MARCIA SILVA QUEIROZ

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  • article 27 Citação(ões) na Scopus
    Insulin Glargine U100 Improved Glycemic Control and Reduced Nocturnal Hypoglycemia in Patients with Type 2 Diabetes Mellitus and Chronic Kidney Disease Stages 3 and 4
    (2019) BETONICO, Carolina C.; TITAN, Silvia Maria O.; LIRA, Aecio; PELAES, Tatiana S.; CORREA-GIANNELLA, Maria Lucia C.; NERY, Marcia; QUEIROZ, Marcia
    Purpose: Glycemic control in patients with chronic kidney disease (CKD) is particularly hard to achieve because of a slower insulin degradation by the kidney. It might modify the long-acting insulin analogue pharmacokinetics, increasing its time-action and the risk of hypoglycemia. However, because this insulin has no peak action, it might be a more tolerable approach to patients with CKD. This hypothesis remains to be tested, because no study has thus far examined the efficacy and safety profile of long-acting basal analogues in patients with significant loss of renal function. The purpose of this study was to compare the glycemic response to treatment with glargine U100 or neutral protamine Hagedorn (NPH) insulin in patients with type 2 diabetes mellitus (T2DM) and CKD stages 3 and 4. Methods: Thirty-four patients were randomly assigned to glargine U100 or NPH insulin after a 2-way crossover open-label design. The primary end point was the difference in glycosylated hemoglobin (HbA(1c)) and in the number of hypoglycemic events between weeks 1 and 24, whereas secondary end points included changes in glycemic patterns, weight and body mass index, and total daily dose of insulin. HbA(1)(c) was determined by ion-exchange HPLC, and hypoglycemia was defined as glucose concentration of 54 mg/dL (3.0 mmol/L) detected by self-monitoring of plasma glucose or continuous glucose monitoring. Findings: After 24 weeks, mean HbA(1c )decreased on glargine U100 treatment (-0.91%; P < 0.001), but this benefit was not observed for NPH (0.23%; P = 0.93). Moreover, incidence of nocturnal hypoglycemia was 3 times lower with glargine than with NPH insulin (P = 0.047). (C) 2019 Published by Elsevier Inc.
  • article 8 Citação(ões) na Scopus
    Short-term effects of intravitreal bevacizumab in contrast sensitivity of patients with diabetic macular edema and optimizing glycemic control
    (2019) MOTTA, Augusto A. L.; BONANOMI, Maria Teresa B. C.; FERRAZ, Daniel A.; PRETI, Rony C.; SOPHIE, Raafay; ABALEM, Maria F.; QUEIROZ, Marcia S.; PIMENTEL, Sergio L. G.; TAKAHASHI, Walter Y.; DAMICO, Francisco M.
    Aims: To analyze contrast sensitivity of intravitreal bevacizumab injections with optimizing glycemic control versus optimizing glycemic control (in combination with sham injections) in eyes with Diabetic Macular Edema (DME). Design: Prospective, interventional, masked, randomized controlled trial. Methods: Forty-one eyes of 34 patients with type 2 diabetes mellitus and DME with glycated hemoglobin (HbA1c) < 11% received either intravitreal bevacizumab injection (Group 1) or sham injection (Group 2) at 0 and 6 weeks along with optimizing glycemic control. Mean change in best-corrected visual acuity (BCVA), contrast sensitivity (CS), optical coherence tomography (OCT)-measured by central macular thickness (CMT) were compared and correlated at baseline, 2, 6 and 12 weeks. Results: The study showed a mean CS improved in group 1 from 1.14 +/- 0.36 logCS to 1.32 +/- 0.24 logCS and also in group 2 from 1.11 +/- 0.29 logCS to 1.18 +/- 0.29 logCS at 12 weeks (P = 0.12). CS and CMT promptly decreased in group 1 compared to group 2 at 2 weeks (Delta CS = 0.15 +/- 0.25 vs. 0.03 +/- 0.15 logCS; P = 0.04; Delta CMT = 116 +/- 115 vs. 17 +/- 71 mu m; P = 0.01). There was a mean reduction of approximately 0.5% in HbA1c levels in both groups at 12 weeks (P = 0.002). Conclusion: The use of bevacizumab in combination with optimizing glycemic control results in earlier improvement of contrast sensitivity in type 2 diabetes patients with DME. However, the optimizing glycemic control itself has shown also to be effective at 12 weeks.
  • article 9 Citação(ões) na Scopus
    Serum RBP4 and CKD: Association with insulin resistance and lipids
    (2017) DOMINGOS, Maria Alice M.; QUEIROZ, Marcia; LOTUFO, Paulo Andrade; BENSENOR, Isabela Judith; TITAN, Silvia Maria de Oliveira
    Objective: Serum RBP4 is new adipokine and it has been related to insulin resistance and diabetes risk in animal and clinical studies. However, there is controversy on this relationship among CKD patients. In this study, we evaluated the association of serum RBP4 with insulin resistance and cardiovascular risk factors in CKD. Methods: Baseline data from the PROGREDIR Study (Sao Paulo, Brazil) comprising 454 participants (mainly stages 3 and 4) was analyzed. Results: In univariable analysis, RBP4 was inversely related to renal function, age and HDL, and positively related to other lipids, insulinemia, HOMA, glycemia, albumin, phosphorus and right hepatic lobe diameter. After adjustment for sex, age and eGFR, HOMA and lipids remained associated to RBP4. In multivariable analysis, eGFR and triglyceride remained significantly associated with RBP4, while HOMA showed no longer a significant positive association. An interaction term between RBP4 and eGFR was significantly related to HOMA. Conclusions: Renal function is inversely related to serum RBP4. As GFR decreases, the relationship between RBP4 and HOMA is attenuated. On the other hand, triglycerides remained strongly related to RBP4 and this was not affected by eGFR, suggesting that in the CKD population triglycerides may be a better marker of RBP4-associated metabolic effects.
  • article 23 Citação(ões) na Scopus
    Beta-2-microglobulin (B2M) expression in the urinary sediment correlates with clinical markers of kidney disease in patients with type 1 diabetes
    (2016) MONTEIRO, Maria Beatriz; THIEME, Karina; SANTOS-BEZERRA, Daniele Pereira; QUEIROZ, Marcia Silva; WORONIK, Viktoria; PASSARELLI, Marisa; MACHADO, Ubiratan Fabres; GIANNELLA-NETO, Daniel; OLIVEIRA-SOUZA, Maria; CORREA-GIANNELLA, Maria Lucia
    Purpose. After observing variation in the expression of the housekeeping gene B2M in cells of the urinary sediment during a study of candidate genes potentially involved in diabetic kidney disease (DKD), we hypothesized that B2M mRNA expression in the urinary sediment could reflect the presence of DKD. Methods. qPCR was used to quantify B2M mRNA expression in cells of the urinary sediment of 51 type 1 diabetes (T1D) patients (61% women, 33.5 [27.0-39.7] years old, with diabetes duration of 21.0 [15.0-28.0] years and HbA1c of 8.2% [7.3-8.9]; median [interquartile interval]) sorted according to the diabetic nephropathy (DN) stages; 8 focal segmental glomerulosclerosis (FSGS) patients and 10 healthy controls. B2M mRNA expression was also evaluated in human embryonic kidney epithelium-like (HEK-293) cells exposed to 25 mM glucose and to albumin in order to mimic, respectively, a diabetic and a proteinuric milieu. Results. No differences were found in B2M mRNA expression among healthy controls, FSGS and T1D patients. Nonetheless B2M mRNA expression was higher in the group composed by T1D patients with incipient or overt DN combined with FSGS patients versus T1D patients without DN combined with healthy controls (P = 0.0007). B2M mRNA expression was higher in T1D patients with incipient or overt DN versus without DN (P = 0.03). B2M mRNA expression positively correlated with albuminuria in the overall T1D population (r = 0.43; P = 0.01) and negatively correlated with estimated glomerular filtration rate in male T1D patients (r = - 0.57; P = 0.01). Increased B2M expression was observed in HEK-293 cells exposed to 25 mM glucose and to albumin. Conclusions. B2M mRNA expression in cells of the urinary sediment is higher in T1D patients with DKD and in patients with FSGS in comparison to healthy subjects, maybe reflecting a tubulointerstitial injury promoted by albumin. Given the proinflammatory nature of B2M, we suggest that this protein contributes to diabetic (and possibly, to non-diabetic) tubulopathy.
  • article 64 Citação(ões) na Scopus
    Improvement in medication adherence and self-management of diabetes with a clinical pharmacy program: a randomized controlled trial in patients with type 2 diabetes undergoing insulin therapy at a teaching hospital
    (2015) CANI, Catarina Gomes; LOPES, Laura da Silva Girao; QUEIROZ, Marcia; NERY, Marcia
    OBJECTIVE: To evaluate the impact of a clinical pharmacy program on health outcomes in patients with type 2 diabetes undergoing insulin therapy at a teaching hospital in Brazil. METHOD: A randomized controlled trial with a 6-month follow-up period was performed in 70 adults, aged 45 years or older, with type 2 diabetes who were taking insulin and who had an HbA1c level >= 8%. Patients in the control group (CG) (n = 36) received standard care, patients in the intervention group (IG) (n = 34) received an individualized pharmacotherapeutic care plan and diabetes education. The primary outcome measure was change in HbA1c. Secondary outcomes included diabetes and medication knowledge, adherence to medication, insulin injection and home blood glucose monitoring techniques and diabetes-related quality of life. Outcomes were evaluated at baseline and 6 months using questionnaires. RESULTS: Diabetes knowledge, medication knowledge, adherence to medication and correct insulin injection and home blood glucose monitoring techniques significantly improved in the intervention group but remained unchanged in the control group. At the end of the study, mean HbA1c values in the control group remained unchanged but were significantly reduced in the intervention group. Diabetes-related quality of life significantly improved in the intervention group but worsened significantly in the control group. CONCLUSION: The program improved health outcomes and resulted in better glycemic control in patients with type 2 diabetes undergoing insulin therapy.
  • article 7 Citação(ões) na Scopus
    Allelic variations in genes belonging to glutathione system increase proliferative retinopathy risk in type 1 diabetes individuals
    (2019) PEREZ, Ricardo Vessoni; MACHADO, Cleide Guimaraes; SANTOS-BEZERRA, Daniele Pereira; ADMONI, Sharon Nina; PATENTE, Thiago Andrade; MONTEIRO, Maria Beatriz; CAVALEIRO, Ana Mercedes; QUEIROZ, Marcia Silva; NERY, Marcia; CORREA-GIANNELLA, Maria Lucia
    Aims: Given the participation of oxidative stress in the pathogenesis of diabetic complications, we evaluated, in type 1 diabetes (T1D) individuals, the association between diabetic retinopathy (DR) and functional single nucleotide polymorphisms (SNPs) in regulatory regions of two genes belonging to the antioxidant glutathione (GSH) system: rs17883901 in GCLC and rs713041 in GPX4. Methods: A cross-sectional case-control study included 288 individuals (61% women, 34[+/- 11] years old, diabetes duration of 22[+/- 9] years, mean [+/- SD]) sorted according to DR stages: absence of DR (ADR), non proliferative DR (NPDR) and proliferative DR (PDR). SNPs were genotyped by real-time PCR using fluorescent labelled probes. Logistic regression models with adjustment for confounding covariates were employed. Results: The presence of at least one T-allele of rs17883901 in GCLC was an independent risk factor for PDR (OR 4.13, 95% CI 1.38-13.66, p = 0.014) in a polytomous regression model (PDR versus ADR). The presence of at least one T-allele of rs713041 in GPX4 conferred protection against PDR (OR 0.30, 95% CI 0.11-0.80, p = 0.017) in female T1D individuals. Conclusion: The functional SNPs rs17883901 and rs713041 modulate the risk for PDR in the studied population of T1D individuals, widening the spectrum of candidate genes for this complication.
  • article 11 Citação(ões) na Scopus
    Assessment guidance of carbohydrate counting method in patients with type 2 diabetes mellitus
    (2014) MARTINS, Michelle R.; AMBROSIO, Ana Cristina T.; NERY, Marcia; AQUINO, Rita de Cassia; QUEIROZ, Marcia S.
    Aims: We evaluated the application of the method of carbohydrate counting performed by 21 patients with type 2 diabetes, 1 year later attending a guidance course. Methods: Participants answered a questionnaire to assess patients' adhesion to carbohydrate counting as well as to identify habit changes and the method's applicability, and values of glycated hemoglobin were also analyzed. Results: Most participants (76%) were females, and 25% of them had obesity degree III. There was a statistically significant decrease in glycated hemoglobin from 8.42 +/- 0.02% to 7.66 +/- 0.01% comparing values before and after counseling. We observed that although patients stated that the method was difficult they understood that carbohydrate counting could allow them make choices and have more freedom in their meals; we also verified if they understood accurately how to replace some foods used regularly in their diets and most patients correctly chose replacements for the groups of bread (76%), beans (67%) and noodles (67%). Conclusions: We concluded that participation in the course led to improved blood glucose control with a significant reduction of glycated hemoglobin, better understanding of food groups and the adoption of healthier eating habits.
  • article 10 Citação(ões) na Scopus
    Association of single nucleotide polymorphisms in the gene encoding GLUT1 and diabetic nephropathy in Brazilian patients with type 1 diabetes mellitus
    (2015) MARQUES, T.; PATENTE, T. A.; MONTEIRO, M. B.; CAVALEIRO, A. M.; QUEIROZ, M. S.; NERY, M.; AZEVEDO, M. J. de; CANANI, L. H.; PARISI, M. C.; MOURA-NETO, A.; PASSARELLI, M.; GIANNELLA-NETO, D.; MACHADO, U. F.; CORREA-GIANNELLA, M. L.
    Mesangial cells subject to high extracellular glucose concentrations, as occur in hyperglycaemic states, are unable to down regulate glucose influx, resulting in intracellular activation of deleterious biochemical pathways. A high expression of GLUT1 participates in the development of diabetic glomerulopathy. Variants in the gene encoding GLUT1 (SLC2A1) have been associated to this diabetic complication. The aim of this study was to test whether polymorphisms in SLC2A1 confer susceptibility to diabetic nephropathy (DN) in Brazilian type I diabetes patients. Four polymorphisms (rs3820589, rs1385129, rs841847 and rs841848) were genotyped in a Brazilian cohort comprised of 452 patients. A prospective analysis was performed in 155 patients. Mean duration of follow-up was 5.6 +/- 2.4 years and the incidence of renal events was 18.0%. The rs3820589 presented an inverse association with the prevalence of incipient DN (OR: 0.36,95% CI: 0.16 - 0.80, p = 0.01) and with progression to renal events (HR: 0.20; 95% CI: 0.03 - 0.70; p = 0.009). AGGT and AGAC haplotypes were associated with the prevalence of incipient ON and the AGAC haplotype was also associated with the prevalence of established/advanced DN. In conclusion, rs3820589 in the SLC2A1 gene modulates the risk to DN in Brazilian patients with inadequate type I diabetes control.
  • article 19 Citação(ões) na Scopus
    Impact of type 1 diabetes mellitus and celiac disease on nutrition and quality of life
    (2017) NUNES-SILVA, J. G.; NUNES, V. S.; SCHWARTZ, R. P.; TRECCO, S. M. L. S. S.; EVAZIAN, D.; CORREA-GIANNELLA, M. L.; NERY, M.; QUEIROZ, M. S.
    OBJECTIVE: Type 1 diabetes mellitus (T1DM) and celiac disease (CD) are autoimmune diseases and have similar genetic patterns. T1DM treatment is based on diet, physical activity and insulin therapy, whereas CD depends on dietary changes with restriction of wheat, rye and barley. The aim of the study was to evaluate the quality of life (QoL) of individuals with the association of T1DM and CD, to characterize their nutritional status and to compare it with those with only one disease and healthier controls. SUBJECTS/METHODS: Sixty patients controlled by sex, age and body mass index (BMI) were stratified by previous diagnosis in: T1DM and CD (DMCD group); T1DM (DM group); CD (CD group); or healthy participants (HC). The SF-36 questionnaire was applied to assess psychological well being and results were compared with glycemic control and presence of complications related to diabetes, adhesion to gluten-free diet (GFD). Nutritional status and body mass composition were determined by BMI, waist circumference, bioimpedance, general laboratory tests and whole-body densitometry. RESULTS: The time of diagnosis of T1DM was similar between DMCD and DM groups; however, the duration of CD was significantly higher in the CD group compared with DMCD. The SF-36 analysis revealed statistically significant differences between DM and HC groups in two domains: general health (P = 0.042) and energy/vitality (P = 0.012). QoL was also correlated with compliance to a GFD, and scores were similar in both groups: DMCD and CD. Forty percent of individuals in the CD group had visceral fat area above 100 cm(2), as opposed to 20% in the other groups. CONCLUSIONS: Individuals of DMCD group had similar scores to DM, CD and HC on QoL, as well as on their nutritional status and bone metabolism. Thereby, we should conclude that the association of T1DM and CD did not deteriorate their health status.
  • article 6 Citação(ões) na Scopus
    Linkage disequilibrium with HLA-DRB1-DQB1 haplotypes explains the association of TNF-308G > A variant with type 1 diabetes in a Brazilian cohort
    (2015) PATENTE, Thiago A.; MONTEIRO, Maria B.; VIEIRA, Suzana M.; SILVA, Maria E. Rossi da; NERY, Marcia; QUEIROZ, Marcia; AZEVEDO, Mirela J.; CANANI, Luis H.; PARISI, Maria C.; PAVIN, Elizabeth J.; MAINARDI, Debora; JAVOR, Juraj; VELHO, Gilberto; COIMBRA, Cassio N.; CORREA-GIANNELLA, Maria Lucia
    Background: A functional variant in the promoter region of the gene encoding tumor necrosis factor (TNF; rs1800629, -308G>A) showed to confer susceptibility to T1D. However, TNF rs1800629 was found, in several populations, to be in linkage disequilibrium with HLA susceptibility haplotypes to T1D. We evaluated the association of TNF rs1800629 with T1D in a cohort of Brazilian subjects, and assessed the impact of HLA susceptibility haplotypes in this association.. Methods: 659 subjects with T1D and 539 control subjects were genotyped for TNF-308G>A variant. HLA-DRB1 and HIA-DQB1 genes were genotyped in a subset of 313 subjects with T1D and 139 control subjects. Results: Associations with T1D were observed for the A-allele of rs1800629 (OR 1.69,95% Cl 133-2.15, p < 0.0001, in a codominant model) and for 3 HLA haplotypes: DRB1*03:01-DQB1*02:01 (OR 5.37, 95% Cl 3.23-8.59, p < 0.0001), DRB1*04:01-DQB1*03:02 (OR 2.95, 95% Cl 1.21-7.21, p = 0.01) and DRB1*04:02-DQB1*03:02 (OR 2.14,95% Cl 1.02-4.50, p = 0.04). Linkage disequilibrium was observed between TNF rs1800629 and HLA-DRB1 and HLA-DQB1 alleles. In a stepwise regression analysis HLA haplotypes, but not TNF rs1800629, remained independently associated with T1D. Conclusion: Our results do not support an independent effect of allelic variations of TNF in the genetic susceptibility to T1D.