Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-04-25T22:57:37Z No. of bitstreams: 1 AnaCellySouzaDosSantos_DISSERT.pdf: 1317537 bytes, checksum: b64edb8897e90d29039563de6db801af (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-04-27T21:45:33Z (GMT) No. of bitstreams: 1 AnaCellySouzaDosSantos_DISSERT.pdf: 1317537 bytes, checksum: b64edb8897e90d29039563de6db801af (MD5) / Made available in DSpace on 2016-04-27T21:45:33Z (GMT). No. of bitstreams: 1 AnaCellySouzaDosSantos_DISSERT.pdf: 1317537 bytes, checksum: b64edb8897e90d29039563de6db801af (MD5) Previous issue date: 2015-03-27 / A s?ndrome dos ov?rios polic?sticos (SOP) ? considerada a endocrinopatia mais comum na fase reprodutiva da mulher, com preval?ncia que varia entre 15 a 20%. Al?m das altera??es hormonais e reprodutivas, ? comum na SOP a presen?a de fatores de risco para desenvolvimento de doen?as cardiovasculares (DCV) como diabetes mellitus, resist?ncia ? insulina (RI), obesidade visceral, inflama??o cr?nica de baixo grau e dislipidemia. Devido ? elevada frequ?ncia da obesidade associada ? SOP, a perda de peso ? considerada como o tratamento de primeira linha para a s?ndrome por melhorar as altera??es metab?licas e normalizar os andr?genos s?ricos, restaurando a fun??o reprodutiva destas pacientes. Objetivos: avaliar os marcadores inflamat?rios e a RI em mulheres com SOP e ovulat?rias saud?veis com diferentes estados nutricionais e como os par?metros inflamat?rios e hormonais se apresentam ap?s a perda de peso, atrav?s da restri??o cal?rica nas portadoras da s?ndrome. M?todos: O fator de necrose tumoralalfa (TNF-?), a interleucina-6 (IL-6) e a prote?na c-reativa (PCR) foram avaliados em amostras de soro de 40 mulheres em idade reprodutiva. Na primeira fase do estudo, as volunt?rias foram divididas em quatro grupos: Grupo I (n?o eutr?ficas com SOP, n=12); Grupo II (n?o eutr?ficas sem SOP, n=10), Grupo III (eutr?ficas com SOP, n=08) e Grupo IV (eutr?ficas sem SOP, n=10). A categoriza??o dos grupos foi realizada pelo ?ndice de massa corporal (IMC), de acordo com a organiza??o mundial de sa?de (OMS) em n?o eutr?fica, mulheres com IMC ? 25 (kg/m?) e eutr?ficas, IMC entre 18,9-24,9 (kg/m?). A RI foi determinada atrav?s do ?ndice HOMA-IR. Na segunda fase do estudo foi realizada uma interven??o nutricional controlada e os par?metros inflamat?rios foram avaliados em 21 mulheres sobrepeso e obesas com SOP, antes e depois da perda de peso. Todas as pacientes receberam uma dieta hipocal?rica com redu??o de 500 kcal/dia do consumo habitual com concentra??es padr?o de macronutrientes. Resultados: Fase 1: pacientes com SOP apresentaram n?veis aumentados da PCR (p<0,01) e HOMA-IR (p<0,01). Quando divididas por IMC, tanto o grupo n?o eutr?fico com SOP (I) quanto eutr?fico com SOP(III) apresentou n?veis aumentados de PCR (I=2,35?0,55mg/L e III= 2,63?0,65mg/L; p<0,01) e HOMA-IR (I= 2,16?2,54 e III= 1,07?0,55; p<0,01). N?o foram encontradas diferen?as de TNF-? e IL-6 entre os grupos. Fase 2: Ap?s a perda de peso de 5% do peso inicial ocorreu uma redu??o em todos os n?veis s?ricos dos componentes do perfil inflamat?rio avaliados, PCR (154.75 ? 19.33) vs (78.06 ? 9.08), TNF- ? (10.89 ? 5.09) vs (6.39 ? 1.41) e IL6 (154.75 ? 19.33) vs (78.06 ? 9.08) (p < 0.00) em associa??o com a melhora de alguns par?metros hormonais avaliados. Conclus?o: A SOP contribuiu para o surgimento da inflama??o cr?nica e das altera??es no metabolismo da glicose atrav?s do aumento da PCR, da insulina e do HOMA-IR, independente do estado nutricional e a perda de peso melhoraram o estado inflamat?rio e o perfil hormonal das pacientes avaliadas. / The polycystic ovary syndrome (PCOS) is considered the most common endocrine disorder in reproductive age women, with a prevalence ranging from 15 to 20%. In addition to hormonal and reproductive changes, it is common in PCOS the presence of risk factors for developing cardiovascular disease (CVD) and diabetes mellitus, insulin resistance (IR), visceral obesity, chronic low-grade inflammation and dyslipidemia. Due to the high frequency of obesity associated with PCOS, weight loss is considered as the first-line treatment for the syndrome by improving metabolic and normalizes serum androgens, restoring reproductive function of these patients. Objectives: To evaluate the inflammatory markers and IR in women with PCOS and healthy ovulatory with different nutritional status and how these parameters are displayed after weight loss through caloric restriction in with Down syndrome. Methods: Tumor necrosis factor-alpha (TNF-?), interleukin-6 (IL-6) and C-reactive protein (CRP) were assessed in serum samples from 40 women of childbearing age. The volunteers were divided into four groups: Group I (not eutrophic with PCOS, n = 12); Group II (not eutrophic without PCOS, n = 10), Group III (eutrophic with PCOS, n = 08) and Group IV (eutrophic without PCOS, n = 10). The categorization of groups was performed by body mass index (BMI), according to the World Health Organization (WHO) does not eutrophic, overweight and obesity (BMI> 25 kg / m?) and normal weight (BMI <24.9 kg / m?). IR was determined by HOMA-IR index. In the second phase of the study a controlled dietary intervention was performed and inflammatory parameters were evaluated in 21 overweight and obese women with PCOS, before and after weight loss. All patients received a low-calorie diet with reduction of 500 kcal / day of regular consumption with standard concentrations of macronutrients. Results: Phase 1: PCOS patients showed increased levels of CRP (p <0.01) and HOMAIR (p <0.01). When divided by BMI, both not eutrophic group with PCOS (I) as eutrophic with PCOS (III) showed increased levels of CRP (I = 2.35 ? 0,55mg / L and 2.63 ? III = 0,65mg / L; p <0.01) and HOMA-IR (I = 2.16 ? 2.54 and III = 1.07 ? 0.55; p <0.01). There were no differences in TNF-? and IL-6 between groups. Step 2: After the weight loss of 5% of the initial weight was reduced in all of the components of serum assessed inflammatory profile, PCR (154.75 ? 19:33) vs (78.06 ? 8.9) TNF ? (10.89 ? 5.09) vs (6:39 ? 1:41) and IL6 (154.75 ? 19:33) vs (78.06 ? 08.09) (p <0:00) in association with improvement some hormonal parameters evaluated. Conclusion: PCOS contributed to the development of chronic inflammation and changes in glucose metabolism by increasing CRP, insulin and HOMA-IR, independent of nutritional status. The weight loss, caloric restriction has improved the inflammatory condition and hormonal status of the evaluated patients.