Victoria Z C Borba

Universidade Federal do Paraná, Pontal do Paraná, Paraná, Brazil

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Publications (30)27.1 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective The objective is to present an update on the diagnosis and treatment of hypovitaminosis D, based on the most recent scientific evidence. Materials and methods The Department of Bone and Mineral Metabolism of the Brazilian Society of Endocrinology and Metabology (SBEM) was invited to generate a document following the rules of the Brazilian Medical Association (AMB) Guidelines Program. Data search was performed using PubMed, Lilacs and SciELO and the evidence was classified in recommendation levels, according to the scientific strength and study type. Conclusion A scientific update regarding hypovitaminosis D was presented to serve as the basis for the diagnosis and treatment of this condition in Brazil.
    Arquivos brasileiros de endocrinologia e metabologia. 07/2014; 58(5):411-433.
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    ABSTRACT: Osteocalcin is a bone matrix protein that has been associated with several hormonal actions on energy and glucose metabolism. Animal and experimental models have shown that osteocalcin is released into the bloodstream and exerts biological effects on pancreatic beta cells and adipose tissue. Undercarboxylated osteocalcin is the hormonally active isoform and stimulates insulin secretion and enhances insulin sensitivity in adipose tissue and muscle. Insulin and leptin, in turn, act on bone tissue, modulating the osteocalcin secretion, in a traditional feedback mechanism that places the skeleton as a true endocrine organ. Further studies are required to elucidate the role of osteocalcin in the regulation of glucose and energy metabolism in humans and its potential therapeutic implications in diabetes, obesity and metabolic syndrome.
    Arquivos Brasileiros de Endocrinologia & Metabologia 07/2014; 58(5):444-451. · 0.88 Impact Factor
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    ABSTRACT: Organ transplantation is the gold standard therapy for several end-stage diseases. Bone loss is a common complication that occurs in transplant recipients. Osteoporosis and fragility fractures are serious complication, mainly in the first year post transplantation. Many factors contribute to the pathogenesis of bone disease following organ transplantation. This review address the mechanisms of bone loss including the contribution of the immunosuppressive agents as well as the specific features to bone loss after kidney, lung, liver, cardiac and bone marrow transplantation. Prevention and management of bone loss in the transplant recipient should be included in their post transplant follow-up in order to prevent fractures.
    Arquivos Brasileiros de Endocrinologia & Metabologia 07/2014; 58(5):484-492. · 0.88 Impact Factor
  • C A M Kulak, V Z Cochenski Borba, J Kulak, M Ribeiro Custódio
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    ABSTRACT: Osteoporosis and high risk of fractures have emerged as frequent and devastating complications of organ solid transplantation process. Bone loss after organ transplant is related to adverse effects of immunosuppressive drugs on bone remodeling and bone quality. Many factors contribute to the pathogenesis of osteoporosis in transplanted patients. This review address the mechanisms of bone loss that occurs both in the early and late post-transplant periods including the contribution of the immunosuppressive agents as well as the specific features to bone loss after kidney, lung, liver and cardiac transplantation. Therapy for bone loss and prevention of fragility fracture in the transplant recipient will also be discussed.
    Minerva endocrinologica 09/2012; 37(3):221-31. · 1.40 Impact Factor
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    Mauricio Carvalho, Carolina Aguiar Moreira Kulak, Victória Zegbi Cochenski Borba
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    ABSTRACT: To determine the prevalence of hypercalciuria (HC) in postmenopausal women with osteoporosis and its relationship with clinical data and bone mineral metabolism. Calciuria was measured in 24-hour urine samples of 127 women. BMD was measured in the lumbar spine and femur by dual-energy X-ray absorptiometry (DXA). Mean age (±SD) was 64 (±8) years. According to urinary calcium excretion, patients were divided into normo- and hypercalciuric (HC). Of the 127 patients, 19 (15%) were classified as HC. The only difference between the groups was the age of onset of menopause (46 ± 6 vs. 50 ± 3 years HC, p < 0.0005). No association was found between calciuria and age, BMI, BMD, calcium, phosphorus, PTH, and alkaline phosphatase. HC is frequent in postmenopausal women with osteoporosis, and calciuria measurement should be included in the investigation of these patients.
    Arquivos brasileiros de endocrinologia e metabologia 02/2012; 56(1):1-5. · 0.68 Impact Factor
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    ABSTRACT: Transplantation is an established therapy for end-stage diseases of kidney, lung, liver, and heart among others. Osteoporosis and fragility fractures are serious complications of organ transplantation, particularly in the first post-transplant year. Many factors contribute to the pathogenesis of osteoporosis following organ transplantation. This review addresses the mechanisms of bone loss that occurs both in the early and late post-transplant periods, including the contribution of the immunosuppressive agents as well as the specific features to bone loss after kidney, lung, liver, cardiac, and bone marrow transplantation. Prevention and treatment for osteoporosis in the transplant recipient are also discussed.
    Current Osteoporosis Reports 12/2011; 10(1):48-55.
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    Victória Z Cochenski Borba, Nádila Cecyn Pietszkowski Mañas
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    ABSTRACT: Anabolic drugs have recently widened therapeutic options in osteoporosis treatment, as they influence processes associated with bone formation to a greater extent and earlier than bone reabsortion. They positively affect a number of skeletal properties besides bone density, as intermittent administration of parathyroid hormone (PTH) results in an increase in the number and activity of osteoblasts leading to an increase in bone mass and improvement in skeletal architecture at both the trabecular and cortical bone. Human recombinant parathyroid hormone (hrPTH 1-84) and human recombinant PTH peptide 1-34 (teriparatide) belong to this group. The objective of this paper is to review PTH actions, benefits and adverse effects, action on biochemical markers, combination therapy with antiresorptive agents, impact of antiresorptive therapy prior to anabolic treatment, sequential treatment, and effect on glucocorticoid-induced osteoporosis.
    Arquivos brasileiros de endocrinologia e metabologia 03/2010; 54(2):213-9. · 0.68 Impact Factor
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    ABSTRACT: Transplantation is an established therapy for many hematologic disorders as well as for end-stage diseases of the kidney, lung, liver, heart among others. Osteoporosis and a high incidence of fragility fractures have emerged as a complication of organ transplantation. Many factors contribute to the pathogenesis of osteoporosis following organ transplantation. In addition, most patients have some form of bone disease prior to transplantation, which is usually related to adverse effects of end-stage organ failure on the skeleton. This chapter reviews the mechanisms of bone loss that occur both in the early and late post-transplant periods including the contribution of immunosuppressive agents as well as the specific features of bone loss after kidney, lung, liver, cardiac and bone marrow transplantation. Prevention and treatment for osteoporosis in the transplant recipient will also be addressed.
    Arquivos brasileiros de endocrinologia e metabologia 03/2010; 54(2):143-9. · 0.68 Impact Factor
  • Biology of Blood and Marrow Transplantation - BIOL BLOOD MARROW TRANSPLANT. 01/2010; 16(2).
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    ABSTRACT: Compare levels of androgens and bone mineral density (BMD) of ovariectomized (OVX) and non-ovariectomized (NOVX) postmenopausal women. Forty women, 20 OVX and 20 NOVX, (53.9 +/- 4 years) were selected. Total testosterone (TT), free testosterone (FT), androstenedione (AN), dehidroepiandrostenedione (DHEA) and its sulfate (DHEA-S) were measured. BMD was measured in 14 OVX and 16 NOVX. No differences between groups with regard to age, body mass index (BMI) and time since menopause were found. Mean levels of TT and FT were two-fold higher in NOVX group (60.91 versus 30.17 ng/dL, p = 0.0001; 1.00 versus 0.48 pg/mL, p = 0.003). BMD was not different between groups. Inverse correlations were found between BMI and TT (r = -0.3; p = 0.05); time since menopause and AN (r = -0.35; p = 0.02) and time since menopause and DHEA (r = -0.3; p = 0.01). Bilateral ovariectomy leads to a more severe androgen deficiency than natural menopause in postmenopausal women and did not compromise bone mass.
    Arquivos brasileiros de endocrinologia e metabologia 11/2009; 53(8):1033-9. · 0.68 Impact Factor
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    ABSTRACT: The antiepileptic drugs (AED) have been widely used for a great deal of people--in the treatment of epilepsy and other diseases--throughout the world. Continuous and prolonged use of AED may be associated with adverse effects in different systems, including a variety of endocrine and metabolic abnormalities. In this review, the relationship of AED with alterations in bone mineral metabolism, energy balance and body weight, gonadal function and thyroid metabolism was revised, as well as their clinical utility in the treatment of diabetic neuropathy.
    Arquivos brasileiros de endocrinologia e metabologia 10/2009; 53(7):795-803. · 0.68 Impact Factor
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    ABSTRACT: Genetic and racial background, body composition, bone mineral density (BMD), diet, physical activity and life style help to explain the wide difference observed in the world prevalence and incidence of osteoporosis. Recently, a fracture assessment tool, named FRAX TM, was developed to integrate clinical risk factors (genetic and environmental conditions) and BMD, in order to quantify the ten-year probability of an osteoporotic fracture. Shortly, it will be used to indicate treatment for high risk patients. However, this tool is now available only to those populations with known reliable and prospective epidemiologic data of the osteoporotic fractures - fact that does not include the Brazilian population. The aim of this paper was to review the main national and international epidemiologic studies to better understand the differences between the clinical risk factors, BMD and fracture probability of these populations. The authors concluded that, to use the FRAX TM tool, it is necessary more epidemiological data that could characterize the Brazilian population. The future studies should be prospective, evaluate the quality of life, mortality and morbidity after a fracture, as well the life expectancy of the population and the cost-effectiveness and utility related to the osteoporotic fracture. In fact, it is not recommended to use any of the populations available in the FRAX TM tool, as a substitute for the Brazilian population.
    Arquivos brasileiros de endocrinologia e metabologia 08/2009; 53(6):783-90. · 0.68 Impact Factor
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    [Show abstract] [Hide abstract]
    ABSTRACT: Genetic and racial background, body composition, bone mineral density (BMD), diet, physical activity and life style help to explain the wide difference observed in the world prevalence and incidence of osteoporosis. Recently, a fracture assessment tool, named FRAXTM, was developed to integrate clinical risk factors (genetic and environmental conditions) and BMD, in order to quantify the ten-year probability of an osteoporotic fracture. Shortly, it will be used to indicate treatment for high risk patients. However, this tool is now available only to those populations with known reliable and prospective epidemiologic data of the osteoporotic fractures - fact that does not include the Brazilian population. The aim of this paper was to review the main national and international epidemiologic studies to better understand the differences between the clinical risk factors, BMD and fracture probability of these populations. The authors concluded that, to use the FRAXTM tool, it is necessary more epidemiological data that could characterize the Brazilian population. The future studies should be prospective, evaluate the quality of life, mortality and morbidity after a fracture, as well the life expectancy of the population and the cost-effectiveness and utility related to the osteoporotic fracture. In fact, it is not recommended to use any of the populations available in the FRAXTM tool, as a substitute for the Brazilian population.
    Arquivos Brasileiros de Endocrinologia & Metabologia 08/2009; 53(6):783-790. · 0.88 Impact Factor
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    ABSTRACT: We did a cross-sectional analysis of chronic pulmonary obstructive disease (COPD) patients without chronic use of systemic glucocorticoids (CUG). Osteoporosis was found in 51% and bone mineral density (BMD) was correlated with severity of disease. Low levels of vitamin D were found in 94%. All COPD patients may benefit from vitamin D supplementation and screening for low BMD. Patients with chronic pulmonary obstructive disease have low bone mineral density, caused by chronic use of systemic glucocorticoids and hypovitaminosis D. However, patients without CUG may also have low BMD. We performed a cross-sectional analysis in 49 patients (21 men, 28 postmenopausal women), with COPD without CUG, from Brazil (25 degrees 25' S). Several markers of bone metabolism were measured, plus BMD. Osteoporosis risk factors and history of fractures were investigated. Respiratory function was assessed by venous gasometry, spirometry, and oximetry. BMD results were compared to those of 40 healthy non-smokers controls. COPD patients had lower BMD at all sites (p < 0.01). Osteoporosis was observed in 51%. BMD independently correlated with stage of disease (lumbar spine, R = 0.38, p = 0.01; total femur, R = 0.36, p = 0.01; femoral neck, R = 0.40, p < 0.01). Ninety-four percent had low levels of vitamin D (<30 ng/mL) and 67% had secondary hyperparathyroidism. Vitamin D was correlated with oxygen saturation (R = 0.36, p = 0.01), with lower levels in those with saturation <88% (p = 0.01). Patients with COPD without CUG have increased risk for osteoporosis. Such patients have hypovitaminosis D, which is correlated with the severity of disease. Screening for low BMD and vitamin D supplementation may be warranted to all COPD patients.
    Osteoporosis International 03/2009; 20(11):1881-7. · 4.04 Impact Factor
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    Arquivos Brasileiros De Endocrinologia E Metabologia - ARQ BRAS ENDOCRINOL METABOL. 01/2009; 53(7).
  • Arquivos Brasileiros De Endocrinologia E Metabologia - ARQ BRAS ENDOCRINOL METABOL. 01/2009; 53(8).
  • Biology of Blood and Marrow Transplantation - BIOL BLOOD MARROW TRANSPLANT. 01/2009; 15(2):79-80.
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    ABSTRACT: To study efficacy, safety and compliance of GH therapy for 4 years in 18 GH deficient (GHD) adults [12 women; mean age 50.5 yrs (25-66 yrs)]. Clinical, biochemical and body composition (DXA) measurements were performed before and every year after GH therapy. Ecocardiography was performed at baseline and after 4 years. Dose of GH was 0.2 mg/day during the first year with subsequent titration to attain normal IGF-1 levels. There was a significant reduction of total body fat (mean 2.8 kg), truncal fat (mean 1.9 kg) and an increase of lean body mass (mean 0.8 kg) and bone mineral density (BMD) on lumbar spine and femur, particularly in sites with T-score<-1,0 at baseline. Insulin levels and HOMA index worsened in the first year, but at the end no changes were noted on glucose, insulin, HOMA index and glycosylated hemoglobin. Two patients with altered glucose tolerance at baseline developed type 2 diabetes during follow-up. Total and LDL-cholesterol were significantly lower after therapy, with changes directly associated with baseline values. Cardiac parameters did not change. Side effects were mild and disappeared spontaneously. Tumor recurrence was not observed. Low compliance (estimated by low IGF-1 levels) was observed in 4 (22%), 2 (11%) and 6 (33%) patients at the end of second, third and fourth year, respectively. Four years of GH therapy in GHD adults had a positive impact on body composition, BMD and lipid profile, with no effects on insulin sensitivity and heart. Glucose tolerance should be monitored carefully during long-term GH therapy.
    Arquivos brasileiros de endocrinologia e metabologia 08/2008; 52(5):879-88. · 0.68 Impact Factor
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    ABSTRACT: We investigated the effects of disease activity on bone metabolism in 36 patients with systemic lupus erythematosus (SLE). Changes in bone remodeling were not explained by corticosteroid use. A high prevalence of 25OHD deficiency in SLE patients indicates the need for vitamin D replacement, mainly during high disease activity periods. We investigated the effects of SLE disease activity on bone metabolism, their relation to inflammatory cytokines and vitamin D levels. We performed a cross-sectional analysis of 36 SLE patients classified according to the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) in high activity (group I: 12 patients, mean age 29.6 years) or in minimal activity (group II: 24 patients, mean age 30.0 years), and compared them to normal controls (group III: 26 women, 32.8 years). Serum calcium, phosphorus, parathyroid and sex hormones, bone remodeling markers, interleukin (IL)-6, soluble IL-6 receptor (sIL-6R), IL-1, tumor necrosis factor-alpha (TNF), 25-hydroxivitamin D (25OHD), and 1,25-dihydroxyvitamin D3 were measured, plus bone mineral density. All cytokines were significantly higher in SLE groups; IL-6 could differentiate SLE patients from controls. In group I, 25OHD levels were lower (P < 0.05), which was related to the SLEDAI (R = -0.65, P < 0.001). In multiple regression analysis, the 25OHD level was associated with SLEDAI, osteocalcin and bone-specific alkaline phosphatase. The SLEDAI score was positively correlated with all measured cytokines and especially TNF (R = 0.75, P < 0.001). SLE patients demonstrated changes in bone remodeling strongly related to disease activity. A high prevalence of 25OHD deficiency was observed in SLE patients, indicating the need for vitamin D replacement.
    Osteoporosis International 07/2008; 20(3):427-33. · 4.04 Impact Factor
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    ABSTRACT: Patients with inflammatory bowel disease (IBD) are at risk of having vitamin D deficiency (25-OHD) and low bone mineral density (BMD). To measure 25OHD in a young group of IBD patients submitted to a clinical evaluation, routine biochemistry and BMD measurement (lumbar spine and proximal femur). 39 Crohn disease (CD) and 37 ulcerative colitis (UC) patients had lower serum levels of 25OHD compared to the control group (CD p = 0.003; UC p < 0.001), and 48.5% of the UC patients were 25OHD deficient. Lumbar spine BMD was lower in patients than controls (CD p = 0.001; UC p = 0.008). In CD patients, serum levels of 25OHD were significantly correlated with total femur (r = 0.391; p = 0.027) and femoral neck (r = 0.384; p = 0.03) BMD. It was found lower levels of 25OHD and BMD in young IBD patients compared to normal controls, suggesting an important role of 25OHD deficiency in the pathogenesis of the IBD bone disease.
    Arquivos brasileiros de endocrinologia e metabologia 06/2008; 52(4):684-91. · 0.68 Impact Factor

Publication Stats

239 Citations
27.10 Total Impact Points

Institutions

  • 2003–2014
    • Universidade Federal do Paraná
      • • Department of Clinical Medicine
      • • Hospital de Clínicas
      Pontal do Paraná, Paraná, Brazil
  • 2009
    • CEP America
      Emeryville, California, United States
  • 2005–2009
    • Universidade Federal de São Paulo
      • • School of Medicine
      • • Departamento de Patologia
      San Paulo, São Paulo, Brazil