Índice inflamatório da dieta em indivíduos com hipertensão: associação com adiposidade corporal, perfil metabólico e sarcopenia

Abstract

Background: Hypertension is a chronic non-communicable and multifactorial disease, it is the main risk factor for cardiovascular diseases, the leading cause of death in the world. Recent studies indicate hypertension is associated with a higher risk of sarcopenia, a progressive, generalized skeletal muscle disease associated with adverse outcomes. These two diseases are associated with chronic low-grade inflammation, influenced by dietary intake. The dietary inflammatory index (DII) is an instrument to quantify diet inflammatory potential; it can vary from 7.89 (maximally pro-inflammatory) to -8.87 (maximally anti-inflammatory). Studies suggest positive associations of DII with adverse health outcomes, including obesity, hypertension and sarcopenia. Only one study that investigated DII and sarcopenia in individuals with hypertension was found, however, the definition of sarcopenia was based only on muscle mass. Thus, there is a gap in the investigation of the association of DII with obesity, body composition, sarcopenia and, sarcopenic obesity in individuals with hypertension. Objective: To evaluate the DII and its association with body adiposity (total, central, and visceral), insulin resistance, lipid profile, inflammatory markers, and sarcopenia in individuals with hypertension. Methods: This is a cross-sectional study with patients diagnosed with hypertension. Patients eligible for the study are submitted for food intake evaluation, and the energy-adjusted inflammatory index was calculated through collection of three 24-hour recall (R24h), clinical history, lifestyle, blood pressure, quality of life (SF-36-(QSF-36)), physical activity (Baecke’s questionnaire), anthropometric, laboratory (blood collection), and body composition (Bioelectrical impedance and dual-energy X-ray absorptiometry). Results: A total of 79 individuals (59 women; 75%) with a mean age of 58 ± 7 years were evaluated. The group with a pro-inflammatory diet (E-IID≥0) vs. anti-inflammatory (E-IID<0) presented significantly higher values of low-density lipoprotein cholesterol (LDL-c) (122±28 vs. 106±23 mg/dL), interleukin 6 (IL-6) (7.5±14 vs. 3.4±7 pg/mL), and muscle quality index (MQI) in men (9.9±1.4 vs. 10.7±1.5); worse quality of life according to some parameters of SF-36; in addition to a higher frequency of obesity by DXA (100% vs. 88%) and by the waist-to-hip ratios (71% vs. 47%) and waist-to-height (89% vs. 76%)). In correlation analyses, E-IID showed a significant association (p<0.05) with total cholesterol (r=0.268), LDL-c (r=0.248), HOMA-IR (r=0.256), IL-6 (r=0.314), general health status (r=-0.263) and only in men with the IQM (r=-0.492). In linear regression analyses, after adjustments for sex, age, physical activity and energy intake, significant associations of E-IID with total cholesterol, LDL-c, HOMA-IR, IL-6, general health status, total body adiposity, trunk and visceral adiposity assessed by DXA were observed. There were no cases of sarcopenia or sarcopenic obesity, nor was there any association between E-DII and its components, except for IQM. In conclusion, individuals with hypertension and pro-inflammatory diets are associated with a worse lipid profile, insulin resistance, systemic inflammation, and total and central adiposity.