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Copetti M, Baroni MG, Buzzetti R, Cavallo MG, Cossu E, D'Angelo P, Cosmo SD, Leonetti F, Morano S, Morviducci L, Napoli N, Prudente S, Pugliese G, Savino AF, Trischitta V. Validation in type 2 diabetes of a metabolomic signature of all-cause mortality. Diabetes Metab Res Rev 2024; 40:e3734. [PMID: 37839040 DOI: 10.1002/dmrr.3734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 08/29/2023] [Accepted: 09/25/2023] [Indexed: 10/17/2023]
Abstract
CONTEXT Mortality in type 2 diabetes is twice that of the normoglycemic population. Unravelling biomarkers that identify high-risk patients for referral to the most aggressive and costly prevention strategies is needed. OBJECTIVE To validate in type 2 diabetes the association with all-cause mortality of a 14-metabolite score (14-MS) previously reported in the general population and whether this score can be used to improve well-established mortality prediction models. METHODS This is a sub-study consisting of 600 patients from the "Sapienza University Mortality and Morbidity Event Rate" (SUMMER) study in diabetes, a prospective multicentre investigation on all-cause mortality in patients with type 2 diabetes. Metabolic biomarkers were quantified from serum samples using high-throughput proton nuclear magnetic resonance metabolomics. RESULTS In type 2 diabetes, the 14-MS showed a significant (p < 0.0001) association with mortality, which was lower (p < 0.0001) than that reported in the general population. This difference was mainly due to two metabolites (histidine and ratio of polyunsaturated fatty acids to total fatty acids) with an effect size that was significantly (p = 0.01) lower in diabetes than in the general population. A parsimonious 12-MS (i.e. lacking the 2 metabolites mentioned above) improved patient discrimination and classification of two well-established mortality prediction models (p < 0.0001 for all measures). CONCLUSIONS The metabolomic signature of mortality in the general population is only partially effective in type 2 diabetes. Prediction markers developed and validated in the general population must be revalidated if they are to be used in patients with diabetes.
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Affiliation(s)
- Massimiliano Copetti
- Fondazione IRCCS Casa Sollievo della Sofferenza, Unit of Biostatistics, San Giovanni Rotondo, Italy
| | - Marco Giorgio Baroni
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences (MeSVA), University of L'Aquila, L'Aquila, Italy
- Neuroendocrinology and Metabolic Diseases, IRCCS Neuromed, Pozzilli, Italy
| | - Raffaella Buzzetti
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | | | - Efiso Cossu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Paola D'Angelo
- Department of Clinical Medicine and Health Service Integration, Diabetology and Nutrition Unit, Sandro Pertini Hospital - aslrm2, Rome, Italy
| | - Salvatore De Cosmo
- Department of Medicine, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Frida Leonetti
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - Susanna Morano
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Lelio Morviducci
- Unit of Diabetology, Santo Spirito Hospital - ASL RM1, Rome, Italy
| | - Nicola Napoli
- Unit of Endocrinology and Diabetes, Department of Medicine, Campus Bio-medico University of Rome, Rome, Italy
| | - Sabrina Prudente
- Fondazione IRCCS Casa Sollievo della Sofferenza, Research Unit of Metabolic and Cardiovascular diseases, San Giovanni Rotondo, Italy
| | - Giuseppe Pugliese
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Antonio Fernando Savino
- Fondazione IRCCS Casa Sollievo della Sofferenza, Laboratory of Clinical Chemistry, San Giovanni Rotondo, Italy
| | - Vincenzo Trischitta
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
- Fondazione IRCCS Casa Sollievo della Sofferenza, Research Unit of Diabetes and Endocrine Diseases, San Giovanni Rotondo, Italy
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2
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Catanzaro G, Conte F, Trocchianesi S, Splendiani E, Bimonte VM, Mocini E, Filardi T, Po A, Besharat ZM, Gentile MC, Paci P, Morano S, Migliaccio S, Ferretti E. Network analysis identifies circulating miR-155 as predictive biomarker of type 2 diabetes mellitus development in obese patients: a pilot study. Sci Rep 2023; 13:19496. [PMID: 37945677 PMCID: PMC10636008 DOI: 10.1038/s41598-023-46516-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 11/02/2023] [Indexed: 11/12/2023] Open
Abstract
Obesity is the main risk factor for many non-communicable diseases. In clinical practice, unspecific markers are used for the determination of metabolic alterations and inflammation, without allowing the characterization of subjects at higher risk of complications. Circulating microRNAs represent an attractive approach for early screening to identify subjects affected by obesity more at risk of developing connected pathologies. The aim of this study was the identification of circulating free and extracellular vesicles (EVs)-embedded microRNAs able to identify obese patients at higher risk of type 2 diabetes (DM2). The expression data of circulating microRNAs derived from obese patients (OB), with DM2 (OBDM) and healthy donors were combined with clinical data, through network-based methodology implemented by weighted gene co-expression network analysis. The six circulating microRNAs overexpressed in OBDM patients were evaluated in a second group of patients, confirming the overexpression of miR-155-5p in OBDM patients. Interestingly, the combination of miR-155-5p with serum levels of IL-8, Leptin and RAGE was useful to identify OB patients most at risk of developing DM2. These results suggest that miR-155-5p is a potential circulating biomarker for DM2 and that the combination of this microRNA with other inflammatory markers in OB patients can predict the risk of developing DM2.
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Affiliation(s)
- Giuseppina Catanzaro
- Department of Experimental Medicine, Sapienza University of Rome, Policlinico Umberto I, Viale Regina Elena 324, 00161, Rome, Italy
| | - Federica Conte
- Institute for Systems Analysis and Computer Science "A. Ruberti" (IASI), National Research Council (CNR), 00185, Rome, Italy
| | - Sofia Trocchianesi
- Department of Experimental Medicine, Sapienza University of Rome, Policlinico Umberto I, Viale Regina Elena 324, 00161, Rome, Italy
| | - Elena Splendiani
- Department of Experimental Medicine, Sapienza University of Rome, Policlinico Umberto I, Viale Regina Elena 324, 00161, Rome, Italy
| | - Viviana Maria Bimonte
- Department of Movement, Human and Health Sciences, University of Foro Italico, 00135, Rome, Italy
| | - Edoardo Mocini
- Department of Experimental Medicine, Sapienza University of Rome, Policlinico Umberto I, Viale Regina Elena 324, 00161, Rome, Italy
| | - Tiziana Filardi
- Department of Experimental Medicine, Sapienza University of Rome, Policlinico Umberto I, Viale Regina Elena 324, 00161, Rome, Italy
| | - Agnese Po
- Department of Molecular Medicine, Sapienza University, 00161, Rome, Italy
| | - Zein Mersini Besharat
- Department of Experimental Medicine, Sapienza University of Rome, Policlinico Umberto I, Viale Regina Elena 324, 00161, Rome, Italy
| | - Maria Cristina Gentile
- Department of Experimental Medicine, Sapienza University of Rome, Policlinico Umberto I, Viale Regina Elena 324, 00161, Rome, Italy
| | - Paola Paci
- Department of Computer, Control and Management Engineering, Sapienza University, 00161, Rome, Italy
| | - Susanna Morano
- Department of Experimental Medicine, Sapienza University of Rome, Policlinico Umberto I, Viale Regina Elena 324, 00161, Rome, Italy
| | - Silvia Migliaccio
- Department of Movement, Human and Health Sciences, University of Foro Italico, 00135, Rome, Italy.
| | - Elisabetta Ferretti
- Department of Experimental Medicine, Sapienza University of Rome, Policlinico Umberto I, Viale Regina Elena 324, 00161, Rome, Italy.
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Maddaloni E, Carlone A, Pitocco D, Leanza G, Suraci C, Altomare M, Cavallo MG, Barchetta I, Morano S, Moretti C, Coraggio L, Visalli N, Tramontana F, Schiaffini R, Crinò A, Buzzetti R, Pozzilli P. Glycated haemoglobin in the first year after diagnosis of type 1 diabetes is an independent risk factor for diabetic retinopathy: The IMDIAB 25 years follow-up study. Diabetes Obes Metab 2023; 25:3415-3419. [PMID: 38014612 DOI: 10.1111/dom.15213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/22/2023] [Accepted: 06/23/2023] [Indexed: 11/29/2023]
Affiliation(s)
- Ernesto Maddaloni
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Angela Carlone
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Dario Pitocco
- Diabetes unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giulia Leanza
- Research Unit of Endocrinology and Diabetes, Campus Bio-Medico University of Rome, Rome, Italy
| | | | | | - Maria G Cavallo
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Ilaria Barchetta
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Susanna Morano
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Chiara Moretti
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Lucia Coraggio
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | | | - Flavia Tramontana
- Research Unit of Endocrinology and Diabetes, Campus Bio-Medico University of Rome, Rome, Italy
| | - Riccardo Schiaffini
- Endocrinology and Diabetes Unit, Bambino Gesù Hospital Research Institute, Rome, Italy
| | - Antonino Crinò
- Endocrinology and Diabetes Unit, Bambino Gesù Hospital Research Institute, Rome, Italy
| | - Raffaella Buzzetti
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Paolo Pozzilli
- Research Unit of Endocrinology and Diabetes, Campus Bio-Medico University of Rome, Rome, Italy
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Venditti V, Bleve E, Morano S, Filardi T. Gender-Related Factors in Medication Adherence for Metabolic and Cardiovascular Health. Metabolites 2023; 13:1087. [PMID: 37887412 PMCID: PMC10609002 DOI: 10.3390/metabo13101087] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/05/2023] [Accepted: 10/12/2023] [Indexed: 10/28/2023] Open
Abstract
This review explores the impact of gender on medication adherence in the context of metabolic and cardiovascular diseases. Optimal adherence to medication is crucial for achieving treatment goals and preventing adverse outcomes in chronic diseases. The review examines specific conditions such as type 2 diabetes, hypercholesterolemia, arterial hypertension, cardiovascular diseases, and heart failure. In type 2 diabetes, female sex, younger age, new drug prescription, non-white ethnicity, low education level, and low income were identified as predictors of non-adherence. Depressive disorders were also found to influence adherence. In hypercholesterolemia, women exhibited poorer adherence to statin therapy compared to men, with statin-related side effects and patient perception being significant factors. Adherence to anti-hypertensive therapy showed conflicting results, with studies reporting both higher and lower adherence in women. Limited evidence suggests that women may have poorer adherence after acute myocardial infarction and stroke. Regarding heart failure, adherence studies have shown inconsistent findings. The reasons for gender differences in medication adherence are multifactorial and include sociodemographic, disease-related, treatment-related, and psychological factors. This review emphasizes the need for further research to better understand these differences and develop gender-customized interventions that can improve medication adherence and reduce the burden of metabolic and cardiovascular diseases.
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Affiliation(s)
- Vittorio Venditti
- Department of Experimental Medicine, “Sapienza” University of Rome, Viale Regina Elena 324, 00161 Rome, Italy; (V.V.); (E.B.); (S.M.)
| | - Enrico Bleve
- Department of Experimental Medicine, “Sapienza” University of Rome, Viale Regina Elena 324, 00161 Rome, Italy; (V.V.); (E.B.); (S.M.)
| | - Susanna Morano
- Department of Experimental Medicine, “Sapienza” University of Rome, Viale Regina Elena 324, 00161 Rome, Italy; (V.V.); (E.B.); (S.M.)
| | - Tiziana Filardi
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Via di Val Cannuta, 247, 00166 Rome, Italy
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Tiberti C, Nenna R, Tromba V, Filardi T, Petrarca L, Silvestri F, Fassino V, Montuori M, Mancino E, Lenzi A, Midulla F, Costantino F, Morano S. Correction to: No effects of COVID‑19 on the development of type 1 diabetes autoimmunity and no evidence of an increased frequency of SARS‑CoV‑2 antibodies in newly diagnosed type 1 diabetes patients relative to healthy subjects. Acta Diabetol 2023; 60:1309. [PMID: 37474814 PMCID: PMC10442254 DOI: 10.1007/s00592-023-02152-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Affiliation(s)
- Claudio Tiberti
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Raffaella Nenna
- Department of Maternal, Infantile and Urological Sciences, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Valeria Tromba
- Department of Maternal, Infantile and Urological Sciences, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Tiziana Filardi
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Laura Petrarca
- Department of Maternal, Infantile and Urological Sciences, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Francesca Silvestri
- Department of Maternal, Infantile and Urological Sciences, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Valeria Fassino
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Monica Montuori
- Department of Maternal, Infantile and Urological Sciences, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Enrica Mancino
- Department of Maternal, Infantile and Urological Sciences, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Andrea Lenzi
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Fabio Midulla
- Department of Maternal, Infantile and Urological Sciences, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Francesco Costantino
- Department of Maternal, Infantile and Urological Sciences, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Susanna Morano
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
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6
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Tiberti C, Nenna R, Tromba V, Filardi T, Petrarca L, Silvestri F, Fassino V, Montuori M, Mancino E, Lenzi A, Midulla F, Costantino F, Morano S. No effects of COVID-19 on the development of type 1 diabetes autoimmunity and no evidence of an increased frequency of SARS-CoV-2 antibodies in newly diagnosed type 1 diabetes patients relative to healthy subjects. Acta Diabetol 2023; 60:1301-1307. [PMID: 37171699 PMCID: PMC10175916 DOI: 10.1007/s00592-023-02103-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 01/07/2023] [Indexed: 05/13/2023]
Abstract
AIMS To evaluate the relationship between SARS-CoV-2 infection and autoimmunity in type 1 diabetes (T1D) and SARS-CoV-2 antibodies frequency at diagnosis of T1D during pandemic. METHODS The presence of T1D-specific autoimmunity was evaluated in a cohort of 99 children and adolescents without diabetes that contracted SARS-CoV-2 infection. Moreover, the frequency of IgM- and IgG-SARS-CoV-2 antibodies was evaluated in 41 newly diagnosed T1D patients not yet vaccinated against SARS-CoV-2 disease, collected during the pandemic, compared to healthy subjects (CTRL). RESULTS None of the 99 patients that contracted SARS-CoV-2 infection during the pandemic period was found positive for T1D autoantibodies. The frequency of SARS-CoV-2 antibodies was not significantly different in patients newly diagnosed with T1D (12.2%), compared with CTRL (8.4%). Among SARS-CoV-2 antibody positive T1D patients, 80% were target of diabetes autoantibodies and 60% had another concomitant autoimmune disease. Among the CTRL subjects positive for SARS-CoV-2Abs (n = 10), none was found positive for T1D autoantibodies. CONCLUSIONS The results of the present study do not confirm, at least in the short term, a role of COVID-19 as a potential trigger of T1D autoimmunity and do not provide evidence of an increased frequency of SARS-CoV-2 antibodies in newly diagnosed T1D patients in comparison with healthy population.
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Affiliation(s)
- Claudio Tiberti
- Department of Experimental Medicine, “Sapienza” University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Raffaella Nenna
- Department of Maternal, Infantile and Urological Sciences, “Sapienza” University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Valeria Tromba
- Department of Maternal, Infantile and Urological Sciences, “Sapienza” University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Tiziana Filardi
- Department of Experimental Medicine, “Sapienza” University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Laura Petrarca
- Department of Maternal, Infantile and Urological Sciences, “Sapienza” University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Francesca Silvestri
- Department of Maternal, Infantile and Urological Sciences, “Sapienza” University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Valeria Fassino
- Department of Experimental Medicine, “Sapienza” University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Monica Montuori
- Department of Maternal, Infantile and Urological Sciences, “Sapienza” University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Enrica Mancino
- Department of Maternal, Infantile and Urological Sciences, “Sapienza” University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Andrea Lenzi
- Department of Experimental Medicine, “Sapienza” University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Fabio Midulla
- Department of Maternal, Infantile and Urological Sciences, “Sapienza” University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Francesco Costantino
- Department of Maternal, Infantile and Urological Sciences, “Sapienza” University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Susanna Morano
- Department of Experimental Medicine, “Sapienza” University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
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Dule S, Barchetta I, Cimini FA, Passarella G, Dellanno A, Filardi T, Venditti V, Bleve E, Bailetti D, Romagnoli E, Morano S, Baroni MG, Cavallo MG. Reduced High-Density Lipoprotein Cholesterol Is an Independent Determinant of Altered Bone Quality in Women with Type 2 Diabetes. Int J Mol Sci 2023; 24:ijms24076474. [PMID: 37047445 PMCID: PMC10095189 DOI: 10.3390/ijms24076474] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/21/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) is associated with an increased fracture risk. Our study aimed to explore differences in bone alterations between T2DM women and controls and to assess clinical predictors of bone impairment in T2DM. For this observational case control study, we recruited 126 T2DM female patients and 117 non-diabetic, age- and BMI-comparable women, who underwent clinical examination, routine biochemistry and dual-energy X-ray absorptiometry (DXA) scans for bone mineral density (BMD) and trabecular bone score (TBS) assessment-derived indexes. These were correlated to metabolic parameters, such as glycemic control and lipid profile, by bivariate analyses, and significant variables were entered in multivariate adjusted models to detect independent determinants of altered bone status in diabetes. The T2DM patients were less represented in the normal bone category compared with controls (5% vs. 12%; p = 0.04); T2DM was associated with low TBS (OR: 2.47, C.I. 95%: 1.19–5.16, p = 0.016) in a regression model adjusted for age, menopausal status and BMI. In women with T2DM, TBS directly correlated with plasma high-density lipoprotein cholesterol (HDL-c) (p = 0.029) and vitamin D (p = 0.017) levels. An inverse association was observed with menopausal status (p < 0.001), metabolic syndrome (p = 0.014), BMI (p = 0.005), and waist circumference (p < 0.001). In the multivariate regression analysis, lower HDL-c represented the main predictor of altered bone quality in T2DM, regardless of age, menopausal status, BMI, waist circumference, statin treatment, physical activity, and vitamin D (p = 0.029; R2 = 0.47), which likely underlies common pathways between metabolic disease and bone health in diabetes.
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Affiliation(s)
- Sara Dule
- Department of Experimental Medicine, Sapienza University, 00161 Rome, Italy
| | - Ilaria Barchetta
- Department of Experimental Medicine, Sapienza University, 00161 Rome, Italy
| | | | - Giulia Passarella
- Department of Experimental Medicine, Sapienza University, 00161 Rome, Italy
| | - Arianna Dellanno
- Department of Experimental Medicine, Sapienza University, 00161 Rome, Italy
| | - Tiziana Filardi
- Department of Experimental Medicine, Sapienza University, 00161 Rome, Italy
| | - Vittorio Venditti
- Department of Experimental Medicine, Sapienza University, 00161 Rome, Italy
| | - Enrico Bleve
- Department of Experimental Medicine, Sapienza University, 00161 Rome, Italy
| | - Diego Bailetti
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences (MeSVA), University of L’Aquila, 67100 L’Aquila, Italy
| | | | - Susanna Morano
- Department of Experimental Medicine, Sapienza University, 00161 Rome, Italy
| | - Marco Giorgio Baroni
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences (MeSVA), University of L’Aquila, 67100 L’Aquila, Italy
- Neuroendocrinology and Metabolic Diseases, IRCCS Neuromed, 86077 Pozzilli, Italy
- Correspondence:
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Maddaloni E, Coraggio L, Amendolara R, Baroni MG, Cavallo MG, Copetti M, Cossu E, D'Angelo P, D'Onofrio L, Cosmo SD, Leonetti F, Morano S, Morviducci L, Napoli N, Prudente S, Pugliese G, Park K, Holman RR, Trischitta V, Buzzetti R. Association of osteocalcin, osteoprotegerin, and osteopontin with cardiovascular disease and retinopathy in type 2 diabetes. Diabetes Metab Res Rev 2023:e3632. [PMID: 36880127 DOI: 10.1002/dmrr.3632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 12/02/2022] [Accepted: 02/26/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND Novel biomarkers of vascular disease in diabetes could help identify new mechanistic pathways. Osteocalcin, osteoprotegerin, and osteopontin are key molecules involved in bone and vascular calcification processes, both of which are compromised in diabetes. We aimed to evaluate possible associations of osteocalcin, osteoprotegerin, and osteopontin with cardiovascular disease (CVD) and diabetic retinopathy (DR) among people with type 2 diabetes (T2D). MATERIALS AND METHODS Osteocalcin, osteoprotegerin, and osteopontin concentrations were measured at enrolment in 848 participants with T2D from the Sapienza University Mortality and Morbidity Event Rate (SUMMER) Study (ClinicalTrials.gov: NCT02311244). Logistic regression models and propensity score matching were used to assess possible associations of osteocalcin, osteoprotegerin, and osteopontin with a history of CVD and with evidence of any grade of DR adjusting for confounders. RESULTS Previous CVD was reported in 139 (16.4%) participants, while 144 (17.0%) had DR. After adjusting for possible confounders, osteocalcin but not osteoprotegerin or osteopontin concentrations were associated with a history of CVD (Odds Ratio [OR] and 95% CI for one standard deviation (SD) increase in osteocalcin concentrations (natural log): 1.35 (1.06-1.72), p = 0.014). Associations with prevalent DR were seen for osteoprotegerin (OR for one SD increase in osteoprotegerin concentrations (natural log): 1.25 (1.01-1.55), p = 0.047) and osteopontin (OR for one SD increase in osteopontin concentrations (natural log): 1.25 (1.02-1.53), p = 0.022), but not osteocalcin. CONCLUSIONS In T2D, higher serum osteocalcin concentrations are associated with macrovascular complications and higher osteoprotegerin and osteopontin concentrations with microvascular complications, suggesting that these osteokines might be involved in pathways directly related to vascular disease.
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Affiliation(s)
- Ernesto Maddaloni
- Sapienza University of Rome, Rome, Italy
- Diabetes Trials Unit, OCDEM, University of Oxford, Oxford, UK
| | | | | | | | | | - Massimiliano Copetti
- Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Rome, Italy
| | | | | | | | - Salvatore De Cosmo
- Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Rome, Italy
| | | | | | | | | | - Sabrina Prudente
- Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Rome, Italy
| | | | - Kyoungmin Park
- Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Rury R Holman
- Diabetes Trials Unit, OCDEM, University of Oxford, Oxford, UK
| | - Vincenzo Trischitta
- Sapienza University of Rome, Rome, Italy
- Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Rome, Italy
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Orsi E, Solini A, Bonora E, Vitale M, Garofolo M, Fondelli C, Trevisan R, Vedovato M, Cavalot F, Laviola L, Morano S, Pugliese G. Risk of all-cause mortality according to the European Society of Cardiology risk categories in individuals with type 2 diabetes: the Renal Insufficiency And Cardiovascular Events (RIACE) Italian Multicenter Study. Acta Diabetol 2022; 59:1369-1381. [PMID: 35902419 PMCID: PMC9402482 DOI: 10.1007/s00592-022-01942-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 07/04/2022] [Indexed: 11/13/2022]
Abstract
AIMS The 2019 and 2021 European Society of Cardiology (ESC) classifications stratified patients with type 2 diabetes into three categories according to the 10-year risk of death from atherosclerotic cardiovascular disease (ASCVD). The very high-risk category included individuals with established ASCVD, target organ damage (TOD), and/or, in the 2019 classification only, ≥ 3 additional ASCVD risk factors. We assessed risk of all-cause mortality according to the two ESC classifications in the Renal Insufficiency And Cardiovascular Events cohort. METHODS Participants (n = 15,773) were stratified based on the presence of ASCVD, TOD, and ASCVD risk factors at baseline (2006-2008). Vital status was retrieved in 2015. RESULTS Less than 1% of participants fell in the moderate-risk category. According to the 2019 classification, ~ 1/3 fell in the high-risk and ~ 2/3 in the very high-risk category, whereas the opposite occurred with the 2021 classification. Mortality risk increased across categories according to both classifications. Among very high-risk patients, mortality was much lower in those with ≥ 3 additional ASCVD risk factors and almost equal in those with TOD and ASCVD ± TOD, using the 2019 classification, whereas it was much higher in those with ASCVD + TOD and, to a lesser extent, TOD only than in those with ASCVD only, using the 2021 classification. CONCLUSIONS The negligible number of moderate-risk patients suggests that these classifications might overestimate risk of ASCVD death. Downgrading patients with ≥ 3 additional ASCVD risk factors to the high-risk category is consistent with mortality data. Risk of death is very high in the presence of TOD irrespective of established ASCVD. TRIAL REGISTRATION ClinicalTrials.gov, NCT00715481.
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Affiliation(s)
- Emanuela Orsi
- Diabetes Unit, IRCCS "Cà Granda - Ospedale Maggiore Policlinico" Foundation, Milan, Italy
| | - Anna Solini
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy
| | - Enzo Bonora
- Division of Endocrinology, Diabetes and Metabolism, University and Hospital Trust of Verona, Verona, Italy
| | - Martina Vitale
- Department of Clinical and Molecular Medicine, "La Sapienza" University, Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Monia Garofolo
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Roberto Trevisan
- Endocrinology and Diabetes Unit, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | - Monica Vedovato
- Department of Clinical and Experimental Medicine, University of Padua, Padua, Italy
| | - Franco Cavalot
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
| | - Luigi Laviola
- Department of Emergency and Transplants, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, Bari, Italy
| | - Susanna Morano
- Department of Experimental Medicine, "La Sapienza" University, Rome, Italy
| | - Giuseppe Pugliese
- Department of Clinical and Molecular Medicine, "La Sapienza" University, Via di Grottarossa, 1035-1039, 00189, Rome, Italy.
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10
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Prudente S, Andreozzi F, Mercuri L, Alberico F, Di Giamberardino A, Mannino GC, Ludovico O, Piscitelli P, Di Paola R, Morano S, Penno G, Carella M, De Cosmo S, Trischitta V, Barbetti F. Contribution of ONECUT1 variants to different forms of non-autoimmune diabetes mellitus in Italian patients. Acta Diabetol 2022; 59:1113-1116. [PMID: 35482136 DOI: 10.1007/s00592-022-01889-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 01/24/2023]
Affiliation(s)
- Sabrina Prudente
- Research Unit of Metabolic and Cardiovascular Diseases, Fondazione IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Italy.
| | - Francesco Andreozzi
- Department of Medical and Surgical Sciences, University Magna Graecia, Catanzaro, Italy
- Research Center for the Prevention and Treatment of Metabolic Diseases (CR METDIS), University Magna Grecia, Catanzaro, Italy
| | - Luana Mercuri
- Research Unit of Metabolic and Cardiovascular Diseases, Fondazione IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Italy
| | - Federica Alberico
- Research Unit of Metabolic and Cardiovascular Diseases, Fondazione IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Italy
| | - Alessandra Di Giamberardino
- Research Unit of Metabolic and Cardiovascular Diseases, Fondazione IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Italy
- Department of Molecular Medicine, Sapienza University, Rome, Italy
| | - Gaia Chiara Mannino
- Department of Medical and Surgical Sciences, University Magna Graecia, Catanzaro, Italy
| | - Ornella Ludovico
- Department of Medicine, Fondazione IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Italy
| | - Pamela Piscitelli
- Department of Medicine, Fondazione IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Italy
| | - Rosa Di Paola
- Research Unit of Diabetes and Endocrine Diseases, Fondazione IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Italy
| | - Susanna Morano
- Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Giuseppe Penno
- Section of Diabetes and Metabolic Disease, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Massimo Carella
- Medical Genetics Division, Fondazione IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Italy
| | - Salvatore De Cosmo
- Department of Medicine, Fondazione IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Italy
| | - Vincenzo Trischitta
- Research Unit of Diabetes and Endocrine Diseases, Fondazione IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Italy
- Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Fabrizio Barbetti
- Department of Experimental Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy.
- Clinical Laboratory Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
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11
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Bleve E, Venditti V, Lenzi A, Morano S, Filardi T. COVID-19 vaccine and autoimmune diabetes in adults: report of two cases. J Endocrinol Invest 2022; 45:1269-1270. [PMID: 35349113 PMCID: PMC8960710 DOI: 10.1007/s40618-022-01796-5] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 03/24/2022] [Indexed: 01/08/2023]
Affiliation(s)
- E Bleve
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - V Venditti
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - A Lenzi
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - S Morano
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
| | - T Filardi
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
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12
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Giannattasio S, Citarella A, Trocchianesi S, Filardi T, Morano S, Lenzi A, Ferretti E, Crescioli C. Cell-Target-Specific Anti-Inflammatory Effect of Empagliflozin: In Vitro Evidence in Human Cardiomyocytes. Front Mol Biosci 2022; 9:879522. [PMID: 35712355 PMCID: PMC9194473 DOI: 10.3389/fmolb.2022.879522] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 04/11/2022] [Indexed: 12/21/2022] Open
Abstract
The antidiabetic sodium–glucose cotransporter type 2 inhibitor (SGLT2i) empagliflozin efficiently reduces heart failure (HF) hospitalization and cardiovascular death in type 2 diabetes (T2D). Empagliflozin-cardioprotection likely includes anti-inflammatory effects, regardless glucose lowering, but the underlying mechanisms remain unclear. Inflammation is a primary event in diabetic cardiomyopathy (DCM) and HF development. The interferon (IFN)γ-induced 10-kDa protein (IP-10/CXCL10), a T helper 1 (Th1)-type chemokine, promotes cardiac inflammation, fibrosis, and diseases, including DCM, ideally representing a therapeutic target. This preliminary study aims to explore whether empagliflozin directly affects Th1-challenged human cardiomyocytes, in terms of CXCL10 targeting. To this purpose, empagliflozin dose–response curves were performed in cultured human cardiomyocytes maintained within a Th1-dominant inflammatory microenvironment (IFNγ/TNFα), and CXCL10 release with the intracellular IFNγ-dependent signaling pathway (Stat-1) was investigated. To verify possible drug–cell-target specificity, the same assays were run in human skeletal muscle cells. Empagliflozin dose dependently inhibited CXCL10 secretion (IC50 = 76,14 × 10-9 M) in association with Stat-1 pathway impairment only in Th1-induced human cardiomyocytes, suggesting drug-selective cell-type-targeting. As CXCL10 plays multifaceted functions in cardiac remodeling toward HF and currently there is no effective method to prevent it, these preliminary data might be hypothesis generating to open new scenarios in the translational approach to SGLT2i-dependent cardioprotection.
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Affiliation(s)
- Silvia Giannattasio
- Laboratory of Endocrine Research, Department of Movement, Human and Health Sciences, Section of Health Sciences, University of Rome “Foro Italico”, Rome, Italy
- Laboratory of Nutrigenetic and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Anna Citarella
- Laboratory of Oncogemics, Department of Experimental Medicine, “Sapienza” University of Rome, Rome, Italy
| | - Sofia Trocchianesi
- Laboratory of Molecular Medicine “Alberto Gulino” Group, Department of Molecular Medicine, “Sapienza” University of Rome, Rome, Italy
| | - Tiziana Filardi
- Laboratory of Oncogemics, Department of Experimental Medicine, “Sapienza” University of Rome, Rome, Italy
| | - Susanna Morano
- Laboratory of Oncogemics, Department of Experimental Medicine, “Sapienza” University of Rome, Rome, Italy
| | - Andrea Lenzi
- Laboratory of Oncogemics, Department of Experimental Medicine, “Sapienza” University of Rome, Rome, Italy
| | - Elisabetta Ferretti
- Laboratory of Oncogemics, Department of Experimental Medicine, “Sapienza” University of Rome, Rome, Italy
- *Correspondence: Elisabetta Ferretti, ; Clara Crescioli,
| | - Clara Crescioli
- Laboratory of Endocrine Research, Department of Movement, Human and Health Sciences, Section of Health Sciences, University of Rome “Foro Italico”, Rome, Italy
- *Correspondence: Elisabetta Ferretti, ; Clara Crescioli,
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13
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Pezzilli S, Mazza T, Scarale MG, Tang Y, Andreozzi F, Baroni MG, Buzzetti R, Cavallo MG, Cossu E, D'Angelo P, De Cosmo S, Lamacchia O, Leonetti F, Morano S, Morviducci L, Penno G, Pozzilli P, Pugliese G, Sesti G, Doria A, Trischitta V, Prudente S. Pathogenic variants of MODY-genes in adult patients with early-onset type 2 diabetes. Acta Diabetol 2022; 59:747-750. [PMID: 35112188 DOI: 10.1007/s00592-021-01847-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 12/27/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Serena Pezzilli
- Research Unit of Metabolic and Cardiovascular Diseases, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Tommaso Mazza
- Unit of Bioinformatics, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Maria Giovanna Scarale
- Research Unit of Diabetes and Endocrine Diseases, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Yaling Tang
- Research Division, Joslin Diabetes Center, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Francesco Andreozzi
- Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Marco Giorgio Baroni
- Department of Clinical Medicine, Health & Environmental Sciences, University of L'Aquila, L' Aquila, Italy
- IRCCS Neuromed, Pozzilli (Is), Italy
| | | | | | - Efisio Cossu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Paola D'Angelo
- Unit of Diabetology, Sandro Pertini Hospital, Rome, Italy
| | - Salvatore De Cosmo
- Department of Medicine, Fondazione IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Italy
| | - Olga Lamacchia
- Unit of Endocrinology, Department of Medical and Surgical Sciences, University Hospital of Foggia, Foggia, Italy
| | - Frida Leonetti
- Diabetes Unit, Department of Medical-Surgical Sciences and Biotechnologies, Santa Maria Goretti Hospital, Sapienza University of Rome, Latina, Italy
| | - Susanna Morano
- Department of Experimental Medicine, Sapienza University, Rome, Italy
| | | | - Giuseppe Penno
- Section of Diabetes and Metabolic Disease, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Paolo Pozzilli
- Department of Endocrinology and Diabetes, Campus Bio-Medico University of Rome, Rome, Italy
| | - Giuseppe Pugliese
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Giorgio Sesti
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Alessandro Doria
- Research Division, Joslin Diabetes Center, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Vincenzo Trischitta
- Research Unit of Metabolic and Cardiovascular Diseases, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
- IRCCS Neuromed, Pozzilli (Is), Italy
| | - Sabrina Prudente
- Research Unit of Metabolic and Cardiovascular Diseases, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
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14
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Pezzilli S, Tohidirad M, Biagini T, Scarale MG, Alberico F, Mercuri L, Mannino GC, Garofolo M, Filardi T, Tang Y, Giuffrida F, Mendonca C, Andreozzi F, Baroni MG, Buzzetti R, Cavallo MG, Cossu E, D'Angelo P, De Cosmo S, Lamacchia O, Leonetti F, Morano S, Morviducci L, Penno G, Pozzilli P, Pugliese G, Sesti G, Mazza T, Doria A, Trischitta V, Prudente S. Contribution of rare variants in monogenic diabetes-genes to early-onset type 2 diabetes. Diabetes Metab 2022; 48:101353. [PMID: 35487478 DOI: 10.1016/j.diabet.2022.101353] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/14/2022] [Accepted: 04/22/2022] [Indexed: 11/30/2022]
Abstract
AIM This study investigated whether rare, deleterious variants in monogenic diabetes-genes are associated with early-onset type 2 diabetes (T2D). METHODS A nested case-control study was designed from 9,712 Italian patients with T2D. Individuals with age at diabetes onset ≤35 yrs (n=300; cases) or ≥65 yrs (n=300; controls) were selected and screened for variants in 27 monogenic diabetes-genes by targeted resequencing. Rare (minor allele frequency-MAF <1%) and possibly deleterious variants were collectively tested for association with early-onset T2D. The association of a genetic risk score (GRS) based on 17 GWAS-SNPs for T2D was also tested. RESULTS When all rare variants were considered together, each increased the risk of early-onset T2D by 65% (allelic OR =1.64, 95% CI: 1.08-2.48, p=0.02). Effects were similar when the 600 study participants were stratified according to their place of recruitment (Central-Southern Italy, 182 cases vs. 142 controls, or Rome urban area, 118 vs. 158, p for heterogeneity=0.53). Progressively less frequent variants showed increasingly stronger effects in the risk of early-onset T2D for those with MAF <0.001% (OR=6.34, 95% CI: 1.87-22.43, p=0.003). One unit of T2D-GRS significantly increased the risk of early-onset T2D (OR 1.09, 95% CI: 1.01-1.18; p=0.02). This association was stronger among rare variants carriers as compared to non-carriers (p=0.02). CONCLUSION Rare variants in monogenic-diabetes genes are associated with an increased risk of early-onset T2D, and interact with common T2D susceptibility variants in shaping it. These findings might help develop prediction tools to identify individuals at high risk of developing T2D in early adulthood.
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Affiliation(s)
- Serena Pezzilli
- Research Unit of Metabolic and Cardiovascular Diseases, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Manoush Tohidirad
- Research Unit of Metabolic and Cardiovascular Diseases, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Tommaso Biagini
- Unit of Bioinformatics, Fondazione IRCSS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Maria Giovanna Scarale
- Research Unit of Diabetes and Endocrine Diseases, Fondazione IRCSS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Federica Alberico
- Research Unit of Metabolic and Cardiovascular Diseases, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Luana Mercuri
- Research Unit of Metabolic and Cardiovascular Diseases, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Gaia Chiara Mannino
- Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Monia Garofolo
- Section of Diabetes and Metabolic Disease, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Tiziana Filardi
- Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Yaling Tang
- Research Division, Joslin Diabetes Center, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA
| | | | | | - Francesco Andreozzi
- Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy; Research Center for the Prevention and Treatment of Metabolic Diseases (CR METDIS), University Magna Grecia, Catanzaro, Italy
| | - Marco Giorgio Baroni
- Department of Clinical Medicine, Life, Health & Environmental Sciences, University of L'Aquila, L'Aquila, Italy; Neuroendocrinology and Metabolic Diseases, IRCCS Neuromed, Pozzilli, Italy
| | | | | | - Efisio Cossu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Paola D'Angelo
- Unit of Diabetology, Sandro Pertini Hospital, Rome, Italy
| | - Salvatore De Cosmo
- Department of Medicine, Fondazione IRCSS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Olga Lamacchia
- Unit of Endocrinology, Department of Medical and Surgical Sciences, University Hospital of Foggia, Foggia, Italy
| | - Frida Leonetti
- Diabetes Unit, Department of Medical-Surgical Sciences and Biotechnologies, Santa Maria Goretti Hospital, Sapienza University of Rome, Latina, Italy
| | - Susanna Morano
- Department of Experimental Medicine, Sapienza University, Rome, Italy
| | | | - Giuseppe Penno
- Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Paolo Pozzilli
- Department of Endocrinology and Diabetes, Campus Bio-Medico University of Rome, Rome, Italy
| | - Giuseppe Pugliese
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Giorgio Sesti
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Tommaso Mazza
- Unit of Bioinformatics, Fondazione IRCSS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Alessandro Doria
- Research Division, Joslin Diabetes Center, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA
| | - Vincenzo Trischitta
- Research Unit of Diabetes and Endocrine Diseases, Fondazione IRCSS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy; Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Sabrina Prudente
- Research Unit of Metabolic and Cardiovascular Diseases, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
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Filardi T, Catanzaro G, Grieco GE, Splendiani E, Trocchianesi S, Santangelo C, Brunelli R, Guarino E, Sebastiani G, Dotta F, Morano S, Ferretti E. Identification and Validation of miR-222-3p and miR-409-3p as Plasma Biomarkers in Gestational Diabetes Mellitus Sharing Validated Target Genes Involved in Metabolic Homeostasis. Int J Mol Sci 2022; 23:ijms23084276. [PMID: 35457094 PMCID: PMC9028517 DOI: 10.3390/ijms23084276] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 12/16/2022] Open
Abstract
Gestational diabetes mellitus (GDM) causes both maternal and fetal adverse outcomes. The deregulation of microRNAs (miRNAs) in GDM suggests their involvement in GDM pathogenesis and complications. Exosomes are extracellular vesicles (EVs) of endosomal origin, released via exocytosis into the extracellular compartment. Through EVs, miRNAs are delivered in distant target cells and are able to affect gene expression. In this study, miRNA expression was analyzed to find new miRNAs that could improve GDM classification and molecular characterization. MiRNA were profiled in total plasma and EVs in GDM patients and normal glucose tolerance (NGT) women. Samples were collected at third trimester of gestation from two diabetes centers. MiRNA expression was profiled in a discovery cohort using the multiplexed NanoString nCounter Human v3 miRNA. Validation analysis was performed in a second independent cohort using RT-qPCR. A set of miRNAs resulted to be differentially expressed (DE) in total plasma and EVs in GDM. Among them, total plasma miR-222-3p and miR-409-3p were validated in the independent cohort. MiR-222-3p levels correlated with fasting plasma glucose (FPG) (p < 0.001) and birth weight (p = 0.012), whereas miR-409-3p expression correlated with FPG (p < 0.001) and inversely with gestational age (p = 0.001). The major validated target genes of the deregulated miRNAs were consistently linked to type 2 diabetes and GDM pathophysiology. MiR-222-3p and miR-409-3p are two circulating biomarkers that could improve GDM classification power and act in the context of the molecular events leading to the metabolic alterations observed in GDM.
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Affiliation(s)
- Tiziana Filardi
- Department of Experimental Medicine, “Sapienza” University, 00161 Rome, Italy; (T.F.); (S.M.); (E.F.)
| | - Giuseppina Catanzaro
- Department of Experimental Medicine, “Sapienza” University, 00161 Rome, Italy; (T.F.); (S.M.); (E.F.)
- Correspondence:
| | - Giuseppina Emanuela Grieco
- Diabetes Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (G.E.G.); (G.S.); (F.D.)
- Fondazione Umberto di Mario, Toscana Life Sciences, 53100 Siena, Italy
| | - Elena Splendiani
- Department of Molecular Medicine, “Sapienza” University, 00161 Rome, Italy; (E.S.); (S.T.)
| | - Sofia Trocchianesi
- Department of Molecular Medicine, “Sapienza” University, 00161 Rome, Italy; (E.S.); (S.T.)
| | - Carmela Santangelo
- Center for Gender-Specific Medicine, Gender Specific Prevention and Health Unit, Istituto Superiore di Sanità, 00161 Rome, Italy;
| | - Roberto Brunelli
- Maternal and Child Health and Urological Sciences, “Sapienza” University, 00161 Rome, Italy;
| | - Elisa Guarino
- UOC Diabetologia, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy;
| | - Guido Sebastiani
- Diabetes Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (G.E.G.); (G.S.); (F.D.)
- Fondazione Umberto di Mario, Toscana Life Sciences, 53100 Siena, Italy
| | - Francesco Dotta
- Diabetes Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (G.E.G.); (G.S.); (F.D.)
- Fondazione Umberto di Mario, Toscana Life Sciences, 53100 Siena, Italy
- UOC Diabetologia, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy;
- Tuscany Centre for Precision Medicine (CReMeP), 53100 Siena, Italy
| | - Susanna Morano
- Department of Experimental Medicine, “Sapienza” University, 00161 Rome, Italy; (T.F.); (S.M.); (E.F.)
| | - Elisabetta Ferretti
- Department of Experimental Medicine, “Sapienza” University, 00161 Rome, Italy; (T.F.); (S.M.); (E.F.)
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16
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Sottili M, Filardi T, Cantini G, Cosmi L, Morano S, Luconi M, Lenzi A, Crescioli C. Human cell-based anti-inflammatory effects of rosiglitazone. J Endocrinol Invest 2022; 45:105-114. [PMID: 34170488 DOI: 10.1007/s40618-021-01621-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/17/2021] [Indexed: 12/20/2022]
Abstract
PURPOSE The C-X-C motif chemokine ligand 10 (CXCL10) participates in diabetes and diabetic cardiomyopathy development from the early stages. Rosiglitazone (RGZ) exhibits anti-inflammatory properties and can target cardiomyocytes secreting CXCL10, under interferon (IFN)γ and tumor necrosis factor (TNF)α challenge. Cardiomyocyte remodeling, CD4 + T cells and dendritic cells (DCs) significantly contribute to the inflammatory milieu underlying and promoting disease development. We aimed to study the effect of RGZ onto inflammation-induced secretion of CXCL10, IFNγ, TNFα, interleukin (IL)-6 and IL-8 by human CD4 + T and DCs, and onto IFNγ/TNFα-dependent signaling in human cardiomyocytes associated with chemokine release. METHODS Cells maintained within an inflammatory-like microenvironment were exposed to RGZ at near therapy dose (5 µM). ELISA quantified cytokine secretion; qPCR measured mRNA expression; Western blot analyzed protein expression and activation; immunofluorescent analysis detected intracellular IFNγ/TNFα-dependent trafficking. RESULTS In human CD4 + T cells and DCs, RGZ inhibited CXCL10 release likely with a transcriptional mechanism, and reduced TNFα only in CD4 + T cells. In human cardiomyocytes, RGZ impaired IFNγ/TNFα signal transduction, blocking the phosphorylation/nuclear translocation of signal transducer and activator of transcription 1 (Stat1) and nuclear factor-kB (NF-kB), in association with a significant decrease in CXCL10 expression, IL-6 and IL-8 release. CONCLUSION As the combination of Th1 biomarkers like CXCL10, IL-8, IL-6 with classical cardiovascular risk factors seems to improve the accuracy in predicting T2D and coronary events, future studies might be desirable to further investigate the anti-Th1 effect of RGZ.
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Affiliation(s)
- M Sottili
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50139, Florence, Italy
| | - T Filardi
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - G Cantini
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50139, Florence, Italy
- DENOTHE Center of Excellence for Research, Transfer and High Education, University of Florence, 50139, Florence, Italy
| | - L Cosmi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - S Morano
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - M Luconi
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50139, Florence, Italy
- DENOTHE Center of Excellence for Research, Transfer and High Education, University of Florence, 50139, Florence, Italy
- Istituto Nazionale Biostrutture E Biosistemi (INBB), viale delle Medaglie d'Oro 305, 00136, Rome, Italy
| | - A Lenzi
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - C Crescioli
- Department of Movement, Human and Health Sciences, Section of Health Sciences, University of Rome "Foro Italico", Piazza L. de Bosis 6, 00135, Rome, Italy.
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Scazzocchio B, Filardi T, Varì R, Brunelli R, Galoppi P, Morano S, Masella R, Santangelo C. Protocatechuic acid influences immune-metabolic changes in the adipose tissue of pregnant women with gestational diabetes mellitus. Food Funct 2021; 12:7490-7500. [PMID: 34213517 DOI: 10.1039/d1fo00267h] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Gestational diabetes mellitus (GDM) is associated with immune metabolic changes that increase women's risk of developing metabolic disorders later in life. Nutritional intervention is a crucial component in reducing the burden of these pathological features. We examined whether protocatechuic acid (PCA), a major metabolite of anthocyanins abundant in plant food, is able to exert insulin-mimetic activity and modulate inflammation in the visceral adipose tissue (VAT) obtained at delivery, from pregnant women with GDM or normal glucose tolerance (NGT). PCA stimulated glucose uptake in the VAT from both GDM and NGT women. This capability was associated with increased phosphorylation of p38 mitogen-activated protein kinase (p38MAPK), as further demonstrated by the inhibitory effect of SB203580, a p38MAPK inhibitor, on PCA-induced glucose uptake. The GDM-VAT expressed lower adiponectin levels and PCA stimulated adiponectin release in the NGT-VAT and, albeit to a lower extent, in the GDM-VAT. Higher levels of IL6 and TNFα were secreted by the GDM-VAT compared with the NGT one, and PCA had no effects on them. PCA reduced the overexpression of vasoactive intestinal peptide receptor 2 (VPAC2) in the GDM-VAT. Further studies are needed to establish whether and how anthocyanins and food rich in these compounds may contribute to prevent or delay metabolic disorders in women with GDM.
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Affiliation(s)
- Beatrice Scazzocchio
- Center for Gender-Specific Medicine, Gender Specific Prevention and Health Unit, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy.
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Catanzaro G, Filardi T, Sabato C, Vacca A, Migliaccio S, Morano S, Ferretti E. Tissue and circulating microRNAs as biomarkers of response to obesity treatment strategies. J Endocrinol Invest 2021; 44:1159-1174. [PMID: 33111214 PMCID: PMC8124039 DOI: 10.1007/s40618-020-01453-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/15/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Obesity, characterized by an increased amount of adipose tissue, is a metabolic chronic alteration which has reached pandemic proportion. Lifestyle changes are the first line therapy for obesity and a large variety of dietary approaches have demonstrated efficacy in promoting weight loss and improving obesity-related metabolic alterations. Besides diet and physical activity, bariatric surgery might be an effective therapeutic strategy for morbid obese patients. Response to weight-loss interventions is characterised by high inter-individual variability, which might involve epigenetic factors. microRNAs have critical roles in metabolic processes and their dysregulated expression has been reported in obesity. AIM The aim of this review is to provide a comprehensive overview of current studies evaluating changes in microRNA expression in obese patients undergoing lifestyle interventions or bariatric surgery. RESULTS A considerable number of studies have reported a differential expression of circulating microRNAs before and after various dietary and bariatric surgery approaches, identifying several candidate biomarkers of response to weight loss. Significant changes in microRNA expression have been observed at a tissue level as well, with entirely different patterns between visceral and subcutaneous adipose tissue. Interestingly, relevant differences in microRNA expression have emerged between responders and non-responders to dietary or surgical interventions. A wide variety of dysregulated microRNA target pathways have also been identified, helping to understand the pathophysiological mechanisms underlying obesity and obesity-related metabolic diseases. CONCLUSIONS Although further research is needed to draw firm conclusions, there is increasing evidence about microRNAs as potential biomarkers for weight loss and response to intervention strategies in obesity.
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Affiliation(s)
- G Catanzaro
- Department of Experimental Medicine, Policlinico Umberto I, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - T Filardi
- Department of Experimental Medicine, Policlinico Umberto I, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - C Sabato
- Department of Experimental Medicine, Policlinico Umberto I, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - A Vacca
- Department of Experimental Medicine, Policlinico Umberto I, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - S Migliaccio
- Department of Movement, Human and Health Sciences, "Foro Italico" University of Rome, Rome, Italy
| | - S Morano
- Department of Experimental Medicine, Policlinico Umberto I, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - E Ferretti
- Department of Experimental Medicine, Policlinico Umberto I, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
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Albanese S, Liberatore C, Morano S, Rosignoli P, Anastasio G, Civitelli F. [Gender Diversity and Impact on Work and Life Expectancy in Health Care. Results of a Survey Conducted in the Tuscany Region]. Ig Sanita Pubbl 2021; 77:502-508. [PMID: 34342599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The percentage of female doctors employed in the health sector is constantly increasing both in Europe and in Italy with repercussions on organizational and socio-family models, currently not conceived in terms of equal opportunities, career and quality of life. The published studies have mainly taken into consideration economic and career disparities, (1) however, to date no study combined with surveys has highlighted criteria for evaluating the quality of work through the direct and sincere experience of workers. This reflection gave rise to the idea of a survey organized by the ANAAO Medical Women Group with the patronage of the Tuscan Medical Orders Federation organized on a homogeneous sample, i.e. female doctors from a single Region, Tuscany, in order to evaluate and new approaches in the management of human resources that take into account the delicate balance between the real possibilities available to the doctor and the complexities of experiential work that arise over the course of a lifetime. Empirical evidence deriving from specific investigations conducted at trade union and ordinistic level still document the existence of a gender gap between male and female doctors with respect to the reference parameters of quality work, such as the economic and ergonomic dimension, in relation to the physical and psychological aspects of people.
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20
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Tavaglione F, De Vincentis A, Jamialahmadi O, Pujia R, Spagnuolo R, Picardi A, Morano S, Valenti L, Romeo S, Vespasiani-Gentilucci U. Inborn and acquired risk factors for severe liver disease in Europeans with type 2 diabetes from the UK Biobank. JHEP Rep 2021; 3:100262. [PMID: 33997749 PMCID: PMC8099786 DOI: 10.1016/j.jhepr.2021.100262] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/08/2021] [Accepted: 02/23/2021] [Indexed: 02/07/2023] Open
Abstract
Background & Aims Type 2 diabetes is a major driver of fatty liver disease and its long-term complications. The aim of this study was to investigate the individual contribution of inborn and acquired risk factors for severe liver disease in individuals with type 2 diabetes from the UK Biobank study. Methods A total of 22,812 UK Biobank participants of European descent without clinical history of liver disease and liver cancer were prospectively followed for the development of severe liver disease, defined as a composite diagnosis of cirrhosis, decompensated liver disease, hepatocellular carcinoma, and/or liver transplantation from the National Health Service records. The contribution of inborn and acquired risk factors to the risk of incident severe liver disease was assessed by Cox proportional hazards models. Results During a median follow-up of 8.9 years (IQR 8.1-9.6), there were 279 individuals with severe liver disease, including 255 with cirrhosis and/or decompensated liver disease, 47 with hepatocellular carcinoma, and 5 with liver transplantation; death from severe liver disease occurred in 83 individuals. Risk factors independently associated with increased risk of incident severe liver disease included abnormal aspartate aminotransferase (adjusted hazard ratio [aHR] 4.85, 95% CI 2.76-8.54), decrease in serum albumin (aHR 2.39, 95% CI 1.76-3.24) and platelet count (aHR 1.12, 95% CI 1.09-1.16), cardiovascular disease (aHR 1.86, 95% CI 1.23-2.79), microalbuminuria (aHR 1.55, 95% CI 1.04-2.30), PNPLA3 rs738409 (aHR 1.67, 95% CI 1.27-2.18) and TM6SF2 rs58542926 (aHR 1.63, 95% CI 1.12-2.39), while the net effect of male sex was protective (aHR 0.49, 95% CI 0.26-0.94). Conclusions These findings may help in clinical care to identify individuals with type 2 diabetes at risk of severe liver disease, in turn leading to personalised risk prediction and prevention strategies. Lay summary Type 2 diabetes is a key driver of severe liver disease, namely cirrhosis, hepatocellular carcinoma, and liver-related mortality. In Europeans with type 2 diabetes from the prospective UK Biobank study, abnormal liver function, cardiovascular disease, microalbuminuria, and genetic variants in PNPLA3 and TM6SF2 genes are the major independent risk factors for severe liver disease. These findings may contribute in clinical care to identify and closely monitor individuals with type 2 diabetes at risk of developing severe liver disease, requiring more intensive follow-up strategies.
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Affiliation(s)
- Federica Tavaglione
- Clinical Medicine and Hepatology Unit, Department of Internal Medicine and Geriatrics, Campus Bio-Medico University, Rome, Italy.,Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, Wallenberg Laboratory, University of Gothenburg, Gothenburg, Sweden
| | - Antonio De Vincentis
- Internal Medicine Unit, Department of Internal Medicine and Geriatrics, Campus Bio-Medico University, Rome, Italy.,Clinical Lecturer of Internal Medicine, Saint Camillus International University of Health and Medical Sciences, Rome, Italy
| | - Oveis Jamialahmadi
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, Wallenberg Laboratory, University of Gothenburg, Gothenburg, Sweden
| | - Roberta Pujia
- Clinical Nutrition Unit, Department of Medical and Surgical Sciences, University Magna Graecia, Catanzaro, Italy
| | - Rocco Spagnuolo
- Clinical Nutrition Unit, Department of Medical and Surgical Sciences, University Magna Graecia, Catanzaro, Italy
| | - Antonio Picardi
- Clinical Medicine and Hepatology Unit, Department of Internal Medicine and Geriatrics, Campus Bio-Medico University, Rome, Italy
| | - Susanna Morano
- Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Luca Valenti
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.,Translational Medicine, Department of Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefano Romeo
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, Wallenberg Laboratory, University of Gothenburg, Gothenburg, Sweden.,Clinical Nutrition Unit, Department of Medical and Surgical Sciences, University Magna Graecia, Catanzaro, Italy.,Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Umberto Vespasiani-Gentilucci
- Clinical Medicine and Hepatology Unit, Department of Internal Medicine and Geriatrics, Campus Bio-Medico University, Rome, Italy
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21
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Filardi T, Panimolle F, Tiberti C, Crescioli C, Lenzi A, Pallotta N, Morano S. Circulating levels of fetuin-A are associated with moderate-severe hepatic steatosis in young adults. J Endocrinol Invest 2021; 44:105-110. [PMID: 32350824 DOI: 10.1007/s40618-020-01274-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 04/22/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE The hepatokine fetuin-A might have a role as molecular link between non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM). The aim of this study was to evaluate the association between fetuin-A and the prevalence and severity of NAFLD in a population of young adults. METHODS Ninety-seven adults (age 35.7 ± 12.4 years, female 64.9%), enrolled in a previous study evaluating NAFLD prevalence in the presence or absence of family history of T2DM, were included. Serum levels of fetuin-A (ELISA BioVendor, Czech Republic) and the main biochemical parameters were assessed. Presence and severity of NAFLD were evaluated by ultrasonography (Toshiba, Japan). A linear regression was run to predict fetuin-A levels and a logistic regression was performed to predict moderate-severe steatosis. RESULTS Fetuin-A associated inversely with age (ß - 0.12, p = 0.03) and directly with body mass index (BMI) (ß 0.5, p = 0.048), waist circumference (WC) (ß 0.3, p = 0.027), triglycerides (TG) (ß 0.1, p = 0.001) and uric acid (ß 1.7, p = 0.018), after adjustment for age and sex. In a model including age, BMI, WC, TG and uric acid, age (ß - 0.2, p = 0.002) and TG (ß 0.04, p = 0.02) were independent predictors of fetuin-A. Prevalence of steatosis was 66%. The rates of mild and moderate-severe steatosis were 50.5% and 15.5%, respectively. In the logistic model, the independent predictors of moderate-severe steatosis were fetuin-A (OR 1.22, p = 0.036), age (OR 1.17, p = 0.01) and BMI (OR 2.75, p = 0.011). CONCLUSION In a sample of young adults, circulating levels of fetuin-A correlated with moderate-severe NAFLD, independent of confounders, and with some metabolic parameters. Fetuin-A might be a useful marker to predict NAFLD and metabolic disorders.
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Affiliation(s)
- T Filardi
- Department of Experimental Medicine, Policlinico Umberto I, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - F Panimolle
- Department of Experimental Medicine, Policlinico Umberto I, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - C Tiberti
- Department of Experimental Medicine, Policlinico Umberto I, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - C Crescioli
- Department of Movement, Human and Health Sciences, Section of Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - A Lenzi
- Department of Experimental Medicine, Policlinico Umberto I, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - N Pallotta
- Department of Internal Medicine and Medical Specialties, "Sapienza" University, Rome, Italy
| | - S Morano
- Department of Experimental Medicine, Policlinico Umberto I, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
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22
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Filardi T, Morano S, Tartaglione S, Porpora MG, Tiberti C, Lenzi A, Angeloni A, Anastasi E. Anti-Müllerian hormone as marker of ovarian reserve in patients with long-standing type 1 diabetes. J BIOL REG HOMEOS AG 2020; 34:1959-1962. [PMID: 33179464 DOI: 10.23812/20-365-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- T Filardi
- Department of Experimental Medicine, "Sapienza" University, Rome, Italy
| | - S Morano
- Department of Experimental Medicine, "Sapienza" University, Rome, Italy
| | - S Tartaglione
- Department of Molecular Medicine, "Sapienza" University, Rome, Italy
| | - M G Porpora
- Department of Maternal and Child Health and Urology, "Sapienza" University, Rome, Italy
| | - C Tiberti
- Department of Experimental Medicine, "Sapienza" University, Rome, Italy
| | - A Lenzi
- Department of Experimental Medicine, "Sapienza" University, Rome, Italy
| | - A Angeloni
- Department of Experimental Medicine, "Sapienza" University, Rome, Italy
| | - E Anastasi
- Department of Molecular Medicine, "Sapienza" University, Rome, Italy
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Abstract
BACKGROUND The Coronavirus disease 2019 (COVID-19) and type 2 diabetes (T2D) are two pandemics that share the dramatic impact on global mortality and economic resources. COVID-19 largely exhibits mild to moderate clinical manifestations. However, severe pneumonia with high fatality rate may occur, especially in the elderly and in patients with underlying conditions, such as diabetes and cardiovascular disease. SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) binds to the angiotensin-converting enzyme 2 (ACE2), a ubiquitous trans-membrane carboxypeptidase, to enter the cells. AIMS This short review discusses some open questions about the link between COVID-19 and diabetes, principally focusing on the possible effects of commonly used drugs in patients with diabetes. RESULTS Preclinical studies have reported that angiotensin receptor blockers (ARBs) and ACE inhibitors might increase ACE2 expression in several cell types. Hence, it has been speculated that the treatment with these agents might influence the course of the infection, and both harmful and beneficial effects have been supposed. Other pharmacological agents are thought to increase ACE2 expression, including statins and proliferator-activated receptor gamma (PPAR-γ) agonists. All these drug classes are broadly adopted in T2D. Besides ACE2, other unknown co-factors might be involved in cell infection. It has been recently observed that dipeptidyl peptidase-4 (DPP4), the receptor for MERS-CoV (Middle East respiratory syndrome-related coronavirus) and ACE2 have similar expression profiles in the lung. DPP4 has important metabolic and immune functions and is a target for commonly used therapies in T2D. CONCLUSIONS Although clinical data supporting an influence of all these drugs on the course of the disease are limited, this is an interesting background for further research that might help unravel the complex mechanisms underlying the link between COVID-19 and diabetes.
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Affiliation(s)
- T Filardi
- Department of Experimental Medicine, Policlinico Umberto I, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - S Morano
- Department of Experimental Medicine, Policlinico Umberto I, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
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24
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Tiberti C, Montuori M, Trovato CM, Panimolle F, Filardi T, Valitutti F, Lenzi A, Cucchiara S, Morano S. Gluten-free diet impact on dynamics of pancreatic islet-specific autoimmunity detected at celiac disease diagnosis. Pediatr Diabetes 2020; 21:774-780. [PMID: 32418261 DOI: 10.1111/pedi.13054] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 04/29/2020] [Accepted: 05/06/2020] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE Almost 6% of celiac disease (CD) patients at diagnosis are positive for at least one of the main pancreatic islet autoantibodies that characterize type 1 diabetes (T1D). Few information, dated back to almost two decades ago, exist as to whether a gluten-free diet (GFD) could reduce the islet-specific autoimmunity detected in patients at CD diagnosis. Aim of the study was to evaluate the impact of GFD on 31 patients who presented islet-specific autoimmunity at CD diagnosis. METHODS CD patient sera collected at diagnosis and throughout the GFD were analyzed for the main humoral autoantibodies so far identified in T1D, directed against one or more among insulin, glutamic-acid decarboxylase, tyrosine-phosphatase 2, and zinc cation-efflux transporter autoantigens. RESULTS GFD (median duration 39 months) was associated to a decrease or disappearance of the islet-specific autoantibodies in 71% of CD patients. Almost 80% of the patients who became autoantibody-negative during the GFD were positive for only one of the islet-specific autoimmune markers at CD diagnosis, with none of them developing diabetes. Conversely, 80% of the CD patients positive at diagnosis for ≥2 islet-specific autoantibodies were still positive after more than two years of GFD, with 25% of them developing T1D. CONCLUSIONS Various factors appear to influence, individually or in combination, the effects of the GFD on pancreatic islet-specific autoimmune response detected at CD diagnosis. These factors include the number of diabetes autoantibodies found at CD diagnosis, the adherence to the GFD, its duration and an asymptomatic clinical presentation of CD.
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Affiliation(s)
- Claudio Tiberti
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Monica Montuori
- Department of Pediatrics, Pediatric Gastroenterology, and Liver Unit, Sapienza University of Rome, Rome, Italy
| | - Chiara Maria Trovato
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.,Department of Pediatrics, Pediatric Gastroenterology, and Liver Unit, Sapienza University of Rome, Rome, Italy
| | - Francesca Panimolle
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Tiziana Filardi
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Francesco Valitutti
- Department of Pediatrics, Pediatric Gastroenterology, and Liver Unit, Sapienza University of Rome, Rome, Italy
| | - Andrea Lenzi
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Salvatore Cucchiara
- Department of Pediatrics, Pediatric Gastroenterology, and Liver Unit, Sapienza University of Rome, Rome, Italy
| | - Susanna Morano
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
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Sciannameo V, Berchialla P, Orsi E, Lamacchia O, Morano S, Querci F, Consoli A, Avogaro A, Fadini GP. Enrolment criteria for diabetes cardiovascular outcome trials do not inform on generalizability to clinical practice: The case of glucagon-like peptide-1 receptor agonists. Diabetes Obes Metab 2020; 22:817-827. [PMID: 31943710 DOI: 10.1111/dom.13962] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 12/26/2019] [Accepted: 01/08/2020] [Indexed: 02/06/2023]
Abstract
AIM To evaluate the generalizability of cardiovascular outcome trials (CVOTs) on glucagon-like peptide-1 receptor agonists (GLP-1RAs), we assessed what proportion of real-world patients with type 2 diabetes (T2D) constitute true CVOT-like populations. MATERIALS AND METHODS We applied inclusion/exclusion (I/E) criteria of each GLP-1RA CVOT to a cross-sectional database of 281 380 T2D patients from Italian diabetes outpatient clinics. We calculated the proportion of patients eligible for each CVOT and compared their clinical characteristics with those of trial patients. In addition, we used a Bayesian network-based method to sample the greatest subsets of real-world patients yielding true CVOT-like populations. RESULTS Between 98 725 and 124 164 T2D patients could be evaluated for CVOT eligibility. After excluding patients who were already on GLP-1RAs and applying I/E criteria, 35.8% of patients would be eligible for REWIND, 34.1% for PIONEER-6, 13.4% for EXSCEL, 10.1% for SUSTAIN-6, 9.5% for HARMONY and 9.4% for LEADER. Overall, 45.4% of patients could be eligible for at least one of the CVOTs. These patients, however, were extremely different to trial patients in most of the clinical characteristics, including demographics, concomitant medications and complications. The greatest CVOT-like subsets of real-world patients were 0.5% for SUSTAIN-6, 1.0% for EXSCEL, 1.2% for LEADER, 1.8% for PIONEER-6 and 7.9% for REWIND. CONCLUSIONS A very small proportion of real-world patients constitute true CVOT-like populations. These findings question whether any meaningful information can be drawn from applying trial enrolment criteria to real-world T2D patients.
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Affiliation(s)
- Veronica Sciannameo
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Paola Berchialla
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Emanuela Orsi
- Unit of Endocrinology and Metabolic Diseases, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Olga Lamacchia
- Unit of Endocrinology, Department of Medical and Surgical Sciences, University Hospital of Foggia, Foggia, Italy
| | - Susanna Morano
- Unit of Diabetes Complications, V Clinica Medica, Department of Experimental Medicine, University of Rome "La Sapienza", Rome, Italy
| | - Fabrizio Querci
- Unit of Diabetology, ASST Bergamo Est, Alzano Lombardo, Italy
| | - Agostino Consoli
- Department of Medicine and Aging Science, "G. D'Annunzio" University of Chieti, Chieti, Italy
| | - Angelo Avogaro
- Department of Medicine, University of Padova, Padova, Italy
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Filardi T, Panimolle F, Lenzi A, Morano S. Bisphenol A and Phthalates in Diet: An Emerging Link with Pregnancy Complications. Nutrients 2020; 12:nu12020525. [PMID: 32092855 PMCID: PMC7071371 DOI: 10.3390/nu12020525] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 02/17/2020] [Accepted: 02/18/2020] [Indexed: 12/11/2022] Open
Abstract
Endocrine-disrupting chemicals (EDCs) are exogenous substances that are able to interfere with hormone action, likely contributing to the development of several endocrine and metabolic diseases. Among them, Bisphenol A (BPA) and phthalates contaminate food and water and have been largely studied as obesogenic agents. They might contribute to weight gain, insulin resistance and pancreatic β-cell dysfunction in pregnancy, potentially playing a role in the development of pregnancy complications, such as gestational diabetes mellitus (GDM), and adverse outcomes. Pregnancy and childhood are sensitive windows of susceptibility, and, although with not univocal results, preclinical and clinical studies have suggested that exposure to BPA and phthalates at these stages of life might have an impact on the development of metabolic diseases even many years later. The molecular mechanisms underlying this association are largely unknown, but adipocyte and pancreatic β-cell dysfunction are suspected to be involved. Remarkably, transgenerational damage has been observed, which might be explained by epigenetic changes. Further research is needed to address knowledge gaps and to provide preventive measure to limit health risks connected with exposure to EDCs.
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Grieco M, Giorgi A, Gentile MC, d'Erme M, Morano S, Maras B, Filardi T. Glucagon-Like Peptide-1: A Focus on Neurodegenerative Diseases. Front Neurosci 2019; 13:1112. [PMID: 31680842 PMCID: PMC6813233 DOI: 10.3389/fnins.2019.01112] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 10/02/2019] [Indexed: 12/13/2022] Open
Abstract
Diabetes mellitus is one of the major risk factors for cognitive dysfunction. The pathogenesis of brain impairment caused by chronic hyperglycemia is complex and includes mitochondrial dysfunction, neuroinflammation, neurotransmitters’ alteration, and vascular disease, which lead to cognitive impairment, neurodegeneration, loss of synaptic plasticity, brain aging, and dementia. Glucagon-like peptide-1 (GLP-1), a gut released hormone, is attracting attention as a possible link between metabolic and brain impairment. Several studies have shown the influence of GPL-1 on neuronal functions such as thermogenesis, blood pressure control, neurogenesis, neurodegeneration, retinal repair, and energy homeostasis. Moreover, modulation of GLP-1 activity can influence amyloid β peptide aggregation in Alzheimer’s disease (AD) and dopamine (DA) levels in Parkinson’s disease (PD). GLP-1 receptor agonists (GLP-1RAs) showed beneficial actions on brain ischemia in animal models, such as the reduction of cerebral infarct area and the improvement of neurological deficit, acting mainly through inhibition of oxidative stress, inflammation, and apoptosis. They might also exert a beneficial effect on the cognitive impairment induced by diabetes or obesity improving learning and memory by modulating synaptic plasticity. Moreover, GLP-1RAs reduced hippocampal neurodegeneration. Besides this, there are growing evidences on neuroprotective effects of these agonists in animal models of neurodegenerative diseases, regardless of diabetes. In PD animal models, GPL-1RAs were able to protect motor activity and dopaminergic neurons whereas in AD models, they seemed to improve nearly all neuropathological features and cognitive functions. Although further clinical studies of GPL-1RAs in humans are needed, they seem to be a promising therapy for diabetes-associated cognitive decline.
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Affiliation(s)
- Maddalena Grieco
- Department of Biochemical Sciences, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Rome, Italy
| | - Alessandra Giorgi
- Department of Biochemical Sciences, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Rome, Italy
| | - Maria Cristina Gentile
- Department of Experimental Medicine, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Maria d'Erme
- Department of Biochemical Sciences, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Rome, Italy
| | - Susanna Morano
- Department of Experimental Medicine, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Bruno Maras
- Department of Biochemical Sciences, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Rome, Italy
| | - Tiziana Filardi
- Department of Experimental Medicine, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
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Filardi T, Ghinassi B, Di Baldassarre A, Tanzilli G, Morano S, Lenzi A, Basili S, Crescioli C. Cardiomyopathy Associated with Diabetes: The Central Role of the Cardiomyocyte. Int J Mol Sci 2019; 20:ijms20133299. [PMID: 31284374 PMCID: PMC6651183 DOI: 10.3390/ijms20133299] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 07/02/2019] [Accepted: 07/03/2019] [Indexed: 12/18/2022] Open
Abstract
The term diabetic cardiomyopathy (DCM) labels an abnormal cardiac structure and performance due to intrinsic heart muscle malfunction, independently of other vascular co-morbidity. DCM, accounting for 50%–80% of deaths in diabetic patients, represents a worldwide problem for human health and related economics. Optimal glycemic control is not sufficient to prevent DCM, which derives from heart remodeling and geometrical changes, with both consequences of critical events initially occurring at the cardiomyocyte level. Cardiac cells, under hyperglycemia, very early undergo metabolic abnormalities and contribute to T helper (Th)-driven inflammatory perturbation, behaving as immunoactive units capable of releasing critical biomediators, such as cytokines and chemokines. This paper aims to focus onto the role of cardiomyocytes, no longer considered as “passive” targets but as “active” units participating in the inflammatory dialogue between local and systemic counterparts underlying DCM development and maintenance. Some of the main biomolecular/metabolic/inflammatory processes triggered within cardiac cells by high glucose are overviewed; particular attention is addressed to early inflammatory cytokines and chemokines, representing potential therapeutic targets for a prompt early intervention when no signs or symptoms of DCM are manifesting yet. DCM clinical management still represents a challenge and further translational investigations, including studies at female/male cell level, are warranted.
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Affiliation(s)
- Tiziana Filardi
- Department of Experimental Medicine, "Sapienza" University, Viale del Policlinico 155, 00161 Rome, Italy
| | - Barbara Ghinassi
- Department of Medicine and Aging Sciences, "G. D'Annunzio" University of Chieti and Pescara, Via dei Vestini 31, 66100 Chieti, Italy
| | - Angela Di Baldassarre
- Department of Medicine and Aging Sciences, "G. D'Annunzio" University of Chieti and Pescara, Via dei Vestini 31, 66100 Chieti, Italy
| | - Gaetano Tanzilli
- Department of Cardiovascular Sciences, "Sapienza" University, Viale del Policlinico 155, 00161 Rome, Italy
| | - Susanna Morano
- Department of Experimental Medicine, "Sapienza" University, Viale del Policlinico 155, 00161 Rome, Italy
| | - Andrea Lenzi
- Department of Experimental Medicine, "Sapienza" University, Viale del Policlinico 155, 00161 Rome, Italy
| | - Stefania Basili
- Department of Translational and Precision Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Clara Crescioli
- Department of Movement, Human and Health Sciences, Section of Health Sciences, University of Rome "Foro Italico", Piazza L. de Bosis 6, 00135 Rome, Italy.
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Giannattasio S, Corinaldesi C, Colletti M, Di Luigi L, Antinozzi C, Filardi T, Scolletta S, Basili S, Lenzi A, Morano S, Crescioli C. The phosphodiesterase 5 inhibitor sildenafil decreases the proinflammatory chemokine IL-8 in diabetic cardiomyopathy: in vivo and in vitro evidence. J Endocrinol Invest 2019; 42:715-725. [PMID: 30415310 PMCID: PMC6531405 DOI: 10.1007/s40618-018-0977-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 11/01/2018] [Indexed: 01/13/2023]
Abstract
PURPOSE Interleukin (IL)-8 is a proinflammatory C-X-C chemokine involved in inflammation underling cardiac diseases, primary or in comorbid condition, such diabetic cardiomyopathy (DCM). The phosphodiesterase type 5 inhibitor sildenafil can ameliorate cardiac conditions by counteracting inflammation. The study aim is to evaluate the effect of sildenafil on serum IL-8 in DCM subjects vs. placebo, and on IL-8 release in human endothelial cells (Hfaec) and peripheral blood mononuclear cells (PBMC) under inflammatory stimuli. METHODS IL-8 was quantified: in sera of (30) DCM subjects before (baseline) and after sildenafil (100 mg/day, 3-months) vs. (16) placebo and (15) healthy subjects, by multiplatform array; in supernatants from inflammation-challenged cells after sildenafil (1 µM), by ELISA. RESULTS Baseline IL-8 was higher in DCM vs. healthy subjects (149.14 ± 46.89 vs. 16.17 ± 5.38 pg/ml, p < 0.01). Sildenafil, not placebo, significantly reduced serum IL-8 (23.7 ± 5.9 pg/ml, p < 0.05 vs. baseline). Receiver operating characteristic (ROC) curve for IL-8 was 0.945 (95% confidence interval of 0.772 to 1.0, p < 0.01), showing good capacity of discriminating the response in terms of drug-induced IL-8 decrease (sensitivity of 0.93, specificity of 0.90). Sildenafil significantly decreased IL-8 protein release by inflammation-induced Hfaec and PBMC and downregulated IL-8 mRNA in PBMC, without affecting cell number or PDE5 expression. CONCLUSION Sildenafil might be suggested as potential novel pharmacological tool to control DCM progression through IL-8 targeting at systemic and cellular level.
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Affiliation(s)
- S Giannattasio
- Department of Movement, Human and Health Sciences, Section of Health Sciences, Unit of Endocrinology, Università degli Studi di Roma "Foro Italico", 00135, Rome, Italy
| | - C Corinaldesi
- Department of Movement, Human and Health Sciences, Section of Health Sciences, Unit of Endocrinology, Università degli Studi di Roma "Foro Italico", 00135, Rome, Italy
- Institute for Cancer Genetics, University of Columbia, New York, USA
| | - M Colletti
- Department of Movement, Human and Health Sciences, Section of Health Sciences, Unit of Endocrinology, Università degli Studi di Roma "Foro Italico", 00135, Rome, Italy
| | - L Di Luigi
- Department of Movement, Human and Health Sciences, Section of Health Sciences, Unit of Endocrinology, Università degli Studi di Roma "Foro Italico", 00135, Rome, Italy
| | - C Antinozzi
- Department of Movement, Human and Health Sciences, Section of Health Sciences, Unit of Endocrinology, Università degli Studi di Roma "Foro Italico", 00135, Rome, Italy
| | - T Filardi
- Department of Experimental Medicine, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - S Scolletta
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - S Basili
- Department of Internal Medicine and Medical Specialties, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - A Lenzi
- Department of Experimental Medicine, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - S Morano
- Department of Experimental Medicine, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - C Crescioli
- Department of Movement, Human and Health Sciences, Section of Health Sciences, Unit of Endocrinology, Università degli Studi di Roma "Foro Italico", 00135, Rome, Italy.
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Santangelo C, Filardi T, Perrone G, Mariani M, Mari E, Scazzocchio B, Masella R, Brunelli R, Lenzi A, Zicari A, Morano S. Cross-talk between fetal membranes and visceral adipose tissue involves HMGB1-RAGE and VIP-VPAC2 pathways in human gestational diabetes mellitus. Acta Diabetol 2019; 56:681-689. [PMID: 30820673 DOI: 10.1007/s00592-019-01304-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 02/13/2019] [Indexed: 01/08/2023]
Abstract
AIMS Gestational diabetes mellitus (GDM) is defined as glucose intolerance that is first diagnosed during pregnancy. Maternal adipose tissue and fetal membranes secrete various molecules that are relevant players in the pathogenesis of GDM. This pilot study aimed to examine whether the expression of the high mobility group box 1 protein (HMGB1) and its receptor for advanced glycation end products (RAGE), and the vasoactive intestinal peptide (VIP) and its receptors (VPAC-1,-2) were modified in pregnant women with GDM. METHODS Fetal membranes (FMs), omental adipose tissue (VAT) explants, and serum samples were obtained from 12 women with GDM and 12 with normal glucose tolerance (NGT) at delivery. The expression of HMGB1, RAGE and VIP, VPAC-1,-2 was detected by Western Blotting in explants; circulating levels and "in vitro" release of HMGB1 and VIP were measured by ELISA tests. RESULTS HMGB1 tissue expression was higher in FMs obtained from GDM women (p = 0.02) than in FMs from NGT women. VPAC2 (p = 0.03) and RAGE (p = 0.03) tissue expressions were significantly increased in VAT from GDM subjects. Only FMs of NGT released detectable levels of HMGB1, which was not observed in samples obtained from GDM. VAT of GDM released lower levels of VIP (p = 0.05) than NGT samples. CONCLUSIONS This study indicates that a fine tuned regulation exists between FMs and VAT throughout pregnancy to maintain immune metabolic homeostasis. In GDM a balance between inflammatory and anti-inflammatory mediators has been observed. Further studies are needed to establish their exact role on fetal and maternal outcomes in GDM.
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Affiliation(s)
- Carmela Santangelo
- Center for Gender-Specific Medicine, Gender Specific Prevention and Health Unit, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
| | - Tiziana Filardi
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
| | - Giuseppina Perrone
- Department of Gynecology Obstetrics and Urology, "Sapienza" University of Rome, Rome, Italy
| | - Marianna Mariani
- Department of Gynecology Obstetrics and Urology, "Sapienza" University of Rome, Rome, Italy
| | - Emanuela Mari
- Department of Experimental Medicine, 2nd Section of Cell Pathology, Sapienza University of Rome, Viale Regina Elena 324, Rome, Italy
| | - Beatrice Scazzocchio
- Center for Gender-Specific Medicine, Gender Specific Prevention and Health Unit, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Roberta Masella
- Center for Gender-Specific Medicine, Gender Specific Prevention and Health Unit, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Roberto Brunelli
- Department of Gynecology Obstetrics and Urology, "Sapienza" University of Rome, Rome, Italy
| | - Andrea Lenzi
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
| | - Alessandra Zicari
- Department of Experimental Medicine, 2nd Section of Cell Pathology, Sapienza University of Rome, Viale Regina Elena 324, Rome, Italy
| | - Susanna Morano
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
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Fobelets M, Beeckman K, Healy P, Grylka-Baeschlin S, Nicoletti J, Devane D, Gross MM, Morano S, Daly D, Begley C, Putman K. Health economic analysis of a cluster-randomised trial (OptiBIRTH) designed to increase rates of vaginal birth after caesarean section. BJOG 2019; 126:1043-1051. [PMID: 30957402 DOI: 10.1111/1471-0528.15673] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To perform a health economic analysis of an intervention designed to increase rates of vaginal birth after caesarean, compared with usual care. DESIGN Economic analysis alongside the cluster-randomised OptiBIRTH trial (Optimising childbirth by increasing vaginal birth after caesarean section (VBAC) through enhanced women-centred care). SETTING Fifteen maternity units in three European countries - Germany (five), Ireland (five), and Italy (five) - with relatively low VBAC rates. POPULATION Pregnant women with a history of one previous lower-segment caesarean section; sites were randomised (3:2) to intervention or control. METHODS A cost-utility analysis from both societal and health-services perspectives, using a decision tree. MAIN OUTCOME MEASURES Costs and resource use per woman and infant were compared between the control and intervention group by country, from pregnancy recognition until 3 months postpartum. Based on the caesarean section rates, and maternal and neonatal morbidities and mortality, the incremental cost-utility ratios were calculated per country. RESULTS The mean difference in costs per quality-adjusted life years (QALYs) gained from a societal perspective between the intervention and the control group, using a probabilistic sensitivity analysis, was: €263 (95% CI €258-268) and 0.008 QALYs (95% CI 0.008-0.009 QALYs) for Germany, €456 (95% CI €448-464) and 0.052 QALYs (95% CI 0.051-0.053 QALYs) for Ireland, and €1174 (95% CI €1170-1178) and 0.006 QALYs (95% CI 0.005-0.007 QALYs) for Italy. The incremental cost-utility ratios were €33,741/QALY for Germany, €8785/QALY for Ireland, and €214,318/QALY for Italy, with a 51% probability of being cost-effective for Germany, 92% for Ireland, and 15% for Italy. CONCLUSION The OptiBIRTH intervention was likely to be cost-effective in Ireland and Germany. TWEETABLE ABSTRACT The OptiBIRTH intervention (to increase VBAC rates) is likely to be cost-effective in Germany and Ireland.
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Affiliation(s)
- M Fobelets
- Department of Public Health I-CHER (Interuniversity Centre for Health Economics Research), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium.,Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus University College Brussels, Brussels, Belgium
| | - K Beeckman
- Department of Public Health I-CHER (Interuniversity Centre for Health Economics Research), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Nursing and Midwifery, Nursing and Midwifery Research Group, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - P Healy
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
| | - S Grylka-Baeschlin
- Midwifery Research and Education Unit, Hannover Medical School, Hannover, Germany
| | - J Nicoletti
- School of Medicine and Midwifery, Department of Neurology, Ophthalmology, Maternal and Childhood Sciences, Genoa University, Genoa, Italy
| | - D Devane
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland.,HRB-Trials Methodology Research Network, National University of Ireland Galway, Galway, Ireland
| | - M M Gross
- Midwifery Research and Education Unit, Hannover Medical School, Hannover, Germany
| | - S Morano
- School of Medicine and Midwifery, Department of Neurology, Ophthalmology, Maternal and Childhood Sciences, Genoa University, Genoa, Italy
| | - D Daly
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - C Begley
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland.,Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - K Putman
- Department of Public Health I-CHER (Interuniversity Centre for Health Economics Research), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
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Filardi T, Carnevale V, Massoud R, Russo C, Nieddu L, Tavaglione F, Turinese I, Lenzi A, Romagnoli E, Morano S. High serum osteopontin levels are associated with prevalent fractures and worse lipid profile in post-menopausal women with type 2 diabetes. J Endocrinol Invest 2019; 42:295-301. [PMID: 29916137 DOI: 10.1007/s40618-018-0914-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 03/07/2018] [Accepted: 06/13/2018] [Indexed: 12/16/2022]
Abstract
PURPOSE Patients with type 2 diabetes (T2DM) have increased fracture risk. Osteopontin (OPN) is a protein involved in bone remodeling and inflammation. The aim of this study was to evaluate the association of OPN with fracture prevalence and with metabolic parameters in post-menopausal women with T2DM. METHODS Sixty-four post-menopausal women with T2DM (age 67.0 ± 7.8 years, diabetes duration 8.9 ± 6.7 years), enrolled in a previous study, were followed up (3.6 ± 0.9 years). Previous fragility fractures were recorded. The FRAX score (without BMD) was calculated and biochemical parameters (plasma glucose, HbA1c, lipid profile and renal function) were assessed. Serum 25OH-vitamin D, calcium, PTH and OPN were evaluated at baseline. The association between OPN and fracture prevalence at baseline was evaluated by a logistic model. RESULTS OPN levels were higher in patients with previous fractures (n.25) than in patients without previous fractures at baseline (n.39) (p = 0.006). The odds of having fractures at baseline increased by 6.7 (1.9-31.4, 95% CI, p = 0.007) for each increase of 1 ng/ml in OPN levels, after adjustment for vitamin D and HbA1c levels. Fracture incidence was 4.7%. Higher OPN associated with a decrease in HDL-cholesterol (p = 0.048), after adjustment for age, basal HDL-cholesterol, basal and follow-up HbA1c and follow-up duration. 25OH-vitamin D associated with an increase in FRAX-estimated probability of hip fracture at follow-up (p = 0.029), after adjustment for age, 25OH-vitamin D and time. CONCLUSIONS In post-menopausal women with T2DM, OPN might be a useful marker of fracture and worse lipid profile.
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Affiliation(s)
- T Filardi
- Department of Experimental Medicine, Policlinico Umberto I, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - V Carnevale
- Unit of Internal Medicine, Casa Sollievo della Sofferenza Hospital, IRCCS, San Giovanni Rotondo, Italy
| | - R Massoud
- Department of Experimental Medicine and Surgery, Tor Vergata University, Rome, Italy
| | - C Russo
- Department of Experimental Medicine and Surgery, Tor Vergata University, Rome, Italy
| | - L Nieddu
- Faculty of Economics, UNINT University, Rome, Italy
| | - F Tavaglione
- Department of Experimental Medicine, Policlinico Umberto I, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - I Turinese
- Department of Public Health and Infectious Diseases, "Sapienza" University, Rome, Italy
| | - A Lenzi
- Department of Experimental Medicine, Policlinico Umberto I, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - E Romagnoli
- Department of Experimental Medicine, Policlinico Umberto I, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - S Morano
- Department of Experimental Medicine, Policlinico Umberto I, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
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Saglimbene V, Palmer SC, Ruospo M, Natale P, Maione A, Nicolucci A, Vecchio M, Tognoni G, Craig JC, Pellegrini F, Lucisano G, Hegbrant J, Ariano R, Lamacchia O, Sasso A, Morano S, Filardi T, De Cosmo S, Pugliese G, Procaccini DA, Gesualdo L, Palasciano G, Johnson DW, Tonelli M, Strippoli GFM. The Long-Term Impact of Renin-Angiotensin System (RAS) Inhibition on Cardiorenal Outcomes (LIRICO): A Randomized, Controlled Trial. J Am Soc Nephrol 2018; 29:2890-2899. [PMID: 30420421 DOI: 10.1681/asn.2018040443] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 10/04/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The comparative effectiveness of treatment with angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), or their combination in people with albuminuria and cardiovascular risk factors is unclear. METHODS In a multicenter, randomized, open label, blinded end point trial, we evaluated the effectiveness on cardiovascular events of ACE or ARB monotherapy or combination therapy, targeting BP<130/80 in patients with moderate or severe albuminuria and diabetes or other cardiovascular risk factors. End points included a primary composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, and hospitalization for cardiovascular causes and a revised end point of all-cause mortality. Additional end points included ESRD, doubling of serum creatinine, albuminuria, eGFR, BP, and adverse events. RESULTS Because of slow enrollment, the trial was modified and stopped 41% short of targeted enrollment of 2100 participants, corresponding to 35% power to detect a 25% reduced risk in the primary outcome. Our analysis included 1243 adults, with median follow-up of 2.7 years. Efficacy outcomes were similar between groups (ACE inhibitor versus ARB, ACE inhibitor versus combination, ARB versus combination) as were rates of serious adverse events. The rate of permanent discontinuation for ARB monotherapy (6.3%) was significantly lower than for ACE inhibitor monotherapy (15.7%) or combined therapy (18.3%). CONCLUSIONS Patients may tolerate ARB monotherapy better than ACE inhibitor monotherapy. However, data from this trial and similar trials, although as yet inconclusive, show no trend suggesting differences in mortality and renal outcomes with ACE inhibitors or ARBs as dual or monotherapy in patients with albuminuria and diabetes or other cardiovascular risk factors.
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Affiliation(s)
- Valeria Saglimbene
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney, Australia.,Medical Scientific Office, Diaverum Renal Services Group, Lund, Sweden
| | - Suetonia C Palmer
- Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | - Marinella Ruospo
- Medical Scientific Office, Diaverum Renal Services Group, Lund, Sweden
| | - Patrizia Natale
- Medical Scientific Office, Diaverum Renal Services Group, Lund, Sweden.,Emergency and Organ Transplantation and
| | - Ausilia Maione
- Freelance Consultant (formerly Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, S Maria Imbaro, Chieti, Italy
| | - Antonio Nicolucci
- Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy
| | | | - Gianni Tognoni
- Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy
| | - Jonathan C Craig
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney, Australia.,College of Medicine and Public Health, Flinders University, Health Sciences Building, Adelaide 5001, South Australia
| | | | - Giuseppe Lucisano
- Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy
| | - Jörgen Hegbrant
- Medical Scientific Office, Diaverum Renal Services Group, Lund, Sweden
| | - Rosario Ariano
- Department of Nephrology and Dialysis, Azienda Ospedaliera Instituti Ospedalieri di Cremona, Cremona, Italy
| | - Olga Lamacchia
- Department of Endocrinology, Azienda Ospedaliera Universitaria Foggia, Foggia, Italy
| | - Antonio Sasso
- Department of Medicine, Ospedale Civile S. Pellegrino, Trani, Italy
| | - Susanna Morano
- Department of Clinical Sciences, Azienda Policlinico Umberto I-Università La Sapienza, Rome, Italy
| | - Tiziana Filardi
- Department of Clinical Sciences, Azienda Policlinico Umberto I-Università La Sapienza, Rome, Italy
| | - Salvatore De Cosmo
- Department of Medical Sciences, Scientific Institute Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Giuseppe Pugliese
- Department of Clinical and Molecular Medicine, "La Sapienza" University, Rome, Italy
| | - Deni A Procaccini
- Division of Nephrology, University of Foggia, Foggia, Italy; Departments of
| | | | | | - David W Johnson
- Department of Nephrology, University of Queensland at Princess Alexandra Hospital, Brisbane, Australia
| | - Marcello Tonelli
- Research Office of the Vice-President, Cumming School of Medicine, University of Calgary, Calgary, Canada; and
| | - Giovanni F M Strippoli
- Sydney School of Public Health, Faculty of Medicine and Health, Sydney, Australia; .,Medical Scientific Office, Diaverum Renal Services Group, Lund, Sweden.,Emergency and Organ Transplantation and.,Diaverum Academy, Bari, Italy
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Orsi E, Solini A, Bonora E, Fondelli C, Trevisan R, Vedovato M, Cavalot F, Gruden G, Morano S, Nicolucci A, Penno G, Pugliese G. Haemoglobin A1c variability is a strong, independent predictor of all-cause mortality in patients with type 2 diabetes. Diabetes Obes Metab 2018; 20:1885-1893. [PMID: 29582548 DOI: 10.1111/dom.13306] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 03/22/2018] [Accepted: 03/23/2018] [Indexed: 01/06/2023]
Abstract
AIMS To evaluate various measures of haemoglobin (Hb) A1c variability, compared with average HbA1c, as independent predictors of mortality. MATERIALS AND METHODS The Renal Insufficiency And Cardiovascular Events Italian multicentre study enroled 15 733 patients with type 2 diabetes from 19 diabetes clinics during 2006-2008. A total of 3 to 5 HbA1c measures, obtained during the 2-year period before enrolment, were available from 9 centres (8290 patients) and were used to calculate average HbA1c (HbA1c -MEAN) and HbA1c variability, measured as intra-individual standard deviation (HbA1c-SD), SD adjusted for the number of HbA1c assessments (HbA1c-AdjSD) and coefficient of variation (HbA1c-CV), that is, the HbA1c-SD to HbA1c-MEAN ratio. Vital status on October 31, 2015 was retrieved for 8252 patients (99.5%). RESULTS The measures of HbA1c variability increased according to quartiles of HbA1c-MEAN and vice versa. HbA1c-MEAN and measures of HbA1c variability were associated with all-cause mortality; however, the strength of association of HbA1c-MEAN was lower than that of HbA1c -SD, HbA1c-CV or HbA1c-AdjSD, and disappeared after adjusting for confounders and any of the measures of HbA1c variability. Mortality increased with quartiles of HbA1c-MEAN, HbA1c -SD, HbA1c-CV and HbA1c-AdjSD, but only the association with HbA1c variability measures remained after adjustment for confounders and/or each other measure. In the fully adjusted model, mortality risk was lower for HbA1c-SD below the median and higher for HbA1c-SD above the median, regardless of whether HbA1c-MEAN was below or above the median. Conclusions HbA1c variability is a strong, independent predictor of all-cause mortality in type 2 diabetes and appears to be even more powerful than average HbA1c in predicting mortality.
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Affiliation(s)
- Emanuela Orsi
- Diabetes Unit, Fondazione IRCCS 'Cà Granda - Ospedale Maggiore Policlinico' and Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Anna Solini
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy
| | - Enzo Bonora
- Division of Endocrinology, Diabetes and Metabolism, University and Hospital Trust of Verona, Verona, Italy
| | - Cecilia Fondelli
- Diabetes Unit, Azienda Ospedaliera Universitaria Senese, and Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Roberto Trevisan
- Endocrinology and Diabetes Unit, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | - Monica Vedovato
- Department of Clinical and Experimental Medicine, University of Padua, Padua, Italy
| | - Franco Cavalot
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
| | - Gabriella Gruden
- Department of Internal Medicine, University of Turin, Turin, Italy
| | - Susanna Morano
- Department of Experimental Medicine, 'La Sapienza' University, Rome, Italy
| | - Antonio Nicolucci
- Center for Outcomes Research and Clinical Epidemiology (CORESEARCH), Pescara, Italy
| | - Giuseppe Penno
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giuseppe Pugliese
- Department of Clinical and Molecular Medicine, 'La Sapienza' University, Rome, Italy
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Filardi T, Tavaglione F, Di Stasio M, Fazio V, Lenzi A, Morano S. Impact of risk factors for gestational diabetes (GDM) on pregnancy outcomes in women with GDM. J Endocrinol Invest 2018; 41:671-676. [PMID: 29150756 DOI: 10.1007/s40618-017-0791-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 10/30/2017] [Indexed: 01/30/2023]
Abstract
PURPOSE In this study, we evaluated the impact of risk factors for gestational diabetes on clinical/biochemical parameters and maternal/fetal outcomes. METHODS One hundred eighty-three (n 183) women (age 33.8 ± 5.5 years, 59% Caucasians, 41% non-Caucasians) with gestational diabetes were included in the study. Anamnestic information, anthropometric and laboratory parameters, and maternal and fetal outcomes at delivery were collected. RESULTS Insulin therapy prevalence was higher in Asians vs Caucasians (p = 0.006), despite lower pre-pregnancy BMI in Asians (p = 0.0001) and in pre-pregnancy overweight vs normal weight patients (p = 0.04). Insulin-treated patients had higher fasting OGTT glucose than patients on diet therapy (p = 0.003). In multivariate analysis, Asian ethnicity, age ≥ 35 years and pre-pregnancy BMI ≥ 25 kg/m2 were independent predictors of insulin therapy. Cesarean section occurred more in women aged ≥ 35 years than < 35 years (p = 0.02). Duration of pregnancy and age showed inverse correlation (r - 0.3 p = 0.013). Week of delivery was lower in patients ≥ 35 years vs patients < 35 years (p = 0.013). Fasting OGTT glucose was higher in overweight than in normal weight patients (p = 0.016). 1-h OGTT glucose was lower in obese vs normal weight (p = 0.03) and overweight patients (p = 0.03). Prevalence of prior gestational diabetes was higher in overweight/obese women (p = 0.002). CONCLUSIONS Ethnicity, age, and BMI have the heaviest impact on pregnancy outcomes.
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Affiliation(s)
- T Filardi
- Department of Experimental Medicine, Policlinico Umberto I, "Sapienza" University, Viale del Policlinico 155, 00161, Rome, Italy
| | - F Tavaglione
- Department of Experimental Medicine, Policlinico Umberto I, "Sapienza" University, Viale del Policlinico 155, 00161, Rome, Italy
| | - M Di Stasio
- Department of Experimental Medicine, Policlinico Umberto I, "Sapienza" University, Viale del Policlinico 155, 00161, Rome, Italy
| | - V Fazio
- Department of Experimental Medicine, Policlinico Umberto I, "Sapienza" University, Viale del Policlinico 155, 00161, Rome, Italy
| | - A Lenzi
- Department of Experimental Medicine, Policlinico Umberto I, "Sapienza" University, Viale del Policlinico 155, 00161, Rome, Italy
| | - S Morano
- Department of Experimental Medicine, Policlinico Umberto I, "Sapienza" University, Viale del Policlinico 155, 00161, Rome, Italy.
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Lepore G, Bonfanti R, Bozzetto L, Di Blasi V, Girelli A, Grassi G, Iafusco D, Laviola L, Rabbone I, Schiaffini R, Bruttomesso D, Mammì F, Bruzzese M, Schettino M, Nuzzo M, Di Blasi V, Fresa R, Lambiase C, Iafusco D, Zanfardino A, Confetto S, Bozzetto L, Annuzzi G, Alderisio A, Riccardi G, Gentile S, Marino G, Guarino G, Zucchini S, Maltoni G, Suprani T, Graziani V, Nizzoli M, Acquati S, Cavani R, Romano S, Michelini M, Manicardi E, Bonadonna R, Dei Cas A, Dall'aglio E, Papi M, Riboni S, Manicardi V, Manicardi E, Manicardi E, Pugni V, Lasagni A, Street M, Pagliani U, Rossi C, Assaloni R, Brunato B, Tortul C, Zanette G, Li Volsi P, Zanatta M, Tonutti L, Agus S, Pellegrini M, Ceccano P, Pozzilli G, Anguissola B, Buzzetti R, Moretti C C, Leto G, Pozzilli P, Manfrini S, Maurizi A, Leotta S, Altomare M, Abbruzzese S, Carletti S, Suraci C, Filetti S, Manca Bitti M, Arcano S, Cavallo M, De Bernardinis M, Pitocco D, Caputo S, Rizzi A, Manto A, Schiaffini R, Cappa M, Benevento D, Frontoni S, Malandrucco I, Morano S, Filardi T, Lauro D, Marini M, Castaldo E, Sabato D, Tuccinardi F, Forte E, Viterbori P, Arnaldi C, Minuto N, d'Annunzio G, Corsi A, Rota R, Scaranna C, Trevisan R, Valentini U, Girelli A, Bonfadini S, Zarra E, Plebani A, Prandi E, Felappi B, Rocca A, Meneghini E, Galli P, Ruggeri P, Carrai E, Fugazza L, Baggi V, Conti D, Bosi E, Laurenzi A, Caretto A, Molinari C, Orsi E, Grancini V, Resi V, Bonfanti R, Favalli V, Bonura C, Rigamonti A, Bonomo M, Bertuzzi F, Pintaudi B, Disoteo O, Perseghin G, Perra S, Chiovato L, De Cata P, Zerbini F, Lovati E, Laneri M, Guerraggio L, Bossi A, De Mori V, Galetta M, Meloncelli I, Aiello A A, Di Vincenzo S, Nuzzi A, Fraticelli E, Ansaldi E, Battezzati M, Lombardi M, Balbo M, Lera R, Secco A, De Donno V, Cadario F, Savastio S, Ponzani C, Aimaretti G, Rabbone I, Ignaccolo G, Tinti D, Cerutti F, Bari F, Giorgino F, Piccinno E, Zecchino O, Cignarelli M, Lamacchia O, Picca G, De Cosmo S, Rauseo A, Tomaselli L, Tumminia A, Egiziano C, Scarpitta A, Maggio F, Cardella F, Roppolo R, Provenzano V, Fleres M, Scorsone A, Scatena A, Gregori G, Lucchesi S, Gadducci F, Di Cianni S, Pancani S, Del Prato S, Aragona M, Crisci I, Calianno A, Fattor B, Crazzolara D, Reinstadler P, Longhi S, Incelli G, Rauch S, Romanelli T, Orrasch M, Cauvin V, Franceschi R, Lalli C, Pianta A, Marangoni A, Aricò C, Marin N, Nogara N, Simioni N, Filippi A, Gidoni Guarneri G, Contin M.L M, Decata A, Bondesan L, Confortin L, Coracina A, Lombardi S, Costa Padova S, Cipponeri E, Scotton R, Galasso S, Boscari F, Zanon M, Vinci C, Lisato G, Gottardo L, Bonora E, Trombetta M, Negri C, Brangani C, Maffeis C, Sabbion A, Marigliano M. Metabolic control and complications in Italian people with diabetes treated with continuous subcutaneous insulin infusion. Nutr Metab Cardiovasc Dis 2018; 28:335-342. [PMID: 29428572 DOI: 10.1016/j.numecd.2017.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 10/31/2017] [Accepted: 12/02/2017] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND AIM The objective of this cross-sectional study was to evaluate the degree of glycaemic control and the frequency of diabetic complications in Italian people with diabetes who were treated with continuous subcutaneous insulin infusion (CSII). METHODS AND RESULTS Questionnaires investigating the organisation of diabetes care centres, individuals' clinical and metabolic features and pump technology and its management were sent to adult and paediatric diabetes centres that use CSII for treatment in Italy. Information on standard clinical variables, demographic data and acute and chronic diabetic complications was derived from local clinical management systems. The sample consisted of 6623 people with diabetes, which was obtained from 93 centres. Of them, 98.8% had type 1 diabetes mellitus, 57.2% were female, 64% used a conventional insulin pump and 36% used a sensor-augmented insulin pump. The median glycated haemoglobin (HbA1c) level was 60 mmol/mol (7.6%). The HbA1c target (i.e. <58 mmol/mol for age <18 years and <53 mmol/mol for age >18 years) was achieved in 43.4% of paediatric and 23% of adult participants. Factors such as advanced pump functions, higher rate of sensor use, pregnancy in the year before the study and longer duration of diabetes were associated with lower HbA1c levels. The most common chronic complications occurring in diabetes were retinopathy, microalbuminuria and hypertension. In the year before the study, 5% of participants reported ≥1 episode of severe hypoglycaemic (SH) episodes (SH) and 2.6% reported ≥1 episode of ketoacidosis. CONCLUSIONS Advanced personal skills and use of sensor-based pump are associated with better metabolic control outcomes in Italian people with diabetes who were treated with CSII. The reduction in SH episodes confirms the positive effect of CSII on hypoglycaemia. CLINICAL TRIAL REGISTRATION NUMBER NCT 02620917 (ClinicalTrials.gov).
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Raparelli V, Morano S, Franconi F, Lenzi A, Basili S. Sex Differences in Type-2 Diabetes: Implications for Cardiovascular Risk Management. Curr Pharm Des 2018; 23:1471-1476. [PMID: 28137219 DOI: 10.2174/1381612823666170130153704] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 01/27/2017] [Indexed: 01/07/2023]
Abstract
BACKGROUND Among individuals with Type 2 diabetes (T2DM), cardiovascular disease (CVD) is the leading cause of morbidity and mortality. Sex and gender differences (SGDs) in the cardiovascular consequences of T2DM are relevant suggesting the need for a more aggressive CVD preventive strategy in diabetic women as they lose the so-called &quot;female advantage&quot; in terms of CVD risk comparing with the nondiabetic population. Multiple factors may explain the disproportion in CVD risk among women with diabetes comparing with diabetic men or non-diabetic women. Both genetic and hormonal factors only partially explain SGDs in CVD risk in diabetes. However, women likely reach diagnosis later and in worse conditions, they undergo both diagnostic and therapeutic supports in lower percentage and, finally, they are not able to obtain therapeutic goals recommended by guidelines. Concerning the cardiovascular system, diabetes amplifies the extent of damage at both micro- and macrovascular level differently among sexes. METHODS The aim of this review is to clarify, in a sex and gender perspective, the impact of diabetes in CVD risk and to summarize the most important SGDs in CVD primary and secondary prevention strategies such as antiplatelet drugs and statins. RESULTS The efficacy of ASA and/or statins in secondary prevention is documented in both sexes independently by the presence of T2DM. A different approach to CVD primary prevention with ASA using the age cut-off to discriminate sex differences has been recommended. The use of statins for primary prevention in women should be accurately monitored for the occurrence of myalgia and risk of developing diabetes. CONCLUSION A gender approach in CVD prevention strategies is urgently required to achieve a sensible reduction of adverse CV events.
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Affiliation(s)
- Valeria Raparelli
- Department of Experimental Medicine, Sapienza University of Rome, Italy
| | - Susanna Morano
- Department of Experimental Medicine, Sapienza University of Rome, Italy
| | - Flavia Franconi
- Department of Biomedical Sciences, University of Sassari, Laboratory of Sex-Gender Medicine, National Institute of Biostructures and Biosystems, Osilo, Italy
| | - Andrea Lenzi
- Department of Experimental Medicine, Sapienza University of Rome, Italy
| | - Stefania Basili
- Department of Internal Medicine and Medical Specialties, Viale del Policlinico 155, 00144 Rome, Italy
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Morano S, Migliorini L, Rania N, Piano L, Tassara T, Nicoletti J, Lundgren I. Emotions in labour: Italian obstetricians' experiences of presence during childbirth. J Reprod Infant Psychol 2017. [PMID: 29517301 DOI: 10.1080/02646838.2017.1395399] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The present study represents a qualitative research aimed to explore the obstetricians' psychological experiences of birth. BACKGROUND During labour the role of obstetricians assumes a fundamental importance in hospitalised childbirth. However, literature analysis has shown that the psychological side of birth has been investigated only considering the woman's and midwife's points of view. The obstetricians' psychological experiences have not been considered enough and only a few studies at a quantitative level have been performed. METHODS Seven focus groups for a total of 72 obstetricians were conducted in hospital contexts in Italy. The qualitative methodology of grounded theory was adopted. FINDINGS The results were divided into three different core themes: obstetricians' approaches to delivery, critical aspects about relationships in the delivery room, and obstetricians' feelings and emotions in the delivery room. Each theme was subdivided into different subthemes. CONCLUSION The results highlight different ways obstetricians approach their profession, the complex and multifaceted relationship with the woman and the extraordinary variety of feelings and emotions, which enrich, but also may complicate, life in the delivery room. Further studies could provide more details to help researchers to develop new and more effective strategies to support obstetricians' training and work.
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Affiliation(s)
- S Morano
- a Department of Neurosciences, Rehabilitation, Ophtalmology, Genetics, Mother Infant Sciences , University of Genoa , Genova , Italy
| | - L Migliorini
- b Department of Education Sciences , University of Genoa , Genoa , Italy
| | - N Rania
- b Department of Education Sciences , University of Genoa , Genoa , Italy
| | - L Piano
- b Department of Education Sciences , University of Genoa , Genoa , Italy
| | - T Tassara
- b Department of Education Sciences , University of Genoa , Genoa , Italy
| | - J Nicoletti
- a Department of Neurosciences, Rehabilitation, Ophtalmology, Genetics, Mother Infant Sciences , University of Genoa , Genova , Italy
| | - I Lundgren
- c Institute of Health and Care Sciences , The Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden
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Turinese I, Marinelli P, Bonini M, Rossetti M, Statuto G, Filardi T, Paris A, Lenzi A, Morano S, Palange P. "Metabolic and cardiovascular response to exercise in patients with type 1 diabetes". J Endocrinol Invest 2017; 40:999-1005. [PMID: 28386795 DOI: 10.1007/s40618-017-0670-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 03/30/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE Physical activity is an effective therapeutic tool for cardiovascular risk prevention. However, exercise aerobic capacity of patients with type 1 diabetes (T1DM) has not been thoroughly investigated. Aim of the present study is to evaluate exercise aerobic capacity in patients with T1DM compared to a normal control population. METHODS This observational study included 17 T1DM patients and 17 matched healthy volunteers. Cardiopulmonary exercise test (CPET) was conducted on an electronically-braked cycle ergometer. Blood samples were collected for evaluation of glycemia and lactate levels. RESULTS Mean oxygen uptake at peak exercise (V'O2,peak) was significantly lower in T1DM subjects (V'O2,peak T1DM 2200 ± 132ml/min vs V'O2,peak Healthy subjects of 2659 ± 120 ml/min p = 0.035). Cardiovascular response analysis did not show statistically significant differences. Respiratory exchange ratio (RER) was significantly higher in healthy subjects at peak exercise and at the first minute of recovery (p = 0.022, p = 0.024). Peak exercise lactate levels were significantly higher in healthy subjects. There was no statistical correlation between CPET results and diabetes-related parameters. CONCLUSIONS Patients affected by T1DM have a worse exercise tolerance than normal subjects. The two groups differed by RER which can be greatly influenced by the substrate type utilized to produce energy. Because of the impaired carbohydrate utilization, T1DM subjects may use a larger amount of lipid substrates, such hypothesis could be strengthened by the lower lactate levels found in T1DM group at peak exercise. The lack of correlation between exercise tolerance and disease-related variables suggests that the alterations found could be independent from the glycemic levels.
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Affiliation(s)
- I Turinese
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Viale dell' Università 37, 00185, Rome, Italy.
| | - P Marinelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Viale dell' Università 37, 00185, Rome, Italy
| | - M Bonini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Viale dell' Università 37, 00185, Rome, Italy
| | - M Rossetti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Viale dell' Università 37, 00185, Rome, Italy
| | - G Statuto
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Viale dell' Università 37, 00185, Rome, Italy
| | - T Filardi
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 151, 00185, Rome, Italy
| | - A Paris
- Department of Clinical Medicine, "Sapienza" University of Rome, Viale dell' Università 37, 00185, Rome, Italy
| | - A Lenzi
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 151, 00185, Rome, Italy
| | - S Morano
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 151, 00185, Rome, Italy
| | - P Palange
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Viale dell' Università 37, 00185, Rome, Italy
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Giorgi A, Tempera I, Napoletani G, Drovandi D, Potestà C, Martire S, Mandosi E, Filardi T, Eugenia Schininà M, Morano S, d'Erme M, Maras B. Poly(ADP-ribosylated) proteins in mononuclear cells from patients with type 2 diabetes identified by proteomic studies. Acta Diabetol 2017; 54:833-842. [PMID: 28608282 DOI: 10.1007/s00592-017-1013-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Accepted: 06/01/2017] [Indexed: 12/15/2022]
Abstract
AIMS In diabetes, hyperglycemia increases reactive oxygen species that induce DNA damage and poly(ADP-ribose)polymerase activation. The aim of this study is to characterize the proteomic profile and the role of poly(ADP-ribosylation) in patients with type 2 diabetes. METHODS A proteomic platform based on 2DE and MALDI-ToF spectrometry was applied to peripheral blood mononuclear cells obtained from two different cohorts in which diabetic (n = 14) and normoglycemic patients (n = 11) were enrolled. RESULTS Proteomic maps identified WD repeat protein, 78-kDa glucose-regulated protein precursor and myosin regulatory light chain 2, as unique proteins in diabetic patients; vimentin, elongation factor 2, annexin A1, glutathione S-transferase P, moesin and cofilin-1 as unique in the normoglycemic; and calreticulin, rho GDP-dissociation inhibitor 2, protein disulfide isomerase and tropomyosin alpha-4-chain as differentially expressed between the two cohorts. An enrichment in PARylation in diabetic patients was observed in particular, affecting GAPDH and α-Enolase leading to a decrease in their enzymatic activity. CONCLUSIONS As the GAPDH and α-Enolase are involved in energy metabolism, protein synthesis and DNA repair, loss of their function or change in their activity can significantly contribute to the molecular mechanisms responsible for the development of type 2 diabetes. These data along with the proteomic profile associated with the disease may provide new insight into the pathophysiology of type 2 diabetes.
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Affiliation(s)
- Alessandra Giorgi
- Departments of Biochemical Sciences and of Experimental Medicine, Sapienza University of Roma, Rome, Italy
| | - Italo Tempera
- Department of Microbiology and Immunology, Fels Institute for Cancer Research, Temple University School of Medicine, Philadelphia, PA, USA
| | - Giorgia Napoletani
- Departments of Biochemical Sciences and of Experimental Medicine, Sapienza University of Roma, Rome, Italy
| | - Diego Drovandi
- Departments of Biochemical Sciences and of Experimental Medicine, Sapienza University of Roma, Rome, Italy
| | - Cinzia Potestà
- Departments of Biochemical Sciences and of Experimental Medicine, Sapienza University of Roma, Rome, Italy
| | - Sara Martire
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Elisabetta Mandosi
- Departments of Biochemical Sciences and of Experimental Medicine, Sapienza University of Roma, Rome, Italy
| | - Tiziana Filardi
- Departments of Biochemical Sciences and of Experimental Medicine, Sapienza University of Roma, Rome, Italy
| | - M Eugenia Schininà
- Departments of Biochemical Sciences and of Experimental Medicine, Sapienza University of Roma, Rome, Italy
| | - Susanna Morano
- Departments of Biochemical Sciences and of Experimental Medicine, Sapienza University of Roma, Rome, Italy
| | - Maria d'Erme
- Departments of Biochemical Sciences and of Experimental Medicine, Sapienza University of Roma, Rome, Italy.
| | - Bruno Maras
- Departments of Biochemical Sciences and of Experimental Medicine, Sapienza University of Roma, Rome, Italy
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Pallotta N, Filardi T, Carnovale A, Nieddu L, Mariani P, Vincoli G, Lenzi A, Morano S. Two-hour postload glycemia is associated to an increased risk of NAFLD in healthy subjects with family history of type 2 diabetes: a case control study. Endocrine 2017; 57:352-355. [PMID: 27422790 DOI: 10.1007/s12020-016-1008-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 05/28/2016] [Indexed: 01/01/2023]
Affiliation(s)
- Nadia Pallotta
- Department of Internal Medicine and Medical Specialties "Sapienza" University, Viale del Policlinico 155, Rome, 00161, Italy
| | - Tiziana Filardi
- Department of Experimental Medicine, "Sapienza" University, Viale del Policlinico 155, Rome, 00161, Italy
| | - Anna Carnovale
- Department of Experimental Medicine, "Sapienza" University, Viale del Policlinico 155, Rome, 00161, Italy
| | - Luciano Nieddu
- Faculty of Economics, UNINT University, via Cristoforo Colombo 200, Rome, 00145, Italy
| | - Paola Mariani
- Department of General Surgery "P. Stefanini", "Sapienza" University, Viale del Policlinico 155, Rome, 00161, Italy
| | - Giuseppina Vincoli
- Department of Internal Medicine and Medical Specialties "Sapienza" University, Viale del Policlinico 155, Rome, 00161, Italy
| | - Andrea Lenzi
- Department of Experimental Medicine, "Sapienza" University, Viale del Policlinico 155, Rome, 00161, Italy
| | - Susanna Morano
- Department of Experimental Medicine, "Sapienza" University, Viale del Policlinico 155, Rome, 00161, Italy.
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Prudente S, Di Paola R, Pezzilli S, Garofolo M, Lamacchia O, Filardi T, Mannino GC, Mercuri L, Alberico F, Scarale MG, Sesti G, Morano S, Penno G, Cignarelli M, Copetti M, Trischitta V. Pharmacogenetics of oral antidiabetes drugs: evidence for diverse signals at the IRS1 locus. Pharmacogenomics J 2017; 18:431-435. [PMID: 28696414 DOI: 10.1038/tpj.2017.32] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Revised: 03/27/2017] [Accepted: 04/14/2017] [Indexed: 01/01/2023]
Abstract
To investigate the role of IRS1 locus on failure to oral antidiabetes drugs (OADs) we genotyped single-nucleotide polymorphisms (SNPs), rs2943641, rs7578326 (tagging all SNPs genome-wide associated with type 2 diabetes (T2D) and related traits at this locus) and rs1801278 (that is, the loss-of-function IRS1 G972R amino acid substitution) in 2662 patients with T2D. Although no association with OAD failure was observed for rs2943641 and rs7578326 SNPs (odds ratio (OR): 1.04, 95% confidence interval (CI): 0.93-1.16 and OR: 0.97, 95% CI: 0.87-1.09 respectively), a significant association was observed for rs1801278 (OR: 1.34, 95% CI: 1.08-1.66). When meta-analyzed with previous published data, an allelic OR of 1.41 (1.15-1.72; P=0.001) was obtained, so that homozygous R972R individuals have >80% higher risk of failing to OADs as compared with their G972G counterparts. In all, though further studies are needed for confirming this finding, our present data point to IRS1 rs1801278 as a potential biomarker for pursuing the goal of stratified medicine in the field of antihyperglycemic treatment in T2D.
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Affiliation(s)
- S Prudente
- Research Unit of Metabolic and Cardiovascular Diseases, IRCCS 'Casa Sollievo della Sofferenza', San Giovanni Rotondo, Italy
| | - R Di Paola
- Research Unit of Diabetes and Endocrine Diseases, IRCCS 'Casa Sollievo della Sofferenza', San Giovanni Rotondo, Italy
| | - S Pezzilli
- Research Unit of Metabolic and Cardiovascular Diseases, IRCCS 'Casa Sollievo della Sofferenza', San Giovanni Rotondo, Italy.,Department of Experimental Medicine, 'Sapienza' University, Rome, Italy
| | - M Garofolo
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - O Lamacchia
- Unit of Endocrinology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - T Filardi
- Department of Experimental Medicine, 'Sapienza' University, Rome, Italy
| | - G C Mannino
- Department of Medical and Surgeon Science, University Magna Graecia, Catanzaro, Italy
| | - L Mercuri
- Research Unit of Metabolic and Cardiovascular Diseases, IRCCS 'Casa Sollievo della Sofferenza', San Giovanni Rotondo, Italy
| | - F Alberico
- Research Unit of Metabolic and Cardiovascular Diseases, IRCCS 'Casa Sollievo della Sofferenza', San Giovanni Rotondo, Italy
| | - M G Scarale
- Research Unit of Diabetes and Endocrine Diseases, IRCCS 'Casa Sollievo della Sofferenza', San Giovanni Rotondo, Italy.,Unit of Biostatistics, IRCCS 'Casa Sollievo della Sofferenza', San Giovanni Rotondo, Italy
| | - G Sesti
- Department of Medical and Surgeon Science, University Magna Graecia, Catanzaro, Italy
| | - S Morano
- Department of Experimental Medicine, 'Sapienza' University, Rome, Italy
| | - G Penno
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - M Cignarelli
- Unit of Endocrinology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - M Copetti
- Unit of Biostatistics, IRCCS 'Casa Sollievo della Sofferenza', San Giovanni Rotondo, Italy
| | - V Trischitta
- Research Unit of Metabolic and Cardiovascular Diseases, IRCCS 'Casa Sollievo della Sofferenza', San Giovanni Rotondo, Italy.,Research Unit of Diabetes and Endocrine Diseases, IRCCS 'Casa Sollievo della Sofferenza', San Giovanni Rotondo, Italy.,Department of Experimental Medicine, 'Sapienza' University, Rome, Italy
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43
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Tiberti C, Montuori M, Panimolle F, Trovato CM, Anania C, Valitutti F, Vestri AR, Lenzi A, Cucchiara S, Morano S. Screening for Type 1 Diabetes-, Thyroid-, Gastric-, and Adrenal-Specific Humoral Autoimmunity in 529 Children and Adolescents With Celiac Disease at Diagnosis Identifies as Positive One in Every Nine Patients. Diabetes Care 2017; 40:e10-e11. [PMID: 27899493 DOI: 10.2337/dc16-2095] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 10/28/2016] [Indexed: 02/03/2023]
Affiliation(s)
- Claudio Tiberti
- Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Monica Montuori
- Department of Pediatrics, Pediatric Gastroenterology and Liver Unit, "Sapienza" University of Rome, Rome, Italy
| | - Francesca Panimolle
- Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Chiara M Trovato
- Department of Pediatrics, Pediatric Gastroenterology and Liver Unit, "Sapienza" University of Rome, Rome, Italy
| | - Caterina Anania
- Department of Pediatrics, Pediatric Gastroenterology and Liver Unit, "Sapienza" University of Rome, Rome, Italy
| | - Francesco Valitutti
- Department of Pediatrics, Pediatric Gastroenterology and Liver Unit, "Sapienza" University of Rome, Rome, Italy
| | - Anna R Vestri
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy
| | - Andrea Lenzi
- Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Salvatore Cucchiara
- Department of Pediatrics, Pediatric Gastroenterology and Liver Unit, "Sapienza" University of Rome, Rome, Italy
| | - Susanna Morano
- Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy
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Romagnoli E, Lubrano C, Carnevale V, Costantini D, Nieddu L, Morano S, Migliaccio S, Gnessi L, Lenzi A. Assessment of trabecular bone score (TBS) in overweight/obese men: effect of metabolic and anthropometric factors. Endocrine 2016; 54:342-347. [PMID: 26815904 DOI: 10.1007/s12020-016-0857-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Accepted: 01/02/2016] [Indexed: 12/19/2022]
Abstract
The "trabecular bone score" (TBS) indirectly explores bone quality, independently of bone mineral density (BMD). We investigated the effects of anthropometric and metabolic parameters on TBS in 87 overweight/obese men. We assessed BMD and TBS by DXA, and some parameters of glucose metabolism, sex-and calciotropic hormone levels. Regression models were adjusted for either age and BMI, or age and waist circumference, or age and waist/hip ratio, also considering BMI >35 (y/n) and metabolic syndrome (MS) (y/n). Correlations between TBS and parameters studied were higher when correcting for waist circumference, although not significant in subjects with BMI >35. The analysis of covariance showed that the same model always had a higher adjusted r-square index. BMD at lumbar spine and total hip, fasting glucose, bioavailable testosterone, and sex hormone-binding globulin are the only covariates having a significant effect (p < 0.05) on the variations of TBS. The presence of MS negatively affected only the association between TBS and BMD at total hip. We did not find any significant effect of BMI >35 on TBS values or significant interaction terms between each covariate and either BMI >35 or the presence of MS. Obesity negatively affected TBS, despite unchanged BMD. Alterations of glucose homeostasis and sex hormone levels seem to influence this relationship, while calciotropic hormones have no role. The effect of waist circumference on TBS is more pronounced than that of BMI.
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Affiliation(s)
- Elisabetta Romagnoli
- Department of Experimental Medicine, Medical Pathophysiology, Food and Science and Endocrinology Section, "Sapienza" University of Rome, Rome, Italy.
| | - Carla Lubrano
- Department of Experimental Medicine, Medical Pathophysiology, Food and Science and Endocrinology Section, "Sapienza" University of Rome, Rome, Italy
| | - Vincenzo Carnevale
- Unit of Internal Medicine, ''Casa Sollievo della Sofferenza'' Hospital I.R.C.C.S., San Giovanni Rotondo, FG, Italy
| | - Daniela Costantini
- Department of Experimental Medicine, Medical Pathophysiology, Food and Science and Endocrinology Section, "Sapienza" University of Rome, Rome, Italy
| | | | - Susanna Morano
- Department of Experimental Medicine, Medical Pathophysiology, Food and Science and Endocrinology Section, "Sapienza" University of Rome, Rome, Italy
| | - Silvia Migliaccio
- Endocrinology Unit, Department of Movement, Human and Health Sciences, University of "Foro Italico", Rome, Italy
| | - Lucio Gnessi
- Department of Experimental Medicine, Medical Pathophysiology, Food and Science and Endocrinology Section, "Sapienza" University of Rome, Rome, Italy
| | - Andrea Lenzi
- Department of Experimental Medicine, Medical Pathophysiology, Food and Science and Endocrinology Section, "Sapienza" University of Rome, Rome, Italy
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45
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Santangelo C, Filesi C, Varì R, Scazzocchio B, Filardi T, Fogliano V, D'Archivio M, Giovannini C, Lenzi A, Morano S, Masella R. Consumption of extra-virgin olive oil rich in phenolic compounds improves metabolic control in patients with type 2 diabetes mellitus: a possible involvement of reduced levels of circulating visfatin. J Endocrinol Invest 2016; 39:1295-1301. [PMID: 27344308 DOI: 10.1007/s40618-016-0506-9] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 06/16/2016] [Indexed: 12/11/2022]
Abstract
AIM Phenolic compounds naturally contained in extra-virgin olive oil (EVOO) have demonstrated anti-inflammatory and antioxidant properties. The present study aimed at evaluating the effects of a polyphenol-rich extra-virgin olive oil (EVOO) (high-polyphenol EVOO, HP-EVOO) on the metabolic control and the production of specific pro-/anti-inflammatory adipokines in overweight patients with type 2 diabetes mellitus (T2D). METHODS Eleven overweight T2D patients not in treatment with insulin were invited to follow their habitual diet for a total of 8 weeks. During the first 4 weeks (wash-out period), they were asked to consume refined olive oil (ROO, polyphenols not detectable) and then to replace ROO with HP-EVOO (25 mL/day, 577 mg of phenolic compounds/kg) for the remaining 4 weeks. Anthropometric parameters, fasting glycaemia, glycated haemoglobin (HbA1c), high-sensitive C-reactive protein, plasma lipid profile, liver function and serum levels of TNF-α, IL-6, adiponectin, visfatin and apelin were assessed at the end of each 4-week period. RESULTS HP-EVOO consumption significantly reduced fasting plasma glucose (P = 0.023) and HbA1c (P = 0.039) levels as well as BMI (P = 0.012) and body weight (P = 0.012). HP-EVOO ingestion determined a reduction in serum level of aspartate aminotransferase (AST, P = 0.0056) and alanine aminotransferase (ALT, P = 0.024). Serum visfatin levels strongly decreased after HP-EVOO ingestion (P = 0.0021). CONCLUSIONS Daily consumption of polyphenol-rich EVOO might improve metabolic control and circulating inflammatory adipokines profile in overweight T2D patients.
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Affiliation(s)
- C Santangelo
- Unit of Nutrition, Department of Veterinary Public Health and Food Safety, Italian National Institute of Health, Viale Regina Elena 299, 00161, Rome, Italy.
| | - C Filesi
- Unit of Nutrition, Department of Veterinary Public Health and Food Safety, Italian National Institute of Health, Viale Regina Elena 299, 00161, Rome, Italy
| | - R Varì
- Unit of Nutrition, Department of Veterinary Public Health and Food Safety, Italian National Institute of Health, Viale Regina Elena 299, 00161, Rome, Italy
| | - B Scazzocchio
- Unit of Nutrition, Department of Veterinary Public Health and Food Safety, Italian National Institute of Health, Viale Regina Elena 299, 00161, Rome, Italy
| | - T Filardi
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - V Fogliano
- Food Quality and Design Group, Wageningen University, Wageningen, The Netherlands
| | - M D'Archivio
- Unit of Nutrition, Department of Veterinary Public Health and Food Safety, Italian National Institute of Health, Viale Regina Elena 299, 00161, Rome, Italy
| | - C Giovannini
- Unit of Nutrition, Department of Veterinary Public Health and Food Safety, Italian National Institute of Health, Viale Regina Elena 299, 00161, Rome, Italy
| | - A Lenzi
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - S Morano
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - R Masella
- Unit of Nutrition, Department of Veterinary Public Health and Food Safety, Italian National Institute of Health, Viale Regina Elena 299, 00161, Rome, Italy
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46
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Pacilli A, Fallarino M, Massa M, Filardi T, De Cosmo S, Morano S, Trischitta V. Patient/disease features and glycemic targets in type 2 diabetes: Where do we stand? Acta Diabetol 2016; 53:673-5. [PMID: 26754323 DOI: 10.1007/s00592-015-0833-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 12/25/2015] [Indexed: 10/22/2022]
Affiliation(s)
- A Pacilli
- Department of Medical Sciences, Scientific Institute "Casa Sollievo della Sofferenza", S. Giovanni Rotondo, FG, Italy.
| | - M Fallarino
- Department of Experimental Medicine, "Sapienza" University, Rome, Italy
| | - M Massa
- Department of Medical Sciences, Scientific Institute "Casa Sollievo della Sofferenza", S. Giovanni Rotondo, FG, Italy
| | - T Filardi
- Department of Experimental Medicine, "Sapienza" University, Rome, Italy
| | - S De Cosmo
- Department of Medical Sciences, Scientific Institute "Casa Sollievo della Sofferenza", S. Giovanni Rotondo, FG, Italy
| | - S Morano
- Department of Experimental Medicine, "Sapienza" University, Rome, Italy
| | - V Trischitta
- Department of Experimental Medicine, "Sapienza" University, Rome, Italy
- Research Unit of Diabetes and Endocrine Diseases, Scientific Institute "Casa Sollievo della Sofferenza", S. Giovanni Rotondo, FG, Italy
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47
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Barchetta I, Capoccia D, Baroni MG, Buzzetti R, Cavallo MG, De Cosmo S, Leonetti F, Leotta S, Morano S, Morviducci L, Prudente S, Pugliese G, Trischitta V. The "Sapienza University Mortality and Morbidity Event Rate (SUMMER) study in diabetes": Study protocol. Nutr Metab Cardiovasc Dis 2016; 26:103-108. [PMID: 26698225 DOI: 10.1016/j.numecd.2015.09.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 06/24/2015] [Revised: 09/21/2015] [Accepted: 09/28/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND AIMS The rate of mortality in diabetic patients, especially of cardiovascular origin, is about twice as much that of nondiabetic individuals. Thus, the pathogenic factors shaping the risk of mortality in such patients must be unraveled in order to target intensive prevention and treatment strategies. The "Sapienza University Mortality and Morbidity Event Rate (SUMMER) study in diabetes" is aimed at identifying new molecular promoters of mortality and major vascular events in patients with type 2 diabetes mellitus (T2DM). METHODS/DESIGN The "SUMMER study in diabetes" is an observational, prospective, and collaborative study conducted on at least 5000 consecutive patients with T2DM, recruited from several diabetes clinics of Central-Southern Italy and followed up for a minimum of 5 years. The primary outcome is all-cause mortality; the secondary outcomes are cardiovascular mortality, acute myocardial infarction, stroke, and dialysis. A biobank will be created for genomic, transcriptomic, and metabolomic analysis, in order to unravel new molecular predictors of mortality and vascular morbidity. DISCUSSION The "SUMMER study in diabetes" is aimed at identifying new molecular promoters of mortality and major vascular events in patients with T2DM. These novel pathogenic factors will most likely be instrumental in unraveling new pathways underlying such dramatic events. In addition, they will also be used as additional markers to increase the performance of the already existing risk-scoring models for predicting the above-mentioned outcomes in T2DM, as well as for setting up new preventive and treatment strategies, possibly tailored to specific pathogenic backgrounds. TRIAL REGISTRATION ClinicalTrials.gov, NCT02311244; URL https://clinicaltrials.gov/ct2/show/NCT02311244?term=SUMMER&rank=5.
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Affiliation(s)
- I Barchetta
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - D Capoccia
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - M G Baroni
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - R Buzzetti
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - M G Cavallo
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - S De Cosmo
- IRCSS Casa Sollievo della Sofferenza, Department of Medicine, San Giovanni Rotondo, Italy
| | - F Leonetti
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - S Leotta
- Unit of Diabetology, Ospedale Sandro Pertini, Rome, Italy
| | - S Morano
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - L Morviducci
- Unit of Diabetology, Ospedale San Camillo Forlanini, Rome, Italy
| | - S Prudente
- IRCCS Casa Sollievo della Sofferenza, Mendel-Laboratory, San Giovanni Rotondo, Italy
| | - G Pugliese
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - V Trischitta
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy; IRCCS Casa Sollievo della Sofferenza, Mendel-Laboratory, San Giovanni Rotondo, Italy.
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48
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Bonetti I, Sceni G, Cefalì E, Morano S, Scaffidi V, Guerrisi M. Performance characteristics of biograph mCT TOF-PET/CT scanner. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.01.342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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49
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Tavaglione F, Filardi T, Fallarino M, Mandosi E, Turinese I, Rossetti M, Lenzi A, Morano S. The SNP rs9677 of VPAC1 gene is associated with glycolipid control and heart function in female patients with type 2 diabetes: A follow-up study. Nutr Metab Cardiovasc Dis 2016; 26:109-113. [PMID: 26712708 DOI: 10.1016/j.numecd.2015.10.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 08/31/2015] [Accepted: 10/21/2015] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND AIMS In a previous study, the single-nucleotide polymorphism (SNP) rs9677, mapped in the 3'-UTR of vasoactive intestinal peptide receptor 1 (VPAC1) gene, was found to be associated with type 2 diabetes (T2D) in Caucasian women. Moreover, the CC genotype correlated with a worse glycolipid profile. The objectives of this study were to confirm this correlation and assess the prevalence of coronary artery disease (CAD) in the previously investigated diabetic women after a follow-up of 4.6 years. METHODS AND RESULTS A total of 143 women with T2D, with 53 carrying the CC genotype (age: 71.7 ± 7.4 years, diabetes duration: 17.2 ± 9.9 years) and 90 carrying the CT + TT genotypes (age: 69.4 ± 8.8 years, diabetes duration: 14.3 ± 8.2 years), were followed up for 4.6 ± 1.8 years. At follow-up, the clinical and haematochemical parameters were analysed. Twelve-lead electrocardiography, Doppler echocardiography and the percentage of patients with acute myocardial infarction (AMI) or of those subjected to coronary angioplasty and coronary artery bypass surgery were evaluated. At follow-up, there was no significant difference in terms of the clinical and haematochemical parameters between the two groups. However, despite a significantly increased use of statin therapy, no significant improvement in the LDL cholesterol levels was observed in CC female patients unlike those with CT + TT (P = 0.02). Moreover, the CC female patients presented a significantly higher percentage of echocardiographic abnormalities (P = 0.035), especially left ventricular (LV) diastolic dysfunction (P = 0.04). CONCLUSIONS The rs9677 CC genotype could be correlated with a reduced response to statin therapy and seems to be involved in diabetes cardiomyopathy in female patients with T2D.
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MESH Headings
- 3' Untranslated Regions
- Aged
- Angioplasty, Balloon, Coronary
- Biomarkers/blood
- Cholesterol, LDL/blood
- Coronary Artery Bypass
- Coronary Artery Disease/ethnology
- Coronary Artery Disease/genetics
- Coronary Artery Disease/physiopathology
- Coronary Artery Disease/therapy
- Diabetes Mellitus, Type 2/diagnosis
- Diabetes Mellitus, Type 2/ethnology
- Diabetes Mellitus, Type 2/genetics
- Diabetic Angiopathies/ethnology
- Diabetic Angiopathies/genetics
- Diabetic Angiopathies/physiopathology
- Diabetic Angiopathies/therapy
- Diabetic Cardiomyopathies/ethnology
- Diabetic Cardiomyopathies/genetics
- Diabetic Cardiomyopathies/physiopathology
- Diabetic Cardiomyopathies/therapy
- Dyslipidemias/blood
- Dyslipidemias/drug therapy
- Dyslipidemias/ethnology
- Dyslipidemias/genetics
- Echocardiography, Doppler
- Electrocardiography
- Female
- Follow-Up Studies
- Gene Frequency
- Genetic Association Studies
- Genetic Predisposition to Disease
- Humans
- Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use
- Italy/epidemiology
- Middle Aged
- Myocardial Infarction/ethnology
- Myocardial Infarction/genetics
- Myocardial Infarction/physiopathology
- Phenotype
- Polymorphism, Single Nucleotide
- Prevalence
- Receptors, Vasoactive Intestinal Polypeptide, Type I/genetics
- Risk Factors
- Time Factors
- Ventricular Dysfunction, Left/ethnology
- Ventricular Dysfunction, Left/genetics
- Ventricular Dysfunction, Left/physiopathology
- White People/genetics
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Affiliation(s)
- F Tavaglione
- Department of Experimental Medicine, "Sapienza" University, Rome, Italy
| | - T Filardi
- Department of Experimental Medicine, "Sapienza" University, Rome, Italy
| | - M Fallarino
- Department of Experimental Medicine, "Sapienza" University, Rome, Italy
| | - E Mandosi
- Department of Experimental Medicine, "Sapienza" University, Rome, Italy
| | - I Turinese
- Department of Experimental Medicine, "Sapienza" University, Rome, Italy
| | - M Rossetti
- Department of Experimental Medicine, "Sapienza" University, Rome, Italy
| | - A Lenzi
- Department of Experimental Medicine, "Sapienza" University, Rome, Italy
| | - S Morano
- Department of Experimental Medicine, "Sapienza" University, Rome, Italy.
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50
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Caputo S, Maran A, Mannino D, Morano S, Lastoria G, Nicoziani P. Safety and effectiveness of insulin detemir in combination with oral antidiabetic agents in an outpatient specialist setting: results of the Italian SOLVE™ observational study. MINERVA ENDOCRINOL 2015; 40:249-258. [PMID: 26551483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIM The addition of basal insulin to oral antidiabetics (OADs) is described by a large number of guidelines and commonly used in clinical practice as a way to start insulin therapy in patients with type 2 diabetes mellitus in order to maximize compliance and minimise the impact of side effects (mainly hypoglycemia and body weight increase). METHODS SOLVE™ was a 24-week international observational study conducted in 10 countries (including Italy) for the evaluation of the safety and effectiveness of once-daily insulin detemir as add-on therapy in patients with type 2 diabetes mellitus (T2DM) already treated with one or more OADs. The Italian arm of the Solve™ Study aimed to evaluate the safety and the effectiveness of once-daily insulin detemir in combination with OAD agents for the treatment of patients with T2DM in the Italian outpatient specialist setting. The primary endpoint was to assess the incidence of serious adverse drug reactions (SADRs) including in the specific major hypoglycemic events during 24 weeks of once-daily insulin detemir treatment. RESULTS A total of 4625 patients were enrolled in the study by 223 Italian centres for diabetes care. At baseline the mean (±SD) demographic characteristics of the patients were: age 66.5 (±10.0) years, duration of diabetes 13.25 (±8.14) years, weight 78.95 (±15.86) kg and BMI 29.5 (±5.0) kg/m2. At the end of the study, 3 SADRs (of which 2 were major hypoglycemia) were reported in 2 patients (<0.1%). The percentage of patients with at least 1 minor hypoglycemic event during the 4 weeks preceding insulin initiation was 3.6%. Following insulin initiation, 5.7% (as recorded at baseline visit) had at least 1 minor hypoglycemic event, which decreased slightly by the end of the study compared to baseline (4.8%). In addition, before insulin initiation the mean (±SD) glycemic control values were: fasting plasma glucose (FPG) 11.43 (±3.2) mmol/L and HbA1c 9.16% (±1.46). At the end of the study, HbA1c was reduced by 1.35% (±1.57) (P<0.001), FPG was reduced by 3.34 mmol/L (P<0.001) and the percentage of patients with HbA1c<7% was 21.9%. A mean reduction of 0.52 kg of body weight (P<0.001) was observed compared to before insulin initiation; the body weight reduction was more pronounced in patients with higher BMI before insulin initiation (-1.0 kg for 30<BMI<35; -2.1 kg for BMI<35). CONCLUSION In the Italian outpatient setting, once-daily insulin detemir as add-on therapy to OADs was associated with a favourable tolerability profile. The improvement of the glycemic control after initiation with insulin detemir was clinically significant and did not cause an increase in body weight or hypoglycemia.
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Affiliation(s)
- S Caputo
- Unit of Diabetology, Policlinico Gemelli, Catholic University, Rome, Italy -
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