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Doctoral Thesis
DOI
https://doi.org/10.11606/T.6.2018.tde-09102017-103019
Document
Author
Full name
Antonio Augusto Ferreira Carioca
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2017
Supervisor
Committee
Marchioni, Dirce Maria Lobo (President)
Benseñor, Isabela Judith Martins
Crispim, Sandra Patricia
Latorre, Maria do Rosario Dias de Oliveira
Vivolo, Sandra Roberta Gouvea Ferreira
Title in Portuguese
Migração interna para São Paulo: relações com dieta e risco cardiovascular
Keywords in Portuguese
Consumo Alimentar
Metabolômica
Migração Interna
Padrão Alimentar
Síndrome Metabólica
Abstract in Portuguese
Introdução: Estudos observacionais têm contribuído para consolidar a ideia de que os imigrantes geralmente apresentam taxas de morbidade e mortalidade diferentes dos nativos. Estudos com imigrantes podem melhorar a compreensão da influência ambiental no risco de doenças crônicas. A maioria dos estudos têm sido centrado sobre os efeitos da migração internacional, uma vez que os fatores de risco tendem a ser mais uniformemente distribuídos dentro de um único país. No entanto, o Brasil se destaca por possuir extenso território, com regiões com marcadas diferenças geográficas, sociais e culturais. Em países com dimensões continentais (p.ex. Índia e China), a migração interna foi associada com modificações na dieta e status de saúde. Objetivos: Avaliar diferenças no padrão alimentar e risco cardiometabólico entre migrantes internos e nativos e avaliar a associação entre metabolômica plasmática e síndrome metabólica. Métodos: Trata-se de um estudo transversal de base populacional no município de São Paulo. Considerou-se migrantes internos, indivíduos que não nasceram na cidade de São Paulo e que apresentassem tempo de residência no município igual ou superior a dez anos. A população final (n=999) foi dividida em três grupos: nativos (n=354), migrantes do Sudeste (n=349) e do Nordeste (n=296). Para diagnóstico de síndrome metabólica foi utilizado critério harmonizado pelo International Diabetes Federation. Os padrões da dieta foram obtidos por análise fatorial por componentes principais. A quantificação absoluta (?mol/L) de metabólitos no sangue foi realizada por espectrometria de massa no plasma. As análises foram realizadas por meio de modelos lineares generalizados ajustados por fatores de confusão. Resultados: Em comparação aos nativos, os migrantes do Sudeste tiveram adesão inversamente proporcional ao padrão moderno e os migrantes do Nordeste tiveram associação inversa com o padrão prudente e moderno e positiva com o tradicional. Migrantes do Nordeste com mais de 60 anos tiveram maior chance de apresentar síndrome metabólica em comparação com nascidos em São Paulo da mesma faixa etária. Os perfis metabolômicos plasmáticos foram associados com a síndrome metabólica, destacando alguns aminoácidos e classes lipídicas. Conclusão: Nativos e migrantes internos do Brasil apresentam consumo, padrão alimentar e fatores de risco cardiovascular distintos e a metabolômica identificou modificações metabólicas em decorrência da síndrome metabólica.
Title in English
Internal migration to São Paulo: relationships with diet and cardiovascular risk
Keywords in English
Dietary Consumption
Dietary Pattern
Internal Migration
Metabolic Syndrome
Metabolomics
Abstract in English
Introduction: Observational studies have helped consolidate the notion that immigrants generally exhibit different morbidity and mortality rates to those of natives. Studies involving immigrants can broaden understanding of the environmental influence on risk of chronic diseases. The majority of studies have focused on the effects of international migration, considering that risk factors tend to be uniformly distributed within a country. However, Brazil differs for its large territory comprising regions with marked geographic, social and cultural disparities. In countries of continental size (e.g. India and China), internal migration has been associated with changes in diet and health status. Objectives: To assess differences in dietary patterns and cardiometabolic risk among internal migrants and natives, and also to assess the association between plasma metabolomics and metabolic syndrome. Methods: A cross-sectional, population-based study was conducted in the city of São Paulo. The study involved internal migrants, defined as individuals born outside São Paulo city who had lived in the city for ten years or longer. The final population (n=999) was divided into three groups: natives of São Paulo (n=354), migrants from the Southeast (n=349) and from the Northeast (n=296). The harmonized criteria of the International Diabetes Federation were employed for metabolic syndrome diagnosis. Dietary patterns were derived by factor and principal component analysis. Absolute quantification (?mol/L) of blood metabolites was performed by mass spectrometry in plasma. Analyses were carried out based on generalized linear models adjusted for confounding factors. Results: Compared to locals, migrants from the Southeast had an inversely proportional adherence to the modern pattern whereas migrants from the Northeast had an inverse association with the prudent and modern patterns and a positive association with the traditional pattern. Northeastern migrants older than 60 years had greater odds of having the metabolic syndrome compared to São Paulo-born individuals of the same age. The plasma metabolomic profiles were associated with the metabolic syndrome, particularly for some aminoacids and lipid classes. Conclusion: São Paulo natives and internal migrants in Brazil have different consumption, dietary patterns and cardiovascular risk. Metabolomics detected metabolic changes secondary to metabolic syndrome.
 
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Release Date
2021-09-18
Publishing Date
2018-01-18
 
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