Doença de Chagas e alteração do metabolismo da glicose

• Ano de defesa: 2017
• Autor(a) principal: Bruna Araujo Martins Resende
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Minas Gerais; UFMG
• Palavras-chave em Português: resistência insulínica; diabetes mellitus; Doença de Chagas; cardiopatia chagásica; disfunção de célula beta; Diabetes mellitus; Glicemia/análise; Estudos transversais; Medicina; Resistência à insulina
• Link de acesso: http://hdl.handle.net/1843/BUBD-AXNEQQ

The prevalence of diabetes mellitus (DM) has been increasing worldwide. There are many studies on diabetes risk factors, however, only a few analyzed the role of infectious diseases, such as the Chagas disease and its pathogenesis. The Chagas disease, whose etiological agent is Trypanosoma cruzi (T. cruzi), still represents a serious public health problem, despite the drastic reduction of vector and transfusional transmission. Besides the classic forms of parasitism, T. cruzi also parasites adipose and pancreatic tissue. The parasitism of adipose tissue leads to an inflammatory response similar to the one that occurs in obesity. In the pancreatic tissue, the presence of the protozoan generates an inflammatory response, which might lead to fibrosis, and neural pancreatic denervation, mainly parasympathetic. This study has as main objectives to study the association of positive sorology for Chagas disease (with or withou Chagas heart disease) with diabetes mellitus, insulin resistance and beta-cell function. The present study analyses baseline data from the Longitudinal Adult Health Study (Estudo Longitudinal de Saúde do Adulto - ELSA - Brasil) which consisted of multicenter cohort of active and retired employees; volunteers from universities and research institution. Baseline data were collected between 2008 and 2010. ELSA- Brasil aims to investigate epidemiological, clinical and molecular chronic diseases, particularly cardiovascular diseases and diabetes mellitus, and baseline is composed of 15,105 participants, of which 14,922 (98,8%) were included in this study. Of these, 283 (1,9%) had a positive sorology for Chagas disease, of whom 49 (17,3%) had heart disease. Participants were classified as the presence or absence of DM, and those diagnosed with diabetes were 2939 (19,7%), among individuals with negative serology for Chagas disease, the prevalence of DM was 19.6% and those with positive serology had a prevalence of 23.3% (p = 0.24), respectively. Insulin resistance and beta cell function was appraised by Homeostasis model assessment of insulin resistance and Homeostasis model assessment of beta-cell function (to HOMA-IR and HOMA-B, respectively), using the 90% percentile as the cutoff point. The association of positive serology for Chagas disease (without and with heart disease) with DM, HOMA-IR and HOMA-B was investigated using the binary logistic regression model adjusted for age, sex, schooling, waist circumference (cm), hypertension Systemic arterial hypertension, HDL cholesterol and triglycerides. The present study showed that there was no significant association between DM, RI by Homeostasis model assessement-insulin resistance (HOMA-IR) or beta cell function by Homeostasis model assessement-beta (HOMA-B) and positive serology for Chagas disease (without and with heart disease), after all adjustments.