RESUMO
INTRODUCTION: Single nucleotide polymorphisms (SNP) in the fat mass and obesity-associated (FTO) gene have been associated with type 2 diabetes (T2D) and its complications. The aim of the present research was to investigate which and how (directly or indirectly) clinical and metabolic variables mediate the association between fat mass and the FTO gene and early chronic kidney disease (CKD) in individuals with T2D. METHODS: This cross-sectional study was conducted in a sample of 236 participants with T2D (53.4% women, mean age 60 ± 10 years). DNA samples were genotyped for the rs7204609 polymorphism (C/T) in the FTO gene. Clinical, anthropometric, and metabolic data were collected. Path analysis was used to evaluate the associations. RESULTS: Of the sample, 78 individuals with T2D had CKD (33%). Presence of the risk allele (C) was higher among participants with CKD (21.8 vs. 10.8%; p = 0.023). This polymorphism was positively associated with higher waist circumference, which in turn was associated with higher glycated hemoglobin and higher blood pressure. A higher blood-pressure level was associated with higher urinary albumin excretion (UAE) and as expected, higher UAE was associated with CKD. Path analysis showed an indirect relationship between the FTO gene and early CKD, mediated by waist circumference, blood-pressure levels, and UAE. CONCLUSIONS: These findings suggest that the C allele may contribute to genetic susceptibility to CKD in individuals with T2D through the presence of central obesity, hypertension, and high albuminuria.
Assuntos
Diabetes Mellitus Tipo 2 , Hipertensão , Insuficiência Renal Crônica , Idoso , Albuminúria/genética , Dioxigenase FTO Dependente de alfa-Cetoglutarato/genética , Índice de Massa Corporal , Estudos Transversais , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/genética , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/genética , Obesidade Abdominal , Polimorfismo de Nucleotídeo Único , Insuficiência Renal Crônica/etiologia , Insuficiência Renal Crônica/genéticaRESUMO
BACKGROUND AND AIMS: Recently, studies have shown a positive association between serum uric acid (UA) and metabolic syndrome (MS). To evaluate the predictive capacity and the association of serum UA with pre-MS and MS, by sex, in adults. METHODS AND RESULTS: Cross-sectional study with 932 adults, of both sexes, from Viçosa, Minas Gerais (MG), Brazil. Sociodemographic and behavioral data were obtained through a questionnaire and anthropometric, clinical, and biochemical evaluation. We used multinomial logistic regression and the area under receiver operating characteristic curve (AUC). The prevalence of pre-MS was 17.8% and of MS was 26.5%. The fitted models showed positive association of serum UA with pre-MS (OR = 1.62, 95% CI = 1.09-2.40) and MS (OR = 2.61, 95% CI = 1.99-3.42) among men. For women, similar results were found for MS (OR = 2.59, 95% CI = 1.81-3.73). The optimal cutoff points obtained by AUC for pre-MS and MS were 4.7 and 4.9 mg/dL among men and 3.1 and 3.4 mg/dL among women, respectively. CONCLUSION: The results point to a positive association of UA with pre-MS and MS, with no significant differences between sexes. Therefore, UA can be used as an additional marker in the screening of these conditions.
Assuntos
Hiperuricemia/sangue , Síndrome Metabólica/sangue , Ácido Úrico/sangue , Adulto , Biomarcadores/sangue , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Hiperuricemia/diagnóstico , Hiperuricemia/epidemiologia , Masculino , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prevalência , Medição de Risco , Fatores de Risco , Fatores Sexuais , Regulação para Cima , Adulto JovemRESUMO
BACKGROUND: The objective of this study was to evaluate Dietary Inflammatory Index (DII®) in the preoperative period as well as 3 and 12 months post-surgery and its association with cardiometabolic risk factors after RYGB. MATERIALS AND METHODS: This is a prospective cohort study of 50 patients (both sexes) who underwent RYGB. All data were collected in 3 phases: before surgery, 3, and 12 months post-surgery. To calculate DII scores, we utilized mean nutrients from three 24-h recalls at each time point. RESULTS: The patients had median age of 39.1 ± 7.9 years (70% women). Mean preoperative DII® score of 0.39 ± 1.49 was slightly pro-inflammatory. Mean DII score reduced to - 1.52 ± 1.27 after 3 months post-surgery and was classified anti-inflammatory. This value rebounded to - 0.88 ± 1.49 at 12 months but was still anti-inflammatory. From the adjusted linear regression analysis, we observed that preoperative DII score was statistically associated with variations in neck circumference (ß = - 0.50; p = 0.03), waist-hip ratio (ß = 0.01; p = 0.02), total cholesterol (ß = 6.47; p = 0.002), and LDL cholesterol (ß = 6.42; p = 0.001) after 12 months post-surgery. Changes in DII® at 3 and 12 months were not associated with changes in cardiometabolic risk factors. CONCLUSION: We observe significant changes in the inflammation potential of diet after 3 and 12 months of RYGB. Patients with higher preoperative E-DII scores have a greater metabolic improvement after 12 months of surgery.
Assuntos
Derivação Gástrica , Obesidade Mórbida , Adulto , Índice de Massa Corporal , Fatores de Risco Cardiometabólico , Dieta , Feminino , Derivação Gástrica/efeitos adversos , Humanos , Inflamação/etiologia , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/cirurgia , Estudos Prospectivos , Fatores de RiscoRESUMO
OBJECTIVE: Dietary patterns have been pointed out as useful diet quality indicators, but evidence about their relationship to metabolic phenotypes is still scarce. Thus, the present study aimed to verify the relationship between dietary patterns and metabolic phenotypes in Brazilian adults. DESIGN: Cross-sectional study. A food consumption frequency questionnaire assessed food consumption profiles. Metabolic phenotypes were defined based on the criteria of the National Health and Nutrition Examination Survey: overweight or normal weight and metabolically healthy (MHOW and MHNW) or unhealthy (MUOW and MUNW). Dietary patterns were established through exploratory factor analysis and principal component analysis. The associations were tested using multinomial logistic regression. SETTING: Viçosa, Minas Gerais, Brazil. PARTICIPANTS: Individuals (n 896) aged 20-59 years of both sexes, selected using probabilistic sampling. RESULTS: Three dietary patterns were identified: Unhealthy pattern (alcoholic beverages, oils and fats, condiments, soda and juice, sugars and sweets, snacks, and meat and derivatives), Traditional pattern (culinary preparations, beans, milk and dairy products, and coffee and tea) and Healthy pattern (vegetables and fruits, whole grains, chicken and fish, and skimmed milk). Unhealthy pattern was positively associated with the MHOW and MUOW phenotypes in the fourth quartile (OR = 1·84; 95 % CI 1·06, 3·22) and in the third (OR = 1·94; 95 % CI 1·11, 3·39) and fourth (OR = 2·56; 95 % CI 1·41, 4·64) quartiles of consumption, respectively. Healthy pattern was also associated with these phenotypes. CONCLUSIONS: Both the pattern comprising energy-dense foods and the healthier pattern were associated with overweight phenotypes among Brazilian adults.