LILIAM TAKAYAMA GUERRA

(Fonte: Lattes)
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Departamento de Clínica Médica, Faculdade de Medicina
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina

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Revista / Livro: Osteoporosis International ×

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  • conferenceObject
    PREVALENCE OF SARCOPENIA AND ASSOCIATED RISK FACTORS BY TWO DIAGNOSTIC CRITERIA IN COMMUNITY-DWELLING OLDER WOMEN: THE SAO PAULO AGEING & HEALTH STUDY (SPAH)
    (2016) DOMICIANO, D. S.; FIGUEIREDO, C. P.; LOPES, J. B.; CAPARBO, V. F.; TAKAYAMA, L.; MENEZES, P. R.; PEREIRA, R. M.
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    BONE MINERAL DENSITY AND PARATHYROID HORMONE AS INDEPENDENT RISK FACTORS FOR MORTALITY IN COMMUNITY-DWELLING OLDER ADULTS: A POPULATION-BASED PROSPECTIVE COHORT STUDY IN BRAZIL. THE SAO PAULO AGEING & HEALTH (SPAH) STUDY
    (2016) DOMICIANO, D.; MACHADO, L.; LOPES, J.; FIGUEIREDO, C.; CAPARBO, V.; TAKAYAMA, L.; OLIVEIRA, R.; SCAZUFCA, M.; MCCLUNG, M.; PEREIRA, R.
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    VERTEBRAL FRACTURE ASSESSMENT (VFA): A VALID TOOL TO DETECT VERTEBRAL FRACTURES IN COMMUNITY-DWELLING OLDER INDIVIDUALS - THE SAO PAULO AGEING & HEALTH STUDY (SPAH)
    (2012) DOMICIANO, D.; LOPES, J. B.; FIGUEIREDO, C. P.; CAPARBO, V.; TAKAYAMA, L.; BONFA, E.; PEREIRA, R. M. R.
    Aims: Vertebral fractures (VFx) are associated with higher morbidity and mortality in the general population. Since 70 % of the VFx are clinically silent, radiologic image of spine has to be acquired for the diagnosis. Vertebral Fracture Assessment (VFA) has emerged as possible alternative for the gold standard radiologic image to detect prevalent VFx. Previous studies evaluating this method are hampered by the limited sample size, selection of women with specific indication for spine X-ray and inclusion of patients under 70 years. Thus, the aim of this study was to compare the performance of VFA with X-ray to identify VFx in healthy community-dwelling older men and women. Methods: 429 noninstitutionalized subjects (60 % women), aged over 65 years, from community, were enrolled in this cohort. VFA by DXA measurements was evaluated by two expert rheumatologists by consensus and spine X-ray (T4 to L4) were analyzed according to semiquantitative method (Genant HK, 1993) by an expert radiologist. The correlation between VFA and spine X-ray to identify VFx was analyzed by kappa ( κ ) scores. P<0.05 was set as significant. Results: The average age ofsubjects was 73.1±5.1 years.The prevalence of VFx in VFA and X-ray were 29.7 and 28.6 % in women (p= 0.69), and 28.2 and 30.6 % in men (p=0.50), respectively. The frequency of unavailable vertebrae was significantly lower in spine X-ray than VFA (0.9 % and 5.6 %, respectively, p<0.001), particularly along with T4-T6. According to VFA, 5013 (96 %) vertebrae were identified as normal, 144 (2.7 %) had grade 1 fractures, 58 (1.1 %) grade 2 fractures and 12 (0.2) grade 3 fractures. The sensitivity of VFA was 72.93 % and the specificity was 99.1 % to identify VFx. The sensitivity increased to 92 % and specificity to 99.9 % excluding deformities grade 1. A good correlation between VFA and X-ray (κ=0.74) was observed and the exclusion of grade 1 resulted in an even better agreement(κ=0.84). The correlation vertebrae by vertebrae between VFA and spine X-ray was lower for T4-T7 (0.61-0.67). Correlations between the two methods were comparable in both gender (κ=0.73 in men,κ=0.75 in women). Conclusion: In elderly community, VFA and X-ray had comparable performances to identify VFx, particularly if mild deformities are excluded. Thus, this methodology is an easy and feasible promising alternative to improve the identification and management of patients with high risk of osteoporotic fractures.
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    EXERCISE AS A TREATMENT TO ATTENUATE BONE LOSS IN WOMEN AFTER ROUX-EN-Y GASTRIC BY PASS : A RANDOMIZED CONTROLLED TRIAL
    (2019) MURAI, I. H.; ROSCHEL, H.; DANTAS, W. S.; GIL, S.; MEREGE-FILHO, C. A.; CAPARBO, V.; TAKAYAMA, L.; SA-PINTO, A. L.; CLEVA, R.; SANTO, M. A.; KIRWAN, J.; PEREIRA, R. M.; GUALANO, B.
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    VISCERAL FAT MEASURED BY DXA IS ASSOCIATED WITH INCREASED RISK OF NONSPINE FRACTURES IN NONOBESE ELDERLY WOMEN: A POPULATION-BASED PROSPECTIVE COHORT ANALYSIS FROM THE SAO PAULO AGEING & HEATHY (SPAH) STUDY
    (2016) MACHADO, L.; PEREIRA, R. M.; DOMICIANO, D.; FIGUEIREDO, C.; LOPES, J.; CAPARBO, V.; TAKAYAMA, L.; OLIVEIRA, R.; MENEZES, P.
  • article 46 Citação(ões) na Scopus
    Prevalence and risk factors of radiographic vertebral fracture in Brazilian community-dwelling elderly
    (2011) LOPES, J. B.; DANILEVICIUS, C. F.; TAKAYAMA, L.; CAPARBO, V. F.; MENEZES, P. R.; SCAZUFCA, M.; KUROISHI, M. E.; PEREIRA, R. M. R.
    The prevalence and risk factors of radiographic vertebral fracture were determined among Brazilian community-dwelling elderly. Vertebral fractures were a common condition in this elderly population, and lower hip bone mineral density was a significant risk factor for vertebral fractures in both genders. The aim of the study was to estimate the prevalence of radiographic vertebral fracture and investigate factors associated with this condition in Brazilian community-dwelling elderly. This cross-sectional study included 943 elderly subjects (561 women and 382 men) living in So Paulo, Brazil. Thoracic and lumbar spine radiographs were obtained, and vertebral fractures were evaluated using Genant's semiquantitative method. Bone mineral density (BMD) was measured by dual X-ray absorptiometry, and bone biochemical markers were also evaluated. Female and male subjects were analyzed independently, and each gender was divided into two groups based on whether vertebral fractures were present. The prevalence of vertebral fracture was 27.5% (95% CI 23.8-31.1) in women and 31.8% in men (95% CI 27.1-36.5) (P = 0.116). Cox regression analyses using variables that were significant in the univariate analysis showed that age (prevalence ratio = 1.03, 95% CI 1.01-1.06; p = 0.019) and total femur BMD (PR = 0.27, 95% CI 0.08-0.98; p = 0.048) were independent factors in predicting vertebral fracture for the female group. In the male group, Cox regression analyses demonstrated that femoral neck BMD (PR = 0.26, 95% CI 0.07-0.98; p = 0.046) was an independent parameter in predicting vertebral fractures. Our results suggest that radiographic vertebral fractures are common in Brazilian community-dwelling elderly and that a low hip BMD was an important risk factor for this condition in both genders. Age was also significantly correlated with the presence of vertebral fractures in women.
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    ASSOCIATION BETWEEN METABOLIC SYNDROME AND BONE MINERAL DENSITY IN COMMUNITY-DWELLING OLDER WOMEN: THE SAO PAULO AGEING AND HEALTH STUDY (SPAH)
    (2017) MACHADO, L. G.; DOMICIANO, D. S.; FIGUEIREDO, C. P.; LOPES, J. B.; CAPARBO, V. F.; TAKAYAMA, L.; OLIVEIRA, R.; PEREIRA, R. M.
  • article 12 Citação(ões) na Scopus
    Exercise training, creatine supplementation, and bone health in ovariectomized rats
    (2015) MURAI, I. H.; ROSCHEL, H.; PABIS, L. V. S.; TAKAYAMA, L.; OLIVEIRA, R. B. de; PEREIRA, R. T. dos Santos; DANTAS, W. S.; PEREIRA, R. M. R.; JORGETTI, V.; BALLESTER, R. Y.; GUALANO, B.
    Evidence suggests that creatine may have some beneficial effects on bone. The study aimed to investigate the effects of exercise alone or combined with creatine on bone health in ovariectomized rats. Findings show that exercise, but not creatine, has an important role in improving bone health. Introduction The aim of this study was to investigate the effects of exercise training alone or combined with creatine supplementation on bone health parameters in ovariectomized rats. Methods Wistar rats were randomly allocated into one of five groups: (i) sham-operated, (ii) ovariectomized non-trained placebo-supplemented, (iii) ovariectomized non-trained creatine- supplemented, (iv) ovariectomized exercise-trained placebo-supplemented, and (v) ovariectomized exercise-trained creatine-supplemented. Downhill running training and/or creatine supplementation (300 mg/kg body weight) were administered for 12 weeks. Bone mineral content (BMC), bone mineral density (BMD), and biomechanical and histomorphometric parameters were assessed. Results No interaction effects were observed for BMC and BMD at whole body, femur, and lumbar spine (p>0.05). Importantly, a main effect of training was detected for whole body BMC and BMD (p=0.003 and p<0.001, respectively), femoral BMC and BMD (p=0.005 and p<0.001, respectively), and lumbar spine BMC and BMD (p<0.001 and p<0.001, respectively), suggesting that the trained animals had higher bone mass, irrespective of creatine supplementation. Main effects of training were also observed for maximal load (p< 0.001), stiffness (p<0.001), and toughness (p=0.046), indicating beneficial effects of exercise training on bone strength. Neither a main effect of supplementation nor an interaction effect was detected for biomechanical parameters (p>0.05). No main or interaction effects were observed for any of the histomorphometric parameters evaluated (p>0.05). Conclusions Exercise training, but not creatine supplementation, attenuated ovariectomy-induced bone loss in this rat model.
  • article 6 Citação(ões) na Scopus
    Persistent hypovitaminosis D and loss of hip bone mineral density over time as additional risk factors for recurrent falls in a population-based prospective cohort of elderly persons living in the community. The Sao Paulo Ageing & Health (SPAH) Study
    (2015) MACHADO, K. L. L. L.; DOMICIANO, D. S.; MACHADO, L. G.; LOPES, J. B.; FIGUEIREDO, C. P.; TAKAYAMA, L.; OLIVEIRA, R. M.; MENEZES, P. R.; PEREIRA, R. M. R.
    A Summary We performed concomitant evaluation of clinical, laboratory, and bone mineral density (BMD) parameters as potential risk factors for falls in a population-based prospective cohort of older adults, since previous studies have focused mostly in clinical risk factors. Loss of hip BMD and persistent hypovitaminosis D were associated with recurrent falls in community-dwelling elderly. Introduction Few studies have performed a concomitant evaluation of clinical data, laboratory bone parameters, and bone mineral density (BMD) to determine more accurately the contribution of each of these variables to risk of falls in elderly persons. We investigated the association between bone parameters and recurrent falls in a population-based prospective cohort of community-dwelling older adults. Methods A total of 705 elderly individuals (448 women, 257 men) were evaluated with clinical data, BMD, and laboratory bone tests at baseline and after a mean follow-up of 4.3 +/- 0.8 years. Individuals with recurrent falls (a parts per thousand yen2 falls in the previous year from the date of the second evaluation) were considered chronic fallers. Logistic regression models were used to identify independent risk factors for recurrent falls. Results The frequency of chronic fallers was 16.5 %. In multivariate analyses, risk factors for recurrent falls were visual impairment (odds ratio (OR) = 2.49, 95 % confidence interval (CI) 1.30-4.74, p = 0.006), use of psychotropic drugs (OR = 2.47, 95 % CI 1.37-4.49, p = 0.003), clinical fracture (OR = 2.78, 95 % CI 1.48-5.20, p = 0.001), persistently low 25-hydroxyvitamin D (25OHD) (< 20 ng/mL) (OR = 1.71, 95 % CI 1.10-2.64, p = 0.016), and loss of total hip BMD during the study (OR = 1.21, 95 % CI 1.17-1.25, p = 0.035 for each 4 % decrease). Conclusions In addition to traditional clinical risk factors for falls, loss of hip BMD and hypovitaminosis D were associated with recurrent falls in community-dwelling elderly persons. Thus, recognizing these factors is essential to preventing falls and improving the outcomes of this population.