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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" article-type="research-article" dtd-version="1.0" specific-use="sps-1.6" xml:lang="en">
  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">ijcs</journal-id>
      <journal-title-group>
        <journal-title>International Journal of Cardiovascular Sciences</journal-title>
        <abbrev-journal-title abbrev-type="publisher">Int. J. Cardiovasc. Sci.</abbrev-journal-title>
      </journal-title-group>
      <issn pub-type="ppub">2359-4802</issn>
      <issn pub-type="epub">2359-5647</issn>
      <publisher>
        <publisher-name>Sociedade Brasileira de Cardiologia</publisher-name>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="publisher-id" specific-use="scielo-v3">dDSyHL54qDLzLjy68cY4gHG</article-id>
      <article-id pub-id-type="publisher-id" specific-use="scielo-v2">S2359-56472017000600476</article-id>
      <article-id pub-id-type="doi">10.5935/2359-4802.20170075</article-id>
      <article-id pub-id-type="publisher-id" specific-use="previous-pid">S2359-56472017005001103</article-id>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Original Articles</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Safflower Oil (Carthamus tinctorius L.) Intake Increases Total Cholesterol and LDL-cholesterol Levels in an Experimental Model of Metabolic Syndrome</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <name>
            <surname>Santana</surname>
            <given-names>Lidiani Figueiredo</given-names>
          </name>
          <xref ref-type="aff" rid="aff1">1</xref>
          <xref ref-type="corresp" rid="c1"/>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Dutra</surname>
            <given-names>Thaisa da Silva</given-names>
          </name>
          <xref ref-type="aff" rid="aff2">2</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Souza</surname>
            <given-names>Marcos Alexandre de</given-names>
          </name>
          <xref ref-type="aff" rid="aff2">2</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Freitas</surname>
            <given-names>Karine de C&#225;ssia</given-names>
          </name>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Oesterreich</surname>
            <given-names>Silvia Aparecida</given-names>
          </name>
          <xref ref-type="aff" rid="aff2">2</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Kassuya</surname>
            <given-names>C&#226;ndida Aparecida Leite</given-names>
          </name>
          <xref ref-type="aff" rid="aff2">2</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Soares</surname>
            <given-names>Fab&#237;ola Lacerda Pires</given-names>
          </name>
          <xref ref-type="aff" rid="aff3">3</xref>
        </contrib>
      </contrib-group>
      <aff id="aff1">
        <label>1</label>
        <institution content-type="orgname">Universidade Federal do Mato Grosso do Sul</institution>
        <addr-line>
          <named-content content-type="city">Campo Grande</named-content>
          <named-content content-type="state">MS</named-content>
        </addr-line>
        <country country="BR">Brazil</country>
        <institution content-type="original">Universidade Federal do Mato Grosso do Sul (UFMS), Campo Grande, MS</institution>
        <institution content-type="normalized">Universidade Federal de Mato Grosso do Sul</institution>
      </aff>
      <aff id="aff2">
        <label>2</label>
        <institution content-type="orgname">Universidade Federal da Grande Dourados</institution>
        <institution content-type="orgdiv1">Faculdade de Ci&#234;ncias da Sa&#250;de</institution>
        <addr-line>
          <named-content content-type="city">Dourados</named-content>
          <named-content content-type="state">MS</named-content>
        </addr-line>
        <country country="BR">Brazil</country>
        <institution content-type="original">Faculdade de Ci&#234;ncias da Sa&#250;de, Universidade Federal da Grande Dourados (UFGD), Dourados, MS</institution>
        <institution content-type="normalized">Universidade Federal da Grande Dourados</institution>
      </aff>
      <aff id="aff3">
        <label>3</label>
        <institution content-type="orgname">Universidade Federal do Esp&#237;rito Santo</institution>
        <institution content-type="orgdiv1">Centro de Ci&#234;ncias da Sa&#250;de</institution>
        <addr-line>
          <named-content content-type="city">Esp&#237;rito Santo</named-content>
          <named-content content-type="state">ES</named-content>
        </addr-line>
        <country country="BR">Brazil</country>
        <institution content-type="original">Centro de Ci&#234;ncias da Sa&#250;de, Universidade Federal do Esp&#237;rito Santo (UFES), Esp&#237;rito Santo, ES - Brazil</institution>
        <institution content-type="normalized">Universidade Federal do Esp&#237;rito Santo</institution>
      </aff>
      <author-notes>
        <corresp id="c1"><bold>Mailing Address: Lidiani Figueiredo Santana</bold>, Av. Costa e Silva, s/n - Cidade Universit&#225;ria, Postal Code: 79070-900. Campo Grande, MS - Brazil E-mail: <email>lidi_lfs@hotmail.com</email>; <email>lidi_lfs@hotmail.com</email>
				</corresp>
        <fn fn-type="con">
          <p>
            <bold>Author contributions</bold>
          </p>
          <p>Conception and design of the research: Santana LF, Dutra TS, Freitas CF, Soares FLP. Acquisition of data: Santana LF, Dutra TS, Souza MA, Freitas CF, Oesterriech AS, Kassuya CPL, Soares FLP. Analysis and interpretation of the data: Santana LF, Souza MA, Freitas CF, Oesterriech AS, Kassuya CPL, Soares FLP. Statistical analysis: Santana LF, Souza MA, Freitas CF, Oesterriech AS, Kassuya CPL, Soares FLP. Writing of the manuscript: Santana LF, Freitas CF, Kassuya CPL, Soares FLP. Critical revision of the manuscript for intellectual content: Santana LF, Freitas CF, Kassuya CPL, Soares FLP.</p>
        </fn>
        <fn fn-type="conflict">
          <p>
            <bold>Potential Conflict of Interest</bold>
          </p>
          <p>No potential conflict of interest relevant to this article was reported.</p>
        </fn>
      </author-notes>
      <pub-date pub-type="epub">
        <day>21</day>
        <month>09</month>
        <year>2017</year>
      </pub-date>
      <pub-date pub-type="collection">
        <season>Nov-Dec</season>
        <year>2017</year>
      </pub-date>
      <volume>30</volume>
      <issue>6</issue>
      <fpage>476</fpage>
      <lpage>483</lpage>
      <history>
        <date date-type="received">
          <day>11</day>
          <month>10</month>
          <year>2016</year>
        </date>
        <date date-type="rev-recd">
          <day>01</day>
          <month>11</month>
          <year>2016</year>
        </date>
        <date date-type="accepted">
          <day>24</day>
          <month>03</month>
          <year>2017</year>
        </date>
      </history>
      <permissions>
        <license license-type="open-access" xlink:href="https://creativecommons.org/licenses/by/4.0/" xml:lang="en">
          <license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
        </license>
      </permissions>
      <abstract>
        <title>Abstract</title>
        <sec>
          <title>Background:</title>
          <p>Overweight has been considered an important public health problem. To reverse this situation, various types of treatment are proposed. The safflower oil (Carthamus tinctorius L.) has been used in the prevention/treatment of obesity.</p>
        </sec>
        <sec>
          <title>Objectives:</title>
          <p>The aim of this study was to evaluate the therapeutic effects of this oil in an experimental model of metabolic syndrome.</p>
        </sec>
        <sec>
          <title>Methods:</title>
          <p>Male Wistar rats initially received a highly palatable (HP) diet for ten weeks for validation of a metabolic syndrome model. Following confirmation, the animals were treated with a HP diet and soybean oil (HPSO) or safflower oil (HPSA) supplementation (1.0 mL/1000 g of animal weight). At the end of the experiment, the body composition, lipid profile and blood glucose levels of the animals were assessed. Student t test was used for statistical analysis.</p>
        </sec>
        <sec>
          <title>Results:</title>
          <p>In the first stage (induction of metabolic syndrome), the animals given the HP diet showed gain weight (p &lt; 0.001), visceral adiposity (p = 0.001), and significantly higher levels of blood glucose (p = 0.001) and triglycerides (p = 0.03) than those of the control group. Also, there was a difference in liver weight (p = 0.01). These results demonstrate that the HP diet administration is an effective model for the experimental metabolic syndrome study. In the second stage, the animals of the HPSA group showed increased total cholesterol (p &lt; 0.05) and LDL-cholesterol (p &lt; 0.001) levels.</p>
        </sec>
        <sec>
          <title>Conclusion:</title>
          <p>Under the referred experimental conditions, the use of safflower oil can cause possible deleterious effects on the lipid profile in a metabolic syndrome experimental model.</p>
        </sec>
      </abstract>
      <kwd-group xml:lang="en">
        <title>Keywords</title>
        <kwd>Oils</kwd>
        <kwd>Carthamus</kwd>
        <kwd>Cholesterol</kwd>
        <kwd>Metabolic Syndrome</kwd>
        <kwd>Dyslipidemias</kwd>
        <kwd>Obesity / prevention &amp; control</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec sec-type="intro">
      <title>Introduction</title>
      <p>Obesity is a chronic, multifactorial disease defined as abnormal or excessive fat accumulation, representing a serious health risk. The prevalence of overweight and obesity is increasing, and 12% of the world population is considered obese.<xref ref-type="bibr" rid="B1">1</xref> According to Brazilian studies, 52.5% of the adult population is over ideal healthy weight and 17.9% are considered obese. The accumulation of adipose tissue, particularly visceral fat, can contribute to changes in the body, triggering the metabolic syndrome. This syndrome can be defined as a complex disorder characterized by a set of cardiovascular risk factors related to central fat deposition and insulin resistance.<xref ref-type="bibr" rid="B2">2</xref>
			</p>
      <p>In general, the pathophysiological basis for cardiovascular events is atherosclerosis, which is characterized by a chronic inflammatory process of the vascular wall and elevation of circulating serum inflammatory markers, such as C-reactive protein (CRP). Regarding dyslipidemia, the primary goal in cardiovascular prevention is to achieve lower LDL-cholesterol (LDL-c) levels, and then reduce triglyceride levels and raise HDL-cholesterol (HDL-c) levels, and this latter goal is considered potentially beneficial for inhibiting the atherothrombotic process.<xref ref-type="bibr" rid="B3">3</xref>
			</p>
      <p>To reduce these levels, dietary treatments that require changes in eating habits are proposed.<xref ref-type="bibr" rid="B4">4</xref> In this context, the use of safflower oil (<italic>Carthamus tinctorius</italic> L.) is proposed to prevent or treat obesity. Safflower oil is extracted from saffron, a plant belonging to the <italic>Asteraceae</italic> family,<xref ref-type="bibr" rid="B5">5</xref><sup>,</sup><xref ref-type="bibr" rid="B6">6</xref> contains high content of polyunsaturated (75% linoleic acid) and monounsaturated fatty acids.<xref ref-type="bibr" rid="B7">7</xref> This composition stimulated further studies that demonstrated that dietary supplementation with safflower oil had a positive effect on lipid profile, with an antiatherogenic role.</p>
      <p>Thus, given the lack of studies on the use of safflower oil on metabolic syndrome, and the existence of conflicting results in the literature, the present study aimed to assess the therapeutic effects of safflower oil on body composition, lipid profile and blood glucose in an experimental model of metabolic syndrome.</p>
    </sec>
    <sec sec-type="methods">
      <title>Methods</title>
      <sec>
        <title>Animals and diet</title>
        <p>The animals were provided by the central vivarium of the Health Sciences School of the Federal University of Grande Dourados (UFGD), city of Dourados, Mato Grosso do Sul state, Brazil. The procedures used in this study were approve by the Ethics Committee on Animal Use at UFGD (N&#186; 016/2013), according to the standards established by the Brazilian Committee for the protection of animals used for scientific purposes.<xref ref-type="bibr" rid="B8">8</xref>
				</p>
        <p>A highly palatable (HP) diet was prepared based on the study by Naderali et al.,<xref ref-type="bibr" rid="B9">9</xref> using 33% of ground Labina Purina&#174; food preparation, 33% of condensed milk, 27% of water and 7% of sucrose (2.78 calories/g). The diet was kept under refrigeration until the moment of use, and the normal diet given to the control group was commercial food preparation of the Labina Purina<sup>&#174;</sup> brand.</p>
        <p>The experiment was divided into two stages. In the first stage, an animal model of metabolic syndrome was developed, and, in the second stage, intervention with safflower oil was performed in a disease model similar to the one observed in humans. Male Wistar rats aged 90 days (adult) were used in both experiments.</p>
        <p>In the first stage, the animals were divided into two groups (n = 8): one group was fed a normal diet and water <italic>ad libitum</italic>, and the other group was fed a HP diet and water <italic>ad libitum</italic>, for ten weeks. In the second stage, the animals were also divided into two groups (n = 5-6), and both groups were fed a HP diet and water <italic>ad libitum</italic>, for ten weeks. The HP diet and soybean oil (HPSO) and HP diet and safflower oil (HPSA) were given by oral gavage to the animals. The daily administered dose was 1.0 mL/1000 g of animal weight.<xref ref-type="bibr" rid="B10">10</xref><sup>,</sup><xref ref-type="bibr" rid="B11">11</xref>
				</p>
        <p>The safflower oil (Galena<sup>&#174;</sup>) and soybean oil (Liza<sup>&#174;</sup>) used in this study were purchased at a local store in the city of Dourados.</p>
        <p>The same parameters were assessed in both stages. Therefore, food consumption and animal weight were daily measured. After ten weeks of treatment, the animals were fasted for 12 hours, anesthetized with xylazine and ketamine (10 mg/kg: 75 mg/kg) and euthanized by exsanguination via the inferior vena cava. The blood samples were centrifuged at 3000rpm for 15 minutes, and the serum was kept in freezer at -20&#176;C until analysis. Adipose tissue samples from five sites was removed and weighed. The livers were subjected to histological analysis for the presence of hepatic steatosis.</p>
      </sec>
      <sec>
        <title>Fasting blood glucose</title>
        <p>For blood glucose assessment, the animals were fasted for 16 hours, and glucose was measured in blood collected from the tail artery, by using a glucometer (<italic>Testline Striptsl25</italic>), according to Formagio et al.<xref ref-type="bibr" rid="B11">11</xref>
				</p>
      </sec>
      <sec>
        <title>Concentration of total cholesterol, HDL-c, LDL-c and triglycerides</title>
        <p>The determination of total cholesterol, HDL-c and triglycerides in serum was based on the colorimetric enzymatic method, using commercial kit (<italic>Labtest<sup>&#174;</sup>)</italic>, according to the manufacturer's instructions. The results were obtained with a spectrophotometer (<italic>Aaker/Bel</italic> - SF325NM - S05<sup>&#174;</sup>). The concentration of LDL-c was obtained with a formula, according to the instructions of the manufacturer of the kit for quantification of HDL-c, using the Friedewald equation, where: <italic>VLDL-c = Triglycerides / 5</italic> and <italic>LDL-c = Total Cholesterol - (HDL-c + VLDL-c)</italic>.</p>
      </sec>
      <sec>
        <title>Liver weight</title>
        <p>The extracted liver was immediately immersed in saline solution to remove excess blood and then dried on paper and weighed.</p>
      </sec>
      <sec>
        <title>Weight of adipose tissue</title>
        <p>Adipose tissue samples from five sites (epididymal, retroperitoneal, perirenal, mesenteric and omental) were removed and weighed, and subsequently the animal fat (percentage of adipose tissue in each site to final body weight) was determined.</p>
      </sec>
      <sec>
        <title>Liver histology</title>
        <p>After euthanasia, the liver was removed for histological analysis and fixed in 10% formaldehyde solution until it was embedded in paraffin. Then, microtome sections, 7 &#181;m thick, were made and then mounted on glass slides. Each slide had a total of four sections removed from the paraffin block. The slides were then stained with hematoxylin and eosin, and analyzed under the microscope coupled to a digital camera with 200x magnification, for the classification of the presence of steatosis, according to Abbas et al<italic>.</italic><xref ref-type="bibr" rid="B12">12</xref> and Alves and Mello.<xref ref-type="bibr" rid="B13">13</xref>
				</p>
      </sec>
      <sec>
        <title>Statistical analysis</title>
        <p>The results were expressed in mean &#177; standard error of mean (SEM), and analyzed with Prisma 5.0 software (GraphPad Software, USA). Student <italic>t</italic> test was used to assess whether the means of the groups were statistically significant, and p &lt; 0.05 values were considered statistically significant.</p>
      </sec>
    </sec>
    <sec sec-type="results">
      <title>Results</title>
      <p>The results of the first stage of the study where we attempted to develop an animal model of metabolic syndrome can be seen in <xref ref-type="table" rid="t1">Table I</xref>. There was no statistically significant difference between the groups regarding water intake (unreported data).</p>
      <table-wrap id="t1">
        <label>Table 1</label>
        <caption>
          <title>Total diatary intake, body composition, liver weight and biochemical parameters in rats fed with a normal diet and a highly palatable diet</title>
        </caption>
        <table frame="hsides" rules="groups">
          <colgroup>
            <col width="33%"/>
            <col width="33%"/>
            <col width="33%"/>
          </colgroup>
          <thead>
            <tr>
              <th align="left" style="background-color:#B2B2B2">
							</th>
              <th align="center" style="background-color:#B2B2B2">Control</th>
              <th align="center" style="background-color:#B2B2B2">Highly Palatable</th>
            </tr>
          </thead>
          <tbody>
            <tr>
              <td align="left">Dietary intake (calories/group/week)</td>
              <td align="center">2606 &#177; 33.32</td>
              <td align="center">3084 &#177; 66.56 <xref ref-type="table-fn" rid="TFN4">***</xref>
							</td>
            </tr>
            <tr>
              <td align="left">Visceral Adiposity (%)</td>
              <td align="center">4.5 &#177; 0.3</td>
              <td align="center">6.401 &#177; 0.3 <xref ref-type="table-fn" rid="TFN4">***</xref>
							</td>
            </tr>
            <tr>
              <td align="left">Liver weight (g)</td>
              <td align="center">11.3 &#177; 0.4</td>
              <td align="center">12.8 &#177; 0.4 <xref ref-type="table-fn" rid="TFN3">**</xref>
							</td>
            </tr>
            <tr>
              <td align="left">Total cholesterol (mg/dl)</td>
              <td align="center">82.8 &#177; 13.2</td>
              <td align="center">86.2 &#177; 7.1</td>
            </tr>
            <tr>
              <td align="left">Triglycerides (mg/dl)</td>
              <td align="center">96.6 &#177; 13.1</td>
              <td align="center">150.2 &#177; 19.0 <xref ref-type="table-fn" rid="TFN2">*</xref>
							</td>
            </tr>
            <tr>
              <td align="left">Fasting blood glucose (mg/dl)</td>
              <td align="center">73.7 &#177; 1.4</td>
              <td align="center">85.6 &#177; 2.2 <xref ref-type="table-fn" rid="TFN4">***</xref>
							</td>
            </tr>
          </tbody>
        </table>
        <table-wrap-foot>
          <fn id="TFN1">
            <p>Values expressed in man &#177; standard error of mean (SEN). Student t test.</p>
          </fn>
          <fn id="TFN2">
            <label>*</label>
            <p>p &lt; 0.05;</p>
          </fn>
          <fn id="TFN3">
            <label>**</label>
            <p>p &lt; 0.01;</p>
          </fn>
          <fn id="TFN4">
            <label>***</label>
            <p>p &lt; 0.001; n = 8-9.</p>
          </fn>
        </table-wrap-foot>
      </table-wrap>
      <p>In the second stage, the animals were fed a HP diet (that induces metabolic syndrome) supplemented with soybean oil (HPSO) or safflower oil (HPSA). Food and water intake of the animals was measured. However, there was no statistically significant difference between the groups for these parameters (unreported data).</p>
      <p>Significant changes were observed in the lipid profile of the animals, and the HPSA group showed a higher concentration of total cholesterol and LDL-c than the control group (HPSO) (<xref ref-type="fig" rid="f1">Figures 1A</xref> and <xref ref-type="fig" rid="f1">1B</xref>, p = 0.03 and p = 0.001, respectively). In contrast, HDL-c and triglycerides did not statistically differ between the groups (<xref ref-type="fig" rid="f1">Figures 1C</xref> and <xref ref-type="fig" rid="f1">1D</xref>).</p>
      <p>
        <fig id="f1">
          <label>Figure 1</label>
          <caption>
            <title>Concentration of total cholesterol (A), LDL-cholesterol (B), HDL-cholesterol (C) and triglycerides (D) of rats fed with a highly palatable (HP) diet for 10 weeks, supplemented with soybean oil (HPSO) or safflower oil (HPSA). n = 5-6. Values expressed in mean &#177; standard error of mean (SEM). Student t test. * p &lt; 0.05; ** p &lt; 0.01.</title>
          </caption>
          <graphic xlink:href="2359-5647-ijcs-30-06-0476-70075-gf01.jpg"/></fig>
      </p>
      <p>The HPSA group showed lower levels of fasting blood glucose as compared to the control group, but this difference was not statistically significant (<xref ref-type="fig" rid="f2">Figure 2</xref>).</p>
      <p>
        <fig id="f2">
          <label>Figure 2</label>
          <caption>
            <title>Fasting blood glucose of rats fed with a highly palatable (HP) diet for 10 weeks, supplemented with soybean oil (HPSO) or safflower oil (HPSA). n = 5-6. Values expressed in mean &#177; standard error of mean (SEM). Student t test.</title>
          </caption>
          <graphic xlink:href="2359-5647-ijcs-30-06-0476-70075-gf02.jpg"/></fig>
      </p>
      <p>According to our results, there was no statistically significant difference regarding liver weight and weight gain between the control group and the HPSA group (<xref ref-type="fig" rid="f3">Figures 3</xref> and <xref ref-type="fig" rid="f4">4A</xref>, respectively). However, the HPSA group showed higher values of total adipose tissue, and epididymal and visceral adiposity, which were not statistically significant though (<xref ref-type="fig" rid="f4">Figures 4B</xref>, <xref ref-type="fig" rid="f4">4C</xref> and <xref ref-type="fig" rid="f4">4D</xref>, respectively).</p>
      <p>
        <fig id="f3">
          <label>Figure 3</label>
          <caption>
            <title>Liver weight of rats fed with a highly palatable (HP) diet for 10 weeks, supplemented with soybean oil (HPSO) or safflower oil (HPSA). n = 5-6. Values expressed in mean &#177; standard error of mean (SEM). Student t test.</title>
          </caption>
          <graphic xlink:href="2359-5647-ijcs-30-06-0476-70075-gf03.jpg"/></fig>
      </p>
      <p>
        <fig id="f4">
          <label>Figure 4</label>
          <caption>
            <title>Body weight gain (A), weight of total adipose tissue (B), epididymal adipose tissue (C) and visceral adiposity (D) of rats fed with a highly palatable (HP) diet for 10 weeks, supplemented with soybean oil (HPSO) or safflower oil (HPSA). n = 5-6. Values expressed in mean &#177; standard error of mean (SEM). Student t test.</title>
          </caption>
          <graphic xlink:href="2359-5647-ijcs-30-06-0476-70075-gf04.jpg"/></fig>
      </p>
      <p>Regarding histological analysis of the liver, groups HPSO and HPSA showed mild microvesicular steatosis and moderate micro- and macrovesicular steatosis, respectively (<xref ref-type="fig" rid="f5">Figure 5</xref>).</p>
      <p>
        <fig id="f5">
          <label>Figure 5</label>
          <caption>
            <title>Histological section of liver stained with Hematoxylin and Eosin (H&amp;E) of rats fed with a highly palatable (HP) diet for 10 weeks, supplemented with soybean oil (HPSO) or safflower oil (HPSA) for 10 weeks n = 5-6. HPSO group: mild microgoticular steatosis. HPSA group: moderate micro and macrogoticular steatosis.</title>
          </caption>
          <graphic xlink:href="2359-5647-ijcs-30-06-0476-70075-gf05.jpg"/></fig>
      </p>
    </sec>
    <sec sec-type="discussion">
      <title>Discussion</title>
      <p>Several experimental models have been proposed for the study of obesity and its metabolic disorders, most of them based on genetic modifications.<xref ref-type="bibr" rid="B14">14</xref><sup>,</sup><xref ref-type="bibr" rid="B15">15</xref> However, the animal model that most resembles the etiology of human obesity is the one involving high intake of dietary fat.<xref ref-type="bibr" rid="B16">16</xref> However, the extrapolation of many of these animal models to human obesity is limited by the difficulty in reproducing disorders that characterize metabolic syndrome, such as central obesity and changes in the metabolism of lipids and glucose. Also, they require long periods of time for the induction of obesity.<xref ref-type="bibr" rid="B17">17</xref><sup>,</sup><xref ref-type="bibr" rid="B18">18</xref> Thus, the model used in this study is the most suitable for the research of metabolic syndrome interventions, because it effectively mimics the disorder observed in humans, and requires a relatively lower induction time compared to other studies,<xref ref-type="bibr" rid="B19">19</xref><sup>,</sup><xref ref-type="bibr" rid="B20">20</xref> which reduces research costs.</p>
      <p>Such findings (visceral obesity, hyperglycemia and hypertriglyceridemia) are consistent with the diagnosis of metabolic syndrome, also including hepatic steatosis. Several studies indicate an association between obesity and metabolic disorders, particularly the intake of hypercaloric and high carbohydrate diets, which is also demonstrated in our study.<xref ref-type="bibr" rid="B16">16</xref><sup>-</sup><xref ref-type="bibr" rid="B21">21</xref>
			</p>
      <p>According to the results obtained in the second stage of the study, there was no statistically significant difference between the groups regarding weight gain, which is similar to the findings obtained in a study by Fernandes et al<italic>.</italic>,<xref ref-type="bibr" rid="B22">22</xref> where no significant difference was found in the weight gain of animals in the groups given a diet supplemented with 1% of conjugated linoleic acid (CLA) compared to the groups that were not given the referred supplement. This finding is also corroborated by the study by Bhattachaya et al<italic>.</italic>,<xref ref-type="bibr" rid="B23">23</xref> where BALB/C mice fed with a high-fat diet supplemented with 0.4% of CLA showed no change in body weight.</p>
      <p>Nevertheless, different results were obtained by DeLany et al.<xref ref-type="bibr" rid="B19">19</xref> and Park and Pariza.<xref ref-type="bibr" rid="B21">21</xref> According to these studies, changes in body composition following the supplementation of CLA may be related to decreased proliferation and differentiation of preadipocytes, elevation of energy expenditure and changes in the concentration of leptin, a protein synthesized and secreted by adipocytes, involved in energy homeostasis. In contrast with the suggestions of these studies, in our study the group supplemented with safflower oil showed higher visceral adiposity, although this difference was not statistically significant. This fact indicates that there are conflicting reports in the literature regarding changes in body composition associated with the use of safflower or its main component, CLA.</p>
      <p>Analysis of the lipid profile of the animals showed that the HPSA group had a higher concentration of total cholesterol and LDL-c compared to the control group (HPSO). Similar results were obtained by Fernandes et al.,<xref ref-type="bibr" rid="B22">22</xref> who demonstrated increase in cholesterol levels following supplementation with 1% of CLA. This fact can be explained by changes in hepatic lipid metabolism caused by CLA, which may affect metabolic interconversion of fatty acids in the liver, resulting in a modified composition of fatty acids, causing changes in lipoproteins.<xref ref-type="bibr" rid="B24">24</xref>
			</p>
      <p>Still regarding cholesterol, in the above-mentioned study by Fernandes et al<italic>.</italic><xref ref-type="bibr" rid="B22">22</xref> with animals supplemented with CLA distributed into active and sedentary, there was improvement in HDL-c levels in the sedentary group supplemented with CLA. However, in our study, as well as in the study by Marques et al.,<xref ref-type="bibr" rid="B25">25</xref> which used safflower oil other than CLA, there was no statistically significant difference between the groups regarding HDL-c and serum triglycerides.</p>
      <p>In turn, analysis of fasting blood glucose showed that the HPSA group had higher values compared to the control group, though this difference was not statistically significant. Marques et al.<xref ref-type="bibr" rid="B25">25</xref> concluded that exclusive supplementation with 2% CLA affected the metabolism of glucose in mice, and these animals had severe hyperglycemia compared to the control group. This difference may not have been observed in our study because we used safflower oil, not isolated CLA.</p>
      <p>The study by Tanaka et al<italic>.</italic><xref ref-type="bibr" rid="B26">26</xref> indicate that supplementation with CLA induces insulin resistance in animals and humans. However, other studies had controversial results, such as the study of Parra et al.,<xref ref-type="bibr" rid="B27">27</xref> these authors demonstrated that the mixture of CLA isomers did not increase insulin resistance in rats given oral supplementation.</p>
      <p>Therefore, there is no consensus on the relationship between CLA intake and insulin sensitivity. Further studies are needed to clarify such metabolic changes.</p>
      <p>Also, there were no differences in the groups regarding the relative liver weight. The study by Gaiva et al.<xref ref-type="bibr" rid="B28">28</xref> with rats fed diets rich in polyunsaturated fatty acids reported increased liver weight. It can be suggested that in our study there was no statistically significant difference in liver weight between the groups because soybean oil and safflower oil are both sources of polyunsaturated fatty acids, and, thus, have the same action on liver.</p>
      <p>However, analysis of liver histological sections showed that supplementation with safflower oil interferes with hepatic steatosis, and the presence of micro- and macrovesicular steatosis is noticeable in this group. According to Reddy,<xref ref-type="bibr" rid="B29">29</xref> fatty acid synthesis is stimulated to promote the storage of energy substrate in adipose tissue, a process that affects lipid metabolism, especially oxidation homeostasis and lipid synthesis, resulting in obesity, resistance to insulin, dyslipidemia and hepatic steatosis.</p>
    </sec>
    <sec sec-type="conclusions">
      <title>Conclusion</title>
      <p>Our results showed that animals fed a HP diet constitute an effective model for the experimental study of metabolic syndrome, due to its similarity with the etiology of the syndrome observed in humans, and also because that model does not require the use of genetically modified animals, has shorter induction time and relatively low costs.</p>
      <p>We concluded that the effect of safflower oil on the prevention of adverse impacts on body composition, lipid profile and blood glucose was not confirmed under the conditions of the present study. Instead, supplementation with safflower oil resulted in the elevation of total serum cholesterol and its most atherogenic fraction, LDL-c, as well as in hepatic steatosis, indicating that the use of safflower oil may have deleterious effects on lipid profile and health.</p>
    </sec>
  </body>
  <back>
    <fn-group>
      <fn fn-type="financial-disclosure">
        <p>
          <bold>Sources of Funding</bold>
        </p>
        <p>The present study had no external sources of funding.</p>
      </fn>
      <fn fn-type="presented-at">
        <p>
          <bold>Study Association</bold>
        </p>
        <p>This article is part of the conclusion of the Bachelor's Degree in Nutrition from Lidiani Figueiredo Santana of the Federal University of Grande Dourados (UFGD).</p>
      </fn>
    </fn-group>
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  <sub-article article-type="translation" id="s1" xml:lang="pt">
    <front-stub>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Artigos Originais</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>&#211;leo de C&#225;rtamo (<italic>Carthamus tinctorius</italic>) Aumenta os N&#237;veis de Colesterol Total e LDL-Colesterol em Modelo Experimental de S&#237;ndrome Metab&#243;lica</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <name>
            <surname>Santana</surname>
            <given-names>Lidiani Figueiredo</given-names>
          </name>
          <xref ref-type="aff" rid="aff4">1</xref>
          <xref ref-type="corresp" rid="c2"/>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Dutra</surname>
            <given-names>Thaisa da Silva</given-names>
          </name>
          <xref ref-type="aff" rid="aff5">2</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Souza</surname>
            <given-names>Marcos Alexandre de</given-names>
          </name>
          <xref ref-type="aff" rid="aff5">2</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Freitas</surname>
            <given-names>Karine de C&#225;ssia</given-names>
          </name>
          <xref ref-type="aff" rid="aff4">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Oesterreich</surname>
            <given-names>Silvia Aparecida</given-names>
          </name>
          <xref ref-type="aff" rid="aff5">2</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Kassuya</surname>
            <given-names>C&#226;ndida Aparecida Leite</given-names>
          </name>
          <xref ref-type="aff" rid="aff5">2</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Soares</surname>
            <given-names>Fab&#237;ola Lacerda Pires</given-names>
          </name>
          <xref ref-type="aff" rid="aff6">3</xref>
        </contrib>
      </contrib-group>
      <aff id="aff4">
        <label>1</label>
        <institution content-type="original">Universidade Federal do Mato Grosso do Sul (UFMS), Campo Grande, MS</institution>
      </aff>
      <aff id="aff5">
        <label>2</label>
        <institution content-type="original">Faculdade de Ci&#234;ncias da Sa&#250;de, Universidade Federal da Grande Dourados (UFGD), Dourados, MS</institution>
      </aff>
      <aff id="aff6">
        <label>3</label>
        <institution content-type="original">Centro de Ci&#234;ncias da Sa&#250;de, Universidade Federal do Esp&#237;rito Santo (UFES), Esp&#237;rito Santo, ES - Brasil</institution>
      </aff>
      <author-notes>
        <corresp id="c2"><bold>Correspond&#234;ncia: Lidiani Figueiredo Santana</bold>, Av. Costa e Silva, s/n - Cidade Universit&#225;ria, CEP: 79070-900. Campo Grande, MS - Brasil. E-mail: <email>lidi_lfs@hotmail.com</email>; <email>lidi_lfs@hotmail.com</email>
				</corresp>
        <fn fn-type="con">
          <p>
            <bold>Contribui&#231;&#227;o dos autores</bold>
          </p>
          <p>Concep&#231;&#227;o e desenho da pesquisa: Santana LF, Dutra TS, Freitas CF, Soares FLP. Obten&#231;&#227;o de dados: Santana LF, Dutra TS, Souza MA, Freitas CF, Oesterriech AS, Kassuya CPL, Soares FLP. An&#225;lise e interpreta&#231;&#227;o dos dados: Santana LF, Souza MA, Freitas CF, Oesterriech AS, Kassuya CPL, Soares FLP. An&#225;lise estat&#237;stica: Santana LF, Souza MA, Freitas CF, Oesterriech AS, Kassuya CPL, Soares FLP. Reda&#231;&#227;o do manuscrito: Santana LF, Freitas CF, Kassuya CPL, Soares FLP. Revis&#227;o cr&#237;tica do manuscrito quanto ao conte&#250;do intelectual importante: Santana LF, Freitas CF, Kassuya CPL, Soares FLP.</p>
        </fn>
        <fn fn-type="conflict">
          <p>
            <bold>Potencial Conflito de Interesse</bold>
          </p>
          <p>Declaro n&#227;o haver conflito de interesses pertinentes.</p>
        </fn>
      </author-notes>
      <abstract>
        <title>Resumo</title>
        <sec>
          <title>Fundamentos:</title>
          <p>O excesso de peso vem sendo considerado um importante problema de sa&#250;de p&#250;blica. Na tentativa de reverter esse quadro, s&#227;o propostos diversos tipos de tratamento. O &#243;leo de c&#225;rtamo (<italic>Carthamus tinctorius</italic>) vem sendo utilizado na preven&#231;&#227;o/tratamento da obesidade.</p>
        </sec>
        <sec>
          <title>Objetivos:</title>
          <p>O objetivo deste trabalho foi avaliar os efeitos terap&#234;uticos desse &#243;leo em um modelo experimental de s&#237;ndrome metab&#243;lica.</p>
        </sec>
        <sec>
          <title>M&#233;todos:</title>
          <p>Inicialmente foram utilizados ratos <italic>Wistar</italic> alimentados com dieta altamente palat&#225;vel (AP) por dez semanas. Ap&#243;s, os animais receberam a dieta AP com suplementa&#231;&#227;o de &#243;leo de soja (APOS) ou &#243;leo de c&#225;rtamo (APOC), na dosagem 1,0 ml/1000 g de peso do animal. No final do experimento, a composi&#231;&#227;o corporal, o perfil lip&#237;dico e glicemia dos animais foram avaliados. Para a an&#225;lise estat&#237;stica, utilizou-se o teste <italic>t</italic> de Student.</p>
        </sec>
        <sec>
          <title>Resultados:</title>
          <p>Na primeira fase (indu&#231;&#227;o da s&#237;ndrome metab&#243;lica), os animais que receberam a dieta AP mostraram ganho de peso (p &lt; 0,001), adiposidade visceral (p = 0,001), glicemia (p = 0,001) e triglicer&#237;deos s&#233;ricos (p = 0,03) significativamente mais elevados do que aqueles do grupo controle. Al&#233;m disso, houve uma diferen&#231;a no peso do f&#237;gado (p = 0,01). Esses resultados demonstram que a administra&#231;&#227;o de dieta AP &#233; um modelo eficaz para o estudo experimental da s&#237;ndrome metab&#243;lica. Na segunda etapa, os animais do grupo APOC mostraram aumento de colesterol total (p &lt; 0,05) e de LDL-colesterol (p &lt; 0,001).</p>
        </sec>
        <sec>
          <title>Conclus&#227;o:</title>
          <p>Sob as condi&#231;&#245;es experimentais referidas, conclui-se que a utiliza&#231;&#227;o de &#243;leo de c&#225;rtamo pode causar efeitos delet&#233;rios sobre o perfil lip&#237;dico em um modelo experimental de s&#237;ndrome metab&#243;lica.</p>
        </sec>
      </abstract>
      <kwd-group xml:lang="pt">
        <title>Palavras-chave:</title>
        <kwd>&#211;leos</kwd>
        <kwd>Carthamus</kwd>
        <kwd>Colesterol</kwd>
        <kwd>S&#237;ndrome Metab&#243;lica</kwd>
        <kwd>Dislipidemias</kwd>
        <kwd>Obesidade / controle &amp; preven&#231;&#227;o</kwd>
      </kwd-group>
    </front-stub>
    <body>
      <sec sec-type="intro">
        <title>Introdu&#231;&#227;o</title>
        <p>A obesidade &#233; uma doen&#231;a cr&#244;nica multifatorial definida como ac&#250;mulo anormal ou excessivo de gordura, representando um s&#233;rio risco &#224; sa&#250;de. A preval&#234;ncia de sobrepeso e obesidade est&#225; aumentando, sendo 12% da popula&#231;&#227;o mundial considerada obesa.<xref ref-type="bibr" rid="B1">1</xref> Segundo estudos brasileiros, 52,5% da popula&#231;&#227;o adulta acha-se acima do peso saud&#225;vel ideal, sendo 17,9% dela considerada obesa. O ac&#250;mulo de tecido adiposo, em particular gordura visceral, pode contribuir para mudan&#231;as corporais, desencadeando s&#237;ndrome metab&#243;lica. Essa s&#237;ndrome pode ser definida como um dist&#250;rbio complexo, caracterizado por um conjunto de fatores de risco cardiovascular relacionados &#224; deposi&#231;&#227;o de gordura central e resist&#234;ncia &#224; insulina.<xref ref-type="bibr" rid="B2">2</xref>
				</p>
        <p>Em geral, a base fisiopatol&#243;gica para os eventos cardiovasculares &#233; a aterosclerose, caracterizada por um processo inflamat&#243;rio cr&#244;nico da parede vascular e eleva&#231;&#227;o dos marcadores inflamat&#243;rios s&#233;ricos circulantes, como a prote&#237;na C reativa (PCR). Com rela&#231;&#227;o &#224; dislipidemia, o objetivo prim&#225;rio na preven&#231;&#227;o cardiovascular &#233; baixar os n&#237;veis de LDL-colesterol (LDL-c), reduzir os n&#237;veis de triglicer&#237;deos e elevar os de HDL-colesterol (HDL-c), sendo esse &#250;ltimo objetivo considerado potencialmente ben&#233;fico para inibir o processo aterotromb&#243;tico.<xref ref-type="bibr" rid="B3">3</xref>
				</p>
        <p>Para reduzir esses n&#237;veis, foram propostos tratamentos diet&#233;ticos que requerem mudan&#231;as nos h&#225;bitos alimentares.<xref ref-type="bibr" rid="B4">4</xref> Nesse contexto, o uso de &#243;leo de c&#225;rtamo (<italic>Carthamus tinctorius</italic>) foi proposto para prevenir ou tratar a obesidade. O &#243;leo de c&#225;rtamo &#233; extra&#237;do do a&#231;afr&#227;o, uma planta da fam&#237;lia <italic>Asteraceae</italic>,<xref ref-type="bibr" rid="B5">5</xref><sup>,</sup><xref ref-type="bibr" rid="B6">6</xref> e cont&#233;m alto teor de &#225;cidos graxos poli-insaturados (75% &#225;cido linoleico) e monoinsaturados.<xref ref-type="bibr" rid="B7">7</xref> Tal composi&#231;&#227;o estimulou estudos posteriores que demonstraram ter a suplementa&#231;&#227;o diet&#233;tica com &#243;leo de c&#225;rtamo um efeito positivo no perfil lip&#237;dico e desempenhar um papel antiaterog&#234;nico.</p>
        <p>Devido &#224; falta de estudos sobre o uso do &#243;leo de c&#225;rtamo na s&#237;ndrome metab&#243;lica, al&#233;m da exist&#234;ncia de resultados conflitantes na literatura, o presente estudo buscou avaliar os efeitos terap&#234;uticos do &#243;leo de c&#225;rtamo sobre a composi&#231;&#227;o corporal, o perfil lip&#237;dico e a glicemia em um modelo experimental de s&#237;ndrome metab&#243;lica.</p>
      </sec>
      <sec sec-type="methods">
        <title>M&#233;todos</title>
        <sec>
          <title>Animais e dieta</title>
          <p>Os animais foram fornecidos pelo Biot&#233;rio Central da Faculdade de Ci&#234;ncias da Sa&#250;de da Universidade Federal da Grande Dourados (UFGD), Dourados, Mato Grosso do Sul. Os procedimentos usados neste estudo foram aprovados pelo Comit&#234; de &#201;tica para o Uso de Animais Experimentais da UFGD (N&#186; 016/2013), segundo os padr&#245;es estabelecidos pelo Conselho Nacional de Controle de Experimenta&#231;&#227;o Animal.<xref ref-type="bibr" rid="B8">8</xref>
					</p>
          <p>Uma dieta altamente palat&#225;vel (AP) foi preparada com base no estudo de Naderali et al.,<xref ref-type="bibr" rid="B9">9</xref> usando 33% de ra&#231;&#227;o mo&#237;da da marca Labina Purina&#174;, 33% de leite condensado, 27% de &#225;gua e 7% de sucrose (2,78 calorias/g). A dieta foi mantida sob refrigera&#231;&#227;o at&#233; ser usada, tendo o grupo controle recebido dieta normal (ra&#231;&#227;o comercial da marca Labina Purina<sup>&#174;</sup>).</p>
          <p>O experimento foi dividido em duas etapas. Na primeira, desenvolveu-se um modelo animal de s&#237;ndrome metab&#243;lica e, na segunda, realizou-se interven&#231;&#227;o com &#243;leo de c&#225;rtamo em um modelo da doen&#231;a similar ao observado em seres humanos. Ratos Wistar machos com 90 dias (adultos) foram usados nas duas etapas.</p>
          <p>Na primeira etapa, os animais foram divididos em dois grupos (n = 8): um grupo recebeu dieta normal e &#225;gua <italic>ad libitum</italic>, e o outro recebeu uma dieta AP e &#225;gua <italic>ad libitum</italic>, por 10 semanas. Na segunda etapa, os animais tamb&#233;m foram divididos em dois grupos (n = 5-6), tendo ambos os grupos recebido uma dieta AP e &#225;gua <italic>ad libitum</italic>, por 10 semanas. A dieta AP com &#243;leo de soja (APOS) e a dieta AP com &#243;leo de c&#225;rtamo (APOC) foram administradas por gavagem aos animais. A dose di&#225;ria administrada foi de 1,0 ml/1000 g de peso do animal.<xref ref-type="bibr" rid="B10">10</xref><sup>,</sup><xref ref-type="bibr" rid="B11">11</xref>
					</p>
          <p>O &#243;leo de c&#225;rtamo (Galena<sup>&#174;</sup>) e o &#243;leo de soja (Liza<sup>&#174;</sup>) usados neste estudo foram comprados em estabelecimentos comerciais da cidade de Dourados.</p>
          <p>Os mesmos par&#226;metros foram avaliados nas duas etapas. O consumo de alimento e o peso dos animais foram medidos diariamente. Ap&#243;s 10 semanas de tratamento, os animais foram submetidos a jejum de 12 horas, anestesiados com xilazina e cetamina (10 mg/kg: 75 mg/kg) e sacrificados por exsanguina&#231;&#227;o pela veia cava inferior. As amostras de sangue foram centrifugadas a 3000 rpm por 15 minutos, sendo o soro mantido congelado a -20&#176;C at&#233; a an&#225;lise. Amostras de tecido adiposo de cinco locais foram removidas e pesadas. Os f&#237;gados foram submetidos a estudo histol&#243;gico para a presen&#231;a de esteatose hep&#225;tica.</p>
        </sec>
        <sec>
          <title>Glicemia de jejum</title>
          <p>Para a avalia&#231;&#227;o da glicemia, os animais foram submetidos a jejum de 16 horas, sendo o sangue coletado da art&#233;ria da cauda, e usando-se um glicos&#237;metro (<italic>Testline Striptsl25</italic>), segundo Formagio et al.<xref ref-type="bibr" rid="B11">11</xref>
					</p>
        </sec>
        <sec>
          <title>Concentra&#231;&#245;es de colesterol total, HDL-c, LDL-c e triglicer&#237;deos</title>
          <p>A determina&#231;&#227;o de colesterol total, HDL-c e triglicer&#237;deos s&#233;ricos baseou-se no m&#233;todo enzim&#225;tico colorim&#233;trico, usando-se <italic>kit</italic> comercial (<italic>Labtest<sup>&#174;</sup>)</italic>, segundo as instru&#231;&#245;es do fabricante. Os resultados foram obtidos com um espectrofot&#244;metro (<italic>Aaker/Bel</italic> - SF325NM - S05<sup>&#174;</sup>). A concentra&#231;&#227;o de LDL-c foi obtida com uma f&#243;rmula, segundo as instru&#231;&#245;es do fabricante do <italic>kit</italic> para quantifica&#231;&#227;o de HDL-c, usando-se a equa&#231;&#227;o de Friedewald, onde: <italic>VLDL-c = Triglicer&#237;deos / 5</italic> e <italic>LDL-c = Colesterol total - (HDL-c + VLDL-c)</italic>.</p>
        </sec>
        <sec>
          <title>Peso do f&#237;gado</title>
          <p>Logo ap&#243;s ser extra&#237;do, o f&#237;gado foi imerso em solu&#231;&#227;o salina para remover o excesso de sangue, sendo em seguida secado com papel e pesado.</p>
        </sec>
        <sec>
          <title>Peso do tecido adiposo</title>
          <p>As amostras de tecido adiposo de cinco s&#237;tios (epididimal, retroperitoneal, perirrenal, mesent&#233;rico e omental) foram removidas e pesadas, com determina&#231;&#227;o subsequente da gordura do animal (porcentagem de tecido adiposo em cada s&#237;tio em rela&#231;&#227;o ao peso corporal).</p>
        </sec>
        <sec>
          <title>Histologia hep&#225;tica</title>
          <p>Ap&#243;s a eutan&#225;sia, o f&#237;gado foi removido para estudo histol&#243;gico, sendo fixado em solu&#231;&#227;o de formalde&#237;do a 10% at&#233; inclus&#227;o em parafina. Foram ent&#227;o realizados cortes de 7 &#181;m de espessura no micr&#243;tomo, com posterior montagem em l&#226;minas de vidro. Cada l&#226;mina tinha quatro cortes extra&#237;dos do bloco de parafina. As l&#226;minas foram coradas com hematoxilina e eosina, sendo analisadas em microsc&#243;pio acoplado a c&#226;mara digital com aumento de 200x para classifica&#231;&#227;o quanto &#224; presen&#231;a de esteatose, segundo Abbas et al<italic>.</italic><xref ref-type="bibr" rid="B12">12</xref> e Mello e Alves.<xref ref-type="bibr" rid="B13">13</xref>
					</p>
        </sec>
        <sec>
          <title>An&#225;lise estat&#237;stica</title>
          <p>Os resultados foram expressos como m&#233;dia &#177; erro-padr&#227;o da m&#233;dia (EPM), sendo analisados com o programa Prisma 5.0 (GraphPad Software, EUA). O teste <italic>t</italic> de Student foi usado para avaliar se as m&#233;dias dos grupos eram estatisticamente significativas, sendo p &lt; 0,05 considerado estatisticamente significativo.</p>
        </sec>
      </sec>
      <sec sec-type="results">
        <title>Resultados</title>
        <p>Os resultados da primeira etapa do estudo, em que se tentou desenvolver um modelo animal de s&#237;ndrome metab&#243;lica, podem ser vistos na <xref ref-type="table" rid="t2">Tabela 1</xref>. N&#227;o houve diferen&#231;a estatisticamente significativa entre os grupos com rela&#231;&#227;o &#224; ingest&#227;o de &#225;gua (dados n&#227;o relatados).</p>
        <table-wrap id="t2">
          <label>Tabela 1</label>
          <caption>
            <title>Ingest&#227;o diet&#233;tica total, composi&#231;&#227;o corporal, peso do f&#237;gado e par&#226;metros bioqu&#237;micos em ratos recebendo uma dieta normal e uma dieta altamente palat&#225;vel</title>
          </caption>
          <table frame="hsides" rules="groups">
            <colgroup>
              <col width="33%"/>
              <col width="33%"/>
              <col width="33%"/>
            </colgroup>
            <thead>
              <tr>
                <th align="left" style="background-color:#B2B2B2">
								</th>
                <th align="center" style="background-color:#B2B2B2">Controle</th>
                <th align="center" style="background-color:#B2B2B2">Altamente palat&#225;vel</th>
              </tr>
            </thead>
            <tbody>
              <tr>
                <td align="left">Ingest&#227;o diet&#233;tica (calorias/grupo/semana)</td>
                <td align="center">2606 &#177; 33,32</td>
                <td align="center">3084 &#177; 66,56 <xref ref-type="table-fn" rid="TFN8">***</xref>
								</td>
              </tr>
              <tr>
                <td align="left">Adiposidade visceral (%)</td>
                <td align="center">4,5 &#177; 0,3</td>
                <td align="center">6,401 &#177; 0,3 <xref ref-type="table-fn" rid="TFN8">***</xref>
								</td>
              </tr>
              <tr>
                <td align="left">Peso do f&#237;gado (g)</td>
                <td align="center">11,3 &#177; 0,4</td>
                <td align="center">12,8 &#177; 0,4 <xref ref-type="table-fn" rid="TFN7">**</xref>
								</td>
              </tr>
              <tr>
                <td align="left">Colesterol total (mg/dl)</td>
                <td align="center">82,8 &#177; 13,2</td>
                <td align="center">86,2 &#177; 7,1</td>
              </tr>
              <tr>
                <td align="left">Triglicer&#237;deos (mg/dl)</td>
                <td align="center">96,6 &#177; 13,1</td>
                <td align="center">150,2 &#177; 19,0 <xref ref-type="table-fn" rid="TFN6">*</xref>
								</td>
              </tr>
              <tr>
                <td align="left">Glicemia de jejum (mg/dl)</td>
                <td align="center">73,7 &#177; 1,4</td>
                <td align="center">85,6 &#177; 2,2 <xref ref-type="table-fn" rid="TFN8">***</xref>
								</td>
              </tr>
            </tbody>
          </table>
          <table-wrap-foot>
            <fn id="TFN5">
              <p>Valores expressos em m&#233;dia &#177; erro-padr&#227;o da m&#233;dia (EPM). Test t de Student.</p>
            </fn>
            <fn id="TFN6">
              <label>*</label>
              <p>p &lt; 0,05;</p>
            </fn>
            <fn id="TFN7">
              <label>**</label>
              <p>p &lt; 0,01;</p>
            </fn>
            <fn id="TFN8">
              <label>***</label>
              <p>p &lt; 0,001; n = 8-9.</p>
            </fn>
          </table-wrap-foot>
        </table-wrap>
        <p>Na segunda etapa, os animais receberam uma dieta AP (que induz s&#237;ndrome metab&#243;lica) suplementada com &#243;leo de soja (APOS) ou &#243;leo de c&#225;rtamo (APOC). A ingest&#227;o de alimentos e &#225;gua dos animais foi medida. Entretanto, n&#227;o houve diferen&#231;a estatisticamente significativa entre os grupos quanto &#224;queles par&#226;metros (dados n&#227;o relatados).</p>
        <p>Observaram-se mudan&#231;as significativas no perfil lip&#237;dico dos animais, tendo o grupo APOC apresentado mais alta concentra&#231;&#227;o de colesterol total e LDL-c do que o grupo controle (APOS) (<xref ref-type="fig" rid="f6">Figuras 1A</xref> e <xref ref-type="fig" rid="f6">1B</xref>, p = 0,03 e p = 0,001, respectivamente). Por outro lado, os n&#237;veis de HDL-c e triglicer&#237;deos n&#227;o diferiram estatisticamente entre os grupos (<xref ref-type="fig" rid="f6">Figures 1C</xref> e <xref ref-type="fig" rid="f6">1D</xref>).</p>
        <p>
          <fig id="f6">
            <label>Figura 1</label>
            <caption>
              <title>Concentra&#231;&#227;o de colesterol total (A), LDL-colesterol (B), HDL-colesterol (C) e triglicer&#237;deos (D) de ratos recebendo uma dieta altamente palat&#225;vel (AP) por 10 semanas, suplementada com &#243;leo de soja (APOS) ou &#243;leo de c&#225;rtamo (APOC), n = 5-6. Valores expressos em m&#233;dia &#177; erro-padr&#227;o da m&#233;dia (EPM). Test t de Student. * p &lt; 0,05; ** p &lt; 0,01.</title>
            </caption>
            <graphic xlink:href="2359-5647-ijcs-30-06-0476-70075-gf01-pt.jpg"/></fig>
        </p>
        <p>O grupo APOC apresentou n&#237;veis mais baixos de glicemia de jejum em compara&#231;&#227;o ao grupo controle, mas tal diferen&#231;a n&#227;o foi estatisticamente significativa (<xref ref-type="fig" rid="f7">Figura 2</xref>).</p>
        <p>
          <fig id="f7">
            <label>Figura 2</label>
            <caption>
              <title>Glicemia de jejum de ratos alimentados com uma dieta altamente palat&#225;vel (AP) durante 10 semanas, suplementado com &#243;leo de soja (APSO) ou &#243;leo de c&#225;rtamo (APOC). N = 5-6. Valores expressos em m&#233;dia &#177; erro padr&#227;o de m&#233;dia (SEM). Teste t de Student. </title>
            </caption>
            <graphic xlink:href="2359-5647-ijcs-30-06-0476-70075-gf02-pt.jpg"/></fig>
        </p>
        <p>Segundo nossos resultados, n&#227;o houve diferen&#231;a estatisticamente significativa quanto ao peso do f&#237;gado e ao ganho de peso entre o grupo controle e o grupo APOC (<xref ref-type="fig" rid="f8">Figuras 3</xref> e <xref ref-type="fig" rid="f9">4A</xref>, respectivamente). Entretanto, o grupo APOC apresentou valores mais altos de tecido adiposo total, e adiposidade epididimal e visceral, mas sem significado estat&#237;stico (<xref ref-type="fig" rid="f9">Figuras 4B</xref>, <xref ref-type="fig" rid="f9">4C</xref> e <xref ref-type="fig" rid="f9">4D</xref>, respectivamente).</p>
        <p>
          <fig id="f8">
            <label>Figura 3</label>
            <caption>
              <title>Peso do f&#237;gado de ratos recebendo uma dieta altamente palat&#225;vel (AP) por 10 semanas, suplementada com &#243;leo de soja (APOS) ou &#243;leo de c&#225;rtamo (APOC), n = 5-6. Valores expressos em m&#233;dia &#177; erro-padr&#227;o da m&#233;dia (EPM). Test t de Student.</title>
            </caption>
            <graphic xlink:href="2359-5647-ijcs-30-06-0476-70075-gf03-pt.jpg"/></fig>
        </p>
        <p>
          <fig id="f9">
            <label>Figura 4</label>
            <caption>
              <title>Ganho de peso corporal (A), peso do tecido adiposo total (B), tecido adiposo epididimal (C) e adiposidade visceral (D) de ratos recebendo uma dieta altamente palat&#225;vel (AP) por 10 semanas, suplementada com &#243;leo de soja (APOS) ou &#243;leo de c&#225;rtamo (APOC), n = 5-6. Valores expressos em m&#233;dia &#177; erro-padr&#227;o da m&#233;dia (EPM). Test t de Student.</title>
            </caption>
            <graphic xlink:href="2359-5647-ijcs-30-06-0476-70075-gf04-pt.jpg"/></fig>
        </p>
        <p>Com rela&#231;&#227;o &#224; an&#225;lise histol&#243;gica do f&#237;gado, os grupos APOS e APOC apresentaram leve esteatose microvesicular e moderada esteatose micro- e macrovesicular, respectivamente (<xref ref-type="fig" rid="f10">Figura 5</xref>).</p>
        <p>
          <fig id="f10">
            <label>Figura 5</label>
            <caption>
              <title>Cortes histol&#243;gicos de f&#237;gado corados com Hematoxilina e Eosina (H&amp;E) de ratos recebendo uma dieta altamente palat&#225;vel (AP) por 10 semanas, suplementada com &#243;leo de soja (APOS) ou &#243;leo de c&#225;rtamo (APOC), n = 5-6. Grupo APOS: leve esteatose microvesicular; grupo HPSA: moderada esteatose micro- e macrovesicular.</title>
            </caption>
            <graphic xlink:href="2359-5647-ijcs-30-06-0476-70075-gf05-pt.jpg"/></fig>
        </p>
      </sec>
      <sec sec-type="discussion">
        <title>Discuss&#227;o</title>
        <p>V&#225;rios modelos experimentais foram propostos para o estudo de obesidade e seus dist&#250;rbios metab&#243;licos, a maioria deles com base em modifica&#231;&#245;es gen&#233;ticas.<xref ref-type="bibr" rid="B14">14</xref><sup>,</sup><xref ref-type="bibr" rid="B15">15</xref> O modelo animal que mais se aproxima da etiologia da obesidade humana envolve alta ingest&#227;o de gordura diet&#233;tica.<xref ref-type="bibr" rid="B16">16</xref> Entretanto, a extrapola&#231;&#227;o de muitos desses modelos animais para obesidade humana &#233; limitada pela dificuldade em se reproduzir os dist&#250;rbios que caracterizam a s&#237;ndrome metab&#243;lica, como obesidade central e altera&#231;&#245;es no metabolismo dos lip&#237;deos e da glicose. Al&#233;m disso, requerem longos per&#237;odos de tempo para a indu&#231;&#227;o de obesidade.<xref ref-type="bibr" rid="B17">17</xref><sup>,</sup><xref ref-type="bibr" rid="B18">18</xref> O modelo usado neste estudo &#233;, portanto, o mais adequado para a pesquisa de interven&#231;&#245;es de s&#237;ndrome metab&#243;lica, por efetivamente imitar o dist&#250;rbio observado em seres humanos, necessitando de tempo de indu&#231;&#227;o relativamente menor comparado ao de outros estudos,<xref ref-type="bibr" rid="B19">19</xref><sup>,</sup><xref ref-type="bibr" rid="B20">20</xref> reduzindo os custos da pesquisa.</p>
        <p>Tais achados (obesidade visceral, hiperglicemia e hipertrigliceridemia) s&#227;o consistentes com o diagn&#243;stico de s&#237;ndrome metab&#243;lica, que tamb&#233;m inclui esteatose hep&#225;tica. V&#225;rios estudos indicam existir uma associa&#231;&#227;o entre obesidade e dist&#250;rbios metab&#243;licos, em particular a ingest&#227;o de dietas hipercal&#243;ricas e ricas em carboidratos, tamb&#233;m demonstrado no nosso estudo.<xref ref-type="bibr" rid="B16">16</xref><sup>-</sup><xref ref-type="bibr" rid="B21">21</xref>
				</p>
        <p>Segundo os resultados obtidos na segunda etapa deste estudo, n&#227;o houve diferen&#231;a estatisticamente significativa entre os grupos com rela&#231;&#227;o a ganho de peso. Tal achado &#233; similar ao do estudo de Fernandes et al<italic>.</italic>,<xref ref-type="bibr" rid="B22">22</xref> que n&#227;o obtiveram significativa diferen&#231;a no ganho de peso dos animais nos grupos recebendo uma dieta suplementada com 1% de &#225;cido linoleico conjugado (CLA) em compara&#231;&#227;o ao dos grupos que n&#227;o receberam o referido suplemento. Tal achado &#233; ainda corroborado pelo estudo de Bhattacharya et al<italic>.</italic>,<xref ref-type="bibr" rid="B23">23</xref> em que camundongos BALB/C alimentados com uma dieta rica em gordura suplementada com 0,4% de CLA n&#227;o apresentaram altera&#231;&#227;o no peso corporal.</p>
        <p>Diferentes resultados, no entanto, foram obtidos por DeLany et al.<xref ref-type="bibr" rid="B19">19</xref> e Park e Pariza.<xref ref-type="bibr" rid="B21">21</xref> Segundo esses autores, mudan&#231;as na composi&#231;&#227;o corporal ap&#243;s suplementa&#231;&#227;o com CLA podem estar relacionadas &#224; reduzida prolifera&#231;&#227;o e diferencia&#231;&#227;o de pr&#233;-adip&#243;citos, eleva&#231;&#227;o do gasto de energia e mudan&#231;as na concentra&#231;&#227;o de leptina, uma prote&#237;na sintetizada e secretada por adip&#243;citos, envolvida na homeostase energ&#233;tica. Diferentemente do sugerido por esses autores, no nosso estudo, o grupo suplementado com &#243;leo de c&#225;rtamo apresentou maior adiposidade visceral, embora tal diferen&#231;a n&#227;o tenha significado estat&#237;stico. Na literatura, portanto, h&#225; relatos conflitantes com rela&#231;&#227;o &#224;s mudan&#231;as na composi&#231;&#227;o corporal associadas ao uso de c&#225;rtamo ou seu principal componente, CLA.</p>
        <p>A an&#225;lise do perfil lip&#237;dico dos animais mostrou que o grupo APOC tinha uma maior concentra&#231;&#227;o de colesterol total e LDL-c em compara&#231;&#227;o ao grupo controle (APOS). Resultados similares foram obtidos por Fernandes et al.,<xref ref-type="bibr" rid="B22">22</xref> que demonstraram eleva&#231;&#227;o dos n&#237;veis de colesterol ap&#243;s suplementa&#231;&#227;o com 1% de CLA. Tal fato pode ser explicado por mudan&#231;as no metabolismo lip&#237;dico hep&#225;tico causadas por CLA, que podem afetar a interconvers&#227;o metab&#243;lica de &#225;cido graxos no f&#237;gado, resultando em composi&#231;&#227;o modificada de &#225;cido graxos, alterando as lipoprote&#237;nas.<xref ref-type="bibr" rid="B24">24</xref>
				</p>
        <p>Ainda em rela&#231;&#227;o ao colesterol, no j&#225; mencionado estudo de Fernandes et al<italic>.</italic><xref ref-type="bibr" rid="B22">22</xref> com animais suplementados com CLA distribu&#237;dos em grupos 'ativos' e 'sedent&#225;rios', houve melhora nos n&#237;veis de HDL-c no grupo 'sedent&#225;rios' suplementados com CLA. No nosso estudo, entretanto, assim como no de Marques et al.,<xref ref-type="bibr" rid="B25">25</xref> que usaram &#243;leo de c&#225;rtamo em lugar do CLA, n&#227;o houve diferen&#231;a estatisticamente significativa entre os grupos com rela&#231;&#227;o a HDL-c e triglicer&#237;deos s&#233;ricos.</p>
        <p>Ao analisar a glicemia de jejum, o grupo APOC mostrou valores mais altos em compara&#231;&#227;o ao grupo controle, embora sem significado estat&#237;stico. Marques et al.<xref ref-type="bibr" rid="B25">25</xref> relataram que suplementa&#231;&#227;o exclusiva com 2% de CLA afetou o metabolismo da glicose em camundongos, que apresentaram grave hiperglicemia em compara&#231;&#227;o ao grupo controle. A n&#227;o observa&#231;&#227;o dessa diferen&#231;a em nosso estudo, pode dever-se ao fato de termos usado &#243;leo de c&#225;rtamo em lugar de CLA isolado.</p>
        <p>O estudo de Tanaka et al<italic>.</italic><xref ref-type="bibr" rid="B26">26</xref> indica que a suplementa&#231;&#227;o com CLA induz resist&#234;ncia &#224; insulina em animais e seres humanos. Entretanto, outros estudos, como o de Parra et al.,<xref ref-type="bibr" rid="B27">27</xref> apresentaram resultados controversos. Aqueles autores demonstraram que a mistura de is&#244;meros CLA n&#227;o aumentou a resist&#234;ncia &#224; insulina em ratos recebendo suplementa&#231;&#227;o oral.</p>
        <p>Logo, n&#227;o h&#225; consenso quanto &#224; rela&#231;&#227;o entre ingest&#227;o de CLA e sensibilidade &#224; insulina. Estudos adicionais s&#227;o necess&#225;rios para esclarecer tais altera&#231;&#245;es metab&#243;licas.</p>
        <p>Al&#233;m disso, n&#227;o houve diferen&#231;a nos grupos quanto ao peso relativo do f&#237;gado. O estudo de Gaiva et al.<xref ref-type="bibr" rid="B28">28</xref> com ratos recebendo dieta rica em &#225;cidos graxos poli-insaturados relatou aumento do peso hep&#225;tico. Pode-se sugerir que, no nosso estudo, n&#227;o houve diferen&#231;a estatisticamente significativa no peso do f&#237;gado entre os grupos, pois o &#243;leo de soja e o &#243;leo de c&#225;rtamo s&#227;o fontes de &#225;cido graxos poli-insaturados, exercendo a mesma a&#231;&#227;o no f&#237;gado.</p>
        <p>Entretanto, a an&#225;lise dos cortes histol&#243;gicos do f&#237;gado mostrou que a suplementa&#231;&#227;o com &#243;leo de c&#225;rtamo interfere com a esteatose hep&#225;tica, sendo a presen&#231;a de esteatose micro- e macrovesicular percept&#237;vel naquele grupo. Segundo Reddy,<xref ref-type="bibr" rid="B29">29</xref> a s&#237;ntese de &#225;cido graxo &#233; estimulada para promover o armazenamento de substrato energ&#233;tico em tecido adiposo, um processo que afeta o metabolismo lip&#237;dico, em especial homeostase oxidativa e s&#237;ntese lip&#237;dica, resultando em obesidade, resist&#234;ncia &#224; insulina, dislipidemia e esteatose hep&#225;tica.</p>
      </sec>
      <sec sec-type="conclusions">
        <title>Conclus&#227;o</title>
        <p>Nossos resultados mostram que animais recebendo uma dieta AP constituem um modelo efetivo para o estudo experimental da s&#237;ndrome metab&#243;lica, devido &#224;s suas semelhan&#231;as com a etiologia da s&#237;ndrome observada em seres humanos. Ademais, tal modelo n&#227;o requer o uso de animais geneticamente modificados, tem menor tempo de indu&#231;&#227;o e relativamente baixo custo.</p>
        <p>Concluindo, a a&#231;&#227;o do &#243;leo de c&#225;rtamo na preven&#231;&#227;o de efeitos adversos na composi&#231;&#227;o corporal, perfil lip&#237;dico e glicemia n&#227;o foi confirmada nas condi&#231;&#245;es do presente estudo. Ao contr&#225;rio, a suplementa&#231;&#227;o com &#243;leo de c&#225;rtamo resultou em eleva&#231;&#227;o do colesterol s&#233;rico total e de sua fra&#231;&#227;o mais aterog&#234;nica, LDL-c, assim como em esteatose hep&#225;tica, indicando que o uso de &#243;leo de c&#225;rtamo possa ter efeitos delet&#233;rios no perfil lip&#237;dico e na sa&#250;de.</p>
      </sec>
    </body>
    <back>
      <fn-group>
        <fn fn-type="financial-disclosure">
          <p>
            <bold>Fontes de Financiamento</bold>
          </p>
          <p>O presente estudo n&#227;o teve fontes de financiamento externas.</p>
        </fn>
        <fn fn-type="presented-at">
          <p>
            <bold>Vincula&#231;&#227;o Acad&#234;mica</bold>
          </p>
          <p>Este artigo &#233; parte do trabalho de conclus&#227;o do curso Bacharel em Nutri&#231;&#227;o da Lidiani Figueiredo Santana da Universidade Federal da Grande Dourados</p>
        </fn>
      </fn-group>
    </back>
  </sub-article>
</article>
