Sarah Monte Alegre

Universidade Estadual de Campinas (UNICAMP)

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Aglécio Luiz de Souza

Universidade Estadual de Campinas (UNICAMP)

ÉA

Élinton Adami Chaim

Universidade Estadual de Campinas (UNICAMP)

Elizabeth João Pavin

Hospital de Clínicas da Unicamp

Denise Engelbrecht Zantut‐Wittmann

Universidade Estadual de Campinas (UNICAMP)

Daniela Miguel Marin

Universidade Estadual de Campinas (UNICAMP)

Brenno Astiarraga

Institut d'Investigació Sanitària Pere Virgili

Arlete Fernandes

Universitario Francisco de Asís

Alex Broom

University of Sydney

Camila Puzzi de Carvalho

Universidade Estadual de Campinas (UNICAMP)

Sı́lvia de Barros-Mazon

Universidade Estadual de Campinas (UNICAMP)

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Universidade Estadual de Campinas (UNICAMP)

101

Hospital de Clínicas da Unicamp

Universidade de São Paulo

Pontifícia Universidade Católica de Campinas

Centro Universitário da Cidade

University of Pisa

Universidade Estadual Paulista (Unesp)

Weatherford College

National Research Council

Inserm

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Vitamin D in Hashimoto’s thyroiditis and its relationship with thyroid function and inflammatory status

Endocrine Journal (2018)

Ilka Mara Borges Botelho Arnaldo Moura Neto Conceição Aparecida Silva Marcos Antônio Tambascia Sarah Monte Alegre

Several studies have shown the correlation between vitamin D [25(OH)D] deficiency and thyroid autoimmunity and reducing of thyroid autoantibodies in patients with normal levels of vitamin D combining with thyroid hormone replacement. However, other authors not agree with this association. It is still unclear whether the low 25(OH)D levels are the result of HT disease or a part of its cause. We studied 88 patients with HT regarding vitamin D status and thyroid autoimmunity markers as well as the relationship with cytokines produced by Th1, Th2, and Th17 cells compared with a control group of 71 euthyroid healthy subjects. The present study demonstrated that vitamin D concentrations were similar in patients HT and the control group. The reduction of free T4 levels was a predictor of vitamin D insufficiency for Hashimoto's thyroiditis, but not for the control group. Lower concentrations of TNF-α was a predictor of lower levels of vitamin D. Differences in the association between HT and vitamin D insufficiency remain unresolved in the literature. The thyroid hormone status would play a role in the maintenance of vitamin D sufficiency, and its immunomodulatory role would influence the presence of autoimmune thyroid disease. The positive correlation between free T4 and vitamin D concentrations suggests that adequate levothyroxine replacement in HT would be an essential factor in maintaining vitamin D at sufficient levels.

Levothyroxine

Anti-thyroid autoantibodies

Autoimmune thyroiditis

10.1507/endocrj.ej18-0166

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Citations (58)

Childhood-Onset GH Deficiency versus Adult-Onset GH Deficiency: Relevant Differences Regarding Insulin Sensitivity

Metabolites (2022)

Heraldo Mendes Garmes Alejandro Rosell Castillo Sarah Monte Alegre Aglécio Luiz de Souza Yeelen Ballesteros Atala

The results of the studies on the pattern of insulin sensitivity (IS) are contradictory in patients with GH deficiency (GHD); however, the interference of the GHD onset stage, childhood or adulthood in the IS has not been assessed by euglycemic hyperinsulinemic clamp (EHC), a gold-standard method for the assessment of insulin sensitivity. In a prospective cross-sectional study, we assessed IS and body composition in 17 adults with hypopituitarism without GH replacement, ten with childhood-onset (COGHD) and seven with adulthood-onset (AOGHD) and compared them to paired control groups. COGHD presented higher IS (p = 0.0395) and a similar percentage of fat mass (PFM) to AOGHD. COGHD showed higher IS than the control group (0.0235), despite a higher PFM (0.0022). No differences were found between AODGH and the control group. In AOGHD and the control group, IS was negatively correlated with PFM (rs: −0.8214, p = 0.0234 and rs: −0.3639, p < 0.0344), while this correlation was not observed with COGHD (rs: −0.1152, p = 0.7514). Despite the higher PFM, patients with COGHD were more sensitive to insulin than paired healthy individuals, while patients with AOGHD showed similar IS compared to controls. The lack of GH early in life could modify the metabolic characteristics of tissues related to the glucose metabolism, inducing beneficial effects on IS that persist into adulthood. Thus, the glycometabolic findings in patients with COGHD seems to be not applicable to AOGHD.

10.3390/metabo12121251

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Evidências produzidas por pesquisas qualitativas sobre diabetes tipo 2: revisão da literatura

Interface - Comunicação, Saúde, Educação (2011)

Marcelo Eduardo Pfeiffer Castellanos Nélson Filice de Barros Cristiane Spadacio Sarah Monte Alegre Philip Tovey

O diabetes tipo 2 produz um grande impacto sobre a vida dos pacientes e a rede assistencial. Diante do crescimento de informacoes qualitativas sobre diabetes, torna-se importante a sistematizacao desse conhecimento. Foi realizado um metaestudo sobre diabetes, por meio da analise de 42 artigos disponibilizados em revistas do portal de periodicos da Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (Capes). Identificamos bom grau de teorizacao nos estudos revisados, os quais abordaram: gerenciamento do cuidado, concepcoes saude-doenca, relacao profissional-paciente, praticas profissionais e adesao ao tratamento. Os artigos descreveram claramente os procedimentos metodologicos adotados. Houve predominio do uso de entrevistas e grupos focais para a coleta de dados, buscando explorar diferentes visoes dos sujeitos investigados. Afirma-se a importância dos profissionais de saude e gestores implementarem politicas, programas e modelos de atencao adequados as especificidades do adoecimento cronico, orientados pelo eixo da integralidade e corresponsabilizacao pelo cuidado.

SciELO

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Leptina e interleucina-6 - importância nos metabolismos glicídico e lipídico, estudo de coorte transversal em mulheres não obesas no climatério. Resultados preliminares.

Anais do Congresso de Iniciação Científica da Unicamp (2017)

Camila Fiuza Branco Louise Franciscato Trivelato Allan O. Santos Aglécio Luiz de Souza Sarah Monte Alegre

10.19146/pibic-2017-78423

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Evidence produced by qualitative investigations on type 2 diabetes: a review of the literature

Interface - Comunicação Saúde Educação (2011)

Marcelo Eduardo Pfeiffer Castellanos Nélson Filice de Barros Cristiane Spadacio Sarah Monte Alegre Philip Tovey

Type 2 diabetes has a major impact on patients lives and the healthcare network. Given the growth in qualitative information on diabetes, it becomes important to systematize this knowledge. A meta-study on diabetes was conducted through analysis on 42 articles that were made in journals at the periodicals portal of the Coordination Office for Advancement of Higher-level Personnel (Capes). We found that the studies reviewed had a good theoretical basis, which included: care management, health-disease concepts, professional-patient relationships, professional practices and treatment compliance. The articles clearly described the methodological procedures used. The use of interviews and focal groups for data gathering predominated, and it was sought to explore different views of the individuals investigated. It was reaffirmed that it was important for health professionals and managers to implement healthcare policies, programs and models that are appropriate for the specific features of chronic illness, guided by comprehensive care and co-responsibility.

Health Professionals

Qualitative analysis

10.1590/s1414-32832011005000002

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Como diagnosticar e tratar. Anemias

RBM. Revista brasileira de medicina (2009)

Sarah Monte Alegre Olga Carvalho

As anemias constituem as doencas do sangue mais frequentes. O termo anemia significa reducao da hemoglobina por unidade de volume de sangue, de acordo com a idade, sexo e tensao de oxigenio do ambiente. Pode referir-se ainda a uma sindrome clinica ou a um quadro laboratorial. As anemias podem ser provocadas por varios fatores e se classificam segundo os criterios morfologicos (normocitica/normocromica microcitica/hipocromica macrocitica/normocromica) ou fisiopatologicos, considerando-se a etiologia, em anemias por falta de producao – hipoproliferacao, por sobrevida diminuida dos eritrocitos – hemolise ou por perda sanguinea – hemorragia. As avaliacoes clinica e laboratorial sao de fundamental importância para a elucidacao diagnostica e tratamento adequado

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Determining the C-Reactive Protein Level in Patients With Different Clinical Forms of Chagas Disease

Revista Española de Cardiología (English Edition) (2010)

Conceição Aparecida da Silva André Fattori Aglécio L. Sousa Sı́lvia de Barros-Mazon Sarah Monte Alegre

Chagas Disease

10.1016/s1885-5857(10)70215-2

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Perfil metabólico de pacientes obesos com diabetes tipo 2 quanto à duração e qualidade do sono

Anais do Congresso de Iniciação Científica da Unicamp (2015)

Sarah Monte Alegre Tayana Cristina Spulverato Da Silva

10.19146/pibic-2015-38094

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The influence of body mass index and low-grade systemic inflammation on thyroid hormone abnormalities in patients with type 2 diabetes

Endocrine Journal (2013)

Arnaldo Moura Neto Maria Cândida Ribeiro Parisi Marcos Antônio Tambascia Sarah Monte Alegre Elizabeth João Pavin

Previous reports highlight the role of systemic inflammation in the genesis of non-thyroidal illness syndrome and type 2 diabetes mellitus (T2DM). Our objective was to assess whether body mass index and the low-grade systemic inflammation would be associated with changes in thyroid hormone metabolism in patients with type 2 diabetes. This was a cross-sectional study of 104 subjects; 52 patients with type 2 diabetes and 52 in a control group, paired by age, gender and body mass index. We measured total (T) and free (F) thyroxine (T4) and triiodothyronine (T3), reverse T3 (rT3), the ratios FT3/rT3, FT3/FT4 and FT4/rT3, clinical parameters (age, gender, diabetes duration and complications, body mass index, waist circumference, hypertension, HbA1c), and high sensitivity C-reactive protein. Patients with DM presented lower levels of TT4 (p=0.006), TT3 (p<0.001) and FT3 (p<0.001) and higher of FT4 (p<0.001), waist circumference (p=0.047) and C-reactive protein (p<0.001). Body mass index was inversely correlated with FT4 (p=0.036) and TT3 (p=0.008). C-reactive protein was positively correlated with rT3 (p=0.001) and inversely with FT4/rT3 (p<0.001) and FT3/rT3 (p=0.014). Body mass index was an independent predictor for FT4 (B=-0.011, p=0.029) and TT3 levels (B=-1.118, p=0.003). Inflammation predicted the FT4/rT3 ratio (B=-0.190, p<0.001). C-reactive protein (B=0.235, p<0.001) and body mass index (B=-0.008, p=0.047) were independent predictors for rT3. In conclusion, type 2 diabetes was associated with a low T3 state. Body mass index and the low-grade systemic inflammation are related to the non-thyroidal illness syndrome in these patients, possibly by altering the activity of peripheral deiodinases.

10.1507/endocrj.ej13-0030

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Acute Effect of Roux-En-Y Gastric Bypass on Whole-Body Insulin Sensitivity: A Study with the Euglycemic-Hyperinsulinemic Clamp

The Journal of Clinical Endocrinology & Metabolism (2010)

Marcelo Miranda de Oliveira Lima José Carlos Pareja Sarah Monte Alegre Sylka R. Geloneze Steven E. Kahn

Insulin resistance ameliorates after bariatric surgery, yet there is still a need for data on the acute effect of Roux-en-Y gastric bypass (RYGBP) on insulin sensitivity.The objective of the study was to describe the acute effect of RYGBP on insulin sensitivity, measured by both the euglycemic-hyperinsulinemic clamp and homeostasis model assessment insulin resistance index (HOMA-IR).Evaluations were conducted before and 1 month after RYGBP at State University of Campinas (São Paulo, Brazil).Patients included 19 premenopausal women with metabolic syndrome aged 35.3 (6.7) yr, body mass index 45.50 (3.74) kg/m2 [mean (sd)]. Six had mild type 2 diabetes, seven impaired glucose tolerance, and six normal glucose tolerance.The volunteers underwent RYGBP either alone or combined with omentectomy. Euglycemic-hyperinsulinemic clamp, HOMA-IR, nonesterified fatty acids, leptin, ultrasensitive C-reactive protein, adiponectin, and IL-6 were assessed at baseline and 4.5 (0.9) wk postoperatively.Fasting glucose decreased [99.2 (13.1) to 83.6 (8.1) mg/dl, P<0.01] along with a reduction in fasting insulin [30.4 (17.0) to 11.4 (6.3) mU/liter, P<0.01]. M value did not improve postoperatively [25.82 (6.30) to 22.02 (6.05) micromol/kgFFM.min] despite of a decrease in body weight [114.8 (14.5) to 102.3 (14.5) kg, P<0.001]. This finding was discordant to the observation of an improvement in HOMA-IR [3.85 (2.10) to 1.42 (0.76), P<0.01]. Nonesterified fatty acids increased. Leptin and C-reactive protein decreased. IL-6 and adiponectin remained unchanged.A month after RYGBP, fasting glucose metabolism improves independent of a change in peripheral insulin sensitivity.

Glucose clamp technique

Homeostasis

Clamp

Homeostatic model assessment

10.1210/jc.2010-0085

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Citations (97)