PAULO ROSSI MENEZES
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Medicina Preventiva, Faculdade de Medicina - Docente
LIM/39 - Laboratório de Processamento de Dados Biomédicos, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/39 - Laboratório de Processamento de Dados Biomédicos, Hospital das Clínicas, Faculdade de Medicina - Líder
16 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 16
conferenceObject PREVALENCE OF SARCOPENIA AND ASSOCIATED RISK FACTORS BY TWO DIAGNOSTIC CRITERIA IN COMMUNITY-DWELLING OLDER WOMEN: THE SAO PAULO AGEING & HEALTH STUDY (SPAH)(2016) DOMICIANO, D. S.; FIGUEIREDO, C. P.; LOPES, J. B.; CAPARBO, V. F.; TAKAYAMA, L.; MENEZES, P. R.; PEREIRA, R. M.- HIGH INCIDENCE OF HIP FRACTURE AND NON-VERTEBRAL OSTEOPOROTIC FRACTURE IN LOW INCOME COMMUNITY-DWELLING ELDERLY: A POPULATION-BASED PROSPECTIVE COHORT STUDY IN BRAZIL. THE SAO PAULO AGEING & HEALTH (SPAH) STUDY(2014) DOMICIANO, D. S.; MACHADO, L. G.; LOPES, J.; FIGUEIREDO, C.; MENEZES, P.; CAPARBO, V.; TAKAYAMA, L.; PEREIRA, R. M. R.
- Risk Factors for Low Muscle Mass in a Population-based Prospective Cohort of Brazilian Community-dwelling Older Women: The Sao Paulo Ageing & Health (SPAH) Study(2020) MACHADO, Ketty L. L. L.; DOMICIANO, Diogo S.; MACHADO, Luana G.; LOPES, Jaqueline B.; FIGUEIREDO, Camille P.; CAPARBO, Valeria F.; TAKAYAMA, Liliam; MENEZES, Paulo R.; PEREIRA, Rosa M. R.Introduction: Sarcopenia is characterized by progressive loss of skeletal muscle mass, which results in decreased muscle strength, functional impairment, and increased risk of death. Few studies have performed a concomitant evaluation of clinical, laboratory, and body composition variables to accurately determine the contribution of each parameter to low muscle mass (LMM) in older subjects. This study aimed to identify risk factors (clinical, laboratory parameters, BMD, and body composition by DXA including visceral fat) for LMM in a prospective cohort of older Brazilian women. Methods: A total of 408 women aged >= 65 yr from the Sao Paulo Ageing & Health study were evaluated with clinical data, laboratory bone tests, BMD, and body composition by DXA using Hologic QDR 4500A equipment. Risk factors were measured at baseline (2005-2007). After a follow-up of 4.3 +/- 0.8 yr, subjects were classified according to the LMM definition of the Foundation for the National Institutes of Health criteria. LMM was defined when appendicular lean mass divided by body mass index was less than 0.512. Multivariate logistic regression models were used to identify independent risk factors for LMM. Results: At the end of follow-up, 116 women (28.4%) had LMM. Age averages were 73.3 +/- 4.9 yr in the LMM group and 72.5 +/- 4.5 yr in the normal group (p = 0.11). Mean BMI was 30.6 +/- 5.2 kg/m(2) in the LMM group and 28.1 +/- 4.7 kg/m(2) in the normal group (p < 0.001). In multivariate analyses, predictors of LMM were: falls (OR = 1.14, p = 0.016), TSH levels (OR = 1.08, p = 0.018, per 1 mu UI/L-increase), serum creatinine levels (OR =11.11, p < 0.001, per 1 mg/dL-decrease), and visceral adipose tissue (VAT) mass (OR = 1.17, p < 0.001, per 100 g increase). Conclusions: Falls, high TSH, low creatinine, and high VAT were risk factors for LMM in older women. More attention should be paid to these factors, since they are potentially reversible with adequate intervention.
conferenceObject VISCERAL FAT MEASURED BY DXA IS ASSOCIATED WITH INCREASED RISK OF NONSPINE FRACTURES IN NONOBESE ELDERLY WOMEN: A POPULATION-BASED PROSPECTIVE COHORT ANALYSIS FROM THE SAO PAULO AGEING & HEATHY (SPAH) STUDY(2016) MACHADO, L.; PEREIRA, R. M.; DOMICIANO, D.; FIGUEIREDO, C.; LOPES, J.; CAPARBO, V.; TAKAYAMA, L.; OLIVEIRA, R.; MENEZES, P.- KLOTHO polymorphisms and age-related outcomes in community-dwelling older subjects: The SAo Paulo Ageing & Health (SPAH) Study(2020) PEREIRA, Rosa Maria R.; FREITAS, Thiago Quadrante; FRANCO, Andre Silva; TAKAYAMA, Liliam; CAPARBO, Valeria F.; DOMICIANO, Diogo S.; MACHADO, Luana G.; FIGUEIREDO, Camille P.; MENEZES, Paulo R.; ONUCHIC, Luiz Fernando; CASTRO, Isac deDefective KLOTHO gene expression in mice led to a syndrome resembling human ageing. This study evaluated three KLOTHO polymorphisms, namely G395A, C1818T, and C370S, in an elderly population (mean age of 73 years) and their associations with ageing-related outcomes (cardiovascular events, kidney function, osteoporosis, sarcopenia) and mortality. Estimated glomerular filtration rates (eGFR) was lower in subjects with 1818TT (P=0.047) and 370SS (P=0.046) genotypes. The 1818TT genotype (P=0.006) and 1818T allele were associated with higher frequency of myocardial infarction (MI) (CC:1.7% vs. CT+TT:7.0%; P=0.002). The 370SS genotype was associated with lower stroke frequency (P=0.001). MI (OR 3.35 [95% CI: 1.29-8.74]) and stroke (OR 3.64 [95% CI: 1.48-8.97]) were associated with mortality. Regarding MI, logistic regression showed 1818T allele was a risk factor for death-related MI (OR 4.29 [95% CI: 1.60-11.52]; P=0.003), while 370C was protective (OR 0.03 [95% CI: 0.01-0.08]; P<0.001). Regarding stroke, the 395A and 370C alleles were protective factors (respectively: OR 0.28 [95% CI: 0.20-0.80]; P=0.018; OR 0.10 [95% CI: 0.05-0.18]; P<0.001). This is the first study to determine potential associations between common ageing-related outcomes/mortality and KLOTHO polymorphisms. The 1818T allele was a risk factor for MI-related death. The 395A and 370C alleles were protective factors for stroke-related death in elderly from community.
- Prevalence and risk factors of radiographic vertebral fracture in Brazilian community-dwelling elderly(2011) LOPES, J. B.; DANILEVICIUS, C. F.; TAKAYAMA, L.; CAPARBO, V. F.; MENEZES, P. R.; SCAZUFCA, M.; KUROISHI, M. E.; PEREIRA, R. M. R.The prevalence and risk factors of radiographic vertebral fracture were determined among Brazilian community-dwelling elderly. Vertebral fractures were a common condition in this elderly population, and lower hip bone mineral density was a significant risk factor for vertebral fractures in both genders. The aim of the study was to estimate the prevalence of radiographic vertebral fracture and investigate factors associated with this condition in Brazilian community-dwelling elderly. This cross-sectional study included 943 elderly subjects (561 women and 382 men) living in So Paulo, Brazil. Thoracic and lumbar spine radiographs were obtained, and vertebral fractures were evaluated using Genant's semiquantitative method. Bone mineral density (BMD) was measured by dual X-ray absorptiometry, and bone biochemical markers were also evaluated. Female and male subjects were analyzed independently, and each gender was divided into two groups based on whether vertebral fractures were present. The prevalence of vertebral fracture was 27.5% (95% CI 23.8-31.1) in women and 31.8% in men (95% CI 27.1-36.5) (P = 0.116). Cox regression analyses using variables that were significant in the univariate analysis showed that age (prevalence ratio = 1.03, 95% CI 1.01-1.06; p = 0.019) and total femur BMD (PR = 0.27, 95% CI 0.08-0.98; p = 0.048) were independent factors in predicting vertebral fracture for the female group. In the male group, Cox regression analyses demonstrated that femoral neck BMD (PR = 0.26, 95% CI 0.07-0.98; p = 0.046) was an independent parameter in predicting vertebral fractures. Our results suggest that radiographic vertebral fractures are common in Brazilian community-dwelling elderly and that a low hip BMD was an important risk factor for this condition in both genders. Age was also significantly correlated with the presence of vertebral fractures in women.
- Persistent hypovitaminosis D and loss of hip bone mineral density over time as additional risk factors for recurrent falls in a population-based prospective cohort of elderly persons living in the community. The Sao Paulo Ageing & Health (SPAH) Study(2015) MACHADO, K. L. L. L.; DOMICIANO, D. S.; MACHADO, L. G.; LOPES, J. B.; FIGUEIREDO, C. P.; TAKAYAMA, L.; OLIVEIRA, R. M.; MENEZES, P. R.; PEREIRA, R. M. R.A Summary We performed concomitant evaluation of clinical, laboratory, and bone mineral density (BMD) parameters as potential risk factors for falls in a population-based prospective cohort of older adults, since previous studies have focused mostly in clinical risk factors. Loss of hip BMD and persistent hypovitaminosis D were associated with recurrent falls in community-dwelling elderly. Introduction Few studies have performed a concomitant evaluation of clinical data, laboratory bone parameters, and bone mineral density (BMD) to determine more accurately the contribution of each of these variables to risk of falls in elderly persons. We investigated the association between bone parameters and recurrent falls in a population-based prospective cohort of community-dwelling older adults. Methods A total of 705 elderly individuals (448 women, 257 men) were evaluated with clinical data, BMD, and laboratory bone tests at baseline and after a mean follow-up of 4.3 +/- 0.8 years. Individuals with recurrent falls (a parts per thousand yen2 falls in the previous year from the date of the second evaluation) were considered chronic fallers. Logistic regression models were used to identify independent risk factors for recurrent falls. Results The frequency of chronic fallers was 16.5 %. In multivariate analyses, risk factors for recurrent falls were visual impairment (odds ratio (OR) = 2.49, 95 % confidence interval (CI) 1.30-4.74, p = 0.006), use of psychotropic drugs (OR = 2.47, 95 % CI 1.37-4.49, p = 0.003), clinical fracture (OR = 2.78, 95 % CI 1.48-5.20, p = 0.001), persistently low 25-hydroxyvitamin D (25OHD) (< 20 ng/mL) (OR = 1.71, 95 % CI 1.10-2.64, p = 0.016), and loss of total hip BMD during the study (OR = 1.21, 95 % CI 1.17-1.25, p = 0.035 for each 4 % decrease). Conclusions In addition to traditional clinical risk factors for falls, loss of hip BMD and hypovitaminosis D were associated with recurrent falls in community-dwelling elderly persons. Thus, recognizing these factors is essential to preventing falls and improving the outcomes of this population.
- Incidence and risk factors for osteoporotic vertebral fracture in low-income community-dwelling elderly: a population-based prospective cohort study in Brazil. The Sao Paulo Ageing & Health (SPAH) Study(2014) DOMICIANO, D. S.; MACHADO, L. G.; LOPES, J. B.; FIGUEIREDO, C. P.; CAPARBO, V. F.; TAKAYAMA, L.; OLIVEIRA, R. M.; MENEZES, P. R.; PEREIRA, R. M. R.We ascertained the incidence and predictors of radiographic vertebral fracture in a Brazilian elderly cohort, since no data in this field have been reported in low-income countries. This is the first population-based study to demonstrate the high frequency of vertebral fracture in elderly Latin Americans. Age, prior fracture, BMD, and bone turnover were predictors of fracture. Vertebral fractures are associated with increased future fracture risk and mortality. No data on incidence of osteoporotic vertebral fracture have been reported in low-income countries where the population's aging has been faster. Thus, we sought to describe the incidence and risk factors for radiographic vertebral fracture in a longitudinal prospective Brazilian population-based elderly cohort. 707 older adults (449 women and 258 men) were evaluated with spinal radiographs obtained at baseline and after a mean follow-up of 4.3 +/- 0.8 years. New vertebral fracture was defined as distinct alteration in the morphology of vertebrae resulting in higher grade of deformity on the second radiograph when compared to the baseline radiograph. Clinical questionnaire, bone mineral density (BMD), and laboratory tests were performed at baseline. Multivariate Poisson regression models were used to identify independent predictors of fracture. The age-standardized incidence of vertebral fracture was 40.3/1,000 person-years in women and 30.6/1,000 in men. In women, three models of risk factors for fracture were fitted: (1) age (relative risks (RR) 2.46, 95 % confidence interval (CI) 1.66-3.65), previous osteoporotic fracture (RR 1.65, 95 % CI 1.00-2.71), and lumbar spine BMD (RR 1.21, 95 % CI 1.03-1.41); (2) age (RR 2.25, 95 % CI 1.52-3.34) and femoral neck BMD (RR 1.42, 95 % CI 1.11-1.81); (3) age (RR 2.11, 95 % CI 1.41-3.15) and total hip BMD (RR 1.56, 95 % CI 1.21-2.0). In men, the highest quartile of cross-linked C-telopeptide (CTx) (RR 1.96, 95 % CI 0.98-3.91) and prior fracture (RR 2.10, 95 % CI 1.00-4.39) were predictors of new vertebral fracture. This is the first population-based study to ascertain the incidence of vertebral fracture in elderly Latin Americans, confirming the high frequency of the disorder. Age, prior fracture, BMD, and bone turnover were predictors of the short-term incidence of vertebral fracture.
- Visceral fat measured by DXA is associated with increased risk of non-spine fractures in nonobese elderly women: a population-based prospective cohort analysis from the So Paulo Ageing & Health (SPAH) Study(2016) MACHADO, L. G.; DOMICIANO, D. S.; FIGUEIREDO, C. P.; CAPARBO, V. F.; TAKAYAMA, L.; OLIVEIRA, R. M.; LOPES, J. B.; MENEZES, P. R.; PEREIRA, R. M. R.The present study investigates the relationship between visceral fat measured by dual-energy X-ray absorptiometry (DXA) and the incidence of non-spine fractures in community-dwelling elderly women. We demonstrated a potential negative effect of visceral fat on bone health in nonobese women. The protective effect of obesity on bone health has been questioned because visceral fat has been demonstrated to have a deleterious effect on bone. The aim of this study was to investigate the association of visceral fat measured by DXA with the incidence of non-spine fractures in community-dwelling elderly women. This longitudinal prospective population-based cohort study evaluated 433 community-dwelling women aged 65 years or older. A specific clinical questionnaire, including personal history of a fragility fracture in non-spine osteoporotic sites, was administered at baseline and after an average of 4.3 years. All incidences of fragility fractures during the study period were confirmed by affected-site radiography. Visceral adipose tissue (VAT) was measured in the android region of a whole-body DXA scan. The mean age was 72.8 +/- 4.7 years, and 28 incident non-spine osteoporotic fractures were identified after a mean follow-up time of 4.3 +/- 0.8 years. According to the Lipschitz classification for nutritional status in the elderly, 38.6 % of women were nonobese (BMI ae 27 kg/m(2)) and 61.4 % were obese/overweight. Logistic regression models were used to estimate the relationship between VAT and non-spine fractures in elderly women. After adjusting for age, race, previous fractures, and BMD, VAT (mass, area, volume) had a significant association with the incidence of non-spine fractures only in nonobese elderly women (VAT mass: OR, 1.42 [95 % CI, 1.09-1.85; p = 0.010]; VAT area: OR, 1.19 [95 % CI, 1.05-1.36; p = 0.008]; VAT volume: OR, 1.40 [95 % CI, 1.09-1.80; p = 0.009]). This study suggests a potential negative effect of visceral adiposity on bone health in nonobese women.
- INCIDENCE AND RISK FACTORS FOR OSTEOPOROTIC VERTEBRAL FRACTURE IN BRAZILIAN COMMUNITY-DWELLING ELDERLY: A POPULATION-BASED PROSPECTIVE COHORT ANALYSIS FROM THE SAO PAULO AGEING & HEALTH (SPAH) STUDY(2014) DOMICIANO, D. S.; MACHADO, L. G.; LOPES, J.; FIGUEIREDO, C.; MENEZES, P.; CAPARBO, V.; TAKAYAMA, L.; PEREIRA, R. M. R.