CARLOS ALBERTO ABUJABRA MEREGE FILHO

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Projetos de Pesquisa
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LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina

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Agora exibindo 1 - 9 de 9
  • article 0 Citação(ões) na Scopus
    Exercise-Induced Increases in Insulin Sensitivity After Bariatric Surgery Are Mediated By Muscle Extracellular Matrix Remodeling (vol 69, pg 1675, 2020)
    (2021) DANTAS, Wagner S.; ROSCHEL, Hamilton; MURAI, Igor H.; GIL, Saulo; DAVULURI, Gangarao; AXELROD, Christopher L.; GHOSH, Sujoy; NEWMAN, Susan S.; ZHANG, Hui; SHINJO, Samuel K.; NEVES, Willian das; MEREGE-FILHO, Carlos; TEODORO, Walcy R.; CAPELOZZI, Vera L.; PEREIRA, Rosa Maria; BENATTI, Fabiana B.; SA-PINTO, Ana L. de; CLEVA, Roberto de; SANTO, Marco A.; KIRWAN, John P.; GUALANO, Bruno
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    Effects Of Exercise Training On Strength And Functionality In Obese Subjects Undergoing Bariatric Surgery: Preliminary Findings
    (2018) ROSCHEL, Hamilton; GIL, Saulo; DANTAS, Wagner S.; MURAI, Igor H.; MEREGE FILHO, Carlos; SANTO, Marco A.; CLEVA, Roberto; GUALANO, Bruno
  • article 7 Citação(ões) na Scopus
    Exercise Enhances the Effect of Bariatric Surgery in Markers of Cardiac Autonomic Function
    (2021) GIL, Saulo; PECANHA, Tiago; DANTAS, Wagner S.; MURAI, Igor Hisashi; MEREGE-FILHO, Carlos Alberto Abujabra; SA-PINTO, Ana Lucia de; PEREIRA, Rosa Maria Rodrigues; CLEVA, Roberto de; SANTO, Marco Aurelio; REZENDE, Diego Augusto Nunes; KIRWAN, John P.; GUALANO, Bruno; ROSCHEL, Hamilton
    Background Bariatric surgery improves cardiovascular health, which might be partly ascribed to beneficial alterations in the autonomic nervous system. However, it is currently unknown whether benefits from surgery on cardiac autonomic regulation in post-bariatric patients can be further improved by adjuvant therapies, namely exercise. We investigated the effects of a 6-month exercise training program on cardiac autonomic responses in women undergoing bariatric surgery. Methods Sixty-two women eligible for bariatric surgery were randomly allocated to either standard of care (control) or an exercise training intervention. At baseline (PRE) and 3 (POST3) and 9 (POST9) months after surgery, we assessed chronotropic response to exercise (CR%; i.e., percentage change in heart rate from rest to peak exercise) and heart rate recovery (HRR30s, HRR60s, and HRR120s; i.e., decay of heart rate at 30, 60, and 120 s post exercise) after a maximal exercise test. Results Between-group absolute changes revealed higher CR% (Delta = 8.56%, CI95% 0.22-19.90, P = 0.04), HRR30s (Delta = 12.98 beat/min, CI95% 4.29-21.67, P = 0.01), HRR60s (Delta = 22.95 beat/min, CI95% 11.72-34.18, P = 0.01), and HRR120s (Delta = 34.54 beat/min, CI95% 19.91-49.17, P < 0.01) in the exercised vs. non-exercised group. Conclusions Our findings demonstrate that exercise training enhanced the benefits of bariatric surgery on cardiac autonomic regulation. These results highlight the relevance of exercise training as a treatment for post-bariatric patients, ensuring optimal cardiovascular outcomes.
  • article 1 Citação(ões) na Scopus
    Exercise modifies hypothalamic connectivity and brain functional networks in women after bariatric surgery: a randomized clinical trial
    (2023) MEREGE-FILHO, Carlos A. A.; GIL, Saulo S.; KIRWAN, John P.; MURAI, Igor H.; DANTAS, Wagner S.; NUCCI, Mariana P.; PASTORELLO, Bruno; LIMA, Alisson Padilha de; BAZAN, Paulo R.; PEREIRA, Rosa M. R.; SA-PINTO, Ana L. de; LIMA, Fernanda R.; BRUCKI, Sonia M. D.; CLEVA, Roberto de; SANTO, Marco A.; LEITE, Claudia da Costa; OTADUY, Maria Concepcion Garcia; ROSCHEL, Hamilton; GUALANO, Bruno
    BackgroundObesity is a disease that may involve disrupted connectivity of brain networks. Bariatric surgery is an effective treatment for obesity, and the positive effects on obesity-related conditions may be enhanced by exercise. Herein, we aimed to investigate the possible synergistic effects of Roux-en-Y Gastric Bypass (RYGB) and exercise training on brain functional networks. MethodsThirty women eligible for bariatric surgery were randomly assigned to a Roux-en-Y gastric bypass (RYGB: n = 15, age = 41.0 & PLUSMN; 7.3 years) or RYGB plus Exercise Training (RYGB + ET: n = 15, age = 41.9 & PLUSMN; 7.2 years). Clinical, laboratory, and brain functional connectivity parameters were assessed at baseline, and 3 (POST3) and 9 months (POST9) after surgery. The 6-month, three-times-a-week, exercise intervention (resistance plus aerobic exercise) was initiated 3 months post-surgery (for RYGB + ET). ResultsExercise superimposed on bariatric surgery (RYGB + ET) increased connectivity between hypothalamus and sensorial regions (seed-to-voxel analyses of hypothalamic connectivity), and decreased default mode network (DMN) and posterior salience (pSAL) network connectivity (ROI-to-ROI analyses of brain networks connectivity) when compared to RYGB alone (all p-FDR < 0.05). Increases in basal ganglia (BG) network connectivity were only observed in the exercised training group (within-group analyses). ConclusionExercise training is an important component in the management of post-bariatric patients and may improve the hypothalamic connectivity and brain functional networks that are involved in controlling food intake.
  • article 18 Citação(ões) na Scopus
    Reversal of Improved Endothelial Function After Bariatric Surgery Is Mitigated by Exercise Training
    (2018) DANTAS, Wagner Silva; GIL, Saulo; MURAI, Igor Hisashi; COSTA-HONG, Valeria; PECANHA, Tiago; MEREGE-FILHO, Carlos Alberto Abujabra; SA-PINTO, Ana Lucia de; CLEVA, Roberto de; SANTO, Marco Aurelio; PEREIRA, Rosa Maria Rodrigues; KIRWAN, John P.; ROSCHEL, Hamilton; GUALANO, Bruno
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    Exercise Suppresses The Ubiquitin-proteasome System In The Skeletal Muscle Of Obese Women Following Bariatric Surgery
    (2020) GIL, Saulo; GUALANO, Bruno; DANTAS, Wagner S.; MURAI, Igor H.; GHOSH, Sujoy; SHINJO, Samuel K.; MEREGE-FILHO, Carlos; TEODORO, Walcy R.; PEREIRA, Rosa Maria; BENATTI, Fabiana B.; SA-PINTO, Ana L. de; LIMA, Fernanda; CLEVA, Roberto de; SANTO, Marco A.; KIRWAN, John P.; ROSCHEL, Hamilton
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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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    Exercise Mitigates The Loss In Muscle Mass And Functionality In Obese Women Undergoing Bariatric Surgery
    (2019) GIL, Saulo; DANTAS, Wagner Silva; MURAI, Igor Hisashi; MEREGE FILHO, Carlos; SANTO, Marco Aurelio; CLEVA, Roberto de; PEREIRA, Rosa Maria Rodrigues; SHINJO, Samuel Katsuyuki; KIRWAN, John P.; GUALANO, Bruno; ROSCHEL, Hamilton
  • article 11 Citação(ões) na Scopus
    A randomized clinical trial on the effects of exercise on muscle remodelling following bariatric surgery
    (2021) GIL, Saulo; KIRWAN, John P.; MURAI, Igor H.; DANTAS, Wagner S.; MEREGE-FILHO, Carlos Alberto Abujabra; GHOSH, Sujoy; SHINJO, Samuel K.; PEREIRA, Rosa M. R.; TEODORO, Walcy R.; FELAU, Sheylla M.; BENATTI, Fabiana B.; SA-PINTO, Ana L.; LIMA, Fernanda; CLEVA, Roberto; SANTO, Marco Aurelio; GUALANO, Bruno; ROSCHEL, Hamilton
    Background Muscle atrophy and strength loss are common adverse outcomes following bariatric surgery. This randomized, controlled trial investigated the effects of exercise training on bariatric surgery-induced loss of muscle mass and function. Additionally, we investigated the effects of the intervention on molecular and histological mediators of muscle remodelling. Methods Eighty women with obesity were randomly assigned to a Roux-en-Y gastric bypass (RYGB: n = 40, age = 42 +/- 8 years) or RYGB plus exercise training group (RYGB + ET: n = 40, age = 38 +/- 7 years). Clinical and laboratory parameters were assessed at baseline, and 3 (POST3) and 9 months (POST9) after surgery. The 6 month, three-times-a-week, exercise intervention (resistance plus aerobic exercise) was initiated 3 months post-surgery (for RYGB + ET). A healthy, lean, age-matched control group was recruited to provide reference values for selected variables. Results Surgery resulted in a similar (P = 0.66) reduction in lower-limb muscle strength in RYGB and RYGB+ET (-26% vs. -31%), which was rescued to baseline values in RYGB + ET (P = 0.21 vs. baseline) but not in RYGB (P < 0.01 vs. baseline). Patients in RYGB+ET had greater absolute (214 vs. 120 kg, P < 0.01) and relative (2.4 vs. 1.4 kg/body mass, P < 0.01) muscle strength compared with RYGB alone at POST9. Exercise resulted in better performance in timed-up-and-go (6.3 vs. 7.1 s, P = 0.05) and timed-stand-test (18 vs. 14 repetitions, P < 0.01) compared with RYGB. Fat-free mass was lower (POST9-PRE) after RYBG than RYGB + ET (total: -7.9 vs. -4.9 kg, P < 0.01; lower-limb: -3.8 vs. -2.7 kg, P = 0.02). Surgery reduced Types I (similar to - 21%; P = 0.99 between-group comparison) and II fibre cross-sectional areas (similar to - 27%; P = 0.88 between-group comparison), which were rescued to baseline values in RYGB+ET (P > 0.05 vs. baseline) but not RYGB (P > 0.01 vs. baseline). RYGB + ET showed greater Type I (5187 vs. 3898 mu m(2), P < 0.01) and Type II (5165 vs. 3565 mu m(2), P < 0.01) fCSA than RYGB at POST9. RYGB + ET also resulted in increased capillarization (P < 0.01) and satellite cell content (P < 0.01) than RYGB at POST9. Gene-set normalized enrichment scores for the muscle transcriptome revealed that the ubiquitin-mediated proteolysis pathway was suppressed in RYGB + ET at POST9 vs. PRE (NES: -1.7; P < 0.01), but not in RYGB. Atrogin-1 gene expression was lower in RYGB + ET vs. RYGB at POST9 (0.18 vs. 0.71-fold change, P < 0.01). From both genotypic and phenotypic perspectives, the muscle of exercised patients resembled that of healthy lean individuals. Conclusions This study provides compelling evidence-from gene to function-that strongly supports the incorporation of exercise into the recovery algorithm for bariatric patients so as to counteract the post-surgical loss of muscle mass and function.