INTRODUÇÃO: Síndrome antifosfolípide está associada com aterosclerose acelerada. Embora adipocitocinas exerçam um papel fundamental na interface entre obesidade, inflamação, resistência insulínica e aterosclerose, a exata natureza e relativa contribuição das adipocitocinas, como potenciais marcadores, requer investigação na síndrome antifosfolípide primária (SAFP). OBJETIVO: Este estudo foi desenvolvido para avaliar a possível associação das adipocitocinas com síndrome metabólica (SM), inflamação e outros fatores de risco cardiovascular na SAFP. MÉTODOS: 56 pacientes com SAFP e 72 controles saudáveis pareados por sexo e idade foram incluídos. Adiponectina, leptina, visfatina, resistina, inibidor do ativador de plasminogênio-1 (PAI-1), lipoproteina (a), glicemia, insulina, VHS, PCR, ácido úrico e perfil lipídico foram dosados. SM foi definida de acordo com os critérios da Federação Internacional de Diabetes (IDF) e resistência insulínica foi estabelecida pelo índice de homeostasis model assessment (HOMA). RESULTADOS: Leptina [21,5 (12,9- 45,7) vs 12,1 (6,9-26,8) ng/mL, P=0.001] foi maior em SAFP do que em controles. Adiponectina (P=0,10), resistina (P=0,23), visfatina (P=0,68) and PAI-1 (P=0,77) não diferiu entre os grupos. Em SAFP, leptina e PAI-1 foram positivamente correlacionada com IMC (r=0,61 and 0,29), HOMA-IR (r=O,71 and 0,28) and CRP (r=0,32 and 0,36). Adiponectina foi negativamente correlacionada com IMC (r=-0,28), triglicérides (r=-0,43), HOMA-IR (r=-0,36) e positivamente correlacionada com HDL (r=0,37), aCL IgG (r=0,41), anti- 2GPI IgG (r=0,31) e anti- 2GPI IgM (r=0,38). A análise de pacientes com e sem SM revelou uma associação positiva com leptina (P=0,002) e PAI-1 (P=0,03) e uma associação negativa com adiponectina (P=0,042). No modelo de regressão linear múltipla, observamos que as variáveis que independentemente influenciam a adiponectina foram triglicérides (P<0,001), VLDL-c (P=0,002) e anti-2GPI IgG (P=0,042), leptina foram IMC (P<0,001), glicemia (P=0,046), HOMA-IR (P<0,001) e VHS (P=0,006) e PAI-1 foram PCR (P=0,013) e SM (P=0,048). CONCLUSÕES: O presente estudo demonstra que as adipocitocinas podem estar envolvidas com inflamação, resistência insulínica e SM em pacientes com SAFP / INTRODUCTION: Antiphospholipid syndrome is associated with accelerated atherosclerosis. Although adipocytokines play a key role in the interface between obesity, inflammation, insulin resistance and atherosclerosis, the exact nature and relative contribution of adipocytokines as potential markers warrant further investigation in primary antiphospholipid syndrome (PAPS). OBJECTIVE: This study was undertaken to evaluate a possible association of adipocytokines with metabolic syndrome (MetS), inflammation and other cardiovascular risk factors in PAPS. METHODS: Fifty-six PAPS patients and 72 age- and gender-matched healthy controls were included. Sera samples were tested for adiponectin, leptin, visfatin, resistin, plasminogen activator inhibitor-1 (PAI-1), lipoprotein (a), glucose, insulin, ESR, CRP, uric acid and lipid profiles. MetS was defined according to the guidelines of the International Diabetes Federation (IDF) and insulin resistance was established using the homeostasis model assessment (HOMA) index. RESULTS: Concentrations of leptin [21.5 (12.1-45.7) vs 12.1 (6.9-26.8) ng/mL, P=0.001] were higher in PAPS than in controls. Concentrations of adiponectin (P=0.10), resistin (P=0.23), visfatin (P=0.68) and PAI-1 (P=0.77) did not differ between patients and controls. In PAPS, leptin and PAI-1 levels were positively correlated with BMI (r=0.61 and 0.29), HOMA-IR (r=0.71 and 0.28) and CRP (r=0.32 and 0.36). Adiponectin was negatively correlated with BMI (r=-0.28), triglycerides (r=-0.43) and HOMA-IR index (r=-0.36) and positively correlated with HDL (r=0.37), aCL IgG (r=0.41), anti- 2GPI IgG (r=0.31) and anti- 2GPI IgM (r=0.38). Further analysis of patients with and without MetS revealed a positive association of the syndrome with leptin (P=0.002) and PAI-1 (P=0.03) and a negative association with adiponectin (P=0.042). In the multiple linear regression model, we observed that the variables that independently influence the adiponectin were triglycerides (P<0.001), VLDL-C (P=0.002) and anti-2GPI IgG (P=0.042), leptin were BMI (P<0.001), glucose (P=0.046), HOMA-IR (P <0.001) and ESR (P=0.006) and PAI-1 were CRP (P=0.013) and MetS (P=0.048). CONCLUSION: The findings of the present study provide evidence that adipocytokines may be involved in inflammation, insulin resistance and metabolic syndrome of PAPS patients
| Identifer | oai:union.ndltd.org:IBICT/oai:teses.usp.br:tde-17062011-163644 |
| Date | 23 May 2011 |
| Creators | Carlos Ewerton Maia Rodrigues |
| Contributors | Jozélio Freire de Carvalho, Simone Appenzeller, Rosa Maria Rodrigues Pereira, Clovis Artur Almeida da Silva, Alexandre Wagner Silva de Souza |
| Publisher | Universidade de São Paulo, Ciências Médicas, USP, BR |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da USP, instname:Universidade de São Paulo, instacron:USP |
| Rights | info:eu-repo/semantics/openAccess |
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