Banca de DEFESA: PAULO HENRIQUE BISPO LIMA

Postmenopausal diabetes and hypertension: interactions between severity and failure to control inflammation

Postmenopause, Hypertension, Diabetes mellitus, Inflammation

INTRODUCTION/OBJECTIVE: Aging in women is associated with changes resulting from the climacteric, which culminates in changes in body composition, metabolic and hormonal changes, which are more susceptible to the development of chronic non-communicable diseases (NCDs). Among the chronic diseases with the highest incidence in this population, diabetes mellitus (DM) and systemic arterial hypertension (SAH) stand out. These diseases, despite the different organs and systems involved, have a common risk factor: in general, clinically silent low-grade inflammation that contributes to the pathogenesis and progression of age-related diseases. Therefore, this work aimed to carry out an expanded study on the interactions of anthropometric, biochemical and inflammatory parameters associated with the risk of the severity of these diseases in elderly postmenopausal women. METHODS: The study involved the evaluation of 126 elderly women with a positive diagnosis of arterial hypertension and diabetes mellitus. The groups were divided into risks proposed by the European Society of Cardiology. Anthropometric data were collected with bioimpedance analysis, while inflammatory and biochemical data were obtained from blood collection. The sera obtained were evaluated by enzymatic assays. Statistical analyzes were performed using GraphPad Prism, and correlations were analyzed using R Studio software. RESULTS: Waist circumference and waist circumference/height ratio were higher in the very severe risk group when compared to the mild risk group. Lean body mass (p< 0.011) decreases with increasing risk of severity. Systolic (p< 0.0002) and diastolic (p< 0.0054) pressures increased in parallel with the increase in severity in relation to groups. Biochemical markers increased with the risk of severity: glucose, triglycerides, cholesterol, LDLc and VLDLc, except HDLc. Regarding the inflammatory data, it was possible to observe that the inflammatory cytokines IL-1β, IFN-γ, TNF-α increased together with the severity. However, the anti-inflammatory cytokine IL10 (p=0.0293) decreased in the very severe risk group. Cytokine ratios showed different patterns between groups. The group of elderly women at very severe 9 risk had lower values for the ratios IL-10/IL-1β (p< 0.05), IL-10/IL-17 (p< 0.05) and IL-10/TNF- ɑ (p< 0.01) when compared with elderly women at severe risk. The patterns of correlations for biochemical, inflammatory and body composition variables are different between groups. However, the very severe risk group observes lower correlation forces for some parameters and the emergence of other interactions. CONCLUSION: The results showed to be extensively altered in the very severe risk group, where the inflammatory profile loses its responsiveness as the severity increases. This is the first work that shows an expanded view of the complex interaction between the different parameters evaluated in elderly hypertensive and diabetic women.