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Petrin S, Tiengo A, Longo A, Furlan M, Marafin E, Zavagnin P, Orsini M, Losasso C, Barco L. Uncommon Salmonella Infantis Variants with Incomplete Antigenic Formula in the Poultry Food Chain, Italy. Emerg Infect Dis 2024; 30:795-799. [PMID: 38526241 PMCID: PMC10977818 DOI: 10.3201/eid3004.231074] [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] [Indexed: 03/26/2024] Open
Abstract
Uncommon Salmonella Infantis variants displaying only flagellar antigens phenotypically showed identical incomplete antigenic formula but differed by molecular serotyping. Although most formed rough colonies, all shared antimicrobial resistances and the presence of usg gene with wild-type Salmonella Infantis. Moreover, they were undistinguishable wild-type Salmonella Infantis by whole-genome sequencing.
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Affiliation(s)
| | | | - Alessandra Longo
- National and World Organisation for Animal Health Reference Laboratory for Salmonella, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
| | - Maddalena Furlan
- National and World Organisation for Animal Health Reference Laboratory for Salmonella, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
| | - Elisa Marafin
- National and World Organisation for Animal Health Reference Laboratory for Salmonella, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
| | - Paola Zavagnin
- National and World Organisation for Animal Health Reference Laboratory for Salmonella, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
| | - Massimiliano Orsini
- National and World Organisation for Animal Health Reference Laboratory for Salmonella, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
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Napoleoni M, Villa L, Barco L, Lucarelli C, Tiengo A, Baggio G, Dionisi AM, Angellotti A, Ferretti E, Ruggeri S, Staffolani M, Rocchegiani E, Silenzi V, Morandi B, Blasi G. Monophasic Variant of Salmonella Typhimurium 4,[5],12:i:- (ACSSuGmTmpSxt Type) Outbreak in Central Italy Linked to the Consumption of a Roasted Pork Product (Porchetta). Microorganisms 2023; 11:2567. [PMID: 37894225 PMCID: PMC10609469 DOI: 10.3390/microorganisms11102567] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/10/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
The monophasic variant of S. Typhimurium 4,[5],12:i:- (MVST) is the third most commonly reported Salmonella serovar involved in human infections (8.8%) in the EU and ranks after S. Enteritidis (54.6%) and S. Typhimurium (11.4%). In Italy, in contrast, the MVST has achieved peculiar epidemiological and ecological success which has allowed it to be, since 2011, the serovar most frequently isolated from humans. In the summer of 2022, a foodborne outbreak of the MVST involving 63 people occurred in the Marche Region (Central Italy). A common food exposure source among some human cases was a roasted, ready-to-eat (RTE) pork product, porchetta, which is a typical product of Central Italy. This paper describes the results of investigations conducted to clarify this outbreak. The porchetta was produced by a local manufacturing plant and distributed to at least two local retail stores, one of which was the retail outlet for the manufacturing plant. The MVST was isolated from surface samples collected at the porchetta manufacturing plant and at both local retail stores via bacterial analysis, and the porchetta sampled at one store contained the MVST. These data confirm this type of RTE pork product can be a source of Salmonella infection in humans.
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Affiliation(s)
- Maira Napoleoni
- Centro di Riferimento Regionale Patogeni Enterici Marche, Istituto Zooprofilattico Sperimentale dell’Umbria e delle Marche “Togo Rosati”, Via Maestri del Lavoro, 7, 62029 Tolentino, Macerata, Italy; (M.S.); (E.R.); (V.S.); (G.B.)
| | - Laura Villa
- Dipartimento di Malattie Infettive, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161 Roma, Italy; (L.V.); (C.L.); (A.M.D.)
| | - Lisa Barco
- Centro di Referenza Nazionale e Laboratorio di Referenza WOAH per le Salmonellosi, Istituto Zooprofilattico Sperimentale Delle Venezie, Viale dell’Università, 10, 35020 Legnaro, Padova, Italy; (L.B.); (A.T.); (G.B.)
| | - Claudia Lucarelli
- Dipartimento di Malattie Infettive, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161 Roma, Italy; (L.V.); (C.L.); (A.M.D.)
| | - Alessia Tiengo
- Centro di Referenza Nazionale e Laboratorio di Referenza WOAH per le Salmonellosi, Istituto Zooprofilattico Sperimentale Delle Venezie, Viale dell’Università, 10, 35020 Legnaro, Padova, Italy; (L.B.); (A.T.); (G.B.)
| | - Giulia Baggio
- Centro di Referenza Nazionale e Laboratorio di Referenza WOAH per le Salmonellosi, Istituto Zooprofilattico Sperimentale Delle Venezie, Viale dell’Università, 10, 35020 Legnaro, Padova, Italy; (L.B.); (A.T.); (G.B.)
| | - Anna Maria Dionisi
- Dipartimento di Malattie Infettive, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161 Roma, Italy; (L.V.); (C.L.); (A.M.D.)
| | - Antonio Angellotti
- UOC Igiene degli Alimenti di Origine Animale, Azienda Sanitaria Territoriale Fermo—Marche, Via Zeppilli, 22A, 63900 Fermo, Italy; (A.A.); (E.F.); (S.R.)
| | - Ezio Ferretti
- UOC Igiene degli Alimenti di Origine Animale, Azienda Sanitaria Territoriale Fermo—Marche, Via Zeppilli, 22A, 63900 Fermo, Italy; (A.A.); (E.F.); (S.R.)
| | - Simonetta Ruggeri
- UOC Igiene degli Alimenti di Origine Animale, Azienda Sanitaria Territoriale Fermo—Marche, Via Zeppilli, 22A, 63900 Fermo, Italy; (A.A.); (E.F.); (S.R.)
| | - Monica Staffolani
- Centro di Riferimento Regionale Patogeni Enterici Marche, Istituto Zooprofilattico Sperimentale dell’Umbria e delle Marche “Togo Rosati”, Via Maestri del Lavoro, 7, 62029 Tolentino, Macerata, Italy; (M.S.); (E.R.); (V.S.); (G.B.)
| | - Elena Rocchegiani
- Centro di Riferimento Regionale Patogeni Enterici Marche, Istituto Zooprofilattico Sperimentale dell’Umbria e delle Marche “Togo Rosati”, Via Maestri del Lavoro, 7, 62029 Tolentino, Macerata, Italy; (M.S.); (E.R.); (V.S.); (G.B.)
| | - Valentina Silenzi
- Centro di Riferimento Regionale Patogeni Enterici Marche, Istituto Zooprofilattico Sperimentale dell’Umbria e delle Marche “Togo Rosati”, Via Maestri del Lavoro, 7, 62029 Tolentino, Macerata, Italy; (M.S.); (E.R.); (V.S.); (G.B.)
| | - Benedetto Morandi
- Laboratorio di Diagnostica Animale, Istituto Zooprofilattico Sperimentale dell’Umbria e delle Marche “Togo Rosati”, Via Maestri del Lavoro, 7, 62029 Tolentino, Macerata, Italy;
| | - Giuliana Blasi
- Centro di Riferimento Regionale Patogeni Enterici Marche, Istituto Zooprofilattico Sperimentale dell’Umbria e delle Marche “Togo Rosati”, Via Maestri del Lavoro, 7, 62029 Tolentino, Macerata, Italy; (M.S.); (E.R.); (V.S.); (G.B.)
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Tiengo A, Orsini M, Petrin S, Losasso C, Longo A, Cento G, Ciot L, Ceruti R, Cibin V, Barco L. Whole-Genome Sequence of Salmonella enterica Serovar Bispebjerg from Turkey Reveals Its Pathogenic Potential. Microbiol Resour Announc 2023; 12:e0004323. [PMID: 37022181 DOI: 10.1128/mra.00043-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
We report the genome sequence of a Salmonella enterica subsp. enterica serovar Bispebjerg strain that was isolated from a turkey flock in 2011. The genome analysis of the strain, a rare and multihost serovar, revealed its pathogenic potential due to antimicrobial resistance and a plethora of Salmonella pathogenicity islands and virulence factors.
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Affiliation(s)
- Alessia Tiengo
- Italian National Reference Laboratory for Salmonellosis, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Padua, Italy
| | - Massimiliano Orsini
- Italian National Reference Laboratory for Salmonellosis, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Padua, Italy
| | - Sara Petrin
- Italian National Reference Laboratory for Salmonellosis, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Padua, Italy
| | - Carmen Losasso
- Italian National Reference Laboratory for Salmonellosis, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Padua, Italy
| | - Alessandra Longo
- Italian National Reference Laboratory for Salmonellosis, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Padua, Italy
| | - Giulia Cento
- Italian National Reference Laboratory for Salmonellosis, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Padua, Italy
| | - Laura Ciot
- Italian National Reference Laboratory for Salmonellosis, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Padua, Italy
| | | | - Veronica Cibin
- Epidemiology Department, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Padua, Italy
| | - Lisa Barco
- Italian National Reference Laboratory for Salmonellosis, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Padua, Italy
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Tata A, Marzoli F, Cordovana M, Tiengo A, Zacometti C, Massaro A, Barco L, Belluco S, Piro R. A multi-center validation study on the discrimination of Legionella pneumophila sg.1, Legionella pneumophila sg. 2-15 and Legionella non- pneumophila isolates from water by FT-IR spectroscopy. Front Microbiol 2023; 14:1150942. [PMID: 37125166 PMCID: PMC10133462 DOI: 10.3389/fmicb.2023.1150942] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 03/20/2023] [Indexed: 05/02/2023] Open
Abstract
This study developed and validated a method, based on the coupling of Fourier-transform infrared spectroscopy (FT-IR) and machine learning, for the automated serotyping of Legionella pneumophila serogroup 1, Legionella pneumophila serogroups 2-15 as well as their successful discrimination from Legionella non-pneumophila. As Legionella presents significant intra- and inter-species heterogeneities, careful data validation strategies were applied to minimize late-stage performance variations of the method across a large microbial population. A total of 244 isolates were analyzed. In details, the method was validated with a multi-centric approach with isolates from Italian thermal and drinking water (n = 82) as well as with samples from German, Italian, French, and British collections (n = 162). Specifically, robustness of the method was verified over the time-span of 1 year with multiple operators and two different FT-IR instruments located in Italy and Germany. Moreover, different production procedures for the solid culture medium (in-house or commercial) and different culture conditions (with and without 2.5% CO2) were tested. The method achieved an overall accuracy of 100, 98.5, and 93.9% on the Italian test set of Legionella, an independent batch of Legionella from multiple European culture collections, and an extra set of rare Legionella non-pneumophila, respectively.
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Affiliation(s)
- Alessandra Tata
- Laboratorio di Chimica Sperimentale, Istituto Zooprofilattico Sperimentale delle Venezie, Vicenza, Italy
- *Correspondence: Alessandra Tata,
| | - Filippo Marzoli
- Department of Food Safety, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
| | | | - Alessia Tiengo
- OIE Italian Reference Laboratory for Salmonella, Istituto Zooprofilattico Sperimentale delle Venezie, Padova, Italy
| | - Carmela Zacometti
- Laboratorio di Chimica Sperimentale, Istituto Zooprofilattico Sperimentale delle Venezie, Vicenza, Italy
| | - Andrea Massaro
- Laboratorio di Chimica Sperimentale, Istituto Zooprofilattico Sperimentale delle Venezie, Vicenza, Italy
| | - Lisa Barco
- OIE Italian Reference Laboratory for Salmonella, Istituto Zooprofilattico Sperimentale delle Venezie, Padova, Italy
| | - Simone Belluco
- Department of Food Safety, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
| | - Roberto Piro
- Laboratorio di Chimica Sperimentale, Istituto Zooprofilattico Sperimentale delle Venezie, Vicenza, Italy
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Patuzzi I, Orsini M, Cibin V, Petrin S, Mastrorilli E, Tiengo A, Gobbo F, Catania S, Barco L, Ricci A, Losasso C. The Interplay between Campylobacter and the Caecal Microbial Community of Commercial Broiler Chickens over Time. Microorganisms 2021; 9:221. [PMID: 33499060 PMCID: PMC7911313 DOI: 10.3390/microorganisms9020221] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/18/2021] [Accepted: 01/20/2021] [Indexed: 12/27/2022] Open
Abstract
Campylobacter is the most frequent foodborne zoonotic bacteria worldwide, with chicken meat being overwhelmingly the most important reservoir for human infections. Control measures implemented at the farm level (i.e., biosecurity or vaccination), which have been successfully applied to limit other pathogens, such as Salmonella, have not been effective in reducing Campylobacter occurrence. Thus, new approaches are needed to fully understand the ecological interactions of Campylobacter with host animals to effectively comprehend its epidemiology. The objective of this study was to analyse longitudinally the gut microbiota composition of Campylobacter-infected and non-infected farms to identify any difference that could potentially be indicative of gut colonization by Campylobacter spp. Differences in the colonization rate and timing were observed at the farms that became positive for Campylobacter jejuni over the investigated time points, even though in positive tests, the occurrence of Campylobacter jejuni gut colonization was not observed before the second week of the life of the birds. Significant differences were observed in the abundances of specific bacterial taxa between the microbiota of individuals belonging to farms that became Campylobacter positive during the study and those who remained negative with particular reference to Bacteroidales and Clostridiales, respectively. Moreover, Campylobacter colonization dramatically influenced the microbiota richness, although to a different extent depending on the infection timing. Finally, a key role of Faecalibacterium and Lactobacillus genera on the Campylobacter microbial network was observed. Understanding the ecology of the Campylobacter interaction with host microbiota during infection could support novel approaches for broiler microbial barrier restoration. Therefore, evidence obtained through this study can be used to identify options to reduce the incidence of infection at a primary production level based on the targeted influence of the intestinal microbiota, thus helping develop new control strategies in order to mitigate the risk of human exposure to Campylobacter by chicken meat consumption.
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Affiliation(s)
- Ilaria Patuzzi
- Microbial Ecology and Genomics Laboratory, Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell’Università 10, 35120 Legnaro, Italy; (I.P.); (M.O.); (S.P.); (E.M.)
| | - Massimiliano Orsini
- Microbial Ecology and Genomics Laboratory, Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell’Università 10, 35120 Legnaro, Italy; (I.P.); (M.O.); (S.P.); (E.M.)
| | - Veronica Cibin
- National Reference Laboratory for Salmonella, Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell’Università 10, 35120 Legnaro, Italy; (V.C.); (A.T.); (A.R.)
| | - Sara Petrin
- Microbial Ecology and Genomics Laboratory, Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell’Università 10, 35120 Legnaro, Italy; (I.P.); (M.O.); (S.P.); (E.M.)
| | - Eleonora Mastrorilli
- Microbial Ecology and Genomics Laboratory, Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell’Università 10, 35120 Legnaro, Italy; (I.P.); (M.O.); (S.P.); (E.M.)
| | - Alessia Tiengo
- National Reference Laboratory for Salmonella, Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell’Università 10, 35120 Legnaro, Italy; (V.C.); (A.T.); (A.R.)
| | - Federica Gobbo
- Avian Pathology Laboratory, Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell’Università 10, 35120 Legnaro, Italy; (F.G.); (S.C.)
| | - Salvatore Catania
- Avian Pathology Laboratory, Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell’Università 10, 35120 Legnaro, Italy; (F.G.); (S.C.)
| | - Lisa Barco
- Experimental Microbiology Department, Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell’Università 10, 35120 Legnaro, Italy;
| | - Antonia Ricci
- National Reference Laboratory for Salmonella, Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell’Università 10, 35120 Legnaro, Italy; (V.C.); (A.T.); (A.R.)
| | - Carmen Losasso
- Microbial Ecology and Genomics Laboratory, Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell’Università 10, 35120 Legnaro, Italy; (I.P.); (M.O.); (S.P.); (E.M.)
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Petrin S, Patuzzi I, Di Cesare A, Tiengo A, Sette G, Biancotto G, Corno G, Drigo M, Losasso C, Cibin V. Evaluation and quantification of antimicrobial residues and antimicrobial resistance genes in two Italian swine farms. Environ Pollut 2019; 255:113183. [PMID: 31541814 DOI: 10.1016/j.envpol.2019.113183] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 08/27/2019] [Accepted: 09/04/2019] [Indexed: 06/10/2023]
Abstract
Antimicrobial resistance genes (ARGs) are considered emerging environmental pollutants, posing potential risks for human and animal health: the misuse of antimicrobials in food-producing animals could favour the maintenance and spread of resistances in bacteria. The occurrence of ARGs in Italian swine farming - which has specific characteristics - was investigated in order to explore resistance spread dynamics. Two farrow-to-finish pig farms were longitudinally monitored: faecal samples from animals and environmental samples were collected. DNA was extracted and tetA, ermB, qnrS and mcr1 ARGs were analysed by qPCR for their ability to confer resistance to highly or critically important antimicrobials (CIAs). Moreover, 16SrDNA gene was analysed to assess bacterial abundance. ermB and tetA genes were found in animal samples and manure samples. On the contrary, mcr1 was exclusively found in weaners, while qnrS occurred in all animal categories but sows and finishers. Among the analysed genes, ermB and tetA showed the highest absolute and relative abundances. Our results indicate that ermB and tetA ARGs are widely disseminated in the explored farms, suggesting efficient maintenance among bacteria and persistence in the environment. Interestingly, the presence of qnrS and mcr1, limited to just a few animal categories, highlights inefficient dissemination of these genes in the farm environment, in particular for mcr1, a stable plasmid gene conferring resistance to the last-resort antimicrobial, colistin. Paying close attention only to the finishing phase would have hampered the discovery of resistances to CIAs at farm level, which we instead identified thanks to an intensive longitudinal monitoring programme.
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Affiliation(s)
- Sara Petrin
- OU Microbial Ecology, Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, 35020, Legnaro, Italy
| | - Ilaria Patuzzi
- OU Microbial Ecology, Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, 35020, Legnaro, Italy
| | | | - Alessia Tiengo
- Food Pathogens and Antimicrobial Resistance Laboratory, Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, 35020, Legnaro, Italy
| | - Giovanni Sette
- Chemistry Department, Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, 35020, Legnaro, Italy
| | - Giancarlo Biancotto
- Chemistry Department, Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, 35020, Legnaro, Italy
| | - Gianluca Corno
- CNR-IRSA, Corso Tonolli, 50, 28922, Pallanza, Verbania, Italy
| | - Michele Drigo
- Department of Animal Medicine, Production and Health (MAPS), University of Padua, Viale dell'Università 16, 35020, Legnaro, Italy
| | - Carmen Losasso
- OU Microbial Ecology, Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, 35020, Legnaro, Italy.
| | - Veronica Cibin
- Food Pathogens and Antimicrobial Resistance Laboratory, Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, 35020, Legnaro, Italy
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Veres P, Bhat PN, Briggs MS, Cleveland WH, Hamburg R, Hui CM, Mailyan B, Preece RD, Roberts OJ, von Kienlin A, Wilson-Hodge CA, Kocevski D, Arimoto M, Tak D, Asano K, Axelsson M, Barbiellini G, Bissaldi E, Dirirsa FF, Gill R, Granot J, McEnery J, Omodei N, Razzaque S, Piron F, Racusin JL, Thompson DJ, Campana S, Bernardini MG, Kuin NPM, Siegel MH, Cenko SB, O’Brien P, Capalbi M, Daì A, De Pasquale M, Gropp J, Klingler N, Osborne JP, Perri M, Starling RLC, Tagliaferri G, Tohuvavohu A, Ursi A, Tavani M, Cardillo M, Casentini C, Piano G, Evangelista Y, Verrecchia F, Pittori C, Lucarelli F, Bulgarelli A, Parmiggiani N, Anderson GE, Anderson JP, Bernardi G, Bolmer J, Caballero-García MD, Carrasco IM, Castellón A, Segura NC, Castro-Tirado AJ, Cherukuri SV, Cockeram AM, D’Avanzo P, Di Dato A, Diretse R, Fender RP, Fernández-García E, Fynbo JPU, Fruchter AS, Greiner J, Gromadzki M, Heintz KE, Heywood I, van der Horst AJ, Hu YD, Inserra C, Izzo L, Jaiswal V, Jakobsson P, Japelj J, Kankare E, Kann DA, Kouveliotou C, Klose S, Levan AJ, Li XY, Lotti S, Maguire K, Malesani DB, Manulis I, Marongiu M, Martin S, Melandri A, Michałowski MJ, Miller-Jones JCA, Misra K, Moin A, Mooley KP, Nasri S, Nicholl M, Noschese A, Novara G, Pandey SB, Peretti E, del Pulgar CJP, Pérez-Torres MA, Perley DA, Piro L, Ragosta F, Resmi L, Ricci R, Rossi A, Sánchez-Ramírez R, Selsing J, Schulze S, Smartt SJ, Smith IA, Sokolov VV, Stevens J, Tanvir NR, Thöne CC, Tiengo A, Tremou E, Troja E, de Ugarte Postigo A, Valeev AF, Vergani SD, Wieringa M, Woudt PA, Xu D, Yaron O, Young DR. Observation of inverse Compton emission from a long γ-ray burst. Nature 2019; 575:459-463. [DOI: 10.1038/s41586-019-1754-6] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Accepted: 10/18/2019] [Indexed: 11/09/2022]
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Longo A, Petrin S, Mastrorilli E, Tiengo A, Lettini AA, Barco L, Ricci A, Losasso C, Cibin V. Characterizing Salmonella enterica Serovar Choleraesuis, var. Kunzendorf: A Comparative Case Study. Front Vet Sci 2019; 6:316. [PMID: 31620457 PMCID: PMC6763558 DOI: 10.3389/fvets.2019.00316] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 09/04/2019] [Indexed: 11/15/2022] Open
Abstract
Different Salmonella serovars generally display different antigenic formulae, but there are some exceptions. For instance, the same antigenic formula, 6,7:c:1,5, is shared by Salmonella enterica serovar, Paratyphi C, Typhisuis, and Choleraesuis. Moreover, three biotypes have been described within the S. Choleraesuis serovar. A distinction among such biotypes can only be based on biochemical behaviors (biotyping) posing serious concerns when rapid characterization is required. The study of an outbreak of severe epizootic salmonellosis in wild boars occurred in Italy between 2012 and 2014 and the typing of the isolates recovered from the outbreak were used to test different approaches for serovar identification. A number of 30 S. Choleraesuis var. Kunzendorf isolates from the outbreak were typed by means of four different methods to derive serovar and biotype: (i) slide agglutination method followed by biochemical tests, (ii) suspension array xMAP® Salmonella Serotyping Assay (SSA), (iii) whole genome sequencing (WGS) and data analysis using SeqSero tool, and (iv) WGS and data analysis using Salmonella TypeFinder tool. Slide agglutination, xMAP® SSA and WGS, followed by SeqSero analysis, are methods that infer the serovars according to the White-Kauffmann-Le Minor (WKL) scheme, based exclusively on antigens. Using these methods, isolates with incomplete antigenic formulae could be misleadingly excluded from an outbreak. On the contrary, WGS followed by Salmonella TypeFinder data analysis, which predicts the serotype on the basis of Multilocus sequence typing (MLST), might be able to cluster together isolates belonging to the same outbreak irrespective of the antigenic formula. Results suggest the benefit of routine use of a combination of in silico MLST and antigenic formula analysis to solve specific ambiguous case studies for outbreak investigation purposes.
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Affiliation(s)
| | | | | | | | | | | | | | - Carmen Losasso
- World Organisation for Animal Health (OIE), National Reference Laboratory for Salmonellosis, Istituto Zooprofilattico Sperimentale delle Venezie, viale dell'Università, Legnaro, Italy
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Israel GL, Papitto A, Esposito P, Stella L, Zampieri L, Belfiore A, Rodríguez Castillo GA, De Luca A, Tiengo A, Haberl F, Greiner J, Salvaterra R, Sandrelli S, Lisini G. Discovery of a 0.42-s pulsar in the ultraluminous X-ray source NGC 7793 P13. ACTA ACUST UNITED AC 2016. [DOI: 10.1093/mnrasl/slw218] [Citation(s) in RCA: 218] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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10
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Trevisan R, Bonizzoni E, Bosi E, Ceriello A, Cucinotta D, Giorgino F, Tiengo A, Scavini M. Glycated haemoglobin does not accurately predict average capillary glucose in non insulin-treated type 2 diabetes: The PRISMA study experience. Nutr Metab Cardiovasc Dis 2016; 26:169-170. [PMID: 26803592 DOI: 10.1016/j.numecd.2015.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Revised: 12/13/2015] [Accepted: 12/14/2015] [Indexed: 11/29/2022]
Affiliation(s)
- R Trevisan
- Unit of Endocrinology and Diabetology, AO Papa Giovanni XXIII, Bergamo, Italy
| | - E Bonizzoni
- Department of Occupational Health Clinica del Lavoro L. Devoto, Section of Medical Statistics and Biometry G.A. Maccacaro, School of Medicine, University of Milan, Milan, Italy
| | - E Bosi
- Diabetes Research Institute, San Raffaele Hospital & Scientific Institute, Milan, Italy; San Raffaele Vita-Salute University, Milan, Italy
| | - A Ceriello
- Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS) and Centro de Investigacion Biomedica en Red de Diabetes y Enfermedades Metabolicas Asociadis (CIBERDEM), Barcelona, Spain
| | - D Cucinotta
- Department of Clinical and Experimental Medicine, Policlinico Universitario Gaetano Martino, Messina, Italy
| | - F Giorgino
- Department of Emergency and Organ Transplantation, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, Bari, Italy
| | - A Tiengo
- Department of Medicine, University of Padova, Padova, Italy
| | - M Scavini
- Diabetes Research Institute, San Raffaele Hospital & Scientific Institute, Milan, Italy.
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Esposito P, Israel GL, Belfiore A, Novara G, Sidoli L, Rodríguez Castillo GA, De Luca A, Tiengo A, Haberl F, Salvaterra R, Read AM, Salvetti D, Sandrelli S, Marelli M, Wilms J, D'Agostino D. EXTraS discovery of an 1.2-s X-ray pulsar in M 31. ACTA ACUST UNITED AC 2015. [DOI: 10.1093/mnrasl/slv194] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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12
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Borghese A, Rea N, Zelati FC, Tiengo A, Turolla R. DISCOVERY OF A STRONGLY PHASE-VARIABLE SPECTRAL FEATURE IN THE ISOLATED NEUTRON STAR RX J0720.4–3125. ACTA ACUST UNITED AC 2015. [DOI: 10.1088/2041-8205/807/1/l20] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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13
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Maggi S, Noale M, Pilotto A, Tiengo A, Cavallo Perin P, Crepaldi G. The METABOLIC Study: Multidimensional assessment of health and functional status in older patients with type 2 diabetes taking oral antidiabetic treatment. Diabetes & Metabolism 2013; 39:236-43. [DOI: 10.1016/j.diabet.2013.02.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Revised: 02/08/2013] [Accepted: 02/10/2013] [Indexed: 10/27/2022]
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14
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Mereghetti S, La Palombara N, Esposito P, Tiengo A. X-ray emission from hot subdwarfs with compact companions. EPJ Web of Conferences 2013. [DOI: 10.1051/epjconf/20134304003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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15
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Fadini GP, de Kreutzenberg SV, Mariano V, Boscaro E, Bertolini F, Mancuso P, Quarna J, Marescotti M, Agostini C, Tiengo A, Avogaro A. Optimized glycaemic control achieved with add-on basal insulin therapy improves indexes of endothelial damage and regeneration in type 2 diabetic patients with macroangiopathy: a randomized crossover trial comparing detemir versus glargine. Diabetes Obes Metab 2011; 13:718-25. [PMID: 21410861 DOI: 10.1111/j.1463-1326.2011.01396.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [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: 01/04/2023]
Abstract
AIMS In diabetes, endothelial damage promotes macroangiopathy and endothelial regeneration is impaired, owing to reduced endothelial progenitor cells (EPCs). Given that insulin influences endothelial biology, we compared the effects of add-on basal insulin analogues on endothelial damage and regeneration in type 2 diabetes (T2D). METHODS This was a 6-month randomized crossover trial comparing add-on insulin detemir versus glargine in poorly controlled T2D with macroangiopathy. At baseline, crossover (3 months) and study end (6 months), we measured HbA1c, EPCs, circulating endothelial cells (CECs), VCAM-1, ICAM-1 and E-selectin. Body weight and hypoglycaemic episodes were also recorded. RESULTS Forty-two patients completed the study, randomly assigned to the glargine-detemir (n = 21) or the detemir-glargine (n = 21) schedule. At crossover, EPC levels did not change compared with baseline, but significantly increased at study end. CECs decreased over time and were significantly reduced at study end. ICAM-1, VCAM-1 and E-selectin were significantly reduced at crossover and further decreased at study end. No differences were seen in these effects between detemir and glargine. HbA1c showed a carryover effect and its reduction was similar with detemir and glargine in the first arm. Incidence of hypoglycaemia and weight gain was lower with detemir than with glargine in both arms. CONCLUSION Optimized glycaemic control by add-on basal insulin improved indexes of endothelial damage and regeneration. Compared to glargine, detemir achieved similar endothelial protection with lower weight gain and less hypoglycaemia. These results might have implications for therapy of aging T2D patients with cardiovascular disease.
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Affiliation(s)
- G P Fadini
- Department of Clinical and Experimental Medicine, University of Padova Medical School, Padova, Italy.
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16
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de Kreutzenberg SV, Coracina A, Volpi A, Fadini GP, Frigo AC, Guarneri G, Tiengo A, Avogaro A. Microangiopathy is independently associated with presence, severity and composition of carotid atherosclerosis in type 2 diabetes. Nutr Metab Cardiovasc Dis 2011; 21:286-293. [PMID: 20163939 DOI: 10.1016/j.numecd.2009.10.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [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] [Received: 07/14/2009] [Revised: 10/07/2009] [Accepted: 10/09/2009] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIMS Common mechanisms for the development of micro- and macroangiopathic diabetic complications have been suggested. We aimed to cross-sectionally investigate strength and characteristics of the association between carotid atherosclerosis and microangiopathy in type 2 diabetic patients. METHODS AND RESULTS Common carotid artery intima-media thickness (cIMT), carotid plaque (CP) type and degree of stenosis were evaluated by ultrasound, along with the determination of anthropometric parameters, HbA1c, lipid profile, assessment of diabetic retinopathy and nephropathy, in 662 consecutive patients with type 2 diabetes mellitus (T2DM). Patients were divided according to high/low cIMT, presence/absence of CP and of retinopathy and nephropathy. Patients with CP were older, more prevalently males, past smokers, had longer diabetes duration, significantly lower HDL cholesterol and more prevalent ischemic heart disease (all p<0.05) as compared to those with cIMT < 1 mm. Microangiopathies were more prevalent in patients with CP than in those without. At multivariate logistic regression, factors independently associated with the presence of CP were age, past smoke, HDL cholesterol, retinopathy and retinopathy plus nephropathy. A significant independent correlation of CP stenosis with stage of retinopathy and nephropathy was found. Finally, echolucent CPs were associated with a lower prevalence of proliferative retinopathy than CP containing calcium deposits. CONCLUSION In T2DM, retinopathy, alone or in combination with nephropathy, is independently associated to CP, and severity of microangiopathy correlates with severity of carotid atherosclerosis. These observations, together with the different prevalence of proliferative retinopathy according to CP types, point to possible common pathogenic mechanisms in micro- and macrovascular complications.
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Affiliation(s)
- S Vigili de Kreutzenberg
- Department of Clinical and Experimental Medicine, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
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17
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Rea N, Esposito P, Turolla R, Israel GL, Zane S, Stella L, Mereghetti S, Tiengo A, Gotz D, Gogus E, Kouveliotou C. A Low-Magnetic-Field Soft Gamma Repeater. Science 2010; 330:944-6. [DOI: 10.1126/science.1196088] [Citation(s) in RCA: 237] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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18
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Vigili de Kreutzenberg S, Tiengo A, Avogaro A. Cerebrovascular disease in diabetes mellitus: the role of carotid intima-media thickness. Nutr Metab Cardiovasc Dis 2009; 19:667-673. [PMID: 19500958 DOI: 10.1016/j.numecd.2009.03.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [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] [Received: 10/06/2008] [Revised: 01/14/2009] [Accepted: 03/17/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND PURPOSE Cerebrovascular disease in diabetes appears to be less considered than coronary and peripheral disease, the reason being the intrinsic difficulty in finding available diagnostic tools for its early identification. Among these, carotid artery intima-media thickness (cIMT) represents the simplest measurable parameter for pre-atherosclerotic lesions in extra-cranic arteries. METHODS The role of cIMT as a surrogate marker of cerebral atherosclerosis and predictor of stroke, its relationship to microangiopathy and chronic inflammation, along with its role as an outcome parameter in anti-hyperglycemic therapeutical intervention trials in type 2 and 1 diabetes mellitus are discussed in this paper. RESULTS AND CONCLUSIONS Carotid IMT is increased in diabetes. It is an independent predictor of stroke, in particular of the ischemic subtype, and of stroke recurrence in diabetic, as well as in non-diabetic populations. A possible role of cIMT as a predictor of microangiopathy has also been suggested, but it needs further investigation. A weak association with chronic inflammation has been demonstrated in diabetic patients. Carotid IMT has been successfully employed as an outcome parameter for several anti-hyperglycemic therapeutic trials. However data on cIMT as a predictor of cerebrovascular disease are scarce in diabetic patients, particularly in type 1 diabetes, and more studies are needed to define the risk of cerebrovascular disease in diabetic patients.
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Affiliation(s)
- S Vigili de Kreutzenberg
- Department of Clinical and Experimental Medicine, University of Padova, Via Giustiniani, 2, 35128 Padova, Italy.
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19
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Mereghetti S, Tiengo A, Esposito P, La Palombara N, Israel GL, Stella L. An Ultramassive, Fast-Spinning White Dwarf in a Peculiar Binary System. Science 2009; 325:1222-3. [PMID: 19729650 DOI: 10.1126/science.1176252] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- S. Mereghetti
- Istituto Nazionale di Astrofisica–Istituto di Astrofisica Spaziale e Fisica cosmica di Milano, via E. Bassini 15, 20133 Milano, Italy
| | - A. Tiengo
- Istituto Nazionale di Astrofisica–Istituto di Astrofisica Spaziale e Fisica cosmica di Milano, via E. Bassini 15, 20133 Milano, Italy
| | - P. Esposito
- Istituto Nazionale di Astrofisica–Istituto di Astrofisica Spaziale e Fisica cosmica di Milano, via E. Bassini 15, 20133 Milano, Italy
- Istituto Nazionale di Fisica Nucleare, Sezione di Pavia, via A. Bassi 6, 27100 Pavia, Italy
| | - N. La Palombara
- Istituto Nazionale di Astrofisica–Istituto di Astrofisica Spaziale e Fisica cosmica di Milano, via E. Bassini 15, 20133 Milano, Italy
| | - G. L. Israel
- Istituto Nazionale di Astrofisica–Osservatorio Astronomico di Roma, via Frascati 33, 00040 Monteporzio Catone, Italy
| | - L. Stella
- Istituto Nazionale di Astrofisica–Osservatorio Astronomico di Roma, via Frascati 33, 00040 Monteporzio Catone, Italy
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20
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21
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Tessari P, Coracina A, Cosma A, Tiengo A. Hepatic lipid metabolism and non-alcoholic fatty liver disease. Nutr Metab Cardiovasc Dis 2009; 19:291-302. [PMID: 19359149 DOI: 10.1016/j.numecd.2008.12.015] [Citation(s) in RCA: 218] [Impact Index Per Article: 14.5] [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] [Received: 04/22/2008] [Revised: 12/10/2008] [Accepted: 12/29/2008] [Indexed: 12/16/2022]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is an increasingly recognized pathology with a high prevalence and a possible evolution to its inflammatory counterpart (non-alcoholic steatohepatitis, or NASH). The pathophysiology of NAFLD and NASH has many links with the metabolic syndrome, sharing a causative factor in insulin resistance. According to a two-hit hypothesis, increased intrahepatic triglyceride accumulation (due to increased synthesis, decreased export, or both) is followed by a second step (or "hit"), which may lead to NASH. The latter likely involves oxidative stress, cytochrome P450 activation, lipid peroxidation, increased inflammatory cytokine production, activation of hepatic stellate cells and apoptosis. However, both "hits" may be caused by the same factors. The aim of this article is to overview the biochemical steps of fat regulation in the liver and the alterations occurring in the pathogenesis of NAFLD and NASH.
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Affiliation(s)
- P Tessari
- Department of Clinical and Experimental Medicine, Chair of Metabolism, University of Padua, Italy.
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22
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Esposito P, Israel GL, Zane S, Senziani F, Starling RLC, Rea N, Palmer DM, Gehrels N, Tiengo A, De Luca A, Götz D, Mereghetti S, Romano P, Sakamoto T, Barthelmy SD, Stella L, Turolla R, Feroci M, Mangano V. The 2008 May burst activation of SGR 1627-41. ACTA ACUST UNITED AC 2008. [DOI: 10.1111/j.1745-3933.2008.00530.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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23
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Tiengo A, Fadini GP, Avogaro A. The metabolic syndrome, diabetes and lung dysfunction. Diabetes Metab 2008; 34:447-54. [PMID: 18829364 DOI: 10.1016/j.diabet.2008.08.001] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2008] [Revised: 07/15/2008] [Accepted: 08/05/2008] [Indexed: 02/06/2023]
Abstract
Sleep-disordered breathing and sleep apnoea are conditions frequently associated with comorbidity, including obesity, diabetes, hypertension, insulin resistance (metabolic syndrome) and cardiovascular disease. The diabetic state (type 1 and type 2 diabetes) may be associated to diminished lung function and, in particular, decreased vital capacity, and the association between chronic obstructive pulmonary disease (COPD) and type 2 diabetes may be due to a shared inflammatory process. Also, the alteration in circulating endothelial progenitor cells found in respiratory disease, the metabolic syndrome and cardiovascular disease reflect a common condition of endothelial dysfunction.
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Affiliation(s)
- A Tiengo
- Division of Metabolic Diseases, Department of Clinical Medicine, University of Padova, Padova, Italy.
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24
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Bruttomesso D, Crazzolara D, Maran A, Costa S, Dal Pos M, Girelli A, Lepore G, Aragona M, Iori E, Valentini U, Del Prato S, Tiengo A, Buhr A, Trevisan R, Baritussio A. In Type 1 diabetic patients with good glycaemic control, blood glucose variability is lower during continuous subcutaneous insulin infusion than during multiple daily injections with insulin glargine. Diabet Med 2008; 25:326-32. [PMID: 18307459 DOI: 10.1111/j.1464-5491.2007.02365.x] [Citation(s) in RCA: 107] [Impact Index Per Article: 6.7] [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: 01/25/2023]
Abstract
AIMS The superiority of continuous subcutaneous insulin infusion (CSII) over multiple daily injections (MDI) with glargine is uncertain. In this randomized cross-over study, we compared CSII and MDI with glargine in patients with Type 1 diabetes well controlled with CSII. The primary end-point was glucose variability. METHODS Thirty-nine patients [38.1 +/- 9.3 years old (mean +/- sd), diabetes duration 16.6 +/- 8.2 years, glycated haemoglobin (HbA(1c)) 7.6 +/- 0.8%], already on CSII for at least 6 months, were randomly assigned to CSII with lispro or MDI with lispro and glargine. After 4 months they were switched to the alternative treatment. During the last month of each treatment blood glucose variability was analysed using glucose standard deviation, mean amplitude of glycaemic excursions (MAGE), lability index and average daily risk range (ADRR). As secondary end-points we analysed blood glucose profile, HbA(1c), number of episodes of hypo- and hyperglycaemia, lipid profile, free fatty acids (FFA), growth hormone and treatment satisfaction. RESULTS During CSII, glucose variability was 5-12% lower than during MDI with glargine. The difference was significant only before breakfast considering glucose standard deviation (P = 0.011), significant overall using MAGE (P = 0.016) and lability index (P = 0.005) and not significant using ADRR. Although HbA(1c) was similar during both treatments, during CSII blood glucose levels were significantly lower, hyperglycaemic episodes were fewer, daily insulin dose was less, FFA were lower and treatment satisfaction was greater than during MDI with glargine. The frequency of hypoglycaemic episodes was similar during both treatments. CONCLUSIONS During CSII, glucose variability is lower, glycaemic control better and treatment satisfaction higher than during MDI with glargine.
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Affiliation(s)
- D Bruttomesso
- Department of Clinical and Experimental Medicine, Division of Metabolic Diseases, University of Padova, Padova, Italy.
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25
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Fadini GP, Pucci L, Vanacore R, Baesso I, Penno G, Balbarini A, Di Stefano R, Miccoli R, de Kreutzenberg S, Coracina A, Tiengo A, Agostini C, Del Prato S, Avogaro A. Glucose tolerance is negatively associated with circulating progenitor cell levels. Diabetologia 2007; 50:2156-63. [PMID: 17579827 DOI: 10.1007/s00125-007-0732-y] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.8] [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] [Received: 01/04/2007] [Accepted: 05/17/2007] [Indexed: 01/08/2023]
Abstract
AIMS/HYPOTHESIS Circulating progenitor cells participate in cardiovascular homeostasis. Depletion of the pool of endothelial progenitor cells (EPCs) is associated with increased cardiovascular risk. Furthermore, EPCs are reduced in the presence of classical risk factors for atherosclerotic disease, including diabetes mellitus. This study was designed to evaluate progenitor cell levels in volunteers with different degrees of glucose tolerance. METHODS Cardiovascular parameters and the levels of circulating CD34(+) and CD34(+) kinase insert domain receptor (KDR)(+) cells were determined in 219 middle-aged individuals with no pre-diagnosed alterations in carbohydrate metabolism. Glucose tolerance was determined by fasting and 2 h post-challenge glucose levels, with IFG and IGT considered as pre-diabetic states. RESULTS CD34(+) and CD34(+)KDR(+) cells were significantly reduced in individuals who were found to have diabetes mellitus, and were negatively correlated with both fasting and post-challenge glucose in the whole population. While only CD34(+) cells, but not CD34(+)KDR(+) cells, were significantly reduced in pre-diabetic individuals, post-challenge glucose was an independent determinant of the levels of both CD34(+) and CD34(+)KDR(+) cells. CONCLUSIONS/INTERPRETATION Glucose tolerance was negatively associated with progenitor cell levels in middle-aged healthy individuals. Depletion of endothelial progenitors with increasing fasting and post-meal glucose may be one cause of the high incidence of cardiovascular damage in individuals with pre-diabetes.
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Affiliation(s)
- G P Fadini
- Department of Clinical and Experimental Medicine, Medical School, University of Padua, Via Giustiniani 2, 35100, Padua, Italy.
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Abstract
Observations with the Newton X-ray Multimirror Mission satellite show a strong periodic modulation at 6.67 +/- 0.03 hours of the x-ray source at the center of the 2000-year-old supernova remnant RCW 103. No fast pulsations are visible. If genetically tied to the supernova remnant, the source could either be an x-ray binary, composed of a compact object and a low-mass star in an eccentric orbit, or an isolated neutron star. In the latter case, the combination of its age and period would indicate that it is a peculiar magnetar, dramatically slowed down, possibly by a supernova debris disc. Both scenarios require nonstandard assumptions about the formation and evolution of compact objects in supernova explosions.
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Affiliation(s)
- A De Luca
- Istituto Nazionale d'Astrofisica-Istituto di Astrofisica Spaziale e Fisica Cosmica, Via Bassini 15, I-20133 Milano, Italy.
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Bruttomesso D, Costa S, Dal Pos M, Crazzolara D, Realdi G, Tiengo A, Baritussio A, Gagnayre R. Educating diabetic patients about insulin use: changes over time in certainty and correctness of knowledge. Diabetes & Metabolism 2006; 32:256-61. [PMID: 16799403 DOI: 10.1016/s1262-3636(07)70277-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
AIM Diabetic patients should understand their disease correctly and be sure of what they know, but certainty is rarely considered by educators. Furthermore little is known about how certainty changes with time after an educational intervention. To clarify this, in 38 patients with type 1 diabetes (0.3-36 years duration) we analysed the effect of a course on insulin use by administering a questionnaire before the course, after the course and 1 and 3 years later. METHODS Answers, accompanied by a subjective estimate of the degree of certainty, were assigned to mastered knowledge (certainty>or=90%, correctness>or=90%), hazardous knowledge (certainty>or=90%, correctness<or=50%), uncertain knowledge (certainty<or=50%, correctness>or=90%) and residual knowledge (total-[mastered+hazardous+uncertain]). Answers were then counted and changes in distribution among areas were analysed by the chi2 test. We also followed the fate of wrong answers. RESULTS The course increased mastered knowledge, while other types of knowledge decreased. With time mastered knowledge decreased, patients losing both correctness and certainty. The loss affected declarative knowledge, based purely on theory, more than procedural knowledge, which concerns the way things are done. Wrong answers, mostly given with high degree of certainty, were heterogeneous since some became correct after the course, some remained wrong, some became wrong after the course, some became mistaken after having been corrected earlier. CONCLUSIONS The analysis of certainty helps in evaluating patient's knowledge; programmes tending to improve procedural knowledge are more likely to have long lasting effects; wrong answers need to be considered on a individual basis.
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Affiliation(s)
- D Bruttomesso
- Department of Clinical and Experimental Medicine, University of Padova, Italy.
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Haak T, Tiengo A, Draeger E, Suntum M, Waldhäusl W. Lower within-subject variability of fasting blood glucose and reduced weight gain with insulin detemir compared to NPH insulin in patients with type 2 diabetes. Diabetes Obes Metab 2005; 7:56-64. [PMID: 15642076 DOI: 10.1111/j.1463-1326.2004.00373.x] [Citation(s) in RCA: 214] [Impact Index Per Article: 11.3] [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: 11/29/2022]
Abstract
AIM The aim of this study was to compare the efficacy and safety of a basal-bolus insulin regimen comprising either insulin detemir or neural protamine hagedorn (NPH) insulin in combination with mealtime insulin aspart in patients with type 2 diabetes. METHODS This was a 26-week, multinational, open-label, parallel group trial with 505 patients with type 2 diabetes (mean age, 60.4 +/- 8.6 years; mean BMI, 30.4 +/- 5.3 kg/m(2); mean HbA(1c), 7.9 +/- 1.3%). Patients, randomized 2:1 to insulin detemir or NPH insulin, received basal insulin either once or twice daily according to their pretrial insulin treatment and insulin aspart at mealtimes. RESULTS After 26 weeks of treatment, significant reductions in HbA(1c) were observed for insulin detemir (0.2%-points, p = 0.004) and NPH insulin (0.4%-points; p = 0.0001); HbA(1c) levels were comparable at study end (insulin detemir, 7.6%; NPH insulin, 7.5%). The number of basal insulin injections administered per day had no effect on HbA(1c) levels (p = 0.50). Nine-point self-measured blood glucose (SMBG) profiles were similar for the two treatment groups (p = 0.58), as were reductions in fasting plasma glucose (FPG) (insulin detemir, 0.5 mmol/l; NPH insulin, 0.6 mmol/l). At study end, FPG concentrations were similar for the two treatment groups (p = 0.66). By contrast, within-subject day-to-day variation in fasting SMBG was significantly lower with insulin detemir (p = 0.021). Moreover, patients receiving insulin detemir gained significantly less body weight than those who were administered NPH insulin (1.0 and 1.8 kg, respectively, p = 0.017). The frequency of adverse events and the risk of hypoglycaemia were comparable for the two treatment groups. CONCLUSIONS Patients with type 2 diabetes, treated for 26 weeks with insulin detemir plus insulin aspart at mealtimes, experienced comparable glycaemic control but significantly lower within-subject variability and less weight gain compared to patients treated with NPH insulin and insulin aspart. Insulin detemir was well tolerated and had a similar safety profile to NPH insulin.
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Affiliation(s)
- T Haak
- Research Institute of the Diabetes Academy Mergentheim, D-97980 Bad Mergentheim, Germany.
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Vedovato M, Lepore G, Coracina A, Dodesini AR, Jori E, Tiengo A, Del Prato S, Trevisan R. Effect of sodium intake on blood pressure and albuminuria in Type 2 diabetic patients: the role of insulin resistance. Diabetologia 2004; 47:300-3. [PMID: 14704836 DOI: 10.1007/s00125-003-1303-5] [Citation(s) in RCA: 105] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2003] [Revised: 10/27/2003] [Indexed: 10/26/2022]
Abstract
AIMS/HYPOTHESIS This study was done to measure the effect of Na+ intake on blood pressure and albuminuria, in relation with insulin sensitivity and kidney haemodynamics, in Type 2 diabetic patients with and without microalbuminuria. METHODS Type 2 diabetic patients, 20 with microalbuminuria, 21 without, spent two consecutive 7-day periods, one on a high (250 mmol), the other on a low-Na+ (20 mmol) diet. Body weight, 24-h blood pressure and albuminuria were measured at the end of each period. At the end of high-Na+ diet insulin sensitivity (euglycaemic insulin clamp; 2 mU.kg(-1).min(-1)) and kidney haemodynamics were measured in nine patients from each group. RESULTS Switching from low to high-Na+ diet resulted in an increase in blood pressure (7.4+/-4.7 mmHg; p<0.001), body weight (1.9+/-0.4 kg; p<0.05) and albuminuria [from 80 (31-183) microg/min to 101 (27-965) microg/min; p<0.01) in patients with microalbuminuria. No changes occurred in patients without microalbuminuria. Patients with microalbuminuria also had greater intraglomerular pressure (44+/-1 mmHg vs 36+/-1; p<0.001), calculated from glomerular filtration rate, renal plasma flow, plasma protein concentration and the relationship between pressure and natriuresis. In these patients insulin sensitivity was lower (5.16+/-49 vs 7.36+/-0.63 mg.kg(-1).min(-1); p=0.007). Urinary albumin excretion (r=0.40; p=0.009) and insulin sensitivity (r=-0.59; p=0.01) were correlated with intraglomerular pressure. CONCLUSION/INTERPRETATION High salt intake increases blood pressure and albuminuria in Type 2 diabetic patients with microalbuminuria. These responses are associated with insulin resistance and increased glomerular pressure. Insulin resistance could contribute to greater salt sensitivity, increased glomerular pressure and albuminuria.
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Affiliation(s)
- M Vedovato
- Unit for Metabolic Disease, Department of Clinical and Experimental Medicine, University of Padua, Padua, Italy
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Rubello D, Casara D, Maran A, Avogaro A, Tiengo A, Muzzio PC. Role of anti-granulocyte Fab??? fragment antibody scintigraphy (LeukoScan) in evaluating bone infection: acquisition protocol, interpretation criteria and clinical results. Nucl Med Commun 2004; 25:39-47. [PMID: 15061263 DOI: 10.1097/00006231-200401000-00006] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Scintigraphy using anti-granulocyte Fab' fragment (LeukoScan) was performed in a series of 220 consecutive patients with suspected bone infection referred to our centre between September 1999 and June 2002. Two protocols were compared for interpreting scans: (1) evaluation of early 4 h imaging alone (protocol A), and (2) evaluation both of early and delayed 24 h imaging (protocol B). Protocol A and protocol B showed equal values of sensitivity (91.9% in patients with diabetic foot and 84.2% in patients with joint prosthesis/peripheral bone implants). Conversely, specificity was higher adopting protocol B than protocol A: 87.5% vs 75.0% in patients with diabetic foot, and 85.7% vs 76.2% in patients with joint prosthesis/peripheral bone implants, respectively. In particular, an improvement in specificity using protocol B was found in those patients with infection and with only a mild LeukoScan uptake in the early 4 h imaging: in these patients an increasing uptake intensity pattern observed in the delayed 24 h imaging was indicative of infection while a decreasing pattern suggested a negative result. Instead, the evidence of a high uptake intensity in the early LeukoScan imaging was a strong indicator of infection and delayed imaging in these cases did not further improve specificity. In conclusion, in our experience, LeukoScan showed high sensitivity in diagnosing bone infection in patients with diabetic foot and joint prosthesis or other peripheral bone implants. Moreover, in patients with an early high LeukoScan uptake intensity further delayed images appears unnecessary for the purpose of diagnosing infection. In contrast in patients with an early mild LeukoScan uptake intensity only, delayed imaging appears to be recommendable for improving specificity.
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Affiliation(s)
- D Rubello
- 2nd Nuclear Medicine Service, General Hospital of Padova, Padova, Italy.
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Avogaro A, Sambataro M, Marangoni A, Pianta A, Vettor R, Pagano C, Marescotti MC, Tiengo A, Beltramello G. Moderate alcohol consumption, glucose metabolism and lipolysis: the effect on adiponectin and tumor necrosis factor alpha. J Endocrinol Invest 2003; 26:1213-8. [PMID: 15055475 DOI: 10.1007/bf03349160] [Citation(s) in RCA: 8] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Moderate alcohol consumption has a cardioprotective effect on coronary artery disease. Among the beneficial effects of alcohol, a suppression of the plasma free fatty acid (FFA) concentration has been shown but the mechanism which accounts for this action is not clear. We assessed whether moderate alcohol intake affects plasma adiponectin levels and tumor necrosis factor (TNF)-alpha, two regulators of lipolysis. Oral glucose tolerance tests were performed twice on 22 volunteers: "the alcohol study" and "control study". In the former, red wine was sipped to maintain steady state alcohol concentration. Samples for plasma glucose, insulin, FFA, adiponectin, and TNF-alpha concentrations were obtained. In the latter, tap water was sipped. Insulin action has been assessed by the Oral Glucose Insulin Sensitivity (OGIS) Model. The mean blood alcohol concentration was 5+/-2 mg/dl. No differences were observed between the two studies in the OGIS (406+/-19 ml x min(-1) x m(-2) with alcohol and 402+/-20 without, respectively). Baseline FFA levels were lower in the alcohol study; however, post-glucose inhibition was comparable. No differences in the TNF-alpha and adiponectin responses were observed. A significant correlation was observed between the OGIS index and the fasting adiponectin level (r=0.589, p<0.0001). Moderate red wine intake improves post-glucose FFA profiles but does not modify the plasma concentrations of both TNF-alpha and of adiponectin concentrations: the latter is significantly and positively associated to the insulin action. Further studies are needed to clarify the antilipolytic effect of moderate alcohol intake.
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Affiliation(s)
- A Avogaro
- Division of Metabolic Diseases, University of Padua Medical School, Padua, Italy.
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Abstract
BACKGROUND Endothelial dysfunction has been described in obesity. This study examines the impact of visceral obesity on nitric oxide-independent relaxation in the human forearm. METHODS AND RESULTS In ten viscerally obese and ten matched controls forearm blood flow (FBF) was measured by venous occlusion plethysmography during intrabrachial infusion of: (1) sodium nitroprusside; (2) bradykinin, before and after inhibition of vasoactive prostaglandins and nitric oxide; (3) potassium; (4) ouabain (Na(+)/K(+)ATPase inhibitor) alone or (5) in combination with BaCl(2)(K(IR)inhibitor). Baseline FBF and endothelium-independent vasodilatation were similar in the two groups. In obese patients, bradykinin-induced increase of FBF was significantly less than in controls (P<0.01). Irrespective of prostaglandins and nitric oxide inhibition, bradykinin response was lower in the viscerally obese. Intrabrachial potassium determined a significantly blunted response (P<0.05). Ouabain caused a similar, moderate decrease in basal FBF in the two groups; the coinfusion of BaCl(2)caused a more intense decline in FBF which was significantly relevant in obese (-24+/-5%, P<0.01). CONCLUSIONS In obese patients there is a blunted nitric oxide-independent relaxation determined by a decreased response of inwardly rectifying potassium channels.
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Iori E, Marescotti MC, Vedovato M, Ceolotto G, Avogaro A, Tiengo A, Del Prato S, Trevisan R. In situ protein Kinase C activity is increased in cultured fibroblasts from Type 1 diabetic patients with nephropathy. Diabetologia 2003; 46:524-30. [PMID: 12739026 DOI: 10.1007/s00125-003-1061-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [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] [Received: 09/03/2002] [Revised: 11/19/2002] [Indexed: 10/20/2022]
Abstract
AIMS/HYPOTHESIS To verify whether individual susceptibility to diabetic nephropathy resides in an intrinsic difference in Protein Kinase C (PKC) activity. METHODS We compared the effect of different glucose concentrations on PKC activity, PKC isoform expression and diacylglycerol (DAG) content in cultured fibroblasts from 14 Type 1 diabetic patients who developed nephropathy with those in cells from 14 patients without nephropathy. We recruited 14 normal subjects as control patients. Forearm skin fibroblasts were cultured in either normal (5 mmol/l) or high (20 mmol/l) glucose concentrations. RESULTS In normal glucose, in situ PKC activity was higher in Type 1 patients with nephropathy (10.1+/-1.4 pmol/min/mg protein; p<0.01) than in those without (6.8+/-0.8) and the normal control subjects (6.3+/-0.5). This difference was due to increased concentrations of PKCalpha isoform in the membrane fraction of fibroblasts from patients with nephropathy. DAG content was also higher in cells from Type 1 patients with nephropathy. Incubation in high glucose concentration caused a further increase in PKC activity and DAG content in quiescent fibroblasts from patients with diabetic nephropathy, with no significant changes in cells from diabetic patients without nephropathy and normal control subjects. CONCLUSION/INTERPRETATION Differences in PKC activation could contribute to the individual susceptibility to renal damage in Type 1 diabetic patients.
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Affiliation(s)
- E Iori
- Department of Clinical and Experimental Medicine, University of Padua, Italy
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Abstract
AIMS Inappropriate production of nitric oxide (NO) may be responsible for the haemodynamic disturbances of diabetic ketoacidosis. We investigated whether this metabolic condition is associated with increased plasma nitrate (the stable oxidation product of NO) levels and NO synthase gene expression in lymphomonocytes. RESEARCH DESIGN AND METHODS Plasma nitrate concentrations, lymphomonocyte-inducible nitric oxide synthase (iNOS) gene expression, tumour necrosis factor-alpha (TNF-alpha) and soluble thrombomodulin were measured in 11 Type 1 diabetic patients at baseline, during mild ketosis and after euglycaemia was re-established. RESULTS During diabetic ketosis plasma nitrate concentrations were higher (18 (16-21) vs. 9 (7-11) micro mol/l; (95% lower-upper confidence interval) P < 0.05) than at baseline. At baseline lymphomonocyte iNOS mRNA expression and iNOS protein levels were undetectable, but in ketosis both were increased (both at P < 0.0001). After recovery from ketosis, NO3 concentration, iNOS mRNA, and iNOS expression (270 +/- 36%, mean +/- sd) decreased but not significantly. No significant changes were observed in either TNF-alpha or soluble thrombomodulin levels between the three conditions. CONCLUSIONS Diabetic ketosis is associated with increased nitrate levels and the activation of iNOS expression in circulating lymphomonocytes, but it does not affect either the proinflammatory cytokine TNF-alpha or a marker of endothelial dysfunction such as thrombomodulin. Our data support the hypothesis that, during diabetic ketosis, alterations in NO homeostasis are present in circulating lymphomonocytes.
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Affiliation(s)
- E Iori
- Department of Clinical and Experimental Medicine, University of Padova, Padova, Italy
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Lepore G, Bruttomesso D, Nosari I, Tiengo A, Trevisan R. Glycaemic control and microvascular complications in a large cohort of Italian Type 1 diabetic out-patients. Diabetes Nutr Metab 2002; 15:232-9. [PMID: 12416660] [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: 02/27/2023]
Abstract
The purpose of this cross-sectional study was to evaluate the degree of metabolic control, the prevalence of microvascular complications (nephropathy, retinopathy, and peripheral neuropathy) and their association with risk factors for cardiovascular diseases in all adult Type 1 diabetic out-patients attending 2 Diabetes Clinics of Northern Italy over 12 months. A total of 458 patients (mean age 37 +/- 12 yr, duration of diabetes 15.3 +/- 10.6 yr, BMI 23.2 +/- 3.1 kg/m2) were studied. Clinical characteristics and microvascular complications were evaluated. The proportion of patients with a good glycaemic control (HbA1c < 7%) was 14.7%. Nephropathy was observed in 24.4%, retinopathy in 41%, peripheral neuropathy in 23.7%. The prevalence of hypertension was 30.3%. Microvascular complications were associated with age, duration of diabetes, systolic blood pressure, creatinine, triglycerides and cholesterol plasma levels. Mean HbA1c was 8.5 +/- 1.6. Patients with HbA1c levels < 7% presented a lower prevalence of complications and lower levels of cholesterol, triglycerides, systolic blood pressure than patients with HbA1c > 9%. Our study indicates that an acceptable metabolic control is achieved in a too low proportion of Type 1 diabetic patients, even under multiple insulin injections. The association of poor metabolic control and microalbuminuria identifies a group of patients at higher risk of diabetic complications.
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Affiliation(s)
- G Lepore
- Diabetes Unit, A.O. Ospedali Riuniti, Bergamo, Italy.
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37
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Bruttomesso D, Pianta A, Crazzolara D, Scaldaferri E, Lora L, Guarneri G, Mongillo A, Gennaro R, Miola M, Moretti M, Confortin L, Beltramello GP, Pais M, Baritussio A, Casiglia E, Tiengo A. Continuous subcutaneous insulin infusion (CSII) in the Veneto region: efficacy, acceptability and quality of life. Diabet Med 2002; 19:628-34. [PMID: 12147142 DOI: 10.1046/j.1464-5491.2002.00750.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.1] [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: 11/20/2022]
Abstract
AIM To study the effect of continuous subcutaneous insulin infusion (CSII) on metabolic control and well-being in patients with Type 1 diabetes. METHODS Efficacy, safety and interference with everyday life associated with CSII were studied retrospectively in 138 diabetic patients from the Veneto region treated for 7.4 +/- 0.4 years. RESULTS Glycosylated haemoglobin decreased during the first year of CSII from 9.3 +/- 0.2% to 7.9 +/- 0.1% (P < 0.0001), and then remained unchanged. Serious hypoglycaemia decreased from 0.31 +/- 0.07/year to 0.09 +/- 0.02/year (P < 0.003), as did ketoacidosis (from 0.41 +/- 0.12/year to 0.11 +/- 0.03/year, P < 0.013). During the first year of therapy daily insulin requirement decreased from 49 +/- 1 to 42 +/- 2 U/day (P < 0.0001) and did not change thereafter. The number of out-patient consultations and hospital admissions per year also decreased significantly. CSII was associated with a progressive increase of body weight (P < 0.05) and with 0.2 +/- 0.04 infections/patient per year at the infusion site. Infection was rated as mild in 72%, moderate in 18%, severe in 10%. Patients reported that CSII improved metabolic control (71%), sense of well-being (41%), and allowed more freedom (40%). Quality of life, assessed using the DQOL, after 7 years of CSII was rated as good by patients (score of 73.0 +/- 1.8 on a scale from 0 to 100). CONCLUSIONS This retrospective analysis suggests that CSII improves metabolic control in Type 1 diabetic patients, reduces hypoglycaemic and ketoacidotic events, is well accepted, allows a good quality of life and decreases out-patient consultations and hospital admissions.
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Affiliation(s)
- D Bruttomesso
- Department of Clinical and Experimental Medicine, Cattedra di Malattie del Metabolismo, University of Padua, Via Giustiniani 2, 35128 Padua, Italy.
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Bruttomesso D, Iori E, Kiwanuka E, Zanetti M, Pianta A, Vettore M, Tiengo A, Tessari P. Insulin infusion normalizes fasting and post-prandial albumin and fibrinogen synthesis in Type 1 diabetes mellitus. Diabet Med 2001; 18:915-20. [PMID: 11703437 DOI: 10.1046/j.1464-5491.2001.00606.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [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: 11/20/2022]
Abstract
AIMS The effect of metabolic control on hepatic synthesis of plasma proteins in Type 1 diabetes mellitus (T1DM), in the post-absorptive and post-prandial state, is not known. METHODS We measured fractional synthetic rates (FSR) of albumin and fibrinogen in six insulin-infused T1DM patients and in five to nine control subjects, before and for approx. 4 h after a mixed liquid meal. Phenylalanine tracer precursor/product relationships and steady-state conditions were used. In the post-absorptive state, patients were studied in near euglycaemic conditions after an overnight intravenous insulin infusion. During the meal (approx. 11 kcal/kg), the insulin infusion rate was increased to maintain plasma glucose concentrations below approx. 10 mmol/l. RESULTS Post-absorptive FSR of albumin (5.7 +/- 0.6%/day) and fibrinogen (11.3 +/- 0.6%/day) in T1DM were similar to control values (6.4 +/- 0.9 and 13.1 +/- 1.1, respectively). After the meal, albumin FSR increased (P = 0.0032 by anova) in both groups (T1DM, to 14.4 +/- 2.7%/day; controls, to 18.2 +/- 3.7%/day). Fibrinogen FSR also increased (P = 0.0048 by anova) in both the T1DM (to 18.2 +/- 2.6) and the control subjects (to 27.3 +/- 6.2). There was no difference between T1DM and control subjects in the post-prandial FSR of both proteins. CONCLUSIONS Albumin and fibrinogen FSR in T1DM can be maintained within near-normal ranges by insulin infusion under post-absorptive and post-prandial conditions.
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Affiliation(s)
- D Bruttomesso
- Department of Clinical and Experimental Medicine, Chair of Metabolism, University of Padova, Padova, Italy
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Bruttomesso D, Pianta A, Crazzolara D, Capparotto C, Dainese E, Zurlo C, Minicuci N, Briani G, Tiengo A. Teaching and training programme on carbohydrate counting in Type 1 diabetic patients. Diabetes Nutr Metab 2001; 14:259-67. [PMID: 11806466] [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: 02/23/2023]
Abstract
Carbohydrates (CHO) are a major determinant of post-prandial blood glucose in the diet of people with Type 1 diabetes mellitus, but patients frequently fail to evaluate CHO food content. Poor education is thought to contribute heavily to this failure. Our aim was to plan and evaluate a simple educational program to improve dietary knowledge and teach how to count CHO in Type 1 diabetic subjects. Forty-eight patients (age 27+/-1 yr, diabetes duration 11+/-1 yr, HbA1c 9%) attended 4 interactive meetings held at monthly intervals. The targets of the course were: 1) to identify sources of CHO, fats and proteins; 2) to count CHO and to split them among meals; 3) to assume CHO-rich foods without changing daily calorie or carbohydrate intake; 4) to modify the diet so as to correct hypoglycaemic events. To evaluate the effect of the course, patients completed a 7-day food record and answered a questionnaire covering the targets of the course at baseline, at the end of the course and 7 months later. After the course dietary knowledge improved significantly. The number of patients who weighed foods, estimated CHO food content and correctly distributed CHO among meals also increased. After the course patients reacted better when faced with hypoglycaemia. The knowledge acquired persisted 7 months after the end of the course. Therefore, we conclude that a simple teaching program can improve diet knowledge in Type 1 diabetics and establish a sustained habit of counting CHO.
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Affiliation(s)
- D Bruttomesso
- Department of Clinical and Experimental Medicine, University of Padova, Italy.
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Avogaro A, Miola M, Favaro A, Gottardo L, Pacini G, Manzato E, Zambon S, Sacerdoti D, de Kreutzenberg S, Piliego T, Tiengo A, Del Prato S. Gemfibrozil improves insulin sensitivity and flow-mediated vasodilatation in type 2 diabetic patients. Eur J Clin Invest 2001; 31:603-9. [PMID: 11454015 DOI: 10.1046/j.1365-2362.2001.00856.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.8] [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: 11/20/2022]
Abstract
BACKGROUND Endothelial dysfunction is an early feature of atherosclerosis. The relationship between insulin action and hypertriglyceridaemia on endothelial function is still debated. MATERIALS AND METHODS This study was designed to determine the effect of a 3 month treatment with Gemfibrozil (GF) on flow-mediated vasodilatation and insulin sensitivity. Ten type 2 diabetic patients were randomised in crossover, double blind fashion, either to GF, 600 mg b.i.d. or placebo, for 12 weeks. Lipid profile, low-density lipoprotein (LDL) distribution and flotation properties, insulin action and flow-mediated vasodilatation (FMD) by brachial artery ultrasound, were assessed. RESULTS GF decreased serum triglyceride (TG) concentration with an absolute difference of 1.79 +/- 1.28 mmol L-1 (P < 0.0016) between active treatment and placebo, and significantly increased serum high-density lipoprotein (HDL) cholesterol (P = 0.0233). No differences were observed in total, intermediate-density lipoproteins (IDL), LDL cholesterol concentration and LDL peak buoyancy between treatments. GF also improved SI, an index of insulin action (P = 0.005). The FMD was 7 +/- 3% in the baseline condition, 7 +/- 2% during placebo and 14 +/- 3% after GF (P < 0.006). CONCLUSIONS GF treatment improves both insulin action and flow-mediated vasodilatation in type 2 diabetic patients. The reduction of TG concentration allows the simultaneous correction of two important components of the metabolic syndrome.
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Affiliation(s)
- A Avogaro
- University of Padova, Padova, Italy, LADSEB CNR, Padova, Italy, Parke-Davis Italia, Lainate, Milan, Italy.
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Abstract
Type 2 diabetes is a heterogeneous disorder characterized by defects in insulin secretion and action. Insulin resistance is a key feature of type 2 diabetes. However, insulin resistance alone does not appear to be sufficient to cause diabetes. Longitudinal studies have shown that the development of overt hyperglycemia is associated with a decline in beta-cell secretion. In patients with impaired glucose tolerance or in the early stages of type 2 diabetes, first-phase insulin release is almost invariably lost despite the enhancement of second-phase secretion. Both animal and human studies support the critical physiologic role of the first-phase of insulin secretion in the maintenance of postmeal glucose homeostasis. This effect is primarily mediated at the level of the liver, allowing prompt inhibition of endogenous glucose production (EGP) and thereby restraining the mealtime rise in plasma glucose. In type 2 diabetes, the loss of the early surge of insulin release is a precocious and quite common defect that plays a pathogenic role in postmeal hyperglycemia and one that may require specific therapeutic intervention. This becomes even more apparent if the negative impact of prandial glucose spikes is taken into consideration. Epidemiological evidence exists to indicate that 2-h postload plasma glucose levels are strongly associated with all-cause and cardiovascular mortality relative risk. Indeed the acute elevation of plasma glucose concentration triggers an array of tissue responses that may contribute to the development of diabetic complications. Considering that type 2 diabetes begins with meal-related hyperglycemia in many patients, it becomes apparent that normalization of postmeal plasma glucose levels should be the target for rational therapy and the goal in the early stages of the disease. If a primary goal of diabetes therapy is control of postmeal glucose excursion, then the regulation of glucose absorption from the gut and entry into the circulation is an important mechanism to consider. The restoration of the rapid increase in plasma insulin concentration may be quite an efficient therapeutic approach.
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Affiliation(s)
- S Del Prato
- Cattedra di Malattie del Metabolismo, School of Medicine, University of Pisa, Italy.
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Bruttomesso D, Fongher C, Silvestri B, Barberio S, Marescotti MC, Iori E, Valerio A, Crazzolara D, Pianta A, Tiengo A, Del Prato S. Combination of continuous subcutaneous infusion of insulin and octreotide in Type 1 diabetic patients. Diabetes Res Clin Pract 2001; 51:97-105. [PMID: 11165689 DOI: 10.1016/s0168-8227(00)00210-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [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: 10/18/2022]
Abstract
The effect of 7 day continuous subcutaneous infusion of octreotide (200 microg day(-1)) was evaluated in seven insulin-pump treated Type 1 diabetic patients (age 43+/-1.5 year; BMI 25.1+/-0.7 kg m(-2); HbA(1c) 7.4+/-0.3%). A 24-h metabolic and hormonal profile, and a euglycaemic hyperinsulinaemic clamp (0.25, 0.5, 1.0 mg kg(-1) min(-1)), with [3H]glucose infusion and indirect calorimetry, were performed before and after a 7-day octreotide infusion. Mean 24-h plasma glucose was similar before and after octreotide (9.7+/-0.8 vs. 9.1+/-1.0 mmol l(-1)) but insulin requirement dropped by 45% (49+/-4 vs. 27+/-2 U day(-1); P<0.01). Both 24-h plasma hGH and glucagon were suppressed by octreotide (1.85+/-0.35 vs. 0.52+/-0.04 microg l(-1), and 117+/-23 vs. 102+/-14 ng l(-1), respectively). Glucose utilisation increased after octreotide (insulin 0.5 mU kg(-1) min(-1) clamp 3.09+/-0.23 vs. 4.19+/-0.19 mg kg(-1) min(-1); 1 mU kg(-1) min(-1) clamp 5.64+/-0.61 vs. 7.93+/-0.57 mg kg(-1) min(-1); both P<0.05) and endogenous glucose production was similarly suppressed. Glucose oxidation was not affected by octreotide, while the improvement in glucose storage (insulin 1.0 mU kg(-1) min(-1) clamp 3.89+/-0.60 vs. 5.64+/-0.67 mg kg(-1) min(-1), P<0.05) entirely accounted for the increase in glucose disposal. Endogenous glucose production was more effectively suppressed at the two lower insulin infusion rates (P>0.05). Energy expenditure declined after octreotide. Continuous subcutaneous octreotide infusion suppresses counterregulatory hormones, increases insulin-mediated glucose metabolism by enhancing glucose storage, and reduces energy expenditure. These results support a role for counterregulatory hormones in the genesis of insulin resistance and the catabolic state of Type 1 diabetes.
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Affiliation(s)
- D Bruttomesso
- Department of Clinical and Experimental Medicine, Cattedra di Malattie del Metabolismo, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
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Valerio A, Basso D, Mazza S, Baldo G, Tiengo A, Pedrazzoli S, Seraglia R, Plebani M. Serum protein profiles of patients with pancreatic cancer and chronic pancreatitis: searching for a diagnostic protein pattern. Rapid Commun Mass Spectrom 2001; 15:2420-2425. [PMID: 11746913 DOI: 10.1002/rcm.528] [Citation(s) in RCA: 28] [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] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
In this study, 13 sera from patients with pancreatic cancer, 9 from chronic pancreatitis and 10 from healthy subjects were analyzed by matrix-assisted laser desorption/ionization (MALDI) mass spectrometry. The MALDI mass spectra revealed the presence of several low molecular weight peptides, among which some were detected only in the sera from both pathological conditions. On the other hand many peptides were observed only in control sera, and were absent in the sera from the two diseases. Therefore, MALDI analysis of the low molecular weight fraction (<10 000 Da) of sera from patients with pancreatic diseases enabled us to identify the presence of some disease-related signals and also some signals characteristic of normal subjects.
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Affiliation(s)
- A Valerio
- Department of Clinical and Experimental Medicine, University of Padova, Italy.
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Paroni R, Comuzzi B, Arcelloni C, Brocco S, de Kreutzenberg S, Tiengo A, Ciucci A, Beck-Peccoz P, Genovese S. Comparison of capillary electrophoresis with HPLC for diagnosis of factitious hypoglycemia. Clin Chem 2000; 46:1773-80. [PMID: 11067812] [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] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
BACKGROUND The diagnosis of "factitious hypoglycemia" is essentially based on the disclosure of hypoglycemic agents in blood or urine. The aim of this study was to evaluate the performance of capillary electrophoresis (CE) as a quantitative method for determination of chlorpropamide, tolbutamide, glipizide, gliclazide, and glibenclamide in serum. METHODS Serum samples (1 mL), with internal standard added, were purified by solid-phase extraction on OASIS(TM) HLB cartridges (Waters), dried under reduced pressure, and reconstituted with 30-60 microL of acetonitrile:H(2)O. Analysis was carried out by micellar electrokinetic capillary chromatography in 5 mmol/L borate, 5 mmol/L phosphate, 75 mmol/L sodium cholate, pH 8.5, containing 25 mL/L methanol. Separation was accomplished in a 20 cm x 50 microm (i.d.) silica capillary at 25 degrees C and a constant voltage of +10 kV. Pharmacokinetics of gliclazide (80-mg tablet) in a diabetic patient were assayed by both HPLC and CE. Two hypoglycemic patients positive by HPLC analysis for unreported gliclazide and tolbutamide overdose were also screened by CE. RESULTS Separation of six drugs (including the internal standard) was accomplished in 5 min plus 5 min rinsing. The between-day CV of the ratio of the areas of the sulfonylurea drugs to internal standard was <1% (n = 10). Linearity (r(2) > or =0.998) and recovery (> or =80%) were good for all sulfonylurea drugs tested. Pharmacokinetic curves for gliclazide by CE and HPLC were superimposable. CE analysis confirmed the HPLC diagnosis of surreptitious abuse of gliclazide and tolbutamide. CONCLUSION CE is a useful tool in the clinical chemistry and toxicology laboratory for drug monitoring and pharmacokinetic investigations.
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Affiliation(s)
- R Paroni
- Laboratory of Separative Techniques, IRCCS Ospedale San Raffaele, 20132 Milano, Italy.
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45
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Barazzoni R, Zanetti M, Davanzo G, Kiwanuka E, Carraro P, Tiengo A, Tessari P. Increased fibrinogen production in type 2 diabetic patients without detectable vascular complications: correlation with plasma glucagon concentrations. J Clin Endocrinol Metab 2000; 85:3121-5. [PMID: 10999796 DOI: 10.1210/jcem.85.9.6779] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [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: 02/09/2023]
Abstract
Fibrinogen is a strong cardiovascular risk factor in the general population, and increased fibrinogen plasma concentrations have been reported in type 2 diabetic patients. However, the mechanisms leading to hyperfibrinogenemia in type 2 diabetes are not known. It is also not known whether possible alterations of fibrinogen turnover may precede clinical diabetic micro- and macrovascular complications and therefore potentially contribute to their onset. To address these questions, fibrinogen production was determined in six male type 2 diabetic patients without detectable micro- and macrovascular complications (age, 45 +/- 4 yr; body mass index, 27 +/- 0.9 kg/m2) and in seven nondiabetic matched controls using leucine isotope precursor-product relationships. Plasma glucose (P < 0.001), insulin (P < 0.05), and glucagon concentrations (P < 0.01) were increased in the patients. Diabetic patients also had increased plasma fibrinogen concentration (+ approximately 50%; P < 0.01) and pool (+ approximately 40%; P < 0.01) as well as fractional (+ approximately 35%; P = 0.08) and absolute (+ approximately 100%; P < 0.01) synthetic rates. The plasma glucagon concentration was positively related (P < 0.005 or less) to the fibrinogen concentration as well as to fractional and absolute synthetic rates. Thus, fibrinogen production is markedly enhanced, and this alteration is likely to determine the observed hyperfibrinogenemia in type 2 diabetic patients. Hyperglucagonemia may contribute to the increased fibrinogen production. These findings in normoalbuminuric patients without clinical complications support the hypothesis that increased fibrinogen production and plasma concentrations may precede and possibly contribute to the onset of clinical cardiovascular complications in type 2 diabetes.
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Affiliation(s)
- R Barazzoni
- Department of Clinical and Experimental Medicine, University of Padova, Italy
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46
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Maran A, Crepaldi C, Trupiani S, Lucca T, Jori E, Macdonald IA, Tiengo A, Avogaro A, Del Prato S. Brain function rescue effect of lactate following hypoglycaemia is not an adaptation process in both normal and type I diabetic subjects. Diabetologia 2000; 43:733-41. [PMID: 10907119 DOI: 10.1007/s001250051371] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.2] [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: 11/28/2022]
Abstract
AIMS/HYPOTHESIS We have previously shown that lactate protects brain function during insulin-induced hypoglycaemia. An adaptation process could, however, not be excluded because the blood lactate increase preceded hypoglycaemia. METHODS We studied seven healthy volunteers and seven patients with Type I (insulin-dependent) diabetes mellitus with a hyperinsulinaemic (1.5 mU.kg-1.min-1) stepwise hypoglycaemic clamp (4.8 to 3.6, 3.0 and 2.8 mmol/l) with and without Na-lactate infusion (30 mumol.kg-1.min-1) given after initiation of hypoglycaemic symptoms. RESULTS The glucose threshold for epinephrine response was similar (control subjects 3.2 +/- 0.1 vs 3.2 +/- 0.1, diabetic patients = 3.5 +/- 0.1 vs 3.5 +/- 0.1 mmol/l) in both studies. The magnitude of the response was, however, blunted by lactate infusion (AUC; control subjects 65 +/- 28 vs 314 +/- 55 nmol/l/180 min, zenith = 2.6 +/- 0.5 vs 4.8 +/- 0.7 nmol/l, p < 0.05; diabetic patients = 102 +/- 14 vs 205 +/- 40 nmol/l/180 min, zenith = 1.4 +/- 0.4 vs 3.2 +/- 0.3 nmol/l, p < 0.01). The glucose threshold for symptoms was also similar (C = autonomic 3.0 +/- 0.1 vs 3.0 +/- 0.1, neuroglycopenic = 2.8 +/- 0.1 vs 2.9 +/- 0.1 mmol/l, D = autonomic 3.2 +/- 0.1 vs 3.2 +/- 0.1, neuroglycopenic 3.1 +/- 0.1 vs 3.2 +/- 0.1 mmol/l) but peak responses were significantly attenuated by lactate (score at 160 min C = 2.6 +/- 1 vs 8.8 +/- 1, and 0.4 +/- 0.4 vs 4.8 +/- 1, respectively; p = 0.02-0.01, D = 1.3 +/- 0.5 vs 6.3 +/- 1.7, and 2.3 +/- 0.6 vs 5.7 +/- 1.1 p = 0.07-0.02). Cognitive function deteriorated in both studies at similar glucose thresholds (C = 3.1 +/- 0.1 vs 3.0 +/- 0.1, D = 3.2 +/- 0.1 vs 3.3 +/- 0.2 mmol/l). Although in normal subjects a much smaller impairment was observed with lactate infusion (delta four-choice reaction time at 160 min = 22 +/- 12 vs 77 +/- 31 ms; p = 0.02), in Type I diabetic patients lactate infusion was associated with an improvement in cognitive dysfunction (0.2 +/- 0.4 vs -38 +/- 0.2 delta ms, p = 0.0001). CONCLUSION/INTERPRETATION A blood lactate increase after the development of hypoglycaemic symptoms reduces counterregulatory and symptomatic responses to insulin-induced hypoglycaemia and favours brain function rescue both in normal and diabetic subjects. These findings confirm that lactate is an alternative substrate to glucose for cerebral metabolism under hypoglycaemic conditions.
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Affiliation(s)
- A Maran
- Department of Clinical and Experimental Medicine, University of Padua, Italy
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de Kreutzenberg SV, Avogaro A, Tiengo A, Del Prato S. Left ventricular mass in type 2 diabetes mellitus. A study employing a simple ECG index: the Cornell voltage. J Endocrinol Invest 2000; 23:139-44. [PMID: 10803469 DOI: 10.1007/bf03343696] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [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: 10/25/2022]
Abstract
Both type 2 diabetes mellitus (DM2) and left ventricular hypertrophy are associated with an increased risk of cardiovascular diseases (CVD). A strong association between hyperinsulinemia, which is the hallmark of DM2 and of insulin resistance syndrome (a cohort of metabolic abnormalities such as DM2, dyslipidemia, hyperuricemia, obesity, hypertension, hyperfibrinogenemia), and left ventricular (LV) hypertrophy was found in several studies. We studied 140 consecutive (both normo- and hypertensive) DM2 patients to determine a possible link between metabolic features and the degree of LV mass, calculated by the ECG method of Cornell voltage. The Cornell voltage value was 12.9+/-0.5 mm in the DM2 population as a whole, and 13.6+/-0.7 vs 11.7+/-0.9 mm (p=NS) in hypertensive and normotensive DM2 subgroups, respectively. Among all the metabolic parameters taken into account, the multivariate analysis shows that the fasting plasma insulin level is the strongest independent predictor of LV mass, both in the whole population (p=0.0005) and in the normo (p=0.0460) and hypertensive DM2 (p=0.0184) subgroups.
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Affiliation(s)
- S V de Kreutzenberg
- Department of Clinical and Experimental Medicine, Chair of Metabolic Diseases, University of Padua, Italy.
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48
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de Kreutzenberg SV, Crepaldi C, Marchetto S, Calò L, Tiengo A, Del Prato S, Avogaro A. Plasma free fatty acids and endothelium-dependent vasodilation: effect of chain-length and cyclooxygenase inhibition. J Clin Endocrinol Metab 2000; 85:793-8. [PMID: 10690892 DOI: 10.1210/jcem.85.2.6352] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [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: 02/12/2023]
Abstract
Free fatty acids (FFA) are known to interfere with glucose metabolism. Moreover, it has been shown that they are able to impair the endothelium-dependent vasodilation. Therefore, we sought to determine whether their negative effect on endothelial function depends on their chain length or on their ability to modify PG production. Fourteen normal volunteers were studied under baseline conditions and then randomly allocated to two of the following four studies: 1) long chain triglyceride (LCT) emulsion and heparin infusion (n = 7), 2) infusion of an emulsion containing 56% medium chain triglycerides (MCT) and 44% LCT plus heparin (n = 7), 3) infusion of LCT and heparin preceded by an i.v. bolus of 900 mg lysine-salicylate (ASA; n = 7), and 4) after an i.v. bolus of ASA (n = 7). Basal forearm blood flow (FBF), endothelium-dependent vasodilation in response to intraarterial acetylcholine (Ach), and endothelium-independent vasodilation in response to intraarterial nitroprusside were assessed by venous occlusion plethysmography. Both LCT and MCT infusions significantly increased basal FBF from 1.58 +/- 0.35 to 2.60 +/- 0.76 and 2.28 +/- 0.56 mL/min 100 mL tissue, respectively (both P < 0.05). This increase was also observed for LCT plus heparin, but not after ASA alone. The percent increase in FBF during Ach was lowered during both LCT (252 +/- 34% of the ratio infused/control arm at maximal Ach dose) and MCT (255 +/- 41%) compared to the baseline conditions (436 +/- 44%; both P < 0.05). The response to Ach was also lower during LCT plus ASA, whereas it was similar to baseline with ASA alone. No differences were observed in the response to nitroprusside among the experimental conditions. In conclusion, 1) the effect of FFA on endothelium-dependent vasodilation is independent of their chain length; 2) both LCT and MCT increase baseline FBF, independently from cyclooxygenase inhibition; and 3) acute ASA administration does not affect endothelium-dependent vasodilation. The FFA effect on the endothelial response to Ach may contribute to altered endothelial function and, hence, to the development and progression of atherosclerotic cardiovascular disease.
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Affiliation(s)
- S V de Kreutzenberg
- Department of Clinical and Experimental Medicine, University of Padova, Italy
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49
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da Tos V, Maran A, Vigili de Kreutzenberg S, Marchetto S, Tadiotto F, Bettio M, Marescotti MC, Tiengo A, Del Prato S. Mechanisms of acute and chronic hypoglycemic action of gliclazide. Acta Diabetol 2000; 37:201-6. [PMID: 11450504 DOI: 10.1007/s005920070006] [Citation(s) in RCA: 9] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
An extrapancreatic effect of sulfonylureas has been postulated. However, in vivo results have been disputed because the amelioration of insulin action that follows sulfonylurea may represent the relief from glucose toxicity rather than a direct effect of the drug. Therefore, we studied the hypoglycemic action of gliclazide acutely and after 2 months of therapy in seven type 2 diabetic patients. All patients received a 240-minute i.v. glucose infusion with [3-3H]glucose. In a random order, 160 mg gliclazide (study 1) or placebo (study 2) was given orally before glucose infusion. Finally, the effect of 160 mg gliclazide was reassessed after a two-month treatment with the same sulfonylurea (80 mg t.i.d.). Basal plasma glucose, insulin, C-peptide and endogenous glucose production (EGP) were similar before the two initial studies. During glucose infusion, EGP was more suppressed after gliclazide in spite of comparable increase in plasma insulin and C-peptide. After the two-month therapy, basal plasma glucose levels and HbA1c were lower while plasma insulin and C-peptide were higher with respect to baseline (p < 0.05). Gliclazide further reduced plasma glucose, the incremental area above baseline, and EGP during glucose infusion, while plasma insulin and C-peptide achieved higher plateaus (p < 0.05). When data were pooled, plasma glucose concentration and EGP correlated both in the basal state (r = 0.71) and during the last hour of glucose infusion (r = 0.84; both p < 0.05). These data suggest that gliclazide enhances the suppression of EGP induced by insulin and that this effect is greater with chronic treatment because of concomitant improvement of insulin secretion.
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Affiliation(s)
- V da Tos
- Department of Metabolic Diseases, University of Padua, Via Giustiniani 2, I-35128 Padua, Italy
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Tessari P, Barazzoni R, Zanetti M, Kiwanuka E, Tiengo A. Protein metabolism in Type 1 and Type 2 diabetes mellitus in the fasted and fed states. Diabetes Nutr Metab 1999; 12:428-34. [PMID: 10782566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Affiliation(s)
- P Tessari
- Department of Internal Medicine and Endocrinology, University of Bari, Italy.
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