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Master's Dissertation
DOI
https://doi.org/10.11606/D.5.2011.tde-27022012-142226
Document
Author
Full name
Janaína Proença de Oliveira Maul
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2011
Supervisor
Committee
Nakagawa, Naomi Kondo (President)
Aikawa, Priscila
Fló, Claudia Marina
Title in Portuguese
Efeitos do envelhecimento, isolado e associado ao diabetes e/ou à hipertensão sobre o transporte mucociliar e propriedades físicas do muco nasal
Keywords in Portuguese
Diabetes
Envelhecimento
Hipertensão
Propriedades do muco
Transporte mucociliar
Abstract in Portuguese
A pneumonia é uma das principais causas de morte na população idosa. O prejuízo do transporte mucociliar pode aumentar a susceptibilidade à infecção respiratória. Nosso objetivo foi avaliar os efeitos do envelhecimento, isolado e combinado com diabetes ou hipertensão, sobre a transporte mucociliar nasal e as propriedades do muco. De 440 pacientes contactados por telefone, 252 pessoas participaram do estudo: 79 saudáveis (18-94 anos, 50 homens), 38 indivíduos com diabetes (14-85 anos, 13 homens), 51 indivíduos com hipertensão (23-90 anos, 12 homens) e 84 indivíduos com diabetes e hipertensão (18-84 anos, 33 homens). Os indivíduos foram divididos em dois grupos principais, saudável e co-morbidade. Cada grupo foi separado em três sub-grupos de faixas etárias: (a) <40 anos, (b) 40-59 anos e (c) 60 anos. Foram avaliados os dados demográficos, os dados clínicos, o questionário de Qualidade de Vida SF-36, o pH nasal, o transporte mucociliar nasal por meio do teste de tempo de trânsito da sacarina (TTS), as propriedades do muco in vitro por meio da transportabilidade do muco por alto fluxo e o ângulo de contato. Neste estudo, observamos no grupo saudável uma maior frequência de mulheres (p=0,040) no sub-grupo 60 anos (70%) comparado com <40 anos (35%) e 40-59 anos (22%). Nos indivíduos saudáveis não observamos diferença entre as faixas etárias quanto aos seguintes parâmetros: sumário do componente físico do SF-36 (51±7), sumário do componente mental do SF-36 (51±9), pressão arterial sistólica (116±7 mmHg), pressão arterial diastólica (76±6 mmHg), freqüência cardíaca (74±10 bpm), frequência respiratória (17±3 rpm), oximetria de pulso (97±1%), glicemia (98±8 mg/dl), pH nasal (6,7±1,3), TTS (9,5±2,7 min), transportabilidade do muco por alto fluxo (46±18 mm) e ângulo de contato do muco (42±7°). No entanto, no grupo co-morbidade, o subgrupo 60 anos apresentou aumento do índice de massa corpórea (p=0,021), da pressão arterial sistólica (p<0,001), da frequência respiratória (p<0,001) e do TTS (p=0,003) e redução do sumário do componente físico SF-36 (p<0,001) em comparação com o sub-grupo <40 anos. Observamos correlação entre TTS e idade associada a co-morbidades (p<0,001). Nosso estudo sugere que o envelhecimento combinado com o diabetes e/ou a hipertensão podem reduzir a eficiência do transporte mucociliar nasal
Title in English
The effects of aging, isolated and associated with diabetes and/or hypertension on nasal mucociliary clearance and mucus properties
Keywords in English
Aging
Diabetes
Hypertension
Mucociliary clearance
Mucus properties
Abstract in English
Pneumonia is a leading cause of death in elderly populations. Impairment of mucociliary clearance may increase susceptibility to respiratory infection. We aimed to evaluate the effects of aging alone and in combination with diabetes or hypertension on nasal mucociliary clearance and mucus properties. Of 440 subjects contacted by telephone, 252 entered the study: 79 healthy subjects (18-94 yrs, 50 male); 38 with diabetes (14-85 yrs, 13 male); 51 with hypertension (23-90 yrs, 12 male); and 84 with both diabetes and hypertension (18-84 yrs, 33 male). The subjects were divided into healthy and co-morbid groups. Each group was separated into three subgroups by age: (a) <40 yrs, (b) 40-59 yrs, and (c) 60 yrs. We assessed demographic data, clinical data, quality of life questionnaire (SF-36), nasal pH, nasal mucociliary clearance using the saccharine transit test (STT) and in vitro mucus properties by examining the high-flow clearability and contact angle. In this study, in the healthy group there was a high frequency of female (p=0.040) in the sub-group 60 yrs (70%) compared with <40 yrs (35%) and 40-59 yrs (22%). In healthy group, there were no differences between age groups in SF-36 physical component summary (51±7), SF-36 mental component summary (51±9), systolic blood pressure (116±7 mmHg), diastolic blood pressure (78±6 mmHg), heart rate (74±10 bpm), respiratory rate (17±3), pulse oximetry (97±1%), glycemia (98±8 mg/dl), nasal pH (6.7±1.3), STT (9.5±2.7 min), high-flow clearability (46±18 mm), and mucus contact angle (42±7o). In the co-morbid group, however, subjects aged 60 yrs had higher body mass indices (p=0.021), systolic blood pressures (p<0.001), respiratory rate (p<0.001), STT (p=0.003) and decreased SF-36 physical component summary scores (p<0.001) compared to the subjects aged <40 yrs. There was a significant correlation between STT and aging associated with co-morbid conditions (p<0.001). Our study suggests that aging combined with diabetes and/or hypertension can reduce nasal mucociliary clearance efficiency
 
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Publishing Date
2012-02-28
 
WARNING: The material described below relates to works resulting from this thesis or dissertation. The contents of these works are the author's responsibility.
  • OLIVEIRA-MAUL, J. P., et al. Aging, diabetes and hypertension are associated with decreased nasal mucociliary clearance [doi:10.1378/chest.12-1183]. Chest (American College of Chest Physicians) [online], 2013, vol. 143, p. 1091-1097.
  • RESPIRATORY CARE: The Editor´s Pen - American Association for Respiratory Care
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