Associação entre gordura corporal, inflamação e estresse oxidativo na hemodiálise

Abstract

The presence of malnutrition has been associated with inflammation and oxidative stress (OS) in patients on chronic hemodialysis (HD). To assess the association between nutritional status markers, such as body fat (BF), markers of inflammation and of OS in patients on HD. Cross-sectional study performed with 40 patients on HD. The nutritional status was evaluated by use of the modified subjective global assessment (SGAm), normalized total protein equivalent of nitrogen appearance (PNAn), serum albumin (Alb-s), body mass index (BMI), BF, and lean body mass (LBM). Inflammation and OS were assessed by use of high sensitivity protein C-reactive (HS-PCR), interleukin-6 (IL-6), advanced oxidation protein products (AOPP), 8-hydroxydeoxyguanosine (8OHdG), and pentosidine. Some degree of malnutrition was observed in 37% of the patients assessed through SGAm. Median and variation of BF (kg) were 16.2 and 5.3-36.7, respectively. Regarding the markers of inflammation and of OS, a positive and significant correlation was observed between BMI and HS-PCR (R = 0.37; p = 0.02), BF and HS-PCR (R = 0.32; p = 0.04), and between HS-PCR and IL-6 (R = 0.51; p = 0.0007). A negative correlation was found between Alb-s and HS-PCR (R = -0.31; p = 0.05). Only in males HS-PCR related to BMI (R = 0.54; p = 0.01) and to BF (R = 0.52; p = 0.01). No association was found between markers of inflammation and of OS. Markers of malnutrition and of overweight did not correlate with OS. The association of HS-PCR with BMI and BF only in the male sex may suggest differences in the inflammatory response between the sexes.