MARCIO CORREA MANCINI
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/18 - Laboratório de Carboidratos e Radioimunoensaios, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/18 - Laboratório de Carboidratos e Radioimunoensaios, Hospital das Clínicas, Faculdade de Medicina - Líder
12 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 12
- Metabolic Improvements in Obese Type 2 Diabetes Subjects Implanted for 1 Year with an Endoscopically Deployed Duodenal-Jejunal Bypass Liner(2012) MOURA, Eduardo G. H. de; MARTINS, Bruno C.; LOPES, Guilherme S.; ORSO, Ivan R.; OLIVEIRA, Suzana L. de; GALVAO NETO, Manoel P.; SANTO, Marco A.; SAKAI, Paulo; RAMOS, Almino C.; GARRIDO JUNIOR, Arthur B.; MANCINI, Marcio C.; HALPERN, Alfredo; CECCONELLO, IvanBackground: The purpose of this study was to evaluate the effect of the duodenal-jejunal bypass liner (DJBL), a 60-cm, impermeable fluoropolymer liner anchored in the duodenum to create a duodenal-jejunal bypass, on metabolic parameters in obese subjects with type 2 diabetes. Methods: Twenty-two subjects (mean age, 46.2 +/- 10.5 years) with type 2 diabetes and a body mass index between 40 and 60 kg/m(2) (mean body mass index, 44.8 +/- 7.4 kg/m(2)) were enrolled in this 52-week, prospective, open-label clinical trial. Endoscopic device implantation was performed with the patient under general anesthesia, and the subjects were examined periodically during the next 52 weeks. Primary end points included changes in fasting blood glucose and insulin levels and changes in hemoglobin A1c (HbA1c). The DJBL was removed endoscopically at the end of the study. Results: Thirteen subjects completed the 52-week study, and the mean duration of the implant period for all subjects was 41.9 +/- 3.2 weeks. Reasons for early removal of the device included device migration (n = 3), gastrointestinal bleeding (n = 1), abdominal pain (n = 2), principal investigator request (n = 2), and discovery of an unrelated malignancy (n = 1). Using last observation carried forward, statistically significant reductions in fasting blood glucose (-30.3 +/- 10.2 mg/dL), fasting insulin (-7.3 +/- 2.6 mu U/mL), and HbA1c (-2.1 +/- 0.3%) were observed. At the end of the study, 16 of the 22 subjects had an HbA1c < 7% compared with only one of 22 at baseline. Upper abdominal pain (n = 11), back pain (n = 5), nausea (n = 7), and vomiting (n = 7) were the most common device-related adverse events. Conclusions: The DJBL improves glycemic status in obese subjects with diabetes and therefore represents a nonsurgical, reversible alternative to bariatric surgery.
- Changes in Neuropsychological Tests and Brain Metabolism After Bariatric Surgery(2014) MARQUES, Emerson Leonildo; HALPERN, Alfredo; MANCINI, Marcio Correa; MELO, Maria Edna de; HORIE, Ndia Celeste; BUCHPIGUEL, Carlos Alberto; COUTINHO, Artur Martins Novaes; ONO, Carla Rachel; PRANDO, Silvana; SANTO, Marco Aurelio; CUNHA-NETO, Edecio; FUENTES, Daniel; CERCATO, CintiaContext: The mechanisms by which obesity alters the cerebral function and the effect of weight loss on the brain have not been completely clarified. Objective: The objective of the study was to assess the effect of bariatric surgery on the cognitive function and cerebral metabolism. Design: Seventeen obese women were studied prior to and 24 weeks after bariatric surgery using neuropsychological tests and positron emission tomography. Setting: The study was conducted in a reference center for the treatment of obesity of a Brazilian public university. Participants: Thirty-three women paired by age and level of education made up two groups: 17 severely obese patients and 16 lean patients. They did not have diabetes mellitus or a family history of dementia. Main Outcome Measures: Comparison of performance in neuropsychological tests and cerebral metabolism of the obese women before and after bariatric surgery was measured. The results found at the two moments were compared with those of the women of normal weight. Results: Women with a mean age of 40.5 years and mean body mass index of 50.1 kg/m(2) when compared with women with mean body mass index of 22.3 kg/m(2) showed increased cerebral metabolism, especially in the posterior cingulate gyrus (P <.004). No difference was found between the groups for the neuropsychological tests. After 24 weeks the cerebral metabolism of the obese women was lower, similar to the lean women, and there was an improvement of executive function, accompanying changes of metabolic and inflammatory parameters. Conclusions: Obese women may have increased cerebral metabolism when compared with women of normal weight, and this appears to reverse after weight loss induced by bariatric surgery, accompanied by improved executive function.
- Tratamento de curto prazo com liraglutide no reganho de peso após cirurgia bariátrica(2013) PAJECKI, Denis; HALPERN, Alfredo; CERCATO, Cintia; MANCINI, Marcio; CLEVA, Roberto de; SANTO, Marco AurélioOBJECTIVE: To evaluate the results of the use of liraglutide in a group of patients undergoing surgical treatment of morbid obesity with unsatisfactory weight loss or regain of more than 15% of minimum reached weight. METHODS: The authors conducted a retrospective analysis of 15 operated patients who had excess weight loss <50% after two years of follow-up or regained weight more than 15% of the minimum reached weight. We included only patients who had the expected ""surgical anatomy"", assessed by contrast radiography and endoscopy. Mean age was 47.2 ± 12.5 years, and patients received liraglutide at doses from 1.2 to 3.0 mg/day for eight to 28 weeks follow-up. RESULTS: Surgical treatment induced a weight loss of 34.1 ± 16.5 kg. The average weight regain after 5.3 ± 3.3 years was 14.2 ± 12.1 Kg. The average weight was significantly reduced after treatment with liraglutide (100.9 ± 18.3 kg. vs Kg 93.5 ± 17.4, p <0.0001). Six patients had nausea and two discontinued therapy due to the cost of medication. CONCLUSION: medical treatment directed to the control of satiety using liraglutide may be an alternative treatment of patients with poor weight loss or weight regain after surgery when no technical problem has been identified.
- Lack of mutations in the leptin receptor gene in severely obese children(2012) DIAS, Natasha Favoretto; FERNANDES, Ariana Ester; MELO, Maria Edna de; REINHARDT, Heidi Lui; CERCATO, Cintia; VILLARES, Sandra Mara Ferreira; HALPERN, Alfredo; MANCINI, Marcio C.Objective: To analyze the LEPR gene in obese children and to investigate the associations between molecular findings and anthropometric and metabolic features. Subjects and methods: Thirty-two patients were evaluated regarding anthropometric characteristics, blood pressure, heart rate, serum glucose, insulin, leptin levels, and lipid profile. The molecular study consisted of the amplification and automatic sequencing of the coding region of LEPR in order to investigate new mutations. Results: We identified a high prevalence of metabolic disorders: impaired fasting glucose in 12.5% of the patients, elevated HOMA-IR in 85.7%, low HDL-cholesterol levels in 46.9%, high triglyceride levels in 40.6%, and hypertension in 58.6% of the patients. The molecular study identified 6 already described allelic variants: rs1137100 (exon-2), rs1137101 (exon-4), rs1805134 (exon-7), rs8179183 (exon-12), rs1805096 (exon-18), and the deletion/insertion of the pentanucleotide CTTTA at 3'untranslated region. Conclusions: The frequency of alleles observed in this cohort is similar to that described in the literature, and was not correlated with any clinical feature. The molecular findings in the analysis of the LEPR did not seem to be implicated in the etiology of obesity in these patients.
- Brown adipose tissue: what have we learned since its recent identification in human adults(2014) HALPERN, Bruno; MANCINI, Marcio Correa; HALPERN, AlfredoBrown adipose tissue, an essential organ for thermoregulation in small and hibernating mammals due to its mitochondrial uncoupling capacity, was until recently considered to be present in humans only in newborns. The identification of brown adipose tissue in adult humans since the development and use of positron emission tomography marked with 18-fluorodeoxyglucose (PET-FDG) has raised a series of doubts and questions about its real importance in our metabolism. In this review, we will discuss what we have learnt since its identification in humans as well as both new and old concepts, some of which have been marginalized for decades, such as diet-induced thermogenesis.
conferenceObject ASSOCIATION BETWEEN RS1137100 SNP IN LEPR GENE AND WAIST-TO-HEIGHT RATIO IN BRAZILIAN OVERWEIGHT CHILDREN AND ADOLESCENTS(2013) FUJIWARA, C. T. H.; FERNADES, A. E.; MELO, M. E.; SANTOS, A.; CERCATO, C.; HALPERN, A.; MANCINI, M. C.conferenceObject RS1137101 SNP IN LEPR GENE IS NOT ASSOCIATED WITH BINGE EATING AND CARDIOMETABOLIC RISK IN BRAZILIAN OVERWEIGHT CHILDREN AND ADOLESCENTS(2013) FUJIWARA, C. T. H.; FERNANDES, A. E.; MELO, M. E.; SANTOS, A.; CERCATO, C.; HALPERN, A.; MANCINI, M. C.- Cognitive Effects of Intentional Weight Loss in Elderly Obese Individuals With Mild Cognitive Impairment(2016) HORIE, Nidia Celeste; SERRAO, Valeria T.; SIMON, Sharon Sanz; GASCON, Maria Rita Polo; SANTOS, Alessandra Xavier dos; ZAMBONE, Maria Aquimara; FREITAS, Marta Merenciana del Bigio de; CUNHA-NETO, Edecio; MARQUES, Emerson Leonildo; HALPERN, Alfredo; MELO, Maria Edna de; MANCINI, Marcio C.; CERCATO, CintiaContext: Obesity in midlife is a risk factor for dementia, but it is unknown if caloric restriction-induced weight loss could prevent cognitive decline and therefore dementia in elderly patients with cognitive impairment. Objective: To evaluate the cognitive effect of intentional weight loss in obese elderly patients with mild cognitive impairment (MCI), considering the influence of age, apolipoprotein E (APOE) genotype, physical activity, biochemical markers, and diet. Design: Single-center, prospective controlled trial. Setting: Academic medical center. Participants: Eighty obese patients with MCI, aged 60 or older (68.1 +/- 4.9 y, body mass index [BMI] 35.5 +/- 4.4 kg/m(2), 83.7% women, 26.3% APOE allele epsilon 4 carriers). Intervention: Random allocation to conventional medical care alone (n = 40) or together with nutritional counselling (n = 40) in group meetings aiming to promote weight loss through caloric restriction for 12 months. Outcome Measurements: clinical data, body composition, neuropsychological tests (main outcome), serum biomarkers, APOE genotype, physical performance, dietary recalls. Results: Seventy-five patients completed the follow-up. BMI, on average, decreased 1.7 +/- 1.8kg/m(2) (P = .021), and most of the cognitive tests improved, without difference between the groups. In analysis with linear generalized models, the BMI decrease was associated with improvements in verbal memory, verbal fluency, executive function, and global cognition, after adjustment for education, gender, physical activity, and baseline tests. This association was strongest in younger seniors (for memory and fluency) and in APOE allele epsilon 4 carriers (for executive function). Changes in homeostasis model assessment-estimated insulin resistance, C-reactive protein, leptin and intake of energy, carbohydrates, and fats were associated with improvement in cognitive tests. Conclusions: Intentional weight loss through diet was associated with cognitive improvement in patients with MCI.
conferenceObject RS12970134 IN MC4R GENE IS NOT RELATED TO WORST METABOLIC PROFILE IN OVERWEIGHT CHILDREN(2013) FERNANDES, A. E.; FUJIWARA, C. T. H.; MELO, M. E.; SANTOS, A.; CERCATO, C.; HALPERN, A.; MANCINI, M.- Associations between a common variant near the MC4R gene and serum triglyceride levels in an obese pediatric cohort(2015) FERNANDES, Ariana Ester; MELO, Maria Edna de; FUJIWARA, Clarissa Tamie Hiwatashi; PIOLTINE, Marina Brosso; MATIOLI, Sergio Russo; SANTOS, Aritania; CERCATO, Cintia; HALPERN, Alfredo; MANCINI, Marcio C.Polymorphisms near the MC4R gene may be related to an increased risk for obesity, but studies of variations in this gene and its relation to cardiometabolic profiles and food intake are scarce and controversial. The aim of this study is to evaluate the influence of the variants rs12970134 and rs17782313 near the MC4R gene in food intake, binge eating (BE) behavior, anthropometric parameters, body composition, metabolic profile, and cardiometabolic risk factors in obese children and adolescents. This is a cross-sectional study that included obese children and adolescents. We evaluated anthropometric, metabolic parameters and cardiometabolic risk factors, including hypertension, impaired fasting glucose, hypertriglyceridemia, and low HDL-cholesterol. BE was assessed through the BE scale, and a 24-h recall was used to evaluate total caloric intake and percentage of macronutrients and types of dietary fat. The MC4R variants rs12970134 and rs17782313 were genotyped using TaqMan assay. To assess the magnitude of risk, a logistic regression adjusted for Z-BMI, age, and gender was performed, adopting the significance level of 0.05. The study included 518 subjects (52.1 % girls, 12.7 +/- A 2.7 years old, Z-BMI = 3.24 +/- A 0.57). Carriers of the variant rs17782313 exhibit increased triglyceride levels (108 +/- A 48 vs. 119 +/- A 54, p = 0.034) and an increased risk of hypertriglyceridemia (OR 1.985, 95 % CI 1.288-3.057, p = 0.002). There was no association of the SNP rs12970134 with clinical, metabolic, or nutritional parameters. The variant rs12970134 and rs17782313 did not influence food intake or the presence of BE. The variant rs17782313 is associated with an increased risk of hypertriglyceridemia in obese children and adolescents.