Avaliação do CD36 nas Subpopulações de monócitos e sua associação com marcadores bioquímicos, dietéticos e antropométricos em pacientes pré e pós-operatório de cirurgia bariátrica
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2023-02-28
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Universidade Federal de Viçosa
Resumo
Introdução: O excesso de adiposidade e consequente quadro de inflamação de baixo grau são características da obesidade e estão relacionadas ao desenvolvimento de diversas doenças, como as doenças cardiovasculares que são hoje principal causa de morte e incapacidade em todo mundo. O processo inflamatório induzido pela obesidade recruta as células do sistema imune monócitos/macrófagos, que expressam a glicoproteína de membrana CD36. Esse receptor tem papel fundamental no metabolismo lipídico cardíaco e está estreitamente ligado à formação de lesões ateroscleróticas. Indivíduos com obesidade grave que passaram por cirurgia bariátrica apresentam expressiva perda de peso e de adiposidade, o que promoveria melhora no perfil inflamatório e em marcadores antropométricos. A dieta assume importante papel como agente imunorregulador no organismo de acordo com o potencial inflamatório ou anti-inflamatório dos alimentos. Objetivos: Determinar a expressão de CD36 em monócitos e suas subpopulações e avaliar sua associação ao Índice Inflamatório da Dieta (IID), marcadores bioquímicos e antropométricos no pré e pós- operatório de cirurgia bariátrica. Metodologia: Estudo transversal realizado com 31 indivíduos divididos em três grupos (controle, pré cirurgia e pós cirurgia bariátrica). Avaliações antropométricas e de composição corporal foram realizadas através do cálculo de índice de massa corporal (IMC) e bioimpedância. O consumo alimentar e cálculo do IID foram avaliadas través de registro alimentar de 72 horas. Os marcadores metabólicos foram avaliados através da análise de sangue periférico fresco. A avaliação da molécula CD36 em monócitos foi analisada por citometria de fluxo. A estatística descritiva foi utilizada para caracterizar a nossa amostra. O teste de Shapiro-Wilk foi utilizado para analisar a normalidade dos dados. Para analisar a associação entre as variáveis utilizamos heatmap e coeficiente de correlação de Spearman. O teste de Kruskal-Wallis foi utilizado para determinar as diferenças entre os grupos, seguido do teste de Dunn. O nível de significância foi estabelecido em p<0,05. Todas as análises foram realizadas no GraphPad Prism 9.4.1. Resultados: A expressão de CD36 nas três subpopulações de monócitos foi maior no grupo pré- bariátrico quando comparado aos outros grupos. No grupo pré-bariátrico, observamos correlação positiva entre CD36 expressos em monócitos não-clássicos e massa gorda (r=0.67, p=0.04), e negativa com massa magra (r=-0.67, p=0.04). Em monócitos clássicos, a expressão do CD36 apresenta correlação positiva com massa gorda (r=0.79, p=0.009), HDL (r=0.82, p=0.006), adiponectina (r=0.79, p=0.009) e negativa com massa gorda (r=0.79 p=0.009). Os marcadores bioquímicos PCR (p=0.005), VLDL (p=0.003) e TG (p=0.003) apresentaram níveis maiores no grupo pré-bariátrico, mas não correlacionaram com a expressão de CD36. Conclusão: A expressão de CD36 nas três subpopulações de monócitos apresenta níveis maiores em indivíduos no pré-operatório e está associada a marcadores bioquímicos e antropométricos. A redução da inflamação causada pela cirurgia pode contribuir para menor expressão de CD36 nessas células e consequentemente menor risco de formação e progressão da placa aterosclerótica. Palavras-chave: Obesidade. Cirurgia Bariátrica. Inflamação. Monócitos. CD36. Risco Cardiovascular.
Introduction: Excess adiposity and consequent low-grade inflammation are characteristics of obesity and are related to the development of several diseases, such as cardiovascular diseases, which are today the main cause of death and disability worldwide. The inflammatory process induced by obesity recruits the cells of the immune system monocytes/macrophages, which express the membrane glycoprotein CD36. This receptor plays a fundamental role in cardiac lipid metabolism and is closely linked to the formation of atherosclerotic lesions. Individuals with severe obesity who have undergone bariatric surgery have significant weight and adiposity loss, which would promote improvement in the inflammatory profile and in anthropometric markers. Diet assumes an important role as an immunoregulatory agent in the body according to the inflammatory or anti-inflammatory potential of foods. Objectives: To determine the expression of CD36 in monocytes and their subpopulations and evaluate its association with the Dietary Inflammatory Index (DII), biochemical and anthropometric markers in the pre and postoperative period of bariatric surgery. Methodology: Cross- sectional study with 31 individuals divided into three groups (control, pre-surgery and post-bariatric surgery). Anthropometric and body composition assessments were performed by calculating body mass index (BMI) and bioimpedance. Dietary intake and IID calculation were assessed using a 72-hour food record. Metabolic markers were assessed by analyzing fresh peripheral blood. The evaluation of the CD36 molecule in monocytes was analyzed by flow cytometry. Descriptive statistics were used to characterize our sample. The Shapiro-Wilk test was used to analyze data normality. To analyze the association between variables, we used a heatmap and Spearman's correlation coefficient. The Kruskal-Wallis test was used to determine differences between groups, followed by the Dunn test. The significance level was set at p<0.05. All analyzes were performed using GraphPad Prism 9.4.1. Results: CD36 expression in the three subpopulations of monocytes was higher in the pre-bariatric group when compared to the other groups. In the pre-bariatric group, we observed a positive correlation between CD36 expressed in non-classical monocytes and fat mass (r=0.67, p=0.04), and a negative correlation with lean mass (r=-0.67, p=0.04). In classic monocytes, CD36 expression is positively correlated with fat mass (r=0.79, p=0.009), HDL (r=0.82, p=0.006), adiponectin (r=0.79, p=0.009) and negative with fat mass (r=0.79p=0.009). The biochemical markers PCR (p=0.005), VLDL (p=0.003) and TG (p=0.003) showed higher levels in the pre-bariatric group, but did not correlate with CD36 expression. Conclusion: The expression of CD36 in the three subpopulations of monocytes shows higher levels in preoperative individuals and is associated with biochemical and anthropometric markers. The reduction of inflammation caused by surgery may contribute to a lower expression of CD36 in these cells and, consequently, a lower risk of formation and progression of atherosclerotic plaque. Keywords: Obesity. Bariatric surgery. Inflammation. Monocytes. CD36. Cardiovascular risk.
Introduction: Excess adiposity and consequent low-grade inflammation are characteristics of obesity and are related to the development of several diseases, such as cardiovascular diseases, which are today the main cause of death and disability worldwide. The inflammatory process induced by obesity recruits the cells of the immune system monocytes/macrophages, which express the membrane glycoprotein CD36. This receptor plays a fundamental role in cardiac lipid metabolism and is closely linked to the formation of atherosclerotic lesions. Individuals with severe obesity who have undergone bariatric surgery have significant weight and adiposity loss, which would promote improvement in the inflammatory profile and in anthropometric markers. Diet assumes an important role as an immunoregulatory agent in the body according to the inflammatory or anti-inflammatory potential of foods. Objectives: To determine the expression of CD36 in monocytes and their subpopulations and evaluate its association with the Dietary Inflammatory Index (DII), biochemical and anthropometric markers in the pre and postoperative period of bariatric surgery. Methodology: Cross- sectional study with 31 individuals divided into three groups (control, pre-surgery and post-bariatric surgery). Anthropometric and body composition assessments were performed by calculating body mass index (BMI) and bioimpedance. Dietary intake and IID calculation were assessed using a 72-hour food record. Metabolic markers were assessed by analyzing fresh peripheral blood. The evaluation of the CD36 molecule in monocytes was analyzed by flow cytometry. Descriptive statistics were used to characterize our sample. The Shapiro-Wilk test was used to analyze data normality. To analyze the association between variables, we used a heatmap and Spearman's correlation coefficient. The Kruskal-Wallis test was used to determine differences between groups, followed by the Dunn test. The significance level was set at p<0.05. All analyzes were performed using GraphPad Prism 9.4.1. Results: CD36 expression in the three subpopulations of monocytes was higher in the pre-bariatric group when compared to the other groups. In the pre-bariatric group, we observed a positive correlation between CD36 expressed in non-classical monocytes and fat mass (r=0.67, p=0.04), and a negative correlation with lean mass (r=-0.67, p=0.04). In classic monocytes, CD36 expression is positively correlated with fat mass (r=0.79, p=0.009), HDL (r=0.82, p=0.006), adiponectin (r=0.79, p=0.009) and negative with fat mass (r=0.79p=0.009). The biochemical markers PCR (p=0.005), VLDL (p=0.003) and TG (p=0.003) showed higher levels in the pre-bariatric group, but did not correlate with CD36 expression. Conclusion: The expression of CD36 in the three subpopulations of monocytes shows higher levels in preoperative individuals and is associated with biochemical and anthropometric markers. The reduction of inflammation caused by surgery may contribute to a lower expression of CD36 in these cells and, consequently, a lower risk of formation and progression of atherosclerotic plaque. Keywords: Obesity. Bariatric surgery. Inflammation. Monocytes. CD36. Cardiovascular risk.
Descrição
Palavras-chave
Obesidade, Cirurgia bariátrica, Antígenos CD36, Monócitos
Citação
FERNANDES, Paola Negri. Avaliação do CD36 nas Subpopulações de monócitos e sua associação com marcadores bioquímicos, dietéticos e antropométricos em pacientes pré e pós-operatório de cirurgia bariátrica. 2023. 56 f. Dissertação (Mestrado em Ciência da Nutrição) - Universidade Federal de Viçosa, Viçosa. 2023.