Associação entre perfil de ácidos graxos do tecido adiposo, concentrações plasmáticas de citocinas pró-inflamatórias e padrão alimentar de mulheres submetidas à cirurgia bariátrica
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2014-02-21
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Universidade Federal de Viçosa
Resumo
A obesidade é caracterizada pelo peso corporal excessivo, resultante do demasiado acúmulo de gordura corporal, estocada nos depósitos de tecido adiposo, que anatômica e funcionalmente, podem ser subcutâneo ou visceral. Os adipócitos funcionam como depósitos de ácidos graxos, na forma de triacilgliceróis, bem como possuem funções endócrinas, relacionadas à secreção de fatores como hormônios e adipocinas. Dentre as adipocinas pró- inflamatórias relacionadas à obesidade, destacam-se o TNF (Fator de Necrose Tumoral) e a IL-6 (Interleucina 6). Para o tratamento da obesidade grave, a cirurgia bariátrica representa um método eficaz, com resultados sustentáveis. Diante destas considerações, o presente estudo objetivou avaliar o perfil lipídico do tecido adiposo, padrão alimentar, estado nutricional e concentrações plasmáticas de adipocinas, em mulheres submetidas a duas técnicas bariátricas, a Gastroplastia Vertical com Anel e Derivação Gástrica em Y-de- Roux (GVAYR) e Gastrectomia Vertical com Anel (GVA), a fim de investigar a associação entre a composição de ácidos graxos do tecido adiposo visceral e subcutâneo abdominal pré-cirurgia e a resposta pós-cirúrgica, referente à evolução do peso e das concentrações de TNF e IL-6; além de analisar a possível concordância entre o perfil de ácidos graxos da dieta pré-cirurgia e dos tecidos. Foram recrutadas mulheres participantes de um Programa de Combate à Obesidade. Das 288 mulheres inscritas, 33 foram selecionadas, de acordo com critérios da Sociedade Brasileira de Cirurgia Bariátrica e Metabólica (SBCBM, 2006) para a realização das cirurgias bariátricas. As mulheres foram dividas entre os grupos GVA (n=19) e GVAYR (n=14) e acompanhadas nos períodos pré-cirurgia, 1, 3 e 6 anos pós-cirurgia. Realizaram-se coletas de sangue, dados dietéticos e medidas antropométricas. Ainda, no ato da cirurgia, foram coletadas amostras de tecido adiposo visceral e subcutâneo. Foram mensurados a IL-6 e o TNF plasmáticos, bem como analisado o perfil de ácidos graxos dos tecidos e o perfil de macronutrientes, cálcio e ácidos graxos da dieta. A composição de ácidos graxos do tecido adiposo subcutâneo abdominal e visceral pré-cirurgia correlacionou-se com as concentrações de marcadores inflamatórios e parâmetros de perda de peso pós-cirurgia. Dentre as associações observadas, destacam-se o perfil pró- inflamatório dos ácidos graxos saturados C14:0 (subcutâneo e visceral) e C15:0 (visceral). Com relação à perda de peso, entretanto, os ácidos graxos C17:0 (visceral) e C22:0 (subcutâneo) exibiram correlação positiva. Da mesma forma, diversos ácidos graxos monoinsaturados (14:1, subcutâneo; 16:1, 17:1, ambos os tecidos; 18:1, 20:1, visceral) foram positivamente associados com as concentrações plasmáticas de IL-6. Além disso, os ácidos graxos linoléico (subcutâneo) e esteárico (visceral), foram preditores da perda de peso após 6 anos da cirurgia. Ademais, o ácido graxo linoléico foi correlacionado negativamente com as concentrações de IL-6 e positivamente com os parâmetros de perda de peso. O ácido graxo α-linolênico exibiu potencial anti- inflamatório quanto à concentração de IL-6. Quanto ao consumo dietético de ácidos graxos, as diferenças encontradas entre os tipos de cirurgia não refletiram as encontradas entre os tipos de tecido adiposo. No entanto, houve concordância entre os tipos de ácidos graxos abundantes na dieta e os abundantes nos tecidos, especialmente no tecido visceral.
Obesity is characterized by excessive body weight, resulting in exceeding accumulation of body fat stored in fatty tissue depots, which anatomically and functionally, can be subcutaneous or visceral. The adipocyte function as depots of fatty acids in the triglycerides form as well as endocrine related to secretion of hormones factors such as adipokines functions. Among the proinflammatory adipokines related to obesity, we highlight the TNF (Tumor Necrosis Factor) and IL-6 (Interleukin 6). For the treatment of severe obesity, bariatric surgery is an effective method to achieve sustainable results. Given these considerations, the present study aimed to evaluate the lipid profile of adipose tissue, dietary patterns, nutritional status and plasma levels of adipokines in women undergoing two bariatric techniques, Roux-en-Y Gastric Bypass (GVAYR) and Sleeve Gastrectomy (GVA) in order to investigate the association between the baseline fatty acid composition of visceral and abdominal subcutaneous adipose tissue and post-surgical response concerning the progress of the weight and the levels of TNF and IL-6, besides to analyze the possible correlation between fatty acid profile of the baseline diet and tissues. Participating women in a program to combat obesity were recruited. Were selected 33 out of 288 women enrolled according to criteria of the Brazilian Society of Metabolic and Bariatric Surgery (SBCBM) in order to perform the bariatric surgeries. The women were divided between GVA (n=19) and GVAYR (n=14) groups and followed the pre-surgery and 1, 3 and 6 years post-surgery. There were blood samples, dietary and anthropometric data. Still at the time of surgery, samples of visceral and subcutaneous adipose tissue were collected. Plasma IL-6 and TNF were measured, as well as analyzed the fatty acid tissues profile and dietary macronutrients, calcium and fatty acid profile. The fatty acid composition of the pre-surgery abdominal subcutaneous and visceral adipose tissue correlated with levels of inflammatory markers and parameters of post- surgery weight loss. Among the observed associations, we highlight the pro- inflammatory profile of saturated fatty acids C14:0 (subcutaneous and visceral) and C15:0 (visceral). Regarding to weight loss, however, the C17:0 fatty acids (visceral) and C22:0 (subcutaneous) showed positive correlation. Likewise, many of monounsaturated fatty acids (C14:1, subcutaneous; C16:1, C17:1, both tissues; C18:1, C20:1, visceral) were associated with plasma levels of IL-6. Furthermore linoleic acids (subcutaneous) and stearic (visceral) were predictors of weight loss after 6 years of surgery. Moreover, the fatty acid linoleic was negatively correlated the levels of IL-6 and positively with parameters of weight loss. Linolenic fatty acid exhibited anti-inflammatory potential for levels of IL-6. Regarding the dietary intake of fatty acids, the differences between the types of surgery did not reflect those found between the types of adipose tissue. However, there was agreement between the types of abundant fatty acids in the diet and abundant in tissues, especially in visceral adipose tissue.
Obesity is characterized by excessive body weight, resulting in exceeding accumulation of body fat stored in fatty tissue depots, which anatomically and functionally, can be subcutaneous or visceral. The adipocyte function as depots of fatty acids in the triglycerides form as well as endocrine related to secretion of hormones factors such as adipokines functions. Among the proinflammatory adipokines related to obesity, we highlight the TNF (Tumor Necrosis Factor) and IL-6 (Interleukin 6). For the treatment of severe obesity, bariatric surgery is an effective method to achieve sustainable results. Given these considerations, the present study aimed to evaluate the lipid profile of adipose tissue, dietary patterns, nutritional status and plasma levels of adipokines in women undergoing two bariatric techniques, Roux-en-Y Gastric Bypass (GVAYR) and Sleeve Gastrectomy (GVA) in order to investigate the association between the baseline fatty acid composition of visceral and abdominal subcutaneous adipose tissue and post-surgical response concerning the progress of the weight and the levels of TNF and IL-6, besides to analyze the possible correlation between fatty acid profile of the baseline diet and tissues. Participating women in a program to combat obesity were recruited. Were selected 33 out of 288 women enrolled according to criteria of the Brazilian Society of Metabolic and Bariatric Surgery (SBCBM) in order to perform the bariatric surgeries. The women were divided between GVA (n=19) and GVAYR (n=14) groups and followed the pre-surgery and 1, 3 and 6 years post-surgery. There were blood samples, dietary and anthropometric data. Still at the time of surgery, samples of visceral and subcutaneous adipose tissue were collected. Plasma IL-6 and TNF were measured, as well as analyzed the fatty acid tissues profile and dietary macronutrients, calcium and fatty acid profile. The fatty acid composition of the pre-surgery abdominal subcutaneous and visceral adipose tissue correlated with levels of inflammatory markers and parameters of post- surgery weight loss. Among the observed associations, we highlight the pro- inflammatory profile of saturated fatty acids C14:0 (subcutaneous and visceral) and C15:0 (visceral). Regarding to weight loss, however, the C17:0 fatty acids (visceral) and C22:0 (subcutaneous) showed positive correlation. Likewise, many of monounsaturated fatty acids (C14:1, subcutaneous; C16:1, C17:1, both tissues; C18:1, C20:1, visceral) were associated with plasma levels of IL-6. Furthermore linoleic acids (subcutaneous) and stearic (visceral) were predictors of weight loss after 6 years of surgery. Moreover, the fatty acid linoleic was negatively correlated the levels of IL-6 and positively with parameters of weight loss. Linolenic fatty acid exhibited anti-inflammatory potential for levels of IL-6. Regarding the dietary intake of fatty acids, the differences between the types of surgery did not reflect those found between the types of adipose tissue. However, there was agreement between the types of abundant fatty acids in the diet and abundant in tissues, especially in visceral adipose tissue.
Descrição
Palavras-chave
Ácidos graxos, Tecido adiposo, Cirurgia bariátrica, Interleucina-6, Fator de necrose tumoral, Fatty acids, Adipose tissue, Bariatric surgery, Interleukin-6, Tumor necrosis factor
Citação
ALMEIDA, Crislaine das Graças de. Association between adipose tissue fatty acid profile, plasma pro-inflammatory cytokines concentrations and dietary pattern of women undergoing bariatric surgery. 2014. 128 f. Dissertação (Mestrado em Valor nutricional de alimentos e de dietas; Nutrição nas enfermidades agudas e crônicas não transmis) - Universidade Federal de Viçosa, Viçosa, 2014.