Status de zinco e cobre e associações com parâmetros biodemográficos, clínicos, bioquímicos e nutricionais em indivíduos com insuficiência cardíaca

• Ano de defesa: 2019
• Autor(a) principal: Andrade, Fernanda Lambert de
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Brasil; UFRN; PROGRAMA DE PÓS-GRADUAÇÃO EM NUTRIÇÃO
• Palavras-chave em Português: Insuficiência cardíaca; Zinco; Cobre; Estado nutricional; Biomarcadores; CNPQ::CIENCIAS DA SAUDE::NUTRICAO
• Link de acesso: https://repositorio.ufrn.br/jspui/handle/123456789/28050

Heart failure (HF) is a complex syndrome with two predominant etiologies, ischemic HF and non-ischemic HF. There are gaps on the impact of the etiology and other factors associated with HF on zinc and copper status. The aim was to investigate the zinc and copper status in individuals with ischemic and non-ischemic HF, and the associations with biodemographic, clinical, biochemical and nutritional parameters. This is a cross-sectional study that included 80 patients with HF who were treated in an outpatient setting, grouped with ischemic (n=36) and non-ischemic HF (n=44). Zinc biomarkers (plasma, urine and dietary zinc), copper biomarkers (plasma and dietary copper, and ceruloplasmin) and copper/zinc ratio were investigated. Student's t-tests, Mann-Whitney, Chi-square or Fisher's exact test were used when appropriate. Multiple linear regression using the stepwise method was used to evaluate associations. We observed lower zinc intake and higher copper intake in the group with ischemic HF (both p=0.02). No differences were detected in plasma zinc and copper, copper/zinc ratio, ceruloplasmin and urine zinc between the groups (all p≥0.05). The median values of these biomarkers were within reference range in both groups. Inverse associations were observed between plasma zinc and age (β=-0.001, p=0.005) and use of diuretic (β=-0.047, p=0.013). Transferrin saturation (β=-0.002, p=0.014), plasma copper (β=0.001, p<0.001), albumin (β=0.090, p<0.001) and ischemic etiology (β=0.038; p=0.012) were directly associated with plasma zinc. It was identified a direct association between ceruloplasmin (β=0.011, p<0.001), GGT (β=0.001, p <0.001), albumin (β=0.077, p=0.001), hs-CRP (β=0.001, p=0.024), dietary calcium (β=0.00015, p=0.015) and plasma copper. On the other hand, the independent variables previous alcoholism (β=-0.070, p<0.001) and dietary fiber (β=-0.016, p=0.008) were inversely associated with plasma copper. The results suggest that there are no significant changes in zinc and copper status in ambulatory individuals with HF, regardless of the etiology of HF. It is important to monitore the predictive variables of plasma zinc and copper related to the context of HF, especially those associated with oxidative stress and inflammation.