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Article ; Online: Bone quality, mineral density, and fractures in heart failure.

Andre Luiz Canteri / Luana Bassan Gusmon / Cesar Luiz Boguszewski / Victoria Zeghbi Cochenski Borba

PLoS ONE, Vol 18, Iss 11, p e

2023 Volume 0293903

Abstract: Background The trabecular bone score (TBS) indirectly estimates bone quality and predicts low-impact fractures independently of bone mineral density (BMD). However, there is still a paucity of data linking bone and heart diseases, mainly with gaps in the ...

Abstract	Background The trabecular bone score (TBS) indirectly estimates bone quality and predicts low-impact fractures independently of bone mineral density (BMD). However, there is still a paucity of data linking bone and heart diseases, mainly with gaps in the TBS analysis. Methods In this cross-sectional study, we evaluated TBS, BMD, and fractures in patients with heart failure with reduced ejection fraction (HFrEF) and in sex-, BMI- and age-matched controls, and we assessed the fracture probability using the FRAX tool, considering active search for fractures by vertebral fracture assessment (VFA) and the adjustment for the TBS. Results TBS values were 1.296 ± 0.14 in 85 patients (43.5% women; age 65 ± 13 years) and 1.320 ± 0.11 in 142 controls (P = 0.07), being reduced (< 1.31) in 51.8% and 46.1% of them, respectively (P = 0.12). TBS was lower in patients than in the controls when BMD was normal (P = 0.04) and when the BMI was 15-37 kg/m2 (P = 0.03). Age (odds ratio [OR] 1.05; P = 0.026), albumin (OR 0.12; P = 0.046), statin use (OR 0.27; P = 0.03), and energy intake (OR 1.03; P = 0.014) were associated with reduced TBS. Fractures on VFA occurred in 42.4% of the patients, and VFA and TBS adjustment increased the fracture risk by 16%-23%. Conclusion Patients with HFrEF had poor bone quality, with a better discriminating impact of the TBS assessment when BMD was normal, and BMI was suitable for densitometric analysis. Variables related to the prognosis, severity, and treatment of HFrEF were associated with reduced TBS. VFA and TBS adjustment increased fracture risk.
Keywords	Medicine ; R ; Science ; Q
Subject code	616
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: What’s in a name? What we call growth hormone is much more than just a growth-related peptide

Cesar Luiz Boguszewski / Margaret Cristina da Silva Boguszewski

Archives of Endocrinology and Metabolism, Vol 63, Iss 6, Pp 546-

2020 Volume 548

Keywords	Medicine ; R ; Diseases of the endocrine glands. Clinical endocrinology ; RC648-665
Language	English
Publishing date	2020-01-01T00:00:00Z
Publisher	Brazilian Society of Endocrinology and Metabolism
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Growth Hormone Deficiency (GHD) in Adults

Cesar Luiz Boguszewski

Revista Argentina de Endocrinología y Metabolismo, Vol 47, Iss 3, Pp 30-

To Treat or Not To Treat? Deficiencia de hormona de crecimiento en el adulto ¿debe tratarse?

2010 Volume 38

Abstract: Over the last decade, different guidelines have been published for the diagnosis, treatment and monitoring of adult growth hormone deficiency (AGHD). Themes and recommendations common to the guidelines offer a pragmatic approach to the management of AGHD. ...

Abstract	Over the last decade, different guidelines have been published for the diagnosis, treatment and monitoring of adult growth hormone deficiency (AGHD). Themes and recommendations common to the guidelines offer a pragmatic approach to the management of AGHD. Nevertheless, there is a need for more research in some key areas in which recommendations in the guidelines are supported by moderate evidence, at best. Recent meta-analysis and long-term follow-up studies have contributed with valuable information on the efficacy and safety of GH therapy in adults. This review brings a historical perspective of the AGHD, with an emphasis on the following aspects: (I) who are the appropriate candidates for GH therapy in adult life? (II) how to make the diagnosis (III) the impact of GH therapy; (IV) which therapeutic approach should be used? (V) how to follow and monitor the patients; and (VI) special aspects on mortality and longevity related to the GH-IGF-1 axis.
Keywords	Growth hormone ; Deficiency ; Hypopituitarism ; Young adult ; Hormone replacement therapy ; Diseases of the endocrine glands. Clinical endocrinology ; RC648-665 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Internal medicine ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Subject code	610
Language	Spanish
Publishing date	2010-09-01T00:00:00Z
Publisher	Sociedad Argentina de Endocrinología y Metabolismo
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The new obesity classification based on weight history is not proposed as a guideline

Bruno Halpern / Marcio C. Mancini / Maria Edna de Melo / Rodrigo N. Lamounier / Rodrigo O. Moreira / Mario K. Carra / Cintia Cercato / Cesar Luiz Boguszewski

Archives of Endocrinology and Metabolism, Vol 66, Iss 6, Pp 936-

2022 Volume 937

Keywords	Medicine ; R ; Diseases of the endocrine glands. Clinical endocrinology ; RC648-665
Language	English
Publishing date	2022-11-01T00:00:00Z
Publisher	Brazilian Society of Endocrinology and Metabolism
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Prevalence of sarcopenia in women at stable weight phase after Roux-en-Y gastric bypass

Andreia Fabiana Bueno Buzza / Cristina Aquino Machado / Felipe Pontes / Letícia Guadanhim Sampaio / Júlia Soares Contador / Carolina Labigalini Sampaio / Rosana Bento Radominski / Cesar Luiz Boguszewski / Victoria Zeghbi Cochenski Borba

Archives of Endocrinology and Metabolism (2022)

2022

Abstract: ABSTRACT Objective: Evaluating the prevalence of sarcopenia in women submitted to bariatric surgery – Roux-en-Y gastric bypass. Design: Observational, cross-sectional study. Subjects and methods: Women (18-65 years old) who underwent bariatric surgery ( ... ...

Abstract	ABSTRACT Objective: Evaluating the prevalence of sarcopenia in women submitted to bariatric surgery – Roux-en-Y gastric bypass. Design: Observational, cross-sectional study. Subjects and methods: Women (18-65 years old) who underwent bariatric surgery (BG) ≥ 2 years and reached stable weight ≥ 6 months, were investigated. Control group (CG) comprised non-operated matched women with obesity. Body composition was determined through dual-energy X-ray absorptiometry. Low lean mass (LLM) was defined as appendicular lean mass index (ALM kg/height m2) < 5.5 kg/m2. Physical strength was assessed through dynamometer and sit-to-stand test (SST), whereas performance was assessed through 4-m gait speed and Short Physical Performance Battery Tests (SPPB). Sarcopenia was diagnosed in the presence of LLM and low strength. Results: One-hundred and twenty women (60 in each group, 50 ± 9.7 years old) were investigated. All anthropometric and body composition parameters were lower in BG than in CG, whereas strength and performance were similar between groups. Women with reduced strength presented high total fat mass and low physical activity level (p < 0.005). LLM was observed in 35% of BG and in 18.3% of CG (p = 0.04), whereas sarcopenia was diagnosed in 28.3% of BG and in 16.6% of CG (p = 0.12). Sarcopenic women in BG had better performance both in SST (p = 0.001) and SPPB (p = 0.004). Total lean mass (OR:1.41, 95% CI [1.18; 1.69], p < 0.001) and obesity (OR: 38.2 [2.27; 644.12], p < 0.001) were associated with sarcopenia in the multivariate analysis. Conclusion: Despite great weight loss, sarcopenia prevalence did not increase in BG and its presence was influenced by total lean mass and obesity.
Keywords	Obesity ; bariatric surgery ; sarcopenia ; physical performance ; strength ; Medicine ; R ; Diseases of the endocrine glands. Clinical endocrinology ; RC648-665
Subject code	796
Language	English
Publishing date	2022-06-01T00:00:00Z
Publisher	Brazilian Society of Endocrinology and Metabolism
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Proposal of an obesity classification based on weight history

Bruno Halpern / Marcio C. Mancini / Maria Edna de Melo / Rodrigo N. Lamounier / Rodrigo O. Moreira / Mario K. Carra / Theodore K. Kyle / Cintia Cercato / Cesar Luiz Boguszewski

Archives of Endocrinology and Metabolism, Vol 66, Iss 2, Pp 139-

an official document by the Brazilian Society of Endocrinology and Metabolism (SBEM) and the Brazilian Society for the Study of Obesity and Metabolic Syndrome (ABESO)

2022 Volume 151

Abstract: ABSTRACT Obesity is a chronic disease associated with impaired physical and mental health. A widespread view in the treatment of obesity is that the goal is to normalize the individual's body mass index (BMI). However, a modest weight loss (usually above ...

Abstract	ABSTRACT Obesity is a chronic disease associated with impaired physical and mental health. A widespread view in the treatment of obesity is that the goal is to normalize the individual's body mass index (BMI). However, a modest weight loss (usually above 5%) is already associated with clinical improvement, while weight losses of 10%-15% bring even further benefits, independent from the final BMI. The percentage of weight reduction is accepted as a treatment goal since a greater decrease in weight is frequently difficult to achieve due to metabolic adaptation along with environmental and lifestyle factors. In this document, the Brazilian Society of Endocrinology and Metabolism (SBEM) and the Brazilian Society for the Study of Obesity and Metabolic Syndrome (ABESO) propose a new obesity classification based on the maximum weight attained in life (MWAL). In this classification, individuals losing a specific proportion of weight are classified as having “reduced” or “controlled” obesity. This simple classification – which is not intended to replace others but to serve as an adjuvant tool – could help disseminate the concept of clinical benefits derived from modest weight loss, allowing individuals with obesity and their health care professionals to focus on strategies for weight maintenance instead of further weight reduction. In future studies, this proposed classification can also be an important tool to evaluate possible differences in therapeutic outcomes between individuals with similar BMIs but different weight trajectories.
Keywords	Medicine ; R ; Diseases of the endocrine glands. Clinical endocrinology ; RC648-665
Subject code	616
Language	English
Publishing date	2022-04-01T00:00:00Z
Publisher	Brazilian Society of Endocrinology and Metabolism
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Body composition and nutritional and metabolic parameters in postmenopausal women sufficient, insufficient and deficient in vitamin D

Luisa Amábile Wolpe Simas / Leila Caroline Bianchet Zanatta / Carolina Aguiar Moreira / Victoria Zeghbi Cochenski Borba / Cesar Luiz Boguszewski

Archives of Endocrinology and Metabolism, Iss

2019

Abstract: ABSTRACT Objective We investigated changes in body composition and nutritional and metabolic parameters in a group of postmenopausal women who were classified as sufficient, insufficient and deficient in vitamin D. Subjects and methods A total of 106 ... ...

Abstract	ABSTRACT Objective We investigated changes in body composition and nutritional and metabolic parameters in a group of postmenopausal women who were classified as sufficient, insufficient and deficient in vitamin D. Subjects and methods A total of 106 postmenopausal women were included in this cross-sectional study and classified according to their serum levels of 25-OH-vitamin D as sufficient (≥ 30 ng/mL; group S), insufficient (20.1 and 29.9 ng/mL; group I) or deficient (≤ 20 ng/mL; group D) in vitamin D. Body composition was measured by dual-energy X-ray absorptiometry (DXA); dietary recall questionnaires were completed; and blood samples were analysed to compare the metabolic and nutritional status of the study groups. Results Eleven (10.4%) of the women were classified in group S, 50 (47.2%) in group I and 45 (42.4%) in group D, with a mean serum level for 25-OH-D of 21.1 ± 7.0 ng/mL in all participants. Body composition did not differ among the groups. Serum levels of 25-OH-D were negatively correlated with serum levels of triglycerides, total cholesterol and LDL cholesterol. Conclusions Vitamin D insufficiency and deficiency were highly prevalent in our group of postmenopausal women, showing an association with an unfavourable lipid profile.
Keywords	Vitamin D ; body composition ; nutrition ; metabolic syndrome ; menopause ; Medicine ; R ; Diseases of the endocrine glands. Clinical endocrinology ; RC648-665
Subject code	796
Language	English
Publishing date	2019-04-01T00:00:00Z
Publisher	Brazilian Society of Endocrinology and Metabolism
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Sobre o universo hormonal, música e encantamento

César Luiz Boguszewski

Arquivos brasileiros de Endocrinologia e Metabologia, Vol 47, Iss 4, Pp 297-

2003 Volume 298

Keywords	Diseases of the endocrine glands. Clinical endocrinology ; RC648-665 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Internal medicine ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Language	Portuguese
Publishing date	2003-08-01T00:00:00Z
Publisher	Sociedade Brasileira de Endocrinologia e Metabologia
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: O Laboratório no Diagnóstico e Seguimento da Acromegalia The Laboratory in the Diagnosis and Follow-up of Acromegaly

César Luiz Boguszewski

Arquivos brasileiros de Endocrinologia e Metabologia, Vol 46, Iss 1, Pp 34-

2002 Volume 44

Abstract: Acromegalia é uma síndrome clínica característica, que na maior parte das vezes resulta de um macroadenoma hipofisário produtor de hormônio de crescimento (GH, growth hormone). A hipersecreção tumoral crônica de GH provoca deformidades esqueléticas, ... ...

Abstract	Acromegalia é uma síndrome clínica característica, que na maior parte das vezes resulta de um macroadenoma hipofisário produtor de hormônio de crescimento (GH, growth hormone). A hipersecreção tumoral crônica de GH provoca deformidades esqueléticas, distúrbios metabólicos, complicações em vários órgãos e sistemas, e acaba reduzindo a expectativa de vida do paciente. O diagnóstico presuntivo baseia-se nos achados clínicos característicos da doença, com a confirmação vindo através de exames laboratoriais e da avaliação radiológica. Do ponto de vista laboratorial, a abordagem diagnóstica inclui dosagens basais e testes endócrinos que comprovem o excesso de GH, através de dosagens diretas do GH e/ou de fatores circulantes GH-dependentes, cujo melhor exemplo é o fator de crescimento insulina-símile-1 (IGF-1, insulin-like growth factor-1). A adenomectomia transesfenoidal permanece como o tratamento inicial de escolha na acromegalia, mas infelizmente a cura cirúrgica ocorre em menos da metade dos pacientes portadores de macroadenomas. Conseqüentemente, os exames laboratoriais têm um papel muito importante no seguimento dos pacientes após a cirurgia, para definir os critérios de cura e monitorar a atividade da doença durante tratamento complementar com radioterapia ou medicamentos. Neste artigo, revisaremos os exames laboratoriais mais freqüentemente utilizados no diagnóstico da acromegalia e alguns métodos experimentais que vêm sendo testados na sua abordagem. Na parte final, apresentaremos as principais recomendações de dois workshops internacionais realizados nos últimos anos com o objetivo de padronizar a avaliação diagnóstica e a conduta terapêutica na acromegalia. Acromegaly is a characteristic clinical syndrome caused in most cases by a GH-producing pituitary macroadenoma. Tumoral GH hypersecretion results in skeletal changes, metabolic abnormalities, multi-systemic complications and a significant increase in the overall mortality. The diagnosis is suspected on clinical grounds, and it is normally confirmed by biochemical and radiological examinations. From the biochemical standpoint, the diagnostic approach for demonstration of GH excess involves either basal hormone measurements, mainly GH and insulin-like growth factor-1 (IGF-1), and endocrine tests, such as the oral glucose load. Transphenoidal adenomectomy remains the primary therapy of choice for most patients but, unfortunately, post-surgical remission is observed in less than half of the patients with macroadenomas. Consequently, hormone measurements have an important role in the follow-up of acromegalic patients, not only to define criteria for remission ("cure"), both also to evaluate the outcome of other therapeutic approaches such as radiotherapy and medical treatment. In this article, the most common biochemical measurements used in the management of acromegaly and some novel experimental assays are reviewed. In addition, a summary of a recently published consensus statement with guidelines for the diagnosis and therapeutic approach of acromegaly is presented.
Keywords	Hormônio de crescimento ; Acromegalia ; IGF-1 ; Growth hormone ; Acromegaly ; Diseases of the endocrine glands. Clinical endocrinology ; RC648-665 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Internal medicine ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Language	Portuguese
Publishing date	2002-02-01T00:00:00Z
Publisher	Sociedade Brasileira de Endocrinologia e Metabologia
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Genética molecular do eixo GH-IGF1

César Luiz Boguszewski

Arquivos brasileiros de Endocrinologia e Metabologia, Vol 45, Iss 1, Pp 5-

2001 Volume 14

Abstract: O hormônio de crescimento (GH, growth hormone), o fator de crescimento insulina símile-1 (IGF1, insulin-like growth factor-1) e uma enorme variedade de moléculas afins formam um eixo regulador do crescimento pré e pós-natal. Os permanentes avanços nas ... ...

Abstract	O hormônio de crescimento (GH, growth hormone), o fator de crescimento insulina símile-1 (IGF1, insulin-like growth factor-1) e uma enorme variedade de moléculas afins formam um eixo regulador do crescimento pré e pós-natal. Os permanentes avanços nas técnicas de biologia molecular têm facilitado a identificação de defeitos genéticos nos diferentes componentes do eixo GH-IGF1 em crianças com baixa estatura. Por outro lado, a aplicação de novos métodos de dosagens hormonais tem revelado a existência de formas inativas de GH ou quantidades aumentadas de formas com menor atividade biológica, cuja presença na circulação poderia justificar o retardo de crescimento em certas crianças com baixa estatura. Clinicamente, os defeitos genéticos no eixo GH-IGF1 podem se manifestar tanto em síndromes de deficiência como de resistência hormonal, enfatizando a importância de se avaliar não apenas a secreção de GH numa criança com baixa estatura, mas também marcadores periféricos de uma possível resistência tecidual ao hormônio. Neste artigo, os principais defeitos genéticos descritos até o presente momento no eixo GH/IGF1 são revisados, com enfoque sobre as repercussões clínicas destes defeitos e a importância da avaliação genética no diagnóstico diferencial da baixa estatura idiopática e da baixa estatura familiar. Na parte final, alguns breves comentários são feitos sobre defeitos genéticos encontrados em dois importantes fatores de transcrição da hipófise, que provocam um quadro clínico de deficiência combinada de hormônios pituitários, incluindo a deficiência de GH. Growth hormone (GH), insulin-like growth factor-1 (IGF1) and several related molecules are involved in the growth regulation axis at both pre and postnatal life. The advances in molecular biology techniques have improved the way of identifying genetic defects in different elements of the GH-IGF1 axis in children with short stature. On the other hand, the use of new GH assays have revealed the presence of GH with no biological activity or increased amounts of less active GH isoforms in the circulation, which could potentially be the cause of growth retardation in certain children with short stature. Clinically, the genetic defects might result in either hormone deficiency or resistance, showing the importance of evaluating both GH secretion and GH responsiveness in a short child. In the present article, the main genetic defects within the GH-IGF1 axis are reviewed with focus in their clinical repercussion and their importance in the differential diagnosis of idiopathic and familial short stature. In addition, a short review on the genetic abnormalities found in two of the most important pituitary transcription factors will be presented.
Keywords	GH ; IGF1 ; Crescimento ; Baixa estatura ; Genética molecular ; Growth ; Short stature ; Molecular genetics ; Diseases of the endocrine glands. Clinical endocrinology ; RC648-665 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Internal medicine ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Language	Portuguese
Publishing date	2001-02-01T00:00:00Z
Publisher	Sociedade Brasileira de Endocrinologia e Metabologia
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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