Fatores ambientais, comportamentais, nutricionais e bioquímicos associados à obesidade, resistência à insulina e Diabetes mellitus tipo 2

Abstract

The aim of this study was to analyze the associations between socioeconomic, cultural, behavioral and biochemical aspects on body mass index, insulin resistance and DM2 diagnosis. The survey was carried out with 32 women who filled out electronic questionnaires about socioeconomic conditions, eating habits and physical activity. Blood was collected for biochemical analysis of blood glucose, glycated hemoglobin, insulin (to calculate insulin resistance using the HOMA-IR model), lipid profile, 14.15 EET and 14.15 DHET, in addition to anthropometric data of weight, height, waist and hip circumference for calculation of body mass index (BMI) and waist-hip ratio (WHR). According to the normality of the sample distribution, one-way ANOVA tests were used, followed by Tukey, or Kruskal-Wallis complemented by Dunns, T-test or Mann-Whitney. Correlations were evaluated using the Spearman test. The sample consisted of 68.8% of overweight or obese women, 37.5% with a diagnosis of DM2, 50% with arterial hypertension and 50.1% with high waist circumference values related to a high risk for cardiovascular disease. . Women diagnosed with DM2 had higher values of BMI, WHR, fasting glucose, glycated hemoglobin, HOMA-IR, triacylglycerol, very low-density lipoprotein and 14.15EET. High-density lipoprotein values were lower in women with DM2. Regarding modifiable factors, we observed a high prevalence of women with poor eating habits (74% reported having unhealthy habits) and 62.5% reported physical activity. Women with lower socioeconomic conditions had a higher prevalence of abdominal obesity, poor glycemic control and lower HDL levels than women with better socioeconomic conditions. Although we did not find associations between eating habits and increased risk for the development of insulin resistance and DM2, the reported practice of physical activity was important for glycemic, lipid and body mass index control. The highest serum levels of 14.15 TSE in women with T2DM were paradoxical, as they should have been lower. We hypothesize that the use of metformin and liraglutide associated with physical activity by patients with DM2 may have increased the activity of the enzyme 5'-monophosphate-adenosine (AMPK). AMPK, in turn, reduced the activity of the sEH enzyme, consequently decreasing the conversion of 14.15 EET into 14.15 DHET. In conclusion, there was a high prevalence of overweight and obesity in the sample, especially in women with DM2. While eating habits were associated with body mass, physical activity was important in lipid control, evidencing the importance of a healthy lifestyle for the prevention and treatment of obesity and DM2. Environmental factors related to socioeconomic conditions, such as family income and education, were relevant for outcomes related to obesity, insulin resistance and DM2, demonstrating the importance of basic research to support public health policies for vulnerable populations