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
32 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 32
- 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.
- Effects of clomiphene citrate on male obesity-associated hypogonadism: a randomized, double-blind, placebo-controlled study(2018) SOARES, Andressa Heimbecher; HORIE, Nidia Celeste; CHIANG, Lucas Augusto Piccinin; CARAMELLI, Bruno; MATHEUS, Mariana Gomes; CAMPOS, Alexandre Holthausen; MARTI, Luciana Cavalheiro; ROCHA, Fernanda Agostini; MANCINI, Marcio C.; COSTA, Elaine Maria Frade; CERCATO, CintiaBackground Obesity causes secondary hypogonadism (HG) in men. Standard testosterone (T) replacement therapy improves metabolic parameters but leads to infertility. Objective To evaluate clomiphene citrate (CC) treatment of adult men with male obesity-associated secondary hypogonadism (MOSH). Design Single-center, randomized, double-blind, placebo-controlled trial. Participants Seventy-eight men aged 36.5 +/- 7.8 years with a body mass index (BMI) > 30 kg/m(2), total testosterone (TT) <= 300 ng/dL, and symptoms in the ADAM questionnaire. Intervention Random allocation to receive 50 mg CC or placebo (PLB) for 12 weeks. Outcomes (1) Clinical features: ADAM and sexual behavior questionnaires; (2) hormonal profile: serum TT, free T, estradiol (E2), luteinizing hormone (LH), follicle-stimulating hormone (FSH), and sex hormone-binding globulin (SHBG); (3) body composition: BMI, waist circumference, and bioelectric impedance analysis; (4) metabolic profile: blood pressure, fasting blood glucose, HbA lc, insulin, HOMA-IR, and lipid profile; (5) endothelial function: flow-mediated dilation of the brachial artery, quantitative assessment of endothelial progenitor cells and serum sICAM-1, sVCAM-1, and selectin-sE levels; (6) safety aspects: hematocrit, serum prostate-specific antigen, International Prostate Symptom Score, and self-reported adverse effects. Results There was an improvement in one sexual complaint (weaker erections; P < 0.001); increases (P < 0.001) in TT, free T, E2, LH, FSH, and SHBG; and improvements in lean mass (P < 0.001), fat-free mass (P = 0.004), and muscle mass (P < 0.001) in the CC group. CC reduced HDL (P < 0.001). No statistically significant differences were seen in endothelial function. Conclusions CC appeared to effectively improve the hormonal profile and body composition. CC may be an alternative treatment for MOSH in adult men.
- 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.
- 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.
- Differences in the gut microbiota of women according to ultra- processed food consumption(2023) FERNANDES, Ariana E.; ROSA, Paula W. L.; MELO, Maria E.; MARTINS, Roberta C. R.; SANTIN, Fernanda G. O.; MOURA, Aline M. S. H.; COELHO, Graziele S. M. A.; SABINO, Ester C.; CERCATO, Cintia; MANCINI, Marcio C.Background and aims: High consumption of ultra-processed food (UPF) has been associated with increased risk of obesity and other metabolic diseases, and this dietary pattern seems to be responsible for chronic changes in the gut microbiota. The aim of this study was to assess the associations of UPF with the gut microbiota and obesity-associated biometrics in women. Methods and results: This cross-sectional study examined 59 women. The following parameters were evaluated: food consumption using NOVA classification, anthropometric and metabolic parameters, and gut microbiome by next-generation sequencing. The mean age was 28.0 & PLUSMN; 6.6 years. The mean caloric intake was 1624 & PLUSMN; 531 kcal, of which unprocessed or minimally processed food (G1) accounted for 52.4 & PLUSMN; 13.5%, and UPF accounted for 31.4 & PLUSMN; 13.6%. Leptin levels adjusted for fat mass were negatively associated with G1 and positively associated with UPF. We found 15 species in the gut microbiota that correlated with G1 (3 positively and 12 negatively) and 9 species associated with UPF (5 positively and 4 negatively). Conclusion: Higher consumption of UPF was directly associated with leptin resistance, and this study suggests that the consumption of UPF or G1 may affect the composition of the gut micro biota. & COPY; 2022 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University.
- Bariatric surgery - An update for the endocrinologist(2014) MANCINI, Marcio C.Obesity is a major public health problem, is associated with increased rates of mortality risk and of developing several comorbidities, and lessens life expectancy. Bariatric surgery is the most effective treatment for morbidly obese patients, reducing risk of developing new comorbidities, health care utilization and mortality. The establishment of centers of excellence with interdisciplinary staff in bariatric surgery has been reducing operative mortality in the course of time, improving surgical safety and quality. The endocrinologist is part of the interdisciplinary team. The aim of this review is to provide endocrinologists, physicians and health care providers crucial elements of good clinical practice in the management of morbidly obese bariatric surgical candidates. This information includes formal indications and contraindications for bariatric operations, description of usual bariatric and metabolic operations as well as endoscopic treatments, preoperative assessments including psychological, metabolic and cardiorespiratory evaluation and postoperative dietary staged meal progression and nutritional supplementation follow-up with micronutrient deficiencies monitoring, surgical complications, suspension of medications in type 2 diabetic patients, dumping syndrome and hypoglycemia.
- 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.
- Diabetes remission off medications is not a suitable endpoint for comparing bariatric/metabolic surgery with pharmacotherapy(2016) HALPERN, Bruno; CERCATO, Cintia; MANCINI, Marcio C.
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.- Bariatric/Metabolic Surgery to Treat Type 2 Diabetes in Patients With a BMI < 35 kg/m(2). Diabetes Care 2016;39:924-933(2017) HALPERN, Bruno; CERCATO, Cintia; MANCINI, Marcio Correa