Fatores que influenciam a composição corporal em pacientes portadores de diabetes mellitus tipo 1
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Data
2021-12-02
Autores
Pereira, Filipe Welson Leal
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Universidade Estadual Paulista (Unesp)
Resumo
Introdução: O diabetes mellitus tipo 1 (DM1) caracteriza-se pela deficiência absoluta de insulina decorrente da destruição autoimune de células-β pancreáticas. Como consequência de seus efeitos metabólicos e do seu tratamento, podem surgir alterações na composição corporal. Estas alterações, que se manifestam tanto como obesidade quanto como redução da massa muscular, podem estar associadas a desenvolvimento de comorbidades e pior controle da doença. Para a aferição da composição corporal, vários métodos são disponíveis, sendo alguns deles de melhor aplicação na assistência clínica, como a antropometria, bioimpedância elétrica e ultrassonografia. Estes métodos permitem estabelecer a distribuição dos compartimentos corporais em termos quantitativos, mas também permitem em alguns casos a avaliação qualitativa destes compartimentos. Objetivo: Estabelecer a relação entre composição corporal e características clínicas e laboratoriais de pacientes adultos jovens portadores de diabetes mellitus tipo 1 e comparar variáveis de composição corporal e força com grupo controle. Pacientes e métodos: Este é um estudo seccional analítico que avaliou pacientes portadores de DM1 e controles quanto a composição corporal e força muscular por meio dos métodos de antropometria, bioimpedância elétrica, ultrassonografia e dinamometria. Os dados clínicos, demográficos e laboratoriais foram obtidos por meio de avaliação clínica ou consulta ao prontuário. A avaliação da associação entre variáveis clínicas e laboratoriais com composição corporal e força muscular, no grupo DM1 foi realizada por regressão linear múltipla. A comparação entre os grupos DM1 e controle foi realizada por teste t de Student, Mann Whitney ou Fisher a depender do tipo de distribuição dos dados. Por fim, a avaliação da presença de DM1 na composição corporal e força muscular foi realizada por regressão linear múltipla. Nível de significância de 5%. Resultados: Foram selecionados 45 pacientes portadores de DM1 e 12 pacientes controles. O descontrole glicêmico dos pacientes diabéticos tipo 1 está associado a menores valores de ângulo de fase. Além disso, quando comparados ao grupo controle, os portadores de DM1 apresentaram maiores valores de massa gorda e de ecointensidade no músculo vasto intermédio e menores valores de massa muscular e força muscular. Ao ajustar a presença de DM1 por sexo, idade e presença de atividade física resistida, o DM1 continuou explicando os parâmetros acima, exceto a ecogenicidade. Em relação a avaliação da força muscular, ao ajustar a presença de DM1 pelas variáveis acima acrescida da espessura dos músculos da coxa ou ecogenicidade, observou-se que o maior determinante da força está relacionado com características do músculo e não com a presença da doença. Conclusão: Em jovens com DM1, o descontrole glicêmico associa-se com menores ângulos de fase, refletindo pior integridade celular. Adicionalmente, na presença de DM1, a composição corporal mostra menor massa e qualidade muscular com maior acúmulo de gordura, quando comparado ao grupo controle.
Introduction: type 1 diabetes mellitus (DM1) is characterized by absolute insulin deficiency resulting from autoimmune destruction of pancreatic β-cells. As a consequence of metabolic effects and treatment, changes in body composition can occur. These changes, which manifest as both obesity and reduced muscle mass, may be associated eith development of comorbidites and poor disease control. Several methods are available to measure body composition characteristics, which are better applied in clinical care, such as anthropometry, electrical bioimpedance (BIA) and ultrasonography (US). These methods establish the distribuition of body compartiments in quantitative way and, in some cases, qualitative too. Objective: to establish a relationship between body composition and clinical and laboratory characteristics of Young adult patients with DM1 and compare body composition variables and muscle strength with a control group. Patients and methods: this is na analytical cross-sectional study that evaluated DM1 patients and control for body composition and muscle strength through anthropometry, BIA, US and dynamometry. Clinical, demographic and laboratory data were obtained through clinical evaluation or medical records. The evaluation of the association between clinical and laboratory variables with body composition and muscle strength in the DM1 group was performed by multiple linear regression. The comparison between DM1 and control groups was performed using Student’s t-test, Mann Whitney or Fisher, depending on the type of data distribution. Finally, multiple linear regression evaluated the presence of DM1 in body composition and muscle strength. Significance level at 5%. Results: 45 DM1 and 12 controls patients were selected. decompensated glycemic control in type 1 diabetic patients is associated with lower phase angle values. In addition, compared to the control group, patients with DM1 had higher values for fat mass and echogenicity in the vastus intermedius muscle and lower values for lean mass and muscle strength. When adjusting the presence of DM1 by sex, age, and resistance to physical activity, DM1 continued to explain the parameters abovementioned, except for the echogenicity. Regarding the assessment of muscle strength, when adjusting the presence of DM1 by variables above and thigh muscles thickness or echogenicity, it was observed that the most significant determinant of strength is related to muscle characteristics and not to the presence of disease. Conclusion: in young Abstract 6 people with DM1, inadequate glycemic control is associated with lower phase angles, reflecting poor cell quality. Additionally, in the presence of DM1, body composition shows lower muscle mass and quality with a more significant accumulation of fat when compared to the control group.
Introduction: type 1 diabetes mellitus (DM1) is characterized by absolute insulin deficiency resulting from autoimmune destruction of pancreatic β-cells. As a consequence of metabolic effects and treatment, changes in body composition can occur. These changes, which manifest as both obesity and reduced muscle mass, may be associated eith development of comorbidites and poor disease control. Several methods are available to measure body composition characteristics, which are better applied in clinical care, such as anthropometry, electrical bioimpedance (BIA) and ultrasonography (US). These methods establish the distribuition of body compartiments in quantitative way and, in some cases, qualitative too. Objective: to establish a relationship between body composition and clinical and laboratory characteristics of Young adult patients with DM1 and compare body composition variables and muscle strength with a control group. Patients and methods: this is na analytical cross-sectional study that evaluated DM1 patients and control for body composition and muscle strength through anthropometry, BIA, US and dynamometry. Clinical, demographic and laboratory data were obtained through clinical evaluation or medical records. The evaluation of the association between clinical and laboratory variables with body composition and muscle strength in the DM1 group was performed by multiple linear regression. The comparison between DM1 and control groups was performed using Student’s t-test, Mann Whitney or Fisher, depending on the type of data distribution. Finally, multiple linear regression evaluated the presence of DM1 in body composition and muscle strength. Significance level at 5%. Results: 45 DM1 and 12 controls patients were selected. decompensated glycemic control in type 1 diabetic patients is associated with lower phase angle values. In addition, compared to the control group, patients with DM1 had higher values for fat mass and echogenicity in the vastus intermedius muscle and lower values for lean mass and muscle strength. When adjusting the presence of DM1 by sex, age, and resistance to physical activity, DM1 continued to explain the parameters abovementioned, except for the echogenicity. Regarding the assessment of muscle strength, when adjusting the presence of DM1 by variables above and thigh muscles thickness or echogenicity, it was observed that the most significant determinant of strength is related to muscle characteristics and not to the presence of disease. Conclusion: in young Abstract 6 people with DM1, inadequate glycemic control is associated with lower phase angles, reflecting poor cell quality. Additionally, in the presence of DM1, body composition shows lower muscle mass and quality with a more significant accumulation of fat when compared to the control group.
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Palavras-chave
Diabetes mellitus tipo 1, Composição corporal, Ângulo de fase, Ecointensidade do músculo, Força muscular, Type 1 diabetes mellitus, Body composition, Phase angle, Muscle echointensity