Distúrbios metabólicos associados à infecção pelo vírus da hepatite C: prevalência em pacientes ambulatoriais seguidos em hospital de referência do Estado do Ceará, Brasil

Detalhes bibliográficos
Ano de defesa: 2014
Autor(a) principal: Oliveira, Ana Paula Pires Lázaro de
Orientador(a): Montenegro Junior, Renan Magalhães
Banca de defesa: Não Informado pela instituição
Tipo de documento: Dissertação
Tipo de acesso: Acesso aberto
Idioma: por
Instituição de defesa: Não Informado pela instituição
Programa de Pós-Graduação: Não Informado pela instituição
Departamento: Não Informado pela instituição
País: Não Informado pela instituição
Palavras-chave em Português:
Link de acesso: http://www.repositorio.ufc.br/handle/riufc/34204
Resumo: Chronic infection with hepatitis C virus (HCV) is a serious public health problem due to the high cost involved in the treatment of this disease and its complications. Metabolic disorders have been recognized as an important class of extrahepatic manifestations of this virus. HCV is related to the development of insulin resistance (IR) which, in turn, is also associated with a higher degree of hepatic fibrosis, more rapid disease progression and reduction in the rate of sustained virologic. Interferon (INF) is the standard drug for these patients is also associated with the development of other metabolic disorders, especially autoimmune thyroid disease (ATD). The aim of this study was to determine the prevalence of metabolic disorders in a population of patients with and without HCV cirrhosis. A study of quantitative approach, analytical and cross, where 57 patients followed in a referral in hepatology in northeastern Brazil, randomly selected between January and July 2014. For the control group were included 95 volunteers selected randomly with negative HCV serology. Patients underwent medical evaluation, physical examination and collection of blood samples. HOMA-IR was calculated to infer IR. Data were subjected to statistical analysis, being used for this purpose, SPSS version 15.0. In data analysis, bivariate and multivariate analyzes were performed to try to characterize the occurrence of metabolic disorders for the presence of HCV and cirrhosis, with statistical significance level of 5% (p <0.05). A higher frequency of T2DM, IR and hypocholesterolemia among patients with HCV infection compared with the group control (p<0,05). T2DM and IR were also more frequent among individuals with cirrhosis (p <0.05). We observed an increased frequency of obesity and overweight in all groups evaluated. Patients with HCV have high prevalence of ATD, regardless of whether liver fibrosis. Genotype 1 was the most frequently found among individuals diagnosed with metabolic disorders. In conclusion, these data indicate a high prevalence of metabolic disorders among patients with HCV infection in our country and guide it in the context of public health, we must consider the need to develop strategies that promote the reduction of metabolic complications in this susceptible group.
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spelling Oliveira, Ana Paula Pires Lázaro deMontenegro Junior, Renan Magalhães2018-07-19T11:41:52Z2018-07-19T11:41:52Z2014-08-27OLIVEIRA, A. P. P. L. Distúrbios metabólicos associados à infecção pelo vírus da Hepatite C: prevalência em pacientes ambulatoriais seguidos em hospital de referência do Estado do Ceará, Brasil. 2014. 102 f. Dissertação (Mestrado em Saúde Pública) - Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2014.http://www.repositorio.ufc.br/handle/riufc/34204Chronic infection with hepatitis C virus (HCV) is a serious public health problem due to the high cost involved in the treatment of this disease and its complications. Metabolic disorders have been recognized as an important class of extrahepatic manifestations of this virus. HCV is related to the development of insulin resistance (IR) which, in turn, is also associated with a higher degree of hepatic fibrosis, more rapid disease progression and reduction in the rate of sustained virologic. Interferon (INF) is the standard drug for these patients is also associated with the development of other metabolic disorders, especially autoimmune thyroid disease (ATD). The aim of this study was to determine the prevalence of metabolic disorders in a population of patients with and without HCV cirrhosis. A study of quantitative approach, analytical and cross, where 57 patients followed in a referral in hepatology in northeastern Brazil, randomly selected between January and July 2014. For the control group were included 95 volunteers selected randomly with negative HCV serology. Patients underwent medical evaluation, physical examination and collection of blood samples. HOMA-IR was calculated to infer IR. Data were subjected to statistical analysis, being used for this purpose, SPSS version 15.0. In data analysis, bivariate and multivariate analyzes were performed to try to characterize the occurrence of metabolic disorders for the presence of HCV and cirrhosis, with statistical significance level of 5% (p <0.05). A higher frequency of T2DM, IR and hypocholesterolemia among patients with HCV infection compared with the group control (p<0,05). T2DM and IR were also more frequent among individuals with cirrhosis (p <0.05). We observed an increased frequency of obesity and overweight in all groups evaluated. Patients with HCV have high prevalence of ATD, regardless of whether liver fibrosis. Genotype 1 was the most frequently found among individuals diagnosed with metabolic disorders. In conclusion, these data indicate a high prevalence of metabolic disorders among patients with HCV infection in our country and guide it in the context of public health, we must consider the need to develop strategies that promote the reduction of metabolic complications in this susceptible group.A infecção crônica pelo vírus da hepatite C (HCV) representa um grave problema de saúde pública devido ao alto custo envolvido no tratamento desta doença e suas complicações. Os distúrbios metabólicos vêm sendo reconhecidos com uma importante classe de manifestações extra-hepáticas deste vírus. O HCV está relacionado ao desenvolvimento de resistência à insulina (RI), que, por sua vez, está associada a um grau mais elevado de fibrose hepática, progressão mais rápida da doença e redução na taxa de resposta virológica sustentada. O interferon (INF) usado para o tratamento destes pacientes também está associado à ocorrência de distúrbios metabólicos, especialmente doença autoimune tireoidiana (DAT). O objetivo do presente estudo foi determinar a prevalência dos distúrbios metabólicos em uma população de portadores do HCV com e sem cirrose. Tratou-se de um estudo de abordagem quantitativa, analítico e transversal, onde foram incluídos 57 pacientes acompanhados em um ambulatório de referência no nordeste do Brasil, selecionados de forma aleatória no período entre janeiro e julho de 2014. Para o grupo controle, foram selecionados aleatoriamente 95 voluntários com sorologia negativa para o HCV. Os pacientes foram submetidos à avaliação médica, exame físico e coleta de amostras de sangue em jejum. Foi calculado o HOMA-IR para inferir a RI. Os dados foram submetidos à análise estatística através do programa SPSS versão 15.0, sendo realizadas análises bivariadas e multivariadas para se tentar caracterizar a ocorrência de distúrbios metabólicos em relação à presença de HCV e cirrose, com nível de significância estatística de 5% (p<0,05). Os portadores de HCV apresentaram uma maior prevalência de DM2, RI e hipocolesterolemia em comparação com o grupo controle (p<0,05). Os indivíduos cirróticos apresentaram uma maior prevalência de RI e o DM2 em comparação com os indivíduos sem cirrose (p<0,05). Observamos ainda uma frequência aumentada de sobrepeso e obesidade em todos os grupos. Os pacientes com HCV apresentaram elevada prevalência de DAT, independente da presença de cirrose hepática. O genótipo 1 foi o mais associado a ocorrência de distúrbios endocrinológicos, especialmente RI, DM2 e DAT. Em conclusão, estes dados indicam a elevada prevalência de distúrbios metabólicos entre os pacientes com HCV em nosso meio e orientam que é preciso considerar o desenvolvimento de estratégias que favoreçam a redução das complicações metabólicas neste grupo susceptível.Hepatite C CrônicaMetabolismoResistência à InsulinaDiabetes MellitusDistúrbios metabólicos associados à infecção pelo vírus da hepatite C: prevalência em pacientes ambulatoriais seguidos em hospital de referência do Estado do Ceará, BrasilMetabolic disorders associated with hepatitis C virus infection: prevalence in outpatients followed at a referral hospital in the state of Ceará, Brazilinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisporreponame:Repositório Institucional da Universidade Federal do Ceará (UFC)instname:Universidade Federal do Ceará (UFC)instacron:UFCinfo:eu-repo/semantics/openAccessORIGINAL2014_dis_apploliveira.pdf2014_dis_apploliveira.pdfapplication/pdf1396050http://repositorio.ufc.br/bitstream/riufc/34204/1/2014_dis_apploliveira.pdfdfed3f0327b14926d925a322d426319aMD51LICENSElicense.txtlicense.txttext/plain; charset=utf-81812http://repositorio.ufc.br/bitstream/riufc/34204/2/license.txt9351db63ea91b32e01910aaf21c0fd0aMD52riufc/342042021-03-20 10:38:25.76oai:repositorio.ufc.br:riufc/34204w4kgbmVjZXNzw6FyaW8gY29uY29yZGFyIGNvbSBhIGxpY2Vuw6dhIGRlIGRpc3RyaWJ1acOnw6NvIG7Do28tZXhjbHVzaXZhLCBhbnRlcyBxdWUgbyBkb2N1bWVudG8gcG9zc2EgYXBhcmVjZXIgbm8gUmVwb3NpdMOzcmlvLiBQb3IgZmF2b3IsIGxlaWEgYQ0KbGljZW7Dp2EgYXRlbnRhbWVudGUuIENhc28gbmVjZXNzaXRlIGRlIGFsZ3VtIGVzY2xhcmVjaW1lbnRvIGVudHJlIGVtIGNvbnRhdG8gYXRyYXbDqXMgZGU6IHJlcG9zaXRvcmlvQHVmYy5iciBvdSAoODUpMzM2Ni05NTA4Lg0KDQpMSUNFTsOHQSBERSBESVNUUklCVUnDh8ODTyBOw4NPLUVYQ0xVU0lWQQ0KDQpBbyBhc3NpbmFyIGUgZW50cmVnYXIgZXN0YSBsaWNlbsOnYSwgby9hIFNyLi9TcmEuIChhdXRvciBvdSBkZXRlbnRvciBkb3MgZGlyZWl0b3MgZGUgYXV0b3IpOg0KDQphKSBDb25jZWRlIMOgIFVuaXZlcnNpZGFkZSBGZWRlcmFsIGRvIENlYXLDoSBvIGRpcmVpdG8gbsOjby1leGNsdXNpdm8gZGUgcmVwcm9kdXppciwgY29udmVydGVyIChjb21vIGRlZmluaWRvIGFiYWl4byksIGNvbXVuaWNhciBlL291DQpkaXN0cmlidWlyIG8gZG9jdW1lbnRvIGVudHJlZ3VlIChpbmNsdWluZG8gbyByZXN1bW8vYWJzdHJhY3QpIGVtIGZvcm1hdG8gZGlnaXRhbCBvdSBpbXByZXNzbyBlIGVtIHF1YWxxdWVyIG1laW8uDQoNCmIpIERlY2xhcmEgcXVlIG8gZG9jdW1lbnRvIGVudHJlZ3VlIMOpIHNldSB0cmFiYWxobyBvcmlnaW5hbCwgZSBxdWUgZGV0w6ltIG8gZGlyZWl0byBkZSBjb25jZWRlciBvcyBkaXJlaXRvcyBjb250aWRvcyBuZXN0YSBsaWNlbsOnYS4gRGVjbGFyYQ0KdGFtYsOpbSBxdWUgYSBlbnRyZWdhIGRvIGRvY3VtZW50byBuw6NvIGluZnJpbmdlLCB0YW50byBxdWFudG8gbGhlIMOpIHBvc3PDrXZlbCBzYWJlciwgb3MgZGlyZWl0b3MgZGUgcXVhbHF1ZXIgb3V0cmEgcGVzc29hIG91IGVudGlkYWRlLg0KDQpjKSBTZSBvIGRvY3VtZW50byBlbnRyZWd1ZSBjb250w6ltIG1hdGVyaWFsIGRvIHF1YWwgbsOjbyBkZXTDqW0gb3MgZGlyZWl0b3MgZGUgYXV0b3IsIGRlY2xhcmEgcXVlIG9idGV2ZSBhdXRvcml6YcOnw6NvIGRvIGRldGVudG9yIGRvcw0KZGlyZWl0b3MgZGUgYXV0b3IgcGFyYSBjb25jZWRlciDDoCBVbml2ZXJzaWRhZGUgRmVkZXJhbCBkbyBDZWFyw6Egb3MgZGlyZWl0b3MgcmVxdWVyaWRvcyBwb3IgZXN0YSBsaWNlbsOnYSwgZSBxdWUgZXNzZSBtYXRlcmlhbCBjdWpvcyBkaXJlaXRvcyBzw6NvIGRlDQp0ZXJjZWlyb3MgZXN0w6EgY2xhcmFtZW50ZSBpZGVudGlmaWNhZG8gZSByZWNvbmhlY2lkbyBubyB0ZXh0byBvdSBjb250ZcO6ZG8gZG8gZG9jdW1lbnRvIGVudHJlZ3VlLg0KDQpTZSBvIGRvY3VtZW50byBlbnRyZWd1ZSDDqSBiYXNlYWRvIGVtIHRyYWJhbGhvIGZpbmFuY2lhZG8gb3UgYXBvaWFkbyBwb3Igb3V0cmEgaW5zdGl0dWnDp8OjbyBxdWUgbsOjbyBhIFVuaXZlcnNpZGFkZSBGZWRlcmFsIGRvIENlYXLDoSwgZGVjbGFyYSBxdWUNCmN1bXByaXUgcXVhaXNxdWVyIG9icmlnYcOnw7VlcyBleGlnaWRhcyBwZWxvIHJlc3BlY3Rpdm8gY29udHJhdG8gb3UgYWNvcmRvLg0KDQpBIFVuaXZlcnNpZGFkZSBGZWRlcmFsIGRvIENlYXLDoSBpZGVudGlmaWNhcsOhIGNsYXJhbWVudGUgbyhzKSBzZXUgKHMpIG5vbWUgKHMpIGNvbW8gbyAocykgYXV0b3IgKGVzKSBvdSBkZXRlbnRvciAoZXMpIGRvcyBkaXJlaXRvcyBkbyBkb2N1bWVudG8NCmVudHJlZ3VlLCBlIG7Do28gZmFyw6EgcXVhbHF1ZXIgYWx0ZXJhw6fDo28sIHBhcmEgYWzDqW0gZGFzIHBlcm1pdGlkYXMgcG9yIGVzdGEgbGljZW7Dp2EuDQoNCg0KRepositório InstitucionalPUBhttp://www.repositorio.ufc.br/ri-oai/requestbu@ufc.br || repositorio@ufc.bropendoar:2021-03-20T13:38:25Repositório Institucional da Universidade Federal do Ceará (UFC) - Universidade Federal do Ceará (UFC)false
dc.title.pt_BR.fl_str_mv Distúrbios metabólicos associados à infecção pelo vírus da hepatite C: prevalência em pacientes ambulatoriais seguidos em hospital de referência do Estado do Ceará, Brasil
dc.title.en.pt_BR.fl_str_mv Metabolic disorders associated with hepatitis C virus infection: prevalence in outpatients followed at a referral hospital in the state of Ceará, Brazil
title Distúrbios metabólicos associados à infecção pelo vírus da hepatite C: prevalência em pacientes ambulatoriais seguidos em hospital de referência do Estado do Ceará, Brasil
spellingShingle Distúrbios metabólicos associados à infecção pelo vírus da hepatite C: prevalência em pacientes ambulatoriais seguidos em hospital de referência do Estado do Ceará, Brasil
Oliveira, Ana Paula Pires Lázaro de
Hepatite C Crônica
Metabolismo
Resistência à Insulina
Diabetes Mellitus
title_short Distúrbios metabólicos associados à infecção pelo vírus da hepatite C: prevalência em pacientes ambulatoriais seguidos em hospital de referência do Estado do Ceará, Brasil
title_full Distúrbios metabólicos associados à infecção pelo vírus da hepatite C: prevalência em pacientes ambulatoriais seguidos em hospital de referência do Estado do Ceará, Brasil
title_fullStr Distúrbios metabólicos associados à infecção pelo vírus da hepatite C: prevalência em pacientes ambulatoriais seguidos em hospital de referência do Estado do Ceará, Brasil
title_full_unstemmed Distúrbios metabólicos associados à infecção pelo vírus da hepatite C: prevalência em pacientes ambulatoriais seguidos em hospital de referência do Estado do Ceará, Brasil
title_sort Distúrbios metabólicos associados à infecção pelo vírus da hepatite C: prevalência em pacientes ambulatoriais seguidos em hospital de referência do Estado do Ceará, Brasil
author Oliveira, Ana Paula Pires Lázaro de
author_facet Oliveira, Ana Paula Pires Lázaro de
author_role author
dc.contributor.author.fl_str_mv Oliveira, Ana Paula Pires Lázaro de
dc.contributor.advisor1.fl_str_mv Montenegro Junior, Renan Magalhães
contributor_str_mv Montenegro Junior, Renan Magalhães
dc.subject.por.fl_str_mv Hepatite C Crônica
Metabolismo
Resistência à Insulina
Diabetes Mellitus
topic Hepatite C Crônica
Metabolismo
Resistência à Insulina
Diabetes Mellitus
description Chronic infection with hepatitis C virus (HCV) is a serious public health problem due to the high cost involved in the treatment of this disease and its complications. Metabolic disorders have been recognized as an important class of extrahepatic manifestations of this virus. HCV is related to the development of insulin resistance (IR) which, in turn, is also associated with a higher degree of hepatic fibrosis, more rapid disease progression and reduction in the rate of sustained virologic. Interferon (INF) is the standard drug for these patients is also associated with the development of other metabolic disorders, especially autoimmune thyroid disease (ATD). The aim of this study was to determine the prevalence of metabolic disorders in a population of patients with and without HCV cirrhosis. A study of quantitative approach, analytical and cross, where 57 patients followed in a referral in hepatology in northeastern Brazil, randomly selected between January and July 2014. For the control group were included 95 volunteers selected randomly with negative HCV serology. Patients underwent medical evaluation, physical examination and collection of blood samples. HOMA-IR was calculated to infer IR. Data were subjected to statistical analysis, being used for this purpose, SPSS version 15.0. In data analysis, bivariate and multivariate analyzes were performed to try to characterize the occurrence of metabolic disorders for the presence of HCV and cirrhosis, with statistical significance level of 5% (p <0.05). A higher frequency of T2DM, IR and hypocholesterolemia among patients with HCV infection compared with the group control (p<0,05). T2DM and IR were also more frequent among individuals with cirrhosis (p <0.05). We observed an increased frequency of obesity and overweight in all groups evaluated. Patients with HCV have high prevalence of ATD, regardless of whether liver fibrosis. Genotype 1 was the most frequently found among individuals diagnosed with metabolic disorders. In conclusion, these data indicate a high prevalence of metabolic disorders among patients with HCV infection in our country and guide it in the context of public health, we must consider the need to develop strategies that promote the reduction of metabolic complications in this susceptible group.
publishDate 2014
dc.date.issued.fl_str_mv 2014-08-27
dc.date.accessioned.fl_str_mv 2018-07-19T11:41:52Z
dc.date.available.fl_str_mv 2018-07-19T11:41:52Z
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dc.identifier.citation.fl_str_mv OLIVEIRA, A. P. P. L. Distúrbios metabólicos associados à infecção pelo vírus da Hepatite C: prevalência em pacientes ambulatoriais seguidos em hospital de referência do Estado do Ceará, Brasil. 2014. 102 f. Dissertação (Mestrado em Saúde Pública) - Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2014.
dc.identifier.uri.fl_str_mv http://www.repositorio.ufc.br/handle/riufc/34204
identifier_str_mv OLIVEIRA, A. P. P. L. Distúrbios metabólicos associados à infecção pelo vírus da Hepatite C: prevalência em pacientes ambulatoriais seguidos em hospital de referência do Estado do Ceará, Brasil. 2014. 102 f. Dissertação (Mestrado em Saúde Pública) - Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2014.
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