CINTIA CERCATO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/10 - Laboratório de Lípides, Hospital das Clínicas, Faculdade de Medicina
LIM/10 - Laboratório de Lípides, Hospital das Clínicas, Faculdade de Medicina
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bookPart Obesidade - abordagem clínica(2022) MANCINI, Marcio C.; MELO, Maria Edna de; CERCATO, Cintia- Plasma Concentration of Essential and Toxic Trace Elements After Brazil Nut Intake: Results from a Randomized Controlled Trial(2023) DUARTE, Graziela Biude Silva; REIS, Bruna Zavarize; ROGERO, Marcelo Macedo; JR, Fernando Barbosa; CERCATO, Cintia; COZZOLINO, Silvia Maria FranciscatoBrazil nut (BN) is a good source of essential nutrients, but little is known about the content of other components, such as toxic elements. Moreover, the high consumption of BN could probably contribute to increased levels of toxic and essential elements in the blood. Thus, this study aimed to evaluate the concentration of essential and toxic trace elements in BN and their concentration in plasma of obese women after regular intake of BN. A randomized controlled clinical trial was carried out with 55 subjects that were randomly assigned to either the Brazil nut group (BN) (n = 29) or the control group (CO) (n = 26) and followed up for 2 months. The BN group consumed one unit of Brazil nut per day, and the CO group did not receive any intervention. The concentration of essential elements (zinc, copper, manganese, and cobalt) and toxic (barium, lead, and cadmium) in BN samples and plasma of obese women (before and after the intervention) were determined by inductively coupled plasma mass spectrometry. Barium followed by copper, and manganese were the trace elements present in higher amounts in Brazil nuts. After the BN intervention period was observed an increase in plasma cadmium (p = 0.002) and a reduction of plasma manganese (p < 0.001) levels. In conclusion, our findings suggest that the regular consumption of BN from the Brazilian Amazon rainforest contributes to the intake of essential trace elements and can be considered safe regarding the content of heavy metals.
- Effects of clomiphene citrate on male obesity-associated hypogonadism: a randomized, double-blind, placebo-controlled study(2018) SOARES, Andressa Heimbecher; HORIE, Nidia Celeste; CHIANG, Lucas Augusto Piccinin; CARAMELLI, Bruno; MATHEUS, Mariana Gomes; CAMPOS, Alexandre Holthausen; MARTI, Luciana Cavalheiro; ROCHA, Fernanda Agostini; MANCINI, Marcio C.; COSTA, Elaine Maria Frade; CERCATO, CintiaBackground Obesity causes secondary hypogonadism (HG) in men. Standard testosterone (T) replacement therapy improves metabolic parameters but leads to infertility. Objective To evaluate clomiphene citrate (CC) treatment of adult men with male obesity-associated secondary hypogonadism (MOSH). Design Single-center, randomized, double-blind, placebo-controlled trial. Participants Seventy-eight men aged 36.5 +/- 7.8 years with a body mass index (BMI) > 30 kg/m(2), total testosterone (TT) <= 300 ng/dL, and symptoms in the ADAM questionnaire. Intervention Random allocation to receive 50 mg CC or placebo (PLB) for 12 weeks. Outcomes (1) Clinical features: ADAM and sexual behavior questionnaires; (2) hormonal profile: serum TT, free T, estradiol (E2), luteinizing hormone (LH), follicle-stimulating hormone (FSH), and sex hormone-binding globulin (SHBG); (3) body composition: BMI, waist circumference, and bioelectric impedance analysis; (4) metabolic profile: blood pressure, fasting blood glucose, HbA lc, insulin, HOMA-IR, and lipid profile; (5) endothelial function: flow-mediated dilation of the brachial artery, quantitative assessment of endothelial progenitor cells and serum sICAM-1, sVCAM-1, and selectin-sE levels; (6) safety aspects: hematocrit, serum prostate-specific antigen, International Prostate Symptom Score, and self-reported adverse effects. Results There was an improvement in one sexual complaint (weaker erections; P < 0.001); increases (P < 0.001) in TT, free T, E2, LH, FSH, and SHBG; and improvements in lean mass (P < 0.001), fat-free mass (P = 0.004), and muscle mass (P < 0.001) in the CC group. CC reduced HDL (P < 0.001). No statistically significant differences were seen in endothelial function. Conclusions CC appeared to effectively improve the hormonal profile and body composition. CC may be an alternative treatment for MOSH in adult men.
- Brazilian evidence-based guideline for screening, diagnosis, treatment, and follow-up of metabolic dysfunction-associated steatotic liver disease (MASLD) in adult individuals with overweight or obesity: A joint position statement from the Brazilian Society of Endocrinology and Metabolism (SBEM), Brazilian Society of Hepatology (SBH), and Brazilian Association for the Study of Obesity and Metabolic Syndrome (Abeso)(2023) MOREIRA, Rodrigo Oliveira; VALERIO, Cynthia Melissa; VILLELA-NOGUEIRA, Cristiane Alves; CERCATO, Cintia; GERCHMAN, Fernando; LOTTENBERG, Ana Maria Pita; GODOY-MATAS, Amelio Fernando; OLIVEIRA, Ricardo de Andrade; MELLO, Carlos Eduardo Brandao; ALVARES-DA-SILVA, Mario Reis; LEITE, Nathalie Carvalho; COTRIM, Helma Pinchemel; PARISI, Edison Roberto; SILVA, Giovanni Faria; MIRANDA, Paulo Augusto Carvalho; HALPERN, Bruno; OLIVEIRA, Claudia PintoIntroduction: Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as Nonalcoholic fatty liver disease (NAFLD), is one of the most common hepatic diseases in individuals with overweight or obesity. In this context, a panel of experts from three medical societies was organized to develop an evidence-based guideline on the screening, diagnosis, treatment, and follow-up of MASLD. Material and methods: A MEDLINE search was performed to identify randomized clinical trials, meta-analyses, cohort studies, observational studies, and other relevant studies on NAFLD. In the absence of studies on a certain topic or when the quality of the study was not adequate, the opinion of experts was adopted. Classes of Recommendation and Levels of Evidence were determined using prespecified criteria. Results: Based on the literature review, 48 specific recommendations were elaborated, including 11 on screening and diagnosis, 9 on follow-up, 14 on nonpharmacologic treatment, and 14 on pharmacologic and surgical treatment. Conclusions: A literature search allowed the development of evidence-based guidelines on the screening, diagnosis, treatment, and follow-up of MASLD in individuals with overweight or obesity.
- Proposal of an obesity classification based on weight history: an official document by the Brazilian Society of Endocrinology and Metabolism (SBEM) and the Brazilian Society for the Study of Obesity and Metabolic Syndrome (ABESO)(2022) HALPERN, Bruno; MANCINI, Marcio C.; MELO, Maria Edna de; LAMOUNIER, Rodrigo N.; MOREIRA, Rodrigo O.; CARRA, Mario K.; KYLE, Theodore K.; CERCATO, Cintia; BOGUSZEWSKI, Cesar LuizObesity is a chronic disease associated with impaired physical and mental health. A widespread view in the treatment of obesity is that the goal is to normalize the individual's body mass index (BMI). However, a modest weight loss (usually above 5%) is already associated with clinical improvement, while weight losses of 10%-15% bring even further benefits, independent from the final BMI. The percentage of weight reduction is accepted as a treatment goal since a greater decrease in weight is frequently difficult to achieve due to metabolic adaptation along with environmental and lifestyle factors. In this document, the Brazilian Society of Endocrinology and Metabolism (SBEM) and the Brazilian Society for the Study of Obesity and Metabolic Syndrome (ABESO) propose a new obesity classification based on the maximum weight attained in life (MWAL). In this classification, individuals losing a specific proportion of weight are classified as having ""reduced"" or ""controlled"" obesity. This simple classification - which is not intended to replace others but to serve as an adjuvant tool - could help disseminate the concept of clinical benefits derived from modest weight loss, allowing individuals with obesity and their health care professionals to focus on strategies for weight maintenance instead of further weight reduction. In future studies, this proposed classification can also be an important tool to evaluate possible differences in therapeutic outcomes between individuals with similar BMIs but different weight trajectories.
- Consumption of Brazil nuts with high selenium levels increased inflammation biomarkers in obese women: A randomized controlled trial(2019) DUARTE, Graziela Biude Silva; REIS, Bruna Zavarize; ROGERO, Marcelo Macedo; VARGAS-MENDEZ, Ernesto; BARBOSA JUNIOR, Fernando; CERCATO, Cintia; COZZOLINO, Silvia Maria FranciscatoObjective: Increased inflammatory response is an important factor in the pathophysiology of obesity. The mineral selenium (Se), of which one of the main food sources is the Brazil nut, has important antioxidant and anti-inflammatory functions through the action of selenoproteins. Thus, the evaluation of the influence of this micronutrient in this context is of great relevance. The aim of this study was to evaluate the effects of Brazil nut intake with high Se concentrations on inflammatory biomarkers and its relation to Se status in obese women. Methods: A randomized controlled clinical trial was carried out with 55 women recruited at Clinical Hospital in Sao Paulo, Brazil. Patients were randomly assigned to either the Brazil nut group (BN) or the control group (CO) and followed up for 2 mo. The BN group consumed 1 unit/d of Brazil nuts (similar to 1261 mu g/Se); the CO group did not receive any intervention. At baseline and after 2 mo, analysis of biochemical parameters related to Se status, oxidative stress, and inflammatory biomarkers were performed. Results: At baseline, both groups did not present Se deficiency. In the BN group, a significant increase (P < 0.05) in all Se biomarkers and in gene expression of several proinflammatory parameters (interleukin-6, tumor necrosis factor-a, and Toll-like receptors 2 and 4) were observed after the intervention period. No changes were observed for the CO group. Conclusion: Although there were no changes in plasma inflammatory biomarkers levels, a significant increase in gene expression may be an indication of a proinflammatory stimulus in obesity, induced by the consumption of Brazil nuts with high Se levels.
- Changes in Neuropsychological Tests and Brain Metabolism After Bariatric Surgery(2014) MARQUES, Emerson Leonildo; HALPERN, Alfredo; MANCINI, Marcio Correa; MELO, Maria Edna de; HORIE, Ndia Celeste; BUCHPIGUEL, Carlos Alberto; COUTINHO, Artur Martins Novaes; ONO, Carla Rachel; PRANDO, Silvana; SANTO, Marco Aurelio; CUNHA-NETO, Edecio; FUENTES, Daniel; CERCATO, CintiaContext: The mechanisms by which obesity alters the cerebral function and the effect of weight loss on the brain have not been completely clarified. Objective: The objective of the study was to assess the effect of bariatric surgery on the cognitive function and cerebral metabolism. Design: Seventeen obese women were studied prior to and 24 weeks after bariatric surgery using neuropsychological tests and positron emission tomography. Setting: The study was conducted in a reference center for the treatment of obesity of a Brazilian public university. Participants: Thirty-three women paired by age and level of education made up two groups: 17 severely obese patients and 16 lean patients. They did not have diabetes mellitus or a family history of dementia. Main Outcome Measures: Comparison of performance in neuropsychological tests and cerebral metabolism of the obese women before and after bariatric surgery was measured. The results found at the two moments were compared with those of the women of normal weight. Results: Women with a mean age of 40.5 years and mean body mass index of 50.1 kg/m(2) when compared with women with mean body mass index of 22.3 kg/m(2) showed increased cerebral metabolism, especially in the posterior cingulate gyrus (P <.004). No difference was found between the groups for the neuropsychological tests. After 24 weeks the cerebral metabolism of the obese women was lower, similar to the lean women, and there was an improvement of executive function, accompanying changes of metabolic and inflammatory parameters. Conclusions: Obese women may have increased cerebral metabolism when compared with women of normal weight, and this appears to reverse after weight loss induced by bariatric surgery, accompanied by improved executive function.
- Brazil nut intake increases circulating miR-454-3p and miR-584-5p in obese women(2019) REIS, Bruna Zavarize; DUARTE, Graziela Biude Silva; VARGAS-MENDEZ, Ernesto; FERREIRA, Ludmila Rodrigues Pinto; JR, Fernando Barbosa; CERCATO, Cintia; ROGERO, Marcelo Macedo; COZZOLINO, Silvia Maria FranciscatoThe Brazil nut is an excellent source of selenium (Se), an essential micronutrient for human health. In this study, we hypothesized that Brazil nut intake modulates circulating microRNAs (miRNAs) in obese women and aimed to evaluate the effects of this nut intake on circulating miRNAs in women with obesity or metabolic syndrome (MetS). A randomized controlled clinical trial was conducted on 54 subjects recruited from the Clinical Hospital in Sao Paulo, Brazil. Patients were randomly assigned to 2 groups: a Brazil nut group (BN group, n = 29) and a control group (CO group, n = 25); both were monitored for 2 months. BN group members were instructed to consume 1 Brazil nut (approximately 1261 g/Se) per day; CO group members were instructed not to consume any. Biochemical parameters related to Se status and 25 circulating miRNAs in plasma were evaluated in all patients both at baseline and after 2 months. Expression levels of 2 miRNAs (miR-454-3p and miR-584-5p) were significantly increased after Brazil nut intake. To investigate the effect of MetS on circulating miRNAs at baseline, we performed comparisons between women with MetS (n = 23) and women without MetS (others, n = 31). Circulating miR-375 levels were significantly lower (P =.012) in women with MetS. In conclusion, our findings suggested that a daily intake of 1 Brazil nut increased circulating miR-454-3p and miR-584-5p expression levels in obese women, and our network analysis indicated a link between Se intake, vitamin D metabolism, and calcium homeostasis.
conferenceObject Hepatic iron overload analysis bymagnetic resonance imaging in a non-alcoholic fatty liver disease population(2017) FILHO, H. M. L.; FABREGA, P.; CHUA-ANUSORN, W.; OLIVEIRA, C. P.; CARRILHO, F. J.; LIMA, F.; CERCATO, C.; CLARK, P.; ROCHA, M.- Tratamento de curto prazo com liraglutide no reganho de peso após cirurgia bariátrica(2013) PAJECKI, Denis; HALPERN, Alfredo; CERCATO, Cintia; MANCINI, Marcio; CLEVA, Roberto de; SANTO, Marco AurélioOBJECTIVE: To evaluate the results of the use of liraglutide in a group of patients undergoing surgical treatment of morbid obesity with unsatisfactory weight loss or regain of more than 15% of minimum reached weight. METHODS: The authors conducted a retrospective analysis of 15 operated patients who had excess weight loss <50% after two years of follow-up or regained weight more than 15% of the minimum reached weight. We included only patients who had the expected ""surgical anatomy"", assessed by contrast radiography and endoscopy. Mean age was 47.2 ± 12.5 years, and patients received liraglutide at doses from 1.2 to 3.0 mg/day for eight to 28 weeks follow-up. RESULTS: Surgical treatment induced a weight loss of 34.1 ± 16.5 kg. The average weight regain after 5.3 ± 3.3 years was 14.2 ± 12.1 Kg. The average weight was significantly reduced after treatment with liraglutide (100.9 ± 18.3 kg. vs Kg 93.5 ± 17.4, p <0.0001). Six patients had nausea and two discontinued therapy due to the cost of medication. CONCLUSION: medical treatment directed to the control of satiety using liraglutide may be an alternative treatment of patients with poor weight loss or weight regain after surgery when no technical problem has been identified.