Avaliação dos níveis de glicohemoglobina, curvas glicêmicas e proteína C reativa como preditores complementares para o diagnóstico de pré-diabetes

• Ano de defesa: 2015
• Autor(a) principal: Biavaschi, Marcelo da Silva
• Orientador(a): Morsch, Vera Maria
• Banca de defesa: Rosemberg, Denis Broock , Gonçalves, Jamile Fabbrin
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Santa Maria
• Programa de Pós-Graduação: Programa de Pós-Graduação em Ciências Biológicas: Bioquímica Toxicológica
• Departamento: Bioquímica
• País: BR
• Palavras-chave em Português: Pré-diabetes; Curva glicêmica; Glicohemoglobina e proteína C reativa
• Palavras-chave em Inglês: Prediabetes; Glycemic curve; Glycohemoglobin; C-reactive protein
• Área do conhecimento CNPq: CNPQ::CIENCIAS BIOLOGICAS::BIOQUIMICA
• Link de acesso: http://repositorio.ufsm.br/handle/1/11254

Diabetes Mellitus (DM) is a heterogeneous group of diseases that have hyperglycemia as a common condition. Prevalence as well as morbidity and mortality stand out as public health problems. The Americam Diabetes Association (ADA) has considered impaired fasting glucose, if fasting glucose >99<126mg/dl and impaired glucose tolerance, if glycemia 2h in oral tolerance test (2h-OGTT) ≥140<200mg/dl, prediabetic conditions. It also recommends that glycohemoglobin (HbA1c)(≥5.7<6.5%) be used as a criterion to diagnose prediabetes. However, the diagnosis of prediabetes are not in agreement up to 70% of the times when these methods are used. Thus, this study aimed to assess other variables that may contribute to the diagnosis of prediabetes, such as the relationship between levels of HbA1c, C-reactive protein (CRP) and alterations in the blood glucose curve during the OGTT in individuals who are at increased risk of developing type 2 diabetes mellitus. Lipid profile, oxidative profile through malondialdehyde and carbonyl protein, and the insulin resistance index by Homeostatic Model Assessment-IR were also analyzed. We selected 59 individuals who were non-diabetic and relatives of diabetic and non-diabetic patients who were assisted at the University Hospital of Santa Maria and on the International Day of the Diabetes program. The subjects were between 40 and 60 years old with BMI≥25Kg/m² who firstly had a clinical evaluation and answered a questionnaire. Then, they underwent blood sampling after fasting for 12 hours to determine the biochemical parameters and oxidative stress. Next, individuals underwent OGTT with 75g of glucose and blood was collected after 30, 60 and 120 min to assess blood glucose. Five patients who had a diagnosis of diabetes were excluded and the 54 participants who remained were divided into two subgroups: with family history of diabetes in first-degree relative (FH +) or without family history (FH-). Subsequently, 6 patients without prediabetes and with 1h-OGTT≤fasting glycemia were excluded out of 54 participants. Then, 48 subjects were divided into two groups, one without prediabetes and with 1h-OGTT>fasting glycemia and the other with prediabetes. Results showed no significant difference between groups with HF+ and HF-. Moreover, there was no significant difference between the group with prediabetes and the group without prediabetes and with 1h-OGTT>fasting glycemia, when considering the levels of HbA1c, CRP, profile lipid and malondialdehyde. However ,a significant difference was observed between these two groups when glucose levels, insulin, HOMA-IR and carbonyl protein were analyzed. There was no difference between the groups regarding the other parameters. These results identify predictors to increased cardiovascular and diabetes risk in individuals without prediabetes and with 1h-OGTT>fasting glycemia, which are similar to those predictors in individuals with prediabetes established by the ADA criteria.