Resumen
Objetivo: Investigar la asociación entre los niveles séricos de 25-hidroxivitamina D y el perfil lipídico en adultos mayores hipertensos que viven en Alagoas, considerando variables cardiometabólicas asociadas [. Métodos: Estudio observacional transversal, basado en el análisis secundario de datos del proyecto “I Diagnóstico Alagoano sobre la Salud de la Persona Mayor”. Se incluyeron 270 individuos de ≥60 años con hipertensión arterial. Se evaluaron variables antropométricas, composición corporal, presión arterial y exámenes de laboratorio. Los participantes fueron clasificados en vitamina D suficiente (≥30 ng/mL) e insuficiente (<30 ng/mL). Resultados: La muestra presentó una edad mediana de 71 años, predominio femenino (68,5%) y alta inactividad física (84,1%). La insuficiencia de vitamina D se asoció con mayores niveles de colesterol total, LDL-c y colesterol no-HDL (p<0,001). No se observaron diferencias en HDL-c, glucemia ni presión arterial. Se observó una correlación inversa entre 25(OH)D y colesterol no-HDL (p<0,001), LDL-c (p<0,001) y colesterol total (p=0,001). En la regresión logística multivariada ajustada por sexo, edad, glucemia e IMC, el colesterol total (p=0,003), LDL-c (p=0,012), colesterol no-HDL (p=0,003) y HDL-c (p=0,018) mostraron asociación significativa con la insuficiencia de vitamina D. Conclusión: La insuficiencia de vitamina D se asoció a un peor perfil lipídico en adultos mayores hipertensos, lo que sugiere la relevancia clínica del monitoreo de la vitamina D como componente complementario en la evaluación metabólica.
Referencias
AMERICAN DIABETES ASSOCIATION PROFESSIONAL PRACTICE COMMITTEE. Standards of Care in Diabetes—2025. Diabetes Care, 2025; 48(Suppl. 1).
BRASIL. Instituto Brasileiro de Geografia e Estatística. Censo demográfico 2022. Rio de Janeiro: IBGE, 2022.
BRASIL. Ministério da Saúde. Secretaria de Vigilância em Saúde. Vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico: VIGITEL 2023. Brasília: Ministério da Saúde, 2023.
FERREIRA CES, et al. Posicionamento Oficial da Sociedade Brasileira de Patologia Clínica/Medicina Laboratorial e da Sociedade Brasileira de Endocrinologia e Metabologia sobre o diagnóstico laboratorial da deficiência de vitamina D: atualização 2024. Archives of Endocrinology and Metabolism, 2024.
FRASER A, et al. Associations of serum 25-hydroxyvitamin D, parathyroid hormone and calcium with cardiovascular risk factors: analysis of 3 NHANES cycles (2001–2006). PLoS One, 2010; 5(11): e13882.
GALLAGHER D, et al. Healthy percentage body fat ranges: an approach for developing guidelines based on body mass index. The American Journal of Clinical Nutrition, 2000; 72(3): 694-701.
GANJI V, et al. Serum 25-hydroxyvitamin D concentrations are associated with prevalence of metabolic syndrome and various cardiometabolic risk factors in US children and adolescents based on assay-adjusted serum 25-hydroxyvitamin D data from NHANES 2001–2006. The American Journal of Clinical Nutrition, 2011; 94(1): 225-233.
GRANT WB, et al. Vitamin D and cardiovascular health: a narrative review of risk reduction evidence. Nutrients, 2025; 17(13): 2102.
GRIZ LHM, et al. Vitamina D e diabetes mellitus: uma atualização de 2013. Arquivos Brasileiros de Endocrinologia e Metabologia, 2014; 58(1): 1-8.
HASKELL WL, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Medicine & Science in Sports & Exercise, 2007; 39(8): 1423-1434.
LATIC N, ERBEN RG. Vitamin D and cardiovascular disease, with emphasis on hypertension, atherosclerosis, and heart failure. International Journal of Molecular Sciences, 2020; 21(18): 6483.
LIEFAARD MC, et al. Vitamin D and C-reactive protein: a Mendelian randomization study. PLoS One, 2015; 10(7): e0131740.
LUPTON JR, et al. Deficient serum 25-hydroxyvitamin D is associated with an atherogenic lipid profile: the Very Large Database of Lipids (VLDL-3) study. Journal of Clinical Lipidology, 2016; 10(1): 72-81.
ORGANIZAÇÃO MUNDIAL DA SAÚDE. Global atlas on cardiovascular disease prevention and control: policies, strategies, and interventions. Geneva: World Health Organization, 2017.
ORGANIZACIÓN PANAMERICANA DE LA SALUD. Encuesta multicéntrica: salud, bienestar y envejecimiento (SABE) en América Latina y el Caribe: informe preliminar. Washington, DC: OPAS, 2002.
RENKE G, et al. Effects of vitamin D on cardiovascular risk and oxidative stress. Nutrients, 2023; 15(3): 769.
ROCK CL, et al. Weight loss is associated with increased serum 25-hydroxyvitamin D in overweight or obese women. Obesity, 2012; 20(11): 2296-2301.
SECONDULFO C, et al. Vitamin D: a bridge between kidney and heart. Life, 2024; 14(5): 617.
SKAABY T, et al. Vitamin D, cardiovascular disease and risk factors. In: FELDMAN D, et al. Advances in Experimental Medicine and Biology. Cham: Springer, 2017; 996: 221-230.
SOCIEDADE BRASILEIRA DE CARDIOLOGIA. Diretriz Brasileira de Prevenção Cardiovascular. Arquivos Brasileiros de Cardiologia, 2019; 113(4 Suppl. 2): 1-78.
UNITED NATIONS. Department of Economic and Social Affairs. Our world is growing older: UN DESA releases new report on ageing. New York: United Nations, 2023.
VIEIRA NFL. Associação entre níveis séricos de 25-hidroxivitamina D com composição corporal e risco cardiovascular em idosos. Tese (Doutorado em Biologia Celular e Molecular Aplicada). Universidade de Pernambuco, Recife, 2023.
VIEIRA NFL, et al. 25-hydroxyvitamin D insufficiency and inflammation increase cardiovascular risk in older people. Experimental Gerontology, 2022; 165: 111864.
WIMALAWANSA SJ. Vitamin D and cardiovascular diseases: causality. The Journal of Steroid Biochemistry and Molecular Biology, 2018; 175: 29-43.
WORLD HEALTH ORGANIZATION. Waist circumference and waist-hip ratio: report of a WHO expert consultation, Geneva, 8–11 December 2008. Geneva: World Health Organization, 2011.
