Razão gordura-massa magra e fatores de risco cardiometabólico em mulheres, operadas bariátricas e não operadas

• Autor(a) principal: Dada, Rafaela Pilegi
• Data de Publicação: 2016
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da Universidade Estadual de Maringá (RI-UEM)
• Texto Completo: http://repositorio.uem.br:8080/jspui/handle/1/2237
• topic: Cirurgia bariátrica - Mulheres; Composição corporal - Obesidade; Risco cardiometabólico; Relação gordura-massa magra; Síndrome metabólica; Ciências da Saúde; Educação Física

The prevalence of obesity has increased in the Brazilian adult population. The higher the degree of obesity, the worse the distribution of body composition and increased the risks for changes in cardiometabolic risk parameters. Thus, the implementation of intervention for the treatment of obese and its comorbidities is urgent to control the situation and improves morbidity and mortality condations. Among the alternatives are the conventional interventions, that not result in significant improvements and the process is headed for the surgical method, called bariatric surgery (BS). Studies have shown significant results in BS results compared to conventional, and the methods among them are: will marked weight loss, reduced of comorbidities related to obesity grade I, II and III and the improvement in metabolic risk behaviors. However, our searches in the literature to date indicative, no studies reporting on the usual body composition (Lean Body Mass [LM] and Fat Mass [FM] and unusual (lean body mass index [LMI] fat mass index [FMI] and the fat to lean mass (F/L) ratio) in cardiometabolic risk variables among the adult population in Brazil, and even after the BS and the influence of the surgical time in the short, medium and long term. To evaluate, FMI, F/L ratio and the variables of the metabolic syndrome (triglycerides [TG], fasting glucose [FG], high-density lipoprotein [HDL-c], waist circumference [WC] and systolic blood pressure [SBP] and diastolic blood pressure [DBP]); to evaluate the influence of surgical time on o LMI, IMF, FRLM and the risk of changes in the variables of the metabolic syndrome (TG, FG, HDL-c, WC and blood pressure) between a group of operated patients and an equivalent not operated groups. The sample individual 338 adult women (170 operated by BS [OG] and 168 non-operated [NOG]) with a mean age of 47 (17) years (OG) and 46.5 (18) years (NOG), who participated at MSOC -SUM until December 2013. Participate in to research the composition of the OG, women should have at least one year after BS and a maximum of 10 years for the other group was selected for convenience following the search equivalence by gender, age and current BMI range. Considering only the operated subjects were categorized into three groups according to the time of BS: a) operated from 0-24 months; b) operated between 25-96 months and c) operated ≥ 97 months. Evaluations were carried out in body composition through a bioimpedanciometro, WC, SBP and DBP and blood collection to quantify the metabolic parameters (FG, TG and HDL-c). With the results of body composition by bioimpedanciometro were calculated LMI and FMI criteria proposed by VanItallie et al. (1990) and FRLM proposed by Prado et al. (2012). He was diagnosed with MS in women according to the references of the NCEP-ATP III for changes in WC ≥ 88 cm in TG≥150 mg / dL, low values for HDL-C (<50 mg / dL), blood pressure high (SBP ≥ 130 mmHg and / or DBP ≥ 85 mmHg) and hyperglycemia ≥ 100 mg / dL. All evaluations were performed at the Multidisciplinary Study of Obesity Center (MSOC) of the State University of Maringá (SUM). The inferential statistics were performed by the Kolmogorov-Smirnov normality test and Shapiro-Wilk, from which the parametric and nonparametric procedures were defined appropriate. Levene's test was used to determine the homogeneity of the data. It was later performed an Analysis of Variance (ANOVA) to a factor (one-way) when detected differences between the five groups (normal weight, overweight, obese I, obese II and obese III), by using the Bonferroni test as post-hoc. The sphericity was tested by the Mauchly test and the Greenhouse-Geisser correction was applied when necessary. Additionally, to assess the magnitude of the differences observed, the size of the effect (effect size) was calculated by (eta squared, η2) and interpreted according to the classification Cohen (1988): <0.2 [small] >0.2 to <0.8 [moderate] and >0.8 [large]. Subsequently, the Pearson correlation between the parameters of usual and unusual body composition was performed, as well as the cardiovascular risk factors of MS. Correlations were interpreted according to the classification of Hopkins et al. (2009): <0.1 [trivial] ≥0.1 to <0.3 [small], ≥0.3 to 0.5 [moderate], ≥0.5 to 0.7 [high], ≥0.7 to 0.9 [very high] and ≥0.9 to 1.0 [high]. When compared with GO GNO were applied the non-parametric Mann-Whitney test for the anthropometric variables, body composition usual and unusual and blood were verified by Anova one way - Kruskal-Wallis in order to analyze the influence of surgical time. Statistical significance was set at P<0.05 for all tests. The nutritional status indicated in an increase in anthropometric, hemodynamic, body composition (P <0.001) and blood (FG (P<0.001), TG (P= 0.004) and HDL-C (P= 0.015) usual. (P <0.001) i, BMI x MS parameters, although all have different statistics, only WC has a very high correlation, while the moderate FG and the other with a small effect size (SBP, DBP, TG) and composition not x usual parameters of the MS (P<0.05, except LMI x PAD, DC strongly correlated with all unusual compositions compared OG x NOG, there were no significant differences in anthropometric and body composition analysis between GO and GNO. However, we observed significant differences in blood variables and WC (P <0.05). Regarding the post BS time, there is significant difference in body mass, MM, MG, MG%, F/L ratio, LMI, FMI, but also in WC, DBP, between G1 to G3 and G2 to G3 (P <0.05). Based on these results, it becomes substantial the development of primary education programs in health in order to combat obesity, changes in body composition and metabolic syndrome in women. Regarding the operated women can be seen that the metabolic variables were better and significant for the OG compared to NOG. However, for the body composition it was not observed if the same behavior, reinforcing the importance of studies on the influence BS time because it is noted that there are significant differences in the short, medium and long term, reinforcing the need for the creation of a multidisciplinary team to supervise and guide changes in eating behavior and physical activity, necessary for the maintenance of results with the BS.