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Percorrer por autor "Teles, Ana Elisa"

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  • Age-related decline in intestinal villus length : a cross-sectional study on the human gut
    Publication . Vara-Luiz, Francisco; Palma, Carolina; Mendes, Ivo; Piçarra, Francisco; Teles, Ana Elisa; Nogueira, Filipe; Costa-Santos, Inês; Nunes, Gonçalo; Patita, Marta; Mocanu, Irina; Pires, Sara; Meira, Tânia; Vieira, Ana; Pinto-Marques, Pedro; Mascarenhas, Paulo; Leskiv, Iryna; Gomes-Pinto, Daniel; Fonseca, Jorge
    Background/Objectives: There is widespread agreement that age is a significant predictor of impaired response to nutritional support. This is generally attributed to anabolic resistance, with impaired absorption considered irrelevant/non-existent. However, animal models demonstrate age-related structural changes in the intestinal mucosa that may reduce absorptive capacity. We aimed to evaluate potential histological changes in the duodenal mucosa associated with aging. Methods: We conducted a single-center observational cross-sectional study. Ambulatory younger (18–45 years) and older (≥70 years) adults referred for upper endoscopy were included and underwent duodenal biopsies. Those biopsies were analyzed and compared for histological/histomorphometric changes, including villus length. Clinical and laboratory data were also recorded. Results: One hundred patients were included (46 men/54 women), 50 aged 18–45 years and 50 aged ≥70 years. There were no duodenal endoscopic changes. The median villus length was 0.35 mm (IQR 0.32–0.41 mm) in older people, lower than in younger adults (0.57 mm; IQR 0.47–0.68 mm) (p < 0.001). In a multivariable regression model including age, sex, and Charlson comorbidity index, age remained inversely associated with villus length (p < 0.001). Older participants also exhibited lower hemoglobin, iron, folate, vitamin B12, albumin and vitamin D levels, despite normal inflammatory markers. Conclusions: Aging is associated with histological changes in the intestinal mucosa, including villus shortening. These findings support the concept of mucosal aging as a distinct biological process. Villus shortening may reflect reduced absorptive surface area and could contribute to age-related nutritional vulnerability, although its functional implications remain to be determined.
    2026-04Contributo em revista Acesso aberto Ver mais
  • Clinical, endoscopic and histologic differences in gastric mucosa between younger and older adults : an observational study on the aging stomach
    Publication . Vara-Luiz, Francisco; Mendes, Ivo; Palma, Carolina; Mascarenhas, Paulo; Teles, Ana Elisa; Santos, Inês Costa; Nunes, Gonçalo; Patita, Marta; Mocanu, Irina; Pires, Sara; Meira, Tânia; Vieira, Ana; Pinto-Marques, Pedro; Gomes-Pinto, Daniel; Fonseca, Jorge
    Background/Objectives: Age-related changes in the gastric mucosa remain incompletely understood. We aimed to assess and compare clinical, endoscopic and histologic changes in the gastric mucosa associated with aging, and to explore whether gastric aging is associated with a distinct histological pattern. Methods: Single-center observational study. Younger (18–45 years) and older (≥70 years) adults undergoing elective upper endoscopy were included and underwent gastric biopsies. The clinical, endoscopic and histologic features were analyzed and compared. Results: A total of 100 patients were included (45 men/55 women), 50 with 18–45 years and 50 with ≥70 years. Dyspepsia, gastro-esophageal reflux disease and peptic ulcer disease were the most common indications for upper endoscopy. Gastric lesions (erythema, erosions, ulceration and polyps) were more common in older patients (80% vs. 50%, p = 0.003), as well as histologic changes such as chronic gastritis (56% vs. 38%, p = 0.004), chronic atrophic gastritis (CAG; 28% vs. 4%, p < 0.001) and intestinal metaplasia (28% vs. 4%, p < 0.001). These findings persisted after adjusting for Helicobacter pylori (H. pylori) status and proton pump inhibitor intake on the multivariate analysis. Prevalence of H. pylori was similar between both groups (28% vs. 32%, p = 0.189). Conclusions: Aging is associated with clinical, endoscopic and histologic changes in the gastric mucosa including CAG and metaplasia, independent of the presence of H. pylori. These findings may result from several aging-related pathophysiological processes and decades of cumulative gastric injury and support the hypothesis of an aging stomach phenotype, underscoring the need for an age-adjusted interpretation of gastric biopsies.
    2025-10Contributo em revista Acesso aberto Ver mais