Avaliação do estado nutricional, de parâmetros inflamatórios e de estresse oxidativo de mulheres com diabetes mellitus tipo 2

Abstract

Type 2 diabetes mellitus (T2DM) is the most common type among the classifications of diabetes (DM). It has a complex and multifactorial origin, involving genetics and environmental factors, such as obesity and inadequate eating habits that will affect an individual's nutritional status. Environmental factors also contribute to increased oxidative stress, inflammation and generate changes in the lipid profile, which can influence the function and quantity of pancreatic beta cells, contributing to the worsening or development of T2DM. The objective of this study was to evaluate parameters of oxidative stress, inflammatory profile, nutritional status and functional strength in women with T2DM. This is a cross-sectional, analytical case-control study using a quantitative approach conducted with 44 women diagnosed with T2DM who were members of the diabetes group (DG) and 36 healthy women who were members of the control group (CG) in the western state of Santa Catarina, Brazil. The proposed methodology included the assessment of nutritional status through anthropometric data collection, dietary survey and biochemical parameters, such as lipid profile and fasting blood glucose, followed by a clinical history questionnaire, functional strength assessment, measurement of oxidative stress and inflammation by analyses performed on plasma and blood serum. The parameters investigated demonstrated that although the muscle mass index (BMI) values did not demonstrate a significant difference (p>0,05) between the groups, the participants in the DG were obese grade I and had a very high concentration of fat mass percentage (FM%) consistent with obesity, while the CG was overweight and had high FM%. The DG demonstrated higher fasting blood glucose (p<0,05) compared to the CG expected for a DM2 condition. Regarding the lipid profile, high-density protein (HDL) was lower in the DG compared to the CG (p<0,05), in addition to its classification corresponding to deficit and normality, respectively. Furthermore, total cholesterol (TC) was altered in both groups, but only the DG had elevated low-density protein (LDL). Although both groups were sedentary, the DG had impaired mobility and balance due to the increased exercise time compared to the CG (p<0,05); in the same sense, functional strength was worse in the DG compared to the CG (p<0,05). By analyzing the inflammatory profile, the pro-inflammatory cytokines tumor necrosis factor alpha (TNF) and interleukin 6 (IL-6) were higher in the DG compared to the CG (p<0,05), and interleukin 10 (IL-10), an anti-inflammatory marker, was found to be lower in the DG compared to the CG (p<0,05). Regarding oxidative stress, the enzyme catalase (CAT) had greater enzymatic activity compared to GC (p<0,05), lipid oxidative damage measured by TBARS was greater in DG compared to GC (p<0,05). Analyzing non-enzymatic antioxidants, vitamin C and non-protein thiols (NPSH) were more reduced in DG compared to GC. ROS showed higher values in DG compared to GC, a statistically significant difference (p<0,5). Applying the correlations to the data, this study elucidated the negative correlation of hyperglycemia, oxidative stress, inflammation for functional strength in DG and the positive correlation of the same markers for mobility and functional balance. Furthermore, the correlations of oxidative stress and inflammation markers with glycemia confirm the relationship between DM2, oxidative stress and inflammation, and the negative correlation between EROS x NPSH and the positive correlation between EROS x CAT and EROS x TBARS in the DG confirms the presence of oxidative stress in this group. It is concluded that women with DM2 have worse functional strength and mobility and functional balance related to parameters of hyperglycemia, inflammation and oxidative stress. In addition to confirming that altered nutritional status in anthropometric parameters, lipid profile, inflammation and oxidative stress influences DM2, as well as DM2 influences these parameters, demonstrating the relationship between DM2, inflammation and oxidative stress.