Parâmetros hormonais, comportamentais e de composição corporal de crianças e adolescentes com dupla carga de desnutrição

Abstract

Previous studies have shown that undernutrition early in life is related with the development of non-communicable diseases in adulthood, such as obesity, diabetes mellitus 2 and hypertension. The coexistence between undernutrition and overweight, known as a double burden of malnutrition, has been reported mainly in poor countries. In undernutrition a decrease in the concentration of thyroid hormones has been demonstrated, while overweight there is an increase, consequently showing an inverse behavior of undernutrition compared to overweight. The aim of this study was to analyze the hormonal, behavioral and body composition parameters in children and adolescents with a double burden of malnutrition in comparison with eutrophic and with excess weight and adequate height students. To answer these questions, children and adolescents from 7 to 15 years old, of both genders, were recruited through an active search in public schools in the city of João Pessoa / PB and allocated into 3 groups according to their nutritional status: 1) control group, height/age (H/A) > 0.0 and <2.0 Z score and BMI/I > -1.0 and <0.5 Z score; 2) group overweight, height/age (H/A) > 0.0 and < 2.0 Z score and BMI/I > 1.0 Z score; 3) group double burden, height/age < –1.0 Z score and BMI/I > 1.0 Z score. Measured weight, height, waist and hip circumference, body composition, TSH, free T3, free T4, insulin, leptin, total cholesterol, yours fractions, triglycerides and glucose, in addition to applying the socioeconomic and food addiction questionnaire. Was found an increase in the concentration of total cholesterol in the double burden and overweight groups in relation to the control group, (143.10 ± 7.60mg/dL, 147.29 ± 7.44mg/dL and 116.48 ± 6.75mg/dL, p= 0.005 , respectively), as well as for insulin (57.95pmol/L (47.88-70.14), 74.41pmol/L (61.72-89.80) and 40.03pmol/L (34.04-47.83), p< 0.001), HOMA-IR (2.16 (1.75-2.68), 2.51 (2.04-3.11) and 1.45 (1.21-1.77) p= 0.001) and leptin (21.75ng/dL (15.06-31.87), 25.27ng/dL (17.65-36.77) and 3.78ng/dL (2.71-5.27), p<0.001). No differences were observed in thyroid function between groups. The metabolic load was significantly higher in the double burden group compared to overweight and control (194.31mg/dL (174.9-216.0), 179.37mg/dL (163.1-200.6) and 162.30mg/dL (148.4-179.0), p= 0.047). The percentage of body fat adjusted per kilogram of body weight was significantly higher in the double burden group compared to the overweight and control group (31.87 ± 1.07%, 30.61 ± 1.15% and 19.95 ± 0.99%, p<0.001, respectively). There were a significant number of diagnoses of food dependence in the double burden and weight excess groups than in the control group. In this view, the main findings of the present study were a higher lipid profile, insulin resistance, body fat, leptin and metabolic load, but normal thyroid function in the double burden group in relation to the control group. Together, these findings may be positively associated with the development of long-term chronic non-communicable diseases.