Avalia??o da suplementa??o com vitamina E, na forma natural ou sint?tica, em mulheres no p?s-parto imediato e sua concentra??o no colostro

Autor: Clemente, Heleni Aires
Jazyk: portugalština
Rok vydání: 2013
Předmět:
Zdroj: Repositório Institucional da UFRNUniversidade Federal do Rio Grande do NorteUFRN.
Druh dokumentu: masterThesis
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Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico
The Vitamin E consists of eight chemically homologous forms, designated alpha, beta, gamma and delta tocopherols and tocotrienols. Biologically, the alpha-tocopherol (α-TOH) is the most important. Commercially, are found two types of α-TOH a natural (RRR-alpha-tocopherol) and another synthetic (all-rac-alpha-tocopherol). Both forms are absorbed in the intestine, the liver is a preference in favor of forms 2R, due to transfer protein α-TOH. It has higher affinity to these stereoisomers. Newborns are considered high risk for vitamin E deficiency, mainly premature, these have breast milk as a food source for maintenance of serum α-TOH. Clinical signs such as thrombocytosis, hemolytic anemia, retrolental fibroplasia, intraventricular hemorrhage, bronchopulmonary dysplasia and spinocerebellar degeneration can be found in case of a low intake of α-TOH. Thus, maternal supplementation on postpartum with α-TOH can be an efficient way to increase levels of vitamin E in breast milk and thus the consequently increase the supply of micronutrient for the newborn. However, most studies with vitamin E supplementation have been conducted in animals and little is known about the effect of maternal supplementation in humans, as well as on its efficiency to increase levels of α-TOH in human milk, depending on the shape natural or synthetic. The study included 109 women, divided into three groups: control without supplementation (GC) (n=36), supplemented with natural capsule (GNAT) (n=40) and the synthetic capsule (GSINT) (n=33). Blood samples were collected for determination of maternal nutritional status, and colostrums at initial contact and after 24 hours post-supplementation. Analyses were performed by High Performance Liquid Chromatography. Values of α-TOH in serum below 499.6mg/dL were considered deficient. We used the Kruskal-Wallis test and Tukey test to confirm the increase of alpha-tocopherol in milk and efficiency of administered capsules. Daily consumption of α-TOH was based on daily intake of 500 mL of colostrum by the newborn and compared with the nutritional requirement for children from 0 to 6 months of age, 4 mg / day. The mothers had mean concentration of serum α-TOH in 1016 ? 52, 1236 ? 51 and 1083 ? 61 mg / dL, in CG, GNAT and GSINT respectively. There were no women with deficiiency. The GC did not change the concentrations of α-TOH in colostrum. While women supplemented with natural and synthetic forms increased concentrations of α-TOH colostrum in 57.6% and 39%, respectively. By comparing supplemented groups, it was observed a significant difference (p=0.04), the natural capsule more efficient than the synthetic, approximately 49.6%. Individually, 21.1% of the women provided below 4mg/day of α-TOH, after supplementation for this index declined4.1%. Thus, maternal supplementation postpartum raised the levels of alpha-tocopherol in colostrum, and increased efficiency was observed with the natural form
A vitamina E consiste em oito formas quimicamente hom?logas, denominadas, alfa, beta, gama e delta, tocofer?is e tocotrien?is. Biologicamente, o alfa-tocoferol (α-TOH) ? o mais importante. Comercialmente s?o encontradas duas formas de α-TOH, uma natural (RRR-alfa-tocoferol) e outra sint?tica (all-rac-alfa-tocoferol). Ambas as formas s?o absorvidas no intestino, entretanto, no f?gado ocorre uma prefer?ncia em favor das formas 2R, devido ? prote?na de transfer?ncia de α-TOH, apresentar maior afinidade a estes estereois?meros. Os neonatos s?o considerados grupo de risco para defici?ncia de vitamina E, principalmente os pr?-maturos, estes t?m o leite materno como a fonte alimentar para manuten??o dos n?veis s?ricos de α-TOH. Sinais cl?nicos como trombocitose, anemia hemol?tica, fibroplasia retrolental, hemorragia intraventricular, displasia bronco pulmonar e degenera??o espinocerebelar podem ser encontrados caso ocorra uma baixa ingest?o de α-TOH. Sendo assim, a suplementa??o materna nos p?s-parto com α-TOH pode ser uma forma eficiente de aumentar os n?veis de vitamina E no leite materno e, consequentemente aumento no fornecimento do micronutriente para o rec?m-nascido. Entretanto, a maioria dos estudos com suplementa??o de vitamina E foram realizados em animais e s?o escassos os conhecimentos de sua suplementa??o em humanos, bem como, sobre sua efici?ncia para aumentar os n?veis de α-TOH no leite humano, em fun??o da forma natural ou sint?tica. Participaram do estudo 109 mulheres, distribu?das em tr?s grupos: controle sem suplementa??o (GC) (n=36), suplementadas com a c?psula natural (GNAT) (n=40) e com a c?psula sint?tica (GSINT) (n=33). Foram coletadas amostras de sangue para determina??o do estado nutricional materno, e de colostro no contato inicial e ap?s 24 horas p?s-suplementa??o. As an?lises foram realizadas por Cromatografia L?quida de Alta Efici?ncia. Valores de α-TOH no soro inferiores a 499,6 μg/dL foram considerados como deficientes. Foram utilizados o teste de Kruskal Wallis e teste de Tukey para confirmar o aumento de alfa-tocoferol no leite e a efici?ncia das c?psulas administradas. O consumo di?rio de α-TOH foi baseado na ingest?o di?ria de 500 mL de colostro pelo rec?m-nascido e comparada com o requerimento nutricional para crian?as de 0 ? 6 meses de idade, 4 mg/dia. As parturientes apresentaram concentra??o m?dia de α-TOH no soro de 1016 ? 52, 1236 ? 51 e 1083 ? 61 μg/dL, nos grupos GC, GNat e GSINT, respectivamente. N?o foram encontradas mulheres com defici?ncia. O GC n?o apresentou varia??o nas concentra??es de α-TOH no colostro. Enquanto mullheres suplementadas com as formas natural e sint?tica aumentaram as concentra??es de α-TOH no colostro em 57,6% e 39%, respectivamente. Ao comparar os grupos suplementados foi observado uma diferen?a significativa (p=0,04), sendo a c?psula natural mais eficiente que a sint?tica em aproximadamente 49,6%. Individualmente 21,1% das mulheres forneceram valores inferiores as 4mg/dia de α-TOH, ap?s a suplementa??o este ?ndice declinou para 4,1%. Sendo assim, a suplementa??o materna no p?s-parto elevou os n?veis de alfa-tocoferol no colostro e maior efici?ncia foi observada com a forma natural
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