Hormônios tireoidianos e sua relação com os sintomas de vício alimentar em mulheres obesas socialmente vulneráveis

Abstract

Excess consumption of palatable foods, in addition to hedonic pleasure, is a risk factor for the development of food addiction and chronic non-communicable diseases, such as obesity. This practice is also linked to changes in thyroid hormones, whose dysfunction impacts the regulation of metabolism, thermogenesis, energy expenditure and adipogenesis, which can result in changes in appetite and body weight. In this context, the present study aims to evaluate thyroid hormones and symptoms of food addiction in women with obesity who live in socially vulnerable situations. This is a cross-sectional study within the scope of the research “Nutritional, endocrine and oral health profile of women living in subnormal settlements in Maceió-AL” with the sample consisting of 61 women of reproductive age who have a Body Mass Index (BMI ) greater than 30kg/m², of which 47 were included. Household-based research in which adapted and validated questionnaires were used for demographic and socioeconomic characterization. The anthropometric assessment was carried out by measuring weight and height to calculate the Body Mass Index (BMI). To assess food addiction, the modified Yale Food Addiction Scale 2.0 (mYFAS 2.0) was used, a screening based on the DSM-5 criteria for substance use disorders. The laboratory evaluation was carried out by collecting a blood sample to determine the concentrations of T3, free T4, thyroglobulins, thyroid-stimulating hormone (TSH) and anti-thyroperoxidase antibodies, and subsequently sent for analysis in an accredited laboratory. The data were tabulated with double entry and validated with Excel software and for statistical analysis the statistical software Jamovi (Version 2.3, The jamovi project, Sydney, Australia) was used, in which descriptive statistics and analysis of the difference between the medians of the thyroid hormones evaluated with the symptoms of food addiction, adopting a significance level of 5%. It was found through the results that 76.6% were in economic classes D and E and 23.4% were diagnosed with food addiction, being more prevalent among those with grade 3 obesity (72.7%). When evaluating hormones, the median concentration was: T3, 3.4 pg/mL (0.56); T4-free, 0.76 ng/dL (0.12); TSH, 2.55 μUI/mL (2.13); anti thyroperoxidase, 1.0 IU/mL (1.35); and thyroglobulin, 20.9 ng/mL (18.6). In positive cases of food addiction, there was an association between hormone levels and the following symptoms: “withdrawal”, lower concentration of thyroglobulins (p=0.035); “tolerance”, higher T3 concentration (p=0.049); “persistent desire”, higher concentrations of TSH (p=0.011) and antithyroid peroxidase (p=0.019); “failure to reduce/withdraw”, higher TSH concentration (p=0.024), and lower antithyroid peroxidase concentration (p=0.025); “danger”, higher concentrations of T3 (p=0.043) and TSH (p=0.048), and lower concentrations of free-T4 (p=0.038). In cases positive for food addiction, the present study observed an association between changes in thyroid hormones and symptoms of addiction such as withdrawal, tolerance, persistent desire, failure to reduce/desist and danger, in addition to a higher prevalence of women with a high degree of obesity.