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Adorni M, Biolo M, Palumbo M, Zimetti F, Scarinzi P, Zambon S, Bernini F, Zambon A. Achilles tendon xanthoma thickness associates to serum lipoprotein functions alterations. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.146] [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: 11/17/2022]
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Ferri N, Lupo M, Trevisin M, Zambon S, Zambon A. Evolocumab and alirocumab increases total PCSK9 plasma levels in hypocholesterolemic patients: Investigation of the basic molecular mechanisms. Atherosclerosis 2021. [DOI: 10.1016/j.atherosclerosis.2021.06.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Vaillancourt C, Charette M, Naidoo S, Taljaard M, Church M, Hodges S, Leduc S, Christenson J, Cheskes S, Dainty K, Feldman M, Goldstein J, Tallon J, Helmer J, Sibley A, Spidel M, Blanchard I, Garland J, Cyr K, Brehaut J, Dorian P, Lacroix C, Zambon S, Thiruganasambandamoorthy V. Multi-centre implementation of an Educational program to improve the Cardiac Arrest diagnostic accuracy of ambulance Telecommunicators and survival outcomes for sudden cardiac arrest victims: the EduCATe study design and methodology. BMC Emerg Med 2021; 21:26. [PMID: 33663395 PMCID: PMC7931555 DOI: 10.1186/s12873-021-00416-4] [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] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 02/11/2021] [Indexed: 12/03/2022] Open
Abstract
Background Sudden cardiac death remains a leading cause of mortality in Canada, resulting in more than 35,000 deaths annually. Most cardiac arrest victims collapse in their own home (85% of the time) and 50% are witnessed by a family member or bystander. Survivors have a quality of life similar to the general population, but the overall survival rate for out-of-hospital cardiac arrest (OHCA) rarely exceeds 8%. Victims are almost four times more likely to survive when receiving bystander CPR, but bystander CPR rates have remained low in Canada over the past decade, not exceeding 15–25% until recently. Telecommunication-assisted CPR instructions have been shown to significantly increase bystander CPR rates, but agonal breathing may be misinterpreted as a sign of life by 9–1-1 callers and telecommunicators, and is responsible for as much as 50% of missed OHCA diagnoses. We sought to improve the ability and speed with which ambulance telecommunicators can recognize OHCA over the phone, initiate timely CPR instructions, and improve survival. Methods In this multi-center national study, we will implement and evaluate an educational program developed for ambulance telecommunicators using a multiple baseline interrupted time-series design. We will compare outcomes 12 months before and after the implementation of a 20-min theory-based educational video addressing barriers to recognition of OHCA while in the presence of agonal breathing. Participating Canadian sites demonstrated prior ability to collect standardized data on OHCA. Data will be collected from eligible 9–1-1 recordings, paramedic documentation and hospital medical records. Eligible cases will include suspected or confirmed OHCA of presumed cardiac origin in patients of any age with attempted resuscitation. Discussion The ability of telecommunication-assisted CPR instructions to improve bystander CPR and survival rates for OHCA victims is undeniable. The ability of telecommunicators to recognize OHCA over the phone is unequivocally impeded by relative lack of training on agonal breathing, and reluctance to initiate CPR instructions when in doubt. Our pilot data suggests the potential impact of this project will be to increase absolute OHCA recognition and bystander CPR rates by at least 10%, and absolute out-of-hospital cardiac arrest survival by 5% or more. Trial registration Prospectively registered on March 28, 2019 at ClinicalTrials.gov identifier: NCT03894059.
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Affiliation(s)
- Christian Vaillancourt
- Clinical Epidemiology Unit, Ottawa Hospital Research Institute, The Ottawa Hospital, Civic Campus, Rm F649, 1053 Carling Ave., Ottawa, Ontario, K1Y 4E9, Canada. .,Department of Emergency Medicine, University of Ottawa, Ottawa, Canada. .,School of Epidemiology & Public Health-Faculty of Medicine, University of Ottawa, Ottawa, Canada.
| | - Manya Charette
- Clinical Epidemiology Unit, Ottawa Hospital Research Institute, The Ottawa Hospital, Civic Campus, Rm F649, 1053 Carling Ave., Ottawa, Ontario, K1Y 4E9, Canada
| | - Sarika Naidoo
- Clinical Epidemiology Unit, Ottawa Hospital Research Institute, The Ottawa Hospital, Civic Campus, Rm F649, 1053 Carling Ave., Ottawa, Ontario, K1Y 4E9, Canada
| | - Monica Taljaard
- Clinical Epidemiology Unit, Ottawa Hospital Research Institute, The Ottawa Hospital, Civic Campus, Rm F649, 1053 Carling Ave., Ottawa, Ontario, K1Y 4E9, Canada.,School of Epidemiology & Public Health-Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Matthew Church
- Cardiac Arrest Survivor, Study Patient Partner, Toronto, Canada
| | - Stephanie Hodges
- Central Ambulance Communications Centre, Ottawa Paramedic Service, Ottawa, Canada
| | | | - Jim Christenson
- Department of Emergency Medicine, University of British Columbia, Vancouver, Canada.,Provincial Health Services Authority, British Columbia Emergency Health Services, Vancouver, Canada.,Center for Health Evaluation and Outcomes Sciences, Providence Health Care Research Institute, Vancouver, Canada
| | - Sheldon Cheskes
- Sunnybrook Centre for Prehospital Medicine, Toronto, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, Canada
| | - Katie Dainty
- Department of Research and Innovation, North York General Hospital, Toronto, Canada.,Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Canada
| | | | - Judah Goldstein
- Division of Emergency Medical Services, Dalhousie University, Halifax, Canada.,Emergency Health Services Operations, Nova Scotia, Canada
| | - John Tallon
- Department of Emergency Medicine, University of British Columbia, Vancouver, Canada.,Provincial Health Services Authority, British Columbia Emergency Health Services, Vancouver, Canada.,Department of Emergency Medicine, Dalhousie University, Halifax, Canada
| | - Jennie Helmer
- Provincial Health Services Authority, British Columbia Emergency Health Services, Vancouver, Canada
| | - Aaron Sibley
- Department of Emergency Medicine, Dalhousie University, Halifax, Canada.,Division of Paramedicine, University of Prince Edward Island, Charlottetown, Canada
| | - Matthew Spidel
- Island Emergency Medical Services, Prince Edward Island, Charlottetown, Canada
| | - Ian Blanchard
- Department of Emergency Medical Services, Alberta Health Services, Calgary, Canada.,Department of Community Health Sciences-Cumming School of Medicine, University of Calgary, Calgary, Canada
| | | | - Kathryn Cyr
- Clinical Epidemiology Unit, Ottawa Hospital Research Institute, The Ottawa Hospital, Civic Campus, Rm F649, 1053 Carling Ave., Ottawa, Ontario, K1Y 4E9, Canada
| | - Jamie Brehaut
- Clinical Epidemiology Unit, Ottawa Hospital Research Institute, The Ottawa Hospital, Civic Campus, Rm F649, 1053 Carling Ave., Ottawa, Ontario, K1Y 4E9, Canada.,School of Epidemiology & Public Health-Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Paul Dorian
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.,Division of Cardiology and Division of Clinical Pharmacology, University of Toronto, Toronto, Canada
| | - Colette Lacroix
- International Business Machines (IBM) Canada, Ottawa, Canada
| | - Sandra Zambon
- Heart and Stroke Foundation of Canada, Toronto, Canada
| | - Venkatesh Thiruganasambandamoorthy
- Clinical Epidemiology Unit, Ottawa Hospital Research Institute, The Ottawa Hospital, Civic Campus, Rm F649, 1053 Carling Ave., Ottawa, Ontario, K1Y 4E9, Canada.,Department of Emergency Medicine, University of Ottawa, Ottawa, Canada.,School of Epidemiology & Public Health-Faculty of Medicine, University of Ottawa, Ottawa, Canada
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4
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Scarinzi P, Bigolin P, Simoni F, Benvegnù L, Antonucci A, Biolo M, Panzavolta C, Bertocco S, Zambon S, Fabris F, Manzato E, Previato L, Zambon A. Ultrasonographic detection of xanthomas in achilles tendon of patients with heterozygous familial hypercholesterolemia. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.411] [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]
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Schaap L, Timmermans E, Zambon S, Maggi S, Deeg D. THE ASSOCIATION BETWEEN DIABETES AND OSTEOARTHRITIS: THE ROLE OF WAIST CIRCUMFERENCE. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.5090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- L. Schaap
- Health Sciences, VU University, Amsterdam, Netherlands,
| | - E. Timmermans
- VU University Medical Center, Amsterdam, Netherlands,
| | - S. Zambon
- Department of Medicine, University of Padova, Padova, Italy
| | - S. Maggi
- CNR Center on Aging, Padova, Italy,
| | - D.J. Deeg
- VU University Medical Center, Amsterdam, Netherlands,
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6
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Panzavolta C, Benvegnù L, Aghi A, Biolo M, Giannini S, Noale M, Tripepi G, Plebani M, Veronese N, Messa P, Rossini M, Gallieni M, Sella S, Fabris F, Manzato E, Previato L, Bertocco S, Zambon A, Fusaro M, Zambon S. Statin therapy reduces phospate levels in dialysis patients: Results from the epidemiological vitamin K Italian study (VIKI study). Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2016.07.437] [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: 10/21/2022]
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van Schoor NM, Zambon S, Castell MV, Cooper C, Denkinger M, Dennison EM, Edwards MH, Herbolsheimer F, Maggi S, Sánchez-Martinez M, Pedersen NL, Peter R, Schaap LA, Rijnhart JJM, van der Pas S, Deeg DJH. Impact of clinical osteoarthritis of the hip, knee and hand on self-rated health in six European countries: the European Project on OSteoArthritis. Qual Life Res 2016; 25:1423-32. [PMID: 26547441 PMCID: PMC4870285 DOI: 10.1007/s11136-015-1171-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2015] [Indexed: 12/25/2022]
Abstract
PURPOSE Osteoarthritis (OA) has been shown to be associated with decreased physical function, which may impact upon a person's self-rated health (SRH). Only a few studies have examined the association between OA and SRH in the general population, but to date none have used a clinical definition of OA. The objectives are: (1) To examine the cross-sectional association between clinical OA and fair-to-poor SRH in the general population; (2) To examine whether this association differs between countries; (3) To examine whether physical function is a mediator in the association between clinical OA and SRH. METHODS Baseline data of the European Project on OSteoArthritis (EPOSA) were used, which includes pre-harmonized data from six European cohort studies (n = 2709). Clinical OA was defined according to the American College of Rheumatology criteria. SRH was assessed using one question: How is your health in general? Physical function was assessed using the Western Ontario and McMaster Universities OA Index and Australian/Canadian OA Hand Index. RESULTS The prevalence of fair-to-poor SRH ranged from 19.8 % in the United Kingdom to 63.5 % in Italy. Although country differences in the strength of the associations were observed, clinical OA of the hip, knee and hand were significantly associated with fair-to-poor SRH in five out of six European countries. In most countries and at most sites, the association between clinical OA and fair-to-poor SRH was partly or fully mediated by physical function. CONCLUSIONS Clinical OA at different sites was related to fair-to-poor SRH in the general population. Most associations were (partly) mediated by physical functioning, indicating that deteriorating physical function in patients with OA should be a point of attention in patient care.
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Affiliation(s)
- N M van Schoor
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center Research, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - S Zambon
- Department of Medical and Surgical Sciences, University of Padova, Padua, Italy
- National Research Council, Aging Branch, Institute of Neuroscience, Padua, Italy
| | - M V Castell
- Unit of Primary Care and Family Medicine, Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, Southampton, UK
| | - M Denkinger
- Bethesda Geriatric Clinic, University of Ulm, Ulm, Germany
| | - E M Dennison
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, Southampton, UK
| | - M H Edwards
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, Southampton, UK
| | - F Herbolsheimer
- Institute of the History, Philosophy and Ethics of Medicine, University of Ulm, Ulm, Germany
| | - S Maggi
- National Research Council, Aging Branch, Institute of Neuroscience, Padua, Italy
| | - M Sánchez-Martinez
- Unit of Primary Care and Family Medicine, Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
| | - N L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - R Peter
- Institute of the History, Philosophy and Ethics of Medicine, University of Ulm, Ulm, Germany
| | - L A Schaap
- Department of Health Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, The Netherlands
| | - J J M Rijnhart
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center Research, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - S van der Pas
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center Research, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - D J H Deeg
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center Research, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
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Zurlo A, Veronese N, Giantin V, Maselli M, Zambon S, Maggi S, Musacchio E, Toffanello ED, Sartori L, Perissinotto E, Crepaldi G, Manzato E, Sergi G. High serum uric acid levels increase the risk of metabolic syndrome in elderly women: The PRO.V.A study. Nutr Metab Cardiovasc Dis 2016; 26:27-35. [PMID: 26643208 DOI: 10.1016/j.numecd.2015.10.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [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: 05/08/2015] [Revised: 09/24/2015] [Accepted: 10/13/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Serum uric acid (SUA) is the end-product of purine metabolism in humans, and its levels often increase in subjects with metabolic syndrome (MetS). Despite several studies demonstrating a relationship between increased SUA levels and the prevalence of MetS, prospective data on SUA as a predictor of the incidence of MetS in the elderly are limited. Our aim was to conduct a prospective study on the association between SUA concentrations and the onset of MetS in an elderly Italian cohort. METHODS AND RESULTS This is a cohort study (Progetto Veneto Anziani; Pro.V.A.) involving community-dwelling subjects aged ≥65 years and followed up for a mean 4.4 years. We included 1128 participants (aged 74.7 ± 7.1 years) without MetS at the baseline. Gender-specific SUA groups according to the standard deviation (SD) from the mean were considered, taking the incidence of MetS as the main outcome. The mean SUA level was significantly higher in men than in women (5.4 ± 1.2 vs. 4.5 ± 1.2 mg/dl; p < 0.0001). Over the 4.4-year follow-up, 496 individuals developed MetS. After adjusting for potential confounders, Cox's regression analysis revealed no relationship between higher baseline SUA concentrations and the incidence of MetS in men or in the sample as whole, while women with SUA levels more than 1 SD above the mean (≥5.7 mg/dl) carried a 58% higher risk (95%CI: 1.03-2.40; p = 0.03) of being newly diagnosed with MetS during the follow-up. CONCLUSION High SUA levels significantly and independently predicted MetS in older women, but not in men, over a 4.4-year follow-up.
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Affiliation(s)
- A Zurlo
- Department of Medicine, Geriatrics Division, University of Padova, Italy.
| | - N Veronese
- Department of Medicine, Geriatrics Division, University of Padova, Italy
| | - V Giantin
- Department of Medicine, Geriatrics Division, University of Padova, Italy
| | - M Maselli
- Department of Medicine, Geriatrics Division, University of Padova, Italy
| | - S Zambon
- Department of Medicine, Clinica Medica 1, University of Padova, Italy; National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy
| | - S Maggi
- National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy
| | - E Musacchio
- Department of Medicine, Clinica Medica 1, University of Padova, Italy
| | - E D Toffanello
- Department of Medicine, Geriatrics Division, University of Padova, Italy
| | - L Sartori
- Department of Medicine, Clinica Medica 1, University of Padova, Italy
| | - E Perissinotto
- Department of Cardiac, Thoracic and Vascular Sciences, Biostatistics, Epidemiology, and Public Health Unit, University of Padova, Italy
| | - G Crepaldi
- National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy
| | - E Manzato
- Department of Medicine, Geriatrics Division, University of Padova, Italy; National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy
| | - G Sergi
- Department of Medicine, Geriatrics Division, University of Padova, Italy
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9
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van der Pas S, Schaap L, Castell M, Cooper C, Denkinger M, Edwards M, Herbolsheimer F, Maggi S, Sánchez-Martinez M, Pedersen N, Peter R, Zambon S, Wiegersma S, Dekker J, Dennison E, Deeg D. Availability and use of neighborhood resources by older people with osteoarthritis: Results from the European Project on OSteoArthritis. Health Place 2016; 37:1-7. [DOI: 10.1016/j.healthplace.2015.10.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Revised: 09/28/2015] [Accepted: 10/11/2015] [Indexed: 11/15/2022]
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De Stefano F, Zambon S, Giacometti L, Sergi G, Corti MC, Manzato E, Busetto L. Obesity, Muscular Strength, Muscle Composition and Physical Performance in an Elderly Population. J Nutr Health Aging 2015; 19:785-91. [PMID: 26193864 DOI: 10.1007/s12603-015-0482-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To evaluate the association between BMI levels, muscular strength, muscle composition and physical performance in the elderly. DESIGN Italians subjects from the Progetto Veneto Anziani (ProVA) study were analyzed. SETTING The ProVa was a population study focused on chronic diseases and functional limitations in Italian subjects aged ≥65 years living in two Northeast Italian cities. PARTICIPANTS The ProVa study included 3099 subjects. ProVa participants with unknown information on BMI or disability status were excluded. The final sample was thus represented by 1.188 men, and 1.723 women. MEASUREMENTS Physical performance was measured with the Short Physical Performance Battery (SPPB) and leg muscular strength with dynamometry. Fat distribution and skeletal muscle composition were measured in an abdominal single-scan magnetic resonance (MRI) in a randomly selected sample of 348 subjects. Study population was stratified by BMI classes. RESULTS An association between BMI levels and SPPB was observed. Normal weight subjects showed the best SPPB scores (8.29±0.03), with significant differences compared to underweight (7.50±0.15; p<0.001), overweight (8.12±0.02; p<0.001), class I (7.72±0.04; p<0.001), class II (6.67±0.09; p<0.001) and class III obesity (5.88±0.24; p<0.001). This pattern was not modified by adjustment for possible confounders. Compared to normal weight subjects (22.9±0.1 kg), leg muscular strength was higher in overweight (23.8±0.1; p<0.001) and in class I obesity (24.5±0.1; p<0.001), but it was reduced in class II (21.4±0.3; p<0.001) and class III (19.8±0.9; p<0.001). The association between BMI and impaired physical performance was not affected by adjustment for muscular strength. An inverse association between SPPB scores and fat infiltration in skeletal muscle was observed in patients with abdominal MRI. CONCLUSION A poor physical performance was observed in overweight and obese elderly subjects. Leg strength was reduced only in subjects with severe obesity. Physical performance was negatively influenced by the degree of fat infiltration in skeletal muscle.
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Affiliation(s)
- F De Stefano
- Fabio De Stefano Dipartimento di Scienze Mediche e Chirurgiche, Università degli Studi di Padova, Clinica Medica I, Policlinico Universitario, Via Giustiniani 2, 35128 Padova, Italy,: Tel (+39) 049 821 2171, Fax (+39) 049 821 2149 E-mail:
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Crepaldi G, Zambon S, Manzato E. Unsaturated fatty acids in the management of hyperlipidemias. World Rev Nutr Diet 2015; 76:38-40. [PMID: 7856232 DOI: 10.1159/000423986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- G Crepaldi
- Department of Internal Medicine, University of Padova, Italy
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12
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Bolzetta F, Veronese N, Toffanello E, Perissinotto E, Sergi G, Coin A, Baggio G, Zambon S, Musacchio E, Maggi S, Crepaldi G, Manzato E. Risk of fall and physical performance in elderly. Eur Geriatr Med 2013. [DOI: 10.1016/j.eurger.2013.07.196] [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: 11/28/2022]
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Noale M, Maggi S, Zanoni S, Limongi F, Zambon S, Crepaldi G. Lipid risk factors among elderly with normal fasting glucose, impaired fasting glucose and type 2 diabetes mellitus. The Italian longitudinal study on aging. Nutr Metab Cardiovasc Dis 2013; 23:220-226. [PMID: 21937208 DOI: 10.1016/j.numecd.2011.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Revised: 06/23/2011] [Accepted: 06/23/2011] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Three groups of subjects were identified within a representative sample of older Italians: subjects with normal fasting glucose (NFG), with impaired fasting glucose (IFG) or with type 2 diabetes mellitus (T2D). The aim of the present study was to evaluate the relationship among plasma lipids, lipoproteins, other metabolic factors in the three groups, and their role in predicting total fatal events. METHODS AND RESULTS 2422 subjects, aged 65-84 years, taking part into the Italian Longitudinal Study on Aging were included in the analyses. Factor analysis was conducted separately for men and women. Factor scores were used as independent variables in Cox Proportional Hazard models, to determine factors predicting death at the follow-up in NFG, IFG and T2D subjects. Four major factors were found for men ("insulin resistance", "body size", "total cholesterol", "HDL cholesterol") and four also for women ("insulin resistance", "total cholesterol", "body size", "HDL cholesterol"). For NFG and IFG men, and for both T2D men and women, the "HDL cholesterol" was a significant protective factor for total deaths (NFG men: HR = 0.79, 95% CI 0.67-0.93; IFG men: HR = 0.59, 95% CI 0.45-0.79; T2D men: HR = 0.55, 95% CI 0.34-0.89; T2D women: HR = 0.61, 95% CI 0.44-0.86). Among NFG women, the "body size" factor was also a protective factor with respect to total deaths (HR = 0.74, 95% CI 0.57-0.95). CONCLUSION A factor including HDL Cholesterol and Apo A-I showed protection against all-cause mortality in older men, independently from the glycemia level, and in women only in those diagnosed with T2D.
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Affiliation(s)
- M Noale
- CNR-Institute of Neuroscience, Padova, Via Giustiniani, 2, 35128 Padova, Italy.
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Noale M, Maggi S, Zanoni S, Limongi F, Zambon S, Crepaldi G. The metabolic syndrome, incidence of diabetes and mortality among the elderly: The Italian Longitudinal Study of Ageing. Diabetes & Metabolism 2012; 38:135-41. [DOI: 10.1016/j.diabet.2011.09.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2011] [Revised: 09/14/2011] [Accepted: 09/19/2011] [Indexed: 11/25/2022]
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Sergi G, Imoscopi A, Sarti S, Perissinotto E, Coin A, Inelmen EM, Zambon S, Busetto L, Seresin C, Manzato E. Changes in total body and limb composition and muscle strength after a 6-8 weeks sojourn at extreme altitude (5000-8000 m). J Sports Med Phys Fitness 2010; 50:450-455. [PMID: 21178932] [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]
Abstract
AIM Weight loss at extreme altitudes affects quantitative changes in fat-free mass (FFM), muscle mass and fat mass. No studies to date have focused on regional body composition and physical performance using reference methods after stays at extreme altitudes. The aim of this study was to investigate the changes in total and regional body composition, and muscle strength induced by the extreme altitudes. METHODS Eight men aged 38.8±5.8 who took part in two different Italian expeditions on Mt. Everest (group A) and on Gasherbrum II (group B). Before and after the expedition all participants underwent anthropometric measurements, total and regional body composition assessment by DEXA, and handgrip and knee extensor strength measurements by dynamometry. RESULTS The variations in body composition mainly involved FFM, with a similar loss in group A (-2.4±1.9 kg; P<0.05) and group B (-2.4±1.2 kg; P<0.05). Most of the FFM loss involved the limbs (-2.1±1.4 kg; P<0.01), and especially the upper limbs (-1.6±1.1 kg; P<0.01). The isotonic knee extensor strength declined in 6 of the 8 study participants, with a mean drop of -4.4±6.1 kg. CONCLUSIONS In conclusion, our study evidence that extreme altitudes induce weight loss due mainly to a loss of fat-free mass in the limb.
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Affiliation(s)
- G Sergi
- Department of Medical and Surgical Sciences, University of Padua, Padua, Italy.
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Ramonda R, Musacchio E, Perissinotto E, Sartori L, Punzi L, Corti MC, Hirsch R, Manzato E, Zambon S, Baggio G, Crepaldi G. Prevalence of chondrocalcinosis in Italian subjects from northeastern Italy. The Pro.V.A. (PROgetto Veneto Anziani) study. Clin Exp Rheumatol 2009; 27:981-984. [PMID: 20149316] [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: 05/28/2023]
Abstract
OBJECTIVES To undertake an epidemiological survey of the prevalence of radiological chondrocalcinosis (CC) of the lower limbs in the elderly Italian population of the Pro.V.A. study. METHODS Knee and pelvic basin radiographs were performed on 3099 subjects aged 65 and older, residing in the Veneto Region of Italy (Rovigo and Camposampiero areas). Two readers independently analysed the knee, coxofemoral and pubic symphysis x-rays of a consecutive sample of 1629 subjects according to Altman. Some laboratory indexes, such as serum parathyroid hormone (PTH), vitamin D (vit D), bone alkaline phosphatase (bALP), deyidroepiandrosterone (DHEA), urinary CrossLaps (XL), and inflammatory biomarkers were evaluated. Quantitative variables were summarised as mean + or - standard deviation and qualitative ones as distributions. Unpaired t-test was used to compare mean values among groups for normally distributed variables, and non-parametric Mann-Whitney test for non normal variables. RESULTS CC was found in 169 (mean age 78.2 + or - 8.0 yrs) out of the 1629 subjects studied (10.4%). After adjusting for the sex and age structure of the target population, the prevalence was 10.0%. CC was more often observed in women than in men (M: 7.0%; F: 12.8%, p=0.0002), and increased in occurrence with age, rising from 7.8% in subjects aged 65-74 yrs, to 9.4% in those aged 75-84 yrs, and to 21.1% in subjects older than 85 yrs. The knee was the most prevalent location since it was affected in 94.1% of all the subjects with CC, in particular the right limb. Knee CC was bilateral in 71.7% of the affected patients. The occurrence of rheumatic disorders did not differ significantly between the subjects with CC and those without (rheumatoid arthritis 0.59% vs. 0.48%, p=ns). CONCLUSIONS Although the detection of CC was limited to few joints with the knee being the most affected location, our study confirms the frequent presence of CC at different sites, in keeping with the possible role of systemic factors. Articular CC is an age-related disorder, which could partly explain the prevalence discrepancies reported by various studies. The prevalence of CC found in our survey based on standardised x-ray reading was high, suggesting that CC could be an underdiagnosed disease in the absence of radiographic investigation.
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Affiliation(s)
- R Ramonda
- Cattedra e Divisione di Reumatologia, Dipartmento di Medicina Clinica e Sperimentale, Università di Padova, Italy.
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Romanato G, Scarpa M, Angriman I, Faggian D, Ruffolo C, Marin R, Zambon S, Basato S, Zanoni S, Filosa T, Pilon F, Manzato E. Plasma lipids and inflammation in active inflammatory bowel diseases. Aliment Pharmacol Ther 2009; 29:298-307. [PMID: 19035968 DOI: 10.1111/j.1365-2036.2008.03886.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [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] [Indexed: 12/08/2022]
Abstract
BACKGROUND Ulcerative colitis (UC) and Crohn's disease (CD) can cause metabolic and inflammatory alterations. AIM To evaluate the relationships between inflammatory parameters, plasma lipids and phospholipid fatty acid (FA) composition in patients with active UC and CD. METHODS Diet, the Harvey-Bradshaw Activity Index (HBAI), inflammatory parameters, lipoproteins and FA composition were assessed in 60 CD and 34 UC. RESULTS No differences in clinical parameters were observed in the two groups. Total cholesterol correlated inversely with the number of bowel movements in both groups and directly with BMI in UC. Arachidonic acid correlated inversely with HBAI in UC and total and HDL cholesterol were inversely related to C-reactive protein (CRP) in CD while HDL correlated with CRP in UC. Docosapentaenoic acid was the only polyunsaturated n-3 FA that was correlated to CRP in both groups. Total cholesterol was independently associated in the multiple regression analysis with the number of bowel movements and systemic inflammation. CONCLUSIONS Total and LDL cholesterol were lower in the active UC and CD than in the healthy subjects and were correlated with the systemic inflammatory status. Phospholipid FA composition was correlated to the systemic inflammatory status, but was unrelated to dietary intake and intestinal disease activity.
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Affiliation(s)
- G Romanato
- CNR-Institute of Neurosciences-Aging Section, Padova, Italy.
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Lathan P, Moore G, Zambon S, Scott-Moncrieff J. Use of a Low-Dose ACTH Stimulation Test for Diagnosis of Hypoadrenocorticism in Dogs. J Vet Intern Med 2008; 22:1070-3. [DOI: 10.1111/j.1939-1676.2008.0118.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Sartore G, Lapolla A, Reitano R, Zambon S, Romanato G, Marin R, Cosma C, Manzato E, Fedele D. Desaturase activities and metabolic control in type 2 diabetes. Prostaglandins Leukot Essent Fatty Acids 2008; 79:55-8. [PMID: 18771908 DOI: 10.1016/j.plefa.2008.07.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2008] [Revised: 06/27/2008] [Accepted: 07/11/2008] [Indexed: 10/21/2022]
Abstract
The aim of this study was to elucidate the effects of a poor glycemic control on fatty acid composition and desaturase activities in type 2 diabetic patients. Plasma phospholipid fatty acid composition and desaturase activities (estimated from fatty acid product to precursor ratios) were measured in 30 type 2 diabetic patients during poor metabolic control and after achieving a good metabolic control. Significant changes were recorded in the percentages of palmitic, stearic, dihomo-gamma-linolenic, docosatetraenoic and docosapentaenoic acid. The delta-5 desaturase activity was significantly higher with poor than with good metabolic control. The changes identified in plasma phospholipid fatty acid composition and the desaturase activity in type 2 diabetic patients go in the opposite direction to those described in similar conditions in type 1 diabetic patients and may be relevant to a better understanding of the role of metabolic control in the progression of chronic complications in type 2 diabetic patients.
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Affiliation(s)
- G Sartore
- Department of Medical and Surgical Sciences, University of Padua, Via Dei Colli, 4, 35143 Padova, Italy.
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Manzato E, Romanato G, Zambon S. [The future of the metabolic syndrome: certainties, open questions and discussions]. Minerva Med 2006; 97:5-12. [PMID: 16565691] [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: 05/08/2023]
Abstract
The metabolic syndrome is a topic of hot debate among experts due to different opinions about its definition and its clinical relevance. The metabolic syndrome is identified by the presence of abnormalities of the glucose metabolism, blood pressure, fat deposition, and some plasma lipids. Several authors have attempted to find a physiopathological explanation for the association of the abnormalities in this syndrome. Recently, some aspects of the inflammation seem relevant to understand the association of visceral fat deposition, insulin-resistance and diabetes and vascular complications. From a clinical point of view this syndrome must be considered an important vascular risk factor.
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Affiliation(s)
- E Manzato
- Dipartimento di Scienze Mediche e Chirurgiche, Università degli Studi di Padova, Padova.
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Roselli della Rovere G, Lapolla A, Sartore G, Rossetti C, Zambon S, Minicuci N, Crepaldi G, Fedele D, Manzato E. Plasma lipoproteins, apoproteins and cardiovascular disease in type 2 diabetic patients. A nine-year follow-up study. Nutr Metab Cardiovasc Dis 2003; 13:46-51. [PMID: 12772437 DOI: 10.1016/s0939-4753(03)80167-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIM To evaluate the role of lipoprotein abnormalities as risk factors for macroangiopathy in Type 2 diabetes. METHODS AND RESULTS This prospective nine-year follow-up study involved 113 Type 2 diabetic patients (50 men and 63 women, mean age 66.9 +/- 9.9 years), 37 of whom had clinical signs of coronary heart disease (CHD) and cerebrovascular disease (CVD) at baseline. During the follow-up, 32 patients died: 17 of CHD, five of CVD, and 10 of non-vascular causes. The patients who died because of vascular disease were more frequently smokers, and had baseline symptoms of vascular disease; they were also significantly different from the other patients insofar as they were older, and had higher fasting plasma glucose levels, lower fasting C-peptide levels, and lower apoprotein (apo) AII, apo CII, apo CIII and apo E levels. Univariate analysis showed that baseline symptoms of vascular disease, current smoking, age, high fasting plasma glucose levels, low fasting C-peptide levels, and low apo AII, apo CII, apo CIII and apo E levels [but not cholesterol, triglyceride, high-density lipoprotein (HDL)-cholesterol or qualitative low-density lipoprotein or HDL abnormalities] were associated with cardiovascular mortality. Multivariate analysis showed that only age, smoking, glycated hemoglobin (HbA1c) and fasting C-peptide levels were significant independent determinants of macrovascular death. CONCLUSIONS In Type 2 normolipidemic diabetic patients, only age, smoking, HbA1c and fasting C-peptide levels are independent vascular risk factors. The differences in apo concentrations between patients with and without vascular disease may reflect qualitative abnormalities in plasma lipoproteins related to vascular disease.
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Avogaro A, Miola M, Favaro A, Gottardo L, Pacini G, Manzato E, Zambon S, Sacerdoti D, de Kreutzenberg S, Piliego T, Tiengo A, Del Prato S. Gemfibrozil improves insulin sensitivity and flow-mediated vasodilatation in type 2 diabetic patients. Eur J Clin Invest 2001; 31:603-9. [PMID: 11454015 DOI: 10.1046/j.1365-2362.2001.00856.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Endothelial dysfunction is an early feature of atherosclerosis. The relationship between insulin action and hypertriglyceridaemia on endothelial function is still debated. MATERIALS AND METHODS This study was designed to determine the effect of a 3 month treatment with Gemfibrozil (GF) on flow-mediated vasodilatation and insulin sensitivity. Ten type 2 diabetic patients were randomised in crossover, double blind fashion, either to GF, 600 mg b.i.d. or placebo, for 12 weeks. Lipid profile, low-density lipoprotein (LDL) distribution and flotation properties, insulin action and flow-mediated vasodilatation (FMD) by brachial artery ultrasound, were assessed. RESULTS GF decreased serum triglyceride (TG) concentration with an absolute difference of 1.79 +/- 1.28 mmol L-1 (P < 0.0016) between active treatment and placebo, and significantly increased serum high-density lipoprotein (HDL) cholesterol (P = 0.0233). No differences were observed in total, intermediate-density lipoproteins (IDL), LDL cholesterol concentration and LDL peak buoyancy between treatments. GF also improved SI, an index of insulin action (P = 0.005). The FMD was 7 +/- 3% in the baseline condition, 7 +/- 2% during placebo and 14 +/- 3% after GF (P < 0.006). CONCLUSIONS GF treatment improves both insulin action and flow-mediated vasodilatation in type 2 diabetic patients. The reduction of TG concentration allows the simultaneous correction of two important components of the metabolic syndrome.
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Affiliation(s)
- A Avogaro
- University of Padova, Padova, Italy, LADSEB CNR, Padova, Italy, Parke-Davis Italia, Lainate, Milan, Italy.
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Abstract
Patients with hypercholesterolemia without vascular disease have an impaired endothelium-dependent (nitric oxide-mediated) vasodilation in coronary and peripheral vascular beds. This study was designed to establish whether hypercholesterolemia (and its reduction) affects also the microcirculation vasomotion during postischemic hyperemia in both calf and forearm. Thirteen male patients, aged 36.2+/-8.5 years, mean +/-SD, with heterozygous familial hypercholesterolemia and 10 male control subjects, aged 32.2+/-3.6 years free from vascular lesions were studied. Plasma lipids, hematologic parameters, and limb vasoreactivity were evaluated while the patients were treated only with diet and during therapy with simvastatin. Calf and forearm blood flows were determined by venous occlusion strain gauge plethysmography at rest, during reactive hyperemia, and after sublingual isosorbide dinitrate administration. Calf resting flow rate of the hypercholesterolemic patients during and without treatment was similar to that of the controls. Calf resting vascular resistance was greater in the untreated hypercholesterolemic subjects than in the normal controls, but during treatment this difference was abolished. Peak flow during reactive hyperemia and flow debt repayment were lower in the untreated hypercholesterolemic subjects as compared to the controls, but they were normalized following hypocholesterolemic therapy. No differences were observed in forearm blood flow measurements between hypercholesterolemic subjects (without and during therapy) and control subjects. The blood flow and vascular resistance after isosorbide dinitrate were modified in a similar manner in the hypercholesterolemic (without and during therapy) and control subjects at both calf and forearm. Hypercholesterolemia does not affect vasodilation in the forearm as determined by postocclusive reactive hyperemia, while in the calf hypercholesterolemia is associated with higher resting vascular resistance, lower peak flow during reactive hyperemia, and lower flow debt repayment. These abnormalities are corrected by the hypocholesterolemic treatment.
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Affiliation(s)
- A Cortella
- Department of Internal Medicine, University of Padova, Italy
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Zambon A, Sartore G, Passera D, Francini-Pesenti F, Bassi A, Basso C, Zambon S, Manzato E, Crepaldi G. Effects of hypocaloric dietary treatment enriched in oleic acid on LDL and HDL subclass distribution in mildly obese women. J Intern Med 1999; 246:191-201. [PMID: 10447788 DOI: 10.1046/j.1365-2796.1999.00550.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To study the effects of a carbohydrate-enriched (HiCarbo) or olive-oil-enriched (HiMUFA) hypocaloric diet on plasma lipoprotein levels and physical properties. DESIGN A six-month follow-up dietary intervention study with a HiCarbo diet providing 60% of total calories as complex carbohydrates, 15% as proteins and 25% as fats [10% saturated (SFA); 7% monounsaturated (MUFA); 8% polyunsaturated fatty acids (PUFA)]; or a HiMUFA diet with 40% complex carbohydrates, 15% proteins and 45% fats (10% SFA; 27% MUFA; 8% PUFA). SUBJECTS Twenty consecutive, mildly obese, normolipidemic premenopausal women (11 on HiCarbo and nine on HiMUFA diets) and 14 age- and sex-matched, lean controls. MEASUREMENTS Body mass index (BMI), waist/hip ratio, plasma lipoproteins, apolipoprotein (apo) AI and B, LDL and HDL density distribution, and phospholipid fatty acid composition at baseline, and after 3 and 6 months on dietary treatment. RESULTS Body weight progressively decreased during the first 3 months and then it stabilized during the following 3 months (-11% vs. baseline in both groups; P < 0.01). LDL-Cholesterol decreased significantly in both groups. HDL-Cholesterol increased significantly in the HiMUFA group, whereas a decreased level was observed in the HiCarbo group. At baseline the obese women had higher very low density lipoprotein (VLDL) and dense LDL-Cholesterol, and lower HDL2 cholesterol levels than the controls; these abnormalities persisted in the HiCarbo diet, whilst a significant decrease in the dense LDL associated with an increase in the HDL2 cholesterol was seen in the HiMUFA diet. HDL3 was not affected by either diet. The LDL/HDL-Cholesterol ratio was not affected by the HiCarbo diet, whilst it was significantly reduced after 6 months of HiMUFA diet as compared with baseline. Apo AI increased in the HiMUFA group, and decreased in the HiCarbo group. CONCLUSIONS Both diets were effective in decreasing body weight. At steady weight conditions, only the HiMUFA diet improved LDL and HDL subclass distribution abnormalities present in mildly obese normolipidemic women.
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Affiliation(s)
- A Zambon
- Institute of Internal Medicine, University of Padova, Italy
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Abstract
OBJECTIVES This investigation assessed motivational factors and psychosocial barriers that affect individual readiness to perform cardiopulmonary resuscitation (CPR). This is the first study to use the Transtheoretical model in assessing readiness to perform CPR. METHODS A sample of 786 subjects, > or = 45 years of age and who resided in a private residence, were randomly selected to participate in a structured telephone interview. Data on motivational readiness, emotional state, perceived psychosocial barriers, and perceived efficacy in performing CPR were collected using dichotomous and Likert-type ratings. RESULTS Subjects with greater motivational readiness expected to experience significantly fewer symptoms of emotional distress during a cardiac emergency and to encounter fewer psychosocial barriers. This group also reported greater efficacy in their ability to perform CPR. These findings were independent of gender, medical history, age, and educational level. CONCLUSIONS Meaningful differences are apparent in individual readiness to perform CPR. These findings provide additional support for the need to tailor CPR training strategies using behavioral methods that enhance motivational readiness and decrease apprehension about anticipated emotional distress and psychosocial barriers.
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Affiliation(s)
- R P Nolan
- Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ontario, Canada.
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Zambon S, Sartore G, Marin R, Rovere GD, Proto S, Lapolla A, Fedele D, Manzato E, Crepaldi G. P14 Reduction of LDL flotation rate in type 2 diabetics in a longitudinal follow-up observation. Atherosclerosis 1999. [DOI: 10.1016/s0021-9150(99)90160-0] [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: 10/26/2022]
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Rovere GD, Giglia G, Lapolla A, Fedele D, Zambon S, Manzato E, Crepaldi G. C38 Plasma lipids, apoproteins and macrovascular disease in type 2 diabetic patients. A seven year follow-up study. Atherosclerosis 1999. [DOI: 10.1016/s0021-9150(99)90141-7] [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: 10/26/2022]
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Calò L, Sartore G, Bassi A, Basso C, Bertocco S, Marin R, Zambon S, Cantaro S, D'Angelo A, Davis PA, Manzato E, Crepaldi G. Reduced susceptibility to oxidation of low-density lipoprotein in patients with overproduction of nitric oxide (Bartter's and Gitelman's syndrome). J Hypertens 1998; 16:1001-8. [PMID: 9794741 DOI: 10.1097/00004872-199816070-00014] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.4] [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: 12/11/2022]
Abstract
BACKGROUND The oxidation of low-density lipoprotein (LDL) might play an important role in the development of atherosclerosis. OBJECTIVE To establish whether greater than normal production of nitric oxide (NO) in vivo protects LDL from oxidation. PATIENTS AND METHODS We studied nine subjects affected by Bartter's and Gitelman's syndrome (both characterized by greater than normal production of NO), and 10 subjects matched for age, sex and lipid levels as controls. LDL particles were isolated from plasma by density gradient ultracentrifugation. Susceptibility of LDL to oxidation was evaluated after incubation with copper sulfate solution, by measuring the formation of conjugated dienes, the thiobarbituric acid-reactive substances, and the volatile peroxidation products of n-3 (propanal) and n-6 (pentanal and hexanal) polyunsaturated fatty acids. Phospholipid fatty acid composition of LDL was determined by gas chromatography. LDL alpha-tocopherol concentrations were measured. RESULTS Patients with Bartter's and Gitelman's syndrome had LDL particles smaller and/or denser than those of controls [Rf = 0.38 +/- 0.03 versus 0.42 +/- 0.02 (mean +/- SD), P < 0.01], which hence were assumed to be more oxidizable. The phospholipid fatty acid composition of LDL and the alpha-tocopherol concentrations did not significantly differ between patients and controls. The duration of the lag phase, which is the time preceding formation of conjugated dienes, did not differ between groups, but the lag phase times were related to urinary excretion of nitrite/nitrate from patients (r = 0.66, P < 0.05). Moreover, patient LDL had produced less thiobarbituric acid-reactive substances after 5 h (P < 0.04), and less pentanal and hexanal after 5 and 6 h (P < 0.04 and P < 0.02, respectively) than had that of controls. CONCLUSIONS Greater than normal production of NO in vivo is associated with lower than normal susceptibility of LDL to oxidation in vitro, suggesting that NO plays a protective role in the development of atherosclerosis.
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Affiliation(s)
- L Calò
- Division of Nephrology, University of Padova, Italy
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Rowe BH, Shuster M, Zambon S, Wilson E, Stewart D, Nolan RP, Webster K. Preparation, attitudes and behaviour in nonhospital cardiac emergencies: evaluating a community's readiness to act. Can J Cardiol 1998; 14:371-7. [PMID: 9551031] [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: 02/07/2023] Open
Abstract
OBJECTIVE To determine how people in a moderately sized Ontario city believe they will react if they witness someone colapsing. DESIGN Telephone survey. SETTING The cities of Kitchener and Waterloo, part of the Regional Municipality of Waterloo, Ontario, with a combined population of 378,000. PARTICIPANTS Households were randomly contacted and a questionnaire was administered, provided the respondent was over 44 years of age and agreed to be interviewed. Of 2479 households with eligible respondents, 811 (33%) completed the questionnaire. OUTCOMES Age, sex, educational level, cardiac risk factors and cardiopulmonary resuscitation (CPR) training of respondents were determined, as well as actions they would take if cardiac arrest occurred in a family member at home or in stranger in the street, and associated emotions and barriers to implementing actions. RESULTS Among the first three actions that respondents who were not prompted with possible responses said they would take, 311 (72%) witnessing a collapse at home, compared with 166 (44%) witnessing a collapse on the street, would call 911, the police or an ambulance. Other 'first three actions' in home collapse were checking for breathing (120 [28%]), checking for pulse (91 [21%]) and administering CPR (34 [8%]); these actions were less commonly selected in response to a strangers collapse and when respondents were not prompted. Respondents felt they would be more likely to perform CPR on a friend than on a stranger (OR 1.38, 95% CI 1.10 to 1.58). When asked how likely they would be to perform specific acts when witnessing a collapse, 254 (69%) of respondents thought they would call their family doctor and 179 (48%) thought they were likely to begin chest compressions. Barriers to performing CPR centred around legalities and disease transmission. CONCLUSION Older people do not know how to act effectively in a cardiac emergency. Traditional CPR and public awareness programs have been ineffective in reaching this population; alternative means are required to help the public respond more effectively to cardiac emergencies.
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Affiliation(s)
- B H Rowe
- Division of Emergency Medicine, Faculty of Medicine, University of Alberta, Edmonton.
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Sartore G, Zambon S, Roselli Della Rovere G, Basso C, Marin R, Lapolla A, Fedele D, Manzato E, Crepaldi G. 4.P.97 Lipoproteins and metabolic control in non insulin-dependent diabetes. Atherosclerosis 1997. [DOI: 10.1016/s0021-9150(97)89623-2] [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: 11/30/2022]
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Calò L, Sartore G, Bassi A, Basso C, Bertocco S, Marin R, Zambon S, Davis P, D'Angelo A, Manzato E, Crepaldi G. 3.P.107 LDL oxidative status in NO overproduction: Bartter's (BS) and Gitelman (GS) syndrome. Atherosclerosis 1997. [DOI: 10.1016/s0021-9150(97)89181-2] [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: 10/17/2022]
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Manzato E, Zambon S, Crepaldi G. [Progress in hypocholesterolemic therapy in the prevention of recurrent infarction]. Ann Ital Med Int 1996; 11 Suppl 2:127S-131S. [PMID: 9004812] [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: 02/03/2023]
Abstract
The role of the hypocholesterolemic therapy in reinfarction prevention is evaluated using data from observational and secondary prevention studies. Even though survival after myocardial infarction is largely determined by the extension of the necrotic lesion, hypercholesterolemia remains an important risk factor for new vascular events. A total cholesterol reduction < 200 mg/dL (or even better LDL cholesterol < 100 mg/dL) in these patients is associated within few years with a significant reduction of both clinical events and total mortality. The reduction of clinical events is obtained in a relatively short period of time thus suggesting that plasma cholesterol reduction induces quite rapidly some modifications of the natural history of the atherosclerotic plaques, this effect being more relevant in vulnerable or unstable lesions that are responsible for most of the clinical events. These observations show that after myocardial infarction it is useful to reduce cholesterol < 200 mg/dL also with the use of drugs.
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Affiliation(s)
- E Manzato
- Istituto di Medicina Interna, Università degli Studi di Padova
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Bassi A, Avogaro A, Crepaldi C, Pavan P, Zambon S, Marin R, Macdonald I, Manzato E. Short-term diabetic ketosis alters n-6 polyunsaturated fatty acid content in plasma phospholipids. J Clin Endocrinol Metab 1996; 81:1650-3. [PMID: 8636382 DOI: 10.1210/jcem.81.4.8636382] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
At present, no information is available about the possibility that acute loss of metabolic control might be able to modify fatty acid composition in IDDM patients. Therefore, the aim of this study was to determine whether a short-term period of ketosis has any effect on the composition of fatty acid of plasma phospholipids in a group of insulin-dependent diabetes mellitus (IDDM) patients. Eleven IDDM patients and nine healthy volunteers were studied. Patients were studied over a 2-day period; each 2-day period consisted of initial baseline measurements followed by a day of hyperglycemia and mild ketosis, which was promptly alleviated by insulin infusion. No significant difference in baseline percent fatty acid composition was observed between normal controls and IDDM patients. In IDDM patients, ketosis induced a significant decrease in percent arachidonic acid (20:4 n-6) content, with a significant parallel decline in n-6 total polyunsaturated fatty acids. A significant inverse correlation between the prevailing plasma glucose and the relative content of arachidonic acid in plasma phospholipids was observed (r = -0.35; P = 0.0488). A highly significant inverse correlation was observed between the change from baseline condition to ketosis of the ratio C20:4/C20:3, the product/precursor ratio for the reaction catalyzed by delta5-desaturase, and the values of hemoglobin A1c,(r = -0.855; P = 0.0015). In conclusion, short term diabetic ketosis is associated with a significant decrease in n-6 polyunsaturated fatty acid content in plasma phospholipids, especially arachidonic acid. This decrease in arachidonic acid appears to be related to the degree of metabolic derangement, whereas the influence of short-term diabetic ketosis on the ratio of C20:4 to C20:3 seems to be due to the degree of long-term metabolic control.
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Affiliation(s)
- A Bassi
- Department of Internal Moffcine, University of Padova, Italy
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Baggio B, Gambaro G, Zambon S, Marchini F, Bassi A, Bordin L, Clari G, Manzato E. Anomalous phospholipid n-6 polyunsaturated fatty acid composition in idiopathic calcium nephrolithiasis. J Am Soc Nephrol 1996; 7:613-20. [PMID: 8724896 DOI: 10.1681/asn.v74613] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.6] [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: 02/01/2023] Open
Abstract
Anomalies in the erythrocyte transport of anions and cations have been described in idiopathic calcium oxalate nephrolithiasis and seem to play a pathogenetic role in this disease. In consideration of the hypothesis that the complex array of ion flux cell abnormalities is an epiphenomenon of an anomaly in the composition of cell membranes, this study investigated cell-membrane lipid composition. In idiopathic calcium oxalate renal stone formers, in which ion transport abnormalities were present, and in healthy control subjects, plasma and erythrocyte membrane lipid composition, the erythrocyte oxalate exchange, and Na/K/2Cl cotransport activity were evaluated. Furthermore, in stone formers, the effect of a 30-day fish-oil diet supplementation on plasma lipids, erythrocyte oxalate exchange, oxaluria, and calciuria was investigated. The effect of archidonic acid released by phospholipase A2 on anion-carrier phosphorylation and activity in erythrocytes was evaluated as well. Patients had a lower content of linoleic and higher concentration of archidonic acids in both plasma and erythrocyte membrane phospholipids, and an increased archidonic/linoleic acid ratio. The archidonic acid level correlated with the erythrocyte oxalate exchange and sodium cotransport activity. Fish-oil supplementation lowered calcium and oxalate urine excretion, and normalized the erythrocyte oxalate exchange. Phospholipase A2 increased the erythrocyte anion-carrier protein phosphorylation and the oxalate exchange. This study shows that idiopathic calcium nephrolithiasis in the patient group reported here is characterized by a systemic defect in phospholipid archidonic acid levels that might provide an answer to the link between genetic background, dietary habits, and renal lithiasis.
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Affiliation(s)
- B Baggio
- Institute of Internal Medicine, School of Medicine, University of Padova, Italy
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Abstract
Lipoprotein particles were examined in plasma and ascitic fluid from nine patients (5 males and 4 females) with liver cirrhosis and in plasma from nine control subjects. LDL and HDL fractions were isolated by ultracentrifugation under rate flotation conditions in a zonal rotor. LDL size was analysed by non-denaturing polyacrylamide gradient gel electrophoresis. Plasma lipids in cirrhotic patients were markedly reduced compared to controls. Free cholesterol represented 45.3% of the total cholesterol in plasma and 70.4% of the total cholesterol in the ascitic fluid. The total cholesterol-triglyceride ratio was three times higher in the plasma than in the ascitic fluid of cirrhotic patients. The LDL particles had the same flotation properties in plasma from cirrhotic patients as in that from controls. In cirrhotic patients the IDL concentration was higher than that in controls. In ascitic fluid the LDL particles had a higher flotation rate than in the plasma. The LDL diameter as measured by gradient gel electrophoresis was similar in both plasma and ascitic fluid of the cirrhotic patients as well as in the plasma of controls. In plasma and ascitic fluid of cirrhotic patients only a single HDL subclass (HDL1) could be identified. HDL1 particles had a higher flotation rate than normal HDL particles. The plasma levels of all the apoproteins were reduced in cirrhotic subjects compared to controls, but to a variable degree; while apo CII level in cirrhosis represented only 9% of the control level, the apo E level represented 77% of the control level.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- S Zambon
- Department of Internal Medicine, University of Padua, Italy
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Avogaro A, Beltramello P, Marin R, Zambon S, Bonanome A, Biffanti S, Confortin L, Manzato E, Crepaldi G, Tiengo A. Insulin action and glucose metabolism are improved by gemfibrozil treatment in hypertriglyceridemic patients. Atherosclerosis 1995; 113:117-24. [PMID: 7755647 DOI: 10.1016/0021-9150(94)05437-n] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.8] [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: 01/27/2023]
Abstract
The aim of this study was to determine whether gemfibrozil-mediated decrease in very low density lipoprotein triglyceride (VLDL-TG) concentration is accompanied by an improvement in overall glucose metabolism in hypertriglyceridemic patients. We assessed this hypothesis in 7 hypertriglyceridemic without (HTG) and in 11 hypertriglyceridemic with noninsulin-dependent diabetes mellitus (NIDDM-HTG) who followed three-months treatment either with the drug or with placebo. Placebo VLDL-TG concentrations in both HTG (3.82 +/- 0.92 mmol/l (mean +/- S.D.) vs. 3.91 +/- 1.01 mmol/l) and in NIDDM-HTG (6.62 +/- 3.93 mmol/l vs. 6.84 +/- 4.16 mmol/l) were not different from baseline values, whereas gemfibrozil decreased VLDL-TG in both groups (1.84 +/- 0.56 mmol/l, P < 0.001 for HTG, and 1.93 +/- 2.68 mmol/l, P = 0.013 in NIDDM-HTG). In both groups, gemfibrozil treatment was associated with an improvement in fasting plasma glucose levels (from 5.85 +/- 0.92 mmol/l to 4.87 +/- 0.40 mmol/l in HTG, P = 0.001, and from 11.47 +/- 2.92 mmol/l to 9.56 +/- 3.41 mmol/l in NIDDM-HTG, P = 0.042). In NIDDM-HTG, gemfibrozil treatment was associated with a significantly lower 2 h-postprandial plasma glucose level (9.87 +/- 3.63 vs. 13.09 +/- 3.62, P = 0.05). A significant decrease in fasting free fatty acids (FFA) level was observed during gemfibrozil treatment in both groups, whereas in NIDDM-HTG, a significant drop of these substrates was observed in both fasting and postprandial conditions.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- A Avogaro
- Cattedra di Malattie del Metabolismo, Università degli Studi, Padova, Italy
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Zambon S, Baldo-Enzi G, Baiocchi M, Nosadini R, Manzato E, Crepaldi G. Lipoprotein(a) levels in type II diabetic patients are not influenced by metabolic control or by microalbuminuria. Diabetes Care 1994; 17:1548-9. [PMID: 7882836 DOI: 10.2337/diacare.17.12.1548] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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38
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Zambon S, Manzato E, Solini A, Sambataro M, Brocco E, Sartore G, Crepaldi G, Nosadini R. Lipoprotein abnormalities in non-insulin-dependent diabetic patients with impaired extrahepatic insulin sensitivity, hypertension, and microalbuminuria. Arterioscler Thromb 1994; 14:911-6. [PMID: 8199181 DOI: 10.1161/01.atv.14.6.911] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
We investigated whether specific lipoprotein abnormalities are present in non-insulin-dependent diabetes mellitus (NIDDM) patients with hypertension and/or microalbuminuria. Fifteen normotensive normoalbuminuric (H-M-), 32 hypertensive normoalbuminuric (H+M-), and 22 hypertensive microalbuminuric (H+M+) NIDDM patients and 20 sex-, age-, and weight-matched nondiabetic control subjects were studied. Lipoprotein size was measured by nondenaturing polyacrylamide gradient gel electrophoresis; insulin sensitivity was assessed by using a euglycemic hyperinsulinemic clamp and [6,6(2)H]glucose tracer infusion for simultaneous measurement of hepatic glucose output and whole-body glucose utilization. Total plasma and very-low-density lipoprotein cholesterol were higher in H+M+ than in control subjects (5.84 +/- 0.98 versus 4.97 +/- 0.98 and 0.57 +/- 0.54 versus 0.26 +/- 0.21 mmol/L, mean +/- SD, P < .05). Plasma triglycerides were higher in H+M+ than in either control or H-M- subjects (2.17 +/- 1.32 versus 1.18 +/- 0.67 and 1.30 +/- 0.59 mmol/L, respectively; P < .05). The mean low-density lipoprotein diameter was 27.2 +/- 0.8 in control, 26.7 +/- 0.8 in H-M-, 26.5 +/- 0.8 nm in H+M- (P < .05 versus control subjects), and 26.0 +/- 0.8 nm in H+M+ subjects (P < .05 versus control subjects). The mean cholesterol level of the large high-density lipoprotein particles was lower in H+M- and H+M+ (0.37 +/- 0.14 and 0.36 +/- 0.16 mmol/L) than in control and H-M- (0.54 +/- 0.41 and 0.54 +/- 0.27 mmol/L, P < .05) subjects.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- S Zambon
- Department of Internal Medicine, University of Padova, Italy
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Nosadini R, Manzato E, Solini A, Fioretto P, Brocco E, Zambon S, Morocutti A, Sambataro M, Velussi M, Cipollina MR. Peripheral, rather than hepatic, insulin resistance and atherogenic lipoprotein phenotype predict cardiovascular complications in NIDDM. Eur J Clin Invest 1994; 24:258-66. [PMID: 8050454 DOI: 10.1111/j.1365-2362.1994.tb01083.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [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: 01/28/2023]
Abstract
Microalbuminuria, hypertension and hyperinsulinaemia are three independent risk factors for cardiac disease in non insulin-dependent diabetes (NIDDM). However, it is unknown to what extent hyperinsulinaemia reflects resistance to insulin action at hepatic, extrahepatic or at both sites. A cross-sectional study from our Department showed that peripheral insulin resistance, hypertension, microalbuminuria and lipid abnormalities are associated in NIDDM. Non diabetic individuals with the so-called 'atherogenic lipoprotein phenotype', characterized by small dense low density lipoproteins (LDL subclass pattern B) have up to 3-fold higher risk of myocardial infarction. The aim of the present study was to investigate whether impaired peripheral insulin sensitivity, during euglycaemic-hyperinsulinaemic clamp, as well as abnormalities in lipid concentrations and LDL size, predict abnormalities in albumin excretion rate, blood pressure and cardiac function in 73 consecutive normotensive (< 85 mmHg diastolic level) and normoalbuminuric (< 15 micrograms min-1 daily albumin excretion rate) NIDDM patients. These patients showed a bimodal distribution of whole body glucose utilization rate, a parameter of peripheral insulin sensitivity. The cut-off point between the two modes of distribution was located close to the mean value minus one standard deviation in a population of 24 control subjects. Therefore, this latter value was used to identify two subgroups inside the overall population of NIDDM patients, i.e. 28 patients (group 1), with whole body glucose utilization rate, above, and 45 patients (group 2), below, the mean value minus 1 SD in the 24 controls.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- R Nosadini
- Department of Internal Medicine, University of Padua School of Medicine, Italy
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40
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Zambon S, Cortella A, Sartore G, Baldo-Enzi G, Manzato E, Crepaldi G. Pravastatin treatment in combined hyperlipidaemia. Effect on plasma lipoprotein levels and size. Eur J Clin Pharmacol 1994; 46:221-4. [PMID: 8070502 DOI: 10.1007/bf00192552] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [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: 01/28/2023]
Abstract
Combined hyperlipidaemia and the presence of small and dense LDL particles in the circulation are associated with an increased risk of myocardial infarction. The effect of pravastatin on plasma lipoproteins and on LDL size has been evaluated in a single-blind, randomised, placebo-controlled study in 24 patients with combined hyperlipidaemia; 12 patients on pravastatin and 12 on placebo. After 16 weeks on pravastatin, plasma total (-15%) and LDL (-23%) cholesterol and apo B (-13%) levels were significantly reduced and apo AI (+6%) had increased. LDL size (measured by gradient gel electrophoresis) had not changed. No adverse effect was observed. The study suggests that, in combined hyperlipidaemia, LDL size is not affected by variation in LDL receptor activity.
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Affiliation(s)
- S Zambon
- Department of Internal Medicine, University of Padua, Italy
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Manzato E, Zambon S, Zambon A, Cortella A, Sartore G, Crepaldi G. Levels and physicochemical properties of lipoprotein subclasses in moderate hypertriglyceridemia. Clin Chim Acta 1993; 219:57-65. [PMID: 8306464 DOI: 10.1016/0009-8981(93)90197-c] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [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: 01/29/2023]
Abstract
Moderate hypertriglyceridemia is associated with several abnormalities of the plasma lipoprotein particles and it may be a risk factor for atherosclerotic vascular diseases. Plasma lipid, lipoprotein and apolipoprotein levels, as well as lipoprotein composition and physical properties, were examined by ultracentrifugation in a zonal rotor and by gradient gel electrophoresis in 14 patients with moderate hypertriglyceridemia (plasma triglycerides 4.00 +/- 0.32 mmol/l, mean +/- S.D.) and in 14 control subjects. Based on zonal ultracentrifugation hypertriglyceridemic patients have higher levels of cholesterol in all VLDL subclasses (Sf > 200, 100-200, 60-100 and 20-60), in IDL and in small and dense LDL. Both HDL2 and HDL3 cholesterol levels are reduced. The LDL flotation rate is inversely related to plasma triglyceride levels, thus indicating that the higher the plasma triglycerides the smaller and/or denser the LDL are. The triglyceride percent content of LDL2 and HDL3 is increased, while that of esterified cholesterol is reduced in hypertriglyceridemic patients. Gradient gel electrophoresis shows that the LDL peak size is lower (25.2 +/- 0.5 nm, mean +/- S.D.) in hypertriglyceridemic than in control subjects (27.1 +/- 0.4 nm; P < 0.0001). Considering both hypertriglyceridemic and control subjects the LDL peak effluent volume from the zonal rotor (which reflects the LDL flotation rate) is inversely related to the LDL peak size determined by gradient gel electrophoresis (r = -0.71; P = 0.0006) and the plasma triglyceride levels are related to LDL peak effluent volume (r = 0.74; P = 0.0002) and to LDL peak size (r = -0.95; P < 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- E Manzato
- Department of Internal Medicine, University of Padua, Italy
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Abstract
OBJECTIVES To analyse by ultracentrifugation in a zonal rotor the plasma lipoproteins in hypertriglyceridaemic patients on long-term haemodialysis. DESIGN Case-control study. SETTING Tertiary referred care centre. SUBJECTS Ten consecutive hypertriglyceridaemic patients on haemodialysis and 12 consecutive healthy controls. MAIN OUTCOME MEASURES Plasma lipid and lipoprotein cholesterol concentrations, lipoprotein physical properties and compositions, apolipoprotein concentrations. RESULTS Hypertriglyceridaemia in patients undergoing haemodialysis is characterized by an increased amount of small and slow floating very-low density lipoproteins (VLDL), higher concentrations of intermediate density lipoproteins (IDL) and small and dense low-density lipoprotein (LDL) particles; reduced levels of high-density lipoproteins (HDL), in particular of HDL2. The lipoprotein composition of such patients indicates reduced cholesterol ester and increased triglyceride content. Compared to controls, they have lower levels of plasma apolipoprotein A-I and A-II and higher B, C-II, C-III and E values. CONCLUSIONS The lipoprotein abnormalities observed in hypertriglyceridaemic patients undergoing haemodialysis have recently been associated with an increased incidence of vascular complications and may in part explain the high incidence of vascular disease reported in these subjects.
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Affiliation(s)
- S Zambon
- Department of Internal Medicine, University of Padova, Italy
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Abstract
OBJECTIVE To investigate lipoprotein levels and composition in well-treated type II diabetic patients. RESEARCH DESIGN AND METHODS Cholesterol and triglyceride levels were measured in plasma, VLDL, LDL, and HDL in 120 type II diabetic patients in good to fair metabolic control (HbA1c, 7.2 +/- 1.6%) and in 30 normal control subjects. ApoAI, AII, B, CII, CIII, and E levels in plasma were also determined. RESULTS The diabetic patients have significantly higher levels of mean plasma cholesterol (5.85 vs. 5.43 mM, P = 0.03), LDL triglycerides (0.41 vs. 0.31 mM, P = 0.003), and HDL triglycerides (0.24 vs. 0.19 mM, P = 0.02), whereas total triglycerides, VLDL cholesterol and triglycerides, LDL cholesterol, and HDL cholesterol are not significantly different from normal control subjects. ApoB (150 vs. 135 mg/dl, P = 0.02) and apoCIII (10.6 vs. 8.4 mg/dl, P = 0.01) are significantly higher in diabetic patients compared with control subjects. No significant differences are observed in all the parameters among diabetic patients treated with diet only, sulphonylurea, sulphonylurea plus biguanides, or insulin. Body weight is significantly related to VLDL lipids. The VLDL triglycerides are inversely related to the HDL cholesterol in both diabetic patients and control subjects. The VLDL triglycerides are directly related to the HDL triglycerides only in diabetic patients. No other lipid or lipoprotein parameters are significantly related to body weight or metabolic control. CONCLUSIONS Type II diabetic patients in good to fair metabolic control are characterized by minor alterations of the plasma lipids, but LDL and HDL triglycerides, apoB, and apoCIII are increased, thus indicating that the lipoprotein composition is altered, possibly because of an abnormal triglyceride metabolism and/or lipid transfer activity.
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Affiliation(s)
- E Manzato
- Department of Internal Medicine, University of Padova, Italy
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Manzato E, Zambon A, Zambon S, Nosadini R, Doria A, Marin R, Crepaldi G. Lipoprotein compositional abnormalities in type 1 (insulin-dependent) diabetic patients. Acta Diabetol 1993; 30:11-6. [PMID: 8329725 DOI: 10.1007/bf00572867] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Patients with type 1 (insulin-dependent) diabetes mellitus in good metabolic control usually have normal plasma lipid levels yet they have an increased incidence of vascular complications. Abnormalities in the distribution and composition of lipoprotein subfractions might in part be responsible for the macroangiopathy seen in type 1 diabetes mellitus. The plasma lipids, lipoproteins and apolipoproteins were studied in 9 type 1 diabetic patients during conventional insulin therapy and in 14 healthy controls. Plasma lipoproteins were analysed by ultracentrifugation in a zonal rotor to evaluate their concentrations and flotation properties and for compositional analysis. In diabetic patients the mean glycosylated haemoglobin (HbA1c) was 9.44 +/- 1.02% and the plasma lipid concentrations were not significantly different from healthy controls. The very low density lipoprotein (VLDL) subclass cholesterol concentrations were no different in diabetic patients and control subjects, but the VLDL cholesterol/triglyceride ratio was significantly lower in diabetic patients than in control subjects (0.43 +/- 0.05 vs 0.85 +/- 0.14; p < 0.05). The flotation rate LDL2, the major component of low density lipoprotein (LDL) was lower in the diabetic patients compared with the control subjects. The cholesterol concentrations of intermediate density lipoprotein and LDL3, the minor component of LDL, were significantly higher (0.17 +/- 0.03 and 0.83 +/- 0.14 mmol/l respectively) in diabetic patients than in control subjects (0.05 +/- 0.02 and 0.24 +/- 0.08 mmol/l). The flotation properties and cholesterol concentrations of the high density lipoprotein (HDL) subclass, and the protein-lipid composition of LDL2, HDL2 and HDL3, were no different in diabetic patients and control subjects.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- E Manzato
- Department of Internal Medicine, University of Padua, Italy
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Zambon S, Friday KE, Childs MT, Fujimoto WY, Bierman EL, Ensinck JW. Effect of glyburide and omega 3 fatty acid dietary supplements on glucose and lipid metabolism in patients with non-insulin-dependent diabetes mellitus. Am J Clin Nutr 1992; 56:447-54. [PMID: 1636624 DOI: 10.1093/ajcn/56.2.447] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Using a random crossover design, we examined the effects of glyburide for 4 wk on glucose, insulin, lipid, and lipoprotein metabolism in 10 men with non-insulin-dependent diabetes (NIDDM) receiving dietary fish-oil concentrates containing omega 3 (n-3) fatty acids (8 g/d). Compared with glyburide alone, fasting plasma glucose concentrations increased with fish oil. Although glyburide with fish oil decreased fasting glucose concentrations, they did not return to baseline. Basal insulin concentrations were unaltered by fish oil without or with glyburide; however, postprandial insulin concentrations were decreased by fish oil. Although total cholesterol and triglyceride concentrations were unchanged, very-low-density-lipoprotein cholesterol concentrations decreased and low-density-lipoprotein cholesterol rose and apolipoprotein B concentrations trended higher. Thus, glyburide only partially rectified the impaired fuel homeostasis associated with fish-oil supplements in patients with NIDDM. Therefore, we do not recommend intake of fish oil concentrates containing n-3 fatty acids in patients with NIDDM.
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Affiliation(s)
- S Zambon
- Department of Medicine, University of Washington, Seattle
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Zambon S, Lapolla A, Sartore G, Gherardingher C, Cortella A, Manzato E, Crepaldi G, Fedele D. Long-term treatment with simvastatin in hypercholesterolemic non-insulin-dependent diabetic patients. Curr Ther Res Clin Exp 1992. [DOI: 10.1016/s0011-393x(05)80471-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Manzato E, Zambon S, Zambon A, Digito M, Carraro R, Crepaldi G, Enzi G. Lipoprotein sub-fraction levels and composition in obese subjects before and after gastroplasty. Int J Obes Relat Metab Disord 1992; 16:573-8. [PMID: 1326487] [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: 12/26/2022]
Abstract
Obesity is frequently associated with several alterations of plasma lipid levels and lipoprotein metabolism. To evaluate the effects of severe obesity and weight loss on plasma lipoprotein sub-class levels and composition 11 grossly obese patients were examined before and six and 12 months after gastroplasty. Plasma lipoproteins were isolated by ultracentrifugation in a zonal rotor under rate flotation conditions. Mean body weight was 121.9 kg before gastroplasty, 97.6 kg after six months, and 90.7 kg after 12 months. Total plasma cholesterol was not affected by the weight reduction. Obese patients were characterized by increased levels of IDL and small dense LDL (LDL3). LDL levels, but not LDL3, were reduced following weight reduction. Plasma apo B levels of obese patients were always higher than in controls and were not affected by the weight reduction. After 12 month's weight loss total HDL cholesterol increased without modification of HDL sub-class cholesterol distribution, which was similar to that of normal controls. Plasma apo AI in obese patients was not affected by changes in body weight, and remained below normal. The percentage protein-lipid composition of LDL2 and HDL3 in obese patients was characterized by a decreased cholesterol ester content before gastroplasty which was normalized 12 months after gastroplasty. The presence of IDL and LDL3 in increased concentrations in severely obese patients may represent a vascular risk factor since similar abnormalities were recently observed in non-obese patients affected with vascular diseases.
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Affiliation(s)
- E Manzato
- Department of Internal Medicine, University of Padua, Italy
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48
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Abstract
It has been suggested that the antioxidant drug probucol can prevent arterial cholesterol accumulation in part by promoting HDL-mediated cholesterol removal from cells. In this study, the effect of probucol in vitro on the interaction of HDL3 with cultured skin fibroblasts, bovine aortic endothelial cells and human monocyte-derived macrophages was tested. Treatment of cholesterol-loaded cells with up to 20 microM probucol had no effect on [3H]cholesterol efflux from plasma membranes. No effect of probucol on HDL3-mediated efflux of labeled sterol was seen after intracellular sterol was labeled either with the biosynthetic precursor [3H]mevalonolactone or after incubation with lipoprotein-associated [3H]cholesterol linoleate. Further, no effect of probucol on cell cholesterol mass efflux was observed. Thus these results demonstrate that probucol does not affect movement of sterol from different cellular radiolabeled sterol pools. Within the limitations of cell culture studies, it is suggested that the proposed antiatherogenic effect of probucol in vivo is not likely to be the result of modulation of major cellular pathways for removal of cholesterol.
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Affiliation(s)
- S Zambon
- University of Washington, Department of Medicine, Seattle 98195
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49
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Cattin L, Da Col PG, Feruglio FS, Finazzo L, Rimondi S, Descovich G, Manzato E, Zambon S, Crepaldi G, Siepi D. Efficacy of ciprofibrate in primary type II and IV hyperlipidemia: the Italian multicenter study. Clin Ther 1990; 12:482-8. [PMID: 2289217] [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: 12/31/2022]
Abstract
The 127 diet-resistant primary hyperlipidemic patients received 100 mg of ciprofibrate daily for 12 weeks. In the 63 patients with type IIa hyperlipidemia and 41 patients with type IIb hyperlipidemia, serum levels of total cholesterol, very-low-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, very-low-density lipoprotein triglycerides, and apolipoprotein (apo) B decreased significantly and levels of high-density lipoprotein cholesterol and apo A-I increased significantly. Similar changes occurred in the 23 type IV patients, except that high-density lipoprotein cholesterol levels increased significantly and apo B levels did not change. No clinically significant side effects or drug-related abnormal laboratory test results were noted. It is concluded that ciprofibrate is a safe and potent hypolipidemic agent.
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Affiliation(s)
- L Cattin
- Institute of Internal Medicine, University of Trieste, Italy
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50
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Manzato E, Zambon S, Marin R, Baggio G, Crepaldi G. Modifications of plasma lipoproteins after lipase activation in patients with chylomicronemia. J Lipid Res 1990. [DOI: 10.1016/s0022-2275(20)38739-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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