Márcia Regina Simas Torres Klein

• PhD
• Professor at Rio de Janeiro State University

Coffee is a complex brew that contains several bioactive compounds and some of them can influence blood pressure (BP) and endothelial function (EF), such as caffeine and chlorogenic acids (CGAs). This study aimed to evaluate the acute effects of coffee on BP and EF in individuals with hypertension on drug treatment who were habitual coffee consumer...

Background & aims: Recent evidence suggests that moderate coffee intake is associated with multiple health benefits, including lower risk of obesity, sarcopenia and cardiovascular disease (CVD) in the general population. However, to date, no study has evaluated these associations in kidney transplant recipients (KTR). The aim of the present study...

Introduction: Obstructive Sleep Apnea (OSA) is a chronic disorder associated with several risk factors, and increased Body Mass Index (BMI) and waist circumference are correlated with it is severity. Aim: To evaluate vascular function, central hemodynamics, and autonomic modulation in obese individuals with moderate and severe OSA. Methods: In...

Obesity is a complex chronic metabolic disease that impairs health and reduces lifespan. Therefore, effective strategies for the prevention and treatment of obesity are necessary. Although several studies have demonstrated that gut dysbiosis is associated with obesity it, remains controversial whether the altered gut microbiota is a risk factor for...

Obstructive sleep apnea (OSA) is known to be an independent cardiovascular risk factor. The presence of OSA and obesity may have synergistic effects on the progression of cardiovascular disease. To evaluate the effect of weight loss on vascular disease in obese patients with moderate or severe OSA. Individuals of both sexes, aged 40 to 70 years, bo...

Introduction: The American Heart Association updated the original recommendations for cardiovascular health (CVH) promotion, defining the Life's Essential 8 (L8). Aim: the aim of this cross-sectional study was to compare vascular function, central hemodynamics and autonomic modulation in obese individuals with low and moderate CVH-L8. Methods:...

Background & aims The effects of calorie restriction and physical activity on autonomic regulation and cardiac vagal control in overweight and obese individuals remain inconsistent. Thus, this systematic review aimed to evaluate the weight loss effects through lifestyle changes on heart rate variability (HRV) markers in overweight and obese subject...

Purpose of review: This review summarizes literature from the last 18 months reporting on sarcopenia (or its components) in chronic kidney disease (CKD). Recent findings: The prevalence of sarcopenia in CKD is reported to be 5-62.5%, with higher rates observed later in the disease. Sarcopenic obesity rates are reported to be 2-23%. Sarcopenia in...

Objective: To achieve and maintain normal serum potassium and phosphorus levels reducing potassium and phosphorus intake is frequently recommended for adults living with chronic kidney disease (CKD). Exploring food preparation methods to reduce potassium and phosphorus content appears warranted. The study aim was to determine the impact of soaking...

Introduction Chronic kidney disease (CKD) is associated with a reduction in bone mineral density (BMD), but less is understood regarding the relation between BMD and muscle mass, especially in non-dialysis dependent-CKD (NDD-CKD). The aim of this study was to explore the prevalence and association of low BMD (osteopenia and osteoporosis) with marke...

Background & Aims Evidence suggests that gut microbiota is a potential factor in the pathophysiology of both obesity and related metabolic disorders. While individual randomized controlled trials (RCTs) have evaluated the effects of probiotics on adiposity and cardiovascular disease (CVD) risk factors in subjects with overweight and obesity, the re...

Objectives Cardiovascular (CV) mortality is higher in male compared to female patients with chronic kidney disease (CKD), but biological mechanisms for sex-specific differences are not established. Inflammation and high body fat are both associated with the development of CKD and CV diseases. Yet, little is known about the relationship between sex,...

Objectives Abnormal bone mineral density (BMD) is common in chronic kidney disease (CKD) and related with higher risk of disease progression, cardiovascular disease, and mortality. The aim of this study was to assess BMD, its change overtime and association with body composition and biochemical parameters of mineraly metabolism. Methods This was a...

Background: To analyze the results regarding weight loss and complications related to the Spatz3® adjustable intragastric balloon (IGB) in Brazil. Methods: This randomized prospective study covered patients who had undergone treatment using a Spatz3® adjustable IGB between October 2016 and June 2018 at a private clinic in Rio de Janeiro, Brazil....

Background: Endoscopic methods, especially the intragastric balloon (IGB), have been shown to be effective for the treatment of excess weight. This study aimed to assess the tolerance, complications, and efficacy of excess weight treatment with a non-adjustable IGB during 6 months. Methods: A total of 5874 patients treated with a liquid-filled I...

AHEAD OF PRINT

Introduction: Excessive adipose tissue is associated with adverse metabolic effects and is an important risk factor for chronic diseases. According to the American Heart Association, most cardiovascular events can be prevented by adhering to healthy practices, reflecting cardiovascular health as poor, intermediate, and good. Objective: To evaluate...

Introduction: Hypertension often clusters with other cardiovascular risk factors such as obesity, dyslipidemia and glucose intolerance. Weight loss can decrease Blood Pressure (BP) and improve cardiometabolic abnormalities. There is evidence that hypertension and obesity are associated with alterations in gut microbiome. Recent studies evaluating t...

Background & Aims Bioelectrical impedance analysis (BIA) and anthropometric predictive equations have been proposed to estimate whole-body (SMM) and appendicular skeletal muscle mass (ASM) as surrogate for dual energy X-ray absorptiometry (DXA) in distinct population groups. However, their accuracy in estimating body composition in non-dialysis dep...

Introduction The effects of magnesium (Mg) supplementation on vascular function have been evaluated in some randomized controlled trials (RCT) but their results are conflicting. Aim A systematic review and meta-analysis were conducted to summarize the effects of oral Mg supplementation on vascular function in RCT. Methods The databases MEDLINE (P...

Sarcopenia is a progressive and generalized skeletal muscle disorder, associated with adverse outcomes. Aging causes primary sarcopenia, while secondary causes include chronic kidney disease (CKD), long-term use of glucocorticoids and obesity. The aim of this study was to evaluate: the prevalence of sarcopenia using guidelines recommended by The Eu...

Background Obesity is accompanied by adipose tissue remodeling characterized by increased production of tumor necrosis factor-alpha (TNF-α), interleukin (IL)-6, leptin and resistin and reduced secretion of adiponectin, which favors inflammation, metabolic disorders, and cardiovascular diseases. Although intragastric balloon (IGB) can be considered...

Obesity is associated with increased risk of cardiovascular disease (CVD). Body mass index (BMI) is the most used parameter for obesity screening. However, the evaluation of CVD risk in overweight individuals should include the assessment of body fat distribution and body composition. Renal transplant recipients (RTR) have a high CVD risk and frequ...

The aim of the present study was to evaluate the prevalence of vitamin B12 (B12) deficiency in kidney transplant recipients (KTR), and its possible association with B12 dietary intake, body adiposity, and immunosuppressive drugs. In this cross-sectional study were included 225 KTR, aged 47.50±12.11years, and 125 (56%) were men. Serum levels of B12...

Background: High body adiposity, inflammatory cytokines, insulin resistance (IR), and the endothelial markers-soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular adhesion molecule-1 (sVCAM-1)-are among cardiovascular risk factors observed in chronic kidney disease (CKD). Synergistic interaction of inflammatory cytokines with a...

Background Obesity is an important risk factor for several chronic diseases and also is associated with worse quality of life. Intragastric balloon (IGB) is an effective method for weight loss. Although changes in lifestyle are critical to weight loss during and after IGB therapy, only a few studies evaluated dietary intake and none evaluated chang...

Background: Observational studies have highlighted an association between serum uric acid (SUA) levels and cardiovascular risk factors. Despite the growing body of evidences, several studies were conducted in older individuals or in carriers of diseases susceptible to affect SUA levels and cardiometabolic risk markers. Objective: To evaluate the...

Objectives: Obstructive sleep apnea (OSA) is a risk factor for cardiovascular disease (CVD), the main cause of mortality in chronic kidney disease (CKD). Although the prevalence of OSA in patients with CKD has not been established, a few studies suggest that it is higher than in the general population, potentially increasing the risk for CVD. Obes...

Phytosterols are bioactive compounds found in foods of plant origin, which can be divided into plant sterols and plant stanols. Clinical studies consistently indicate that the intake of phytosterols (2 g/day) is associated with a significant reduction (8-10%) in levels of low-density lipoprotein cholesterol (LDL-cholesterol). Thus, several guidelin...

Background: Several studies conducted in adults suggest that intragastric balloon (IGB) is an effective and safe method for weight loss. Although the prevalence of obesity in adolescents has increased in recent years, the outcomes of IGB treatment in this age group are not known. The aim of this study was to evaluate the safety and efficacy of IGB...

Non-fasting hypertriacylglycerolaemia is a risk factor for CVD and the amount of fat in a meal seems to be the main factor influencing postprandial lipaemia. Although several studies suggest that Ca can increase faecal fat excretion, it is not known whether Ca can decrease postprandial TAG. This study aimed to evaluate the influence of dietary Ca (...

Recent evidence suggests that vitamin D deficiency is associated with CVD, impaired kidney function and proteinuria. To date, no study has evaluated these associations in renal transplant recipients (RTR) adjusting for body adiposity assessed by a ‘gold standard’ method. This study aimed to evaluate the vitamin D status and its association with bod...

Background: Green tea consumption has been inversely associated with cardiovascular disease (CVD) in epidemiological studies. Although some interventional trials suggest that green tea has beneficial effects on CVD risk factors, such as hypertension and obesity, others have failed to show such benefits. Aims: To evaluate the short-term effects of g...

Recent studies suggest that supplemental Ca (SC) increases the risk of cardiovascular events, whereas dietary Ca (DC) decreases the risk of cardiovascular events. Although frequently consumed with meals, it remains unclear whether Ca can mitigate or aggravate the deleterious effects of a high-fat meal on cardiovascular risk factors. This study aime...

Objectives: The association of vitamin D status with high body adiposity is poorly investigated in the chronic kidney disease (CKD) population. The aim of the present study was to describe vitamin D status and to identify body adiposity predictors of vitamin D deficiency, in a nondialyzed CKD population inhabiting a tropical city. Methods: This...

Nutritional intervention for weight loss is one of the treatment options for obstructive sleep apnoea (OSA) in patients with overweight or obesity. However, the effects of moderate energy restriction on OSA severity are not yet known. The present study aimed to evaluate the effects of moderate energy restriction on OSA severity and CVD risk factors...

Abstract Objective Obstructive sleep apnea (OSA) is associated with an increased risk of cardiovascular disease (CVD). Several of the proposed mechanisms for the development of CVD in OSA are similar to those proposed for the increased risk of CVD in obesity, being difficult to determine the influence of OSA on these pathogenic mechanisms in obese...

Evidências consistentes indicam forte associação entre hiperuricemia e desenvolvimento de doenças cardiovasculares, destacando o ácido úrico como fator independente de risco cardiovascular. Entretanto, os mecanismos envolvidos nessa associação não estão totalmente elucidados. Objetivo: Avaliar a relação dos níveis séricos de ácido úrico com ingestã...

Evidências consistentes indicam forte associação entre hiperuricemia e desenvolvimento de doenças cardiovasculares, destacando o ácido úrico como fator independente de risco cardiovascular. Entretanto, os mecanismos envolvidos nessa associação não estão totalmente elucidados. Objetivo: Avaliar a relação dos níveis séricos de ácido úrico com ingestã...

Background: There is evidence that vitamin D deficiency is associated with increased risk of cardiovascular disease. However, it is not known if this association is independent of dietary calcium, intracellular calcium and serum levels of parathormone, calcitriol and calcium. Objectives: To investigate the independent relationship of vitamin D d...

Background: There is evidence that vitamin D deficiency is associated with increased risk of cardiovascular disease. However, it is not known if this association is independent of dietary calcium, intracellular calcium and serum levels of parathormone, calcitriol and calcium. Objectives: To investigate the independent relationship of vitamin D defi...

Objective: Chronic kidney disease (CKD) is associated with metabolic disorders, including insulin resistance (IR), mainly when associated with obesity and characterized by high abdominal adiposity (AbAd). Anthropometric measures are recommended for assessing AbAd in clinical settings, but their accuracies need to be evaluated. The aim of this stud...

Background: Recent evidence suggests that vitamin D deficiency is associated with an increased risk of cardiovascular morbidity and mortality. However, the relationship between vitamin D deficiency and cardiovascular disease risk factors has not been established. Objectives: To investigate the prevalence of vitamin D deficiency and its association...

Background: Obstructive sleep apnea (OSA) is considered an independent risk factor for cardiovascular disease and reported as the most common secondary cause of high blood pressure (BP) maintenance. Objective: To determine the prevalence of OSA and verify its association with endothelial function behavior and anthropometric parameters in patients w...

Background: Cardiovascular diseases are the leading cause of mortality in Western countries. Some studies have suggested that green tea has beneficial effects on different cardiovascular risk factors. However, others have failed to show such an association. Objective: To evaluate the effects of green tea on blood pressure, endothelial function, met...

Introdução: A combinação de exercícios de força e aeróbio numa mesma sessão de treino é conhecida como exercício concorrente e pode promover reduções nos níveis da pressão arterial logo após o término da sessão em normotensos e hipertensos, fenômeno conhecido como hipotensão pós-exercício (HPE). Os mecanismos envolvidos na HPE em diferentes interve...

The aim of this study was to evaluate high body adiposity and cardiovascular disease (CVD) risk factors prevalence, in renal transplant recipients (RTR), comparing men with women. In this retrospective cross-sectional study, 102 patients (55 men) who were 49 ± 1.2 y and 114.3 ± 9 mo post-transplant (post-tx) were evaluated. Pretransplant (pre-tx) p...

High body fat (BF) is an alarming condition that also affects nondialyzed chronic kidney disease (CKD) patients. Distinct methods are used to evaluate BF; however, in CKD population it remains unclear which one is more reliable showing high accuracy. Dual-energy X-ray absorptiometry (DXA), used as reference method to estimate adiposity, is expensiv...

Recent studies have suggested that dietary Ca may have beneficial effects on adiposity, insulin resistance, dyslipidaemia and blood pressure (BP). One potential mechanism underlying these benefits involves modifications in intracellular Ca concentration ([Ca2+]i). The present study aimed to evaluate the associations of dietary Ca with adiposity, er...

Background. Hypertension and excess body weight are important risk factors for endothelial dysfunction. Recent evidence suggests that high-polyphenol dark chocolate improves endothelial function and lowers blood pressure. This study aimed to evaluate the association of chocolate 70% cocoa intake with metabolic profile, oxidative stress, inflammatio...

Objective: Obesity is characterized by chronic subclinical inflammation, which is critical to endothelial dysfunction. Weight loss, induced by lifestyle interventions, is associated with a decline in biomarkers of inflammation and endothelial dysfunction. There is little evidence that high dietary calcium intake may reduce inflammation and improve...

Background: Recent studies suggest that dietary calcium may have beneficial effects on adiposity, insulin resistance, dyslipidemia and blood pressure (BP). One potential mechanism underlying these benefits involves modifications in intracellular calcium concentration ([Ca ²⁺ ]i). Objectives: To evaluate the associations of dietary calcium with adip...

Objective: To evaluate the behavior of BP and endothelial function after spironolactone or clonidine, associated with optimized antihypertensive treatment in patients with resistant hypertension (PRH). Methods: Prospective and randomized study, visits every 4 weeks. VISIT (V) 0: Inclusion of patients with BP>160/100mmHg and <220mmHg. They receive c...

Background: Obstructive sleep apnea (OSA) is considered an independent risk factor for cardiovascular disease. There is evidence that individuals with OSA may have increased levels of inflammatory mediators, altered metabolic profile and endothelial dysfunction. Objective: To evaluate the relation of OSA with endothelial function, anthropometric pa...

Dietary intervention is an important approach in the prevention of cardiovascular disease. Over the last decade, some studies have suggested that a calcium-rich diet could help to control body weight, with anti-obesity effects. The potential mechanism underlying the impact of calcium on body fat has been investigated, but it is not fully understood...

This study aimed to evaluate long-term weight loss in overweight hypertensive patients receiving dietary counseling. Longitudinal study included overweight hypertensive patients who had an initial individual consultation with a nutritionist between January 2002 and December 2005 and were followed for four years in a hypertension clinic. Patients wh...

This aim of this study was to evaluate the association between dietary calcium and variables that include body mass index, abdominal obesity, metabolic profile, and blood pressure levels in renal transplant patients. A cross-sectional study was conducted. Eligible patients were recruited from renal transplant outpatient clinics at Pedro Ernesto Uni...

The method capable of best identifying protein-energy wasting (PEW) in hemodialysis (HD) patients is controversial. Thus, we assessed the nutritional status of HD patients by use of different methods and verified which one identified the highest number of patients with PEW. The study assessed the nutritional status of 15 HD patients (age: 52.7 ± 10...

An inverse relation between dietary calcium and adiposity has been found in several epidemiologic studies. Recent evidence has also suggested that a calcium-rich diet may have beneficial effects on insulin resistance and dyslipidemia. This study aimed to evaluate the association of dietary calcium intake with global adiposity, abdominal obesity, an...

Clinical trials designed to examine the effects of calcium supplementation on abdominal obesity have had ambiguous results. This study aimed to evaluate, during energy restriction, the effects of a high-calcium diet (HCD) on measures of abdominal obesity and cardiometabolic risk factors in Brazilian obese subjects of multiethnic origin. We conducte...

Recent evidence has suggested obesity as an independent risk factor for chronic kidney disease. However, the temporal relation between body mass index (BMI) and early renal dysfunction is unknown. This study aimed at evaluating whether longitudinal variations in BMI would reflect on changes in estimated glomerular filtration rate (GFR) in hypertens...

Obesity may be a risk factor for renal graft loss. The purpose of this study was to assess weight gain and its association with glomerular filtration rate after kidney transplant. This retrospective analysis of 152 adult renal transplant outpatients (77 males, 75 females; mean age, 45.6 +/- 10.1 years) with at least 6 months posttransplantation (po...

Cardiovascular disease (CVD) is the major cause of death in renal transplant recipients. The aim of this study was to assess the prevalence of CVD risk factors among Brazilian adult renal transplant recipients. This cross-sectional study included 192 cases in which the evaluated CVD risk factors were hypertension, diabetes mellitus, impaired fastin...

Recent clinical evidence suggests that calcium-rich diets help reduce body weight and abdominal obesity; increase insulin sensitivity; enhance lipid profile; modulate blood pressure and reduces the inflammatory state associated with obesity. The Objective: evaluate the effects of dietary calcium during energy restriction on weight loss, body fat, a...