Associações da espessura do complexo médio-intimal da carótida com o estado oxidativo, metabólico e nutricional em crianças pré-púberes obesas e eutróficas

Abstract

The prevalence of childhood obesity is increasing worldwide and is associated with greater morbidity and mortality from cardiovascular disease in adulthood. Childhood obesity, changes in glucose and lipid metabolism and increased oxidative stress and inflammatory state contribute to the increased carotid artery intima-medial thickness (cIMT) in young children, elevating the risk of atherosclerosis. The aim of this study was to measure and compare cIMT, data of glucose and lipid metabolism, oxidative and antioxidant status, body composition and food intake in pré-pubertal normal-weight and obese children. We measured total body mass (TBM), height (H), waist circumference (WC); glucose, insulin, total cholesterol (TC), low density lipoprotein (LDL-cholesterol), high density lipoprotein (HDL-cholesterol), uric acid, ultra-sensitive C-reactive protein (hs-CRP) and antioxidant capacity (DPPH); cIMT (USG, General Electric ®), dietary intake (three 24 h recalls) for analysis of macronutrients and fatty acids. Also, we calculated the body mass index (BMI) for age and HOMA-IR. Obese children (n = 30) had a BMI above the p97 (WHO, 2007) and data were compared with a control group (n = 25) composed of normal-weight children of similar age. Statistical analysis followed the characteristics of the sample for non-parametric data, and considered significant results when p <0.05. The mean age of children was 7.8 ± 1.3 years. A comparison between groups showed significantly higher values of TBM, BMI, WC, energy and carbohydrates intake, TC, LDL-cholesterol, insulin, HOMA-IR, uric acid, hs-CRP and cIMT in obesity group. Positive associations were found of cIMT with TBM, BMI and WC. The WC was positively associated with uric acid, insulin and HOMA-IR. hs-CRP was positively associated with TBM, BMI, WC, uric acid, insulin and HOMA-IR. In conclusion, obese children had higher abdominal fat mass, increased energy and carbohydrate intake, and more cardiovascular disease risk factors than normal-weight children. Our results, showed that childhood obesity leads to cardiometabolic damage that may cause morbidity later in life. The process of early atherosclerosis is influenced by the total and abdominal fat mass, which is directly related to insulin resistance, to inflammatory and antioxidant status. The knowledge of risk factors in this population should be a basis for treatment strategies to reduce morbidity and mortality from cardiovascular disease later in adulthood.