Predi??o das concentra??es plasm?ticas de IL-1B, IL-6 e TNF-? por agrupamentos de fatores de risco cardiovascular em adolescentes.

Programa de P?s-Gradua??o em Sa?de e Nutri??o. Escola de Nutri??o, Universidade Federal de Ouro Preto.As doen?as cardiovasculares (DCV) s?o as principais causas de mobi-mortalidade em todo o mundo e est?o bem relacionadas a diversos fatores de risco cardiovascular tradicionais (RCV), incluindo obesidade central, resist?ncia ? insulina (RI), intoler?ncia ? glicose, dislipidemias e hipertens?o arterial sist?mica (HAS). A inflama??o tem sido associada a muitos destes fatores de risco, apresentando consider?vel papel na instala??o das DCV. Seus mediadores inflamat?rios, incluindo as citocinas pr?-inflamat?rias interleucina 1? (IL-1?), interleucina 6 (IL-6) e fator de necrose tumoral ? (TNF-?) desempenham importantes fun??es associadas ao metabolismo de carboidratos, lip?deos e processo ateroscler?tico, sendo consideradas fatores de RCV emergentes. Estudos t?m sido desenvolvidos a fim de investigar os agrupamentos desses fatores na fisiopatologia da DCV em crian?as e adolescentes, pois sabe-se que sua instala??o se inicia precocemente e leva a graves consequ?ncias na vida adulta. Nesse sentido, o objetivo deste trabalho foi Investigar a associa??o entre agrupamentos de fatores de risco cardiovascular e IL-1?, IL-6 e TNF-?, em adolescentes. Foi realizado um estudo transversal com 487 adolescentes (236 meninos e 251 meninas) no qual foram obtidas medidas antropom?tricas e de composi??o corporal (peso, altura, per?metro da cintura e porcentagem de gordura corporal), calculado o ?ndice de massa corporal (IMC), a rela??o cintura/estatura (RCE) e o ?ndice de conicidade (?ndice C), aferida a press?o arterial e foram determinadas as concentra??es plasm?ticas de IL-6, IL-1? e TNF-?, concentra??es s?ricas de colesterol total e fra??es (HDL-c e LDL-c), triacilglicer?is, glicose e insulina e calculado posteriormente o ?ndice HOMA-IR (?ndice de avalia??o da homeostase de resist?ncia ? insulina). As vari?veis de RCV cl?nicas e bioqu?micas foram inclu?das na an?lise de componentes principais. A associa??o entre os agrupamentos de fatores de risco cardiovascular e interleucina 6, interleucina 1? e fator de necrose tumoral ?, foi obtida atrav?s da an?lise de regress?o linear m?ltipla. As an?lises foram realizadas separadamente para meninos e meninas, considerando p<0,05 e com aux?lio do programa estat?stico PASW 18.0. A an?lise de componentes principais revelou cinco componentes independentes, respons?veis por 80% e 81% de explica??o da varia??o total das 14 vari?veis originais em meninos e meninas, respectivamente. Em ambos os sexos, foram encontrados componentes que foram caracterizados por adiposidade, metabolismo de glicose, press?o arterial, HDL/triacilglicer?is e colesterol/LDL. Metabolismo de glicose foi inversamente associado ? interleucina 1?, em ambos os sexos (p=0,015 para meninas e p=0,039 para meninos); press?o arterial foi inversamente associada ao fator de necrose tumoral ?, em meninas (p=0,003) e, por fim, o componente representado por HDL/triacilglicer?is foi positivamente associado ? interleucina 6, em meninas (p=0,01), e ? interleucina 1? (p<0,001) e fator de necrose tumoral ? (p<0,001), em meninos. Os resultados sugerem que metabolismo de lip?deos possui forte liga??o com o processo inflamat?rio, sendo uma das primeiras altera??es presentes no desenvolvimento de doen?as cardiovasculares, ainda na adolesc?ncia. Mais estudos s?o necess?rios a fim de melhor elucidar as rela??es encontradas entre metabolismo de glicose, press?o arterial e inflama??o, em adolescentes.Cardiovascular diseases (CVD) are a major cause of mobility and mortality worldwide and are well related to several factors of traditional cardiovascular risk (CVR), including central obesity, insulin resistance (IR), glucose intolerance, dyslipidemia and systemic arterial hypertension (SAH). Inflammation has been linked to many of these risk factors, presenting considerable role in the onset of CVD. Inflammatory mediators, including proinflammatory cytokines interleukin 1? (IL-1?), interleukin 6 (IL-6) and tumor necrosis factor ? (TNF- ?) play important functions associated with the metabolism of carbohydrates, lipids and atherosclerosis, being considered cardiovascular risk factors emerging. Studies have been conducted to investigate the clusters of these factors in the pathophysiology of CVD in children and adolescents, since it is known that the installation begins early and leads to serious consequences in adulthood. In this sense, the aim of this study was to investigate the association between clusters of cardiovascular risk factors and IL-1?, IL-6 and TNF-? in adolescents. A cross-sectional study of 487 adolescents ( 236 boys and 251 girls ) in which anthropometric and body composition (weight, height, waist circumference and percentage of body fat) measurements were obtained, calculated body mass index (BMI) was conducted waist / height ratio (WHR) and conicity index, measured blood pressure and were determined plasma concentrations of IL-6 , IL-1? and TNF-?, serum total cholesterol and its fractions (HDL - c and LDL-c), triglycerides, glucose and insulin, and subsequently calculates the HOMA-IR index (homeostasis assessment of insulin resistance). Clinical and biochemical variable of CVR were included in the principal components analysis. The association between clusters of cardiovascular risk factors and IL-6, IL-1? and TNF-? was obtained by multiple linear regression. Analyses were performed separately for boys and girls, considering p < 0.05 with PASW 18.0 statistical program. The principal components analysis revealed five independent components, accounting for 80 % and 81 % of the explained total variance of 14 original variables in boys and girls, respectively. In both sexes, components that are characterized by adiposity, glucose metabolism, blood pressure, HDL/triglycerides and cholesterol/LDL were found. Metabolism of glucose was inversely related to IL-1? in both sexes (p = 0.015 for girls and p = 0.039 for boys), blood pressure was inversely related to tumor necrosis factor ? in girls (p = 0.003) and, finally, the component represented by HDL/triglycerides was positively associated with IL-6 in girls (p=0.01 and IL-1? (p < 0.001) and TNF-? (p < 0.001) in boys. The results suggest that lipid metabolism has a strong link with the inflammatory process, being one of the first changes present in the development of CVD, in adolescence. More studies are needed to elucidate the relationships between glucose metabolism, blood pressure and inflammation in adolescents