THIAGO BITAR MORAES BARROS
Índice h a partir de 2011
4
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
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conferenceObject Metabolic Syndrome: The Genesis of Nephrolithiasis in Gout Patients?(2012) MELLO, Filipi M.; TOMITA, Rafael B.; FULLER, Ricardo; FILHO, Marco Antonio G. P.; BARROS, Thiago B. M.; PRADO, Leandro L. do; AUGUSTO, Kristopherson L.; GOLDENSTEIN-SCHAINBERG, ClaudiaBackground/Purpose: Gout patients have a high frequency of metabolic syndrome (MS), a disorder known to be associated with hyperinsulinemia. The latter condition augments proximal tubular sodium reabsorption and leads to reduced renal urate excretion and hyperuricemia. There are no data, however, evaluating whether MS can influence gout-associated clinical characteristics. Thus, we aimed to determine the prevalence of MS in our population and to investigate if the presence of MS would characterize a particular clinical and laboratorial gout profile. Methods: This was a cross-sectional study of 158 gout patients (ACR criteria). MS was defined in accordance to the National Cholesterol Education Program ATP III (NCEP-ATP III) and the International Diabetes Federation (IDF) criteria. Demographic, anthropometric (body mass index - BMI) and clinical data were evaluated. Fasting serum levels of UA, glucose, triglycerides and cholesterol fractions were analyzed by routine laboratory tests. Nephrolithiasis was demonstrated by usual ultrasonography and urate under-excretion defined as UA clearance lower than 7.5 ml/min. Statistical comparisons were performed using Fisher’s exact, chi-square, students T and Spearman’s tests and P<0.05 was considered significant. Results: The frequency of MS in gout patients was 73% and 71% according to NCEP ATPIII and IDF criteria respectively. Further comparison of 125 patients with MS and those 33 without this condition revealed similar mean ages (63.0 ± 11.5 vs 62.5 ± 12.9; p>0,05) and male predominance (94% and 75%). As expected, those with MS had higher BMI (30.2 ± 5.5kg/m2 vs 27.0 5.8kg/m2; p=0.005) and higher prevalences of systemic arterial hypertension (93.3% vs 75% p=0.012) and diabetes (25.8% vs 0, p=0.001), though comparable frequency of coronary artery disease (22.5% vs 16.7%; p=0.469). With regard to gout clinical/laboratorial characteristic, patients with MS had more nephrolitiasis (37.1% vs 16.7%, p=0.026), but they did not differ from patients without MS concerning the presence of tophi (52.8% vs. 55.6%; p = 0.780) or uric acid underexcretion (83.1% vs 94.4%; p=0.148). Current alcohol consumption, mean estimated creatinine clearance and mean serum levels of uric acid, were alike in both groups (p>0.05). Conclusion: The novel demonstration that MS in gout is associated to nephrolithiasis suggests that this condition may underlie the genesis of uric acid stones. Whether insulin resistance may account for a renal alteration that may ultimately impair buffering and amplification of acidic urine remains to be determined. Moreover, the elevated prevalence of MS in gout patients from our country (almost 3⁄4) is higher than overall rates of 63% MS in gout worldwide, indicating possible influence of dietary, geographical and/or genetic background.conferenceObject Cross-Cultural Adaptation, Validation and Reliability Of The Brazilian Version Of The Psoriatic Arthritis Screening Evaluation Tool(2013) RANZA, Roberto; SCHAINBERG, Claudia G.; CARNEIRO, Sueli; MARTINS, Gladys; RODRIGUES, Jose Joaquim; CARNEIRO, Jamille; ROMITI, Ricardo; BARROS, Thiago B. M.; SAMPAIO, Ana Luiza; PEDREIRA, Amanda; COSTA, Carolina Z.; PINTO, Rogerio M. C.; HUSNI, M. Elaine; QURESHI, Abrar A.conferenceObject An Analysis of Metabolic Syndrome in Adult Dermatomyositis with a Focus On Cardiovascular Disease(2012) MORAES, Mariana T.; SOUZA, Fernando H. C.; BARROS, Thiago B. M.; SHINJO, Samuel K.Background/Purpose: Metabolic syndrome (MetS) is a cluster of metabolic abnormalities associated with increased cardiovascular risk. MetS has been systematically evaluated in all systemic autoimmune rheumatic diseases except for dermatomyositis (DM). Hence, we evaluated the frequency of MetS in DM patients and analyzed the possible association of MetS with traditional cardiovascular disease (CVD) risk factors and DM-related clinical and laboratorial features. Methods: The present cross-sectional single center study included 84 consecutive DM patients (Bohan & Peter, 1975) and 105 healthy control individuals. MetS was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III. Results: The median age was similar in both the DM and control groups (aged 41.5 vs. aged 42.0, respectively; p=0.378) with a comparable predominance of the female gender (p=0.904) and white race (p=0.654) in both groups. The median disease duration was 4 years (range: 1–7). The DM patients had a higher prevalence of MetS (41.7 vs. 7.0%, p<0.001), diabetes mellitus (17.9 vs. 1.0%, p<0.001), ischemic stroke (4.8 vs. 0%, p=0.024), and a family history of premature CVD (32.8 vs. 8.6%, p=0.004). However, the frequency of sedentarism, hypothyroidism, smoking habit and alcohol intake were similar in both groups (p>0.05). Further analysis of the DM patients with (n=35) and without MetS (n=49) revealed that the patients with this complication were older (50.0±14.5 vs. 40.9±14.6, p=0.006) and had a similar disease duration (p=0.925) and a higher incidence of systemic arterial hypertension prior to the disease (54.3 vs. 10.2%, p=0.001). The frequency of other comorbidities, previously mentioned lifestyle contributing factors, clinical and laboratory disease features, and therapy schemes were similar in both groups (p>0.05). In a multivariate analysis, only hypertension diagnosed prior to the disease was associated with MetS (odds ratio 10.47, 95% confidence interval 2.62–44.81). Conclusion: MetS is highly prevalent in DM and prior hypertension seems to be a major determinant of its development while disease and therapy related factors do not appear to play a relevant role.