Vitamin D deficiency is highly prevalent in COPD and correlates with variants in the vitamin D-binding gene

Defisiensi vitamin D sering terjadi pada COPD, dan berhubungan dengan beratnya serangan.

Dianjurkan pemberian suplemen vitamin D pada penderita COPD berat, terutama bagi penderita dengan varian gen rs7041.

Thorax 65:215-220, March 2010 © 2010 BMJ Publishing Group Ltd & British Thoracic Society
Vitamin D deficiency is highly prevalent in COPD and correlates with variants in the vitamin D-binding gene. Wim Janssens, Roger Bouillon, Bart Claes, et al. 

Abstract

Introduction Vitamin D deficiency has been associated with many chronic illnesses, but little is known about its relationship with chronic obstructive pulmonary disease (COPD).

Objectives Serum 25-hydroxyvitamin D (25-OHD) levels were measured in 414 (ex)-smokers older than 50 years and the link between vitamin D status and presence of COPD was assessed. The rs7041 and rs4588 variants in the vitamin D-binding gene (GC) were genotyped and their effects on 25-OHD levels were tested.

Results In patients with COPD, 25-OHD levels correlated significantly with forced expiratory volume in 1 s (FEV₁) (r=0.28, p<0.0001). Compared with 31% of the smokers with normal lung function, as many as 60% and 77% of patients with GOLD (Global Initiative for Obstructive Lung Disease) stage 3 and 4 exhibited deficient 25-OHD levels <20 ng/ml (p<0.0001). Additionally, 25-OHD levels were reduced by 25% in homozygous carriers of the rs7041 at-risk T allele (p<0.0001). This correlation was found to be independent of COPD severity, smoking history, age, gender, body mass index, corticosteroid intake, seasonal variation and rs4588 (p<0.0001). Notably, 76% and 100% of patients with GOLD stage 3 and 4 homozygous for the rs7041 T allele exhibited 25-OHD levels <20 ng/ml. Logistic regression corrected for age, gender and smoking history further revealed that homozygous carriers of the rs7041 T allele exhibited an increased risk for COPD (OR 2.11; 95% CI 1.20 to 3.71; p=0.009).

Conclusion Vitamin D deficiency occurs frequently in COPD and correlates with severity of COPD. The data warrant vitamin D supplementation in patients with severe COPD, especially in those carrying at-risk rs7041 variants.

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Salam sehat,
Dr. David Fadjar Putra, MS
Spesialis Gizi Klinik
@
www.kliniknutrisi.com
kliniknutrisi.blogspot.com

Apakah statin dapat menurunkan tekanan darah ?

Apakah pemberian preparat statin dapat menurunkan tekanan darah ?

Penelitian dari berikut ini tidak mendapatkan efek penurunan tekanan darah dari pemberian statin.

BMJ 340: c1197, 25 March 2010 © 2010 Mancia et al.
Statins, antihypertensive treatment, and blood pressure control in clinic and over 24 hours: evidence from PHYLLIS randomised double blind trial. Giuseppe Mancia, Gianfranco Parati, Miriam Revera, et al. 

Objective To investigate the possibility that statins reduce blood pressure as well as cholesterol concentrations through clinic and 24 hour ambulatory blood pressure monitoring.

Design Randomised placebo controlled double blind trial.

Setting 13 hospitals in Italy

Participants 508 patients with mild hypertension and hypercholesterolaemia,aged 45 to 70 years.

Intervention Participants were randomised to antihypertensive treatment (hydrochlorothiazide 25 mg once daily or fosinopril 20 mg once daily) with or without the addition of a statin (pravastatin 40 mg once daily).

Main outcome measures Clinic and ambulatory blood pressure measuredevery year throughout an average 2.6 year treatment period.

Results Both the group receiving antihypertensive treatment without pravastatin (n=254) (with little change in total cholesterol) and the group receiving antihypertensive treatment with pravastatin (n=253) (with marked and sustained reduction in total cholesterol and low density lipoprotein cholesterol) had a clear cut sustained reduction in clinic measured systolic and diastolic blood pressure as well as in 24 hour, and day and night, systolic and diastolic blood pressure. Pravastatin performed slightly worse than placebo, and between group differences did not exceed 1.9 (95% confidenceinterval –0.6 to 4.3, P=0.13) mm Hg throughout the treatment period. This was also the case when participants who remained on monotherapy with hydrochlorothiazide or fosinopril throughout the study were considered separately.

Conclusions Administration of a statin in hypertensive patients in whom blood pressure is effectively reduced by concomitant antihypertensive treatment does not have an additional blood pressure lowering effect.

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Salam sehat,
Dr. David Fadjar Putra, MS
Spesialis Gizi Klinik
@
www.kliniknutrisi.com
kliniknutrisi.blogspot.com

Physical activity and weight gain prevention

Pada perempuan dengan IMT <25 olahraga dapat mencegah kenaikan berat badan. Pada IMT >25 kemungkinan faktor diet lebih berperan.

Perempuan yang berhasil mempertahankan BB (naik <2,3kg selama 13 tahun) rata2 melakukan olahraga selama 60 menit per hari dengan intensitas sedang.

JAMA 303(12):1173-1179, 24 March 2010 © 2010 the American Medical Association
Physical Activity and Weight Gain Prevention. I-Min Lee, Luc Djoussé, Howard D. Sesso, Lu Wang, and Julie E. Buring. 

Context  The amount of physical activity needed to prevent long-term weight gain is unclear. In 2008, federal guidelines recommended at least 150 minutes per week (7.5 metabolic equivalent [MET] hours per week) of moderate-intensity activity for "substantial health benefits."

Objective  To examine the association of different amounts of physical activity with long-term weight changes among women consuming a usual diet.

Design, Setting, and Participants  A prospective cohort study involving 34 079 healthy US women (mean age, 54.2 years) from 1992-2007. At baseline and months 36, 72, 96, 120, 144, and 156, women reported their physical activity and bodyweight. Women were classified as expending less than 7.5, 7.5 to less than 21, and 21 or more MET hours per week of activity at each time. Repeated-measures regression prospectively examined physical activity and weight change over intervals averaging 3 years.

Main Outcome Measure  Change in weight.

Results  Women gained a mean of 2.6 kg throughout the study. A multivariate analysis comparing women expending 21 or more MET hours per week with those expending from 7.5 to less than 21 MET hours per week showed that the latter group gained a mean (SD) 0.11 kg (0.04 kg; P = .003) over a mean interval of 3 years, and those expending less than 7.5 MET hours per week gained 0.12 kg (0.04; P = .002). There was a significant interaction with body mass index (BMI), such that there was an inverse dose-response relation between activity levels and weight gain among women with a BMI of less than 25 (P for trend < .001) but no relation among women with a BMI from 25 to 29.9 (P for trend = .56) or with a BMI of 30.0 or higher (P for trend = .50). A total of 4540 women (13.3%) with a BMI lower than 25 at study start successfully maintained their weight by gaining less than 2.3 kg throughout. Their mean activity level over the study was 21.5 MET hours per week ( 60 minutes a day of moderate-intensity activity).

Conclusions  Among women consuming a usual diet, physical activity was associated with less weight gain only among women whose BMI was lower than 25. Women successful in maintaining normal weight and gaining fewer than 2.3 kg over 13 years averaged approximately 60 minutes a day of moderate-intensity activity throughout the study.

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Salam sehat,
Dr. David Fadjar Putra, MS
Spesialis Gizi Klinik
@
www.kliniknutrisi.com
kliniknutrisi.blogspot.com