RAFAELA ALKMIN DA COSTA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/57 - Laboratório de Fisiologia Obstétrica, Hospital das Clínicas, Faculdade de Medicina
LIM/57 - Laboratório de Fisiologia Obstétrica, Hospital das Clínicas, Faculdade de Medicina
96 resultados
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- Variant rs17619600 in the gene encoding serotonin receptor 2B (HTR2B) increases the risk of gestational diabetes mellitus: a case-control study(2023) PENNO, Juliana Regina Chamlian Zucare; SANTOS-BEZERRA, Daniele Pereira; CAVALEIRO, Ana Mercedes; SOUSA, Ana Maria da Silva; ZACCARA, Tatiana Assuncao; COSTA, Rafaela Alkmin da; FRANCISCO, Rossana Pulcineli Vieira; CORREA-GIANNELLA, Maria LuciaBackgroundDuring pregnancy, the increase in maternal insulin resistance is compensated by hyperplasia and increased function of maternal pancreatic beta cells; the failure of this compensatory mechanism is associated with gestational diabetes mellitus (GDM). Serotonin participates in beta cell adaptation, acting downstream of the prolactin pathway; the blocking of serotonin receptor B (HTR2B) signaling in pregnant mice impaired beta cell expansion and caused glucose intolerance. Thus, given the importance of the serotoninergic system for the adaptation of beta cells to the increased insulin demand during pregnancy, we hypothesized that genetic variants (single nucleotide polymorphisms [SNPs]) in the gene encoding HTR2B could influence the risk of developing GDM.MethodsThis was a case-control study. Five SNPs (rs4973377, rs765458, rs10187149, rs10194776, and s17619600) in HTR2B were genotyped by real-time polymerase chain reaction in 453 women with GDM and in 443 pregnant women without GDM.ResultsOnly the minor allele C of SNP rs17619600 conferred an increased risk for GDM in the codominant model (odds ratio [OR] 2.15; 95% confidence interval [CI] 1.53-3.09; P < 0.0001) and in the rare dominant model (OR 2.32; CI 1.61-3.37; P < 0.0001). No associations were found between the SNPs and insulin use, maternal weight gain, newborn weight, or the result of postpartum oral glucose tolerance test (OGTT). In the overall population, carriers of the XC genotype (rare dominant model) presented a higher area under the curve (AUC) of plasma glucose during the OGTT, performed for diagnostic purposes, compared with carriers of the TT genotype of rs17619600.ConclusionsSNP rs17619600 in the HTR2B gene influences glucose homeostasis, probably affecting insulin release, and the presence of the minor allele C was associated with a higher risk of GDM.
bookPart Placenta, sistema amniótico e cordão umbilical(2020) PAGANOTI, Cristiane de Freitas; CABAR, Fábio Roberto; MIKAMI, Fernanda Cristina Ferreira; COSTA, Rafaela Alkmin da; RIBEIRO, Renata Lopes; FRANCISCO, Rossana Pulcineli Vieira; BUNDUKI, VictorconferenceObject Longitudinal serum levels of Placental Growth Factor and sFlt-1 throughout gestation in normotensive pregnancies and those complicated by hypertensive disorders(2013) COSTA, R. A.; HOSHIDA, M. S.; ALVES, E. A.; V, R. P. Francisco; ZUGAIB, M.Background: Preeclampsia (PE) prevalence is higher in women with chronic hypertension (CH). Predictive markers for PE in this group could be particularly important. We aimed to evaluate serum levels of PlGF and sFlt-1 throughout pregnancies complicated by isolated PE, CH and PE superimposed on CH (PE+CH) compared to normotensive (NT) pregnancies. Methods: Peripheral blood samples have been collected from NT and CH pregnancies at gestational ages of 20, 26, 32 and 36 weeks and stored to be assayed by ELISA. This study was approved by local Ethics Committee. To date, samples have been partially assayed. Results: Levels of sFlt-1 increased throughout pregnancy in all groups. Levels of PlGF increased until 32 weeks in pregnancies not complicated by PE (NT and CH) and until 26 weeks in those complicated by PE (PE and PE+HC), thereafter PlGF levels decreased in all groups. Conclusions: preliminary data, still too short for statistical testing.bookPart Doenças infecciosas parasitárias(2016) YOSHIZAKI, Carlos Tadashi; BAPTISTA, Fernanda Spadotto; OSMUNDO JUNIOR, Gilmar de Souza; LIN, Lawrence Hsu; BORTOLOTTO, Maria Rita de Figueiredo Lemos; PEREIRA, Pedro Paulo; COSTA, Rafaela Alkmin da; MARTINELLI, SilviobookPart Restrição do crescimento fetal(2016) LIAO, Adolfo Wenjaw; FITTIPALDI, Felipe Silva; LIN, Lawrence Hsu; BERNARDES, Lisandra Stein; BORTOLOTTO, Maria Rita de Figueiredo Lemos; PEREIRA, Pedro Paulo; COSTA, Rafaela Alkmin da; BITTAR, Roberto Eduardo; CODARIN, Rodrigo Rocha- Influência da amamentação nos resultados do teste oral de tolerância à glicose pós-parto de mulheres com diabetes mellitusgestacional(2015) DIJIGOW, Fernanda Borges; PAGANOTI, Cristiane de Freitas; COSTA, Rafaela Alkmin da; FRANCISCO, Rossana Pulcineli Vieira; ZUGAIB, MarceloPURPOSE: To determine the influence of breastfeeding on the results of a postpartum oral glucose tolerance test in women recently diagnosed with gestational diabetes mellitus. METHODS: The data were obtained from the electronic medical records of the Endocrinopathy Sector during pregnancy, HCMED laboratory system ofHospital das Clínicas of São Paulo , and by telephone. According to the inclusion criteria adopted, 132 patients were eligible for the study. For statistical analysis, the patients were divided into two groups according to whether or not they breastfed. The results were analyzed by the Student t-test and by the Mann-Whitney, Chi-square and Fisher's exact tests, depending on the variable analyzed, with the level of significance set at p<0.05. RESULTS: Of the 132 patients included in the study, 114 breastfed and 18 did not. Most of the patients in both groups were overweight or obese. The breastfeeding group had a lower pre-pregnancy Body Mass Index than the non-breastfeeding group (p=0.006). Insulin was introduced earlier in the group that did not breastfeed (23.21±4.33 versus 28.84±6.17; p=0.04). The group that did not breastfeed had a higher mean postpartum fasting glucose value in the oral glucose tolerance test than the group that breastfed (91.3±8.7 versus 86.5±9.3; p=0.01). Breastfeeding acted as a protective factor against the development of glucose intolerance in the postpartum oral glucose tolerance test (OR=0.27; 95%CI 0.09-0.8). By logistic regression, breastfeeding was shown to be an independent protective factor. CONCLUSION: There was a statistically significant relationship between breastfeeding and a decreased risk of developing glucose intolerance. Breastfeeding should be encouraged because it is an effective, low cost intervention easily accessible to all patients during the postpartum period.
bookPart Doenças hematológicas(2016) YOSHIZAKI, Carlos Tadashi; BAPTISTA, Fernanda Spadotto; OSMUNDO JUNIOR, Gilmar de Souza; LIN, Lawrence Hsu; BORTOLOTTO, Maria Rita de Figueiredo Lemos; PEREIRA, Pedro Paulo; COSTA, Rafaela Alkmin da; MARTINELLI, SilviobookPart Doenças endócrinas(2016) YOSHIZAKI, Carlos Tadashi; BAPTISTA, Fernanda Spadotto; OSMUNDO JUNIOR, Gilmar de Souza; LIN, Lawrence Hsu; BORTOLOTTO, Maria Rita de Figueiredo Lemos; PEREIRA, Pedro Paulo; COSTA, Rafaela Alkmin da; MARTINELLI, SilviobookPart Obesidade e gravidez(2020) YOSHIZAKI, Carlos Tadashi; TESTA, Carolina Burgarelli; PAGANOTI, Cristiane de Freitas; BAPTISTA, Fernanda Spadotto; OSMUNDO JUNIOR, Gilmar de Souza; LIN, Lawrence Hsu; GALLETTA, Marco Aurélio Knippel; BORTOLOTTO, Maria Rita de Figueiredo Lemos; PEREIRA, Pedro Paulo; COSTA, Rafaela Alkmin da; RIBEIRO, Renata Lopes; FRANCISCO, Rossana Pulcineli VieirabookPart Leiomioma uterino(2013) COSTA, Rafaela Alkmin da; JúNIOR, José Maria Soares; BOZZINI, Nilo; BARACAT, Edmund Chada