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Iannuzzo F, Basile GA, Campolo D, Genovese G, Pandolfo G, Giunta L, Ruggeri D, Di Benedetto A, Bruno A. Metabolic and clinical effect of alpha-lipoic acid administration in schizophrenic subjects stabilized with atypical antipsychotics: A 12-week, open-label, uncontrolled study. Current Research in Pharmacology and Drug Discovery 2022; 3:100116. [PMID: 35992380 PMCID: PMC9389248 DOI: 10.1016/j.crphar.2022.100116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 11/18/2022] Open
Abstract
Background Many of the atypical antipsychotics induce metabolic side effects, limiting their use in clinical practice. Alpha-lipoic acid (ALA) was proposed as a new approach in schizophrenia to improve metabolic effects of atypical antipsychotics. The aim of the study is to evaluate the effect of ALA on metabolic and clinical parameters among schizophrenic subjects. Methods 15 schizophrenic subjects, in stable atypical antipsychotic monotherapy were included in the study. ALA was administrated at the oral daily dose of 600 mg/d in addition to antipsychotic therapy. Metabolic, clinical, and psychopathological parameters were measured at typical antipsychotics. e initial screening, and after 12 weeks. Results ALA produced a statistically significant reduction in QTc (p = 0.012), blood glucose (p = 0.005), AST (p = 0.021), γGT (p = 0.035), CPK (p = 0.005) and prolactinaemia (p = 0.026). In contrast, there was a significant increase in HbA1c (p = 0.026). No effects on body weight and blood lipid levels (triglycerides, total cholesterol, HDL, LDL) emerged. Conclusions ALA treatment appeared to be effective for reducing diabetes risk, liver functionality parameters, hyperprolactinaemia and QTC interval. ALA appears to be safe as adjunctive components in schizophrenia. Atypical antipsychotics induce the frequent occurrence of metabolic side effects. Prevalence rates of Metabolic Syndrome in patients with schizophrenia are high. No specific therapies for metabolic effects of SGAs in schizophrenia are still available. ALA was suggested as a potential therapeutic agent in various chronic diseases. ALA appeared to be effective to improve metabolic values in schizophrenia.
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Affiliation(s)
- Fiammetta Iannuzzo
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, Contesse, Messina, 98125, Italy
- Corresponding author. Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Policlinico Universitario, Via Consolare Valeria, 1, 98125, Messina, Italy.
| | - Gianpaolo Antonio Basile
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, Contesse, Messina, 98125, Italy
| | - Domenica Campolo
- Psychiatry Unit, Polyclinic Hospital University of Messina, Via Consolare Valeria 1, Contesse, 98125, Messina, Italy
| | - Giovanni Genovese
- Psychiatry Unit, Polyclinic Hospital University of Messina, Via Consolare Valeria 1, Contesse, 98125, Messina, Italy
| | - Gianluca Pandolfo
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, Contesse, Messina, 98125, Italy
- Psychiatry Unit, Polyclinic Hospital University of Messina, Via Consolare Valeria 1, Contesse, 98125, Messina, Italy
| | - Loretta Giunta
- Department of Internal Medicine, Polyclinic Hospital University of Messina, Via Consolare Valeria 1, Contesse, 98125, Messina, Italy
| | - Domenica Ruggeri
- Department of Internal Medicine, Polyclinic Hospital University of Messina, Via Consolare Valeria 1, Contesse, 98125, Messina, Italy
| | - Antonino Di Benedetto
- Department of Internal Medicine, Polyclinic Hospital University of Messina, Via Consolare Valeria 1, Contesse, 98125, Messina, Italy
| | - Antonio Bruno
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, Contesse, Messina, 98125, Italy
- Psychiatry Unit, Polyclinic Hospital University of Messina, Via Consolare Valeria 1, Contesse, 98125, Messina, Italy
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Di Bartolomeo L, Di Benedetto A, Giunta L, Guarneri F, Vaccaro M. Hypoplastic nails and brachydactyly in a girl with moderate acne and hirsutism. Pediatr Dermatol 2021; 38:1322-1323. [PMID: 34750885 DOI: 10.1111/pde.14700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Luca Di Bartolomeo
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Antonino Di Benedetto
- Section of Internal Medicine, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Loretta Giunta
- Section of Internal Medicine, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Fabrizio Guarneri
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Mario Vaccaro
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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Vitale SG, Corrado F, Caruso S, Di Benedetto A, Giunta L, Cianci A, D'Anna R. Myo-inositol supplementation to prevent gestational diabetes in overweight non-obese women: bioelectrical impedance analysis, metabolic aspects, obstetric and neonatal outcomes - a randomized and open-label, placebo-controlled clinical trial. Int J Food Sci Nutr 2020; 72:670-679. [PMID: 33238798 DOI: 10.1080/09637486.2020.1852191] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
This study aims to evaluate the effects of myo-inositol supplementation on gestational diabetes mellitus (GDM) rates and body water distribution in overweight non-obese women. 223 overweight non-obese women pregnant were randomly assigned to the treatment group (2 g of myo-inositol plus 200 µg of folic acid) or to the placebo one (200 µg of folic acid). The treatment lasted until three weeks after delivery. A tetrapolar impedance analyser was used to study body composition. The incidence of GDM was significantly reduced in the myo-inositol group compared with the placebo group. There was a significant increase in TBW, ECW and ICW values in the placebo group compared to the myo-inositol group. We have recorded a significant reduction in the overall incidence of pregnancy-induced hypertension in the myo-inositol group compared with the placebo group. Our results demonstrate the effectiveness of myo-inositol supplementation in preventing GDM in overweight non-obese pregnant women.
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Affiliation(s)
- Salvatore Giovanni Vitale
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Francesco Corrado
- Department of Obstetrics and Gynecology, University of Messina, Messina, Italy
| | - Salvatore Caruso
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | | | - Loretta Giunta
- Department of Internal Medicine, University of Messina, Messina, Italy
| | - Antonio Cianci
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Rosario D'Anna
- Department of Obstetrics and Gynecology, University of Messina, Messina, Italy
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Torlone E, Sculli MA, Bonomo M, Di Benedetto A, Di Cianni G, Festa C, Formoso G, Lapolla A, Mannino D, Napoli A, Scavini M, Succurro E, Vitacolonna E, Sciacca L. Recommendations and management of hyperglycaemia in pregnancy during COVID-19 pandemic in Italy. Diabetes Res Clin Pract 2020; 166:108345. [PMID: 32710999 PMCID: PMC7375279 DOI: 10.1016/j.diabres.2020.108345] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/01/2020] [Accepted: 07/09/2020] [Indexed: 12/18/2022]
Abstract
Many specialists use the remote management of people with chronic disease as diabetes, but structured management protocols have not been developed yet. The COVID-19 pandemic has given a big boost to the use of telemedicine, as it allows to maintain the physical distance, essential to the containment of contagion having regular health contact. Encouraging results related to the use of telemedicine in women with hyperglycaemia in pregnancy, have been recently published. It is well known that hyperglycaemia alters the immune response to infections, that inflammation, in turn, worsens glycaemic control and that any form of hyperglycaemia in pregnancy (HIP) has effects not only on the mother but also on development of the foetus. Therefore, the Italian Diabetes and Pregnancy Study Group, together with a group of experts, developed these recommendations in order to guide physicians in the management of HIP, providing specific diagnostic, therapeutic and assistance pathways (PDTAs) for the COVID-19 emergency. Three detailed PDTAs were developed, for type 1, type 2 and gestational diabetes.
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MESH Headings
- Betacoronavirus/isolation & purification
- Blood Glucose/analysis
- COVID-19
- Coronavirus Infections/complications
- Coronavirus Infections/epidemiology
- Coronavirus Infections/prevention & control
- Coronavirus Infections/virology
- Diabetes, Gestational/drug therapy
- Diabetes, Gestational/physiopathology
- Diabetes, Gestational/virology
- Disease Management
- Female
- Humans
- Hyperglycemia/epidemiology
- Hyperglycemia/prevention & control
- Hyperglycemia/virology
- Hypoglycemic Agents/therapeutic use
- Insulin/therapeutic use
- Italy/epidemiology
- Pandemics/prevention & control
- Pneumonia, Viral/complications
- Pneumonia, Viral/epidemiology
- Pneumonia, Viral/prevention & control
- Pneumonia, Viral/virology
- Practice Guidelines as Topic/standards
- Pregnancy
- Pregnancy Complications, Infectious/epidemiology
- Pregnancy Complications, Infectious/prevention & control
- Pregnancy Complications, Infectious/virology
- SARS-CoV-2
- Telemedicine/methods
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Affiliation(s)
- Elisabetta Torlone
- Interassociative Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Italian Society of Diabetology (SID), Rome, Italy; Department of Medicine, Endocrinology and Metabolism, S. Maria della Misericordia University Hospital, Perugia, Italy.
| | - Maria Angela Sculli
- Interassociative Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Italian Society of Diabetology (SID), Rome, Italy; Grande Ospedale Metropolitano Bianchi-Melacrino-Morelli, Reggio Calabria, Italy
| | - Matteo Bonomo
- Diabetes Unit, Interdisciplinary Diabetes and Pregnancy Center, Ospedale Metropolitano Niguarda, Milano, Italy
| | - Antonino Di Benedetto
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Graziano Di Cianni
- UOC Diabetologia e Malattie Metaboliche ASL Toscana Nord Ovest, Livorno, Italy
| | - Camilla Festa
- Interassociative Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Italian Society of Diabetology (SID), Rome, Italy
| | - Gloria Formoso
- Interassociative Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Italian Society of Diabetology (SID), Rome, Italy; Department of Medicine and Aging Sciences, Centre for Advanced Studies and Technology (CAST, ex CeSIMet), G. d'Annunzio University Chieti-Pescara, Pescara, Italy
| | - Annunziata Lapolla
- Department of Medicine, Diabetology and Dietetics Unit, Padua University, Padua, Italy
| | | | - Angela Napoli
- A.O.S.Andrea, Department of Clinical and Molecular Medicine, Università degli Studi La Sapienza, Roma, Italy
| | - Marina Scavini
- Interassociative Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Italian Society of Diabetology (SID), Rome, Italy; Diabetes Research Institute (DRI), San Raffaele Scientific Institute, Milan, Italy
| | - Elena Succurro
- Interassociative Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Italian Society of Diabetology (SID), Rome, Italy; Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Ester Vitacolonna
- Department of Medicine and Aging, University ''G. d'Annunzio", Chieti, Italy
| | - Laura Sciacca
- Interassociative Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Italian Society of Diabetology (SID), Rome, Italy; Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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Vitacolonna E, Succurro E, Lapolla A, Scavini M, Bonomo M, Di Cianni G, Di Benedetto A, Napoli A, Tumminia A, Festa C, Lencioni C, Torlone E, Sesti G, Mannino D, Purrello F. Guidelines for the screening and diagnosis of gestational diabetes in Italy from 2010 to 2019: critical issues and the potential for improvement. Acta Diabetol 2019; 56:1159-1167. [PMID: 31396699 DOI: 10.1007/s00592-019-01397-4] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 07/30/2019] [Indexed: 12/17/2022]
Abstract
AIMS In 2010, Italian health professionals rapidly implemented the one-step screening for gestational diabetes mellitus (GDM) based on a 75 g OGTT, to comply with the diagnostic criteria proposed by the International Association of Diabetes and Pregnancy Study Groups (IADPSG). The change was promoted by the two main Italian scientific societies of diabetology, Associazione Medici Diabetologi (AMD) and Società Italiana di Diabetologia (SID), and it took just a few months for the Istituto Superiore di Sanità, together with several scientific societies, to revise the criteria and include them in the National Guidelines System. Over the last 9 years, the implementation of these guidelines has shown some benefits and some drawbacks. METHODS In order to evaluate the critical issues arisen from the implementation of the current Italian guidelines for the diagnosis of GDM, the studies published on this topic have been reviewed. The search was performed using the following keywords: "gestational diabetes" AND "diagnostic criteria" OR screening AND Ital*. The study is an expert opinion paper, based on the relevant scientific literature published between 2010 and 2019. The databases screened for the literature review included PubMed, MEDLINE, and Scopus. RESULTS The implementation of the Guidelines for Screening and Diagnosis of GDM in Italy present some strengths and some weaknesses. One of the positive aspects is that high-risk women are required to perform an OGTT early in pregnancy. By contrast, there are several aspects in need of improvement: (1) In spite of the current indications, only a minority of high-risk women perform OGTT early in pregnancy; (2) several low-risk women are screened for GDM; (3) in some low-risk women affected by GDM, the diagnosis might be missed with the application of the current guidelines; (4) there is a lack of homogeneity in the risk assessment data from different regions. CONCLUSIONS In order to improve the current Italian GDM guidelines, some practical solutions have been suggested.
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Affiliation(s)
- Ester Vitacolonna
- Diabetes and Pregnancy Study Group, Italian Society of Diabetology (SID), Rome, Italy.
- Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Rome, Italy.
- Department of Medicine and Aging, School of Medicine and Health Sciences, "G. d'Annunzio" University, Chieti-Pescara, Chieti, Italy.
| | - Elena Succurro
- Diabetes and Pregnancy Study Group, Italian Society of Diabetology (SID), Rome, Italy
- Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Rome, Italy
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Annunziata Lapolla
- Diabetes and Pregnancy Study Group, Italian Society of Diabetology (SID), Rome, Italy
- Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Rome, Italy
- Department of Medicine, Diabetology and Dietetics Unit, Padova University, Padua, Italy
| | - Marina Scavini
- Diabetes and Pregnancy Study Group, Italian Society of Diabetology (SID), Rome, Italy
- Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Rome, Italy
- Division of Immunology, Transplantation and Infectious Diseases, Diabetes Research Institute (DRI), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Matteo Bonomo
- Diabetes and Pregnancy Study Group, Italian Society of Diabetology (SID), Rome, Italy
- Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Rome, Italy
- SSD Diabetology, Ca'Granda Niguarda Hospital, Milan, Italy
| | - Graziano Di Cianni
- Diabetes and Pregnancy Study Group, Italian Society of Diabetology (SID), Rome, Italy
- Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Rome, Italy
- Diabetes and Metabolic Diseases Unit, Health Local Unit Nord-West Tuscany, Livorno Hospital, Leghorn, Italy
| | - Antonino Di Benedetto
- Diabetes and Pregnancy Study Group, Italian Society of Diabetology (SID), Rome, Italy
- Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Rome, Italy
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy
| | - Angela Napoli
- Diabetes and Pregnancy Study Group, Italian Society of Diabetology (SID), Rome, Italy
- Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Rome, Italy
- Department of Experimental Medicine, Faculty of Medicine and Dentistry, Sapienza University, Rome, Italy
| | - Andrea Tumminia
- Diabetes and Pregnancy Study Group, Italian Society of Diabetology (SID), Rome, Italy
- Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Rome, Italy
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Camilla Festa
- Diabetes and Pregnancy Study Group, Italian Society of Diabetology (SID), Rome, Italy
- Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Rome, Italy
- Department of Experimental Medicine, Faculty of Medicine and Dentistry, Sapienza University, Rome, Italy
| | - Cristina Lencioni
- Diabetes and Pregnancy Study Group, Italian Society of Diabetology (SID), Rome, Italy
- Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Rome, Italy
- Diabetes Unit, Usl Nord Ovest Tuscany, Lucca, Italy
| | - Elisabetta Torlone
- Diabetes and Pregnancy Study Group, Italian Society of Diabetology (SID), Rome, Italy
- Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Rome, Italy
- Internal Medicine, Endocrinology and Metabolism, S. Maria della Misericordia Hospital, Perugia, Italy
| | - Giorgio Sesti
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
- Italian Diabetes and Research Foundation, Italian Society of Diabetology (SID), Rome, Italy
| | - Domenico Mannino
- Diabetes and Pregnancy Study Group, Italian Society of Diabetology (SID), Rome, Italy
- Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Rome, Italy
- Section of Endocrinology and Diabetes, Bianchi Melacrino Morelli Hospital, Reggio Calabria, Italy
- Italian Association of Diabetologists (AMD), Rome, Italy
| | - Francesco Purrello
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Italian Society of Diabetology (SID), Rome, Italy
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Maimone S, Saffioti F, Oliva G, Di Benedetto A, Alibrandi A, Filomia R, Caccamo G, Saitta C, Cacciola I, Pitrone C, Squadrito G, Raimondo G. Erectile dysfunction in compensated liver cirrhosis. Dig Liver Dis 2019; 51:843-849. [PMID: 30467076 DOI: 10.1016/j.dld.2018.10.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 10/17/2018] [Accepted: 10/18/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Data on erectile dysfunction (ED) in cirrhotic patients are limited as yet. Aim of this study was to investigate the prevalence of ED and the factors potentially involved in its development in compensated cirrhosis. METHODS We prospectively enrolled 102 male (mean age 63 ± 10 years) affected by cirrhosis in Child-Pugh Class A. The following questionnaires were used: simplified International Index of Erectile Function (IIEF-5) Questionnaire, Centre of Epidemiologic Studies Depression Scale and ANDROTEST. RESULTS ED was found in 57/102(55.9%) patients, and was mild, moderate and severe in 21(36.8%), 6(10.5%) and 30(52.6%) subjects, respectively. ED patients were significantly older than those without (66 ± 10 vs 60 ± 10,p = 0.006); ED prevalence gradually increased with age. There was no statistically significant difference between patients with and without ED concerning the coexistence of diabetes, hypertension, and cardiovascular disease. Age(p = 0.040) and serum haemoglobin(p = 0.027) were identified as predictors of ED on multivariate analysis. Liver-related factors and pharmacological treatment, including β-blockers, were not associated with the presence of ED. CONCLUSIONS In patients with compensated liver cirrhosis, even in concomitance with other chronic comorbidities, the prevalence of ED is not markedly different from the general population. Compensated cirrhosis per se is not a risk factor for ED occurrence. Older age and low haemoglobin values are significantly associated with ED in cirrhotics.
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Affiliation(s)
- Sergio Maimone
- Division of Clinical and Molecular Hepatology, University Hospital of Messina, Messina, Italy.
| | - Francesca Saffioti
- Division of Clinical and Molecular Hepatology, University Hospital of Messina, Messina, Italy; Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Giovanni Oliva
- Division of Clinical and Molecular Hepatology, University Hospital of Messina, Messina, Italy
| | - Antonino Di Benedetto
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Angela Alibrandi
- Department of Economics, Unit of Statistical and Mathematical Sciences, University of Messina, Italy
| | - Roberto Filomia
- Division of Clinical and Molecular Hepatology, University Hospital of Messina, Messina, Italy; Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Gaia Caccamo
- Division of Clinical and Molecular Hepatology, University Hospital of Messina, Messina, Italy
| | - Carlo Saitta
- Division of Clinical and Molecular Hepatology, University Hospital of Messina, Messina, Italy
| | - Irene Cacciola
- Division of Clinical and Molecular Hepatology, University Hospital of Messina, Messina, Italy; Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Concetta Pitrone
- Division of Clinical and Molecular Hepatology, University Hospital of Messina, Messina, Italy
| | - Giovanni Squadrito
- Division of Clinical and Molecular Hepatology, University Hospital of Messina, Messina, Italy; Department of Human Pathology of the Adult and Evolutive Age, University of Messina, Messina, Italy
| | - Giovanni Raimondo
- Division of Clinical and Molecular Hepatology, University Hospital of Messina, Messina, Italy; Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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Vaccaro O, Masulli M, Nicolucci A, Bonora E, Del Prato S, Maggioni AP, Rivellese AA, Squatrito S, Giorda CB, Sesti G, Mocarelli P, Lucisano G, Sacco M, Signorini S, Cappellini F, Perriello G, Babini AC, Lapolla A, Gregori G, Giordano C, Corsi L, Buzzetti R, Clemente G, Di Cianni G, Iannarelli R, Cordera R, La Macchia O, Zamboni C, Scaranna C, Boemi M, Iovine C, Lauro D, Leotta S, Dall'Aglio E, Cannarsa E, Tonutti L, Pugliese G, Bossi AC, Anichini R, Dotta F, Di Benedetto A, Citro G, Antenucci D, Ricci L, Giorgino F, Santini C, Gnasso A, De Cosmo S, Zavaroni D, Vedovato M, Consoli A, Calabrese M, di Bartolo P, Fornengo P, Riccardi G. Effects on the incidence of cardiovascular events of the addition of pioglitazone versus sulfonylureas in patients with type 2 diabetes inadequately controlled with metformin (TOSCA.IT): a randomised, multicentre trial. Lancet Diabetes Endocrinol 2017; 5:887-897. [PMID: 28917544 DOI: 10.1016/s2213-8587(17)30317-0] [Citation(s) in RCA: 183] [Impact Index Per Article: 26.1] [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] [Received: 08/03/2017] [Revised: 08/29/2017] [Accepted: 08/29/2017] [Indexed: 12/24/2022]
Abstract
BACKGROUND The best treatment option for patients with type 2 diabetes in whom treatment with metformin alone fails to achieve adequate glycaemic control is debated. We aimed to compare the long-term effects of pioglitazone versus sulfonylureas, given in addition to metformin, on cardiovascular events in patients with type 2 diabetes. METHODS TOSCA.IT was a multicentre, randomised, pragmatic clinical trial, in which patients aged 50-75 years with type 2 diabetes inadequately controlled with metformin monotherapy (2-3 g per day) were recruited from 57 diabetes clinics in Italy. Patients were randomly assigned (1:1), by permuted blocks randomisation (block size 10), stratified by site and previous cardiovascular events, to add-on pioglitazone (15-45 mg) or a sulfonylurea (5-15 mg glibenclamide, 2-6 mg glimepiride, or 30-120 mg gliclazide, in accordance with local practice). The trial was unblinded, but event adjudicators were unaware of treatment assignment. The primary outcome, assessed with a Cox proportional-hazards model, was a composite of first occurrence of all-cause death, non-fatal myocardial infarction, non-fatal stroke, or urgent coronary revascularisation, assessed in the modified intention-to-treat population (all randomly assigned participants with baseline data available and without any protocol violations in relation to inclusion or exclusion criteria). This study is registered with ClinicalTrials.gov, number NCT00700856. FINDINGS Between Sept 18, 2008, and Jan 15, 2014, 3028 patients were randomly assigned and included in the analyses. 1535 were assigned to pioglitazone and 1493 to sulfonylureas (glibenclamide 24 [2%], glimepiride 723 [48%], gliclazide 745 [50%]). At baseline, 335 (11%) participants had a previous cardiovascular event. The study was stopped early on the basis of a futility analysis after a median follow-up of 57·3 months. The primary outcome occurred in 105 patients (1·5 per 100 person-years) who were given pioglitazone and 108 (1·5 per 100 person-years) who were given sulfonylureas (hazard ratio 0·96, 95% CI 0·74-1·26, p=0·79). Fewer patients had hypoglycaemias in the pioglitazone group than in the sulfonylureas group (148 [10%] vs 508 [34%], p<0·0001). Moderate weight gain (less than 2 kg, on average) occurred in both groups. Rates of heart failure, bladder cancer, and fractures were not significantly different between treatment groups. INTERPRETATION In this long-term, pragmatic trial, incidence of cardiovascular events was similar with sulfonylureas (mostly glimepiride and gliclazide) and pioglitazone as add-on treatments to metformin. Both of these widely available and affordable treatments are suitable options with respect to efficacy and adverse events, although pioglitazone was associated with fewer hypoglycaemia events. FUNDING Italian Medicines Agency, Diabete Ricerca, and Italian Diabetes Society.
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Affiliation(s)
- Olga Vaccaro
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
| | - Maria Masulli
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Antonio Nicolucci
- Center for Outcomes Research and Clinical Epidemiology (CORESEARCH), Pescara, Italy
| | - Enzo Bonora
- Division of Endocrinology, Diabetes and Metabolism, University and Hospital Trust of Verona, Verona, Italy
| | - Stefano Del Prato
- Department of Clinical & Experimental Medicine, University of Pisa, Pisa, Italy
| | - Aldo P Maggioni
- National Association of Hospital Cardiologists (ANMCO) Research Center, Florence, Italy
| | - Angela A Rivellese
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | | | - Carlo B Giorda
- Diabetes Unit, Azienda Sanitaria Locale (ASL) Torino 5, Torino, Italy
| | - Giorgio Sesti
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Italy
| | - Paolo Mocarelli
- University Department Laboratory Medicine, Hospital of Desio, Monza, Italy
| | - Giuseppe Lucisano
- Center for Outcomes Research and Clinical Epidemiology (CORESEARCH), Pescara, Italy
| | - Michele Sacco
- Center for Outcomes Research and Clinical Epidemiology (CORESEARCH), Pescara, Italy
| | - Stefano Signorini
- University Department Laboratory Medicine, Hospital of Desio, Monza, Italy
| | | | | | | | | | - Giovanna Gregori
- Diabetes Unit, Massa Carrara, Azienda Unità Sanitarie Locali (USL) Toscana Nord Ovest, Carrara, Italy
| | - Carla Giordano
- Section of Endocrinology, Diabetology and Metabolic Diseases, University of Palermo, Palermo, Italy
| | - Laura Corsi
- Diabetes Unit, ASL 4 Chiavarese, Chiavari, Italy
| | | | - Gennaro Clemente
- Institute for Research on Population and Social Policies-National Research Council, Penta di Fisciano, Italy
| | | | - Rossella Iannarelli
- Diabetes Unit, Department of Medicine, San Salvatore Hospital, L'Aquila, Italy
| | - Renzo Cordera
- Diabetes Unit, School of Medicine, University of Genova, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Martino Hospital, Genova, Italy
| | - Olga La Macchia
- Endocrinology, Azienda Ospedaliero Universitaria Ospedali Riuniti, Foggia, Italy
| | | | - Cristiana Scaranna
- Endocrinology and Diabetology, Azienda Socio Sanitaria Territoriale (ASST) Papa Giovanni XXIII, Bergamo, Italy
| | - Massimo Boemi
- Diabetes and Metabolism Unit, IRCCS Istituto Nazionale Riposo e Cura Anziani, Ancona, Italy
| | - Ciro Iovine
- Diabetes Unit, University of Naples Federico II, Naples, Italy
| | - Davide Lauro
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Sergio Leotta
- UOC Diabetologia Ospedale Sandro Pertini, Rome, Italy
| | | | | | - Laura Tonutti
- Endocrinology, Diabetes, Metabolism and Clinical Nutrition Unit, Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
| | - Giuseppe Pugliese
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | | | | | - Francesco Dotta
- Diabetes Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Antonino Di Benedetto
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Giuseppe Citro
- Endocrinology and Diabetes Unit, Azienda Sanitaria Locale di Potenza, Potenza, Italy
| | | | | | - Francesco Giorgino
- Department of Emergency and Organ Transplantation, Endocrinology and Metabolic Diseases, University of Bari Aldo Moro, Bari, Apulia, Italy
| | - Costanza Santini
- Department Endocrinology and Diabetology, Cesena Hospital, Cesena, Italy
| | - Agostino Gnasso
- Department of Clinical and Experimental Medicine, Magna Graecia University of Catanzaro, Italy
| | - Salvatore De Cosmo
- Unit of Internal Medicine, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | | | - Monica Vedovato
- Metabolism Unit, Azienda Ospedaliera di Padova, Padova, Italy
| | - Agostino Consoli
- Department of Medicine and Aging Sciences, and Aging and Translational Medicine Research Center (CeSI-Met), D'Annunzio University, Chieti-Pescara, Italy
| | | | - Paolo di Bartolo
- Diabetes Unit, Ravenna Internal Medicine Department, Romagna Local Health Unit, Ravenna, Italy
| | - Paolo Fornengo
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Gabriele Riccardi
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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Muscatello MRA, Troili GM, Pandolfo G, Mento C, Gallo G, Lanza G, Pintaudi B, Di Vieste G, Di Benedetto A, Zoccali RA, Bruno A. [Depression, anxiety and anger in patients with type 1 diabetes mellitus.]. Recenti Prog Med 2017; 108:77-82. [PMID: 28287201 DOI: 10.1701/2636.27098] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION The aim of this study is to evaluate the influence of negative emotions such as depression, anxiety and anger on clinical expression of type 1 diabetes, also assessing possible gender differences. MATERIALS AND METHODS 75 subjects with type 1 diabetes mellitus afferent to Diabetology Unit of the University Hospital in Messina underwent the following psychodiagnostic tests: Hamilton Rating Scale For Depression (HDRS), State-Trait Anxiety Inventory form Y (STAI-Y), State-Trait Anger Expression Inventory-2 (STAXI-2). Continuous data were expressed as mean ± standard deviation, and the comparison between groups was performed using T Student test; the data not continuous were expressed as a percentage and the differences between groups were evaluated using Chi-square test. We considered the results for values of p<0.05. RESULTS The mean age of 75 subjects (49.3% males) was 41.0±11.4 years, age of disease onset was 21.1 ± 11.8 years and mean duration of disease was 19.9±11.9 years; 30.7% of subjects were treated with CSII (Subcutaneus Insulin Infusion). Mild levels of depression (HDRS= 10.71±7.9) and anxiety (STAI-Y= 52.37±6.11) were found, whereas STAXI-2 subscales scores were within the normal range. Statistical analysis did not show significant gender differences. DISCUSSION Our results, according to data from literature, confirm the association between negative emotions, particularly anxiety, and diabetes. No gender differences were found. CONCLUSIONS Our results suggest the importance of investigating the association between diabetes and negative emotional states and the psychological and psychopathological dimensions which may have a potential role in the therapeutic management of diabetes.
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Affiliation(s)
- Maria Rosaria Anna Muscatello
- Dipartimento di Scienze biomediche, odontoiatriche e delle immagini morfologiche e funzionali, Università di Messina
| | - Giulia Maria Troili
- Dipartimento di Scienze biomediche, odontoiatriche e delle immagini morfologiche e funzionali, Università di Messina
| | - Gianluca Pandolfo
- Dipartimento di Scienze biomediche, odontoiatriche e delle immagini morfologiche e funzionali, Università di Messina
| | - Carmela Mento
- Dipartimento di Scienze biomediche, odontoiatriche e delle immagini morfologiche e funzionali, Università di Messina
| | - Giuseppa Gallo
- Dipartimento di Scienze biomediche, odontoiatriche e delle immagini morfologiche e funzionali, Università di Messina
| | - Giulia Lanza
- Dipartimento di Scienze biomediche, odontoiatriche e delle immagini morfologiche e funzionali, Università di Messina
| | - Basilio Pintaudi
- Dipartimento di Medicina Clinica e Sperimentale, Università di Messina
| | - Giacoma Di Vieste
- Dipartimento di Medicina Clinica e Sperimentale, Università di Messina
| | | | - Rocco Antonio Zoccali
- Dipartimento di Scienze biomediche, odontoiatriche e delle immagini morfologiche e funzionali, Università di Messina
| | - Antonio Bruno
- Dipartimento di Scienze biomediche, odontoiatriche e delle immagini morfologiche e funzionali, Università di Messina
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Corrado F, Giunta L, Granese R, Corrado S, Micali M, Santamaria A, D'Anna R, Di Benedetto A. Metabolic effects of breastfeeding in women with previous gestational diabetes diagnosed according to the IADPSG criteria. J Matern Fetal Neonatal Med 2017; 32:225-228. [PMID: 28877616 DOI: 10.1080/14767058.2017.1377175] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Some studies have already investigated about the short-term favorable metabolic effects of breastfeeding in women with previous gestational diabetes mellitus (GDM). AIM The aim of our study is to confirm whether the positive effects reported are maintained in the larger cohorts of patients with mild form of gestational diabetes mellitus (GDM) because recently diagnosed according to IADPSG criteria. MATERIALS AND METHODS This retrospective study includes 97 evaluable consecutive women with prior GDM who have the follow-up oral glucose tolerance test at least 3 months after delivery. Fasting and 2-h plasma glucose values, homeostasis model assessment (HOMA-IR), total cholesterol, and triglycerides were obtained in pregnancy and during the post-partum control. RESULTS These patients were divided in 81 (83.5%) who lactate until 3 months and 16 (16.5%) who did not lactate. During pregnancy, there are no significant differences between the two groups for age, BMI, fasting and 2-h plasma glucose values, HOMA-IR, total cholesterol and triglycerides. At the postpartum control, we have at univariate analysis significant differences for all these parameters except total cholesterol. After adjustment for confounders we still have, in the breastfeeding group, HOMA-IR reduction (OR 0.370; 95% CI 0.170-0.805; p < .01) as significant independent variable, whose improvement is the most acknowledged important factor for the prevention of abnormal glucose tolerance later in life. CONCLUSION These encouraging results confirm our determination to warmly advice the women affected by GDM to breastfeeding at least for 3 months.
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Affiliation(s)
- Francesco Corrado
- a Dipartimento di Patologia Umana dell'Adulto e dell'Età Evolutiva "G. Barresi" , Università degli Studi di Messina , Messina , Italy
| | - Loretta Giunta
- b Dipartimento di Medicina Clinica e Sperimentale , Università degli Studi di Messina , Messina , Italy
| | - Roberta Granese
- a Dipartimento di Patologia Umana dell'Adulto e dell'Età Evolutiva "G. Barresi" , Università degli Studi di Messina , Messina , Italy
| | - Silvia Corrado
- a Dipartimento di Patologia Umana dell'Adulto e dell'Età Evolutiva "G. Barresi" , Università degli Studi di Messina , Messina , Italy
| | - Marina Micali
- a Dipartimento di Patologia Umana dell'Adulto e dell'Età Evolutiva "G. Barresi" , Università degli Studi di Messina , Messina , Italy
| | - Angelo Santamaria
- a Dipartimento di Patologia Umana dell'Adulto e dell'Età Evolutiva "G. Barresi" , Università degli Studi di Messina , Messina , Italy
| | - Rosario D'Anna
- a Dipartimento di Patologia Umana dell'Adulto e dell'Età Evolutiva "G. Barresi" , Università degli Studi di Messina , Messina , Italy
| | - Antonino Di Benedetto
- b Dipartimento di Medicina Clinica e Sperimentale , Università degli Studi di Messina , Messina , Italy
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10
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Giordano D, Loddo S, Laganà AS, Coppolino G, Zoccali G, Di Benedetto A, Santamaria A, Buemi M, D’Anna R. Peripheral blood CD34+ cells as a novel and noninvasive early marker of first trimester miscarriage: results from a case-control analysis. J Matern Fetal Neonatal Med 2017; 31:258-260. [DOI: 10.1080/14767058.2016.1277703] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Domenico Giordano
- Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood “G. Barresi”, University of Messina, Messina, Italy
| | - Saverio Loddo
- Department of Experimental Medicine, University of Messina, Messina, Italy
| | - Antonio Simone Laganà
- Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood “G. Barresi”, University of Messina, Messina, Italy
| | - Giuseppe Coppolino
- Nephrology and Dialysis Unit, “Pugliese-Ciaccio” Hospital of Catanzaro, Catanzaro, Italy
| | - Giuseppe Zoccali
- Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood “G. Barresi”, University of Messina, Messina, Italy
| | | | - Angelo Santamaria
- Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood “G. Barresi”, University of Messina, Messina, Italy
| | - Michele Buemi
- Department of Experimental Medicine, University of Messina, Messina, Italy
| | - Rosario D’Anna
- Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood “G. Barresi”, University of Messina, Messina, Italy
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Santamaria A, Di Benedetto A, Petrella E, Pintaudi B, Corrado F, D'Anna R, Neri I, Facchinetti F. Myo-inositol may prevent gestational diabetes onset in overweight women: a randomized, controlled trial. J Matern Fetal Neonatal Med 2015; 29:3234-7. [PMID: 26698911 DOI: 10.3109/14767058.2015.1121478] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To evaluate whether myo-inositol supplementation may reduce gestational diabetes mellitus (GDM) rate in overweight women. METHODS In an open-label, randomized trial, myo-inositol (2 g plus 200 μg folic acid twice a day) or placebo (200 μg folic acid twice a day) was administered from the first trimester to delivery in pregnant overweight non-obese women (pre-pregnancy body mass index ≥ 25 and < 30 kg/m(2)). The primary outcome was the incidence of GDM. RESULTS From January 2012 to December 2014, 220 pregnant women were randomized at two Italian University hospitals, 110 to myo-inositol and 110 to placebo. The incidence of GDM was significantly lower in the myo-inositol group compared to the placebo group (11.6% versus 27.4%, respectively, p = 0.004). Myo-inositol treatment was associated with a 67% risk reduction of developing GDM (OR 0.33; 95% CI 0.15-0.70). CONCLUSIONS Myo-inositol supplementation, administered since early pregnancy, reduces GDM incidence in overweight non-obese women.
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Affiliation(s)
- Angelo Santamaria
- a Department of Pediatrics , Gynecology, Microbiology and Biomedical Sciences, University of Messina , Messina , Italy
| | - Antonino Di Benedetto
- b Department of Clinical and Experimental Medicine , University of Messina , Messina , Italy , and
| | - Elisabetta Petrella
- c Obstetric Unit, Mother-Infant Department, University of Modena and Reggio Emilia , Modena , Italy
| | - Basilio Pintaudi
- b Department of Clinical and Experimental Medicine , University of Messina , Messina , Italy , and
| | - Francesco Corrado
- a Department of Pediatrics , Gynecology, Microbiology and Biomedical Sciences, University of Messina , Messina , Italy
| | - Rosario D'Anna
- a Department of Pediatrics , Gynecology, Microbiology and Biomedical Sciences, University of Messina , Messina , Italy
| | - Isabella Neri
- c Obstetric Unit, Mother-Infant Department, University of Modena and Reggio Emilia , Modena , Italy
| | - Fabio Facchinetti
- c Obstetric Unit, Mother-Infant Department, University of Modena and Reggio Emilia , Modena , Italy
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Abstract
CONTEXT Autoimmune thyroid diseases (AITDs) can be associated with type 1 diabetes (DM1). The prevalence of serum antibodies against thyroid hormones (THAb) in subjects with autoimmune diseases other than DM1 is increasing. No data are available for DM1. OBJECTIVE The objectives were evaluate the rate of associated AITD; the rate of positiveness for serum THAb; the panel of THAb based on thyroid hormone interaction and on Ig class; and the association of AITD alone, THAb alone, or AITD plus THAb with diabetes-related complications. DESIGN This was an observational, prospective study with 6-year (2005-2011) follow-up. SETTING The setting was an outpatient diabetes clinic. PATIENTS Fifty-two consecutive subjects (53.8% males; mean age, 37.4 ± 7.4 y; diabetes duration, 19.9 ± 8.2 y) with DM1. All participants completed the study. MAIN OUTCOME MEASURES Main outcome measures were AITD rate; THAb positivity according to hormone interaction and Ig class; association of AITD and THAb with diabetes-related complications. RESULTS AITD rate increased from baseline (34.6%) to follow-up (38.5%). Subjects with DM1 had a high prevalence of THAb (92.3%). The presence of AITD at baseline was associated with subsequent development of macroangiopathy (0 vs 33% at baseline and follow-up, respectively; P = .029). Some THAb patterns, the majority having T3 binding in common, were associated with the progression and development of diabetes-related complications. CONCLUSIONS THAb synthesis in DM1 might be driven by increased glycosylation of thyroglobulin. Anti T3-THAb may cause a relative "tissue hypothyroidism" by sequestering thyroid hormone, this at least partially contributing to worsening diabetes-related vascular complications. In a clinical setting THAb positivity could identify subjects more likely to develop diabetes complications.
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Affiliation(s)
- Salvatore Benvenga
- Department of Clinical and Experimental Medicine (R.V.), Master Program on Childhood, Adolescent and Women's Endocrine Health (S.B.), University of Messina School of Medicine, 98125 Messina, Italy; Interdepartmental Program on Molecular & Clinical Endocrinology (S.B.) and Women's Endocrine Health, University Hospital, University of Messina, 98125 Messina, Italy; Department of Clinical Pharmacology and Epidemiology (B.P.), Fondazione Mario Negri Sud, 66030 Santa Maria Imbaro (CH), Italy; and Department of Clinical and Experimental Medicine (G.D.V., A.D.B.), University of Messina, 98125 Messina, Italy
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14
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Gallo M, Mannucci E, De Cosmo S, Gentile S, Candido R, De Micheli A, Di Benedetto A, Esposito K, Genovese S, Medea G, Ceriello A. Algorithms for personalized therapy of type 2 diabetes: results of a web-based international survey. BMJ Open Diabetes Res Care 2015; 3:e000109. [PMID: 26301097 PMCID: PMC4537916 DOI: 10.1136/bmjdrc-2015-000109] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2015] [Revised: 06/17/2015] [Accepted: 07/12/2015] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE In recent years increasing interest in the issue of treatment personalization for type 2 diabetes (T2DM) has emerged. This international web-based survey aimed to evaluate opinions of physicians about tailored therapeutic algorithms developed by the Italian Association of Diabetologists (AMD) and available online, and to get suggestions for future developments. Another aim of this initiative was to assess whether the online advertising and the survey would have increased the global visibility of the AMD algorithms. RESEARCH DESIGN AND METHODS The web-based survey, which comprised five questions, has been available from the homepage of the web-version of the journal Diabetes Care throughout the month of December 2013, and on the AMD website between December 2013 and September 2014. Participation was totally free and responders were anonymous. RESULTS Overall, 452 physicians (M=58.4%) participated in the survey. Diabetologists accounted for 76.8% of responders. The results of the survey show wide agreement (>90%) by participants on the utility of the algorithms proposed, even if they do not cover all possible needs of patients with T2DM for a personalized therapeutic approach. In the online survey period and in the months after its conclusion, a relevant and durable increase in the number of unique users who visited the websites was registered, compared to the period preceding the survey. CONCLUSIONS Patients with T2DM are heterogeneous, and there is interest toward accessible and easy to use personalized therapeutic algorithms. Responders opinions probably reflect the peculiar organization of diabetes care in each country.
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Affiliation(s)
- Marco Gallo
- Department of Oncological Endocrinology, AOU Città della Salute e della Scienza-Molinette, Turin, Italy
| | - Edoardo Mannucci
- Department of Diabetes Agency, Careggi Teaching Hospital, Florence, Italy
| | - Salvatore De Cosmo
- Unit of Internal Medicine, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Sandro Gentile
- Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy
| | | | | | | | - Katherine Esposito
- Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy
| | - Stefano Genovese
- Department of Cardiovascular and Metabolic Diseases, Istituto di Ricovero e Cura a Carattere Scientifico Gruppo Multimedica, Sesto San Giovanni, Italy
| | - Gerardo Medea
- Italian College of General Practitioners (Società Italiana di Medicina Generale), Florence, Italy
| | - Antonio Ceriello
- Department of Endocrinology, Hospital Clinic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigacion Biomèdica en Red de Diabetes y Enfermedades Metabolicas Asociadas (CIBERDEM), Barcelona, Spain
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Catalano A, Pintaudi B, Morabito N, Di Vieste G, Giunta L, Bruno ML, Cucinotta D, Lasco A, Di Benedetto A. Gender differences in sclerostin and clinical characteristics in type 1 diabetes mellitus. Eur J Endocrinol 2014; 171:293-300. [PMID: 24891138 DOI: 10.1530/eje-14-0106] [Citation(s) in RCA: 31] [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: 11/08/2022]
Abstract
BACKGROUND Sclerostin is an osteocyte-derived inhibitor of the Wnt/β-catenin signaling pathway, which acts as a negative regulator of bone formation. Published data on sclerostin levels in type 1 diabetes mellitus (T1DM) are few. OBJECTIVE To evaluate gender differences in sclerostin serum levels and the association among sclerostin, bone mass, bone metabolism, and the main clinical characteristics of subjects with T1DM. DESIGN AND METHODS A total of 69 patients with T1DM (mean age, 33.7±8.1; 49% males) were enrolled in this cross-sectional study in a clinical research center. Bone mineral density was measured by phalangeal quantitative ultrasound (QUS); bone turnover markers (urinary pyridinoline, deoxypyridinoline (D-PYR), and urine hydroxyproline (OH-PRO) to evaluate bone resorption; serum bone alkaline phosphatase and BGP to evaluate bone formation) and sclerostin were assessed. RESULTS D-PYR and sclerostin were significantly higher in women when compared with men (P=0.04). A disease duration >15 years was associated with higher sclerostin levels (P=0.03). Bone turnover markers and QUS parameters were not correlated with sclerostin. A significant negative correlation was observed among QUS parameters, BMI, and OH-PRO. Sclerostin serum levels were correlated with homocysteine (r=-0.34, P=0.005) and vitamin B12 (r=-0.31, P=0.02). Generalized linear model showed that macroangiopathy was the only predictor of sclerostin serum levels (β=-11.8, 95% CI from -21.9 to -1.7; P=0.02). CONCLUSIONS Our data demonstrate that women with T1DM exhibit higher sclerostin levels than men and that circulating sclerostin is not associated with bone turnover markers and phalangeal QUS measurements. Macroangiopathy was associated with sclerostin levels.
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Affiliation(s)
- Antonino Catalano
- Department of Clinical and Experimental MedicineUniversity Hospital of Messina, A.O.U. Policlinico 'G.Martino', Via C. Valeria, 98125 Messina, ItalyDepartment of Clinical Pharmacology and EpidemiologyFondazione Mario Negri Sud, Santa Maria Imbaro (CH), Italy
| | - Basilio Pintaudi
- Department of Clinical and Experimental MedicineUniversity Hospital of Messina, A.O.U. Policlinico 'G.Martino', Via C. Valeria, 98125 Messina, ItalyDepartment of Clinical Pharmacology and EpidemiologyFondazione Mario Negri Sud, Santa Maria Imbaro (CH), Italy
| | - Nancy Morabito
- Department of Clinical and Experimental MedicineUniversity Hospital of Messina, A.O.U. Policlinico 'G.Martino', Via C. Valeria, 98125 Messina, ItalyDepartment of Clinical Pharmacology and EpidemiologyFondazione Mario Negri Sud, Santa Maria Imbaro (CH), Italy
| | - Giacoma Di Vieste
- Department of Clinical and Experimental MedicineUniversity Hospital of Messina, A.O.U. Policlinico 'G.Martino', Via C. Valeria, 98125 Messina, ItalyDepartment of Clinical Pharmacology and EpidemiologyFondazione Mario Negri Sud, Santa Maria Imbaro (CH), Italy
| | - Loretta Giunta
- Department of Clinical and Experimental MedicineUniversity Hospital of Messina, A.O.U. Policlinico 'G.Martino', Via C. Valeria, 98125 Messina, ItalyDepartment of Clinical Pharmacology and EpidemiologyFondazione Mario Negri Sud, Santa Maria Imbaro (CH), Italy
| | - Maria Lucia Bruno
- Department of Clinical and Experimental MedicineUniversity Hospital of Messina, A.O.U. Policlinico 'G.Martino', Via C. Valeria, 98125 Messina, ItalyDepartment of Clinical Pharmacology and EpidemiologyFondazione Mario Negri Sud, Santa Maria Imbaro (CH), Italy
| | - Domenico Cucinotta
- Department of Clinical and Experimental MedicineUniversity Hospital of Messina, A.O.U. Policlinico 'G.Martino', Via C. Valeria, 98125 Messina, ItalyDepartment of Clinical Pharmacology and EpidemiologyFondazione Mario Negri Sud, Santa Maria Imbaro (CH), Italy
| | - Antonino Lasco
- Department of Clinical and Experimental MedicineUniversity Hospital of Messina, A.O.U. Policlinico 'G.Martino', Via C. Valeria, 98125 Messina, ItalyDepartment of Clinical Pharmacology and EpidemiologyFondazione Mario Negri Sud, Santa Maria Imbaro (CH), Italy
| | - Antonino Di Benedetto
- Department of Clinical and Experimental MedicineUniversity Hospital of Messina, A.O.U. Policlinico 'G.Martino', Via C. Valeria, 98125 Messina, ItalyDepartment of Clinical Pharmacology and EpidemiologyFondazione Mario Negri Sud, Santa Maria Imbaro (CH), Italy
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Pintaudi B, Di Vieste G, Corrado F, Lucisano G, Pellegrini F, Giunta L, Nicolucci A, D'Anna R, Di Benedetto A. Improvement of selective screening strategy for gestational diabetes through a more accurate definition of high-risk groups. Eur J Endocrinol 2014; 170:87-93. [PMID: 24114434 DOI: 10.1530/eje-13-0759] [Citation(s) in RCA: 31] [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: 12/25/2022]
Abstract
OBJECTIVE This study aimed to assess the predictive value of risk factors (RFs) for gestational diabetes mellitus (GDM) established by selective screening (SS) and to identify subgroups of women at a higher risk of developing GDM. DESIGN A retrospective, single-center study design was employed. METHODS Data of 1015 women screened for GDM at 24-28 weeks of gestation and diagnosed according to the International Association of Diabetes and Pregnancy Study Groups criteria were evaluated. Information on RFs established by SS was also collected and their association with GDM was determined. To identify distinct and homogeneous subgroups of patients at a higher risk, the RECursive Partitioning and AMalgamation (RECPAM) method was used. RESULTS Overall, 113 (11.1%) women were diagnosed as having GDM. The application of the SS criteria would result in the execution of an oral glucose tolerance test (OGTT) in 58.3% of women and 26 (23.0%) cases of GDM would not be detected due to the absence of any RF. The RECPAM analysis identified high-risk subgroups characterized by fasting plasma glucose values >5.1 mmol/l (odds ratio (OR)=26.5; 95% CI 14.3-49.0) and pre-pregnancy BMI (OR=7.0; 95% CI 3.9-12.8 for overweight women). In a final logistic model including RECPAM classes, previous macrosomia (OR=3.6; 95% CI 1.1-11.6), and family history of diabetes (OR=1.8; 95% CI 1.1-2.8), but not maternal age, were also found to be associated with an increased risk of developing GDM. A screening approach based on the RECPAM model would reduce by over 50% (23.0 vs 10.6%) the number of undiagnosed GDM cases when compared with the current SS approach, at the expense of 50 additional OGTTs required. CONCLUSIONS A screening approach based on our RECPAM model results in a significant reduction in the number of undetected GDM cases compared with the current SS procedure.
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Affiliation(s)
- Basilio Pintaudi
- Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, Via Nazionale, 66030 S. Maria Imbaro (CH), Italy
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Lacquaniti A, Donato V, Pintaudi B, Di Vieste G, Chirico V, Buemi A, Di Benedetto A, Arena A, Buemi M. "Normoalbuminuric" diabetic nephropathy: tubular damage and NGAL. Acta Diabetol 2013; 50:935-42. [PMID: 23754672 DOI: 10.1007/s00592-013-0485-7] [Citation(s) in RCA: 58] [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: 12/08/2012] [Accepted: 05/21/2013] [Indexed: 12/11/2022]
Abstract
The aim of this study was to demonstrate that neutrophil gelatinase-associated lipocalin (NGAL) increased before the onset of microalbuminuria in patients with type 1 diabetes mellitus (T1DM), representing an important biochemical parameter with high sensitivity and specificity to make a precocious diagnosis of "normoalbuminuric" diabetic nephropathy (DN). Serum NGAL (sNGAL) and urinary NGAL (uNGAL) levels were evaluated in a cohort of fifty patients affected by T1DM. They had no signs of clinical nephropathy. Thirty-five healthy subjects (HS) were recruited. sNGAL levels were significantly higher compared with those measured in HS [193.7 (103.2-405.4) vs. 46.4 (39.8-56.2) ng/ml; p < 0.0001], as were uNGAL levels [25.5 (14.2-40.2) vs. 6.5 (2.9-8.5) ng/ml; p < 0.0001]. sNGAL was found to be directly correlated with glycated hemoglobin. uNGAL also positively correlated with albuminuria, whereas an inverse correlation was found with uric acid. After multivariate analysis, significance was maintained for the correlation between uNGAL and microalbuminuria. In ROC analysis, sNGAL showed a good diagnostic profile such as uNGAL. NGAL increases in patients with T1DM, even before diagnosis of microalbuminuria representing an early biomarker of "normoalbuminuric" DN with a good sensitivity and specificity. NGAL measurement could be useful for the evaluation of early renal involvement in the course of diabetes.
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Irace C, Marini H, Bitto A, Altavilla D, Polito F, Adamo EB, Arcoraci V, Minutoli L, Di Benedetto A, Di Vieste G, de Gregorio C, Gnasso A, Corrao S, Licata G, Squadrito F. Genistein and endothelial function in postmenopausal women with metabolic syndrome. Eur J Clin Invest 2013; 43:1025-31. [PMID: 23899172 DOI: 10.1111/eci.12139] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 07/06/2013] [Indexed: 12/24/2022]
Abstract
BACKGROUND Previous data have suggested that genistein could exert beneficial effects on endothelial function and on predictors of cardiovascular risk in healthy postmenopausal women. In a randomized clinical trial, we studied the effects of genistein on endothelial function in postmenopausal women with metabolic syndrome (MS). METHODS Twenty postmenopausal women with MS, according to modified NCEP-ATP III criteria were randomly assigned to receive placebo or genistein (54 mg/day) for 6 months, along with a Mediterranean-style diet. Postmenopausal women without MS (n = 15), served as controls. The primary goal was the assessment of endothelial function by flow-mediated vasodilation (FMD) of brachial artery; moreover, time-to-peak dilation in the FMD response has been evaluated. Secondary outcomes were fasting glucose, fasting insulin, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, visfatin, adiponectin and homocysteine blood levels. Data on adverse events were also recorded. RESULTS After 6 months of treatment, FMD at 50s and peak FMD significantly increased in genistein recipients compared with placebo. Moreover, genistein significantly decreased the blood levels of total cholesterol, triglycerides, homocysteine and visfatin compared with placebo, while blood adiponectin levels were increased. Genistein recipients neither experienced more side-adverse effects than placebo nor discontinued the study. CONCLUSIONS Six months of treatment with genistein effectively improves brachial artery flow-mediated vasodilation in postmenopausal women with metabolic syndrome.
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Affiliation(s)
- Concetta Irace
- Department of Experimental and Clinical Medicine, University "Magna Graecia", Catanzaro, Italy
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Squadrito F, Marini H, Bitto A, Altavilla D, Polito F, Adamo EB, D'Anna R, Arcoraci V, Burnett BP, Minutoli L, Di Benedetto A, Di Vieste G, Cucinotta D, de Gregorio C, Russo S, Corrado F, Saitta A, Irace C, Corrao S, Licata G. Genistein in the metabolic syndrome: results of a randomized clinical trial. J Clin Endocrinol Metab 2013; 98:3366-74. [PMID: 23824420 DOI: 10.1210/jc.2013-1180] [Citation(s) in RCA: 112] [Impact Index Per Article: 10.2] [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: 12/11/2022]
Abstract
CONTEXT This study was performed to evaluate the effects of genistein on metabolic and cardiovascular risk factors in Caucasian postmenopausal subjects with metabolic syndrome (MetS). OBJECTIVE Our objective was to assess the effects of genistein on surrogate endpoints associated with diabetes and cardiovascular disease. DESIGN AND SETTING This was a randomized, double-blind, placebo-controlled trial at 3 university medical centers in Italy. PATIENTS Patients included 120 postmenopausal women with MetS according to modified Third Report of the National Cholesterol Education Program (NCEP), Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) criteria. INTERVENTION After a 4-week stabilization period, postmenopausal women with MetS were randomly assigned to receive placebo (n = 60) or 54 mg genistein daily (n = 60) for 1 year. MAIN OUTCOME MEASURES The primary outcome was homeostasis model assessment for insulin resistance (HOMA-IR) at 1 year. Secondary outcomes were fasting glucose, fasting insulin, total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, visfatin, adiponectin, and homocysteine levels. Data on adverse events were also recorded. RESULTS At 1 year in genistein recipients, fasting glucose, fasting insulin, and HOMA-IR (mean from 4.5 to 2.7; P < .001) decreased and were unchanged in placebo recipients. Genistein statistically increased HDL-C (mean from 46.4 to 56.8 mg/dL) and adiponectin and decreased total cholesterol, LDL-C (mean from 108.8 to 78.7 mg/dL), triglycerides, visfatin, and homocysteine (mean from 14.3 to 11.7 μmol/L) blood levels. Systolic and diastolic blood pressure was also reduced in genistein recipients. Genistein recipients neither experienced more side adverse effects than placebo nor discontinued the study. CONCLUSION One year of treatment with genistein improves surrogate endpoints associated with risk for diabetes and cardiovascular disease in postmenopausal women with MetS.
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Affiliation(s)
- Francesco Squadrito
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy.
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20
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D'Anna R, Scilipoti A, Giordano D, Caruso C, Cannata ML, Interdonato ML, Corrado F, Di Benedetto A. myo-Inositol supplementation and onset of gestational diabetes mellitus in pregnant women with a family history of type 2 diabetes: a prospective, randomized, placebo-controlled study. Diabetes Care 2013; 36:854-7. [PMID: 23340885 PMCID: PMC3609506 DOI: 10.2337/dc12-1371] [Citation(s) in RCA: 107] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To check the hypothesis that myo-inositol supplementation may reduce gestational diabetes mellitus (GDM) onset in pregnant women with a family history of type 2 diabetes. RESEARCH DESIGN AND METHODS A 2-year, prospective, randomized, open-label, placebo-controlled study was carried out in pregnant outpatients with a parent with type 2 diabetes who were treated from the end of the first trimester with 2 g myo-inositol plus 200 µg folic acid twice a day (n = 110) and in the placebo group (n = 110), who were only treated with 200 µg folic acid twice a day. The main outcome measure was the incidence of GDM in both groups. Secondary outcome measures were as follows: the incidence of fetal macrosomia (>4,000 g), gestational hypertension, preterm delivery, caesarean section, shoulder dystocia, neonatal hypoglycemia, and neonatal distress respiratory syndrome. GDM diagnosis was performed according to the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) recommendations. RESULTS Incidence of GDM was significantly reduced in the myo-inositol group compared with the placebo group: 6 vs. 15.3%, respectively (P = 0.04). In the myo-inositol group, a reduction of GDM risk occurrence was highlighted (odds ratio 0.35). A statistically significant reduction of fetal macrosomia in the myo-inositol group was also highlighted together with a significant reduction in mean fetal weight at delivery. In the other secondary outcome measures, there were no differences between groups. CONCLUSIONS myo-Inositol supplementation in pregnant women with a family history of type 2 diabetes may reduce GDM incidence and the delivery of macrosomia fetuses.
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Affiliation(s)
- Rosario D'Anna
- Department of Gynecological and Obstetrical Sciences, University of Messina, Messina, Italy.
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21
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Russo GT, Di Benedetto A, Magazzù D, Giandalia A, Giorda CB, Ientile R, Previti M, Di Cesare E, Cucinotta D. Mild hyperhomocysteinemia, C677T polymorphism on methylenetetrahydrofolate reductase gene and the risk of macroangiopathy in type 2 diabetes: a prospective study. Acta Diabetol 2011; 48:95-101. [PMID: 19937354 DOI: 10.1007/s00592-009-0169-5] [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: 08/07/2009] [Accepted: 11/05/2009] [Indexed: 12/31/2022]
Abstract
The role of hyperhomocysteinemia as a risk factor for diabetic long-term complications has not been sufficiently evaluated in prospective studies, considering specific correlates of homocysteine (tHcy) concentration and traditional cardiovascular disease (CVD) risk factors. Fasting tHcy, vitamin B12 and folate plasma levels, the common methylenetetrahydrofolate reductase (MTHFR) C677T gene polymorphism, as well as clinical and lifestyle information were assessed in 216 type 2 diabetic patients attending two outpatient clinics, who had a follow-up evaluation at 65 ± 9 months for the incidence of macroangiopathy. At basal evaluation, mild hyperhomocysteinemia (tHcy ≥ 15 μmol/l) was diagnosed in 21.3% of participants. At follow-up, hyperhomocysteinemia and the distribution of MTHFR C677T genotype did not significantly differ according to the incidence of macroangiopathy. Multiple variables adjusted ORs (95% CI) for CVD associated with mild hyperhomocysteinemia were 1.01 (0.37-2.82); P > 0.05; those associated with MTHFR TT genotype were 0.46 (0.15-1.38); P > 0.05. Although the prevalence of hyperhomocysteinemia was higher in diabetic men (26.9%) than in women (16.1%; P > 0.05), similar results were also observed in a separate sex-analysis. At the multivariate analysis, including in the model other potential CVD risk factors, only creatinine clearance was a significant risk factor for the development of macroangiopathy. In this cohort of diabetic subjects, mild hyperhomocysteinemia and the MTHFR TT genotype are not significant risk factors for the development of macroangiopathy; impaired renal function was confirmed as a significant predictor of this complication.
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Affiliation(s)
- Giuseppina Tiziana Russo
- Department of Internal Medicine, Policlinico Universitario "G. Martino" Via C. Valeria, University of Messina, Italy.
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Fera MT, Russo GT, Di Benedetto A, La Camera E, Orlando A, Giandalia A, Ruffa VF, Lanza G, Lentini V, Perdichizzi G, Cucinotta D. High prevalence of arcobacter carriage in older subjects with type 2 diabetes. J Biomed Biotechnol 2010; 2010:489784. [PMID: 20508853 PMCID: PMC2874994 DOI: 10.1155/2010/489784] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2010] [Accepted: 03/25/2010] [Indexed: 11/17/2022] Open
Abstract
Arcobacters are potential pathogens related to diarrheic infections and, rarely, septicaemia. This study evaluated the prevalence of arcobacters in stool samples of subjects with (n = 38) and without (n = 61) type 2 diabetes by using cultural and molecular techniques. Three Arcobacter positive cultures were found, all among diabetic subjects, whereas molecular analysis showed a carriage rate of 79% and 26.2% in subjects with and without type 2 diabetes (P < .001), respectively. The multivariate analysis showed that type 2 diabetes (beta = 1.913; 95%CI: 2.378-19.285; P < .0001) and age (beta = 1.744; 95%CI: 2.077-15.766; P = .001) were the only factors independently associated with arcobacters colonization in this population. Our study demonstrated a high prevalence of arcobacters colonization in type 2 diabetic and older subjects. The clinical significance and the potential health risk associated with these emerging species remain to be determined.
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Affiliation(s)
- Maria Teresa Fera
- Department of Pathology and Experimental Microbiology, University of Messina, 98125 Messina, Italy
| | - Giuseppina T. Russo
- Department of Internal Medicine, University of Messina, 98125 Messina, Italy
| | | | - Erminia La Camera
- Department of Pathology and Experimental Microbiology, University of Messina, 98125 Messina, Italy
| | - Angelo Orlando
- Department of Internal Medicine, University of Messina, 98125 Messina, Italy
| | - Annalisa Giandalia
- Department of Internal Medicine, University of Messina, 98125 Messina, Italy
| | - Vincenzo F. Ruffa
- Department of Internal Medicine, University of Messina, 98125 Messina, Italy
| | - Giulia Lanza
- Department of Internal Medicine, University of Messina, 98125 Messina, Italy
| | - Valeria Lentini
- Department of Animal Biology and Marine Ecology, University of Messina, 98166 Messina, Italy
| | | | - Domenico Cucinotta
- Department of Internal Medicine, University of Messina, 98125 Messina, Italy
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Corrado F, Benedetto AD, Cannata ML, Cannizzaro D, Giordano D, Indorato G, Rizzo P, Stella NC, D'Anna R. A single abnormal value of the glucose tolerance test is related to increased adverse perinatal outcome. J Matern Fetal Neonatal Med 2009; 22:597-601. [PMID: 19488948 DOI: 10.1080/14767050902801801] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To evaluate which pregnant women with a single abnormal value in the oral glucose tolerance test are at increased risk for adverse perinatal outcome. METHODS In this retrospective cohort study, we have evaluated the course of pregnancy in 152 consecutive women with only one abnormal value (OAV), and 624 with a 100 g - glucose tolerance test totally within the range values. RESULTS The prevalence of caesarean delivery, hypertensive disorders and macrosomia was higher in the study group when compared with the control group, whereas no difference was noted concerning gestational age at delivery, Apgar score at 1 and 5 min and neonatal hypoglycemia. Moreover, in the study group hypertensive disorders were more frequent in the subgroup with the elevated value at 1 h after the glucose load (25%), whereas macrosomia is more frequent when it is the fasting value to be elevated (29.7%). CONCLUSIONS Our results show that the implications of a single elevated glucose tolerance test value vary in relation to the timing of the abnormal value. In fact, OAV fasting or 1-h after load has a higher prevalence for an adverse obstetric outcome, whereas a 2 or 3-h value does not present significant differences when compared with the control group.
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Affiliation(s)
- Francesco Corrado
- Department of Obstetrics and Gynecology, University of Messina, Italy.
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24
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Firenze A, Morici M, Calamus G, Gelsomino V, Aprea L, Di Benedetto A, Muangala MAL, Centineo G, Romano N. [Evaluation of customer satisfaction with the hospital catering system in the city of Palermo (Italy)]. Ig Sanita Pubbl 2009; 65:29-39. [PMID: 19494921] [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: 05/27/2023]
Abstract
The aim of the study was to evaluate patients' customer satisfaction with the hospital catering services of two public hospitals and one private sector hospital in the city of Palermo (Italy). A multiple choice questionnaire was administered by face-to-face interview to 207 of 227 hospitalized patients. Positive responses regarding the perceived quality of food were given especially by patients of the private sector hospital, 80% of which reported being satisfied with the catering service. A higher percentage of patients in the private sector hospital were satisfied with the food distribution modalities with respect to the two public hospitals. Only 3% of patients in the private sector hospital required their families to bring food from home, with respect to 7.9% and 30% respectively in the two public hospitals. Private sector patients also reported appreciating the wide availability of food and the help given by health care workers (79% vs a mean of 55% in the two public hospitals). No differences were found amongst hospitals with regards to the hygienic characteristics of meals. The results of this study indicate the need to make changes in the management of the catering service of one of the involved public hospitals especially.
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Affiliation(s)
- Alberto Firenze
- Scuola di Specializzazione in Igiene e Medicina Preventiva - Università degli Studi di Palermo
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Corrado F, D'Anna R, Cannata ML, Cannizzaro D, Caputo F, Raffone E, Di Benedetto A. Positive association between a single abnormal glucose tolerance test value in pregnancy and subsequent abnormal glucose tolerance. Am J Obstet Gynecol 2007; 196:339.e1-5. [PMID: 17403413 DOI: 10.1016/j.ajog.2006.11.016] [Citation(s) in RCA: 17] [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] [Subscribe] [Scholar Register] [Received: 05/28/2006] [Revised: 09/14/2006] [Accepted: 11/16/2006] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To study the prevalence of abnormal glucose tolerance among women with a single abnormal glucose tolerance test value in previous pregnancy and identify factors predictive of the later development of abnormal glucose tolerance in this group. STUDY DESIGN In all, 58 women with gestational diabetes, 66 with a single abnormal value in a glucose tolerance test, and 56 control women underwent a 75-g oral glucose tolerance test at a mean of 6.9 years from the index pregnancy. RESULTS Abnormal glucose tolerance was present in 34.5% of women with previous gestational diabetes and in 28.7% of women with 1 previous abnormal value, significantly different from the controls (9.7%). Independent risk factors that distinguished the subjects who later developed an abnormal glucose tolerance were prepregnancy BMI, parity > 1, and first-degree relatives affected by diabetes mellitus in the group with gestational diabetes, and prepregnancy BMI, maternal age, (> or = 30 y) and parity > 1 in the group with a single abnormal value. Prepregnancy BMI (> or = 26.9) proved to be the most predictive factor of abnormal glucose tolerance later in life. CONCLUSION Sicilian women with a single abnormal value at the glucose tolerance test in pregnancy have an increased likelihood of developing an abnormal glucose tolerance later in life, similar to gestational diabetes. Prepregnancy BMI was confirmed as the strongest predictive factor in both groups.
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Affiliation(s)
- Francesco Corrado
- Department of Obstetrics and Gynecology, University of Messina, Messina, Italy.
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26
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D'Anna R, Baviera G, Cannata ML, De Vivo A, Di Benedetto A, Corrado F. Midtrimester amniotic fluid leptin and insulin levels and subsequent gestational diabetes. Gynecol Obstet Invest 2007. [PMID: 17264515 DOI: 10.1159/000099149.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
AIMS To evaluate midtrimester amniotic fluid leptin levels in pregnancies subsequently complicated by gestational diabetes. METHODS We studied 32 pregnant women with gestational diabetes and a control group of 43 normal pregnancies with an adequate gestational age fetus. All underwent a midtrimester amniocentesis: leptin and insulin were measured in the amniotic fluid. Data were compared with the Mann-Whitney U-test. RESULTS Median leptin concentrations in the amniotic fluid of the gestational diabetes mellitus patients were significantly higher than in the control group (15.1 vs. 7.9 ng/ml) (p = 0.001); amniotic insulin concentrations were also higher in the gestational diabetes mellitus than in the control group (0.67 vs. 0.38 microU/ml) (p = 0.02). Furthermore, amniotic fluid leptin levels were directly correlated with amniotic insulin concentrations; instead, there was no correlation with maternal BMI and birth weight. CONCLUSION Our data suggest that in pregnancies subsequently complicated by gestational diabetes, amniotic fluid leptin and insulin levels are higher in the early fetal period.
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Affiliation(s)
- Rosario D'Anna
- Department of Obstetrics and Gynecology, University of Messina, Messina, Italy.
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D'Anna R, Baviera G, Cannata ML, De Vivo A, Di Benedetto A, Corrado F. Midtrimester amniotic fluid leptin and insulin levels and subsequent gestational diabetes. Gynecol Obstet Invest 2007; 64:65-8. [PMID: 17264515 DOI: 10.1159/000099149] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2006] [Accepted: 12/18/2006] [Indexed: 11/19/2022]
Abstract
AIMS To evaluate midtrimester amniotic fluid leptin levels in pregnancies subsequently complicated by gestational diabetes. METHODS We studied 32 pregnant women with gestational diabetes and a control group of 43 normal pregnancies with an adequate gestational age fetus. All underwent a midtrimester amniocentesis: leptin and insulin were measured in the amniotic fluid. Data were compared with the Mann-Whitney U-test. RESULTS Median leptin concentrations in the amniotic fluid of the gestational diabetes mellitus patients were significantly higher than in the control group (15.1 vs. 7.9 ng/ml) (p = 0.001); amniotic insulin concentrations were also higher in the gestational diabetes mellitus than in the control group (0.67 vs. 0.38 microU/ml) (p = 0.02). Furthermore, amniotic fluid leptin levels were directly correlated with amniotic insulin concentrations; instead, there was no correlation with maternal BMI and birth weight. CONCLUSION Our data suggest that in pregnancies subsequently complicated by gestational diabetes, amniotic fluid leptin and insulin levels are higher in the early fetal period.
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Affiliation(s)
- Rosario D'Anna
- Department of Obstetrics and Gynecology, University of Messina, Messina, Italy.
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Corica F, Corsonello A, Ientile R, Cucinotta D, Di Benedetto A, Perticone F, Dominguez LJ, Barbagallo M. Serum ionized magnesium levels in relation to metabolic syndrome in type 2 diabetic patients. J Am Coll Nutr 2006; 25:210-5. [PMID: 16766779 DOI: 10.1080/07315724.2006.10719534] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.3] [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: 10/26/2022]
Abstract
OBJECTIVE To evaluate circulating serum ionized magnesium (i-Mg) concentrations in patients with type 2 diabetes mellitus, and to investigate its relationship with the components of the metabolic syndrome. DESIGN cross-sectional study. SETTING Outpatients' service for diabetic patients at the University Hospital of Messina, Italy. SUBJECTS 290 patients with type 2 diabetes mellitus. MEASURES OF OUTCOME Serum i-Mg was measured by ion selective electrode. Age, gender, body mass index (BMI), waist circumference, blood pressure, fasting glucose, HbA1c, HDL cholesterol, triglycerides, and urinary albumin excretion rate (UAER) were considered in the analyses. Patients with hypomagnesemia, defined as serum i-Mg <0.46 mmol/l, were compared with those having normal serum i-Mg levels, and variables proven to be associated with low i-Mg levels in the univariate analysis were entered in a multivariable logistic regression model to obtain a deconfounded estimate of the association between metabolic parameters and hypomagnesemia. RESULTS In univariate analysis, serum i-Mg levels were significantly reduced in patients with low HDL cholesterol, high triglycerides values, high waist circumference, high blood pressure, microalbuminuria and clinical proteinuria. Hypomagnesemia was highly prevalent in our study population (N = 143, 49.3%). After adjusting for potential confounders, plasma triglycerides (OR = 4.71; 95% CI = 2.56-8.67), waist circumference (OR = 2.21; 95% CI = 1.21-4.04), microalbuminuria (OR = 2.43; 95% CI = 1.16-5.08) and clinical proteinuria (OR = 2.04; 95% CI = 1.02-5.68) were independently associated with hypomagnesemia. CONCLUSIONS Hypomagnesemia is highly prevalent in diabetic outpatients. High plasma triglycerides, waist circumference and albuminuria are independent correlates of hypomagnesemia.
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Affiliation(s)
- Francesco Corica
- Department of Internal Medicine, University of Messina, Messina, Italy
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D'Anna R, Baviera G, De Vivo A, Facciolà G, Di Benedetto A, Corrado F. C-reactive protein as an early predictor of gestational diabetes mellitus. J Reprod Med 2006; 51:55-8. [PMID: 16482778] [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: 05/06/2023]
Abstract
OBJECTIVE To assess whether C-reactive protein at the beginning of the midtrimester is significantly increased in patients who subsequently develop gestational diabetes mellitus (GDM). STUDY DESIGN A total of 72 subjects who underwent a Down screening program between the 14th and 16th weeks of gestation were studied: 32 developed GDM, and 40 were controls. The C-reactive protein serum levels were evaluated in all patients. RESULTS There was a significant difference in body mass index (BMI) mean values between the GDM group (30.8 +/- 8.5) and control group (24.7 +/- 2.8), but in spite of this, no significant difference in C-reactive protein was found in the 2 groups. The median serum C-reactive protein values were 9.0 mg/dL (2.4-17, 5-95% CI) in the GDM group and 8.7 mg/dL (3.8-11.2, 5-95% CI) in the control group (p = 0.3). There was no correlation between C-reactive protein serum levels and BMI, birth weight or fasting insulin. CONCLUSION C-reactive protein has no predictive value in GDM, and no positive correlation is found between BMI and this inflammation marker.
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Affiliation(s)
- Rosario D'Anna
- Department of Obstetrics and Gynecology, University of Messina, Messina, Italy
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D'Anna R, Baviera G, Corrado F, Giordano D, Di Benedetto A, Jasonni VM. Plasma Adiponectin Concentration in Early Pregnancy and Subsequent Risk of Hypertensive Disorders. Obstet Gynecol 2005; 106:340-4. [PMID: 16055585 DOI: 10.1097/01.aog.0000168441.79050.03] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.9] [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
OBJECTIVE Adiponectin is an exclusively adipose tissue-derived protein. Low plasma adiponectin levels have been found in hypertensive men. Our objective was to evaluate whether low first-trimester plasma adiponectin values were predictive of hypertensive disorders later in pregnancy. METHODS A nested case-control study was carried out on a cohort of 1,842 pregnant women who participated in the first-trimester Down syndrome screening program; 34 developed preeclampsia and 48 gestational hypertension. A control group of 82 nonhypertensive uneventful pregnancies was selected. Plasma adiponectin was determined using an enzyme-linked immunosorbent assay (ELISA). RESULTS Adiponectin median concentrations in the group which subsequently became hypertensive were significantly lower than those in the control group (7.6 versus 13.0 microg/mL) (P < .001). When the 2 hypertensive subgroups were considered, the plasma adiponectin median value in the preeclampsia group was significantly lower than that in the gestational hypertension group (6.6 versus 9.3 microg/mL) (P = .01). Regression analysis showed an inverse correlation between plasma adiponectin concentrations and maternal age, gestational age, body mass index, systolic blood pressure, and proteinuria. Approximately 34% of hypertensive pregnancies, compared with 7% of controls (P < .001), had plasma adiponectin concentrations less than 6.4 microg/mL (mean value of lower quartile of distribution among control patients). After adjusting for maternal age, all these women experienced a 6.6-fold (95% confidence interval 2.5-17.8) increased risk of pregnancy hypertension, compared with those women who had higher concentrations. CONCLUSION Our findings suggest a strong association between hypoadiponectinemia and the risk of hypertensive disorders in pregnancy, especially with preeclampsia.
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Affiliation(s)
- Rosario D'Anna
- Department of Obstetrics and Gynecology, University of Messina, Messina, Italy.
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Abstract
Diagnosis of Gestational Diabetes Mellitus (GDM) requires at least two or more values to be abnormal on the 3 h-100 g oral glucose tolerance test: but how to care for pregnant women with only one abnormal glucose value remains a point of discussion. In fact, although a large number of studies on this argument exist, the clinical significance of "one abnormal value" has yet to be clarified. Our review of previous studies and personal experience on prevalence, metabolic findings and maternal-fetal outcome suggests this pregnancy induced carbohydrate intolerance is a continuum with GDM, associated with an increased incidence of materno-fetal complications. For this reason we believe that it should be diagnosed, monitored and treated.
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Affiliation(s)
- Francesco Corrado
- Department of Obstetrics and Gynecology, University of Messina, Italy.
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Aragona P, Giuffrida S, Di Stefano G, Ferreri F, Di Benedetto A, Bucolo C, Cro M. Ocular surface changes in type 1 diabetic patients. Adv Exp Med Biol 2003; 506:667-72. [PMID: 12613975 DOI: 10.1007/978-1-4615-0717-8_93] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Pasquale Aragona
- Institute of Ophthalmology, University of Messina, Messina, Italy
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