Cara ou coroa: poderia ser a atividade física mais importante do que a idade em homens com diabetes e hipertensão?

Abstract

INTRODUCTION / OBJECTIVE: Systemic arterial hypertension (SAH) and type 2 diabetes mellitus (T2DM) are two important chronic noncommunicable diseases (NCDs) responsible for a high worldwide mortality associated with a high cardiometabolic risk. Aging is marked by a broad spectrum of physiological changes that configure the elderly as a risk group for the development of NCDs. Drug therapy for SAH and DMT2 is often accompanied by physical activity, and this approach is associated with the reduction of cardiometabolic risk associated with these comorbidities. However, little is known about the existence of distinct therapeutic benefit profiles of physical activity among elderly and middle-aged hypertensive and diabetic men. Therefore, the objective of this study was to compare pathophysiological markers of SAH and DMT2 among middle-aged and elderly individuals, while physical activity practitioners or sedentary. METHODS: In this study, 94 men with SAH and DMT2 were included. The work involved the application of the International Physical Activity Questionnaire (IPAQ) and the Quality of Life and Health Assessment Questionnaire (QVS-80). A blood sample was collected from the participants and an anthropometric evaluation was performed. the practice of physical activity was defined by at least 150 minutes of physical activity per week for a period of at least three months. Individuals older than or equal to 60 years were classified as elderly. Blood samples were submitted to biochemical (HDL, LDL, VLDL, triglyceride and fasting glucose), hormonal (total testosterone and estradiol) and immunological analysis (IL-1β, IL-17, IFN-γ, TNF-α and IL-10). RESULTS: Physical activity practitioners presented higher lean mass and bone mass, as well as lower fat mass than sedentary individuals. The lean mass participated in an axis of multiple negative correlations with pathological markers of SAH and DMT2, correlating negatively with the ratio between waist circumference and height, fat mass, and body mass index. In physically active elderly, lean mass still correlated negatively with systemic inflammatory markers and positively with IL-10 and serum estradiol. Physical activity subjects also had lower serum concentrations of LDL, VLDL, triglycerides and fasting glucose. Physically active elderly exhibited lower serum concentrations of IL-1β and TNF-α than sedentary middle-aged men, as well as lower serum concentrations of IL-17, IL-1β, TNF-α and IFN-γ than its sedentary counterpart. In this study we detected differences between the serum concentrations of testosterone and estradiol between the groups. CONCLUSION: Together, our results suggest that, for men with SAH and DMT2, the practice of physical activity is more valuable than the aging phenom in the modulation of pathophysiological markers of these SAH and DMT2, mainly because it participates in the regulation of the systemic inflammation observed in these comorbidities. However, the practice of physical activity has shown to be beneficial for both middle-aged and elderly diabetic and hypertensive men, being associated with have a lower cardiovascular risk in the pathogenesis of these diseases.