Made available in DSpace on 2014-12-17T14:03:42Z (GMT). No. of bitstreams: 1
FernandaBSR_DISSERT.pdf: 1261202 bytes, checksum: 37b0751e1ff652078acf0329a1653ef1 (MD5)
Previous issue date: 2013-06-27 / Universidade Federal do Rio Grande do Norte / Micronutrient deficiencies affect individuals mainly in developing countries, where vitamin A deficiency is a public health problem worldwide more worrying, especially in groups with increased physiological needs such as children and women of reproductive age. Vitamin A is supplied to the body through diet and has an important role in the visual process, cell differentiation, maintenance of epithelial tissue, reproductive and resistance to infection. The literature has demonstrated the relationship between vitamin A and diabetes, including gestational, leading to a risk to both mother and child. Gestational diabetes is any decrease in glucose tolerance of variable magnitude diagnosed each the first time during pregnancy, and may or may not persist after delivery. Insulin resistance during pregnancy is associated with placental hormones, as well as excess fat. Studies have shown that retinol transport protein produced in adipose tissue in high concentrations, this would be associated with resistance by interfering with insulin signaling. Therefore, this study aimed to evaluate the concentration of retinol in serum and colostrum from healthy and diabetic mothers in the immediate postpartum period. One hundred and nine parturient women were recruited, representing seventy-three healthy and thirty-six diabetic. Retinol was extracted and subsequently analyzed by High Performance Liquid Chromatography. Among the results highlights the mothers with gestational diabetes were older than mothers healthy, had more children and a higher prevalence of cases of cesarean section. Fetal macrosomia was present in 1.4% of healthy parturient women and in 22.2% of diabetic mothers. The maternal serum retinol showed an average of 39.7 ? 12.5 mg/dL for healthy parturients 35.12 ? 15 mg/dL for diabetic and showed no statistical difference. It was observed that in the group of diabetic had 17% vitamin A deficiency, whereas in the healthy group, only 4% of the women were deficentes. Colostrum, the concentration of retinol in healthy was 131.3 ? 56.2 mg/dL and 125.3 ? 41.9 mg/dL in diabetic did not differ statistically. This concentration of retinol found in colostrum provides approximately 656.5 mg/day for infants born to healthy mothers and 626.5 mg/day for infants of diabetic mothers, based on a daily consumption of 500 mL of breast milk and need Vitamin A 400 mg/day, thus reaching the requirement of the infant. The diabetic mothers showed significant risk factors and complications related to gestational diabetes. Although no
11
difference was found in serum retinol concentration and colostrum among women with and without gestational diabetes, the individual analysis shows that parturients women with diabetes are 4.9 times more likely to develop vitamin A deficiency than healthy parturients. However, the supply of vitamin A to the newborn was not committed in the presence of gestational diabetes / As car?ncias de micronutrientes afetam indiv?duos principalmente nos pa?ses em desenvolvimento, em que a hipovitaminose A ? um dos problemas de sa?de p?blica mais preocupante mundialmente, principalmente nos grupos com necessidades fisiol?gicas aumentadas como crian?as e mulheres em idade reprodutiva. A vitamina A ? fornecida ao organismo por meio da dieta e possui papel essencial no processo visual, diferencia??o celular, manuten??o do tecido epitelial, reprodu??o e resist?ncia ?s infec??es. A literatura tem demonstrado rela??o entre a vitamina A e diabetes, inclusive a gestacional, levando a um risco para bin?mio m?e-filho. A diabetes gestacional ? qualquer diminui??o da toler?ncia ? glicose de magnitude vari?vel diagnosticada pela primeira vez na gesta??o, podendo ou n?o persistir ap?s o parto. A resist?ncia ? insulina na gesta??o est? associada aos horm?nios placent?rios, bem como ao excesso de tecido adiposo. Estudos t?m demonstrado que a prote?na transportadora de retinol produzida no tecido adiposo, em altas concentra??es, estaria associada a esta resist?ncia por interferir na sinaliza??o da insulina. Com isso, este trabalho objetivou avaliar a concentra??o de retinol no soro e colostro de parturientes diab?ticas e saud?veis no p?s-parto imediato. Cento e nove parturientes foram recrutadas, correspondendo a setenta e tr?s saud?veis e trinta e seis diab?ticas. O retinol foi extra?do e posteriormente analisado por Cromatografia L?quida de Alta Efici?ncia. Dentre os resultados destaca-se que as parturientes com diabetes gestacional tinham idade superior a das parturientes saud?veis, possu?am mais filhos e maior preval?ncia de casos de cesarianas. A macrossomia estava presente em 1,4% das parturientes saud?veis e em 22,2% das parturientes diab?ticas. O retinol do soro materno apresentou uma m?dia de 39,7 ? 12,5 μg/dL para parturientes saud?veis e 35,12 ? 15 μg/dL para diab?ticas e n?o apresentaram diferen?a estat?stica. Foi observado que no grupo de diab?ticas 17% tinham hipovitaminose A, enquanto que no grupo saud?vel, apenas 4% das mulheres estavam deficientes. No colostro, a concentra??o de retinol nas saud?veis foi de 131,3 ? 56,2 μg/dL e nas diab?ticas 125,3 ? 41,9 μg/dL, n?o diferindo estatisticamente. Esta concentra??o de retinol encontrada no colostro fornece aproximadamente 656,5μg/dia para os rec?m-nascidos de m?es saud?veis e 626,5 μg/dia para os rec?m-nascidos de diab?ticas, com base em um consumo di?rio de 500 mL de leite materno e necessidade nutricional de vitamina A de 400 μg/dia,
9
atingindo assim, o requerimento do lactente. As parturientes diab?ticas apresentaram importantes fatores de risco e complica??es relacionadas ? diabetes gestacional. Apesar de n?o ter sido encontrada diferen?a na concentra??o de retinol s?rico e do colostro entre as mulheres com e sem diabetes gestacional, a an?lise individual demonstra que as parturientes diab?ticas est?o 4,9 vezes mais prop?cias a desenvolver hipovitaminose A do que as parturientes saud?veis. Contudo, o fornecimento de vitamina A para o rec?m-nascido n?o foi comprometido na presen?a da diabetes gestacional
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/12616 |
| Date | 27 June 2013 |
| Creators | Resende, Fernanda Barros Soares |
| Contributors | CPF:18095640425, http://lattes.cnpq.br/8520928220989866, Lanza, Daniel Carlos Ferreira, CPF:05372896663, http://lattes.cnpq.br/6851351991421755, Melo, Illana Louise Pereira de, CPF:01179385489, http://lattes.cnpq.br/0775872968532285, Dimenstein, Roberto |
| Publisher | Universidade Federal do Rio Grande do Norte, Programa de P?s-Gradua??o em Bioqu?mica, UFRN, BR, Bioqu?mica; Biologia Molecular |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
Page generated in 0.0028 seconds