Função de barreira do epitélio intestinal e fatores de risco cardiovascular em indivíduos com excesso de peso com ou sem síndrome metabólica

Abstract

Intestinal epithelial barrier dysfunction in the face of systemic inflammatory state observed in conditions of overweight/obesity or associated metabolic syndrome is well discussed in animal models. However, there is a lack of studies that evaluate this thematic in humans. This study aimed to verify if there was alteration of the intestinal epithelial barrier function (IEBF) due overweight/obesity, the metabolic syndrome and the risk factors for cardiovascular diseases. A case-control study was carried out from September 2019 to July 2022 with adults and elderly people in Natal-RN. Socio-demographic data, anthropometric assessment data, and urine and blood samples were collected. Anthropometric, biochemical and inflammatory assessment estimated cardiovascular risk factors. IEBF was performed by lactulose:mannitol test using urine samples analyzed by High Pressure Liquid Chromatography (HPLC-PAD). Correlations between IEBF, anthropometric and metabolic parameters were evaluated using Spearman’s correlations (ρ). In overall, 92 individuals participated in the study, where 34 were controls, 30 were overweight/obese without metabolic syndrome and 28 were overweight/obese with metabolic syndrome. It was observed that individuals with metabolic syndrome had increased some cardiovascular risk factors, but did not alter IEBF. The urinary excretion of lactulose/mannitol ratio was similar between the groups (p = 0.473). In the group of overweight/obese people without metabolic syndrome, there were significant positive correlations between mannitol excretion and diastolic pressure (ρ = 0,394, p = 0,031), waist circumference (ρ = 0,429, p = 0,018) and visceral adiposity index (ρ = 0,423, p = 0,02). In the overweight/obesity with metabolic syndrome group, there were significantly positive correlations between lactulose excretion and waist circumference (ρ = 0,397, p = 0,037), between mannitol excretion and Very Low Density Lipoprotein (VLDL) (ρ = 0,381, p = 0,045) and between lactulose/mannitol ratio and weight (ρ = 0,503, p = 0,006) and waist circumference (ρ = 0,447, p = 0,017). The data showed that was no change in IEBF associated with overweight/obesity or the metabolic syndrome compared to controls. However, cardiovascular risk variables were correlated with IEBF parameters in overweight/obesity with or without metabolic syndrome suggesting that the increased cardiovascular risk factors were associated with alteration of IEBF parameters.