Avaliação dos níveis de ácido úrico salivar como marcador do excesso de peso e alterações metabólicas em adultos com obesidade mórbida
Data
2022-12-12
Autores
Silva, André Jesus 
Orientadores
Castelo, Paula Midori
Tipo
Trabalho de conclusão de curso
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Alterações metabólicas podem influenciar a síntese, composição e secreção de saliva, uma matriz biológica rica em marcadores de doenças. Para tanto, o desenvolvimento de novos métodos analíticos se faz necessário para torná-la viável e confiável. O objetivo do estudo foi aprimorar um método analítico para avaliar as concentrações de ácido úrico salivar e sua relação com marcadores metabólicos séricos em pacientes com obesidade mórbida submetidos à dieta ou gastroplastia e acompanhados por um período de 6 meses. Dois grupos foram seguidos: grupo Gastroplastia (GG; n=39) com participantes submetidos à gastroplastia (bypass) e grupo Controle (GC; n=34), cujos participantes receberam aconselhamento dietético por 6 meses. O exame clínico envolveu avaliação antropométrica e bucal (índice de cárie/CPOD e índice periodontal comunitário). Amostras de saliva estimulada e não estimulada foram coletadas para dosagem do fluxo salivar, capacidade tampão, proteína total e ácido úrico por cromatografia líquida de alta eficiência (HPLC). Dados quanto aos marcadores séricos metabólicos foram extraídos dos prontuários médicos. Utilizou-se estatística exploratória, teste de correlação de Spearman e ANOVA modelo misto. Foi observada redução significativa do IMC no grupo Gastroplastia (p<0,001) e aumento da atividade de cárie em ambos os grupos. Correlação significativa foi observada entre os níveis de ácido úrico salivar e ácido úrico sérico (rho=0,46), proteína total salivar (rho=0,32), LDL (rho=-0,39) e circunferência do pescoço (rho=0,30) e cintura (rho=0,24) (p<0,05). Não houve alteração significativa nos níveis de ácido úrico salivar após 6 meses de acompanhamento, enquanto os níveis séricos diminuíram em ambos os grupos (efeito tempo p<0,001). As variações nos níveis de ácido úrico e proteína total salivares foram muito semelhantes ao longo dos 6 meses no grupo gastroplastia. A metodologia empregada para a dosagem de ácido úrico salivar mostrou-se viável e com parâmetros laboratoriais adequados para a aplicação proposta, e os resultados enfatizam a importância de se considerar o status de saúde bucal como possível fator de influência na avaliação do ácido úrico como biomarcador salivar.
Metabolic changes can influence the synthesis, composition and secretion of saliva, a biological matrix rich in disease markers. Therefore, the development of new analytical methods is necessary to make it viable and reliable. The aim of the study was to improve an analytical method to assess salivary uric acid concentrations and their relationship with serum metabolic markers in patients with morbidly obesity undergoing diet or gastroplasty and followed for a period of 6 months. Two groups were followed: Gastroplasty group (GG; n=39) with participants undergoing gastroplasty (bypass) and Control group (GC; n=34), whose participants received dietary counseling for 6 months. Clinical examination involved anthropometric and oral evaluation (caries index/DMFT and community periodontal index). Samples of stimulated and non-stimulated saliva were collected for measurement of salivary flow, buffering capacity, total protein and uric acid by high performance liquid chromatography (HPLC). Data regarding serum metabolic markers were extracted from medical records. Exploratory statistics, Spearman correlation test and mixed model ANOVA were used. A significant reduction in BMI was observed in the Gastroplasty group (p<0.001), along with an increase in caries activity in both groups. Significant correlation was observed between salivary and serum uric acid levels (rho=0.46), salivary total protein (rho=0.32), LDL (rho=-0.39), and neck (rho= 0.30) and waist circumferences (rho=0.24) (p<0.05). There was no significant change in salivary uric acid levels after 6 months of follow-up, while serum levels decreased in both groups (time effect p<0.001). Variations in salivary uric acid and total protein levels were very similar over the 6 months in the gastroplasty group. The methodology used for measuring salivary uric acid proved to be viable and with adequate laboratory parameters for the proposed application, and the results emphasize the importance of considering oral health status as a possible influencing factor in the evaluation of uric acid as a salivary biomarker.
Metabolic changes can influence the synthesis, composition and secretion of saliva, a biological matrix rich in disease markers. Therefore, the development of new analytical methods is necessary to make it viable and reliable. The aim of the study was to improve an analytical method to assess salivary uric acid concentrations and their relationship with serum metabolic markers in patients with morbidly obesity undergoing diet or gastroplasty and followed for a period of 6 months. Two groups were followed: Gastroplasty group (GG; n=39) with participants undergoing gastroplasty (bypass) and Control group (GC; n=34), whose participants received dietary counseling for 6 months. Clinical examination involved anthropometric and oral evaluation (caries index/DMFT and community periodontal index). Samples of stimulated and non-stimulated saliva were collected for measurement of salivary flow, buffering capacity, total protein and uric acid by high performance liquid chromatography (HPLC). Data regarding serum metabolic markers were extracted from medical records. Exploratory statistics, Spearman correlation test and mixed model ANOVA were used. A significant reduction in BMI was observed in the Gastroplasty group (p<0.001), along with an increase in caries activity in both groups. Significant correlation was observed between salivary and serum uric acid levels (rho=0.46), salivary total protein (rho=0.32), LDL (rho=-0.39), and neck (rho= 0.30) and waist circumferences (rho=0.24) (p<0.05). There was no significant change in salivary uric acid levels after 6 months of follow-up, while serum levels decreased in both groups (time effect p<0.001). Variations in salivary uric acid and total protein levels were very similar over the 6 months in the gastroplasty group. The methodology used for measuring salivary uric acid proved to be viable and with adequate laboratory parameters for the proposed application, and the results emphasize the importance of considering oral health status as a possible influencing factor in the evaluation of uric acid as a salivary biomarker.