DENISE CERQUEIRA PARANAGUA VEZOZZO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
6 resultados
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- Randomized clinical trial: benefits of aerobic physical activity for 24 weeks in postmenopausal women with nonalcoholic fatty liver disease(2016) REZENDE, Rosamar E. F.; DUARTE, Sebastiao M. B.; STEFANO, Jose T.; ROSCHEL, Hamilton; GUALANO, Bruno; PINTO, Ana L. de Sa; VEZOZZO, Denise C. P.; CARRILHO, Flair J.; OLIVEIRA, Claudia P.Objective: The aim of the study was to evaluate the effectiveness of aerobic physical activity in reducing the frequency of hepatic steatosis and metabolic and cardiovascular risk in postmenopausal women with nonalcoholic fatty liver disease (NAFLD). Methods: Forty sedentary postmenopausal women (mean age 55.3 +/- 8.0 y) with biopsy-proven NAFLD were randomly divided into two groups: an exercising group (19 participants) and a control group (nonexercising, 21 participants). The exercise group underwent a supervised aerobic physical activity program of 120 min/wk for 24 weeks. The anthropometric parameters; body composition; hepatic, lipid, and glycemic profiles; homeostasis model assessment of insulin resistance index; cytokines; transient elastography (FibroScan; liver stiffness/controlled attenuation parameter); and cardiopulmonary exercise test were evaluated at baseline and after 24 weeks of protocol. Results: At baseline there were no significant differences in anthropometric, metabolic, and inflammatory parameters-stiffness and liver fat content by FibroScan between the groups. After 24 weeks, we observed a decrease of waist circumference, an increase of high-density lipoprotein cholesterol levels (P < 0.05), and improved cardiopulmonary functional capacity in the exercise group. In addition, the controlled attenuation parameter analysis showed no significant decrease of hepatic steatosis in the exercise group. With regard to the systemic inflammation, there were, however, no significant differences in the cytokines between the groups. Conclusions: An aerobic physical activity program of 24 weeks in NAFLD postmenopausal women showed improvement in some variables such as waist circumference, high-density lipoprotein cholesterol, and cardiopulmonary performance that may be beneficial in improving cardiovascular risk factors in this population.
- Hepatocellular Carcinoma Management in Nonalcoholic Fatty Liver Disease Patients Applicability of the BCLC Staging System(2016) KIKUCHI, Luciana; OLIVEIRA, Claudia P.; ALVARES-DA-SILVA, Mario R.; TANI, Claudia M.; DINIZ, Marcio A.; STEFANO, Jose T.; CHAGAS, Aline L.; ALENCAR, Regiane S. S. M.; VEZOZZO, Denise C. P.; SANTOS, Gilmar R.; CAMPOS, Priscila B.; ALVES, Venancio A. F.; RATZIU, Vlad; CARRILHO, Flair J.Background/Aims: Nonalcoholic fatty liver disease (NAFLD) has emerged as an important cause of chronic liver disease, cirrhosis, and hepatocellular carcinoma (HCC). The Barcelona Clinic Liver Cancer (BCLC) system is the preferred staging system to evaluate patients with HCC and links prognosis assessment with treatment recommendation. The aim of this retrospective study was to evaluate whether the BCLC staging system and its treatment algorithm are suitable for,patients with HCC arising from NAFLD. Methods: Forty-two patients with HCC related to either to NAFLD or cryptogenic cirrhosis were retrieved retrospectively from 2 centers in Brazil. Patients were classified according to BCLC staging system. If the proposed HCC therapy could not be applied, the case was considered to represent deviations from the recommended BCLC guideline. Causes of treatment deviations were investigated. Results: There were 4 patients without evidence of cirrhosis according to liver biopsy and/or clinical evaluation. One (2%), 21 (50%), 10 (24%), 5 (12%), and 5 patients (12%) were classified initially to the very early (0), early (A), intermediate (B), advanced (C), and terminal (D) BCLC stages, respectively. Thirty-five patients (83%) were treated according to BCLC recommendations. There were 3 cases (of 5) of protocol deviation in BCLC C patients. The 1- and 2-year overall survival rates were 81% and 66%, respectively. Conclusions: The BCLC system is applied in most cases of NAFLD-related HCC cases. Deviation of BCLC is found more frequently in BCLC C stage patients.
- HCC in patients with NAFLD/NASH(2020) STEFANO, J. T.; MALTA, F. De Mello; CAMPOS, P. B. De; ANDRADE, P. F.; PARANAGUá-VEZZOZO, D. C.; CARRILHO, F. J.; OLIVEIRA, C. P.Hepatocellular carcinoma (HCC) associated with NAFLD has been steadily increasing and non-alcoholic steatohepatitis (NASH) is the most rapidly growing risk for liver transplantation in patients with HCC in the last years. In the vast majority of cases, HCC develops in the context of hepatic cirrhosis, but recent data suggest that there is a proportion of patients with NAFLD who are at high risk for HCC in the absence of cirrhosis. Although no study clearly explains the evolution of NAFLD to HCC, researchers suggest that the most likely mechanism involves fatty acid (FA) accumulation in hepatocytes due to predisposing factors, such as MtS, increased oxidative stress, endoplasmic reticulum (ER) stress, mitochondrial dysfunction and chronic endotoxaemia. Genetic and epigenetic changes in pathogenesis and hepatic carcinogenesis potentially serve as potential diagnostic biomarkers and/or therapeutic targets. MicroRNAs (miRNAs) play a key role in the pathogenesis of HCC related to NAFLD by closely regulating lipid metabolism, glucose homeostasis, cell proliferation, apoptosis, and cell migration and differentiation. In other words, there are currently no guidelines for the screening and early detection of NAFLD-related HCC in the absence of cirrhosis. However, there is an increasing number of HCC cases without cirrhosis. Thus, there is a strong interest in identifying biomarkers to detect early detection of HCC risk related to NAFLD progression. © Springer Nature Switzerland AG 2020.
- NAFLD in Polycystic Ovary Syndrome: Association with PNPLA3 and Metabolic Features(2022) RECUERO, Amanda Medeiros; GOMES, Larissa Garcia; MACIEL, Gustavo Arantes Rosa; MALTA, Fernanda de Mello; SALLES, Ana Paula Moreira; VEZOZZO, Denise Cerqueira Paranagua; BARACAT, Edmund Chada; PINHO, Joao Renato Rebello; CARRILHO, Flair Jose; STEFANO, Jose Tadeu; OLIVEIRA, Claudia P.Background: The aim of this study was to determine the frequency of the rs738409 polymorphism in the patatin-like phospholipase domain containing 3 (PNPLA3) gene in patients with polycystic ovary syndrome (PCOS) and its impact on nonalcoholic fatty liver disease (NAFLD) risk and severity. We also evaluated other risk factors associated with NAFLD and advanced fibrosis. Methods: This was a cross-sectional study involving 163 patients with PCOS at a tertiary center. Genotyping for the PNPLA3 polymorphism was undertaken using a TaqMan assay. The degree of fibrosis was defined by transient elastography. Results: The prevalence of NAFLD was 72.4%, and the polymorphism was heterozygous in 41.7% and homozygous in 8% of patients. Homeostasis model assessment of insulin resistance >= 2.5 was the main factor associated with the risk of developing NAFLD (OR = 4.313, p = 0.022), and its effect was amplified by the polymorphism (OR = 12.198, p = 0.017). Age > 32 years also conferred a higher risk for NAFLD. HDL values >= 50 mg/dL conferred protection against the outcome. Metabolic syndrome (OR = 13.030, p = 0.020) and AST > 32 U/L (OR = 9.039, p = 0.009) were independent risk factors for advanced fibrosis. Conclusions: In women with PCOS, metabolic characteristics are more relevant than PNPLA3 polymorphism regarding the risk for NAFLD and its advanced forms, but these factors can act synergistically, increasing disease risk.
conferenceObject PREVALENCE AND INFLUENCE OF ""PATATIN-LIKE PHOSPHOLIPASE DOMAIN CONTAINING 3"" (PNPLA3) GENE POLYMORPHISM ON SUSCEPTIBILITY TO NON-ALCOHOLIC FATTY LIVER DISEASE IN PATIENTS WITH POLYCYSTIC OVARY SYNDROME(2019) RECUERO, Amanda Medeiros; MALTA, Fernanda; STEFANO, Jose Tadeu; VEZOZZO, Denise Paranagua; GOMES, Larissa Garcia; MACIEL, Gustavo Arantes Rosa; BARACAT, Edmund; CASSENOTE, Alex Jones Flores; PINHO, Joao Renato R.; CARRILHO, Flair J.; OLIVEIRA, Claudia P. M. S.conferenceObject IMPACT OF AEROBIC EXERCISE IN POSTMENOPAUSAL WOMEN WITH NONALCOHOLIC FATTY LIVER DISEASE: A 24 WEEKS RANDOMIZED CLINICAL TRIAL(2015) REZENDE, R. E.; DUARTE, S. M.; STEFANO, J. T.; PERANDINI, L. A.; DASSOUKI, T.; SA-PINTO, A. L.; ROSCHEL, H.; GUALANO, B.; VEZOZZO, D. C.; CARRILHO, F. J.; OLIVEIRA, C. P.