Detalhes bibliográficos
| Ano de defesa: |
2020 |
| Autor(a) principal: |
Pedron, Flaviana Freitas |
| Orientador(a): |
Moraes, Cristina Bragança de |
| Banca de defesa: |
Chagas, Patricia,
Schuch, Natielen Jacques |
| Tipo de documento: |
Dissertação
|
| Tipo de acesso: |
Acesso aberto |
| Idioma: |
por |
| Instituição de defesa: |
Universidade Franciscana
|
| Programa de Pós-Graduação: |
Mestrado em Ciências da Saúde e da Vida
|
| Departamento: |
Ciências da Saúde e da Vida
|
| País: |
Brasil
|
| Palavras-chave em Português: |
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| Palavras-chave em Inglês: |
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| Área do conhecimento CNPq: |
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| Link de acesso: |
http://www.tede.universidadefranciscana.edu.br:8080/handle/UFN-BDTD/876
|
Resumo: |
Objective: Assessment of the impact of% EWL on Cardiovascular Risk (CVR), liver markers and lipid profile two years after bariatric surgery (BS). Methods: Retrospective, descriptive and cross-sectional study by accessing the database of an Obesity and Digestive Surgery Clinic located in Santa Maria - RS, from March 2018 to March 2019. Female and male patients aged 18 and older who underwent bariatric surgery from March 2014 to March 2016 were analysed. The Framinghan Heart Study score was used in order to stablish the Cardiovascular Risk (CVR) due to its possibility to estimate the absolute risk of Cardiovascular Diseases (CVD) (Systemic Arterial Hypertension, Smoking, Diabetes Mellitus, Dyslipidemias) in ten subsequent years. The following data were obtained from the patients’ medical records: a) weight and height, to calculate body mass index (BMI); b) personal data (age and gender); c) presence of associated morbidities (systemic arterial hypertension (SAH, Diabetes Mellitus - DM2, Metabolic Syndrome – MS, Liver Steatosis - LS, Dyslipidemia and CVR); d) Biochemical parameters - Cholesterol, High Density Lipoprotein (HDLc) and Low Density Lipoprotein (LDLc), Triglycerides (TG), Glucose, Glycated Haemoglobin (Hb1Ac), Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST). Percentages of Excess Weight Loss (% EWL) which were categorized into Group 1 (G1) with weight loss <70% and Group 2 (G2) with weight loss ≥70% were calculated. The data were inserted into the Microsoft Excel 2010® program and transferred to the IBM SPSS® program (Statistical Package for Social Science) version 20.0 after being checked. The results were considered statistically significant at p <0.05. The analyses of quantitative data were described by mean and standard deviation. The distributional breakdown was used in the median and interquartile range. Categorical data were included by using counts and percentages. The analysis of the longitudinal variability was evaluated through Generalized Estimating Equations taken as factors in the interaction model between the two groups (<70% − ≥70%). Results: It was observed that all female patients (80,9%) reduced weight, decreased glycated haemoglobin (Hb1Ac) and glucose in the postoperative period, thus minimizing cardiovascular risk (CVR). When comparing variations between 6 and 12 months, only group 1 reduced Hb1Ac and group 2 decreased the CVR. There was no difference in both groups between 12 and 18 months. There was a significant reduction in the level of glucose in group 1 (p = 0.036) at T4 (18 months) and T5 (24 months) within 2 years after BS. There was a reduction in the% EWL in patients evaluated at T2 (6 months), T3 (12 months), T4 (18 months) and T5 (24 months) in relation to the liver and lipid profiles, in addition to the reduction of the variables Hb1Ac, Glucose, TG, HDLc, LDLc, Total Cholesterol - TC, ALT and AST. There was a decrease in Hb1Ac, Glucose, TG, CT, LDLc and an increase in HDLc in the postoperative period, minimizing liver changes. There was a reduction in TG, CT, LDLc and an increase in HDLc when comparing the variations between 0 and 6 months in groups 1 and 2. Both G1 and G2 showed a reduction in TG and LDLc; group 2 showed a reduction in TC; and HDLc increased in both groups between 6 and 12 months. Only G1 reduced triglycerides between 12 and 18 months; HDLc increased in G1 and G2. There was a significant reduction in the level of glucose in group 1 between 18 and 24 months. The variables AST and ALT were within normal values with no significance. Conclusion: The positive impact determined by BS in the loss of excess weight, in the reduction of biochemical parameters and cardiovascular risk is extremely significant after six months and is maintained for up to 24 months. BS is effective in weight loss, in improving anthropometric, metabolic and biochemical parameters as well as liver and lipid markers, and in reducing morbidities caused by obesity. |
