Os efeitos do consumo de biomassa de banana verde no controle glicêmico, modulação de incretinas e adipocitocina em pacientes com pré diabetes ou diabetes
Arquivos
Data
2024-09-10
Autores
Costa, Edna Silva 
Orientadores
Izar, Maria Cristina de Oliveira
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Fundamento: A biomassa de banana verde, rica em amido resistente, é efetiva na diminuição dos fatores de risco associados ao Diabetes Mellitus (DM), como parâmetros antropométricos e controle glicêmico, porém não está claro seu papel na modulação das incretinas e adiponectina. Objetivo: Verificar os efeitos do consumo de biomassa de banana verde nos níveis de glucagon-like peptide-1 (GLP-1), glucagon-like peptide-2 (GLP-2) e adiponectina em participantes com pré-diabetes (Pré DM) ou DM. Objetivo secundário: avaliar seus efeitos nos parâmetros antropométricos, consumo alimentar e controle glicêmico. Métodos: Participantes portadores de Pré DM ou DM (n=113) foram randomizados em grupo intervenção que recebeu orientação nutricional e 40g/dia (4,5g de amido resistente) de biomassa de banana verde ou grupo controle com orientação nutricional apenas, durante seis meses, entre os anos de 2017 e 2019. Realizou-se uma pesquisa exploratória dos participantes do grupo intervenção (n=51) onde foram analisados os exames bioquímicos, avaliação antropométrica, características da dieta e dosagens plasmáticas de GLP-1, GLP-2 e adiponectina (ELISA). Para a análise estatística foi utilizado o software R, considerando o momento basal e após intervenção do grupo todo (n=51) e subgrupos Pré DM, DM, feminino e masculino, sendo considerados significantes valores de p<0,05. Resultados: Após consumo de biomassa da banana verde observamos que houve uma redução significativa por todos os participantes: glicemia (p=0,01), HbA1c (p<0,0001), glicemia média estimada (p<0,0001), circunferência de cintura (CC) (p<0,0001), circunferência de quadril (CQ) (p<0,0001), peso (p<0,0001), IMC (p=0,01) e aumento significativo da ingestão de fibras (p<0,0001). No subgrupo Pré DM houve redução da HbA1c (p<0,0001), glicemia média estimada (p<0,0001), PAS (p=0,04), CC (p=0,01), CQ (p<0,0001), peso (p<0,0001), IMC (p=0,03) e aumento na ingestão de fibras (p=0,03). No subgrupo DM houve redução da CC (p<0,0001), CQ (p=0,04) e aumento na ingestão de fibras (p<0,0001). No subgrupo feminino, redução da glicemia (p=0,01), HbA1c (p<0,0001), glicemia média estimada (p<0,0001), CC (p=0,01), CQ (p=0,03), peso (p=0,01), consumo de lipídeos (p=0,01) e aumento na ingestão de fibras (p=0,01). No subgrupo masculino: diminuição da CC (p=0,01), CQ (p=0,02), RCQ (p=0,04), Kcal/dia (p=0,01), peso (p= 0,02) e aumento na ingestão de fibras (p<0,0001). Em relação as incretinas houve aumento da secreção de GLP-1 (p= 0,04) no subgrupo masculino e de GLP-2 (p=0,02) no subgrupo DM. Não foram observadas diferenças nas concentrações plasmáticas de adiponectina. Conclusão: Sugere-se que o consumo de biomassa de banana verde, associado ao acompanhamento nutricional, por pacientes com Pré DM ou DM, seja uma boa estratégia nutricional, visto que contribuiu para um melhor controle glicêmico, melhora de parâmetros antropométricos, maior secreção de GLP-1 e GLP-2 e aumento da ingestão de fibras, além de ser acessível do ponto de vista econômico, sem relatos de efeitos adversos.
Background: Green banana biomass, rich in resistant starch, is effective in reducing risk factors associated with Diabetes Mellitus (DM), such as anthropometric parameters and glycemic control, but its role in modulating incretins and adiponectin is unclear. Objective: To verify the effects of green banana biomass consumption on glucagon-like peptide-1 (GLP-1), glucagon-like peptide-2 (GLP-2) and adiponectin levels in participants with prediabetes (Pre-DM) or DM. Secondary objective: to evaluate its effects on anthropometric parameters, food intake and glycemic control. Methods: Participants with Pre-DM or DM (n = 113) were randomized into an intervention group that received nutritional guidance and 40g/day (4.5g of resistant starch) of green banana biomass or a control group with nutritional guidance only, for six months, between 2017 and 2019. An exploratory study was carried out on the participants in the intervention group (n=51), where biochemical tests, anthropometric assessment, diet characteristics and plasma levels of GLP-1, GLP-2 and adiponectin (ELISA) were analyzed. For statistical analysis, the R software was used, considering the baseline and post-intervention moments of the entire group (n = 51) and Pre-DM, DM, female and male subgroups, with p-values <0.05 being considered significant. Results: After consumption of green banana biomass, we observed a significant reduction in all participants: blood glucose (p=0.01), HbA1c (p<0.0001), estimated mean blood glucose (p<0.0001), waist circumference (WC) (p<0.0001), hip circumference (HC) (p<0.0001), weight (p<0.0001), BMI (p=0.01) and a significant increase in fiber intake (p<0.0001). In the Pre-DM subgroup, there was a reduction in HbA1c (p<0.0001), estimated mean blood glucose (p<0.0001), SBP (p=0.04), WC (p=0.01), HC (p<0.0001), weight (p<0.0001), BMI (p=0.03) and an increase in fiber intake (p=0.03). In the DM subgroup, there was a reduction in WC (p<0.0001), HC (p=0.04) and an increase in fiber intake (p<0.0001). In the female subgroup, there was a reduction in blood glucose (p=0.01), HbA1c (p<0.0001), estimated mean blood glucose (p<0.0001), WC (p=0.01), HC (p=0.03), weight (p=0.01), lipid consumption (p=0.01) and an increase in fiber intake (p=0.01). In the male subgroup: a decrease in WC (p=0.01), HC (p=0.02), WHR (p=0.04), Kcal/day (p=0.01), weight (p=0.02) and an increase in fiber intake (p<0.0001). Regarding incretins, there was an increase in the secretion of GLP-1 (p=0.04) in the male subgroup and of GLP-2 (p=0.02) in the DM subgroup. No differences were observed in the plasma concentrations of adiponectin. Conclusion: It is suggested that the consumption of green banana biomass, associated with nutritional monitoring, by patients with PreDM or DM, is a good nutritional strategy, since it contributed to better glycemic and anthropometric control, through the stimulation of the secretion of GLP-1 and GLP-2, and by increasing the intake of dietary fiber, in addition to being affordable from an economic point of view, with no reports of adverse effects.
Background: Green banana biomass, rich in resistant starch, is effective in reducing risk factors associated with Diabetes Mellitus (DM), such as anthropometric parameters and glycemic control, but its role in modulating incretins and adiponectin is unclear. Objective: To verify the effects of green banana biomass consumption on glucagon-like peptide-1 (GLP-1), glucagon-like peptide-2 (GLP-2) and adiponectin levels in participants with prediabetes (Pre-DM) or DM. Secondary objective: to evaluate its effects on anthropometric parameters, food intake and glycemic control. Methods: Participants with Pre-DM or DM (n = 113) were randomized into an intervention group that received nutritional guidance and 40g/day (4.5g of resistant starch) of green banana biomass or a control group with nutritional guidance only, for six months, between 2017 and 2019. An exploratory study was carried out on the participants in the intervention group (n=51), where biochemical tests, anthropometric assessment, diet characteristics and plasma levels of GLP-1, GLP-2 and adiponectin (ELISA) were analyzed. For statistical analysis, the R software was used, considering the baseline and post-intervention moments of the entire group (n = 51) and Pre-DM, DM, female and male subgroups, with p-values <0.05 being considered significant. Results: After consumption of green banana biomass, we observed a significant reduction in all participants: blood glucose (p=0.01), HbA1c (p<0.0001), estimated mean blood glucose (p<0.0001), waist circumference (WC) (p<0.0001), hip circumference (HC) (p<0.0001), weight (p<0.0001), BMI (p=0.01) and a significant increase in fiber intake (p<0.0001). In the Pre-DM subgroup, there was a reduction in HbA1c (p<0.0001), estimated mean blood glucose (p<0.0001), SBP (p=0.04), WC (p=0.01), HC (p<0.0001), weight (p<0.0001), BMI (p=0.03) and an increase in fiber intake (p=0.03). In the DM subgroup, there was a reduction in WC (p<0.0001), HC (p=0.04) and an increase in fiber intake (p<0.0001). In the female subgroup, there was a reduction in blood glucose (p=0.01), HbA1c (p<0.0001), estimated mean blood glucose (p<0.0001), WC (p=0.01), HC (p=0.03), weight (p=0.01), lipid consumption (p=0.01) and an increase in fiber intake (p=0.01). In the male subgroup: a decrease in WC (p=0.01), HC (p=0.02), WHR (p=0.04), Kcal/day (p=0.01), weight (p=0.02) and an increase in fiber intake (p<0.0001). Regarding incretins, there was an increase in the secretion of GLP-1 (p=0.04) in the male subgroup and of GLP-2 (p=0.02) in the DM subgroup. No differences were observed in the plasma concentrations of adiponectin. Conclusion: It is suggested that the consumption of green banana biomass, associated with nutritional monitoring, by patients with PreDM or DM, is a good nutritional strategy, since it contributed to better glycemic and anthropometric control, through the stimulation of the secretion of GLP-1 and GLP-2, and by increasing the intake of dietary fiber, in addition to being affordable from an economic point of view, with no reports of adverse effects.
Descrição
Citação
COSTA, Edna Silva França, Os Efeitos do consumo de biomassa de banana verde no controle glicêmico, modulação de incretinas e adipocitocina em pacientes com pré diabetes ou diabetes. 2024. 143 f. Tese (Doutorado em Cardiologia) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP). São Paulo, 2024.