Poli Mara Spritzer

Universidade Federal do Rio Grande do Sul | UFRGS

Objective: The impact of gender-affirming hormone therapy (GAHT) on cardiovascular health is still not entirely established. A systematic review was conducted to summarize the evidence on the risk of subclinical atherosclerosis in transgender people receiving GAHT. Methods: A systematic review was performed following PRISMA guidelines, and data...

Objectives: The aim of this study was to explore body composition parameters and hormone levels as risk factors for low bone mass (osteopenia/osteoporosis) in postmenopausal women. Methods: We analyzed biorepository samples from 139 postmenopausal women with no clinical evidence of cardiovascular disease. Inclusion criteria were menopause occurr...

Emerging evidence suggests an association between FSH and bone mass in peri- and postmenopausal women. The aim of the present study was to assess body composition parameters and hormone levels as risk factors for low bone mass in women with recent menopause. In this cross-sectional study, we analyzed biorepository samples from 139 postmenopausal wo...

The process of gender transitioning includes the employment of gender-affirming hormone therapy (GAHT) to attenuate gender dysphoria. Although considered relatively safe, there is still debate whether GAHT may increase the risk of cardiovascular disease (CVD) in transgender men (TM). Non-conventional subclinical cardiovascular (CV) risk markers, su...

Introduction Obesity surgeries improve type 2 diabetes (T2D) in most cases, with effects frequently evident before substantial weight reduction. Therefore, this study hypothesizes that the increase in indolepropionic acid (IPA), a gut-derived tryptophan metabolite considered to be a potential biomarker for the development of T2D, might contribute t...

Polycystic ovary syndrome (PCOS) is a common endocrine disorder, affecting women of reproductive age and has been associated with metabolic and reproductive abnormalities. Evidence from different geographic regions indicates that the metabolic features of PCOS may be influenced by ethnicity, lifestyle and sociocultural backgrounds. Also, metabolic...

Introduction: The cognitive effects of cross-sex hormone therapy (CSHT) are not well understood. In cisgender individuals, sex hormone therapy can impact neurotransmitter levels and structural anatomy. Similarly, in gender-diverse persons, CSHT has been associated with neural adaptations, such as growth in brain structures resembling those observe...

Background: Suppressive levothyroxine therapy (sT4) is a cornerstone in the management of differentiated thyroid cancer (DTC). Long-term sT4 may affect bone mineral density (BMD). We evaluated the effect of sT4 on the bone mass of young DTC patients. Methods: In this cross-sectional study, BMD was evaluated via dual-energy X-ray absorptiometry in D...

Desenvolvido pelo Departamento de Endocrinologia Feminina, Andrologia e Transgeneridade (DEFAT) da Sociedade Brasileira de Endocrinologia e Metabologia (SBEM), este é um volume que em 31 capítulos traz desde conceitos básicos de anatomia e fisiologia até aspectos diagnósticos, éticos e terapêuticos das principais condições ligadas à incongruência d...

Hirsutism is defined as the presence of terminal hair with male pattern distribution in women. While in the general population, hirsutism affects around 4–11% of women, it is the main manifestation of hyperandrogenism in women with polycystic ovary syndrome (PCOS), with a prevalence estimated at 65–75%. Hirsutism in PCOS is associated with both and...

Introduction Systemic sclerosis (SSc) is a chronic disease characterized by autoimmunity, vasculopathy and fibrosis of several organs, such as skin, lungs, and heart. During the disease course, patients with SSc are prone to accumulating multiple organ damage and increasing their vulnerability to adverse outcomes. This increased vulnerability to ad...

Objectives: The present study aimed to evaluate the body composition of hepatic glycogen storage disorders (GSDs) through dual energy x-ray absorptiometry. Methods: This was an exploratory, observational, cross-sectional study. Twenty-four patients with GSD (type Ia: n = 13, Ib: n = 5, III: n = 2, and IX-α/β/γ: n = 4; female sex: n = 13; age <8...

Le syndrome des ovaires polykystiques (SOPK) est une endocrinopathie fréquente, affectant entre 8 et 13 % des femmes en âge de procréer. Elle se caractérise par une hyperandrogénie, une anovulation chronique, et une morphologie polykystique des ovaires. Les femmes qui en sont atteintes ont aussi une prévalence plus élevée d’obésité, de troubles mét...

Polycystic ovary syndrome, characterized by ovarian dysfunction and androgen excess, is a frequent and complex condition affecting women of reproductive age. Insulin resistance and central adiposity are often present, and women with PCOS are at higher risk for prediabetes and type 2 diabetes. Adipose tissue is regarded as an endocrine organ that sy...

Background It has been described that physiological changes in glucose metabolism, represented by insulin resistance (IR), are predicted during pubertal evolution, and obesity may be associated with its persistence even at the end of puberty. The aim of this study was to investigate the prevalence of IR in female adolescents with possible associate...

Background: Polycystic ovary syndrome (PCOS) is an endocrine disorder that commonly affects women of childbearing age and has been associated with metabolic and reproductive abnormalities. Only a few studies have investigated metabolic traits in women with PCOS in Latin America. Therefore, we conducted a systematic review to provide an overview of...

The association between bone mineral density (BMD) and hepatic glycogen storage diseases (GSDs) is still unclear. To evaluate the BMD of patients with GSD I, IIIa and IXα, a cross-sectional study was performed, including 23 patients (GSD Ia = 13, Ib = 5, IIIa = 2 and IXα = 3; median age = 11.9 years; IQ = 10.9–20.1) who underwent a dual-energy X-ra...

Background: Gender dysphoria is defined as a feeling of distress resulting from the incongruence between the sex assigned at birth and the gender identity, lasting longer than 6 months. In individuals with gender dysphoria, gender-affirming hormone therapy (GAHT) may improve quality of life (QoL). Objectives: We aimed to assess perceived QoL, to co...

Among the various aspects of health promotion and lifestyle adaptation to the postmenopausal period, nutritional habits are essential because they concern all women, can be modified, and impact both longevity and quality of life. In this narrative review, we discuss the current evidence on the association between dietary patterns and clinical endpo...

Brazil is a large country with rich cultural and ethnic diversity among its different regions. In this ongoing nationwide collaborative study, we are evaluating modifiable lifestyle factors, metabolic and reproductive abnormalities and prevalence of anxiety/depression in a less-well represented population of women with PCOS from Brazil. The design...

Postmenopausal status has been associated with an unfavorable phenotype tied to hormonal and metabolic changes, which collectively could contribute to an increased risk of cardiovascular disease. Vitamin D deficiency is frequent in postmenopausal women and may be linked to this phenotype and especially to an increased risk of developing hypertensio...

Background: Gender dysphoria is defined as a feeling of distress resulting from the incongruence between the gender assigned at birth and the identity gender and lasting longer than 6 months. In individuals with gender dysphoria, gender-affirming hormone therapy(GAHT) may improve quality of life (QoL). Objectives: Here, we aimed to assess perceived...

Objectives To assess the vitamin D levels, prevalence of vitamin D deficiency and genotypes of Fok-I, Bsm-I, Apa-I and Taq-I polymorphisms in the VDR gene and to determine whether vitamin D deficiency and VDR gene variants are associated with blood pressure levels and systemic arterial hypertension as defined by the 2017 ACC/AHA criteria. Study de...

Objective: This study aims to compare the acoustic vocal analysis results of a group of transgender women relative to those of cisgender women. Methods: Thirty transgender women between the ages of 19 and 52 years old participated in the study. The control group was composed of 31 cisgender women between the ages of 20 and 48 years old. A standardi...

This study aimed to investigate the association of perceived stress and salivary cortisol levels with the snack and fast-food dietary pattern in a sample of women shift workers. We conducted a cross-sectional study of 539 women aged 18-53 years working in the production line of a poultry processing plant. Stress was assessed with the 10-item Percei...

Background Polycystic ovary syndrome (PCOS) is a common endocrine disease affecting women of reproductive age and associated with reproductive and metabolic dysfunction. Few studies are available regarding metabolic traits in Brazilian women with PCOS. The aim of this systematic review and meta-analysis was to summarize the available evidence regar...

Objective: To investigate whether increasing protein consumption to twice the recommended daily allowance (RDA) by The Institute of Medicine affects lean body mass (LBM), muscle strength, and physical performance in late postmenopausal women. Methods: Parallel-group randomized trial with 26 apparently healthy women aged ≥ 65 years. Participants...

The effects of gluteal implants on bone mass remain unclear. Transgender women with ILS presented higher BMD in the hip compared with transgender women without implants, while no difference was observed in other sites. These results may be artifactual and suggest using spine/forearm sites for DXA in individuals with ILS. Purpose: The inappropriat...

Background: Cardiovascular disease is the leading cause of death in postmenopausal women, and inflammation is a key mechanism involved in the pathogenesis of atherosclerosis. High-sensitivity C-reactive protein (hs-CRP) has been used as a biomarker of inflammation. Considering that CRP gene rs1205 polymorphism has been associated with hs-CRP circu...

Background Rheumatoid arthritis (RA) is an inflammatory disease that leads to altered body composition. The loss of lean mass with a preservation or increase in fat mass has been termed rheumatoid cachexia (RC), to contrast with classic cachexia, which is characterized by severe weight loss. There are limited data on the prevalence and progression...

Congenital adrenal hyperplasia (CAH), an autosomal recessive disease, is characterized by impairment of metabolic cortisol synthesis, with or without insufficient aldosterone production. It is caused by mutations in the CYP21A2 gene in approximately 90% of all cases, leading to 21-hydroxylase deficiency and androgen precursors elevation. The main d...

Estrogen deficiency is classically associated with bone loss in both men and women. In transgender women, after being submitted to gender-affirming surgery (GAS), the main goal of hormone therapy (HT) is to maintain the female phenotype and prevent the consequences of the orchiectomy-related hypogonadal state. The aim of this study was to evaluate...

Introduction. PCOS is a frequent endocrine disease and its clinical expression may be influenced by ethnicity and sociocultural backgrounds. Despite its high prevalence, few studies are available regarding clinical characteristics of Brazilian women with PCOS. The aim of this study was to summarize the available evidence regarding metabolic risks i...

Objective To analyze the association between age at menarche and variables of body composition in girls from the Northern region of Brazil, the Brazilian Legal Amazon. Method The sample was composed of 926 school girls, aged between 8 and 18 years, divided into two groups, those who had (G1; n = 727; 72.5%) and had not undergone menarche (G2; n =...

Metformin may decrease cell senescence, including bone; hence we aimed at evaluating the association between metformin use and osteoporosis. This was a cross-sectional study carried out in 1259 Latin American adult women aged 40 or more who were not on anti-osteoporotic drugs, were on metformin and had a bone densitometry performed. Of the whole sa...

Vitamin D deficiency is highly prevalent worldwide, and vitamin D-binding protein (DBP) a major regulator of serum vitamin D levels. The rs4588 and rs7041 polymorphisms of the GC gene constitute the genetic basis of the three major isoforms of circulating DBP (GC1s, GC1f, and GC2), while the rs2282679 variant is located in an important regulatory r...

Introduction Brazil is a large country, with a population of mixed ethnic background and broad variation in dietary and physical activity traits across its five main regions. Because data on Brazilian women with polycystic ovary syndrome (PCOS) are still scarce, a nation-wide collaborative study was designed to determine the prevalence of metabolic...

For transgender individuals, gender-affirming surgery (GAS) and cross-sex hormone therapy (CSHT) are part of the gender transition process. Scientific evidence supporting the maintenance of CSHT after GAS-related gonadectomy is accumulating. However, few data are available with respect to the impact of CSHT on brain structure following hypogonadism...

An extreme incongruence between sex and gender identity leads individuals with gender dysphoria (GD) to seek cross-sex hormone therapy (CSHT), and gender-affirming surgery (GAS). Although few studies have investigated the effects of CSHT on the brain prior to GAS, no studies in the extant literature have evaluated its impact during hypogonadism in...

Background: Menopause has been associated with an increased risk of cardiovascular disease. It has been shown that isoflavones protect vascular endothelial cells against induced oxidative stress injury. Therefore, the present study aimed to investigate the association between the dietary intake of isoflavones and the presence of subclinical cardio...

Objective: To summarize current evidence regarding testosterone treatment for women with low sexual desire. Materials and methods: The Female Endocrinology and Andrology Department of the Brazilian Society of Endocrinology and Metabolism invited nine experts to review the physiology of testosterone secretion and the use, misuse, and side effects...

Síndrome de Ovários Policísticos Portaria SAS/MS nº 6 - 02/07/2019

Objective To describe the results obtained in a neonatal screening program after its implementation and to assess the clinical and molecular profiles of confirmed and suspicious congenital adrenal hyperplasia cases. Methods A cross-sectional study was conducted. Newborns with suspected disease due to high 17-hydroxyprogesterone levels and adjusted...

The aim of this study was to investigate the association between individual risk factors and coronary artery calcification (CAC), as a marker of subclinical cardiovascular disease, in a population-based nested cross-sectional study of midlife women. Anthropometric and metabolic data from 295 women from the South of Brazil were analyzed. Habitual ph...

Low bone mineral density (BMD) and changes of bone quality are common in postmenopausal women with osteoporosis. Among the factors related to bone loss are the estrogen decrease, aging and alteration of body composition. The aim of this cross-sectional study, nested to the Passo Fundo cohort study¹, was to investigate risk factors associated with B...

In transgender men (FtM), testosterone therapy may induce changes in different body compartments. The aim of this study was to evaluate body fat and muscle mass, visceral adipose tissue and bone mineral density in FtM transgender individuals receiving cross-sex hormone therapy (CSHT). Sixty two FtM were included in the protocol and performed labora...

Vitamin D binding protein (DBP) is one of regulators of vitamin D serum levels. rs4588 and rs7041 polymorphisms of the DBP gene constitute the genetic basis of the three major isoforms of circulating DBP, called GC1s, GC1f and GC2. We evaluated the association between the rs4588, rs7041, rs2282679 SNPs and of DBP isoforms with DBP and 25(OH)D serum...

The profound incongruence between sex and gender identity leads transgender individuals to seek cross-sex hormone therapy (CSHT) and gender affirming surgery (GAS). After GAS, a transient period of hypogonadism is established. Literature suggests that sex hormones exert important effects on the brain during physiologic development and aging. Also,...

Context The impact of long-term cross-hormone therapy (CSHT) in transgender men and women is still uncertain. Objective To perform a systematic review and metanalysis and update the evidence regarding the effects of CSHT on bone mass density (BMD) in transgender men and women. Data sources MEDLINE, Cochrane Central Register of Controlled Trials,...

Objective To assess the association of insulin resistance markers, body mass index (BMI), age, and androgen levels with systemic arterial hypertension (SAH) defined according to 2017 American College of Cardiology/American Heart Association (ACC/AHA) criteria in polycystic ovary syndrome (PCOS); and to determine the risk of metabolic abnormalities...

Purpose: This study aimed to investigate the association between the Mediterranean diet (MD), body composition, and bone mineral density (BMD) in postmenopausal women. Methods: In this cross-sectional study, 105 apparently healthy postmenopausal women aged between 45 and 65 years were included. BMD, percentage body fat, and appendicular lean mass i...

A Comissão Nacional de Ginecologia Endócrina da Febrasgo (...) não reconhece a prescrição de terapias antiaging ou outras quaisquer que não se embasem na literatura. Dessa forma, concorda plenamente com a decisão do Judiciário e preza pela consciência ética que protege a boa prática da aventura, assegurando às pessoas, ao menos na esfera normativa,...

Objective: To analyze the association between age at menarche and variables of body composition in girls from the Northern region of Brazil, the Brazilian Legal Amazon. Method: The sample was composed of 926 school girls, aged between 8 and 18 years, divided into two groups, those who had (G1; n=727; 72.5%) and had not undergone menarche (G2; n=...

Polycystic ovary syndrome (PCOS) is the most prevalent endocrine disorder affecting women of reproductive age. PCOS has been associated with distinct metabolic and cardiovascular diseases and with autoimmune conditions, predominantly autoimmune thyroid disease (AITD). AITD has been reported in 18-40% of PCOS women, depending on PCOS diagnostic crit...

Study Question What is the recommended assessment and management of women with polycystic ovary syndrome (PCOS), based on the best available evidence, clinical expertise, and consumer preference? Summary Answer International evidence‐based guidelines including 166 recommendations and practice points, addressed prioritized questions to promote cons...

Study question: What is the recommended assessment and management of women with polycystic ovary syndrome (PCOS), based on the best available evidence, clinical expertise and consumer preference? Summary answer: International evidence-based guidelines, including 166 recommendations and practice points, addressed prioritized questions to promote...

Guanosine (GUO) has neuroprotective effects in experimental models of brain diseases involving glutamatergic excitotoxicity in male animals; however, its effects in female animals are poorly understood. Thus, we investigated the influence of gender and GUO treatment in adult male and female Wistar rats submitted to focal permanent cerebral ischemia...

Study question: What is the recommended assessment and management of women with polycystic ovary syndrome (PCOS), based on the best available evidence, clinical expertise, and consumer preference? Summary answer: International evidence-based guidelines including 166 recommendations and practice points, addressed prioritized questions to promote...

Introduction: Hormone therapy (HT) is an effective treatment for climacteric symptoms. Nevertheless, combined estrogen-progestin therapy and the oral route seem to entail higher risk of venous thromboembolism (VTE) than estrogen-only therapy and transdermal administration. The present study aimed to investigate the risk of thromboembolic events in...

Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder determined by polygenic traits as well as environmental factors. Lower vitamin D levels have been detected in PCOS women and related to hormone and metabolic disturbances. Vitamin D acts in tissues through the vitamin D receptor (VDR). VDR gene variants have been associate...

Objective Cross‐sex hormone therapy (CSHT) has been associated with changes in bone and lean/fat mass. This study assessed BMD, appendicular lean mass (ALM), and total fat mass in transwomen undergoing CSHT. Patients and Design We evaluated 142 transwomen (mean age: 33.7±10.3 years; BMI: 25.4±4.6; 86.6% with previous CSHT) during the first three m...

Objective: To describe the results obtained in a neonatal screening program after its implementation and to assess the clinical and molecular profiles of confirmed and suspicious congenital adrenal hyperplasia cases. Methods: A cross-sectional study was conducted. Newborns with suspected disease due to high 17-hydroxyprogesterone levels and adju...

Potential relationship of vitamin D, vitamin D receptor (VDR), and vitamin D binding protein (DBP) have been suggested in the pathophysiology of hepatitis C virus (HCV) infection. The aim of this observational study is to determine vitamin D levels, and VDR and DBP genetic polymorphism according demographic and laboratory data in chronic HCV patien...

Background/aims: There is a heightened risk for cardiovascular diseases in women with polycystic ovary syndrome (PCOS). Alterations in heart rate variability (HRV) may reflect subclinical cardiovascular disease, with a putative association between HRV and dietary fat. This study evaluated HRV in PCOS and control women based on the dietary intake o...

Introduction: Gender dysphoria (GD) (DMS-5) is a condition marked by increasing psychological suffering that accompanies the incongruence between one's experienced or expressed gender and one's assigned gender. Manifestation of GD can be seen early on during childhood and adolescence. During this period, the development of undesirable sexual charac...

Background: We describe body composition, lipid metabolism and Stearoyl-CoA desaturase-1 (SCD-1) indices in patients with classical homocystinuria (HCU). Methods: Eleven treated HCU patients and 16 healthy controls were included. Body composition and bone mineral density were assessed by dual X-ray absorptiometry. Sulfur-containing amino acids (...

Current data are inconsistent regarding the association between interleukin-6 (IL-6), a marker of acute phase inflammation, and pelvic endometriosis. The aim of the present study was to assess IL-6 levels in serum and peritoneal fluid (PF), as well as IL-6 gene expression in adipose tissue (AT) and endometrial samples in pelvic endometriosis. A tot...