Obesidade e aterosclerose subclínica: uma abordagem multifatorial em adolescentes do arquipélago de Fernando de Noronha
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Data
2016-12-21
Autores
Miguel, Lílian Débora Paschoalin [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
A obesidade tornou-se uma epidemia mundial – “Globesidade”. O tecido adiposo é essencial à homeostase corpórea, produzindo moléculas biologicamente ativas como reguladores do metabolismo glicolipídico, moduladores da saciedade e substâncias pró ou antinflamatórias. Seu acúmulo, porém, associa-se à maior incidência de Diabetes mellitus tipo 2, doenças cardiovasculares e câncer. Diversos estudos longitudinais demonstraram a correlação entre obesidade infantil ou adolescente a maior risco cardiovascular na vida adulta e, neste, objetivou-se avaliar a presença de alterações ligadas à obesidade em população brasileira com hábito alimentar irregular. Foram avaliados 75 adolescentes de 10 a 18 anos, escolares e residentes no arquipélago de Fernando de Noronha, utilizando-se cinco diferentes parâmetros: a) nutricional (IMC, cintura [CC], quadril, índice cintura-quadril [ICQ] e frequência de consumo alimentar, aferindo-se itens de risco [I] e protetores [II] do sistema cardiovascular); b) bioquímico (glicemia em jejum, triglicerídeos [TG], colesterol total [CT] e lipoproteínas de alta [HDL-c] e baixa [LDL-c] densidades); c) inflamatório (proteína C-reativa [PCR] ultrassensível, IL-6 e TNF-α); d) vascular (hipertensão arterial sistêmica e espessura do complexo médio-intimal [EMI] carotídeo); e) genotóxico (células micronucleadas). Os participantes foram distribuídos nos grupos nutricionais: obesos (classe I, n = 21), com sobrepeso (classe II, n = 20) e eutróficos (classe III, n = 34), e foi observada diferença significativa entre os grupos para todos os parâmetros antropométricos, exceto altura. Os obesos apresentaram níveis mais altos de TG, PCR e IL-6. A EMI foi similar entre os grupos, porém meninos apresentaram medidas significativamente maiores que as meninas, assim como ICQ e glicemia. O IMC esteve negativamente correlacionado aos níveis de HDL-c e positivamente a CC, CT, TG, LDL-c, PCR, IL-6 e a brotos nucleares nas células bucais. Foram ainda observadas correlação entre a frequência de brotos nucleares e os níveis de IL-6 e TG, e correlação entre a frequência de consumo alimentar dos itens contidos nos grupos I e II. Os dados indicaram que: a) a frequência de acúmulo ponderal entre os adolescentes do arquipélago de Fernando de Noronha é expressiva; b) indivíduos do gênero masculino apresentaram maior número de fatores de risco cardíaco, incluindo maior EMI; c) a dislipidemia tende a ser endêmica nesta população.
Obesity has become a global epidemic – “Globesity”. The adipose tissue is essential to body homeostasis and is responsible for the production of countless molecules with biological activity, such as some interleukins and others linked to glicolipidic metabolism or appetite control. However, obesity is associated with a higher incidence of type 2 diabetes, cardiovascular diseases and some types of cancer. Once overweight in childhood and adolescence may produce overweight adults, with higher risk for the comorbidities, the present study was designed to evaluate lipidic disease in a population from the Northeastern region of Brazil, with irregular feeding habits. It was evaluated 75 teenagers between 10 to 18 years old, inhabitants from Fernando de Noronha archipelago and selected among students. Five distinct and correlated profiles were established: a) nutritional (waist, hip, BMI and food consumption questionnaire, with qualitative evaluation of items classified as dangerous [I] or protective [II] for cardiovascular system); b) biochemical (serum fasting blood glucose, triglycerides, total cholesterol and fractions); c) inflammatory (C-reactive protein [CRP], IL-6 and TNF-α); d) vascular (high blood pressure and carotid intima-media thickness [IMT]); and e) genotoxic (micronucleated cells from buccal mucosa). Adolescents were classified as: obese (class I, n = 21), overwheighted (class II, n = 20) and eutrophic (class III, n = 34). It was observed significant difference among the three groups for each anthropometric end-points, except height. Serum concentrations of triglycerides, CRP and IL-6 was higher on obese group. No significant difference was observed for IMT among the groups, however boys had superior measures than girls. Similar result occurred to waist-to-hip and serum glucose indexes. Negative association between BMI and HDL-c, and positive association among BMI, cholesterol, triglycerides, waist, LDL-c, CRP, IL-6 and nuclear buds in exfoliated buccal cells were detected. Frequency of cells with nuclear buds was also associated with IL-6 and TG, and there was positive association between intake of food groups I and II. Our data showed: a) a high weight-gain index among adolescents from Fernando de Noronha archipelago; b) cardiovascular risk factors was increased in number among boys, including higher EMI; c) a dyslipidemic condition may be endemic in this population.
Obesity has become a global epidemic – “Globesity”. The adipose tissue is essential to body homeostasis and is responsible for the production of countless molecules with biological activity, such as some interleukins and others linked to glicolipidic metabolism or appetite control. However, obesity is associated with a higher incidence of type 2 diabetes, cardiovascular diseases and some types of cancer. Once overweight in childhood and adolescence may produce overweight adults, with higher risk for the comorbidities, the present study was designed to evaluate lipidic disease in a population from the Northeastern region of Brazil, with irregular feeding habits. It was evaluated 75 teenagers between 10 to 18 years old, inhabitants from Fernando de Noronha archipelago and selected among students. Five distinct and correlated profiles were established: a) nutritional (waist, hip, BMI and food consumption questionnaire, with qualitative evaluation of items classified as dangerous [I] or protective [II] for cardiovascular system); b) biochemical (serum fasting blood glucose, triglycerides, total cholesterol and fractions); c) inflammatory (C-reactive protein [CRP], IL-6 and TNF-α); d) vascular (high blood pressure and carotid intima-media thickness [IMT]); and e) genotoxic (micronucleated cells from buccal mucosa). Adolescents were classified as: obese (class I, n = 21), overwheighted (class II, n = 20) and eutrophic (class III, n = 34). It was observed significant difference among the three groups for each anthropometric end-points, except height. Serum concentrations of triglycerides, CRP and IL-6 was higher on obese group. No significant difference was observed for IMT among the groups, however boys had superior measures than girls. Similar result occurred to waist-to-hip and serum glucose indexes. Negative association between BMI and HDL-c, and positive association among BMI, cholesterol, triglycerides, waist, LDL-c, CRP, IL-6 and nuclear buds in exfoliated buccal cells were detected. Frequency of cells with nuclear buds was also associated with IL-6 and TG, and there was positive association between intake of food groups I and II. Our data showed: a) a high weight-gain index among adolescents from Fernando de Noronha archipelago; b) cardiovascular risk factors was increased in number among boys, including higher EMI; c) a dyslipidemic condition may be endemic in this population.
Descrição
Palavras-chave
Dislipidemia, Espessamento médio-intimal, Fatores de risco cardíaco, Marcadores de inflamação, Micronúcleos, Obesidade, Sobrepeso, Dyslipidemia, Intimal-media thickness, Cardiovascular risk factors, Inflammatory markers, Micronucleous, Obesity, Overweight