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Master's Dissertation
DOI
https://doi.org/10.11606/D.6.2007.tde-03112023-120816
Document
Author
Full name
Jesuana Oliveira Lemos
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2007
Supervisor
Committee
Rondó, Patricia Helen de Carvalho (President)
Bergamaschi, Denise Pimentel
Freire, Maria Beatriz Sayeg
Title in Portuguese
Efeito do peso ao nascimento e da idade gestacional no desenvolvimento de obesidade, resistência à insulina e dislipidemia em pré-escolares
Keywords in Portuguese
Dislipidemias
Obesidade
Peso ao Nascimento
Resistência à Insulina
Abstract in Portuguese
Introdução - Estudos recentes relacionam a ocorrência de doenças crônicas. típicas da idade adulta, à desnutrição em fases precoces da vida, como na intra-uterina Este fenômeno é denominado de "Programação" ou "Origem Fetal das Doenças". Objetivo - Avaliar a relação entre peso ao nascimento (PN) e idade gestacional (IG) e situação nutricional na infância e o risco de desenvolvimento de obesidade, resistência à insulina e dislipidemias em crianças. Metodologia - Estudo epidemiológico de coorte. realizado no município de Jundiaí, São Paulo, considerando-se 890 crianças do estudo de RONDÓ (2003). com idades entre 5 a 8 anos. nascidas em hospitais conveniados ao Sistema Único de Saúde - SUS. A corte incluiu 509 crianças, nas quais, determinou-se níveis de glicose (método glicose hexoquinase automatizado). colesterol total (método colesterol oxidase automatizado). HDL-c (método HDL colesterol direto automatizado). LDL-c (fórmula de FRIEDWALD), triglicérides (método glicerol peroxidase automatizado), insulina (método quimioluminescente- IMMULITE 2000). resistência a insulina (homeostasis model assessment- HOMA) e situação nutricional segundo o escore-z (NCHS) e IMC (CDC/2000). A relação entre as variáveis foi determinada pelo modelo de regressão linear múltipla, considerando-se como variável dependente a insulina e RI-HOMA Resultados - Os níveis médios (95% IC) de glicose, RI- HOMA, CT e LDL-c; foram respectivamente: 92,86 mg/dl (92,27-93,45); 1,0 μmol/Uml (0,93-1,07); 159,13 mg/dl (156,55-161,71); 89,38 mgl/dl (87,13-91,64) e não se relacionaram com o sexo (p=0,352; p=0,337; p=0,861 e p=0,341). A média (95% IC) do HDL-c e TG foram respectivamente: 55,41 mg/dl (54,44-56,39) e 71,69 mg/dl (68,93-74,45) e houve relação com o sexo (p=0,003 e p=0,018). No teste de regressão linear, observou-se relação significativa inversa entre PN e insulina (p<0,001) e PN e RI-HOMA (p<0,001). A prevalência de sobrepeso, considerando o IMC, foi de 8,5%, e não houve relação com o sexo. Conclusão - O baixo peso ao nascer está associado a alterações no metabolismo da insulina e com a elevação da resistência à insulina em crianças de 5 a 8 anos. É importante o acompanhamento do desenvolvimento de crianças com PN inadequado, para se detectar elevações na resistência à insulina e prevenir o surgimento de doenças crônicas na vida adulta.
Title in English
The effect of birth weight and gestational age on the development of obesity, insulin resistance and dyslipidemia in preschool children
Keywords in English
Birth Weight
Dyslipidemia
Insulin Resistance
Obesity
Abstract in English
Introduction - Recent studies relate the occurrence of chronic diseases, typical of adult age, to malnutrition in earlier phases of life, as the fetal life. This phenomenon is called "Programming" or "Fetal Origin of diseases". Objective - To evaluate the relationship between birth weight (BW) and gestational age (GA) with anthropometric measurements, obesity, insulin resistance and dyslipidemia in children. Methodology - Epidemiological cohort study carried out in Jundiaí, involving 890 children from the RONDÓ (2003) study, born in hospitals that belonged to the National Health Service - SUS. Five hundred and nine (509) from 5 to 8 years of age were included in the study. Glucose was determined in blood by the glucose hexoquinase automated method; Total cholesterol (cholesterol oxidase automated method); HDL-c (direct HDL cholesterol automated method); LDL (formula of FRIEDWALC); Triglycerides (glycerol peroxidase automated method); Insulin by chemiluminescent method (IMMULITE 2000) and insulin resistance (homeostasis model assessment -IR HOMA). Evaluation of the nutritional state was assessed according to the NCHS z score and to the CDC (2000) body mass index (BMI) classification. Results - Mean levels (95% IC) of glucose, IR-HOMA, and LDL-c; were respectively: 92,86 mg/dl (92.27-93,45); 1,0 μmol/Uml (0,93-1,07); 159,13 mg/dl (156,55-161,71); 89,38 mg/dl (87,13-91,64) and did not relate with gender (p=0,352; p=0,337; p=0,861 e p=0,341). Mean levels (95% IC) of HDL-c; and TG were respectively: 55,41 mg/dl (54,44-56,39) 71,69 mg/dl (68,93-74,45) and were related with gender (p=0,003 e p=0,018). Linear regression models were used to asses the relationship between the variables. There were significant inverse relationships BW and insulin (p<0,001) and BW and RI-HOMA (p< 0,001). BW did not relate with the CT, HDL-c and TG. GA did not relate with any of the observed variables. The prevalence of overweight according to the BMI measurements was 8,5% and there was no relation between obesity and gender. Conclusions - Low BW causes alterations in insulin metabolism, with an increase in insulin resistance in children from 5 to 8 years of age. It is important to follow the development of children with inadequate BW to detect increases in insulin resistance and to prevent chronic diseases in adult life.
 
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Publishing Date
2023-11-03
 
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