Associação de marcadores musculares, endócrinos e imunológicos com a fragilidade em idosos
Autor(a) principal: | |
---|---|
Data de Publicação: | 2020 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da PUC_RS |
Texto Completo: | http://tede2.pucrs.br/tede2/handle/tede/9482 |
Resumo: | The frailty syndrome has been conceptualized as a decline in spiral energy, which is based on a tripod of changes related to aging, namely sarcopenia, neuroendocrine dysregulation and immune dysfunction. The objective of this thesis was to associate muscular, endocrine and immunological markers with the frailty criteria in older people assisted by primary care in a municipality in the southern region of Brazil. This is a cross-sectional, probabilistic study, linked to the project “Comprehensive Care for the Health of the Older people”, developed in the city of Ijuí in the state of Rio Grande do Sul. The research population included individuals aged 60 years or over, both sexes, attached to the Family Health Strategies in the urban area. To obtain the variables of interest, a questionnaire prepared by the researchers was used, physical evaluations to measure and classify the levels of fragility and sarcopenia and laboratory tests to measure creatinine, serum calcium, growth factor similar to insulin-1, parathyroid hormone, 25-hydroxyvitamin D, C-reactive protein, interleukin 6 and blood count. Frailty was assessed according to Fried's criteria and sarcopenia took into account the protocol created by the European working group on sarcopenia in older people. The research protocol was applied in the home space and blood samples were previously scheduled to be collected in health units. The data obtained were compiled and analyzed using the Statistical Package for the Social Sciences (SPSS) software (version 22.0). Inferential statistics of a quantitative nature were analyzed using the means comparison test for independent samples. The dependence of qualitative variables was also analyzed using Pearson's chi-square or Fisher's exact tests. To analyze the risk between the groups, the prevalence odds ratio was used and to analyze the relationship between the dependent variables and the independent variables, the linear regression model was used. In the analysis referring to the frailty criteria, there was a relationship between creatinine in the prediction of weight loss (p<0,001), leukocytes in the prediction of handgrip strength (p=0,022), interleukin-6 in the prediction of energy expenditure (p=0,026) and 25-hydroxyvitamin D in the prediction of walking time (p=0,036). In the analysis referring to the sarcopenia criteria, it was observed that the older people with altered muscle strength had lower hematocrit (p=0,037) and higher interleukin-6 (p=0,002) values than the older people with normal muscle strength; and the older people with altered physical performance had lower values of leukocytes (p=0,024), hemoglobin (p<0,001), hematocrit (p=0,007) and 25-hydroxyvitamin D (p=0,034) and more high levels of parathyroid hormone (p=0,018) and interleukin 6 (p=0,002) when compared to the older people with normal physical performance. It is concluded that the combined use of muscle, endocrine and immunological markers can be useful for the diagnosis of frailty and sarcopenia and for proposing resolutive interventions to reduce negative outcomes for the older people. |
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Schneider, Rodolfo Herbertohttp://lattes.cnpq.br/3981128306152418Berlezi, Evelise Moraeshttp://lattes.cnpq.br/8373298120143786http://lattes.cnpq.br/2324549051311419Pillatt, Ana Paula2021-01-23T11:29:07Z2020-12-11http://tede2.pucrs.br/tede2/handle/tede/9482The frailty syndrome has been conceptualized as a decline in spiral energy, which is based on a tripod of changes related to aging, namely sarcopenia, neuroendocrine dysregulation and immune dysfunction. The objective of this thesis was to associate muscular, endocrine and immunological markers with the frailty criteria in older people assisted by primary care in a municipality in the southern region of Brazil. This is a cross-sectional, probabilistic study, linked to the project “Comprehensive Care for the Health of the Older people”, developed in the city of Ijuí in the state of Rio Grande do Sul. The research population included individuals aged 60 years or over, both sexes, attached to the Family Health Strategies in the urban area. To obtain the variables of interest, a questionnaire prepared by the researchers was used, physical evaluations to measure and classify the levels of fragility and sarcopenia and laboratory tests to measure creatinine, serum calcium, growth factor similar to insulin-1, parathyroid hormone, 25-hydroxyvitamin D, C-reactive protein, interleukin 6 and blood count. Frailty was assessed according to Fried's criteria and sarcopenia took into account the protocol created by the European working group on sarcopenia in older people. The research protocol was applied in the home space and blood samples were previously scheduled to be collected in health units. The data obtained were compiled and analyzed using the Statistical Package for the Social Sciences (SPSS) software (version 22.0). Inferential statistics of a quantitative nature were analyzed using the means comparison test for independent samples. The dependence of qualitative variables was also analyzed using Pearson's chi-square or Fisher's exact tests. To analyze the risk between the groups, the prevalence odds ratio was used and to analyze the relationship between the dependent variables and the independent variables, the linear regression model was used. In the analysis referring to the frailty criteria, there was a relationship between creatinine in the prediction of weight loss (p<0,001), leukocytes in the prediction of handgrip strength (p=0,022), interleukin-6 in the prediction of energy expenditure (p=0,026) and 25-hydroxyvitamin D in the prediction of walking time (p=0,036). In the analysis referring to the sarcopenia criteria, it was observed that the older people with altered muscle strength had lower hematocrit (p=0,037) and higher interleukin-6 (p=0,002) values than the older people with normal muscle strength; and the older people with altered physical performance had lower values of leukocytes (p=0,024), hemoglobin (p<0,001), hematocrit (p=0,007) and 25-hydroxyvitamin D (p=0,034) and more high levels of parathyroid hormone (p=0,018) and interleukin 6 (p=0,002) when compared to the older people with normal physical performance. It is concluded that the combined use of muscle, endocrine and immunological markers can be useful for the diagnosis of frailty and sarcopenia and for proposing resolutive interventions to reduce negative outcomes for the older people.A síndrome da fragilidade vem sendo conceituada como um declínio de energia em espiral, que tem como base um tripé de alterações relacionadas ao envelhecimento, sendo elas a sarcopenia, a desregulação neuroendócrina e a disfunção imunológica. O objetivo desta tese foi associar marcadores musculares, endócrinos e imunológicos com os critérios de fragilidade em idosos assistidos pela atenção primária em um município da região sul do Brasil. Trata-se de um estudo transversal, probabilístico, vinculado ao projeto “Atenção Integral à Saúde do Idoso”, desenvolvido no município de Ijuí do Estado do Rio Grande do Sul. Foram incluídos na população da pesquisa indivíduos com idade igual ou superior a 60 anos, ambos os sexos, adstritos às Estratégias de Saúde da Família da área urbana. Para a obtenção das variáveis de interesse foi utilizado um questionário elaborado pelos pesquisadores, as avaliações físicas para aferir e classificar os níveis de fragilidade e sarcopenia e os exames laboratoriais para aferir creatinina, cálcio sérico, fator de crescimento semelhante à insulina-1, paratormônio, 25-hidroxivitamina D, proteína C reativa, interleucina 6 e hemograma. A fragilidade foi avaliada conforme os critérios de Fried e a sarcopenia levou em consideração o protocolo criado pelo grupo europeu de trabalho sobre sarcopenia em idosos. O protocolo de pesquisa foi aplicado no espaço domiciliar e as coletas de sangue foram previamente agendadas para serem coletadas nas unidades de saúde. Os dados obtidos foram compilados e analisados por meio do software Statistical Package for the Social Sciences (SPSS) (versão 22.0). A estatística inferencial de natureza quantitativa foi analisada a partir de teste de comparação de médias para amostras independentes. Também foi analisada a dependência das variáveis qualitativas pelos testes de Qui-quadrado de Pearson ou Exato de Fisher. Para analisar o risco entre os grupos foi utilizada a razão de chance de prevalência e para analisar a relação entre as variáveis dependentes com as variáveis independentes foi utilizado o modelo de regressão linear. Na análise referente aos critérios de fragilidade verificou-se relação da creatinina na predição de perda de peso (p<0,001), leucócitos na predição de força de preensão manual (p=0,022), interleucina-6 na predição do gasto energético (p=0,026) e da 25-hidroxivitamina D na predição de tempo de marcha (p=0,036). Na análise referente aos critérios de sarcopenia observou-se que os idosos com força muscular alterada apresentaram valores mais baixos de hematócrito (p=0,037) e mais altos de interleucina-6 (p=0,002) que os idosos com força muscular normal; e os idosos com desempenho físico alterado apresentaram valores mais baixos de leucócitos (p=0,024), hemoglobina (p<0,001), hematócrito (p=0,007) e 25-hidroxivitamina D (p=0,034) e mais altos de paratormônio (p=0,018) e interleucina 6 (p=0,002) quando comparados aos idosos com desempenho físico normal. Conclui-se que o uso combinado dos marcadores musculares, endócrinos e imunológicos possa ser útil para o diagnóstico da fragilidade e da sarcopenia e para a proposição de intervenções resolutivas com redução de desfechos negativos para o idoso.Submitted by PPG Gerontologia Biomédica (geronbio@pucrs.br) on 2021-01-20T12:32:23Z No. of bitstreams: 1 PILLATT_ANA_PAULA_TES.pdf: 3640683 bytes, checksum: 8f7e56edd0a0f22c3c014411f93da129 (MD5)Approved for entry into archive by Clarissa Selbach (clarissa.selbach@pucrs.br) on 2021-01-23T11:25:18Z (GMT) No. of bitstreams: 1 PILLATT_ANA_PAULA_TES.pdf: 3640683 bytes, checksum: 8f7e56edd0a0f22c3c014411f93da129 (MD5)Made available in DSpace on 2021-01-23T11:29:07Z (GMT). No. of bitstreams: 1 PILLATT_ANA_PAULA_TES.pdf: 3640683 bytes, checksum: 8f7e56edd0a0f22c3c014411f93da129 (MD5) Previous issue date: 2020-12-11Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPESapplication/pdfhttp://tede2.pucrs.br:80/tede2/retrieve/179893/TES_ANA_PAULA_PILLATT_CONFIDENCIAL.pdf.jpgporPontifícia Universidade Católica do Rio Grande do SulPrograma de Pós-Graduação em Gerontologia BiomédicaPUCRSBrasilEscola de MedicinaIdoso fragilizadoSarcopeniaBiomarcadoresDiagnósticoEstudos epidemiológicosFrail elderlySarcopeniaBiomarkersDiagnosisEpidemiologic studiesCIENCIAS DA SAUDE::MEDICINAAssociação de marcadores musculares, endócrinos e imunológicos com a fragilidade em idososinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisTrabalho será publicado como artigo ou livro60 meses23/01/20268969645070886364160500600500600-224747486637135387-9693694523087866273590462550136975366info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da PUC_RSinstname:Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)instacron:PUC_RSTHUMBNAILTES_ANA_PAULA_PILLATT_CONFIDENCIAL.pdf.jpgTES_ANA_PAULA_PILLATT_CONFIDENCIAL.pdf.jpgimage/jpeg4088http://tede2.pucrs.br/tede2/bitstream/tede/9482/4/TES_ANA_PAULA_PILLATT_CONFIDENCIAL.pdf.jpgd5d9f5a028d6abd068264b862ffe33b4MD54TEXTTES_ANA_PAULA_PILLATT_CONFIDENCIAL.pdf.txtTES_ANA_PAULA_PILLATT_CONFIDENCIAL.pdf.txttext/plain2437http://tede2.pucrs.br/tede2/bitstream/tede/9482/3/TES_ANA_PAULA_PILLATT_CONFIDENCIAL.pdf.txtaf09577ea0a52e5f0a375c6837074629MD53ORIGINALTES_ANA_PAULA_PILLATT_CONFIDENCIAL.pdfTES_ANA_PAULA_PILLATT_CONFIDENCIAL.pdfapplication/pdf617337http://tede2.pucrs.br/tede2/bitstream/tede/9482/2/TES_ANA_PAULA_PILLATT_CONFIDENCIAL.pdfbcf46ca07672fc33581d2d869e117e4aMD52LICENSElicense.txtlicense.txttext/plain; charset=utf-8590http://tede2.pucrs.br/tede2/bitstream/tede/9482/1/license.txt220e11f2d3ba5354f917c7035aadef24MD51tede/94822021-01-23 12:00:19.905oai:tede2.pucrs.br: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Biblioteca Digital de Teses e Dissertaçõeshttp://tede2.pucrs.br/tede2/PRIhttps://tede2.pucrs.br/oai/requestbiblioteca.central@pucrs.br||opendoar:2021-01-23T14:00:19Biblioteca Digital de Teses e Dissertações da PUC_RS - Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)false |
dc.title.por.fl_str_mv |
Associação de marcadores musculares, endócrinos e imunológicos com a fragilidade em idosos |
title |
Associação de marcadores musculares, endócrinos e imunológicos com a fragilidade em idosos |
spellingShingle |
Associação de marcadores musculares, endócrinos e imunológicos com a fragilidade em idosos Pillatt, Ana Paula Idoso fragilizado Sarcopenia Biomarcadores Diagnóstico Estudos epidemiológicos Frail elderly Sarcopenia Biomarkers Diagnosis Epidemiologic studies CIENCIAS DA SAUDE::MEDICINA |
title_short |
Associação de marcadores musculares, endócrinos e imunológicos com a fragilidade em idosos |
title_full |
Associação de marcadores musculares, endócrinos e imunológicos com a fragilidade em idosos |
title_fullStr |
Associação de marcadores musculares, endócrinos e imunológicos com a fragilidade em idosos |
title_full_unstemmed |
Associação de marcadores musculares, endócrinos e imunológicos com a fragilidade em idosos |
title_sort |
Associação de marcadores musculares, endócrinos e imunológicos com a fragilidade em idosos |
author |
Pillatt, Ana Paula |
author_facet |
Pillatt, Ana Paula |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Schneider, Rodolfo Herberto |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/3981128306152418 |
dc.contributor.advisor-co1.fl_str_mv |
Berlezi, Evelise Moraes |
dc.contributor.advisor-co1Lattes.fl_str_mv |
http://lattes.cnpq.br/8373298120143786 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/2324549051311419 |
dc.contributor.author.fl_str_mv |
Pillatt, Ana Paula |
contributor_str_mv |
Schneider, Rodolfo Herberto Berlezi, Evelise Moraes |
dc.subject.por.fl_str_mv |
Idoso fragilizado Sarcopenia Biomarcadores Diagnóstico Estudos epidemiológicos |
topic |
Idoso fragilizado Sarcopenia Biomarcadores Diagnóstico Estudos epidemiológicos Frail elderly Sarcopenia Biomarkers Diagnosis Epidemiologic studies CIENCIAS DA SAUDE::MEDICINA |
dc.subject.eng.fl_str_mv |
Frail elderly Sarcopenia Biomarkers Diagnosis Epidemiologic studies |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::MEDICINA |
description |
The frailty syndrome has been conceptualized as a decline in spiral energy, which is based on a tripod of changes related to aging, namely sarcopenia, neuroendocrine dysregulation and immune dysfunction. The objective of this thesis was to associate muscular, endocrine and immunological markers with the frailty criteria in older people assisted by primary care in a municipality in the southern region of Brazil. This is a cross-sectional, probabilistic study, linked to the project “Comprehensive Care for the Health of the Older people”, developed in the city of Ijuí in the state of Rio Grande do Sul. The research population included individuals aged 60 years or over, both sexes, attached to the Family Health Strategies in the urban area. To obtain the variables of interest, a questionnaire prepared by the researchers was used, physical evaluations to measure and classify the levels of fragility and sarcopenia and laboratory tests to measure creatinine, serum calcium, growth factor similar to insulin-1, parathyroid hormone, 25-hydroxyvitamin D, C-reactive protein, interleukin 6 and blood count. Frailty was assessed according to Fried's criteria and sarcopenia took into account the protocol created by the European working group on sarcopenia in older people. The research protocol was applied in the home space and blood samples were previously scheduled to be collected in health units. The data obtained were compiled and analyzed using the Statistical Package for the Social Sciences (SPSS) software (version 22.0). Inferential statistics of a quantitative nature were analyzed using the means comparison test for independent samples. The dependence of qualitative variables was also analyzed using Pearson's chi-square or Fisher's exact tests. To analyze the risk between the groups, the prevalence odds ratio was used and to analyze the relationship between the dependent variables and the independent variables, the linear regression model was used. In the analysis referring to the frailty criteria, there was a relationship between creatinine in the prediction of weight loss (p<0,001), leukocytes in the prediction of handgrip strength (p=0,022), interleukin-6 in the prediction of energy expenditure (p=0,026) and 25-hydroxyvitamin D in the prediction of walking time (p=0,036). In the analysis referring to the sarcopenia criteria, it was observed that the older people with altered muscle strength had lower hematocrit (p=0,037) and higher interleukin-6 (p=0,002) values than the older people with normal muscle strength; and the older people with altered physical performance had lower values of leukocytes (p=0,024), hemoglobin (p<0,001), hematocrit (p=0,007) and 25-hydroxyvitamin D (p=0,034) and more high levels of parathyroid hormone (p=0,018) and interleukin 6 (p=0,002) when compared to the older people with normal physical performance. It is concluded that the combined use of muscle, endocrine and immunological markers can be useful for the diagnosis of frailty and sarcopenia and for proposing resolutive interventions to reduce negative outcomes for the older people. |
publishDate |
2020 |
dc.date.issued.fl_str_mv |
2020-12-11 |
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2021-01-23T11:29:07Z |
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info:eu-repo/semantics/publishedVersion |
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http://tede2.pucrs.br/tede2/handle/tede/9482 |
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por |
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por |
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8969645070886364160 |
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Pontifícia Universidade Católica do Rio Grande do Sul |
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PUCRS |
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Brasil |
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Escola de Medicina |
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Pontifícia Universidade Católica do Rio Grande do Sul |
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