Exceso de grasa visceral asociado a severidad de COVID-19, cuantificado por bioimpedancia
Resumen
Hay dos tipos principales de tejido adiposo; el subcutáneo, que es menos activo metabólicamente, y el tejido adiposo visceral, que secreta constantemente citocinas inflamatorias y está relacionado a enfermedades metabólicas y cardiovasculares. Nuestro objetivo fue identificar la asociación entre el exceso de grasa visceral y la severidad de enfermedad en pacientes con COVID-19. Se realizó un estudioobservacional analítico que incluyó a pacientes con COVID-19 admitidos al Hospital Carrión de Huancayo, Perú. Se utilizó la balanza de bioimpedancia para cuantificar la composición corporal, la variable dependiente fue la severidad de enfermedad. Se utilizó el análisis de regresión logística para determinar la asociación de la grasa visceral y otros parámetros antropométricos con severidad de enfermedad. Se analizaron a 120 personas con COVID-19, la edad promedio fue 50 años, el sexo masculino fue 60%. De acuerdo a los valores de la composición corporal emitidos por el equipo de bioimpedancia: La grasa visceral > 15Kg (OR 7,31; p = 0,001); la grasa corporal total > 35% (OR 5,58; p = 0,009) y el exceso de peso > 20Kg (OR 6,96; p = 0,011) fueron los parámetros asociados a enfermedad severa por COVID-19. La relación positiva entre el perímetro abdominal y la cantidad de grasa visceral fue significativo (p = 0,01). En la composición corporal, el exceso de grasa visceral es el mayor parámetro asociado a enfermedad severa por COVID-19.
Palabras clave
Texto completo:
PDFReferencias
Cercato C, Fonseca FA. Cardiovascular risk and obesity. Diabetol Metab Syndr. 2019; 11:74. https://doi.org/10.1186/s13098-019-0468-0
Du, Y., Tu, L., Zhu, P., Mu, M., Wang, R., Yang, P., Wang, X., Hu, C., Ping, R., Hu, P., Li, T., Cao, F., Chang, C., Hu, Q., Jin, Y., & Xu, G. (2020). Clinical Features of 85 Fatal Cases of COVID-19 from Wuhan. A Retrospective Observational Study. American journal of respiratory and critical care medicine, 201(11), 1372–1379. https://doi.org/10.1164/rccm.202003-0543OC
Ellulu MS, Patimah I, Khaza’ai H, Rahmat A, Abed Y. Obesity and inflammation: the linking mechanism and the complications. Arch Med Sci. 2017; 13(4):851-863. https://doi.org/10.5114/aoms.2016.58928
Favre GA, Esnault VL, Van Obberghen E. Modulation of glucose metabolism by the renin-angiotensin-aldosterone system. Am J Physiol Endocrinol Metab. 2015; 308: E435–49. https://doi.org/10.1152/ajpendo.00391.2014
Favre, G., Legueult, K., Pradier, C., Raffaelli, C., Ichai, C., Iannelli, A., Redheuil, A., Lucidarme, O., & Esnault, V. (2021). Visceral fat is associated to the severity of COVID-19. Metabolism: clinical and experimental, 115, 154440. https://doi.org/10.1016/j.metabol.2020.154440
Fox CS, Massaro JM, Hoffmann U, et al. Abdominal visceral and subcutaneous adipose tissue compartments: association with metabolic risk factors in the Framingham Heart Study. Circulation. 2007; 116(1):39-48. https://doi.org/10.1161/CIRCULATIONAHA.106.675355
Gualtieri P, Falcone C, Romano L, Macheda S, Correale P, Arciello P, Polimeni N, De Lorenzo A. Body Composition Findings by Computed Tomography in SARS-CoV-2 Patients: Increased Risk of Muscle Wasting in Obesity. Int. J. Mol. Sci. 2020, 21, 4670. https://doi.org/10.3390/ijms21134670
Ibrahim MM. Subcutaneous and visceral adipose tissue: structural and functional differences. Obes Rev. 2010; 11(1):11-18. https://doi.org/10.1111/j.1467-789X.2009.00623.x
Kalligeros M, Shehadeh F, Mylona EK, et al. Association of Obesity with Disease Severity among Patients with COVID-19. Obesity (Silver Spring). 2020. https://doi.org/10.1002/oby.22859
Kass DA, Duggal P, Cingolani O. Obesity could shift severe COVID-19 disease to younger ages. The Lancet. 2020; 395(10236):1544–5. https://doi.org/10.1016/S0140-6736(20)31024-2
Lacobellis, G., Malavazos, A. E., & Ferreira, T. (2020). COVID-19 Rise in Younger Adults with Obesity: Visceral Adiposity Can Predict the Risk. Obesity (Silver Spring, Md.), 28(10), 1795. https://doi.org/10.1002/oby.22951
Livingston E, Bucher K. Coronavirus Disease 2019 (COVID-19) in Italy. JAMA. 2020; 323(14):1335. https://doi.org/10.1001/jama.2020.4344
Maier HE, Lopez R, Sanchez N, Ng S, Gresh L, Ojeda S, et al. Obesity increases the duration of influenza a virus shedding in adults. J Infect Dis. 2018; 218(9):1378–82. https://doi.org/10.1093/infdis/jiy370.
Muscogiuri, G., Pugliese, G., Barrea, L., Savastano, S., & Colao, A. (2020). Commentary: Obesity: The "Achilles heel" for COVID-19?. Metabolism: clinical and experimental, 108, 154251. https://doi.org/10.1016/j.metabol.2020.154251
Palaiodimos L, Kokkinidis DG, Li W, Karamanis D, Ognibene J, Arora S, et al. Severe obesity, increasing age and male sex are independently associated with worse in hospital outcomes, and higher in-hospital mortality, in a cohort of patients with COVID-19 in the Bronx, New York. Metabolism. 2020; 108:154262. https://doi.org/10.1016/j.metabol.2020.154262
Petersen, A., Bressem, K., Albrecht, J., Thieß, H. M., Vahldiek, J., Hamm, B., Makowski, M. R., Niehues, A., Niehues, S. M., & Adams, L. C. (2020). The role of visceral adiposity in the severity of COVID-19: Highlights from a unicenter cross-sectional pilot study in Germany. Metabolism: clinical and experimental, 110, 154317. https://doi.org/10.1016/j.metabol.2020.154317
Pettit NN, MacKenzie EL, Ridgway J, Pursell K, Ash D, Patel B, et al. Obesity is associated with increased risk for mortality among hospitalized patients with COVID-19 [published online ahead of print, 2020 Jun 26]. Obesity (Silver Spring) 2020. https://doi.org/10.1002/oby.22941.
Petrilli CM, Jones SA, Yang J, et al. Factors associated with hospital admission and critical illness among 5279 people with coronavirus disease 2019 in New York City: prospective cohort study. BMJ. 2020; 369:m1966. https://doi.org/10.1136/bmj.m1966
Reynolds HR, Adhikari S, Pulgarin C, Troxel AB, Iturrate E, Johnson SB, et al. Reninangiotensin-aldosterone system inhibitors and risk of COVID-19. N Engl J Med. 2020; 382:2441–8. https://doi.org/10.1056/NEJMoa2008975
Vardhana SA, Wolchok JD. The many faces of the anti-COVID immune response. J Exp Med. 2020; 217(6). https://doi.org/10.1084/jem.20200678
Watanabe M, Caruso D, Tuccinardi D, Risi R, Zerunian M, Polici M, Pucciarelli F, Tarallo M, Strigari L, Manfrini S, Mariani S, Basciani S, Lubrano C, Laghi A, Gnessi L. Visceral fat shows the strongest association with the need of intensive care in patients with COVID- 19. Metabolism Clinical and Experimental 111 (2020) 154319. https://doi.org/10.1016/j.metabol.2020.154319
World Health Organization. Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/patient-management. Updated 13 March 2020
Yang Y, Ding L, Zou X, Shen Y, Hu D, Hu X, et al. Visceral Adiposity and High Intramuscular Fat Deposition Independently Predict Critical Illness in Patients with Sars-COV-2 [published online ahead of print, 2020 Jul 17]. Obesity (Silver Spring). 2020. https://doi.org/10.1002/oby.22971
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 395:1054–62. Disponible en: https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(20)30566-3.pdf (Acceso septiembre 2022)
Enlaces refback
- No hay ningún enlace refback.
Copyright (c) 2022 Boletín de Malariología y Salud Ambiental