JOSE ANTONIO MIGUEL MARCONDES
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- Association of glucocorticoid receptor polymorphisms with clinical and metabolic profiles in polycystic ovary syndrome(2014) MACIEL, Gustavo A.Rosa; MOREIRA, Ricardo P.P.; BUGANO, Diogo D.G.; HAYASHIDA, Sylvia A.Y.; MARCONDES, Jose A.M.; GOMES, Larissa G.; MENDONCA, Berenice B.; BACHEGA, Tania A.S.S.; BARACAT, Edmund C.OBJECTIVES: We aimed to investigate whether glucocorticoid receptor gene polymorphisms are associated with clinical and metabolic profiles in patients with polycystic ovary syndrome. Polycystic ovary syndrome is a complex endocrine disease that affects 5-8% of women and may be associated with metabolic syndrome, which is a risk factor for cardiovascular disease. Cortisol action and dysregulation account for metabolic syndrome development in the general population. As glucocorticoid receptor gene (NR3C1) polymorphisms regulate cortisol sensitivity, we hypothesized that variants of this gene may be involved in the adverse metabolic profiles of patients with polycystic ovary syndrome. METHOD: Clinical, metabolic and hormonal profiles were evaluated in 97 patients with polycystic ovary syndrome who were diagnosed according to the Rotterdam criteria. The alleles of the glucocorticoid gene were genotyped. Association analyses were performed using the appropriate statistical tests. RESULTS: Obesity and metabolic syndrome were observed in 42.3% and 26.8% of patients, respectively. Body mass index was positively correlated with blood pressure, triglyceride, LDL-c, total cholesterol, glucose and insulin levels as well as HOMA-IR values and inversely correlated with HDL-c and SHBG levels. The BclI and A3669G variants were found in 24.7% and 13.4% of alleles, respectively. BclI carriers presented a lower frequency of insulin resistance compared with wild-type subjects. CONCLUSION: The BclI variant is associated with a lower frequency of insulin resistance in women with polycystic ovary syndrome. Glucocorticoid gene polymorphism screening during treatment of the syndrome may be useful for identifying subgroups of at-risk patients who would benefit the most from personalized treatment.
- Discriminating between virilizing ovary tumors and ovary hyperthecosis in postmenopausal women: clinical data, hormonal profiles and image studies(2017) YANCE, V. R. V.; MARCONDES, J. A. M.; ROCHA, M. P.; BARCELLOS, C. R. G.; DANTAS, W. S.; AVILA, A. F. A.; BARONI, R. H.; CARVALHO, F. M.; HAYASHIDA, S. A. Y.; MENDONCA, B. B.; DOMENICE, S.Background: The presence of virilizing signs associated with high serum androgen levels in postmenopausal women is rare. Virilizing ovarian tumors (VOTs) and ovarian stromal hyperthecosis (OH) are the most common etiologies in virilized postmenopausal women. The differential diagnosis between these two conditions is often difficult. Objective: To evaluate the contribution of clinical features, hormonal profiles and radiological studies to the differential diagnosis of VOT and OH. Design: A retrospective study. Setting: A tertiary center. Main outcome measures: Clinical data, hormonal status (T, E2, LH and FSH), pelvic images (transvaginal sonography and MRI) and anatomopathology were reviewed. Patients: Thirty-four postmenopausal women with a diagnosis of VOT (13 women) and OH (21 women) were evaluated retrospectively. Results: Clinical signs of hyperandrogenism were more prevalent in the VOT group than the OH group. Although the VOT group showed higher T and E2 levels and lower gonadotropin levels than the OH group, a great overlap occurred among the hormone levels. A pelvic MRI provided an accurate differentiation of these two conditions. Conclusion: In this group of patients, the main features contributing to the differential diagnosis of VOT and OH were serum levels of testosterone and gonadotropins and the presence of an ovarian nodule identified on the MRI. Although the association of clinical, hormonal and radiological features contributes to the differential diagnosis of these two conditions, histopathological analysis remains the gold standard for the diagnosis of ovarian hyperandrogenism in postmenopausal women.
- GLUT4 translocation is not impaired after acute exercise in skeletal muscle of women with obesity and polycystic ovary syndrome(2015) DANTAS, Wagner Silva; MARCONDES, Jose Antonio Miguel; SHINJO, Samuel Katsuyuki; PERANDINI, Luiz Augusto; ZAMBELLI, Vanessa Olzon; NEVES, Willian Das; BARCELLOS, Cristiano Roberto Grimaldi; ROCHA, Michele Patrocinio; YANCE, Viviane Dos Reis Vieira; PEREIRA, Renato Tavares Dos Santos; MURAI, Igor Hisashi; PINTO, Ana Lucia De Sa; ROSCHEL, Hamilton; GUALANO, BrunoObjectiveThe aim of this study was to examine the effects of acute exercise on insulin signaling in skeletal muscle of women with polycystic ovary syndrome (PCOS) and controls (CTRL). MethodsFifteen women with obesity and PCOS and 12 body mass index-matched CTRL participated in this study. Subjects performed a 40-min single bout of exercise. Muscle biopsies were performed before and 60 min after exercise. Selected proteins were assessed by Western blotting. ResultsCTRL, but not PCOS, showed a significant increase in PI3-k p85 and AS160 Thr 642 after a single bout of exercise (P=0.018 and P=0.018, respectively). Only PCOS showed an increase in Akt Thr 308 and AMPK phosphorylation after exercise (P=0.018 and P=0.018, respectively). Total GLUT4 expression was comparable between groups (P>0.05). GLUT4 translocation tended to be significantly higher in both groups after exercise (PCOS: P=0.093; CTRL: P=0.091), with no significant difference between them (P>0.05). ConclusionsA single bout of exercise elicited similar GLUT4 translocation in skeletal muscle of PCOS and CTRL, despite a slightly differential pattern of protein phosphorylation. The absence of impairment in GLUT4 translocation suggests that PCOS patients with obesity and insulin resistance may benefit from exercise training.
- Metformin versus lifestyle changes in treating women with polycystic ovary syndrome(2012) CURI, Daniella D. G.; FONSECA, Angela Maggio; MARCONDES, Jose Antonio M.; ALMEIDA, Jose Alcione M.; BAGNOLI, Vicente R.; SOARES- JR., Jose Maria; BARACAT, Edmund ChadaObjective: To compare the efficacy of metformin with that of lifestyle changes in patients with polycystic ovary syndrome (PCOS). Design: Prospective, randomized clinical trial of 40 women with PCOS to analyze the effects of metformin and lifestyle intervention treatments on menstrual pattern and hormone and metabolic profile. The duration of treatment was 6 months. Statistical analysis was done using Student's t-test. Results: Fifteen women in the metformin group and 12 in the lifestyle changes group completed the study. The menstrual pattern improved by similar to 67% in both groups. There was a significant decrease in waist circumference in the lifestyle changes group (101.8 +/- 3.9 and 95.1 +/- 3.6, at baseline and at 6 months of treatment, respectively; p<0.001) and in body mass index (BMI) in both groups. The predictor of menstrual pattern improvement was BMI. Conclusions: Both metformin and lifestyle changes may increase the number of menstrual cycles in PCOS. This effect was related to a decrease in BMI.
bookPart Hiperandrogenismo(2013) HAYASHIDA, Sylvia Asaka Yamashita; MACIEL, Gustavo Arantes Rosa; MARCONDES, Jose Antonio Miguel; JúNIOR, José Maria Soares; BARACAT, Edmund ChadabookPart Hirsutismo e síndrome dos ovários policísticos(2017) MARCONDES, José Antonio Miguel; HAYASHIDA, Sylvia Asaka Yamashita; GOMES, Larissa Garcia- The Presence of Clitoromegaly in the Nonclassical Form of 21-Hydroxylase Deficiency Could Be Partially Modulated by the CAG Polymorphic Tract of the Androgen Receptor Gene(2016) MOURA-MASSARI, Vivian Oliveira; CUNHA, Flavia Siqueira; GOMES, Larissa Garcia; GOMES, Diogo Bugano Diniz; MARCONDES, Jose Antonio Miguel; MADUREIRA, Guiomar; MENDONCA, Berenice Bilharinho de; BACHEGA, Tania A. Sartori SanchezBackground In the nonclassical form (NC), good correlation has been observed between genotypes and 17OH-progesterone (17-OHP) levels. However, this correlation was not identified with regard to the severity of hyperandrogenic manifestations, which could depend on interindividual variability in peripheral androgen sensitivity. Androgen action is modulated by the polymorphic CAG tract (nCAG) of the androgen receptor (AR) gene and by polymorphisms in 5 alpha-reductase type 2 (SRD5A2) enzyme, both of which are involved in the severity of hyperandrogenic disorders. Objectives To analyze whether nCAG-AR and SRD5A2 polymorphisms influence the severity of the nonclassical phenotype. Patients NC patients (n = 114) diagnosed by stimulated-17OHP >= 10 ng/mL were divided into groups according to the beginning of hyperandrogenic manifestations (pediatric and adolescent/adult) and CYP21A2 genotypes (C/C: homozygosis for mild mutations; A/C: compound heterozygosis for severe/mild mutations). Methods CYP21A2 mutations were screened by allelic-specific PCR, MLPA and/or sequencing. HpaII-digested and HpaII-undigested DNA samples underwent GeneScan analysis to study nCAG, and the SRD5A2 polymorphisms were screened by RLFP. Results Mean nCAG did not differ among pediatric, adolescent/adult and asymptomatic subjects. In the C/C genotype, we observed a significantly lower frequency of longer CAG alleles in pediatric patients than in adolescent/adults (p = 0.01). In patients carrying the A/C genotype, the frequencies of shorter and longer CAG alleles did not differ between pediatric patients and adolescent/adults (p>0.05). Patients with clitoromegaly had significantly lower weighted CAG biallelic mean than those without it: 19.1 +/- 2.7 and 21.6 +/- 2.5, respectively (p = 0.007), independent of the CYP21A2 genotype's severity. The SRD5A2 polymorphisms were not associated with the variability of hyperandrogenic NC phenotypes. Conclusions In this series, we observed a modulatory effect of the CAG-AR tract on clinical manifestations of the NC form. Although the NC form is a monogenic disorder, our preliminary data suggested that the interindividual variability of the hyperandrogenic phenotype could arise from polygenic interactions.
conferenceObject The Influence of Insulin on the Degree of Hirsutism of Patients with Polycystic Ovary Syndrome(2014) HAYASHIDA, Sylvia Yamashita; SOARES JR., Jose Maria; MIRALDI, Priscila Dias; MARCONDES, Jose Antonio; BARCELLOS, Cristiano Roberto; ANZAI, Alvaro; MACIEL, Gustavo Arantes R.; BARACAT, Edmund Chada- Changing pattern of gonadotropins in a patient with an adrenal-androgen secreting tumor(2011) MARCONDES, Jose Antonio Miguel; BARCELLOS, Cristiano R. G.; ROCHA, Michelle P.; BISI, Helio
- GLUT4 Translocation is not Impaired After Acute Exercise in Skeletal Muscle of Women with Obesity and Polycystic Ovary Syndrome (vol 23, pg 2207, 2015)(2016) DANTAS, Wagner Silva; MARCONDES, Jose Antonio Miguel; SHINJO, Samuel Katsuyuki; PERANDINI, Luiz Augusto; ZAMBELLI, Vanessa Olzon; NEVES, Willian Das; BARCELLOS, Cristiano Roberto Grimaldi; ROCHA, Michele Patrocinio; YANCE, Viviane Dos Reis Vieira; PEREIRA, Renato Tavares Dos Santos; MURAI, Igor Hisashi; PINTO, Ana Lucia De Sa; ROSCHEL, Hamilton; GUALANO, Bruno
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