Philosophiae Doctor - PhD / The aim of this study was to determine whether dietary fats constituting specific ω-6/ω-3 fatty acids (FA) ratio has chemopreventive modulating effects on the development of colon cancer. Western diets intake of saturated FA (SATS) and ω-6 polyunsaturated FA (PUFA) are very high relative to low ω-3 PUFA consumption. This high ω-6 and low ω-3 FA intake, resulting in a high ω-6/ω-3 FA ratio, appears to have a promoting effect on disease outcome, whilst increased ω-3 FA intake exhibiting anti-cancer effects. An animal cancer model was employed to evaluate the effects of dietary fat ratios on chemically induced carcinogenesis during cancer promotion. This was to determine whether the FA diets have a promoting or inhibitory effect on early neoplastic lesions by quantifying aberrant crypt foci (ACF) development and monitoring the crypt cells proliferative and apoptotic indices. The expressions of genes associated with changes in cells redox balance were also assessed. Common dietary fats were combined to produce the dietary fat ratios: sunflower oil (S), borage oil (B) and fish oil (F). Combinations of these oils generated the different ω-6/ω-3 FA ratios: SB (ω-6/ω-3: 38:1), SF (ω-6/ω-3: 13:1) and SBF (10:1). To represent the Western diet's high ω-6/ω-3 FA ratio profile, S (ω-6/ω-3: 501: 1) was used as a control, and canola oil and olive oil as additional reference. The dietary fats had no toxic effects on the liver and kidney based on serum clinical biochemical measurements. Diets containing borage oil (SB and SBF diets), canola and olive oil decreased (p<0.05) the crypt multiplicity of large (≥7 crypts/focus) ACF, exhibiting anti-cancer effects by decreasing (p<0.05) the proliferative activity of the rat colon crypts. Borage oil's protective effect resulted from the enhanced supply of C18:3ω-6 that has anti-inflammatory and anti-proliferative properties. The observed decrease (p<0.05) in apoptosis in the ACF was also facilitated by the up- and down-regulation of DNA repair and DNA replication associated genes, Xpa and Ercc2 by borage oil, respectively. Canola oil and olive had the largest inhibitory effect on suppressing crypt multiplicity by reducing (p<0.05) proliferation in the colon. Both oils effected the up-regulation (p<0.05) of the expression of several oxidative stress and anti-oxidant defence genes mediating the regulation of cell proliferation. The increased supply of C18:1ω-9 (canola and olive) and total polyphenolic content (olive) protected cells against oxidative stress induced apoptosis, which provided interesting interactive effects between FA and polyphenolic oil constituents that should be further elucidated. In contrast, the fish oil containing (SF diet) and the control sunflower (S diet) increased (p<0.05) the total ACF and colon crypt multiplicity (≥7 crypts/focus) when compared to the SB, SBF, olive oil and canola oil diets. An increased resistance to oxidative stress induced apoptosis appears to facilitate fish oil’s enhancing effect on crypt multiplicity despite the increased supply of LC ω-3 FA, which are prone to oxidation and leads to increased oxidative stress. This protective effect on crypt multiplicity and ACF development was mainly due to enhanced cellular antioxidant and DNA repair responses through the up-regulation (p<0.05) of Gpx4 and Nudt1, which favoured the increase (p<0.05) of crypt cells proliferation.The in vitro study demonstrated that oil ratio emulsions (S: ω-6/ω-3 = 249:1; SB: ω-6/ω-3 = 28:1; SF: ω-6/ω-3 = 12:1 and SBF: ω-6/ω-3 = 12:1) had differential effects on the survival indices of HT-29 and Caco-2 colon cancer cells. Contrary to the in vivo model, fish oil (SF and SBF emulsions) significantly (p<0.05) reduced the viability and proliferation of both cell lines, with the HT-29 cells showing greater sensitivity to the oil’s anti-proliferative effect. The HT-29 cells exposure to increased levels of C20:5ω-3 and C22:6ω-3 predisposes it to lipid peroxidation that increases the potential for cell removal via apoptosis. However, apoptotic effects were absent due to the HT-29 cells removal via necrosis as the cells energy status (ATP production) was significantly (p<0.05) depleted. Similar to the animal cancer model, borage oil (SB and SBF emulsions) had a reducing (p<0.05) effect on cell proliferation in both cell lines. However, as ATP was decreased (p<0.05), the S, SF and SBF emulsions resulted in an increased (p<0.05) apoptotic response in the Caco-2 cells in a dose dependent manner. This response resulted from the altered FA and lipid composition effected by the oil emulsions. Increased (p<0.05) incorporation of C20:5ω-3 and C22:6ω-3 in membrane phospholipid, phosphatidylethanolamine (PE), resulted in a significant decrease (p<0.05) in total SATS and MUFA content. A decrease (p<0.05) in membranes ω-6/ω-3 FA ratio was noted as well. This effect seems to selectively favour the induction of apoptosis by borage oil (SB and SBF). Similarly, an increase (p<0.05) in the PC/PE ratio by all oil emulsions, and a decrease (S and SB) and increase (SF and SBF) (p<0.05) in the chol/PL ratio appears to facilitate apoptosis too. A different threshold of the FA and lipid composition parameters elicits the inhibition of cell proliferation utilising lower oil emulsion concentrations. Therefore, the dietary supply of fats characterised by a defined low ω-6/ω-3 FA ratio can selectively modulate the growth indices of colon cancer. Specific oil ratio combinations by incorporating borage oil and fish oil hereby provide a selective strategy for chemoprevention in the colon, although underlying interactions and threshold effects of specific FA seems to prevail that should be further unravelled. / Medical Research Council (MRC) and Cancer Association of South Africa (CANSA)

Orientador: Marilisa Berti de Azevedo Barros / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-26T19:46:46Z (GMT). No. of bitstreams: 1 Barbosa_LhaisdePaula_M.pdf: 791897 bytes, checksum: 09592e243e99dc95526c900c976e262a (MD5) Previous issue date: 2015 / Resumo: O consumo de gorduras é essencial na alimentação humana. Os lipídios contribuem ativamente como precursores na síntese de hormônios, fazem parte da estrutura das membranas celulares, compõe a bile, participam da resposta autoimune e do transporte de vitaminas lipossolúveis e garantem o aporte energético da dieta. Contudo, o excesso na ingestão deste nutriente representa risco para o desenvolvimento de uma série de doenças crônicas e o aumento da ingestão de gorduras na dieta das populações foi uma característica marcante no processo de transição nutricional. O objetivo desta dissertação foi analisar o perfil de ingestão de gordura segundo escolaridade e sexo na população adulta residente no município de Campinas. Trata-se de estudo transversal de base populacional que avaliou a dieta de 949 adultos residentes na área urbana do município de Campinas por meio do instrumento Recordatório de 24 horas (R24h). A composição nutricional da dieta foi calculada a partir do software NDS-R versão 2007 e para a análise dos dados foram calculadas as proporções e estimadas as médias com seus respectivos intervalos de confiança de 95% utilizando os modelos lineares generalizados, com base na distribuição do tipo Gamma, para variáveis assimétricas. Como resultados, pode-se observar que a dieta apresentou-se normoglicídica, normolipídica e normoproteica, segundo as recomendações do IOM de 2005, tanto para homens quanto para mulheres e em todos os estratos de escolaridade. Sobre o consumo dos diferentes tipos de gordura, quando analisados por sexo e escolaridade, foi verificado para o sexo masculino maior consumo de gordura total, gordura saturada, gordura monoinsaturada e gordura trans entre os mais escolarizados. Entre as mulheres, foi observado maior consumo de gordura saturada e menor consumo de gorduras poliinsaturadas nos estratos de maior escolaridade. Os resultados do estudo mostraram que, em linhas gerais, o consumo de determinados tipos de gordura é elevado na população estudada e que as gorduras mais consumidas foram àquelas com potencial de prejudicar a saúde: gordura saturada e gordura trans. Pode-se dizer diante dos resultados encontrados que o nível de escolaridade está associado à maior ingestão de gorduras na alimentação já que os indivíduos mais escolarizados, de um modo geral, apresentaram maior consumo médio de gorduras. Estes resultados podem sinalizar uma etapa do processo de transição nutricional em que as populações mais favorecidas apresentam piores indicadores para doenças crônicas não transmissíveis. Por esta razão faz-se necessária a realização de inquéritos alimentares periódicos a fim de monitorar a tendência deste comportamento na população / Abstract: The intake of fat is essential in human nutrition. Lipids actively contribute as precursors in the synthesis of hormones; they are part of the structure of cell membranes and bile, participate in autoimmune response and in the transport of fat-soluble vitamins and ensure the energy intake of the diet. However, the excess intake of this nutrient represents a risk for the development of several chronic diseases and the increased intake of fats in the population diet was a remarkable feature in the nutritional transition process. The aim of this dissertation was to analyse the fat intake profile according to the education and sex in the adult population living in the city of Campinas. This is a cross-sectional population-based study which evaluate the diet of 949 adults living in the urban area of Campinas through the instrument 24-hours Recall (R24h). The nutritional composition of the diet was calculated with the NDS-R software version 2007 and for the data analysis was calculated the proportions and estimated the means with its respective confidence interval of 95% using the generalized linear models, based in the distribution of Gamma type, for the asymmetric variables. As results, it could be observed the diet was normal for carbohydrates, fats and proteins, according to the 2005 IOM recommendations, for both men and women and in all educational strata. For the intake of different types of fat, when analysed by sex and education, it was verified for male a greater intake of total fat, saturated fat, monounsaturated fat and trans fat among the more educated. Among women, it was observed a greater intake of saturated fat and lower intake of polyunsaturated fat in the more educated strata. The results of the study show that, in general, the intake of certain types of fat is high in the population evaluated and the most consumed fats were those with potential to jeopardize health: saturated and trans fat. Thus, the results affirm that education is associated with a greater intake of fat since the most educated, in general, had a greater mean intake of fat. This results can signalize a stage in the process of nutritional transition where the most rich population have the worst indicators for noncommunicable chronic diseases. Therefore it is necessary to perform regular food surveys to monitor this behavior trend in the population / Mestrado / Epidemiologia / Mestra em Saúde Coletiva

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Introdução: O consumo de manteigas e margarinas faz parte do hábito alimentar da população e é uma forma eficaz de suplementação de ácidos graxos. No entanto, até o momento se desconhece os efeitos de ácidos graxos saturados, trans, monoinsaturados, poliinsaturados e de fitosteróis no perfil lipídico, inflamatório, de marcadores de disfunção endotelial e no metabolismo da HDL em indivíduos com síndrome metabólica (SM). Objetivo: Examinar os efeitos do consumo diário de manteiga, margarina com ácido graxo trans, margarina com fitosterol e margarina sem ácido graxo trans, em quantidades recomendadas por diretrizes, sobre: 1) o perfil lipídico, apolipoproteínas (Apo), marcadores inflamatórios e de disfunção endotelial e transferência de lipídeos para HDL, em indivíduos com SM, sem alterar seus hábitos usuais de vida, 2) a associação desses parâmetros com a composição nutricional das dietas dos indivíduos estudados. Métodos: Este estudo foi randomizado, cego, onde 100 indivíduos receberam porções diárias isocalóricas de manteiga ou margarina com ácido graxo trans ou margarina com fitosterol ou margarina sem ácido graxo trans em adição às suas dietas usuais, por 5 semanas. Foram determinados: perfil lipídico, Apos, marcadores inflamatórios e de disfunção endotelial, LDL pequenas e densas e transferências de lipídeos para a HDL. Diferenças entre os grupos foram avaliados por ANOVA. Resultados: A amostra final foi composta por 66 indivíduos (63,6% mulheres, idade média 47,6 anos). Houve redução de -10,3% na Apo B (p=0,043) e de -15,2% na razão Apo B/Apo A-I (p=0,034) após consumo de margarina com fitosterol. Não foram verificadas diferenças significativas nos lípides após consumo de manteiga, margarina com trans ou margarina sem trans. Transferências de fosfolípides foram reduzidas no grupo margarina com fitosterol (-4,7% vs. margarina com trans p=0,037); no grupo margarina sem trans foram reduzidas as transferências de: colesterol éster (-27% vs. manteiga e margarina com trans p=0,002), triglicérides (-43,3% vs. outros grupos p<0,001) e colesterol livre (-16,4%, vs. margarina com trans e margarina com fitosterol p=0,006). Não foram verificadas alterações significantes nos marcadores inflamatórios e de disfunção endotelial entre os grupos. Associações foram observadas entre os marcadores inflamatórios e de disfunção endotelial e consumo de lipídeos totais, ácidos graxos saturados, mono e poliinsaturados, colesterol, além de consumo energético e de carboidratos. As transferências de lipídeos para HDL associaram-se inversamente com o consumo de fibra alimentar. Conclusão: Nossos resultados indicam que o consumo de manteiga, margarina com ácido graxo trans e margarina sem ácido graxo trans, nas quantidades estudadas, por indivíduos com síndrome metabólica que não alteraram seus hábitos usuais de vida, não modificam o perfil lipídico ou marcadores inflamatórios e de disfunção endotelial. O consumo de margarina com fitosterol e margarina sem trans nas quantidades recomendadas reduziram respectivamente a concentração de Apo B e a habilidade da HDL de receber lípides. Os marcadores inflamatórios e de disfunção endotelial associaram-se com o consumo de gorduras e carboidratos, sugerindo que dietas ricas em gorduras e calorias podem modular a resposta inflamatória em indivíduos com SM. / Introduction: The consumption of butter and margarines are part of population dietary habits and is an effective form of fatty acid supplementation. However, the effects of saturated, trans, monounsaturated and polyunsaturated fatty acids and of plant sterol supplementation in the lipid profile, inflammation and endothelial dysfunction markers, and in the metabolism of HDL in individuals with the metabolic syndrome (MS) are unknown. Objective: Examine the effects of daily servings of butter, trans fat margarine, no trans fat margarine, and plant sterol margarine, within guideline recommended amounts, on: 1) plasma lipids, apolipoproteins (Apo), biomarkers of inflammation and endothelial dysfunction and on the lipid transfer of radioactive lipids to HDL particles in free-living subjects with the MS, 2) to analyze the association of these parameters with the nutritional composition of the individuals\' diets. Methods: This was a randomized, single-blind study where 100 MS subjects received isocaloric servings of butter, trans fat margarine, no-trans fat margarine or plant sterol margarine in addition to their usual diets for 5 weeks. The main outcome measures were plasma lipids, Apo, inflammatory and endothelial dysfunction markers, small dense LDL cholesterol concentration and in vitro radioactive lipid transfer from cholesterol-rich emulsions to HDL. Difference among groups was evaluated by ANOVA. Results: Sixty-six subjects completed the study (63.6% women, mean age 47.6 years). There was a significant reduction in Apo B (-10.3 %, p=0.043) and in the Apo B/A-1 ratio (-15.2%, p=0.034) with plant sterol margarine. No changes in plasma lipids were noticed with butter, trans fat margarine and no-trans fat margarine. Transfer rates of lipids to HDL were reduced in the plant sterol margarine group: phospholipids -4.7% (p=0.037 vs. trans fat margarine) and in the no-trans fat margarine group: triglycerides -43.3%, (P<0.001 vs. other groups), cholesterol ester -27% (p=0.002 vs. butter and trans fat margarine) and free cholesterol -16.4% (p=0.006 vs. trans fat and plant sterol margarine). No significant effects were noted on inflammatory and endothelial dysfunction markers concentrations among the groups. An association was observed among the inflammatory markers and of endothelial dysfunction and the consumption of total lipids, saturated, monounsaturated and polyunsaturated fatty acids, cholesterol, energy consumption and carbohydrates. The transfer rates of lipids to HDL were inversely associated with the consumption of dietary fiber. Conclusions: In free living subjects with the MS the consumption of butter, trans fat margarine and no-trans fat margarine, within recommended amounts did not modify the lipid profile or markers of inflammation and endothelial dysfunction. The consumption of plant sterol and no-trans fat margarines reduced respectively Apo B concentrations and the ability of HDL to accept lipids. The inflammatory and endothelial dysfunction markers were positively associated with the consumption of fats and carbohydrates suggesting that diets rich in fats and calories can modulate inflammation in subjects with the MS.

Indivíduos portadores do glutamato na posição 27 do gene que codifica para o receptor beta2-adrenérgico têm resposta vasodilatadora muscular aumentada durante manobras fisiológicas. No entanto, o impacto do consumo agudo de gordura nessa resposta não é conhecido. Neste estudo, testou-se a hipótese de que o consumo gordura afetaria a resposta vasodilatadora aumentada destes indivíduos durante manobras fisiológicas. Vinte e cinco indivíduos saudáveis foram subdivididos em dois grupos: 11 homozigotos para o glutamato (Glu27Glu, 40+-3 anos; 65+-3kg) e 14 homozigotos para a glutamina (Gln27Gln, 40+-2 anos; 64+-2kg). O fluxo sangüíneo muscular foi medido por pletismografia de oclusão venosa. A resposta vasodilatadora muscular foi avaliada durante 3 minutos de exercício e estresse mental em jejum e 3 horas após consumo de 62 g de gordura. A condutância basal foi semelhante entre grupos (Glu27Glu=2,3+-0,1; Gln27Gln=2,2+-0,1; P=0,21). O aumento da condutância vascular durante exercício e durante o estresse mental foi maior no grupo Glu27Glu (0,73+-0,2 vs 0,22+-0,1; P=0,008 e 1,8?0,3 vs 1,2+-0,2; P=0,04, respectivamente). O consumo agudo de uma preparação rica em gordura eliminou esta diferença. A resposta de pressão arterial e freqüência cardíaca foi semelhante antes e após a ingestão de gordura. Os níveis de triglicérides, glicose e insulina foram semelhantes ao longo de todo período de estudo. O consumo agudo de gordura elimina a resposta aumentada do fluxo sangüíneo muscular durante manobras fisiológicas dos indivíduos portadores do genótipo Glu27Glu no receptorbeta2- adrenérgico. / Subjects who have glutamic acid at position 27 in gene encoding to beta2-adrenoceptor have increased muscle vasodilatory response during physiological maneuvers. However, the impact of a high-fat meal in this response is unknown. We tested the hypothesis that a high-fat meal would modify the increased muscle vascular reactivity during handgrip and mental stress in these subjects. Twenty-five healthy subjects were subdivided in two groups: 11 were homozygous to glutamic acid (Glu27Glu, 40?3 years; 65+-3kg) and 14 were homozygous to glutamine (Gln27Gln, 40+-2 years; 64+-2kg). Forearm blood flow was measured by venous occlusion pletysmography. Forearm blood flow was recorded for 3 minutes of handgrip and mental stress during fasting and three hours after 62g of fat consumption. Baseline forearm vascular conductance was similar between groups (Glu27Glu=2.3+-0.1; Gln27Gln=2.2+-0.1; P=0.21). Forearm vascular conductance during handgrip and mental stress was greater in the genotype Glu27Glu (0.73+-0.2 vs 0.22+-0.1; P=0.008 and 1.8+-0.3 vs 1.2+-0.2; P=0.04, respectively). Acute fat consumption eliminated the difference of vasodilatory response previously achieved. Blood pressure and heart rate response were similar before and after fat intake. Triglycerides, glucose and insulin levels were also similar between groups. We concluded that high-fat ingestion abolishes the augmented muscle blood flow responses during physiological maneuvers in individuals who are homozygous for the Glu27 allele of the beta2-adrenoceptor gene.

Dietas ricas em gordura ou carboidrato têm sido difundidas e consumidas nas últimas décadas, entretanto pouco é conhecido sobre as consequências metabólicas destas em longo prazo. Neste estudo, foram analisados a quantidade de gordura intramiocelular (IMCL), a função endotelial, além da lipemia, glicemia, insulinemia e resistência à insulina após semanas de dieta rica em gordura ou carboidrato, perdendo ou mantendo peso. De 43 mulheres triadas com sobrepeso (25< BMI <29.9 Kg/m2), 22 foram randomizadas para duas diferentes sequências de dietas. O IMCL foi medido através de espectroscopia por ressonância magnética 1H e a função endotelial pela pletismografia. Após 4 semanas de dieta rica em carboidrato, mantendo peso, foi observado aumento no IMCL do músculo tibial anterior (2.06 ± 1.27 vs. 3.52 ± 1.92, p=0.04) e na insulinemia em jejum (11.55 ± 4.43 vs. 14.03 ± 5.23, p=0.04), enquanto a dieta rica em gordura, no mesmo período, ocasionou aumento no HDL-C (37.06 ± 8.42 vs. 42.5 ± 9.32, p=0.003) e redução nos níveis de triglicerídeos em jejum (102,83 ± 34,10 vs. 75,83 ± 20,91, p=0,02). A função endotelial, colesterol total, LDL-C e resistência à insulina não mudaram durante esta fase. A perda de peso (média de 5%, por 8 semanas), não promoveu modificações nos parâmetros metabólicos vistos com a dieta de manutenção de peso. A partir destes resultados, concluiu-se que a ingestão de dieta rica em carboidrato, por 4 semanas de manutenção de peso, aumenta a insulinemia em jejum e o IMCL do músculo tibial anterior, enquanto a dieta rica em gordura pelo mesmo período aumenta o HDL-C e reduz triglicerídeos em mulheres saudáveis com sobrepeso. / High fat or high carbohydrate (cab) diet have been widely difunded and consumed during last decades; however it is not clear their metabolic effects in long term. In the present study we analyzed intramyocellular lipids (IMCL), endothelial function, plasma lipids, glucose, insulin and insulin resistance after high fat or high cab diet during weeks, maintaining or losing weight. 43 overweight women (25< BMI <29.9 Kg/m2) were screened, 22 of them were randomized to two different diet sequence. IMCL was measured by using 1H magnetic resonance spectroscopy and endothelial function by using plethysmography method. Tibialis anterior IMCL (2.06 ± 1.27 vs. 3.52 ± 1.92, p=0.04) and fasting insulinemia increased (11.55 ± 4.43 vs. 14.03 ± 5.23, p=0.04) after four weeks of high cab diet after maintenance phase, while fasting HDL-C increased (37.06 ± 8.42 vs. 42.5 ± 9.32, p=0.003) and triglycerides levels decreased (102.83 ± 34.10 vs. 75.83 ± 20.91, p=0.02) after maintenance phase of high fat diet. Endothelial function, total cholesterol, LDL-C and insulin resistance did not alter during maintenance phase. A weight loss of 5%, after eight weeks, did not promote changes in the metabolic parameters, as seen during maintenance phase. Based on these results, it was concluded that high cab diet, four weeks with no weight change, increases tibialis anterior IMCL and fasting insulinemia, while high fat diet during same period increases HDL-C and decreases triglycerides in a healthy overweight women population.

Endocannabinoids are products of phospholipid-derived arachidonic acid that regulate hypothalamus-pituitary-adrenal axis activity. We hypothesize that differences in the quality and quantity of maternal dietary fat will modulate the neonatal phospholipid arachidonic acid content of the brain affecting the stress response via differences in endocannabinoid concentration of stress-activated brain areas. Dams were fed a 5% (C) or 300.10 fat diet rich in either n-6 (C, HF) or n-3 (HFF) fat during the perinatal period. PND4-5 HFF milk displays a reduced n-6/n-3 ratio compared to C and HF milk. PND10 hypothalamic and hippocampal PL AA levels are reduced in HFF pups relative to C and HF offspring; and predict endocannabinoid levels in a region-specific manner. In all pups pre-treated with an endocannabinoid receptor antagonist (AM251) or an inhibitor of the endocannabinoid degradative enzyme (URB597), basal and stress-induced ACTH secretion dose-dependently increased. Moreover, HFF pups exhibited a tendency towards reduced AM251 sensitivity under stressful conditions. These data suggest that the nature of perinatal dietary fat can differentially influence neonatal brain arachidonic acid levels and their endocannabinoid derivatives; and endocannabinoid signaling may be altered between diet groups since pups exhibit differences in sensitivity to endocannabinoid receptor blockade.

Diss. (sammanfattning) Uppsala : Univ., 2002. / Härtill 4 uppsatser.

Submitted by GABRIEL PERES (gabrielperes@uol.com.br) on 2017-01-12T17:59:41Z No. of bitstreams: 1 Dissertacao_Gabriel_Peres__MEPAREM - final_PG.pdf: 1188057 bytes, checksum: 3d743000ee2199b4bada7a4a8ceff65e (MD5) / Approved for entry into archive by LUIZA DE MENEZES ROMANETTO (luizamenezes@reitoria.unesp.br) on 2017-01-16T16:15:03Z (GMT) No. of bitstreams: 1 peres_g_me_bot.pdf: 1188057 bytes, checksum: 3d743000ee2199b4bada7a4a8ceff65e (MD5) / Made available in DSpace on 2017-01-16T16:15:03Z (GMT). No. of bitstreams: 1 peres_g_me_bot.pdf: 1188057 bytes, checksum: 3d743000ee2199b4bada7a4a8ceff65e (MD5) Previous issue date: 2016-12-14 / Outra / Fundamentos: Diversos estudos realizados visam a prevenção de complicações em cirurgia dermatológica, dentre as quais o sangramento. Trabalhos anteriores demonstraram que uma dieta com sobrecarga lipídica poderia influenciar o padrão coagulatório, reduzindo o sangramento cirúrgico. Este trabalho visa avaliar o efeito da sobrecarga lipídica nos parâmetros laboratoriais de coagulação e sangramento. Casuística e métodos: Dez indivíduos coletaram amostras de sangue em jejum e após trinta minutos da ingestão de sorvete (21g de gordura). Procederam-se exames: hemograma, tempo de sangramento, TTPA, TP, VHS, viscosidade plasmática e perfil lipídico. Os dados foram tabulados e analisados (teste t de Student para amostras dependentes ou Wilcoxon). Considerou-se significativo p<0,05. Resultados: Houve alteração no perfil lipídico (p<0,05): colesterol total (média: 190,3 para 194,4), VLDL (mediana: 19,5 para 21,0) e triglicerídeos (mediana: 101,5 para 105,0), porém, sem alteração significativa das frações LDL e HDL. A contagem de plaquetas apresentou diminuição (média: 243,2 mil para 232,1 mil; p<0,05), entretanto, sem alterações significativas no coagulograma, hemossedimentação e viscosidade sanguínea. Conclusão: A modificação no perfil lipídico indicou adequada absorção da gordura, todavia, não se demonstrou, sob os parâmetros laboratoriais avaliados, e o protocolo empregado, evidências de que a sobrecarga lipídica por via oral promova alterações coagulatórias ou de viscosidade sanguínea. / Background: Several studies have already been performed for the prevention of complications in dermatologic surgery, including bleeding. Previous researches have shown that a diet with fat overload could influence the pattern of coagulation and repair mechanisms, reducing surgical bleeding. This study aims to evaluate the effect of a lipid overload in the parameters of coagulation and bleeding. Patients and Methods: Blood samples were performed in ten individuals, collected on fasting and thirty minutes after eating ice cream (21g of fat). Held up tests: blood count, bleeding time, aPTT, PT, ESR, plasma viscosity and lipid profile. The data were tabulated and analyzed (Student t test for dependent samples or Wilcoxon). A significant p<0,05 was considered. Results: There was an increase in lipid profile (p<0,05): total cholesterol (mean: 190,3 to 194,4), VLDL (median: 19,5 to 21,0) and triglycerides (median: 101,5 to 105,0), but no significant changes on LDL and HDL fractions. The platelet count also showed a decrease (mean: 243200 to 232100; p < 0,05), however, no significant changes in coagulation, erythrocyte sedimentation rate and blood viscosity. Conclusion: The increase in lipid profile indicated adequate absorption of fat, however, not shown, under these laboratory parameters with the chosen protocol, evidences that an orally fat overload is able to modify coagulation or blood viscosity. / FUNADERSP (RESP-SBD): 28/06/2016