1. Department of Internal Medicine Escola Paulista de Medicina, Sao Paulo-SP, Brazil
2. University of Rio Grande, Rio Grande-RS; the Endocrine Service, Escola Paulista de Medicina, Sao Paulo-SP, Brazil
3. Hospital das Clinicas, University of Sao Paulo Medical School Sao Paulo-SP; and the Department of Preventive Medicine, Escola Paulista de Medicina, Sao Paulo-SP, Brazil