Associação entre a modulação autonômica cardíaca e fatores de risco cardiovasculares e consumo alimentar em obesos graves

Detalhes bibliográficos
Ano de defesa: 2018
Autor(a) principal: Oliveira, Camila Grasiele Araújo de lattes
Orientador(a): Rebelo, Ana Cristina Silva lattes
Banca de defesa: Rebelo, Ana Cristina Silva, Silveira, Erika Aparecida da, Santos, Renata Carvalho dos
Tipo de documento: Dissertação
Tipo de acesso: Acesso aberto
Idioma: por
Instituição de defesa: Universidade Federal de Goiás
Programa de Pós-Graduação: Programa de Pós-graduação em Ciências da Saúde (FM)
Departamento: Faculdade de Medicina - FM (RG)
País: Brasil
Palavras-chave em Português:
Palavras-chave em Inglês:
Área do conhecimento CNPq:
Link de acesso: http://repositorio.bc.ufg.br/tede/handle/tede/9017
Resumo: Introduction: There is strong evidence that obesity leads to an imbalance of the Autonomic Nervous System (ANS), especially in the increase of sympathetic modulation and a decrease in vagal tone, and that associated cardiovascular risk factors may increase the risk of developing cardiovascular diseases. Objective: To analyze the association between cardiovascular autonomic modulation and clinical variables, food consumption and level of physical activity in obese patients. Methodology: A cross-sectional study with 64 volunteers submitted to biochemical tests, accelerometry, 24-hour recall (R24H), and evaluation of cardiac autonomic modulation. For the analysis of heart rate variability (HRV), the R-R (iRR) intervals were captured in the sitting position for 10 minutes. Statistical analysis: Kolmogorov-Smirnov test; linear regression to identify the association between HRV data and BMI, CC, HOMA-IR, insulin, glycemia, MVPAS, TS, VET, macronutrient, SBP and PAD. The multiple linear regression between the indexes of the frequency domain and the adjusted variables CC, HOMA-IR, insulin, glycemia, MVPA, TS, VET, carbohydrate and lipids (p <0.05). Results: Of the 64 severe obese patients analyzed in the present study, 9 were male (14.06%) and 55 female (85.93%), with a mean age of 39.10 ± 7.74 years ( 27 to 58 years). For the anthropometric data evaluated, the mean BMI was 46.61 ± 6.86 kg / m2, with a more frequent degree of morbid obesity (60.93%). The mean WC was 118.83 ± 10.66 cm for men and women, with a higher risk for all males and 84.37% for females. Patients were insulinresistant (HOMA-IR 6.03 ± 4.10 mg / dl). In the MVPA analysis it was verified that the obese patients had a mean of 98.92 ± 41.00 min / week. In the frequency domain, the severely obese had a sympathetic predominance (LF 56.44 ± 20.31 un) and low parasympathetic modulation (HF 42.52 ± 19.18 un). From the Simple Linear Regression analysis, it was observed that the BMI, CC, VET, carbohydrate, lipid, protein, SBP and DBP were not associated with cardiovascular autonomic modulation (p> 0.05). However, a negative association between HOMA-IR and HF (p = 0.049), HOMA-IR and LF / HF variables was observed (p = 0.001). For insulin and glycemia, there was a negative association with the sympatho-vagal balance (p = 0.002 and p = 0.021, respectively). In the AF analysis, there was a negative association between MVPA and the sympathetic component (p = 0.042), and for TS there was a negative association with HF (p = 0.049) and LF / HF (p = 0.036) and LF p = 0.014). For multiple linear regression, CC and HOMAIR values were negatively and significantly associated with HF (p = 0.010). HOMA-IR and lipid values were negatively associated with LF / HF (p = 0.003 and p = 0.043, respectively). There were no associations between insulin, glycemia, MVPA, TS, VET and carbohydrate and cardiac autonomic modulation. Conclusion: The study reveals that, among cardiovascular risk factors, insulin resistance, glycemia, and sedentary time influence the cardiac autonomic modulation of the severely obese, increasing the risk for the occurrence of cardiovascular diseases