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Publication
Composição corporal e insulino-resistência
| Name: | Description: | Size: | Format: | |
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| Trabalho | 951.34 KB | Adobe PDF | ||
| Anexos | 233.46 KB | Adobe PDF |
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Advisor(s)
Abstract(s)
A síndrome metabólica (SM) é vista actualmente como uma epidemia mundial, com
números alarmantes, associada a alta morbi-mortalidade cardiovascular e elevado custo sócioeconómico. O ganho ponderal é preditor independente para o desenvolvimento da SM, embora nem
todos os indivíduos obesos a apresentem. Por outro lado, certas populações com baixa prevalência
de obesidade apresentam elevada prevalência da SM e mortalidade cardiovascular. A distribuição
da gordura corporal é relevante, e especificamente a gordura visceral (GV) parece ser o elo entre o
tecido adiposo e a resistência à insulina (RI),característica da SM. Na última década, o tecido
adiposo deixou de ser um simples reservatório de energia para se transformar num complexo órgão
com múltiplas funções. A GV apresenta características metabólicas diferentes da gordura
subcutânea glúteo-femoral, as quais favorecem a instalação do quadro de RI. Diversos estudos
revelam a estreita relação da adiposidade abdominal com a tolerância à glicose, hiperinsulinemia,
hipertrigliceridemia e hipertensão arterial. Mais que uma simples associação, recentemente,
acredita-se que a GV desempenha um papel central na fisiopatologia da SM. Assim, a quantificação
da GV se torna importante para identificar indivíduos com maior risco para o desenvolvimento da
SM, eleitos para sofrer intervenções precoces na tentativa de reduzir o impacto das anormalidades
metabólicas sobre a mortalidade cardiovascular. Este trabalho discute a relação próxima entre a
composição corporal (Índice de Massa Corporal, massa magra, massa gorda, água corporal, nível de
gordura visceral e perímetro abdominal) e a resistência à insulina, abordando particularidades da
distribuição central de gordura, no contexto da SM, possíveis mecanismos fisiopatogénicos
relacionados à GV e os métodos disponíveis para a avaliação da composição corporal.
O presente estudo envolveu 140 sujeitos voluntários (71 mulheres e 69 homens), com idades
entre os 15 e 79 anos, com uma média de idades de 43±04 anos. População maioritariamente
activa/trabalhadora (67,9%), cerca de 14,2% da população era estudante e 17,9% reformada. A
recolha de dados decorreu durante o mês de Outubro de 2010. A recolha de dados decorreu no
Centro de Saúde de Esposende, sendo que todos os indivíduos participantes o fizeram de forma
voluntária e foram previamente informados acerca dos objectivos e procedimentos metodológicos
do mesmo. A avaliação da condição física foi realizada através de inquérito elaborado em conjunto
com a Academia Saúde e Laser da Universidade Fernando Pessoa, Porto. A recolha de dados para a avaliação da composição corporal foi realizada por bio-impedância eléctrica. E quanto aos valores
de glicemia de jejum, estes foram obtidos por punção venosa.
Perante os resultados obtidos, verificou-se que a média do IMC obtido é 27,09±4,73 e que
35% da população apresenta excesso de peso, 37,9 apresenta uma elevada quantidade de massa
gorda e no que diz respeito ao perímetro da cinta, 41,4% apresenta um risco muito aumentado para
o desenvolvimento de doença cardiovascular. Verificou-se ainda uma relação positiva entre os
valores de glicemia e gordura visceral, perímetro da cinta, massa gorda e a idade e por outro lado,
verificou-se uma relação negativa entre a glicemia e a actividade física. Por último, verificou-se
ainda que a amostra de homens, Não Praticantes e Rural, foram os que obtiveram maiores valores
no que diz respeito aos parâmetros avaliados na composição corporal, tais como IMC, massa gorda,
perímetro da cinta e gordura visceral.
Metabolic syndrome (MS) is seen nowadays as a worldwide epidemic event associated with high cardiovascular morbi-mortality and high socioeconomic cost. The ponderal gain is an independent predictor for the development of MS, although not all obese individuals present it. On other hand, some populations with low obesity prevalence present high prevalence of MS and cardiovascular mortality. The distribution of corporal fat is relevant and visceral fat (VF),specifically, seems to be the link between adipose tissue and insulin resistance (IR), a mean feature of MS. Adipose tissue is now considered a complex organ with multiple functions. VF presents metabolic properties, which are different from the gluteo-femoral subcutaneous fat and related to IR. Several studies show the narrow relationship of abdominal adiposity with the glucose tolerance, hyperinsulinemia, hypertriglyceridemia and arterial hypertension. More than a simple association, recently it is thought that the VF plays a central part in the physiopathology of MS. Consequently, the quantification of VF plays an important role to identify individuals with larger risk for development of MS, who should be chosen for early interventions in the attempt of reducing the impact of metabolic abnormalities an cardiovascular mortality. This paper discusses the close relationship between body composition (body mass index, lean mass, fat mass, body water, level of visceral fat and waist circumference) and insulin resistance, addressing the particularities of the central distribution of fat in the context of MS, possible pathogenetic mechanism related to the VF and the methods available for assessing body composition. This study involved 140 volunteer subjects (71 women and 69 men) aged between 15 and 79 years with a mean age 43 ± 04 years. Population mostly active / working (67.9%), approximately 14.2% of the student population and 17.9% was reformed. Data collection took place during the month of October 2010. Data collection took place at the Health Center of Esposende, and all individuals who participated did so voluntarily and were informed about the objectives and methodological procedures of the same. The assessment of physical condition was conducted through a survey developed in conjunction with the Laser and Health Academy at the University Fernando Pessoa, Porto. Data collection for the evaluation of body composition was performed by bioelectrical impedance. What about the values of fasting glucose, these were obtained by venipuncture. Given these results, it was found that the mean BMI 27.09 ± 4.73 is obtained and that 35% of the population is overweight, 37.9% had a high amount of fat mass and with respect to waist circumference, 41.4% have a very increased risk for developing cardiovascular disease. There was also a positive relationship between blood glucose levels and visceral fat, waist circumference, fat mass and age and on the other hand, there was a negative relationship between blood glucose and physical activity. Finally, it was found that populations of men, Not Practitioners and Rural, obtained the highest values with regard to parameters of body composition, such as BMI, fat mass, waist circumference and the visceral fat.
Metabolic syndrome (MS) is seen nowadays as a worldwide epidemic event associated with high cardiovascular morbi-mortality and high socioeconomic cost. The ponderal gain is an independent predictor for the development of MS, although not all obese individuals present it. On other hand, some populations with low obesity prevalence present high prevalence of MS and cardiovascular mortality. The distribution of corporal fat is relevant and visceral fat (VF),specifically, seems to be the link between adipose tissue and insulin resistance (IR), a mean feature of MS. Adipose tissue is now considered a complex organ with multiple functions. VF presents metabolic properties, which are different from the gluteo-femoral subcutaneous fat and related to IR. Several studies show the narrow relationship of abdominal adiposity with the glucose tolerance, hyperinsulinemia, hypertriglyceridemia and arterial hypertension. More than a simple association, recently it is thought that the VF plays a central part in the physiopathology of MS. Consequently, the quantification of VF plays an important role to identify individuals with larger risk for development of MS, who should be chosen for early interventions in the attempt of reducing the impact of metabolic abnormalities an cardiovascular mortality. This paper discusses the close relationship between body composition (body mass index, lean mass, fat mass, body water, level of visceral fat and waist circumference) and insulin resistance, addressing the particularities of the central distribution of fat in the context of MS, possible pathogenetic mechanism related to the VF and the methods available for assessing body composition. This study involved 140 volunteer subjects (71 women and 69 men) aged between 15 and 79 years with a mean age 43 ± 04 years. Population mostly active / working (67.9%), approximately 14.2% of the student population and 17.9% was reformed. Data collection took place during the month of October 2010. Data collection took place at the Health Center of Esposende, and all individuals who participated did so voluntarily and were informed about the objectives and methodological procedures of the same. The assessment of physical condition was conducted through a survey developed in conjunction with the Laser and Health Academy at the University Fernando Pessoa, Porto. Data collection for the evaluation of body composition was performed by bioelectrical impedance. What about the values of fasting glucose, these were obtained by venipuncture. Given these results, it was found that the mean BMI 27.09 ± 4.73 is obtained and that 35% of the population is overweight, 37.9% had a high amount of fat mass and with respect to waist circumference, 41.4% have a very increased risk for developing cardiovascular disease. There was also a positive relationship between blood glucose levels and visceral fat, waist circumference, fat mass and age and on the other hand, there was a negative relationship between blood glucose and physical activity. Finally, it was found that populations of men, Not Practitioners and Rural, obtained the highest values with regard to parameters of body composition, such as BMI, fat mass, waist circumference and the visceral fat.
Description
Trabalho apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Ciências Farmacêuticas.
Keywords
Gordura visceral Resistência à insulina Síndrome metabólica Composição corporal Risco cardiovascular Visceral fat Insulin resistance Metabolic syndrome Body composition Cardiovascular risk