GILIANE BELARMINO DA SILVA
Projetos de Pesquisa
Unidades Organizacionais
LIM/35 - Laboratório de Nutrição e Cirurgia Metabólica do Aparelho Digestivo, Hospital das Clínicas, Faculdade de Medicina
3 resultados
Resultados de Busca
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- Gastrointestinal Transcriptomic Response of Metabolic Vitamin B12 Pathways in Roux-en-Y Gastric Bypass(2017) SALA, Priscila; BELARMINO, Giliane; TORRINHAS, Raquel S.; MACHADO, Natasha M.; FONSECA, Danielle C.; RAVACCI, Graziela R.; ISHIDA, Robson K.; GUARDA, Ismael F. M. S.; MOURA, Eduardo G. de; SAKAI, Paulo; SANTO, Marco A.; SILVA, Ismael D. C. G. da; PEREIRA, Claudia C. A.; LOGULLO, Angela F.; HEYMSFIELD, Steven; GIANNELLA-NETO, Daniel; WAITZBERG, Dan L.OBJECTIVES: Vitamin B12 (B12) deficiency after Roux-en-Y gastric bypass (RYGB) is highly prevalent and may contribute to postoperative complications. Decreased production of intrinsic factor owing to gastric fundus removal is thought to have a major role, but other components of B12 metabolism may also be affected. We evaluated changes in the expression levels of multiple B12 pathway-encoding genes in gastrointestinal (GI) tissues to evaluate the potential roles in contributing to post-RYGB B12 deficiency. METHODS: During double-balloon enteroscopy, serial GI biopsies were collected from 20 obese women (age, 46.9 +/- 6.2 years; body mass index, 46.5 +/- 5.3 kg/m(2)) with adult-onset type 2 diabetes (fasting plasma glucose >= 126 mg/dl; hemoglobin A1c >= 6.5%) before and, at the same site, 3 months after RYGB. Gene expression levels were assessed by the Affymetrix Human GeneChip 1.0 ST microarray. Findings were validated by real-time quantitative PCR (RT-qPCR). RESULTS: Gene expression levels with significant changes (P <= 0.05) included: transcobalamin I (TCN1) in remnant (-1.914-fold) and excluded (-1.985-fold) gastric regions; gastric intrinsic factor (GIF) in duodenum (-0.725-fold); and cubilin (CUBN) in duodenum (+0.982-fold), jejunum (+1.311-fold), and ileum (+0.685-fold). Validation by RT-qPCR confirmed (P <= 0.05) observed changes for TCN1 in the remnant gastric region (-0.132-fold) and CUBN in jejunum (+2.833-fold). CONCLUSIONS: RYGB affects multiple pathway-encoding genes that may be associated with postoperative B12 deficiency. Decreased TCN1 levels seem to be the main contributing factor. Increased CUBN levels suggest an adaptive genetic reprogramming of intestinal tissue aiming to compensate for impaired intestinal B12 delivery.
- Phase angle obtained by bioelectrical impedance analysis independently predicts mortality in patients with cirrhosis(2017) BELARMINO, Giliane; GONZALEZ, Maria Cristina; TORRINHAS, Raquel S.; SALA, Priscila; ANDRAUS, Wellington; D'ALBUQUERQUE, Luiz Augusto Carneiro; PEREIRA, Rosa Maria R.; CAPARBO, Valeria F.; RAVACCI, Graziela R.; DAMIANI, Lucas; HEYMSFIELD, Steven B.; WAITZBERG, Dan L.AIM To evaluate the prognostic value of the phase angle (PA) obtained from bioelectrical impedance analysis (BIA) for mortality prediction in patients with cirrhosis. METHODS In total, 134 male cirrhotic patients prospectively completed clinical evaluations and nutritional assessment by BIA to obtain PAs during a 36-mo follow-up period. Mortality risk was analyzed by applying the PA cutoff point recently proposed as a malnutrition marker (PA <= 4.9 degrees) in Kaplan-Meier curves and multivariate Cox regression models. RESULTS The patients were divided into two groups according to the PA cutoff value (PA > 4.9 degrees, n = 73; PA <= 4.9 degrees, n = 61). Weight, height, and body mass index were similar in both groups, but patients with PAs > 4.9 degrees were younger and had higher mid-arm muscle circumference, albumin, and handgrip-strength values and lower severe ascites and encephalopathy incidences, interleukin (IL)-6/IL-10 ratios and C-reactive protein levels than did patients with PAs <= 4.9 degrees (P <= 0.05). Forty-eight (35.80%) patients died due to cirrhosis, with a median of 18 mo (interquartile range, 3.3-25.6 mo) follow-up until death. Thirty-one (64.60%) of these patients were from the PA <= 4.9 degrees group. PA <= 4.9 degrees significantly and independently affected the mortality model adjusted for Model for End-Stage Liver Disease score and age (hazard ratio = 2.05, 95% CI: 1.11-3.77, P = 0.021). In addition, Kaplan-Meier curves showed that patients with PAs <= 4.9 degrees were significantly more likely to die. CONCLUSION In male patients with cirrhosis, the PA <= 4.9 degrees cutoff was associated independently with mortality and identified patients with worse metabolic, nutritional, and disease progression profiles. The PA may be a useful and reliable bedside tool to evaluate prognosis in cirrhosis.
- A new anthropometric index for body fat estimation in patients with severe obesity(2018) BELARMINO, G.; TORRINHAS, R. S.; SALA, P.; HORIE, L. M.; DAMIANI, L.; LOPES, N. C.; HEYMSFIELD, S. B.; WAITZBERG, D. L.Background: Body mass index (BMI) has been used to assess body adiposity, but it cannot adequately reflect body fat (BF) amount. The body adiposity index (BAI) has been shown a better performance than BMI for this purpose, but it can be inaccurate to estimate BF under extreme amounts of fat. Here, we propose a new anthropometric index, the Belarmino-Waitzberg (BeW) index, for specific estimation of BF in severely obese patients. Methods: In 144 adult patients with severe obesity, BF was estimated by air displacement plethysmography (ADP), as the reference method, along with the follow anthropometric measurements: height, abdominal circumference (AC), hip circumference (HC), weight, BMI (weight/ height2) and BAI ([HC(cm) / height (m)1.5) - 18] × 100). Patients were proportionately distributed into two distinct databases, the building model database (BMD) and the validation model database (VMD), which were applied to develop and validate the BeW index, respectively. The BeW index was tested for gender and ethnicity adjustment as independent variables. The agreement of BF% values obtained by the new index and by BAI with ADP was also assessed. Results: The BF% was 52.05 ± 5.42 for ADP and 59.11 ± 5.95 for the BeW index (all results are expressed as the mean ± standard deviation). A positive Pearson correlation (r = 0.74), a good accuracy (Cb = 0.94), and a positive Lin's concordance correlation (CCC = 0.70) were observed between the two groups. The 95% limits of individual agreement between the BeW index and ADP were 6.8 to 7.9%, compared to - 7.5 to 14.8% between the BAI and ADP. The new index, called the Belarmino-Waitzberg (BeW) index, showed an improvement of 2.1% for the R2 value and a significant gender effect, therefore resulting in two different indexes for females and males, as follows: Female BeW = - 48.8 + 0.087 × AC(cm) + 1.147 × HC(cm) - 0.003 × HC(cm)2 and Male BeW = - 48.8 + 0.087 × AC(cm) + 1.147 × HC(cm) - 0.003 × HC(cm)2-7.195. Conclusions: The new BeW index showed a good performance for BF estimation in patients with severe obesity and can be superior to the BAI for this purpose. © 2018 The Author(s).