RELAÇÃO ENTRE ÍNDICES ANTROPOMÉTRICOS E RESISTÊNCIA À INSULINA EM PACIENTES COM OBESIDADE GRAUS 2 E 3
Keywords:
Obesidade, Resistência à insulina, Antropometria, Circunferência abdominalAbstract
Introdução: A resistência à insulina (RI) tem papel central na fisiopatologia da obesidade e doenças associadas, porém não há método universalmente aceito para avaliá-la na prática clínica. Como a RI é associada à composição corporal, é possível estimá-la por meio de índices antropométricos. Objetivo: Correlacionar medidas antropométricas e o índice de adiposidade visceral (IAV) com o modelo de avaliação da homeostase de resistência à insulina (HOMA-IR) em pacientes com obesidade graus 2 e 3. Métodos: Estudo transversal que avaliou pacientes adultos no pré-operatório, que foram submetidos a cirurgia bariátrica no período de 2013 a 2018, no Serviço de Endocrinologia e Metabologia do HU-UFSC, excluindo-se os que faziam uso de insulina. Foram analisadas as correlações do HOMA-IR com o índice de massa corporal (IMC), a circunferência abdominal (CA), a relação cintura estatura (RCE), o índice de conicidade (ICO) e o IAV. Resultados: Foram incluídos 131 pacientes, 81% do sexo feminino, 95% com obesidade grau 3 e 32% com diabetes mellitus tipo 2 (DM2). Os índices que tiveram correlação com o HOMA-IR foram CA e ICO (p < 0,01) e IAV (p = 0,04), sendo que a CA apresentou o maior coeficiente (r = 0,293). Não houve correlação com RCE e IMC. Os indicadores de obesidade central e o HOMA-IR foram maiores nos pacientes com DM2. Conclusões: Os índices CA, ICO e IAV apresentaram correlação significativa com o HOMA-IR. A CA foi superior e configura uma medida simples e sem custo, o que reforça seu uso rotineiro na prática clínica.
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