Investigação do estado nutricional, bioquímico e de citocinas pró e antinflamatórias de tabagistas após intervenção multiprofissional para cessação tabágica

Abstract

This thesis is presented in three articles that had the following objectives: characterize the profile of smokers seeking multi-professional treatment for smoking cessation (Article 1); To assess serum pro-and anti-inflammatory cytokine concentrations in smokers at baseline and after 4 months of smoking cessation treatment (Article 2); To evaluate the relationship of SM components with proinflammatory cytokines in smokers undergoing treatment (Article 3).Article 1: The aim of the present study was to characterize the profile of smokers in multi professional treatment for smoking cessation. Retrospective data collected from 149 smokers were evaluated during the evaluation for admission in the Interdisciplinary Center for Research and Intervention in Smoking at the University Hospital of the Federal University of Juiz de Fora (CIPIT-HU/UFJF). The sample was predominantly characterized by adult patients, the majority being female (63.1%), married (45.6%), white (48.4%), incomplete elementary school (38.3%) and were overweight/obese (71.2%). The smoking history showed that cigarette use began in adolescence (16.95±6.16 years) and presented high daily cigarette consumption (21.95±12.89 cigarettes/day), high degree of dependence and intense craving, mainly among women, 62.7% and 58.5%, respectively. The Knowledge of the nicotine user profile of smoking abstinence program allows a better reception of this population as well as the development of efficient and dynamic health strategies. Such strategies allow the increase of the participation and adherence of smokers, contributing to the permanent increase of abstinence rates. Article 2: It was evaluated the serum concentrations of pro and antiinflammatory cytokines in smokers at baseline and after 4 months of treatment for smoking cessation. Nutritional assessment was based on measurements of body weight, height, and waist circumference (WC), to calculate the Body Mass Index (BMI), Body Adiposity Index (BAI) and Waist-to-height ratio (WHtR). The serum levels of leptin, adiponectin and ghrelin was determined by Enzyme-Linked Immunosorbent Assay (ELISA). The leptin/adiponectin ratio (L/A) was calculated. At the end of treatment, the abstinent had higher levels of adiponectin when compared those who remained smoker (p = 0.024). There was an increase in leptin levels, L/A and reduction in adiponectin levels after the treatment in abstinent and smokers. The medium values of WHtR and BAI showed above of the proposed cutoff point, indicating abdominal obesity .This study has demonstrated that smoking cessation improves adiponectin levels when compared with smokers and the leptin and L/A levels increased throughout the treatment in both groups. The increased values of leptin and L / A in abstinents may indicate risk of metabolic events associated with smoking history that should be investigated.Article 3: Clinical aspects were evaluted (body mass, height, waist circumference, and blood pressure) and biochemical parameters (HDL-cholesterol, triglycerides, fasting glycemia, leptin, IL-1β, IL-6, IL-8 , IL10, IL-12 and TNF-α) from a subsample of smokers undergoing treatment at the Interdisciplinary Center for Research and Intervention in Smoking at the University Hospital of the Federal University of Juiz de Fora (CIPIT-HU / UFJF). Sixteen smokers participated in the study. A total of 43.8% of smokers started treatment with MS. All interleukins and TNF-α maintained the same serum levels throughout the treatment (beginning and after 4 months). Serum leptin levels were higher for those with MS at the start of treatment (Median: 19.06 ng / mL X 5.45 ng / mL, Z = -2.17, p = 0.03). The presence of SM was associated with TNF-α (R = 0.958, p = 0.001), IL-1β (R = 0.958, p = 0.012), IL- 0.958, p = 0.001). Elevated SBP levels were associated with TNFα (R = 0.923, p = 0.016) and IL-1β (R = 0.923, p = 0.031). Hypertriglyceridemia was associated with TNF-α (R = 0.912, p = 0.013), IL-1β (R = 0.912, p = 0.026), IL-10 (R = 0.912, p = 0.024) 0.912, p = 0.038). CD was associated with leptin (p = 0.003R = 0.911, R2 = 0.831). After 4 months of treatment, certain cytokines were associated with HDL and CC levels. IL-6, IL-8 and TNFα were associated with HDL (R = 0.922), with significance of p = 0.002, p = 0.029 and p = 0.045, respectively. On the other hand, CC was associated with leptin (p = 0.017, R = 0.796). Most of the changes in the anthropometric parameters that make up SM and its occurrence can be attributed to IL-1β, IL-6, IL-8, IL-12 and TNF-α and leptin. Leptin is a risk marker for MS in smokers at the start of treatment for smoking cessation.