Avaliação dos fatores preditores da Síndrome Metabólica e análise dos polimorfismos da APOE em pacientes com obesidade extrema submetidos à derivação gástrica em y-de-roux: Um estudo retrospectivo

Abstract

Introduction: The increase in obesity occurs at pandemic proportions, a fact aggravated by its association with comorbidities, including metabolic syndrome (MS). Bariatric surgery (BC) appears to be the most effective treatment, acting both on weight loss and on improving metabolism, resulting in remission of type 2 diabetes (DM2), systemic arterial hypertension (SAH) and dyslipidemia. It is known that this response is influenced by several agents, including lifestyle habits, psychosocial aspects and genetic/epigenetic factors, including the polymorphism in Apolipoprotein E (APOE). Objectives: To evaluate the components of metabolic syndrome in patients with extreme obesity undergoing bariatric surgery. Methodology: This is a prospective longitudinal study carried out with 109 patients who underwent BC and who maintained follow-up. Pre- and 24- and 60-month postoperative data were collected from medical records, including clinical data, energy and macronutrient intake, and physical exercise. Polymorphisms in the APOE gene were obtained using the TaqMan™ SNP Genotyping assays and PCR-RFLP methodology. Logistic regression models were used to verify variables associated with the diagnosis of metabolic syndrome. The significance level adopted was p<0.05. Results: The sample was composed primarily of female individuals (82.6%). After CB there was a reduction in the presence of MS (74% vs. 8.4% vs. 3.6%) and a significant association was found between SAH (OR=15.9) and DM2 (OR=10.6) in the pre- surgery and DM2 (OR=20.3) and TC/HDL (OR=6.7) after 24 months of surgery. No association was found between MS and APOE gene alleles and the other variables analyzed. Conclusion: Before surgery, HAS and DM2 were shown to be factors strongly associated with MS, and these factors underwent changes over time PO, highlighting diabetes and the TC/HDL ratio at 24 months. However, we found no association between the diagnosis of MS and the APOE gene polymorphism, physical activity, eating habits and anthropometric parameters.