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Cicero AFG, Fogacci F, Giovannini M, Rizzoli E, Grandi E, D’Addato S, Borghi C. The Effect of Dietary Supplementation with Plant Sterols on Total and LDL-Cholesterol in Plasma Is Affected by Adherence to Mediterranean Diet: Insights from the DESCO Randomized Clinical Study. Nutrients 2023; 15:4555. [PMID: 37960208 PMCID: PMC10649106 DOI: 10.3390/nu15214555] [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: 10/02/2023] [Revised: 10/15/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023] Open
Abstract
Plant sterols are well-known natural lipid-lowering agents. The DESCO (Diet and plant sterols in the control of cholesterolemia) study was a single-center, randomized, double-blind, placebo-controlled, two-way crossover clinical trial designed to investigate the effect of a once-a-day ready-to-drink dietary supplement containing 2.5 g of phytosterols on the lipid profile, also in relation to the quality of the diet, in a cohort of 50 Italian individuals with polygenic hypercholesterolemia and low global cardiovascular risk. Eligible individuals were enrolled in a run-in period of 2 weeks. Then, participants who qualified for continuation in the study were randomly allocated (1:1) to a 3-week treatment with either phytosterols or placebo. After a 2-week washout period, enrolled individuals were crossed over to receive the alternative treatment. Dietary supplementation with phytosterols was associated with significant improvement in plasma levels of total cholesterol (TC; -11.8 ± 4.0 mg/dL, p = 0.016), low-density lipoprotein cholesterol (LDL-C; -7.8 ± 7.7 mg/dL, p = 0.021), and apolipoprotein B-100 (Apo B-100, -3.7 ± 4.1 mg/dL, p = 0.048) compared to baseline. The changes in TC and LDL-C were also significant compared to placebo, and greater adherence to the Mediterranean diet was significantly associated with greater reductions in LDL-C. Dietary supplementation with phytosterols was well tolerated and adherence to treatment was high. According to the findings of DESCO, the once-a-day ready-to-drink dietary supplement we tested is able to quickly and significantly decrease plasma levels of TC, LDL-C, and Apo B-100, with a greater effect in individuals more adhering to the Mediterranean dietary pattern.
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Affiliation(s)
- Arrigo F. G. Cicero
- Hypertension and Cardiovascular Risk Research Group, Medical and Surgical Sciences Department, University of Bologna, 40138 Bologna, Italy; (A.F.G.C.); (M.G.); (E.R.); (E.G.); (S.D.); (C.B.)
- IRCCS Azienda Ospedaliero, Universitaria di Bologna, 40138 Bologna, Italy
| | - Federica Fogacci
- Hypertension and Cardiovascular Risk Research Group, Medical and Surgical Sciences Department, University of Bologna, 40138 Bologna, Italy; (A.F.G.C.); (M.G.); (E.R.); (E.G.); (S.D.); (C.B.)
- Italian Nutraceutical Society (SINut), 40100 Bologna, Italy
| | - Marina Giovannini
- Hypertension and Cardiovascular Risk Research Group, Medical and Surgical Sciences Department, University of Bologna, 40138 Bologna, Italy; (A.F.G.C.); (M.G.); (E.R.); (E.G.); (S.D.); (C.B.)
| | - Elisabetta Rizzoli
- Hypertension and Cardiovascular Risk Research Group, Medical and Surgical Sciences Department, University of Bologna, 40138 Bologna, Italy; (A.F.G.C.); (M.G.); (E.R.); (E.G.); (S.D.); (C.B.)
- IRCCS Azienda Ospedaliero, Universitaria di Bologna, 40138 Bologna, Italy
| | - Elisa Grandi
- Hypertension and Cardiovascular Risk Research Group, Medical and Surgical Sciences Department, University of Bologna, 40138 Bologna, Italy; (A.F.G.C.); (M.G.); (E.R.); (E.G.); (S.D.); (C.B.)
- IRCCS Azienda Ospedaliero, Universitaria di Bologna, 40138 Bologna, Italy
| | - Sergio D’Addato
- Hypertension and Cardiovascular Risk Research Group, Medical and Surgical Sciences Department, University of Bologna, 40138 Bologna, Italy; (A.F.G.C.); (M.G.); (E.R.); (E.G.); (S.D.); (C.B.)
- IRCCS Azienda Ospedaliero, Universitaria di Bologna, 40138 Bologna, Italy
| | - Claudio Borghi
- Hypertension and Cardiovascular Risk Research Group, Medical and Surgical Sciences Department, University of Bologna, 40138 Bologna, Italy; (A.F.G.C.); (M.G.); (E.R.); (E.G.); (S.D.); (C.B.)
- IRCCS Azienda Ospedaliero, Universitaria di Bologna, 40138 Bologna, Italy
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Fogacci F, Giovannini M, Imbalzano E, Grandi E, Rizzoli E, D’Addato S, Cicero AF. Metabolic and vascular effect of a new standardized bergamot phytocomplex: a three-arm, placebocontrolled, double-blind clinical trial. Arch Med Sci 2023; 19:1228-1235. [PMID: 37732063 PMCID: PMC10507770 DOI: 10.5114/aoms/163368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 04/17/2023] [Indexed: 09/22/2023] Open
Abstract
Introduction In addition to healthy lifestyle and balanced diet, nutraceutical supplementation may be useful to maintain overall metabolic wellness. The aim of the present study was to assess the metabolic and vascular effects of a new, highly standardized bergamot phytocomplex supplement in healthy volunteers with the features of metabolic syndrome. Material and methods We carried out a double-blind, randomized, placebo-controlled, three-arm, parallel-group clinical trial in 90 adult subjects (30 per group) treated for 12 weeks with two different dosages of a highly standardized bergamot phytocomplex (Endoberg by AKHYNEX and Kalita by Giellepi) or placebo. Lipid plasma levels, glycemia, plasma hs-CRP, HOMA-IR, body fat, endothelial reactivity and fatty liver index were assessed at baseline, after 6 weeks and at the end of treatment in all subjects. Results At the end of treatment, both tested bergamot extract doses were able to significantly improve atherogenic dyslipidemia and insulin sensitivity (p < 0.05) compared to placebo. In the high-dose treated group, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), non high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) improved versus placebo (p < 0.05) just after 6 weeks of treatment. After 12 weeks of treatment, TC decreased by 13.2 ±2.1%, LDL-C by 17.7 ±3.2%, non-HDL-C by 17.5 ±3.1%, TG by 16.6 ±3.3%, TG/HDL-C by 22.5 ±4.4%, homeostasis insulin resistance index (HOMA-IR) by 12.2 ±2.1%, γ-glutamyl transferase (GGT) by 22.2 ±4.6%, and high-sensitivity C-reactive protein (hs-CRP) by 17.9 ±3.4% versus baseline (p < 0.05) and vs. placebo (p < 0.05). Percentage body fat and endothelial reactivity improved versus baseline, but not versus placebo, in the high-dose treatment only (p < 0.05). Conclusions The tested bergamot phytocomplex was able to significantly improve glucose and lipid metabolism, as well as inflammation, and might represent a novel multi-target approach to control metabolic syndrome.
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Affiliation(s)
- Federica Fogacci
- Hypertension and cardiovascular risk research center, Medical and Surgical Sciences Department, University of Bologna, Bologna, Italy
- Italian Nutraceutical Society (SINut), Bologna, Italy
| | - Marina Giovannini
- Hypertension and cardiovascular risk research center, Medical and Surgical Sciences Department, University of Bologna, Bologna, Italy
- Italian Nutraceutical Society (SINut), Bologna, Italy
| | - Edigio Imbalzano
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Elisa Grandi
- Hypertension and cardiovascular risk research center, Medical and Surgical Sciences Department, University of Bologna, Bologna, Italy
| | - Elisabetta Rizzoli
- Hypertension and cardiovascular risk research center, Medical and Surgical Sciences Department, University of Bologna, Bologna, Italy
| | - Sergio D’Addato
- Hypertension and cardiovascular risk research center, Medical and Surgical Sciences Department, University of Bologna, Bologna, Italy
| | - Arrigo F.G. Cicero
- Hypertension and cardiovascular risk research center, Medical and Surgical Sciences Department, University of Bologna, Bologna, Italy
- Italian Nutraceutical Society (SINut), Bologna, Italy
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D'Agostino A, Di Marco G, Marvelli S, Marchesini M, Rizzoli E, Rolfo MF, Canini A, Gismondi A. Neolithic dental calculi provide evidence for environmental proxies and consumption of wild edible fruits and herbs in central Apennines. Commun Biol 2022; 5:1384. [PMID: 36536113 PMCID: PMC9763411 DOI: 10.1038/s42003-022-04354-0] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022] Open
Abstract
Looking for a biological fingerprint relative to new aspects of the relationship between humans and natural environment during prehistoric times is challenging. Although many issues still need to be addressed in terms of authentication and identification, microparticles hidden in ancient dental calculus can provide interesting information for bridging this gap of knowledge. Here, we show evidence about the role of edible plants for the early Neolithic individuals in the central Apennines of the Italian peninsula and relative cultural landscape. Dental calculi from human and animal specimens exhumed at Grotta Mora Cavorso (Lazio), one of the largest prehistoric burial deposits, have returned an archaeobotanical record made up of several types of palaeoecological proxies. The organic fraction of this matrix was investigated by a multidisciplinary approach, whose novelty consisted in the application of next generation sequencing to ancient plant DNA fragments, specifically codifying for maturase K barcode gene. Panicoideae and Triticeae starches, together with genetic indicators of Rosaceae fruits, figs, and Lamiaceae herbs, suggested subsistence practices most likely still based on wild plant resources. On the other hand, pollen, and non-pollen palynomorphs allowed us to outline a general vegetational framework dominated by woodland patches alternated with meadows, where semi-permanent settlements could have been established.
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Affiliation(s)
- Alessia D'Agostino
- PhD Program in Evolutionary Biology and Ecology, Department of Biology, University of Rome Tor Vergata, Rome, Italy
- Laboratory of Botany, Department of Biology, University of Rome "Tor Vergata", Rome, Italy
| | - Gabriele Di Marco
- Laboratory of Botany, Department of Biology, University of Rome "Tor Vergata", Rome, Italy
| | - Silvia Marvelli
- Laboratorio di Palinologia e Archeobotanica-C.A.A. Giorgio Nicoli, San Giovanni in Persiceto, Bologna, Italy
| | - Marco Marchesini
- Laboratorio di Palinologia e Archeobotanica-C.A.A. Giorgio Nicoli, San Giovanni in Persiceto, Bologna, Italy
| | - Elisabetta Rizzoli
- Laboratorio di Palinologia e Archeobotanica-C.A.A. Giorgio Nicoli, San Giovanni in Persiceto, Bologna, Italy
| | - Mario Federico Rolfo
- Department of History, Culture and Society, University of Rome "Tor Vergata", Rome, Italy
| | - Antonella Canini
- Laboratory of Botany, Department of Biology, University of Rome "Tor Vergata", Rome, Italy
| | - Angelo Gismondi
- Laboratory of Botany, Department of Biology, University of Rome "Tor Vergata", Rome, Italy.
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Cicero AFG, Fogacci F, Rizzoli E, Giovannini M, D'Addato S, Borghi C. Impact of simultaneous management of hypertension and hypercholesterolemia with ACE inhibitors and statins on cardiovascular outcomes in the Brisighella Heart Study: A 8-year follow-up. Nutr Metab Cardiovasc Dis 2022; 32:2246-2254. [PMID: 35843791 DOI: 10.1016/j.numecd.2022.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/12/2022] [Accepted: 06/17/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND AND AIMS To evaluate the long-term effect of simultaneous treatment of hypertension and hypercholesterolemia with angiotensin-converting enzyme (ACE) inhibitors and statins on the incidence of major cardiovascular events (MACE) and other clinical outcomes. METHODS AND RESULTS We considered data from a subset of Brisighella Heart Study (BHS) participants who were consecutively evaluated in three epidemiological surveys between 2012 and 2020. We excluded normotensive subjects and individuals with a low calculated 10-year CVD risk, hypertensive patients treated with antihypertensive drugs different from ACE inhibitors and patients who changed antihypertensive medications during follow-up. The remaining participants were divided into four groups depending on whether they were treated with (I) perindopril ± amlodipine without statin treatment (N. 132), (II) perindopril ± amlodipine and atorvastatin (N. 132), (III) an ACE inhibitor other than perindopril ± a calcium-channel blocker without statin therapy (N. 133), (IV) an ACE inhibitor other than perindopril ± a calcium-channel blocker and statin therapy (N. 145). The long-term (8 years) effects of the different combined treatment were compared among the pre-defined groups. Over the follow-up period of 8 years, the proportion of subjects who developed MACE, type 2 diabetes mellitus and hyperuricemia, and the proportion of subjects needing for the intensification of antihypertensive treatment to improve blood pressure control were statistically different among the predefined groups (P < 0.05). CONCLUSION Combined treatment with ACE inhibitors and statins (especially atorvastatin) in hypertensive patients seems to significantly reduce the risk of developing CVD in comparison with treatment with ACE inhibitors alone.
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Affiliation(s)
- A F G Cicero
- IRCCS AOU S. Orsola-Malpighi, Bologna, Italy; Hypertension and Cardiovascular Risk Factors Research Center, Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, Bologna, Italy.
| | - F Fogacci
- Hypertension and Cardiovascular Risk Factors Research Center, Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - E Rizzoli
- IRCCS AOU S. Orsola-Malpighi, Bologna, Italy; Hypertension and Cardiovascular Risk Factors Research Center, Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - M Giovannini
- Hypertension and Cardiovascular Risk Factors Research Center, Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - S D'Addato
- IRCCS AOU S. Orsola-Malpighi, Bologna, Italy; Hypertension and Cardiovascular Risk Factors Research Center, Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - C Borghi
- IRCCS AOU S. Orsola-Malpighi, Bologna, Italy; Hypertension and Cardiovascular Risk Factors Research Center, Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, Bologna, Italy
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Fogacci F, Rizzoli E, Giovannini M, Bove M, D’Addato S, Borghi C, Cicero AFG. Effect of Dietary Supplementation with Eufortyn ® Colesterolo Plus on Serum Lipids, Endothelial Reactivity, Indexes of Non-Alcoholic Fatty Liver Disease and Systemic Inflammation in Healthy Subjects with Polygenic Hypercholesterolemia: The ANEMONE Study. Nutrients 2022; 14:2099. [PMID: 35631240 PMCID: PMC9145013 DOI: 10.3390/nu14102099] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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: 04/10/2022] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 01/07/2023] Open
Abstract
We aimed to evaluate if dietary supplementation with a nutraceutical compound (Eufortyn® Colesterolo Plus) containing standardized bergamot polyphenolic fraction phytosome (Vazguard®), artichoke extract (Pycrinil®), artichoke dry extract. (Cynara scolymus L.), Q10 phytosome(Ubiqosome®) and zinc, could positively affect serum lipids concentration, systemic inflammation and indexes of non-alcoholic fatty liver disease (NAFLD) in 60 healthy subjects with polygenic hypercholesterolemia. Participants were adhering to a low-fat, low-sodium Mediterranean diet for a month before being randomly allocated to 8-week treatment with 1 pill each day of either Eufortyn® Colesterolo Plus or placebo. Dietary supplementation with Eufortyn® Colesterolo Plus was associated with significant improvement in total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), high-sensitivity C-reactive protein (hs-CRP) and endothelial reactivity (ER) in comparison with baseline, and with significant reductions in waist circumference, TC, LDL-C, LDL-C/HDL-C, lipid accumulation product and fatty liver index compared to placebo. The study shows that dietary supplementation with standardized bergamot polyphenolic fraction phytosome, artichoke extracts, Q10 phytosome and zinc safely exerts significant improvements in serum lipids, systemic inflammation, indexes of NAFLD and endothelial reactivity in healthy subjects with moderate hypercholesterolemia.
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Affiliation(s)
- Federica Fogacci
- Hypertension and Cardiovascular Risk Research Center, Medical and Surgical Sciences Department, Sant’Orsola-Malpighi University Hospital, 40138 Bologna, Italy; (F.F.); (E.R.); (M.G.); (M.B.); (S.D.); (C.B.)
- IRCCS Policlinico S. Orsola—Malpighi di Bologna, 40138 Bologna, Italy
- Italian Nutraceutical Society (SINut), 40138 Bologna, Italy
| | - Elisabetta Rizzoli
- Hypertension and Cardiovascular Risk Research Center, Medical and Surgical Sciences Department, Sant’Orsola-Malpighi University Hospital, 40138 Bologna, Italy; (F.F.); (E.R.); (M.G.); (M.B.); (S.D.); (C.B.)
- IRCCS Policlinico S. Orsola—Malpighi di Bologna, 40138 Bologna, Italy
| | - Marina Giovannini
- Hypertension and Cardiovascular Risk Research Center, Medical and Surgical Sciences Department, Sant’Orsola-Malpighi University Hospital, 40138 Bologna, Italy; (F.F.); (E.R.); (M.G.); (M.B.); (S.D.); (C.B.)
- IRCCS Policlinico S. Orsola—Malpighi di Bologna, 40138 Bologna, Italy
| | - Marilisa Bove
- Hypertension and Cardiovascular Risk Research Center, Medical and Surgical Sciences Department, Sant’Orsola-Malpighi University Hospital, 40138 Bologna, Italy; (F.F.); (E.R.); (M.G.); (M.B.); (S.D.); (C.B.)
- IRCCS Policlinico S. Orsola—Malpighi di Bologna, 40138 Bologna, Italy
| | - Sergio D’Addato
- Hypertension and Cardiovascular Risk Research Center, Medical and Surgical Sciences Department, Sant’Orsola-Malpighi University Hospital, 40138 Bologna, Italy; (F.F.); (E.R.); (M.G.); (M.B.); (S.D.); (C.B.)
- IRCCS Policlinico S. Orsola—Malpighi di Bologna, 40138 Bologna, Italy
| | - Claudio Borghi
- Hypertension and Cardiovascular Risk Research Center, Medical and Surgical Sciences Department, Sant’Orsola-Malpighi University Hospital, 40138 Bologna, Italy; (F.F.); (E.R.); (M.G.); (M.B.); (S.D.); (C.B.)
- IRCCS Policlinico S. Orsola—Malpighi di Bologna, 40138 Bologna, Italy
| | - Arrigo F. G. Cicero
- Hypertension and Cardiovascular Risk Research Center, Medical and Surgical Sciences Department, Sant’Orsola-Malpighi University Hospital, 40138 Bologna, Italy; (F.F.); (E.R.); (M.G.); (M.B.); (S.D.); (C.B.)
- IRCCS Policlinico S. Orsola—Malpighi di Bologna, 40138 Bologna, Italy
- Italian Nutraceutical Society (SINut), 40138 Bologna, Italy
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Cicero A, Fogacci F, Rizzoli E, D'addato S, Borghi C. Long-term impact of different triple antihypertensive drug treatments on blood pressure control, metabolic pattern and incident events: data from the Brisighella Heart Study. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): University of Bologna
Purpose
The aim of this study was to comparatively evaluate clinical, laboratory and hemodynamic effects on the long term of different triple combination antihypertensive medications in a well-characterized population cohort.
Methods
We considered data of a subset of Brisighella Heart Study (BHS) participants who were consecutively evaluated in three epidemiological surveys between 2008 and 2020. For the current analysis, we excluded normotensive subjects, patients treated with <3 or ≥3 high blood pressure (BP) medications without taking angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), calcium-channel blockers (CCB) and/or thiazide/thiazide-like diuretics. The remaining participants were divided into three groups depending on whether they were treated with ACE-inhibitors/CCBs/Thiazide, ARBs/CCBs/Thiazide or Perindopril/Amlodipine/Indapamide, either with separate drugs or fixed pill combinations. A further group of age- and sex-matched volunteers was selected as control and included patients receiving other antihypertensive medications. The long term effects of the different antihypertensive medications were compared among the pre-defined groups.
Results
On the long-term, combination treatment with renin-angiotensin system (RAS) modulators, CCBs and thiazide/thiazide-like diuretics was associated with better control of diastolic BP and lipid pattern than other triple combination antihypertensive medication. Patients treated with Perindopril/Amlodipine/Indapamide did not experience any age-related increase in serum levels of total cholesterol. Moreover, during the follow-up they neither developed type 2 diabetes nor had a need for a greater number of antihypertensive drugs to improve BP control.
Conclusion
Based on our observations, combination treatment with RAS modulators, amlodipine and thiazides/thiazide-like diuretics is more effective than other combination antihypertensive medications for lowering the diastolic BP and has a better impact on serum lipids. Perindopril/amlodipine/indapamide is associated with better lipids’ profile than any other considered combination antihypertensive medication.
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Affiliation(s)
- A Cicero
- Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - F Fogacci
- Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - E Rizzoli
- Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - S D'addato
- Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - C Borghi
- Alma Mater Studiorum, University of Bologna, Bologna, Italy
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Cicero AFG, Fogacci F, Tocci G, Ventura F, Presta V, Grandi E, Rizzoli E, D'Addato S, Borghi C. Awareness of major cardiovascular risk factors and its relationship with markers of vascular aging: Data from the Brisighella Heart Study. Nutr Metab Cardiovasc Dis 2020; 30:907-914. [PMID: 32249143 DOI: 10.1016/j.numecd.2020.03.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 01/04/2020] [Accepted: 03/03/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND AIM General population awareness about cardiovascular risk factors is usually low. The aim of the present study was to evaluate the vascular aging of subjects aware and not aware to be hypertensive, hypercholesterolemic, hypertriglyceridemic or diabetics in a general population sample. METHODS AND RESULTS We interviewed 1652 subjects without atherosclerotic cardiovascular diseases (M: 46.6%, F: 53.4%) about their awareness of hypertension, hypercholesterolemia, hypertriglyceridemia or type 2 diabetes. Then we compared the augmentation index and pulse wave velocity of subjects aware and not aware of the investigated cardiovascular risk factors. 1049 participants declared not to be hypertensive, while 32 were not sure. Among them, respectively, 23.5% and 50% were hypertensive. Subjects not aware of their hypertension had significantly higher aortic blood pressure than aware ones (p < 0.001). 841 participants declared not to be hypercholesterolemic, while 60 were not sure. Among them, respectively, 18.1% and 40% were hypercholesterolemic. Subjects not aware of their hypercholesterolemia had significantly higher augmentation index than the aware ones (p < 0.05). 1226 participants declared not to be hypertriglyceridemic, while 200 were not sure. Among them, respectively, 19.2% and 44% were hypertriglyceridemic. Subjects not aware of their hypertriglyceridemia had significantly higher TG levels aware ones (p < 0.05), although this seemed to not related to increased arterial stiffness. 1472 participants declared not to be diabetic, while 20 were not sure. Among them, respectively, 2.0% and 25.0% were diabetics. Subjects not aware of their diabetes had significantly higher augmentation index than the aware ones (p < 0.05). CONCLUSIONS In conclusion, the lack of awareness of hypertension and hypercholesterolemia is relatively frequent in the general population and is associated to significantly higher arterial stiffness.
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Affiliation(s)
- Arrigo F G Cicero
- Hypertension and Atherosclerosis Research Group, Medical and Surgical Sciences Department, Sant'Orsola-Malpighi University Hospital, Via Albertoni 15, 40138 Bologna, Italy.
| | - Federica Fogacci
- Hypertension and Atherosclerosis Research Group, Medical and Surgical Sciences Department, Sant'Orsola-Malpighi University Hospital, Via Albertoni 15, 40138 Bologna, Italy
| | - Giuliano Tocci
- Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy; IRCCS Neuromed, Pozzilli, IS, Italy
| | - Fulvio Ventura
- Hypertension and Atherosclerosis Research Group, Medical and Surgical Sciences Department, Sant'Orsola-Malpighi University Hospital, Via Albertoni 15, 40138 Bologna, Italy
| | - Vivianne Presta
- Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Elisa Grandi
- Hypertension and Atherosclerosis Research Group, Medical and Surgical Sciences Department, Sant'Orsola-Malpighi University Hospital, Via Albertoni 15, 40138 Bologna, Italy
| | - Elisabetta Rizzoli
- Hypertension and Atherosclerosis Research Group, Medical and Surgical Sciences Department, Sant'Orsola-Malpighi University Hospital, Via Albertoni 15, 40138 Bologna, Italy
| | - Sergio D'Addato
- Hypertension and Atherosclerosis Research Group, Medical and Surgical Sciences Department, Sant'Orsola-Malpighi University Hospital, Via Albertoni 15, 40138 Bologna, Italy
| | - Claudio Borghi
- Hypertension and Atherosclerosis Research Group, Medical and Surgical Sciences Department, Sant'Orsola-Malpighi University Hospital, Via Albertoni 15, 40138 Bologna, Italy
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Cicero AF, Fogacci F, Veronesi M, Strocchi E, Grandi E, Rizzoli E, Poli A, Marangoni F, Borghi C. A randomized Placebo-Controlled Clinical Trial to Evaluate the Medium-Term Effects of Oat Fibers on Human Health: The Beta-Glucan Effects on Lipid Profile, Glycemia and inTestinal Health (BELT) Study. Nutrients 2020; 12:nu12030686. [PMID: 32138344 PMCID: PMC7146517 DOI: 10.3390/nu12030686] [Citation(s) in RCA: 45] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 02/21/2020] [Accepted: 02/28/2020] [Indexed: 12/14/2022] Open
Abstract
The Beta-glucan Effects on Lipid profile, glycemia and inTestinal health (BELT) Study investigated the effect of 3 g/day oat beta-glucans on plasma lipids, fasting glucose and self-perceived intestinal well-being. The Study was an 8-week, double-blind, placebo-controlled, cross-over randomized clinical trial, enrolling a sample of 83 Italian free-living subjects, adherent to Mediterranean diet, with a moderate hypercholesterolemia and a low cardiovascular risk profile. Beta-glucans reduced mean LDL-Cholesterol (LDL-C) levels from baseline by 12.2% (95%CI: -15.4 to -3.8) after 4 weeks of supplementation and by 15.1% (95%CI: -17.8 to -5.9) after 8 weeks of supplementation (p < 0.01 for both comparison and versus placebo). Between baseline and 4 weeks Total Cholesterol (TC) levels showed an average reduction of 6.5% (95%CI: -10.9 to -1.9) in the beta-glucan sequence; while non-HDL-C plasma concentrations decreased by 11.8% (95%CI: -14.6 to -4.5). Moreover, after 8 weeks of beta-glucan supplementation TC was reduced by 8.9% (95%CI: -12.6 to -2.3) and non-HDL-C levels by 12.1% (95%CI: -15.6 to -5.3). Decreses in TC and non HDL-C were significant also versus placebo (respectively p < 0.05 and p < 0.01 to both follow-up visits). Fasting plasma glucose and self-perceived intestinal well-being were not affected by both beta-glucan and placebo supplementation.
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Affiliation(s)
- Arrigo F.G. Cicero
- Atherosclerosis and Hypertension Research Group, Medical and Surgical Sciences Department, Sant’Orsola-Malpighi University Hospital, Building 2-IV Floor, Via Albertoni 15, 40138 Bologna, Italy; (F.F.); (M.V.); (E.S.); (E.G.); (E.R.); (C.B.)
- Correspondence:
| | - Federica Fogacci
- Atherosclerosis and Hypertension Research Group, Medical and Surgical Sciences Department, Sant’Orsola-Malpighi University Hospital, Building 2-IV Floor, Via Albertoni 15, 40138 Bologna, Italy; (F.F.); (M.V.); (E.S.); (E.G.); (E.R.); (C.B.)
| | - Maddalena Veronesi
- Atherosclerosis and Hypertension Research Group, Medical and Surgical Sciences Department, Sant’Orsola-Malpighi University Hospital, Building 2-IV Floor, Via Albertoni 15, 40138 Bologna, Italy; (F.F.); (M.V.); (E.S.); (E.G.); (E.R.); (C.B.)
| | - Enrico Strocchi
- Atherosclerosis and Hypertension Research Group, Medical and Surgical Sciences Department, Sant’Orsola-Malpighi University Hospital, Building 2-IV Floor, Via Albertoni 15, 40138 Bologna, Italy; (F.F.); (M.V.); (E.S.); (E.G.); (E.R.); (C.B.)
| | - Elisa Grandi
- Atherosclerosis and Hypertension Research Group, Medical and Surgical Sciences Department, Sant’Orsola-Malpighi University Hospital, Building 2-IV Floor, Via Albertoni 15, 40138 Bologna, Italy; (F.F.); (M.V.); (E.S.); (E.G.); (E.R.); (C.B.)
| | - Elisabetta Rizzoli
- Atherosclerosis and Hypertension Research Group, Medical and Surgical Sciences Department, Sant’Orsola-Malpighi University Hospital, Building 2-IV Floor, Via Albertoni 15, 40138 Bologna, Italy; (F.F.); (M.V.); (E.S.); (E.G.); (E.R.); (C.B.)
| | - Andrea Poli
- Nutrition Foundation of Italy, Viale Tunisia 38, 20124 Milan, Italy; (A.P.); (F.M.)
| | - Franca Marangoni
- Nutrition Foundation of Italy, Viale Tunisia 38, 20124 Milan, Italy; (A.P.); (F.M.)
| | - Claudio Borghi
- Atherosclerosis and Hypertension Research Group, Medical and Surgical Sciences Department, Sant’Orsola-Malpighi University Hospital, Building 2-IV Floor, Via Albertoni 15, 40138 Bologna, Italy; (F.F.); (M.V.); (E.S.); (E.G.); (E.R.); (C.B.)
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Cicero AF, Fogacci F, Desideri G, Grandi E, Rizzoli E, D’Addato S, Borghi C. Arterial Stiffness, Sugar-Sweetened Beverages and Fruits Intake in a Rural Population Sample: Data from the Brisighella Heart Study. Nutrients 2019; 11:nu11112674. [PMID: 31694231 PMCID: PMC6893603 DOI: 10.3390/nu11112674] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 10/22/2019] [Accepted: 10/28/2019] [Indexed: 12/18/2022] Open
Abstract
Introduction: There is conflicting information linking fruit and fructose intake with cardiometabolic disorders. The main objective of our study was to evaluate the association between intake of fruits and sugar-sweetened beverages, and carotid-femoral pulse wave velocity (cfPWV), a non-invasive marker of arterial aging, in a large population sample. Methods: For this study, we selected four age and sex-matched subgroups from the last Brisighella Heart Study population survey, after exclusion of those in secondary prevention for cardiovascular diseases, affected by gout and moderate-to-severe chronic kidney disease (defined as eGFR < 60 mL/min), and/or actively treated with direct vasodilating drugs (calcium-antagonists, alpha-blockers, nitrates). The remaining subjects were classified into four groups: (1) low fruit and low sugar-sweetened beverage intake (LFLB), (2) high fruit and low sugar-sweetened beverage intake (HFLB), (3) low fruit and high sugar-sweetened beverage intake (LFHB), (4) high fruit and high sugar-sweetened beverage intake (HFHB). Results: CfPWV was significantly elevated in subjects consuming a higher fructose load, particularly when it was derived from industrially sweetened beverages (pooled LFHB & HFHB: 9.6 ± 2.3 m/s; pooled LFLB & HFLB: 8.6 ± 2.3 m/s, p < 0.001). Moreover, the main predictors of cfPWV values were serum uric acid (B = 0.391, 95%CI 0.321–0.486, p = 0.001), fructose load from both fruits and sugar-sweetened beverages (B = 0.310, 95%CI 0.099–0.522, p = 0.004), triglycerides (B = 0.228, 95%CI 0.117–0.389, p = 0.018), fasting plasma glucose (B = 0.015, 95%CI 0.008–0.022, p < 0.001) and estimated Glomerular Filtration Rate (B = −0.043, 95%CI −0.052–−0.035, p < 0.001). Conclusion: our data suggest that increased intake of fructose derived from industrial sweetened beverages, though not from fruits, is associated with higher pulse wave velocity.
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Affiliation(s)
- Arrigo F.G. Cicero
- Hypertension and Atherosclerosis Research Group, Medical and Surgical Sciences Department; Sant’Orsola-Malpighi University Hospital, Building 2–IV Floor, Via Albertoni 15, 40138 Bologna, Italy; (F.F.); (E.G.); (E.R.); (S.D.); (C.B.)
- Correspondence: ; Tel.: +39-512142224; Fax: +39-51390646
| | - Federica Fogacci
- Hypertension and Atherosclerosis Research Group, Medical and Surgical Sciences Department; Sant’Orsola-Malpighi University Hospital, Building 2–IV Floor, Via Albertoni 15, 40138 Bologna, Italy; (F.F.); (E.G.); (E.R.); (S.D.); (C.B.)
| | - Giovambattista Desideri
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Coppito, 67100 L’Aquila, Italy;
| | - Elisa Grandi
- Hypertension and Atherosclerosis Research Group, Medical and Surgical Sciences Department; Sant’Orsola-Malpighi University Hospital, Building 2–IV Floor, Via Albertoni 15, 40138 Bologna, Italy; (F.F.); (E.G.); (E.R.); (S.D.); (C.B.)
| | - Elisabetta Rizzoli
- Hypertension and Atherosclerosis Research Group, Medical and Surgical Sciences Department; Sant’Orsola-Malpighi University Hospital, Building 2–IV Floor, Via Albertoni 15, 40138 Bologna, Italy; (F.F.); (E.G.); (E.R.); (S.D.); (C.B.)
| | - Sergio D’Addato
- Hypertension and Atherosclerosis Research Group, Medical and Surgical Sciences Department; Sant’Orsola-Malpighi University Hospital, Building 2–IV Floor, Via Albertoni 15, 40138 Bologna, Italy; (F.F.); (E.G.); (E.R.); (S.D.); (C.B.)
| | - Claudio Borghi
- Hypertension and Atherosclerosis Research Group, Medical and Surgical Sciences Department; Sant’Orsola-Malpighi University Hospital, Building 2–IV Floor, Via Albertoni 15, 40138 Bologna, Italy; (F.F.); (E.G.); (E.R.); (S.D.); (C.B.)
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Ruscica M, Macchi C, Fogacci F, Ferri N, Grandi E, Rizzoli E, D'Addato S, Borghi C, Cicero AF. Angiopoietin-like 3 and subclinical peripheral arterial disease: Evidence from the Brisighella Heart Study. Eur J Prev Cardiol 2019; 27:2251-2254. [PMID: 31648549 DOI: 10.1177/2047487319884378] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Massimiliano Ruscica
- Pharmacological and Biomolecular Sciences Department, University of Milan, Italy
| | - Chiara Macchi
- Pharmacological and Biomolecular Sciences Department, University of Milan, Italy
| | - Federica Fogacci
- Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, Italy
| | - Nicola Ferri
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Italy
| | - Elisa Grandi
- Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, Italy
| | - Elisabetta Rizzoli
- Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, Italy
| | - Sergio D'Addato
- Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, Italy
| | - Claudio Borghi
- Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, Italy
| | - Arrigo Fg Cicero
- Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, Italy
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Rosticci M, Pervjakova N, Kaakinen M, Cicero AF, Feufer AP, Marullo L, Mägi R, Fischer K, Jiang L, D'Addato S, Rizzoli E, Massimo G, Giovannini M, Angelini S, Hrelia P, Scapoli C, Borghi C, Prokopenko I. A meta-analysis of Italian and Estonian individuals shows an effect of common variants in HMGCR on blood apoB levels. Biomark Med 2019; 13:931-940. [PMID: 30191727 DOI: 10.2217/bmm-2017-0431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: The aim of the study was to explore the effects of variants at HMGCR-KIF6loci on a range of cardio-metabolic phenotypes. Methods: We analyzed the range of variants within Genetics in Brisighella Health Study and KIF6 genes using an additive genetic model on 18 cardiometabolic phenotypes in a sample of 1645 individuals from the Genetics in Brisighella Health Study and replicated in 10,662 individuals from the Estonian Genome Center University of Tartu. Results: We defined directly the effects of rs3846662:C>A at HMGCR on apoB levels. The analysis also confirmed effects of on low-density lipoprotein-cholesterol and total cholesterol levels. Variants in KIF6 gene did not reveal any associations with cardiometabolic phenotypes. Conclusion: This study highlights effect of HMGCR locus on assay-determined apoB levels, an infrequent measure of blood lipids in large studies.
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Affiliation(s)
- Martina Rosticci
- Medicine & Surgery Sciences Department, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Natalia Pervjakova
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia.,Department of Biotechnology, Institute of Molecular & Cell Biology, University of Tartu, Tartu, Estonia.,Genomics of Common Disease, Division of Diabetes, Endocrinology & Metabolism, Department of Medicine, Imperial College London, London, UK
| | - Marika Kaakinen
- Genomics of Common Disease, Division of Diabetes, Endocrinology & Metabolism, Department of Medicine, Imperial College London, London, UK.,Pharmacology & Therapeutics, Division of Experimental Medicine, Department of Medicine, Imperial College London, London, UK
| | - Arrigo F Cicero
- Medicine & Surgery Sciences Department, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Arne P Feufer
- Institute of Bioinformatics & Systems Biology, Helmholtz Zentrum München, München, Germany
| | - Letizia Marullo
- Department of Life Sciences & Biotechnology, University of Ferrara, Ferrara, Italy
| | - Reedik Mägi
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Krista Fischer
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Longda Jiang
- Genomics of Common Disease, Division of Diabetes, Endocrinology & Metabolism, Department of Medicine, Imperial College London, London, UK
| | - Sergio D'Addato
- Medicine & Surgery Sciences Department, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Elisabetta Rizzoli
- Medicine & Surgery Sciences Department, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Gianmichele Massimo
- Department of Pharmacy & Biotechnology, Alma Mater Studiorum University of Bologna, Italy
| | - Marina Giovannini
- Medicine & Surgery Sciences Department, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Sabrina Angelini
- Department of Pharmacy & Biotechnology, Alma Mater Studiorum University of Bologna, Italy
| | - Patrizia Hrelia
- Department of Pharmacy & Biotechnology, Alma Mater Studiorum University of Bologna, Italy
| | - Chiara Scapoli
- Department of Life Sciences & Biotechnology, University of Ferrara, Ferrara, Italy
| | - Claudio Borghi
- Medicine & Surgery Sciences Department, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Inga Prokopenko
- Genomics of Common Disease, Division of Diabetes, Endocrinology & Metabolism, Department of Medicine, Imperial College London, London, UK
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12
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Angelini S, Rosticci M, Massimo G, Musti M, Ravegnini G, Consolini N, Sammarini G, D'Addato S, Rizzoli E, Botbayev D, Borghi C, Cantelli-Forti G, Cicero AF, Hrelia P. Relationship between Lipid Phenotypes, Overweight, Lipid Lowering Drug Response and KIF6 and HMG-CoA Genotypes in a Subset of the Brisighella Heart Study Population. Int J Mol Sci 2017; 19:ijms19010049. [PMID: 29295555 PMCID: PMC5795999 DOI: 10.3390/ijms19010049] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 12/19/2017] [Accepted: 12/20/2017] [Indexed: 01/14/2023] Open
Abstract
The existence of genetic traits might explain the susceptibility to develop hypercholesterolemia and the inter-individual differences in statin response. This study was performed to evaluate whether individuals' polymorphisms in HMG-CoA and KIF6 genes are independently associated with hypercholesterolemia, other lipid-associated traits, and statin response in unselected individuals enrolled in the Brisighella heart study (Survey 2012). A total of 1622 individuals, of which 183 under statin medication, were genotyped for a total of five polymorphisms (KIF6 rs20455, rs9471077, rs9462535; HMG-CoA rs3761740, rs3846662). The relationships between the five loci and clinical characteristics were analyzed. The principal basic parameters calculated on 12 h fasting blood included total cholesterol (TC), High Density Lipoprotein Cholesterol (HDL-C), Low-Density Lipoprotein Cholesterol (LDL-C), and triglycerides (TG). Hypercholesterolemia was defined as a TC >200 mg/dL or use of lipid-lowering medication. 965 individuals were characterized by hypercholesterolemia; these subjects were significantly older (p < 0.001), with body mass index (BMI) and waist circumference significantly higher (p < 0.001) compared to the others. HMG-CoA rs3846662 GG genotype was significantly over-represented in the hypercholesterolemic group (p = 0.030). HMG-CoA rs3846662 genotype was associated with the level of TC and LDL-C. Furthermore, in the same subset of untreated subjects, we observed a significant correlation between the KIF6 rs20455 and HDL-C. KIF6 variants were associated with a significantly lower (rs20455) or higher (rs9471077 and rs9462535) risk of obesity, in males only. No association between responsiveness to statins and the polymorphisms under investigation were observed. Our results showed associations between HMG-CoA rs3846662 and KIF6 rs20455 and lipid phenotypes, which may have an influence on dyslipidemia-related events. Moreover, this represents the first study implicating KIF6 variants with obesity in men, and point to the possible involvement of this genetic locus in the known gender-related differences in coronary artery disease.
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Affiliation(s)
- Sabrina Angelini
- Department of Pharmacy and Biotechnology, via Irnerio 48, University of Bologna, 40126 Bologna, Italy.
| | - Martina Rosticci
- Department of Medical and Surgical, University of Bologna, 40126 Bologna, Italy.
| | - Gianmichele Massimo
- Department of Pharmacy and Biotechnology, via Irnerio 48, University of Bologna, 40126 Bologna, Italy.
- Department of Medical and Surgical, University of Bologna, 40126 Bologna, Italy.
| | - Muriel Musti
- Department of Public Health, Epidemiological Service, Local Health Authority of Bologna, 40126 Bologna, Italy.
| | - Gloria Ravegnini
- Department of Pharmacy and Biotechnology, via Irnerio 48, University of Bologna, 40126 Bologna, Italy.
| | - Nicola Consolini
- Department of Pharmacy and Biotechnology, via Irnerio 48, University of Bologna, 40126 Bologna, Italy.
| | - Giulia Sammarini
- Department of Pharmacy and Biotechnology, via Irnerio 48, University of Bologna, 40126 Bologna, Italy.
| | - Sergio D'Addato
- Department of Medical and Surgical, University of Bologna, 40126 Bologna, Italy.
| | - Elisabetta Rizzoli
- Department of Medical and Surgical, University of Bologna, 40126 Bologna, Italy.
| | - Dauren Botbayev
- Department of Pharmacy and Biotechnology, via Irnerio 48, University of Bologna, 40126 Bologna, Italy.
- Department of Biotechnology, Faculty of Biology and Biotechnology, Кazakh National University Named after al-Farabi, 050040 Almaty, Kazakhstan.
| | - Claudio Borghi
- Department of Medical and Surgical, University of Bologna, 40126 Bologna, Italy.
| | - Giorgio Cantelli-Forti
- Department for Life Quality Studies, Corso d'Augusto 237, University of Bologna, 47921 Rimini, Italy.
| | - Arrigo F Cicero
- Department of Medical and Surgical, University of Bologna, 40126 Bologna, Italy.
| | - Patrizia Hrelia
- Department of Pharmacy and Biotechnology, via Irnerio 48, University of Bologna, 40126 Bologna, Italy.
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Fogacci F, Cicero AF, D'Addato S, Giovannini M, Borghi C, Cicero AF, D'Addato S, Giovannini M, Rosticci M, Fogacci F, Morbini M, Grandi E, Bertagnin E, Iamino IR, Palmisano S, Rizzoli E, Parini A, Urso R, Cagnati M, Derosa G, Bacchelli S, Borghi C. Effect of spontaneous changes in dietary components and lipoprotein(a) levels: Data from the Brisighella Heart Study. Atherosclerosis 2017; 262:202-204. [DOI: 10.1016/j.atherosclerosis.2017.03.036] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Accepted: 03/28/2017] [Indexed: 11/26/2022]
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Caudarella R, Simonelli L, Vasi V, Rizzoli E, Malavolta N, Stefani F, Cappelletti R. New in vitro methodological approaches to GAG study in idiopathic calcium lithiasis. Contrib Nephrol 2015; 58:89-92. [PMID: 3691155 DOI: 10.1159/000414494] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- R Caudarella
- Istituti di Patologia Medica II, Università di Bologna, Italia
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Caudarella R, Vescini F, Buffa A, Rizzoli E, Ceccoli L, Francucci CM. Role of calcium-sensing receptor in bone biology. J Endocrinol Invest 2011; 34:13-7. [PMID: 21985974] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
Extracellular calcium concentration changes are recognized by Ca++ sensing receptor (CaR), a member of the G-protein-coupled receptor family. Recently, progress has been made in the understanding of CaR functional role in bone cells, notwithstanding a lack of detailed knowledge about the identity of the cation receptors. It is generally agreed that a high extracellular calcium induces osteoblast proliferation and osteoclastogenesis inhibition. Potential implications that may be considered include a role for CaR in osteogenesis, in serum calcium homeostasis regulation, and as a factor coupling bone formation to resorption in bone remodeling. The localization of CaR in bone cells provides further knowledge of the mechanisms operating in the bone remodeling model; in fact, increased calcium gradient in the site of bone resorption favors osteoblast precursors chemotaxis and inhibits osteoclasts through the increase of [Ca++]e. In vitro data indicate that CaR is a physiological regulator of bone cells, regulating the recruitment, differentiation and survival of osteoblasts and osteoclasts. This leads to the concept that the CaR present in bone cells may be targeted by agonists or antagonists to control bone cell metabolism and bone remodeling.
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Affiliation(s)
- R Caudarella
- Maria Cecilia Hospital, GVM Care and Research, Cotignola, Ravenna, Italy.
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Caudarella R, Tonello L, Rizzoli E, Vescini F. Predicting five-year recurrence rates of kidney stones: an artificial neural network model. Arch Ital Urol Androl 2011; 83:14-19. [PMID: 21585163] [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: 05/30/2023] Open
Abstract
OBJECTIVE Due to high recurrence rates of urolithiasis, many attempts have been performed to identify tools for predicting the risk of stone formation. The application of Artificial Neural Networks (ANNs) seems to be a valid candidate for reaching this endpoint. The aim of this study was to find a set of parameters able to predict recurrence episodes immediately after clinical and metabolic evaluation performed at the first visit in a 5-year window. MATERIAL AND METHODS Data were collected from 80 outpatients who presented idiopathic calcium stone disease both at baseline and after 5 years; patients underwent treatment including both general measures and medical therapy. After 5 years, patients were classified into two subsets, namely SSFs (without recurrence episodes), consisting of 45 subjects (56.25%) and RSFs, with at least one episode of recurrence after the baseline, consisting of 35 subjects (43.75%). Helped by conventional statistics (One-way ANOVA and three Discriminant Analyses: standard, backward stepwise and forward stepwise), an Artificial Neural Network (ANN) approach was used to predict recurrence episodes. RESULTS An optimal set of 6 parameters was identified from amongst the different combinations in order to efficiently predict the outcome of stone recurrence in approximately 90% of cases. This set consist of serum Na and K as well as Na, P, Oxalate and AP (CaP) index from urine. The results obtained with ANN seem to suggest that some kind of relationship is present between the identified parameters and future stone recurrence. This relationship is probably very complex (in the mathematical sense) and non-linear In fact, a Logistic Regression was built as a comparative method and performed less good results at least in terms of accuracy and sensitivity. CONCLUSIONS The application of ANN to the database led to a promising predicting algorithm and suggests that a strongly non-linear relationship seems to exist between the parameters and the recurrence episodes. In particular, the ANN approach identifies as optimal parameters serum concentration of Na and K as well as urinary excretion of Na, P, Oxalate and AP (CaP) index. This study suggest that ANNs could potentially be a useful approach because of their ability to work with complex dynamics such as recurrent stone formation seems to have.
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Caudarella R, Vescini F, Rizzoli E, Francucci CM. Salt intake, hypertension, and osteoporosis. J Endocrinol Invest 2009; 32:15-20. [PMID: 19724161] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
A high salt intake has been correlated with several pathological conditions such as hypertension, cardiovascular disease, renal calcium stones, and osteoporosis. Some of these diseases present a high prevalence in the elderly and common pathogenetic mechanisms are proposed for some of them. A high salt intake has been associated with hypertension as well as osteoporosis and one of the proposed pathogenetic mechanisms is an increased calcium excretion in urine. Urinary calcium loss induces a negative calcium balance that may predispose hypertensive subjects to developing greater bone loss. The gene which encodes for the thiazide- sensitive sodium-chloride cotransporter (NCCT) represents a possible link between hypertension and osteoporosis. Subjects heterozygous for an inactivating mutation of NCCT present a positive effect on bone density as shown by the significantly higher Z-scores at the lumbar spine and total femur. Recent clinical studies also support the benefit of ACE inhibitors in reducing fracture risk or improving bone metabolism. These data suggest that the renin-angiotensin system may be one of the several factors involved in bone metabolism. Hypertension, together with stroke, has been demonstrated to be a risk factor for osteoporosis. Although the risk associated with hypertension was limited in terms of relative risk, it may have a significant impact on the general population owing to the high prevalence of hypertension. The treatment of hypertension may thus be very useful in also giving protection against fractures.
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Affiliation(s)
- R Caudarella
- GVM Hospitals of Care and Research, Cotignola, Italy.
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Vescini F, Buffa A, La Manna G, Ciavatti A, Rizzoli E, Bottura A, Stefoni S, Caudarella R. Long-term potassium citrate therapy and bone mineral density in idiopathic calcium stone formers. J Endocrinol Invest 2005; 28:218-22. [PMID: 15952405 DOI: 10.1007/bf03345376] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Several authors have described an association between idiopathic calcium (Ca) stone disease and bone mass reduction. Hypocitraturia is a frequent feature of urolithiasis, and alkaline citrate has been recommended as one of the choice treatments in this disease. Some evidence exists as to the positive effect of potassium (K) citrate therapy on bone mass. The aim of this work was the longitudinal evaluation of bone mineral density (BMD) changes in a group of Ca oxalate stone formers treated with K citrate for two years. Enrolled patients were 120; 109 subjects completed the study (51 males and 58 females). A metabolic study and distal radius BMD measurements were conducted both at baseline (BAS) and at the end of the study (END). BMD (0.451 +/- 0.081 vs 0.490 +/- 0.080 g/cm2), T-score (-1.43 +/- 1.02 vs -0.90 +/- 1.04), net gastrointestinal alkali absorption (40.37 +/- 50.57 vs 61.26 +/- 42.26 mEq/day), urinary citrate (2.53 +/- 1.15 vs 3.10 +/- 1.44 mmol/day) and K (58.93 +/- 22.28 vs 65.45 +/- 23.97 mmol/day) excretion significantly increased from BAS to END. Urinary Ca excretion remained unchanged from BAS to END (5.16 +/- 2.74 vs 5.57 +/- 2.85 mmol/ day). Our results indicate that long-term treatment with K citrate increases forearm BMD in idiopathic Ca stone formers. It seems probable that the alkali load provided by this drug reduces bone resorption by a buffering of the endogenous acid production. K citrate appears to be a further therapeutic opportunity for the management of osteoporosis in Ca stone formers.
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Affiliation(s)
- F Vescini
- Department of Clinical Medicine and Applied Biotechnology D. Campanacci, Alma Mater Studiorum, University of Bologna, Bologna, Italy
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Caudarella R, Vescini F, Buffa A, Sinicropi G, Rizzoli E, La Manna G, Stefoni S. Bone mass loss in calcium stone disease: focus on hypercalciuria and metabolic factors. J Nephrol 2003; 16:260-6. [PMID: 12768074] [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] [Received: 07/25/2002] [Revised: 02/10/2003] [Accepted: 02/19/2003] [Indexed: 03/02/2023]
Abstract
BACKGROUND Several authors have observed that idiopathic calcium stone formers show a bone mass reduction, which is more evident in those with idiopathic hypercalciuria. The aim of this work was the evaluation of osteopenia and osteoporosis rate in a group of idiopathic calcium stone formers. The influence of hypercalciuria, nutritional factors and anthropometric parameters on bone mass was evaluated in these patients as well. METHODS We enrolled 196 idiopathic calcium stone formers; 102 males, and 94 females. All subjects underwent a metabolic study. BMC and BMD were evaluated as well as QUS. RESULTS Males showed greater weight, height, BMI, densitometric values and plasma creatinine, uric acid, urea, sodium, magnesium, GFR and urinary osmolarity than females. Moreover males excreted more uric acid, urea, creatinine, sulphate, phosphate, oxalate and citrate than females. The prevalence of osteopenia and osteoporosis, according to T-score, was 54% and 14% respectively. Hypercalciuria was demonstrated in 21.7% of the patients. Hypercalciuric men showed a higher excretion of urea, phosphate, sulphate and magnesium. CONCLUSIONS Our results confirm the importance of QUS in the evaluation of stone formers' bone mass. Anthropometric characteristics and dietary habits seem to play a role in bone loss. We did not demonstrate any influence of hypercalciuria on bone mass. Although the pathogenesis of bone loss in stone formers still remains unclear, it can be hypothesized that a slight degree of metabolic acidosis, probably of alimentary origin, may be involved in the reduction of bone mass.
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Affiliation(s)
- Renata Caudarella
- Department of Nephrology, Dialysis and Kidney Transplant, Unit of Mineral Metabolism, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy.
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Caudarella R, Rizzoli E, Buffa A, Bottura A, Stefoni S. Comparative study of the influence of 3 types of mineral water in patients with idiopathic calcium lithiasis. J Urol 1998; 159:658-63. [PMID: 9474120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE While there is general agreement on the need to increase urinary volume in stone formers, contrasting opinions have been expressed about the hardness of water and stone incidence. We evaluate the influence of 3 types of mineral water on urinary analytes in 22 idiopathic calcium oxalate stone formers. MATERIALS AND METHODS All patients underwent a nutritional and metabolic evaluation at baseline, and after a controlled diet including water with a high, medium or low calcium content. RESULTS In patients who drank water with high and medium calcium contents calcium excretion increased, although the results did not reach statistical significance. In those who drank water with the highest calcium content oxalate excretion significantly decreased (p = 0.05), as did the oxalate-to-calcium ratio (p = 0.05). Moreover, these modifications did not induce relevant changes in urinary saturation. In patients who drank water with the greatest amount of bicarbonate citrate excretion increased (p = 0.03). CONCLUSIONS Mineral water with a higher calcium content induced increased calcium excretion but significantly decreased oxalate excretion. These data are in accordance with those of others, who did not find definite evidence that hard water is more lithogenic than soft water. Furthermore, water components other than calcium can modify the tendency toward crystal formation, affecting inhibitory power and/or lithogenic salt excretion.
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Affiliation(s)
- R Caudarella
- Dipartimento di Medicina Clinica e Biotecnologia Applicata D. Campanacci, Universitá degli Studi, Bologna, Italy
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Caudarella R, Rizzoli E, Pironi L, Malavolta N, Martelli G, Poggioli G, Gozzetti G, Miglioli M. Renal stone formation in patients with inflammatory bowel disease. Scanning Microsc 1993; 7:371-9; discussion 379-80. [PMID: 8316806] [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: 01/29/2023]
Abstract
Kidney stones are more common in patients with inflammatory bowel disease (IBD) than in the general population. The main lithogenetic risk factors were evaluated in patients affected by Crohn's disease and ulcerative colitis. Our results show the presence of several factors, besides hyperoxaluria, in patients with IBD although their behaviour appears different in Crohn's disease and ulcerative colitis at pre- and post-operative stages. Before surgery in patients with Crohn's disease we found a decreased citrate (p < 0.001) and magnesium (p < 0.005) excretion together with a low urinary volume (p < 0.001) and pH (p < 0.005). After surgery patients with Crohn's disease showed a further reduction of magnesium and citrate. Patients with ulcerative colitis before surgery showed a reduced citrate excretion (p < 0.05) and a more acidic pH (p < 0.05) than healthy subjects. Surgical treatment of proctocolectomy with ileal pouch-anal anastomosis seems to increase the risk of stone formation; in fact, after surgery we observed a relevant decrease of urinary volume (p < 0.001), pH (p < 0.0001) and urinary excretion of citrate (p < 0.0001) as well as magnesium (p < 0.005). Patients with IBD seem to be at greater risk of stone formation than patients with idiopathic calcium lithiasis; in fact, they show a lower excretion of citrate (p < 0.001) and magnesium (p < 0.001) together with a low urinary pH (p < 0.001) and volume (p < 0.001). Urinary volume reduction is probably one of the major risk factors together with the decrease of small molecular weight inhibitors that is a constant finding in all patients with IBD.
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Affiliation(s)
- R Caudarella
- Istituto di Patologia Medica II e Medicina del Lavoro D. Campanacci, Bologna Italy
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Caudarella R, Tolomelli B, Berveglieri F, Rizzoli E, Malavolta N, Marchetti M. Vitamin-B6 Status and Oxalate Excretion in Patients with Calcium Lithiasis. Urolithiasis 1989. [DOI: 10.1007/978-1-4899-0873-5_271] [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: 11/24/2022]
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Caudarella R, Malavolta N, Rizzoli E, Stefani F, D'Antuono G. [Evaluation of citrates in a group of patients with idiopathic calcium calculi]. G Clin Med 1985; 66:126-34. [PMID: 4029530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Caudarella R, Stefani F, Malavolta N, Rizzoli E, Maccaferri M, D'Antuono G. [Allopurinol in the therapy of idiopathic calcic lithiasis]. G Clin Med 1983; 64:198-208. [PMID: 6618055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Caudarella R, Stefani F, Rizzoli E, Malavolta N, D'Antuono G. Preliminary results of glycosminoglycans excretion in normal and stone forming subjects: relationship with uric acid excretion. J Urol 1983; 129:665-7. [PMID: 6834573 DOI: 10.1016/s0022-5347(17)52274-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
In calcium lithiasis, pathogenesis inhibitors have a significant role to play which permits raising of the upper metastability limit in the urine, thus reducing the crystallization processes. The aim of this work is to evaluate glycosaminoglycans excretion and concentration in a group of patients with idiopathic calcium lithiasis, and in a control group for detecting possible differences between the 2 groups. Analysis of our results shows that no significant differences exist between the 24-hour average excretion of glycosaminoglycans in normal and stone forming subjects, but there was a significant difference in the mean concentration values between the 2 groups, either as whole or when separately considered with respect to normal or increased uric acid excretion. Particularly interesting was the correlation study between glycosaminoglycans and uric acid which shows a linear relationship with a positive slope in all groups but in stone formers with hyperuricosuria.
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