POLIMORFISMO DO APOE E A SUA RELAÇÃO COM O NÍVEL DE ATIVIDADE FÍSICA EM INDIVÍDUOS PORTADORES DE ACIDENTE VASCULAR CEREBRAL, HIPERTENSOS DIABÉTICOS E INDIVÍDUOS SAUDÁVEIS

Abstract

Cardiovascular diseases are the leading cause of mortality among chronic noncommunicable diseases and account for 30% of all global deaths, making up a large and growing burden in low- and middle-income countries. An effective strategy to study the attribution of genetic factors in multifactorial and polygenic diseases is represented by the approach of genetic polymorphisms. This involves first identifying a molecular variant within a relevant gene by analyzing its distribution in a target population and then evaluating the possible association between the different polymorphisms and the presence of the disease. Among these molecular markers are Apolipoprotein E (ApoE) which is a low density lipoprotein receptor and plays a crucial role in cholesterol metabolism. Studies indicate that ApoE gene polymorphisms act in the modulation of the effects of physical activity, physical exercise and even body fat. Therefore, this research aimed to verify the relationship of ApoE polymorphism with the level of physical activity of healthy individuals and patients with cardiovascular diseases. The sample consisted of 117 adult individuals, of both sexes, between 36 and 89 years of age. The subjects were organized into three groups: Group A (patients with Cerebral Vascular Accident - Stroke) composed of 43 individuals; Group B (diabetic hypertensive) consisting of 40 people; and 34 made up Group C (healthy). The International Physical Activity Questionnaire - IPAQ (short version) was applied to assess the level of physical activity performed by the individual in the previous week. A self-administered questionnaire was also applied, which included sociodemographic, cultural and health data of individuals. Afterwards, the oral mucosa was scraped and the DNA extracted for the genetic evaluation of ApoE polymorphisms. Regarding the analyzes, the sample calculation was initially performed, adopting a 95% confidence level. Data were normal after characterization of the groups using the Shapiro-Wilk test. The relative values were analyzed using the chi-square test (c 2). When observed a significant difference in some variable with the association between genotypes or ApoE alleles were expressed as odds ratio (OR) with 95% confidence intervals (CI) using the logistic regression model. The associations were tested using the chi-square test and Fisher's exact test. Poisson regression with Robust Estimator was applied to calculate the Prevalence Ratio between Physical Activity and Genotype. The decision tree was applied to detect the patterns of proportions of genotype associated to the combinations of the other variables. A p <0.05 was used as the level of significance. The mean age of participants was 59.4 years (± 12.39), in which 66.6% women, 71.7% married, 69.2% were white, 45.2 % had a monthly income of 1-2 minimum wages. Other cardiovascular diseases were reported by 28.2% of the individuals. The cancer variable was indicated by 7.6% of the sample; respiratory disease in 9.4%; 18.8% reported having depression and 43.5% reported being a smoker or having been smoker for more than 10 years. The averages of the allele frequencies found in the three groups were as follows: ꞓ 3 (69.2%); ꞓ 2 (15.8%) and ꞓ 4 (15.0%). The present study revealed that the allelic frequencies were similar to those found in other regions of the world, with the presence of the ꞓ 3 allele prevailing in the sample. Significant associations between the presence of the ꞓ 2 allele and being a carrier of stroke as well as diabetes and hypertension were observed. Genotype ꞓ 2ꞓ 3 showed a significant association in stroke patients, as we observed that ꞓ 3ꞓ 3 genotype was significantly less frequent in this group. The data obtained in this study suggest that patients with the ꞓ 3ꞓ 3 genotype, especially men, were associated with higher weekly physical activity times.