Programa de intervenção interdisciplinar em saúde : efeitos sobre indicadores de risco em adolescentes com sobrepeso e obesidade que apresentam diferentes genótipos do polimorfismo rs9939609 do gene FTO.

Abstract

INTRODUCTION: the association between obesity and FTO (fat mass and obesity-associated) rs9939609 gene polymorphism is reported in literature showing that the presence of A allele increases the risk of obesity, being important to provide information about the genes related with obesity. AIM: evaluate possible effects of an interdisciplinary intervention program on anthropometric, biochemical, blood pressure and physical fitness indicators of adolescents with overweight or obesity with different genotypes of FTO rs9939609 gene polymorphism. ARTICLE I: has as goal verify whether adolescents with overweight/obesity, carriers of the risk genotypes for obesity (AA/AT), of FTO rs9939609 gene polymorphism, presented different response to an interdisciplinary intervention program, regarding anthropometric, biochemical and blood pressure variables when compared to TT genotype. 34 adolescents aged 10 to 15 years, both genders, participated of this quasi experimental study, being divided in experimental group (EG; n=17) and control group (CG; n=17). EG participated of the intervention with physical exercises and nutritional and psychological counseling during six months. Anthropometric (body mass index, waist circumference, waist-hip ratio and fat percentage), biochemical (glucose, insulin, total, LDL and HDL cholesterol and triglycerides) and blood pressure evaluations were performed pre and post intervention. Genotyping of FTO rs9939609 gene polymorphism was performed using allelic discrimination assays through polymerase chain reaction (PCR). EG subjects with AA/AT genotypes had decreased total cholesterol (p=0.004), LDL cholesterol (p=0.003) and glucose (p=0.014), and regardless the genotype had increased the HDL cholesterol (p=0.028 for TT and p=0.033 for AA/AT). There were no significant differences between the results pre and post intervention when compared subjects with AA/AT and TT genotypes. We conclude that the interdisciplinary intervention program decreased biochemical parameters; however, subjects had the same response to the intervention regardless of genotype. ARTICLE II: aims to verify whether the presence of the obesity risk allele (A), of the FTO RS9939609 gene polymorphism, interferes the physical fitness indicators of adolescents with overweight/obesity after an interdisciplinary intervention program focused on physical exercises. Quasi experimental study with 46 adolescents with overweight/obesity aged 10 to 15 years divided in two groups: experimental (EG) and control (CG). EG participated of the 6 months intervention with physical exercises and nutritional and psychological counseling. Body mass index, cardiorespiratory fitness, abdominal resistance, flexibility, agility, speed, strength of upper and lower limbs were evaluated. Genotyping of FTO rs9939609 gene polymorphism was performed using allelic discrimination assays through real time polymerase chain reaction (RT-PCR). Regardless of genotype, schoolchildren of EG presented increasing in strength of upper limbs (p=0.018 for TT and p=0.035 for AA/AT) as well as for the AA/AT genotype improvement in flexibility (p=0.015). After the intervention there were no differences for the physical fitness between AA/AT and TT genotypes. We conclude that after the interdisciplinary intervention the schoolchildren presented better physical fitness indicators, but there were no differences between the genotypes. CONCLUDING REMARKS: after 6 months of the interdisciplinary intervention program the adolescents with the AA/AT genotype decreased total and LDL cholesterol and glucose, as well as improve agility. Regardless the genotype adolescents increased HDL cholesterol, strength of upper limbs and abdominal resistance, showing that the program was effective for improving risk indicators. At the same time, when compared adolescents with overweight and different FTO rs9939609 gene polymorphism genotypes we didn’t observe significant differences in anthropometric, biochemical, blood pressure and physical fitness indicators showing that adolescents with genetic predisposition for obesity can also benefit of an interdisciplinary intervention program focused on physical exercises.