ROSA FERREIRA DOS SANTOS
Projetos de Pesquisa
Unidades Organizacionais
LIM/18 - Laboratório de Carboidratos e Radioimunoensaios, Hospital das Clínicas, Faculdade de Medicina - Líder
17 resultados
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- TCF7L2 correlation in both insulin secretion and postprandial insulin sensitivity(2018) FERREIRA, Mari Cassol; SILVA, Maria Elizabeth Rossi da; FUKUI, Rosa Tsuneshiro; ARRUDA-MARQUES, Maria do Carmo; SANTOS, Rosa Ferreira dosBackground: The TCF7L2 rs7903146 variant is strongly associated with type 2 diabetes mellitus (T2DM). However, the mechanisms involved in this association remain unknown and may include extrapancreatic effects. The aim of this study was to perform a metabolic characterization of T2DM patients with and without the TCF7L2 rs7903146 risk T allele and analyze some influences of the TCF7L2 genotype on glucose metabolism. Methods: Patients with T2DM (n = 162) were genotyped for the TCF7L2 rs7903146 single nucleotide polymorphism. Individuals with CT/TT and CC genotypes were compared regarding basal serum levels of glucose, glycosylated hemoglobin A1C, HDL, uric acid, insulin, and C-peptide. A subset of 56 individuals was evaluated during a 500-calorie mixed-meal test with measurements of glucose, insulin, proinsulin, C-peptide and glucagon. Additional secondary assessments included determination of insulinogenic index (IGI(30)), and insulin sensitivity (%S) and resistance (IR) by Homeostatic model assessment (HOMA). Results: Patients with the CT/TT genotype showed lower baseline plasma concentrations of C-peptide when compared with those with the CC genotype. Of the 56 individuals who participated in the mixed-meal test, 26 and 30 had the CC and CT/TT genotypes, respectively. CT/TT subjects, compared with CC individuals, had higher post prandial plasma levels of insulin and C-peptide at 30-120 min (p < 0.05) and proinsulin at 45-240 min (p < 0.05). Interestingly CT/TT individuals presented at baseline higher % S (p = 0.021), and lower IR (p = 0.020) than CC individuals. No significant differences in IGI(30) values were observed between groups. Conclusions: The T2DM individuals carrying the rs7903146 T allele of the TCF7L2 gene presented higher IR pattern in response to a mix-meal test, different of beta cell function at baseline assessed by C-peptide levels which was lower, and Homa-IR was lower when comparing with non-carriers.
- Left ventricular diastolic function in patients with type 2 diabetes treated with a dipeptidyl peptidase-4 inhibitor- a pilot study(2014) NOGUEIRA, Katia Camarano; FURTADO, Meive; FUKUI, Rosa Tsuneshiro; CORREIA, Marcia Regina Silva; SANTOS, Rosa Ferreira dos; ANDRADE, Jose Lazaro; SILVA, Maria Elizabeth Rossi daBackground: Blood glucose control is fundamental albeit not enough to prevent diabetic macrovascular complications. Dipeptidyl peptidase-4 (DPP-4) inhibitors are effective in improving metabolic parameters in patients with type 2 diabetes mellitus (T2DM) but little is known about its cardiovascular effects. We compared the DPP-4 inhibitor sitagliptin with bedtime NPH insulin (NPH) as add-on therapy in patients with T2DM, aiming to ascertain which drug would have additional cardioprotective effects. Methods: Thirty-five T2DM patients inadequately controlled with metformin plus glyburide were randomized to receive sitagliptin (n = 18) or NPH (n = 17) for 24 weeks. Fasting plasma glucose, HbA1c, lipid profile, C-reactive protein, active glucagon-like peptide (aGLP-1) levels, 24-hour ambulatory blood pressure measurement and comprehensive 2-dimensional echocardiogram were determined before and after treatments. Results: Both sitagliptin and NPH therapies decreased HbA1c levels after 24 weeks. Fasting plasma glucose and triglyceride levels decreased in the NPH group whereas only sitagliptin increased aGLP-1 levels. Left ventricular diastolic dysfunction (LVDD) was detected in 58.6% of twenty-nine patients evaluated. Beneficial effects in LVDD were observed in 75% and 11% of patients treated with sitagliptin and NPH, respectively (p = 0.015). Neither therapy changed C-reactive protein or blood pressure. Conclusions: Sitagliptin and bedtime NPH were similarly effective on glucose control. Improvement in LVDD in T2DM patients treated with sitagliptin was suggested, probably related to the increase of aGLP-1 levels. Therefore, DPP-4 inhibitor seems to have cardioprotective effects independent of glucose control and may have a role in the prevention of diabetic cardiomyopathy.
- Improvement of Body Composition and Quality of Life Following Intragastric Balloon(2018) REIMAO, Silvia Mansur; SILVA, Maria Elizabeth Rossi da; NUNES, Gabriel Cairo; MESTIERI, Luiz Henrique Mazzonetto; SANTOS, Rosa Ferreira dos; MOURA, Eduardo Guimaraes Hourneaux deThe aim is to evaluate the effects of IGB in overweight or class I obese patients, by analyzing body composition and quality of life (QOL). Prospective study including patients with BMI 27-34.9 kg/m(2.)body composition analysis (BCA) was performed before IGB implantation and its removal, after 6 months of treatment. QOL was assessed by the Short Form 36 (SF-36) Health Survey at baseline and after treatment. Forty patients were included in this study, but four were excluded. The total weight decreased by 12.29 kg after 6 months of use of IGB, which corresponds to loss of 13.69% of the total weight. There was a significant reduction in body fat mass and fat area. QOL improved in all eight sections analyzed (p < 0.001 to 0.041): functional capacity, physical aspects, pain, general health status, vitality, social aspects, emotional aspects, and mental health. IGB induces not only weight loss but changes in body composition through the reduction of body fat mass and fat area. Furthermore, it improves QOL.
- Effect of TCF7L2 polymorphism on pancreatic hormones after exenatide in type 2 diabetes(2019) FERREIRA, Mari Cassol; SILVA, Maria Elizabeth Rossi da; FUKUI, Rosa Tsuneshiro; ARRUDA-MARQUES, Maria do Carmo; AZHAR, Salman; SANTOS, Rosa Ferreira dosBackgroundGlucagon-like peptide 1 (GLP-1) stimulates insulin secretion and reduces blood glucose in type 2 diabetes mellitus (T2DM). TCF7L2 rs7903146 polymorphism has been associated with decreased insulin secretion, reduced GLP-1 action, and possible impaired peripheral insulin sensitivity.ObjectivesTo evaluate the postprandial pancreatic hormone response in patients with T2DM carriers of the TCF7L2 variant rs7903146 (CT/TT) compared with noncarriers of this variant (CC) after treatment with the GLP-1 agonist exenatide.MethodsIntervention study. Patients with T2DM (n=162) were genotyped for the TCF7L2 rs7903146 single nucleotide polymorphism (SNP). Individuals with CT/TT and CC genotypes were compared regarding basal serum levels of glucose, glycosylated hemoglobin A1C (HbA1c), HDL, uric acid, insulin, and C-peptide. A subset of 56 individuals was evaluated during a 500-calorie mixed-meal test with measurements of glucose, insulin, proinsulin, C-peptide and glucagon before and after treatment with exenatide for 8weeks.ResultsPatients with genotypes CC and CT/TT presented similar glucose area under the curve (AUC) 0-180min before treatment and a similar decrease after treatment (p<0.001). Before exenatide, insulin levels at 30-120min were higher in CT/TT versus CC subjects (p<0.05). After treatment with exenatide, only CT/TT individuals demonstrated insulin reduction at 30-180 min during the meal test (p<0.05). Patients with the CC genotype presented no differences in insulin concentrations before and after treatment. The areas under the glucagon curve between 0 and 180min were similar before treatment and reduced after treatment in both groups (p<0.001).ConclusionsThe presence of the TCF7L2 rs7903146 T allele in patients with T2DM was associated with increased secretion of insulin response to a mixed-meal test. Furthermore, after treatment with exenatide, only the carriers of the T allele showed significantly decreased postprandial plasma insulin peak levels comparing with non carriers.
- Metformin, but not glimepiride, improves carotid artery diameter and blood flow in patients with type 2 diabetes mellitus(2012) MACHADO, Helena Atroch; VIEIRA, Marcelo; CUNHA, Maria Rosaria; CORREIA, Marcia Regina Soares; FUKUI, Rosa Tsunechiro; SANTOS, Rosa Ferreira dos; ROCHA, Dalva Marreiro; WAJCHENBERG, Bernardo Leo; LAGE, Silvia G.; SILVA, Maria Elizabeth Rossi daOBJECTIVE: To compare the effects of glimepiride and metformin on vascular reactivity, hemostatic factors and glucose and lipid profiles in patients with type 2 diabetes. METHODS: A prospective study was performed in 16 uncontrolled patients with diabetes previously treated with dietary intervention. The participants were randomized into metformin or glimepiride therapy groups. After four months, the patients were crossed over with no washout period to the alternative treatment for an additional four-month period on similar dosage schedules. The following variables were assessed before and after four months of each treatment: 1) fasting glycemia, insulin, catecholamines, lipid profiles and HbA(1) levels; 2) t-PA and PAI-1 (antigen and activity), platelet aggregation and fibrinogen and plasminogen levels; and 3) the flow indices of the carotid and brachial arteries. In addition, at the end of each period, a 12-hour metabolic profile was obtained after fasting and every 2 hours thereafter. RESULTS: Both therapies resulted in similar decreases in fasting glucose, triglyceride and norepinephrine levels, and they increased the fibrinolytic factor plasminogen but decreased t-PA activity. Metformin caused lower insulin and pro-insulin levels and higher glucagon levels and increased systolic carotid diameter and blood flow. Neither metformin nor glimepiride affected endothelial-dependent or endothelial-independent vasodilation of the brachial artery. CONCLUSIONS: Glimepiride and metformin were effective in improving glucose and lipid profiles and norepinephrine levels. Metformin afforded more protection against macrovascular diabetes complications, increased systolic carotid artery diameter and total and systolic blood flow, and decreased insulin levels. As both therapies increased plasminogen levels but reduced t-PA activity, a coagulation process was likely still ongoing.
bookPart Diagnóstico de síndrome metabólica no adulto(2015) SANTOS, Rosa Ferreira dosconferenceObject The importance of Zinc transporter 8 autoantibody (ZNT8A) in the diagnosis of type 1 diabetes in the Brazilian population(2015) GOMES, K. F. B.; SEMZEZEM, C.; FUKUI, R. T.; SANTOS, A. S.; SANTOS, R. F.; SILVA, M. E. R.- Short and Long Term Effects of a DPP-4 Inhibitor Versus Bedtime NPH Insulin as ADD-ON Therapy in Patients with Type 2 Diabetes(2016) SILVA, Giordana Maluf da; NOGUEIRA, Katia Camarano; FUKUI, Rosa Tsuneshiro; CORREIA, Marcia Regina Soares; SANTOS, Rosa Ferreira dos; SILVA, Maria Elizabeth Rossi daBackground: We conducted a comparison between the dipeptidyl-peptidase-4(DPP-4) inhibitor sitagliptin versus NPH insulin as an add-on therapies in patients with type 2 diabetes mellitus (T2D) failing oral medications. The objective was to ascertain the better indication in long-duration diabetes. Methods: thirty-five T2D patients inadequately controlled with metformin plus glyburide were randomized to receive sitagliptin (n=18) or bedtime NPH insulin (n=17) for 12 months. HbA1c levels and a metabolic and hormonal profile at fasting and post-meal (every 30 minutes for 4 hours) were evaluated before and after 6 months (short-term) and 12 months (long-term) after adding sitagliptin or bedtime NPH insulin to their drug regime. Results: Sitagliptin and NPH insulin decreased HbA1c levels equally after 6 months (p<0.001) with no further improvement after 12 months: sitagliptin (8.1 +/- 0.7% vs. 7.3 +/- 0.8% vs. 7.4 +/- 1.9%) and insulin (8.1 +/- 0.6% vs. 7.3 +/- 0.7% vs. 7.2 +/- 1.0%). Fasting glucose, fasting and postprandial triglyceride and C-peptide levels were also reduced by NPH insulin whereas postprandial insulin was decreased by sitagliptin. Body weight and postchallenge free fatty acid levels increased with insulin treatment. The transitory suppression (at 6 months) of postprandial proinsulin levels with both therapies, and of glucagon with sitagliptin, was followed by values similar or worse to those at pre-treatment. Conclusion: The use of either NPH insulin or a DPP-4 inhibitor as add-on treatments improves glucose control in patients with T2D failing on metformin plus glyburide therapy. The results were not attributed to a permanent improvement in alpha or beta cell function in patients with long-duration diabetes.
- Postprandial glucose-lowering effect of cagaita (Eugenia dysenterica DC) fruit juice in dysglycemic subjects with metabolic syndrome: An exploratory study(2021) ARAUJO, Renata Luise de; TOMAS-BARBERAN, Francisco A.; SANTOS, Rosa Ferreira dos; MARTINEZ-BLAZQUEZ, J. Alberto; GENOVESE, Maria InesCagaita (Eugenia dysenterica DC) is an ellagitannin-containing Myrtaceae fruit from Cerrado biome. This fruit seems to be a promising candidate for an adjuvant in glucose regulation in healthy subjects. However, it is not known whether cagaita juice would have the same effect on dysglycemic subjects with metabolic syndrome (MetS). Therefore, the present work aimed to evaluate the effect of cagaita fruit juice on postprandial glycemia in dysglycemic subjects with MetS, and whether cagaita ellagitannins could be metabolized to urolithins. To evaluate glycemic effects, two different meals were consumed by volunteers (n = 12) with a 1-week interval among them. The first one consisted of white bread (50 g) plus water (300 mL) as a control; the second one, white bread (50 g) plus clarified cagaita juice (300 mL). Bioavailability was assessed in 24 h urine, after the consumption of a single amount of 300 mL of cagaita juice by healthy (n = 16) and MetS subjects (n = 7). The results showed that dysglycemic subjects with MetS presented a 53% reduction of incremental area under the curve (iAUC) of glucose, 38% reduction of insulin, 78% reduction of GIP (glucose-dependent insulinotropic polypeptide), and 58% reduction of C-peptide (p < 0.05), after the consumption of cagaita juice along with bread, in comparison to control water. However, both GLP-1 (glucagon-like peptide-1) and glucagon were not affected by cagaita juice ingestion. Concerning bioavailability, it was observed, for the first time, the metabo-lization of cagaita ellagitannins to urolithins by healthy and dysglycemic individuals with MetS, with a preva-lence of metabotype B in both groups (44% and 42%, respectively), followed by metabotype A (37% and 29%, respectively), and metabotype 0 (19% and 29%, respectively).
- Reduction of functional mobility and cognitive capacity in type 2 diabetes mellitus(2014) FERREIRA, Mari Cassol; TOZATTI, Joana; FACHIN, Silvia Maria; OLIVEIRA, Patricia Pereira de; SANTOS, Rosa Ferreira dos; SILVA, Maria Elisabeth Rossi daObjectives: The aim of the present study was to evaluate the functional mobility and its relationship to cognitive ability in patients with type 2 diabetes (T2DM), age between 50 and 65 years and under 10 years of diagnosis. Materials and methods: An observational, analytical and cross-sectional study, involving no diabetic and type 2 diabetic individuals with inadequate glycemic control, selected by convenience sampling. In both groups, were administered structured questionnaire and cognitive assessment with Mini-Mental State Examination (MMSE) and the clock drawing test (CDT), besides assessment of functional mobility by the Timed Up & Go (TUG). Results: In TUG, DM2 patients presented a mean time of 11.27 seconds versus 9.52 seconds (p = 0.013). The association between cognitive decline and decrease of mobility was positive in individuals with T2DM (p = 0.037). In the subgroup that showed decrease of mobility and associated cognitive decline, 18% were patients with DM2 and 1.6% were individuals without T2DM (p < 0.01). Conclusions: Patients with T2DM presented worse functional mobility and cognitive performance, supporting the hypothesis that DM2 influence functional mobility and cognitive ability, regardless of neuropathic or vascular complications. These data suggest that hyperglycemia is an aggravating factor in the performance of activities requiring mental functions such as attention, working memory and orientation.