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Di Serio F, Giustino A, Calamita C, Savoia G, Lovero R, Mascolo E, Buttiglione M, Finelli C, Zambetta G, De Salvia MA. Acute alcohol intoxication across different age groups in 2014-2018: Prehospital care and biochemical correlates at a large University Hospital in southern Italy. Int Emerg Nurs 2022; 60:101113. [PMID: 34942538 DOI: 10.1016/j.ienj.2021.101113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 10/29/2021] [Accepted: 11/10/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Risky alcohol consumption can occur from a young age and affects people of all age groups, sometimes requiring the intervention of the emergency medical services. OBJECTIVES Determining the timing and characteristics of emergency calls (to the "118" emergency number) relating to subjects in all age groups, in which alcohol was a contributing factor, along with the biochemical correlates, in a great metropolitan area. On the basis of these, future interventions would target specific training for nurses and paramedics working in emergency medical services. METHOD An observational single-centre retrospective study carried out from 1 January 2014 to 31 December 2018 involving patients requiring emergency care and attending the Emergency Department of an University Hospital. RESULTS Out of a total of 47,252 emergency calls, 2.22% were for alcohol-related conditions and mainly involved male patients (78.4%). A high incidence of alcoholic coma was found in patients aged 11 to 17 years. Emergency medical assistance was required mainly at night on weekdays by patients aged 11-17, 25-44 years and during the weekend and on weekdays by patients aged 18-24 years. A blood alcohol concentration higher than 50 mg/dL was found in more than 67% of patients aged 11-17 and 18-24 years at weekends. CONCLUSIONS The most alarming finding from our data is that, despite prevention policies, young people requiring emergency medical assistance showed similar alcohol levels as adults and a high incidence of alcoholic coma.
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Affiliation(s)
- Francesca Di Serio
- Clinical Pathology Unit, AOU Policlinico Consorziale di Bari-Ospedale Giovanni XXIII, Bari, Italy
| | - Arcangela Giustino
- Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - Cesare Calamita
- Operations Centre of Emergency Services (118) - Policlinico Hospital, Bari, Italy
| | - Giovanni Savoia
- Operations Centre of Emergency Services (118) - Policlinico Hospital, Bari, Italy
| | - Roberto Lovero
- Clinical Pathology Unit, AOU Policlinico Consorziale di Bari-Ospedale Giovanni XXIII, Bari, Italy
| | - Elisa Mascolo
- Clinical Pathology Unit, AOU Policlinico Consorziale di Bari-Ospedale Giovanni XXIII, Bari, Italy
| | - Maura Buttiglione
- Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - Carmine Finelli
- Department of Internal Medicine, Hospital "Cavalier Raffaele Apicella"-ASL Naples 3 Sud, Pollena (Napoli), Italy
| | - Giovanni Zambetta
- Forensic Medicine, Hospital "Miulli", Acquaviva delle Fonti (Bari), Italy
| | - Maria A De Salvia
- Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy.
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2
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Finelli C. Metabolic Syndrome, Alzheimer's Disease, and Covid 19: A Possible Correlation. Curr Alzheimer Res 2021; 18:915-924. [PMID: 34886772 DOI: 10.2174/1567205018666211209095652] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 11/05/2021] [Accepted: 11/18/2021] [Indexed: 02/07/2023]
Abstract
Age and comorbidities are key indicators of hospital admission, serious illness, and mortality in COVID-19 patients. Patients with age-related comorbidities, such as cardiovascular disease, hypertension, diabetes, chronic kidney disease, NAFLD, obesity, and metabolic syndrome, are more likely to require hospitalization and suffer severe sickness of COVID-19. Patients with Alzheimer's disease and risk factors associated with dementia may also be more vulnerable to serious COVID-19 infection. Peripheral inflammation, including in patients who recover from illness, may promote the course of neurodegenerative disorders through neuroinflammatory pathways. The aim of this study is to examine the impact of COVID-19 on immunity in patients with age-related diseases such as metabolic syndrome and Alzheimer's disease and also to hypothesize the possible correlation between metabolic syndrome, Alzheimer's disease, and COVID-19. Identifying the mechanisms that explain the complicated interaction between metabolic syndrome, Alzheimer's disease, COVID-19, inflammation, and immunity could be crucial to designing effective pharmacological therapies and procedures. This study adds to our basic information about the new coronavirus by synthesizing current knowledge of these linkages. To reduce inflammation and enhance immunity, patients should acquire good lifestyle practices. Walking, breathing exercises, and a nutritious diet all help in improving lung capacity and immunity. Future research into novel therapeutics for patients with metabolic syndrome, Alzheimer's disease, and COVID-19 inflammation and immunology is encouraged by this paper.
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Affiliation(s)
- Carmine Finelli
- Department of Internal Medicine, ASL Napoli 3 SUD, Napoli, Italy
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Affiliation(s)
- Carmine Finelli
- 1Department of Internal Medicine, Ospedale Cav R Apicella, ASL Napoli 3 Sud, Via di Massa, 1, 80040 Pollena, Napoli, Italy
- 2COVID Hospital Boscotrecase, ASL Napoli 3 Sud, Via Lenza, 3, 80042 Boscotrecase, Napoli, Italy
- Author for correspondence:
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Affiliation(s)
- Carmine Finelli
- Department of Internal Medicine, Ospedale Cav. R. Apicella - ASL Napoli 3 Sud, Via di Massa, 1, 80040 Pollena (Napoli), Italy
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Finelli C. Obesity and adenovirus 36: a possible correlation? Future Virol 2020. [DOI: 10.2217/fvl-2019-0098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Carmine Finelli
- Department of Internal Medicine, Ospedale Cav. R. Apicella – ASL Napoli 3 Sud, Via di Massa, 1, 80040 Pollena, Napoli, Italy
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6
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De Salvia MA, DʼUggento AM, Aquilino G, Tattoli M, Finelli C, Imbrici P, Desaphy JF, Giustino A. Characterization of Student Drinking Behaviors at the Beginning of the First Academic Year at One University in Southern Italy. J Addict Nurs 2019; 30:193-200. [PMID: 31478967 DOI: 10.1097/jan.0000000000000288] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
It is well recognized that both college and noncollege students are at-risk age groups for alcohol consumption. We investigated the alcohol consumption habits of undergraduate students with an emphasis on binge drinking. Participants (N = 809, 61.2% female) were freshmen attending courses at one of the main universities of southern Italy. They were asked to fill out a paper-and-pencil questionnaire that was administered between October 2017 and January 2018. Nearly 90% of the questioned students reported drinking alcohol during the 12 months before the survey. Among them, 31.4% of female students and 41.5% of male students engaged in binge drinking, mainly once a month; binge drinkers preferred highly alcoholic beverages during parties, underestimated the alcoholic content of their drinks, started drinking alcohol at a younger age than nonbinge drinkers, and drank weekly and between meals. Binge drinkers started smoking earlier than their peers, and a great number of them consumed illicit drugs. Moreover, 30.3% of female and 34.8% of male nonbinge drinkers declared that they consumed 6 or more units of alcohol in one occasion, making them unaware binge drinkers. Furthermore, approximately 50% of students recognized that alcohol consumption has effects similar to those induced by illicit drugs but only considered their peers' drinking behavior to be risky.This study highlights that most students involved in this survey expose themselves to a risky lifestyle by heavy drinking and, most alarmingly, that some of them are not even aware of that.
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Affiliation(s)
- Maria Antonietta De Salvia
- Maria A. De Salvia, PhD, Maria Tattoli, MD, PhD, Jean Francois Desaphy, PhD, and Arcangela Giustino, PhD, Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro," Bari, Italy. Angela Maria D'Uggento, PhD, Department of Economics and Finance, University of Bari "Aldo Moro," Bari, Italy. Giovanni Aquilino, PhD, Department of Humanities, University of Foggia, Foggia, Italy. Carmine Finelli, MD, Department of Internal Medicine, Hospital "Cavalier Raffaele Apicella"-ASL Naples, Naples, Italy. Paola Imbrici, PhD, Department of Pharmacy-Drug Sciences, University of Bari "Aldo Moro," Bari, Italy
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Giustino A, Stefanizzi P, Ballini A, Renzetti D, De Salvia MA, Finelli C, Coscia MF, Tafuri S, De Vito D. Alcohol use and abuse: a cross-sectional study among Italian adolescents. J Prev Med Hyg 2018; 59:E167-E171. [PMID: 30083625 DOI: pmid/30083625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 05/30/2018] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Alcohol is recognized as one of four major risk factors for non-communicable diseases. Exposure to alcoholic beverages during the adolescence has been linked to increased heavier drinking habits: obviously, the age of alcohol initiation resulted an important determinant of alcohol dependence. The aim of this study is to analyze knowledge, attitudes and practices in alcohol habit of adolescent population. METHODS 943 students from 13 schools (middle and upper secondary schools) of the Bari district were enrolled in the study: in each school one class for each age was randomly selected. The research was carried out by an anonymous, self-administered questionnaire which investigated alcohol consumption, knowledge of alcohol consumption of parents and knowledge of the law regulating alcohol consumption. RESULTS 34.8% (328) have never consumed alcoholic drinks while 65.2% (615) declare the use of alcohol; the average age of alcohol initiation was 12.2 years. 35.7% (329/921) of mothers and 36.6% (335/915) of fathers drink alcohol only on special occasions. 17.9% (168/939) considered that alcohol could be free sale at all while 16.4% (154/939) reported that sale is forbidden for children under 14. CONCLUSIONS The higher prevalence of alcohol habits and the poor knowledge on alcohol law seemed to indicated the need of improving public health efforts in the prevention of alcohol consumption among Italian adolescents.
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Affiliation(s)
- A Giustino
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy
| | - P Stefanizzi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy
| | - A Ballini
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, Aldo Moro University of Bari, Italy
| | - D Renzetti
- Internal Medicine Department, Cbh Mater Day, Bari, Italy
| | - M A De Salvia
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy
| | - C Finelli
- Department of Emergency and Internal Medicine, Ospedale S. Maria della Pietà - ASL Napoli 3 Sud Nola (Napoli), Italy
| | - M F Coscia
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, Aldo Moro University of Bari, Italy
| | - S Tafuri
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy
| | - D De Vito
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, Aldo Moro University of Bari, Italy
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Tarantino G, Finelli C, Scopacasa F, Pasanisi F, Contaldo F, Capone D, Savastano S. Corrigendum to "Circulating Levels of Sirtuin 4, a Potential Marker of Oxidative Metabolism, Related to Coronary Artery Disease in Obese Patients Suffering from NAFLD, with Normal or Slightly Increased Liver Enzymes". Oxid Med Cell Longev 2018; 2018:6357164. [PMID: 30186546 PMCID: PMC6109998 DOI: 10.1155/2018/6357164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Accepted: 07/11/2018] [Indexed: 02/07/2023]
Abstract
[This corrects the article DOI: 10.1155/2014/920676.].
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Affiliation(s)
- Giovanni Tarantino
- 1Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
- 2Centro Ricerche Oncologiche di Mercogliano, Istituto Nazionale Per Lo Studio E La Cura Dei Tumori “Fondazione Giovanni Pascale”, IRCCS, 83013 Mercogliano, Italy
| | | | - Franco Scopacasa
- 4Department of Biochemistry and Medical Biotechnology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Fabrizio Pasanisi
- 1Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Franco Contaldo
- 1Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Domenico Capone
- 5Department of Neuroscience, Unit of Clinical Pharmacology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Silvia Savastano
- 1Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
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Labruna G, Pasanisi F, Fortunato G, Nardelli C, Finelli C, Farinaro E, Contaldo F, Sacchetti L. Corrigendum to "Sequence Analysis of the UCP1 Gene in a Severe Obese Population from Southern Italy". J Obes 2018; 2018:3260210. [PMID: 30123581 PMCID: PMC6079434 DOI: 10.1155/2018/3260210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Accepted: 05/28/2018] [Indexed: 02/07/2023] Open
Abstract
[This corrects the article DOI: 10.1155/2011/269043.].
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Affiliation(s)
- Giuseppe Labruna
- Fondazione IRCCS SDN, Istituto di Ricerca Diagnostica e Nucleare, Via Gianturco 113, 80143 Naples, Italy
| | - Fabrizio Pasanisi
- Centro Interuniversitario di Studi e Ricerche sull'Obesità e Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Napoli Federico II, Via Pansini 5, 80131 Naples, Italy
| | - Giuliana Fortunato
- CEINGE Biotecnologie Avanzate S.C. a R.L., Via Gaetano Salvatore 486, 80145 Naples, Italy
- Dipartimento di Biochimica e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Via Pansini 5, 80131 Naples, Italy
| | - Carmela Nardelli
- CEINGE Biotecnologie Avanzate S.C. a R.L., Via Gaetano Salvatore 486, 80145 Naples, Italy
- Dipartimento di Biochimica e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Via Pansini 5, 80131 Naples, Italy
| | | | - Eduardo Farinaro
- Dipartimento di Scienze Mediche Preventive, Università degli Studi di Napoli Federico II, Via Pansini 5, 80131 Naples, Italy
| | - Franco Contaldo
- Centro Interuniversitario di Studi e Ricerche sull'Obesità e Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Napoli Federico II, Via Pansini 5, 80131 Naples, Italy
| | - Lucia Sacchetti
- CEINGE Biotecnologie Avanzate S.C. a R.L., Via Gaetano Salvatore 486, 80145 Naples, Italy
- Dipartimento di Biochimica e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Via Pansini 5, 80131 Naples, Italy
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Finelli C, Tarantino G. Retraction: Nonalcoholic fatty liver disease, diet and gut microbiota. EXCLI J 2017; 16:1164. [PMID: 29075166 PMCID: PMC5653906 DOI: pmid/29075166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 10/18/2017] [Indexed: 02/07/2023]
Abstract
[This retracts the article on p. 461 in vol. 13, PMID: 26417275.].
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Affiliation(s)
- Carmine Finelli
- Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, C/da S. Lucia, Chiaromonte, 80035 Potenza, Italy
| | - Giovanni Tarantino
- Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, Via Sergio Pansini, 5, 80131Naples, Italy
- National Cancer Institute "Foundation G. Pascale" -IRCS- 83013 Mercogliano (Av), Italy
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11
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Finelli C. WITHDRAWN: Dealing with visceral fat reduction to slow the progression of NAFLD. Surg Obes Relat Dis 2016:S1550-7289(16)30885-1. [PMID: 28254261 DOI: 10.1016/j.soard.2016.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 12/20/2016] [Indexed: 02/07/2023]
Affiliation(s)
- Carmine Finelli
- Department of Emergency and Internal Medicine, Ospedale S. Maria della Pietà-ASL Napoli 3 Sud, Nola (Napoli), Italy
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Tarantino G, Finelli C, Gioa S, Citro V, La Sala N, Gentile M. Serum levels of Lp(a) are related to waist circumference in NAFLD patients with low prevalence of co-morbidities. Scand J Clin Lab Invest 2016; 76:544-552. [PMID: 27433943 DOI: 10.1080/00365513.2016.1207249] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Novel evidence suggests a relationship between circulating Lp(a) levels and the presence of cardiovascular events independently from the cardio-metabolic profile. METHODS AND RESULTS The purpose of this study was to investigate serum Lp(a) concentrations in relation to carotid intima-media thickness (IMT), anthropometric measures, lipid profile, assessment of insulin resistance, and other parameters conventionally used to predict CVD risk, in obese patients suffering from hepatic steatosis (HS), the well-known nonalcoholic fatty liver disease (NAFLD). Evidencing the key-points of this research, firstly, serum Lp(a) concentrations were not associated with carotid IMT in this selected population or, consequently, with early atherosclerosis, at least as evaluated by IMT. Secondly, carotid IMT was not predicted by HS severity, as evaluated by ultrasound. Finally, in the adjusted model, Lp(a) was positively predicted by waist circumference (WC) (β = 0.25, t = 2.3, p = 0.02) and negatively by central adiposity, assessed as visceral adipose tissue at US (β = -0.33, t = -3.0, p = 0.003). CONCLUSION Serum Lp(a) values may not play a direct role in increasing IMT, albeit associated with WC.
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Affiliation(s)
- Giovanni Tarantino
- a Department of Clinical Medicine and Surgery , Federico II University Medical School of Naples , Italy
- b Centro Ricerche Oncologiche Di Mercogliano , Istituto Nazionale per Lo Studio E La Cura Dei Tumori "Fondazione Giovanni Pascale", IRCCS , Italy
| | - Carmine Finelli
- c Center of Obesity and Eating Disorders , Stella Maris Mediterraneum Foundation , C/Da S. Lucia , Chiaromonte , Potenza , Italy
| | - Saverio Gioa
- c Center of Obesity and Eating Disorders , Stella Maris Mediterraneum Foundation , C/Da S. Lucia , Chiaromonte , Potenza , Italy
| | - Vincenzo Citro
- d Department of Internal Medicine , Umberto I Hospital , Nocera Inferiore , Salerno , Italy
| | - Nicolina La Sala
- c Center of Obesity and Eating Disorders , Stella Maris Mediterraneum Foundation , C/Da S. Lucia , Chiaromonte , Potenza , Italy
| | - Marco Gentile
- a Department of Clinical Medicine and Surgery , Federico II University Medical School of Naples , Italy
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Morello G, Imperatore R, Palomba L, Finelli C, Labruna G, Pasanisi F, Sacchetti L, Buono L, Piscitelli F, Orlando P, Di Marzo V, Cristino L. Orexin-A represses satiety-inducing POMC neurons and contributes to obesity via stimulation of endocannabinoid signaling. Proc Natl Acad Sci U S A 2016; 113:4759-64. [PMID: 27071101 PMCID: PMC4855580 DOI: 10.1073/pnas.1521304113] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
In the hypothalamic arcuate nucleus (ARC), proopiomelanocortin (POMC) neurons and the POMC-derived peptide α-melanocyte-stimulating hormone (α-MSH) promote satiety. POMC neurons receive orexin-A (OX-A)-expressing inputs and express both OX-A receptor type 1 (OX-1R) and cannabinoid receptor type 1 (CB1R) on the plasma membrane. OX-A is crucial for the control of wakefulness and energy homeostasis and promotes, in OX-1R-expressing cells, the biosynthesis of the endogenous counterpart of marijuana's psychotropic and appetite-inducing component Δ(9)-tetrahydrocannabinol, i.e., the endocannabinoid 2-arachidonoylglycerol (2-AG), which acts at CB1R. We report that OX-A/OX-1R signaling at POMC neurons promotes 2-AG biosynthesis, hyperphagia, and weight gain by blunting α-MSH production via CB1R-induced and extracellular-signal-regulated kinase 1/2 activation- and STAT3 inhibition-mediated suppression of Pomc gene transcription. Because the systemic pharmacological blockade of OX-1R by SB334867 caused anorectic effects by reducing food intake and body weight, our results unravel a previously unsuspected role for OX-A in endocannabinoid-mediated promotion of appetite by combining OX-induced alertness with food seeking. Notably, increased OX-A trafficking was found in the fibers projecting to the ARC of obese mice (ob/ob and high-fat diet fed) concurrently with elevation of OX-A release in the cerebrospinal fluid and blood of mice. Furthermore, a negative correlation between OX-A and α-MSH serum levels was found in obese mice as well as in human obese subjects (body mass index > 40), in combination with elevation of alanine aminotransferase and γ-glutamyl transferase, two markers of fatty liver disease. These alterations were counteracted by antagonism of OX-1R, thus providing the basis for a therapeutic treatment of these diseases.
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Affiliation(s)
- Giovanna Morello
- Institute of Biomolecular Chemistry, National Research Council, 80078 Pozzuoli, Italy; Department of Neurological and Movement Sciences, University of Verona, 37137 Verona, Italy
| | - Roberta Imperatore
- Institute of Biomolecular Chemistry, National Research Council, 80078 Pozzuoli, Italy
| | - Letizia Palomba
- Department of Biomolecular Sciences, University of Urbino "Carlo Bo," 61029 Urbino, Italy
| | - Carmine Finelli
- Interuniversity Center for Research and Study of Obesity, Department of Clinical and Experimental Medicine, Federico II University Hospital, 80131 Naples, Italy
| | - Giuseppe Labruna
- Istituto di Ricovero e Cura a Carattere Scientifico, Institute of Diagnostic and Nuclear Research, 80131 Naples, Italy
| | - Fabrizio Pasanisi
- Interuniversity Center for Research and Study of Obesity, Department of Clinical and Experimental Medicine, Federico II University Hospital, 80131 Naples, Italy
| | - Lucia Sacchetti
- Centro di Ingegneria Genetica-Advanced Biotechnology (Società Cooperativa a Responsabilità Limitata), 80131 Naples, Italy
| | - Lorena Buono
- Institute of Biomolecular Chemistry, National Research Council, 80078 Pozzuoli, Italy; Centro de Biología Molecular "Severo Ochoa," Consejo Superior de Investigaciones Científicas-Universidad Autónoma de Madrid, 28049 Cantoblanco, Spain
| | - Fabiana Piscitelli
- Institute of Biomolecular Chemistry, National Research Council, 80078 Pozzuoli, Italy
| | - Pierangelo Orlando
- Institute of Protein Biochemistry, National Research Council, 80131 Naples, Italy
| | - Vincenzo Di Marzo
- Institute of Biomolecular Chemistry, National Research Council, 80078 Pozzuoli, Italy
| | - Luigia Cristino
- Institute of Biomolecular Chemistry, National Research Council, 80078 Pozzuoli, Italy;
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Finelli C, Crispino P, Gioia S, La Sala N, D'amico L, La Grotta M, Miro O, Colarusso D. Retraction: The improvement of large High-Density Lipoprotein (HDL) particle levels, and presumably HDL metabolism, depend on effects of low-carbohydrate diet and weight loss. EXCLI J 2016; 15:570. [PMID: 27932940 PMCID: PMC5138495 DOI: 10.17179/excli2016-570] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 09/19/2016] [Indexed: 02/05/2023]
Abstract
[This retracts the article DOI: 10.17179/excli2015-642.].
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Affiliation(s)
- C. Finelli
- Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, Chiaromonte, Potenza, Italy
- *To whom correspondence should be addressed: C. Finelli, Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, Chiaromonte, Potenza, Italy, E-mail:
| | - P. Crispino
- U.O.C. Medicina Interna, Urgenza ed Accettazione, P.O. S. Giovanni, Lagonegro - ASP Potenza
| | - S. Gioia
- Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, Chiaromonte, Potenza, Italy
| | - N. La Sala
- Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, Chiaromonte, Potenza, Italy
| | - L. D'amico
- Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, Chiaromonte, Potenza, Italy
| | - M. La Grotta
- Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, Chiaromonte, Potenza, Italy
| | - O. Miro
- Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, Chiaromonte, Potenza, Italy
| | - D. Colarusso
- U.O.C. Medicina Interna, Urgenza ed Accettazione, P.O. S. Giovanni, Lagonegro - ASP Potenza
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Finelli C, Crispino P, Gioia S, La Sala N, D'amico L, La Grotta M, Miro O, Colarusso D. The improvement of large High-Density Lipoprotein (HDL) particle levels, and presumably HDL metabolism, depend on effects of low-carbohydrate diet and weight loss. EXCLI J 2016; 15:166-76. [PMID: 27103896 PMCID: PMC4834750 DOI: 10.17179/excli2015-642] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 02/10/2016] [Indexed: 02/05/2023]
Abstract
Depressed levels of atheroprotective large HDL particles are common in obesity and cardiovascular disease (CVD). Increases in large HDL particles are favourably associated with reduced CVD event risk and coronary plaque burden. The objective of the study is to compare the effectiveness of low-carbohydrate diets and weight loss for increasing blood levels of large HDL particles at 1 year. This study was performed by screening for body mass index (BMI) and metabolic syndrome in 160 consecutive subjects referred to our out-patient Metabolic Unit in South Italy. We administered dietary advice to four small groups rather than individually. A single team comprised of a dietitian and physician administered diet-specific advice to each group. Large HDL particles at baseline and 1 year were measured using two-dimensional gel electrophoresis. Dietary intake was assessed via 3-day diet records. Although 1-year weight loss did not differ between diet groups (mean 4.4 %), increases in large HDL particles paralleled the degree of carbohydrate restriction across the four diets (p<0.001 for trend). Regression analysis indicated that magnitude of carbohydrate restriction (percentage of calories as carbohydrate at 1 year) and weight loss were each independent predictors of 1-year increases in large HDL concentration. Changes in HDL cholesterol concentration were modestly correlated with changes in large HDL particle concentration (r=0.47, p=.001). In conclusion, reduction of excess dietary carbohydrate and body weight improved large HDL levels. Comparison trials with cardiovascular outcomes are needed to more fully evaluate these findings.
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Affiliation(s)
- C. Finelli
- Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, Chiaromonte, Potenza, Italy
- *To whom correspondence should be addressed: C. Finelli, Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, Chiaromonte, Potenza, Italy, E-mail:
| | - P. Crispino
- U.O.C. Medicina Interna, Urgenza ed Accettazione, P.O. S. Giovanni, Lagonegro - ASP Potenza
| | - S. Gioia
- Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, Chiaromonte, Potenza, Italy
| | - N. La Sala
- Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, Chiaromonte, Potenza, Italy
| | - L. D'amico
- Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, Chiaromonte, Potenza, Italy
| | - M. La Grotta
- Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, Chiaromonte, Potenza, Italy
| | - O. Miro
- Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, Chiaromonte, Potenza, Italy
| | - D. Colarusso
- U.O.C. Medicina Interna, Urgenza ed Accettazione, P.O. S. Giovanni, Lagonegro - ASP Potenza
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Tarantino G, Citro V, Finelli C. Hype or Reality: Should Patients with Metabolic Syndrome-related NAFLD be on the Hunter-Gatherer (Paleo) Diet to Decrease Morbidity? J Gastrointestin Liver Dis 2015; 24:359-68. [PMID: 26405708 DOI: 10.15403/jgld.2014.1121.243.gta] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The current Western diet figures centrally in the pathogenesis of several chronic diseases such as obesity, type 2 diabetes, cardiovascular disease and the emerging major health problem nonalcoholic fatty liver disease, all of them negatively impacting on life expectancy. This type of diet is represented by a high calorie uptake, high glycemic load, high fat and meat intake, as well as increased consumption of fructose. On the contrary, a simplified way of eating healthily by excluding highly-processed foods, is presumed to be the Paleolithic diet (a diet based on vegetables, fruits, nuts, roots, meat, organ meats) which improves insulin resistance, ameliorates dyslipidemia, reduces hypertension and may reduce the risk of age-related diseases. The diet is the foundation of the treatment of obesity- and type 2 diabetes-related nonalcoholic fatty liver disease and a diet similar to those of pre-agricultural societies may be an effective option. To lend sufficient credence to this type of diet, well-designed studies are needed.
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Affiliation(s)
- Giovanni Tarantino
- Department of Clinical Medicine and Surgery, Federico II University, Medical School of Naples, ;Centro Ricerche Oncologiche di Mercogliano, Istituto Nazionale Per Lo Studio E La Cura Dei Tumori Fondazione Giovanni Pascale, IRCCS, Mercogliano (Av), Naples, Italy
| | - Vincenzo Citro
- Department of Internal Medicine, Umberto I Hospital, Nocera Inferiore, Salerno, Italy
| | - Carmine Finelli
- Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, C/da S. Lucia, Chiaromonte, Potenza, Italy
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Savastano S, Tarantino G, D'Esposito V, Passaretti F, Cabaro S, Liotti A, Liguoro D, Perruolo G, Ariemma F, Finelli C, Beguinot F, Formisano P, Valentino R. Bisphenol-A plasma levels are related to inflammatory markers, visceral obesity and insulin-resistance: a cross-sectional study on adult male population. J Transl Med 2015; 13:169. [PMID: 26021871 PMCID: PMC4467609 DOI: 10.1186/s12967-015-0532-y] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 05/12/2015] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The current increase of obesity and metabolic syndrome (MS) focuses attention on bisphenol-A (BPA), "obesogen" endocrine disruptor, main plastic component. Aim was to verify the role of BPA in metabolic alterations, insulin resistance, low grade inflammation and visceral obesity. METHODS A cross-sectional study was performed in 76 out of 139 environmentally exposed adult males, unselected Caucasian subjects, enrolled by routine health survey at the "Federico II" University of Naples outpatient facilities. BPA plasma levels (ELISA), metabolic risk factors, homeostasis model assessment of insulin resistance index, plasma monocyte chemoattractant protein 1, interleukin-6 (IL-6) and tumor necrosis factor-alpha were performed. Clinical and biochemical parameters have been compared with BPA and pro-inflammatory cytokines levels. RESULTS In total 24 subjects out of 76 (32%) presented with waist circumference (WC) >102 cm, 36 (47%) had impaired fasting glucose and 24 (32%) subjects had insulin resistance [11 out 52 (21%) with WC ≤102 cm and 13 out of 24 with WC >102 cm (54%), χ(2) 6.825, p = 0.009]. BPA and pro-inflammatory cytokine levels were significantly higher in subjects with visceral adiposity (WC > 102 cm). BPA correlated with WC, triglycerides, glucose homeostasis and inflammatory markers. At the multivariate analysis WC and IL-6 remained the main predictors of BPA. CONCLUSIONS Detectable BPA plasma levels have been found also in our population. The strictly association between BPA and WC, components of MS, and inflammatory markers, further supports the BPA role in visceral obesity-related low grade chronic inflammation.
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Affiliation(s)
- Silvia Savastano
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples, via Pansini, 5, 80131, Naples, Italy.
| | - Giovanni Tarantino
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples, via Pansini, 5, 80131, Naples, Italy.
- INT "Fondazione Pascale", Cancer Research Center of Mercogliano, 83013, Mercogliano, AV, Italy.
| | - Vittoria D'Esposito
- Department of Translational Medical Sciences, "Federico II" University of Naples, via Pansini, 5, 80131, Naples, Italy.
| | - Federica Passaretti
- Department of Translational Medical Sciences, "Federico II" University of Naples, via Pansini, 5, 80131, Naples, Italy.
| | - Serena Cabaro
- Department of Translational Medical Sciences, "Federico II" University of Naples, via Pansini, 5, 80131, Naples, Italy.
| | - Antonietta Liotti
- Department of Translational Medical Sciences, "Federico II" University of Naples, via Pansini, 5, 80131, Naples, Italy.
| | - Domenico Liguoro
- Institute of Experimental Endocrinology and Oncology (IEOS), National Council of Research (CNR), "Federico II" University of Naples, via Pansini, 5, 80131, Naples, Italy.
| | - Giuseppe Perruolo
- Institute of Experimental Endocrinology and Oncology (IEOS), National Council of Research (CNR), "Federico II" University of Naples, via Pansini, 5, 80131, Naples, Italy.
| | - Fabiana Ariemma
- Department of Translational Medical Sciences, "Federico II" University of Naples, via Pansini, 5, 80131, Naples, Italy.
| | - Carmine Finelli
- Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, C/da S. Lucia, Chiaromonte, Potenza, Italy.
| | - Francesco Beguinot
- Department of Translational Medical Sciences, "Federico II" University of Naples, via Pansini, 5, 80131, Naples, Italy.
- Institute of Experimental Endocrinology and Oncology (IEOS), National Council of Research (CNR), "Federico II" University of Naples, via Pansini, 5, 80131, Naples, Italy.
| | - Pietro Formisano
- Department of Translational Medical Sciences, "Federico II" University of Naples, via Pansini, 5, 80131, Naples, Italy.
- Institute of Experimental Endocrinology and Oncology (IEOS), National Council of Research (CNR), "Federico II" University of Naples, via Pansini, 5, 80131, Naples, Italy.
| | - Rossella Valentino
- Institute of Experimental Endocrinology and Oncology (IEOS), National Council of Research (CNR), "Federico II" University of Naples, via Pansini, 5, 80131, Naples, Italy.
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Savastano S, Di Somma C, Colao A, Barrea L, Orio F, Finelli C, Pasanisi F, Contaldo F, Tarantino G. Preliminary data on the relationship between circulating levels of Sirtuin 4, anthropometric and metabolic parameters in obese subjects according to growth hormone/insulin-like growth factor-1 status. Growth Horm IGF Res 2015; 25:28-33. [PMID: 25466907 DOI: 10.1016/j.ghir.2014.10.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 10/20/2014] [Accepted: 10/21/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND The main components of GH/insulin-like growth factor (IGF)-1 axis and Sirtuin 4 (Sirt4), highly expressed in liver and skeletal muscle mitochondria, serve as active regulators of mitochondrial oxidative capacity with opposite functions. In obesity both GH/IGF-1 status and serum Sirt4 levels, likely mirroring its reduced mitochondrial expression, might be altered. OBJECTIVE To evaluate the association between circulating levels of Sirt4, body composition, metabolic parameters and cardio-metabolic risk profile in obese patients according to their different GH/IGF-1 status. DESIGN Cross-sectional study with measurement of serum Sirt4, GH after GH releasing hormone (GHRH)+Arginine test, IGF-1 and assessment of body composition, glucose and lipid metabolism in 50 class II-III obese subjects (BMI 35.6 to 62.1 kg/m(2)) and 15 normal weight subjects. Low GH secretion and IGF-1 were defined using pre-determined cutoff-points. The Homeostatic Metabolic Assessment of insulin resistance index and Visceral adiposity index were also calculated. The association of Sirt4 with peak stimulated GH and IGF-1, body composition, metabolic parameters and cardio-metabolic risk profile was assessed. RESULTS Serum Sirt4 was inversely related to anthropometric and metabolic parameters and positively related to peak GH and IGF-1. After adjusting for peak GH and IGF-1, the relationships between Sirt4 and BMI became not significant. At multiple regression analysis IGF-1 (p<0.001) was the independent predictor for Sirt4. CONCLUSION There was a close relationship between low IGF-1 and low serum Sirt4. This observation suggested that in obese patients, low GH/IGF-1 status was likely associated with a major compensatory decrease in circulating levels of Sirt4 to oppose to its negative regulator effect on mitochondrial oxidative capacity.
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Affiliation(s)
- Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Università Federico II di Napoli, Italy.
| | | | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Università Federico II di Napoli, Italy
| | | | - Francesco Orio
- Dipartimento di Scienze Motorie e del Benessere Università Parthenope Napoli, Italy
| | - Carmine Finelli
- Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, C/da S. Lucia, Chiaromonte, 80035 Potenza, Italy
| | - Fabrizio Pasanisi
- Dipartimento di Medicina Clinica e Chirurgia, Università Federico II di Napoli, Italy
| | - Franco Contaldo
- Dipartimento di Medicina Clinica e Chirurgia, Università Federico II di Napoli, Italy
| | - Giovanni Tarantino
- Centro Ricerche Oncologiche di Mercogliano, Istituto Nazionale Per Lo Studio e La Cura Dei Tumori "Fondazione Giovanni Pascale", IRCCS, Italy
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Tarantino G, Finelli C. Systematic review on intervention with prebiotics/probiotics in patients with obesity-related nonalcoholic fatty liver disease. Future Microbiol 2015; 10:889-902. [PMID: 26000656 DOI: 10.2217/fmb.15.13] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The gut microbiota is modulated by metabolic derangements, such as nutrition overload and obesity. AIM The aim of this systematic review is to summarize the role of these gut modifiers in nonalcoholic fatty liver disease (NAFLD) and obesity. METHODS A systematic search of MEDLINE (from 1946), PubMed (from 1946) and EMBASE (from 1949) databases through May 2014 was carried out to identify relevant articles. The search terms were 'probiotic' AND 'NAFLD', 'prebiotic' AND 'NAFLD', 'antibiotic' AND 'NAFLD', 'probiotics' AND 'obesity', 'prebiotic' AND 'obesity' or 'antibiotic' AND 'obesity'; these terms were searched as text word in 'clinical trials' and as exploded medical subject headings where possible. RESULTS The evidence in the literature is scant, due to the scarcity of appropriately powered, randomized, controlled clinical trials, involving various centers and population of different origin. CONCLUSION Although probiotics and prebiotics have been proposed in the treatment and prevention of patients with obesity-related NAFLD, their therapeutic use is not supported by high-quality clinical studies.
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Affiliation(s)
- Giovanni Tarantino
- 2Centro Ricerche Oncologiche di Mercogliano, Istituto Nazionale Per Lo Studio E La Cura Dei Tumori 'Fondazione Giovanni Pascale', IRCCS, Mercogliano (Av), Italy
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Finelli C, Padula MC, Martelli G, Tarantino G. Could the improvement of obesity-related co-morbidities depend on modified gut hormones secretion? World J Gastroenterol 2014; 20:16649-16664. [PMID: 25469034 PMCID: PMC4248209 DOI: 10.3748/wjg.v20.i44.16649] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 05/27/2014] [Accepted: 06/26/2014] [Indexed: 02/06/2023] Open
Abstract
Obesity and its associated diseases are a worldwide epidemic disease. Usual weight loss cures - as diets, physical activity, behavior therapy and pharmacotherapy - have been continuously implemented but still have relatively poor long-term success and mainly scarce adherence. Bariatric surgery is to date the most effective long term treatment for morbid obesity and it has been proven to reduce obesity-related co-morbidities, among them nonalcoholic fatty liver disease, and mortality. This article summarizes such variations in gut hormones following the current metabolic surgery procedures. The profile of gut hormonal changes after bariatric surgery represents a strategy for the individuation of the most performing surgical procedures to achieve clinical results. About this topic, experts suggest that the individuation of the crosslink among the gut hormones, microbiome, the obesity and the bariatric surgery could lead to new and more specific therapeutic interventions for severe obesity and its co-morbidities, also non surgical.
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Tarantino G, Citro V, Finelli C. What non-alcoholic fatty liver disease has got to do with obstructive sleep apnoea syndrome and viceversa? J Gastrointestin Liver Dis 2014. [PMID: 25267958 DOI: 10.1543/jgld.2014.1121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Non-alcoholic fatty liver disease (NAFLD) and obstructive sleep apnoea syndrome (OSAS) are common conditions, frequently encountered in patients with obesity and/or metabolic syndrome. NAFLD and OSAS are complex diseases that involve an interaction of several intertwined factors. Several lines of evidence lend credence to an immune system derangement in these patients, i.e. the low grade chronic inflammation status, reckoned to be the most important factor in causing and maintaining these two illnesses. Furthermore, it is emphasized the main role of spleen involvement, as a novel mechanism. In this review the contribution of the visceral adiposity in both NAFLD and OSAS is stressed as well as the role of intermittent hypoxia. Finally, a post on the prevention of systemic inflammation is made.
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Affiliation(s)
- Giovanni Tarantino
- Department of Clinical Medicine and Surgery, Federico II University, Medical School of Naples, Naples; INT Fondazione Pascale - Cancer Research Center of Mercogliano, Mercogliano (AV). ;
| | - Vincenzo Citro
- Department of Internal Medicine, Umberto I Hospital, Nocera Inferiore, Salerno,Italy
| | - Carmine Finelli
- Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, C/da S. Lucia 80035, Chiaromonte, Potenza, Italy
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Tarantino G, Citro V, Finelli C. What non-alcoholic fatty liver disease has got to do with obstructive sleep apnoea syndrome and viceversa? J Gastrointestin Liver Dis 2014; 23:291-9. [PMID: 25267958 DOI: 10.15403/jgld.2014.1121.233.gvt] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Non-alcoholic fatty liver disease (NAFLD) and obstructive sleep apnoea syndrome (OSAS) are common conditions, frequently encountered in patients with obesity and/or metabolic syndrome. NAFLD and OSAS are complex diseases that involve an interaction of several intertwined factors. Several lines of evidence lend credence to an immune system derangement in these patients, i.e. the low grade chronic inflammation status, reckoned to be the most important factor in causing and maintaining these two illnesses. Furthermore, it is emphasized the main role of spleen involvement, as a novel mechanism. In this review the contribution of the visceral adiposity in both NAFLD and OSAS is stressed as well as the role of intermittent hypoxia. Finally, a post on the prevention of systemic inflammation is made.
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Affiliation(s)
- Giovanni Tarantino
- Department of Clinical Medicine and Surgery, Federico II University, Medical School of Naples, Naples; INT Fondazione Pascale - Cancer Research Center of Mercogliano, Mercogliano (AV). ;
| | - Vincenzo Citro
- Department of Internal Medicine, Umberto I Hospital, Nocera Inferiore, Salerno,Italy
| | - Carmine Finelli
- Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, C/da S. Lucia 80035, Chiaromonte, Potenza, Italy
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Tarantino G, Costantini S, Finelli C, Capone F, Guerriero E, La Sala N, Gioia S, Castello G. Is serum Interleukin-17 associated with early atherosclerosis in obese patients? J Transl Med 2014; 12:214. [PMID: 25092442 PMCID: PMC4256548 DOI: 10.1186/s12967-014-0214-1] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Accepted: 07/21/2014] [Indexed: 02/07/2023] Open
Abstract
Atherosclerosis is a chronic inflammatory process of the vessel walls, and CD4+ T-cells are peculiar to both human and murine atherosclerotic lesions. There is a recent line of research favoring hypothetic allergic mechanisms in the genesis of atherosclerosis and, consequently, coronary artery disease (CAD), among which Interleukin (IL)-17 appears to be a key cytokine regulating local tissue inflammation. The objective was to add a piece of information on the role of IL-17 in the genesis of atherosclerosis. Eighty obese patients with normal liver enzyme levels but presenting with ultrasonographic evidence of NAFLD formed the population of this cross-sectional study. Anthropometric measures, data on excess adiposity, metabolic profile, serum concentrations of IL-17, eotaxin-3, IL-8, and CCL4/MIP1β, C-reactive protein, fibrinogen, ferritin, TNF-α, as well carotid intima-media thickness (IMT), a marker of atherosclerosis, and the main risk factors for CAD, such as blood pressure and smoking status, but also less determinant ones such as degree of NAFLD severity, Intramuscular Triglyceride storage and Resting Metabolic Rate were evaluated. Serum concentrations of Il-17 were detected as related to those of inflammatory cytokines, IL-6, IFN-γ and TNF-α. Furthermore, circulating levels of IL-17 were linked to those mirroring allergic process, IL-8, CCL4/MIP1β and eotaxin. Early atherosclerosis, evidenced as increased IMT, was not associated with circulating IL-17 levels. At multiple regression,IMT was predicted, other than by age, by the amount of the visceral adiposity, expressed as visceral adipose tissue at ultrasonography, and by serum eotaxin. In conclusion, a strong relationship was found between the IL-17-related chemokine eotaxin and IMT. The association found between the amount of visceral fat and circulating levels of eotaxin on the one hand, and IMT on the other, could reinforce the hypothesis that IL-17, released by the visceral adipose tissue, induces eotaxin secretion via the smooth muscle cells present in the atheromatosus vessels.
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Affiliation(s)
- Giovanni Tarantino
- Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
- Centro Ricerche Oncologiche di Mercogliano, Istituto Nazionale Per Lo Studio E La Cura Dei Tumori “Fondazione Giovanni Pascale”, IRCCS, 83013 Mercogliano, (Av) Italy
| | - Susan Costantini
- Centro Ricerche Oncologiche di Mercogliano, Istituto Nazionale Per Lo Studio E La Cura Dei Tumori “Fondazione Giovanni Pascale”, IRCCS, 83013 Mercogliano, (Av) Italy
| | - Carmine Finelli
- Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, C/da S. Lucia, Chiaromonte, 80035 Potenza, Italy
| | - Francesca Capone
- Centro Ricerche Oncologiche di Mercogliano, Istituto Nazionale Per Lo Studio E La Cura Dei Tumori “Fondazione Giovanni Pascale”, IRCCS, 83013 Mercogliano, (Av) Italy
| | - Eliana Guerriero
- Centro Ricerche Oncologiche di Mercogliano, Istituto Nazionale Per Lo Studio E La Cura Dei Tumori “Fondazione Giovanni Pascale”, IRCCS, 83013 Mercogliano, (Av) Italy
| | - Nicolina La Sala
- Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, C/da S. Lucia, Chiaromonte, 80035 Potenza, Italy
| | - Saverio Gioia
- Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, C/da S. Lucia, Chiaromonte, 80035 Potenza, Italy
| | - Giuseppe Castello
- Centro Ricerche Oncologiche di Mercogliano, Istituto Nazionale Per Lo Studio E La Cura Dei Tumori “Fondazione Giovanni Pascale”, IRCCS, 83013 Mercogliano, (Av) Italy
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Tarantino G, Citro V, Finelli C. Recreational drugs: a new health hazard for patients with concomitant chronic liver diseases. J Gastrointestin Liver Dis 2014; 23:79-84. [PMID: 24689101 DOI: pmid/24689101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Our purpose in this article is to review the effects of recreational drugs, used either on their own but principally combined with alcohol consumption, in determining hepatic injury or influencing the evolution of some chronic diseases of the liver, specifically HCV infection and NAFLD. A deleterious role of daily use of recreational drugs, in particularly cannabis, has been shown to demonstrate clearly a rapid progression of fibrosis and steatosis, leading to a major severity in patients with chronic hepatitis C. On the other hand, the effects of the misuse of these substances on NAFLD, the main obesity-related comorbidity, leading to addiction, is still to be elucidated even though some clues to the recreational drugs hepatotoxicity are already present in the literature. This short review aims at raising awareness about this topic.
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Affiliation(s)
- Giovanni Tarantino
- Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, Italy. ;
| | - Vincenzo Citro
- Department of Internal Medicine, Umberto I Hospital, Nocera Inferiore, Salerno, Italy
| | - Carmine Finelli
- Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, C/da S. Lucia, Chiaromonte, Potenza, Italy
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Tarantino G, Costantini S, Finelli C, Capone F, Guerriero E, La Sala N, Gioia S, Castello G. Carotid intima-media thickness is predicted by combined eotaxin levels and severity of hepatic steatosis at ultrasonography in obese patients with Nonalcoholic Fatty Liver Disease. PLoS One 2014; 9:e105610. [PMID: 25268946 PMCID: PMC4182088 DOI: 10.1371/journal.pone.0105610] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Accepted: 07/18/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Non-Alcoholic Fatty Liver Disease (NAFLD) is a distinct coronary artery disease (CAD) risk factor. The atherosclerotic process predisposing to CAD includes altered lipid profile and inflammatory processes. The available evidence suggests that increased circulating levels of eotaxin, an eosinophil chemoattractant cytokine implicated in allergic responses, are detected in the serum of patients with CAD. Relationships were sought between serum eotaxin on the one hand, and intima-media thickness--an early predictor of the atherosclerotic process, hepatic steatosis, arterial blood pressure values, as well as inflammation/immune markers and angiogenetic factors--on the other. METHODS Eighty obese patients with NAFLD, diagnosed at ultrasonography, without evident cytolysis, formed our study population. Anthropometric measures, metabolic profile, serum concentrations of interleukin-1β, C-reactive protein, interleukin-6, fibrinogen, ferritin, TNF-α, spleen size, vascular endothelial growth factor, platelet-derived growth factor-BB and heat shock protein-70 were evaluated. RESULTS Serum eotaxin concentrations were distinctly associated with TNF α, IL-6, IL-1β, VEGF and PDGF-BB levels but not with CRP, fibrinogen, heat shock protein-70 or spleen size. Among the metabolic and anthropometric parameters, a significant predictive power emerged when comparing eotaxin to insulin resistance, expressed as HOMA. NAFLD was distinctly associated with HOMA (P = 0.0005). Intima-media thickness was well predicted by both eotaxin levels and severity of NAFLD at ultrasonography, although no relation was detected between these last two variables. DISCUSSION AND CONCLUSION A role for insulin resistance in mediating the interplay between eotaxin and other inflammation/immune parameters could be evidenced in the induction/maintenance of atherosclerosis of obese patients with NAFLD.
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Affiliation(s)
- Giovanni Tarantino
- Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, Naples, Italy
- Centro Ricerche Oncologiche di Mercogliano, Istituto Nazionale Per Lo Studio E La Cura Dei Tumori “Fondazione Giovanni Pascale”, IRCCS, Mercogliano, Italy
- * E-mail:
| | - Susan Costantini
- Centro Ricerche Oncologiche di Mercogliano, Istituto Nazionale Per Lo Studio E La Cura Dei Tumori “Fondazione Giovanni Pascale”, IRCCS, Mercogliano, Italy
| | - Carmine Finelli
- Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, Chiaromonte, Potenza, Italy
| | - Francesca Capone
- Centro Ricerche Oncologiche di Mercogliano, Istituto Nazionale Per Lo Studio E La Cura Dei Tumori “Fondazione Giovanni Pascale”, IRCCS, Mercogliano, Italy
| | - Eliana Guerriero
- Centro Ricerche Oncologiche di Mercogliano, Istituto Nazionale Per Lo Studio E La Cura Dei Tumori “Fondazione Giovanni Pascale”, IRCCS, Mercogliano, Italy
| | - Nicolina La Sala
- Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, Chiaromonte, Potenza, Italy
| | - Saverio Gioia
- Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, Chiaromonte, Potenza, Italy
| | - Giuseppe Castello
- Centro Ricerche Oncologiche di Mercogliano, Istituto Nazionale Per Lo Studio E La Cura Dei Tumori “Fondazione Giovanni Pascale”, IRCCS, Mercogliano, Italy
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Finelli C, Martelli G, Rossano R, Padula MC, La Sala N, Sommella L, Tarantino G. Nesfatin-1: role as possible new anti-obesity treatment. EXCLI J 2014; 13:586-91. [PMID: 26417285 PMCID: PMC4464156 DOI: pmid/26417285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 05/08/2014] [Indexed: 02/07/2023]
Abstract
In this article, we review on the current concepts about Nesfatin-1 as a new anti-obesity treatment and evaluate the existing issues in the context of this knowledge and the available literature. The intent is to enable clinicians to know Nesfatin-1 as a new anti-obesity treatment and make rational decisions based on this perspective as possible clinical application. Future research should seek to clarify whether Nesfatin-1 would be beneficial in the management of obesity.
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Affiliation(s)
- Carmine Finelli
- Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, Chiaromonte, Potenza, Italy
- *To whom correspondence should be addressed: Carmine Finelli, Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, Chiaromonte, Potenza, Italy, E-mail:
| | - Giuseppe Martelli
- Department of Science, University of Basilicata, Potenza, Viale dell'Ateneo Lucano, 10, 85100, Italy
| | - Rocco Rossano
- Department of Science, University of Basilicata, Potenza, Viale dell'Ateneo Lucano, 10, 85100, Italy
| | - Maria Carmela Padula
- Department of Science, University of Basilicata, Potenza, Viale dell'Ateneo Lucano, 10, 85100, Italy
| | - Nicolina La Sala
- Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, Chiaromonte, Potenza, Italy
| | - Luigi Sommella
- Unit of Surgery, S. Giovanni Hospital - Lagonegro, Potenza, Italy
| | - Giovanni Tarantino
- National Cancer Institute "Pascale Foundation" - IRCS- 83013 Mercogliano (Av), Italy
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Finelli C, Tarantino G. Non-alcoholic fatty liver disease, diet and gut microbiota. EXCLI J 2014; 13:461-90. [PMID: 26417275 PMCID: PMC4464355 DOI: pmid/26417275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 03/31/2014] [Indexed: 02/07/2023]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is a severe liver disease that is increasing in prevalence with the worldwide epidemic of obesity and its related insulin-resistance state. Evidence for the role of the gut microbiota in energy storage and the subsequent development of obesity and some of its related diseases is now well established. More recently, a new role of gut microbiota has emerged in NAFLD. The gut microbiota is involved in gut permeability, low-grade inflammation and immune balance, it modulates dietary choline metabolism, regulates bile acid metabolism and produces endogenous ethanol. All of these factors are molecular mechanisms by which the microbiota can induce NAFLD or its progression toward overt non-alcoholic steatohepatitis. Modification of the gut microbiota composition and/or its biochemical capacity by specific dietary or pharmacological interventions may advantageously affect host metabolism. Large-scale intervention trials, investigating the potential benefit of prebiotics and probiotics in improving cardiometabolic health in high-risk populations, are fervently awaited.
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Affiliation(s)
- Carmine Finelli
- Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, Potenza, Italy
| | - Giovanni Tarantino
- Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, Italy
- National Cancer Institute "Foundation G. Pascale" -IRCS- 83013 Mercogliano (Av), Italy
- *To whom correspondence should be addressed: Giovanni Tarantino, Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, Via Sergio Pansini, 5, 80131 Naples, Italy, E-mail:
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Tarantino G, Finelli C, Scopacasa F, Pasanisi F, Contaldo F, Capone D, Savastano S. Circulating levels of sirtuin 4, a potential marker of oxidative metabolism, related to coronary artery disease in obese patients suffering from NAFLD, with normal or slightly increased liver enzymes. Oxid Med Cell Longev 2014; 2014:920676. [PMID: 25045415 PMCID: PMC4086623 DOI: 10.1155/2014/920676] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 05/23/2014] [Indexed: 02/07/2023]
Abstract
The present study shows low circulating levels of SIRT4 in obese patients with nonalcoholic fatty liver disease mirroring its reduced mitochondrial expression in an attempt to increase the fat oxidative capacity and then the mitochondrial function in liver and in muscle. SIRT4 modulates the metabolism of free fatty acids reducing their high circulating levels but, unfortunately, increasing ROS production. Great concentration of free fatty acids, released by adipose tissue, coupled with oxidative stress, directly results in endothelial dysfunction, early atherosclerosis, and coronary artery disease risk factor.
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Affiliation(s)
- Giovanni Tarantino
- 1Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
- 2Centro Ricerche Oncologiche di Mercogliano, Istituto Nazionale Per Lo Studio E La Cura Dei Tumori “Fondazione Giovanni Pascale”, IRCCS, 83013 Mercogliano, Italy
- *Giovanni Tarantino:
| | - Carmine Finelli
- 3Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, C/da Santa Lucia, Chiaromonte, 80035 Potenza, Italy
| | - Franco Scopacasa
- 4Department of Biochemistry and Medical Biotechnology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Fabrizio Pasanisi
- 1Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Franco Contaldo
- 1Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Domenico Capone
- 5Department of Neuroscience, Unit of Clinical Pharmacology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Silvia Savastano
- 1Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
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Tarantino G, Finelli C. Pathogenesis of hepatic steatosis: The link between hypercortisolism and non-alcoholic fatty liver disease. World J Gastroenterol 2013; 19:6735-6743. [PMID: 24187449 PMCID: PMC3812473 DOI: 10.3748/wjg.v19.i40.6735] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 09/17/2013] [Indexed: 02/06/2023] Open
Abstract
Based on the available literature, non alcoholic fatty liver disease or generally speaking, hepatic steatosis, is more frequent among people with diabetes and obesity, and is almost universally present amongst morbidly obese diabetic patients. Non alcoholic fatty liver disease is being increasingly recognized as a common liver condition in the developed world, with non alcoholic steatohepatitis projected to be the leading cause of liver transplantation. Previous data report that only 20% of patients with Cushing’s syndrome have hepatic steatosis. Aiming at clarifying the reasons whereby patients suffering from Cushing’s syndrome - a condition characterized by profound metabolic changes - present low prevalence of hepatic steatosis, the Authors reviewed the current concepts on the link between hypercortisolism and obesity/metabolic syndrome. They hypothesize that this low prevalence of fat accumulation in the liver of patients with Cushing’s syndrome could result from the inhibition of the so-called low-grade chronic-inflammation, mainly mediated by Interleukin 6, due to an excess of cortisol, a hormone characterized by an anti-inflammatory effect. The Cushing’s syndrome, speculatively considered as an in vivo model of the hepatic steatosis, could also help clarify the mechanisms of non alcoholic fatty liver disease.
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Affiliation(s)
- Carmine Finelli
- Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, C/Da S. Lucia, 80035, Chiaromonte, PZ, Italy,
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Finelli C, Sommella L, Gioia S, La Sala N, Tarantino G. Should visceral fat be reduced to increase longevity? Ageing Res Rev 2013; 12:996-1004. [PMID: 23764746 DOI: 10.1016/j.arr.2013.05.007] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2012] [Revised: 05/21/2013] [Accepted: 05/28/2013] [Indexed: 02/07/2023]
Abstract
Several epidemiologic studies have implicated visceral fat as a major risk factor for insulin resistance, type 2 diabetes mellitus, cardiovascular disease, stroke, metabolic syndrome and death. Utilizing novel models of visceral obesity, numerous studies have demonstrated that the relationship between visceral fat and longevity is causal while the accrual of subcutaneous fat does not appear to play an important role in the etiology of disease risk. Specific recommended intake levels vary based on a number of factors, including current weight, activity levels, and weight loss goals. It is discussed the need of reducing the visceral fat as a potential treatment strategy to prevent or delay age-related diseases and to increase longevity.
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Affiliation(s)
- Carmine Finelli
- Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, Chiaromonte, Potenza, Italy.
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Tarantino G, Capone D, Finelli C. Exposure to ambient air particulate matter and non-alcoholic fatty liver disease. World J Gastroenterol 2013; 19:3951-3956. [PMID: 23840139 PMCID: PMC3703181 DOI: 10.3748/wjg.v19.i25.3951] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Accepted: 06/04/2013] [Indexed: 02/06/2023] Open
Abstract
The present study was designed to alert the public opinion and policy makers on the supposed enhancing effects of exposure to ambient air particulate matter with aerodynamic diameters < 2.5 mm (PM2.5) on non-alcoholic fatty liver disease (NAFLD), the most common chronic liver disease in Western countries. For far too long literature data have been fixated on pulmonary diseases and/or cardiovascular disease, as consequence of particulate exposure, ignoring the link between the explosion of obesity with related syndromes such as NAFLD and air pollution, the worst characteristics of nowadays civilization. In order to delineate a clear picture of this major health problem, further studies should investigate whether and at what extent cigarette smoking and exposure to ambient air PM2.5 impact the natural history of patients with obesity-related NAFLD, i.e., development of non alcoholic steatohepatitis, disease characterized by a worse prognosis due its progression towards fibrosis and hepatocarcinoma.
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Tarantino G, Scalera A, Finelli C. Liver-spleen axis: Intersection between immunity, infections and metabolism. World J Gastroenterol 2013; 19:3534-3542. [PMID: 23801854 PMCID: PMC3691032 DOI: 10.3748/wjg.v19.i23.3534] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Accepted: 05/19/2013] [Indexed: 02/06/2023] Open
Abstract
Spleen has been considered a neglected organ so far, even though is strictly linked to liver. The spleen plays an important role in the modulation of the immune system and in the maintenance of peripheral tolerance via the clearance of circulating apoptotic cells, the differentiation and activation of T and B cells and production of antibodies in the white pulp. Moreover, splenic macrophages are able to remove bacteria from the blood and protect from sepsis during systemic infections. We review the spleen function and its assessment in humans starting from the description of spleen diseases, ranging from the congenital asplenia to secondary hyposplenism. From the literature data it is clear that obesity in humans affects different compartments of immune system, even thought there are still few data available on the implicated mechamisms. The intent is to enable clinicians to evaluate the newly recognized role of metabolic and endocrine functions of the spleen with special emphasis to obesity and nonalcoholic fatty liver disease in the context of the available literature. Moreover, understanding the spleen function could be important to develop appropriate prevention strategies in order to counteract the pandemia of obesity. In this direction, we suggest spleen longitudinal diameter at ultrasonography, as simple, cheap and largely available tool, be used as new marker for assessing splenic function, in the context of the so-called liver-spleen axis.
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Tarantino G, Finelli C. What about non-alcoholic fatty liver disease as a new criterion to define metabolic syndrome? World J Gastroenterol 2013; 19:3375-3384. [PMID: 23801829 PMCID: PMC3683675 DOI: 10.3748/wjg.v19.i22.3375] [Citation(s) in RCA: 123] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Accepted: 01/24/2013] [Indexed: 02/06/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is currently not a component of the diagnostic criteria for metabolic syndrome (MetS); however, the development of NAFLD has some common mechanisms with the development of MetS, as they share the pathophysiologic basis of insulin resistance. It is also recognized that NAFLD is the hepatic manifestation of MetS. To define MetS, the presence of at least three of the proposed criteria is required, and sometimes it is sufficient to have only one laboratory value, modified by diet or drugs, for the classification of MetS. Ultrasonographically-detected NAFLD (US-NAFLD) is more stable, only changing during the middle- to long-term. Although controversies over MetS continue, and considering that abdominal ultrasonography for diagnosing NAFLD has high specificity and guidelines to modify the natural course of NAFLD by diet composition or lifestyle have not yet been established, why should we not introduce US-NAFLD as a new criterion to define MetS?
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Abstract
Numerous epidemiologic studies have implicated abdominal obesity as a major risk factor for insulin resistance, type 2 diabetes mellitus, cardiovascular disease, stroke, metabolic syndrome and its further expression, i.e., nonalcoholic fatty liver disease and death. Using novel models of visceral obesity, several studies have demonstrated that the relationship between visceral fat and longevity is causal, while the accrual of subcutaneous fat does not appear to play an important role in the etiology of disease risk. The need of reducing the visceral fat to improve survival, mainly taking into account the strict link between nonalcoholic fatty liver disease and the coronary artery disease is discussed.
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Affiliation(s)
- Carmine Finelli
- Center of Obesity and Eating Disorder, Stella Maris Mediterraneo Foundation Chiaromonte, Potenza, Italy
| | - Giovanni Tarantino
- Department of Clinical and Experimental Medicine, Federico II University Medical School of Naples, Naples, Italy.
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Finelli C, Tarantino G. What is the role of adiponectin in obesity related non-alcoholic fatty liver disease? World J Gastroenterol 2013; 19:802-12. [PMID: 23430039 PMCID: PMC3574877 DOI: 10.3748/wjg.v19.i6.802] [Citation(s) in RCA: 127] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Revised: 12/03/2012] [Accepted: 12/15/2012] [Indexed: 02/06/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is recognized as the most common type of chronic liver disease in Western countries. Insulin resistance is a key factor in the pathogenesis of NAFLD, the latter being considered as the hepatic component of insulin resistance or obesity. Adiponectin is the most abundant adipose-specific adipokine. There is evidence that adiponectin decreases hepatic and systematic insulin resistance, and attenuates liver inflammation and fibrosis. Adiponectin generally predicts steatosis grade and the severity of NAFLD; however, to what extent this is a direct effect or related to the presence of more severe insulin resistance or obesity remains to be addressed. Although there is no proven pharmacotherapy for the treatment of NAFLD, recent therapeutic strategies have focused on the indirect upregulation of adiponectin through the administration of various therapeutic agents and/or lifestyle modifications. In this adiponectin-focused review, the pathogenetic role and the potential therapeutic benefits of adiponectin in NAFLD are analyzed systematically.
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Finelli C, Tarantino G. Have guidelines addressing physical activity been established in nonalcoholic fatty liver disease? World J Gastroenterol 2012; 18:6790-800. [PMID: 23239917 PMCID: PMC3520168 DOI: 10.3748/wjg.v18.i46.6790] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Revised: 06/29/2012] [Accepted: 07/09/2012] [Indexed: 02/06/2023] Open
Abstract
The purpose of this review was to highlight, in relation to the currently accepted pathophysiology of non-alcoholic fatty liver disease (NAFLD), the known exercise habits of patients with NAFLD and to detail the benefits of lifestyle modification with exercise (and/or physical activity) on parameters of metabolic syndrome. More rigorous, controlled studies of longer duration and defined histopathological end-points comparing exercise alone and other treatment are needed before better, evidence-based physical activity modification guidelines can be established, since several questions remain unanswered.
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Finelli C, Tarantino G. Is there any consensus as to what diet or lifestyle approach is the right one for NAFLD patients? J Gastrointestin Liver Dis 2012; 21:293-302. [PMID: 23012671 DOI: pmid/23012671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
In this article, we review the current concepts about the pathogenesis of hepatic steatosis and non-alcoholic steatohepatitis and evaluate the existing diets in the context of this knowledge and the available literature. The intent is to enable clinicians to evaluate the diets of non-alcoholic fatty liver disease (NAFLD) patients and make rational decisions based on this perspective - in the absence of controlled trials - to help their patients. Finally, a tailored approach for the dietary treatment of NAFLD is offered as a way to optimize the dietary management of this condition.
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Affiliation(s)
- Carmine Finelli
- Center of Obesity and Eating Disorder, Stella Maris Mediterraneum Foundation, Chiaromonte, Potenza, Federico II Univ. Medical School, Naples, Italy
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Finelli C, Tarantino G. Is visceral fat reduction necessary to favour metabolic changes in the liver? J Gastrointestin Liver Dis 2012; 21:205-8. [PMID: 22720311 DOI: pmid/22720311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
As excess body weight constitutes a major health problem, it is now important for hepatologists to weigh risk factors that lead to insulin resistance and hepatic steatosis. This mini-review focuses on the type of bodily fat distribution that determines the ectopic fat storage into the liver in overweight or obese people. Although obesity is closely associated with non-alcoholic fatty liver disease, the excess of visceral fat storage is reckoned to be just as or even more important.
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Affiliation(s)
- Carmine Finelli
- Center of Obesity and Eating Disorder, Stella Maris Mediterraneo Foundation Chiaromonte, Potenza, Italy
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Tarantino G, Finelli C, Colao A, Capone D, Tarantino M, Grimaldi E, Chianese D, Gioia S, Pasanisi F, Contaldo F, Scopacasa F, Savastano S. Are hepatic steatosis and carotid intima media thickness associated in obese patients with normal or slightly elevated gamma-glutamyl-transferase? J Transl Med 2012; 10:50. [PMID: 22424154 PMCID: PMC3342159 DOI: 10.1186/1479-5876-10-50] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Accepted: 03/16/2012] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Hepatic steatosis (HS) has been associated with obesity and metabolic syndrome (MS), conditions carrying a high risk of coronary artery disease. We aimed to determine whether HS was an independent factor of atherogenic risk beyond its association with MS and its components. METHODS We assessed the circulating levels of the heat shock protein-70 (HSP-70), a chaperone involved in inflammation, endoplasmic reticulum stress and apoptosis at liver and endothelial level and the gamma-glutamyl transferase activity (γ-GT) correlating them to carotid intima-media thickness (IMT), along with lipid profile, HOMA, C-reactive protein, fibrinogen, ferritin, adiposity type as well as spleen volume in 52 obese pts with grade 1, 128 with grade 2, and 20 with grade 3 of HS evaluated by sonography. RESULTS Patients with different grade of HS demonstrated overlapping HSP-70 levels; similarly performed obese subjects regarding IMT. Using multiple regression analysis, IMT was predicted by age, visceral adiposity and by HOMA (β = 0.50, p < 0.0001, β = 0.30, p = 0.01 and β = 0.18, p = 0.048 respectively, while the severity of HS was predicted by visceral and subcutaneous adiposity and HOMA (β = 0.50, p < 0.0001 and β = 0.27, p = 0.001 and β = 0.18, p = 0.024, respectively). CONCLUSION In our series of patients with normal or mild elevation of γ-GT, the severity of HS does not entail higher IMT, which may be linked to MS stigmata.
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Affiliation(s)
- Giovanni Tarantino
- Department of Clinical and Experimental Medicine, Federico II University Medical School of Naples, Naples, Italy
| | - Carmine Finelli
- Fondazione Stella Maris Mediterraneo, Centro di Riferimento Regionale dei Disturbi e Comportamenti Alimentari e del Peso, "G. Gioia", Chiaromonte, (PZ), Italy
| | - Annamaria Colao
- Department of Molecular and Clinical Endocrinology and Oncology, Endocrinology Section, Federico II University Medical School of Naples, Naples, Italy
| | - Domenico Capone
- Department of Neurosciences, Unit of Clinical Pharmacology, Federico II University Medical School of Naples, Naples, Italy
| | - Marianna Tarantino
- Department of Biomorphological and Functional Sciences, Federico II University Medical School of Naples, Naples, Italy
| | - Ernesto Grimaldi
- Department of Biochemistry and Medical Biotechnology, Federico II University Medical School of Naples, Naples, Italy
| | - Donato Chianese
- Department of Biochemistry and Medical Biotechnology, Federico II University Medical School of Naples, Naples, Italy
| | - Saverio Gioia
- Fondazione Stella Maris Mediterraneo, Centro di Riferimento Regionale dei Disturbi e Comportamenti Alimentari e del Peso, "G. Gioia", Chiaromonte, (PZ), Italy
| | - Fabrizio Pasanisi
- Department of Clinical and Experimental Medicine, Federico II University Medical School of Naples, Naples, Italy
| | - Franco Contaldo
- Department of Clinical and Experimental Medicine, Federico II University Medical School of Naples, Naples, Italy
| | - Francesco Scopacasa
- Department of Biochemistry and Medical Biotechnology, Federico II University Medical School of Naples, Naples, Italy
| | - Silvia Savastano
- Department of Molecular and Clinical Endocrinology and Oncology, Endocrinology Section, Federico II University Medical School of Naples, Naples, Italy
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Bracale R, Labruna G, Finelli C, Daniele A, Sacchetti L, Oriani G, Contaldo F, Pasanisi F. The absence of polymorphisms in ADRB3, UCP1, PPARγ, and ADIPOQ genes protects morbid obese patients toward insulin resistance. J Endocrinol Invest 2012; 35:2-4. [PMID: 22391136 DOI: 10.1007/bf03345413] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS The insulin resistance (IR) is a major metabolic impairment in severe obesity, a multifactorial disease in which the importance of the effect of single nucleotide polymorphisms (SNP) associations in different rather than individual genes was established. The aim of this study was to test the predictive value of presence/absence of polymorphisms/ variants in β3-adrenergic receptor (ADRB3), uncoupling protein 1 (UCP1), peroxisome proliferator-activated receptor γ (PPARγ), and adiponectin (ADIPOQ) genes in diagnosing the IR in obesity. SUBJECTS AND METHODS We studied 112 (40 males, 72 females) severely obese (body mass index: 48.5±7.5 kg/m2) subjects recruited from the outpatient obesity clinic of Federico II University Hospital in Naples. Genomic DNA was extracted from peripheral leukocytes with a commercial kit. The gene polymorphisms Trp64Arg in ADRB3, -3826 A>G in UCP1, Pro12Ala in PPARγ, and c.268G>A, c.331T>C, and c.334C>T in ADIPOQ were characterized by TaqMan assay or by direct sequencing (ADIPOQ). RESULTS AND CONCLUSION Our results demonstrate that -3826A>G UCP1 polymorphism is associated with IR in morbid obesity. Further, the lack of any polymorphisms, Trp64Arg in ADRB3 and/or -3826 A>G in UCP1 and/or Pro12Ala in PPARγ and/or c.268G>A, c.331T>C and c.334C>T in ADIPOQ, appears a useful prognostic factor (NPV=100%) toward the IR onset in these obese patients representing a further parameter for an earlier and appropriate therapy.
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Affiliation(s)
- R Bracale
- Dipartimento di Scienze per la Salute, Università del Molise, Campobasso, Italy
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Finelli C, Gioia S, La Sala N. Physical activity: an important adaptative mechanism for body-weight control. ISRN Obes 2012; 2012:675285. [PMID: 24533208 PMCID: PMC3914278 DOI: 10.5402/2012/675285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Accepted: 12/08/2012] [Indexed: 02/05/2023]
Abstract
We review the current concepts about energy expenditure and evaluate the physical activity (PhA) in the context of this knowledge and the available literature. Regular PhA is correlated with low body weight and low body fat mass. The negative fat balance is probably secondary to this negative energy balance. Nonexercise activity thermogenesis (NEAT) and physical activity, that is crucial for weight control, may be important in the physiology of weight change. An intriguing doubt that remains unresolved is whether changes in nutrient intake or body composition secondarily affect the spontaneous physical activity.
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Affiliation(s)
- Carmine Finelli
- Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, C/da S. Lucia, Chiaromonte, 80035 Potenza, Italy
- *Carmine Finelli:
| | - Saverio Gioia
- Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, C/da S. Lucia, Chiaromonte, 80035 Potenza, Italy
| | - Nicolina La Sala
- Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, C/da S. Lucia, Chiaromonte, 80035 Potenza, Italy
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Tarantino G, Colao A, Capone D, Conca P, Tarantino M, Grimaldi E, Chianese D, Finelli C, Contaldo F, Scopacasa F, Savastano S. Circulating levels of cytochrome C, gamma-glutamyl transferase, triglycerides and unconjugated bilirubin in overweight/obese patients with non-alcoholic fatty liver disease. J BIOL REG HOMEOS AG 2011; 25:47-56. [PMID: 21382273 DOI: pmid/21382273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Non-alcoholic fatty liver disease, characterized by hepatocyte apoptosis, is distinct in fatty liver and non-alcoholic steatohepatitis, the more severe form. Apoptotic cell death is caspase-dependent and associated with mitochondrial membrane depolarization and cytochrome c release. Adhering to the hypothesis that the exposure of hepatocytes to free fatty acids, resulting in increased ROS production and mitochondrial damage, is balanced by the presence of antioxidant substances, circulating levels of gamma-glutamyl transferase, cytochrome c, triglycerides and unconjugated bilirubin were explored in patients suffering from non-alcoholic fatty liver disease with different severity. One hundred and eighty-six consecutive patients who presented recent ultrasound feature of bright liver without any liver disease of known origin were enrolled, eighty-nine of whom underwent liver biopsy. Forty-five subjects were allocated on the basis of histology in fatty liver group while 44 patients formed the group with non-alcoholic steatohepatitis. A cohort of 27 young, lean, apparently healthy individuals was selected as control group. The levels of gamma-glutamyl transferase were normal or slightly increased, while unconjugated bilirubin concentrations were elevated in all the spectra of non-alcoholic fatty liver disease. Comparing the present results with relevant findings from other studies dealing with diseases characterized by apoptosis, we did not find high circulating levels of cytochrome c in non-alcoholic fatty liver disease. What is more, our patients, categorized as suffering from simple fatty liver or from the more severe non-alcoholic steatohepatitis, had similar levels of cytochrome c and gamma-glutamyl transferase, p=0.19 and 0.11. Serum triglycerides were higher in patients with non-alcoholic fatty liver disease than in the healthy group, p=0.001. These findings likely reflect a balance between oxidative stress and anti-oxidant response rather than a lack of reliability of cytochrome c as a reliable biomarker of mitochondrial damage.
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Affiliation(s)
- G Tarantino
- Department of Clinical and Experimental Medicine, Federico II University Medical School of Naples, Italy.
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Labruna G, Pasanisi F, Fortunato G, Nardelli C, Finelli C, Farinaro E, Contaldo F, Sacchetti L. Sequence Analysis of the UCP1 Gene in a Severe Obese Population from Southern Italy. J Obes 2011; 2011:269043. [PMID: 21773003 PMCID: PMC3136174 DOI: 10.1155/2011/269043] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Accepted: 04/08/2011] [Indexed: 02/07/2023] Open
Abstract
Brown adipose tissue, where Uncoupling Protein 1 (UCP1) activity uncouples mitochondrial respiration, is an important site of facultative energy expenditure. This tissue may normally function to prevent obesity. Our aim was to investigate by sequence analysis the presence of UCP1 gene variations that may be associated with obesity. We studied 100 severe obese adults (BMI > 40 kg/m(2)) and 100 normal-weight control subjects (BMI range = 19-24.9 kg/m(2)). We identified 7 variations in the promoter region, 4 in the intronic region and 4 in the exonic region. Globally, 72% of obese patients bore UCP1 polymorphisms. Among UCP1 variants, g.IVS4-208T>G SNP was associated with obesity (OR: 1.77; 95% CI = 1.26-2.50; P = .001). Further, obese patients bearing the g.-451C>T (CT+TT) or the g.940G>A (GA+AA) genotypes showed a higher BMI than not polymorphic obese patients (P = .008 and P = .043, resp.). In conclusion, UCP1 SNPs could represent "thrifty" factors that promote energy storage in prone subjects.
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Affiliation(s)
- Giuseppe Labruna
- Fondazione IRCCS SDN, Istituto di Ricerca Diagnostica e Nucleare, Via Gianturco 113, 80143 Naples, Italy
| | - Fabrizio Pasanisi
- Centro Interuniversitario di Studi e Ricerche sull'Obesità e Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Napoli Federico II, Via Pansini 5, 80131 Naples, Italy
| | - Giuliana Fortunato
- CEINGE Biotecnologie Avanzate S.C. a R.L., Via Gaetano Salvatore 486, 80145, Naples, Italy
- Dipartimento di Biochimica e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Via Pansini 5, Via Pansini 5, 80131 Naples, Italy
| | - Carmela Nardelli
- CEINGE Biotecnologie Avanzate S.C. a R.L., Via Gaetano Salvatore 486, 80145, Naples, Italy
- Dipartimento di Biochimica e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Via Pansini 5, Via Pansini 5, 80131 Naples, Italy
| | - Carmine Finelli
- Fondazione Stella Maris Mediterraneo, Centro Disturbi del Comportamento Alimentare e del Peso “G. Gioia”, Chiaromonte, C/da S. Lucia, 85100, Chiaromonte, Potenza, Italy
| | - Eduardo Farinaro
- Dipartimento di Scienze Mediche Preventive, Università degli Studi di Napoli Federico II, Via Pansini 5, 80131 Naples, Italy
| | - Franco Contaldo
- Centro Interuniversitario di Studi e Ricerche sull'Obesità e Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Napoli Federico II, Via Pansini 5, 80131 Naples, Italy
| | - Lucia Sacchetti
- CEINGE Biotecnologie Avanzate S.C. a R.L., Via Gaetano Salvatore 486, 80145, Naples, Italy
- Dipartimento di Biochimica e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Via Pansini 5, Via Pansini 5, 80131 Naples, Italy
- *Lucia Sacchetti:
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Tarantino G, Pizza G, Colao A, Pasanisi F, Conca P, Colicchio P, Finelli C, Contaldo F, Di Somma C, Savastano S. Hepatic steatosis in overweight/obese females: New screening method for those at risk. World J Gastroenterol 2009; 15:5693-9. [PMID: 19960566 PMCID: PMC2789222 DOI: 10.3748/wjg.15.5693] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To identify which parameters could help to distinguish the “metabolically benign obesity”, which is not accompanied by insulin resistance (IR) and early atherosclerosis.
METHODS: Eighty two of 124 overweight/obese females formed the study population, which was divided into two groups (52 and 30 subjects, respectively) with and without IR according to a HO meostatic Metabolic Assessment (HOMA) cut-off of 2, and were studied in a cross-sectional manner. The main outcome measures were waist circumference, serum uric acid, high-density lipoprotein-cholesterol and triglycerides, alanine aminotransferase, blood pressure and the two imaging parameters, hepatic steatosis and longitudinal diameter of the spleen, which were measured in relation to the presence/absence of IR.
RESULTS: A variable grade of visceral obesity was observed in all subjects with the exception of three. Obesity of a severe grade was represented more in the group of IR individuals (P = 0.01). Hepatic steatosis, revealed at ultrasound, was more pronounced in IR than in non-IR subjects (P = 0.005). The two groups also demonstrated a clear difference in longitudinal spleen diameter and blood pressure, with raised and significant values in the IR group. Metabolic syndrome was frequent in the IR group, and was not modified when adjusted for menopause (P = 0.001). At linear regression, the β values of waist circumference and body mass index predicting HOMA were 0.295, P = 0.007 and 0.41, P = 0.0001, respectively. Measures of spleen longitudinal diameter were well predicted by body mass index (BMI) values, β = 0.35, P = 0.01, and by HOMA, β = 0.41, P = 0.0001. Blood pressure was predicted by HOMA values, β = 0.39, P = 0.0001). HOMA and hepatic steatosis were highly associated (rho = 0.34, P = 0.002). Interestingly, IR patients were almost twice as likely to have hepatic steatosis as non-IR patients. Among the MS criteria, blood pressure was very accurate in identifying the presence of IR (AUROC for systolic blood pressure 0.66, cut-off 125 mm of Hg, sensibility 64%, specificity 75%; AUROC for diastolic blood pressure 0.70, cut-off 85 mm of Hg, sensibility 54.5%, specificity 75%).
CONCLUSION: As health care costs are skyrocketing, reliable and mainly inexpensive tools are advisable to better define subjects who really need to lose weight.
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Del Genio F, Del Genio G, De Sio I, Marra M, Alfonsi L, Finelli C, Contaldo F, Pasanisi F. Noninvasive evaluation of abdominal fat and liver changes following progressive weight loss in severely obese patients treated with laparoscopic gastric bypass. Obes Surg 2009; 19:1664-71. [PMID: 19526270 DOI: 10.1007/s11695-009-9891-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2008] [Accepted: 05/28/2009] [Indexed: 02/07/2023]
Abstract
BACKGROUND Obesity is a chronic complex disease, consequence of an unbalance between energy intake and expenditure and of the interaction between predisposing genotype and facilitating environmental factors. The aim of the study was to evaluate body composition, abdominal fat, and metabolic changes in a group of severely obese patients before and after laparoscopic gastric bypass (LGBP) at standardized (10% and 25%) total weight loss. METHODS Twenty-eight patients (14 M, 14 F; age 41.71 +/- 6.9 years; body mass index (BMI) 49.76 +/- 5.8 kg/m(2)) were treated with laparoscopic gastric bypass. All evaluations before surgery and after achieving ~10% and ~25% weight loss (WL). Body composition was assessed by bioimpedance analysis; resting metabolic rate (RMR) was measured by indirect calorimetry. RESULTS Body weight, BMI, and waist circumference significantly decreased at 10% and 25% WL. We observed a significant reduction of both RMR (2,492 +/- 388 at entry vs. 2,098 +/- 346.6 at 10% WL vs. 2,035 +/- 312 kcal per 24 h at 25% WL, p = 0.001 vs. baseline) as well as of RMR corrected for fat-free mass (FFM; 35.7 +/- 6.7 vs. 34.9 +/- 9.0 at 10% WL vs. 33.5 +/- 5.4 at 25% WL kilocalorie per kilogram FFM x 24 h, p = 0.041 vs. baseline). Body composition analysis showed a relative increase in FFM and a reduction of fat mass at 25% WL. A significant reduction in blood glucose, insulin, homeostasis model assessment index was observed. Ultrasonography showed a marked decrease in the signs of hepatic steatosis. CONCLUSION In conclusion, our study confirms that LGBP is a safe procedure in well-selected severely obese patients and has early favorable effects on both metabolic parameters and body composition. Longer-term observations are required for in-depth evaluation of body composition changes.
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Affiliation(s)
- Federica Del Genio
- Department of Clinical and Experimental Medicine, Interuniversity Center for Obesity and Eating Disorder (CISRO), Federico II School of Medicine, Via Pansini 5, 80131, Naples, Italy.
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Labruna G, Pasanisi F, Nardelli C, Tarantino G, Vitale DF, Bracale R, Finelli C, Genua MP, Contaldo F, Sacchetti L. UCP1 -3826 AG+GG genotypes, adiponectin, and leptin/adiponectin ratio in severe obesity. J Endocrinol Invest 2009; 32:525-9. [PMID: 19474520 DOI: 10.1007/bf03346500] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome (MS) are well-recognized complications of obesity. This study was designed to evaluate the role of the UCP1 -3826 A>G polymorphism, adiponectin levels, leptin/adiponectin ratio (L/A), and main biochemical parameters in 102 unrelated severely obese adults [61 females and 41 males, median body mass index (BMI) = 47.8 kg/m2] with NAFLD, with (MS+) or without MS (MS-) from Southern Italy. SUBJECT AND METHODS The UCP1 polymorphism was tested by the TaqMan method, main biochemical parameters by routinary methods, adiponectin, and leptin serum levels by enzyme-linked immunosorbent assay. MS was diagnosed according to the American Heart Association criteria, liver steatosis was detected by ultrasound. RESULTS MS was present in 53% male and 66% female obese patients. Only total cholesterol (p=0.04 males and p=0.002 females) and L/A ratio (p=0.03 males) differed between MS+ and MS- obese patients. At multivariate analysis, severe liver steatosis was significantly associated with: UCP1 (AG+GG) genotypes [odds ratio-confidence interval (OR-CI): 4.25; 1.12-16.13], MS (OR-CI: 8.47; 1.78-40.25), low adiponectin levels (OR-CI: 0.92; 0.87-0.98), high alanine aminotransferase levels (OR-CI: 1.03; 1.00-1.06), age (ORCI: 1.08; 1.00-1.15), and male gender (OR-CI: 10.78; 1.61- 71.96). CONCLUSION In addition to traditional factors, total cholesterol and L/A ratio appear to contribute to MS characterization in severe obesity. Furthermore, the UCP1 (AG+GG) genotypes and low adiponectin levels could predispose to a more severe liver steatosis independently of MS presence. Based on our data, polymorphic UCP1 (AG+GG) obese patients with low adiponectin levels appear to be high-risk subjects for worsening of liver steatosis, a NAFLD, possibly requiring a second-step evaluation by liver biopsy.
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Affiliation(s)
- G Labruna
- CEINGE Biotecnologie Avanzate S.C. a R.L., Naples, Italy
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Tarantino G, Colicchio P, Conca P, Finelli C, Di Minno MND, Tarantino M, Capone D, Pasanisi F. Young adult obese subjects with and without insulin resistance: what is the role of chronic inflammation and how to weigh it non-invasively? J Inflamm (Lond) 2009; 6:6. [PMID: 19291292 PMCID: PMC2663560 DOI: 10.1186/1476-9255-6-6] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2009] [Accepted: 03/16/2009] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Obesity is a leading risk factor for metabolic syndrome whose further expression is non-alcoholic fatty liver disease. Metabolic syndrome is associated with a proinflammatory state that contributes to insulin resistance. Finally, a "metabolically benign obesity" that is not accompanied by insulin resistance has recently been postulated to exist. AIM To find whether any inflammation markers were independently associated with the presence of insulin resistance, evaluating specific anthropometric, ultrasonographic and laboratory parameters in a population of young adult obese subjects. METHODS Of forty two young individuals, divided into two groups (with or without insulin resistance), were studied serum C-reactive protein and fibrinogen as indexes of chronic pro-inflammatory status. Body mass index, waist circumference and metabolic syndrome presence were assessed as part of the metabolic evaluation. Ultrasonography weighted visceral and subcutaneous abdominal fat thickness, spleen size as longitudinal diameter and liver hyperechogenicity. RESULTS AND DISCUSSION Serum C-reactive protein and fibrinogen as well as spleen longitudinal diameter were significantly increased in the obese young with insulin resistance compared to non-insulin resistance group. Insulin resistance was significantly associated with hepatic steatosis score at sonography (r = 0.33, P = 0.03), spleen longitudinal diameter (r = 0.35, P = 0.02) and C-reactive protein (r = 0.38, P = 0.01), but not with body mass index, visceral or subcutaneous abdominal adipose tissue, waist circumference and fibrinogen (P = 0.18, 0.46, 0.33, 0.37 and 0.4, respectively). Steatosis score at sonography was well associated with spleen volume (rho = 0.40, P = 0.01) and C-reactive protein levels (rho = 0.49, P = 0.002). Metabolic syndrome was much more frequent in obese patients with insulin resistance. These findings show that in young adults the only abdominal adiposity without insulin resistance, plays a scarce role in determining hepatic steatosis as well as metabolic syndrome. CONCLUSION Increases in spleen size and CRP levels represent a reliable tool in diagnosing insulin resistance.
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Affiliation(s)
- Giovanni Tarantino
- Department of Clinical and Experimental Medicine, Federico II University Medical School of Naples, Italy
| | - Patrizia Colicchio
- Department of Clinical and Experimental Medicine, Federico II University Medical School of Naples, Italy
| | - Paolo Conca
- Department of Clinical and Experimental Medicine, Federico II University Medical School of Naples, Italy
| | - Carmine Finelli
- Department of Clinical and Experimental Medicine, Federico II University Medical School of Naples, Italy
| | | | - Marianna Tarantino
- Department of Biomorphological and Functional Sciences, Federico II University Medical School of Naples, Italy
| | - Domenico Capone
- Department of Neurosciences, Unit of Clinical Pharmacology, Federico II University Medical School of Naples, Italy
| | - Fabrizio Pasanisi
- Department of Clinical and Experimental Medicine, Federico II University Medical School of Naples, Italy
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Daniele A, Cammarata R, Pasanisi F, Finelli C, Salvatori G, Calcagno G, Bracale R, Labruna G, Nardelli C, Buono P, Sacchetti L, Contaldo F, Oriani G. Molecular analysis of the adiponectin gene in severely obese patients from southern Italy. Ann Nutr Metab 2008; 53:155-61. [PMID: 19011278 DOI: 10.1159/000172976] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2008] [Accepted: 07/03/2008] [Indexed: 02/05/2023]
Abstract
BACKGROUND Severe obesity is a major worldwide public health concern affecting 0.5-5% of the adult population. Adiponectin (Acpr30), an adipokine secreted from adipocytes, shows pleiotropic beneficial effects on obesity and related disorders. In this study, sequence analysis of Acpr30 gene (ACDC) was performed in a highly selected population of severely obese young adult patients from Southern Italy to investigate the associations between polymorphisms in the ACDC gene and the development of severe obesity concomitantly with other features of the metabolic syndrome. METHODS The ACDC gene was analyzed by direct sequencing in the severely obese patients (n=220) and compared to healthy controls (n=116). The associations between the ACDC gene single-nucleotide polymorphisms (SNPs) and the levels of serum Acpr30 as well as the correlation with the presence of severe obesity jointly associated with other features of the metabolic syndrome were also investigated. Total serum Acpr30 concentrations were measured by the ELISA method. RESULTS ACDC gene molecular screening revealed the presence of previously described SNPs and a new nucleotide alteration, c.355T>G, leading to a protein variant, p.L119V. Measurement of serum concentration of Acpr30 demonstrated lower levels of Acpr30 in the obese population compared to controls (30.5+/-28.3 vs. 43.9+/-35.7 microg/ml, p<0.01); in particular, significantly lower Acpr30 concentrations were observed in obese patients bearing c.-11377C>G SNP CG+GG genotypes than in those with CC genotype (22.9+/-20.5 vs. 33.1+/-29.4 microg/ml, p<0.05). CONCLUSIONS Our results confirmed that low serum levels of Acpr30 are related to severe obesity and a difference in protein expression is associated with variants in ACDC gene promoter region.
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Affiliation(s)
- A Daniele
- Dipartimento di Scienze per la Salute, Università del Molise, Campobasso, Italy
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del Genio F, Alfonsi L, Marra M, Finelli C, del Genio G, Rossetti G, del Genio A, Contaldo F, Pasanisi F. Metabolic and nutritional status changes after 10% weight loss in severely obese patients treated with laparoscopic surgery vs integrated medical treatment. Obes Surg 2007; 17:1592-8. [PMID: 18000718 DOI: 10.1007/s11695-007-9286-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2007] [Accepted: 07/17/2007] [Indexed: 02/07/2023]
Abstract
BACKGROUND Bariatric surgery is considered the most effective treatment for reducing excess body weight and maintaining weight loss (WL) in severely obese patients. There are limited data evaluating metabolic and body composition changes after different treatments in type III obese (body mass index [BMI] > 40 kg/m(2)). METHODS Twenty patients (9 males, 11 females; 37.6 +/- 8 years; BMI = 50.1 +/- 8 kg/m(2)) treated with dietary therapy and lifestyle correction (group 1) have been compared with 20 matched patients (41.8 +/- 6 years; BMI = 50.4 +/- 6 kg/m(2)) treated with laparoscopic gastric bypass (LGBP; group 2). Patients have been evaluated before treatment and after >10% WL obtained on average 6 weeks after LGBP and 30 weeks after integrated medical treatment. Metabolic syndrome (MS) was evaluated using the Adult Treatment Panel III/America Heart Association (ATP III/AHA) criteria. Resting metabolic rate (RMR) and respiratory quotient (RQ) was assessed with indirect calorimetry; body composition with bioimpedance analysis. RESULTS At entry, RMR/fat-free mass (FFM) was 34.2 +/- 7 kcal/24 h.kg in group 1 and 35.1 +/- 8 kcal/24 h.kg in group 2 and did not decrease in both groups after 10% WL (31.8 +/- 6 vs 34.0 +/- 6). Percent FFM and fat mass (FM) was 50.7 +/- 7% and 49.3 +/- 7% in group 1 and 52.1 +/- 6% and 47.9 +/- 6% in group 2, respectively (p = n.s.). After WL, body composition significantly changed only in group 1 (% FFM increased to 55.9 +/- 6 and % FM decreased to 44.1 +/- 6; p = 0.002). CONCLUSION After >10% WL, MS prevalence decreases precociously in surgically treated patients; some improvements in body composition are observed in nonsurgically treated patients only. Further investigations are needed to evaluate long-term effects of bariatric surgery on body composition and RMR after stable WL.
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Affiliation(s)
- Federica del Genio
- Interuniversity Center for Obesity and Eating Disorder (CISRO), Department of Clinical and Experimental Medicine, Federico II School of Medicine, Via Pansini 5, 80131 Naples, Italy
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