RELAÇÕES ENTRE A PRIVAÇÃO DO SONO E A HOMEOSTASE DE GLICOSE: REVISÃO SISTEMÁTICA DA LITERATURA
Resumo
O objetivo deste estudo foi avaliar as relações entre a privação do sono e a homeostase de glicose. Trata-se de uma revisão sistemática da literatura, realizada na base de dados PubMed. A busca foi realizada pela combinação dos descritores “sleep deprivation” AND “metabolism”. Inicialmente, foram listados 2.859 artigos, 1) estudos com adultos de ambos os sexos; 2) casos clínicos; 3) estudos redigidos em inglês ou em português, publicados retrospectivamente até o ano de 2012. Foram excluídos da análise: 1) estudos publicados antes de período estipulado (n= 2.128); 2) estudos com modelo animal (n= 354); 3) estudos com indivíduos em diferentes fases do desenvolvimento (n= 28); 4) estudos de revisão e meta-análises (n= 91); 5) estudos escritos em outros idiomas que não os estipulados (n= 12) e 6) estudos cuja proposta de investigação não apresentara coerência com o objetivo da presente revisão (n= 231). Após a adoção de todos estes critérios de inclusão e exclusão, foram mantidos 13 artigos. Os estudos incluídos mostram que a privação do sono afeta a homeostase de glicose, tanto por aumentar a resistência à insulina, quanto por alterar processos neuroendócrinos. Também se observa que o consumo excessivo de carboidratos e de cafeína agrava tais disfunções. A privação prolongada do sono pode afetar até mesmo a expressão gênica, podendo ocasionar prejuízos na função mitocondrial. Por fim, se observa remissão progressiva da resistência à insulina a medida que indivíduos expostos à privação do sono possuem seu sono estabilizado. Com os dados aqui discutidos, enfatizamos o papel elementar do sono para a homeostase de glicose que reflete na qualidade de vida em um sentido mais ampliado. Destaca-se a importância de disseminar tais informações no contexto da saúde pública, tendo em vista os prejuízos no ajuste do sono ocasionados pela rotina exacerbada de trabalho, bem como o impacto que tais prejuízos representam para a saúde dos indivíduos.
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