Estado nutricional relacionado às vitaminas antioxidantes em psoriáticos atendidos nos ambulatórios na Grande São Paulo
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Data
20/3/2018
Autores
Rocha, Ana Carolina Lavio [UNIFESP]
Orientadores
Tomita, Luciana Yuki [UNIFESP]
Tipo
Dissertação de mestrado
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ISSN da Revista
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Introdução: A psoríase é uma doença inflamatória crônica e autoimune que
acomete pele e articulações, caracterizada pela anormal hiperproliferação de
queratinócitos. No Brasil, a estimativa de prevalência é de 2,5%. Entre os
fatores etiológicos sugeridos estão tabagismo, consumo de álcool, obesidade e
predisposição genética. Objetivo: Investigar o estado nutricional de vitaminas
antioxidantes (licopeno e αtocoferol) em psoriáticos em 2 ambulatórios na
Grande São Paulo. Métodos: Estudo transversal realizado entre Agosto/2012 à
Março/2014. Informações sociodemográficas, estilo de vida, medidas
antropométricas, consumo alimentar utilizando questionário de frequência
alimentar, dosagem sanguínea de licopeno e αtocoferol, colesterol
total/frações, proteína c reativa e gravidade da psoríase segundo o escore do
Psoriasis Area and Severity Index foram coletadas. Realizaramse análises
descritivas. Para comparações entre as médias de licopeno e αtocoferol
segundo as variáveis de interesse foi utilizada ANOVA. Utilizouse modelo de
regressão linear múltipla para investigar os fatores associados à concentração
sérica de licopeno e αtocoferol. Resultados: 81 indivíduos (55,6% mulheres,
61,7% não brancos) com psoríase leve (85%) e moderada (15%) com mediana
(P25P75) de idade de 54(4162) anos, 10(411) anos de escolaridade, 17,3%
fumantes, 44,8% excesso de peso e 34,5% obesidade, 87,3% circunferência da
cintura elevada, 59,4% dislipidemia, 11,9% hipertrigliceridemia e 54,9%
elevadas concentrações de proteína c reativa. Em relação ao consumo
alimentar, observouse diferença estatisticamente significante entre os sexos
no consumo de calorias, ácido graxo monoinsaturado, sódio, ferro, tiamina,
niacina, αcaroteno, grupos de alimentos ultraprocessados e grupo de gorduras
com consumo maior entre os homens, exceto, αcaroteno (p≤0,05). Mediana
(P25P75) de consumo foi 123(61272) g de frutas, 107(43153) g verduras e
legumes por dia, ou seja, 72% dos psoriáticos não atingiram o consumo diário
preconizado de 400g deste grupo de alimentos. Mediana (P25P75) de
licopeno e αtocoferol sérico foram 0,2(0,10,3) µmol/L e 22,5 (18,525,6)
µmol/L, respectivamente. Na análise univariada, ser mulher, praticar atividade
física, ter obesidade abdominal, elevado colesterol total, LDLc e triglicérides,
menor gravidade da psoríase foram relacionados à maior concentração de
licopeno. No modelo múltiplo, sexo feminino, LDLc, triglicérides e Psoriasis
Area and Severity Index predizeram 32% da variação de licopeno sérico. Na
análise univariada, ser mulher, elevado colesterol total, LDLc, triglicérides e
proteína c reativa foram relacionados à maior concentração de αtocoferol. No
modelo múltiplo, sexo feminino, colesterol total, triglicérides e proteína c reativa
predizeram 36% da variação de αtocoferol. Conclusão: Observouse baixa
variabilidade de concentração sérica de licopeno e αtocoferol entre os
psoriáticos. Entre os fatores associados à variação de licopeno sérico foram
sexo, LDLc, triglicérides e gravidade da psoríase, enquanto que para α
tocoferol foram sexo, colesterol total, triglicérides e proteína c reativa.
Introduction: Psoriasis is a chronic inflammatory and autoimmune disease. It affects skin and joints, characterized by abnormal hyperproliferation of keratinocytes. In Brazil, the prevalence is estimated in 2.5%. Etiological factors as smoking, alcohol consumption, obesity and genetic predisposition are suggested. Objective: Investigate the nutritional status of antioxidants vitamins (lycopene and αtocopherol) in psoriatics attended in two outpatient clinic in São Paulo. Methods: A cross sectional study was conducted between August/2012 and March/2014. Sociodemographic, lifestyle, anthropometrics measures, dietary intake using validated Food Frequency Questionnaire, serum lycopene and αtocopherol, total serum cholesterol and fractions, Creactive protein and psoriasis severity, according to Psoriasis Area and Severity Index were obtained. Descriptive analysis and comparisons between serum lycopene and αtocopherol averages according to variables were conducted using the Oneway analysis of variance. Multiple linear regression was used to investigate factors associated with serum lycopene and α tocopherol. Results: 81 participants (55.6% female, 61.7% nonwhite), mild psoriasis (85%) and moderate (15%) with median (P2575) age of 54(4162) years, 10(411) years of education, 17.3% smoker, 44.8% overweight and 34.5% obesity, 87.3% with high waist circumference, 59.4% dyslipidemia, 11.9% hypertriglyceridemia and 59.4% high Creactive protein. Statistically different dietary intake were observed for calories intake, monounsaturated fatty acids, sodium, iron, thiamine, niacin, α carotene, ultraprocessed and fat food group with higher intake between men, exception αcarotene (p≤0.05). Median (P25P75) daily intake of fruits was 123(61 272)g and vegetables was 107(43153)g. 72% of psoriatics did not reach recommendation of fruits and vegetables (400g/day). Median (P25P75) of serum lycopene and αtocopherol were 0.2(0.10.3) µmol/L and 22.5 (18.525.6) µmol/L, respectively. In the univariate analysis being female, physical activity, abdominal obesity, high total serum cholesterol, LDLc, triglycerides and low psoriasis severity were associated with higher serum lycopene. In the multivariate model analysis female, LDLc, triglycerides and psoriasis severity explained 32% of serum lycopene variation. In the univariate analysis being female, high total serum cholesterol, LDLc, triglycerides and Creactive protein were associated with higher serum αtocopherol. In the multivariate model analysis female, total cholesterol serum, triglycerides and Creactive protein explained 36% of αtocopherol. Conclusion: Low variability of the serum lycopene and αtocopherol was observed among psoriatics. Female, LDLc, triglycerides and Psoriasis Area and Severity Index were associated to the variation of serum lycopene, whereas female, total serum cholesterol, triglycerides and C-reactive protein were associated to the serum αtocopherol.
Introduction: Psoriasis is a chronic inflammatory and autoimmune disease. It affects skin and joints, characterized by abnormal hyperproliferation of keratinocytes. In Brazil, the prevalence is estimated in 2.5%. Etiological factors as smoking, alcohol consumption, obesity and genetic predisposition are suggested. Objective: Investigate the nutritional status of antioxidants vitamins (lycopene and αtocopherol) in psoriatics attended in two outpatient clinic in São Paulo. Methods: A cross sectional study was conducted between August/2012 and March/2014. Sociodemographic, lifestyle, anthropometrics measures, dietary intake using validated Food Frequency Questionnaire, serum lycopene and αtocopherol, total serum cholesterol and fractions, Creactive protein and psoriasis severity, according to Psoriasis Area and Severity Index were obtained. Descriptive analysis and comparisons between serum lycopene and αtocopherol averages according to variables were conducted using the Oneway analysis of variance. Multiple linear regression was used to investigate factors associated with serum lycopene and α tocopherol. Results: 81 participants (55.6% female, 61.7% nonwhite), mild psoriasis (85%) and moderate (15%) with median (P2575) age of 54(4162) years, 10(411) years of education, 17.3% smoker, 44.8% overweight and 34.5% obesity, 87.3% with high waist circumference, 59.4% dyslipidemia, 11.9% hypertriglyceridemia and 59.4% high Creactive protein. Statistically different dietary intake were observed for calories intake, monounsaturated fatty acids, sodium, iron, thiamine, niacin, α carotene, ultraprocessed and fat food group with higher intake between men, exception αcarotene (p≤0.05). Median (P25P75) daily intake of fruits was 123(61 272)g and vegetables was 107(43153)g. 72% of psoriatics did not reach recommendation of fruits and vegetables (400g/day). Median (P25P75) of serum lycopene and αtocopherol were 0.2(0.10.3) µmol/L and 22.5 (18.525.6) µmol/L, respectively. In the univariate analysis being female, physical activity, abdominal obesity, high total serum cholesterol, LDLc, triglycerides and low psoriasis severity were associated with higher serum lycopene. In the multivariate model analysis female, LDLc, triglycerides and psoriasis severity explained 32% of serum lycopene variation. In the univariate analysis being female, high total serum cholesterol, LDLc, triglycerides and Creactive protein were associated with higher serum αtocopherol. In the multivariate model analysis female, total cholesterol serum, triglycerides and Creactive protein explained 36% of αtocopherol. Conclusion: Low variability of the serum lycopene and αtocopherol was observed among psoriatics. Female, LDLc, triglycerides and Psoriasis Area and Severity Index were associated to the variation of serum lycopene, whereas female, total serum cholesterol, triglycerides and C-reactive protein were associated to the serum αtocopherol.
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Citação
ROCHA, Ana Carolina Lavio. Estado nutricional relacionado às vitaminas antioxidantes em psoriáticos atendidos nos ambulatórios na Grande São Paulo. 2018. 60 f. Dissertação (Mestrado em Saúde Coletiva) - Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, 2018.