Vitamina D em pediatria

Abstract

A vitamina D (VD) é uma das vitaminas lipossolúveis. Suas principais fontes na natureza são a dieta e a produção endógena mediada pela exposição à luz solar. Descobertas recentes mostraram que outros órgãos, que não o rim e o fígado, são também capazes de sintetizar a VD metabolicamente ativa (calcitriol). A deficiência de vitamina D (DVD) foi descrita há quase 2.000 anos e é classicamente relacionada às doenças do sistema ósteo-muscular (em especial, raquitismo e osteomalácia). Adicionalmente nos últimos anos, a DVD tem sido associada à desordens que acometem outros sistemas do organismo, como, por exemplo, asma e diabetes. Além disso, tem sido observada uma elevação da prevalência da DVD em todo o mundo, mesmo em países com boas condições de insolação. A forma mais adequada de prevenção da DVD se dá pela suplementação vitamínica já que não há limites seguros para a exposição solar. O tratamento da DVD baseia-se, principalmente, na reposição da vitamina e está indicado nas formas sintomáticas (sintomas ósteo-musculares) da carência. A intoxicação pela VD é rara e observada em lactentes e crianças jovens que ingerem doses elevadas de VD de forma aguda. Este artigo de revisão aborda estas e outras questões a respeito da VD, com ênfase especial às particularidades relacionadas às crianças e aos adolescentes. Palavras-chave:Colecalciferol. Lactente. Vitamina D. ABSTRACTVitamin D (VD) is one of the fat-soluble vitamins. Its main sources in nature are diet and exposure to sunlight. Recent findings have shown that organs other than the kidney and liver are also able to synthesize VD metabolically active (calcitriol). Vitamin D deficiency (VDD) has been described almost 2.000 years ago and is classically related to diseases of the musculoskeletal system (especially rickets and osteomalacia). However, in recent years, VDD has been linked to disorders that affect other systems in the body, such as asthma and diabetes. In addition, an increase in the prevalence of VDD worldwide has been observed, even in countries with good insolation conditions. The most appropriate way to prevent VDD is by vitamin supplementation since there are no safe limits to sun exposure.

Assessment of maternal knowledge of solar exposure and vitamin D in the neonatal period

“…Indeed, sun exposure favors an increase in vitamin D levels, and this in turn is of paramount importance in maintaining the homeostatic state of the body, but it is not the most suitable method for this purpose in the neonate period. 2 …”

“…Indeed, sun exposure favors an increase in vitamin D levels, and this in turn is of paramount importance in maintaining the homeostatic state of the body, but it is not the most suitable method for this purpose in the neonate period. 2 Therefore, the erroneous belief that vitamin D is associated with a necessary sun exposure in the neonatal period becomes visible, confronting the current recommendations of the American Academy of Dermatology, which advises that vitamin D be obtained through diet and supplements alone, and emphasizes that sun exposure for this purpose is not recommended, especially in infants under six months, a population in which direct sun exposure should be strictly avoided. 4 In contrast to this information, 68.1% of the mothers stated that isolated sun exposure is able to provide adequate levels of vitamin D for the newborn.…”

“… 1 It is obtained through sun exposure, feeding or using dietary supplements. 2 Its production depends on the amount of UVB that reaches the skin and therefore it is influenced by skin pigmentation, use of sunscreen, type of clothing, season of the year, day period and geographical latitude. 3 …”

“…1 It is obtained through sun exposure, feeding or using dietary supplements. 2 Its production depends on the amount of UVB that reaches the skin and therefore it is influenced by skin pigmentation, use of sunscreen, type of clothing, season of the year, day period and geographical latitude. 3 Although society has extensive notion on the benefits of vitamin D, little is known about the consequences of exposing the newborn to the sun in an inadequate way.…”