Relação da homocisteinemia com a sensibilidade à insulina e com fatores de risco cardiovascular em um grupo indígena brasileiro

Abstract

RESUMOA hiper-homocisteinemia é um fator de risco cardiovascular independente. Há controvérsias sobre uma possível relação entre a homocisteína e a resistência/sensibilidade à insulina. Para testar a relação entre a homocisteinemia e a sensibilidade à insulina, noventa índios Parkatêjê (90% da população adulta, sem miscigenação) tiveram os níveis séricos de homocisteína total (HPLC) dosados. A sensibilidade à insulina (%S) foi calculada pelo HOMA. Uma índia diabética foi excluída das análises envolvendo glicemia, insulina, pró-insulina, HbA1c e %S. Hiper-homocisteinemia e hiperinsulinemia ao jejum foram encontradas em 26,7% e 25,8% dos índios, respectivamente. O logaritmo natural (ln) da homocisteína correlacionou-se positivamente com a pressão arterial sistólica (r= 0,22) e diastólica (r= 0,21), triglicérides (r= 0,39) e ácido úrico (r= 0,40), após ajuste para idade e sexo, mas não com a insulina, pró-insulina e ln %S. O ln da homocisteína foi semelhante em todos os quartis de %S e também entre os indivíduos com e sem hiperinsulinemia de jejum. A insulina, pró-insulina e ln %S foram semelhantes entre os indivíduos com e sem hiper-homocisteinemia. Observamos correlações entre variáveis relacionadas ao risco cardiovascular, mas não entre essas variáveis e a insulina ou o ln %S. Este achado talvez seja peculiar deste grupo. Concluindo, as variações nas concentrações séricas da homocisteína não estão relacionadas à insulina, à pró-insulina e à %S entre os Parkatêjê. Hyperhomocysteinemia is an independent cardiovascular risk factor. There are controversies about a possible relation between homocysteine and insulin resistance/sensitivity. To test the relation between homocysteinemia and insulin sensitivity, serum total homocysteine concentrations (HPLC) were measured in samples from ninety Parkatêjê Indians (90% of the adult population, without admixture). Insulin sensitivity (%S) was estimated by HOMA. A diabetic woman was excluded from the analysis involving glycaemia, insulin, proinsulin, HbA1c and %S. Hyperhomocysteinemia and fasting hyperinsulinemia were found in 26.7% and 25.8% of Indians, respectively. Log-transformed (ln) homocysteine was positively correlated with systolic (r= 0.22) and diastolic (r= 0.21) blood pressure, triglycerides (r= 0.39) and uric acid (r= 0.40), after adjustment for age and sex, but not with insulin, proinsulin and ln %S. Ln homocysteine was similar among the quartiles of %S and between the subjects with and without fasting hyperinsulinemia. Insulin, proinsulin and ln %S were similar between the subjects with and without hyperhomocisteinemia. Correlations between variables related to cardiovascular risk were observed, but not between these variables and insulin or ln %S. Perhaps this finding could be a peculiar characteristic of this group. In conclusion, the artigo originalRelação da Homocisteinemia com a Sensibilidade à Insulina e com Fatores de Risco Cardiovascular em Um Grupo Indígena Brasileiro

Hypertension prevalence among indigenous populations in Brazil: a systematic review with meta-analysis

“…It is important to mention that three articles (18,24,26) presented a different number of participants in the sample from those who had their blood pressure measured and presented in the results. Almost all the studies (21) were performed with both genders, except for one study (11) that investigated only men and another (31) that investigated only indigenous women.…”

“…It is noteworthy that one study (30) established the largest cutoff as higher than or equal to 130/85 mmHg, and one study (10) showed no diagnostic criteria. It is also noteworthy that in seven studies (11,23,(26)(27)(28)30,33) , the presence of previous diagnosis of hypertension and/or treatment with antihypertensive medication were considered in addition to blood pressure levels. (20) .…”

“…In the first study, the data collected from 114 indigenous people from the Aripuanã Indigenous land in the state of Rondônia did not detect hypertension (18) . But in the second, conducted in 2005 with 251 indigenous Suruí from eleven villages of the indigenous territory of Sete de Setembro located on the border between the states of Rondônia and Mato Grosso, the Indians showed hypertension prevalence of 2.8% (26) . Obesity was also evident among the Suruí indigenous in 22% of women and 9.7% of men, with a significant difference between the genders (p=0.007).…”

“…Mercury column 08 (11)(12)18,(21)(22)24,29,30) Aneroid 05 (13,(19)(20)26,33) Mercury column and/ or Aneroid 02 (10,25) Random-Zero 04 (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)23,27) Semi-automatic 04 (28,(31)(32)34) Procedures prior measuring blood pressure…”

“…Supine position 01 (10) Sitting with feet flat on the floor 21 (11)(12)(13)(16)(17)(18)(19)(20)(21)(22)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34) Not specified 01 (23) Number of measurements made Two 19 (11-13,16-27, 29,30-31,33) Three 03 (28,32,34) Not specified 01 (10) Interval between measurements Up to 05 minutes 06 (12,17,(20)(21)30,33) 05 to 10 minutes 06 (11,16,18,(28)(29)31) 10 to 15 minutes 07 (13,19,22,24,26,31,34) Not specified 04 (10,23,25,…”