Efeito da resistência à insulina na variação do índice de massa corporal, glicemia e colesterol em adolescentes.

• Ano de defesa: 2018
• Autor(a) principal: Cruz, Valéria Lima da
• Orientador(a): Sichieri, Rosely
• Banca de defesa: Verly Junior, Eliseu , Aguiar, Luiz Guilherme Kraemer de , Mediano, Mauro Felippe Felix
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade do Estado do Rio de Janeiro
• Programa de Pós-Graduação: Programa de Pós-Graduação em Saúde Coletiva
• Departamento: Centro Biomédico::Instituto de Medicina Social
• País: BR
• Palavras-chave em Português: Obesidade; Resistência à insulina; Adolescentes
• Palavras-chave em Inglês: Obesity; Insulin resistance; Adolescents
• Área do conhecimento CNPq: CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA::EPIDEMIOLOGIA
• Link de acesso: http://www.bdtd.uerj.br/handle/1/4419

Insulin resistance (IR) is positively associated with fatness, however it has been postulated that IR is also a physiological adaptation to obesity that limits fat deposition and leads to weight stabilization. The study aimed to evaluate the effects of IR on one-year variation of body mass index (BMI kg/m²), cholesterol, and glucose levels in adolescents. A subgroup analysis of a school intervention study with 81 adolescents aged 10 to 12 years was performed with oversampling of participants with overweight and obesity at baseline. The intervention was focused on reduction of sodas replacing them for water aiming at reduction of excessive weight gain. The intervention was able to reduce soda intake without change on weight gain due to exchange of sodas for sweetened juices. Weight, height, cholesterol, and fasting glucose were measured at the beginning and at the end of follow-up, insulin was only measured at baseline. RI was defined based on the Homeostasis Model Assessment (HOMA- IR) index, with a cutoff of 2.5 for both genders. Longitudinal analysis used and linear mixed random effects for assess differences between IR groups for continuous BMI, cholesterol, and fasting glucose. Models were adjusted for age and sexual maturation. Interaction of IR with sex was tested. The analyzes were conducted using SAS software (version 9.4, SAS Institute, Cary, NC). The sample comprised 65.4% of girls and the prevalence of overweight/ obesity was 54.7% among girls and 50.0% among boys. The overall prevalence of insulin resistance was 75.2%, 27.9% among boys and 72.1% among girls (p = 0.02). IR at baseline was associated with BMI (p = 0.02) as well as at follow-up, with a relative risk (RR) of 1.29 (95% CI = 1.09 to 1.54) of overweight/obesity among those with IR, compared to without IR. This RR for hyperglycemia was 1.12 (95 = 1.04 to 1.20) and hypercholesterolemia at baseline and follow-up was not associated with IR. In both sexes, those with IR showed less variation in BMI, compared to normal IR. Change in BMI over time was statistically modified by IR at baseline only among girls (p = 0.02). Estimated change in BMI for boys with IR was 18.5 to 19.0 Kg/m², and among those without IR was 21.2 (Kg/m²) para 21.1 (Kg/m²). Among girls these results were 16.9 (Kg/m²) para 17.9 (Kg/m²) and 21.4 (Kg/m²) para 22.1 (Kg/m²). The models for change in fasting glucose and cholesterol showed not significant variation associated with IR while the values for BMI remained unchanged after adjustment for type of intervention and sexual maturation. The results of this study suggest, as indicated in other studies, that although IR is related to BMI in cross sectional studies IR at baseline decreased further weight gain at least in girls. Identification of IR status may help to understand negative longitudinal effects of interventions aimed to reduce weight gain.