VALERIA DE FALCO CAPARBO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Clínica Médica, Faculdade de Medicina
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
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conferenceObject Performance of FRAX (R) Brazil and NOGG Methodology with and Without Bone Mineral Density upon Predicting Fractures on a Community-Dwelling Elderly Population with High Incidence of Osteoporotic Fractures: The Sao Paulo Ageing and Health (SPAH) Study(2022) FREITAS, Thiago Q.; OLALLA, Leonardo F. G.; TAKAYAMA, Liliam; CAPARBO, Valeria; FIGUEIREDO, Camille; MACHADO, Luana; DOMICIANO, Diogo; PEREIRA, Rosa- Lower hand grip in rheumatoid arthritis patients is associated with low finite element analysis using high resolution peripheral quantitative computed tomography scan of the 2nd metacarpophalangeal joint(2022) FIGUEIREDO, Camille Pinto; PEREZ, Mariana Ortega; SALES, Lucas Peixoto; DOMICIANO, Diogo Souza; SAMPAIO-BARROS, Marilia M.; CAPARBO, Valeria de Falco; PEREIRA, Rosa Maria RodriguesAim To evaluate hand function by hand grip test in rheumatoid arthritis (RA) patients, and its association with bone erosions and the estimated bone strength (finite element - FE analysis) through the analysis of the 2nd metacarpal head of the dominant hand using high resolution peripheral quantitative computed tomography (HR-pQCT). Method Eighty-two female RA patients between 18-50 years old were selected. Demographic data, Health Questionnaire Assessment Disability Index (HAQ), Disease Activity Score of 28 joints (DAS)-28, simplified disease activity index (SDAI) and the hand grip test were set. The HR-pQCT scans of 2nd metacarpophalangeal joints of the dominant hand of all patients were performed according to SPECTRA group protocols. The images were used to assess bone erosions and FE analysis. The hand grip test was categorized in 2 groups and separately compared (< 18 vs >= 18 kgf). A logistic regression was performed using hand grip test A significant difference was found between the 2 groups regarding HAQ, inflammatory markers (erythrocyte sedimentation rate, C-reactive protein), DAS-28, SDAI, total volume of erosion and bone strength parameter (FE analysis - Failure Load [F.Load]). The logistic regression analysis showed that the risk factors associated with hand grip test <18 kgf were higher SDAI (odds ratio [OR] 0.912; 95% CI 0.837-0.993) and lower values of bone strength parameter (F.Load) (OR 1.007; 95% CI 1.002-1.012). Conclusion Lower values of hand grip test were associated with higher disease activity score-SDAI and lower bone strength of 2nd metacarpal bone head of the dominant hand evaluated here through a FE analysis using HR-pQCT scan.
- Persistent or new symptoms 1 year after a single high dose of vitamin D-3 in patients with moderate to severe COVID-19(2022) FERNANDES, Alan L. L.; SALES, Lucas P. P.; SANTOS, Mayara D. D.; CAPARBO, Valeria F. F.; MURAI, Igor H. H.; PEREIRA, Rosa M. R.Purpose: The aim of this study was to investigate the reported persistent or new symptoms 1 year after a single dose of 200,000 IU of vitamin D-3 and hospitalization in patients with moderate to severe COVID-19. Methods: This is a post-hoc, exploratory analysis from a multicenter, double-blind, placebo-controlled, randomized clinical trial from two hospitals in Sao Paulo, Brazil, registered in NCT04449718. Discharged patients were followed for up to 1 year and evaluated by telephone interviews at 6 and 12 months. The primary and secondary outcomes were previously published. These post-hoc exploratory secondary outcomes are the persistent or new symptoms and quality of life (QoL) at the post-viral stage of COVID-19. Generalized estimating equations (GEE) for repeated measures with Bonferroni's adjustment were used for testing outcomes.ResultsBetween 2 June and 27 August 2020, we randomized 240 patients of which 144 were included in this study [the vitamin D-3 (n = 71) or placebo (n = 73) group]. The mean (SD) age was 54.3 (13.1) years, and body mass index (BMI) was 32.4 (6.5) kg/m(2). Fever demonstrated a significant main effect of time (P < 0.001) with a reduction from baseline to 6 (52-0) and 12 months (52-0). No significant differences between groups were observed for fever, cough, fatigue, fever, myalgia, joint pain, runny nose, nasal congestion, sore throat, hypertension, diabetes, cardiovascular disease, rheumatic disease, asthma, chronic obstructive pulmonary, chronic kidney disease, QoL, and new or persistent symptoms up to 1-year of follow-up.ConclusionThe findings do not support the use of 200,000 IU of vitamin D-3 compared to placebo for the management of persistence or new symptoms, and QoL reported by moderate to severe patients after hospitalization for COVID-19.
- Effect of a single high dose of vitamin D-3 on cytokines, chemokines, and growth factor in patients with moderate to severe COVID-19(2022) FERNANDES, Alan L.; MURAI, Igor H.; REIS, Bruna Z.; SALES, Lucas P.; SANTOS, Mayara D.; PINTO, Ana J.; GOESSLER, Karla F.; DURAN, Camila S. C.; SILVA, Carla B. R.; FRANCO, Andre S.; MACEDO, Marina B.; DALMOLIN, Henrique H. H.; BAGGIO, Janaina; BALBI, Guilherme G. M.; ANTONANGELO, Leila; CAPARBO, Valeria F.; GUALANO, Bruno; PEREIRA, Rosa M. R.Background: The modulating effect of vitamin D on cytokine concentrations in severe coronavirus disease 2019 (COVID-19) remains unknown. Objectives: We aimed to investigate the effect of a single high dose of vitamin D-3 on cytokincs, chemokines, and growth factor in hospitalized patients with moderate to severe COVID-19. Methods: This is a post hoc, ancillary, and exploratory analysis from a multicenter, double-blind. placebo-controlled, randomized clinical trial. Patients with moderate to severe COVID-19 were recruited from 2 hospitals in Sao Paulo. Brazil. Of 240 randomly assigned patients, 200 were assessed in this study and randomly assigned to receive a single oral dose of 200,000 IU vitamin D-3 (n = 101) or placebo (n = 99). The primary outcome was hospital length of stay, which has been published in our previous study. The prespecified secondary outcomes were serum concentrations of IL-1 beta, IL-6, IL-10. INF-alpha. and 25-hydroxyvitamin D. The post hoc exploratory secondary outcomes were IL-4, IL-12p70. IL-17A, IFN-gamma. granulocyte-macrophage colony-stimulating factor (GM-CSF), IL-8, IFN-inducible protein-10 (IP-10), macrophage inflammatory protein-1 beta (MIP-1 beta), monocyte chemoattractant protein-1 (MCP-1), vascular endothelial growth factor (VEGF), and leukocyte count. Generalized estimating equations for repeated measures, with Bonferroni's adjustment, were used for testing all outcomes. Results: The study included 200 patients with a mean +/- SD age of 55.5 +/- 14.3 y and BMI of 32.2 +/- 7.1 kg/m(2), of which 109 (54.5%) were male. GM-CSF concentrations showed a significant group-by-time interaction effect (P = 0.04). although the between-group difference at postintervention after Bonferroni's adjustment was not significant. No significant effects were observed for the other outcomes. Conclusions: The findings do not support the use of a single dose of 200,000 IU vitamin D-3, compared with placebo, for the improvement of cytokines, chemokines, and growth factor in hospitalized patients with moderate to severe COVID-19.
- Association of Bone Erosions and Osteophytes With Systemic Bone Involvement on High-Resolution Peripheral Quantitative Computed Tomography in Premenopausal Women With Longstanding Rheumatoid Arthritis(2022) PEREZ, Mariana O.; FIGUEIREDO, Camille P.; SALES, Lucas P.; MEDEIROS-RIBEIRO, Ana Cristina; TAKAYAMA, Liliam; DOMICIANO, Diogo S.; BONFIGLIOLI, Karina; CAPARBO, Valeria F.; PEREIRA, Rosa M. R.Objective To evaluate premenopausal women with longstanding rheumatoid arthritis (RA) for potential associations between parameters of localized bone involvement and parameters of systemic bone involvement in the affected joints. Methods Eighty consecutively evaluated premenopausal women with RA were included in the study, along with 160 healthy female control subjects who were matched to the patients by age and body mass index. Volumetric bone mineral density (vBMD), bone microarchitecture, and finite elements of biomechanical bone strength (bone stiffness and estimated failure load) at the distal radius and distal tibia were analyzed by high-resolution peripheral quantitative computed tomography (HR-pQCT) in patients with RA compared to healthy controls. In addition, in patients with RA, localized bone involvement in the metacarpophalangeal and proximal interphalangeal joints was analyzed by HR-pQCT, to identify bone erosions and osteophytes. Results Among the 80 premenopausal women with longstanding RA, the mean +/- SD age was 39.4 +/- 6.7 years and mean +/- SD disease duration was 9.8 +/- 5.3 years. Trabecular and cortical bone parameters and bone strength at the distal radius and distal tibia were all impaired in patients with RA compared to healthy controls (each P < 0.05). In total, 75% of RA patients had evidence of bone erosions, and 41.3% of RA patients had detectable osteophytes on HR-pQCT. RA patients with bone erosions, as compared to RA patients without bone erosions, had lower cortical vBMD (at the distal radius, mean +/- SD 980 +/- 72 mg HA/cm(3) versus 1,021 +/- 47 mg HA/cm(3) [P = 0.03]; at the distal tibia, 979 +/- 47 mg HA/cm(3) versus 1,003 +/- 34 mg HA/cm(3) [P = 0.04]) and higher cortical bone porosity (at the distal radius, mean +/- SD 2.8 +/- 2.5% versus 1.8 +/- 1.6% [P = 0.04]; at the distal tibia, 3.7 +/- 1.6% versus 2.7 +/- 1.6% [P = 0.01]). In patients with RA, osteophyte volume at the distal radius was positively correlated with trabecular vBMD (r = 0.392, P = 0.02), trabecular number (r = 0.381, P = 0.03), and trabecular stiffness (r = 0.411, P = 0.02), and negatively correlated with trabecular separation (r = -0.364, P = 0.04), as determined by Pearson's or Spearman's correlation test. Conclusion The findings show that premenopausal women with longstanding RA have systemic bone fragility at peripheral joint sites. Moreover, the presence of bone erosions is mainly associated with cortical bone fragility at the distal radius and tibia, and presence of osteophytes is associated with repair of trabecular bone at the distal radius.
- Age-related reference data of bone microarchitecture, volumetric bone density, and bone strength parameters in a population of healthy Brazilian men: an HR-pQCT study(2022) ALVARENGA, J. C.; CAPARBO, V. F.; DOMICIANO, D. S.; PEREIRA, R. M. R.In a cross-sectional cohort of 340 healthy Brazilian men aged 20 to 92 years, data on density, structure, and strength of the distal radius and tibia were obtained using high-resolution peripheral quantitative computed tomography (HR-pQCT) to develop age- and site-specific reference curves. Age-dependent changes differed between the sites and bone compartments (trabecular and cortical). Introduction The aim of this study was to establish age-related reference curves for bone densities, microarchitectural properties, and estimated failure load measured by HR-pQCT (distal radius and tibia) in men. Also, to correlate bone stiffness with the other HR-pQCT parameters, areal bone mineral density (BMD) by DXA and trabecular bone score (TBS). Methods Healthy Brazilian men (n = 340) between the ages of 20 and 92 years were recruited. Non-dominant radius and left tibia were scanned using HR-pQCT (Xtreme CT I). Standard and automated segmentation methods were performed, and bone strength estimated by FE analysis. Bone mineral density at lumbar spine, total hip, femoral neck, and TBS were measured using DXA (Hologic, QDR4500). Results Age-related reference curves were constructed at the distal radius and tibia for volumetric bone density, morphometry, and estimated bone strength parameters. There was a linear relationship with age only for thickness measurements of distal radius (trabecular: R-2 0.108, pR(2) 0.062, p=0.002) and tibia (trabecular: R-2 0.109, pR(2) 0.063, p=0.010), and bone strength at distal radius (R-2 0.157, p<0.001). The significant correlations (p <0.05) found by Pearson's correlations (r) between bone stiffness and all other variables measured by HR-pQCT and DXA showed to be stronger at the tibia site than the distal radius. Conclusion The current study expands the HR-pQCT worldwide database and presents an adequate methodology for the construction of reference data in other populations. Moreover, the correlation of bone strength estimated by FEA with other bone microstructural parameters provided by HR-pQCT helps to determine the contribution of each of these variables to fracture risk prediction in men.
conferenceObject Transcriptome Analysis of Elderly Women with Low Muscle Mass Reveals an Association with Immune System Pathway(2022) HOUNKPE, Bidossessi Wilfried; JALES NETO, Levi Higino; FERNANDES, Georgea H.; TAKAYAMA, Liliam; CAPARBO, Valeria F.; LOPES, Neuza H. M.; PEREIRA, Alexandre C.; PEREIRA, Rosa M. R.conferenceObject Bone Mineral Density of Radius 1/3 Led to a Better Fracture Prediction When Combined with Spine but Not Hip BMD: Results from the Sao Paulo Ageing & Health (SPAH) Study(2022) DOMICIANO, Diogo; MACHADO, Luana; CAPARBO, Valeria; CIDON, Carolina Teixeira; GORAYEB, Thais Helena Bonini; SILVA, Maria Aurora Gomes da; OLIVEIRA, Ricardo Manoel de; FIGUEIREDO, Camille; PEREIRA, RosaconferenceObject Bone erosions and osteophytes in premenopausal women with long-standing rheumatoid arthritis: association with systemic bone involvement using HR-pQCT(2022) PEREZ, Mariana; FIGUEIREDO, Camille; SALES, Lucas; MEDEIROS-RIBEIRO, Ana Cristina; TAKAYAMA, Liliam; DOMICIANO, Diogo; BONFIGLIOLI, Karina; CAPARBO, Valeria; PEREIRA, Rosa- BONE AND MUSCLE IMPAIRMENT AND HIGHER VISCERAL ADIPOSE TISSUE MASS IN WOMEN WITH LONG-TERM POLYARTICULAR JUVENIL IDIOPATHIC ARTHRITIS(2022) RIBEIRO, S.; SALES, L. Peixoto; SILVA, L.; CAPARBO, V.; TAKAYAMA, L.; PEREIRA, R. M.