JOSE TADEU STEFANO
Projetos de Pesquisa
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LIM/07 - Laboratório de Gastroenterologia Clínica e Experimental, Hospital das Clínicas, Faculdade de Medicina
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conferenceObject Coronary artery calcium score in evaluating cardiovascular risk 1 and 4 years after liver transplant(2014) LINHARES, Livia M.; ALVARES-DA-SILVA, Mario R.; OLIVEIRA, Claudia P.; STEFANO, Jose Tadeu; GEBRIM, Eloisa M.; CARRILHO, Flair J.; D'ALBUQUERQUE, Luiz C.conferenceObject INTRATUMORAL INJECTION OF S-NITROSO-N-ACETYLCYSTEINE (SNAC) IN A RODENT MODEL OF NON-ALCOHOLIC STEATOHEPATITIS (NASH)-RELATED HEPATOCELLULAR CARCINOMA (HCC)(2014) STEFANO, J. T.; TORRES, M. M.; PEREIRA, I. V. A.; COGLIATI, B.; OLIVEIRA, M. G. de; CHAMMAS, C.; CARRILHO, F. J.; OLIVEIRA, C. P.- Pro-atherosclerotic markers and cardiovascular risk factors one year after liver transplantation(2014) ALVARES-DA-SILVA, Mario Reis; OLIVEIRA, Claudia Pinto Marques Souza de; STEFANO, Jose Tadeu; BARBEIRO, Hermes V.; BARBEIRO, Denise; SORIANO, Francisco G.; FARIAS, Alberto Queiroz; CARRILHO, Flair Jose; D'ALBUQUERQUE, Luiz Augusto CarneiroAIM: To investigate pro-atherosclerotic markers (endothelial dysfunction and inflammation) in patients one year after liver transplantation. METHODS: Forty-four consecutive liver transplant (LT) outpatients who were admitted between August 2009 and July 2010, were followed-up by for 1 year, exhibited no evidences of infection or rejection, all of them underwent tacrolimus-based immunosuppressive regimens were consecutively enrolled. Inflammatory cytokines (TNF alpha, IFN gamma, IL-8, and IL-10), endothelial biomarkers (sVCAM-1, sICAM-1, MPO, adiponectin, PAI-1, SAP, SAA, E-selectin, and MMP-9), high sensitive C-reactive protein, and Framingham risk score (FRS) were assessed. The anthropometric data, aminotransferases, metabolic syndrome features, glucose and lipid profiles, and insulin resistance data were also collected. The LT recipients were compared to 22 biopsy-proven non-alcoholic steatohepatitis (NASH) patients and 20 healthy controls (non-obese, non-diabetics, and non-dyslipidemic). RESULTS: The LT recipients had significantly younger ages and lower body mass indices, aminotransferases, fasting glucose and insulin levels, glucose homeostasis model and metabolic syndrome features than the NASH patients. Classic cardiovascular risk markers, such as Hs-CRP and FRS [2.0 (1.0-8.75)], were lower in the LT patients compared to those observed in the NASH patients (P = 0.009). In contrast, the LT recipients and NASH patients had similar inflammatory and endothelial serum markers compared to the controls (pg/mL): lower IL-10 levels (32.3 and 32.3 vs 62.5, respectively, P = 0.019) and higher IFN gamma (626.1 and 411.9 vs 67.9, respectively, P < 0.001), E-selectin (48.5 and 90.03 vs 35.7, respectively, P < 0.001), sVCAM-1 (1820.6 and 1692.4 vs 1167.2, respectively, P < 0.001), and sICAM-1 (230.3 and 259.7 vs 152.9, respectively, P = 0.015) levels. CONCLUSION: Non-obese LT recipients have similar pro-atherosclerotic serum profiles after a short 1-year follow-up period compared to NASH patients, suggesting a high risk of atherosclerosis in this population.
conferenceObject NADPH OXIDASE (NOX 4) AND P22PHOX GENE POLYMORPHISMS ARE ASSOCIATED WITH HUMAN NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD)(2014) RABELO, F.; STEFANO, J. T.; LIMA, R. V.; SEIXAS, M.; PATENTE, T.; VANNI, D.; CAVALEIRO, A. M.; MAZO, D. C.; CARRILHO, F. J.; CORREA-GIANNELLA, M. L.; OLIVEIRA, C.conferenceObject GENETIC ANCESTRY CHARACTERIZATION IN NAFLD PATIENTS FROM BRAZIL AND PORTUGAL(2014) CAVALCANTE, L. N.; STEFANO, J. T.; MACHADO, M.; RABELO, F.; MAZO, D. C.; ANGELO, A. L. D.; ABE-SANDES, K.; LYRA, L. G. C.; CARRILHO, F. J.; CORTEZ-PINTO, H.; LYRA, A. C.; OLIVEIRA, C. P.- Hypocaloric high-protein diet improves clinical and biochemical markers in patients with nonalcoholic fatty liver disease (NAFLD)(2014) DUARTE, Sebastiao Mauro Bezerra; FAINTUCH, Joel; STEFANO, Jose Tadeu; OLIVEIRA, Maria Beatriz Sobral de; MAZO, Daniel Ferraz de Campos; RABELO, Fabiola; VANNI, Denise; NOGUEIRA, Monize Aydar; CARRILHO, Flair Jose; OLIVEIRA, Claudia Pinto Marques Souza deObjective: To investigate the role of hypocaloric high-protein diet, a prospective clinical study was conducted in NAFLD patients. Research methods and procedures: Pre-versus post-interventional data were analyzed in 48 stable NAFLD patients (submitted to a hypocaloric high-protein diet during 75 days. Variables included anthropometrics (body mass index/ BMI and waist circumference/WC), whole-body and segmental bioimpedance analysis and biochemical tests. Diet compliance was assessed by interviews every two weeks. Results: BMI, WC and body fat mass remained relatively stable (-1.3%, -1.8% and -2.5% respectively, no significance). HDL- cholesterol increased (P < 0.05) whereas total, LDL and VLDL cholesterol, triglycerides, aspartate aminotransferase/AST, gamma glutamyltransferase/GGT, alkaline phosphatase/AP, fasting blood glucose and glycated hemoglobin/HbA1c decreased (P < 0.05). When patients were stratified according to increase (22/48, 45.8%) and decrease (21/48, 43.8%) of BMI, association between weight decrease and liver benefit could be elicited in such circumstances for ALT, AP and AST/ALT ratio. No change could be demonstrated in patients who gained weight. Multivariate assessment confirmed that waist circumference, ferritin, triacylglycerol, and markers of glucose homeostasis were the most relevant associated with liver enzymes. Discussion: Ours results are consistent with the literature of calorie restriction in the management of NAFLD. Changes in lifestyle and weight loss are recommended for NAFLD patients. European guidelines also support this recommendation. Conclusion: This is the first study that demonstrated that a high protein, hypocaloric diet were associated with improvement of lipid profile, glucose homeostasis and liver enzymes in NAFLD independent on BMI decrease or body fat mass reduction.