Browsing by Author "Silva, Ana Paula"
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- Altered serum levels of FGF-23 and magnesium are independent risk factors for an increased albumin-to-creatinine ratio in type 2 diabetics with chronic kidney diseasePublication . Silva, Ana Paula; Mendes, Filipa; Fragoso, André; Jerónimo, Teresa; Pimentel, Ana; Gundlach, Kristina; Büchel, Janine; Santos, Nélio; Neves, Pedro LeãoAims: To investigate the role of FGF-23 and magnesium in relation to the albumin-to-creatinine ratio in type 2 diabetics with chronic kidney disease (CKD) stages 2-4.Methods: In a cross-sectional study we included all eligible type 2 diabetic patients with CKD stages 2-4, followed in our outpatient Diabetic Kidney clinic. We used descriptive statistics, the Student's t-test, ANOVA and the chi-square tests. Our population was divided according to the UACR (G1 30-300 mg/g and G2 >= 300 mg/g), and compared these groups regarding several biological and laboratorial parameters. We employed a multiple regression model to identify risk factors of increased UACR.Results: The patients in G2 displayed a lower eGFR (p = 0.0001) and, had lower levels of magnesium (p = 0.004) as well as higher levels of FGF-23 (p = 0.043) compared to patients in Gl.FGF-23 (beta = 0.562, P = 0.0001) and the magnesium (beta = - 8.916, p = 0.0001) were associated with increased UACR.Conclusions: A dysregulation of mineral metabolism, reflected by altered levels of magnesium and FGF-23, correlates with an increased UACR in type 2 diabetic patients with CKD stages 2-4. (C) 2016 Elsevier Inc. All rights reserved.
- Angels and demons regarding cardiovascular disease in diabetic renal patients: the role of FGF-23 Andklotho on the pulse pressurePublication . Silva, Ana Paula; Mendes, Filipa; Fragoso, André; Santos, Nélio; Rato, Fátima; Faísca, Marilia; Neves, Pedro LeãoThe last decade have shown thatFGF23 and Klotho may have relevant independent actions on the renal and cardiovascular systems. Theyinterfere with vascular functions and may playa role in vascularcalcification, atherosclerosis and arteriolosclerosis. On the other hand, pulse pressureis awell-known risk factorof cardiovascular morbidityand mortality in renal patients. The aim of this study isto investigate the relationship between FGF-23 and Klothowith pulse pressure in type 2 diabetic with chronic kidney disease (CKD) stages 2-3.
- Do saber ao bem estar: uma nova bioexperiência RomanaPublication . Reis, Emanuel; Colaço, Ana; Rodrigues, Miguel; Dias, Filipe; Santos, Ana; Silva, Ana; Francisco, Maria Luisa; Garcia, Cristina; Brigas, Amadeu; Azambuja, Sónia Talhé; Fernandes, Paulo; Silva, Ana Paula; Flores, Ruben; Tomás, André; Marcelo, Pedro; Tomás, André; Veiga-Pires, C.A iniciativa “Do saber ao bem estar: uma nova bio-experiência romana" é uma atividade desenvolvida no âmbito do programa DiVaM e enquadrada nas Jornadas Europeias do Património 2016 e dá continuidade à atividade já realizada no ano anterior, intitulada “Do saber ao sabor: uma bio-experiência romana.” A Villa de Milreu é um exemplo do modelo de ocupação romana da região da Iberia, centrada na exploração dos recursos agrícolas, marinhos e na produção de bens alimentares, que eram exportados por via marítima para os portos do Império. Com esta “nova bio-experiência” pretende-se proporcionar aos participantes a possibilidade de vivenciar a cultura e costumes do Algarve Romano à luz de um enquadramento científico, mas informal e lúdico, segundo uma abordagem alternativa à que foi explorada na edição do ano passado, focando este ano nas plantas.
- Do Saber ao Criar: experiências tecnoromanas na Villa de MilreuPublication . Colaço, Ana; Brigas, Amadeu; Pereira, Angelina; Silva, Ana Paula; Miguel, Carlos; Garcia, Cristina; Veiga-Pires, C.; Moura, Delminda; Reis, Emanuel; Dias, Filipe; Vargues, Filipa; Gonçalves, Luis; Santos, Marco António; Francisco, Maria Luisa; Fernandes, Paulo; Canas, Ricardo; Romba, Sandra; Azambuja, Sónia Talhé; Martins, Susana CaladoO programa DiVaM pretende contribuir para destacar a importância das comunidades locais na valorização do património cultural, indo ao encontro dos princípios da “Convenção de Faro”, pois tenta promover o património cultural como factor de aproximação, de diálogo, de coesão social e de uma cidadania cada vez mais inclusiva. O Centro Ciência Viva do Algarve, no âmbito deste programa, levou “experiências” às ruínas de Milreu pelo quarto ano consecutivo, tendo-se considerado imperativo dedicar pela primeira vez um dia inteiro ao público escolar. A presente comunicação visa dar a conhecer as atividades desenvolvidas.
- Do Saber ao Criar: experiências tecnoromanas na Villa de MilreuPublication . Reis, Emanuel; Colaço, Ana; Miguel, Carlos; Vargues, Filipa; Dias, Filipa; Gonçalves, Luis; Gomes, Tiago; Martins, Susana Calado; Santos, Marco António; Francisco, Maria Luisa; Garcia, Cristina; Brigas, Amadeu; Silva, Ana Paula; Azambuja, Sónia Talhé; Canas, Ricardo; Fernandes, Paulo; Moura, Delminda; C. Veiga-Pires, C.A Villa de Milreu é um exemplo do modelo de ocupação romana da região da Iberia, centrada na exploração dos recursos agrícolas, marinhos e na produção de bens alimentares, que eram exportados por via marítima para os portos do Império. O Centro Ciência Viva do Algarve traz “experiências” às ruínas de Milreu pelo quarto ano consecutivo, altura em que impera que dediquemos pela primeira vez um dia inteiro ao público escolar. Assim, continuando a destacar o “saber" característico da sociedade romana da época, desta vez sob o mote “Do Saber ao Criar: experiências tecnoromanas na Villa de Milreu", esta 4ª edição, para além de no sábado, dia 20, renovar a oportunidade dada nas edições anteriores aos participantes de conhecer e “vivenciar” o estilo de vida dos romanos que habitaram o local, através de atividades de cariz essencialmente prático, estende-a este ano aos alunos durante o dia 19, sexta feira. Ambos os dias do evento são realizados no âmbito do programa DiVaM 2018. Esperamos que passe bons momentos connosco em Milreu!
- Do Saber ao Fazer: Bioexperiências Romanas no Labor e no ÓcioPublication . Reis, Emanuel; Veiga-Pires, C.; Colaço, Ana; Rodrigues, Miguel; Kisauskaré, Vaiva; Martins, Susana Calado; Santos, Marco António; Francisco, Maria Luisa; Garcia, Cristina; Brigas, Amadeu; Azambuja, Sónia Talhé; Fernandes, Paulo; Silva, Ana PaulaA Villa de Milreu é um exemplo do modelo de ocupação romana da região da Iberia, centrada na exploração dos recursos agrícolas, marinhos e na produção de bens alimentares, que eram exportados por via marítima para os portos do Império. É já o terceiro ano que o Centro Ciência Viva do Algarve traz “bioexperiências” às ruínas de Milreu, um conceito que pretende proporcionar aos participantes a possibilidade de vivenciar de forma prática a cultura e costumes do Algarve Romano à luz de um enquadramento científico, mas informal e lúdico. Dado o sucesso dos anos anteriores, recuperamos e reformulamos algumas das atividades já realizadas, mas segundo um novo enquadramento. Assim, após viajarmos “Do saber ao sabor” e “do saber ao bem estar” na era romana, o mote para este ano é “Do saber ao fazer”. Dado que “fazer” foi algo que claramente caracterizou a sociedade romana, sentimos a necessidade de abordar a temática ao longo de dois dias, explorando o “fazer” no âmbito do “labor” no primeiro dia (24 de setembro) e do “ócio” no segundo (1 de outubro). Ambos os eventos “Do saber ao fazer”: bioexperiências romanas" são realizados no âmbito do programa DiVaM 2017 e das Jornadas Europeias do Património 2017. Esperamos que passe bons momentos connosco em Milreu!
- FGF23-klotho axis as predictive factors of fractures in type 2 diabetics with early chronic kidney diseasePublication . Ribeiro, Ana Luisa; Mendes, Filipa; Carias, Eduarda; Rato, Fátima; Santos, Nélio; Neves, Pedro Leão; Silva, Ana PaulaBackground: The aim of our study was to evaluate the relevance of FGF23-klotho axis in the predisposition for bone fractures in type 2 diabetic patients with early chronic kidney disease. Methods: In a prospective study we included 126 type 2 diabetic patients with CKD stages 2-3 (from 2010 to 2017). We used descriptive statistics, ANOVA and chi-square test. Our population was divided into two groups according to the occurrence of a bone fracture event or not, and the groups were compared considering several biological and laboratorial parameters. We employed a multiple regression model to identify risk factors for bone fracture events and hazard ratios (HR) were calculated using a backward stepwise likelihood ratio (LR) Cox regression. Results: Patients with a fracture event displayed higher levels of FGF-23, Phosphorus, PTH, TNF-alpha, OxLDL, HOMA-IR, calcium x phosphorus product and ACR and lower levels of Osteocalcin, alpha-Klotho, 25(OH)D3 and eGFR compared with patients without a fracture event (p < 0.001). The number of patients with a fracture event was higher than expected within inclining CKD stages (chi 2, p = 0.06). The occurrence of fracture and the levels of TNF-alpha, klotho, 25(OH)D3 and OxLDL were found to predict patient entry into RRT (p < 0.05). Age, osteocalcin, alpha-Klotho and FGF-23 independently influenced the occurrence of bone fracture (p < 0.05). Conclusions: alpha-Klotho and FGF-23 levels may have a good clinical use as biomarkers to predict the occurrence of fracture events. (C) 2019 Elsevier Inc. All rights reserved.
- Functional analysis of two novel TBX5 variants present in individuals with Holt-Oram syndrome with different clinical manifestationsPublication . Varela, Debora; Varela, Tatiana; Conceição, Natércia; Ferreira, Angela; Marques, Nuno; Silva, Ana Paula; Azevedo, Pedro; Pereira, Salome; Camacho, Ana; de Jesus, Ilidio; Cancela, M. LeonorHolt-Oram syndrome (HOS) is a rare disorder characterized by cardiac and upper-limb defects. Pathogenic variants in TBX5-a gene encoding a transcription factor important for heart and skeletal development-are the only known cause of HOS. Here, we present the identification and functional analysis of two novel TBX5 pathogenic variants found in two individuals with HOS presenting distinct phenotypes. The individual with the c.905delA variant has a severe cardiac phenotype but mild skeletal defects, unlike the individual with the c.246_249delGATG variant who has no cardiac problems but severe upper limbs malformations, including phocomelia. Both frameshift variants, c.246_249delGATG and c.905delA, generate mRNAs harbouring premature stop codons which, if not degraded by nonsense mediated decay, will lead to the production of shorter TBX5 proteins, p.Gln302Argfs*92 and p.Met83Phefs*6, respectively. Immunocytochemistry results suggest that both mutated proteins are produced and furthermore, like the wild-type protein, p.Gln302Argfs*92 mutant appears to be mainly localized in the nucleus, in contrast with p.Met83Phefs*6 mutant that displays a higher level of cytoplasmic localization. In addition, luciferase activity analysis revealed that none of the TBX5 mutants are capable of transactivating the NPPA promoter. In conclusion, our results provide evidence that both pathogenic variants cause a severe TBX5 loss-of-function, dramatically reducing its biological activity. The absence of cardiac problems in the individual with the p.Met83Phefs*6 variant supports the existence of other mechanisms/genes underlying the pathogenesis of HOS and/or the existence of an age-related delay in the development of a more serious cardiac phenotype. Further studies are required to understand the differential effects observed in the phenotypes of both individuals.
- Klotho levels: association with insulin resistance and albumin-to-creatinine ratio in type 2 diabetic patientsPublication . Silva, Ana Paula; Mendes, Filipa; Pereira, Luisa; Fragoso, André; Baptista Gonçalves, Rui; Santos, Nelio; Rato, Fátima; Neves, Pedro LeãoThe present study aimed at evaluating the relationship between Klotho levels and insulin resistance and albumin-to-creatinine ratio (ACR) in type 2 diabetic patients with CKD. We conducted an observational, cross-sectional study in our outpatient diabetic nephropathy clinic from 2014 to 2016, enrolling a total of 107 type 2 diabetic patients with stage 2-3 CKD, with a mean age of 59 years. Several clinical and laboratorial parameters were evaluated, including those related to mineral and carbohydrate metabolism. The mean eGFR at baseline was 53.2 mL/min, and the mean levels of ACR and Klotho were 181.9 A mu g/mg and 331.1 pg/m, respectively. In the simple linear regression model, Klotho levels were correlated with age, phosphorus, PTH, ACR, HOMA, IL-6, FGF-23, OxLDL, eGFR and vitamin D levels. Applying a multivariate linear regression model, only the ACR, HOMA-IR, FGF-23 and vitamin D independently influenced the Klotho levels. In the generalized linear model, only the Klotho groups were statistically significant as independent variable (p = 0.007). The results show that the group 1 (< 268) compared with group 3 (> 440) had higher odds in the higher ACR (ae181), ORa = 3.429, p = 0.014. There were no statistically significant differences between Klotho groups 2 and 3, and the HOMA-IR obtained showed that group 1 (< 268) had greater odds of HOMA-IR ae2 when compared with group 3 (> 440), ORa = 21.59, p = 0.017. Our results showed that Klotho levels are influenced by FGF23, vitamin D and insulin resistance. This suggests that Klotho levels might be affected by renal function as well as having a relevant role on insulin metabolism and ACR homeostasis.
- Mineral metabolism and inflammation: factors related to left ventricular hypertrophy in patients with diabetic nephropathyPublication . Jerónimo, Teresa; Fragoso, Andr?; Mendes, Filipa; Silva, Ana Paula; Pimentel, Ana; Tavares, Nelson; Camacho, Ana; Neves, Pedro LeãoLeft ventricular hypertrophy (LVH) is an important risk factor for cardiovascular disease in patients with diabetic nephropathy (DN) and is an independent predictor of mortality in patients with chronic kidney disease (CKD). The aim of this study was to evaluate the association of LVH with mineral metabolism and inflammation in a population of patients with DN. In an observational study were included 119 type 2 diabetic patients with CKD stages 3 and 4. The population was divided into two groups, according to the presence of LVH: group 1 (G-1) with LVH (left ventricular mass index (LVMI) > 125 g/m2 in male patients and LVMI > 110 g/m2 in female patients) and group 2 (G-2) without LVH (LVMI ? 125 g/m2 in male patients and LVMI ? 110 g/m2 in female patients). The patient characteristics of each group were compared regarding several biological and laboratory parameters. Patients with LVH displayed lower values of estimated glomerular filtration rate (eGFR) (p = 0.0001) and albumin (p = 0.046), and higher levels of phosphorus (p = 0.0001), intact parathyroid hormone (iPTH) (p = 0.0001), insulin resistance (HOMA-IR) (p = 0.0001) and interleukin-6 (IL-6) (p = 0.0001), compared with patients without LVH. In a logistic regression model, phosphorus (odd ratio (OR) = 1.825 (1.075-4.414), p = 0.038), iPTH (OR = 1.991 (1.098-3.000), p = 0.004) and IL-6 (OR = 3.538 (1.863-6.719), p = 0.0001) were independently related to LVH. In a multiple linear regression model, phosphorus (r = 0.602, p = 0.038), iPTH (r = 1.009, p = 0.044) and IL-6 (r = 1.264, p = 0.0001) were positively related to LVMI. Phosphorus, PTH and IL-6 were related to LVH in our diabetic population with CKD stages 3 and 4