ANA LUCIA DE SA PINTO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
8 resultados
Resultados de Busca
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- Prescribed Versus Preferred Intensity Resistance Exercise in Fibromyalgia Pain(2018) RIBEIRO, Roberta P. da Cunha; FRANCO, Tathiane C.; PINTO, Ana J.; PONTES FILHO, Marco A. G.; DOMICIANO, Diogo S.; PINTO, Ana L. de Sa; LIMA, Fernanda R.; ROSCHEL, Hamilton; GUALANO, BrunoExercise is the treatment of choice for fibromyalgia (FM), but little is known about resistance exercise prescription to modulate pain in this condition. This study aimed to compare the effects of different resistance exercise models, comprising self-selected or prescribed intensity, on pain in FM patients. In a cross-over fashion, 32 patients underwent the following sessions: (i) standard prescription (STD; 3 x 10 repetitions at 60% of maximal strength); (ii) self-selected load with fixed number of repetitions (SS); (iii) self-selected load with volume load (i.e., load x sets x repetitions) matched for STD (SS-VM); and (iv) self-selected load with a free number of repetitions until achieving score 7 of rating perceived exertion (SS-RPE). Pain, assessed by Visual Analogic Scale (VAS) and Short-Form McGill Pain Questionnaire (SF-MPQ), was evaluated before and 0, 24, 48, 72, and 96 h after the sessions. Load was significantly lower in SS, SS-VM, SS-RPE than in STD, whereas rating perceived exertion and volume load were comparable between sessions. VAS scores increased immediately after all sessions (p < 0.0001), and reduced after 48, 72, 96 h (p < 0.0001), remaining elevated compared to prevalues. SF-MPQ scores increased immediately after all exercise sessions (p = 0.025), then gradually reduced across time, reaching baseline levels at 24 h. No significant differences between sessions were observed. Both prescribed and preferred intensity resistance exercises failed in reducing pain in FM patients. The recommendation that FM patients should exercise at preferred intensities to avoid exacerbated pain, which appears to be valid for aerobic exercise, does not apply to resistance exercise.
- Reversal of Improved Endothelial Function After Bariatric Surgery Is Mitigated by Exercise Training(2018) DANTAS, Wagner Silva; GIL, Saulo; MURAI, Igor Hisashi; COSTA-HONG, Valeria; PECANHA, Tiago; MEREGE-FILHO, Carlos Alberto Abujabra; SA-PINTO, Ana Lucia de; CLEVA, Roberto de; SANTO, Marco Aurelio; PEREIRA, Rosa Maria Rodrigues; KIRWAN, John P.; ROSCHEL, Hamilton; GUALANO, Bruno
- Benefits of Resistance Training with Blood Flow Restriction in Knee Osteoarthritis(2018) FERRAZ, Rodrigo Branco; GUALANO, Bruno; RODRIGUES, Reynaldo; KURIMORI, Ceci Obara; FULLER, Ricardo; LIMA, Fernanda Rodrigues; SA-PINTO, Ana Lucia De; ROSCHEL, HamiltonPurpose Evaluate the effects of a low-intensity resistance training (LI-RT) program associated with partial blood flow restriction on selected clinical outcomes in patients with knee osteoarthritis (OA). Methods Forty-eight women with knee OA were randomized into one of the three groups: LI-RT (30% one repetition maximum [1-RM]) associated (blood flow restriction training [BFRT]) or not (LI-RT) with partial blood flow restriction, and high-intensity resistance training (HI-RT, 80% 1-RM). Patients underwent a 12-wk supervised training program and were assessed for lower-limb 1-RM, quadriceps cross-sectional area, functionality (timed-stands test and timed-up-and-go test), and disease-specific inventory (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]) before (PRE) and after (POST) the protocol. Results Similar within-group increases were observed in leg press (26% and 33%, all P < 0.0001), knee extension 1-RM (23% and 22%; all P < 0.0001) and cross-sectional area (7% and 8%; all P < 0.0001) in BFRT and HI-RT, respectively, and these were significantly greater (all P < 0.05) than those of LI-RT. The BFRT and HI-RT showed comparable improvements in timed-stands test (7% and 14%, respectively), with the latter showing greater increases than LI-RT. Timed-up-and-go test scores were not significantly changed within or between groups. WOMAC physical function was improved in BFRT and HI-RT (-49% and -42%, respectively; all P < 0.05), and WOMAC pain was improved in BFRT and LI-RT (-45% and -39%, respectively; all P < 0.05). Four patients (of 16) were excluded due to exercise-induced knee pain in HI-RT. Conclusions Blood flow restriction training and HI-RT were similarly effective in increasing muscle strength, quadriceps muscle mass, and functionality in knee OA patients. Importantly, BFRT was also able to improve pain while inducing less joint stress, emerging as a feasible and effective therapeutic adjuvant in OA management.
- Exercise Increases Insulin Sensitivity and Skeletal Muscle AMPK Expression in Systemic Lupus Erythematosus: A Randomized Controlled Trial(2018) BENATTI, Fabiana B.; MIYAKE, Cintia N. H.; DANTAS, Wagner S.; ZAMBELLI, Vanessa O.; SHINJO, Samuel K.; PEREIRA, Rosa M. R.; SILVA, Maria Elizabeth R.; SA-PINTO, Ana Lucia; BORBA, Eduardo; BONFA, Eloisa; GUALANO, BrunoSystemic lupus erythematosus (SLE) patients may show increased insulin resistance (IR) when compared with their healthy peers. Exercise training has been shown to improve insulin sensitivity in other insulin-resistant populations, but it has never been tested in SLE. Therefore, the aim of the present study was to assess the efficacy of a moderate-intensity exercise training program on insulin sensitivity and potential underlying mechanisms in SLE patients with mild/inactive disease. A 12-week, randomized controlled trial was conducted. Nineteen SLE patients were randomly assigned into two groups: trained (SLE-TR, n = 9) and non-trained (SLE-NT, n = 10). Before and after 12 weeks of the exercise training program, patients underwent a meal test (MT), from which surrogates of insulin sensitivity and beta-cell function were determined. Muscle biopsies were performed after the MT for the assessment of total and membrane GLUT4 and proteins related to insulin signaling [ Akt and AMP-activated protein kinase (AMPK)]. SLE-TR showed, when compared with SLE-NT, significant decreases in fasting insulin [-39 vs. + 14%, p = 0.009, effect size (ES) = -1.0] and in the insulin response to MT (-23 vs. + 21%, p = 0.007, ES = -1.1), homeostasis model assessment IR (-30 vs. + 15%, p = 0.005, ES = -1.1), a tendency toward decreased proinsulin response to MT (-19 vs. + 6%, p = 0.07, ES = -0.9) and increased glucagon response to MT (+3 vs. -3%, p = 0.09, ES = 0.6), and significant increases in the Matsuda index (+66 vs. -31%, p = 0.004, ES = 0.9) and fasting glucagon (+4 vs. -8%, p = 0.03, ES = 0.7). No significant differences between SLT-TR and SLT-NT were observed in fasting glucose, glucose response to MT, and insulinogenic index (all p > 0.05). SLE-TR showed a significant increase in AMPK Thr 172 phosphorylation when compared to SLE-NT (+73 vs. -12%, p = 0.014, ES = 1.3), whereas no significant differences between groups were observed in Akt Ser 473 phosphorylation, total and membrane GLUT4 expression, and GLUT4 translocation (all p > 0.05). In conclusion, a 12-week moderate-intensity aerobic exercise training program improved insulin sensitivity in SLE patients with mild/inactive disease. This effect appears to be partially mediated by the increased insulin-stimulated skeletal muscle AMPK phosphorylation.
- Chronotropic Incompetence and Reduced Heart Rate Recovery in Rheumatoid Arthritis(2018) PECANHA, Tiago; RODRIGUES, Reynaldo; PINTO, Ana Jessica; SA-PINTO, Ana Lucia; GUEDES, Lissiane; BONFIGLIOLI, Karina; GUALANO, Bruno; ROSCHEL, HamiltonBackground/Objective Recent studies have indicated that cardiac autonomic dysfunction is an early sign of cardiovascular impairment in rheumatoid arthritis (RA). Previous studies have mainly focused on resting assessments; however, analysis of heart rate (HR) responses to exercise might provide additional information on cardiac autonomic dysfunction in this disease. Thus, we aimed to assess the HR responses during and after a maximal graded exercise test in patients with RA and healthy controls (CONs). Methods This was a cross-sectional study in which 27 female RA patients and 14 female CONs frequency matched by physical activity, age, and body mass index were compared for HR responses during and after a maximal graded exercise test. Results Rheumatoid arthritis patients showed reduced chronotropic response (94.3% 16.3% vs. 106.1% +/- 10.3%, p = 0.02) and lower HR recovery (HRR) at 30 seconds (8.6 +/- 6.7 vs. 13.4 +/- 5.2 beats/min [bpm], p = 0.02), 60 seconds (16.5 +/- 7.8 vs. 24.0 +/- 9.9 bpm, p = 0.01), 120 seconds (32.6 +/- 9.9 vs. 40.7 +/- 12.3 bpm, p = 0.03), and 180 seconds (46.5 +/- 12.6 vs. 55.5 +/- 13.4 bpm, p = 0.05) post-maximal exercise test when compared with CONs. Moreover, the prevalence of chronotropic incompetence (i.e., failure to reach 80% of the HR-predicted response) and abnormal HRR (i.e., HRR 12 bpm) were, respectively, 22.2% and 37.1% in RA patients. Conclusions Patients with RA showed reduced chronotropic response to exercise and slower postexercise HRR. These abnormal autonomic responses to exercise indicate the presence of cardiac autonomic dysfunction and increased cardiovascular risk in this population.
- Aerobic training modulates salience network and default mode network metabolism in subjects with mild cognitive impairment(2018) PORTO, F. H. G.; COUTINHO, Artur Martins; DURAN, Fabio Luis de Souza; PINTO, Ana Lucia de Sa; GUALANO, Bruno; BUCHPIGUEL, Carlos Alberto; BUSATTO, Geraldo; NITRINI, Ricardo; BRUCKI, Sonia Maria DozziAerobic training (AT) is a promising intervention to improve cognitive functioning. However, its modulatory effects on brain networks are not yet entirely understood. Sixty-five subjects with mild cognitive impairment performed a moderate intensity, 24-week AT program. Differences in resting regional brain glucose metabolism (rBGM) with FDG-PET were assessed before and after AT on a voxel-by-voxel basis. Structural equation modeling was used to create latent variables based on regions with significant rBGM changes and to test a hypothetical model about the inter-relationships between these changes. There were significant rBGM reductions in both anterior temporal lobes (ATL), left inferior frontal gyrus, left anterior cingulate cortex, right hippocampus, left meddle frontal gyrus and bilateral caudate nuclei. In contrast, there was an increase in rBGM in the right precuneus and left inferior frontal gyrus. Latent variables reflecting the salience network and ATL were created, while the precuneus represented the default mode network. In the model, salience network rBGM was decreased after AT. In contrast, rBGM in the default mode network increased as a final outcome. This result suggested improved salience network efficacy and increased control over other brain functional networks. The ATL network decreased its rBGM and connected to the salience network and default mode network with positive and negative correlations, respectively. The model fit values reached statistical significance, demonstrating that this model explained the variance in the measured data. In mild cognitive impairment subjects, AT modulated rBGM in salience network and default mode network nodes. Such changes were in the direction of the normally expected resting-state metabolic patterns of these networks.
- Increased Insulin Resistance and Glucagon Levels in Mild/Inactive Systemic Lupus Erythematosus Patients Despite Normal Glucose Tolerance(2018) MIYAKE, Cintia N. H.; GUALANO, Bruno; DANTAS, Wagner S.; PEREIRA, Renato T.; NEVES, William; ZAMBELLI, Vanessa O.; SHINJO, Samuel K.; PEREIRA, Rosa M.; SILVA, Elizabeth R.; SA-PINTO, Ana Lucia; BORBA, Eduardo; ROSCHEL, Hamilton; BONFA, Eloisa; BENATTI, Fabiana B.ObjectiveTo assess insulin sensitivity in patients with systemic lupus erythematosus (SLE) in response to a meal tolerance test (MTT). MethodsIn this cross-sectional study, 33 adult females with mild/inactive SLE (SLE group) and 16 age- and body mass index-matched female healthy controls (CTRL group) underwent an MTT and were assessed for insulin sensitivity and beta cell function. Skeletal muscle protein expressions of total and membrane insulin-dependent glucose transporter 4 (GLUT-4) were also evaluated (SLE group: n = 10, CTRL group: n = 5); muscle biopsies were performed after MTT. Further measurements included inflammatory cytokines, adipocytokines, physical activity level, body composition, and food intake. ResultsSLE and CTRL groups showed similar fasting glucose, glucose response, and skeletal muscle GLUT-4 translocation after MTT. However, the SLE group demonstrated higher fasting insulin levels (P = 0.01; effect size [ES] 1.2), homeostatic model assessment insulin resistance (IR) (P = 0.03; ES 1.1), insulin-to-glucose ratio response to MTT (P = 0.02; ES 1.2), fasting glucagon levels (P = 0.002; ES 2.7), glucagon response to MTT (P = 0.0001; ES 2.6), and a tendency toward lower Matsuda index of whole-body insulin sensitivity (P = 0.06; ES -0.5) when compared with the CTRL group. Fasting proinsulin-to-insulin ratio and proinsulin-to-insulin ratio response to MTT were similar between groups (P > 0.05), while the SLE group showed a higher insulinogenic index when compared with the CTRL group (P = 0.02; ES = 0.9). ConclusionWe have identified that SLE patients had a bi-hormone metabolic abnormality characterized by increased IR and hyperglucagonemia despite normal glucose tolerance and preserved beta cell function and skeletal muscle GLUT-4 translocation. Strategies capable of ameliorating insulin sensitivity to reduce the risk of type 2 diabetes mellitus and cardiovascular disease in SLE may require more than targeting IR alone.
- Effects of a new intervention based on the Health at Every Size approach for the management of obesity: The ""Health and Wellness in Obesity"" study(2018) ULIAN, Mariana Dimitrov; PINTO, Ana Jessica; SATO, Priscila de Morais; BENATTI, Fabiana B.; CAMPOS-FERRAZ, Patricia Lopes de; COELHO, Desire; ROBLE, Odilon J.; SABATINI, Fernanda; PEREZ, Isabel; ABURAD, Luiz; VESSONI, Andre; UNSAIN, Ramiro Fernandez; ROGERO, Marcelo Macedo; TOPORCOV, Tatiana Natasha; SA-PINTO, Ana Lucia de; GUALANO, Bruno; SCAGLIUSI, Fernanda B.Health at Every Size (R) (HAES (R)) is a weight-neutral approach focused on promoting healthy behaviors in people with different body sizes. This study examined multiple physiological, attitudinal, nutritional, and behavioral effects of a newly developed, intensive, interdisciplinary HAES (R)-based intervention in obese women. This was a prospective, seven-month, randomized (2: 1), controlled, mixed-method clinical trial. The intervention group (I-HAES (R); n = 39) took part in an intensified HAES (R)-based intervention comprising a physical activity program, nutrition counseling sessions, and philosophical workshops. The control group (CTRL; n = 19) underwent a traditional HAES (R)-based intervention. Before and after the interventions, participants were assessed for physiological, psychological, and behavioral parameters (quantitative data) and took part in focus groups (qualitative data). Body weight, body mass index, and waist and hip circumferences did not significantly differ within or between groups (P > 0.05). I-HAES (R) showed increased peak oxygen uptake and improved performance in the timed-stand test (P = 0.004 and P = 0.004, between-group comparisons). No significant within-or between-group differences were observed for objectively measured physical activity levels, even though the majority of the I-HAES (R) participants indicated that they were engaged in or had plans to include physical activity in their routines. I-HAES (R) resulted in improvements in eating attitudes and practices. The I-HAES (R) group showed significantly improved all Body Attitude Questionnaire subscale and all Figure Rating Scale scores (P <= 0.05 for all parameters, within-group comparisons), whereas the CTRL group showed slight or no changes. Both groups had significant improvements in health-related quality of life parameters, although the I-HAES (R) group had superior gains in the ""physical health,"" ""psychological health,"" and ""overall perception of quality of life and health"" (P = 0.05, 0.03, and 0.02, respectively, between-group comparisons) domains. Finally, most of the quantitative improvements were explained by qualitative data. Our results show that this new intensified HAES (R)-based intervention improved participants' eating attitudes and practices, perception of body image, physical capacity, and health-related quality of life despite the lack of changes in body weight and physical activity levels, showing that our novel approach was superior to a traditional HAES (R)-based program.