Associação entre resistência insulínica e osteoporose em pessoas vivendo com HIV assistidas por um serviço público de atenção secundária no interior do RS, Brasil
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações do UFSM |
Texto Completo: | http://repositorio.ufsm.br/handle/1/21696 |
Resumo: | The advent of antiretroviral therapy (HAART) considerably increased the life expectancy of people living with HIV (PVH). However, this increase in survival expose PVH to age-related morbidities, including chronic metabolic and bone diseases, which occur in a high and early way in this population. The time of infection of human immunodeficiency virus (HIV) and the type and duration of the ART affect the reduction of bone mineral density (BMD) and the onset of insulin resistance and it has been established that diabetes mellitus (DM) is associated with an increased risk of osteoporotic fractures. We aimed to study the prevalence of osteoporosis and insulin resistance, as well as the association between these factors in PVH and using TARV in the municipality of Santa Maria, Rio Grande do Sul. A cross-sectional study was conducted. It included people living with HIV over 50 years of age. Individuals registered for the receipt of antiretroviral drugs in the pharmacy of the university Hospital of Santa Maria/RS during the period 2016 to 2018 were invited to participate. Those who accepted to participate have responded a standardized questionnaire, performed a bone density scan and a spinal X-ray examination, underwent peripheral blood collection, and had their weight and height measured. Factors such as BMD, CD4 cell count, total cholesterol and fractions, glycemia and insulinemia were analyzed. Osteoporosis was defined according to the recommendations of the World Health Organization (1994 criteria) and insulin resistance was assessed by calculating HOMA-IR (values > 2.7 were considered positive). One hundred and one individuals agreed to participate in the study and 84 underwent both insulin and BMD measurements. The prevalence of osteoporosis was 19% in this sample. Vertebral fractures were twice as frequent in individuals with osteoporosis. Participants with osteoporosis had lower BMI and triglyceride values than those without it. The frequency of insulin resistance was 68.2%, and this diagnosis was associated with glucocorticoid use, smoking and BMI. It was not associated with viral load and CD4 count. HOMA-IR values were higher in the group without osteoporosis; however, this association disappeared after correction for BMI in the linear regression model. We conclude that PVH in our study that has insulin resistance has higher BMD. Therefore, further studies are needed to assess the effect of insulin resistance on fracture risk in PVH. |
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2021-08-03T13:01:45Z2021-08-03T13:01:45Z2019-10-29http://repositorio.ufsm.br/handle/1/21696The advent of antiretroviral therapy (HAART) considerably increased the life expectancy of people living with HIV (PVH). However, this increase in survival expose PVH to age-related morbidities, including chronic metabolic and bone diseases, which occur in a high and early way in this population. The time of infection of human immunodeficiency virus (HIV) and the type and duration of the ART affect the reduction of bone mineral density (BMD) and the onset of insulin resistance and it has been established that diabetes mellitus (DM) is associated with an increased risk of osteoporotic fractures. We aimed to study the prevalence of osteoporosis and insulin resistance, as well as the association between these factors in PVH and using TARV in the municipality of Santa Maria, Rio Grande do Sul. A cross-sectional study was conducted. It included people living with HIV over 50 years of age. Individuals registered for the receipt of antiretroviral drugs in the pharmacy of the university Hospital of Santa Maria/RS during the period 2016 to 2018 were invited to participate. Those who accepted to participate have responded a standardized questionnaire, performed a bone density scan and a spinal X-ray examination, underwent peripheral blood collection, and had their weight and height measured. Factors such as BMD, CD4 cell count, total cholesterol and fractions, glycemia and insulinemia were analyzed. Osteoporosis was defined according to the recommendations of the World Health Organization (1994 criteria) and insulin resistance was assessed by calculating HOMA-IR (values > 2.7 were considered positive). One hundred and one individuals agreed to participate in the study and 84 underwent both insulin and BMD measurements. The prevalence of osteoporosis was 19% in this sample. Vertebral fractures were twice as frequent in individuals with osteoporosis. Participants with osteoporosis had lower BMI and triglyceride values than those without it. The frequency of insulin resistance was 68.2%, and this diagnosis was associated with glucocorticoid use, smoking and BMI. It was not associated with viral load and CD4 count. HOMA-IR values were higher in the group without osteoporosis; however, this association disappeared after correction for BMI in the linear regression model. We conclude that PVH in our study that has insulin resistance has higher BMD. Therefore, further studies are needed to assess the effect of insulin resistance on fracture risk in PVH.O advento da terapia antirretroviral (TARV) elevou consideravelmente a expectativa de vida de pessoas vivendo com HIV (PVH). Entretanto, esse aumento na sobrevida expõe às PVH a morbidades relacionadas a idade, incluindo doenças crônicas metabólicas e ósseas, que ocorrem de maneira elevada e precoce nessa população. O tempo de infecção pelo HIV (vírus da imunodeficiência humana), o tipo e a duração da TARV repercutem na redução da densidade mineral óssea (DMO) e no aparecimento de resistência à insulina. Com isso, tem-se como estabelecido que diabetes mellitus (DM) está associada a um risco aumentado de fraturas osteoporóticas. Objetivamos estudar a prevalência de osteoporose e resistência à insulina, bem como, a associação entre esses fatores em PVH e em uso de TARV no município de Santa Maria, Rio Grande do Sul. Foi realizado um estudo transversal, que incluiu PVH com mais de 50 anos. Indivíduos cadastrados para o recebimento de drogas antirretrovirais na farmácia do Hospital Universitário de Santa Maria/RS, durante o período de 2016 a 2018, foram convidados a participar. Aqueles que aceitaram responderam a um questionário padronizado, realizaram o exame de densitometria óssea, raio-X de coluna, passaram por coleta de sangue periférico e medidas de peso e altura. Foram analisados fatores como DMO, contagem de células CD4, colesterol total e frações, glicemia e insulinemia. O diagnóstico de osteoporose foi realizado de acordo com as recomendações da Organização Mundial de Saúde (Critério de 1994), e a resistência à insulina foi avaliada através do cálculo do HOMAIR (valores > 2,7 foram considerados positivos). Cento e um indivíduos aceitaram participar do estudo e 84 realizaram a dosagem de insulina e a medida de DMO. A prevalência de osteoporose foi de 19% nessa amostra. As fraturas vertebrais foram duas vezes mais frequentes nos indivíduos com osteoporose. Os participantes com osteoporose apresentaram valores menores de IMC e triglicerídeos do que os sem. A frequência de resistência à insulina foi de 68,2%, sendo que esse diagnóstico foi associado ao uso de glicocorticoide, tabagismo e IMC, e não foi associado a carga viral e a contagem de CD4. Os valores de HOMA-IR foram maiores no grupo sem osteoporose; no entanto, essa associação desapareceu após a correção para o IMC no modelo de regressão linear. Concluímos que as PVH em nosso estudo que tem resistência insulínica, tem maior DMO. Assim, mais estudos são necessários para avaliar o efeito da resistência à insulina no risco de fratura em PVH.porUniversidade Federal de Santa MariaCentro de Ciências da SaúdePrograma de Pós-Graduação em Ciências da SaúdeUFSMBrasilCiências da SaúdeAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessHIV (Vírus da Imunodeficiência Humana)Resistência insulínicaOsteoporoseInsulin resistanceOsteoporosisCNPQ::CIENCIAS DA SAUDEAssociação entre resistência insulínica e osteoporose em pessoas vivendo com HIV assistidas por um serviço público de atenção secundária no interior do RS, BrasilAssociation between insulin resistance and osteoporosis in people living with HIV assisted by a public secondary care service in the interior of RS, Brazilinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisPremaor, Melissa Orlandinhttp://lattes.cnpq.br/1919693261808995Carvalho, Jose Antonio Mainardi deMachry, Rafael VazGuimarães, Nathália Sernizonhttp://lattes.cnpq.br/2420617826764241Caeran, Gabriela400000000001600600600600600600ac7b8248-d4ca-4014-81f1-9c9db5a4eabda659172e-66c1-4bc9-8182-d3e6f99b617bd1090ac7-e965-46a1-9bcb-e895621ed2591e222989-c99c-481f-817e-0289dd9311a6901d8899-f3e3-405f-8b51-29e6d0aefd7areponame:Biblioteca Digital de Teses e Dissertações do UFSMinstname:Universidade Federal de Santa Maria (UFSM)instacron:UFSMORIGINALDIS_PPGCS_2019_CAERAN_GABRIELA.pdfDIS_PPGCS_2019_CAERAN_GABRIELA.pdfDissertaçãoapplication/pdf1766138http://repositorio.ufsm.br/bitstream/1/21696/1/DIS_PPGCS_2019_CAERAN_GABRIELA.pdf73097472ca15af37a5b4213ab13d56daMD51CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; 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dc.title.por.fl_str_mv |
Associação entre resistência insulínica e osteoporose em pessoas vivendo com HIV assistidas por um serviço público de atenção secundária no interior do RS, Brasil |
dc.title.alternative.eng.fl_str_mv |
Association between insulin resistance and osteoporosis in people living with HIV assisted by a public secondary care service in the interior of RS, Brazil |
title |
Associação entre resistência insulínica e osteoporose em pessoas vivendo com HIV assistidas por um serviço público de atenção secundária no interior do RS, Brasil |
spellingShingle |
Associação entre resistência insulínica e osteoporose em pessoas vivendo com HIV assistidas por um serviço público de atenção secundária no interior do RS, Brasil Caeran, Gabriela HIV (Vírus da Imunodeficiência Humana) Resistência insulínica Osteoporose Insulin resistance Osteoporosis CNPQ::CIENCIAS DA SAUDE |
title_short |
Associação entre resistência insulínica e osteoporose em pessoas vivendo com HIV assistidas por um serviço público de atenção secundária no interior do RS, Brasil |
title_full |
Associação entre resistência insulínica e osteoporose em pessoas vivendo com HIV assistidas por um serviço público de atenção secundária no interior do RS, Brasil |
title_fullStr |
Associação entre resistência insulínica e osteoporose em pessoas vivendo com HIV assistidas por um serviço público de atenção secundária no interior do RS, Brasil |
title_full_unstemmed |
Associação entre resistência insulínica e osteoporose em pessoas vivendo com HIV assistidas por um serviço público de atenção secundária no interior do RS, Brasil |
title_sort |
Associação entre resistência insulínica e osteoporose em pessoas vivendo com HIV assistidas por um serviço público de atenção secundária no interior do RS, Brasil |
author |
Caeran, Gabriela |
author_facet |
Caeran, Gabriela |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Premaor, Melissa Orlandin |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/1919693261808995 |
dc.contributor.advisor-co1.fl_str_mv |
Carvalho, Jose Antonio Mainardi de |
dc.contributor.referee1.fl_str_mv |
Machry, Rafael Vaz |
dc.contributor.referee2.fl_str_mv |
Guimarães, Nathália Sernizon |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/2420617826764241 |
dc.contributor.author.fl_str_mv |
Caeran, Gabriela |
contributor_str_mv |
Premaor, Melissa Orlandin Carvalho, Jose Antonio Mainardi de Machry, Rafael Vaz Guimarães, Nathália Sernizon |
dc.subject.por.fl_str_mv |
HIV (Vírus da Imunodeficiência Humana) Resistência insulínica Osteoporose |
topic |
HIV (Vírus da Imunodeficiência Humana) Resistência insulínica Osteoporose Insulin resistance Osteoporosis CNPQ::CIENCIAS DA SAUDE |
dc.subject.eng.fl_str_mv |
Insulin resistance Osteoporosis |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS DA SAUDE |
description |
The advent of antiretroviral therapy (HAART) considerably increased the life expectancy of people living with HIV (PVH). However, this increase in survival expose PVH to age-related morbidities, including chronic metabolic and bone diseases, which occur in a high and early way in this population. The time of infection of human immunodeficiency virus (HIV) and the type and duration of the ART affect the reduction of bone mineral density (BMD) and the onset of insulin resistance and it has been established that diabetes mellitus (DM) is associated with an increased risk of osteoporotic fractures. We aimed to study the prevalence of osteoporosis and insulin resistance, as well as the association between these factors in PVH and using TARV in the municipality of Santa Maria, Rio Grande do Sul. A cross-sectional study was conducted. It included people living with HIV over 50 years of age. Individuals registered for the receipt of antiretroviral drugs in the pharmacy of the university Hospital of Santa Maria/RS during the period 2016 to 2018 were invited to participate. Those who accepted to participate have responded a standardized questionnaire, performed a bone density scan and a spinal X-ray examination, underwent peripheral blood collection, and had their weight and height measured. Factors such as BMD, CD4 cell count, total cholesterol and fractions, glycemia and insulinemia were analyzed. Osteoporosis was defined according to the recommendations of the World Health Organization (1994 criteria) and insulin resistance was assessed by calculating HOMA-IR (values > 2.7 were considered positive). One hundred and one individuals agreed to participate in the study and 84 underwent both insulin and BMD measurements. The prevalence of osteoporosis was 19% in this sample. Vertebral fractures were twice as frequent in individuals with osteoporosis. Participants with osteoporosis had lower BMI and triglyceride values than those without it. The frequency of insulin resistance was 68.2%, and this diagnosis was associated with glucocorticoid use, smoking and BMI. It was not associated with viral load and CD4 count. HOMA-IR values were higher in the group without osteoporosis; however, this association disappeared after correction for BMI in the linear regression model. We conclude that PVH in our study that has insulin resistance has higher BMD. Therefore, further studies are needed to assess the effect of insulin resistance on fracture risk in PVH. |
publishDate |
2019 |
dc.date.issued.fl_str_mv |
2019-10-29 |
dc.date.accessioned.fl_str_mv |
2021-08-03T13:01:45Z |
dc.date.available.fl_str_mv |
2021-08-03T13:01:45Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/masterThesis |
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masterThesis |
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http://repositorio.ufsm.br/handle/1/21696 |
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http://repositorio.ufsm.br/handle/1/21696 |
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Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess |
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Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ |
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openAccess |
dc.publisher.none.fl_str_mv |
Universidade Federal de Santa Maria Centro de Ciências da Saúde |
dc.publisher.program.fl_str_mv |
Programa de Pós-Graduação em Ciências da Saúde |
dc.publisher.initials.fl_str_mv |
UFSM |
dc.publisher.country.fl_str_mv |
Brasil |
dc.publisher.department.fl_str_mv |
Ciências da Saúde |
publisher.none.fl_str_mv |
Universidade Federal de Santa Maria Centro de Ciências da Saúde |
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