KRISTOPHERSON LUSTOSA AUGUSTO
Projetos de Pesquisa
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LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
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- Objectively measured physical activity and its influence on physical capacity and clinical parameters in patients with primary Sjogren's syndrome(2017) DASSOUKI, T.; BENATTI, F. B.; PINTO, A. J.; ROSCHEL, H.; LIMA, F. R.; AUGUSTO, K.; PASOTO, S.; PEREIRA, R. M. R.; GUALANO, B.; PINTO, A. L. de SaObjective The objectives of this paper are to objectively measure habitual physical activity levels in patients with primary Sjogren's syndrome (pSS) with mild disease activity and to determine to which extent it may be associated with physical capacity and function and clinical features. Methods In this cross-sectional study, 29 women with pSS were objectively assessed for habitual physical activity levels (using accelerometry) and compared with 20 healthy women (CTRL) frequency-matched for physical activity levels, age, body mass index, and body fat percentage with regard to physical capacity and function, fatigue, depression, pain, and health-related quality of life. Results pSS showed 8.5min/day of moderate-to-vigorous physical activity (MVPA) when only MVPA accumulated in bouts10min was considered; when considering total MVPA (including bouts<10min), average levels were 26.3min/day, with 62% of pSS patients achieving the recommendation ( 21.4min/day). Moreover, pSS showed lower VO2peak, lower muscle strength and function, higher fatigue, and poorer health-related quality of life when compared with CTRL (p<0.05). These differences (except for aerobic capacity) were sustained even when only individuals achieving the minimum of 21.4min/day of total MVPA in both groups were compared. Finally, MVPA time was significantly correlated with aerobic conditioning, whereas total counts and sedentary time were associated with lower-body muscle strength and the bodily-pain domain of SF-36 in patients with pSS. Conclusion When compared to physical activity-matched healthy controls, pSS patients showed reduced physical capacity and function, increased fatigue and pain, and reduced health-related quality of life. Except for aerobic conditioning, these differences were sustained when only more physically active participants were compared, indicating that minimum recommended levels of physical activity for the general population may not be sufficient to counteract pSS comorbidities.
- Metabolic syndrome in Sjogren's syndrome patients: a relevant concern for clinical monitoring(2016) AUGUSTO, Kristopherson Lustosa; BONFA, Eloisa; PEREIRA, Rosa Maria Rodrigues; BUENO, Cleonice; LEON, Elaine Pires; VIANA, Vilma Santos Trindade; PASOTO, Sandra GofinetMetabolic syndrome (MetS) has been described in autoimmune diseases. However, there are scarce data about MetS and adipocytokine profile in primary Sjogren's syndrome (pSS). Seventy-one female pSS patients (American-European Consensus Group Criteria, 2002) aged 18-65 years and 71 age-, race-matched control women were enrolled in this case-control study. Clinical data were collected by a standardized protocol. Blood levels of glucose, cholesterol, low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), triglycerides, interleukin-1beta (IL-1beta)/IL-6, B-cell activating factor (BAFF), insulin, and leptin/adiponectin/visfatin/resistin were determined. Patients and controls were comparable regarding body mass index (BMI), smoking, sedentariness, and menopause (p > 0.05). MetS (39.4 vs. 16.9 %, p = 0.005), hypertension (p = 0.004), and dyslipidemia (p = 0.002) were more frequent in patients than controls. IL-1beta, IL-6, BAFF, resistin, and adiponectin levels were higher in patients than controls (p < 0.05). pSS patients with MetS (n = 28) had higher BMI, waist circumference, cholesterol, LDL-C, triglycerides, insulin, leptin and HOMA-IR values, and greater hypertension and diabetes rates than pSS patients without MetS (n = 43) (p < 0.05). Current and/or previous prednisone use (75.0 vs. 62.8 %, p = 0.313), current (3.0 +/- 4.5 vs. 1.6 +/- 3.2 mg/day, p = 0.299), and cumulative prednisone doses (p = 0.495) were similar in both groups. Otherwise, IL-1beta level was higher in MetS patients than in non-MetS patients (p = 0.012), and this finding was confirmed (p = 0.048) by multivariate analysis with adjustments for age, ethnicity, prednisone use, current and cumulative prednisone doses, and duration of use. We identified high MetS frequency and abnormal adipocytokine profile in pSS. The association of MetS with elevated IL-1beta level suggests that inflammation plays an important role in its pathogenesis.
- 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.