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Inicio Gastroenterología y Hepatología (English Edition) Vitamin D in dysphagic patients who have undergone endoscopic gastrostomy for lo...
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Vol. 44. Issue 1.
Pages 13-19 (January 2021)
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Vol. 44. Issue 1.
Pages 13-19 (January 2021)
Original Article
DOI: 10.1016/j.gastre.2020.05.010
Vitamin D in dysphagic patients who have undergone endoscopic gastrostomy for long-term enteral feeding
Vitamina D en pacientes con disfagia sometidos a gastrostomía endoscópica percutánea para una nutrición enteral de larga duración
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Carla Adriana Santosa,b,c,
Corresponding author
, Gonçalo Nunesa, Ana Teresa Barataa, Jorge Fonsecaa,d
a GENE – Artificial Feeding Team, Hospital Garcia de Orta, Almada, Portugal
b Nutrition Department – Hospital Garcia de Orta, Almada, Portugal
c Centro de Investigação em Saúde e Tecnologia H&TRC – Lisbon Polytechnic Institute Lisbon School of Health Technology, Portugal
d CiiEM – Center for Interdisciplinary Research Egas Moniz, Almada, Portugal
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Tables (2)
Table 1. Characteristics of the study population (n=200) and the subgroup of patients with vitamin D levels at 4th week.
Table 2. The relationship between Vit. D, albumin and transferrin concentrations at baseline.
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Abstract
Objective

Vitamin D plays a major role in biological processes. Its deficiency is associated with increased morbidity and mortality. Patients who have undergone endoscopic gastrostomy (PEG) present with protein-energy malnutrition, and may be at risk for Vitamin D deficiency, due to their age, less sunlight exposure and lower dietary intake. We aimed to determine the prevalence of hypovitaminosis D in PEG-patients, its change under PEG-feeding, and its relationship with serum proteins and risk factors for Vitamin D deficiency.

Methods

This was a prospective observational study, over 4 weeks, after gastrostomy. Data were collected at the initial PEG procedure (T0), and after 4 weeks (T1). Initial evaluation included age, gender, underlying disorder, NRS-2002, BMI, serum albumin, transferrin and Vitamin D. At T1 we assessed Vit. D, albumin, and transferrin. Vitamin D was performed with Electrochemiluminescence through Elecsys 2010 assay. Patients were fed with blended homemade meals.

Results

200 patients (118 males), 22–92 years of age, were studied. There were initial low values for Vit. D (181), albumin (96), transferrin (121), and BMI (124). A correlation was found between Vit. D and serum albumin (r=0.49, p=0.005) but not with transferrin (r=0.26, p=0.195). At T1 the subgroup who had Vit. D levels assessed (n=48) was part of the initial study group maintained low levels of Vitamin D despite nutritional intervention.

Conclusion

We recommend systematic Vitamin D supplementation of PEG fed patients using homemade meals or at least screening for hypovitaminosis D as a routine part of their care.

Keywords:
Vitamin D
Dysphagia
PEG
Gastrostomy
Nutrition
Resumen
Objetivo

La vitamina D desempeña una función muy importante en los procesos biológicos. Su insuficiencia se asocia a una mayor morbimortalidad. Los pacientes que se han sometido a una gastrostomía endoscópica percutánea (GEP) presentan desnutrición proteinicocalórica y pueden correr riesgo de padecer insuficiencia de vitamina D, debido a su edad, menor exposición solar y menor ingestión alimentaria. Nuestro objetivo consistió en determinar la prevalencia de hipovitaminosis D en pacientes sometidos a GEP, su cambio en el contexto de la alimentación a través de GEP y su relación con las proteínas séricas y los factores de riesgo asociados a la insuficiencia de vitamina D.

Métodos

Se trató de un estudio observacional y prospectivo de cuatro semanas tras la gastrostomía. Se recogieron datos al inicio de la intervención de GEP (T0) y tras 4 semanas (T1). El análisis inicial incluyó edad, sexo, afecciones preexistentes, NRS-2002, IMC, seroalbúmina, transferrina y vitamina D. En el punto temporal T1, analizamos la vitamina D, albúmina y transferrina. La vitamina D se interpretó utilizando electroquimioluminiscencia mediante Elecsys 2010.

Resultados

Se estudió a 200 pacientes (118 varones) con edades comprendidas entre 22 y 92 años. Al inicio, se detectaron niveles bajos de vitamina D (181), albúmina (96), transferrina (121) y un IMC bajo (124). Se halló una correlación entre la vitamina D y la seroalbúmina (r=0,49; p=0,005), pero no con la transferrina (r=0,26; p=0,195). En el punto temporal T1, el subgrupo en el que ya se habían analizado niveles de vitamina D (n=48), que formó parte del estudio inicial, mantuvo niveles bajos, a pesar de la intervención nutricional.

Conclusión

Recomendamos un suplemento sistemático de vitamina D a los pacientes alimentados a través de GEP con comidas caseras o, al menos, la detección de hipovitaminosis D como parte habitual de su tratamiento.

Palabras clave:
Vitamina D
Disfagia
GEP
Gastrostomía
Nutrición

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