Associação entre os lipídeos alimentares e os ácidos graxos séricos com sintomas depressivos e de ansiedade de adolescentes com obesidade: um estudo transversal exploratório
Data
2023-08-11
Autores
Silva, Sandra Maria Chemin Seabra da 
Orientadores
Caranti, Danielle Arisa
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: A obesidade, o transtorno de ansiedade e a depressão são doenças complexas e multifatoriais com alta prevalência e incidência, sendo estabelecidas, atualmente, como um problema de saúde pública global. Todas apresentam a inflamação crônica e o padrão alimentar como importantes fatores. Neste sentido, os ácidos graxos circulantes merecem destaque, especialmente pelos seus efeitos anti e pró-inflamatórios. Objetivo: Verificar o grau de associação entre os lipídeos obtidos por meio da alimentação, lipídeos séricos e mediadores inflamatórios com os sintomas de depressão e a ansiedade-traço de adolescentes com obesidade. Métodos: Trata-se de uma pesquisa retrospectiva de coorte, que visitou o banco com os dados de 399 adolescentes com obesidade, pertencente a um estudo realizado no período de 2008 a 2012, conduzido pelo Grupo de Estudos da Obesidade (GEO) da Universidade Federal de São Paulo (UNIFESP). Este estudo foi aprovado pelo Comitê de Ética e Pesquisa UNIFESP. Este banco era composto pelos dados de massa corporal, estatura, composição corporal, glicemia, insulinemia e perfil lipídico (p. ex., triglicérides, colesterol total e frações), concentração plasmática de leptina, adiponectina, fator de necrose tumoral alfa (TNF-), inibidor da ativador do plasminogênio-1 (PAI-1), proteína C reativa (PCR), interleucinas (IL) 1, 6 e 10, perfil de ácidos graxos séricos livres, dados do consumo alimentar e dados do Inventário de depressão de Beck (BDI) e do Inventário de Ansiedade Traço e Estado (IDATE). Resultados: Artigo 1) A amostra foi composta por 138 adolescentes, com idade média de 16,38 anos (± 1,49), Índice de Massa Corporéa médio de 35,78 kg/m2 (± 4.79), sendo 38,4% do gênero masculino e 61,6% do gênero feminino. Tendo os sintomas de depressão como variável desfecho (dependente), as análises de associação foram feitas para verificar o grau de predição das variáveis independentes (p. ex., composição corporal, metabolismo da glicose, perfil lipídico, perfil de ácidos graxos, concentração de leptina, adiponectina, interleucina IL-6, IL-10, TNF-α, PCR, PAI-1). Os sintomas depressivos foram verificados em 54,6% da amostra. Além disso, houve correlação positiva entre os sintomas depressivos e o teor sérico de ácidos graxos saturados (AGS), gordura corporal e adipocinas inflamatórias, como leptina, IL-6 e a relação leptina/ adiponectina. Por outro lado, a correlação foi negativa entre os sintomas de depressão e o total de ácidos graxos poliinsaturados (AGP) do tipo -3. Artigo 2) Para este estudo foram analisados os dados de 125 adolescentes com obesidade, relacionando a ansiedade-traço com a composição corporal, citocinas e ácidos graxos séricos, massa de gordura visceral e massa de gordura subcutânea, concentrações séricas de glicose, insulina, triglicerídeos, colesterol total e fração (VLDL, HDL, LDL, HDL), alanina aminotransferase, aspartato aminotransferase, γ-glutamil transferase, leptina, adiponectina, PAI-1, PCR, e sintomas de Ansiedade-traço. Foi estudado também a associação da Ansiedade-traço com a ingestão de energia e macronutrientes. Os grupos foram criados com base nos percentis de ingestão total de lipídios. No entanto, não houve associação dos lipídios consumidos ou dos ácidos graxos séricos com ansiedade-traço. Conclusão: Os AGS foram positivamente correlacionados aos sintomas depressivos, ao passo que os AGP apresentaram correlação inversa. Contudo, nenhuma correlação foi verificada com ansiedade-traço, nem com lipídios consumidos. Estes resultados indicam que são necessários estudos novos estudos longitudinais, a fim de confirmar a causalidade entre os AG séricos e depressão e a não causalidade com ansiedade-traço em indivíduos com obesidade.
Background: Obesity, anxiety, and depression are complex and multifactorial diseases with high prevalence and incidence and are currently established as global public health problems. All of them present chronic inflammation and dietary patterns as important factors. Therefore, circulating fatty acids deserve to be highlighted, especially for their anti- and pro-inflammatory effects. Purpose: We aimed to verify the degree of association between lipids obtained through food, serum lipids and inflammatory mediators with symptoms of depression and anxiety in adolescents with obesity Methods: This is a retrospective cohort research, in which data was extracted from 2008 to 2012, conducted by the Obesity Study Group (GEO) of the Federal University of São Paulo (UNIFESP). The Ethics and Research Committee of the UNIFESP approved both this study. This database consisted of data on body mass, height, body composition, blood glucose, insulinemia and lipid profile (eg, triglycerides, total cholesterol and fractions), plasma concentration of leptin, adiponectin, tumor necrosis factor alpha (TNF- ), plasminogen activator-1 inhibitor (PAI-1), C-reactive protein (CRP), interleukins (IL) 1, 6 and 10, serum free fatty acid profile, food consumption data and data from the Depression Inventory Beck (BDI) and State and Trait Anxiety Inventory (STAI). Results: Article 1) The sample consisted of 138 adolescents, with a mean age 16,38 years (± 1,49), mean Body Mass Index of 35,78 kg/m2 (± 4.79), 38,4% male and 61,6% female. With depression symptoms as the (dependent) outcome variable, association analyses were performed to verify the degree of prediction of independent variables (e.g., body composition, glucose metabolism, lipid profile, fatty acid profile, leptin concentration, adiponectin, interleukin IL-6, IL-10, TNF-α, CRP, PAI-1). Depressive symptoms were seen in 54.6% of the sample. Furthermore, there was a positive correlation between depressive symptoms and serum saturated fatty acid (SFA) content, body fat, and inflammatory adipokines, such as leptin, IL-6, and the leptin protein/adiponectin ratio. On the other hand, the correlation was negative between depression and total polyunsaturated fatty acids (PUFA)- 3. Article 2) For this study, data from 125 obese adolescents were analyzed, relating trait anxiety to body composition, cytokines and serum fatty acids, visceral fat mass and subcutaneous fat mass, serum concentrations of glucose, insulin, triglycerides, total cholesterol and fraction (VLDL, HDL, LDL, HDL), alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transferase, leptin, adiponectin, PAI-1, CRP, and symptoms of Trait Anxiety. The association of trait anxiety with energy and macronutrient intake was also studied. Groups were created based on percentiles of total lipid intake. However, there was no association of consumed lipids or serum fatty acids with trait anxiety. Conclusion: The SFA were positively correlated with depressive symptoms, while the AGP showed an inverse correlation. However, no correlation was verified with trait-anxiety, nor with consumed lipids. These results indicate that new longitudinal studies are needed in order to confirm the causality between serum AG and depression and the non-causality with trait anxiety in individuals with obesity.
Background: Obesity, anxiety, and depression are complex and multifactorial diseases with high prevalence and incidence and are currently established as global public health problems. All of them present chronic inflammation and dietary patterns as important factors. Therefore, circulating fatty acids deserve to be highlighted, especially for their anti- and pro-inflammatory effects. Purpose: We aimed to verify the degree of association between lipids obtained through food, serum lipids and inflammatory mediators with symptoms of depression and anxiety in adolescents with obesity Methods: This is a retrospective cohort research, in which data was extracted from 2008 to 2012, conducted by the Obesity Study Group (GEO) of the Federal University of São Paulo (UNIFESP). The Ethics and Research Committee of the UNIFESP approved both this study. This database consisted of data on body mass, height, body composition, blood glucose, insulinemia and lipid profile (eg, triglycerides, total cholesterol and fractions), plasma concentration of leptin, adiponectin, tumor necrosis factor alpha (TNF- ), plasminogen activator-1 inhibitor (PAI-1), C-reactive protein (CRP), interleukins (IL) 1, 6 and 10, serum free fatty acid profile, food consumption data and data from the Depression Inventory Beck (BDI) and State and Trait Anxiety Inventory (STAI). Results: Article 1) The sample consisted of 138 adolescents, with a mean age 16,38 years (± 1,49), mean Body Mass Index of 35,78 kg/m2 (± 4.79), 38,4% male and 61,6% female. With depression symptoms as the (dependent) outcome variable, association analyses were performed to verify the degree of prediction of independent variables (e.g., body composition, glucose metabolism, lipid profile, fatty acid profile, leptin concentration, adiponectin, interleukin IL-6, IL-10, TNF-α, CRP, PAI-1). Depressive symptoms were seen in 54.6% of the sample. Furthermore, there was a positive correlation between depressive symptoms and serum saturated fatty acid (SFA) content, body fat, and inflammatory adipokines, such as leptin, IL-6, and the leptin protein/adiponectin ratio. On the other hand, the correlation was negative between depression and total polyunsaturated fatty acids (PUFA)- 3. Article 2) For this study, data from 125 obese adolescents were analyzed, relating trait anxiety to body composition, cytokines and serum fatty acids, visceral fat mass and subcutaneous fat mass, serum concentrations of glucose, insulin, triglycerides, total cholesterol and fraction (VLDL, HDL, LDL, HDL), alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transferase, leptin, adiponectin, PAI-1, CRP, and symptoms of Trait Anxiety. The association of trait anxiety with energy and macronutrient intake was also studied. Groups were created based on percentiles of total lipid intake. However, there was no association of consumed lipids or serum fatty acids with trait anxiety. Conclusion: The SFA were positively correlated with depressive symptoms, while the AGP showed an inverse correlation. However, no correlation was verified with trait-anxiety, nor with consumed lipids. These results indicate that new longitudinal studies are needed in order to confirm the causality between serum AG and depression and the non-causality with trait anxiety in individuals with obesity.
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Citação
SILVA, Sandra Maria Chemin Seabra da. Associação entre os lipídeos alimentares e os ácidos graxos séricos com sintomas depressivos e de ansiedade de adolescentes com obesidade: um estudo transversal exploratório. 2023. 139 f. Tese (Doutorado Interdisciplinar em Ciências da Saúde) - Universidade Federal de São Paulo, Instituto de Saúde e Sociedade, Santos, 2023.