GUILHERME GIANNINI ARTIOLI
Projetos de Pesquisa
Unidades Organizacionais
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
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- Potential of Creatine in Glucose Management and Diabetes(2021) SOLIS, Marina Yazigi; ARTIOLI, Guilherme Giannini; GUALANO, BrunoCreatine is one of the most popular supplements worldwide, and it is frequently used by both athletic and non-athletic populations to improve power, strength, muscle mass and performance. A growing body of evidence has been identified potential therapeutic effects of creatine in a wide variety of clinical conditions, such as cancer, muscle dystrophy and neurodegenerative disorders. Evidence has suggested that creatine supplementation alone, and mainly in combination with exercise training, may improve glucose metabolism in health individuals and insulin-resistant individuals, such as in those with type 2 diabetes mellitus. Creatine itself may stimulate insulin secretion in vitro, improve muscle glycogen stores and ameliorate hyperglycemia in animals. In addition, exercise induces numerous metabolic benefits, including increases in insulin-independent muscle glucose uptake and insulin sensitivity. It has been speculated that creatine supplementation combined with exercise training could result in additional improvements in glucose metabolism when compared with each intervention separately. The possible mechanism underlying the effects of combined exercise and creatine supplementation is an enhanced glucose transport into muscle cell by type 4 glucose transporter (GLUT-4) translocation to sarcolemma. Although preliminary findings from small-scale trials involving patients with type 2 diabetes mellitus are promising, the efficacy of creatine for improving glycemic control is yet to be confirmed. In this review, we aim to explore the possible therapeutic role of creatine supplementation on glucose management and as a potential anti-diabetic intervention, summarizing the current knowledge and highlighting the research gaps.
- A Systematic Risk Assessment and Meta-Analysis on the Use of Oral beta-Alanine Supplementation(2019) DOLAN, Eimear; SWINTON, Paul A.; PAINELLI, Vitor de Salles; HEMINGWAY, Benedict Stephens; MAZZOLANI, Bruna; SMAIRA, Fabiana Infante; SAUNDERS, Bryan; ARTIOLI, Guilherme G.; GUALANO, Brunobeta-Alanine supplementation is one of the world's most commonly used sports supplements, and its use as a nutritional strategy in other populations is ever-increasing, due to evidence of pleiotropic ergogenic and therapeutic benefits. Despite its widespread use, there is only limited understanding of potential adverse effects. To address this, a systematic risk assessment and meta-analysis was undertaken. Four databases were searched using keywords and Medical Subject Headings. All human and animal studies that investigated an isolated, oral, beta-alanine supplementation strategy were included. Data were extracted according to 5 main outcomes, including 1) side effects reported during longitudinal trials, 2) side effects reported during acute trials, 3) effect of supplementation on circulating health-related biomarkers, 4) effect of supplementation on skeletal muscle taurine and histidine concentration, and 5) outcomes from animal trials. Quality of evidence for outcomes was ascertained using the Grading of Recommendations Assessment Development and Evaluation (GRADE) framework, and all quantitative data were meta-analyzed using multilevel models grounded in Bayesian principles. In total, 101 human and 50 animal studies were included. Paraesthesia was the only reported side effect and had an estimated OR of 8.9 [95% credible interval (CrI): 2.2, 32.6] with supplementation relative to placebo. Participants in active treatment groups experienced similar dropout rates to those receiving the placebo treatment. beta-Alanine supplementation caused a small increase in circulating alanine aminotransferase concentration (effect size, ES: 0.274, CrI: 0.04, 0.527), although mean data remained well within clinical reference ranges. Meta-analysis of human data showed no main effect of beta-alanine supplementation on skeletal muscle taurine (ES: 0.156; 95% CrI: -0.38, 0.72) or histidine (ES: -0.15; 95% CrI: -0.64, 0.33) concentration. A main effect of beta-alanine supplementation on taurine concentration was reported for murine models, but only when the daily dose was >= 3% beta-alanine in drinking water. The results of this review indicate that beta-alanine supplementation within the doses used in the available research designs, does not adversely affect those consuming it.
- 24-Week beta-alanine ingestion does not affect muscle taurine or clinical blood parameters in healthy males(2020) SAUNDERS, Bryan; FRANCHI, Mariana; OLIVEIRA, Luana Farias de; SILVA, Vinicius da Eira; SILVA, Rafael Pires da; PAINELLI, Vitor de Salles; COSTA, Luiz Augusto Riani; SALE, Craig; HARRIS, Roger Charles; ROSCHEL, Hamilton; ARTIOLI, Guilherme Giannini; GUALANO, BrunoPurpose To investigate the effects of chronic beta-alanine (BA) supplementation on muscle taurine content, blood clinical markers and sensory side-effects. Methods Twenty-five healthy male participants (age 27 +/- 4 years, height 1.75 +/- 0.09 m, body mass 78.9 +/- 11.7 kg) were supplemented with 6.4 g day(-1) of sustained-release BA (N = 16; CarnoSyn (TM), NAI, USA) or placebo (PL; N = 9; maltodextrin) for 24 weeks. Resting muscle biopsies of the m. vastus lateralis were taken at 0, 12 and 24 weeks and analysed for taurine content (BA, N = 12; PL, N = 6) using high-performance liquid chromatography. Resting venous blood samples were taken every 4 weeks and analysed for markers of renal, hepatic and muscle function (BA, N = 15; PL, N = 8; aspartate transaminase; alanine aminotransferase; alkaline phosphatase; lactate dehydrogenase; albumin; globulin; creatinine; estimated glomerular filtration rate and creatine kinase). Results There was a significant main effect of group (p = 0.04) on muscle taurine, with overall lower values in PL, although there was no main effect of time or interaction effect (both p > 0.05) and no differences between specific timepoints (week 0, BA: 33.67 +/- 8.18 mmol kg(-1) dm, PL: 27.75 +/- 4.86 mmol kg(-1) dm; week 12, BA: 35.93 +/- 8.79 mmol kg(-1) dm, PL: 27.67 +/- 4.75 mmol kg(-1) dm; week 24, BA: 35.42 +/- 6.16 mmol kg(-1) dm, PL: 31.99 +/- 5.60 mmol kg(-1) dm). There was no effect of treatment, time or any interaction effects on any blood marker (all p > 0.05) and no self-reported side-effects in these participants throughout the study. Conclusions The current study showed that 24 weeks of BA supplementation at 6.4 g day(-1) did not significantly affect muscle taurine content, clinical markers of renal, hepatic and muscle function, nor did it result in chronic sensory side-effects, in healthy individuals. Since athletes are likely to engage in chronic supplementation, these data provide important evidence to suggest that supplementation with BA at these doses for up to 24 weeks is safe for healthy individuals.
- Effect of Carnosine or beta-Alanine Supplementation on Markers of Glycemic Control and Insulin Resistance in Humans and Animals: A Systematic Review and Meta-analysis(2021) MATTHEWS, Joseph J.; DOLAN, Eimear; SWINTON, Paul A.; SANTOS, Livia; ARTIOLI, Guilherme G.; TURNER, Mark D.; ELLIOTT-SALE, Kirsty J.; SALE, CraigThere is growing evidence that supplementation with carnosine, or its rate-limiting precursor beta-alanine, can ameliorate aspects of metabolic dysregulation that occur in diabetes and its related conditions. The purpose of this systematic review and meta-analysis was to evaluate the effect of carnosine or beta-alanine supplementation on markers of glycemic control and insulin resistance in humans and animals. We performed a systematic search of 6 electronic databases up to 31 December 2020. Primary outcomes were changes in 1) fasting glucose, 2) glycated hemoglobin (HbA1c), and 3) 2-h glucose following a glucose-tolerance test. A set of additional outcomes included fasting insulin and homeostatic model assessment of beta-cell function (HOMA-beta) and insulin resistance (HOMA-IR). We assessed risk of bias using the Cochrane risk of bias (RoB) 2.0 (human studies) and the Systematic Review Center for Laboratory Animal Experimentation (SYRCLE) RoB (animal studies) tools; and used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to assess certainty. We used Bayesian hierarchical random- effects models, with informative priors for human data and noninformative priors for animal data. Inferences were made on posterior samples generated by Hamiltonian Markov Chain Monte Carlo using 90% credible intervals (90% CrI) and calculated probabilities. Twenty studies (n=4 human, n=16 rodent) were included, providing data for 2 primary outcomes (fasting glucose and HbA1c) and 3 additional outcomes (fasting insulin, HOMA-beta, and HOMA-IR). Themodel provides evidence that supplementation decreases fasting glucose [humans: mean difference (MD)(0.5) =-0.95 mmol . L-1 (90% CrI: -2.1, 0.08); rodent: MD0.5 =-2.26 mmol . L-1 (90% CrI: -4.03, -0.44)], HbA1c [humans: MD0.5 =-0.91% (90% CrI: -1.46, -0.39); rodents: MD0.5 =-1.05% (90% CrI: -1.64, -0.52)], HOMA-IR [humans: standardizedmean difference (SMD)(0.5) =-0.41 (90% CrI: -0.82, -0.07); rodents: SMD0.5 =-0.63 (90% CrI: -1.98, 0.65)], and fasting insulin [humans: SMD0.5 =-0.41 (90% CrI: -0.77, -0.07)]. GRADE assessment showed our certainty in the effect estimate of each outcome to be moderate (human outcomes) or very low (rodent outcomes). Supplementation with carnosine or beta-alanine may reduce fasting glucose, HbA1c, and HOMA-IR in humans and rodents, and fasting insulin in humans; both compounds show potential as therapeutics to improve glycemic control and insulin resistance.