Influência do nível de atividade física e estado nutricional no perfil de metilação do gene MTHFR em pacientes diabéticos

Abstract

Epidemiological studies show a relationship between the level of physical activity and homocysteine, an independent and early predictor of cardiometabolic diseases. Homocysteine levels in turn affect the activity of MTHFR whose expression is regulated by methylation. Diabetes is a chronic disease in which physical activity is highly recommended without control and prevention of complications, since physical exercise regularly improves blood glucose control, can prevent or delay the onset of type 2 diabetes mellitus and allows for a better and more effective use of glucose, use of insulin resistance. There is evidence of a relationship between the hypermethylated profile of the MTHFR promoter and the occurrence of diabetic retinopathy in patients with type 2 diabetes. It is known that the gene methylation profile is a mechanism of expression control that can be modified by several factors including physical activity.physics. However, a relationship between physical activity and methylation profile in this gene has not yet been investigated. The objective was to evaluate the influence of the level of physical activity and nutritional status on the methylation profile of the MTHFR gene in patients with type 2 diabetes mellitus. The study consisted of 111 patients, with an average age of 58.2 ± 9.4 years, 43 men and 68 women diagnosed with diabetes mellitus 7.0 ± 2.3 years ago, answered a sociodemographic health questionnaire (smoking, alcoholism and diabetes in the family) and the International Physical Activity Questionnaire. Anthropometric data and venous blood were collected to assess the biochemical profile (glycemia, glycated hemoglobin, total cholesterol, HDL, LDL and triglyceride) and DNA extraction to determine the methylation status of the MTHFR gene, analyzed by the MSP method. Thus, a prevalence of 18.01% (n = 20) of insufficiently active diabetics was found, for 81.98% (n = 91) of active ones. The analysis of the methylation profile showed a distribution of 40.5% (n = 45) with a methylated profile and 59.5% (n = 66) were partially methylated for the MTHFR gene, with p = 0.012. The chi-square test revealed a significantly greater distribution of subjects partially methylated in the group of insufficiently active 85%; (n = 17) against 15% (n = 3) of methylates. Regarding the nutritional status and methylation of the gene, no significant associations were found. According to the logistic regression test, data on the glycemic, lipid and health characteristics of patients in relation to the gene were also not significant, only the level of physical activity showed significance. It is concluded that insufficiently active diabetics have a greater tendency to the partially methylated profile, with physical activity being an independent factor for determining the methylation profile of the MTHFR gene.