Efeito da dieta hipocalórica no perfil metabólico e composição corporal de mulheres com e sem Síndrome Metabólica e genótipo Pro12Pro do gene PPARγγ2

Abstract

Obesity is a non-transmissible chronic disease, characterized by excess of body fat. Then, the accumulated fat in the abdominal region promotes insulin resistance and therefore metabolic changes which together form the clustering of the metabolic syndrome (MS). Genotype Pro12Pro seems to be related to reduced insulin sensitivity, triggering the process of the MS. The objective of this study was to evaluate the effect of a low-calorie diet on metabolic profile and body composition in women with and without MS with genotype Pro12Pro on PPARγ2 gene. It is a clinical trial where women between 30 and 45 years, obese class I, without MS (n = 23) and with MS (n = 7) were submitted to a hypocaloric diet for 90 days. The identification of genotype was performed by polymerase chain reaction (PCR). At the beginning and on 30, 60 and 90 days were evaluated body weight, lean body mass (LBM), body fat mass (BFM) components of MS, serum uric acid, insulin, leptin, adiponectin, the indexes HOMA-IR and QUICKI. The energy consumption was assessed at 12 weeks of treatment. The Student t test for independent samples was used for comparison between groups, and the dependent samples test to compare the evolution within each group relative to baseline. All women had Pro12Pro genotype. The MS group had lower HDL-C (44.4±3.2 vs. 56.8±2.4 mg/dL, p=0.013) and higher triglyceride (180.9±26.7 vs. 89.7±6.6 mg/dL, p=0.014) and VLDL-c (36.2±5.3 vs. 17.9±1.3 mg/dL, p=0.014) at baseline. Both groups showed significant weight reduction (-3.3±0.7% without MS group and -4.2±0.9% SM group) and waist circumference (-2.4±0.5% group without SM and -5.9±1.4% SM group). The group without MS reduced BFM progressively until 90 days (37.0±0.8 to 36.6±0.5%, p=0.02), and increased LBM (62.0±0.5 to 63.4±0.5%, p=0.01), also the group with SM reduced BFM during the study (32.6±2.3 to 29.6±2.4%, p<0.01) and increased LBM significantly (62.2±1.0 to 64.3±1.3%). systolic blood pressure (SBP) decreased in the first month of treatment in the group without MS (120.4±1.8 to 112.3±2.1 mmHg, p<0.01). With regard to metabolic parameters, the group without SM showed a reduction of serum insulin (32.5±4.2 to 25.9±2.4 µU/mL, p = 0.05) and increase of serum adiponectin (4.7 ± 0.6 to 5.1±0.8 ng/mL, p=0.02) at 30 days, total cholesterol (180.2±5.8 to 173.8±5.4 mg/dL, p=0.04) and HDL-c (56.8±2.4 to 52.2±2.2 mg/dL, p=0.04) and serum leptin (27.0±1.9 to 18.2±1.4 ng/mL, p< 0.01) at 60 days, although had a reduction of QUICKI to 90 days (0.39±0.03 to 0.35±0.01, p=0.01). The MS group, the serum leptin levels decreased at 60 days (20.3±1.9 to 14.7±1.1 ng/mL, p=0.01) and serum adiponectin to 90 days (5.7±1.2 to 7.1±1.4 ng/mL, p<0.01), there was also a remission of 57,1% in cases of MS. We suggest that the hypocaloric diet was efficient on reduction in body weight and BFM, mainly located in the abdominal region. Therefore, considerable improvement of metabolic profile related to obesity in the group without MS was observed, as well as improvement of markers of insulin sensitivity and cardioprotection related to SM, in addition to remission of cases of MS.