1
|
Bonfiglio C, Campanella A, Donghia R, Bianco A, Franco I, Curci R, Bagnato CB, Tatoli R, Giannelli G, Cuccaro F. Development and Internal Validation of a Model for Predicting Overall Survival in Subjects with MAFLD: A Cohort Study. J Clin Med 2024; 13:1181. [PMID: 38398493 PMCID: PMC10889818 DOI: 10.3390/jcm13041181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/01/2024] [Accepted: 02/18/2024] [Indexed: 02/25/2024] Open
Abstract
Background & Aims: Fatty liver disease with metabolic dysfunction (MAFLD) is a new concept proposed to replace the previous concept of Non-Alcoholic Hepatic Steatosis (NAFLD). We developed and internally validated a prognostic model to predict the likelihood of death in a cohort of subjects with MAFLD. Methods: Our work involved two steps: the first was the construction of a bootstrapped multivariable Cox model for mortality risk prognosis and the second was its validation. Results: The study cohort included 1506 subjects, of which 907 were used for internal validation. Discriminant measures for the final model were R2D 0.6845 and Harrell's C 0.8422 in the development and R2D 0.6930 and Harrell's C 0.8465 in the validation. We used the nine independent prognostic factors selected by the LASSO Cox procedure and fitted by the bootstrap Cox survival model, and observed β were: Gender 0.356 1.42 (p < 0.008), Age 0.146 (p < 0.001), Glycemia 0.004 (p < 0.002), Total Cholesterol -0.0040 (p < 0.009), Gamma Glutamyl Transpeptidase 0.009 (p < 0.001), SBP 0.009 (p < 0.036), DBP -0.016 (p < 0.041), ALP 0.008 (p < 0.071) and Widowhood 0.550 (p < 0.001). Conclusions: We produced and validated a model to estimate the probability of death in subjects with MAFLD. The instruments we used showed satisfactory predictive capabilities.
Collapse
Affiliation(s)
- Caterina Bonfiglio
- National Institute of Gastroenterology—IRCCS ‘S de Bellis’, 70013 Castellana Grotte, BA, Italy; (A.C.); (R.D.); (A.B.); (I.F.); (R.C.); (C.B.B.); (R.T.); (G.G.)
| | - Angelo Campanella
- National Institute of Gastroenterology—IRCCS ‘S de Bellis’, 70013 Castellana Grotte, BA, Italy; (A.C.); (R.D.); (A.B.); (I.F.); (R.C.); (C.B.B.); (R.T.); (G.G.)
| | - Rossella Donghia
- National Institute of Gastroenterology—IRCCS ‘S de Bellis’, 70013 Castellana Grotte, BA, Italy; (A.C.); (R.D.); (A.B.); (I.F.); (R.C.); (C.B.B.); (R.T.); (G.G.)
| | - Antonella Bianco
- National Institute of Gastroenterology—IRCCS ‘S de Bellis’, 70013 Castellana Grotte, BA, Italy; (A.C.); (R.D.); (A.B.); (I.F.); (R.C.); (C.B.B.); (R.T.); (G.G.)
| | - Isabella Franco
- National Institute of Gastroenterology—IRCCS ‘S de Bellis’, 70013 Castellana Grotte, BA, Italy; (A.C.); (R.D.); (A.B.); (I.F.); (R.C.); (C.B.B.); (R.T.); (G.G.)
| | - Ritanna Curci
- National Institute of Gastroenterology—IRCCS ‘S de Bellis’, 70013 Castellana Grotte, BA, Italy; (A.C.); (R.D.); (A.B.); (I.F.); (R.C.); (C.B.B.); (R.T.); (G.G.)
| | - Claudia Beatrice Bagnato
- National Institute of Gastroenterology—IRCCS ‘S de Bellis’, 70013 Castellana Grotte, BA, Italy; (A.C.); (R.D.); (A.B.); (I.F.); (R.C.); (C.B.B.); (R.T.); (G.G.)
| | - Rossella Tatoli
- National Institute of Gastroenterology—IRCCS ‘S de Bellis’, 70013 Castellana Grotte, BA, Italy; (A.C.); (R.D.); (A.B.); (I.F.); (R.C.); (C.B.B.); (R.T.); (G.G.)
| | - Gianluigi Giannelli
- National Institute of Gastroenterology—IRCCS ‘S de Bellis’, 70013 Castellana Grotte, BA, Italy; (A.C.); (R.D.); (A.B.); (I.F.); (R.C.); (C.B.B.); (R.T.); (G.G.)
| | | |
Collapse
|
2
|
Donghia R, Campanella A, Bonfiglio C, Cuccaro F, Tatoli R, Giannelli G. Protective Role of Lycopene in Subjects with Liver Disease: NUTRIHEP Study. Nutrients 2024; 16:562. [PMID: 38398886 PMCID: PMC10892188 DOI: 10.3390/nu16040562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 02/16/2024] [Accepted: 02/17/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Liver diseases are constantly increasing throughout the world and are often associated with other diseases, but above all they are caused by improper diet. Adherence to a diet with abundant vegetables has now been widely demonstrated to be important in combating this pathological condition. The aim of this study was to explore the protective role of lycopene (LYC) extracts from cooked and fresh tomato. METHODS The study cohort included 969 participants assessed in the NUTRIHEP cohort (2005-2006) and the associated follow-up (2014-2016), divided into two groups, based on liver condition: NAFLD, or AFLD and FLD. RESULTS The results indicated a statistical significance of LYC consumption, showing a protective role against liver disease, the best concentration being 9.50 mg/die, with an RR value of 0.59, p = 0.01, 0.39 to 0.90 at 95% C.I., and RRR = 0.40, p = 0.002, 0.22 to 0.71 at 95% C.I. CONCLUSIONS The protective role of LYC extracts from tomato has not been amply demonstrated in humans. We conclude that this is one of the few papers in the literature to evaluate the protective effect of LYC against liver disease, as well as how this molecule could be used in future possible treatments. Utilizing lycopene as a supplement alone or in combination with other foods could be useful for developing treatments with reduced contraindications.
Collapse
Affiliation(s)
- Rossella Donghia
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (A.C.); (C.B.); (R.T.); (G.G.)
| | - Angelo Campanella
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (A.C.); (C.B.); (R.T.); (G.G.)
| | - Caterina Bonfiglio
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (A.C.); (C.B.); (R.T.); (G.G.)
| | | | - Rossella Tatoli
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (A.C.); (C.B.); (R.T.); (G.G.)
| | - Gianluigi Giannelli
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (A.C.); (C.B.); (R.T.); (G.G.)
| |
Collapse
|
3
|
Tatoli R, Bonfiglio C, Cuccaro F, Campanella A, Coletta S, Pesole PL, Giannelli G, Donghia R. Effects of Egg Consumption on Subjects with SLD or Hypertension: A MICOL Study. Nutrients 2024; 16:430. [PMID: 38337714 PMCID: PMC10856908 DOI: 10.3390/nu16030430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Steatotic liver disease (SLD) is defined as a fat accumulation in more than 5% of hepatocytes; it can progress to non-alcoholic steatohepatitis (NASH), associated with an increased state of inflammation. The aim of this study was to explore the protective effects of eating eggs and any association with SLD and hypertension (HTN). METHODS The study cohort included 908 participants assessed in the fourth recall of the MICOL study, grouped into four groups, based on NALFD and/or HTN. RESULTS The prevalence of HTN and SLD among participants was 31.61%. Overall, the results indicated a statistical significance of egg consumption, showing a protective role against the two disease conditions, in both the raw and adjusted models (RRR = 0.34, p = 0.009, 0.15 to 0.76 95% C.I.). CONCLUSIONS Many differences were found among the groups, and the protective role of eating eggs was amply demonstrated. We can conclude that it is unwise to demonize the intake of this food and its nutritional properties, in contrast with previous reports in the literature.
Collapse
Affiliation(s)
- Rossella Tatoli
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (R.T.); (C.B.); (A.C.); (S.C.); (P.L.P.); (G.G.)
| | - Caterina Bonfiglio
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (R.T.); (C.B.); (A.C.); (S.C.); (P.L.P.); (G.G.)
| | | | - Angelo Campanella
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (R.T.); (C.B.); (A.C.); (S.C.); (P.L.P.); (G.G.)
| | - Sergio Coletta
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (R.T.); (C.B.); (A.C.); (S.C.); (P.L.P.); (G.G.)
| | - Pasqua Letizia Pesole
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (R.T.); (C.B.); (A.C.); (S.C.); (P.L.P.); (G.G.)
| | - Gianluigi Giannelli
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (R.T.); (C.B.); (A.C.); (S.C.); (P.L.P.); (G.G.)
| | - Rossella Donghia
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (R.T.); (C.B.); (A.C.); (S.C.); (P.L.P.); (G.G.)
| |
Collapse
|
4
|
Campanella A, Bonfiglio C, Cuccaro F, Donghia R, Tatoli R, Giannelli G. High Adherence to a Mediterranean Alcohol-Drinking Pattern and Mediterranean Diet Can Mitigate the Harmful Effect of Alcohol on Mortality Risk. Nutrients 2023; 16:59. [PMID: 38201889 PMCID: PMC10780794 DOI: 10.3390/nu16010059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/18/2023] [Accepted: 12/22/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Alcohol is a psychoactive substance with deleterious effects on human health and mortality. This study aims to investigate the joint associations between the Mediterranean Diet (MedDiet), alcohol- consumption patterns and mortality from the following: all causes, cardiovascular, neoplastic, the digestive system, and other causes. METHODS A sample of 3411 alcohol consumers aged ≥18 years was selected from two prospective cohort studies: the MICOL and NUTRIHEP Study. Cohorts were enrolled in 2005-2006, and followed up until December 2022, capturing data on alcohol consumption, diet, and mortality. Adherence to the MedDiet was measured by the relative Mediterranean score (rMED), and alcohol consumption by the Mediterranean Alcohol-drinking Pattern index (MADP). Statistical analyses included flexible parametric survival models and subdistribution hazard ratios, to consider different causes of death. RESULTS a significant increase in digestive-system (SHR 2.77, 95% CI 1.16; 63) and cancer mortality risk (SHR 2.25, 95% CI 1.08; 4.70) was observed among individuals with low adherence to the MADP. Low adherence to the Mediterranean pattern of alcohol consumption, combined with low adherence to the MedDiet, was associated with higher overall mortality (HR 2.29, 95% CI 1.04, 5.04), and, in particular, with higher mortality from digestive system diseases (SHR 4.38, 95% CI 1.22, 15.8). CONCLUSIONS This study suggests that deleterious effects of alcohol on mortality vary, depending on alcohol consumption patterns and dietary context. Higher adherence to the MedDiet appears to mitigate the adverse effects of moderate alcohol consumption, particularly for wine drinkers.
Collapse
Affiliation(s)
- Angelo Campanella
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (C.B.); (R.D.); (R.T.); (G.G.)
| | - Caterina Bonfiglio
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (C.B.); (R.D.); (R.T.); (G.G.)
| | | | - Rossella Donghia
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (C.B.); (R.D.); (R.T.); (G.G.)
| | - Rossella Tatoli
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (C.B.); (R.D.); (R.T.); (G.G.)
| | - Gianluigi Giannelli
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (C.B.); (R.D.); (R.T.); (G.G.)
| |
Collapse
|
5
|
Tedesco CC, Bonfiglio C, Notarnicola M, Rendina M, Castellaneta A, Di Leo A, Giannelli G, Fontana L. High Extra Virgin Olive Oil Consumption Is Linked to a Lower Prevalence of NAFLD with a Prominent Effect in Obese Subjects: Results from the MICOL Study. Nutrients 2023; 15:4673. [PMID: 37960329 PMCID: PMC10647576 DOI: 10.3390/nu15214673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 10/27/2023] [Accepted: 10/28/2023] [Indexed: 11/15/2023] Open
Abstract
Extra virgin olive oil (EVOO) has healthy benefits for noncommunicable diseases (NCDs). However, limited evidence is available about the effects of liver disease and non-alcoholic fatty liver disease (NAFLD). We evaluate whether dose-increased consumption of EVOO is associated with a lower prevalence of NAFLD and if these effects vary based on body weight. The study included 2436 subjects with a 33% NAFLD prevalence. Daily EVOO was categorized into tertiles: low (0-24 g/day), moderate (25-37 g/day), and high consumption (>37 g/day). Subjects were also classified by body mass index (BMI) as normo-weight (18.5-24.9), overweight (25-29.9), and obese (≥30). Logistic regression analysis was applied to calculate odds ratios (ORs) for NAFLD, considering a 20-gram increment in EVOO intake and accounting for EVOO categories combined with BMI classes. The ORs were 0.83 (0.74;0.93) C.I. p = 0.0018 for continuous EVOO, 0.89 (0.69;1.15) C.I. p = 0.37, and 0.73 (0.55;0.97) C.I. p = 0.03 for moderate and high consumption, respectively, when compared to low consumption. Overall, the percent relative risk reductions (RRR) for NAFLD from low to high EVOO consumption were 18% (16.4%;19.2%) C.I. and 26% (25%;27.4%) C.I. in overweight and obese subjects. High EVOO consumption is associated with a reduced risk of NAFLD. This effect is amplified in overweight subjects and even more in obese subjects.
Collapse
Affiliation(s)
- Calogero Claudio. Tedesco
- Data Science Unit, National Institute of Gastroenterology, IRCCS “Saverio de Bellis” Research Hospital, 70013 Castellana Grotte, Italy
| | - Caterina Bonfiglio
- Laboratory of Epidemiology and Statistics, National Institute of Gastroenterology, IRCCS “Saverio de Bellis” Research Hospital, 70013 Castellana Grotte, Italy;
| | - Maria Notarnicola
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology, IRCCS “Saverio de Bellis” Research Hospital, 70013 Castellana Grotte, Italy;
| | - Maria Rendina
- Gastroenterology and Digestive Endoscopy, University Hospital, Policlinico of Bari, 70100 Bari, Italy;
| | - Antonino Castellaneta
- Gastroenterology Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Aldo Moro, 70100 Bari, Italy; (A.C.); (A.D.L.)
| | - Alfredo Di Leo
- Gastroenterology Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Aldo Moro, 70100 Bari, Italy; (A.C.); (A.D.L.)
| | - Gianluigi Giannelli
- Scientific Direction, National Institute of Gastroenterology, IRCCS “Saverio de Bellis” Research Hospital, 70013 Castellana Grotte, Italy;
| | - Luigi Fontana
- Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia;
- Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, NSW 2006, Australia
| |
Collapse
|
6
|
Bonfiglio C, Cuccaro F, Campanella A, Rosso N, Tatoli R, Giannelli G, Donghia R. Effect of Intake of Extra Virgin Olive Oil on Mortality in a South Italian Cohort with and without NAFLD. Nutrients 2023; 15:4593. [PMID: 37960246 PMCID: PMC10649270 DOI: 10.3390/nu15214593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 10/20/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Extra-virgin olive oil (EVOO) is the main source of seasoning fat in the Mediterranean diet and it is one of the components with known protective factors on chronic-degenerative disease. We aimed to evaluate the effect of a medium-high level of oil consumption on mortality in a cohort with good adherence to the Mediterranean diet. METHODS A total of 2754 subjects who had completed the food questionnaire in the Multicenter Italian study on Cholelithiasis (MICOL) cohort were included in the study. EVOO consumption was categorized in four levels (<20 g/die, 21-30 g/die, 31-40 g/die, >40 g/die). We performed a flexible parametric survival model to assess mortality by EVOO consumption level adjusted for some covariates. We also performed the analysis on subjects with and without non-alcoholic fatty liver disease (NAFLD) to evaluate the effects of oil in this more fragile sub-cohort. RESULTS We found a statistically significant negative effect on mortality for the whole sample when EVOO consumption was used, both as a continuous variable and when categorized. The protective effect was stronger in the sub-cohort with NAFLD, especially for the highest levels of EVOO consumption (HR = 0.58 with p < 0.05). CONCLUSIONS Our study has shown a protective effect of EVOO consumption towards all causes of mortality. Despite the higher caloric intake, the protective power is greater for a consumption >40 g/day in both the overall cohort and the sub-cohorts with and without NAFLD.
Collapse
Affiliation(s)
- Caterina Bonfiglio
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (A.C.); (R.T.); (G.G.)
| | | | - Angelo Campanella
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (A.C.); (R.T.); (G.G.)
| | - Natalia Rosso
- Fondazione Italiana Fegato, AREA Sciegce Park, Basovizza, 34149 Trieste, Italy;
| | - Rossella Tatoli
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (A.C.); (R.T.); (G.G.)
| | - Gianluigi Giannelli
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (A.C.); (R.T.); (G.G.)
| | - Rossella Donghia
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (A.C.); (R.T.); (G.G.)
| |
Collapse
|
7
|
Bianco A, Russo F, Franco I, Riezzo G, Donghia R, Curci R, Bonfiglio C, Prospero L, D’Attoma B, Ignazzi A, Campanella A, Osella AR. Enhanced Physical Capacity and Gastrointestinal Symptom Improvement in Southern Italian IBS Patients following Three Months of Moderate Aerobic Exercise. J Clin Med 2023; 12:6786. [PMID: 37959251 PMCID: PMC10648315 DOI: 10.3390/jcm12216786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023] Open
Abstract
Moderate-intensity aerobic exercise improves gastrointestinal (GI) health and alleviates irritable bowel syndrome (IBS) symptoms. This study explored its effects on physical capacity (PC) and IBS symptoms in 40 patients from Southern Italy (11 males, 29 females; 52.10 ± 7.72 years). The exercise program involved moderate-intensity aerobic exercise (60/75% of HRmax) for at least 180 min per week. Before and after the intervention, participants completed the IBS-SSS questionnaire to assess IBS symptoms, reported their physical activity levels, and underwent field tests to evaluate PC. PC was quantified as the Global Physical Capacity Score (GPCS). A total of 38 subjects (21 males, 17 females; 53.71 ± 7.27 years) without lower GI symptoms served as a No IBS group. No significant differences were found between IBS patients and No IBS subjects, except for the symptom score, as expected. After the exercise, all participants experienced significant improvements in both IBS symptoms and PC. Higher PC levels correlated with greater benefits in IBS symptomatology, especially with GPCS reaching above-average values. Engaging in moderate-intensity aerobic exercise for at least 180 min per week positively impacts IBS symptoms and PC. Monitoring GPCS in IBS patients provides insights into the connection between physical activity and symptom severity, aiding healthcare professionals in tailoring effective treatment plans.
Collapse
Affiliation(s)
- Antonella Bianco
- Laboratory of Epidemiology and Statistics, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (R.C.); (C.B.); (A.C.); (A.R.O.)
| | - Francesco Russo
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (G.R.); (L.P.); (B.D.); (A.I.)
| | - Isabella Franco
- Laboratory of Epidemiology and Statistics, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (R.C.); (C.B.); (A.C.); (A.R.O.)
| | - Giuseppe Riezzo
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (G.R.); (L.P.); (B.D.); (A.I.)
| | - Rossella Donghia
- Data Science Unit, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy;
| | - Ritanna Curci
- Laboratory of Epidemiology and Statistics, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (R.C.); (C.B.); (A.C.); (A.R.O.)
| | - Caterina Bonfiglio
- Laboratory of Epidemiology and Statistics, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (R.C.); (C.B.); (A.C.); (A.R.O.)
| | - Laura Prospero
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (G.R.); (L.P.); (B.D.); (A.I.)
| | - Benedetta D’Attoma
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (G.R.); (L.P.); (B.D.); (A.I.)
| | - Antonia Ignazzi
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (G.R.); (L.P.); (B.D.); (A.I.)
| | - Angelo Campanella
- Laboratory of Epidemiology and Statistics, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (R.C.); (C.B.); (A.C.); (A.R.O.)
| | - Alberto Ruben Osella
- Laboratory of Epidemiology and Statistics, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (R.C.); (C.B.); (A.C.); (A.R.O.)
| |
Collapse
|
8
|
De Nucci S, Bonfiglio C, Donvito R, Di Chito M, Cerabino N, Rinaldi R, Sila A, Shahini E, Giannuzzi V, Pesole PL, Coletta S, Lanzilotta E, Piazzolla G, Cozzolongo R, Giannelli G, De Pergola G. Effects of an Eight Week Very Low-Calorie Ketogenic Diet (VLCKD) on White Blood Cell and Platelet Counts in Relation to Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) in Subjects with Overweight and Obesity. Nutrients 2023; 15:4468. [PMID: 37892542 PMCID: PMC10610501 DOI: 10.3390/nu15204468] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 10/29/2023] Open
Abstract
Obesity and metabolic dysfunction-associated steatotic liver disease (MASLD) are frequently associated conditions characterized by low-grade inflammation. Very low-calorie ketogenic diet (VLCKD) strategies are commonly used to simultaneously obtain weight loss and an improvement of liver steatosis. We evaluated the efficacy of 8 weeks' VLCKD in decreasing the white blood cell (WBC) and platelet (PLT) counts, as well as liver steatosis and fibrosis, diagnosed using transient elastography (FibroScan). Metabolic and anthropometric parameters commonly associated with MASLD were also evaluated. This study included 87 participants; 58 women and 29 men aged between 18 and 64 years with overweight (18%) or obesity (82%), but not taking any medication. Anthropometric measurements, bioimpedance analysis, and biochemical assays were performed before and after the dietary intervention. BMI (kg/m2) (p-value < 0.001), waist circumference (cm) (p-value < 0.001), and fat mass (kg) (p-value < 0.001) were significantly decreased following VLCKD. After VLCKD, the FibroScan parameter CAP (db/m), which measures the accumulation of fatty liver, significantly decreased (p-value < 0.001), as did liver stiffness (kPA), the FibroScan parameter quantifying liver fibrosis (p-value < 0.05). Seemingly, WBC (p-value < 0.001) and PLT (p-value < 0.001) counts were lowered by VLCKD in the whole group; however, the decrease in WBC and platelet counts were significant only in patients with steatosis (CAP ≥ 215 dB/m). Fasting blood glucose (p-value < 0.001), insulin (p-value < 0.001), HbA1c (p-value < 0.001), triglycerides (p-value < 0.001), total cholesterol (p-value < 0.001), LDL-cholesterol (p-value < 0.001), HDL-cholesterol (p-value < 0.001); γGT (p-value < 0.001) blood levels and insulin resistance (as measured by HOMAIR) (p-value < 0.001); and systolic (p-value < 0.001), and diastolic (p-value < 0.001) blood pressure levels, were all significantly lower after VLCKD. In contrast, blood levels of vitamin D were higher following the diet (p-value < 0.001). We conclude that treating subjects with overweight and obesity with VLCKD is followed by a simultaneous reduction in WBCs and platelets, the expression of low-grade inflammation, and of liver steatosis and fibrosis. Therefore, we can hypothesize that VLCKD decreases general and liver low-grade inflammation, thus improving liver health.
Collapse
Affiliation(s)
- Sara De Nucci
- Center of Nutrition for the Research and the Care of Obesity and Metabolic Diseases, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy (R.R.)
| | - Caterina Bonfiglio
- Laboratory of Epidemiology and Statistics, National Institute of Gastroenterology “Saverio de Bellis”, IRCCS Hospital, Castellana Grotte, 70013 Bari, Italy
| | - Rosanna Donvito
- Center of Nutrition for the Research and the Care of Obesity and Metabolic Diseases, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy (R.R.)
| | - Martina Di Chito
- Center of Nutrition for the Research and the Care of Obesity and Metabolic Diseases, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy (R.R.)
| | - Nicole Cerabino
- Center of Nutrition for the Research and the Care of Obesity and Metabolic Diseases, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy (R.R.)
| | - Roberta Rinaldi
- Center of Nutrition for the Research and the Care of Obesity and Metabolic Diseases, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy (R.R.)
| | - Annamaria Sila
- Center of Nutrition for the Research and the Care of Obesity and Metabolic Diseases, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy (R.R.)
| | - Endrit Shahini
- Department of Gastroenterology, National Institute of Gastroenterology “Saverio de Bellis”, IRCCS Hospital, Castellana Grotte, 70013 Bari, Italy; (E.S.)
| | - Vito Giannuzzi
- Department of Gastroenterology, National Institute of Gastroenterology “Saverio de Bellis”, IRCCS Hospital, Castellana Grotte, 70013 Bari, Italy; (E.S.)
| | - Pasqua Letizia Pesole
- Core Facility Biobank, National Institute of Gastroenterology “Saverio de Bellis”, IRCCS Hospital, Castellana Grotte, 70013 Bari, Italy
| | - Sergio Coletta
- Core Facility Biobank, National Institute of Gastroenterology “Saverio de Bellis”, IRCCS Hospital, Castellana Grotte, 70013 Bari, Italy
| | - Elsa Lanzilotta
- Laboratory of Clinical Pathology, National Institute of Gastroenterology “Saverio de Bellis”, IRCCS Hospital, Castellana Grotte, 70013 Bari, Italy
| | - Giuseppina Piazzolla
- Interdisciplinary Department of Medicine, School of Medicine, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy;
| | - Raffaele Cozzolongo
- Department of Gastroenterology, National Institute of Gastroenterology “Saverio de Bellis”, IRCCS Hospital, Castellana Grotte, 70013 Bari, Italy; (E.S.)
| | - Gianluigi Giannelli
- Scientific Direction, National Institute of Gastroenterology “Saverio de Bellis”, IRCCS Hospital, Castellana Grotte, 70013 Bari, Italy;
| | - Giovanni De Pergola
- Center of Nutrition for the Research and the Care of Obesity and Metabolic Diseases, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy (R.R.)
| |
Collapse
|
9
|
Bianchi FP, Donghia R, Tatoli R, Bonfiglio C. COVID-19 Immunization Rates in Patients with Inflammatory Bowel Disease Worldwide: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2023; 11:1523. [PMID: 37896927 PMCID: PMC10611173 DOI: 10.3390/vaccines11101523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/19/2023] [Accepted: 09/22/2023] [Indexed: 10/29/2023] Open
Abstract
Individuals with Inflammatory Bowel Disease (IBD) are characterized by an increased vulnerability to complications stemming from infectious diseases. While these patients do not inherently face a heightened risk of SARS-CoV-2 infection compared to the general population, their vulnerability to severe COVID-19 complications and subsequent hospitalization is notably increased. The objective of our study is to quantitatively assess the global coverage of COVID-19 vaccination among individuals with IBD, achieved through a comprehensive meta-analysis and systematic review. Thirteen studies were systematically selected from scientific articles available in the MEDLINE/PubMed, ISI Web of Knowledge, and Scopus databases, spanning from 1 January 2021 to 25 July 2023. The pooled prevalence of COVID-19 vaccine uptake was estimated at 72% (95%CI = 59-83%) for at least one dose, 81% (95%CI = 68-91%) for the complete vaccination regimen, and 71% (95%CI = 46-91%) for the third dose. Analysis of the determinants influencing vaccination uptake revealed several significant associations. These encompassed Caucasian ethnicity, female sex, absence of immunosuppressive therapy, advanced age, prior receipt of the anti-influenza vaccine, absence of a history of COVID-19 infection, and the provision of advice from gastroenterologists, all linked to improved compliance. Our study underscores a noteworthy yet not entirely optimal COVID-19 vaccination coverage among individuals with IBD. A multifaceted approach is warranted to enhance vaccination rates. Within this context, the role of gastroenterologists extends beyond direct patient care, encompassing a pivotal responsibility in preventing complications stemming from post-infectious diseases.
Collapse
Affiliation(s)
| | - Rossella Donghia
- National Institute of Gastroenterology, IRCCS S. De Bellis, Research Hospital, 70013 Castellana Grotte, Italy; (R.D.); (R.T.); (C.B.)
| | - Rossella Tatoli
- National Institute of Gastroenterology, IRCCS S. De Bellis, Research Hospital, 70013 Castellana Grotte, Italy; (R.D.); (R.T.); (C.B.)
| | - Caterina Bonfiglio
- National Institute of Gastroenterology, IRCCS S. De Bellis, Research Hospital, 70013 Castellana Grotte, Italy; (R.D.); (R.T.); (C.B.)
| |
Collapse
|
10
|
Giacconi R, Donghia R, Arborea G, Savino MT, Provinciali M, Lattanzio F, Caponio GR, Coletta S, Bianco A, Notarnicola M, Bonfiglio C, Passarino G, D’Aquila P, Bellizzi D, Pesole PL. Plasma Bacterial DNA Load as a Potential Biomarker for the Early Detection of Colorectal Cancer: A Case-Control Study. Microorganisms 2023; 11:2360. [PMID: 37764204 PMCID: PMC10537376 DOI: 10.3390/microorganisms11092360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 09/14/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023] Open
Abstract
The gut microbiota has gained increasing attention in recent years due to its significant impact on colorectal cancer (CRC) development and progression. The recent detection of bacterial DNA load in plasma holds promise as a potential non-invasive approach for early cancer detection. The aim of this study was to examine the quantity of bacterial DNA present in the plasma of 50 patients who have CRC in comparison to 40 neoplastic disease-free patients, as well as to determine if there is a correlation between the amount of plasma bacterial DNA and various clinical parameters. Plasma bacterial DNA levels were found to be elevated in the CRC group compared to the control group. As it emerged from the logistic analysis (adjusted for age and gender), these levels were strongly associated with the risk of CRC (OR = 1.02, p < 0.001, 95% C.I.: 1.01-1.03). Moreover, an association was identified between a reduction in tumor mass and the highest tertile of plasma bacterial DNA. Our findings indicate that individuals with CRC displayed a higher plasma bacterial DNA load compared to healthy controls. This observation lends support to the theory of heightened bacterial migration from the gastrointestinal tract to the bloodstream in CRC. Furthermore, our results establish a link between this phenomenon and the size of the tumor mass.
Collapse
Affiliation(s)
- Robertina Giacconi
- Advanced Technology Center for Aging Research, IRCCS INRCA, Via Birarelli 8, 60121 Ancona, Italy; (M.P.); (F.L.)
| | - Rossella Donghia
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (R.D.); (G.A.); (M.T.S.); (S.C.); (A.B.); (M.N.); (C.B.)
| | - Graziana Arborea
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (R.D.); (G.A.); (M.T.S.); (S.C.); (A.B.); (M.N.); (C.B.)
| | - Maria Teresa Savino
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (R.D.); (G.A.); (M.T.S.); (S.C.); (A.B.); (M.N.); (C.B.)
| | - Mauro Provinciali
- Advanced Technology Center for Aging Research, IRCCS INRCA, Via Birarelli 8, 60121 Ancona, Italy; (M.P.); (F.L.)
| | - Fabrizia Lattanzio
- Advanced Technology Center for Aging Research, IRCCS INRCA, Via Birarelli 8, 60121 Ancona, Italy; (M.P.); (F.L.)
| | - Giusy Rita Caponio
- Department of Bioscience, Biotechnology and Environment, University of Bari Aldo Moro, Via Orabona 4, 70125 Bari, Italy;
| | - Sergio Coletta
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (R.D.); (G.A.); (M.T.S.); (S.C.); (A.B.); (M.N.); (C.B.)
| | - Antonia Bianco
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (R.D.); (G.A.); (M.T.S.); (S.C.); (A.B.); (M.N.); (C.B.)
| | - Maria Notarnicola
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (R.D.); (G.A.); (M.T.S.); (S.C.); (A.B.); (M.N.); (C.B.)
| | - Caterina Bonfiglio
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (R.D.); (G.A.); (M.T.S.); (S.C.); (A.B.); (M.N.); (C.B.)
| | - Giuseppe Passarino
- Department of Biology, Ecology and Earth Sciences (DiBEST), University of Calabria, 87036 Rende, Italy; (G.P.); (P.D.); (D.B.)
| | - Patrizia D’Aquila
- Department of Biology, Ecology and Earth Sciences (DiBEST), University of Calabria, 87036 Rende, Italy; (G.P.); (P.D.); (D.B.)
| | - Dina Bellizzi
- Department of Biology, Ecology and Earth Sciences (DiBEST), University of Calabria, 87036 Rende, Italy; (G.P.); (P.D.); (D.B.)
| | - Pasqua Letizia Pesole
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (R.D.); (G.A.); (M.T.S.); (S.C.); (A.B.); (M.N.); (C.B.)
| |
Collapse
|
11
|
Donghia R, Pesole PL, Castellaneta A, Coletta S, Squeo F, Bonfiglio C, De Pergola G, Rinaldi R, De Nucci S, Giannelli G, Di Leo A, Tatoli R. Age-Related Dietary Habits and Blood Biochemical Parameters in Patients with and without Steatosis-MICOL Cohort. Nutrients 2023; 15:4058. [PMID: 37764841 PMCID: PMC10534690 DOI: 10.3390/nu15184058] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/14/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Steatosis is now the most common liver disease in the world, present in approximately 25% of the global population. The aim of this study was to study the association between food intake and liver disease and evaluate the differences in blood parameters in age classes and steatosic condition. METHODS The present study included 1483 participants assessed in the fourth recall of the MICOL study. Patients were subdivided by age (>65 years) and administered a validated food frequency questionnaire (FFQ) with 28 food groups. RESULTS The prevalence of steatosis was 55.92% in the adult group and 55.88% in the elderly group. Overall, the results indicated many statistically significant blood parameters and dietary habits. Analysis of food choices with a machine learning algorithm revealed that in the adult group, olive oil, grains, processed meat, and sweets were associated with steatosis, while the elderly group preferred red meat, dairy, seafood, and fruiting vegetables. Furthermore, the latter ate less as compared with the adult group. CONCLUSIONS Many differences were found between the two age groups, both in blood parameters and food intake. The random forest also revealed different foods predicted steatosis in the two groups. Future analysis will be useful to understand the molecular basis of these differences and how different food intake causes steatosis in people of different ages.
Collapse
Affiliation(s)
- Rossella Donghia
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (P.L.P.); (S.C.); (C.B.); (G.D.P.); (R.R.); (S.D.N.); (G.G.); (R.T.)
| | - Pasqua Letizia Pesole
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (P.L.P.); (S.C.); (C.B.); (G.D.P.); (R.R.); (S.D.N.); (G.G.); (R.T.)
| | - Antonino Castellaneta
- Gastroenterology and Digestive Endoscopy, University Hospital, 70124 Bari, Italy; (A.C.); (F.S.); (A.D.L.)
| | - Sergio Coletta
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (P.L.P.); (S.C.); (C.B.); (G.D.P.); (R.R.); (S.D.N.); (G.G.); (R.T.)
| | - Francesco Squeo
- Gastroenterology and Digestive Endoscopy, University Hospital, 70124 Bari, Italy; (A.C.); (F.S.); (A.D.L.)
| | - Caterina Bonfiglio
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (P.L.P.); (S.C.); (C.B.); (G.D.P.); (R.R.); (S.D.N.); (G.G.); (R.T.)
| | - Giovanni De Pergola
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (P.L.P.); (S.C.); (C.B.); (G.D.P.); (R.R.); (S.D.N.); (G.G.); (R.T.)
| | - Roberta Rinaldi
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (P.L.P.); (S.C.); (C.B.); (G.D.P.); (R.R.); (S.D.N.); (G.G.); (R.T.)
| | - Sara De Nucci
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (P.L.P.); (S.C.); (C.B.); (G.D.P.); (R.R.); (S.D.N.); (G.G.); (R.T.)
| | - Gianluigi Giannelli
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (P.L.P.); (S.C.); (C.B.); (G.D.P.); (R.R.); (S.D.N.); (G.G.); (R.T.)
| | - Alfredo Di Leo
- Gastroenterology and Digestive Endoscopy, University Hospital, 70124 Bari, Italy; (A.C.); (F.S.); (A.D.L.)
| | - Rossella Tatoli
- National Institute of Gastroenterology—IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy; (P.L.P.); (S.C.); (C.B.); (G.D.P.); (R.R.); (S.D.N.); (G.G.); (R.T.)
| |
Collapse
|
12
|
Riezzo G, Prospero L, D’Attoma B, Ignazzi A, Bianco A, Franco I, Curci R, Campanella A, Bonfiglio C, Osella AR, Russo F. The Impact of a Twelve-Week Moderate Aerobic Exercise Program on Gastrointestinal Symptom Profile and Psychological Well-Being of Irritable Bowel Syndrome Patients: Preliminary Data from a Southern Italy Cohort. J Clin Med 2023; 12:5359. [PMID: 37629401 PMCID: PMC10455088 DOI: 10.3390/jcm12165359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/09/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023] Open
Abstract
Walking is popular moderate-intensity aerobic exercise that improves mental and gastrointestinal (GI) health. It can relieve symptoms associated with irritable bowel syndrome (IBS), e.g., intestinal gas, abdominal distension, and bowel disturbances. This study examined the impact of a moderate-intensity aerobic exercise program on the clinical and psychological parameters of IBS patients. In total, 40 IBS patients (11 males and 29 females; mean age 51.9 ± 7.8 years) participated in a 12-week aerobic exercise program. Participants completed questionnaires assessing GI symptoms, psychological profiles, and quality of life (QoL) before and after the intervention. Field tests, anthropometric measurements, and bioimpedance assessments were also conducted. The present findings confirmed a significant improvement in IBS symptoms after the aerobic exercise program. Bloating was the most common symptom and, together with abdominal pain, was significantly reduced after treatment. Psychological and QoL questionnaires indicated decreased anxiety, depression, somatization, and stress levels. Correlations were found between anxiety/depression and the severity of abdominal pain as well as between stress and the severity of abdominal distension. Moderate-intensity aerobic exercise positively impacted GI symptoms and psychological well-being, complementing dietary and psychological support as a non-pharmacological therapy for the management of IBS. These findings emphasize the importance of alternative approaches for IBS treatment.
Collapse
Affiliation(s)
- Giuseppe Riezzo
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Castellana Grotte, Italy; (G.R.); (L.P.); (B.D.); (A.I.)
| | - Laura Prospero
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Castellana Grotte, Italy; (G.R.); (L.P.); (B.D.); (A.I.)
| | - Benedetta D’Attoma
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Castellana Grotte, Italy; (G.R.); (L.P.); (B.D.); (A.I.)
| | - Antonia Ignazzi
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Castellana Grotte, Italy; (G.R.); (L.P.); (B.D.); (A.I.)
| | - Antonella Bianco
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (R.C.); (A.C.); (C.B.); (A.R.O.)
| | - Isabella Franco
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (R.C.); (A.C.); (C.B.); (A.R.O.)
| | - Ritanna Curci
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (R.C.); (A.C.); (C.B.); (A.R.O.)
| | - Angelo Campanella
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (R.C.); (A.C.); (C.B.); (A.R.O.)
| | - Caterina Bonfiglio
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (R.C.); (A.C.); (C.B.); (A.R.O.)
| | - Alberto Ruben Osella
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (R.C.); (A.C.); (C.B.); (A.R.O.)
| | - Francesco Russo
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Castellana Grotte, Italy; (G.R.); (L.P.); (B.D.); (A.I.)
| |
Collapse
|
13
|
Curci R, Bianco A, Franco I, Bonfiglio C, Campanella A, Mirizzi A, Giannuzzi V, Cozzolongo R, Veronese N, Osella AR. Lifestyle Modification: Evaluation of the Effects of Physical Activity and Low-Glycemic-Index Mediterranean Diet on Fibrosis Score. Nutrients 2023; 15:3520. [PMID: 37630711 PMCID: PMC10459797 DOI: 10.3390/nu15163520] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/03/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Non-Alcoholic Fatty Liver Disease (NAFLD) is one the most prevalent causes of chronic liver disease worldwide. In the absence of an approved drug treatment, lifestyle modification is the first intervention strategy. This study aimed to estimate the main effect of two different physical activity (PA) programs, and a Low-Glycemic-Index Mediterranean Diet (LGIMD), or their combined effect on liver fibrosis parameters in subjects with NAFLD. METHODS Subjects with moderate or severe NAFLD grade of severity (n = 144) were randomly assigned to six intervention arms for three months: LGIMD, PA programs, and their combination. Data were collected at baseline, 45 days, and 90 days. Transient elastography was performed to assess the outcome. RESULTS at 90 days, a statistically significant reduction in kPa was found among subjects following LGMID (-2.85, 95% CI -5.24, -0.45) and those following an LGIMD plus PA1 (-2.37, 95% CI -4.39, -0.35) and LGIMD plus Pa2 (-2.21, 95% CI -4.10, -0.32). The contrast between time 2 and time 1 of the LGIMD plus PA2 treatment showed a statistically significant increase, and vice versa: the contrast between time 3 and time 2 of the same treatment showed a statistically significant reduction. The PA1 and PA2 arms also showed reduced kPa, although the results did not reach statistical significance. CONCLUSIONS The intervention arms, LGIMD, LGIMD+PA1, and LGIMD+PA2, reduced the fibrosis score.
Collapse
Affiliation(s)
- Ritanna Curci
- Laboratory of Epidemiology and Statistics, National Institute of Gastroenterology—IRCCS “S. de Bellis”, Via Turi, 70013 Castellana Grotte, Italy; (R.C.); (A.B.); (I.F.); (C.B.); (A.C.)
| | - Antonella Bianco
- Laboratory of Epidemiology and Statistics, National Institute of Gastroenterology—IRCCS “S. de Bellis”, Via Turi, 70013 Castellana Grotte, Italy; (R.C.); (A.B.); (I.F.); (C.B.); (A.C.)
| | - Isabella Franco
- Laboratory of Epidemiology and Statistics, National Institute of Gastroenterology—IRCCS “S. de Bellis”, Via Turi, 70013 Castellana Grotte, Italy; (R.C.); (A.B.); (I.F.); (C.B.); (A.C.)
| | - Caterina Bonfiglio
- Laboratory of Epidemiology and Statistics, National Institute of Gastroenterology—IRCCS “S. de Bellis”, Via Turi, 70013 Castellana Grotte, Italy; (R.C.); (A.B.); (I.F.); (C.B.); (A.C.)
| | - Angelo Campanella
- Laboratory of Epidemiology and Statistics, National Institute of Gastroenterology—IRCCS “S. de Bellis”, Via Turi, 70013 Castellana Grotte, Italy; (R.C.); (A.B.); (I.F.); (C.B.); (A.C.)
| | | | - Vito Giannuzzi
- Gastroenterology Unit, National Institute of Gastroenterology—IRCCS “S. de Bellis”, Via Turi, 70013 Castellana Grotte, Italy; (V.G.); (R.C.)
| | - Raffaele Cozzolongo
- Gastroenterology Unit, National Institute of Gastroenterology—IRCCS “S. de Bellis”, Via Turi, 70013 Castellana Grotte, Italy; (V.G.); (R.C.)
| | - Nicola Veronese
- Geriatric Unit, Department of Medicine, University of Palermo, 90100 Palermo, Italy;
| | - Alberto Ruben Osella
- Laboratory of Epidemiology and Statistics, National Institute of Gastroenterology—IRCCS “S. de Bellis”, Via Turi, 70013 Castellana Grotte, Italy; (R.C.); (A.B.); (I.F.); (C.B.); (A.C.)
| |
Collapse
|
14
|
Donghia R, Pesole PL, Coletta S, Bonfiglio C, De Pergola G, De Nucci S, Rinaldi R, Giannelli G. Food Network Analysis in Non-Obese Patients with or without Steatosis. Nutrients 2023; 15:2713. [PMID: 37375618 DOI: 10.3390/nu15122713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/05/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Steatosis is the most common liver disease worldwide and the leading cause of liver-associated morbidity and mortality. The aim of this study was to explore the differences in blood parameters and dietary habits in non-obese patients with and without steatosis. METHODS The present study included 987 participants with BMI < 30, assessed in the fourth recall of the MICOL study. Patients were divided by steatosis grade, and a validated food frequency questionnaire (FFQ) with 28 food groups was administered. RESULTS The prevalence of non-obese participants with steatosis was 42.86%. Overall, the results indicated many statistically significant blood parameters and dietary habits. Analysis of dietary habits revealed that non-obese people with or without steatosis had similar dietary habits, although higher daily amounts of red meat, processed meat, ready meals, and alcohol were recorded in participants with liver disease (p < 0.05). CONCLUSIONS Many differences were found in non-obese people with and without steatosis, but in light of a network analysis, the two groups demonstrated similar dietary habits, proving that pathophysiological, genetic, and hormonal patterns are probably the basis of their liver status, regardless of weight. Future genetic analyses will be performed to analyze the expression of genes involved in the development of steatosis in our cohort.
Collapse
Affiliation(s)
- Rossella Donghia
- National Institute of Gastroenterology-IRCCS "Saverio de Bellis", 70013 Castellana Grotte, Italy
| | - Pasqua Letizia Pesole
- National Institute of Gastroenterology-IRCCS "Saverio de Bellis", 70013 Castellana Grotte, Italy
| | - Sergio Coletta
- National Institute of Gastroenterology-IRCCS "Saverio de Bellis", 70013 Castellana Grotte, Italy
| | - Caterina Bonfiglio
- National Institute of Gastroenterology-IRCCS "Saverio de Bellis", 70013 Castellana Grotte, Italy
| | - Giovanni De Pergola
- National Institute of Gastroenterology-IRCCS "Saverio de Bellis", 70013 Castellana Grotte, Italy
| | - Sara De Nucci
- National Institute of Gastroenterology-IRCCS "Saverio de Bellis", 70013 Castellana Grotte, Italy
| | - Roberta Rinaldi
- National Institute of Gastroenterology-IRCCS "Saverio de Bellis", 70013 Castellana Grotte, Italy
| | - Gianluigi Giannelli
- National Institute of Gastroenterology-IRCCS "Saverio de Bellis", 70013 Castellana Grotte, Italy
| |
Collapse
|
15
|
Calabrese FM, Celano G, Bonfiglio C, Campanella A, Franco I, Annunziato A, Giannelli G, Osella AR, De Angelis M. Synergistic Effect of Diet and Physical Activity on a NAFLD Cohort: Metabolomics Profile and Clinical Variable Evaluation. Nutrients 2023; 15:nu15112457. [PMID: 37299420 DOI: 10.3390/nu15112457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/16/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023] Open
Abstract
Together with its comorbidities, nonalcoholic fatty liver disease (NAFLD) is likely to rise further with the obesity epidemic. However, the literature's evidence shows how its progression can be reduced by the administration of calorie-restrictive dietary interventions and physical activity regimens. The liver function and the gut microbiota have been demonstrated to be closely related. With the aim of ascertaining the impact of a treatment based on the combination of diet and physical activity (versus physical activity alone), we recruited 46 NAFLD patients who were divided into two groups. As a result, we traced the connection between volatile organic compounds (VOCs) from fecal metabolomics and a set of statistically filtered clinical variables. Additionally, we identified the relative abundances of gut microbiota taxa obtained from 16S rRNA gene sequencing. Statistically significant correlations emerged between VOCs and clinical parameters, as well as between VOCs and gut microbiota taxa. In comparison with a physical activity regimen alone, we disclose how ethyl valerate and pentanoic acid butyl ester, methyl valerate, and 5-hepten-2-one, 6-methyl changed because of the positive synergistic effect exerted by the combination of the Mediterranean diet and physical activity regimens. Moreover, 5-hepten-2-one, 6-methyl positively correlated with Sanguinobacteroides, as well as the two genera Oscillospiraceae-UCG002 and Ruminococcaceae UCG010 genera.
Collapse
Affiliation(s)
| | - Giuseppe Celano
- Department of Soil, Plant and Food Science, University of Bari Aldo Moro, 70126 Bari, Italy
| | - Caterina Bonfiglio
- National Institute of Gastroenterology S. De Bellis, IRCCS Research Hospital, Via Turi 27, 70013 Castellana Grotte, Italy
| | - Angelo Campanella
- National Institute of Gastroenterology S. De Bellis, IRCCS Research Hospital, Via Turi 27, 70013 Castellana Grotte, Italy
| | - Isabella Franco
- National Institute of Gastroenterology S. De Bellis, IRCCS Research Hospital, Via Turi 27, 70013 Castellana Grotte, Italy
| | - Alessandro Annunziato
- Department of Soil, Plant and Food Science, University of Bari Aldo Moro, 70126 Bari, Italy
| | - Gianluigi Giannelli
- National Institute of Gastroenterology S. De Bellis, IRCCS Research Hospital, Via Turi 27, 70013 Castellana Grotte, Italy
| | - Alberto Ruben Osella
- National Institute of Gastroenterology S. De Bellis, IRCCS Research Hospital, Via Turi 27, 70013 Castellana Grotte, Italy
| | - Maria De Angelis
- Department of Soil, Plant and Food Science, University of Bari Aldo Moro, 70126 Bari, Italy
| |
Collapse
|
16
|
Bianco A, Franco I, Curci R, Bonfiglio C, Campanella A, Mirizzi A, Fucilli F, Di Giovanni G, Giampaolo N, Pesole PL, Osella AR. Diet and Exercise Exert a Differential Effect on Glucose Metabolism Markers According to the Degree of NAFLD Severity. Nutrients 2023; 15:nu15102252. [PMID: 37242135 DOI: 10.3390/nu15102252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/05/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Non-Alcoholic Fatty Liver Disease (NAFLD) and Type 2 Diabetes (T2D) are highly prevalent diseases worldwide. Insulin Resistance (IR) is the common denominator of the two conditions even if the precise timing of onset is unknown. Lifestyle change remains the most effective treatment to manage NAFLD. This study aimed to estimate the effect of the Low Glycemic Index Mediterranean Diet (LGIMD) and exercise (aerobic and resistance) over a one-year period on the longitudinal trajectories of glucose metabolism regulatory pathways. MATERIALS AND METHODS In this observational study, 58 subjects (aged 18-65) with different degrees of NAFLD severity were enrolled by the National Institute of Gastroenterology-IRCCS "S. de Bellis", to follow a 12-month program of combined exercise and diet. RESULTS The mean age was 55 ± 7 years old. Gender was equally distributed among NAFLD categories. There was a statistically significant main effect of time for glycosylated hemoglobin (Hb1Ac) over the whole period (-5.41, 95% CI: -7.51; -3.32). There was a steady, statistically significant decrease of HbA1c in participants with moderate and severe NAFLD whereas this effect was observed after the 9th month in those with mild NAFLD. CONCLUSIONS The proposed program significantly improves glucose metabolism parameters, especially HbA1c.
Collapse
Affiliation(s)
- Antonella Bianco
- Laboratory of Epidemiology and Statistics, National Institute of Gastroenterology-IRCCS "S. de Bellis", Via Turi, 70013 Castellana Grotte, BA, Italy
| | - Isabella Franco
- Laboratory of Epidemiology and Statistics, National Institute of Gastroenterology-IRCCS "S. de Bellis", Via Turi, 70013 Castellana Grotte, BA, Italy
| | - Ritanna Curci
- Laboratory of Epidemiology and Statistics, National Institute of Gastroenterology-IRCCS "S. de Bellis", Via Turi, 70013 Castellana Grotte, BA, Italy
| | - Caterina Bonfiglio
- Laboratory of Epidemiology and Statistics, National Institute of Gastroenterology-IRCCS "S. de Bellis", Via Turi, 70013 Castellana Grotte, BA, Italy
| | - Angelo Campanella
- Laboratory of Epidemiology and Statistics, National Institute of Gastroenterology-IRCCS "S. de Bellis", Via Turi, 70013 Castellana Grotte, BA, Italy
| | - Antonella Mirizzi
- Laboratory of Epidemiology and Statistics, National Institute of Gastroenterology-IRCCS "S. de Bellis", Via Turi, 70013 Castellana Grotte, BA, Italy
| | - Fabio Fucilli
- Department of Radiology, National Institute of Gastroenterology-IRCCS "S. de Bellis", 70013 Castellana Grotte, BA, Italy
| | - Giuseppe Di Giovanni
- Department of Radiology, National Institute of Gastroenterology-IRCCS "S. de Bellis", 70013 Castellana Grotte, BA, Italy
| | - Nicola Giampaolo
- Department of Radiology, National Institute of Gastroenterology-IRCCS "S. de Bellis", 70013 Castellana Grotte, BA, Italy
| | - Pasqua Letizia Pesole
- Laboratory of Clinical Pathology, National Institute of Gastroenterology-IRCCS "S. de Bellis", 70013 Castellana Grotte, BA, Italy
| | - Alberto Ruben Osella
- Laboratory of Epidemiology and Statistics, National Institute of Gastroenterology-IRCCS "S. de Bellis", Via Turi, 70013 Castellana Grotte, BA, Italy
| |
Collapse
|
17
|
Caretto A, Pintus S, Petroni ML, Osella AR, Bonfiglio C, Morabito S, Zuliani P, Sturda A, Castronuovo M, Lagattolla V, Maghetti A, Lapini E, Bianco AM, Cisternino M, Cerutti N, Mulas CA, Hassan O, Cardamone N, Parillo M, Sonni L. Determinants of weight, psychological status, food contemplation and lifestyle changes in patients with obesity during the COVID-19 lockdown: a nationwide survey using multiple correspondence analysis. Int J Obes (Lond) 2022; 46:1280-1287. [PMID: 35306529 PMCID: PMC8933751 DOI: 10.1038/s41366-022-01100-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 12/12/2021] [Accepted: 02/14/2022] [Indexed: 12/25/2022]
Abstract
INTRODUCTION The corona virus disease 2019 (COVID-19) pandemic forced most of the Italian population into lockdown from 11 March to 18 May 2020. A nationwide survey of Italian Clinical Nutrition and Dietetic Services (Obesity Centers or OCs) was carried out to assess the impact of lockdown restrictions on the physical and mental wellbeing of patients with obesity (PWO) who had follow-up appointments postponed due to lockdown restrictions and to compare determinants of weight gain before and after the pandemic. METHODS We designed a structured 77-item questionnaire covering employment status, diet, physical activity and psychological aspects, that was disseminated through follow-up calls and online between 2 May and 25 June 2020. Data were analyzed by multiple correspondence analysis (MCA) and multiple linear regression. RESULTS A total of 1,232 PWO from 26 OCs completed the questionnaires (72% female, mean age 50.2 ± 14.2 years; mean BMI 34.7 ± 7.6 kg/m2; 41% obesity class II to III). During the lockdown, 48.8% gained, 27.1% lost, while the remainder (24.1%) maintained their weight. The mean weight change was +2.3 ± 4.8 kg (in weight gainers: +4.0 ± 2.4 kg; +4.2% ± 5.4%). Approximately 37% of participants experienced increased emotional difficulties, mostly fear and dissatisfaction. Sixty-one percent reduced their physical activity (PA) and 55% experienced a change in sleep quality/quantity. The lack of online contact (37.5%) with the OC during lockdown strongly correlated with weight gain (p < 0.001). Using MCA, two main clusters were identified: those with unchanged or even improved lifestyles during lockdown (Cluster 1) and those with worse lifestyles during the same time (Cluster 2). The latter includes unemployed people experiencing depression, boredom, dissatisfaction and increased food contemplation and weight gain. Within Cluster 2, homemakers reported gaining weight and experiencing anger due to home confinement. CONCLUSIONS Among Italian PWO, work status, emotional dysregulation, and lack of online communication with OCs were determinants of weight gain during the lockdown period.
Collapse
Affiliation(s)
- A Caretto
- Endocrinology, Metabolic diseases and Clinical Nutrition, Ospedale Perrino, Brindisi, Italy.
| | - S Pintus
- Bariatric Surgery Center, ARNAS Brotzu, Cagliari, Italy
| | - M L Petroni
- Metabolism and Clinical Nutrition Unit, IRCCS Policlinico S. Orsola, Alma Mater University of Bologna, Bologna, Italy
| | - A R Osella
- Epidemiology and Statistics, IRCCS Saverio De Bellis, Castellana Grotte, BA, Italy
| | - C Bonfiglio
- Epidemiology and Statistics, IRCCS Saverio De Bellis, Castellana Grotte, BA, Italy
| | | | - P Zuliani
- Obesity Day Center, Sorrento, NA, Italy
| | - A Sturda
- Endocrinology, Metabolic diseases and Clinical Nutrition, Ospedale Perrino, Brindisi, Italy
| | | | - V Lagattolla
- Endocrinology, Metabolic diseases and Clinical Nutrition, Ospedale Perrino, Brindisi, Italy
| | - A Maghetti
- Metabolism and Clinical Nutrition Unit, IRCCS Policlinico S. Orsola, Alma Mater University of Bologna, Bologna, Italy
| | - E Lapini
- Obesity Rehab Unit, Ospedali Privati Forli, Forlì, Italy
| | - A M Bianco
- U.O.C. Igiene degli Alimenti e della Nutrizione ASP, Potenza, Italy
| | - M Cisternino
- Clinical Nutrition, IRCCS "S. De Bellis", Castellana Grotte, BA, Italy
| | - N Cerutti
- UOSD Medicina Generale a Indirizzo Dietologico ASST, Pavia, Italy
| | - C A Mulas
- Clinical Dietary Service "Holy Spirit" Hospital Casale Monferrato ASLAL, Alessandria, Italy
| | - O Hassan
- UOSD Diabetology, San Camillo Hospital -, Roma, Italy
| | | | - M Parillo
- Azienda ospedaliera S. Anna S. Sebastiano, Caserta, Italy
| | | |
Collapse
|
18
|
Alrerio D, Corrao G, Zorzi S, Agostini G, Marvaso G, Volpe S, Bergamaschi L, Pedone C, Franzetti J, Bonfiglio C, Camarda A, Tagliabue M, Cossu Rocca M, Ansarin M, Jereczek-Fossa B. PO-1088 Toxicity Profile Of 100 Oropharyngeal Cancer Patients Treated With Modern Approaches. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03052-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
19
|
Scavo MP, Depalo N, Rizzi F, Carrieri L, Serino G, Franco I, Bonfiglio C, Pesole PL, Cozzolongo R, Gianuzzi V, Curri ML, Osella AR, Giannelli G. Exosomal FZD-7 Expression Is Modulated by Different Lifestyle Interventions in Patients with NAFLD. Nutrients 2022; 14:nu14061133. [PMID: 35334792 PMCID: PMC8950750 DOI: 10.3390/nu14061133] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/24/2022] [Accepted: 03/03/2022] [Indexed: 02/07/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is a multifactorial condition characterized from hypertriglyceridemia and hepatic fat accumulation, in the absence of alcohol intake. NAFLD starts as steatosis (NAFL), and the continued injury relative to the toxic fat induces inflammation, steatohepatitis (NASH), and HCC. One of the factors determining liver degeneration during the evolution of NAFLD is a modification of Wnt/Frizzled (FZD) signaling. In particular, an inhibition of Wnt signaling and an overexpression of a specific FZD receptor protein, namely, the FZD7, have been observed in NAFLD. Actually, the prognosis and the follow-up of NAFLD is not easy, and the liver biopsy is the gold standard for an accurate detection of liver fibrosis. In this study, the modulation of the FZD7 expression levels in plasma-derived exosomes of NAFLD-affected patients, before and after specific lifestyle interventions, were experimentally evaluated by Western blotting analysis. The experimental data were analyzed by an accurate statistical study that indicated, in the exosomes derived from plasma of NAFLD patients with moderate or severe steatosis, an average expression level of FZD7 that was significantly higher than healthy subjects at baseline; conversely, the values were normalized after 90 days of specific lifestyle interventions. The overall results suggested that the FZD7 delivered by exosomes represents a good candidate as a new and effective biomarker for diagnosis and prognosis of NAFLD.
Collapse
Affiliation(s)
- Maria Principia Scavo
- Laboratory of Personalized Medicine, National Institute of Gastroenterology “S. De Bellis” Research Hospital, Via Turi 27, Castellana Grotte, 70013 Bari, Italy;
- Correspondence: (M.P.S.); (N.D.); Tel.: +39-080-4994697 (M.P.S.)
| | - Nicoletta Depalo
- Institute for Chemical-Physical Processes, Italian National Research Council (IPCF)-CNR SS Bari, Via Orabona 4, 70125 Bari, Italy; (F.R.); (M.L.C.)
- Correspondence: (M.P.S.); (N.D.); Tel.: +39-080-4994697 (M.P.S.)
| | - Federica Rizzi
- Institute for Chemical-Physical Processes, Italian National Research Council (IPCF)-CNR SS Bari, Via Orabona 4, 70125 Bari, Italy; (F.R.); (M.L.C.)
- Dipartimento di Chimica, Università degli Studi di Bari Aldo Moro, Via Orabona 4, 70125 Bari, Italy
| | - Livianna Carrieri
- Laboratory of Personalized Medicine, National Institute of Gastroenterology “S. De Bellis” Research Hospital, Via Turi 27, Castellana Grotte, 70013 Bari, Italy;
| | - Grazia Serino
- Molecular Medicine, National Institute of Gastroenterology “S. de Bellis”, Research Hospital, Via Turi 27, Castellana Grotte, 70013 Bari, Italy;
| | - Isabella Franco
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology “S. De Bellis” Research Hospital, Via Turi 27, Castellana Grotte, 70013 Bari, Italy; (I.F.); (C.B.); (A.R.O.)
| | - Caterina Bonfiglio
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology “S. De Bellis” Research Hospital, Via Turi 27, Castellana Grotte, 70013 Bari, Italy; (I.F.); (C.B.); (A.R.O.)
| | - Pasqua Letizia Pesole
- Department of Pathology, National Institute of Gastroenterology “S. de Bellis”, Research Hospital, Via Turi 27, Castellana Grotte, 70013 Bari, Italy;
| | - Raffaele Cozzolongo
- Department of Gastroenterology, National Institute of Gastroenterology, “S. de Bellis” Research Hospital, Castellana Grotte, Via Turi 27, Castellana Grotte, 70013 Bari, Italy; (R.C.); (V.G.)
| | - Vito Gianuzzi
- Department of Gastroenterology, National Institute of Gastroenterology, “S. de Bellis” Research Hospital, Castellana Grotte, Via Turi 27, Castellana Grotte, 70013 Bari, Italy; (R.C.); (V.G.)
| | - Maria Lucia Curri
- Institute for Chemical-Physical Processes, Italian National Research Council (IPCF)-CNR SS Bari, Via Orabona 4, 70125 Bari, Italy; (F.R.); (M.L.C.)
- Dipartimento di Chimica, Università degli Studi di Bari Aldo Moro, Via Orabona 4, 70125 Bari, Italy
| | - Alberto Ruben Osella
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology “S. De Bellis” Research Hospital, Via Turi 27, Castellana Grotte, 70013 Bari, Italy; (I.F.); (C.B.); (A.R.O.)
| | - Gianluigi Giannelli
- Scientific Direction, National Institute of Gastroenterology “S. de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy;
| |
Collapse
|
20
|
Mirizzi A, Aballay LR, Misciagna G, Caruso MG, Bonfiglio C, Sorino P, Bianco A, Campanella A, Franco I, Curci R, Procino F, Cisternino AM, Notarnicola M, D’Aprile PF, Osella AR. Modified WCRF/AICR Score and All-Cause, Digestive System, Cardiovascular, Cancer and Other-Cause-Related Mortality: A Competing Risk Analysis of Two Cohort Studies Conducted in Southern Italy. Nutrients 2021; 13:nu13114002. [PMID: 34836259 PMCID: PMC8620807 DOI: 10.3390/nu13114002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/05/2021] [Accepted: 11/06/2021] [Indexed: 01/19/2023] Open
Abstract
Background: In real life, nutrition goes beyond purely biological domains. Primary prevention is the most efficient approach for reducing the risk of mortality. We aimed to study the association of lifestyle, as measured by a modified World Cancer Research Fund/American Institute for Cancer Research (mWCRF/AICR) scoring system with all-cause, digestive system disease-related (DSD-related), cardiovascular disease-related (CVD-related), cancer–related and other cause-related mortality using data from two population-based cohort studies conducted in Southern Italy. Methods: A random sample of 5271 subjects aged 18 years or older was enrolled in 2005–2006 and followed up until 2020. Usual food intakes were estimated using a validated dietary questionnaire. Competing risks survival models were applied. Results: High adherence to the mWCRF/AICR score was found to be statistically significant and negatively associated with all-cause mortality (HR 0.56, 95%CI 0.39; 0.82), DSD-related mortality (SHR 0.38, 95%CI 0.15; 0.97) and cancer-related mortality (SHR 0.43, 95%CI 0.19; 0.97) in the male sub-cohort and other-cause mortality (SHR 0.43, 95%CI 0.21; 0.88) only in the female group. Conclusions: This mWCRF/AICR score can be seen as a simple, easy tool for use in clinical practice to evaluate both qualitative and quantitative aspects of the diet.
Collapse
Affiliation(s)
- Antonella Mirizzi
- Laboratory of Epidemiology and Biostatistics, National Gastroenterology Institute, “S. de Bellis” Research Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy; (A.M.); (C.B.); (P.S.); (A.B.); (A.C.); (I.F.); (R.C.); (F.P.); (P.F.D.)
| | - Laura R. Aballay
- Human Nutrition Research Center (CenINH), School of Nutrition, Faculty of Medical Sciences, Universidad Nacional de Córdoba, Córdoba X5000, Argentina;
| | - Giovanni Misciagna
- Scientific and Ethical Committee Polyclinic Hospital, University of Bari, 70124 Bari, Puglia, Italy; (G.M.); (M.G.C.)
| | - Maria G. Caruso
- Scientific and Ethical Committee Polyclinic Hospital, University of Bari, 70124 Bari, Puglia, Italy; (G.M.); (M.G.C.)
- Clinical Nutrition Outpatients Clinic, National Gastroenterology Institute, “S. de Bellis” Research Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy;
| | - Caterina Bonfiglio
- Laboratory of Epidemiology and Biostatistics, National Gastroenterology Institute, “S. de Bellis” Research Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy; (A.M.); (C.B.); (P.S.); (A.B.); (A.C.); (I.F.); (R.C.); (F.P.); (P.F.D.)
| | - Paolo Sorino
- Laboratory of Epidemiology and Biostatistics, National Gastroenterology Institute, “S. de Bellis” Research Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy; (A.M.); (C.B.); (P.S.); (A.B.); (A.C.); (I.F.); (R.C.); (F.P.); (P.F.D.)
| | - Antonella Bianco
- Laboratory of Epidemiology and Biostatistics, National Gastroenterology Institute, “S. de Bellis” Research Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy; (A.M.); (C.B.); (P.S.); (A.B.); (A.C.); (I.F.); (R.C.); (F.P.); (P.F.D.)
| | - Angelo Campanella
- Laboratory of Epidemiology and Biostatistics, National Gastroenterology Institute, “S. de Bellis” Research Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy; (A.M.); (C.B.); (P.S.); (A.B.); (A.C.); (I.F.); (R.C.); (F.P.); (P.F.D.)
| | - Isabella Franco
- Laboratory of Epidemiology and Biostatistics, National Gastroenterology Institute, “S. de Bellis” Research Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy; (A.M.); (C.B.); (P.S.); (A.B.); (A.C.); (I.F.); (R.C.); (F.P.); (P.F.D.)
| | - Ritanna Curci
- Laboratory of Epidemiology and Biostatistics, National Gastroenterology Institute, “S. de Bellis” Research Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy; (A.M.); (C.B.); (P.S.); (A.B.); (A.C.); (I.F.); (R.C.); (F.P.); (P.F.D.)
| | - Filippo Procino
- Laboratory of Epidemiology and Biostatistics, National Gastroenterology Institute, “S. de Bellis” Research Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy; (A.M.); (C.B.); (P.S.); (A.B.); (A.C.); (I.F.); (R.C.); (F.P.); (P.F.D.)
| | - Anna M. Cisternino
- Clinical Nutrition Outpatients Clinic, National Gastroenterology Institute, “S. de Bellis” Research Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy;
| | - Maria Notarnicola
- Laboratory of Nutritional Biochemistry (MN), National Gastroenterology Institute, “S. de Bellis” Research Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy;
| | - Pierina F. D’Aprile
- Laboratory of Epidemiology and Biostatistics, National Gastroenterology Institute, “S. de Bellis” Research Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy; (A.M.); (C.B.); (P.S.); (A.B.); (A.C.); (I.F.); (R.C.); (F.P.); (P.F.D.)
| | - Alberto R. Osella
- Laboratory of Epidemiology and Biostatistics, National Gastroenterology Institute, “S. de Bellis” Research Hospital, Via Turi 27, 70013 Castellana Grotte, Bari, Italy; (A.M.); (C.B.); (P.S.); (A.B.); (A.C.); (I.F.); (R.C.); (F.P.); (P.F.D.)
- Correspondence: ; Tel.: +39-0804994655; Fax: +39-0804994650
| |
Collapse
|
21
|
Sorino P, Campanella A, Bonfiglio C, Mirizzi A, Franco I, Bianco A, Caruso MG, Misciagna G, Aballay LR, Buongiorno C, Liuzzi R, Cisternino AM, Notarnicola M, Chiloiro M, Fallucchi F, Pascoschi G, Osella AR. Development and validation of a neural network for NAFLD diagnosis. Sci Rep 2021; 11:20240. [PMID: 34642390 PMCID: PMC8511336 DOI: 10.1038/s41598-021-99400-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 04/16/2021] [Accepted: 09/24/2021] [Indexed: 12/18/2022] Open
Abstract
Non-Alcoholic Fatty Liver Disease (NAFLD) affects about 20–30% of the adult population in developed countries and is an increasingly important cause of hepatocellular carcinoma. Liver ultrasound (US) is widely used as a noninvasive method to diagnose NAFLD. However, the intensive use of US is not cost-effective and increases the burden on the healthcare system. Electronic medical records facilitate large-scale epidemiological studies and, existing NAFLD scores often require clinical and anthropometric parameters that may not be captured in those databases. Our goal was to develop and validate a simple Neural Network (NN)-based web app that could be used to predict NAFLD particularly its absence. The study included 2970 subjects; training and testing of the neural network using a train–test-split approach was done on 2869 of them. From another population consisting of 2301 subjects, a further 100 subjects were randomly extracted to test the web app. A search was made to find the best parameters for the NN and then this NN was exported for incorporation into a local web app. The percentage of accuracy, area under the ROC curve, confusion matrix, Positive (PPV) and Negative Predicted Value (NPV) values, precision, recall and f1-score were verified. After that, Explainability (XAI) was analyzed to understand the diagnostic reasoning of the NN. Finally, in the local web app, the specificity and sensitivity values were checked. The NN achieved a percentage of accuracy during testing of 77.0%, with an area under the ROC curve value of 0.82. Thus, in the web app the NN evidenced to achieve good results, with a specificity of 1.00 and sensitivity of 0.73. The described approach can be used to support NAFLD diagnosis, reducing healthcare costs. The NN-based web app is easy to apply and the required parameters are easily found in healthcare databases.
Collapse
Affiliation(s)
- Paolo Sorino
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013, Castellana Grotte, BA, Italy
| | - Angelo Campanella
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013, Castellana Grotte, BA, Italy
| | - Caterina Bonfiglio
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013, Castellana Grotte, BA, Italy
| | - Antonella Mirizzi
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013, Castellana Grotte, BA, Italy
| | - Isabella Franco
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013, Castellana Grotte, BA, Italy
| | - Antonella Bianco
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013, Castellana Grotte, BA, Italy
| | - Maria Gabriella Caruso
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013, Castellana Grotte, BA, Italy
| | - Giovanni Misciagna
- Scientific and Ethical Committee, Polyclinic Hospital, University of Bari, Piazza Giulio Cesare, 11, 70124, Bari, BA, Italy
| | - Laura R Aballay
- Human Nutrition Research Center (CenINH), School of Nutrition, Faculty of Medical Sciences, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Claudia Buongiorno
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013, Castellana Grotte, BA, Italy
| | - Rosalba Liuzzi
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013, Castellana Grotte, BA, Italy
| | - Anna Maria Cisternino
- Clinical Nutrition Outpatient Clinic, National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013, Castellana Grotte, BA, Italy
| | - Maria Notarnicola
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013, Castellana Grotte, BA, Italy
| | - Marisa Chiloiro
- San Giacomo Hospital, Largo S. Veneziani, 21, 70043, Monopoli, BA, Italy
| | - Francesca Fallucchi
- Department of Engineering Sciences, Guglielmo Marconi University, Via plinio 44, 00193, Rome, Italy
| | - Giovanni Pascoschi
- Department of Electrical and Information Engineering, Polytechnic of Bari, Via Re David, 200, 70125, Bari, BA, Italy
| | - Alberto Rubén Osella
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013, Castellana Grotte, BA, Italy.
| |
Collapse
|
22
|
Bianco A, Franco I, Osella AR, Giannelli G, Riezzo G, Bonfiglio C, Prospero L, Sorino P, Russo F. Physical Activity Reduction and the Worsening of Gastrointestinal Health Status during the Second COVID-19 Home Confinement in Southern Italy. Int J Environ Res Public Health 2021; 18:ijerph18189554. [PMID: 34574477 PMCID: PMC8464817 DOI: 10.3390/ijerph18189554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/03/2021] [Accepted: 09/07/2021] [Indexed: 11/16/2022]
Abstract
Due to the COVID-19 pandemic, in December 2020, the Italian government established a second home confinement during the Christmas holidays. These restrictions offered the opportunity to utilize a well-defined model for observing the consequences of lifestyle changes of healthy individuals. This study aimed at estimating in healthy subjects from Southern Italy the physical activity (PA), the presence and the severity of gastrointestinal (GI) symptoms, and the association between the possible worsening of GI health status and the PA levels. An adapted version of the International PA Questionnaire-short form (IPAQ-SF) and the Gastrointestinal Symptom Rating Scale (GSRS) were proposed through Google’s online survey platform in three different periods via WhatsAppTM to 499 healthy subjects (62% females) from Apulia (25%), Calabria (37%), and Campania (38%). Our results showed statistically significant changes during the home confinement: reduced energy expenditure (EE) among overweight subjects (−239.82, 95%CI −405.74; −73.89) or those who had high GSRS total score (−1079.54, 95%CI −2027.43; −131.66). An increase in GSRS total score was observed in overweight subjects, reaching statistical significance in those from Campania. Our study supports the importance of PA to reduce health risks, including those related to the possible onset of GI tract diseases.
Collapse
Affiliation(s)
- Antonella Bianco
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, “S. de Bellis” Research Hospital, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (A.R.O.); (C.B.); (P.S.)
| | - Isabella Franco
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, “S. de Bellis” Research Hospital, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (A.R.O.); (C.B.); (P.S.)
| | - Alberto Rubén Osella
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, “S. de Bellis” Research Hospital, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (A.R.O.); (C.B.); (P.S.)
| | - Gianluigi Giannelli
- Scientific Direction, National Institute of Gastroenterology, “S. de Bellis” Research Hospital, 70013 Castellana Grotte, Italy;
| | - Giuseppe Riezzo
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology, “S. de Bellis” Research Hospital, 70013 Castellana Grotte, Italy; (G.R.); (L.P.)
| | - Caterina Bonfiglio
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, “S. de Bellis” Research Hospital, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (A.R.O.); (C.B.); (P.S.)
| | - Laura Prospero
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology, “S. de Bellis” Research Hospital, 70013 Castellana Grotte, Italy; (G.R.); (L.P.)
| | - Paolo Sorino
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, “S. de Bellis” Research Hospital, 70013 Castellana Grotte, Italy; (A.B.); (I.F.); (A.R.O.); (C.B.); (P.S.)
| | - Francesco Russo
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology, “S. de Bellis” Research Hospital, 70013 Castellana Grotte, Italy; (G.R.); (L.P.)
- Correspondence: ; Tel.: +39-080-499-4315
| |
Collapse
|
23
|
Campanella A, Misciagna G, Mirizzi A, Caruso MG, Bonfiglio C, Aballay LR, Vas de Arruda Silveira L, Bianco A, Franco I, Sorino P, Buongiorno C, Cisternino AM, Notarnicola M, Guerra VMB, Osella AR. The effect of the Mediterranean Diet on lifespan: a treatment-effect survival analysis of a population-based prospective cohort study in Southern Italy. Int J Epidemiol 2021; 50:245-255. [PMID: 33156916 DOI: 10.1093/ije/dyaa222] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The Mediterranean diet (MedDiet) is associated with good health. We aimed to estimate the effect of levels of adherence to the MedDiet on lifespan by performing treatment effects survival analysis. METHODS A sample of 5250 subjects aged ≥18 years were randomly selected from the electoral list of Castellana Grotte and Putignano (Apulian Region, Italy). Cohorts were enrolled in 2005-06 and followed-up until December 2018. The adherence to the MedDiet was measured by the relative Mediterranean score (rMED) and categorized as high, medium and low. Time-to-death (all-causes) as estimated by average treatment effect on the treated (ATET), potential outcome mean (POM) and relative efficiency of exposure were the outcomes. RESULTS A total of 4896 subjects were included. The median follow-up time was 12.82 (inter quartile range (IQR) 12.22-13.05), 12.91 (IQR 12.21-13.27) and 12.84 (IQR 12.19-13.03) years for high, medium and low rMED subjects respectively. By December 2018, 453 (9.25%) had died. There was a strong effect of medium and low rMED {ATET, -5.10 [95% confidence interval (CI) -9.39, -0.80] and -8.91 (95%CI -13.37, -4.45), respectively}. High rMED has an important effect on mean age at death [POM 90.16 (95% CI 86.06, 94.25)]. The relative effect size for medium and low rMED subjects was a lower lifespan of 5.62% (95% CI 1.01, 10.3) and 9.90% (95% CI 5.30, 5.30), respectively. CONCLUSIONS We observed an important benefit in additional years of survival from adherence to MedDiet in this southern Italian cohort. Further investigation corroborating our findings in other population groups in other geographic regions will be an important contribution to promoting health and longevity.
Collapse
Affiliation(s)
- Angelo Campanella
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology 'S de Bellis' Research Hospital, Castellana, Grotte, (BA), Italy.,Clinical Nutrition Outpatients Clinic, National Institute of Gastroenterology 'S de Bellis' Research Hospital, Castellana, Grotte, (BA), Italy.,Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology 'S de Bellis' Research Hospital, Castellana , Grotte, (BA), Italy
| | - Giovanni Misciagna
- Scientific and Ethical Committee Polyclinic Hospital, University of Bari, Italy
| | - Antonella Mirizzi
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology 'S de Bellis' Research Hospital, Castellana, Grotte, (BA), Italy.,Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology 'S de Bellis' Research Hospital, Castellana , Grotte, (BA), Italy
| | - Maria Gabriella Caruso
- Clinical Nutrition Outpatients Clinic, National Institute of Gastroenterology 'S de Bellis' Research Hospital, Castellana, Grotte, (BA), Italy.,Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology 'S de Bellis' Research Hospital, Castellana Grotte, (BA), Italy
| | - Caterina Bonfiglio
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology 'S de Bellis' Research Hospital, Castellana, Grotte, (BA), Italy.,Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology 'S de Bellis' Research Hospital, Castellana , Grotte, (BA), Italy
| | - Laura R Aballay
- Human Nutrition Research Center (CenINH), School of Nutrition, Faculty of Medical Sciences, Universidad Nacional de Córdoba, Córdoba, Argentina
| | | | - Antonella Bianco
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology 'S de Bellis' Research Hospital, Castellana, Grotte, (BA), Italy.,Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology 'S de Bellis' Research Hospital, Castellana , Grotte, (BA), Italy
| | - Isabella Franco
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology 'S de Bellis' Research Hospital, Castellana, Grotte, (BA), Italy.,Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology 'S de Bellis' Research Hospital, Castellana , Grotte, (BA), Italy
| | - Paolo Sorino
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology 'S de Bellis' Research Hospital, Castellana , Grotte, (BA), Italy
| | - Claudia Buongiorno
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology 'S de Bellis' Research Hospital, Castellana, Grotte, (BA), Italy.,Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology 'S de Bellis' Research Hospital, Castellana , Grotte, (BA), Italy
| | - Anna Maria Cisternino
- Clinical Nutrition Outpatients Clinic, National Institute of Gastroenterology 'S de Bellis' Research Hospital, Castellana, Grotte, (BA), Italy
| | - Maria Notarnicola
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology 'S de Bellis' Research Hospital, Castellana, Grotte, (BA), Italy
| | - Vito M B Guerra
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology 'S de Bellis' Research Hospital, Castellana, Grotte, (BA), Italy.,Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology 'S de Bellis' Research Hospital, Castellana , Grotte, (BA), Italy
| | - Alberto R Osella
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology 'S de Bellis' Research Hospital, Castellana, Grotte, (BA), Italy.,Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology 'S de Bellis' Research Hospital, Castellana , Grotte, (BA), Italy
| |
Collapse
|
24
|
Franco I, Bianco A, Bonfiglio C, Sorino P, Mirizzi A, Campanella A, Buongiorno C, Liuzzi R, Osella AR. Decreased levels of physical activity: results from a cross-sectional study in southern Italy during the COVID-19 lockdown. J Sports Med Phys Fitness 2021; 61:294-300. [PMID: 33570347 DOI: 10.23736/s0022-4707.20.11536-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND During the COVID-19 pandemic, the Italian government took security measures to try to limit infections. Restrictive measures included social distancing, home confinement and the closure of all public structures like gyms and swimming pools. The impact of these limitations on health and lifestyle was inevitably negative. The purpose of this study was to establish the level of physical activity (PA), expressed as energy expenditure (MET-minute/week) in a Southern Italian population before and during the COVID-19 lockdown. METHODS An adapted version of the International Physical Activity Questionnaire-short form (IPAQ-SF) was published on the official website of the National Institute of Gastroenterology IRCCS S. de Bellis, Castellana Grotte, Bari, Italy and on several social media in May 2020. RESULTS Three hundred ten replies (72% women) from Apulia (60%), Calabria (28%), Campania (11%) and Sicily (1%) were included in the study. The COVID-19 lockdown had a negative effect on the vigorous PA intensity level and on walking, but not on the moderate PA intensity level. Additionally, daily time spent sitting down increased by more than 12% during the COVID-19 lockdown. CONCLUSIONS Isolation changed PA behaviors. The decreased energy expenditure (MET-minute/week) during the lockdown had a negative impact in both genders, especially on the young adults and adults' groups.
Collapse
Affiliation(s)
- Isabella Franco
- Laboratory of Epidemiology and Biostatistics, IRCCS S. de Bellis, Castellana Grotte, Bari, Italy
| | - Antonella Bianco
- Laboratory of Epidemiology and Biostatistics, IRCCS S. de Bellis, Castellana Grotte, Bari, Italy
| | - Caterina Bonfiglio
- Laboratory of Epidemiology and Biostatistics, IRCCS S. de Bellis, Castellana Grotte, Bari, Italy
| | - Paolo Sorino
- Laboratory of Epidemiology and Biostatistics, IRCCS S. de Bellis, Castellana Grotte, Bari, Italy
| | - Antonella Mirizzi
- Laboratory of Epidemiology and Biostatistics, IRCCS S. de Bellis, Castellana Grotte, Bari, Italy
| | - Angelo Campanella
- Laboratory of Epidemiology and Biostatistics, IRCCS S. de Bellis, Castellana Grotte, Bari, Italy
| | - Claudia Buongiorno
- Laboratory of Epidemiology and Biostatistics, IRCCS S. de Bellis, Castellana Grotte, Bari, Italy
| | - Rosalba Liuzzi
- Laboratory of Epidemiology and Biostatistics, IRCCS S. de Bellis, Castellana Grotte, Bari, Italy
| | - Alberto R Osella
- Laboratory of Epidemiology and Biostatistics, IRCCS S. de Bellis, Castellana Grotte, Bari, Italy -
| |
Collapse
|
25
|
Bonfiglio C, Leone CM, Silveira LVA, Guerra R, Misciagna G, Caruso MG, Bruno I, Buongiorno C, Campanella A, Guerra VMB, Notarnicola M, Deflorio V, Franco I, Bianco A, Mirizzi A, Aballay LR, Cisternino AM, Sorino P, Pesole PL, Osella AR. Remnant cholesterol as a risk factor for cardiovascular, cancer or other causes mortality: A competing risks analysis. Nutr Metab Cardiovasc Dis 2020; 30:2093-2102. [PMID: 32819783 DOI: 10.1016/j.numecd.2020.07.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 02/11/2020] [Revised: 05/08/2020] [Accepted: 07/01/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIMS Cardiovascular diseases (CVDis) are leading causes of morbidity and mortality. Even after the introduction of pharmacological therapy to lower Cholesterol, there is still a residual risk that may be ascribed to remnant cholesterol (RC). We aimed, by analyzing two prospective cohort studies, to estimate the effect of RC on risk and hazard of cardiovascular deaths (CVDs), while accounting for competing risks such as cancer (CDs) and other-causes deaths (OCDs). METHODS AND RESULTS Cohorts were enrolled in 1992 and 2005. Personal data history was recorded. A fasting venous blood sample was obtained, and RC was calculated at baseline. Cause of Death was coded by using ICD-10th version. Follow-up ended on December 31, 2017. Flexible parametric competing-risks models were applied, with age at death as time-axis. In total, 5729 subjects were enrolled. There were 861 (15.1%) deaths: 234 CVDs (27.2%), 245 CDs (28.5%), 271 OCDs (31.5%) and 111 unknown causes of death (12.8%). RC exposure was a strong risk factor only for CVDs (Risk 2.54, 95% Confidence Interval 1.21; 5.34; Trend 1.26 (1.00; 1.58) for ≥1.29 mmol/L). CONCLUSIONS RC is a strong independent risk factor for cardiovascular mortality. Competing risk analysis is demonstrably a useful tool to disentangle associations among different competing events with a common risk factor.
Collapse
Affiliation(s)
- Caterina Bonfiglio
- Laboratory of Epidemiology and Biostatistics National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Alberto Ruben Osella, Caterina Bonfiglio, Carla Maria Leone, Rocco Guerra, Irene Bruno Claudia Buongiorno, Angelo Campanella, Vito Maria Bernardo Guerra, Valentina Deflorio, Isabella Franco, Antonella Bianco, Antonella Mirizzi, Paolo Sorino)
| | - Carla M Leone
- Laboratory of Epidemiology and Biostatistics National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Alberto Ruben Osella, Caterina Bonfiglio, Carla Maria Leone, Rocco Guerra, Irene Bruno Claudia Buongiorno, Angelo Campanella, Vito Maria Bernardo Guerra, Valentina Deflorio, Isabella Franco, Antonella Bianco, Antonella Mirizzi, Paolo Sorino)
| | - Liciana V A Silveira
- Department of Biostatistics, Biosciences Institute, São Paulo State University, Av Rubião Jr.-Centro, Botucatu-SP, 18618-970 Botucatu, São Paulo, Brazil (Liciana V.A. Silveira)
| | - Rocco Guerra
- Laboratory of Epidemiology and Biostatistics National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Alberto Ruben Osella, Caterina Bonfiglio, Carla Maria Leone, Rocco Guerra, Irene Bruno Claudia Buongiorno, Angelo Campanella, Vito Maria Bernardo Guerra, Valentina Deflorio, Isabella Franco, Antonella Bianco, Antonella Mirizzi, Paolo Sorino)
| | - Giovanni Misciagna
- Scientific and Ethical Committee, Policlinic Hospital, University of Bari, Piazza Giulio Cesare, 11, 70124 Bari, BA, Italy (Giovanni Misciagna)
| | - Maria G Caruso
- Laboratory of Nutritional Biochemistry National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Maria Gabriella Caruso, Maria Notarnicola); Clinical Nutrition Outpatient Clinic National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Anna Maria Cisternino)
| | - Irene Bruno
- Laboratory of Epidemiology and Biostatistics National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Alberto Ruben Osella, Caterina Bonfiglio, Carla Maria Leone, Rocco Guerra, Irene Bruno Claudia Buongiorno, Angelo Campanella, Vito Maria Bernardo Guerra, Valentina Deflorio, Isabella Franco, Antonella Bianco, Antonella Mirizzi, Paolo Sorino)
| | - Claudia Buongiorno
- Laboratory of Epidemiology and Biostatistics National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Alberto Ruben Osella, Caterina Bonfiglio, Carla Maria Leone, Rocco Guerra, Irene Bruno Claudia Buongiorno, Angelo Campanella, Vito Maria Bernardo Guerra, Valentina Deflorio, Isabella Franco, Antonella Bianco, Antonella Mirizzi, Paolo Sorino)
| | - Angelo Campanella
- Laboratory of Epidemiology and Biostatistics National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Alberto Ruben Osella, Caterina Bonfiglio, Carla Maria Leone, Rocco Guerra, Irene Bruno Claudia Buongiorno, Angelo Campanella, Vito Maria Bernardo Guerra, Valentina Deflorio, Isabella Franco, Antonella Bianco, Antonella Mirizzi, Paolo Sorino)
| | - Vito M B Guerra
- Laboratory of Epidemiology and Biostatistics National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Alberto Ruben Osella, Caterina Bonfiglio, Carla Maria Leone, Rocco Guerra, Irene Bruno Claudia Buongiorno, Angelo Campanella, Vito Maria Bernardo Guerra, Valentina Deflorio, Isabella Franco, Antonella Bianco, Antonella Mirizzi, Paolo Sorino)
| | - Maria Notarnicola
- Laboratory of Nutritional Biochemistry National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Maria Gabriella Caruso, Maria Notarnicola)
| | - Valentina Deflorio
- Laboratory of Epidemiology and Biostatistics National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Alberto Ruben Osella, Caterina Bonfiglio, Carla Maria Leone, Rocco Guerra, Irene Bruno Claudia Buongiorno, Angelo Campanella, Vito Maria Bernardo Guerra, Valentina Deflorio, Isabella Franco, Antonella Bianco, Antonella Mirizzi, Paolo Sorino)
| | - Isabella Franco
- Laboratory of Epidemiology and Biostatistics National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Alberto Ruben Osella, Caterina Bonfiglio, Carla Maria Leone, Rocco Guerra, Irene Bruno Claudia Buongiorno, Angelo Campanella, Vito Maria Bernardo Guerra, Valentina Deflorio, Isabella Franco, Antonella Bianco, Antonella Mirizzi, Paolo Sorino)
| | - Antonella Bianco
- Laboratory of Epidemiology and Biostatistics National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Alberto Ruben Osella, Caterina Bonfiglio, Carla Maria Leone, Rocco Guerra, Irene Bruno Claudia Buongiorno, Angelo Campanella, Vito Maria Bernardo Guerra, Valentina Deflorio, Isabella Franco, Antonella Bianco, Antonella Mirizzi, Paolo Sorino)
| | - Antonella Mirizzi
- Laboratory of Epidemiology and Biostatistics National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Alberto Ruben Osella, Caterina Bonfiglio, Carla Maria Leone, Rocco Guerra, Irene Bruno Claudia Buongiorno, Angelo Campanella, Vito Maria Bernardo Guerra, Valentina Deflorio, Isabella Franco, Antonella Bianco, Antonella Mirizzi, Paolo Sorino)
| | - Laura R Aballay
- Human Nutrition Research Center (CenINH), School of Nutrition, Faculty of Medical Sciences, Universidad Nacional de Córdoba, Córdoba, Argentina; Enrique Barros Pabellón Biología Celular, Ciudad Universitaria, X5000 Córdoba, Argentina
| | - Anna M Cisternino
- Clinical Nutrition Outpatient Clinic National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Anna Maria Cisternino)
| | - Paolo Sorino
- Laboratory of Epidemiology and Biostatistics National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Alberto Ruben Osella, Caterina Bonfiglio, Carla Maria Leone, Rocco Guerra, Irene Bruno Claudia Buongiorno, Angelo Campanella, Vito Maria Bernardo Guerra, Valentina Deflorio, Isabella Franco, Antonella Bianco, Antonella Mirizzi, Paolo Sorino)
| | - Pasqua L Pesole
- Laboratory of Clinical Pathology, National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Pasqua Letizia Pesole)
| | - Alberto R Osella
- Laboratory of Epidemiology and Biostatistics National Institute of Gastroenterology, "S de Bellis" Research Hospital, Via Turi 27, 70013 Castellana Grotte, BA, Italy (Alberto Ruben Osella, Caterina Bonfiglio, Carla Maria Leone, Rocco Guerra, Irene Bruno Claudia Buongiorno, Angelo Campanella, Vito Maria Bernardo Guerra, Valentina Deflorio, Isabella Franco, Antonella Bianco, Antonella Mirizzi, Paolo Sorino).
| |
Collapse
|
26
|
Sorino P, Caruso MG, Misciagna G, Bonfiglio C, Campanella A, Mirizzi A, Franco I, Bianco A, Buongiorno C, Liuzzi R, Cisternino AM, Notarnicola M, Chiloiro M, Pascoschi G, Osella AR. Selecting the best machine learning algorithm to support the diagnosis of Non-Alcoholic Fatty Liver Disease: A meta learner study. PLoS One 2020; 15:e0240867. [PMID: 33079971 PMCID: PMC7575109 DOI: 10.1371/journal.pone.0240867] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 10/03/2020] [Indexed: 02/08/2023] Open
Abstract
Background & aims Liver ultrasound scan (US) use in diagnosing Non-Alcoholic Fatty Liver Disease (NAFLD) causes costs and waiting lists overloads. We aimed to compare various Machine learning algorithms with a Meta learner approach to find the best of these as a predictor of NAFLD. Methods The study included 2970 subjects, 2920 constituting the training set and 50, randomly selected, used in the test phase, performing cross-validation. The best predictors were combined to create three models: 1) FLI plus GLUCOSE plus SEX plus AGE, 2) AVI plus GLUCOSE plus GGT plus SEX plus AGE, 3) BRI plus GLUCOSE plus GGT plus SEX plus AGE. Eight machine learning algorithms were trained with the predictors of each of the three models created. For these algorithms, the percent accuracy, variance and percent weight were compared. Results The SVM algorithm performed better with all models. Model 1 had 68% accuracy, with 1% variance and an algorithm weight of 27.35; Model 2 had 68% accuracy, with 1% variance and an algorithm weight of 33.62 and Model 3 had 77% accuracy, with 1% variance and an algorithm weight of 34.70. Model 2 was the most performing, composed of AVI plus GLUCOSE plus GGT plus SEX plus AGE, despite a lower percentage of accuracy. Conclusion A Machine Learning approach can support NAFLD diagnosis and reduce health costs. The SVM algorithm is easy to apply and the necessary parameters are easily retrieved in databases.
Collapse
Affiliation(s)
- Paolo Sorino
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, “S de Bellis” Research Hospital, Castellana Grotte, Bari, Italy
| | - Maria Gabriella Caruso
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology, “S de Bellis” Research Hospital, Castellana Grotte, Bari, Italy
| | - Giovanni Misciagna
- Scientific and Ethical Committee, Polyclinic Hospital, University of Bari, Bari, Italy
| | - Caterina Bonfiglio
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, “S de Bellis” Research Hospital, Castellana Grotte, Bari, Italy
| | - Angelo Campanella
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, “S de Bellis” Research Hospital, Castellana Grotte, Bari, Italy
| | - Antonella Mirizzi
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, “S de Bellis” Research Hospital, Castellana Grotte, Bari, Italy
| | - Isabella Franco
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, “S de Bellis” Research Hospital, Castellana Grotte, Bari, Italy
| | - Antonella Bianco
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, “S de Bellis” Research Hospital, Castellana Grotte, Bari, Italy
| | - Claudia Buongiorno
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, “S de Bellis” Research Hospital, Castellana Grotte, Bari, Italy
| | - Rosalba Liuzzi
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, “S de Bellis” Research Hospital, Castellana Grotte, Bari, Italy
| | - Anna Maria Cisternino
- Clinical Nutrition Outpatient Clinic, National Institute of Gastroenterology, “S de Bellis” Research Hospital, Castellana Grotte, Bari, Italy
| | - Maria Notarnicola
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology, “S de Bellis” Research Hospital, Castellana Grotte, Bari, Italy
| | - Marisa Chiloiro
- San Giacomo Hospital Largo S. Veneziani, Monopoli, Bari, Italy
| | - Giovanni Pascoschi
- Department of Electrical and Information Engineering, Polytechnic of Bari, Bari, Italy
| | - Alberto Rubén Osella
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, “S de Bellis” Research Hospital, Castellana Grotte, Bari, Italy
- * E-mail:
| | | |
Collapse
|
27
|
De Pergola G, Zupo R, Lampignano L, Bonfiglio C, Giannelli G, Osella AR, Triggiani V. Higher Body Mass Index, Uric Acid Levels, and Lower Cholesterol Levels are Associated with Greater Weight Loss. Endocr Metab Immune Disord Drug Targets 2020; 20:1268-1281. [DOI: 10.2174/1871530320666200429235830] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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] [Received: 10/23/2019] [Revised: 12/30/2019] [Accepted: 01/17/2020] [Indexed: 01/02/2023]
Abstract
Background:
Identifying predictive factors that contribute to changes in body weight may
well be an interesting approach to the management of obesity.
Objective:
This study was firstly aimed at examining the effect of a one-year lifestyle program based
on improvements in the habitual diet and increased levels of physical activity on weight loss. Secondly,
it was focused on identifying anthropometric, and serum hormonal, metabolic and haematochemical
factors which can be associated with the degree of weight loss in Kg.
Methods:
488 overweight or obese subjects, 383 women and 105 men, aged 18-67 years, were enrolled
in the study. Body mass index, waist circumference, serum blood glucose, lipids, uric acid, creatinine,
insulin, TSH, FT3, FT4, and 24-h urine catecholamines were measured.
Results:
Weight loss was positively associated with BMI (P < 0.01), waist circumference (P < 0.01),
uric acid (P < 0.01), creatinine (P < 0.05), smoking (P < 0.01), and negatively correlated with age (P <
0.01), total cholesterol (P < 0.05), LDL-cholesterol (P < 0.01), HDL cholesterol (P < 0.05). In a multiple
regression model considering weight loss as a dependent variable, and smoking, age, BMI, uric
acid, creatinine, total cholesterol, LDL-cholesterol and HDL cholesterol as independent variables,
weight loss maintained a direct independent relationship with BMI (P < 0.001), uric acid (P < 0.05),
LDL-cholesterol (P < 0.05), and HDL-cholesterol (P < 0.05), and an inverse independent association
with cholesterol (P < 0.01).
Conclusions:
This study suggests that higher BMI and uric acid levels, and lower total cholesterol concentrations
are associated with a greater potential to lose weight.
Collapse
Affiliation(s)
- Giovanni De Pergola
- Clinical Nutrition Unit, Medical Oncology, Department of Biomedical Science and Human Oncology, University of Bari, School of Medicine, Policlinic, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Roberta Zupo
- National Institute of Gastroenterology "S. de Bellis," Research Hospital, 70013, Castellana Grotte, Italy
| | - Luisa Lampignano
- National Institute of Gastroenterology "S. de Bellis," Research Hospital, 70013, Castellana Grotte, Italy
| | - Caterina Bonfiglio
- National Institute of Gastroenterology "S. de Bellis," Research Hospital, 70013, Castellana Grotte, Italy
| | - Gianluigi Giannelli
- National Institute of Gastroenterology "S. de Bellis," Research Hospital, 70013, Castellana Grotte, Italy
| | - Alberto R. Osella
- National Institute of Gastroenterology "S. de Bellis," Research Hospital, 70013, Castellana Grotte, Italy
| | - Vincenzo Triggiani
- Endocrinology and Metabolic Diseases, Interdisciplinary Department of Medicine, University of Bari “A. Moro” Bari, Italy
| |
Collapse
|
28
|
Campanella A, Iacovazzi PA, Misciagna G, Bonfiglio C, Mirizzi A, Franco I, Bianco A, Sorino P, Caruso MG, Cisternino AM, Buongiorno C, Liuzzi R, Osella AR. The Effect of Three Mediterranean Diets on Remnant Cholesterol and Non-Alcoholic Fatty Liver Disease: A Secondary Analysis. Nutrients 2020; 12:E1674. [PMID: 32512752 PMCID: PMC7352824 DOI: 10.3390/nu12061674] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 06/02/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Elevated fasting remnant cholesterol (REM-C) levels have been associated with an increased cardiovascular risk in patients with metabolic syndrome (Mets) and Non-Alcoholic Fatty Liver Disease (NAFLD). We aimed to estimate the effect of different diets on REM-C levels in patients with MetS, as well as the association between NAFLD and REM-C. METHODS This is a secondary analysis of the MEDIDIET study, a parallel-arm Randomized Clinical Trial (RCT). We examined 237 people with MetS who underwent Liver Ultrasound (LUS) to assess the NAFLD score at baseline, 3-, and 6-months follow-up. Subjects were randomly assigned to the Mediterranean diet (MD), Low Glycemic Index diet (LGID), or Low Glycemic Index Mediterranean diet (LGIMD). REM-C was calculated as [total cholesterol-low density lipoprotein cholesterol (LDL-C)-high density lipoprotein cholesterol (HDL-C)]. RESULTS REM-C levels were higher in subjects with moderate or severe NAFLD than in mild or absent ones. All diets had a direct effect in lowering the levels of REM-C after 3 and 6 months of intervention. In adherents subjects, this effect was stronger among LGIMD as compared to the control group. There was also a significant increase in REM-C levels among Severe NAFLD subjects at 3 months and a decrease at 6 months. CONCLUSIONS fasting REM-C level is independently associated with the grade of severity of NAFLD. LGIMD adherence directly reduced the fasting REM-C in patients with MetS.
Collapse
Affiliation(s)
- Angelo Campanella
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, “S. de Bellis” Research Hospital, Castellana Grotte (Bari), Via Turi 27, 70013 Castellana Grotte, Italy; (A.C.); (C.B.); (A.M.); (I.F.); (A.B.); (P.S.); (C.B.); (R.L.)
| | - Palma A. Iacovazzi
- Department of Clinical Pathology, National Institute of Gastroenterology, “S. de Bellis” Research Hospital, Castellana Grotte (Bari), Via Turi 27, 70013 Castellana Grotte, Italy;
| | - Giovanni Misciagna
- Scientific and Ethical Committee, University Hospital Policlinico, 70124 Bari, Italy;
| | - Caterina Bonfiglio
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, “S. de Bellis” Research Hospital, Castellana Grotte (Bari), Via Turi 27, 70013 Castellana Grotte, Italy; (A.C.); (C.B.); (A.M.); (I.F.); (A.B.); (P.S.); (C.B.); (R.L.)
| | - Antonella Mirizzi
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, “S. de Bellis” Research Hospital, Castellana Grotte (Bari), Via Turi 27, 70013 Castellana Grotte, Italy; (A.C.); (C.B.); (A.M.); (I.F.); (A.B.); (P.S.); (C.B.); (R.L.)
| | - Isabella Franco
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, “S. de Bellis” Research Hospital, Castellana Grotte (Bari), Via Turi 27, 70013 Castellana Grotte, Italy; (A.C.); (C.B.); (A.M.); (I.F.); (A.B.); (P.S.); (C.B.); (R.L.)
| | - Antonella Bianco
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, “S. de Bellis” Research Hospital, Castellana Grotte (Bari), Via Turi 27, 70013 Castellana Grotte, Italy; (A.C.); (C.B.); (A.M.); (I.F.); (A.B.); (P.S.); (C.B.); (R.L.)
| | - Paolo Sorino
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, “S. de Bellis” Research Hospital, Castellana Grotte (Bari), Via Turi 27, 70013 Castellana Grotte, Italy; (A.C.); (C.B.); (A.M.); (I.F.); (A.B.); (P.S.); (C.B.); (R.L.)
| | - Maria G. Caruso
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology, “S. de Bellis” Research Hospital, Castellana Grotte (Bari), Via Turi 27, 70013 Castellana Grotte, Italy; (M.G.C.); (A.M.C.)
| | - Anna M. Cisternino
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology, “S. de Bellis” Research Hospital, Castellana Grotte (Bari), Via Turi 27, 70013 Castellana Grotte, Italy; (M.G.C.); (A.M.C.)
| | - Claudia Buongiorno
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, “S. de Bellis” Research Hospital, Castellana Grotte (Bari), Via Turi 27, 70013 Castellana Grotte, Italy; (A.C.); (C.B.); (A.M.); (I.F.); (A.B.); (P.S.); (C.B.); (R.L.)
| | - Rosalba Liuzzi
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, “S. de Bellis” Research Hospital, Castellana Grotte (Bari), Via Turi 27, 70013 Castellana Grotte, Italy; (A.C.); (C.B.); (A.M.); (I.F.); (A.B.); (P.S.); (C.B.); (R.L.)
| | - Alberto R. Osella
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, “S. de Bellis” Research Hospital, Castellana Grotte (Bari), Via Turi 27, 70013 Castellana Grotte, Italy; (A.C.); (C.B.); (A.M.); (I.F.); (A.B.); (P.S.); (C.B.); (R.L.)
| |
Collapse
|
29
|
Belardinilli F, Capalbo C, Malapelle U, Pisapia P, Raimondo D, Milanetti E, Yasaman M, Liccardi C, Paci P, Sibilio P, Pepe F, Bonfiglio C, Mezi S, Magri V, Coppa A, Nicolussi A, Gradilone A, Petroni M, Di Giulio S, Fabretti F, Infante P, Coni S, Canettieri G, Troncone G, Giannini G. Clinical Multigene Panel Sequencing Identifies Distinct Mutational Association Patterns in Metastatic Colorectal Cancer. Front Oncol 2020; 10:560. [PMID: 32457828 PMCID: PMC7221020 DOI: 10.3389/fonc.2020.00560] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 10/02/2019] [Accepted: 03/27/2020] [Indexed: 12/12/2022] Open
Abstract
Extensive molecular characterization of human colorectal cancer (CRC) via Next Generation Sequencing (NGS) indicated that genetic or epigenetic dysregulation of a relevant, but limited, number of molecular pathways typically occurs in this tumor. The molecular picture of the disease is significantly complicated by the frequent occurrence of individually rare genetic aberrations, which expand tumor heterogeneity. Inter- and intratumor molecular heterogeneity is very likely responsible for the remarkable individual variability in the response to conventional and target-driven first-line therapies, in metastatic CRC (mCRC) patients, whose median overall survival remains unsatisfactory. Implementation of an extensive molecular characterization of mCRC in the clinical routine does not yet appear feasible on a large scale, while multigene panel sequencing of most commonly mutated oncogene/oncosuppressor hotspots is more easily achievable. Here, we report that clinical multigene panel sequencing performed for anti-EGFR therapy predictive purposes in 639 formalin-fixed paraffin-embedded (FFPE) mCRC specimens revealed previously unknown pairwise mutation associations and a high proportion of cases carrying actionable gene mutations. Most importantly, a simple principal component analysis directed the delineation of a new molecular stratification of mCRC patients in eight groups characterized by non-random, specific mutational association patterns (MAPs), aggregating samples with similar biology. These data were validated on a The Cancer Genome Atlas (TCGA) CRC dataset. The proposed stratification may provide great opportunities to direct more informed therapeutic decisions in the majority of mCRC cases.
Collapse
Affiliation(s)
| | - Carlo Capalbo
- Department of Molecular Medicine, University La Sapienza, Rome, Italy
| | | | - Pasquale Pisapia
- Department of Public Health, University Federico II, Naples, Italy
| | - Domenico Raimondo
- Department of Molecular Medicine, University La Sapienza, Rome, Italy
| | | | - Mahdavian Yasaman
- Department of Molecular Medicine, University La Sapienza, Rome, Italy
| | - Carlotta Liccardi
- Department of Molecular Medicine, University La Sapienza, Rome, Italy
| | - Paola Paci
- Institute for System Analysis and Computer Science "Antonio Ruberti", National Research Council, Rome, Italy
| | - Pasquale Sibilio
- Institute for System Analysis and Computer Science "Antonio Ruberti", National Research Council, Rome, Italy
| | - Francesco Pepe
- Department of Public Health, University Federico II, Naples, Italy
| | - Caterina Bonfiglio
- National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Bari, Italy
| | - Silvia Mezi
- Department of Radiological Oncological and Pathological Sciences, University La Sapienza, Rome, Italy
| | - Valentina Magri
- Department of Surgery Pietro Valdoni, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Anna Coppa
- Department of Experimental Medicine, University La Sapienza, Rome, Italy
| | - Arianna Nicolussi
- Department of Experimental Medicine, University La Sapienza, Rome, Italy
| | - Angela Gradilone
- Department of Molecular Medicine, University La Sapienza, Rome, Italy
| | - Marialaura Petroni
- Center for Life Nano Science@Sapienza, Istituto Italiano di Tecnologia, Rome, Italy
| | - Stefano Di Giulio
- Department of Molecular Medicine, University La Sapienza, Rome, Italy
| | | | - Paola Infante
- Center for Life Nano Science@Sapienza, Istituto Italiano di Tecnologia, Rome, Italy
| | - Sonia Coni
- Department of Molecular Medicine, University La Sapienza, Rome, Italy
| | - Gianluca Canettieri
- Department of Molecular Medicine, University La Sapienza, Rome, Italy.,Pasteur Institute-Cenci Bolognetti Foundation, Rome, Italy
| | | | - Giuseppe Giannini
- Department of Molecular Medicine, University La Sapienza, Rome, Italy.,Pasteur Institute-Cenci Bolognetti Foundation, Rome, Italy
| |
Collapse
|
30
|
Zupo R, Lampignano L, Lattanzio A, Mariano F, Osella AR, Bonfiglio C, Giannelli G, Pergola GD. Association between adherence to the Mediterranean Diet and circulating Vitamin D levels. Int J Food Sci Nutr 2020; 71:884-890. [PMID: 32223463 DOI: 10.1080/09637486.2020.1744533] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 12/20/2022]
Abstract
Vitamin D improves bone density and latest studies show adherence to Med-Diet as protective on osteoporosis. This observational study aimed at investigating the relationship between 25(OH)D levels and adherence to Med-Diet. Body weight, BMI, WC, glucose, insulin, 25(OH)D, total cholesterol, high- and low-density lipoprotein cholesterol, triglycerides, uric acid, and creatinine serum levels and insulin resistance were determined in 284 overweight/obese subjects not taking medications or supplements. Adherence to Med-Diet was evaluated by using PREDIMED score. High-level of adherence stood out. 25(OH)D was inversely related to BMI, WC, HOMA-IR, serum insulin and triglycerides, while directly to PREDIMED score. Two different regression models confirmed this positive correlation independently of gender and other parameters showing univariate relationship with 25(OH)D. This study argues that a closer adherence to Med-Diet is independently associated with an increase of 25(OH)D suggesting that higher vitamin D levels may contribute to the protective effect of the Med-Diet on osteoporosis.
Collapse
Affiliation(s)
- Roberta Zupo
- Population Health Unit, "Salus in Apulia Study" National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Italy
| | - Luisa Lampignano
- Population Health Unit, "Salus in Apulia Study" National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Italy
| | - Antonio Lattanzio
- Clinical Nutrition Unit, Medical Oncology, Department of Biomedical Science and Human Oncology, School of Medicine, University of Bari, Bari, Italy
| | - Francesco Mariano
- Clinical Nutrition Unit, Medical Oncology, Department of Biomedical Science and Human Oncology, School of Medicine, University of Bari, Bari, Italy
| | - Alberto R Osella
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, "S. de Bellis", Research Hospital, Castellana Grotte, Italy
| | - Caterina Bonfiglio
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, "S. de Bellis", Research Hospital, Castellana Grotte, Italy
| | - Gianluigi Giannelli
- Population Health Unit, "Salus in Apulia Study" National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Italy
| | - Giovanni De Pergola
- Clinical Nutrition Unit, Medical Oncology, Department of Biomedical Science and Human Oncology, School of Medicine, University of Bari, Bari, Italy
| |
Collapse
|
31
|
Caruso MG, Veronese N, Notarnicola M, Cisternino AM, Reddavide R, Inguaggiato R, Guerra V, Donghia R, Logroscino A, Rotolo O, Chiloiro M, Leandro G, De Leonardis G, Tutino V, Misciagna G, Bonfiglio C, Guerra R, Osella A. Fatty liver and mortality: a cohort population study in South Italy. BMJ Open 2019; 9:e027379. [PMID: 31227533 PMCID: PMC6596964 DOI: 10.1136/bmjopen-2018-027379] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE Alcoholic fatty liver (AFLD) and non-alcoholic fatty liver (NAFLD) are two common conditions. However, if they can increase the risk of death is poorly explored. We therefore aimed to investigate the potential association between the presence and severity of liver steatosis and mortality in a large sample of older people. DESIGN Prospective. SETTING Community. PARTICIPANTS Women and men randomly sampled from the electoral rolls of the population of Castellana Grotte, a town in Southern Italy (Apulia region) between 2005 and 2006. Among 1942 initially contacted, 1708 (=87.9%) participated to the baseline survey (Multicentrica Colelitiasi III (MICOL III)). This specific study included 1445 older participants (mean age=65.2 years, females=44.2%). EXPOSURE NAFLD or AFLD. PRIMARY AND SECONDARY OUTCOMES Mortality (all-cause and specific-cause). RESULTS After a median of 12 years, 312 participants (=21.6%) died. After adjusting for nine potential confounders, the presence of steatosis was not associated with any increased risk of death in both NAFLD and AFLD. The severity of liver steatosis was not associated with any increased risk of mortality in NAFLD, while in AFLD, the presence of moderate steatosis significantly increased the risk of overall (HR=2.16; 95% CI 1.19 to 3.91) and cancer-specific (HR=3.54; 95% CI 1.16 to 10.87) death. CONCLUSIONS Liver steatosis is not associated with any increased risk of death in NAFLD, while moderate steatosis could be a risk factor for mortality (particularly due to cancer) in people affected by AFLD.
Collapse
Affiliation(s)
- Maria Gabriella Caruso
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology-Research Hospital, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - Nicola Veronese
- Istituto di Neuroscienze Consiglio Nazionale delle Ricerche, Padova, Italy
| | - Maria Notarnicola
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology-Research Hospital, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - Anna Maria Cisternino
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - Rosa Reddavide
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - Rosa Inguaggiato
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - Vito Guerra
- Clinical Trial Unit, National Institute of Gastroenterology-Research Hospital, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - Rossella Donghia
- Clinical Trial Unit, National Institute of Gastroenterology-Research Hospital, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - Antonio Logroscino
- I.R.C.C.S. "Giovanni Paolo II", Thoracic Medical Oncology, Castellana Grotte, Italy
| | - Ornella Rotolo
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - Marisa Chiloiro
- Radiology Unit, National Institute for Digestive Disease, National Institute of Gastroenterology-Research Hospital, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - Gioacchino Leandro
- Gastroenterological Hospital, National Institute of Gastroenterology-Research Hospital, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - Giampiero De Leonardis
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology-Research Hospital, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - Valeria Tutino
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology-Research Hospital, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - G Misciagna
- Epidemiology, National Institute of Gastroenterology-Research Hospital, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - Caterina Bonfiglio
- Laboratory of Biostatistics and Epidemiology, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - Rocco Guerra
- Laboratory of Biostatistics and Epidemiology, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - Alberto Osella
- Laboratory of Biostatistics and Epidemiology, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| |
Collapse
|
32
|
Capalbo C, Belardinilli F, Raimondo D, Milanetti E, Malapelle U, Pisapia P, Magri V, Prete A, Pecorari S, Colella M, Coppa A, Bonfiglio C, Nicolussi A, Valentini V, Tessitore A, Cardinali B, Petroni M, Infante P, Santoni M, Filetti M, Colicchia V, Paci P, Mezi S, Longo F, Cortesi E, Marchetti P, Troncone G, Bellavia D, Canettieri G, Giannini G. A Simplified Genomic Profiling Approach Predicts Outcome in Metastatic Colorectal Cancer. Cancers (Basel) 2019; 11:cancers11020147. [PMID: 30691222 PMCID: PMC6406354 DOI: 10.3390/cancers11020147] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 01/19/2019] [Accepted: 01/22/2019] [Indexed: 12/22/2022] Open
Abstract
The response of metastatic colorectal cancer (mCRC) to the first-line conventional combination therapy is highly variable, reflecting the elevated heterogeneity of the disease. The genetic alterations underlying this heterogeneity have been thoroughly characterized through omic approaches requiring elevated efforts and costs. In order to translate the knowledge of CRC molecular heterogeneity into a practical clinical approach, we utilized a simplified Next Generation Sequencing (NGS) based platform to screen a cohort of 77 patients treated with first-line conventional therapy. Samples were sequenced using a panel of hotspots and targeted regions of 22 genes commonly involved in CRC. This revealed 51 patients carrying actionable gene mutations, 22 of which carried druggable alterations. These mutations were frequently associated with additional genetic alterations. To take into account this molecular complexity and assisted by an unbiased bioinformatic analysis, we defined three subgroups of patients carrying distinct molecular patterns. We demonstrated these three molecular subgroups are associated with a different response to first-line conventional combination therapies. The best outcome was achieved in patients exclusively carrying mutations on TP53 and/or RAS genes. By contrast, in patients carrying mutations in any of the other genes, alone or associated with mutations of TP53/RAS, the expected response is much worse compared to patients with exclusive TP53/RAS mutations. Additionally, our data indicate that the standard approach has limited efficacy in patients without any mutations in the genes included in the panel. In conclusion, we identified a reliable and easy-to-use approach for a simplified molecular-based stratification of mCRC patients that predicts the efficacy of the first-line conventional combination therapy.
Collapse
Affiliation(s)
- Carlo Capalbo
- Department of Molecular Medicine, University La Sapienza, 00161 Rome, Italy.
- Department of Medical Oncology Sant' Andrea Hospital, I-00189 Rome, Italy.
| | | | - Domenico Raimondo
- Department of Molecular Medicine, University La Sapienza, 00161 Rome, Italy.
| | | | - Umberto Malapelle
- Department of Public Health, University Federico II, 80131 Naples, Italy.
| | - Pasquale Pisapia
- Department of Public Health, University Federico II, 80131 Naples, Italy.
| | - Valentina Magri
- Department of Radiological Oncological and Pathological Sciences, University La Sapienza, 00161 Rome, Italy.
| | - Alessandra Prete
- Department of Radiological Oncological and Pathological Sciences, University La Sapienza, 00161 Rome, Italy.
| | - Silvia Pecorari
- Department of Radiological Oncological and Pathological Sciences, University La Sapienza, 00161 Rome, Italy.
| | | | - Anna Coppa
- Department of Experimental Medicine, University La Sapienza, 00161 Rome, Italy.
| | - Caterina Bonfiglio
- National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
| | - Arianna Nicolussi
- Department of Experimental Medicine, University La Sapienza, 00161 Rome, Italy.
| | - Virginia Valentini
- Department of Molecular Medicine, University La Sapienza, 00161 Rome, Italy.
| | - Alessandra Tessitore
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
| | - Beatrice Cardinali
- Institute of Cell Biology and Neurobiology, National Research Council, Campus A. Buzzati-Traverso, 00015 Monterotondo Scalo, Italy.
| | - Marialaura Petroni
- Center for Life Nano Science@Sapienza, Istituto Italiano di Tecnologia, 00161 Rome, Italy.
| | - Paola Infante
- Center for Life Nano Science@Sapienza, Istituto Italiano di Tecnologia, 00161 Rome, Italy.
| | - Matteo Santoni
- Oncology Unit, Macerata Hospital, 62012 Macerata, Italy.
| | - Marco Filetti
- Department of Medical Oncology Sant' Andrea Hospital, I-00189 Rome, Italy.
| | - Valeria Colicchia
- Department of Molecular Medicine, University La Sapienza, 00161 Rome, Italy.
| | - Paola Paci
- Institute for Systems Analysis and Computer Science "Antonio Ruberti", National Research Council, 00185 Rome, Italy.
| | - Silvia Mezi
- Department of Radiological Oncological and Pathological Sciences, University La Sapienza, 00161 Rome, Italy.
| | - Flavia Longo
- Department of Radiological Oncological and Pathological Sciences, University La Sapienza, 00161 Rome, Italy.
| | - Enrico Cortesi
- Department of Radiological Oncological and Pathological Sciences, University La Sapienza, 00161 Rome, Italy.
| | - Paolo Marchetti
- Department of Medical Oncology Sant' Andrea Hospital, I-00189 Rome, Italy.
| | - Giancarlo Troncone
- Department of Public Health, University Federico II, 80131 Naples, Italy.
| | - Diana Bellavia
- Department of Molecular Medicine, University La Sapienza, 00161 Rome, Italy.
| | - Gianluca Canettieri
- Department of Molecular Medicine, University La Sapienza, 00161 Rome, Italy.
- Pasteur Institute-Cenci Bolognetti Foundation, 00161 Rome, Italy.
| | - Giuseppe Giannini
- Department of Molecular Medicine, University La Sapienza, 00161 Rome, Italy.
- Pasteur Institute-Cenci Bolognetti Foundation, 00161 Rome, Italy.
| |
Collapse
|
33
|
Veronese N, Notarnicola M, Osella AR, Cisternino AM, Reddavide R, Inguaggiato R, Guerra V, Rotolo O, Zinzi I, Chiloiro M, Leandro G, Correale M, Tutino V, Misciagna G, Bonfiglio C, Caruso MG. Menopause Does Not Affect Fatty Liver Severity In Women: A Population Study in a Mediterranean Area. Endocr Metab Immune Disord Drug Targets 2019; 18:513-521. [PMID: 29692271 DOI: 10.2174/1871530318666180423101755] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 02/23/2018] [Accepted: 03/29/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND OBJECTIVE Estrogens could protect the liver from fatty degeneration, but there is little information about whether menopause is associated with the severity of alcoholic (AFL) and non-alcoholic fatty liver (NAFL). Our aim was to evaluate the distribution of fatty liver detected by ultrasound in pre- and post-menopausal women and the factors associated with these conditions. METHODS In this cross-sectional study, the years from menopause were investigated through selfreported information. The degree of fatty liver was assessed through a standardized ultrasound examination (scores 0 to 6, higher values reflecting a greater severity). Liver steatosis was classified as NAFL or AFL based on a daily alcohol intake > 20g/d. RESULTS The study included 752 women in menopause and 535 in pre-menopause. The years from menopause were not associated with the severity of liver steatosis in NAFL (p for trend=0.74; Spearman correlation=0.04; 95%CI: -0.09 to 0.17), whereas all the indexes of adiposity and the number of metabolic syndrome factors were associated with a higher liver steatosis score. Taking AFL liver steatosis as the outcome, the years since menopause were not significantly associated with liver steatosis in AFL (p for trend=0.50; Spearman correlation=0.09; 95%CI: -0.17 to 0.34), whilst the association between anthropometric parameters and liver steatosis severity resulted stronger in postmenopausal compared to pre- menopausal women. CONCLUSION the higher prevalence of fatty liver observed in post-menopausal women is probably not due to menopause per se, but to the adiposity (particularly abdominal) typical of this age and its consequences (such as metabolic syndrome).
Collapse
Affiliation(s)
- Nicola Veronese
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy.,Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy
| | - Maria Notarnicola
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy
| | - Alberto Ruben Osella
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy
| | - Anna Maria Cisternino
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy
| | - Rosa Reddavide
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy
| | - Rosa Inguaggiato
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy
| | - Vito Guerra
- Clinical Trial Unit, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy
| | - Ornella Rotolo
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy
| | - Iris Zinzi
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy
| | - Marisa Chiloiro
- Unit of Radiology, Hospital San Giacomo, Monopoli, Bari, Italy
| | - Gioacchino Leandro
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy.,Unit of Gastroenterology, National Institute of Gastroenterology- Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy
| | - Mario Correale
- Laboratory of Clinical Pathology, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy
| | - Valeria Tutino
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy
| | - Giovanni Misciagna
- Scientific and Ethical Committee, University Hospital Policlinico, Bari, Italy
| | - Caterina Bonfiglio
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy
| | - Maria Gabriella Caruso
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy.,Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy
| |
Collapse
|
34
|
Procino F, Misciagna G, Veronese N, Caruso MG, Chiloiro M, Cisternino AM, Notarnicola M, Bonfiglio C, Bruno I, Buongiorno C, Campanella A, Deflorio V, Franco I, Guerra R, Leone CM, Mirizzi A, Nitti A, Osella AR. Reducing NAFLD-screening time: A comparative study of eight diagnostic methods offering an alternative to ultrasound scans. Liver Int 2019; 39:187-196. [PMID: 30248233 DOI: 10.1111/liv.13970] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 09/05/2018] [Accepted: 09/16/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS The use of ultrasound scan (US) in non-alcoholic fatty liver disease (NAFLD) screening overloads US waiting lists. We hypothesized and tested a hybrid two-step method, consisting of applying a formula, to exclude subjects at low risk, before US. METHODS The sample included 2970 males and females (937 with NAFLD) diagnosed by US. We selected eight formulas: Fatty Liver Index (FLI), Hepatic Steatosis Index (HIS), body mass index (BMI), waist circumference (WC), Abdominal Volume Index (AVI), waist-to-height ratio (WHtR), waist/height0.5 (WHT.5R) and Body Roundness Index (BRI), and calculated their performance in the two-step method evaluating percentage reduction of the number of liver US (US reduction percentage), percentage of false negative and percentage of NAFLD identified. RESULTS The US reductions percentage were 52.2% (WHtR), 52.1% (HIS), 51.8% (FLI), 50.8% (BRI), 50.7% (BMI and WHt_5R), 46.5% (WC) and 45.2% (AVI). The false negative percentage were 8.5% (WHtR), 7.9% (BRI), 7.3% (WHt_5R), 7.2% (BMI), 6.7% (HIS), 6.6% (FLI), 5.6% (WC) and 5.2% (AVI). The best percentage of NALFD identified was obtained using AVI (83.6%) before US, then WC (82.2%), FLI (79%), HIS (78.9%), BMI (77.3%), WHt_5R (76.9%), BRI (74.8%) and WHtR (73%). CONCLUSION The best formula to use in two-step diagnostic NAFLD screening was AVI, which showed a low false negative rate and a higher percentage of identified NAFLD. Other studies evaluating the economic advantages of this screening method are warranted.
Collapse
Affiliation(s)
- Filippo Procino
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, "Saverio de Bellis" Research Hospital, Castellana Grotte, Bari, Italy
| | - Giovanni Misciagna
- Scientific and Ethical Committee, University Hospital Policlinico, Bari, Italy
| | - Nicola Veronese
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology, "Saverio de Bellis" Research Hospital, Castellana Grotte, Bari, Italy.,Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology, "Saverio de Bellis" Research Hospital, Castellana Grotte, Bari, Italy
| | - Maria G Caruso
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology, "Saverio de Bellis" Research Hospital, Castellana Grotte, Bari, Italy.,Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology, "Saverio de Bellis" Research Hospital, Castellana Grotte, Bari, Italy
| | | | - Anna M Cisternino
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology, "Saverio de Bellis" Research Hospital, Castellana Grotte, Bari, Italy
| | - Maria Notarnicola
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology, "Saverio de Bellis" Research Hospital, Castellana Grotte, Bari, Italy
| | - Caterina Bonfiglio
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, "Saverio de Bellis" Research Hospital, Castellana Grotte, Bari, Italy
| | - Irene Bruno
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, "Saverio de Bellis" Research Hospital, Castellana Grotte, Bari, Italy
| | - Claudia Buongiorno
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, "Saverio de Bellis" Research Hospital, Castellana Grotte, Bari, Italy
| | - Angelo Campanella
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, "Saverio de Bellis" Research Hospital, Castellana Grotte, Bari, Italy
| | - Valentina Deflorio
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, "Saverio de Bellis" Research Hospital, Castellana Grotte, Bari, Italy
| | - Isabella Franco
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, "Saverio de Bellis" Research Hospital, Castellana Grotte, Bari, Italy
| | - Rocco Guerra
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, "Saverio de Bellis" Research Hospital, Castellana Grotte, Bari, Italy
| | - Carla M Leone
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, "Saverio de Bellis" Research Hospital, Castellana Grotte, Bari, Italy
| | - Antonella Mirizzi
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, "Saverio de Bellis" Research Hospital, Castellana Grotte, Bari, Italy
| | - Alessandro Nitti
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, "Saverio de Bellis" Research Hospital, Castellana Grotte, Bari, Italy
| | - Alberto R Osella
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology, "Saverio de Bellis" Research Hospital, Castellana Grotte, Bari, Italy
| | | |
Collapse
|
35
|
Veronese N, Notarnicola M, Cisternino AM, Reddavide R, Inguaggiato R, Guerra V, Rotolo O, Zinzi I, Leandro G, Correale M, Tutino V, Misciagna G, Osella AR, Bonfiglio C, Giannelli G, Caruso MG. Coffee Intake and Liver Steatosis: A Population Study in a Mediterranean Area. Nutrients 2018; 10:nu10010089. [PMID: 29342916 PMCID: PMC5793317 DOI: 10.3390/nu10010089] [Citation(s) in RCA: 24] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 01/10/2018] [Accepted: 01/11/2018] [Indexed: 12/21/2022] Open
Abstract
Coffee drinking seems to have several beneficial effects on health outcomes. However, the effect on hepatic steatosis, depending on a high alcohol consumption (AFLD, alcoholic fatty liver disease) or on metabolic factors (non-alcoholic fatty liver disease, NAFLD), is still equivocal. Thus, we aimed to explore the potential association between coffee consumption and the presence and severity of hepatic steatosis in people with NAFLD or AFLD. In this cross-sectional study, coffee drinking was recorded using a semi-quantitative food frequency questionnaire, and categorized as yes vs. no and as 0, 1, 2, ≥3. The degree of fatty liver was assessed through a standardized ultrasound examination (score 0 to 6, with higher values reflecting higher severity). Liver steatosis was classified as NAFLD or AFLD on daily alcohol intake >30 g/day for men and >20 g/day for women. This study included 2819 middle-aged participants; the great majority were coffee drinkers (86.1%). After adjusting for 12 potential confounders, drinking coffee was not associated with decreased odds for NAFLD (n = 916) (odds ratio, OR = 0.93; 95% confidence intervals, CI: 0.72-1.20) or AFLD (n = 276) (OR = 1.20; 95% CI: 0.66-2.0). The consumption of coffee (categorized as yes vs. no), or an increased consumption of coffee were not associated with the presence of mild, moderate or severe liver steatosis in either NAFLD or AFLD. In conclusion, coffee intake was not associated with any lower odds of hepatic steatosis in either non-alcoholic or alcoholic forms in this large cohort of South Italian individuals.
Collapse
Affiliation(s)
- Nicola Veronese
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
- National Research Council, Neuroscience Institute, Aging Branch, 35128 Padova, Italy.
| | - Maria Notarnicola
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
| | - Anna Maria Cisternino
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
| | - Rosa Reddavide
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
| | - Rosa Inguaggiato
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
| | - Vito Guerra
- Clinical Trial Unit, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
| | - Ornella Rotolo
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
| | - Iris Zinzi
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
| | - Gioacchino Leandro
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
- Unit of Gastroenterology, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
| | - Mario Correale
- Laboratory of Clinical Pathology, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
| | - Valeria Tutino
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
| | - Giovanni Misciagna
- Scientific and Ethical Committee, University Hospital Policlinico, 70124 Bari, Italy.
| | - Alberto Ruben Osella
- National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
| | - Caterina Bonfiglio
- National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
| | - Gianluigi Giannelli
- National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
| | - Maria Gabriella Caruso
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
| |
Collapse
|
36
|
Solfrizzi V, Scafato E, Lozupone M, Seripa D, Giannini M, Sardone R, Bonfiglio C, Abbrescia DI, Galluzzo L, Gandin C, Baldereschi M, Di Carlo A, Inzitari D, Daniele A, Sabbà C, Logroscino G, Panza F. Additive Role of a Potentially Reversible Cognitive Frailty Model and Inflammatory State on the Risk of Disability: The Italian Longitudinal Study on Aging. Am J Geriatr Psychiatry 2017; 25:1236-1248. [PMID: 28689645 DOI: 10.1016/j.jagp.2017.05.018] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [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: 05/03/2016] [Revised: 04/29/2017] [Accepted: 05/26/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Cognitive frailty is a condition recently defined by operationalized criteria describing the simultaneous presence of physical frailty and mild cognitive impairment (MCI). Two subtypes for this clinical construct have been proposed: "potentially reversible" cognitive frailty (physical frailty plus MCI) and "reversible" cognitive frailty (physical frailty plus pre-MCI subjective cognitive decline). Here the prevalence of a potentially reversible cognitive frailty model was estimated. It was also evaluated if introducing a diagnosis of MCI in older subjects with physical frailty could have an additive role on the risk of dementia, disability, and all-cause mortality in comparison with frailty state or MCI condition alone, with analyses separately performed for inflammatory state. METHODS In 2,373 individuals from the population-based Italian Longitudinal Study on Aging with a 3.5-year-follow-up, we operationally categorized older individuals without dementia into four groups: non-frail/non-MCI, non-frail/MCI, frail/non-MCI, and frail/MCI. RESULTS The prevalence of potentially reversible cognitive frailty was 1%, increasing with age and more represented in women than in men, and all groups were associated with significant increased incident rate ratios of dementia, disability, and mortality. A significant difference in rates of disability has been found between the MCI and non-MCI groups (contrasts of adjusted predictions: 0.461; 95% confidence interval: 0.187-0.735) in frail individuals with high inflammatory states (fibrinogen >339 mg/dL). CONCLUSION In older individuals without dementia and with elevated inflammation, a potentially reversible cognitive frailty model could have a significant additional predictive effect on the risk of disability than the single conditions of frailty or MCI.
Collapse
Affiliation(s)
- Vincenzo Solfrizzi
- Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari Aldo Moro, Bari, Italy
| | - Emanuele Scafato
- Population Health and Health Determinants Unit, National Centre for Epidemiology, Surveillance and Health Promotion (CNESPS), Istituto Superiore di Sanità (ISS), Roma, Italy
| | - Madia Lozupone
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Davide Seripa
- Gerontology-Geriatrics Research Laboratory, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Michele Giannini
- Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari Aldo Moro, Bari, Italy
| | - Rodolfo Sardone
- National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Caterina Bonfiglio
- National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Daniela I Abbrescia
- National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Lucia Galluzzo
- Population Health and Health Determinants Unit, National Centre for Epidemiology, Surveillance and Health Promotion (CNESPS), Istituto Superiore di Sanità (ISS), Roma, Italy
| | - Claudia Gandin
- Population Health and Health Determinants Unit, National Centre for Epidemiology, Surveillance and Health Promotion (CNESPS), Istituto Superiore di Sanità (ISS), Roma, Italy
| | - Marzia Baldereschi
- Institute of Neuroscience, Italian National Research Council (CNR), Florence, Italy
| | - Antonio Di Carlo
- Institute of Neuroscience, Italian National Research Council (CNR), Florence, Italy
| | - Domenico Inzitari
- Institute of Neuroscience, Italian National Research Council (CNR), Florence, Italy; Department of Neurofarba, Neuroscience Section, University of Florence, Florence, Italy
| | - Antonio Daniele
- Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy
| | - Carlo Sabbà
- Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari Aldo Moro, Bari, Italy
| | - Giancarlo Logroscino
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Department of Clinical Research in Neurology, University of Bari Aldo Moro, Pia Fondazione Cardinale G. Panico, Tricase, Lecce, Italy
| | - Francesco Panza
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Gerontology-Geriatrics Research Laboratory, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy; Department of Clinical Research in Neurology, University of Bari Aldo Moro, Pia Fondazione Cardinale G. Panico, Tricase, Lecce, Italy.
| |
Collapse
|
37
|
Lozupone M, Seripa D, Stella E, La Montagna M, Solfrizzi V, Quaranta N, Veneziani F, Cester A, Sardone R, Bonfiglio C, Giannelli G, Bisceglia P, Bringiotti R, Daniele A, Greco A, Bellomo A, Logroscino G, Panza F. Innovative biomarkers in psychiatric disorders: a major clinical challenge in psychiatry. Expert Rev Proteomics 2017; 14:809-824. [DOI: 10.1080/14789450.2017.1375857] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Madia Lozupone
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Davide Seripa
- Geriatric Unit & Laboratory of Gerontology and Geriatrics, Department of Medical Sciences, IRCCS “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Foggia, Italy
| | - Eleonora Stella
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Maddalena La Montagna
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Vincenzo Solfrizzi
- Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari Aldo Moro, Italy
| | | | - Federica Veneziani
- Psychiatric Unit, Department of Basic Medicine, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Alberto Cester
- Department of Medicine Organization Geriatric Unit, CDCD, Dolo Hospital, Venezia, Italy
| | - Rodolfo Sardone
- Department of Epidemiology and Biostatistics, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Bari, Italy
| | - Caterina Bonfiglio
- Department of Epidemiology and Biostatistics, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Bari, Italy
| | - Gianluigi Giannelli
- Department of Epidemiology and Biostatistics, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Bari, Italy
| | - Paola Bisceglia
- Geriatric Unit & Laboratory of Gerontology and Geriatrics, Department of Medical Sciences, IRCCS “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Foggia, Italy
| | - Roberto Bringiotti
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Antonio Daniele
- Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy
| | - Antonio Greco
- Geriatric Unit & Laboratory of Gerontology and Geriatrics, Department of Medical Sciences, IRCCS “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Foggia, Italy
| | - Antonello Bellomo
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Giancarlo Logroscino
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
- Department of Clinical Research in Neurology, University of Bari Aldo Moro, “Pia Fondazione Cardinale G. Panico”, Lecce, Italy
| | - Francesco Panza
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
- Geriatric Unit & Laboratory of Gerontology and Geriatrics, Department of Medical Sciences, IRCCS “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Foggia, Italy
- Department of Clinical Research in Neurology, University of Bari Aldo Moro, “Pia Fondazione Cardinale G. Panico”, Lecce, Italy
| |
Collapse
|
38
|
Notarnicola M, Caruso MG, Tutino V, Bonfiglio C, Cozzolongo R, Giannuzzi V, De Nunzio V, De Leonardis G, Abbrescia DI, Franco I, Intini V, Mirizzi A, Osella AR. Significant decrease of saturation index in erythrocytes membrane from subjects with non-alcoholic fatty liver disease (NAFLD). Lipids Health Dis 2017; 16:160. [PMID: 28830448 PMCID: PMC5568099 DOI: 10.1186/s12944-017-0552-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [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: 07/06/2017] [Accepted: 08/15/2017] [Indexed: 12/03/2022] Open
Abstract
Background The lipidomic profiling of erythrocyte membranes is expected to provide a peculiar scenario at molecular level of metabolic and nutritional pathways which may influence the lipid balance and the adaptation and homeostasis of the organism. Considering that lipid accumulation in the cell is important in promoting tissue inflammation, the purpose of this study is to analyze the fatty acid profile in red blood cell membranes of patients with Non-Alcoholic Fatty Liver Disease (NAFLD), in order to identify and validate membrane profiles possibly associated with the degree of hepatic damage. Methods This work presents data obtained at baseline from 101 subjects that participated to a nutritional trial (registration number: NCT02347696) enrolling consecutive subjects with NAFLD. Diagnosis of liver steatosis was performed by using vibration-controlled elastography implemented on FibroScan. Fatty acids, extracted from phospholipids of erythrocyte membranes, were quantified by gas chromatography method. Results The subjects with severe NAFLD showed a significant decrease of the ratio of stearic acid to oleic acid (saturation index, SI) compared to controls, 1.281 ± 0.31 vs 1.5 ± 0.29, respectively. Low levels of SI in red blood cell membranes, inversely associated with degree of liver damage, suggest that an impairment of circulating cell membrane structure can reflect modifications that take place in the liver. Subjects with severe NAFLDalso showed higher levels of elongase 5 enzymatic activity, evaluated as vaccenic acid to palmitoleic acid ratio. Conclusions Starting from these evidences, our findings show the importance of lipidomic approach in the diagnosis and the staging of NAFLD.
Collapse
Affiliation(s)
- Maria Notarnicola
- National Institute of Gastroenterology "S. de Bellis" Research Hospital, 70013 Castellana Grotte, Bari, Italy. .,Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology "S. de Bellis", Research Hospital, Castellana Grotte, Bari, Italy.
| | - Maria Gabriella Caruso
- National Institute of Gastroenterology "S. de Bellis" Research Hospital, 70013 Castellana Grotte, Bari, Italy
| | - Valeria Tutino
- National Institute of Gastroenterology "S. de Bellis" Research Hospital, 70013 Castellana Grotte, Bari, Italy
| | - Caterina Bonfiglio
- National Institute of Gastroenterology "S. de Bellis" Research Hospital, 70013 Castellana Grotte, Bari, Italy
| | - Raffaele Cozzolongo
- National Institute of Gastroenterology "S. de Bellis" Research Hospital, 70013 Castellana Grotte, Bari, Italy
| | - Vito Giannuzzi
- National Institute of Gastroenterology "S. de Bellis" Research Hospital, 70013 Castellana Grotte, Bari, Italy
| | - Valentina De Nunzio
- National Institute of Gastroenterology "S. de Bellis" Research Hospital, 70013 Castellana Grotte, Bari, Italy
| | - Giampiero De Leonardis
- National Institute of Gastroenterology "S. de Bellis" Research Hospital, 70013 Castellana Grotte, Bari, Italy
| | - Daniela I Abbrescia
- National Institute of Gastroenterology "S. de Bellis" Research Hospital, 70013 Castellana Grotte, Bari, Italy
| | - Isabella Franco
- National Institute of Gastroenterology "S. de Bellis" Research Hospital, 70013 Castellana Grotte, Bari, Italy
| | - Vincenza Intini
- National Institute of Gastroenterology "S. de Bellis" Research Hospital, 70013 Castellana Grotte, Bari, Italy
| | - Antonella Mirizzi
- National Institute of Gastroenterology "S. de Bellis" Research Hospital, 70013 Castellana Grotte, Bari, Italy
| | - Alberto R Osella
- National Institute of Gastroenterology "S. de Bellis" Research Hospital, 70013 Castellana Grotte, Bari, Italy
| |
Collapse
|
39
|
Lozupone M, Leo A, Sardone R, Veneziani F, Bonfiglio C, Galizia I, Lofano L, Grasso A, Tursi M, Barulli M, Capozzo R, Tortelli R, Panza F, Seripa D, Osella A, Logroscino G. Swallowing Disturbances and Psychiatric Profile in Older Adults: The GreatAGE Study. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.2067] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
IntroductionSeveral studies have reported controversial links between swallowing disturbances (SD) and psychiatric disorders in older age. The available data on the epidemiology of SD in the general population are scarce and often conflicting, because of numerous methodological factors source of possible counfounders.ObjectivesWe aimed to screen the presence of psychiatric and cognitive disorders associated with SD in a random sampling of the general population ≥ 65.MethodsA sample of 1127 elderly individuals collected in a population-based study (GreatAGE) in Castellana Grotte (53,50% males, mean age 74.1 ± 6.3 years), South-East Italy, were mailed a validated self-report questionnaire to assess SD (Eating Assessment Tool-EAT10). Psychiatric disorders and symptoms [assessed with Semi-structured Clinical Diagnostic Interview for DSM-IV-TR Axis I Disorders, Geriatric Depression Scale-30 (GDS-30) and Symptom Checklist Revised-90 (SCL-90R)], cognitive functions were assessed with a comprehensive neuropsychological battery, neurological exam, and demographics were compared in participants with and without SD using t-tests and Mann–Whitney U-test.ResultsThe prevalence rates of SD amounted at 5.97%. Psychiatric diagnosis (24.22% of the sample) was statistically significant associated with SD (EAT ≥ 3, P = 0.038), and a trend was found for major depressive disorder and generalized anxiety disorder. Among SCL-90R domains, only anxiety showed a significant association with EAT ≥ 3 (P = 0.006). GDS-30 score was found to be higher in subjects with SD (P = 0.008). Cognitive functions did not differ between the two groups except for an increasing trend for Clinical Dementia Rating Scale in EAT ≥ 3 (P = 0.058).ConclusionsThese preliminary results showed an association between SD in older age and late-life major depression and anxiety disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Collapse
|
40
|
Lozupone M, Veneziani F, Lofano L, Galizia I, Stella E, Copetti M, Arcuti S, Leo A, Sardone R, Grasso A, Tursi M, Barulli M, Tortelli R, Capozzo R, Panza F, Seripa D, Bonfiglio C, Osella A, Logroscino G. Educational level influenced the gold standard diagnosis of late-life depression in the GreatAGE study. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.2068] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IntroductionThe validity of the 30-item Geriatric Depression Scale (GDS-30) in detecting late-life depression (LLD) requires a certain level of cognitive functioning. Further research is needed in population-based setting on other socio-demographic and cognitive variables that could potentially influence the accuracy of clinician rated depression.ObjectiveTo compare the diagnostic accuracy of two instruments used to assess depressive disorders [(GDS-30) and the Semi-structured Clinical Diagnostic Interview for DSM-IV-TR Axis I Disorders (SCID)] among three groups with different levels of cognitive functioning (normal, Mild Cognitive Impairment – MCI, Subjective Memory Complain – SMC) in a random sampling of the general population 65+ years.MethodsThe sample, collected in a population-based study (GreatAGE Study) among the older residents of Castellana Grotte, South-East Italy, included 844 subjects (54.50% males). A standardized neuropsychological battery was used to assess MCI, SMC and depressive symptoms (GDS-30). Depressive syndromes were diagnosed through the SCID IV-TR. Socio-demographic and cognitive variables were taken into account in influencing SCID performance.ResultsAccording to the SCID, the rate of depressive disorders was 12.56%. At the optimal cut-off score (≥ 4), GDS-30 had 65.1% sensitivity and 68.4% specificity in diagnosing depressive symptoms. Using a more conservative cut-off (≥ 10), the GDS-30 specificity reached 91.1% while sensitivity dropped to 37,7%. The three cognitive subgroups did not differ in the rate of depression diagnosis. Educational level is the only variable associated to the SCID diagnostic performance (P = 0.015).ConclusionsAt the optimal cut-off, GDS-30 identified lower levels of screening accuracy for subjects with normal cognition rather than for SMC (AUC 0.792 vs. 0.692); educational attainment possibly may modulate diagnostic clinician performance.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Collapse
|
41
|
Misciagna G, Del Pilar Díaz M, Caramia DV, Bonfiglio C, Franco I, Noviello MR, Chiloiro M, Abbrescia DI, Mirizzi A, Tanzi M, Caruso MG, Correale M, Reddavide R, Inguaggiato R, Cisternino AM, Osella AR. Effect of a Low Glycemic Index Mediterranean Diet on Non-Alcoholic Fatty Liver Disease. A Randomized Controlled Clinici Trial. J Nutr Health Aging 2017; 21:404-412. [PMID: 28346567 DOI: 10.1007/s12603-016-0809-8] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Non-Alcoholic Fatty Liver Disease (NAFLD) is currently the most common form of liver disease worldwide affecting all ages and ethnic groups and it has become a consistent threat even in young people. Our aim was to estimate the effect of a Low Glycemic Index Mediterranean Diet (LGIMD) on the NAFLD score as measured by a Liver Ultrasonography (LUS). DESIGN NUTRIzione in EPAtologia (NUTRIEPA) is a population-based Double-Blind RCT. Data were collected in 2011 and analyzed in 2013-14. SETTING/PARTICIPANTS 98 men and women coming from Putignano (Puglia, Southern Italy) were drawn from a previous randomly sampled population-based study and identified as having moderate or severe NAFLD. INTERVENTION The intervention strategy was the assignment of a LGIMD or a control diet. OUTCOME MEASURES The main outcome measure was NAFLD score, defined by LUS. RESULTS After randomization, 50 subjects were assigned to a LGIMD and 48 to a control diet. The study lasted six months and all participants were subject to monthly controls/checks. Adherence to the LGIMD as measured by Mediterranean Adequacy Index (MAI) showed a median of 10.1. A negative interaction between time and LGIMD on the NAFLD score (-4.14, 95% CI -6.78,-1.49) was observed, and became more evident at the sixth month (-4.43, 95%CI -7.15, -1.71). A positive effect of the interaction among LGIMD, time and age (Third month: 0.07, 95% CI 0.02, 0.12; Sixth month: 0.08, 95% CI 0.03,0.13) was also observed. CONCLUSIONS LGIMD was found to decrease the NAFLD score in a relatively short time. Encouraging those subjects who do not seek medical attention but still have NAFLD to follow a LGIMD and other life-style interventions, may reduce the degree of severity of the disease. Dietary intervention of this kind, could also form the cornerstone of primary prevention of Type 2 Diabetes Mellitus (T2DM) and cardiovascular disease.
Collapse
Affiliation(s)
- G Misciagna
- Alberto Rubén Osella, PhD, Laboratory of Epidemiology and Biostatistics, IRCCS Saverio de Bellis, Via Turi 27, 70013 Castellana Grotte (BA), Italy, Tel: +39 0804994655, Fax: +39 0804994650, e-mail:
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Lozupone M, Veneziani F, Galizia I, Lofano L, Montalbò D, Arcuti S, Tortelli R, Barulli M, Capozzo R, Bonfiglio C, Panza F, Seripa D, Todarello O, Logroscino G. Validity of the Geriatric Depression Scale-30 against the gold standard diagnosis of depression in older age: The GreatAGE Study. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.042] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
IntroductionDepression is a common disorder in late-life. Structured clinical interviews may be less efficient compared to self-administered questionnaires, but provide more accurate findings in terms of diagnosis. No population-based studies with both these depression assessment instruments have been ever performed.ObjectivesTo estimate the GDS-30 accuracy for depression assessment against the gold standard [Semi-structured Clinical Diagnostic Interview for DSM-IV-TR Axis I Disorders (SCID)] in subjects 65+ years in a random sampling of the general population.MethodsThe sample was collected in a population-based study (GreatAGE) conducted among elderly residents in Castellana, Southeast Italy. It includes 597 participants (57.62% males, mean age 73 years). Depression was assessed through the GDS-30 and the SCID, both double-blinded administered respectively by a trained neuropsychologist and psychiatrist. The GDS-30 screening performances were analyzed using ROC curves.ResultsAccording to the gold standard SCID, the rate of depressive disorder was 10.22% (15.81% of women; 6.1% of men) while with GDS-30 instrument 12.06% of the residents met the depression cutoff. Only 36.1% of GDS cases were true positive. At the optimal cutoff score (> 5), GDS had 62% sensitivity and 81% specificity. Using a more conservative cutoff (> 9), the GDS-30 specificity reached 91% while sensitivity dropped to 43%.ConclusionsThese preliminary results from the first population-based study that compares GDS-30 and SCID showed that the GDS-30 identified adequate levels of screening accuracy (AUC 0.76) compatible with scores established in community settings.FundingPRIN2009E4RM4Z.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Collapse
|
43
|
Panza F, Solfrizzi V, Barulli MR, Bonfiglio C, Guerra V, Osella A, Seripa D, Sabbà C, Pilotto A, Logroscino G. Coffee, tea, and caffeine consumption and prevention of late-life cognitive decline and dementia: a systematic review. J Nutr Health Aging 2015; 19:313-28. [PMID: 25732217 DOI: 10.1007/s12603-014-0563-8] [Citation(s) in RCA: 118] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A prolonged preclinical phase of more than two decades before the onset of dementia suggested that initial brain changes of Alzheimer's disease (AD) and the symptoms of advanced AD may represent a unique continuum. Given the very limited therapeutic value of drugs currently used in the treatment of AD and dementia, preventing or postponing the onset of AD and delaying or slowing its progression are becoming mandatory. Among possible reversible risk factors of dementia and AD, vascular, metabolic, and lifestyle-related factors were associated with the development of dementia and late-life cognitive disorders, opening new avenues for the prevention of these diseases. Among diet-associated factors, coffee is regularly consumed by millions of people around the world and owing to its caffeine content, it is the best known psychoactive stimulant resulting in heightened alertness and arousal and improvement of cognitive performance. Besides its short-term effect, some case-control and cross-sectional and longitudinal population-based studies evaluated the long-term effects on brain function and provided some evidence that coffee, tea, and caffeine consumption or higher plasma caffeine levels may be protective against cognitive impairment/decline and dementia. In particular, several cross-sectional and longitudinal population-based studies suggested a protective effect of coffee, tea, and caffeine use against late-life cognitive impairment/decline, although the association was not found in all cognitive domains investigated and there was a lack of a distinct dose-response association, with a stronger effect among women than men. The findings on the association of coffee, tea, and caffeine consumption or plasma caffeine levels with incident mild cognitive impairment and its progression to dementia were too limited to draw any conclusion. Furthermore, for dementia and AD prevention, some studies with baseline examination in midlife pointed to a lack of association, although other case-control and longitudinal population-based studies with briefer follow-up periods supported favourable effects of coffee, tea, and caffeine consumption against AD. Larger studies with longer follow-up periods should be encouraged, addressing other potential bias and confounding sources, so hopefully opening new ways for diet-related prevention of dementia and AD.
Collapse
Affiliation(s)
- F Panza
- Francesco Panza, MD, PhD, Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy and Department of Clinical Research in Neurology, University of Bari Aldo Moro, "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy,
| | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Lozupone M, Veneziani F, Lofano L, Montalbò D, Galizia I, Barulli M, Tortelli R, Bonfiglio C, Todarello O, Logroscino G. Prevalence of Anxiety Disorders and Comorbid Affective Disorders in the Elderly of Castellana Grotte (italy). Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)30350-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
45
|
Osella AR, Díaz MDP, Cozzolongo R, Bonfiglio C, Franco I, Abrescia DI, Bianco A, Giampiero ES, Petruzzi J, Elsa L, Mario C, Mastrosimni AM, Giocchino L. Overweight and Obesity in Southern Italy: their association with social and life-style characteristics and their effect on levels of biologic markers. Rev Fac Cien Med Univ Nac Cordoba 2014; 71:113-124. [PMID: 25647553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND In the last decades, overweight and obesity have been transformed from minor public health issues to a major threat to public health affecting the most affluent societies and also the less developed ones. OBJECTIVES To estimate overweight-obesity prevalence in adults, their association with some social determinants and to assess the effect of these two conditions on levels of biologic and biochemical characteristics, by means of a population-based study. METHODS A random sample of the general population of Putignano was drawn. All participants completed a general pre-coded and a Food Frequency questionnaire; anthropometric measures were taken and a venous blood sample was drawn. All subjects underwent liver ultra-sonography. Data description was done by means of tables and then Quantile Regression was performed. RESULTS Overall prevalence of overweight and obesity were 34.5% and 16.1% respectively. Both overweight and obesity were more frequent among male, married and low socio-economic position subjects. There were increasing frequencies of normal weight with higher levels of education. Overweight and obese subjects had more frequently Nonalcoholic Fatty Liver Disease, Hypertension and altered biochemical markers. Quantile regression showed a statistically significant association of age with overweight and obesity (maximum about 64.8 yo), gender (female) and low levels of education in both overweight and obesity. More than 10 gr/day of wine intake was associated with overweight. CONCLUSIONS The prevention and treatment of overweight/obesity on a population wide basis are needed. Population-based strategies should also improve social and physical environmental contexts for healthful lifestyles.
Collapse
Affiliation(s)
- Alberto R Osella
- Laboratory of Epidemiology and Biostatistics IRCCS "Saverio de Bellis" Via Turi 27, 70013, Castellana Grotte (BA), Italy
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Chiloiro M, Caruso MG, Cisternino AM, Inguaggiato R, Reddavide R, Bonfiglio C, Guerra V, Notarnicola M, De Michele G, Correale M, Noviello MR, Misciagna G. Ultrasound evaluation and correlates of fatty liver disease: a population study in a Mediterranean area. Metab Syndr Relat Disord 2013; 11:349-58. [PMID: 23758075 DOI: 10.1089/met.2012.0169] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The aim of this study was to evaluate the distribution of fatty liver-nonalcoholic (NAFL) and alcoholic (AFL)-and its association with metabolic syndrome and its components in a population sample from a Mediterranean area. METHODS A sample of 2974 subjects (1679 males, 1295 females, age range 30-89 years) was randomly drawn from the population of a town in southern Italy. The survey visit included a validated semiquantitative food frequency questionnaire, anthropometric measurements, a blood sample taken in the morning after overnight fasting, as well as abdominal ultrasound examination to evaluate liver fat with a standardized scoring system. The 2001 National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) definition of the metabolic syndrome was adopted. RESULTS In this Mediterranean population, where alcohol intake is mostly as wine with meals, NAFL is present in 36.8% of men and 25.7% of women and AFL in 13.8% of men and 5.5% of women. NAFL and AFL are associated with metabolic syndrome and its characteristics, body mass index (BMI), and visceral and subcutaneous fat (in AFL subjects, only in women) measured by ultrasound. Stratifying by BMI and controlling for confounders (age, height, smoking habit, and alcohol consumption), in overweight and obese subjects, liver and visceral fat are associated with the metabolic syndrome both in men and women and subcutaneous fat only in women. In normal weight subjects, only liver fat in men is associated with the metabolic syndrome. CONCLUSIONS Fatty liver is highly prevalent in this Mediterranean population and is associated with metabolic syndrome in overweight and obese men and women as well as in men with normal BMI.
Collapse
Affiliation(s)
- Marisa Chiloiro
- 1 Radiology Unit, National Institute for Digestive Disease , IRCCS "S. de Bellis," Castellana, Bari, Italy
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Notarnicola M, Misciagna G, Tutino V, Chiloiro M, Osella AR, Guerra V, Bonfiglio C, Caruso MG. Increased serum levels of lipogenic enzymes in patients with severe liver steatosis. Lipids Health Dis 2012; 11:145. [PMID: 23110339 PMCID: PMC3494566 DOI: 10.1186/1476-511x-11-145] [Citation(s) in RCA: 6] [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: 06/06/2012] [Accepted: 10/26/2012] [Indexed: 01/21/2023] Open
Abstract
Background Lipid metabolism is altered in subjects with liver steatosis. FAS is a key enzyme in de novo lipogenesis and both FAS gene expression and enzymatic activity are primarily regulated by metabolic signals in the liver. Lipoprotein lipase (LPL), the rate-limiting enzyme for the hydrolysis of core triglycerides, plays a pivotal role in lipid metabolism. This study aims to investigate if circulating levels of FAS and LPL could be clinically associated with liver steatosis. Methods In this work, we present data obtained from a subsample of 94 subjects with liver steatosis enrolled by NUTRIEPA study, a nutritional trial in subjects with liver steatosis. Serum levels of FAS protein and LPL activity were evaluated by ELISA test and by a fluorescent method, respectively. The diagnosis and the degree of liver steatosis were based on laboratory and ecographic measurements. Statistical methods included Kruskal-Wallis analysis of variance and Wilcoxon signed-rank test, where appropriate. The χ2 test has been performed to analyse categorical variables. Results The subjects with severe steatosis had significantly higher serum levels of FAS protein and LPL activity compared to subjects with mild and moderate liver steatosis. Moreover, a positive trend in serum levels of FAS expression from lower to higher degree of steatosis was also detected. Conclusions We describe a relationship between human liver steatosis and elevated levels of circulating lipogenic enzymes. Increased serum levels of FAS expression and LPL activity could be considered a marker of severe liver steatosis.
Collapse
Affiliation(s)
- Maria Notarnicola
- Laboratory of Biochemistry, National Institute for Digestive Diseases, Castellana Grotte, 70013, Bari, Italy
| | | | | | | | | | | | | | | |
Collapse
|
48
|
Morace C, Spadaro A, Cucunato M, Tortorella V, Consolo P, Luigiano C, Stabile G, Bonfiglio C, Bellerone R, Fortiguerra A, Alibrandi A, Crinò S, Carducci A, Resta ML, Ferraù O, Freni MA. High serum resistin in chronic viral hepatitis is not a marker of metabolic disorder. Hepatogastroenterology 2010; 57:1215-1219. [PMID: 21410061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND/AIMS The role of resistin, an adipocyte-secreted hormone, in insulin resistance and in inflammation is controversial. In chronic hepatitis C, insulin resistance, type 2 diabetes and liver steatosis are frequent and inconsistently correlated to circulating resistin levels. In this study we assessed if viral aetiology and host metabolic parameters influence serum resistin in patients with HCV- and HBV- related chronic hepatitis. METHODOLOGY Serum resistin was measured by ELISA and correlated to viral aetiology, age, gender, BMI, HOMA-IR, liver steatosis, hepatitis staging and grading, blood glucose, triglycerides and cholesterol in 43 patients with chronic hepatitis C, in 16 with chronic hepatitis B and in 29 healthy controls. RESULTS In both groups of patients resistin was significantly higher than in controls, with higher values in HBV- than in HCV-patients (p = 0.0007). Resistin levels were correlated to aetiology and, inversely, to age (p = 0.026), diabetes (p = 0.036) and steatosis (p = 0.029). Multiple regression analysis showed that resistin concentration was dependent only on the aetiology of liver disease (p = 0.001). CONCLUSIONS In chronic viral hepatitis serum resistin levels are high and not associated with altered metabolic parameters or with the histological activity of the disease. The meaning of higher resistin in HBV- than in HCV- chronic hepatitis is unclear.
Collapse
Affiliation(s)
- C Morace
- Dipartimento di Medicina Interna, UOC di Medicina interna ad indirizzo gastroenterologico, Pad. C, 2o piano, AOU Policlinico Universitario, Via Consolare Valeria, 1 - 98125 Messina, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Cozzolongo R, Osella AR, Elba S, Petruzzi J, Buongiorno G, Giannuzzi V, Leone G, Bonfiglio C, Lanzilotta E, Manghisi OG, Leandro G, Donnaloia R, Fanelli V, Mirizzi F, Parziale L, Crupi G, Detomaso P, Labbate A, Zizzari S, Depalma M, Polignano A, Lopinto D, Daprile G. Epidemiology of HCV infection in the general population: a survey in a southern Italian town. Am J Gastroenterol 2009; 104:2740-6. [PMID: 19638964 DOI: 10.1038/ajg.2009.428] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [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: 12/11/2022]
Abstract
OBJECTIVES The objective of this study was to estimate the seroprevalence of hepatitis C virus (HCV) in the general population older than 18 years of age in a southern Italian town. METHODS The survey was conducted from July 2005 through January 2007 in Putignano, Bari, Apulia. A random 1:5 sampling from the list of records maintained by general practitioners was used. Serology for HCV, hepatitis B surface antigen (HBsAg), antibodies to hepatitis B core antigen (anti-HBc), and genotyping for HCV were performed. RESULTS Of a total of 2,195 serum samples tested, 58 (2.6%) were positive for anti-HCV antibodies. The prevalence increased from 1% in subjects aged <30 years to 7.7% in those aged 70 years and was similar in both males and females (3.1 vs. 2.4%, P=0.4). Approximately one-third of 58 positive subjects also showed alanine transaminase levels and 53.5% tested positive for HCV RNA by TaqMan PCR. Genotypes 2a and 1b were represented in 21 and 10 subjects, respectively. In a multivariate logistic regression analysis, age (adjusted odds ratio (OR) 1.05; 95% confidence interval (CI): 1.03-1.07), blood transfusion (adjusted OR 3.3; 95% CI: 1.7-6.3), and household contact with HCV-infected individuals (adjusted OR 4.8; 95% CI: 1.8-13.1) were the independent variables predictive of HCV infection. The overall HBsAg and anti-HBc prevalence rates were 0.5 and 12%, respectively. CONCLUSIONS This survey confirms that HCV infection is clearly also declining in southern Italy, especially among the elderly. HCV genotype 2a predominates, reflecting the current epidemiology of HCV in Italy. Age, blood transfusion, and household contact with HCV-infected individuals may have had a role in the spread of HCV infection.
Collapse
Affiliation(s)
- Raffaele Cozzolongo
- Division of Gastroenterology 1, National Institute of Gastroenterology S. de Bellis, Castellana Grotte, Bari, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Spadaro A, Tortorella V, Morace C, Fortiguerra A, Composto P, Bonfiglio C, Alibrandi A, Luigiano C, Caro GD, Ajello A, Ferraù O, Freni MA. High circulating D-dimers are associated with ascites and hepatocellular carcinoma in liver cirrhosis. World J Gastroenterol 2008; 14:1549-52. [PMID: 18330946 PMCID: PMC2693750 DOI: 10.3748/wjg.14.1549] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
AIM: To measure plasma D-dimer levels in cirrhotic patients with and without ascites, assessing the effect of ascites resolution in D-dimer concentration.
METHODS: Seventy consecutive cirrhotic patients (M = 44, F = 26, mean age 65 years, SD ± 13), observed from October 2005 to March 2006 were enrolled. Circulating D-dimer levels were measured using a latex-enhanced, immunoturbidimetric test. In patients with ascites (n = 42) the test was repeated after ascites resolution.
RESULTS: Ascites was present in 42 patients (group A) and absent in 28 (group B). Group A patients had more advanced liver disease. Hepatocellular carcinoma (HCC) was diagnosed in 14 patients and was more frequent in group B. Above normal range D-dimers were found in 45/70 patients. High D-dimers were more frequent in group A than in group B (P = 0.001). High D-dimers were associated with presence of HCC (P = 0.048) only in group B. After ascites resolution, obtained in all patients, mean D-dimer values decreased in those 34 patients with high basal levels (P = 0.007), returning to normal in 17.
CONCLUSION: In patients with liver cirrhosis, ascites and HCC are the main factors associated with increased fibrinolytic activity.
Collapse
|