A ocorrência e a associação de preditores para diabetes, com marcadores da inflamação e do estresse oxidativo, em adultos jovens e saudáveis

Abstract

Pre-diabetes denotes a high-risk state for type 2 diabetes, and its prevalence is increasing. Therefore, the objective of this research is to evaluate, in a cross-sectional study, which predictors for diabetes may be occurring in young adult individuals, before the pre-diabetes phase, and whether such predictors are associated with low-grade inflammation and oxidative stress. The sample was calculated on 81 young, healthy adult individuals, ≥18 ≤ 45 years old, with a body mass index ≥ 18 ≤ 30 kg/m² and who were not using anti-inflammatory, antidiabetic or antihypertensive drugs. In the blood sample, after fasting for 12 hours, blood glucose, glycohemoglobin, C-reactive protein, blood count, insulin, thiobarbituric acid reactive substance (TBARS) and carbonyl protein (CP) were analyzed. Subsequently, participants underwent an oral test with an overload of 75 g of glucose, with doses at 30, 60 and 120 minutes. The group of participants was subdivided into 2 subgroups: 01 with ≥ 18 < 28 years old (subgroup 1, n = 42) and another with ≥ 28 < 45 years old (subgroup 2, n = 39). The subgroups were equal in terms of positive family history of type 2 diabetes. Subgroup 2 had more predictors (p = 0.000), the most common being 30-minute glucose ≥ 164 mg/dL (p = 0.019) and 60-minute glucose ≥ 125 mg/dL (p = 0.034), glycohemoglobin ≥ 5.5% (p = 0.016) and monophasic glycemic curve (p = 0.007). On the other hand, subgroup 1 had a higher incidence of the predictor blood glucose in 120 minutes ≥ 140 mg/dL (p = 0.014). Subsequently, it was assessed whether the presence of predictors was related to the increase in monocytes, C-reactive protein, TBARS and CP. For this analysis, of the 81 individuals, the 72 that contained all the dosages carried out in the research were studied. They were separated into 2 subgroups: subgroup 1 (without predictors, n = 38) and subgroup 2 (with predictors, n = 34). The differences between these subgroups 1 and 2 were, respectively: fasting glucose (mg/dL) [72 vs 78, (p = 0.011)], at 30 minutes [119 vs 146, (p= 0.000)], in 60 [94 vs 140, (p= 0.000)] and at 120 minutes [86 vs 102, (p= 0.001)], glycohemoglobin [5.1 vs 5.3%, (p = 0.001)] and monocyte count [445 vs 535, (p = 0.006)]. There was no association with the level of C-reactive protein or with TBARS and CP. Finally, we evaluated the proportions of positive family history of diabetes, overweight, increased waist circumference and homeostasis model assessment of insulin resistance (HOMA > 2.7) in these subgroups. There was a significantly higher proportion of these risk factors for type 2 diabetes in subgroup 2. Conclusion: It is possible to identify predictors for diabetes in young, healthy adult individuals, with glycemic levels more modest than pre-diabetes, with a significant increase after the age of 28, and there are more common risk factors for diabetes in the group with predictors, which also presents higher inflammatory cellularity in the blood count.