LILIAM TAKAYAMA GUERRA
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Clínica Médica, Faculdade de Medicina
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
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conferenceObject Association of Moderate/Severe Vertebral Fractures with Reduced Trabecular Volumetric Bone Density in Older Women and Reduced Areal Femoral Neck Bone Density in Older Men from Community: A Cross-Sectional Study (SPAH)(2018) TORRES, Georgea H. F.; GUZMAN, Luis F. S.; ALVARENGA, Jackeline C.; SR., Levi Neto; CAPARBO, Valeria F.; TAKAYAMA, Liliam; DOMICIANO, Diogo S.; SR., Neusa Lopes; PEREIRA, Rosa M. R.conferenceObject Bone Microarchitecture and Bone Strength in Patients with Primary Sjogren's Syndrome: A Case-Control Study Using HR-pQCT(2015) PASOTO, Sandra Gofinet; AUGUSTO, Kristopherson Lustosa; ALVARENGA, Jackeline Couto; TAKAYAMA, Liliam; CAPARBO, Valeria; OLIVEIRA, Ricardo M.; BONFA, Eloisa; PEREIRA, Rosa M. R.conferenceObject Hand Bone Impairment By High-Resolution Peripheral Quantitative Computed Tomography in Patients with Diffuse Systemic Sclerosis: Correlation with Clinical Parameters, Quality of Life and Capillaroscopic Findings(2015) SAMPAIO-BARROS, Marilia; TAKAYAMA, Liliam; ALVARENGA, Jackeline Couto; LUPPINO-ASSAD, Ana Paula; SAMPAIO-BARROS, Percival D.; PEREIRA, Rosa M. R.conferenceObject COMPROMISE OF FOREARM BONE MASS IN PATIENTS WITH SYSTEMIC SCLEROSIS: ASSOCIATION WITH DISEASE DURATION, RANGE OF MOTION, QUALITY OF LIFE AND SYSTEMIC BONE INVOLVEMENT(2014) SAMPAIO-BARROS, P.; SAMPAIO-BARROS, M.; TAKAYAMA, L.; COUTO, J.; CAPARBO, V.; PEREIRA, R. M.- Evaluation of bone mineral density and microarchitectural parameters by DXA and HR-pQCT in 37 children and adults with X-linked hypophosphatemic rickets(2017) COLARES NETO, G. P.; PEREIRA, R. M. R.; ALVARENGA, J. C.; TAKAYAMA, L.; FUNARI, M. F. A.; MARTIN, R. M.In X-linked hypophosphatemic (XLH) rickets, dual-energy X-ray absorptiometry (DXA) measurements must be analyzed with caution. High-resolution peripheral quantitative computed tomography (HR-pQCT) analysis suggested that XLH primarily affects the cancellous compartment, with the tibia more affected than the radius. Effective treatment of XLH appears to positively affect bone mineralization, mainly in the bone cortex. The purpose of this study is to evaluate bone mineral density (BMD) and microarchitecture in 37 patients (13 children and 24 adults) with XLH confirmed by PHEX mutations from a tertiary center compared to healthy controls. Areal BMD (aBMD) was evaluated by DXA, whereas volumetric BMD (vBMD) and microarchitectural parameters were analyzed by HR-pQCT. Adult XLH patients had higher lumbar aBMD (p < 0.01) than the controls. At the radius, the vBMD was similar between XLH patients and controls. At the tibia, XLH patients had lower total vBMD (p = 0.04), likely resulting from decreased trabecular vBMD (p < 0.01), and this difference was observed in the children and adult groups. Analysis based on metabolic status showed that the adult XLH patients with non-compensated disease had lower cortical vBMD at the tibia than the compensated XLH patients (p = 0.03). The microarchitectural differences at the radius and tibia included lower trabecular number (p < 0.01), greater trabecular separation (p < 0.01), and higher trabecular network inhomogeneity (p < 0.01) in XLH patients compared to their controls. At the radius, adults exhibited greater trabecular deficits than were seen in children. In XLH patients, DXA measurements must be analyzed with caution due to the interference of anatomic and anthropometric factors. HR-pQCT analysis suggested that XLH primarily affects the cancellous compartment, with the tibia more affected than the radius. Effective treatment of XLH appears to positively affect bone mineralization, mainly in the bone cortex.
- Distal radius and tibia bone microarchitecture impairment in female patients with diffuse systemic sclerosis(2019) SAMPAIO-BARROS, M. M.; ALVARENGA, J. C.; TAKAYAMA, L.; ASSAD, A. P. L.; SAMPAIO-BARROS, P. D.; PEREIRA, R. M. R.A Summary Radius and tibia bone microarchitecture, analyzed through a high-resolution peripheral quantitative computed tomography, were significantly impaired in female patients with diffuse systemic sclerosis compared with healthy controls. Acroosteolysis, quality of life-grip strength, hand disability, and disease duration were significantly associated with this bone deterioration. Introduction The effect of diffuse systemic sclerosis (dSSc) on the bone is not completely understood. The objective of this study was to analyze the volumetric bone mineral density (vBMD), microarchitecture, and biomechanical parameters at the distal radius and tibia using high-resolution peripheral quantitative computed tomography (HR-pQCT, XtremeCT) in female patients with dSSc and identify clinical and laboratory variables associated with these parameters. Methods Thirty-eight women with dSSc and 76 healthy controls were submitted to HR-pQCT at the distal radius and tibia. Clinical and laboratory findings, bone mineral density(BMD), nailfold capillaroscopy (NC), total passive range of motion(ROM), and quality of life (health assessment questionnaire-HAQ) were associated with HR-pQCT (Scanco Medical AG, Bruttisellen, Switzerland) parameters. Multiple linear regression models adjusted for clinical and laboratory variables, ROM and HAQ, were performed. Results Density, microarchitecture, and biomechanical parameters at the distal radius and tibia were significantly impaired in dSSc patients compared with healthy controls (p < 0.001). Multiple linear regression models showed that lower trabecular density (Tb.vBMD) (radius R-2 = 0.561, p = 0.002; and tibia R-2 = 0.533, p = 0.005), and lower trabecular number (Tb.N) (tibia R-2 = 0.533, p = 0.005) were significantly associated with acroosteolysis. Higher trabecular separation (Tb.Sp) was associated with disease duration and higher HAQ-grip strength (radius R-2 = 0.489, p = 0.013), while cortical density (Ct.vBMD) was associated with ROM (radius R-2 = 0.294, p = 0.002). Conclusion Bone microarchitecture in patients with dSSc, analyzed through HR-pQCT, showed impairment of trabecular and cortical bone at distal radius and tibia. Variables associated with hand involvement (acroosteolysis, quality of life-grip strength, and ROM) and disease duration may be considered prognostic factors of this bone impairment.
conferenceObject Trabecular Bone Microarchitecture Impairment in Juvenile Systemic Lupus Erythematous (JSLE) with Low BMD for Chronological Age(2013) PEREIRA, Rosa; PAUPITZ, Juliane; LIMA, Glauce; TAKAYAMA, Liliam; ALVARENGA, Jackeline; SEGURO, Luciana; BONFA, Eloisa- Cortical bone density and thickness alterations by high-resolution peripheral quantitative computed tomography: association with vertebral fractures in primary Sjogren's syndrome(2016) PASOTO, Sandra G.; AUGUSTO, Kristopherson L.; ALVARENGA, Jackeline C.; TAKAYAMA, Liliam; OLIVEIRA, Ricardo M.; BONFA, Eloisa; PEREIRA, Rosa M. R.Objectives. To evaluate volumetric BMD (vBMD), microarchitecture and strength and vertebral fractures (VFs) in primary SS (pSS). Methods. We evaluated 71 female pSS patients and 71 gender-, age-, and race-matched controls. Clinical data including risk factors for osteoporosis (OP) and fractures were collected through a standardized protocol. Areal BMD and VFs were analysed by DXA. Bone microarchitecture, vBMD and bone strength were assessed by high-resolution peripheral quantitative CT (HR-pQCT), a non-invasive method. Results. pSS patients and controls were comparable for age, BMI, calcium intake, smoking, menopause, sedentary lifestyle and family history of fractures (P > 0.05). OP or low BMD for the patient's age (33.8 vs 5.6%; P < 0.0001) and VFs (19.7 vs 5.6%; P = 0.043) were more frequent in patients than controls. HR-pQCT showed deterioration of cortical and trabecular components and strength at the radius, and of cortical components and strength at the tibia (P < 0.05) in patients compared with controls. pSS patients and controls were also analysed by multivariate analysis adjusted for age, ethnicity, prednisone use, weight and height, which showed that the pSS group had lower values of cortical vBMD, cortical thickness and apparent modulus (P < 0.05) at the radius and cortical vBMD and apparent modulus (P < 0.05) at the tibia. Patients with VFs had more cortical bone deterioration (cortical vBMD/cortical thickness) at the tibia compared with patients without VFs (P < 0.05). Conclusions. This study was the first to assess bone microarchitecture in pSS and demonstrated that cortical deterioration is the most important abnormality observed in pSS patients with VFs. This novel finding shows that this compartment contributes to vertebral fragility, suggesting that this non-invasive evaluation may be useful in the clinical practice.