Marcadores pró-inflamatórios e de estresse oxidativo em pacientes submetidos à gastroplastia com bypass em y de Roux

Abstract

Obesity is an inflammatory condition associated to oxidative stress. This study#s objective was to evaluate the effect of weight loss over the ingestion of energy, vitamin C, carotene and vitamin E (diet / blood), blood concentration of reduced glutathione (GSH), thiobarbituric acid reactive substances (TBARS), catalase (CAT) and myeloperoxidasis (MPO) in patients submitted to Roux-en-Y gastric bypass. Methods: This was a prospective controlled single-blind study composed by a Control Group (CG) and a Surgery Group (SG), both with 5 men and 31 women, mean ages of 38.7±9.4 and 39.6±9.2 years, mean Body Mass Index (BMI) values of 22.2±2.1 and 47.6±9.1 kg/m2, respectively. The CG group was evaluated once and the SG group was evaluated in basal, 3rd, 6th, and 12th days post-surgery. After surgery, the SG group received daily supplementation of vitamin C (60mg), -carotene (3000ìg) and vitamin E (30mg). Results: Compared with basal period, weight loss in SG on the 12th month was of 35.8±1.0% (P<0.001). On the 3rd month, intakes of energy (61.0±2.9%, P<0.001) and vitamin C (21.3±1.8%, P<0.001) decreased while intakes of -carotene (30.1±2.0%, P<0.001) and vitamin E (532.0±37.6%, P<0.001) increased. On the 6th month, MPO e GSH levels decreased (39.9±3.2%, P<0.001; 19.7±6.3%, P=0.037, respectively) while CAT levels increased (46,1±26,3%,P=0,029). On the 12th month there was reduction of NOx (36.9±14.6%, P<0.001), TBARS (74.5±11.0%, P<0.001), TC (31.6±2.4%, P<0.001), TG (31.7±4.5%, P=0.002), -carotene (63.6±2.6%, P<0.001) and vitamin E (26.8±10.5%, P=0.004), and increased vitamin C levels (175.6±7.6%, P<0.001). BMI correlated with TBARS (r=0.409; P<0.001) and vitamin C (r=-0.405; P<0.001), MPO with CT (r=0.329; P>0.001) and TG (r=0.260; P=0.002), and the TBARS with vitamin C (r=- 0.532; P<0.001). Conclusion: After 12 months, the SG presented attenuated oxidative stress and inflammation levels with decreased TBARS and NOx.

Introducao: A obesidade e um estado inflamatorio associado com estresse oxidativo. O objetivo deste estudo foi avaliar o efeito da perda de peso sobre a ingestao de energia, vitamina C, -caroteno e vitamina E (dieta/sangue), concentracao sanguinea de glutationa reduzida (GSH), substancias reativas ao acido tiobarbiturico (TBARS), catalase (CAT) e mieloperoxiadse (MPO) em pacientes submetidos a gastroplastia com bypass em y de Roux. Metodos: Tratou-se de um estudo prospectivo, controlado e mono cego composto por um Grupo Controle (CC) e um Grupo Gastroplastia (GG), ambos com 5 homens e 31 mulheres, com idade media de 38,7#}9,4 e 39,6#}9,2 anos e indice de massa corporal (IMC) medio de 22,2#}2,1 e 47,6#}9,1 kg/m2, respectivamente. Avaliou-se GC uma unica vez e GG no periodo basal, 3o, 6o, e 12o mes pos-cirurgia. Apos a cirurgia, GG foi suplementado diariamente com vitamina C (60mg), -caroteno (3000Êg) e vitamina E (30mg). Resultados: Comparado com o periodo basal, a perda de peso no GG no 12 mes foi de 35,8}1,0% (P<0,001). No 3o mes, houve reducao no consumo de energia (61,0}2,9%, P<0,001) e de vitamina C (21,3}1,8%, P<0,001) e aumento no de -caroteno (30,1}2,0%, P<0,001) e vitamina E (532,0}37,6%, P<0,001). No 6o mes a MPO e GSH reduziram (39,9}3,2%, P<0,001; 19,7}6,3%, P=0,037, respectivamnete) e CAT aumentou (46,1}26,3%,P=0,029). No 12o mes houve reducao de NOx (36,9}14,6%, P<0,001), TBARS (74,5}11,0%, P<0,001), CT (31,6}2,4%, P<0,001), TG (31,7}4,5%, P=0,002), -caroteno (63,6}2,6%, P<0,001) e vitamina E (26,8}10,5%, P=0,004) e aumento de vitamina C (175,6}7,6%, P<0,001). O IMC correlacionou-se com TBARS (r=0,409; P<0,001) e vitamina C (r=-0,405; P<0,001), a MPO com CT (r=0,329; P>0,001) e TG (r=0,260; P=0,002) e o TBARS com vitamina C (r=-0,532; P<0,001). Conclusao: Apos 12 meses, GG apresentou atenuacao do estresse oxidativo e da inflamacao com diminuicao do TBARS e de NOx.