Os ácidos graxos e índices de qualidade da gordura da dieta tem papel importante na homeostase glicêmica, mas estudos sobre o consumo alimentar desses nutrientes e sua associação com o diabetes mellitus gestacional (DMG) são escassos. O objetivo do presente estudo consistiu na investigação da relação entre o diabetes gestacional e a ingestão usual de ácidos graxos específicos e de índices de qualidade da gordura da dieta de mulheres no segundo trimestre gestacional. Estudo transversal conduzido entre 799 gestantes adultas de Ribeirão Preto-SP-Brasil. Para a estimativa da dieta usual o Multiple Source Method foi utilizado, empregando-se dois IR24h obtidos a partir da 24a semana gestacional. As gestantes foram entrevistadas enquanto realizavam teste oral de tolerância à glicose e os critérios da International Association of Diabetes and Pregnancy Study Groups foram empregados para o diagnóstico do DMG. A associação entre os tercis de ácidos graxos da dieta durante a gestação e o DMG foi avaliada por análises de regressão logística, ajustadas por idade, escolaridade, paridade, semana gestacional, IMC pré-gestacional e atual, DMG prévia, histórico familiar de diabetes, tabagismo, prática de atividade física, fibra dietética, energia e ácidos graxos. A média (DP) de idade das gestantes avaliadas foi de 28 (5) anos e 18,9% apresentaram DMG. Verificou-se associação inversa entre o maior tercil de ingestão de ácidos graxos ômega 3 totais [0,21(0,08-0,56)] e ácido graxo linolênico [0,28(0,11-0,71)] e o DMG, após ajuste múltiplo. Observou-se associação direta entre o terceiro tercil do índice de trombogenicidade da dieta [2,55(1,30-5,02)] e associação inversa entre o maior tercil da razão HH [0,43(0,23-0,80)] e o DMG, quando comparados ao menor tercil, após ajuste múltiplo. A qualidade da gordura da dieta durante a gestação é fortemente associada com o diabetes mellitus gestacional. / Fatty acids and indices of dietary fat quality plays an important role in glucose homeostasis, but studies on the dietary intake of these nutrients and its association with gestational diabetes mellitus (GDM) are scarce. The aim of the present study was to investigate the relationship between GDM and the usual intake of specific fatty acids and indices of dietary fat quality in women in the second trimester of pregnancy. This was a cross-sectional study conducted with 799 adult pregnant women in Ribeirão Preto (Sao Paulo), Brazil. We used the Multiple Source Method to estimate participants usual diet, employing two IR24hs obtained from the 24th week of gestation. The women were interviewed when they came in for their oral glucose tolerance test and GDM was diagnosed using the International Association of Diabetes and Pregnancy Study Groups criteria. We used logistic regression analysis to assess the correlation between GDM and dietary fatty acid tertiles during pregnancy, adjusted for age, education, parity, gestational week, pre-pregnancy and current BMI, prior GDM, family history of diabetes, smoking, physical activity, dietary fiber, energy and fatty acids. The mean (SD) age of the pregnant women was 28 (5) years and 18.9% had GDM. There was an inverse correlation between the highest tertile of total omega 3 intake [0.21 (0.08-0.56)] and linolenic fatty acid intake [0.28 (0.11-0.71)] and GDM, after multiple adjustments. We observed a positive correlation between GDM and the highest tertile of the dietary index of thrombogenicity [2.55 (1.30-5.02)] and a negative correlation between GDM and the highest tertile of the hypocholesterolaemic/hypercholesterolaemic fatty acids ratio [0.43 (0.23-0.80)], after multiple adjustments. The quality of dietary fat during pregnancy is strongly associated with gestational diabetes mellitus.

Os ácidos graxos e índices de qualidade da gordura da dieta tem papel importante na homeostase glicêmica, mas estudos sobre o consumo alimentar desses nutrientes e sua associação com o diabetes mellitus gestacional (DMG) são escassos. O objetivo do presente estudo consistiu na investigação da relação entre o diabetes gestacional e a ingestão usual de ácidos graxos específicos e de índices de qualidade da gordura da dieta de mulheres no segundo trimestre gestacional. Estudo transversal conduzido entre 799 gestantes adultas de Ribeirão Preto-SP-Brasil. Para a estimativa da dieta usual o Multiple Source Method foi utilizado, empregando-se dois IR24h obtidos a partir da 24a semana gestacional. As gestantes foram entrevistadas enquanto realizavam teste oral de tolerância à glicose e os critérios da International Association of Diabetes and Pregnancy Study Groups foram empregados para o diagnóstico do DMG. A associação entre os tercis de ácidos graxos da dieta durante a gestação e o DMG foi avaliada por análises de regressão logística, ajustadas por idade, escolaridade, paridade, semana gestacional, IMC pré-gestacional e atual, DMG prévia, histórico familiar de diabetes, tabagismo, prática de atividade física, fibra dietética, energia e ácidos graxos. A média (DP) de idade das gestantes avaliadas foi de 28 (5) anos e 18,9% apresentaram DMG. Verificou-se associação inversa entre o maior tercil de ingestão de ácidos graxos ômega 3 totais [0,21(0,08-0,56)] e ácido graxo linolênico [0,28(0,11-0,71)] e o DMG, após ajuste múltiplo. Observou-se associação direta entre o terceiro tercil do índice de trombogenicidade da dieta [2,55(1,30-5,02)] e associação inversa entre o maior tercil da razão HH [0,43(0,23-0,80)] e o DMG, quando comparados ao menor tercil, após ajuste múltiplo. A qualidade da gordura da dieta durante a gestação é fortemente associada com o diabetes mellitus gestacional. / Fatty acids and indices of dietary fat quality plays an important role in glucose homeostasis, but studies on the dietary intake of these nutrients and its association with gestational diabetes mellitus (GDM) are scarce. The aim of the present study was to investigate the relationship between GDM and the usual intake of specific fatty acids and indices of dietary fat quality in women in the second trimester of pregnancy. This was a cross-sectional study conducted with 799 adult pregnant women in Ribeirão Preto (Sao Paulo), Brazil. We used the Multiple Source Method to estimate participants usual diet, employing two IR24hs obtained from the 24th week of gestation. The women were interviewed when they came in for their oral glucose tolerance test and GDM was diagnosed using the International Association of Diabetes and Pregnancy Study Groups criteria. We used logistic regression analysis to assess the correlation between GDM and dietary fatty acid tertiles during pregnancy, adjusted for age, education, parity, gestational week, pre-pregnancy and current BMI, prior GDM, family history of diabetes, smoking, physical activity, dietary fiber, energy and fatty acids. The mean (SD) age of the pregnant women was 28 (5) years and 18.9% had GDM. There was an inverse correlation between the highest tertile of total omega 3 intake [0.21 (0.08-0.56)] and linolenic fatty acid intake [0.28 (0.11-0.71)] and GDM, after multiple adjustments. We observed a positive correlation between GDM and the highest tertile of the dietary index of thrombogenicity [2.55 (1.30-5.02)] and a negative correlation between GDM and the highest tertile of the hypocholesterolaemic/hypercholesterolaemic fatty acids ratio [0.43 (0.23-0.80)], after multiple adjustments. The quality of dietary fat during pregnancy is strongly associated with gestational diabetes mellitus.

<p>Lipid peroxidation is thought to be an important factor in the pathophysiology of a number of diseases and in the process of ageing, but its measurement <i>in vivo</i> has been difficult. The aim of this thesis was to evaluate methods for measurement of lipid peroxidation <i>in vivo</i> that are suitable for clinical investigations, and to apply these methods in animal and human studies investigating basal conditions and situations associated with increased lipid peroxidation.</p><p>The ferrous oxidation in xylenol orange assay for quantification of total plasma lipid hydroperoxides was re-evaluated regarding sample handling and storage. It was shown to be a useful tool for analyses of fresh but not stored plasma samples.</p><p>A methodology for measurement of the total amount (sum of free and esterified) of an F₂-isoprostane, 8-iso-prostaglandin F_2α, in tissues using alkaline hydrolysis in combination with an existing radioimmunoassay was developed. High levels of 8-iso-prostaglandin F_2α in rat liver tissue were quantified by this technique both at basal conditions and in an experimental model of increased lipid peroxidation induced by carbon tetrachloride.</p><p>Supplementation with vitamin E to rats decreased both non-enzymatic and enzymatic lipid peroxidation as measured by 8-iso-prostaglandin F_2α and a major prostaglandin F_2α metabolite. This was verified both in the urine at basal conditions, and in the urine and liver tissue after carbon tetrachloride induced lipid peroxidation.</p><p>In a randomised cross-over study in humans, a rapeseed oil-based diet with an increased proportion of easily oxidised polyunsaturated fatty acids was compared to a control diet rich in saturated fats. The rapeseed oil-based diet did not seem to increase the degree of lipid peroxidation in plasma and urine as measured by 8-iso-prostaglandin F_2α, hydroperoxides and malondialdehyde, presumably due to a sufficient content of antioxidants in the rapeseed oil diet.</p><p>In conclusion, the simultaneous measurement of several biomarkers of lipid peroxidation is a promising approach for future studies investigating the possible role of lipid peroxidation <i>in vivo</i> under basal conditions and in the pathology of diseases.</p>

<p>Insulin sensitivity is related to the fatty acid profile of skeletal muscle. The aim of this thesis was to investigate whether physical activity and dietary fat quality, independent of each other, influence the fatty acid composition of the skeletal muscle lipids. In an intervention study where middle-aged men were exercising for six weeks, and in a cross-sectional study comparing sedentary with endurance trained young men, it was demonstrated that the fatty acid composition of skeletal muscle lipids differed between physical active and inactive men. In brief, a lower proportion of palmitic acid (16:0) and total n-6 polyunsaturated fatty acids (PUFA) and a higher proportion of stearic (18:0) and oleic acid (18:1n-9) and total n-3 PUFA in the muscle phospholipids were associated with physical activity, despite similar fatty acid composition of the diet. In the second study, that included a larger training volume, differences in the fatty acid profile were also found in the skeletal muscle triglycerides. </p><p>In contrast, after short-term supra-maximal exercise we found no significant changes in the proportion of the fatty acids in skeletal muscle. </p><p>Furthermore, after a treatment period of three months, with diets with various dietary fat quality, the proportions of saturated fatty acids (14:0, 15:0 and 17:0) were higher and the proportion of 18:1 n-9 lower in subjects with a high intake of saturated fatty acids compared with subjects with a high intake of monounsaturated fatty acids. In addition subjects given n-3 supplementation had a higher proportion of total n-3 PUFA and lower n-6 PUFA in the skeletal muscle phospholipids than controls. Differences similar to those observed in the phospholipids were found in the triglycerides. </p><p>In summary, these results suggest that regular aerobic physical activity and dietary fat quality influence the fatty acid composition of the skeletal muscle lipids, which may affect insulin sensitivity and glucose homeostasis. </p>

Lipid peroxidation is thought to be an important factor in the pathophysiology of a number of diseases and in the process of ageing, but its measurement in vivo has been difficult. The aim of this thesis was to evaluate methods for measurement of lipid peroxidation in vivo that are suitable for clinical investigations, and to apply these methods in animal and human studies investigating basal conditions and situations associated with increased lipid peroxidation. The ferrous oxidation in xylenol orange assay for quantification of total plasma lipid hydroperoxides was re-evaluated regarding sample handling and storage. It was shown to be a useful tool for analyses of fresh but not stored plasma samples. A methodology for measurement of the total amount (sum of free and esterified) of an F2-isoprostane, 8-iso-prostaglandin F2α, in tissues using alkaline hydrolysis in combination with an existing radioimmunoassay was developed. High levels of 8-iso-prostaglandin F2α in rat liver tissue were quantified by this technique both at basal conditions and in an experimental model of increased lipid peroxidation induced by carbon tetrachloride. Supplementation with vitamin E to rats decreased both non-enzymatic and enzymatic lipid peroxidation as measured by 8-iso-prostaglandin F2α and a major prostaglandin F2α metabolite. This was verified both in the urine at basal conditions, and in the urine and liver tissue after carbon tetrachloride induced lipid peroxidation. In a randomised cross-over study in humans, a rapeseed oil-based diet with an increased proportion of easily oxidised polyunsaturated fatty acids was compared to a control diet rich in saturated fats. The rapeseed oil-based diet did not seem to increase the degree of lipid peroxidation in plasma and urine as measured by 8-iso-prostaglandin F2α, hydroperoxides and malondialdehyde, presumably due to a sufficient content of antioxidants in the rapeseed oil diet. In conclusion, the simultaneous measurement of several biomarkers of lipid peroxidation is a promising approach for future studies investigating the possible role of lipid peroxidation in vivo under basal conditions and in the pathology of diseases.

Insulin sensitivity is related to the fatty acid profile of skeletal muscle. The aim of this thesis was to investigate whether physical activity and dietary fat quality, independent of each other, influence the fatty acid composition of the skeletal muscle lipids. In an intervention study where middle-aged men were exercising for six weeks, and in a cross-sectional study comparing sedentary with endurance trained young men, it was demonstrated that the fatty acid composition of skeletal muscle lipids differed between physical active and inactive men. In brief, a lower proportion of palmitic acid (16:0) and total n-6 polyunsaturated fatty acids (PUFA) and a higher proportion of stearic (18:0) and oleic acid (18:1n-9) and total n-3 PUFA in the muscle phospholipids were associated with physical activity, despite similar fatty acid composition of the diet. In the second study, that included a larger training volume, differences in the fatty acid profile were also found in the skeletal muscle triglycerides. In contrast, after short-term supra-maximal exercise we found no significant changes in the proportion of the fatty acids in skeletal muscle. Furthermore, after a treatment period of three months, with diets with various dietary fat quality, the proportions of saturated fatty acids (14:0, 15:0 and 17:0) were higher and the proportion of 18:1 n-9 lower in subjects with a high intake of saturated fatty acids compared with subjects with a high intake of monounsaturated fatty acids. In addition subjects given n-3 supplementation had a higher proportion of total n-3 PUFA and lower n-6 PUFA in the skeletal muscle phospholipids than controls. Differences similar to those observed in the phospholipids were found in the triglycerides. In summary, these results suggest that regular aerobic physical activity and dietary fat quality influence the fatty acid composition of the skeletal muscle lipids, which may affect insulin sensitivity and glucose homeostasis.