Associação entre a manutenção da prática esportiva e os parâmetros inflamatório, metabólicos e cardiovasculares entre adolescentes
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Data
2019-08-30
Autores
Cayres-Santos, Suziane Ungari
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Universidade Estadual Paulista (Unesp)
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Objetivo: Analisar a associação entre a manutenção da prática esportiva e os parâmetros inflamatório, metabólicos e cardiovasculares entre adolescentes. Métodos: Estudo de 12 meses de seguimento, dados provenientes do estudo intitulado “Analysis of Behaviors of Children During Growth” (ABCD Growth Study) conduzido em Presidente Prudente, SP. Por meio de amostragem por conveniência foram selecionadas instituições de ensino e clubes esportivos da cidade de Presidente Prudente e região. Destas instituições, após a aprovação dos diretores e técnicos, foram convidados para participar do ABCD Growth Study todos os adolescentes com idade entre 11 e 18 anos. Na primeira fase do estudo, 285 adolescentes aceitaram participar, destes 259 (esportistas n=168; não esportistas n= 91) completaram as avaliações iniciais. Após 12 meses, 189 adolescentes permaneceram no estudo (124 esportistas e 65 não esportistas). Prática esportiva foi autorrelatada. Proteína C reativa (PCR) foi dosada por meio do método de imunoensaio de ponto fixo química seca. Espessura médio-intimal das artérias carótida e femoral e variáveis dopplerfluxométricas foram avaliadas por meio de um aparelho de ultrassonografia. Adiposidade corporal foi estimada pela densitometria óssea. Colesterol total (CT), lipoproteínas de alta (HDL-c), baixa (LDL-c) densidade, triacilglicerol (TG) e glicose foram mensuradas pelo método de inibição seletiva, química seca. A insulina foi analisada pelo método de quimioluminescencia e a resistência a ação da insulina foi calculada. Pressão arterial e frequência cardíaca de repouso foram aferidas pelo método oscilométrico utilizando um aparelho automático. Idade cronológica, sexo, maturação biológica foram tratados como fatores de confusão. Para análises longitudinais foi calculada a mudança absoluta (Δ), e estes valores foram inseridos em um escore padronizado. Inicialmente foi empregada análise de variância (ANOVA) e covariância (ANCOVA) a fim de verificar a média das variáveis separadas por grupos, e posteriormente ajustadas por fatores de confusão. Além disso, foi testada a associação entre a prática esportiva e os desfechos por meio da correlação de Pearson. A relação significativa foi inserida no modelo de mediação. Resultados: A gordura de tronco não mediou a relação entre a prática esportiva e PCR. No entanto, um efeito direto do esporte sobre a PCR foi encontrado quando considerado o engajamento prévio na modalidade (meninos: β= - 0,00295; IC95%= -0,004 a -0,001 e meninas: β= -0,00384; IC95%= -0,006 a -0,001]), bem como a frequência (β= -0,06165; IC95%= -0,090 a -0,032) e o volume dedicado ao esporte (β= -0,00020; IC95%= -0,0003 a -0,00007) entre os meninos. Após 12 meses, adolescentes engajados em esportes classificados como baixa demanda da capacidade cardiorrespiratória apresentaram significativa diminuição no CT (Δ= -8,2 mg/dL; IC95%= -13,1 a -3,4), LDL-c (Δ= -4,4 mg/dL; IC95%= -8,2 a -0,6), e TG (Δ= - 11,3 mg/dL; IC95%= -19,4 a -3,3) quando comparado com os adolescentes não engajados em esportes. Por outro lado, adolescentes engajados em esportes com elevada demanda da capacidade cardiorrespiratória apresentaram significativo aumento nos níveis séricos da HDL-c (Δ= 1,2 mg/dL; IC95%= -0,5 a 3,0) quando comparado com o grupo não esportista (Δ= -2,4 mg/dL; IC95%= -4,4 a -0,5). Além disso, independentemente dos ajustes, nós encontramos significativas mudanças para os seguintes parâmetros: CT (p=0,029), HDL-c (p=0,002), LDL-c (p= 0,002), TG (p=0,017) e HOMA IR (p= 0,005). Adolescentes não obesos engajados em esportes com maior demanda da capacidade cardiorrespiratória foi o único grupo com significante melhora para HDL-c (2,57 mg/dL [IC95%: 0,50 a 4,65]), no qual foi significativamente mais elevada quando comparado aos demais grupos. Somado a isto, adolescentes não obesos engajados em esportes com baixa demanda da capacidade cardiorrespiratória (-1,49 [IC95%: -2,90 a -0,07) e elevada demanda da capacidade cardiorrespiratória (1,25 [IC95%: -2,44 a -0,07) apresentaram singnificante diminuição no escore z metabólico quando comparado ao grupo não engajado em esportes (1,37 [IC95%: 0,14 a 2,60]) e obeso esportista [1,93 [IC95%: 0,42 a 3,44]). Conclusão: Tempo prévio e o volume semanal de envolvimento com o esporte apresentaram inversa relação com a proteína C reativa, sem efeito mediador da gordura de tronco. Além disso, prática esportiva parece ser benéfica para desfechos metabólicos entre adolescentes, principalmente para o perfil lipídico. Além disso, prática esportiva parece ser efetiva para melhorar parâmetros metabólicos entre adolescentes não obesos, enquanto que parâmetros cardiovasculares para ser menos sensível a este efeito. Somado a isto, a demanda da capacidade cardiorrespiratória relacionada ao esporte parece afetar significativamente os parâmetros metabólicos.
Objective: To analyze the association between the maintenance of sport participation and inflammatory, metabolic and cardiovascular parameters in adolescents. Methods: Study of 12 months of follow up, in which dataset is part of an ongoing study intitled “Analysis of Behaviors of Children During Growth” (ABCD Growth Study) developed in Presidente Prudente, SP. Through convenience sampling was selected educational institutions and sport clubs of Presidente Prudente and region (gymnastics, track and field, karate, judo, kung fu, baseball, basketball, swimming and tennis). From these facilities, after principals and coaches approved the study, our staff invited all adolescents aged 11 to 18 years. In the first phase of the study, 285 adolescents accepted to participe, however 259 (sports n=168; non-sport= 91) completed all measurements. After 12 months of follow-up 189 adolescents was examined (124 engaged in sports and 65 non-sport group). Engagement in sport was self reported. C reactive protein (CRP) was determined by the immunoassay method using a specific kit. Carotid and femoral intima-media thickness and blood flow markers were assessed using an ultrasound equipment. Body fatness was estimated through densitometer scanner. Total cholesterol (TC), high (HDL-c), low (LDL-c) density lipoprotein, triacylglycerol (TG) and glucose were measured by the colorimetric method of dry chemistry. Insulin levels was analyzed by chemiluminescence method using a microparticle immunoassay kit. Insulin resistance was estimated. Blood pressure and resting heart rate were assessed by oscilometric method using an automatic device. Chronological age, sex and biological maturation were treated as covariates. Longitudinal analysis was calculated in absolute changes (Δ), and these values were inserted in a standardized score. Initially, it was used Analysis of Variance (ANOVA) and covariance (ANCOVA) to verify the man of variables separated for groups, and after this, those values were adjusted for covariates. Besides, it was analyezed the association between sport participation and outcomes using Pearson correlation. The significant relationships were inserted in the mediation models. Results: Trunk fatness did not mediate the relationship between sports and CRP. However, a direct effect of sports on CRP levels was found when considered the previous engagement in the modality (boys: β= -0.00295; 95%CI= -0.004 to -0.001 and girls: β= -0.00384; 95%CI= -0.006 to - 0.001]), as well as the frequency (β= -0.06165; 95%CI= -0.090 to -0.032) and volume dedicated to sports (β= -0.00020; 95%CI= -0.0003 to -0.00007) between boys. After 12 months, adolescents engaged in sports with lower cardiorrespiratory fitness demand showed significant decrease on TC (Δ= -8.2 mg/dL; 95%CI= -13.1 to -3.4), LDL-c (Δ= -4.4 mg/dL; 95%CI= -8.2 to -0.6) and TG (Δ= -11.3 mg/dL; 95%CI= -19.4 to -3.3). On the other hand, adolescents engaged in sports with higher cardiorrespiratory fitness demand had significant increase on HDL-c (Δ= 1.2 mg/dL; 95%CI= -0.5 to 3.0) when compared to non-sport group (Δ= 2.4 mg/dL; 95%CI= -4.4 to -0.5). Regardless of covariates, we found significant changes according to all four groups for TC (p-value= 0.029), HDL-c (p-value= 0.002), LDL-c (p-value= 0.002), TG (p-value= 0.017) and HOMA-IR (p-value= 0.005). Lean adolescents engaged in sports of high CRF was the only one with significant improvements for HDL-c (2.57 mg/dL [95%CI: 0.50 to 4.65]), which were significantly higher than all the other groups. Furthermore, non-obese adolescents engaged in sports both low (-1.49 [95%CI: -2.90 to -0.07]) and high (-1.25 [95%CI: -2.44 to -0.07]) CRF demand had significant decrease on combined metabolic z score when compared to group not engaged in sports (1.37 [95%CI: 0.14 to 2.60]) and obese adolescents engaged in sports (1.93 [95%CI: 0.42 to 3.44]). Conclusion: Previous time and volume weekly dedicated to sports showed inverse relationship with C reative protein, without mediator effect of trunk fatness. Furthermore, sports participation seems to be beneficial for metabolic outcomes between adolescents, mainly to lipid profile. Sports participation seems effective to improve metabolic parameters in lean adolescents, while cardiovascular parameters seem less sensitive to this effect. Moreover, the CRF demand attributed to the sport seems affect decisive in the metabolic component to be improved.
Objective: To analyze the association between the maintenance of sport participation and inflammatory, metabolic and cardiovascular parameters in adolescents. Methods: Study of 12 months of follow up, in which dataset is part of an ongoing study intitled “Analysis of Behaviors of Children During Growth” (ABCD Growth Study) developed in Presidente Prudente, SP. Through convenience sampling was selected educational institutions and sport clubs of Presidente Prudente and region (gymnastics, track and field, karate, judo, kung fu, baseball, basketball, swimming and tennis). From these facilities, after principals and coaches approved the study, our staff invited all adolescents aged 11 to 18 years. In the first phase of the study, 285 adolescents accepted to participe, however 259 (sports n=168; non-sport= 91) completed all measurements. After 12 months of follow-up 189 adolescents was examined (124 engaged in sports and 65 non-sport group). Engagement in sport was self reported. C reactive protein (CRP) was determined by the immunoassay method using a specific kit. Carotid and femoral intima-media thickness and blood flow markers were assessed using an ultrasound equipment. Body fatness was estimated through densitometer scanner. Total cholesterol (TC), high (HDL-c), low (LDL-c) density lipoprotein, triacylglycerol (TG) and glucose were measured by the colorimetric method of dry chemistry. Insulin levels was analyzed by chemiluminescence method using a microparticle immunoassay kit. Insulin resistance was estimated. Blood pressure and resting heart rate were assessed by oscilometric method using an automatic device. Chronological age, sex and biological maturation were treated as covariates. Longitudinal analysis was calculated in absolute changes (Δ), and these values were inserted in a standardized score. Initially, it was used Analysis of Variance (ANOVA) and covariance (ANCOVA) to verify the man of variables separated for groups, and after this, those values were adjusted for covariates. Besides, it was analyezed the association between sport participation and outcomes using Pearson correlation. The significant relationships were inserted in the mediation models. Results: Trunk fatness did not mediate the relationship between sports and CRP. However, a direct effect of sports on CRP levels was found when considered the previous engagement in the modality (boys: β= -0.00295; 95%CI= -0.004 to -0.001 and girls: β= -0.00384; 95%CI= -0.006 to - 0.001]), as well as the frequency (β= -0.06165; 95%CI= -0.090 to -0.032) and volume dedicated to sports (β= -0.00020; 95%CI= -0.0003 to -0.00007) between boys. After 12 months, adolescents engaged in sports with lower cardiorrespiratory fitness demand showed significant decrease on TC (Δ= -8.2 mg/dL; 95%CI= -13.1 to -3.4), LDL-c (Δ= -4.4 mg/dL; 95%CI= -8.2 to -0.6) and TG (Δ= -11.3 mg/dL; 95%CI= -19.4 to -3.3). On the other hand, adolescents engaged in sports with higher cardiorrespiratory fitness demand had significant increase on HDL-c (Δ= 1.2 mg/dL; 95%CI= -0.5 to 3.0) when compared to non-sport group (Δ= 2.4 mg/dL; 95%CI= -4.4 to -0.5). Regardless of covariates, we found significant changes according to all four groups for TC (p-value= 0.029), HDL-c (p-value= 0.002), LDL-c (p-value= 0.002), TG (p-value= 0.017) and HOMA-IR (p-value= 0.005). Lean adolescents engaged in sports of high CRF was the only one with significant improvements for HDL-c (2.57 mg/dL [95%CI: 0.50 to 4.65]), which were significantly higher than all the other groups. Furthermore, non-obese adolescents engaged in sports both low (-1.49 [95%CI: -2.90 to -0.07]) and high (-1.25 [95%CI: -2.44 to -0.07]) CRF demand had significant decrease on combined metabolic z score when compared to group not engaged in sports (1.37 [95%CI: 0.14 to 2.60]) and obese adolescents engaged in sports (1.93 [95%CI: 0.42 to 3.44]). Conclusion: Previous time and volume weekly dedicated to sports showed inverse relationship with C reative protein, without mediator effect of trunk fatness. Furthermore, sports participation seems to be beneficial for metabolic outcomes between adolescents, mainly to lipid profile. Sports participation seems effective to improve metabolic parameters in lean adolescents, while cardiovascular parameters seem less sensitive to this effect. Moreover, the CRF demand attributed to the sport seems affect decisive in the metabolic component to be improved.
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Palavras-chave
Adiposidade, Atividade física, Fatores de risco, Jovens, Adiposity, Exercise, Risk factors, Young