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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.
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/20301 |
| Date | 27 March 2015 |
| Creators | Santos, Ana Celly Souza dos |
| Contributors | 70155780425, http://lattes.cnpq.br/4311626091295357, Rezende, Adriana Augusto de, 05410395808, http://lattes.cnpq.br/4245215108740331, Souza J?nior, Jos? Edvan de, 83874011453, http://lattes.cnpq.br/8649739086762968, Lemos, Telma Maria Ara?jo Moura |
| Publisher | Universidade Federal do Rio Grande do Norte, PROGRAMA DE P?S-GRADUA??O EM CI?NCIAS FARMACEUTICAS, UFRN, Brasil |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
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