ASSOCIAÇÃO ENTRE O POLIMORFISMO DO GENE APOLIPOPROTEINA ‘‘E’’, COM COMPOSIÇÃO CORPORAL, TOTAL GENOTYPE SCORE E POTÊNCIA DE MEMBROS INFERIORES EM INDIVÍDUOS COM ACIDENTE VASCULAR CEREBRAL E HIPERTENSO-DIABÉTICOS

Abstract

Systemic Arterial Hypertension (SAH) and Diabetes mellitus (DM) are considered Chronic Noncommunicable Diseases (NCDs), among the sequelae associated with NCDs, Stroke is highlighted. Loss of muscle mass (sarcopenia) begins in the third decade of life, becoming significant by the end of the fifth decade, coinciding with the worsening of the reduction in maximal force production capacity and sarcopenia is more severe in the lower limbs (MMII). Molecular markers for stroke include 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 on the modulation of body fat. ApoE has three alleles (ɛ2, ɛ3 and ɛ4) that give rise to six different genotypes, three homozygotes Ɛ2 / Ɛ2, Ɛ3 / Ɛ3, Ɛ4 / Ɛ4 and three heterozygotes, Ɛ2 / Ɛ3, Ɛ2 / Ɛ4 and Ɛ4 / Ɛ3. Recent studies have found a strong association between Apolipoprotein E (ApoE) gene Ɛ4 allele polymorphisms and stroke, and other morbidities. ApoE ɛ2 carriers showed lower strength index and ApoE ɛ4 carriers reduced strength levels. in relation to ApoE ɛ3 carriers. The ɛ2 allele carriers in most individuals are associated with lower levels of low-density lipoprotein (LDL) when compared to the ɛ4 allele carriers. Polymorphisms are currently associated with resistance genotypes. A total score was then mathematically transformed to fall within the range 0 to 100 and labeled as "Total Genotype Score" (TGS). Methods: Sample of 81 adult individuals, male and female, between 40 and 83 years old. These comprised 4 groups: Group 1. Carriers of allele / genotype ɛ2 (Ɛ2 / Ɛ2 and Ɛ2 / Ɛ3) composed of 20 individuals; Group 2. Carriers of the allele / genotype ɛ3 (Ɛ3 / Ɛ3) consisting of 41 people; Group 3. Carriers of allele / genotype ɛ4 (Ɛ4 / Ɛ3 and Ɛ4 / Ɛ4), consisting of 14 members; and 6 comprised Group 4. Carriers of the allele / genotype ɛ2 (Ɛ2 / Ɛ4). DNA was obtained from oral mucosal smear samples and genotypes were determined by PCR. Body composition was assessed by the OMRON bioimpedance scale, and the power of the lower limbs was measured by the Hidrofit contact mat, with the Squat jump (SJ) and Counter movement jump (CMJ) tests. To verify the normality of the data, Shapiro-Wilk was used. The chi-square test was used for genotypes and Hardy-Weinberg Balance (HWE). Chi-square test was used in the association between polymorphism and clinical characteristics and TGS. Levene's test for homogeneity of variances was applied as a presupposition, as well as the one-way ANOVA followed by Bonferroni's post hoc. The two-way ANOVA followed by the Bonferroni test was applied to investigate differences in physical tests and anthropometric characteristics between groups with and without stroke in each of the polymorphism clusters. Logistic regression was applied to identify the magnitude of the relationships between ApoE polymorphism and stroke. It was adopted p <0.05. The sample was shown in HWE. Group ɛ2 presented 65% female; 70% married and white ethnicity; individuals with stroke with 65%, hypertension in 80%, diabetes in 40% and healthy 15% of the sample. Height at CMJ 6.08 ± 3.8 and SJ 4.77 ± 3.4. Group ɛ3 presented 75.6% females; 73.2% married and 65.9% white ethnicity; stroke patients with 17.1%, hypertension in 46.3%, diabetes in 24.4% and healthy 51.2% of the sample. Height at CMJ 10.3 ± 5.4 and SJ 8.3 ± 5.2. The ɛ4 group presented 64.3% females; 78.6% married and 64.3% white ethnicity; individuals with stroke 28.6%, hypertension in 64.3%, diabetes in 28.6% and healthy 28.65% of the sample. Height at CMJ 11.7 ± 7.4 and SJ 9.8 ± 7.3. The Ɛ2 / Ɛ4 group had 66.7% males; 83.3% married and 50% white ethnicity; stroke patients with 83.3%, hypertension in 100%, diabetes in 16.7% and healthy 0% of the sample. Height at CMJ 5.71 ± 4.9 and SJ 4.36 ± 3.2. Alleles ɛ3 and ɛ4 showed significant difference in relation to group ɛ2 in CMJ and SJ tests. Allele means were: ɛ3 (69.8%); ɛ2 (16.6%) and ɛ4 (13.6%). The genotype Ɛ3 / Ɛ3 presented the majority with 50.6%. Body composition and muscle power did not show significant differences between the analyzed groups. Significant associations were found among stroke patients and having the ɛ2 allele. Higher muscle strength levels were also found in individuals without stroke when compared to those affected. The allele frequency that prevailed in the sample of this study was allele ɛ3. It is found that 65% of adores 2 allele carriers have stroke. Patients with allele ɛ3 and ɛ4 had significant differences in muscle strength compared to group grupo2. The TGS presented with 50, in 58% of the sample, and in patients with ɛ3. Significant associations were found between the presence of the ɛ2 allele and having a stroke. In the ApoE Ɛ2 group there was a significant difference only in the BMI variable. Thus, the data from this study show that carriers of alleles ɛ2, ɛ3, ɛ4 not affected by stroke obtained higher results in CMJ and SJ than those affected. Allele ɛ3 showed a higher elasticity index in relation to those affected by stroke.