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Costabile G, Vitale M, Della Pepa G, Cipriano P, Vetrani C, Testa R, Mena P, Bresciani L, Tassotti M, Calani L, Del Rio D, Brighenti F, Napoli R, Rivellese AA, Riccardi G, Giacco R. A wheat aleurone-rich diet improves oxidative stress but does not influence glucose metabolism in overweight/obese individuals: Results from a randomized controlled trial. Nutr Metab Cardiovasc Dis 2022; 32:715-726. [PMID: 35123855 DOI: 10.1016/j.numecd.2021.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 12/16/2021] [Accepted: 12/17/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND AIMS Aleurone is the innermost layer of wheat bran, rich in fiber, minerals, vitamins, phenolic compounds, and betaine. The metabolic effects of aleurone rich foods are still unknown. Our aim was to investigate the effects of consuming a Wheat Aleurone rich diet vs. a Refined Wheat diet for 8 weeks on fasting and postprandial glycemic and lipid metabolism, inflammation, and oxidative stress in overweight/obese individuals. METHODS AND RESULTS According to a randomized cross-over study design, 23 overweight/obese individuals, age 56 ± 9 years (M±SD), were assigned to two isoenergetic diet - Wheat Aleurone and Refined Wheat diets - for 8 weeks. The diets were similar for macronutrient composition but different for the aleurone content (40-50 g/day in the Wheat Aleurone diet). After each diet, fasting and postprandial plasma metabolic profile, ferulic acid metabolites and 8-isoprostane concentrations in 24-h urine samples were evaluated. Compared with the Refined Wheat Diet, the Wheat Aleurone Diet increased fasting plasma concentrations of betaine by 15% (p = 0.042) and decreased the excretion of 8-isoprostane by 33% (p = 0.035). Conversely, it did not affect the fasting and postprandial glucose, insulin and triglyceride responses, homocysteine, and C-Reactive Protein concentrations, nor excretion of phenolic metabolites. CONCLUSION An 8-week Wheat Aleurone Diet improves the oxidative stress and increases plasma betaine levels in overweight/obese individuals with an increased cardiometabolic risk. However, further studies with longer duration and larger sample size are needed to evaluate the benefits of aleurone-rich foods on glucose and lipid metabolism in individuals with more severe metabolic abnormalities. CLINICAL TRIAL REGISTRY NUMBER NCT02150356, (https://clinicaltrials.gov).
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Affiliation(s)
- Giuseppina Costabile
- Department of Clinical Medicine and Surgery, Federico II University, Via Sergio Pansini, 5, 80131 Naples, Italy.
| | - Marilena Vitale
- Department of Clinical Medicine and Surgery, Federico II University, Via Sergio Pansini, 5, 80131 Naples, Italy
| | - Giuseppe Della Pepa
- Department of Clinical Medicine and Surgery, Federico II University, Via Sergio Pansini, 5, 80131 Naples, Italy
| | - Paola Cipriano
- Department of Clinical Medicine and Surgery, Federico II University, Via Sergio Pansini, 5, 80131 Naples, Italy
| | - Claudia Vetrani
- Department of Clinical Medicine and Surgery, Federico II University, Via Sergio Pansini, 5, 80131 Naples, Italy
| | - Roberta Testa
- Department of Clinical Medicine and Surgery, Federico II University, Via Sergio Pansini, 5, 80131 Naples, Italy
| | - Pedro Mena
- Human Nutrition Unit, Department of Food and Drug, University of Parma, Via Volturno, 39, 43125, Parma, Italy
| | - Letizia Bresciani
- Human Nutrition Unit, Department of Food and Drug, University of Parma, Via Volturno, 39, 43125, Parma, Italy
| | - Michele Tassotti
- Human Nutrition Unit, Department of Food and Drug, University of Parma, Via Volturno, 39, 43125, Parma, Italy
| | - Luca Calani
- Human Nutrition Unit, Department of Food and Drug, University of Parma, Via Volturno, 39, 43125, Parma, Italy
| | - Daniele Del Rio
- Human Nutrition Unit, Department of Food and Drug, University of Parma, Via Volturno, 39, 43125, Parma, Italy
| | - Furio Brighenti
- Human Nutrition Unit, Department of Food and Drug, University of Parma, Via Volturno, 39, 43125, Parma, Italy
| | - Raffaele Napoli
- Department of Translational Medical Sciences, Federico II University, Via Sergio Pansini, 5, 80131 Naples, Italy
| | - Angela A Rivellese
- Department of Clinical Medicine and Surgery, Federico II University, Via Sergio Pansini, 5, 80131 Naples, Italy
| | - Gabriele Riccardi
- Department of Clinical Medicine and Surgery, Federico II University, Via Sergio Pansini, 5, 80131 Naples, Italy
| | - Rosalba Giacco
- Institute of Food Sciences, National Research Council, Via Roma 64, 8 Avellino, Italy
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Di Minno A, Gentile M, Iannuzzo G, Calcaterra I, Tripaldella M, Porro B, Cavalca V, Di Taranto MD, Tremoli E, Fortunato G, Rubba POF, Di Minno MND. Endothelial function improvement in patients with familial hypercholesterolemia receiving PCSK-9 inhibitors on top of maximally tolerated lipid lowering therapy. Thromb Res 2020; 194:229-236. [PMID: 33213848 DOI: 10.1016/j.thromres.2020.07.049] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 06/16/2020] [Accepted: 07/29/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Treatment with protein convertase subtilisin kexin type 9 inhibitors (PCSK-9i) reduced cholesterol levels and cardiovascular events in patients with hypercholesterolemia. We assessed changes in lipid profile, oxidation markers and endothelial function in patients with familial hypercholesterolemia (FH) after a 12-week treatment with a PCSK-9i. METHODS Patients with FH starting a treatment with PCSK-9i were included. Total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), lipoprotein(a) (Lp(a)), small dense LDL (assessed by LDL score), 11-dehydro-thromboxane (11-TXB2), 8-isoprostaglandin-2alpha (8-iso-PGF2α), flow-mediated dilation (FMD) and reactive hyperaemia index (RHI) were evaluated before starting PCSK-9i treatment and after a 12-week treatment. RESULTS Twenty-five subjects were enrolled (52% males, mean age 51.5 years). At the 12-week assessment, we observed a 38% median reduction in TC, 52% in LDL-C, 7% in Lp(a) and 46% in LDL score. In parallel, 11-TXB2 and 8-iso-PGF2α showed a reduction of 18% and 17%, respectively. FMD changed from 4.78% ± 2.27 at baseline to 10.6% ± 5.89 at 12 weeks (p < 0.001), with RHI changing from 2.37 ± 1.23 to 3.76 ± 1.36 (p < 0.001). A multivariate analysis showed that, after adjusting for potential confounders, change in LDL score was an independent predictor of changes in FMD (β = -0.846, p = 0.015) and in 8-iso-PGF2α (β = 0.778, p = 0.012). CONCLUSIONS Small dense LDL reduction (assessed by LDL score) is related to changes in oxidation markers and endothelial function in patients with FH treated with PCSK-9i.
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Affiliation(s)
| | - Marco Gentile
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Gabriella Iannuzzo
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Ilenia Calcaterra
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Maria Tripaldella
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Benedetta Porro
- Unit of Metabolomics and Cellular Biochemistry of Atherothrombosis, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Viviana Cavalca
- Unit of Metabolomics and Cellular Biochemistry of Atherothrombosis, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Maria Donata Di Taranto
- Department of Molecular Medicine e Medical Biotechnologies, Federico II University, Naples, Italy
| | - Elena Tremoli
- Unit of Metabolomics and Cellular Biochemistry of Atherothrombosis, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Giuliana Fortunato
- Department of Molecular Medicine e Medical Biotechnologies, Federico II University, Naples, Italy
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Accardo G, Amoresano Paglionico V, Di Fraia R, Cittadini A, Salzano A, Esposito D, De Bellis A, Pasquali D. Management of cardiovascular complications in Klinefelter syndrome patients. Expert Rev Endocrinol Metab 2019; 14:145-152. [PMID: 30793993 DOI: 10.1080/17446651.2019.1584036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 02/14/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Klinefelter syndrome (KS), also known as 47, XXY, shows increased mortality when compared with mortality rates among the general population. Cardiovascular, hemostatic, metabolic diseases are implicated. Moreover, cardiac congenital anomalies in KS can contribute to the increase in mortality. AREAS COVERED In this study, we have systematically reviewed the relationships between KS and the cardiovascular system and the management of cardiovascular complication. In summary, patients with KS display increased cardiovascular risk profile, characterized by increased prevalence of metabolic alterations including dyslipidemia, diabetes mellitus (DM), and abnormalities in biomarkers of cardiovascular disease. KS subjects are characterized by subclinical abnormalities in endothelial function and in left ventricular (LV) systolic and diastolic function, which - when associated with chronotropic incompetence - may negatively influence cardiopulmonary performance. Moreover, KS patients appear to be at a higher risk for cardiovascular disease, due to thromboembolic events with high prevalence of recurrent venous ulcers, venous insufficiency, recurrent venous and arterial thromboembolism leading to deep venous thrombosis or pulmonary embolism. EXPERT OPINION Considering the unequivocal finding of increased mortality of KS patients, we suggest a periodic cardiovascular follow up in specialized centers with multidisciplinary care teams that comprise endocrinologists and cardiologists dedicated to KS syndrome.
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Affiliation(s)
- Giacomo Accardo
- a Department of Medical, Surgical, Neurologic , Metabolic and Aging Sciences, University of Campania "L. Vanvitelli" Naples , Naples , Italy
| | - Vanda Amoresano Paglionico
- a Department of Medical, Surgical, Neurologic , Metabolic and Aging Sciences, University of Campania "L. Vanvitelli" Naples , Naples , Italy
| | - Rosa Di Fraia
- a Department of Medical, Surgical, Neurologic , Metabolic and Aging Sciences, University of Campania "L. Vanvitelli" Naples , Naples , Italy
| | - Antonio Cittadini
- b Department of Translational Medical Sciences , Federico II University School of Medicine , Naples , Italy
| | - Andrea Salzano
- b Department of Translational Medical Sciences , Federico II University School of Medicine , Naples , Italy
| | - Daniela Esposito
- a Department of Medical, Surgical, Neurologic , Metabolic and Aging Sciences, University of Campania "L. Vanvitelli" Naples , Naples , Italy
- c Department of Endocrinology Institute of Medicine , Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital , Gothenburg , Sweden
| | - Annamaria De Bellis
- a Department of Medical, Surgical, Neurologic , Metabolic and Aging Sciences, University of Campania "L. Vanvitelli" Naples , Naples , Italy
| | - Daniela Pasquali
- a Department of Medical, Surgical, Neurologic , Metabolic and Aging Sciences, University of Campania "L. Vanvitelli" Naples , Naples , Italy
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Santilli F, Davì G, Patrono C. Homocysteine, methylenetetrahydrofolate reductase, folate status and atherothrombosis: A mechanistic and clinical perspective. Vascul Pharmacol 2016; 78:1-9. [DOI: 10.1016/j.vph.2015.06.009] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Revised: 06/17/2015] [Accepted: 06/20/2015] [Indexed: 10/23/2022]
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Di Minno MND, Esposito D, Di Minno A, Accardo G, Lupoli G, Cittadini A, Giugliano D, Pasquali D. Increased platelet reactivity in Klinefelter men: something new to consider. Andrology 2015. [DOI: 10.1111/andr.12080] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- M. N. D. Di Minno
- Department of Clinical Medicine and Surgery; University Federico II; Naples Italy
- Unit of Cell and Molecular Biology in Cardiovascular Diseases; Centro Cardiologico Monzino; IRCCS; Milan Italy
| | - D. Esposito
- Department of Cardiothoracic and Respiratory Sciences; Endocrine Unit; Second University of Naples; Naples Italy
| | - A. Di Minno
- Unit of Cell and Molecular Biology in Cardiovascular Diseases; Centro Cardiologico Monzino; IRCCS; Milan Italy
| | - G. Accardo
- Department of Cardiothoracic and Respiratory Sciences; Endocrine Unit; Second University of Naples; Naples Italy
| | - G. Lupoli
- Department of Clinical Medicine and Surgery; University Federico II; Naples Italy
| | - A. Cittadini
- Department of Medical Traslational Sciences; University Federico II; Naples Italy
| | - D. Giugliano
- Department of Medical, Surgical, Neurological, Metabolic Sciences and Geriatrics; Second University of Naples; Naples Italy
| | - D. Pasquali
- Department of Cardiothoracic and Respiratory Sciences; Endocrine Unit; Second University of Naples; Naples Italy
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Ambrosino P, Lupoli R, Di Minno A, Nardo A, Marrone E, Lupoli V, Scaravilli A, Mitidieri E, Tufano A, Di Minno MND. Cyclic supplementation of 5-MTHF is effective for the correction of hyperhomocysteinemia. Nutr Res 2015; 35:489-95. [PMID: 25841618 DOI: 10.1016/j.nutres.2015.02.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Revised: 02/16/2015] [Accepted: 02/23/2015] [Indexed: 10/23/2022]
Abstract
Folic acid supplementation is the mainstay treatment of hyperhomocysteinemia (HHcy). However, no recommendations are currently available in regard to the optimal replacement therapy. Therefore, this prospective study hypothesized that a cyclic schedule (1 month of therapy followed by 2 months of withdrawal) of 5-methyltetrahydrofolate (5-MTHF) would reduce plasma levels of fasting total homocysteine (tHcy) in patients with mild/moderate HHcy. Patients with a new diagnosis of mild/moderate HHcy were evaluated for the methylenetetrahydrofolate reductase genotype and the presence of major features of metabolic syndrome. All enrolled subjects received a cyclic 5-MTHF oral supplementation and were reevaluated after each treatment cycle for a total of 2 years. In the 246 enrolled subjects, a significant reduction of tHcy levels occurred after the first cycle of treatment (from 31.6 ± 13.6 to 14.4 ± 5.77 μmol/L, P < .001) and during the whole 2-year follow-up (from 31.6 ± 13.6 to 12.18 ± 3.03 μmol/L, P < .001). The values of tHcy returned to reference range in 117 subjects (51.3%) after the first cycle and in 198 (86.8%) during the follow-up. The risk of failure in tHcy level normalization was increased in patients with metabolic syndrome (hazard ratio [HR], 3.49; 95% confidence interval [CI], 1.46-8.36), higher baseline tHcy levels (HR, 1.045; 95% CI, 1.018-1.073), or methylenetetrahydrofolate reductase homozygous mutation (HR, 6.59; 95% CI, 2.64-16.4). This study clearly shows that a cyclic schedule (1 month of therapy followed by 2 months of withdrawal) of 5-MTHF supplementation is able to significantly reduce tHcy levels in patients with mild/moderate HHcy.
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Affiliation(s)
- Pasquale Ambrosino
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Roberta Lupoli
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Alessandro Di Minno
- Unit of Cell and Molecular Biology in Cardiovascular Diseases, Centro Cardiologico Monzino, IRCCS, Milan, Italy
| | - Assunta Nardo
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Emiliana Marrone
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | | | | | - Emma Mitidieri
- Department of Pharmacy, Federico II University, Naples, Italy
| | - Antonella Tufano
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Matteo Nicola Dario Di Minno
- Unit of Cell and Molecular Biology in Cardiovascular Diseases, Centro Cardiologico Monzino, IRCCS, Milan, Italy.
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Bauer J, Ripperger A, Frantz S, Ergün S, Schwedhelm E, Benndorf RA. Pathophysiology of isoprostanes in the cardiovascular system: implications of isoprostane-mediated thromboxane A2 receptor activation. Br J Pharmacol 2015; 171:3115-31. [PMID: 24646155 DOI: 10.1111/bph.12677] [Citation(s) in RCA: 109] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 02/20/2014] [Accepted: 03/03/2014] [Indexed: 12/13/2022] Open
Abstract
Isoprostanes are free radical-catalysed PG-like products of unsaturated fatty acids, such as arachidonic acid, which are widely recognized as reliable markers of systemic lipid peroxidation and oxidative stress in vivo. Moreover, activation of enzymes, such as COX-2, may contribute to isoprostane formation. Indeed, formation of isoprostanes is considerably increased in various diseases which have been linked to oxidative stress, such as cardiovascular disease (CVD), and may predict the atherosclerotic burden and the risk of cardiovascular complications in the latter patients. In addition, several isoprostanes may directly contribute to the functional consequences of oxidant stress via activation of the TxA2 prostanoid receptor (TP), for example, by affecting endothelial cell function and regeneration, vascular tone, haemostasis and ischaemia/reperfusion injury. In this context, experimental and clinical data suggest that selected isoprostanes may represent important alternative activators of the TP receptor when endogenous TxA2 levels are low, for example, in aspirin-treated individuals with CVD. In this review, we will summarize the current understanding of isoprostane formation, biochemistry and (patho) physiology in the cardiovascular context.
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Affiliation(s)
- Jochen Bauer
- Institute of Anatomy and Cell Biology, University of Würzburg, Würzburg, Germany
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