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Rosa Maria Rodrigues Pereira - One of the best experts on this subject based on the ideXlab platform.

  • acroosteolysis and bone Metabolism Parameters distinguish female patients with limited systemic sclerosis with and without calcinosis a case control study
    Clinical Rheumatology, 2019
    Co-Authors: Marilia M Sampaiobarros, Lorena Castelo Branco, Marco Antonio Pontes G Filho, Percival D Sampaiobarros, Liliam Takayama, Rosa Maria Rodrigues Pereira
    Abstract:

    : Calcinosis usually represents a late manifestation of systemic sclerosis (SSc), inducing tissue damage and chronic calcifications. To analyze clinical and bone Metabolism Parameters associated with calcinosis in limited systemic sclerosis (lSSc), thirty-six female lSSc patients with calcinosis were compared with 36 female lSSc patients without calcinosis, matched by age, disease duration, and body mass index. Organ involvement, autoantibodies, bone density, and laboratory Parameters were analyzed. Statistical significance was considered if p   30 ng/ml were also significantly more frequent in patients with calcinosis (p = 0.041). Regarding treatment, current use of corticosteroids was lower in patients with calcinosis compared with patients without calcinosis (8% vs. 28%, p = 0.032). On logistic regression analysis, acroosteolysis (OR = 12.04; 95% CI, 2.73-53.04; p = 0.001), mRSS (OR = 1.37; 95% CI, 1.11-1.69; p = 0.003), phosphorus serum levels (OR = 5.07; 95% CI, 1.06-24.23; p = 0.042), and lower glucocorticoid use (OR = 0.07; 95% CI, 0.007-0.66; p = 0.021) are independent risk factors for calcinosis. This study showed that limited SSc patients with calcinosis present a distinct clinic and biochemical profile when compared with a matched group without calcinosis, paired by disease duration, age and BMI. KEY POINTS: • Calcinosis in patients with limited SSc was associated with acroosteolysis, higher mRSS and higher serum levels of phosphorus.

  • acroosteolysis and bone Metabolism Parameters distinguish female patients with limited systemic sclerosis with and without calcinosis a case control study
    Clinical Rheumatology, 2019
    Co-Authors: Marilia M Sampaiobarros, Lorena Castelo Branco, Marco Antonio Pontes G Filho, Percival D Sampaiobarros, Liliam Takayama, Rosa Maria Rodrigues Pereira
    Abstract:

    Calcinosis usually represents a late manifestation of systemic sclerosis (SSc), inducing tissue damage and chronic calcifications. To analyze clinical and bone Metabolism Parameters associated with calcinosis in limited systemic sclerosis (lSSc), thirty-six female lSSc patients with calcinosis were compared with 36 female lSSc patients without calcinosis, matched by age, disease duration, and body mass index. Organ involvement, autoantibodies, bone density, and laboratory Parameters were analyzed. Statistical significance was considered if p   30 ng/ml were also significantly more frequent in patients with calcinosis (p = 0.041). Regarding treatment, current use of corticosteroids was lower in patients with calcinosis compared with patients without calcinosis (8% vs. 28%, p = 0.032). On logistic regression analysis, acroosteolysis (OR = 12.04; 95% CI, 2.73–53.04; p = 0.001), mRSS (OR = 1.37; 95% CI, 1.11–1.69; p = 0.003), phosphorus serum levels (OR = 5.07; 95% CI, 1.06–24.23; p = 0.042), and lower glucocorticoid use (OR = 0.07; 95% CI, 0.007–0.66; p = 0.021) are independent risk factors for calcinosis. This study showed that limited SSc patients with calcinosis present a distinct clinic and biochemical profile when compared with a matched group without calcinosis, paired by disease duration, age and BMI. • Calcinosis in patients with limited SSc was associated with acroosteolysis, higher mRSS and higher serum levels of phosphorus.

  • ab0685 acroosteolysis and bone Metabolism Parameters distinguish female patients with limited systemic sclerosiswith and without calcinosis a case control study
    Annals of the Rheumatic Diseases, 2019
    Co-Authors: Marilia M Sampaiobarros, Lorena Castelo Branco, Marco Antonio Pontes G Filho, Percival D Sampaiobarros, Liliam Takayama, Rosa Maria Rodrigues Pereira
    Abstract:

    Background: Calcinosis represents a late manifestation of limited systemic sclerosis (lSSc), inducing tissue damage and chronic calcifications. Bone Metabolism studies in lSSc patients are rare in literature and there are few studies that analyzed clinical, laboratory and bone mineral density (BMD) Parameters together. Objectives: The aim of this study was to compare and analyze clinical aspects and laboratory Parameters, including bone Metabolism variables in female lSSc patients with and without calcinosis, paired by age, disease duration and body mass index (BMI). Methods: Thirty-six female lSSc patients with calcinosis were compared to 36 female lSSc patients without calcinosis, matched by age, disease duration and BMI. Organ involvement, autoantibodies, BMD by DXA and laboratory Parameters were analyzed. The past and current treatment modalities were also questioned. Statistical significance was considered if p Results: Esophageal hypomotility, digital ulcers, and interstitial lung disease were the most frequent clinical manifestations of lSSc patients, present in similar frequency in both groups. Calcinosis was significantly associated with acroosteolysis (69% vs. 22%, p 30ng/ml were also significantly more frequent in patients with calcinosis (p=0.041). ANA was positive in 89% in both groups. Anticentromere antibody was frequent (44% and 31%), while positive anti-Scl70 was rare in both groups. Regarding treatment, current use of corticosteroids was lower in patients with calcinosis compared to patients without calcinosis (8% vs. 28%; p=0.032). Osteoporosis was more frequent in the group with calcinosis (31% vs.17%), although not statistically significant. Conclusion: This study showed that lSSc patients with calcinosis can present a distinct clinic and biochemical profile when compared to a matched group without calcinosis. Presence of calcinosis in female patients with lSSc can be associated with acroosteolysis and higher serum levels of 25OHD and phosphorus when compared with patients without calcinosis paired by age, disease duration and BMI. Disclosure of interests: MARILIA SAMPAIO-BARROS: None declared, LORENA CASTELO BRANCO: None declared, LILIAM TAKAYAMA: None declared, Marco antonio G Pontes Filho Speakers bureau: Novartis and Janssen, Percival D. Sampaio-Barros: None declared, Rosa M. Pereira: None declared

  • bone mineral apparent density in juvenile dermatomyositis the role of lean body mass and glucocorticoid use
    Scandinavian Journal of Rheumatology, 2008
    Co-Authors: R A Santiago, Clovis A Silva, Valeria F Caparbo, Adriana M E Sallum, Rosa Maria Rodrigues Pereira
    Abstract:

    Objective: To analyse bone mineral density (BMD) in juvenile dermatomyositis (JDM) and its possible association with body composition, disease activity, duration of disease, glucocorticoid (GC) use, and biochemical bone Parameters, including osteoprotegerin (OPG) and receptor activator of nuclear factor κB (RANKL).Methods: Twenty girls with JDM and 20 controls matched for gender and age were selected. Body composition and BMD were analysed by dual‐energy X‐ray absorptiometry (DXA) and bone mineral apparent density (BMAD) was calculated. Duration of disease, cumulative GC, and GC pulse therapy use were determined from medical records. Disease activity and muscle strength were measured by the Disease Activity Score (DAS), the Childhood Myositis Assessment Scale (CMAS), and the Manual Muscle Test (MMT). Inflammatory and bone Metabolism Parameters were also analysed. OPG and RANKL were measured in patients and controls using an enzyme‐linked immunosorbent assay (ELISA).Results: A lower BMAD in the femoral nec...

Dirk Kuypers - One of the best experts on this subject based on the ideXlab platform.

  • natural history of mineral Metabolism bone turnover and bone mineral density in de novo renal transplant recipients treated with a steroid minimization immunosuppressive protocol
    Nephrology Dialysis Transplantation, 2020
    Co-Authors: Pieter Evenepoel, Kathleen Claes, Bjorn Meijers, Michael R Laurent, Bert Bammens, Maarten Naesens, Ben Sprangers, Etienne Cavalier, Dirk Kuypers
    Abstract:

    The skeletal effects of renal transplantation are not completely understood, especially in patients managed with a steroid minimization immunosuppressive protocol and long term. We enrolled 69 adult transplant recipients (39 males; ages 51.1 ± 12.2 years), free of antiresorptive therapy and managed with a steroid minimization immunosuppressive protocol, into a 5-year prospective observational study to evaluate changes in areal bone mineral density (aBMD), mineral Metabolism and bone remodelling. Dual energy X-ray absorptiometry, laboratory Parameters of mineral Metabolism (including parathyroid hormone, sclerostin and fibroblast growth factor 23) and non-renal cleared bone turnover markers (BTMs) (bone-specific alkaline phosphatase, trimeric N-terminal propeptide and tartrate-resistant acid phosphatase 5b) were assessed at baseline and 1 and 5 years post-transplantation. The mean cumulative methylprednisolone exposure at 1 and 5 years amounted to 2.5 ± 0.8 and 5.8 ± 3.3 g, respectively. Overall, bone remodelling activity decreased after transplantation. Post-transplant aBMD changes were minimal and were significant only in the ultradistal radius during the first post-operative year {median -2.2% [interquartile range (IQR) -5.9-1.2] decline, P = 0.01} and in the lumbar spine between Years 1 and 5 [median 1.6% (IQR -3.2-7.0) increase, P = 0.009]. BTMs, as opposed to mineral Metabolism Parameters and cumulative corticosteroid exposure, associated with aBMD changes, both in the early and late post-transplant period. Most notably, aBMD changes inversely associated with bone remodelling changes. In summary, in de novo renal transplant recipients treated with a steroid minimization immunosuppressive protocol, BMD changes are limited, highly variable and related to remodelling activity rather than corticosteroid exposure.

Zoran Dogas - One of the best experts on this subject based on the ideXlab platform.

  • adropin and inflammation biomarker levels in male patients with obstructive sleep apnea a link with glucose Metabolism and sleep Parameters
    Journal of Clinical Sleep Medicine, 2018
    Co-Authors: Josko Bozic, Tea Galic, Danijela Supedomic, Tina Ticinovic Kurir, Josip Anđelo Borovac, Zoran Dogas
    Abstract:

    Study Objectives:The main objectives of the study were to determine plasma adropin, systemic inflammation biomarker levels, and glucose Metabolism Parameters in patients with moderate and severe ob...

  • morning cortisol levels and glucose Metabolism Parameters in moderate and severe obstructive sleep apnea patients
    Endocrine, 2016
    Co-Authors: Josko Bozic, Tea Galic, Danijela Supedomic, Natalija Ivkovic, Tina Ticinovic Kurir, Zoran Valic, Josip Lesko, Zoran Dogas
    Abstract:

    Obstructive sleep apnea (OSA) has been associated with dysregulation of the hypothalamic-pituitary-adrenal axis and alterations in glucose Metabolism with increased risk for type 2 diabetes. The aim of the current study was to compare morning plasma cortisol levels and glucose Metabolism Parameters between moderate (apnea-hypopnea index (AHI): 15-30 events/h) and severe OSA patients (AHI >30 events/h), with respective controls. A total of 56 male OSA patients, 24 moderate (AHI = 21.1 ± 5.3) and 32 severe (AHI = 49.7 ± 18.1), underwent a full-night polysomnography, oral glucose tolerance test (OGTT), and measurement of morning plasma cortisol levels. These groups were compared to 20 matched subjects in a control group. Morning plasma cortisol levels were statistically lower in severe OSA group than in moderate OSA and control groups (303.7 ± 93.5 vs. 423.9 ± 145.1 vs. 417.5 ± 99.8 pmol/L, P < 0.001). Significant negative correlations were found between morning plasma cortisol levels and AHI (r = -0.444, P = 0.002), as well as oxygen desaturation index (r = -0.381, P = 0.011). Fasting plasma glucose (5.0 ± 0.5 vs. 5.4 ± 0.7 vs. 4.9 ± 0.6 mmol/L, P = 0.009) was higher in the severe OSA group compared to moderate OSA and controls. Homeostasis model assessment insulin resistance (HOMA-IR) was higher in the severe OSA group compared to moderate OSA and controls (4.6 ± 3.7 vs. 2.7 ± 2.0 and 2.2 ± 1.8, respectively, P = 0.006). In conclusion, our study showed that morning plasma cortisol levels measured at 8 a.m. were significantly lower in severe OSA patients than those in moderate OSA group and controls. Morning plasma cortisol levels showed a negative correlation with AHI and oxygen desaturation index. Additionally, this study confirmed the evidence of glucose Metabolism impairment in moderate and severe OSA patients, with more pronounced effect in the severe OSA patients group.

Pieter Evenepoel - One of the best experts on this subject based on the ideXlab platform.

  • natural history of mineral Metabolism bone turnover and bone mineral density in de novo renal transplant recipients treated with a steroid minimization immunosuppressive protocol
    Nephrology Dialysis Transplantation, 2020
    Co-Authors: Pieter Evenepoel, Kathleen Claes, Bjorn Meijers, Michael R Laurent, Bert Bammens, Maarten Naesens, Ben Sprangers, Etienne Cavalier, Dirk Kuypers
    Abstract:

    The skeletal effects of renal transplantation are not completely understood, especially in patients managed with a steroid minimization immunosuppressive protocol and long term. We enrolled 69 adult transplant recipients (39 males; ages 51.1 ± 12.2 years), free of antiresorptive therapy and managed with a steroid minimization immunosuppressive protocol, into a 5-year prospective observational study to evaluate changes in areal bone mineral density (aBMD), mineral Metabolism and bone remodelling. Dual energy X-ray absorptiometry, laboratory Parameters of mineral Metabolism (including parathyroid hormone, sclerostin and fibroblast growth factor 23) and non-renal cleared bone turnover markers (BTMs) (bone-specific alkaline phosphatase, trimeric N-terminal propeptide and tartrate-resistant acid phosphatase 5b) were assessed at baseline and 1 and 5 years post-transplantation. The mean cumulative methylprednisolone exposure at 1 and 5 years amounted to 2.5 ± 0.8 and 5.8 ± 3.3 g, respectively. Overall, bone remodelling activity decreased after transplantation. Post-transplant aBMD changes were minimal and were significant only in the ultradistal radius during the first post-operative year {median -2.2% [interquartile range (IQR) -5.9-1.2] decline, P = 0.01} and in the lumbar spine between Years 1 and 5 [median 1.6% (IQR -3.2-7.0) increase, P = 0.009]. BTMs, as opposed to mineral Metabolism Parameters and cumulative corticosteroid exposure, associated with aBMD changes, both in the early and late post-transplant period. Most notably, aBMD changes inversely associated with bone remodelling changes. In summary, in de novo renal transplant recipients treated with a steroid minimization immunosuppressive protocol, BMD changes are limited, highly variable and related to remodelling activity rather than corticosteroid exposure.

Elvira Fernandez - One of the best experts on this subject based on the ideXlab platform.

  • association of the rs495392 klotho polymorphism with atheromatosis progression in patients with chronic kidney disease
    Nephrology Dialysis Transplantation, 2019
    Co-Authors: Jose M Valdivielso, Elvira Fernandez, Milica Bozic, Rajesh Kumar Galimudi, Marcelino Bermudezlopez, Juan F Navarrogonzalez, Angels Betriu
    Abstract:

    Background Prevalence of atherosclerotic cardiovascular disease and its rate of progression are higher in patients with chronic kidney disease (CKD) compared with the general population. Mineral Metabolism Parameters have been shown to be involved in the increased velocity of atheromatosis progression. The aim of this study is to determine the role of 11 single-nucleotide polymorphisms (SNPs) of the Klotho gene on the rate of atherosclerosis progression in CKD. Methods This was a multicentre, prospective, observational study of 1439 CKD patients from the NEFRONA cohort. Carotid and femoral ultrasounds were performed at baseline and after 24 months in 10 arterial territories. Progression of atheromatosis was defined as an increase in the number of territories with plaque. Genotyping of 11 SNPs of the Klotho gene was performed and its association with atheromatosis progression was determined by multivariate logistic regression. Results Bivariate analysis showed that none of the 11 SNPs was associated with atheroma plaque prevalence, but 3 of them (rs495392, rs562020 and rs567170) showed association with atheromatosis progression. The multivariate analysis revealed that only rs495392 showed a statistically significant association with atheromatosis progression, after adjustment for several Parameters known to affect it in CKD patients. Thus, the presence of one allele T was associated with a reduction of 30% of the odds of progression, whereas the presence of the two T alleles was associated with a decrease close to 50%. Conclusions The presence of the allele T of the SNP rs495392 of the Klotho gene is associated with a decrease in the odds of progression of atheromatosis in CKD patients.

  • mineral Metabolism Parameters throughout chronic kidney disease stages 1 5 achievement of k doqi target ranges
    Nephrology Dialysis Transplantation, 2007
    Co-Authors: Lourdes Craver, Jose M Valdivielso, Maria Paz Marco, I Martinez, Montserrat Rue, Merce Borras, Maria Luisa Martin, Felipe Sarro, Elvira Fernandez
    Abstract:

    Background. Dialysis Outcomes and Practice Patterns Study has shown that the proportion of haemodialysis patients with adequate mineral Metabolism Parameters according to the Kidney Disease Outcome Quality Initiative (K/DOQI) guidelines is very low. The adequacy of such Parameters in relation to the recommended ranges in patients with different chronic kidney disease (CKD) stages has not been reported. The objective of this study is to provide an in-depth description of mineral Metabolism in the early stages of CKD in a European population, and to compare it with current recommendations for stages 3–5 (K/DOQI guidelines). Methods. A total of 1836 patients were classified into stages 1–5 according to K/DOQI guidelines. The following clinical and biochemical data were recorded: age, gender, CKD aetiology, presence of diabetes, serum creatinine, creatinine clearance, serum phos