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Romano F, Serpico D, Cantelli M, Di Sarno A, Dalia C, Arianna R, Lavorgna M, Colao A, Di Somma C. Osteoporosis and dermatoporosis: a review on the role of vitamin D. Front Endocrinol (Lausanne) 2023; 14:1231580. [PMID: 37693364 PMCID: PMC10484397 DOI: 10.3389/fendo.2023.1231580] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/10/2023] [Indexed: 09/12/2023] Open
Abstract
Osteoporosis (OP) and Dermatoporosis (DP) are expressions of the aging process at the skin and bone levels, respectively. Both conditions are associated with increased morbidity for elderly people, and this requires necessary interventions. They share many common risk factors; among these, vitamin D (VD) deficiency appears to have a role. VD is involved in either disease with many mechanisms, among which immunomodulation. VD deficiency has been linked to OP because it inhibits the body's capacity to absorb calcium and maintain optimal bone health. Available evidence suggests that proper vitaminosis D also appears to be vital in preventing skin age-related issues. DP is often seen in elderly individuals, particularly those with long-term sun exposure and a history of chronic sun damage. VD deficiency can be linked to DP, since its involvement in collagen production, epidermal barrier function, inflammation regulation, wound healing, and sun protection. Aim of this review is to summarize the most updated existing evidence on the role of VD in the development of fragility syndromes such as DP and OP and the possible benefits of VD supplementation as a simple and harmful weapon against aging.
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Affiliation(s)
- Fiammetta Romano
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Domenico Serpico
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Mariateresa Cantelli
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Antonella Di Sarno
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Carmine Dalia
- Internal Medicine S. Maria Della Pietà Hospital Nola, Nola, Italy
| | - Rossana Arianna
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Mariarosaria Lavorgna
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Annamaria Colao
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
- UNESCO Chair “Education for Health and Sustainable Development”, University of Naples “Federico II”, Naples, Italy
| | - Carolina Di Somma
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
- UNESCO Chair “Education for Health and Sustainable Development”, University of Naples “Federico II”, Naples, Italy
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Di Somma C, Scarano E, Arianna R, Romano F, Lavorgna M, Serpico D, Colao A. Long-Term Safety of Growth Hormone Deficiency Treatment in Cancer and Sellar Tumors Adult Survivors: Is There a Role of GH Therapy on the Neoplastic Risk? J Clin Med 2023; 12:jcm12020662. [PMID: 36675591 PMCID: PMC9861672 DOI: 10.3390/jcm12020662] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/07/2023] [Accepted: 01/12/2023] [Indexed: 01/18/2023] Open
Abstract
Experimental studies support the hypothesis that GH/IGF-1 status may influence neoplastic tissue growth. Epidemiological studies suggest a link between GH/IGF-1 status and cancer risk. However, several studies regarding GH replacement safety in childhood cancer survivors do not show a prevalence excess of de novo cancers, and several reports on children and adults treated with GH have not shown an increase in observed cancer risk in these patients. The aim of this review is to provide an at-a-glance overview and the state of the art of long-term effects of GH replacement on neoplastic risk in adults with growth hormone deficiency who have survived cancer and sellar tumors.
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Affiliation(s)
- Carolina Di Somma
- Endocrinology, Diabetes and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80131 Naples, Italy
- UNESCO Chair “Education for Health and Sustainable Development”, University of Naples “Federico II”, 80131 Naples, Italy
- Correspondence:
| | - Elisabetta Scarano
- Endocrinology, Diabetes and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80131 Naples, Italy
| | - Rossana Arianna
- Endocrinology, Diabetes and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80131 Naples, Italy
| | - Fiammetta Romano
- Endocrinology, Diabetes and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80131 Naples, Italy
| | - Mariarosaria Lavorgna
- Endocrinology, Diabetes and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80131 Naples, Italy
| | - Domenico Serpico
- Endocrinology, Diabetes and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80131 Naples, Italy
| | - Annamaria Colao
- Endocrinology, Diabetes and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80131 Naples, Italy
- UNESCO Chair “Education for Health and Sustainable Development”, University of Naples “Federico II”, 80131 Naples, Italy
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Simeoli C, de Angelis C, Delli Veneri A, Menafra D, Di Paola N, Pivonello C, Di Somma C, Valerio P, Melis D, Alviggi C, Colao A, Pivonello R. Severe impact of late diagnosis of congenital adrenal hyperplasia on gender identity, sexual orientation and function: case report and review of the literature. Front Genet 2022; 13:902844. [DOI: 10.3389/fgene.2022.902844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 08/23/2022] [Indexed: 11/13/2022] Open
Abstract
Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (21-OHD) represents the most frequent form of CAH and of 46, XX disorder of sex development in female newborns. In the majority of cases, particularly in developed countries, female patients suffering from the classic forms of CAH reach the diagnosis at birth or in the early childhood, allowing a prompt treatment with a correct gender assignment. The current manuscript describes an unusual case of an Italian 46-year-old woman, homeborn in the 60s, receiving an extraordinarily late diagnosis of simple virilising classic form of CAH due to 21-OHD, determining a relevant impairment of both physical and psychosexual development. The patient presented primary amenorrhea, height under target, overweight with visceral adiposity, hypercholesterolemia and insulin resistance, hirsutism with a typical male-pattern hair growth, external genital ambiguity, and a severe impairment in the entire series of psychological dimensions, particularly severe depressive symptoms, together with gender dysphoria relative to the female gender assigned at birth, cross-gender behaviours, and body image discomfort, which were associated with homosexual orientation, and sexual dysfunction. Following diagnosis and glucocorticoid (GC) replacement therapy, the hyperandrogenism control and familial and socio-cultural factors changes, particularly, living alone and the interruption of social isolation, were accompanied by menarche appearance, improvement in hirsutism and metabolic profile, and a resolution in all psychological dimensions, depressive symptoms, and gender dysphoria. The patient began to perceive homosexual orientation without discomfort, and ameliorating sexual function. Few cases of female patients with CAH due to 21-OHD receiving an extremely delayed diagnosis have been published. However, to the best of our knowledge, this is the first case including a complete psychosexual assessment at diagnosis with a detailed re-evaluation after 5 years of disease treatment.
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Scarano E, Solari D, Riccio E, Arianna R, Somma T, Cavallo LM, Romano F, Colao A, Di Somma C. Craniopharyngioma and Metabolic Syndrome: A 5-Year Follow-Up Single-Center Experience. Front Neurol 2022; 13:783737. [PMID: 35356458 PMCID: PMC8959765 DOI: 10.3389/fneur.2022.783737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
Patients with craniopharyngioma often have comorbidities, such as obesity and hypopituitarism. These two conditions affect each other and worsen the quality of life of patients, which lead to a higher risk of morbidity and mortality. In addition, abdominal obesity, measured as waist circumference (WC), is together with other parameters [arterial hypertension, hyperglycemia, hypertriglyceridemia, and reduced levels of high-density lipoprotein (HDL) cholesterol], one of the components of metabolic syndrome (MS). Each one of these morbidities occurs in patients with craniopharyngioma more frequently than in the remaining population. On these bases, we evaluated metabolic parameters in patients with craniopharyngioma at the time of diagnosis and after a 5-year follow-up, which compares these data with those of age-, gender-, WC-, and body mass index (BMI)-matched controls. In addition, we evaluated the prevalence of MS according to IDF criteria (MS-IDF) and the prevalence of MS according to ATP III (MS-ATPIII) criteria in patients and controls at baseline and after 5 years. We recruited 20 patients with craniopharyngioma (age 38.5 ± 15 years, 10 M) and 20 age-, gender-, WC- and BMI-matched controls (age 34.16 ± 13.19 years, 10 M). In all patients and controls, we evaluated the following: anthropometric features [height, weight, BMI, WC, hip circumference (HC) and waist-to-hip ratio (WHR)], systolic blood pressure (SBP) and diastolic blood pressure (DBP), lipid profile [total cholesterol (TC), HDL, low-density lipoprotein (LDL) cholesterol, triglycerides (TG)], and blood glucose at baseline and after 5 years. The prevalence of MS, according to IDF and ATPIII criteria, was calculated in the two groups at baseline and after 5 years. According to our results, at baseline, patients with craniopharyngioma had a worse metabolic profile than controls and a higher prevalence of MS. Besides, at a 5-year follow-up, patients still had impaired metabolic characteristics and more frequent MS (according to IDF and ATPIII criteria) when compared to controls. These data confirm that MS in patients with craniopharyngioma is unresponsive to life-changing interventions and to a common pharmacological approach. Other factors may be involved in the evolution of these conditions; so, further studies are needed to establish the correct management of these patients.
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Affiliation(s)
- Elisabetta Scarano
- Endocrinology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Domenico Solari
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Enrico Riccio
- Endocrinology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Rossana Arianna
- Endocrinology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Teresa Somma
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Luigi Maria Cavallo
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Fiammetta Romano
- Endocrinology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Annamaria Colao
- Endocrinology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
- Cattedra Unesco “Educazione alla salute e allo sviluppo sostenibile”, University of Naples Federico II, Naples, Italy
| | - Carolina Di Somma
- Endocrinology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
- Cattedra Unesco “Educazione alla salute e allo sviluppo sostenibile”, University of Naples Federico II, Naples, Italy
- *Correspondence: Carolina Di Somma
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Altieri B, Barrea L, Modica R, Bottiglieri F, de Cicco F, Muscogiuri G, Circelli L, Savarese G, Di Somma C, Savastano S, Colao A, Faggiano A. Vitamin D deficiency and tumor aggressiveness in gastroenteropancreatic neuroendocrine tumors. Endocrine 2022; 75:623-634. [PMID: 34533768 DOI: 10.1007/s12020-021-02869-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 04/30/2021] [Accepted: 09/03/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE Data regarding vitamin D status in patients affected by gastroenteropancreatic (GEP) neuroendocrine tumor (NET) are limited and often showing contrasting results. The aim of the study was to evaluate the incidence of vitamin D deficiency (<20 ng/mL) in GEP-NET patients and compare the 25-hydroxyvitamin D (25(OH)D) levels with clinicopathological parameters and clinical outcome. METHODS A retrospective cross-sectional study including 75 low grade (G1-G2) GEP-NETs and 123 healthy controls matched for age, sex, and body mass index, was performed. RESULTS GEP-NET patients had significantly lower 25(OH)D levels compared to controls (17.9 ± 7.8 vs 24.2 ± 7.7 ng/mL, p < 0.0001). Ileal NETs were associated to lower 25(OH)D levels compared to other primary tumor sites (p = 0.049) and small bowel resection posed a significant increased risk of severe vitamin D deficiency (OR = 2.81, 95% CI = 1.25-3.37, p = 0.018). No correlation with somatostatin analogs treatment was found. 25(OH)D levels were significantly lower in G2 compared to G1 GEP-NETs (15.6 ± 7.8 vs 19.9 ± 7.4 ng/mL, p = 0.016) and in patients with progressive disease (12.6 ± 5.7 ng/mL) compared to those with stable disease (mean 21.5 ± 8.2 ng/mL, p = 0.001) or tumor free after surgery (19.6 ± 7.3 ng/mL, p = 0.002). Patients with vitamin D deficiency and insufficiency had shorter progression-free survival compared to those with sufficiency (p = 0.014), whereas no correlation was found with disease-specific survival. CONCLUSIONS Vitamin D deficiency is highly prevalent among GEP-NETs and could be associated with high tumor grade and disease progression. Therefore, the monitoring of 25(OH)D levels is relevant in these patients and vitamin D supplementation should be considered in the management of GEP-NET patients with vitamin D deficiency or insufficiency.
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Affiliation(s)
- Barbara Altieri
- Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany.
| | - Luigi Barrea
- Department of Clinical Medicine and Surgery, Unit of Endocrinology, Federico II University, Naples, Italy
| | - Roberta Modica
- Department of Clinical Medicine and Surgery, Unit of Endocrinology, Federico II University, Naples, Italy
| | - Filomena Bottiglieri
- Department of Clinical Medicine and Surgery, Unit of Endocrinology, Federico II University, Naples, Italy
| | - Federica de Cicco
- Department of Clinical Medicine and Surgery, Unit of Endocrinology, Federico II University, Naples, Italy
| | - Giovanna Muscogiuri
- Department of Clinical Medicine and Surgery, Unit of Endocrinology, Federico II University, Naples, Italy
| | | | | | - Carolina Di Somma
- Department of Clinical Medicine and Surgery, Unit of Endocrinology, Federico II University, Naples, Italy
| | - Silvia Savastano
- Department of Clinical Medicine and Surgery, Unit of Endocrinology, Federico II University, Naples, Italy
| | - Annamaria Colao
- Department of Clinical Medicine and Surgery, Unit of Endocrinology, Federico II University, Naples, Italy
- UNESCO Chair "Education for Health and Sustainable Development", Federico II University, Naples, Italy
| | - Antongiulio Faggiano
- Endocrinology Unit, Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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Di Somma C, Scarano E, Barrea L, Solari D, Riccio E, Arianna R, Cavallo LM, Romano F, Di Benedetto E, Rodriguez A, de Alteriis G, Colao A. Craniopharyngioma, Chronotypes and Metabolic Risk Profile. Nutrients 2021; 13:nu13103444. [PMID: 34684445 PMCID: PMC8538918 DOI: 10.3390/nu13103444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/24/2021] [Accepted: 09/25/2021] [Indexed: 12/15/2022] Open
Abstract
Aim: To investigate the potential association among Craniopharyngioma (CP), chronotypes and metabolic risk profile. Subjects and Methods: The study population included 28 patients (46.4% males; 42.6 ± 15.8 years) and 28 controls, age, gender and BMI matched (46.4% males; 46.5 ± 12.9 years). In this study sample, we evaluated: anthropometric measurements (waist circumference, WC; BMI), plasma glucose, lipid profile, and systolic (SBP) and diastolic (DBP) blood pressure. Morningness-Eveningness was measured with the Horne-Ostberg Morningness-Eveningness Questionnaire (MEQ), which included 19 questions about preferred sleep time and daily performance. Results: in both patients and controls grade I obesity was detected in 15 subjects (53.6%), grade II obesity in 13 subjects (46.4%). In the patient group, the mean score of chronotype was 47.8 ± 12.6. In particular, 9 patients (32.1%) exhibited the morning chronotype, 6 (21.4%) the intermediate chronotype and 13 (46.4.%) the evening chronotype. No significant difference was found in gender and age among the chronotype categories. Patients with the evening chronotype had higher blood pressure values and worse metabolic parameters than those with the morning chronotype. In the control group, the mean score of the chronotype was 57.6 ± 9.5. In particular, 16 (57.1%) subjects exhibited the morning chronotype, 10 (35.7%) the intermediate chronotype and only 2 (7.1.%) the evening chronotype. The prevalence of intermediate and evening chronotypes was higher in females than males (p = 0.021), while males have a higher prevalence of the morning chronotype. Subjects with intermediate and evening chronotypes had worse metabolic parameters than those with the morning chronotype. In patients, the chronotype score was inversely correlated to WC, BMI, SBP, DBP, plasma glucose, total cholesterol, triglycerides, LDL cholesterol and positively correlated with HDL cholesterol. No correlation was found between age and chronotype. In controls, the chronotype score was inversely correlated to WC, BMI, plasma glucose, total cholesterol, LDL cholesterol. No correlation was found among chronotype and age, blood pressure, triglycerides, HDL cholesterol. Considering the whole population of the study (patients and controls), at logistic regression the chronotype score was significantly associated with the presence of CP. Conclusions: for the first time thus far, our study puts the light on the association of the CP with chronotypes and metabolic alterations in this disease, which are the main determinants of the reduced quality of life, higher morbidity and mortality in this setting of patients. This finding suggests that alterations of chronotype might represent an adjunctive risk for CP patients and a possible target for their integrate management.
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Affiliation(s)
- Carolina Di Somma
- Endocrinology Unit, Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy; (E.S.); (L.B.); (E.R.); (R.A.); (F.R.); (E.D.B.); (A.R.); (G.d.A.); (A.C.)
- Cattedra Unesco “Educazione Alla Salute e allo Sviluppo Sostenibile”, Federico II University, 80131 Naples, Italy
- Correspondence: ; Tel.: +39-081-746-3779
| | - Elisabetta Scarano
- Endocrinology Unit, Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy; (E.S.); (L.B.); (E.R.); (R.A.); (F.R.); (E.D.B.); (A.R.); (G.d.A.); (A.C.)
| | - Luigi Barrea
- Endocrinology Unit, Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy; (E.S.); (L.B.); (E.R.); (R.A.); (F.R.); (E.D.B.); (A.R.); (G.d.A.); (A.C.)
| | - Domenico Solari
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University, 80125 Naples, Italy; (D.S.); (L.M.C.)
| | - Enrico Riccio
- Endocrinology Unit, Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy; (E.S.); (L.B.); (E.R.); (R.A.); (F.R.); (E.D.B.); (A.R.); (G.d.A.); (A.C.)
| | - Rossana Arianna
- Endocrinology Unit, Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy; (E.S.); (L.B.); (E.R.); (R.A.); (F.R.); (E.D.B.); (A.R.); (G.d.A.); (A.C.)
| | - Luigi Maria Cavallo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University, 80125 Naples, Italy; (D.S.); (L.M.C.)
| | - Fiammetta Romano
- Endocrinology Unit, Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy; (E.S.); (L.B.); (E.R.); (R.A.); (F.R.); (E.D.B.); (A.R.); (G.d.A.); (A.C.)
| | - Elea Di Benedetto
- Endocrinology Unit, Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy; (E.S.); (L.B.); (E.R.); (R.A.); (F.R.); (E.D.B.); (A.R.); (G.d.A.); (A.C.)
| | - Alice Rodriguez
- Endocrinology Unit, Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy; (E.S.); (L.B.); (E.R.); (R.A.); (F.R.); (E.D.B.); (A.R.); (G.d.A.); (A.C.)
| | - Giulia de Alteriis
- Endocrinology Unit, Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy; (E.S.); (L.B.); (E.R.); (R.A.); (F.R.); (E.D.B.); (A.R.); (G.d.A.); (A.C.)
| | - Annamaria Colao
- Endocrinology Unit, Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy; (E.S.); (L.B.); (E.R.); (R.A.); (F.R.); (E.D.B.); (A.R.); (G.d.A.); (A.C.)
- Cattedra Unesco “Educazione Alla Salute e allo Sviluppo Sostenibile”, Federico II University, 80131 Naples, Italy
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Zhukouskaya VV, Mannes I, Chaussain C, Kamenický P, Audrain C, Lambert AS, Nevoux J, Wicart P, Briot K, Di Rocco F, Trabado S, Prié D, Di Somma C, Colao A, Adamsbaum C, Rothenbuhler A, Linglart A. Magnetic resonance imaging is a valuable tool to evaluate the therapeutic efficacy of burosumab in children with X-linked hypophosphatemia. Eur J Endocrinol 2021; 185:475-484. [PMID: 34292170 DOI: 10.1530/eje-21-0429] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 07/21/2021] [Indexed: 11/08/2022]
Abstract
PURPOSE To examine the MRI diagnostic performance in the assessment of therapeutic response to burosumab in children with X-linked hypophosphatemia (XLH). DESIGN Prospective longitudinal open cohort. PATIENTS Seventeen children with XLH, average age of 10.2 ± 2.7 years, had a knee MRI at baseline and after 1 year of burosumab. INTERVENTION Children received burosumab at an average dose of 1.4 ± 0.5 mg/kg during 1 year for the treatment of severe rickets (the target serum phosphate ≥ 1.2 mmol/L (≥3.7 mg/dL). The primary endpoint was the change from baseline to 12 months in rachitic lesions on knee MRI. Secondary endpoints were changes in biochemical parameters of phosphate and alkaline phosphatase (ALP). RESULTS One year of treatment with burosumab significantly reduced radiological disease activity on knee MRI (by 44 ± 29% in the transverse extent of widening) which was accompanied by a significant reduction in biochemical activity, namely in serum ALP activity, by 28 ± 17%. Additionally, MRI parameters after 1 year of treatment with burosumab (the maximum width of medial physis at 12 months and the change from baseline in the maximum width of lateral physis) were associated with ALP activity at 12 months. CONCLUSION We suggest that MRI is a valuable and quantitative tool to evaluate the therapeutic response to burosumab. MRI could be an excellent alternative to standard bone radiographs for evaluation of the rachitic lesions in a clinical setting avoiding repeated exposition to ionizing radiation.
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Affiliation(s)
- Volha V Zhukouskaya
- AP-HP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, Filière OSCAR, EndoRare, BOND ERN and Platform of Expertise for Rare Diseases Paris-Saclay, Bicêtre Paris-Saclay Hospital, Le Kremlin-Bicêtre, France
- Genethon, Paris-Saclay University, Univ Evry, Inserm, Integrare research unit UMR_S951, Evry, France
- Division of Endocrinology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
- Université de Paris, Institut des maladies musculo-squelettiques, Laboratory Orofacial Pathologies, Imaging and Biotherapies URP2496 and FHU-DDS-Net, Dental School, and Plateforme d'Imagerie du Vivant (PIV), Montrouge, France
| | - Inès Mannes
- AP-HP, Department of Pediatric Radiology, Bicêtre Paris-Saclay Hospital, Le Kremlin-Bicêtre, France
- University Paris Saclay, Le Kremlin-Bicêtre, France
| | - Catherine Chaussain
- AP-HP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, Filière OSCAR, EndoRare, BOND ERN and Platform of Expertise for Rare Diseases Paris-Saclay, Bicêtre Paris-Saclay Hospital, Le Kremlin-Bicêtre, France
- AP-HP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, Dental Medicine Department, Bretonneau Hospital, GHN-Université de Paris, Paris, France
- Université de Paris, Paris, France
- Université de Paris, Institut des maladies musculo-squelettiques, Laboratory Orofacial Pathologies, Imaging and Biotherapies URP2496 and FHU-DDS-Net, Dental School, and Plateforme d'Imagerie du Vivant (PIV), Montrouge, France
| | - Peter Kamenický
- AP-HP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, Filière OSCAR, EndoRare, BOND ERN and Platform of Expertise for Rare Diseases Paris-Saclay, Bicêtre Paris-Saclay Hospital, Le Kremlin-Bicêtre, France
- University Paris Saclay, Le Kremlin-Bicêtre, France
- AP-HP, Department of Endocrinology and Reproductive Diseases, Bicêtre Paris-Saclay Hospital, Le Kremlin-Bicêtre, France
| | - Christelle Audrain
- AP-HP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, Filière OSCAR, EndoRare, BOND ERN and Platform of Expertise for Rare Diseases Paris-Saclay, Bicêtre Paris-Saclay Hospital, Le Kremlin-Bicêtre, France
| | - Anne-Sophie Lambert
- AP-HP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, Filière OSCAR, EndoRare, BOND ERN and Platform of Expertise for Rare Diseases Paris-Saclay, Bicêtre Paris-Saclay Hospital, Le Kremlin-Bicêtre, France
- AP-HP, Departments of Endocrinology and Diabetology for Children and Adolescent Medicine, Bicêtre Paris-Saclay Hospital, Le Kremlin-Bicêtre, France
| | - Jérôme Nevoux
- AP-HP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, Filière OSCAR, EndoRare, BOND ERN and Platform of Expertise for Rare Diseases Paris-Saclay, Bicêtre Paris-Saclay Hospital, Le Kremlin-Bicêtre, France
- University Paris Saclay, Le Kremlin-Bicêtre, France
- AP-HP, Department of ORL, Bicêtre Paris-Saclay Hospital, Le Kremlin Bicêtre, France
| | - Philippe Wicart
- AP-HP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, Filière OSCAR, EndoRare, BOND ERN and Platform of Expertise for Rare Diseases Paris-Saclay, Bicêtre Paris-Saclay Hospital, Le Kremlin-Bicêtre, France
- Université de Paris, Paris, France
- AP-HP, Department of Pediatric Orthopaedic Surgery, Necker - Sick Kids University Hospital, Paris, France
| | - Karine Briot
- AP-HP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, Filière OSCAR, EndoRare, BOND ERN and Platform of Expertise for Rare Diseases Paris-Saclay, Bicêtre Paris-Saclay Hospital, Le Kremlin-Bicêtre, France
- Université de Paris, Paris, France
- AP-HP, Department of Rheumatology Hospital Cochin, Paris, France
| | - Federico Di Rocco
- AP-HP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, Filière OSCAR, EndoRare, BOND ERN and Platform of Expertise for Rare Diseases Paris-Saclay, Bicêtre Paris-Saclay Hospital, Le Kremlin-Bicêtre, France
- Pediatric Neurosurgery, Hospital Femme Mere Enfant, Hospices Civiles de Lyon and University Claude Bernard Lyon, Bron Cedex, France
- Reference Center for Craniosynostosis, INSERM 1033, Lyon, France
| | - Séverine Trabado
- University Paris Saclay, Le Kremlin-Bicêtre, France
- AP-HP, Department of Molecular Genetics, Pharmacogenetics and Hormonology, Bicêtre Paris-Saclay Hospital, Le Kremlin-Bicêtre, France
| | - Dominique Prié
- Université de Paris, Paris, France
- AP-HP, Hôpital Necker Enfants Malades, INSERM U1151, Paris, France
| | - Carolina Di Somma
- Division of Endocrinology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Annamaria Colao
- Division of Endocrinology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Catherine Adamsbaum
- AP-HP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, Filière OSCAR, EndoRare, BOND ERN and Platform of Expertise for Rare Diseases Paris-Saclay, Bicêtre Paris-Saclay Hospital, Le Kremlin-Bicêtre, France
- AP-HP, Department of Pediatric Radiology, Bicêtre Paris-Saclay Hospital, Le Kremlin-Bicêtre, France
- University Paris Saclay, Le Kremlin-Bicêtre, France
| | - Anya Rothenbuhler
- AP-HP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, Filière OSCAR, EndoRare, BOND ERN and Platform of Expertise for Rare Diseases Paris-Saclay, Bicêtre Paris-Saclay Hospital, Le Kremlin-Bicêtre, France
- AP-HP, Departments of Endocrinology and Diabetology for Children and Adolescent Medicine, Bicêtre Paris-Saclay Hospital, Le Kremlin-Bicêtre, France
| | - Agnès Linglart
- AP-HP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, Filière OSCAR, EndoRare, BOND ERN and Platform of Expertise for Rare Diseases Paris-Saclay, Bicêtre Paris-Saclay Hospital, Le Kremlin-Bicêtre, France
- University Paris Saclay, Le Kremlin-Bicêtre, France
- AP-HP, Departments of Endocrinology and Diabetology for Children and Adolescent Medicine, Bicêtre Paris-Saclay Hospital, Le Kremlin-Bicêtre, France
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Scarano E, Riccio E, Somma T, Arianna R, Romano F, Di Benedetto E, de Alteriis G, Colao A, Di Somma C. Impact of Long-Term Growth Hormone Replacement Therapy on Metabolic and Cardiovascular Parameters in Adult Growth Hormone Deficiency: Comparison Between Adult and Elderly Patients. Front Endocrinol (Lausanne) 2021; 12:635983. [PMID: 33716985 PMCID: PMC7947790 DOI: 10.3389/fendo.2021.635983] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 01/14/2021] [Indexed: 11/13/2022] Open
Abstract
Growth hormone deficiency (GHD) in adults is due to a reduced growth hormone (GH) secretion by the anterior pituitary gland which leads to a well-known syndrome characterized by decreased cognitive function and quality of life (QoL), decreased bone mineral density (BMD), increased central adiposity with a reduction in lean body mass, decreased exercise tolerance, hyperlipidemia and increased predisposition to atherogenesis. Considering some similar features between aging and GHD, it was thought that the relative GH insufficiency of the elderly person could make an important contribution to the fragility of elderly. GH stimulation tests are able to differentiate GHD in elderly patients (EGHD) from the physiological reduction of GH secretion that occurs with aging. Although there is no evidence that rhGH replacement therapy increases the risk of developing Diabetes Mellitus (DM), reducing insulin sensitivity and inducing cardiac hypertrophy, long-term monitoring is, however, also mandatory in terms of glucose metabolism and cardiovascular measurements. In our experience comparing the impact of seven years of rhGH treatment on metabolic and cardiovascular parameters in GHD patients divided in two groups [adult (AGHD) and elderly (EGHD) GHD patients], effects on body composition are evident especially in AGHD, but not in EGHD patients. The improvements in lipid profile were sustained in all groups of patients, and they had a lower prevalence of dyslipidemia than the general population. The effects on glucose metabolism were conflicting, but approximately unchanged. The risk of DM type 2 is, however, probably increased in obese GHD adults with impaired glucose homeostasis at baseline, but the prevalence of DM in GHD is like that of the general population. The increases in glucose levels, BMI, and SBP in GHD negatively affected the prevalence of Metabolic Syndrome (MS) in the long term, especially in AGHD patients. Our results are in accordance to other long-term studies in which the effects on body composition and lipid profile are prominent.
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Affiliation(s)
- Elisabetta Scarano
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Enrico Riccio
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Teresa Somma
- Dipartimento di Neuroscienze e Scienze Riproduttive e Odontostomatologiche, Divisione di Neurochirurgia, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Rossana Arianna
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Fiammetta Romano
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Elea Di Benedetto
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Giulia de Alteriis
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Carolina Di Somma
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università degli Studi di Napoli Federico II, Naples, Italy
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9
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Romano F, Muscogiuri G, Di Benedetto E, Zhukouskaya VV, Barrea L, Savastano S, Colao A, Di Somma C. Vitamin D and Sleep Regulation: Is there a Role for Vitamin D? Curr Pharm Des 2020; 26:2492-2496. [PMID: 32156230 DOI: 10.2174/1381612826666200310145935] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [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: 01/30/2020] [Accepted: 02/29/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Vitamin D exerts multiple pleiotropic effects beyond its role in calcium-phosphate metabolism. Growing evidence suggests an association between hypovitaminosis D and sleep disorders, thus increasing the interest in the role of this vitamin in the regulatory mechanisms of the sleep-wake cycle. OBJECTIVE The study aimed to explore and summarize the current knowledge about the role of vitamin D in sleep regulation and the impact of vitamin D deficiency on sleep disorders. METHODS The main regulatory mechanisms of vitamin D on sleep are explained in this study. The literature was scanned to identify clinical trials and correlation studies showing an association between vitamin D deficiency and sleep disorders. RESULTS Vitamin D receptors and the enzymes that control their activation and degradation are expressed in several areas of the brain involved in sleep regulation. Vitamin D is also involved in the pathways of production of Melatonin, the hormone involved in the regulation of human circadian rhythms and sleep. Furthermore, vitamin D can affect sleep indirectly through non-specific pain disorders, correlated with alterations in sleep quality, such as restless legs syndrome and obstructive sleep apnea syndrome. CONCLUSION Vitamin D has both a direct and an indirect role in the regulation of sleep. Although vitamin D deficiency has been associated to sleep disorders, there is still scant evidence to concretely support the role of vitamin D supplementation in the prevention or treatment of sleep disturbances; indeed, more intervention studies are needed to better clarify these aspects.
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Affiliation(s)
- Fiammetta Romano
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Universita degli Studi di Napoli Federico II, Italy
| | - Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Universita degli Studi di Napoli Federico II, Italy
| | - Elea Di Benedetto
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Universita degli Studi di Napoli Federico II, Italy
| | - Volha V Zhukouskaya
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Universita degli Studi di Napoli Federico II, Italy
| | - Luigi Barrea
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Universita degli Studi di Napoli Federico II, Italy
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Universita degli Studi di Napoli Federico II, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Universita degli Studi di Napoli Federico II, Italy
| | - Carolina Di Somma
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Universita degli Studi di Napoli Federico II, Italy
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10
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Mazziotti G, Battista C, Maffezzoni F, Chiloiro S, Ferrante E, Prencipe N, Grasso L, Gatto F, Olivetti R, Arosio M, Barale M, Bianchi A, Cellini M, Chiodini I, De Marinis L, Del Sindaco G, Di Somma C, Ferlin A, Ghigo E, Giampietro A, Grottoli S, Lavezzi E, Mantovani G, Morenghi E, Pivonello R, Porcelli T, Procopio M, Pugliese F, Scillitani A, Lania AG. Treatment of Acromegalic Osteopathy in Real-life Clinical Practice: The BAAC (Bone Active Drugs in Acromegaly) Study. J Clin Endocrinol Metab 2020; 105:5854706. [PMID: 32511698 DOI: 10.1210/clinem/dgaa363] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 06/05/2020] [Indexed: 01/24/2023]
Abstract
BACKGROUND Vertebral fractures (VFs) are a frequent complication of acromegaly, but no studies have been so far published on effectiveness of antiosteoporotic drugs in this clinical setting. OBJECTIVE To evaluate whether in real-life clinical practice bone active drugs may reduce the risk of VFs in patients with active or controlled acromegaly. STUDY DESIGN Retrospective, longitudinal study including 9 tertiary care endocrine units. PATIENTS AND METHODS Two hundred and forty-eight patients with acromegaly (104 males; mean age 56.00 ± 13.60 years) were evaluated for prevalent and incident VFs by quantitative morphometric approach. Bone active agents were used in 52 patients (20.97%) and the median period of follow-up was 48 months (range 12-132). RESULTS During the follow-up, 65 patients (26.21%) developed incident VFs in relationship with pre-existing VFs (odds ratio [OR] 3.75; P < .001), duration of active acromegaly (OR 1.01; P = .04), active acromegaly at the study entry (OR 2.48; P = .007), and treated hypoadrenalism (OR 2.50; P = .005). In the entire population, treatment with bone active drugs did not have a significant effect on incident VFs (P = .82). However, in a sensitive analysis restricted to patients with active acromegaly at study entry (111 cases), treatment with bone active drugs was associated with a lower risk of incident VFs (OR 0.11; P = .004), independently of prevalent VFs (OR 7.65; P < .001) and treated hypoadrenalism (OR 3.86; P = .007). CONCLUSIONS Bone active drugs may prevent VFs in patients with active acromegaly.
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Affiliation(s)
- Gherardo Mazziotti
- Endocrinology, Diabetology and Medical Andrology Unit, Osteoporosis and Metabolic Bone Disease Section, Humanitas Clinical and Research Center, IRCCS, Rozzano-Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Claudia Battista
- Unit of Endocrinology, "Casa Sollievo della Sofferenza" Hospital, IRCCS, San Giovanni Rotondo (FG), Italy
| | - Filippo Maffezzoni
- Endocrinology and Metabolism, Department of Medicine, ASST Spedali Civili Brescia, Italy
| | - Sabrina Chiloiro
- Pituitary Unit, Department of Endocrinology and Metabolism, Fondazione Policlinico "A. Gemelli", IRCCS - Universita' Cattolica del Sacro Cuore, Rome, Italy
| | - Emanuele Ferrante
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Nunzia Prencipe
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Science, University of Turin, Italy
| | - Ludovica Grasso
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy
| | - Federico Gatto
- Endocrinology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Maura Arosio
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Italy
| | - Marco Barale
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Science, University of Turin, Italy
| | - Antonio Bianchi
- Pituitary Unit, Department of Endocrinology and Metabolism, Fondazione Policlinico "A. Gemelli", IRCCS - Universita' Cattolica del Sacro Cuore, Rome, Italy
| | - Miriam Cellini
- Endocrinology, Diabetology and Medical Andrology Unit, Osteoporosis and Metabolic Bone Disease Section, Humanitas Clinical and Research Center, IRCCS, Rozzano-Milan, Italy
| | - Iacopo Chiodini
- Department of Clinical Sciences and Community Health, University of Milan, Italy
- Department of Endocrine and Metabolic Diseases, IRCCS, Istituto Auxologico Italiano, Milan, Italy
| | - Laura De Marinis
- Pituitary Unit, Department of Endocrinology and Metabolism, Fondazione Policlinico "A. Gemelli", IRCCS - Universita' Cattolica del Sacro Cuore, Rome, Italy
| | - Giulia Del Sindaco
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Italy
| | - Carolina Di Somma
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy
| | - Alberto Ferlin
- Endocrinology and Metabolism, Department of Clinical and Experimental Sciences, University of Brescia, Italy
| | - Ezio Ghigo
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Science, University of Turin, Italy
| | - Antonella Giampietro
- Pituitary Unit, Department of Endocrinology and Metabolism, Fondazione Policlinico "A. Gemelli", IRCCS - Universita' Cattolica del Sacro Cuore, Rome, Italy
| | - Silvia Grottoli
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Science, University of Turin, Italy
| | - Elisabetta Lavezzi
- Endocrinology, Diabetology and Medical Andrology Unit, Osteoporosis and Metabolic Bone Disease Section, Humanitas Clinical and Research Center, IRCCS, Rozzano-Milan, Italy
| | - Giovanna Mantovani
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Italy
| | - Emanuela Morenghi
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Biostatistics Unit, Humanitas Clinical and Research Center, IRCCS, Rozzano-Milan, Italy
| | - Rosario Pivonello
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy
| | - Teresa Porcelli
- Endocrinology, Montichiari Hospital, ASST Spedali Civili Brescia
| | - Massimo Procopio
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Science, University of Turin, Italy
| | - Flavia Pugliese
- Unit of Endocrinology, "Casa Sollievo della Sofferenza" Hospital, IRCCS, San Giovanni Rotondo (FG), Italy
| | - Alfredo Scillitani
- Unit of Endocrinology, "Casa Sollievo della Sofferenza" Hospital, IRCCS, San Giovanni Rotondo (FG), Italy
| | - Andrea Gerardo Lania
- Endocrinology, Diabetology and Medical Andrology Unit, Osteoporosis and Metabolic Bone Disease Section, Humanitas Clinical and Research Center, IRCCS, Rozzano-Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
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11
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Barrea L, Muscogiuri G, Pugliese G, Aprano S, de Alteriis G, Di Somma C, Colao A, Savastano S. The Sun's Vitamin in Adult Patients Affected by Prader-Willi Syndrome. Nutrients 2020; 12:E1132. [PMID: 32316673 PMCID: PMC7230761 DOI: 10.3390/nu12041132] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 04/15/2020] [Accepted: 04/16/2020] [Indexed: 02/06/2023] Open
Abstract
Prader-Willi syndrome (PWS) is a genetic disorder characterized by hyperphagia with progressive, severe obesity, and an increased risk of obesity-related comorbidities in adult life. Although low dietary vitamin D intake and low 25-hydroxy vitamin D (25OHD) levels are commonly reported in PWS in the context of bone metabolism, the association of low 25OHD levels with fat mass has not been extensively evaluated in PWS adults. The aims of this study were to investigate the following in PWS adults: (1) 25OHD levels and the dietary vitamin D intake; (2) associations among 25OHD levels with anthropometric measurements and fat mass; (3) specific cut-off values for body mass index (BMI) and fat mass predictive of the 25OHD levels. In this cross-sectional, single-center study we enrolled 30 participants, 15 PWS adults (age 19-41 years and 40% males) and 15 control subjects matched by age, sex, and BMI from the same geographical area (latitude 40° 49' N; elevation 17 m). Fat mass was assessed using a bioelectrical impedance analysis (BIA) phase-sensitive system. The 25OHD levels were determined by a direct competitive chemiluminescence immunoassay. Dietary vitamin D intake data was collected by three-day food records. The 25OHD levels in the PWS adults were constantly lower across all categories of BMI and fat mass compared with their obese counterpart. The 25OHD levels were negatively associated with BMI (p = 0.04), waist circumference (p = 0.03), fat mass (p = 0.04), and dietary vitamin D intake (p < 0.001). During multiple regression analysis, dietary vitamin D intake was entered at the first step (p < 0.001), thus explaining 84% of 25OHD level variability. The threshold values of BMI and fat mass predicting the lowest decrease in the 25OHD levels were found at BMI ≥ 42 kg/m2 (p = 0.01) and fat mass ≥ 42 Kg (p = 0.003). In conclusion, our data indicate that: (i) 25OHD levels and dietary vitamin D intake were lower in PWS adults than in the control, independent of body fat differences; (ii) 25OHD levels were inversely associated with BMI, waist circumference, and fat mass, but low dietary vitamin D intake was the major determinant of low vitamin D status in these patients; (iii) sample-specific cut-off values of BMI and fat mass might help to predict risks of the lowest 25OHD level decreases in PWS adults. The presence of trained nutritionists in the integrated care teams of PWS adults is strongly suggested in order to provide an accurate nutritional assessment and tailored vitamin D supplementations.
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Affiliation(s)
- Luigi Barrea
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy; (G.M.); (G.P.); (S.A.); (G.d.A.); (C.D.S.); (A.C.); (S.S.)
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy; (G.M.); (G.P.); (S.A.); (G.d.A.); (C.D.S.); (A.C.); (S.S.)
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Gabriella Pugliese
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy; (G.M.); (G.P.); (S.A.); (G.d.A.); (C.D.S.); (A.C.); (S.S.)
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Sara Aprano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy; (G.M.); (G.P.); (S.A.); (G.d.A.); (C.D.S.); (A.C.); (S.S.)
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Giulia de Alteriis
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy; (G.M.); (G.P.); (S.A.); (G.d.A.); (C.D.S.); (A.C.); (S.S.)
| | - Carolina Di Somma
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy; (G.M.); (G.P.); (S.A.); (G.d.A.); (C.D.S.); (A.C.); (S.S.)
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy; (G.M.); (G.P.); (S.A.); (G.d.A.); (C.D.S.); (A.C.); (S.S.)
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
- Cattedra Unesco “Educazione alla salute e allo sviluppo sostenibile”, University Federico II, 80138 Naples, Italy
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy; (G.M.); (G.P.); (S.A.); (G.d.A.); (C.D.S.); (A.C.); (S.S.)
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
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12
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Filippella M, Altieri B, Falchetti A, Cosso R, Cena H, Musso C, Geronutti E, Rassat L, Cipriani G, Colao A, Di Somma C, Faggiano A. Bone metabolism, bone mass and structural integrity profile in professional male football players. J Sports Med Phys Fitness 2020; 60:912-918. [PMID: 32118386 DOI: 10.23736/s0022-4707.20.09913-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Physical exercise plays an important role in bone mineralization as well as factors involved in bone metabolism influence the athletic performance. In European countries, soccer is the most popular sport. The aim of the study was to investigate bone metabolism, bone mass and structural integrity profile in professional male adult football players. METHODS Sixteen professional male football players from a single team of the Second division Italian League (mean age 22.4±0.7 years) were enrolled. Bone biochemical parameters, including serum calcium, phosphorus, albumin, creatinine, alkaline phosphatase, intact plasma PTH, 25-hydroxy-vitamin D (25-OHD), 24-h urinary calcium and phosphorus, and calcaneal quantitative ultrasound (QUS), were evaluated at the beginning (October 2012) and at the end of the League (May 2013). RESULTS 25-OHD levels were significantly lower at the end of the League compared to the beginning (27.1±5.9 vs. 36.6±9.5 ng/mL, fold change [FC]=0.25, P=0.008), and the prevalence of 25-OHD deficiency increased from 25% to 73%. Moreover, higher rate of previous bone, cartilage or ligament injuries correlated with 25-OHD deficiencies (P=0.014). T-score and Z-score were at the upper limits of the normality ranges, without significant difference between the beginning and end of the League. Phosphaturia was slightly decreased at the end of the League (691.0±364.5 vs. 934.0±274.3 mg/24h, FC=0.26, P=0.06). A significant correlation was found between phosphaturia and BQI (R2=0.28, P=0.03), and both T-s and Z-s (R2=0.28, P=0.03) at the beginning of the League. CONCLUSIONS With this pilot study, we demonstrated that vitamin D status significantly worsened at the end of the League. Therefore, vitamin D supplementation might be suggested in adult football players in order to prevent vitamin D deficiency and improve the athletic performance.
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Affiliation(s)
- Mariagiovanna Filippella
- Medicine and Rehabilitation Clinical Institute of Aosta, Aosta, Italy.,Unit of Nutrition and Metabolism, Humanitas Gavezzani, Bergamo, Italy
| | - Barbara Altieri
- Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy -
| | - Alberto Falchetti
- EndOsMet Division, Branch of Metabolic Bone Diseases, Villa Donatello Private Hospital, Florence, Italy
| | - Roberta Cosso
- EndOsMet Division, Branch of Metabolic Bone Diseases, Villa Donatello Private Hospital, Florence, Italy
| | - Hellas Cena
- Service of Endocrinology and Bone Metabolism, Disease Hercolani Center of Bologna, Bologna, Italy.,Experimental Medicine and Forensic Unit of Food Sciences, Department of Public Health, University of Pavia, Pavia, Italy
| | - Corrado Musso
- Unit of Neurosurgery, Humanitas of Bergamo, Bergamo, Italy.,Polyclinic of Monza, Monza, Monza e Brianza, Italy
| | - Erica Geronutti
- Medicine and Rehabilitation Clinical Institute of Aosta, Aosta, Italy
| | - Luciano Rassat
- Medicine and Rehabilitation Clinical Institute of Aosta, Aosta, Italy
| | | | - Annamaria Colao
- Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - Carolina Di Somma
- Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
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Zhukouskaya VV, Rothenbuhler A, Colao A, Di Somma C, Kamenický P, Trabado S, Prié D, Audrain C, Barosi A, Kyheng C, Lambert AS, Linglart A. Increased prevalence of overweight and obesity in children with X-linked hypophosphatemia. Endocr Connect 2020; 9:144-153. [PMID: 31910157 PMCID: PMC6993252 DOI: 10.1530/ec-19-0481] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [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: 12/27/2019] [Accepted: 01/07/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND/AIM X-linked hypophosphatemia (XLH) is a rare disease characterized by low phosphate levels. Scientific evidence points to a link between hypophosphatemia and obesity in general population. The aim of our longitudinal observational study was to investigate the prevalence of obesity and associated factors in a large cohort of children with XLH. PATIENTS/METHODS We studied 172 XLH-children 5-20 years of age (113 girls/59 boys). Anthropometric parameters (weight, height, and BMI) were collected at birth and during follow-up at mean ages of 5.3, 8.2, 11.3, and 15.9 years (groups 1, 2, 3, and 4, respectively). In each group, subjects were classified based on International Obesity Taskforce (IOTF) cut off values of BMI for age and sex as overweight or obese (IOTF 25-30 or ≥30 kg/m2, respectively). RESULTS In each age-group, almost 1/3 of XLH-patients were classified as overweight or obese (29.4, 28.7, 27.5, and 36.7% in groups 1, 2, 3, and 4, respectively). Children without a XLH-family history had higher BMI-IOTF at every point of follow-up, compared to those with positive XLH-family history. Similarly, higher BMI-IOTF was significantly associated with treatment duration (23.3 ± 4.4 vs 23.8 ± 3.8 vs 25.2 ± 4.5 kg/m2, for subjects with treatment duration of <5, 5-10 and >10 years, respectively, P for trend = 0.025). Multiple regression analysis confirmed an association of treatment duration and lack of XLH-family history with higher BMI-IOTF. CONCLUSION One out of three of XLH-children have phenotypically unfavourable metabolic profile expressed as increased prevalence of overweight or obesity in comparison to general population. Both the lack of XLH family history and the duration of treatment increase the risk of higher BMI-IOTF. BMI should be carefully monitored in children, and later in adults, with XLH.
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Affiliation(s)
- Volha V Zhukouskaya
- APHP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, FilièreOSCAR and Platform of Expertise for Rare Diseases Paris-Saclay, Bicêtre Paris-Saclay Hospital, Le Kremlin-Bicêtre, France
- Division of Endocrinology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
- Correspondence should be addressed to V V Zhukouskaya:
| | - Anya Rothenbuhler
- APHP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, FilièreOSCAR and Platform of Expertise for Rare Diseases Paris-Saclay, Bicêtre Paris-Saclay Hospital, Le Kremlin-Bicêtre, France
- APHP, Department of Endocrinology and Diabetology for Children, Bicêtre Paris Saclay Hospital, Le Kremlin-Bicêtre, France
| | - Annamaria Colao
- Division of Endocrinology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Carolina Di Somma
- Division of Endocrinology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
- IRCCS SDN, Naples, Italy
| | - Peter Kamenický
- APHP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, FilièreOSCAR and Platform of Expertise for Rare Diseases Paris-Saclay, Bicêtre Paris-Saclay Hospital, Le Kremlin-Bicêtre, France
- APHP, Department of Endocrinology and Reproductive Diseases, Bicêtre Paris-Saclay Hospital, Le Kremlin-Bicêtre, France
- Paris Sud – Paris Saclay University, Faculté de Médecine, Le Kremlin-Bicêtre, France
| | - Séverine Trabado
- Paris Sud – Paris Saclay University, Faculté de Médecine, Le Kremlin-Bicêtre, France
- APHP, Department of Molecular Genetics, Pharmacogenetics and Hormonology, Bicêtre Paris-Saclay Hospital, Le Kremlin-Bicêtre, France
| | - Dominique Prié
- Université Paris V, Faculté de Médecine, Paris, France
- Hôpital Necker EnfantsMalades APHP, INSERM U1151, Paris, France
| | - Christelle Audrain
- APHP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, FilièreOSCAR and Platform of Expertise for Rare Diseases Paris-Saclay, Bicêtre Paris-Saclay Hospital, Le Kremlin-Bicêtre, France
| | - Anna Barosi
- APHP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, FilièreOSCAR and Platform of Expertise for Rare Diseases Paris-Saclay, Bicêtre Paris-Saclay Hospital, Le Kremlin-Bicêtre, France
| | - Christèle Kyheng
- APHP, Department of Adolescent Medicine, Bicêtre Paris Saclay Hospital, Le Kremlin-Bicêtre, France
| | - Anne-Sophie Lambert
- APHP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, FilièreOSCAR and Platform of Expertise for Rare Diseases Paris-Saclay, Bicêtre Paris-Saclay Hospital, Le Kremlin-Bicêtre, France
- APHP, Department of Endocrinology and Diabetology for Children, Bicêtre Paris Saclay Hospital, Le Kremlin-Bicêtre, France
- APHP, Department of Adolescent Medicine, Bicêtre Paris Saclay Hospital, Le Kremlin-Bicêtre, France
| | - Agnès Linglart
- APHP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, FilièreOSCAR and Platform of Expertise for Rare Diseases Paris-Saclay, Bicêtre Paris-Saclay Hospital, Le Kremlin-Bicêtre, France
- APHP, Department of Endocrinology and Diabetology for Children, Bicêtre Paris Saclay Hospital, Le Kremlin-Bicêtre, France
- Paris Sud – Paris Saclay University, Faculté de Médecine, Le Kremlin-Bicêtre, France
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Muscogiuri G, Barrea L, Somma CD, Laudisio D, Salzano C, Pugliese G, de Alteriis G, Colao A, Savastano S. Sex Differences of Vitamin D Status across BMI Classes: An Observational Prospective Cohort Study. Nutrients 2019; 11:nu11123034. [PMID: 31842281 PMCID: PMC6950363 DOI: 10.3390/nu11123034] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 12/02/2019] [Accepted: 12/06/2019] [Indexed: 12/22/2022] Open
Abstract
Growing evidence reported that vitamin D deficiency is a common finding in obesity. Vitamin D status also seems to be sex-related, although little is known regarding this association. Therefore, the aim of this study was to investigate the sex-related differences of serum 25OH vitamin D (25OHD) concentrations across body mass index (BMI) classes and, if there were any differences, whether they could be explained by sex-related differences in body composition. We enrolled 500 subjects (250 males, age 37.4 ± 11.8 years; 250 females, age 36.6 ± 11.8 years). Body composition was assessed by bioelectrical impedance analysis (BIA) phase-sensitive system. Serum 25OHD concentration was quantified by a direct, competitive chemiluminescence immunoassay. Vitamin D deficiency was defined as a serum 25OHD concentrations < 20 ng/mL (50 nmol/L). Stratifying the sample population according to sex and BMI categories, 25OHD concentrations were significantly higher in males compared to females in all BMI classes and decreased along with the increase of BMI values. Females with vitamin D deficiency had higher fat mass (FM) % compared to males with vitamin D deficiency. The 25OHD concentrations inversely correlated with FM % in both sexes. In a multiple regression analysis model, sex, FM %, and BMI were predictive factors of 25OHD concentration. In conclusion, our study suggests that 25OHD concentrations were lower in females than males across all BMI categories. Given the tight correlation between 25OHD concentrations and FM %, it can be hypothesized that the lower 25OHD concentrations in females than males can be explained by the fact that females have a higher amount of fat than males.
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Muscogiuri G, Barrea L, Altieri B, Di Somma C, Bhattoa HP, Laudisio D, Duval GT, Pugliese G, Annweiler C, Orio F, Fakhouri H, Savastano S, Colao A. Calcium and Vitamin D Supplementation. Myths and Realities with Regard to Cardiovascular Risk. Curr Vasc Pharmacol 2019; 17:610-617. [DOI: 10.2174/1570161117666190408165805] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 02/09/2019] [Accepted: 02/20/2019] [Indexed: 01/05/2023]
Abstract
Vitamin D and calcium are considered crucial for the treatment of bone diseases. Both vitamin
D and calcium contribute to bone homeostasis but also preserve muscle health by reducing the risk
of falls and fractures. Low vitamin D concentrations result in secondary hyperparathyroidism and contribute
to bone loss, although the development of secondary hyperparathyroidism varies, even in patients
with severe vitamin D deficiency. Findings from observational studies have shown controversial
results regarding the association between bone mineral density and vitamin D/calcium status, thus
sparking a debate regarding optimum concentrations of 25-hydroxyvitamin D and calcium for the best
possible skeletal health. Although most of the intervention studies reported a positive effect of supplementation
with calcium and vitamin D on bone in patients with osteoporosis, this therapeutic approach
has been a matter of debate regarding potential side effects on the cardiovascular (CV) system. Thus, the
aim of this review is to consider the current evidence on the physiological role of vitamin D and calcium
on bone and muscle health. Moreover, we provide an overview on observational and interventional studies
that investigate the effect of vitamin D and calcium supplementation on bone health, also taking into
account the possible CV side-effects. We also provide molecular insights on the effect of calcium plus
vitamin D on the CV system.
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Affiliation(s)
- Giovanna Muscogiuri
- Endocrinology Unit, Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Medical School of Naples, Naples, Italy
| | - Luigi Barrea
- Endocrinology Unit, Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Medical School of Naples, Naples, Italy
| | - Barbara Altieri
- Endocrinology Unit, Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Medical School of Naples, Naples, Italy
| | | | - Harjit pal Bhattoa
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Daniela Laudisio
- Endocrinology Unit, Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Medical School of Naples, Naples, Italy
| | - Guillaume T. Duval
- Department of Geriatric Medicine, University Memory Center, Research Center on Autonomy and Longevity (CeRAL), Angers University Hospital, Angers, France, School of Medicine and UPRES EA 4638, University of Angers, Angers, France
| | - Gabriella Pugliese
- Endocrinology Unit, Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Medical School of Naples, Naples, Italy
| | - Cédric Annweiler
- Department of Geriatric Medicine, University Memory Center, Research Center on Autonomy and Longevity (CeRAL), Angers University Hospital, Angers, France, School of Medicine and UPRES EA 4638, University of Angers, Angers, France
| | - Francesco Orio
- Department of Sports Science and Wellness, "Parthenope" University Naples, Naples, Italy
| | - Hana Fakhouri
- Department of Biochemistry and Molecular Biology, College of Medicine, Al Faisal University, Riyadh, Saudi Arabia
| | - Silvia Savastano
- Endocrinology Unit, Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Medical School of Naples, Naples, Italy
| | - Annamaria Colao
- Endocrinology Unit, Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Medical School of Naples, Naples, Italy
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Abstract
In patients with acromegaly, chronic GH and IGF-I excess commonly causes a specific cardiomyopathy characterized by a concentric cardiac hypertrophy associated with diastolic dysfunction and, in later stages, with systolic dysfunction ending in heart failure in untreated and uncontrolled patients. Additional relevant cardiovascular complications are represented by arterial hypertension, valvulopathies, arrhythmias, and vascular endothelial dysfunction, which, together with the respiratory and metabolic complications, contribute to the development of cardiac disease and the increase cardiovascular risk in acromegaly. Disease duration plays a pivotal role in the determination of acromegalic cardiomyopathy. The main functional disturbance in acromegalic cardiomyopathy is the diastolic dysfunction, observed in 11% to 58% of patients, it is usually mild, without clinical consequence, and the progression to systolic dysfunction is generally uncommon, not seen or observed in less than 3% of the patients. Consequently, the presence of overt CHF is rare in acromegaly, ranging between 1 and 4%, in patients with untreated and uncontrolled disease. Control of acromegaly, induced by either pituitary surgery or medical therapy improves cardiac structure and performance, limiting the progression of acromegaly cardiomyopathy to CHF. However, when CHF is associated with dilative cardiomyopathy, it is generally not reversible, despite the treatment of the acromegaly.
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Affiliation(s)
- Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, University Federico II, Naples, Italy.
| | - Ludovica F S Grasso
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, University Federico II, Naples, Italy
| | | | - Rosario Pivonello
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, University Federico II, Naples, Italy
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Barrea L, Muscogiuri G, Laudisio D, Di Somma C, Salzano C, Pugliese G, de Alteriis G, Colao A, Savastano S. Phase Angle: A Possible Biomarker to Quantify Inflammation in Subjects with Obesity and 25(OH)D Deficiency. Nutrients 2019; 11:nu11081747. [PMID: 31362440 PMCID: PMC6723101 DOI: 10.3390/nu11081747] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 07/11/2019] [Accepted: 07/24/2019] [Indexed: 12/12/2022] Open
Abstract
Obesity is associated to chronic low-grade metabolic inflammation and hypovitaminosis D. Among extra-skeletal effects, an important role in inflammation has been described for vitamin D (25(OH)D). Phase angle (PhA) is a bioelectrical impedance analysis (BIA) parameter that represents an indicator of cellular health in chronic inflammatory states. However, it is still unknown whether a low 25(OH)D levels might correlate with PhA in obesity. Considering the lack of evidence correlating the 25(OH)D levels with PhA in obesity, the aim of this study was to investigate their possible relationship in a group of patients with obesity stratified according to body mass index (BMI) categories. Four hundred and fifty-five adult subjects (219 males and 236 females; 36 ± 11 years) were enrolled. Body composition, including PhA, was assessed using a BIA phase-sensitive system. Serum levels of 25(OH)D was determined by a direct competitive chemiluminescence immunoassay. Most of the participants were affected by grade III obesity (24%) and had 25(OH)D deficiency (67%). Subjects with 25(OH)D deficiency had highest BMI (p < 0.001). Stratifying the sample population according to the BMI classes, 25(OH)D levels decreased significantly along with the increase in BMI (p < 0.001), with the lowest 25(OH)D levels in the class III obesity. In addition, stratifying the sample population according to 25(OH)D categories, BMI and fat mass (FM) decreased, while PhA increased significantly along with the 25(OH)D categories (p < 0.001). The 25(OH)D levels showed significant positive associations with PhA (r = -0.59, p < 0.001), and this association remained significant also after adjusting for BMI and FM (r = 0.60, p < 0.001). The lowest values of PhA were significantly associated with the severity of obesity (OR 0.3, p < 0.001) and of 25(OH)D deficiency (OR 0.2, p < 0.001). To compare the relative predictive power of body composition parameters associated with the 25(OH)D levels, we performed a multiple linear regression analysis. The most sensitive and specific cut-off for 25(OH)D levels to predict the PhA above the median was >14 ng/mL (p < 0.001). In conclusion, we provided preliminary insights into a novel link between 25(OH)D levels and PhA in the setting of obesity. This association uncovered a new potential usefulness of PhA as expression of cell membrane integrity and predictor of inflammation in low 25(OH)D status that might help in identifying high-risk patients with obesity who could benefit from careful 25(OH)D supplementation.
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Affiliation(s)
- Luigi Barrea
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | - Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Daniela Laudisio
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | | | - Ciro Salzano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Gabriella Pugliese
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Giulia de Alteriis
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
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Barrea L, Annunziata G, Muscogiuri G, Laudisio D, Di Somma C, Maisto M, Tenore GC, Colao A, Savastano S. Trimethylamine N-oxide, Mediterranean diet, and nutrition in healthy, normal-weight adults: also a matter of sex? Nutrition 2019; 62:7-17. [DOI: 10.1016/j.nut.2018.11.015] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 10/30/2018] [Accepted: 11/20/2018] [Indexed: 01/08/2023]
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Zhukouskaya V, Lambert AS, Rothenbuhler A, Colao A, Di Somma C, Kamenicky P, Trabado S, Prié D, Audrain C, Barosi A, Kyheng C, Linglart A. SAT-259 Natural History of Anthropometric Parametres of Obesity in Children Affected by X-Linked Hypophosphatemia: Longitudinal Obserbational Study. J Endocr Soc 2019. [PMCID: PMC6551732 DOI: 10.1210/js.2019-sat-259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Growing body of scientific evidence points to link between fibroblast growth factor-23 (FGF-23) and unfavourable metabolic profile (obesity, insulin resistance, hyperglycemia) and all-cause mortality in general population with normal kidney function. On the other hand, there is little information about metabolic profile in situations characterized by pathophysiologically high FGF-23 such as chronic kidney disease and X-linked hypophosphatemia (XLH). The aim of the present longitudinal observational study was to investigate anthropometric parameters of obesity and metabolic profile on large cohort of children with XLH. Methods: Among 263 XLH-patients registered in our centre we selected 168 children of 5-20 years (108 girls/60 boys). Total period of FU was divided in five sub-periods according age (group 0: birth, N=168; group 1: 5-7 years, N=122; group 2: 7-10 years, N=86; group 3: 10-15 years, N=89; group 4: 15-20 years, N=49). Anthropometric parameters (weight, height, BMI) were collected from birth (group 0) and for every point of FU (group 1-4). In each group, subjects were classified based on International Obesity Taskforce (IOTF) cut off values of BMI for age and sex as overweight or obese (IOTF 25-30 or ≥30 kg/m2, respectively). Metabolic parameters (total cholesterol, triglycerides, HDL, LDL, fasting glycemia and insulinemia, HOMA-IR) were measured at one point of FU in some patients (N=40). Results: In each group of FU (1,2,3,4) almost 1/3 of patients were classified as overweight or obese (29.5% vs 29.4% vs 28.1% vs 36.7%, respectively). Even without reaching statistical significance (p=0.75), there was a tendency of higher number of overweight or obese patients in group 4 (15-20 years) (36.7%) compared to group 1,2,3, which was explained by gender differences (higher number of overweight or obese girls compared to boys (42.4% vs 25%, respectively, p=0.35). There were no differences in BMI z-score (SDS) and BMI-IOTF between groups 1,2,3,4 during FU (BMI-SDS: 0.9±1.1 vs 0.7±1.0 vs 0.6±1.1 vs 0.6±0.9, respectively, p=0.45; BMI-IOTF: 23.5±4.4 vs 23.5±4.1 vs 23.7±4.2 vs 24.3±3.6, respectively, p=0.72). As regard other metabolic parameters, only 1 patient was diagnosed with diabetes mellitus at age 10. No other alterations were found. In each group of FU, no correlation was found between FGF-23 and BMI, total cholesterol, triglycerides, HDL, LDL, fasting glycemia, insulinemia, HOMA-IR. In conclusion, 1/3 of XLH children have phenotypically unfavourable metabolic profile expressed as overweight or obesity which is higher compared to general paediatric population. This phenomenon has increasing tendency after puberty, especially in girls, and requires strict follow-up of BMI in XLH patients. In order to understand the further development of metabolic parameters, the studies on adult XLH population are needed.
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Affiliation(s)
- Volha Zhukouskaya
- Department of Clinical Medicine Surgery, Division Endocrinology, University of Naples Federico II; APHP, Reference Center for Rare Disorders of Calcium Phosphate Metabolism, Platform of expertise for rare diseases Paris-Sud Bicêtre Hospital, France, Naples, , Italy
| | - Anna-Sophie Lambert
- APHP, Department of Endocrinology and Diabetology for children, Bicêtre Paris Sud Hospital, Le Kremlin- Bicêtre, France, Le Kremlin-Bicetre, , France
| | - Anya Rothenbuhler
- SVC PED DU PR BOUGNERES, APHP, Department of Endocrinology and Diabetology for children, Bicêtre Paris Sud Hospital, Le Kremlin-Bicetre, , France
| | - Annamaria Colao
- Medicina Clinica e Chirurgia, Department of Clinical medicine and Surgery, University Federico II of Naples, Napoli, , Italy
| | | | - Peter Kamenicky
- APHP, Department of Endocrinology and Reproductive Diseases, Bicêtre Paris Sud Hospital, Le Kremlin- Bicêtre, , France
| | - Séverine Trabado
- APHP, Department of Molecular Genetics, Pharmacogenetics and Hormonology, Bicêtre Paris-Sud Hospital, Le Kremlin- Bicêtre, , France
| | - Dominique Prié
- Université Paris V, Faculté de Médecine; Hôpital Necker Enfants Malades APHP, INSERM U1151, Paris, , France
| | - Christelle Audrain
- APHP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, Filiere OSCAR and Platform of expertise for rare diseases Paris-Sud, Bicêtre Paris-Sud Hospital, Le Kremlin- Bicêtre, , France
| | - Anna Barosi
- APHP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, Filiere OSCAR and Platform of expertise for rare diseases Paris-Sud, Bicêtre Paris-Sud Hospital, Le Kremlin- Bicêtre, , France
| | - Christèle Kyheng
- APHP, Department of Adolescent Medicine, Bicêtre Paris Sud Hospital, Le Kremlin-Bicetre, , France
| | - Agnes Linglart
- Paris Sud – Paris Saclay University, Faculté de Médecine; APHP, Department of Endocrinology and Diabetology for children, Bicêtre Paris Sud Hospital, Le Kremlin Bicetre, , France
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Muscogiuri G, Barrea L, Di Somma C, Altieri B, Vecchiarini M, Orio F, Spinosa T, Colao A, Savastano S. Patient empowerment and the Mediterranean diet as a possible tool to tackle prediabetes associated with overweight or obesity: a pilot study. Hormones (Athens) 2019; 18:75-84. [PMID: 30644069 DOI: 10.1007/s42000-018-0090-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 12/14/2018] [Indexed: 01/02/2023]
Abstract
AIM The objective of this study was to investigate the effect of implementation of short-term patient empowerment as applied to Mediterranean diet (MD) adherence on metabolic and anthropometric parameters in prediabetic overweight or obese subjects. METHODS The sample included 42 subjects with prediabetes, aged 18-75 years and with body mass index (BMI) > 25 kg/m2, who received dietary advice on MD by nutritionists during session groups every 2 weeks for 4 months. Data on energy caloric intake and macronutrient consumption were collected using a 7-day food diary record. Adherence to MD was investigated through the PREvención con DIeta MEDiterránea (PREDIMED) questionnaire. No advice was given regarding caloric restriction and physical activity. At baseline and at the end of the study, each subject underwent anthropometric, metabolic, and nutritional assessments. RESULTS Approximately 40.5% of subjects had achieved restoration of normal glucose tolerance by the end of the study. Fasting plasma glucose, glycated hemoglobin (HbA1C), BMI, waist circumference, blood pressure, visceral adiposity index, triglycerides, and total and LDL cholesterol levels were significantly decreased, while HDL cholesterol had significantly increased by the end of the study. The subjects significantly increased adherence to MD, as assessed by the PREDIMED questionnaire at follow-up. A reduction of prevalence of the metabolic syndrome was also reported. Interestingly, the PREDIMED score correlated with HbA1C values at follow-up, after adjusting for BMI and total caloric intake. CONCLUSIONS Implementation of short-term patient empowerment as applied to MD adherence was shown to improve anthropometric and metabolic parameters in prediabetic overweight or obese subjects. This is of considerable importance, given that diet must be the cornerstone of treatment in patients at high risk of developing type 2 diabetes.
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Affiliation(s)
- Giovanna Muscogiuri
- Department of Clinical Medicine and Surgery, University "Federico II", Via Sergio Pasini 5, 80121, Naples, Italy.
| | - Luigi Barrea
- Department of Clinical Medicine and Surgery, University "Federico II", Via Sergio Pasini 5, 80121, Naples, Italy
| | | | - Barbara Altieri
- Department of Clinical Medicine and Surgery, University "Federico II", Via Sergio Pasini 5, 80121, Naples, Italy
| | | | | | - Tiziana Spinosa
- U.O. Assistenza Sanitaria di Base ASL Napoli 1 Centro, Naples, Italy
| | - Annamaria Colao
- Department of Clinical Medicine and Surgery, University "Federico II", Via Sergio Pasini 5, 80121, Naples, Italy
| | - Silvia Savastano
- Department of Clinical Medicine and Surgery, University "Federico II", Via Sergio Pasini 5, 80121, Naples, Italy
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Barrea L, Annunziata G, Muscogiuri G, Di Somma C, Laudisio D, Maisto M, de Alteriis G, Tenore GC, Colao A, Savastano S. Trimethylamine-N-oxide (TMAO) as Novel Potential Biomarker of Early Predictors of Metabolic Syndrome. Nutrients 2018; 10:E1971. [PMID: 30551613 PMCID: PMC6316855 DOI: 10.3390/nu10121971] [Citation(s) in RCA: 148] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 12/07/2018] [Accepted: 12/11/2018] [Indexed: 02/07/2023] Open
Abstract
There is a mechanistic link between the gut-derived metabolite trimethylamine-N-oxide (TMAO) and obesity-related diseases, suggesting that the TMAO pathway may also be linked to the pathogenesis of obesity. The Visceral Adiposity Index (VAI), a gender-specific indicator of adipose dysfunction, and the Fatty Liver Index (FLI), a predictor of non-alcoholic fatty liver disease (NAFLD), are early predictors of metabolic syndrome (MetS). In this cross-sectional observational study, we investigated TMAO levels in adults stratified according to Body Mass Index (BMI) and the association of TMAO with VAI and FLI. One hundred and thirty-seven adult subjects (59 males; 21⁻56 years) were enrolled. TMAO levels were detected using HPLC/MS analysis. Homeostatic Model Assessment of Insulin Resistance (HoMA-IR), VAI and FLI were included as cardio-metabolic indices. TMAO levels increased along with BMI and were positively associated with VAI and FLI, independently, on common potential covariates. The most sensitive and specific cut-offs for circulating levels of TMAO to predict the presence of NAFLD-FLI and MetS were ≥8.02 µM and ≥8.74 µM, respectively. These findings allow us to hypothesize a role of TMAO as an early biomarker of adipose dysfunction and NAFLD-FLI in all borderline conditions in which overt MetS is not present, and suggest that a specific cut-off of TMAO might help in identifying subjects at high risk of NAFLD.
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Affiliation(s)
- Luigi Barrea
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | - Giuseppe Annunziata
- Department of Pharmacy, University of Naples "Federico II", Via Domenico Montesano 49, 80131 Naples, Italy.
| | - Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | | | - Daniela Laudisio
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | - Maria Maisto
- Department of Pharmacy, University of Naples "Federico II", Via Domenico Montesano 49, 80131 Naples, Italy.
| | - Giulia de Alteriis
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | - Gian Carlo Tenore
- Department of Pharmacy, University of Naples "Federico II", Via Domenico Montesano 49, 80131 Naples, Italy.
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
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Muscogiuri G, Barrea L, Annunziata G, Vecchiarini M, Orio F, Di Somma C, Colao A, Savastano S. Water intake keeps type 2 diabetes away? Focus on copeptin. Endocrine 2018; 62:292-298. [PMID: 30027433 DOI: 10.1007/s12020-018-1680-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 01/23/2018] [Accepted: 07/09/2018] [Indexed: 12/11/2022]
Abstract
INTRODUCTION In both diabetic subjects and animal models high levels of vasopressin (AVP) have beendetected. The relationship between AVP and glucose metabolism is mediated through several direct andindirect effects and most of them are still unknown. METHODS We have reviewed 100 manuscripts retrieved from Cochrane Library, Embase and Pubmeddatabases in order to highlight a possible relationship between copeptin and type 2 diabetes and to provideinsights on the molecular mechanism that could explain this association. RESULTS AND CONCLUSIONS AVP potentiates CRH action at pituitary level resulting in an increased ACTH secretion and in turn in an increased cortisol secretion that escapes the negative feedback loop. Further, AVP regulates insulin and glucagon secretion through V1b receptor and promotes hepatic glycogenolysis and gluconeogenesis through V1a receptor. In addition to worsen glucose metabolism, AVP has been reported to have a role in the pathogenesis of diabetic complications such as cardiovascular diseases, kidney and ocular complications. Due to the very low concentration of AVP in the blood, the small size and poor stability, the assay of AVP is very difficult to perform. Thus, copeptin, the stable C-terminal portion of the prepro-vasopressin peptide has been identified as an easier assay to be measured and that mirrors AVP activity. Although there are promising evidence that copeptin could be involved in the pathogenesis of type 2 diabetes, further studies need to demonstrate the importance of copeptin as clinical marker to predict glucose metabolism derangements.
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Affiliation(s)
- Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy.
| | - Luigi Barrea
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy
| | - Giuseppe Annunziata
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy
| | | | - Francesco Orio
- Dipartimento di Scienze Motorie e del Benessere, Università Partenope di Napoli, Naples, Italy
| | | | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy
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Muscogiuri G, Barrea L, Annunziata G, Di Somma C, Laudisio D, Colao A, Savastano S. Obesity and sleep disturbance: the chicken or the egg? Crit Rev Food Sci Nutr 2018; 59:2158-2165. [PMID: 30335476 DOI: 10.1080/10408398.2018.1506979] [Citation(s) in RCA: 104] [Impact Index Per Article: 17.3] [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: 12/17/2022]
Abstract
Epidemiological studies suggested an association between obesity and sleep disturbances. Obstructive sleep apnea is the most prevalent type of obesity-related sleep disorder that lead to an increased risk for numerous chronic health conditions. In addition the increased visceral adipose tissue might be responsible for the secretion of inflammatory cytokines that could contribute to alter the sleep-wake rhythm. Unhealthy food characterized by high consumption of fat and carbohydrate seems to negatively influence the quality of sleep while diet rich of fiber is associated to more restorative and deeper sleep. Although obesity could cause through several pathogenetic mechanisms an alteration of sleep, it has been reported that subjects suffering from sleep disorders are more prone to develop obesity. Experimental laboratory studies have demonstrated that decreasing either the amount or quality of sleep increase the risk of developing obesity. Experimental sleep restriction also causes physiological, hormonal and food behavioral changes that promote a positive energy balance and a compensatory disproportionate increase in food intake, decrease in physical activity, and weight gain. Thus, the aim of this review is to provide observational evidence on the association of obesity with sleep disturbances and viceversa with emphasis on possible pathophysiological mechanisms (hormonal and metabolic) that link these two pathological conditions.
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Affiliation(s)
- Giovanna Muscogiuri
- a Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology , Federico II University Medical School of Naples , Naples , Italy
| | - Luigi Barrea
- a Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology , Federico II University Medical School of Naples , Naples , Italy
| | - Giuseppe Annunziata
- a Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology , Federico II University Medical School of Naples , Naples , Italy
| | | | - Daniela Laudisio
- a Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology , Federico II University Medical School of Naples , Naples , Italy
| | - Annamaria Colao
- a Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology , Federico II University Medical School of Naples , Naples , Italy
| | - Silvia Savastano
- a Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology , Federico II University Medical School of Naples , Naples , Italy
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Barrea L, Muscogiuri G, Di Somma C, Tramontano G, De Luca V, Illario M, Colao A, Savastano S. Association between Mediterranean diet and hand grip strength in older adult women. Clin Nutr 2018; 38:721-729. [PMID: 29643004 DOI: 10.1016/j.clnu.2018.03.012] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 03/07/2018] [Accepted: 03/17/2018] [Indexed: 01/14/2023]
Abstract
BACKGROUND & AIMS Mediterranean Diet (MD) is an eating pattern associated with multiple healthy benefits, including the conservation of skeletal muscle. Frailty is a major geriatric syndrome characterized by low muscle strength. The Hand Grip Strength (HGS) is the most frequently used indicator of muscle functional capacity for clinical purposes. The association between the adherence to the MD and HGS in elderly has not yet fully investigated. The goal of this study was to examine the association between the adherence to the MD and HGS in a not hospitalized elderly who participated in the project PERsonalised ict Supported Services for Independent Living and Active Ageing (PERSSILAA). METHODS Eighty-four elderly women were consecutively enrolled (aged 60-85 years) in this cross-sectional observational study. Anthropometric measures were evaluated. A validated 14-item questionnaire PREDIMED (PREvención con DIeta MEDiterránea) was used for the assessment of adherence to the MD. Dietary data were collected by a 7-day food records. Muscle strength was measured by HGS using a grip strength dynamometer (KERN & SOHN GmbH). RESULTS The majority of participants were overweight (46.4%). An average adherence to the MD was found in 52.4% of participants, while the minority of them showed a low adherence (21.4%). HGS > cut-point of 20 kg were found in 43 subjects (51.2%). According to the adherence to MD, 39% participants with HGS values higher than cut-point presented a high adherence score compared with 14% of those with lower values of HGS (p = 0.018). The participants with HGS > cut-point presented significantly higher PREDIMED score than those with HGS < cut-point (p < 0.001). Based on ROC curves, the most sensitive and specific cut-point for the PREDIMED score to predict HGS categories was ≥8. No evident correlations were observed between HGS and age, while HGS was negatively correlated with hip circumference (r = -0.233, p = 0.033) and BMI (r = -0.219, p = 0.045), and positively correlated with PREDIMED score (r = 0.598, p < 0.001). At binomial logistic regression analysis almost all 14-items of PREDIMED questionnaire were significantly associated with HGS adjusted for BMI. At multinomial logistic regression analysis to assess the association of the three classes of adherence to the MD with the HGS, after adjusting for BMI the lowest adherence to MD was associated with the lowest Odds Ratio of HGS (p < 0.001). CONCLUSIONS This study evidenced a positive association between the adherence to the MD and muscle strength in a sample of active elderly women, stratified according to the HGS > cut-point of 20 kg. Our study highlights the usefulness of the developing health services to detect and prevent age-associated decline in physical performance in elderly subjects by addressing nutritional and physical intervention.
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Affiliation(s)
- Luigi Barrea
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | - Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | | | - Giovanni Tramontano
- Research and Development Unit, Federico II University Hospital, Via Sergio Pansini 5, 80131 Naples, Italy.
| | - Vincenzo De Luca
- Research and Development Unit, Federico II University Hospital, Via Sergio Pansini 5, 80131 Naples, Italy.
| | | | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
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Barrea L, Muscogiuri G, Di Somma C, Annunziata G, Megna M, Falco A, Balato A, Colao A, Savastano S. Coffee consumption, metabolic syndrome and clinical severity of psoriasis: good or bad stuff? Arch Toxicol 2018; 92:1831-1845. [PMID: 29594327 DOI: 10.1007/s00204-018-2193-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [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: 12/14/2017] [Accepted: 03/20/2018] [Indexed: 12/20/2022]
Abstract
Despite the wide consumption of coffee, its anti-inflammatory effect on clinical severity of psoriasis is still debatable. The aim of this study was to evaluate the association between the coffee consumption and clinical severity of psoriasis in a sample of patients stratified according to the presence of the metabolic syndrome (MetS) and smoking. This cross-sectional case-control observational study was conducted on 221 treatment-naïve psoriatic patients. Lifestyle habits, anthropometric measures, clinical and biochemical evaluations were obtained. Clinical severity of psoriasis was assessed by Psoriasis Area and Severity Index (PASI) score. Data on energy caloric intake and coffee consumption were collected using a 7-day food diary record. The coffee consumption was analyzed as coffee intake (consumers and non-consumers) and daily servings (range 0-4 servings/day). Coffee consumers have a lower PASI score vs non-consumers (p < 0.001). The lowest PASI score and MetS prevalence were found in patients consuming 3 cups of coffee/day (p < 0.001), which was also the most common daily serving (34.8%), whereas the highest PASI score was found among those drinking ≥ 4 cups/day. Grouping the case patients according to smoking and MetS, the best odds of PASI score was observed in those drinking 3 cups of coffee per day and no smokers, after adjusting for total energy intake (OR 74.8; p < 0.001). As a novel finding, we reported a negative association between coffee intake, MetS prevalence and clinical severity of psoriasis. The evaluation of the anti-inflammatory effect of coffee on clinical severity of psoriasis, whose metabolic risk increases along with its clinical severity, could be of great importance from a public health perspective.
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Affiliation(s)
- Luigi Barrea
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy.
| | - Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
| | | | - Giuseppe Annunziata
- Department of Pharmacy, University of Naples 'Federico II', Via D. Montesano 49, 80131, Naples, Italy
| | - Matteo Megna
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Dermatology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Andrea Falco
- IOS & COLEMAN, Medicina Futura Medical Center, Via Alcide De Gasperi, 107,109,111, Acerra, 80011, Naples, Italy
| | - Anna Balato
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Dermatology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
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Pivonello R, Di Somma C, Colao A. Cardiovascular risk after cessation of growth hormone treatment in people born small for gestational age. Lancet Diabetes Endocrinol 2017; 5:930-932. [PMID: 29102565 DOI: 10.1016/s2213-8587(17)30323-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 09/04/2017] [Indexed: 11/19/2022]
Affiliation(s)
- Rosario Pivonello
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy.
| | | | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy
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Barrea L, Di Somma C, Muscogiuri G, Tarantino G, Tenore GC, Orio F, Colao A, Savastano S. Nutrition, inflammation and liver-spleen axis. Crit Rev Food Sci Nutr 2017; 58:3141-3158. [DOI: 10.1080/10408398.2017.1353479] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Luigi Barrea
- I.O.S. & COLEMAN Srl, Medicina Futura Medical Center, Acerra, Naples, Italy
| | | | | | - Giovanni Tarantino
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University Medical School of Naples, Via Sergio Pansini 5, Naples, Italy
| | - Gian Carlo Tenore
- Department of Pharmacy, University of Naples “Federico II”, Via D. Montesano 49, Naples, Italy
| | - Francesco Orio
- Department of Sports Science and Wellness, Unit of Endocrinology, “Parthenope” University of Naples, Via Ammiraglio Ferdinando Acton 38, Naples, Italy
- Via Ammiraglio Ferdinando Acton 38, Naples, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, Naples, Italy
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, Naples, Italy
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Abstract
Psoriasis is a chronic immune-mediated inflammatory skin disease. Psoriasis lesions are characterized by hyper-proliferation of epidermal keratinocytes associated with inflammatory cellular infiltrate in both dermis and epidermis. The epidermis is the natural source of vitamin D synthesis by sunlight action. Recently, a role for vitamin D in the pathogenesis of different skin diseases, including psoriasis, has been reported. Indeed, significant associations between low vitamin D status and psoriasis have been systematically observed. Due to its role in proliferation and maturation of keratinocytes, vitamin D has become an important local therapeutic option in the treatment of psoriasis. To date, the successful treatment based on adequate dietary intake of vitamin D or oral vitamin D supplementation in psoriasis represent an unmet clinical need and the evidence of its beneficial effects remains still controversial. This information is important either for Dermatologists and Nutritionists to increases the knowledge on the possible bi-directional relationships between low vitamin D status and psoriasis and on the potential usefulness of vitamin D in psoriasis with the aim not only to reduce its clinical severity, but also for delineating the risk profile for co-morbidities cardiac risk factors that may result from psoriasis. In the current review, we analyzed the possible bi-directional links between psoriatic disease and vitamin D.
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Affiliation(s)
- Luigi Barrea
- I.O.S. & COLEMAN Srl, Acerra, 80011 Naples, Italy
| | | | | | - Maddalena Napolitano
- Dipartimento di Medicina e Scienze della Salute “Vincenzo Tiberio”, Rheumatology Unit, University of Molise, Via Francesco De Sanctis 1, 86100 Campobasso, Italy
| | - Matteo Megna
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Dermatology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
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Abstract
Low vitamin D status and obesity have concomitantly reached epidemic levels worldwide. Up to now the direction of the association between low vitamin D status and obesity, the exact mechanisms responsible for this association and the clinical usefulness to increase vitamin D status for reducing adiposity still warrant further evaluation. The aim of the present review was to examine the current evidence linking low vitamin D status and obesity in relation to the role of the nutritionist. On the one side, considering obesity as a causal factor, low sun exposure in obese individuals due to their sedentary lifestyle and less outdoor activity, vitamin D sequestration in adipose tissue, and volumetric dilution of ingested or cutaneously synthesized vitamin D3 in the large fat mass of obese patients, might represent some of the factors playing a major role in the pathogenesis of the low vitamin D status. On the other side, the expression of both vitamin D3 receptors and enzymes responsible for vitamin D3 metabolism in adipocytes depicted a role for the low vitamin D status per se in the development of obesity by modulating adipocyte differentiation and lipid metabolism. Nutritionists need to accurately address the aspects influencing the low vitamin D status in obesity and the vitamin D supplementation in obese individuals.
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Affiliation(s)
- Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Luigi Barrea
- I.O.S. & COLEMAN Srl, 80011 Acerra, Naples, Italy
| | | | | | | | - Francesco Orio
- Department of Sports Science and Wellness, "Parthenope" University of Naples, Naples, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy.
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Abstract
The aim of this review is to provide a general overview of the possible associations among the vitamin D status, air pollution and obesity. Sunlight exposure accounts in humans for more than 90 % of the production of vitamin D. Among emerging factors influencing sunlight-induced synthesis of vitamin D, prospective and observational studies proved that air pollution constitutes an independent risk factor in the pathogenesis of vitamin D hypovitaminosis. In addition, environmental pollutants can affect risk of obesity when inhaled, in combination with unhealthy diet and lifestyle. In turn, obesity is closely associated with a low vitamin D status and many possible mechanisms have been proposed to explain this association. The associations of air pollution with low vitamin D status on the hand and with obesity on the other hand, could provide a rationale for considering obesity as a further link between air pollution and low vitamin D status. In this respect, a vicious cycle could operate among low vitamin D status, air pollution, and obesity, with additive detrimental effects on cardio-metabolic risk in obese individuals. Besides vitamin D supplementation, nutrient combination, used to maximize the protective effects against air pollution, might also contribute to improve the vitamin D status by attenuating the "obesogen" effects of air pollution.
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Affiliation(s)
- Luigi Barrea
- I. O.S. & COLEMAN Srl, 80011 Acerra, Naples, Italy
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | | | | | | | - Lidia Albanese
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Francesco Orio
- Department of Sports Science and Wellness, “Parthenope” University of Naples, Naples, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
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Savanelli MC, Barrea L, Macchia PE, Savastano S, Falco A, Renzullo A, Scarano E, Nettore IC, Colao A, Di Somma C. Preliminary results demonstrating the impact of Mediterranean diet on bone health. J Transl Med 2017; 15:81. [PMID: 28438173 PMCID: PMC5404307 DOI: 10.1186/s12967-017-1184-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 04/14/2017] [Indexed: 02/08/2023] Open
Abstract
Background Nutrition is an environmental factor affecting bone health. Nutrition is considered essential to achieve and maintain optimal bone mass. Mediterranean diet (MD) has shown to prevent bone disease. Aim of this study is to investigate the relationship between bone health status and adherence the MD. Methods Four-hundred eighteen healthy people (105 males and 313 females, age 50 ± 14 years) were recruited in the outdoor hospital of the “Campus Salute Onlus” held in Piazza del Plebiscito in Naples, October 17–20th 2013 and 09–11th October 2014. All subjects underwent clinical assessment, calcaneal quantitative ultrasound (QUS) scanner and PREvención con DIeta MEDiterránea (PREDIMED) questionnaire. Results Globally, prevalence of osteoporosis and osteopenia were 7.7 and 46.0%, respectively. The majority of subjects (60.5%) had an average score (score 6–9) of adherence to MD. The T-score showed positive correlation with PREDIMED score (r = 0.250, p < 0.001). The higher T-scores were positively associated with a higher consumption of extra-virgin olive oil (EVOO), vegetables, fruits, legumes, and fish and negatively associated with consumption of red meat. The higher T-scores were positively associated with the highest odds of PREDIMED scores (higher adherence) (OR 6.91, IC 6.27–7.61, p < 0.001). Multiple regression analysis models indicated that, among the single food items investigated, high T-score can be predicted by consumption of EVOO (p < 0.001), fish (p < 0.001) and fruit (p = 0.002) intake. A PREDIMED score of 3 was found to be predictive for a low T-score (α = 0.05, R-squared index = 0.417). Conclusions The results demonstrate a positive correlation between bone health status and adherence to MD, suggesting that a high adherence to MD promotes bone health. The observations here reported confirmed that a specific dietary approach, such as MD, can represent a modifiable environmental factor for osteoporosis’ prevention.
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Affiliation(s)
| | - Luigi Barrea
- I.O.S. & COLEMAN Srl, Acerra, 80011, Naples, Italy
| | - Paolo Emidio Macchia
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Napoli, Via Sergio Pansini 5, 80131, Naples, Italy.
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Napoli, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Andrea Falco
- I.O.S. & COLEMAN Srl, Acerra, 80011, Naples, Italy
| | - Andrea Renzullo
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Napoli, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Elisabetta Scarano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Napoli, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Immacolata Cristina Nettore
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Napoli, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Napoli, Via Sergio Pansini 5, 80131, Naples, Italy
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Barrea L, Muscogiuri G, Macchia PE, Di Somma C, Falco A, Savanelli MC, Colao A, Savastano S. Mediterranean Diet and Phase Angle in a Sample of Adult Population: Results of a Pilot Study. Nutrients 2017; 9:E151. [PMID: 28218645 PMCID: PMC5331582 DOI: 10.3390/nu9020151] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 02/03/2017] [Accepted: 02/07/2017] [Indexed: 01/10/2023] Open
Abstract
The Mediterranean diet is a healthy dietary pattern known to actively modulate the cell membrane properties. Phase angle (PhA) is a direct measure by Bioelectrical Impedance Analysis (BIA) used as marker of cell membrane integrity. Both food behaviour and PhA are influenced by age, sex and body weight. The aim of this study was to cross-sectionally evaluate the association between the adherence to Mediterranean diet and PhA in 1013 healthy adult patients stratified according to sex, age, and body mass index (BMI). The adherence to the Mediterranean diet was evaluated using the PREvención con DIeta MEDiterránea (PREDIMED) questionnaire. PhA was calculated by BIA phase-sensitive system (50 kHz BIA 101 RJL, Akern Bioresearch, Florence, Italy Akern). In both sexes, at ROC analysis a PREDIMED score ≥ 6 predicted a PhA beyond the median value. At the multivariate analysis, among PREDIMED score, age, and BMI, the PREDIMED score was the major determinant of PhA, explaining 44.5% and 47.3% of PhA variability, in males and females respectively (p < 0.001). A novel association was reported between the adherence to the Mediterranean diet and PhA, independently of sex, age, and body weight. This association uncovered a new potential benefit of the Mediterranean diet on health outcomes, as in both sexes higher adherence to the Mediterranean diet was associated to larger PhAs, as expression of cell membrane integrity.
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Affiliation(s)
- Luigi Barrea
- I.O.S. COLEMAN Srl, Acerra, 80011 Naples, Italy.
| | | | - Paolo Emidio Macchia
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | | | - Andrea Falco
- I.O.S. COLEMAN Srl, Acerra, 80011 Naples, Italy.
| | | | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
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Abstract
There is a growing body of evidence indicating that patients with adult GH deficiency (GHD) are characterized by a cluster of traditional and emerging cardiovascular risk factors and markers, which can significantly increase their cardiovascular morbidity and mortality possibly linked to aberrations in GH status. Patients with adult GHD present multiple different cardiovascular abnormalities. In addition, cardiovascular risk in adult GHD is increased due to altered body composition, abnormal lipid profile, insulin resistance and impaired glucose metabolism. Cardiovascular risk factors can be reversed, at least partially, after GH replacement. However, evidence on the effects of GH replacement on cardiovascular events and mortality is too limited in adult GHD patients. Aim of this review is to provide an at-a-glance overview of the role of the GH/IGF-I on the cardiovascular system and the state of art of the effects of GH replacement on cardiovascular system.
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Affiliation(s)
| | - Elisabetta Scarano
- Dipartimento di Medicina Clinica e Chirurgia, Divisione di Endocrinologia, Università "Federico II", Napoli, Italy.
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Divisione di Endocrinologia, Università "Federico II", Napoli, Italy.
| | | | - Rosario Pivonello
- Dipartimento di Medicina Clinica e Chirurgia, Divisione di Endocrinologia, Università "Federico II", Napoli, Italy.
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Divisione di Endocrinologia, Università "Federico II", Napoli, Italy.
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Neglia C, Argentiero A, Chitano G, Agnello N, Ciccarese R, Vigilanza A, Pantile V, Argentiero D, Quarta R, Rivezzi M, Di Tanna GL, Di Somma C, Migliore A, Iolascon G, Gimigliano F, Distante A, Piscitelli P. Diabetes and Obesity as Independent Risk Factors for Osteoporosis: Updated Results from the ROIS/EMEROS Registry in a Population of Five Thousand Post-Menopausal Women Living in a Region Characterized by Heavy Environmental Pressure. Int J Environ Res Public Health 2016; 13:ijerph13111067. [PMID: 27809297 PMCID: PMC5129277 DOI: 10.3390/ijerph13111067] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 10/19/2016] [Accepted: 10/24/2016] [Indexed: 11/16/2022]
Abstract
Objectives: We aimed to analyze bone mineralization and the effect of different risk factors for osteoporosis in postmenopausal women. Methods: We found 4909 postmenopausal subjects within ≥10,000 records from the ROIS/EMEROS (Ionian and Salento Osteoporosis Registry/Euro Mediterranean Registry of Osteoporosis) registry, a population study carried out in an area characterized by heavy environmental pressure between Brindisi and Taranto from 2009 to 2016. All subjects were assessed via phalangeal quantitative ultrasound (QUS) to evaluate their bone mineralization (assessed via amplitude dependent speed of sound (AD-SoS)) and the association between demineralization and the presence of other conditions or risk factors. Results: Mean age was 64 ± 9.5 years and mean body mass index (BMI) was 28.7 ± 3.5 kg/m². Pearson correlation analyses revealed a negative association between bone mineralization (AD-SoS) and BMI (p < 0.001). By using multivariate logistic regression analysis, we observed significant values of odds ratios (ORs) of osteoporosis (adjusted for age, physical activity, and the use of drugs known to increase the risk of fractures) in subjects with diabetes and obesity: 1.39 (confidence interval (CI): 1.05-1.83) and 1.46 (CI: 1.20-1.78), respectively. A statistically significant linear trend of higher ORs of osteoporosis was found for increasing values of BMI. Conclusions: Our study confirmed the high impact of obesity and type 1 and type 2 diabetes on osteoporosis.
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Affiliation(s)
- Cosimo Neglia
- ISBEM (Istituto Scientifico Biomedico Euro Mediterraneo), Brindisi 72100, Italy.
| | - Alberto Argentiero
- ISBEM (Istituto Scientifico Biomedico Euro Mediterraneo), Brindisi 72100, Italy.
| | - Giovanna Chitano
- ISBEM (Istituto Scientifico Biomedico Euro Mediterraneo), Brindisi 72100, Italy.
| | - Nadia Agnello
- ISBEM (Istituto Scientifico Biomedico Euro Mediterraneo), Brindisi 72100, Italy.
| | - Roberta Ciccarese
- ISBEM (Istituto Scientifico Biomedico Euro Mediterraneo), Brindisi 72100, Italy.
| | - Antonella Vigilanza
- ISBEM (Istituto Scientifico Biomedico Euro Mediterraneo), Brindisi 72100, Italy.
| | - Valerio Pantile
- ISBEM (Istituto Scientifico Biomedico Euro Mediterraneo), Brindisi 72100, Italy.
| | - Domenico Argentiero
- ISBEM (Istituto Scientifico Biomedico Euro Mediterraneo), Brindisi 72100, Italy.
| | - Raffaele Quarta
- ISBEM (Istituto Scientifico Biomedico Euro Mediterraneo), Brindisi 72100, Italy.
| | - Matteo Rivezzi
- IOS, Southern Italy Hospital Institute, Medicina Futura Research, Naples 80100, Italy.
| | - Gian Luca Di Tanna
- Centre for Primary Care and Public Health, Queen Mary University of London, London E1 4NS, UK.
| | - Carolina Di Somma
- IRCCS SDN Istituto di Ricerca Diagnostica e Nucleare, Naples 80133, Italy.
| | | | - Giovanni Iolascon
- Department of Orthopaedic Surgery and Rehabilitation, Second University of Naples, Naples 81100, Italy.
| | - Francesca Gimigliano
- Department of Orthopaedic Surgery and Rehabilitation, Second University of Naples, Naples 81100, Italy.
| | - Alessandro Distante
- ISBEM (Istituto Scientifico Biomedico Euro Mediterraneo), Brindisi 72100, Italy.
| | - Prisco Piscitelli
- IOS, Southern Italy Hospital Institute, Medicina Futura Research, Naples 80100, Italy.
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Nappi F, Barrea L, Di Somma C, Savanelli MC, Muscogiuri G, Orio F, Savastano S. Endocrine Aspects of Environmental "Obesogen" Pollutants. Int J Environ Res Public Health 2016; 13:ijerph13080765. [PMID: 27483295 PMCID: PMC4997451 DOI: 10.3390/ijerph13080765] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Revised: 07/11/2016] [Accepted: 07/19/2016] [Indexed: 12/12/2022]
Abstract
Growing evidence suggests the causal link between the endocrine-disrupting chemicals (EDCs) and the global obesity epidemics, in the context in the so-called “obesogenic environment”. Dietary intake of contaminated foods and water, especially in association with unhealthy eating pattern, and inhalation of airborne pollutants represent the major sources of human exposure to EDCs. This is of particular concern in view of the potential impact of obesity on chronic non-transmissible diseases, such as type 2 diabetes, cardiovascular disease, and hormone-sensitive cancers. The key concept is the identification of adipose tissue not only as a preferential site of storage of EDCs, but also as an endocrine organ and, as such, susceptible to endocrine disruption. The timing of exposure to EDCs is critical to the outcome of that exposure, with early lifetime exposures (e.g., fetal or early postnatal) particularly detrimental because of their permanent effects on obesity later in life. Despite that the mechanisms operating in EDCs effects might vary enormously, this minireview is aimed to provide a general overview on the possible association between the pandemics of obesity and EDCs, briefly describing the endocrine mechanisms linking EDCs exposure and latent onset of obesity.
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Affiliation(s)
| | | | | | | | | | - Francesco Orio
- Department of Sports Science and Wellness, "Parthenope" University of Naples, 80133 Naples, Italy.
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
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Barrea L, Nappi F, Di Somma C, Savanelli MC, Falco A, Balato A, Balato N, Savastano S. Environmental Risk Factors in Psoriasis: The Point of View of the Nutritionist. Int J Environ Res Public Health 2016; 13:ijerph13070743. [PMID: 27455297 PMCID: PMC4962284 DOI: 10.3390/ijerph13070743] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Revised: 07/01/2016] [Accepted: 07/19/2016] [Indexed: 12/16/2022]
Abstract
Psoriasis is a common, chronic, immune-mediated skin disease with systemic pro-inflammatory activation, where both environmental and genetic factors contribute to its pathogenesis. Among the risk factors for psoriasis, evidence is accumulating that nutrition plays a major role, per se, in psoriasis pathogenesis. In particular, body weight, nutrition, and diet may exacerbate the clinical manifestations, or even trigger the disease. Understanding the epidemiological relationship between obesity and psoriasis is also important for delineating the risk profile for the obesity-related comorbidities commonly found among psoriatic patients. Moreover, obesity can affect both drug’s pharmacokinetics and pharmacodynamics. Additionally, the overall beneficial effects on the obesity-associated comorbidities, clinical recommendations to reduce weight and to adopt a healthy lifestyle could improve the psoriasis severity, particularly in those patients with moderate to severe disease, thus exerting additional therapeutic effects in the conventional treatment in obese patients with psoriasis. Education regarding modifiable environmental factors is essential in the treatment of this disease and represents one of the primary interventions that can affect the prognosis of patients with psoriasis. The goal is to make psoriatic patients and health care providers aware of beneficial dietary interventions. The aim of this review is to assess the relevance of the environmental factors as modifiable risk factors in psoriasis pathogenesis, with particular regard to the involvement of obesity and nutrition in the management of psoriasis, providing also specific nutrition recommendations.
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Affiliation(s)
| | | | | | | | | | - Anna Balato
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Dermatology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | - Nicola Balato
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Dermatology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
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Barrea L, Macchia PE, Di Somma C, Napolitano M, Balato A, Falco A, Savanelli MC, Balato N, Colao A, Savastano S. Bioelectrical phase angle and psoriasis: a novel association with psoriasis severity, quality of life and metabolic syndrome. J Transl Med 2016; 14:130. [PMID: 27165166 PMCID: PMC4863378 DOI: 10.1186/s12967-016-0889-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 04/29/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Obesity, metabolic syndrome (MetS), and psoriasis, largely driven by environmental factors, show multiple bidirectional associations, with important metabolic implications in psoriatic patients. Besides body mass index (BMI) as a measure of obesity, data on phase angle (PhA), a direct measure by bioelectrical impedance analysis (BIA), used as a marker of cellular health and a predictor of morbidity and mortality in various diseases, are still lacking in psoriasis. In this case-control, cross-sectional study, we investigated the PhA in 180 pairs of adult psoriatic patients and healthy controls, evaluating also the potential use of the PhA as marker of the clinical severity, the quality of life, and the presence of the MetS in psoriatic patients. METHODS Anthropometric measures, metabolic profile and bioelectrical variables were evaluated. The clinical severity was assessed by standardized psoriasis area and severity index (PASI) score and c-reactive protein (CRP) levels, and the quality of life was evaluated by dermatology life quality index (DLQI). MetS was diagnosed according to Adult Treatment Panel III. RESULTS Psoriatic patients presented smaller PhA (p < 0.001) and higher prevalence MetS compared with controls. The PhA was significantly associated with number of parameters of MetS in both groups (p < 0.001). After adjusting for BMI, this association remained significant in psoriatic patients only (p < 0.001). Among psoriatic patients, the PhA was the major index value for the diagnosis of MetS (OR 5.87, 95 % CI 5.07-6.79) and was inversely associated with both PASI score and DLQI, independently of BMI (p < 0.001). At multiple regression analysis, the PhA well predicted the PASI score and DLQI. Based on ROC curves, the most sensitive and specific cutoffs of PhA to predict the highest PASI score and the lowest DQLI were ≤4.8° and ≤4.9°, respectively. CONCLUSIONS We reported that psoriatic patients presented small PhAs, with a novel association between PhA, clinical severity, quality of life in psoriatic patients, and MetS. Further studies are required to validate the PhA's prognostic ability in assessing the clinical severity and MetS in psoriatic patients.
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Affiliation(s)
| | - Paolo Emidio Macchia
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
| | | | - Maddalena Napolitano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Dermatology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Anna Balato
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Dermatology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
| | | | | | - Nicola Balato
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Dermatology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
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Maione L, Cantone E, Nettore IC, Cerbone G, De Brasi D, Maione N, Young J, Di Somma C, Sinisi AA, Iengo M, Macchia PE, Pivonello R, Colao A. Flavor perception test: evaluation in patients with Kallmann syndrome. Endocrine 2016. [PMID: 26209039 DOI: 10.1007/s12020-015-0690-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [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] [Indexed: 11/29/2022]
Abstract
In Kallmann syndrome (KS), congenital hypogonadism is associated with olfactory impairment. To evaluate flavor perception-related disability in KS patients, 30 patients with KS, 12 with normosmic hypogonadism (nIHH), 24 with acquired anosmia (AA), and 58 healthy controls entered the study. All participants completed questionnaires concerning dietary habits, olfaction-related quality of life (QoL), and self-determined olfactory, flavor, and taste abilities prior to undergoing standardized olfactometry and gustometry. Each subject underwent flavor testing, using orally administered aqueous aromatic solutions, identifying 21 different compounds by choosing each out of 5 alternative items. Flavor score (FS) was calculated as the sum of correct answers (range 0-21). Flavor perception by self-assessment was similar between KS, nIHH, and controls, and was mostly reduced only in AA. FS was similar between KS (5.4 ± 1.4) and AA (6.4 ± 1.9), and lower than in nIHH (16.2 ± 2.4, p < 0.001) and controls (16.8 ± 1.7, p < 0.0001). FS showed strong reproducibility, and correlated with olfactory scores in the overall population. KS and AA patients identified aromatics eliciting trigeminal stimulation better than pure odorants. Olfaction-related QoL was more impaired in AA than in KS. We report significant flavor impairment in KS. This contrasts with routine clinic evidence; KS patients, in contrast with AA, do not complain of flavor perception impairment, perhaps owing to the congenital nature of the dysfunction. Flavor perception impairment should be considered a specific KS disability, because of important detrimental effects on physical and mental health and on QoL. KS patients should also be advised of this impairment in order to prevent accidental and life-threatening events.
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Affiliation(s)
- Luigi Maione
- Dipartimento di Medicina Clinica e Chirurgia, Area Funzionale di Endocrinologia, Università degli Studi di Napoli Federico II, 80131, Naples, Italy.
| | - Elena Cantone
- Dipartimento di Neuroscienze e Scienze Riproduttive ed Odontostomatologiche, UOC di Otorinolaringoiatria, Università degli Studi di Napoli Federico II, 80131, Naples, Italy
| | - Immacolata Cristina Nettore
- Dipartimento di Medicina Clinica e Chirurgia, Area Funzionale di Endocrinologia, Università degli Studi di Napoli Federico II, 80131, Naples, Italy
| | - Gaetana Cerbone
- Dipartimento Materno Infantile, U.O. Genetica Medica, L'Azienda Ospedaliera di Rilievo Nazionale e di Alta Specialità San Giuseppe Moscati, 83100, Avellino, Italy
| | - Davide De Brasi
- Dipartimento dei Servizi A.O.R.N. Antonio Cardarelli, Unità Operativa Struttura Complessa U.O.S.C. di Genetica Medica, 80131, Naples, Italy
| | - Nunzia Maione
- Dipartimento di Neuroscienze e Scienze Riproduttive ed Odontostomatologiche, UOC di Otorinolaringoiatria, Università degli Studi di Napoli Federico II, 80131, Naples, Italy
| | - Jacques Young
- Service d'Endocrinologie et Maladies de la Reproduction, Assistance Publique Hôpitaux de Paris, Hôpital de Bicêtre, Université Paris Sud, 94275, Le Kremlin-Bicêtre, France
| | - Carolina Di Somma
- IRCCS Istituto di Ricerca Diagnostica e Nucleare SDN, 80143, Naples, Italy
| | - Antonio Agostino Sinisi
- Dipartimento di Scienze Cardio-Toraciche e Respiratorie, Seconda Università Degli Studi di Napoli, 80131, Naples, Italy
| | - Maurizio Iengo
- Dipartimento di Neuroscienze e Scienze Riproduttive ed Odontostomatologiche, UOC di Otorinolaringoiatria, Università degli Studi di Napoli Federico II, 80131, Naples, Italy
| | - Paolo Emidio Macchia
- Dipartimento di Medicina Clinica e Chirurgia, Area Funzionale di Endocrinologia, Università degli Studi di Napoli Federico II, 80131, Naples, Italy
| | - Rosario Pivonello
- Dipartimento di Medicina Clinica e Chirurgia, Area Funzionale di Endocrinologia, Università degli Studi di Napoli Federico II, 80131, Naples, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Area Funzionale di Endocrinologia, Università degli Studi di Napoli Federico II, 80131, Naples, Italy
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Savanelli MC, Scarano E, Muscogiuri G, Barrea L, Vuolo L, Rubino M, Savastano S, Colao A, Di Somma C. Cardiovascular risk in adult hypopituitaric patients with growth hormone deficiency: is there a role for vitamin D? Endocrine 2016; 52:111-9. [PMID: 26511949 DOI: 10.1007/s12020-015-0779-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 10/16/2015] [Indexed: 11/26/2022]
Abstract
Hypovitaminosis D represent an environmental risk factors for cardiovascular (CV) disease. To investigate the prevalence of hypovitaminosis D and the correlation between GH/IGF-I deficiency and hypovitaminosis D with CV risk in GH deficiency (GHD) patients. A link between these hormones has been shown. Forty-one hypopituitaric patients with GHD (22 males, age 18-84 years) and 41 controls were enrolled in the study. Anthropometric parameters, blood pressure, glucose and lipid profile, parathyroid hormone (PTH), 25(OH) vitamin D (vitamin D), metabolic syndrome (MS), GH peak after GHRH + ARG, IGF-I, and standard deviation score (SDS) of IGF-I (zIGF-I) were assessed. Vitamin D levels were lower in patients than in controls (21.3 ± 12.3 vs. 28.2 ± 9.4, p = 0.006). Deficiency was found in 51 % of patients versus 14.6 % of controls (p < 0.01), insufficiency in 26.8 versus 41.4 % (p = 0.269) and normal vitamin D levels in 21.9 versus 43.9 % (p = 0.060). The prevalence of dyslipidemia was 51.2 % in patients versus 12.1 % in controls (p < 0.001), type 2 diabetes mellitus (DM) was 7.3 versus 17 % (p = 0.292), hypertension was 44 versus 22 % (p = 0.060), and MS was 17 versus 14.6 % (p = 0.957). In patients, an association was found between the presence of hypovitaminosis D and the prevalence of dyslipidemia, hypertension and MS and between zIGF-I and the prevalence of hypertension. Hypovitaminosis D was the most powerful predictor of the prevalence of dyslipidemia and hypertension. GHD patients have an increased prevalence of hypovitaminosis D compared with controls. The presence of hypovitaminosis D was the most powerful predictor of the prevalence of dyslipidemia and hypertension in GHD patients, suggesting the involvement of both factors in the CV risk in these patients.
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Affiliation(s)
| | - Elisabetta Scarano
- Dipartimento di Medicina Clinica e Chirurgia, Section of Endocrinology, University "Federico II", Naples, Italy
| | - Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Section of Endocrinology, University "Federico II", Naples, Italy
| | | | - Laura Vuolo
- Dipartimento di Medicina Clinica e Chirurgia, Section of Endocrinology, University "Federico II", Naples, Italy
| | - Manila Rubino
- Dipartimento di Medicina Clinica e Chirurgia, Section of Endocrinology, University "Federico II", Naples, Italy
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Section of Endocrinology, University "Federico II", Naples, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Section of Endocrinology, University "Federico II", Naples, Italy
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Muscogiuri G, Nuzzo V, Gatti A, Zuccoli A, Savastano S, Di Somma C, Pivonello R, Orio F, Colao A. Hypovitaminosis D: a novel risk factor for coronary heart disease in type 2 diabetes? Endocrine 2016; 51:268-73. [PMID: 25931413 DOI: 10.1007/s12020-015-0609-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [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: 11/09/2014] [Accepted: 04/15/2015] [Indexed: 12/21/2022]
Abstract
Vitamin D (25(OH)D) levels have been associated with cardiovascular disease. Thus, the aim of our study was to investigate the association of 25(OH)D levels with coronary heart disease (CHD) in 698 consecutive type 2 diabetic outpatients. 698 consecutive type 2 diabetic outpatients (25.2 % men, age 66 ± 9 years) and 100 (90 % men, age 65 ± 13 years) age-matched non-diabetic volunteers were enrolled. 25(OH)D assay and the main cardiovascular risk factors were explored. 25(OH)D concentration was 22 ± 10 ng/ml in control subjects and 18.23 ± 10 ng/ml in diabetic patients (p < 0.01). The prevalence of hypovitaminosis D was higher in diabetic patients than in control subjects (90 vs. 83 %, p < 0.01). Diabetic subjects with hypovitaminosis D had higher prevalence of high values of A1C (p < 0.01), BMI (p < 0.01), LDL cholesterol (p < 0.01), triglycerides (p < 0.01), and glycemia (p < 0.01) than their vitamin D-sufficient counterparts. 25(OH)D and HDL cholesterol were lower (p < 0.01), while BMI (p < 0.01), age (p < 0.01), systolic (p < 0.01) and diastolic blood pressure (p < 0.01), diabetes duration (p < 0.01), A1C (p < 0.01), glycemia (p < 0.01), fibrinogen (p < 0.01), triglycerides (p < 0.01), and total (p < 0.01) and LDL cholesterol (p < 0.01) were higher in diabetic subjects with CHD than diabetic subjects without CHD. At the logistic regression analysis, the association of vitamin D with CHD was lost, while sex (p = 0.026), diabetes duration (p = 0.023), and age (p = 0.024) were the most powerful predictors of CHD. The current study demonstrates that 25(OH)D does not have a direct effect on CHD but may have an indirect effect mediated by cardiovascular risk factors such as diabetes duration, age, and sex.
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Affiliation(s)
- Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Università di Napoli "Federico II", via S. Pansini 5, 80131, Naples, Italy.
| | - Vincenzo Nuzzo
- Internal Medicine Unit, San Gennaro Hospital, Naples, Italy
| | - Adriano Gatti
- Diabetology Unit, San Gennaro Hospital, Naples, Italy
| | | | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Università di Napoli "Federico II", via S. Pansini 5, 80131, Naples, Italy
| | | | - Rosario Pivonello
- Dipartimento di Medicina Clinica e Chirurgia, Università di Napoli "Federico II", via S. Pansini 5, 80131, Naples, Italy
| | - Francesco Orio
- Department of Endocrinology, University "Parthenope" Naples, Naples, Italy
- Endocrinology of Fertile Age, "S. Giovanni di Dio e Ruggi d'Aragona" University Hospital Salerno, Salerno, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Università di Napoli "Federico II", via S. Pansini 5, 80131, Naples, Italy
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Gatto F, Grasso LF, Nazzari E, Cuny T, Anania P, Di Somma C, Colao A, Zona G, Weryha G, Pivonello R, Ferone D. Clinical outcome and evidence of high rate post-surgical anterior hypopituitarism in a cohort of TSH-secreting adenoma patients: Might somatostatin analogs have a role as first-line therapy? Pituitary 2015; 18:583-91. [PMID: 25326851 DOI: 10.1007/s11102-014-0611-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE Thyrotropin-secreting pituitary adenomas (TSHomas) represent a rare subtype of pituitary tumors. Neurosurgery (NCH) is still considered the first-line therapy. In this study we aimed to investigate the outcome of different treatment modalities, including first line somatostatin analogs (SSA) treatment, with a specific focus on neurosurgery-related complications. METHODS We retrospectively evaluated thirteen patients diagnosed for TSHomas (9 M; age range 27-61). Ten patients had a magnetic resonance evidence of macroadenoma, three with slight visual field impairment. In the majority of patients, thyroid ultrasonography showed the presence of goiter and/or increased gland vascularization. Median TSH value at diagnosis was 3.29 mU/L (normal ranges 0.2-4.2 mIU/L), with median fT4 2.52 ng/dL (0.9-1.7 ng/dL). RESULTS Three patients (two microadenoma) were primarily treated with NCH and achieved disease remission, whereas ten patients (nine macroadenomas) were initially treated with SSA. Despite the optimal biochemical response observed during medical treatment in most patients (mean TSH decrease -72%), only two stayed on medical therapy alone, achieving stable biochemical control at the end of the follow-up. The remaining patients (n = 7) underwent NCH later on during their clinical history, followed by radiotherapy or adjuvant SSA treatment in two cases. Noteworthy, five of them developed hypopituitarism. All patients reached a biochemical control, after a multimodal therapeutic approach. CONCLUSIONS Neurosurgery ultimately led to complete disease remission or to biochemical control in majority of patients, whereas resulting in a considerable percentage of post-operative complications (mainly hypopituitarism, 50%). In the light of the optimal results unanimously reported for medical treatment with SSA, our experience suggests that a careful evaluation of risk/benefit ratio should be taken into consideration when directing the treatment approach in patients with TSHoma.
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Affiliation(s)
- Federico Gatto
- Endocrinology Unit, Department of Internal Medicine and Medical Specialties (DiMI), Center of Excellence for Biomedical Research (CEBR), University of Genova, Viale Benedetto XV, 6, 16132, Genoa, Italy
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42
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Losa M, Beck-Peccoz P, Aimaretti G, Di Somma C, Ambrosio MR, Ferone D, Giampietro A, Corsello SM, Poggi M, Scaroni C, Jia N, Mossetto G, Cannavò S, Rochira V. Characteristics and outcomes of Italian patients from the observational, multicentre, hypopituitary control and complications study (HypoCCS) according to tertiles of growth hormone peak concentration following stimulation testing at study entry. Clin Endocrinol (Oxf) 2015; 83:527-35. [PMID: 26119712 DOI: 10.1111/cen.12839] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 12/29/2014] [Accepted: 06/19/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine whether characteristics and outcomes of Italian patients in the observational global Hypopituitary Control and Complication Study (HypoCCS) differed according to the degree of GH deficiency (GHD). DESIGN Patients were grouped by tertiles of stimulated GH peak concentration at baseline (Group A lowest tertile, n = 342; Group B middle tertile, n = 345; Group C highest tertile, n = 338). RESULTS Baseline demographics, lipid levels, body mass index categories and mean Framingham cardiovascular risk indexes were similar in the three groups and remained substantially unchanged over time, with no subsequent significant between-group differences (except mean levels of triglycerides increased in the highest tertile group). GHD was adult-onset for >75% of patients in all groups. The percentage of patients with multiple pituitary deficiencies was higher in Group A than in the other groups; isolated GHD was reported with highest frequency in Group C. Patients in Group A received the lowest mean starting dose of GH. Hyperlipidaemia at baseline was reported in 35·1%, 31·1% and 24·7% of patients in groups A, B and C, respectively (P = 0·029). Mean duration of GH treatment was 7·21, 5·45 and 4·96 years, respectively. The proportion of patients with adverse events did not differ significantly between groups, with a low prevalence over time of diabetes and cancer. CONCLUSIONS In Italian patients from HypoCCS, the level of GH deficit did not influence changes over time in metabolic parameters or adverse event profile, despite differences in GHD severity at baseline and in the starting GH dose.
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Affiliation(s)
- Marco Losa
- IRCCS San Raffaele Hospital, Milan, Italy
| | - Paolo Beck-Peccoz
- Fondazione IRCCS Cà Granda Policlinico, University of Milan, Milan, Italy
| | | | | | | | | | | | | | | | | | - Nan Jia
- Global Statistical Sciences, Eli Lilly and Company, Indianapolis, IN, USA
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Barrea L, Macchia PE, Tarantino G, Di Somma C, Pane E, Balato N, Napolitano M, Colao A, Savastano S. Nutrition: a key environmental dietary factor in clinical severity and cardio-metabolic risk in psoriatic male patients evaluated by 7-day food-frequency questionnaire. J Transl Med 2015; 13:303. [PMID: 26376719 PMCID: PMC4571062 DOI: 10.1186/s12967-015-0658-y] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [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: 03/30/2015] [Accepted: 09/01/2015] [Indexed: 12/12/2022] Open
Abstract
Background Western dietary pattern is included among the environmental dietary factors involved in the pathogenesis of psoriasis. Nutritional data collection methods and gender differences might affect the association between diet and psoriasis. The 7-day food records is considered the “gold standard” of self-administered food frequency questionnaires. In this study, we evaluated the differences in the dietary intake, anthropometric measurements and cardio-metabolic risk profile in a group of psoriatic patients compared with an age and Body Mass Index (BMI)-matched control group. In addition, in the group of psoriatic patients we investigated the association between the dietary intake and clinical severity of psoriasis. Methods Cross-sectional case control observational study. A total of 82 adult males, 41 treatment-naïve patients with psoriasis and 41 healthy subjects matched for age and BMI were included in the study. The clinical severity of psoriasis was by assessed by Psoriasis Area and Severity Index (PASI) score. The dietary interview data were collected by a 7-day food records. Anthropometric measures, glucose and lipid profile, liver function tests and C-reactive protein levels were measured. Homeostasis Model Assessment of Insulin Resistance (HoMA-IR), Visceral Adiposity Index (VAI) and the Fatty Liver Index (FLI) were calculated. Results Psoriatic patients consumed a higher percentage of total and simple carbohydrates, total fat, polyunsaturated fatty acid (PUFA) and n-6/n-3 PUFAs ratio, and cholesterol, while the consumption of protein, complex carbohydrates, monounsaturated fatty acid (MUFA), n-3 PUFA and fiber was lower than in the control group. In addition, psoriatic patients presented altered anthropometric measurements, glucose and lipid profile, liver function tests, and elevated values of HoMA-IR, VAI and FLI. PASI score well correlated with anthropometric measures, glucose and lipid profile, liver function tests, cardio-metabolic indices, and the dietary components, except for protein and total carbohydrates. At logistic regression analysis between PASI score and MUFA, MetS presence was well predicted only by higher PASI score (OR = 1.794; p = 0.002; CI 1.242–2.591). At multiple regression analysis, MUFA was the best predictor of PASI score (r2 = 0.387, β = −0.635, t = −5.127, p < 0.001). Conclusion Differences in dietary intake were observed in adult male psoriatic patients compared with the controls. These differences were associated to the severity of the psoriasis and cardio-metabolic risk. FLI represented an early indicator of the cardio-metabolic risk profile in psoriatic patients, and dietary MUFA were major predictor of the clinical severity of psoriasis, while the association between psoriasis and metabolic syndrome appeared to be independent of MUFA intake. The low MUFA consumption might act as a possible adjunctive mechanism in increasing the inflammation milieu of psoriatic patients.
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Affiliation(s)
| | - Paolo Emidio Macchia
- Dipartimento di Medicina Clinica e Chirurgia, Medical School of Naples, Federico II University, Via Sergio Pansini, 5, 80131, Naples, Italy.
| | - Giovanni Tarantino
- Dipartimento di Medicina Clinica e Chirurgia, Medical School of Naples, Federico II University, Via Sergio Pansini, 5, 80131, Naples, Italy. .,Centro Ricerche Oncologiche di Mercogliano, Istituto Nazionale per lo studio e la Cura Dei Tumori "Fondazione Giovanni Pascale", IRCCS, Mercogliano, Italy.
| | | | - Elena Pane
- Dipartimento di Medicina Clinica e Chirurgia, Medical School of Naples, Federico II University, Via Sergio Pansini, 5, 80131, Naples, Italy.
| | - Nicola Balato
- Dipartimento di Medicina Clinica e Chirurgia, Medical School of Naples, Federico II University, Via Sergio Pansini, 5, 80131, Naples, Italy.
| | - Maddalena Napolitano
- Dipartimento di Medicina Clinica e Chirurgia, Medical School of Naples, Federico II University, Via Sergio Pansini, 5, 80131, Naples, Italy.
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Medical School of Naples, Federico II University, Via Sergio Pansini, 5, 80131, Naples, Italy.
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Medical School of Naples, Federico II University, Via Sergio Pansini, 5, 80131, Naples, Italy.
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Marotta V, Di Somma C, Rubino M, Sciammarella C, Modica R, Camera L, Del Prete M, Marciello F, Ramundo V, Circelli L, Buonomano P, Colao A, Faggiano A. Second-line sunitinib as a feasible approach for iodine-refractory differentiated thyroid cancer after the failure of first-line sorafenib. Endocrine 2015; 49:854-8. [PMID: 25305056 DOI: 10.1007/s12020-014-0448-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 10/04/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Vincenzo Marotta
- Department of Clinical Medicine and Surgery, Section of Endocrinology, Federico II University of Naples, Via S. Pansini 5, 80131, Naples, Italy,
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Di Somma C, Ciresi A, Amato MC, Savastano S, Savanelli MC, Scarano E, Colao A, Giordano C. Alteration of the growth hormone axis, visceral fat dysfunction, and early cardiometabolic risk in adults: the role of the visceral adiposity index. Endocrine 2015; 49:492-502. [PMID: 25381601 DOI: 10.1007/s12020-014-0471-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 10/29/2014] [Indexed: 01/23/2023]
Abstract
The aim of the study is to clarify the relationship between adipose tissue dysfunction, metabolic profile and growth hormone (GH)/insulin-like growth factor (IGF)-I secretion in healthy adult subjects. We investigated the metabolic profile in a cohort of 231 consecutive healthy subjects in relation to GH, IGF-I levels, and visceral adiposity index (VAI). Anthropometric measures, lipid profile, and glucose and insulin levels during oral glucose tolerance test, Homa-IR and ISI Matsuda, IGF-I and GH peak after GHRH plus Arginine test were analyzed. The subjects with high VAI showed lower GH peak (22.8 ± 11.1 vs. 42.2 ± 21.3 µg/L; p = 0.049) and lower IGF-I (presented as IGF-I under normal range, UNR) (0.54 ± 0.14 vs. 0.64 ± 0.12; p = 0.005) than group with normal VAI. ROC curve analysis identified the cut-off, able to detect subjects with high VAI, i.e., 31.8 µg/L for GH peak and 0.63 for IGF-1 UNR. The subjects with GH peak and IGF-I UNR under the cut-off showed significantly higher levels of VAI, systolic and diastolic blood pressure, glucose and insulin levels, Homa-IR, and lower ISI Matsuda, with a concomitant worse lipid profile (all p < 0.001). A strong relationship between GH axis, VAI and metabolic risk has been demonstrated. A percentage of apparently healthy subjects show a degree of visceral adipose dysfunction associated with GH and IGF-I levels that do not meet the criteria of overt GH deficiency (GHD). Long-term prospective studies could help to clarify and confirm whether a hypothetical condition of subclinical GHD could be taken into account as a new clinical entity.
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46
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Colao A, Muscogiuri G, Rubino M, Vuolo L, Pivonello C, Sabatino P, Pizzo M, Campanile G, Fittipaldi R, Lombardi G, Di Somma C. Hypovitaminosis D in adolescents living in the land of sun is correlated with incorrect life style: a survey study in Campania region. Endocrine 2015; 49:521-7. [PMID: 25414070 DOI: 10.1007/s12020-014-0483-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 11/14/2014] [Indexed: 02/07/2023]
Abstract
PURPOSE The aim of this study is to investigate in a population of adolescents living in Regione Campania, undergoing sun exposure at least 9 months per year the prevalence of severe deficiency (<20 ng/ml) or insufficiency (21-29 ng/ml) of 25-Hydroxyvitamin D (25(OH)D) levels and its relationship with individual body weight, use of smoking, and exercise performance. METHODS From October 2012 to October 2013, 373 healthy subjects (153 girls, 223 boys 11-20 years) without chronic diseases were consecutively enrolled in a campaign to prevent metabolic, cardiovascular, and oncological diseases. 25(OH)D assay, BMI, and lifestyle habitudes (smoking and exercise indoor or outdoor) were assessed. RESULTS In this population, median 25(OH) level was 25.0 ng/ml (95 %CI 23.8-25.2) without any difference between girls (25.0 (95 %CI 23.1-25.7)) and boys (24.3 (95 %CI 23.8-25.2)). Severe deficiency was found in 6 girls (0.02 %), while insufficiency was found in 296 patients (110 girls, 79.3 %). Normal levels were found in 71 patients (37 girls, 19 %). Vitamin D levels were significantly correlated with BMI (r = -0.429, p < 0.0001), smoking (r = -0.241; p < 0.0001), and exercise performance (r = 0.791; p < 0.0001). At the multistep regression analysis, Vitamin D levels were best predicted by exercise performance (t = 19.6, p < 0.0001), less smoking addiction (t = -4.97, p < 0.001), and lower BMI (t = -4.69, p < 0.0001). CONCLUSIONS The current study demonstrates that Vitamin D levels are commonly unsatisfactory in adolescents. Lower levels were found in overweight or obese adolescent, smokers and with low or absence of physical activity outdoors.
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Affiliation(s)
- Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Università di Napoli "Federico II", via S. Pansini 5, 80131, Naples, Italy,
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47
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Marotta V, Di Somma C, Rubino M, Sciammarella C, Del Prete M, Marciello F, Ramundo V, Circelli L, Buonomano P, Modica R, Vitale M, Colao A, Faggiano A. Potential role of cinacalcet hydrochloride in sporadic primary hyperparathyroidism without surgery indication. Endocrine 2015; 49:274-8. [PMID: 25123977 DOI: 10.1007/s12020-014-0381-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 08/01/2014] [Indexed: 12/31/2022]
Affiliation(s)
- Vincenzo Marotta
- Department of Clinical Medicine and Surgery, Federico II University of Naples, Via S. Pansini 5, 80131, Naples, Italy,
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48
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Savastano S, Di Somma C, Colao A, Barrea L, Orio F, Finelli C, Pasanisi F, Contaldo F, Tarantino G. Preliminary data on the relationship between circulating levels of Sirtuin 4, anthropometric and metabolic parameters in obese subjects according to growth hormone/insulin-like growth factor-1 status. Growth Horm IGF Res 2015; 25:28-33. [PMID: 25466907 DOI: 10.1016/j.ghir.2014.10.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 10/20/2014] [Accepted: 10/21/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND The main components of GH/insulin-like growth factor (IGF)-1 axis and Sirtuin 4 (Sirt4), highly expressed in liver and skeletal muscle mitochondria, serve as active regulators of mitochondrial oxidative capacity with opposite functions. In obesity both GH/IGF-1 status and serum Sirt4 levels, likely mirroring its reduced mitochondrial expression, might be altered. OBJECTIVE To evaluate the association between circulating levels of Sirt4, body composition, metabolic parameters and cardio-metabolic risk profile in obese patients according to their different GH/IGF-1 status. DESIGN Cross-sectional study with measurement of serum Sirt4, GH after GH releasing hormone (GHRH)+Arginine test, IGF-1 and assessment of body composition, glucose and lipid metabolism in 50 class II-III obese subjects (BMI 35.6 to 62.1 kg/m(2)) and 15 normal weight subjects. Low GH secretion and IGF-1 were defined using pre-determined cutoff-points. The Homeostatic Metabolic Assessment of insulin resistance index and Visceral adiposity index were also calculated. The association of Sirt4 with peak stimulated GH and IGF-1, body composition, metabolic parameters and cardio-metabolic risk profile was assessed. RESULTS Serum Sirt4 was inversely related to anthropometric and metabolic parameters and positively related to peak GH and IGF-1. After adjusting for peak GH and IGF-1, the relationships between Sirt4 and BMI became not significant. At multiple regression analysis IGF-1 (p<0.001) was the independent predictor for Sirt4. CONCLUSION There was a close relationship between low IGF-1 and low serum Sirt4. This observation suggested that in obese patients, low GH/IGF-1 status was likely associated with a major compensatory decrease in circulating levels of Sirt4 to oppose to its negative regulator effect on mitochondrial oxidative capacity.
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Affiliation(s)
- Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Università Federico II di Napoli, Italy.
| | | | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Università Federico II di Napoli, Italy
| | | | - Francesco Orio
- Dipartimento di Scienze Motorie e del Benessere Università Parthenope Napoli, Italy
| | - Carmine Finelli
- Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, C/da S. Lucia, Chiaromonte, 80035 Potenza, Italy
| | - Fabrizio Pasanisi
- Dipartimento di Medicina Clinica e Chirurgia, Università Federico II di Napoli, Italy
| | - Franco Contaldo
- Dipartimento di Medicina Clinica e Chirurgia, Università Federico II di Napoli, Italy
| | - Giovanni Tarantino
- Centro Ricerche Oncologiche di Mercogliano, Istituto Nazionale Per Lo Studio e La Cura Dei Tumori "Fondazione Giovanni Pascale", IRCCS, Italy
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Barrea L, Balato N, Di Somma C, Macchia PE, Napolitano M, Savanelli MC, Esposito K, Colao A, Savastano S. Nutrition and psoriasis: is there any association between the severity of the disease and adherence to the Mediterranean diet? J Transl Med 2015; 13:18. [PMID: 25622660 PMCID: PMC4316654 DOI: 10.1186/s12967-014-0372-1] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [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: 11/17/2014] [Accepted: 12/23/2014] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Many studies have evaluated the role of individual nutrients on the development of psoriasis. However, only few studies have investigated the effect of a healthy eating pattern, such as the Mediterranean diet. In this study, we aimed to investigate the relationship between adherence to the Mediterranean diet, the body composition and the severity of psoriasis in a group of naïve-treatment patients with psoriasis. METHODS This is a cross-sectional case-control observational study. Sixty-two patients (49 males and 13 females, mean age: 50.2±10.5yrs) affected with mild-to-severe psoriasis were consecutively enrolled. Sixty-two age-, sex- and body mass index (BMI)-matched healthy subjects served as control group. A validated 14-item questionnaire (PREDIMED: PREvención con DIeta MEDiterránea) was used for the assessment of adherence to the Mediterranean diet. The severity of psoriasis was by assessed by standardized Psoriasis Area and Severity Index (PASI) score and C-reactive protein (CRP) levels. Body composition was analyzed with bioelectrical impedance analysis. RESULTS A higher percentage of psoriatic patients had a lower PREDIMED score compared to the control group (30.6% vs 4.8%). PASI score was significantly associated with the percentage of fat mass (FM%) and CRP levels. PASI score and CRP levels were significantly associated with the dietary components included in the PREDIMED questionnaire or with the PREDIMED score. At multiple regression analysis, the major predictor of PASI score were FM among BIA parameters, (r(2)=0.537, β=0.740, p<0.001), and FM (r(2)=0.537, β=0.603, p<0.001) and PREDIMED score (r(2)=0.599, β=-0.296, p=0.007) among anthropometric measures, FM and PREDIMED score. Finally, among all items of the PREDIMED questionnaire, EVOO (r(2)=0.548, β=-0.741, p<0.001), and fish consumption (r(2)=0.139, β=-0.372, p=0.005) have an independent predictive value for PASI score and CRP levels. CONCLUSIONS This is the first study to evaluate the association between adherence to the Mediterranean diet and the severity of psoriasis. Moreover, our study highlights the usefulness of the assessment of body composition by bioelectrical impedance analysis in the evaluation of the psoriatic patients.
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Affiliation(s)
| | - Nicola Balato
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Dermatology, Federico II University Medical School of Naples, Via Sergio Pansini 5, Naples, 80131, Italy.
| | | | - Paolo Emidio Macchia
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, Naples, 80131, Italy.
| | - Maddalena Napolitano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Dermatology, Federico II University Medical School of Naples, Via Sergio Pansini 5, Naples, 80131, Italy.
| | | | - Katherine Esposito
- Department of Clinical and Experimental Medicine, Second University of Naples, Via Costantinopoli, Naples, 84-80138, Italy.
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, Naples, 80131, Italy.
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, Naples, 80131, Italy.
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Giovannini L, Tirabassi G, Muscogiuri G, Di Somma C, Colao A, Balercia G. Impact of adult growth hormone deficiency on metabolic profile and cardiovascular risk [Review]. Endocr J 2015; 62:1037-48. [PMID: 26300280 DOI: 10.1507/endocrj.ej15-0337] [Citation(s) in RCA: 30] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Adult growth hormone deficiency (GHD) is a well defined clinical condition, which is characterized by abnormal body composition, impaired physical activity and decreased quality of life. In addition, in recent years, growing interest has been shown towards cardiovascular risks in adult patients affected by GHD. In this regard, GHD is widely known to be associated with increased mortality, likely due to the increase of risk factors, such as central obesity, impaired lipid and glucose profiles and other less-known risk factors, such as inflammatory cytokines, endothelial dysfunction and oxidative stress. However, very few papers have recently discussed this topic. In this review, the aim is to clarify this issue by discussing evidence regarding the effects of adult GHD on metabolic and cardiovascular profiles.
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Affiliation(s)
- Lara Giovannini
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, School of Medicine, Polytechnic University of Marche, Ancona, Italy
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