Efeito do chá mate (Ilex paraguariensis) no perfil glicêmico e lipídico, nos marcadores inflamatórios e na função endotelial de indivíduos com diabetes mellitus tipo 2

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Programa de Pós-Graduação em Nutrição, Florianópolis, 2014A incidência de diabetes mellitus, particularmente do tipo 2 (DM2), tem crescido em todo o mundo. Sabe-se que a melhor estratégia para prevenir as complicações macrovasculares do DM2 é a redução da glicemia e dos demais fatores de risco cardiometabólico. Neste sentido, há crescente interesse na utilização de espécies vegetais com propriedades anti-hiperglicêmicas, hipocolesterolêmicas e anti-inflamatórias no tratamento adjuvante do DM2, como por exemplo, a erva-mate (Ilex paraguariensis). Assim, o objetivo do presente estudo foi avaliar o efeito do consumo do chá mate tostado (Ilex paraguariensis), durante 60 dias, nos perfis glicêmico e lipídico, marcadores inflamatórios e na função endotelial de indivíduos com DM2. Participaram do estudo 32 indivíduos (19 homens e 13 mulheres), com idade entre 43 e 67 anos, diagnosticados com DM2 há 8,2 ± 5,4 anos (média ± DP). Após período basal de 30 dias, os participantes ingeriram 1 litro de chá mate diariamente e amostras de sangue foram coletadas antes e após 30 e 60 dias para as análises de glicose, hemoglobina glicada, insulina, colesterol total, triglicerídeos, HDL-colesterol, LDL pequena e densa (sd-LDL-colesterol) e marcadores inflamatórios (PCR-as, IL-1ß, IL-4, IL-6, IL-10, TNF-a, MCP-1). A função endotelial foi avaliada por meio da medida da dilatação arterial mediada por fluxo em aparelho de ultrassom. Foram avaliadas as medidas antropométricas, a pressão arterial e o perfil dietético durante o estudo. Além disto, foram verificados os efeitos agudos do chá mate na glicemia pós-prandial e na função endotelial. O consumo de chá mate promoveu redução significativa de 12,5 mg/dL, em média, na glicose de jejum sérica (7,2%) após 30 dias e de 21,1 mg/dL (11,1%) para 66% dos indivíduos após 60 dias (p Abstract: The incidence of diabetes mellitus, particularly type 2 (T2DM), has increased worldwide. It is well known that the best strategy to prevent macrovascular complications of T2DM is the reduction of glycemia and other cardiometabolic risk factors. Thus, there is a crescent interest to use vegetal species with anti-hyperglycemic, hypocholesterolemic, and anti-inflammatory properties in the adjuvant treatment of T2DM, such as yerba mate (Ilex paraguariensis). Therefore, the aim of this study was to assess the effect of mate tea (Ilex paraguariensis) consumption, during 60 days, in the glycemic and lipid profile, inflammatory markers, and endothelial function of T2DM individuals. Thirty-two subjects (19 men and 13 women), aged 43-67 years-old, who had T2DM diagnosis for 8.2 ± 5.4 y, participated of the study. After 30 days of baseline period, the participants ingested 1 liter of mate tea daily and blood samples were collected before and after 30 and 60 days for serum glucose, glycated hemoglobin, insulin, total cholesterol, triglycerides, HDL-cholesterol, small dense LDL (sd-LDL-cholesterol) and inflammatory biomarkers (hs-CRP, IL-1ß, IL-4, IL-6, IL-10, TNF-a, MCP-1) analyses. The endothelial function was measured by flow-mediated dilatation in ultrasound equipment. Anthropometric parameters, arterial pressure and nutritional profile were evaluated during the study. In addition, acute effects of mate tea on postprandial glucose and endothelial function were evaluated. Mate tea intake promoted significant decrease by 12.5 mg/dL (7.2%, in average) in fasting glucose levels after 30 days and 21.1 mg/dL (11.1%) for 66% of individuals after 60 days (p < 0.05). Nevertheless, there was no significant difference in the insulin levels and insulin resistance values. For 80% of subjects, mate tea reduced significantly the postprandial glucose by 31.0%, in average (p = 0.034). Daily intake of mate tea for 30 days also promoted a average decrease in the concentrations of total cholesterol (14.1 mg/dL, or 6.8%), LDL-c (14.6 mg/dL, or 10.4%), and non-HDL-c (20.3 mg/dL or 11.7%). After 30 and 60 days, occurred reduction in the levels of sd-LDL-c (13.6 mg/dL or 22.0%), triglycerides (21.5 mg/dL or 12.8%) and increased HDL-c levels (2.5 mg/dL or 7.0%). Mate tea consumption also promoted significant reduction of interleukin-6 levels after 30 and 60 days (55.4%, in average), and of hs-CRP (37.5%; p < 0.05) and TNF-a (11.6%; p < 0.05) after 60 days. No significant differences were found for endothelial function. However, mate tea intake promoted significant increase by 72% of nitric oxide concentration, after 60 days. In addition, we observed significant reduction in diastolic blood pressure (4.1%) after 30 days and waist circumference (1.8 cm; p < 0.05) after 60 days of mate tea consumption. The participants decreased consumption of energy (15.6%), carbohydrate (14.7%) and protein (16.8%) after 60 days of intervention (p < 0.05). The results indicated that the ingestion of mate tea decreased fasting and postprandial hyperglycemia, improved lipid parameters, including lowering the more atherogenic sd-LDL particles, decreased subclinical inflammation and increased nitric oxide levels in T2DM individuals. Based on these findings, it is suggested that yerba mate could be an important adjuvant in the prevention of T2DM complications