Associação do polimorfismo da ApoE e síndrome metabólica em pacientes submetidos a cirurgia bariátrica

Abstract

In the general population, the 4 allele of apolipoprotein E (Apo E) is related to higher incidence of atherosclerosis and type 2 diabetes mellitus (T2DM), since the 2 allele is related to hypertriglyceridemia and little is known about the relationship of these alleles and severe obesity. This study evaluated the association between the alleles of Apo E and the presence of metabolic syndrome (MS) in morbidly obese patients either undergoing bariatric surgery or not. 147 patients were evaluated preoperatively and 93 preoperatively and postoperatively, who were followed up at the Hospital of the Federal University of Minas Gerais, during the period of August, 2006 to April, 2010. The data collected was: weight, height, blood pressure, blood glucose, lipid profile and triglycerides. MS was diagnosed according to the criteria of the AHA. For the determination of the Apo E genotype, DNA was obtained from cells of mouth swab and genotyping performed by PCR-RFLP. The sample consisted predominantly of women (83%) with a mean age of 41 years (18-77 years). The SM was present in 116/147 patients (78.9%) and 76/93 (81.7%) which showed either higher concentrations of glucose, triglycerides and lower HDL-C or used medication. In the postoperative period, there was a reduction of SM for 23/93 (24.7%). The allele distribution was 4 <2 <3. When subjects with and without MS were compared, it was found that the frequency of the 2 and 3 alleles did not differ between them, but the 4 allele was more frequent in individuals without MS compared to patients with MS (13.8% and 6.5%, respectively) . There was no association between clinical parameters that make up the SM (high blood pressure, blood glucose, low HDL-C cholesterol or triglycerides). A positive association between MS and triglyceride levels and glucose and negative for HDL-C cholesterol was observed. There was an association between the 4 allele and the absence of SM. However, this association was not observed in clinical disease, suggesting different mechanisms related to the onset of the factors of MS.