Efeitos de uma intervenção interdisciplinar sobre indicadores de resistência à insulina em adolescentes com excesso de peso
DOI:
https://doi.org/10.7322/jhgd.v30.10379Palavras-chave:
Obesidade, Resistência à Insulina, Ácido Úrico, Adolescente, Estudos de IntervençãoResumo
Introdução: Crianças e adolescentes com excesso de peso são mais suscetíveis a apresentarem disfunções metabólicas. No entanto, mudanças no estilo de vida podem prevenir ou retardar o surgimento de fatores de risco, destacando a importância de intervir precocemente nesta população.
Objetivo: Analisar os efeitos de seis meses de um programa de intervenção interdisciplinar sobre os indicadores de resistência à insulina e os níveis de ácido úrico em escolares com sobrepeso e obesidade.
Métodos: Estudo de intervenção, realizado com adolescentes com excesso de peso, composto por grupo controle (n=19) e grupo intervenção (n=20), que participou de programa de seis meses com intervenção nutricional, psicológica e de exercícios físicos, três vezes por semana. Foi avaliada a circunferência da cintura (CC), realizada coleta sanguínea para avaliação da glicose, insulina e ácido úrico e calculado o índice HOMA-IR, antes e após o programa.
Resultados: O grupo intervenção apresentou redução significante da circunferência da cintura (p=0,007), índice HOMA-IR (p=0,048) e ácido úrico (p=0,036), após os seis meses do programa; já o grupo controle não apresentou diferenças na pré e pós avaliação.
Conclusão: O programa de intervenção mostrou-se eficiente na redução da circunferência da cintura, HOMA-IR e níveis de ácido úrico em adolescentes com excesso de peso.
Referências
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27. Bordenave S, Brandou F, Manetta J, Fedou C, Mercier, J, Brun JF. Effects of acute exercise on insulin sensitivity, glucose effectiveness and disposition index in type 2 diabetic patients. Diabetes Metab. 2008;34(3):250-7. DOI: http://dx.doi.org/10.1016/j.diabet.2007.12.008
28. Li XH, Lin S, Guo H, Huang Y, Wu L, Zhang Z, et al. Effectiveness of a school-based physical activity intervention on obesity in school children: a nonrandomized controlled trial. BMC Public Health 2014;14:1282. DOI: http://dx.doi.org/10.1186/1471-2458-14-1282
2. Lindström J, Neumann A, Sheppard KE, Gilis-Januszewska A, Greaves CJ, Handke U, et al. Take action to prevent diabetes: the image toolkit for the prevention of type 2 Diabetes in Europe. Horm Metab Res. 2010;42(Suppl 1):S37-55. DOI: https://doi.org/10.1055/s-0029-1240975
3. Reyes M, Gahagan S, Díaz E, Blanco E, Leiva L, Lera L, et al. Relationship of adiposity and insulin resistance mediated by inflammation in a group of overweight and obese Chilean adolescents. Nutr J. 2011;10: 4. DOI: https://doi.org/10.1186/1475-2891-10-4
4. The Healthy Study Group. A school-based intervention for diabetes risk reduction. N Engl J Med. 2010;363:443-53. DOI: https://doi.org/10.1056/NEJMoa1001933
5. Qiu Q, Gong Y, Liu X, Dou L, Wang Y, Wang B, et al. Serum Uric Acid and Impaired Glucose Tolerance: The Cardiometabolic Risk in Chinese (CRC) Study. Cell Biochem Biophys. 2015;73(1):155-162. DOI: https://doi.org/10.1007/s12013-015-0597-5
6. Blüher S, Petroff D, Wagner A, Warich K, Gausche R, Klemm T, et al. The one year exercise and lifestyle intervention program KLAKS: Effects on anthropometric parameters, cardiometabolic risk factors and glycemic control in childhood obesity. Metabolism. 2014; 63(3):422-30. DOI: https://doi.org/10.1016/j.metabol.2013.11.016
7. Calcaterra V, Larizza D, Codrons E, Silvestri A, Brambilla P, Abela S, et al. Improved metabolic and cardiorespiratory fitness during a recreational training program in obese children. J Pediatr Endocrinol Metab 2013;26(3-4):271-6. DOI: https://doi.org/10.1515/jpem-2012-0157
8. Park TG, Hong HR, Lee J, Kang HS. Lifestyle plus exercise intervention improves metabolic syndrome markers without change in adiponectin in obese girls. Ann Nutr Metab. 2007; 51(3):197-203. DOI: https://doi.org/10.1159/000104137
9. Zorba E, Cengiz T, Karacabey K. Exercise training improves body composition, blood lipid profile and serum insulin levels in obese children. J Sports Med Phys Fitness 2011;51(4):664-9.
10. K?l?nç FN, Ça?da? DN. Diet and physical activity interventions do have effects on body composition and metabolic syndrome parameters in overweight and obese adolescents and their mothers. Turk J Pediatr. 2013;55(3):292-9.
11. Uysal Y, Wolters B, Knop C, Reinehr T. Components of the metabolic syndrome are negative predictors of weight loss in obese children with lifestyle intervention. Clin Nutr. 2014; 33(4):620-5. DOI: https://doi.org/10.1016/j.clnu.2013.09.007
12. Chang C, Liu W, Zhao X, Li S, Yu C. Effect of supervised exercise intervention on metabolic risk factors and physical fitness in Chinese obese children in early puberty. Obes Rev. 2008;9(Suppl 1):135-41. DOI: https://doi.org/10.1111/j.1467-789X.2007.00455.x
13. Huang SH, Weng KP, Hsieh KS, Ou SF, Lin CC, Chien KJ, et al. Effects of a classroom-based weight-control intervention on cardiovascular disease in elementary-school obese children. Acta Paediatr Taiwan 2007;48(4):201-6.
14. Lira FS, Rosa JC, Pimentel GD, Santos RV, Carnier J, Sanches PL, et al. Long-term interdisciplinary therapy reduces endotoxin level and insulin resistance in obese adolescentes. Nutr J. 2012;11:74. DOI: https://doi.org/10.1186/1475-2891-11-74
15. Savoye M, Shaw M, Dziura J, Tamborlane WV, Rose P, Guandalini C, et al. Effects of a weight management program on body composition and metabolic parameters in overweight children. JAMA. 2007;297(24):2697-2704. DOI: http://dx.doi.org/10.1016/j.clnu.2013.06.002
16. Hofsteenge GH, Chinapaw MJ, Delemarre-van Waal HA, Weijs PJ. Long-term effect of the Go4it group treatment for obese adolescents: a randomised controlled trial. Clin Nutr 2014; 33(3):385-91. DOI: http://dx.doi.org/10.1016/j.clnu.2013.06.002
17. Togashi K, Masuda H, Iguchi K. Effect of diet and exercise treatment for obese Japanese children on abdominal fat distribution. Res Sports Med 2010;18(1):62-70. DOI: http://dx.doi.org/10.1080/15438620903423924
18. Krzystek-Korpacka M, Patryn E, Kustrzeba-Wojcicka I, Chrzanowska J, Gamian A, Noczynska A. The effect of a one-year weight reduction program on serum uric acid in overweight/obese children and adolescents. Clin Chem Lab Med 2011;49(5):915-21. DOI: http://dx.doi.org/10.1515/CCLM.2011.130
19. World Health Organization (WHO). Growth reference data for 5-19 years. [internet] 2007. [cited 2020 May 12] Available from: http://www.who.int/growthref/en/.
20. Brambilla P, Pozzobon G, Pietrobelli A. Physical activity as the main therapeutic tool for metabolic syndrome in childhood. Int J Obes (Lond). 2011;35(1):16-28. DOI: http://dx.doi.org/10.1038/ijo.2010.255
21. Dietz P, Hoffmann S, Lachtermann E, Simon P. Influence of exclusive resistance training on body composition and cardiovascular risk factors in overweight or obese children: a systematic review. Obes Facts. 2012;5(4):546-60. DOI: http://dx.doi.org/10.1159/000341560
22. Mello MT, Piano A, Carnier J, Sanches Pde L, Corrêa FA, Tock L, et al. Long-term effects of aerobic plus resistance training on the metabolic syndrome and adiponectinemia in obese adolescents. J Clin Hypertens (Greenwich). 2011;13(5):343-50. DOI: http://dx.doi.org/10.1111/j.1751-7176.2010.00388.x
23. Blüher S, Molz E, Wiegand S, Otto KP, Sergeyev E, Tuschy S, et al. Body Mass Index, waist circumference, and waist-to-height ratio as predictors of cardiometabolic risk in childhood obesity depending on pubertal development. J Clin Endocrinol Metab. 2013;98(8): 3384–93. DOI: https://doi.org/10.1210/jc.2013-1389
24. Zimmet P, Alberti G, Kaufman F, Tajima N, Silink M, Arslanian S, et al. The metabolic syndrome in children and adolescents. Lancet. 2007;369(9579):2059-61. DOI: https://doi.org/10.1016/S0140-6736(07)60958-1
25. Maz?c?oglu MM, Hatipoglu N, Ozturk A, Cicek B, Ustunbas HB, Kurtoglu S. Waist circumference and mid-upper arm circumference in evaluation of obesity in children aged between 6 and 17 years. J Clin Res Pediatr Endocrinol. 2010;2(4):144-50. DOI: https://doi.org/10.4274/jcrpe.v2i4.144
26. Oude Luttikhuis H, Baur L, Jansen H, Shrewsbury VA, O'Malley C, Stolk RP, et al. Interventions for treating obesity in children. Cochrane Database Syst Rev. 2009;(1): CD001872. DOI: http://dx.doi.org/10.1002/14651858.CD001872.pub2
27. Bordenave S, Brandou F, Manetta J, Fedou C, Mercier, J, Brun JF. Effects of acute exercise on insulin sensitivity, glucose effectiveness and disposition index in type 2 diabetic patients. Diabetes Metab. 2008;34(3):250-7. DOI: http://dx.doi.org/10.1016/j.diabet.2007.12.008
28. Li XH, Lin S, Guo H, Huang Y, Wu L, Zhang Z, et al. Effectiveness of a school-based physical activity intervention on obesity in school children: a nonrandomized controlled trial. BMC Public Health 2014;14:1282. DOI: http://dx.doi.org/10.1186/1471-2458-14-1282
