subjects we evaluated the augmentation index and the pulse wave velocity. The patients were subdivided into two groups according to the 25(OH)-vitamin D levels, lower or higher than 30 nmol/L. Results: A plasma vitamin D level lower than 30 nmol/L was found in 83 (55%) of 151 patients. Patients with low vitamin D levels were significantly older than those with a normal value of serum vitamin D. No significant differences in carotid artery distensibility, compliance, Young elastic modulus, and beta-stiffness were observed between patients with plasma vitamin D below or above 30 nmol/L. Also, the augmentation index and the pulse wave velocity were comparable in hypertensive patients with lower or higher plasma vitamin D levels. Conclusions: This study does not support the hypothesis of an association between vitamin D deficiency and functional vascular changes in hypertensive patients.

P 11 Hydrogen peroxide-induced inflammation and decreased vitamin D receptor in placental explants

Introduction Placental oxidative stress has been associated with the pathogenesis of preeclampsia (PE). The imbalance between pro- and anti-inflammatory cytokines in this pathology could be explained by the deficiency of regulatory factors capable of modulating this inflammatory state. Vitamin D may act as anti-inflammatory agent, by regulating the production of inflammatory cytokines and generating an immune tolerogenic environment. Objectives The present study evaluated whether there is association between plasma levels of vitamin D and cytokines, as well as gene expression of vitamin D receptor (VDR) and pro-and anti-inflammatory cytokines by placental explants obtained from normotensive (NT) pregnant women, from women with PE and from NT pregnant women explants treated with or without hydrogen peroxide (H2O2). Methods Blood of 20 PE and 20 NT were collected and plasma concentrations of 25-hydroxyvitamin D [25(OH) D] was evaluated by chemiluminescence. Plasma levels of Interleukin-1 beta (IL-1β), IL-10 and tumor necrosis fator alpha (TNF-α) were detected by ELISA. Placental explants from 15 NT pregnant and 15 PE women in the third trimester of pregnancy were obtained from women undergoing elective cesarean section. NT placental explants were cultured with or without 100 μM H2O2 for 4 h. The gene expression of cytokines (IL-1β, IL-10 and TNF-α) and VDR were determined by qPCR. Differences between groups were analyzed by non-parametric tests with significant level set at 5%. Results Plasma concentration of 25(OH) D and IL-10 was significantly lower in PE group than in the NT group, while levels of TNF-α and IL-1β were higher in PE group. Gene expression of VDR was lower in explants from PE group and in the NT group with H2O2. Gene expression of TNF-α and IL-1β were significantly higher in PE and NT with H2O2. However, IL-10 levels were significantly lower in these groups when compared to normotensive group. Positive correlation between IL-10 and VDR gene expression was observed between normotensive groups (r = 0.8857; p = 0.0333). Conclusion The results showed an imbalance between vitamin D and its receptor with cytokine profile in explants from preeclamptic women as well as in placental explants obtained from NT pregnant women and submitted to oxidative stress and inflammation induced by hydrogen peroxide. Financial support – FAPESP 2016/18155–9

P 14 Deficiency of regulatory profile in pregnant women with early-onset preeclampsia

Introduction Preeclampsia (PE) is a pregnancy specific syndrome characterized by a systemic inflammatory response. An imbalance between Th17 and regulatory T cell detected in this pathology seems to be dependent on the deficiency of regulatory factors capable of modulating this inflammation. Vitamin D generates an immune tolerogenic status through its regulatory activities on the inflammatory response. Objectives The present study aimed to evaluate the plasma levels of vitamin D, cytokines and to analyze the profile of CD4+ T cells subsets as well as the expression of vitamin D receptor (VDR) in peripheral blood mononuclear cells from pregnant women with PE. Methods Twenty women with early-onset PE, 20 women with late-onset PE and 20 normotensive (NT) pregnant women were studied. Plasma concentrations of vitamin D was evaluated by chemiluminescence and the levels of IL-10, IL-17 and TNF-a were determined by ELISA. Gene expression of VDR, transcription factors RORc (Th17) and FoxP3 (Treg) were evaluated by qPCR. Results were analyzed by non-parametric tests at 5% significance level. Results Plasma concentration of vitamin D was significantly lower in early-onset PE group compared to late-onset PE and NT groups, while the levels of TNF-α and IL-17 were significantly higher in early-onset PE group. On the other hand, IL-10 levels were significantly lower in both PE groups than in NT group. Gene expression of VDR was significantly decreased in early-onset PE group compared to NT group, while higher expression of mRNA RORc and lower expression of mRNA FoxP3 were observed in preeclamptic women. Positive correlation between vitamin D vs VDR and VDR vs FoxP3 was observed in PE (r = 0.44, p Conclusion In preeclamptic women there is a decrease in regulatory status, suggesting a deficient immunomodulatory role of vitamin D that result in higher inflammatory profile, more evident in the early-onset PE. This imbalance in maternal tolerance indicate that vitamin D may participate in the pathogenesis of the disease.

The risk of plasma vitamin A, C, E and D deficiency in patients with metabolic syndrome: a case-control study

The increasing incidence of metabolic diseases such as obesity or diabetes have made them a major public health problem. Increasing oxidative stress induced by reactive oxygen species, which initiate the oxidative adverse changes in the cell, is mentioned, among other risk factors, to underlie these diseases. Vitamin A, C and E are listed among the non-enzymatic mechanisms counteracting this phenomenon. Vitamin D deficiency is also associated with cardiovascular diseases. The aim of the study was to assess the risk of vitamin A, C, E and D deficit in the plasma of metabolic syndrome (MS) patients. The study included 191 patients with MS and 98 subjects without MS. Loglinear analysis was used in the assessment of mutual interactions between the vitamin concentration and the analysis of classification by ROC curves to predict the frequency of vitamin deficiency in MS patients. A correlation was found between the plasma level of vitamins in the group of MS patients. Vitamin A concentration correlated with that of vitamin C (r = 0.51, p = 0.0000), vitamin D (r = 0.49, p = 0.0000) and E (r = 0.32, p = 0.0001). The plasma level of vitamin D correlated with the level of vitamin E (r = 0.46, p = 0.00000) and vitamin C (r = 0.37, p = 0.0000). Regression analysis showed a correlation between the concentration of the tested vitamins in patients with MS. Interactions were observed between vitamins C and A and between C and D. HDL cholesterol level was lower in patients with vitamin A deficiency compared to patients with its normal level. The plasma levels of vitamin A, C, E and D were significantly lower in patients with MS than in healthy subjects and they mutually correlated with each other. The normalization of glucose and HDL level may contribute to the regulation of the concentration of vitamin A in patients with MS.