Capacidade funcional e mediadores inflamatórios em idosas comunitárias dos municípios de Belo Horizonte, Diamantina e Alfenas

Abstract

Regional disparities and inequalities in socio-demographic and clinical aspects generate a process of heterogeneity of aging with the elderly presenting different health conditions, functionality and quality of life. These differences may lead to changes in the immune system of the elderly with alteration in the production and expression of pro-inflammatory cytokines, which may also influence the health and functionality of these. Thus, it is relevant to carry out studies with specific populations with the objective of knowing their characteristics and, thus, enabling the creation of directed, economically feasible and of quality public health strategies. The present multicenter cross-sectional study approved by the Research Ethics Committee of the Federal University of Minas Gerais (UFMG) (CAAE 14129513.7.1001.5149) compared the plasma levels of inflammatory mediators (IL-6 and sTNFR1), functional capacity and socio-clinical-demographic characteristics among elderly women in the community of Belo Horizonte (BH), Diamantina and Alfenas. Older women with 65 or more were included in the study without distinction of race and / or social status. Exclusion criteria were: suspected cognitive alterations detected by the Mini Mental State Examination (MMSE), acute inflammatory disease, decompensated or exacerbated cardiovascular diseases, neoplasia in the previous five years, fracture or hospitalization in the last year, use of anti-inflammatory drugs or that act on the immune system, Inability to walk independently, neurological changes and sequelae. Thus, one hundred and fifty-four elderly women from the three cities were eligible to participate in the sample. A structured multidimensional questionnaire was used to record the sociodemographic and clinical characteristics of the participants. Plasma levels of interleukin-6 (IL-6) and the soluble receptor of tumor necrosis factor alpha (sTNFR-1) were determined by the Enzyme-Linked Immuno Sorbent Assay (ELISA) method. The functional capacity was evaluated through the Short Physical Performance Battery (SPPB) and usual walking speed (VM). Statistical analysis for comparison between groups defined to the place of residence was performed using ANOVA ONEWAY, with Bonferroni post hoc and Kruskal-Wallis test, with Mann-Whitney-U post hoc test. For all analyzes a significance level of 5% was adopted. Alfenas presented a higher number of diseases and income compared to BH and Diamantina (p <0.05). BH presented the highest education level (p <0.05). Alfenas presented the worst functional capacity (p <0.05). Plasma levels of sTNFR-1 between BH and Alfenas, and between BH and Diamantina were different, with lower concentration of this mediator in BH (p <0.05). There wasnt statistically significant difference in the comparison of IL-6 plasma levels (p> 0.05). Thus, the results of this study, when demonstrating the regional diversities of the cities surveyed, regarding income, associated diseases and schooling may be contributing to alter the levels of sTNFR1 and functional capacity of the elderly.