GILIANE BELARMINO DA SILVA

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LIM/35 - Laboratório de Nutrição e Cirurgia Metabólica do Aparelho Digestivo, Hospital das Clínicas, Faculdade de Medicina

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Revista / Livro: Clinical Nutrition ×

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  • article 10 Citação(ões) na Scopus
    Prognostic value of energy expenditure and respiratory quotient measuring in patients with liver cirrhosis
    (2019) BELARMINO, G.; SINGER, P.; GONZALEZ, M. C.; MACHADO, N. M.; CARDINELLI, C. S.; BARCELOS, S.; ANDRAUS, W.; D'ALBUQUERQUE, L. A. C.; DAMIANI, L.; COSTA, A. C.; PEREIRA, R. M. R.; HEYMSFIELD, S. B.; SALA, P.; TORRINHAS, R. S. M.; WAITZBERG, D. L.
    Background & aims: Resting energy expenditure (REE) and respiratory quotient (RQ) as measured by indirect calorimetry (IC) may correlate with muscle mass and represent prognostic indicators in treating patients with liver cirrhosis. We aimed to assess the correlation of IC-measured REE and RQ with skeletal muscle mass (SM), mortality, and REE values as estimated by Harris-Benedict, European guidelines (EG), and Brazilian guidelines-DITEN (BG) equations in patients with liver cirrhosis. Methods: In this prospectively designed study, REE was measured in 126 male patients with liver cirrhosis by IC and predicted by Harris-Benedict, EG (35 kcal/kg current weight), and BG (30 kcal/kg current weight) guidelines. Measurements were obtained at the time of admission to the study. Body composition was determined by whole-body dual-energy X-ray absorptiometry. The association between REE and 3-year survival was investigated. Results: Cirrhosis etiology was classified as alcohol related (59.0%), viral (20.1%), cryptogenic (11.8%), or other (9.0%). Mean Child-Pugh and MELD indexes were 8.30 +/- 2.0 and 14.38 +/- 6.12, respectively. RQ showed a moderate correlation with SM (r = 0.64), while IC-measured REE was inversely associated with mortality (multivariate Cox Regression, HR = 0.88, 95% CI: 0.78; 1, p = 0.04). Among the predictive equations for REE, only Harris-Benedict yielded values close to the IC, with a positive Pearson correlation (r = 0.77), excellent accuracy (Cb = 0.98), and positive Lin's concordance correlation (CCC = 0.75). However, a large standard deviation was observed; HB-measured REE did not correlate with mortality. Conclusions: RQ and REE, as measured by IC, may be valuable tools for evaluating the severity of cirrhosis, by reflecting SM and predicting mortality, respectively. The predictive equations for REE included in this study cannot replace IC for this purpose. Registered at: www.clinicalTrials.gov (NCT02421848).
  • article 10 Citação(ões) na Scopus
    Reduced intestinal FADS1 gene expression and plasma omega-3 fatty acids following Roux-en-Y gastric bypass
    (2019) GARLA, Priscila; SALA, Priscila; TORRINHAS, Raquel Susana Matos; MACHADO, Natasha Mendonca; FONSECA, Danielle Cristina; SILVA, Mariane Marques da; RAVACCI, Graziela Rosa; BELARMINO, Giliane; ISHIDA, Robson Kiyoshi; GUARDA, Ismael Francisco Mota Siqueira; MOURA, Eduardo Guimardes Hourneaux de; SAKAI, Paulo; SANTO, Marco Aurelio; SILVA, Ismael Dale Cotrim Guerreiro da; PEREIRA, Claudia Cristina Alves; HEYMSFIELD, Steven; CORREA-GIANNELLA, Maria Lucia Cardillo; CALDER, Philip C.; WAITZBERG, Dan Linetzky
    Background & aims: Roux-en-Y gastric bypass (RYGB) limits food ingestion and may alter the intestinal expression of genes involved in the endogenous synthesis of polyunsaturated fatty acids (PUFAs). These changes may decrease the systemic availability of bioactive PUFA5 after RYGB. To study the impact of RYGB on the dietary ingestion and plasma concentration of PUFA5 and on the intestinal expression of genes involved in their endogenous biosynthesis in severely obese women with type 2 diabetes. Methods: Before, and 3 and 12 months after RYGB, obese women (n = 20) self-reported a seven-day dietary record, answered a food frequency query and provided plasma samples for alpha-linolenic (ALA), eicosapentaenoic (EPA), docosahexaenoic (DHA) and arachidonic (ARA) acid assessment by gas chromatography. Intestinal biopsies (duodenum, jejunum and ileum) were collected through double balloon endoscopy before and 3 months after RYGB for gene expression analysis by microarray (Human GeneChip 1.0 ST array) and RT-qPCR validation. Results: Compared to the preoperative period, patients had decreased intakes of PUFAs, fish and soybean oil (p < 0.05) and lower plasma concentrations of ALA and EPA (p < 0.001) 3 and 12 months after RYGB. FADS] gene expression was lower in duodenum (RT-qPCR fold change = 1.620, p < 0.05) and jejunum (RT-qPCR fold change = -1.549, p < 0.05) 3 months following RYGB, compared to before surgery. Conclusion: RYGB decreased PUFA ingestion, plasma ALA and EPA levels, and intestinal expression of FADS] gene. The latter encodes a key enzyme involved in endogenous biosynthesis of PUFA5. These data suggest that supplementation of omega-3 PUFAs may be required for obese patients undergoing RYGB. Clinical Trial Registry number and website: www.clinicaltrials.gov NCT01251016; Plataforma Brasil - 19339913.0.0000.0068. (C) 02018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.