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Malavazos AE, Dubini C, Milani V, Boveri S, Meregalli C, Bertolini C, Buscemi C, Cardani R, Renna LV, Trevisan MB, Scravaglieri V, Cuppone MT, Menicanti L, Costa E, Ambrogi F, Ruocco C, Carruba M, Iacobellis G, Nisoli E, Corsi Romanelli MM. BNT162b2 Booster Dose Elicits a Robust Antibody Response in Subjects with Abdominal Obesity and Previous SARS-CoV-2 Infection. Vaccines (Basel) 2023; 11:1796. [PMID: 38140200 PMCID: PMC10747120 DOI: 10.3390/vaccines11121796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/24/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023] Open
Abstract
Little is known about the long-term durability of the induced immune response in subjects with obesity, particularly in those with an abdominal distribution of adipose tissue. We evaluated SARS-CoV-2-specific antibody responses after BNT162b2 vaccine booster dose, comparing individuals with and without abdominal obesity (AO), discerning between individuals previously infected or not. IgG-TrimericS were measured in 511 subjects at baseline, on the 21st day after vaccine dose 1, and at 1, 3, 6, and 9 months from dose 2, and at 1 and 3 months following the booster dose. To detect SARS-CoV-2 infection, nucleocapsid antibodies were measured at baseline and at the end of the study. Multivariable linear regression evaluated the three-month difference in the absolute variation in IgG-TrimericS levels from booster dose, showing AO and SARS-CoV-2 infection status interactions (p = 0.016). Regardless of possible confounding factors and IgG-TrimericS levels at the booster dose, AO is associated with a higher absolute change in IgG-TrimericS in prior infected individuals (p = 0.0125). In the same regression model, no interaction is highlighted using BMI (p = 0.418). The robust response in the development of antibodies after booster dose, observed in people with AO and previous infection, may support the recommendations to administer a booster dose in this population group.
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Affiliation(s)
- Alexis Elias Malavazos
- Endocrinology Unit, Clinical Nutrition and Cardiometabolic Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy (C.M.)
- Department of Biomedical, Surgical and Dental Sciences, University of Milano, 20122 Milan, Italy
| | - Carola Dubini
- Endocrinology Unit, Clinical Nutrition and Cardiometabolic Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy (C.M.)
| | - Valentina Milani
- Laboratory of Biostatistics and Data Management, Scientific Directorate, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy
| | - Sara Boveri
- Laboratory of Biostatistics and Data Management, Scientific Directorate, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy
| | - Chiara Meregalli
- Endocrinology Unit, Clinical Nutrition and Cardiometabolic Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy (C.M.)
| | | | - Carola Buscemi
- Unit of Internal Medicine, V. Cervello Hospital, 90146 Palermo, Italy
- Clinical Nutrition Unit, Department of Health Promotion, Maternal and Childhood, Internal and Specialized Medicine of Excellence (PROMISE), University of Palermo, 90100 Palermo, Italy
| | - Rosanna Cardani
- Biobank BioCor, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy (L.V.R.)
| | - Laura Valentina Renna
- Biobank BioCor, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy (L.V.R.)
| | - Manuel Bruno Trevisan
- Endocrinology Unit, Clinical Nutrition and Cardiometabolic Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy (C.M.)
| | - Valentina Scravaglieri
- Endocrinology Unit, Clinical Nutrition and Cardiometabolic Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy (C.M.)
| | - Maria Teresa Cuppone
- Scientific Directorate, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy
| | - Lorenzo Menicanti
- Scientific Directorate, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy
| | - Elena Costa
- Service of Laboratory Medicine, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy
| | - Federico Ambrogi
- Laboratory of Biostatistics and Data Management, Scientific Directorate, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milano, 20122 Milan, Italy
| | - Chiara Ruocco
- Centre for Study and Research on Obesity, Department of Medical Biotechnology and Translational Medicine, University of Milan, 20129 Milan, Italy; (C.R.); (E.N.)
| | - Michele Carruba
- Centre for Study and Research on Obesity, Department of Medical Biotechnology and Translational Medicine, University of Milan, 20129 Milan, Italy; (C.R.); (E.N.)
| | - Gianluca Iacobellis
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Miami, Miami, FL 33136, USA;
| | - Enzo Nisoli
- Centre for Study and Research on Obesity, Department of Medical Biotechnology and Translational Medicine, University of Milan, 20129 Milan, Italy; (C.R.); (E.N.)
| | - Massimiliano Marco Corsi Romanelli
- Department of Biomedical Sciences for Health, University of Milan, 00133 Milan, Italy;
- Department of Clinical and Experimental Pathology, Istituto Auxologico Italiano IRCCS, 20100 Milan, Italy
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Malavazos AE, Meregalli C, Sorrentino F, Vignati A, Dubini C, Scravaglieri V, Basilico S, Boniardi F, Spagnolo P, Malagoli P, Romanelli P, Secchi F, Iacobellis G. Semaglutide therapy decreases epicardial fat inflammation and improves psoriasis severity in patients affected by abdominal obesity and type-2 diabetes. Endocrinol Diabetes Metab Case Rep 2023; 2023:23-0017. [PMID: 37551923 PMCID: PMC10448542 DOI: 10.1530/edm-23-0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 07/19/2023] [Indexed: 08/09/2023] Open
Abstract
Summary Psoriasis is often associated with abdominal obesity and type-2 diabetes (T2D). The inflammatory process in psoriasis can target adipose tissue depots, especially those surrounding the heart and coronary arteries, exposing to an increased risk of cardiovascular diseases. A 50-year-old female patient referred to us for abdominal obesity and T2D, which were not controlled with lifestyle modifications. She had suffered from psoriasis for some years and was treated with guselkumab, without success. Epicardial adipose tissue (EAT) attenuation and pericoronary adipose tissue (PCAT) attenuation for each coronary, defined as mean attenuation expressed in Hounsfield unit (HU), were assessed by routine coronary computed tomography angiography. At baseline, EAT attenuation was -80 HU and PCAT attenuation of the right coronary artery (RCA) was -68 HU, values associated with an increased cardiac mortality risk. Psoriasis area and severity index (PASI) was 12.0, indicating severe psoriasis, while dermatology life quality index (DLQI) was 20, indicating a negative effect on the patient's life. Semaglutide (starting with 0.25 mg/week for 4 weeks, increased to 0.50 mg/week for 16 weeks, and then to 1 mg/week) was started. After 10 months, semaglutide treatment normalized glycated hemoglobin and induced weight loss, particularly at abdominal level, also followed by a reduction in computed tomography-measured EAT volume. EAT attenuation and PCAT attenuation of RCA decreased, showing an important reduction of 17.5 and 5.9% respectively, compared with baseline. PASI and DLQI decreased by 98.3 and 95% respectively, indicating an improvement in psoriasis skin lesions and an important amelioration of the patient's quality of life, compared with baseline. Learning points Psoriasis patients affected by obesity and type-2 diabetes (T2D) are often resistant to biologic therapies. Psoriasis is often associated with abdominal obesity, T2D, and cardiovascular diseases (CVD), given their shared inflammatory properties and pathogenic similarities. Epicardial adipose tissue (EAT) inflammation can cause the distinctive pattern of CVD seen in psoriasis. EAT and pericoronary adipose tissue (PCAT) attenuation, assessed by routine coronary computed tomography angiography (CCTA), can be used as biomarkers of inflammation and allow monitoring of medical anti-inflammatory therapies. The actions of semaglutide to reduce energy intake, improve glycemic control, and produce effective weight loss, particularly at the visceral fat depot level, can diminish adipose tissue dysfunction, reduce EAT attenuation and PCAT attenuation of the right coronary artery (RCA) and concomitantly ameliorate the clinical severity of psoriasis. Semaglutide therapy may be considered in psoriasis patients affected by T2D and abdominal obesity, despite low cardiovascular risk by traditional risk scores, who are resistant to biologic therapies.
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Affiliation(s)
- Alexis Elias Malavazos
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Chiara Meregalli
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Fabio Sorrentino
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Andrea Vignati
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Carola Dubini
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Valentina Scravaglieri
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Sara Basilico
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Federico Boniardi
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Pietro Spagnolo
- Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | | | - Paolo Romanelli
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Francesco Secchi
- Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Gianluca Iacobellis
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Miami, Florida, USA
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Malavazos AE, Iacobellis G, Dozio E, Basilico S, Di Vincenzo A, Dubini C, Menicanti L, Vianello E, Meregalli C, Ruocco C, Ragni M, Secchi F, Spagnolo P, Castelvecchio S, Morricone L, Buscemi S, Giordano A, Goldberger JJ, Carruba M, Cinti S, Corsi Romanelli MM, Nisoli E. Human Epicardial Adipose Tissue Expresses Glucose-dependent Insulinotropic Polypeptide, Glucagon and Glucagon-Like Peptide 1 Receptors as Potential Targets of Pleiotropic Therapies. Eur J Prev Cardiol 2023:7044713. [PMID: 36799940 DOI: 10.1093/eurjpc/zwad050] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 12/06/2022] [Revised: 02/06/2023] [Accepted: 02/15/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND Human Epicardial Adipose Tissue (EAT) plays a crucial role in the development and progression of coronary artery disease, atrial fibrillation and heart failure. Microscopically, EAT is composed of adipocytes, nerve tissues, inflammatory, stromovascular and immune cells. EAT is a white adipose tissue, albeit it also has brown-fat like or beige fat features. No muscle fascia divides EAT and myocardium; this allows a direct interaction and cross talk between the epicardial fat and the myocardium. Thus, it might be a therapeutic target for pharmaceutical compounds acting on G-Protein-Coupled Receptors, such as those for Glucose-dependent Insulinotropic Polypeptide (GIP), Glucagon (GCG) and Glucagon-Like Peptide-1 (GLP-1), whose selective stimulation with innovative drugs has demonstrated beneficial cardiovascular effects. The precise mechanism of these novel drugs and their tissue and cellular target(s) need to be better understood. AIM We evaluate whether human EAT expresses GIP, GCG and GLP-1 receptors and whether their presence is related to EAT transcriptome. We also investigated protein expression and cell type localization specifically for GIPR and GCGR. METHODS EAT samples were collected from 33 patients affected by cardiovascular diseases undergoing open heart surgery (90.9% males, age 67.2±10.5 years mean ± SD). Microarray and immunohistochemistry analysis were performed. RESULTS Microarray analysis showed that GIPR and GCGR messenger Ribonucleic Acids (mRNAs) are expressed in EAT, beyond confirming the previously found GLP-1(3776±1377 arbitrary unit (A.U.), 17.77±14.91 A.U., and 3.41±2.27 A.U., respectively). The immunohistochemical analysis consistently indicates that GIPR and GCGR are expressed in EAT, mainly in macrophages, isolated and in crown-like structures. In contrast, only some mature adipocytes of different sizes showed cytoplasmic immunostaining, similar to endothelial cells and pericytes in the capillaries and pre-capillary vascular structures. Notably, EAT GIPR is statistically associated with the low expression of genes involved in Free Fatty Acid (FFA) oxidation and transport and those promoting FFA biosynthesis and adipogenesis (p<0.01). EAT GCGR, in turn, is related to genes involved in FFA transport, mitochondrial fatty acid oxidation, and white-to-brown adipocyte differentiation, in addition to genes involved in the reduction of fatty acid biosynthesis and adipogenesis (p<0.01). CONCLUSIONS Having reported the expression of the GLP-1 receptor previously, here, we showed that GIPR and GCGR similarly present at mRNA and protein levels in human EAT, particularly in macrophages and partially adipocytes, suggesting these G-protein-coupled receptors as pharmacological targets on the ongoing innovative drugs, which seem cardiometabolically healthy well beyond their effects on glucose and body weight..
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Affiliation(s)
- Alexis Elias Malavazos
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy.,Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Gianluca Iacobellis
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Miami, FL, USA
| | - Elena Dozio
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Sara Basilico
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Angelica Di Vincenzo
- Department of Experimental and Clinical Medicine, Center of Obesity, Università Politecnica delle Marche, Ancona, Italy
| | - Carola Dubini
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Lorenzo Menicanti
- Cardiac Surgery Department, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Elena Vianello
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Chiara Meregalli
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Chiara Ruocco
- Center for Study and Research on Obesity, Department of Biomedical Technology and Translational Medicine, Università degli Studi di Milano, Milan, Italy
| | - Maurizio Ragni
- Center for Study and Research on Obesity, Department of Biomedical Technology and Translational Medicine, Università degli Studi di Milano, Milan, Italy
| | - Francesco Secchi
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.,Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Pietro Spagnolo
- Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | | | - Lelio Morricone
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Silvio Buscemi
- Unit of Clinical Nutrition, Policlinico University Hospital, Palermo, Italy.,Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties Università di Palermo, Palermo, Italy
| | - Antonio Giordano
- Department of Experimental and Clinical Medicine, Center of Obesity, Università Politecnica delle Marche, Ancona, Italy
| | | | - Michele Carruba
- Center for Study and Research on Obesity, Department of Biomedical Technology and Translational Medicine, Università degli Studi di Milano, Milan, Italy
| | - Saverio Cinti
- Department of Experimental and Clinical Medicine, Center of Obesity, Università Politecnica delle Marche, Ancona, Italy
| | - Massimiliano Marco Corsi Romanelli
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.,Service of Laboratory Medicine1-Clinical Pathology, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Enzo Nisoli
- Center for Study and Research on Obesity, Department of Biomedical Technology and Translational Medicine, Università degli Studi di Milano, Milan, Italy
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Malavazos AE, Di Vincenzo A, Iacobellis G, Basilico S, Dubini C, Morricone L, Menicanti L, Luca T, Giordano A, Castorina S, Carruba M, Nisoli E, Del Prato S, Cinti S. The density of crown-like structures in epicardial adipose tissue could play a role in cardiovascular diseases. Eat Weight Disord 2022; 27:2905-2910. [PMID: 35678980 DOI: 10.1007/s40519-022-01420-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/07/2022] [Indexed: 10/18/2022] Open
Abstract
PURPOSE The visceral fat of patients affected by abdominal obesity is inflamed, and the main histopathologic feature is the high density of crown-like structures (CLS). Epicardial adipose tissue (EAT) is a visceral fat of paramount importance for its relationships with coronary vessels and myocardium. Its inflammation in patients with abdominal obesity could be of clinical relevance, but histopathological studies on CLS density in EAT are lacking. This study aimed to assess the histopathology of EAT biopsies obtained from patients undergoing open-heart surgery. METHODS We collected EAT biopsies from 10 patients undergoing open-heart surgery for elective coronary artery bypass grafting (CABG) (n = 5) or valvular replacement (VR) (n = 5). Biopsies were treated for light microscopy and immunohistochemistry. We quantify the CLS density in each EAT sample. RESULTS Despite all patients having abdominal obesity, in EAT samples, no CLS were detected in the VR group; in contrast, CLS were detected in the CABG group (about 17 CLS/104 adipocytes vs. 0.0 CLS/104 adipocytes, CABG vs. VR group, respectively). An impressive density of CLS (100 times that of other patients) was found in one patient (LS) in the CABG group that had a relevant anamnestic aspect: relatively rapid increase of weight gain, especially in abdominal adipose tissue, coincident with myocardial infarction. CONCLUSIONS CLS density could be an important predictive tool for cardiovascular diseases. Furthermore, the LS case implies a role for timing in weight gain. LEVEL OF EVIDENCE No level of evidence; this is a basic science study.
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Affiliation(s)
- Alexis Elias Malavazos
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, Milan, Italy.,Department of Biomedical, Surgical and Dental Sciences, University of Milano, Milan, Italy
| | - Angelica Di Vincenzo
- Department of Experimental and Clinical Medicine, Center of Obesity, Marche Polytechnic University, Via Tronto 10a, Ancona, Italy
| | - Gianluca Iacobellis
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Miami, Miami, FL, USA
| | - Sara Basilico
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, Milan, Italy
| | - Carola Dubini
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, Milan, Italy
| | - Lelio Morricone
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, Milan, Italy
| | - Lorenzo Menicanti
- Cardiac Surgery Department, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Tonia Luca
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Catania, Italy.,Mediterranean Foundation "G.B. Morgagni", Catania, Italy
| | - Antonio Giordano
- Department of Experimental and Clinical Medicine, Center of Obesity, Marche Polytechnic University, Via Tronto 10a, Ancona, Italy
| | - Sergio Castorina
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Catania, Italy.,Mediterranean Foundation "G.B. Morgagni", Catania, Italy
| | - Michele Carruba
- Center for Study and Research on Obesity, Department of Biomedical Technology and Translational Medicine, University of Milan, Milan, Italy
| | - Enzo Nisoli
- Center for Study and Research on Obesity, Department of Biomedical Technology and Translational Medicine, University of Milan, Milan, Italy
| | - Stefano Del Prato
- Section of Diabetes and Metabolic Disease, Department of Clinical and Experimental Medicine, University of Pisa and Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Saverio Cinti
- Department of Experimental and Clinical Medicine, Center of Obesity, Marche Polytechnic University, Via Tronto 10a, Ancona, Italy.
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Basilico S, Dubini C, Milani V, Bertolini C, Malavazos AE. Could fat distribution have a greater influence than BMI on the antibody titre after SARS-CoV-2 vaccine? Obesity (Silver Spring) 2022; 30:1321-1322. [PMID: 35538645 PMCID: PMC9348342 DOI: 10.1002/oby.23474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 04/19/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Sara Basilico
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention ServiceIRCCS San Donato PolyclinicMilanItaly
| | - Carola Dubini
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention ServiceIRCCS San Donato PolyclinicMilanItaly
| | - Valentina Milani
- Scientific Directorate, IRCCS San Donato PolyclinicSan Donato MilaneseMilanItaly
| | | | - Alexis Elias Malavazos
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention ServiceIRCCS San Donato PolyclinicMilanItaly
- Department of Biomedical, Surgical and Dental SciencesUniversity of MilanMilanItaly
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6
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Malavazos AE, Basilico S, Iacobellis G, Milani V, Cardani R, Boniardi F, Dubini C, Prandoni I, Capitanio G, Renna LV, Boveri S, Rigolini R, Carrara M, Spuria G, Cuppone T, D'acquisto A, Carpinelli L, Sacchi M, Morricone L, Secchi F, Costa E, Menicanti L, Nisoli E, Carruba M, Ambrogi F, Corsi Romanelli MM. Antibody responses to BNT162b2 mRNA vaccine: Infection-naïve individuals with abdominal obesity warrant attention. Obesity (Silver Spring) 2022; 30:606-613. [PMID: 34850576 DOI: 10.1002/oby.23353] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/11/2021] [Accepted: 11/24/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The excess of visceral adipose tissue might hinder and delay immune response. How people with abdominal obesity (AO) will respond to mRNA vaccines against SARS-CoV-2 is yet to be established. SARS-CoV-2-specific antibody responses were evaluated after the first and second dose of the BNT162b2 mRNA vaccine, comparing the response of individuals with AO with the response of those without, and discerning between individuals with or without prior infection. METHODS Immunoglobulin G (IgG)-neutralizing antibodies against the Trimeric complex (IgG-TrimericS) were measured at four time points: at baseline, at day 21 after vaccine dose 1, and at 1 and 3 months after dose 2. Nucleocapsid antibodies were assessed to detect prior SARS-CoV-2 infection. Waist circumference was measured to determine AO. RESULTS Between the first and third month after vaccine dose 2, the drop in IgG-TrimericS levels was more remarkable in individuals with AO compared with those without AO (2.44-fold [95% CI: 2.22-2.63] vs. 1.82-fold [95% CI: 1.69-1.92], respectively, p < 0.001). Multivariable linear regression confirmed this result after inclusion of assessed confounders (p < 0.001). CONCLUSIONS The waning antibody levels in individuals with AO may further support recent recommendations to offer booster vaccines to adults with high-risk medical conditions, including obesity, and particularly to those with a more prevalent AO phenotype.
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Affiliation(s)
- Alexis Elias Malavazos
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS San Donato Polyclinic, San Donato Milanese, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Sara Basilico
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS San Donato Polyclinic, San Donato Milanese, Milan, Italy
| | - Gianluca Iacobellis
- Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, University of Miami, Miller School of Medicine, Florida, USA
| | - Valentina Milani
- Scientific Directorate, IRCCS San Donato Polyclinic, San Donato Milanese, Milan, Italy
| | - Rosanna Cardani
- Biobank BioCor, Service of Laboratory Medicine1-Clinical Pathology, IRCCS San Donato Polyclinic, San Donato Milanese, Milan, Italy
| | - Federico Boniardi
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS San Donato Polyclinic, San Donato Milanese, Milan, Italy
| | - Carola Dubini
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS San Donato Polyclinic, San Donato Milanese, Milan, Italy
| | - Ilaria Prandoni
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS San Donato Polyclinic, San Donato Milanese, Milan, Italy
| | - Gloria Capitanio
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS San Donato Polyclinic, San Donato Milanese, Milan, Italy
| | - Laura Valentina Renna
- Biobank BioCor, Service of Laboratory Medicine1-Clinical Pathology, IRCCS San Donato Polyclinic, San Donato Milanese, Milan, Italy
| | - Sara Boveri
- Scientific Directorate, IRCCS San Donato Polyclinic, San Donato Milanese, Milan, Italy
| | - Roberta Rigolini
- Operative Unit of Laboratory Medicine1-Clinical Pathology, Department of Pathology and Laboratory Medicine, IRCCS San Donato Polyclinic, San Donato Milanese, Milan, Italy
| | - Matteo Carrara
- Residency Program in Clinical Pathology and Clinical Biochemistry, University of Milan, Milan, Italy
| | - Giovanni Spuria
- Residency Program in Clinical Pathology and Clinical Biochemistry, University of Milan, Milan, Italy
| | - Teresa Cuppone
- Scientific Directorate, IRCCS San Donato Polyclinic, San Donato Milanese, Milan, Italy
| | - Aurelia D'acquisto
- Scientific Directorate, IRCCS San Donato Polyclinic, San Donato Milanese, Milan, Italy
| | - Luca Carpinelli
- Scientific Directorate, IRCCS San Donato Polyclinic, San Donato Milanese, Milan, Italy
| | - Marta Sacchi
- Service of Laboratory Medicine, IRCCS San Donato Polyclinic, San Donato Milanese, Milan, Italy
| | - Lelio Morricone
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS San Donato Polyclinic, San Donato Milanese, Milan, Italy
| | - Francesco Secchi
- Unit of Radiology, IRCCS San Donato Polyclinic, San Donato Milanese, Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Elena Costa
- Service of Laboratory Medicine, IRCCS San Donato Polyclinic, San Donato Milanese, Milan, Italy
| | - Lorenzo Menicanti
- Scientific Directorate, IRCCS San Donato Polyclinic, San Donato Milanese, Milan, Italy
| | - Enzo Nisoli
- Department of Medical Biotechnology and Translational Medicine, Centre for Study and Research on Obesity, University of Milan, Milan, Italy
| | - Michele Carruba
- Department of Medical Biotechnology and Translational Medicine, Centre for Study and Research on Obesity, University of Milan, Milan, Italy
| | - Federico Ambrogi
- Scientific Directorate, IRCCS San Donato Polyclinic, San Donato Milanese, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Massimiliano Marco Corsi Romanelli
- Operative Unit of Laboratory Medicine1-Clinical Pathology, Department of Pathology and Laboratory Medicine, IRCCS San Donato Polyclinic, San Donato Milanese, Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
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7
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Malavazos AE, Secchi F, Basilico S, Capitanio G, Boveri S, Milani V, Dubini C, Schiaffino S, Morricone L, Foschini C, Gobbo G, Piccinni R, Saibene A, Sardanelli F, Menicanti L, Guazzi M, Dong C, Romanelli MMC, Carruba M, Iacobellis G. Abdominal obesity phenotype is associated with COVID-19 chest X-ray severity score better than BMI-based obesity. Eat Weight Disord 2022; 27:345-359. [PMID: 33821453 PMCID: PMC8020829 DOI: 10.1007/s40519-021-01173-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 01/26/2021] [Revised: 03/11/2021] [Accepted: 03/16/2021] [Indexed: 01/06/2023] Open
Abstract
PURPOSE Chest X-ray (CXR) severity score and BMI-based obesity are predictive risk factors for COVID-19 hospital admission. However, the relationship between abdominal obesity and CXR severity score has not yet been fully explored. METHODS This retrospective cohort study analyzed the association of different adiposity indexes, including waist circumference and body mass index (BMI), with CXR severity score in 215 hospitalized patients with COVID-19. RESULTS Patients with abdominal obesity showed significantly higher CXR severity scores and had higher rates of CXR severity scores ≥ 8 compared to those without abdominal obesity (P < 0.001; P = 0.001, respectively). By contrast, patients with normal weight, with overweight and those with BMI-based obesity showed no significant differences in either CXR severity scores or in the rates of CXR severity scores ≥ 8 (P = 0.104; P = 0.271, respectively). Waist circumference and waist-to-height ratio (WHtR) correlated more closely with CXR severity scores than BMI (r = 0.43, P < 0.001; r = 0.41, P < 0.001; r = 0.17, P = 0.012, respectively). The area under the curves (AUCs) for waist circumference and WHtR were significantly higher than that for BMI in identifying a high CXR severity score (≥ 8) (0.68 [0.60-0.75] and 0.67 [0.60-0.74] vs 0.58 [0.51-0.66], P = 0.001). A multivariate analysis indicated abdominal obesity (risk ratio: 1.75, 95% CI: 1.25-2.45, P < 0.001), bronchial asthma (risk ratio: 1.73, 95% CI: 1.07-2.81, P = 0.026) and oxygen saturation at admission (risk ratio: 0.96, 95% CI: 0.94-0.97, P < 0.001) as the only independent factors associated with high CXR severity scores. CONCLUSION Abdominal obesity phenotype is associated with a high CXR severity score better than BMI-based obesity in hospitalized patients with COVID-19. Therefore, when visiting the patient in a hospital setting, waist circumference should be measured, and patients with abdominal obesity should be monitored closely. Level of evidence Cross-sectional descriptive study, Level V.
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Affiliation(s)
- Alexis Elias Malavazos
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, Piazza Edmondo Malan 2, San Donato Milanese, 20097, Milan, Italy.
| | - Francesco Secchi
- Radiology Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
- Department of Biomedical Sciences for Health, Università Degli Studi Di Milano, Milan, Italy
| | - Sara Basilico
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, Piazza Edmondo Malan 2, San Donato Milanese, 20097, Milan, Italy
- School of Food Science, Università Degli Studi Di Milano, Milan, Italy
| | - Gloria Capitanio
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, Piazza Edmondo Malan 2, San Donato Milanese, 20097, Milan, Italy
| | - Sara Boveri
- Scientific Directorate, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Valentina Milani
- Scientific Directorate, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Carola Dubini
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, Piazza Edmondo Malan 2, San Donato Milanese, 20097, Milan, Italy
| | - Simone Schiaffino
- Radiology Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Lelio Morricone
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, Piazza Edmondo Malan 2, San Donato Milanese, 20097, Milan, Italy
| | - Chiara Foschini
- Radiology Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Giulia Gobbo
- General Medicine Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Rosangela Piccinni
- General Medicine Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Alessandro Saibene
- Department of General Medicine, Diabetes and Endocrinology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Francesco Sardanelli
- Radiology Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
- Department of Biomedical Sciences for Health, Università Degli Studi Di Milano, Milan, Italy
| | - Lorenzo Menicanti
- Scientific Directorate, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Marco Guazzi
- Department of Biomedical Sciences for Health, Università Degli Studi Di Milano, Milan, Italy
- Cardiology University Department, Heart Failure Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Chuanhui Dong
- Department of Neurology, Leonard M. Miller School of Medicine, University of Miami, Coral Gables, FL, USA
| | - Massimiliano Marco Corsi Romanelli
- Department of Biomedical Sciences for Health, Università Degli Studi Di Milano, Milan, Italy
- Operative Unit of Laboratory Medicine1-Clinical Pathology, Department of Pathology and Laboratory Medicine, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Michele Carruba
- Department of Medical Biotechnology and Translational Medicine, Center for Study and Research On Obesity, University of Milan, Milan, Italy
| | - Gianluca Iacobellis
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Miami, Coral Gables, FL, USA
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8
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Malavazos AE, Capitanio G, Milani V, Ambrogi F, Matelloni IA, Basilico S, Dubini C, Sironi FM, Stella E, Castaldi S, Secchi F, Menicanti L, Iacobellis G, Corsi Romanelli MM, Carruba MO, Morricone LF. Corrigendum to "Tri-Ponderal Mass Index vs body Mass Index in discriminating central obesity and hypertension in adolescents with overweight" [Nutrition, metabolism and cardiovascular diseases 31 (2021) 1613-1621]. Nutr Metab Cardiovasc Dis 2021; 31:3247-3248. [PMID: 34629259 DOI: 10.1016/j.numecd.2021.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Alexis E Malavazos
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy.
| | - Gloria Capitanio
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Valentina Milani
- Scientific Directorate, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Federico Ambrogi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Irene A Matelloni
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Sara Basilico
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Carola Dubini
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Francesca M Sironi
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Elisabetta Stella
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Silvana Castaldi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Francesco Secchi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy; Radiology Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Lorenzo Menicanti
- Scientific Directorate, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Gianluca Iacobellis
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Miami, FL, USA
| | - Massimiliano M Corsi Romanelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy; U.O.C. SMEL-1 of Clinical Pathology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Michele O Carruba
- Department of Medical Biotechnology and Translational Medicine, Center for Study and Research on Obesity, University of Milan, Milan, Italy
| | - Lelio F Morricone
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
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9
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Iacobellis G, Malavazos AE, Basilico S, Tresoldi S, Rinaldo RF, Dubini C, Capitanio G, Serpi F, Schiaffino S, Oliva OA, Cariati M, Morricone L, Centanni S, Sardanelli F, Carruba M, Corsi Romanelli MM, Secchi F. Epicardial fat inflammation response to COVID-19 therapies. Obesity (Silver Spring) 2021; 29:1427-1433. [PMID: 34028990 PMCID: PMC8242726 DOI: 10.1002/oby.23232] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/23/2021] [Accepted: 05/12/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Adipose tissue plays a role in the novel coronavirus disease 2019 (COVID-19). Epicardial adipose tissue (EAT), a unique visceral fat, presents with a high degree of inflammation in severe COVID-19. Whether and how adipose tissue may respond to the COVID-19 therapies is unknown. METHODS The difference in computed tomography-measured EAT and subcutaneous (SAT) attenuation, defined as mean attenuation expressed in Hounsfield units (HU), was retrospectively analyzed in 72 patients (mean [SD] age was 59.6 [12.4] years, 50 patients [69%] were men) at the hospital admission for COVID-19 and 99 days (interquartile range = 71-129) after discharge. RESULTS At the admission, EAT-HU was significantly correlated with blood glucose levels, interleukin 6, troponin T levels, and waist circumference. EAT-HU decreased from -87.21 (16.18) to -100.0 (11) (p < 0.001), whereas SAT-HU did not change (-110.21 [12.1] to -111.11 [27.82]; p = 0.78) after therapy. Changes in EAT-HU (expressed as ∆) significantly correlated with dexamethasone therapy (r = -0.46, p = 0.006) and when dexamethasone was combined with tocilizumab (r = -0.24, p = 0.04). CONCLUSIONS Dexamethasone therapy was associated with significant reduction of EAT inflammation in COVID-19 patients, whereas SAT showed no changes. Anti-inflammatory therapies targeting visceral fat may be helpful in COVID-19.
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Affiliation(s)
- Gianluca Iacobellis
- Division of Endocrinology, Diabetes and MetabolismDepartment of MedicineUniversity of MiamiMiamiFloridaUSA
| | - Alexis Elias Malavazos
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention ServiceIstituto Ricovero e Cura a Carattere Scientifico San Donato PolyclinicSan Donato Milanese, MilanItaly
| | - Sara Basilico
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention ServiceIstituto Ricovero e Cura a Carattere Scientifico San Donato PolyclinicSan Donato Milanese, MilanItaly
| | - Silvia Tresoldi
- Diagnostic and Interventional Radiology ServiceAzienda Socio‐Sanitaria Territoriale Santi Paolo and CarloMilanItaly
| | - Rocco Francesco Rinaldo
- Respiratory UnitDepartment of Health SciencesAzienda Socio‐Sanitaria Territoriale Santi Paolo and CarloSan Paolo HospitalUniversity of MilanMilanItaly
| | - Carola Dubini
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention ServiceIstituto Ricovero e Cura a Carattere Scientifico San Donato PolyclinicSan Donato Milanese, MilanItaly
| | - Gloria Capitanio
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention ServiceIstituto Ricovero e Cura a Carattere Scientifico San Donato PolyclinicSan Donato Milanese, MilanItaly
| | - Francesca Serpi
- Post‐graduate School in RadiodiagnosticsUniversity of MilanMilanItaly
| | - Simone Schiaffino
- Radiology UnitIstituto Ricovero e Cura a Carattere Scientifico San Donato PolyclinicSan Donato Milanese, MilanItaly
| | - Omar Alessandro Oliva
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention ServiceIstituto Ricovero e Cura a Carattere Scientifico San Donato PolyclinicSan Donato Milanese, MilanItaly
- Department of CardiologyIstituto Ricovero e Cura a Carattere Scientifico San Donato PolyclinicSan Donato Milanese, MilanItaly
| | - Maurizio Cariati
- Diagnostic and Interventional Radiology ServiceAzienda Socio‐Sanitaria Territoriale Santi Paolo and CarloMilanItaly
| | - Lelio Morricone
- Division of Endocrinology, Diabetes and MetabolismDepartment of MedicineUniversity of MiamiMiamiFloridaUSA
| | - Stefano Centanni
- Respiratory UnitDepartment of Health SciencesAzienda Socio‐Sanitaria Territoriale Santi Paolo and CarloSan Paolo HospitalUniversity of MilanMilanItaly
| | - Francesco Sardanelli
- Radiology UnitIstituto Ricovero e Cura a Carattere Scientifico San Donato PolyclinicSan Donato Milanese, MilanItaly
- Department of Biomedical Sciences for HealthUniversity of MilanMilanItaly
| | - Michele Carruba
- Department of Medical Biotechnology and Translational MedicineCenter for Study and Research on ObesityUniversity of MilanMilanItaly
| | - Massimiliano Marco Corsi Romanelli
- Department of Biomedical Sciences for HealthUniversity of MilanMilanItaly
- Operative Unit of Laboratory Medicine 1‐Clinical PathologyDepartment of Pathology and Laboratory MedicineIstituto Ricovero e Cura a Carattere Scientifico San Donato PolyclinicSan Donato Milanese, MilanItaly
| | - Francesco Secchi
- Radiology UnitIstituto Ricovero e Cura a Carattere Scientifico San Donato PolyclinicSan Donato Milanese, MilanItaly
- Department of Biomedical Sciences for HealthUniversity of MilanMilanItaly
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10
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Malavazos AE, Capitanio G, Milani V, Ambrogi F, Matelloni IA, Basilico S, Dubini C, Sironi FM, Stella E, Castaldi S, Secchi F, Menicanti L, Iacobellis G, Corsi Romanelli MM, Carruba MO, Morricone LF. Tri-Ponderal Mass Index vs body Mass Index in discriminating central obesity and hypertension in adolescents with overweight. Nutr Metab Cardiovasc Dis 2021; 31:1613-1621. [PMID: 33741212 DOI: 10.1016/j.numecd.2021.02.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 01/28/2021] [Accepted: 02/13/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND AIMS Recently, it has been hypothesized that Tri-Ponderal Mass Index (TMI) may be a valid alternative to Body Mass Index (BMI) when measuring body fat in adolescents. We aimed to verify whether TMI has better accuracy than BMI in discriminating central obesity and hypertension in adolescents with overweight. METHODS AND RESULTS This monocentric and retrospective cross-sectional study included 3749 pupils, 1889 males and 1860 females, aged 12-13. BMI (kg/m2) was calculated and expressed as percentiles and as z-scores. TMI (kg/m3) was calculated, and we used pre-defined cut-off previously proposed by Peterson et al.. For central obesity we adopted the Waist-to-Height Ratio (WHtR) discriminatory value of 0.5. Hypertension was defined as blood pressure ≥95th percentile of age- sex-, and height-specific references recommended by NHBPEP Working Group. The discriminant ability of TMI, BMI and BMI z-score, with respect to central obesity and hypertension, was investigated using non-parametric receiver operating characteristic analysis. The overall misclassification rate for central obesity was 8.88% for TMI vs 14.10% for BMI percentiles and vs 14.92% for BMI z-scores (P < 0.001). The overall misclassification rate for hypertension was 7.50% for TMI vs 22.03% for BMI percentiles and vs 25.19% for BMI z-scores (P < 0.001). CONCLUSION TMI is a superior body fat index and it could discriminate body fat distribution more accurately than BMI. This supports the use of TMI, in association with WHtR, to characterize adolescents with overweight and high cardio-metabolic risk. Our analysis needs to be extended to other ethnic groups and replicated in a wider age range and in longitudinal studies.
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Affiliation(s)
- Alexis E Malavazos
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy.
| | - Gloria Capitanio
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Valentina Milani
- Scientific Directorate, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Federico Ambrogi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Irene A Matelloni
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Sara Basilico
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Carola Dubini
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Francesca M Sironi
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Elisabetta Stella
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Silvana Castaldi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Francesco Secchi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy; Radiology Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Lorenzo Menicanti
- Scientific Directorate, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Gianluca Iacobellis
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Miami, FL, USA
| | - Massimiliano M Corsi Romanelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy; U.O.C. SMEL-1 of Clinical Pathology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Michele O Carruba
- Department of Medical Biotechnology and Translational Medicine, Center for Study and Research on Obesity, University of Milan, Milan, Italy
| | - Lelio F Morricone
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
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