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Giustina A, di Filippo L, Facciorusso A, Adler RA, Binkley N, Bollerslev J, Bouillon R, Casanueva FF, Cavestro GM, Chakhtoura M, Conte C, Donini LM, Ebeling PR, Fassio A, Frara S, Gagnon C, Latella G, Marcocci C, Mechanick JI, Minisola S, Rizzoli R, Santini F, Shaker JL, Sempos C, Ulivieri FM, Virtanen JK, Napoli N, Schafer AL, Bilezikian JP. Correction: Vitamin D status and supplementation before and after Bariatric Surgery: Recommendations based on a systematic review and meta‑analysis. Rev Endocr Metab Disord 2024; 25:447-448. [PMID: 38502455 PMCID: PMC10950986 DOI: 10.1007/s11154-023-09837-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] [Indexed: 03/21/2024]
Affiliation(s)
- Andrea Giustina
- Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy.
| | - Luigi di Filippo
- Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy
| | - Antonio Facciorusso
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Robert A Adler
- Richmond Veterans Affairs Medical Center and Virginia Commonwealth University, Richmond, VA, USA
| | | | | | - Roger Bouillon
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, 3000 KU, Leuven, Belgium
| | - Felipe F Casanueva
- Molecular Endocrinology Group, Instituto de Investigacion Sanitaria (IDIS), Complejo Hospitalario Universitario de Santiago (CHUS/SERGAS). CIBER de Fisiopatologia de La Obesidad y Nutricion (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Giulia Martina Cavestro
- Gastroenterology and Gastrointestinal Endoscopy Unit, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Marlene Chakhtoura
- Calcium Metabolism and Osteoporosis Program, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Caterina Conte
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Via Di Val Cannuta 247, 00166, Rome, Italy
| | - Lorenzo M Donini
- Experimental Medicine Department, Sapienza University, Rome, Italy
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Australia
| | - Angelo Fassio
- Rheumatology Unit, University of Verona, Verona, Italy
| | - Stefano Frara
- Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy
| | - Claudia Gagnon
- Department of Medicine, Université Laval, Quebec City, Canada
| | - Giovanni Latella
- Gastroenterology, Hepatology and Nutrition Division, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Claudio Marcocci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Jeffrey I Mechanick
- Kravis Center for Clinical Cardiovascular Health at Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | | | - René Rizzoli
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Ferruccio Santini
- Obesity and Lipodystrophy Center, University Hospital of Pisa, Pisa, Italy
| | - Joseph L Shaker
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Fabio Massimo Ulivieri
- Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy
| | - Jyrki K Virtanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Nicola Napoli
- Department of Medicine and Surgery, Research Unit of Endocrinology and Diabetes, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21 - 00128, Roma, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128, Roma, Italy
| | - Anne L Schafer
- University of California, San Francisco and the San Francisco Veterans Affairs Health Care System, San Francisco, USA
| | - John P Bilezikian
- Department of Medicine, Endocrinology Division, Vagelos College of Physicians and Surgeons Columbia University, New York, NY, USA
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Conte C, Cipponeri E, Roden M. Diabetes Mellitus, Energy Metabolism, and COVID-19. Endocr Rev 2024; 45:281-308. [PMID: 37934800 PMCID: PMC10911957 DOI: 10.1210/endrev/bnad032] [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: 04/10/2023] [Revised: 08/30/2023] [Accepted: 11/01/2023] [Indexed: 11/09/2023]
Abstract
Obesity, diabetes mellitus (mostly type 2), and COVID-19 show mutual interactions because they are not only risk factors for both acute and chronic COVID-19 manifestations, but also because COVID-19 alters energy metabolism. Such metabolic alterations can lead to dysglycemia and long-lasting effects. Thus, the COVID-19 pandemic has the potential for a further rise of the diabetes pandemic. This review outlines how preexisting metabolic alterations spanning from excess visceral adipose tissue to hyperglycemia and overt diabetes may exacerbate COVID-19 severity. We also summarize the different effects of SARS-CoV-2 infection on the key organs and tissues orchestrating energy metabolism, including adipose tissue, liver, skeletal muscle, and pancreas. Last, we provide an integrative view of the metabolic derangements that occur during COVID-19. Altogether, this review allows for better understanding of the metabolic derangements occurring when a fire starts from a small flame, and thereby help reducing the impact of the COVID-19 pandemic.
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Affiliation(s)
- Caterina Conte
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome 00166, Italy
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milan 20099, Italy
| | - Elisa Cipponeri
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milan 20099, Italy
| | - Michael Roden
- Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf 40225, Germany
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf 40225, Germany
- German Center for Diabetes Research, Partner Düsseldorf, Neuherberg 85764, Germany
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La Sala L, Carlini V, Conte C, Macas-Granizo MB, Afzalpour E, Martin-Delgado J, D'Anzeo M, Pedretti RFE, Naselli A, Pontiroli AE, Cappato R. Metabolic disorders affecting the liver and heart: Therapeutic efficacy of miRNA-based therapies? Pharmacol Res 2024; 201:107083. [PMID: 38309383 DOI: 10.1016/j.phrs.2024.107083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 01/09/2024] [Accepted: 01/25/2024] [Indexed: 02/05/2024]
Abstract
Liver and heart disease are major causes of death worldwide. It is known that metabolic alteration causing type 2 diabetes (T2D) and Nonalcoholic fatty liver (NAFLD) coupled with a derangement in lipid homeostasis, may exacerbate hepatic and cardiovascular diseases. Some pharmacological treatments can mitigate organ dysfunctions but the important side effects limit their efficacy leading often to deterioration of the tissues. It needs to develop new personalized treatment approaches and recent progresses of engineered RNA molecules are becoming increasingly viable as alternative treatments. This review outlines the current use of antisense oligonucleotides (ASOs), RNA interference (RNAi) and RNA genome editing as treatment for rare metabolic disorders. However, the potential for small non-coding RNAs to serve as therapeutic agents for liver and heart diseases is yet to be fully explored. Although miRNAs are recognized as biomarkers for many diseases, they are also capable of serving as drugs for medical intervention; several clinical trials are testing miRNAs as therapeutics for type 2 diabetes, nonalcoholic fatty liver as well as cardiac diseases. Recent advances in RNA-based therapeutics may potentially facilitate a novel application of miRNAs as agents and as druggable targets. In this work, we sought to summarize the advancement and advantages of miRNA selective therapy when compared to conventional drugs. In particular, we sought to emphasise druggable miRNAs, over ASOs or other RNA therapeutics or conventional drugs. Finally, we sought to address research questions related to efficacy, side-effects, and range of use of RNA therapeutics. Additionally, we covered hurdles and examined recent advances in the use of miRNA-based RNA therapy in metabolic disorders such as diabetes, liver, and heart diseases.
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Affiliation(s)
- Lucia La Sala
- IRCCS MultiMedica, 20138 Milan, Italy; Dept. of Biomedical Sciences for Health, University of Milan, Milan, Italy.
| | | | - Caterina Conte
- IRCCS MultiMedica, 20138 Milan, Italy; Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | | | - Elham Afzalpour
- Dept. of Biomedical Sciences and Clinic, University of Milan, Milan, Italy
| | - Jimmy Martin-Delgado
- Hospital Luis Vernaza, Junta de Beneficiencia de Guayaquil, 090603 Guayaquil, Ecuador; Instituto de Investigacion e Innovacion en Salud Integral, Universidad Catolica de Santiago de Guayaquil, Guayaquil 090603, Ecuador
| | - Marco D'Anzeo
- AUO delle Marche, SOD Medicina di Laboratorio, Ancona, Italy
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Giustina A, di Filippo L, Facciorusso A, Adler RA, Binkley N, Bollerslev J, Bouillon R, Casanueva FF, Cavestro GM, Chakhtoura M, Conte C, Donini LM, Ebeling PR, Fassio A, Frara S, Gagnon C, Latella G, Marcocci C, Mechanick JI, Minisola S, Rizzoli R, Santini F, Shaker JL, Sempos C, Ulivieri FM, Virtanen JK, Napoli N, Schafer AL, Bilezikian JP. Vitamin D status and supplementation before and after Bariatric Surgery: Recommendations based on a systematic review and meta-analysis. Rev Endocr Metab Disord 2023; 24:1011-1029. [PMID: 37665480 PMCID: PMC10698146 DOI: 10.1007/s11154-023-09831-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/04/2023] [Indexed: 09/05/2023]
Abstract
Bariatric surgery is associated with a postoperative reduction of 25(OH) vitamin D levels (25(OH)D) and with skeletal complications. Currently, guidelines for 25(OH)D assessment and vitamin D supplementation in bariatric patients, pre- and post-surgery, are still lacking. The aim of this work is to analyse systematically the published experience on 25(OH)D status and vitamin D supplementation, pre- and post-surgery, and to propose, on this basis, recommendations for management. Preoperatively, 18 studies including 2,869 patients were evaluated. Prevalence of vitamin D insufficiency as defined by 25(OH)D < 30 ng/mL (75 nmol/L) was 85%, whereas when defined by 25(OH)D < 20 ng/mL (50 nmol/L) was 57%. The median preoperative 25(OH)D level was 19.75 ng/mL. After surgery, 39 studies including 5,296 patients were analysed and among those undergoing either malabsorptive or restrictive procedures, a lower rate of vitamin D insufficiency and higher 25(OH)D levels postoperatively were observed in patients treated with high-dose oral vitamin D supplementation, defined as ≥ 2,000 IU/daily (mostly D3-formulation), compared with low-doses (< 2,000 IU/daily). Our recommendations based on this systematic review and meta-analysis should help clinical practice in the assessment and management of vitamin D status before and after bariatric surgery. Assessment of vitamin D should be performed pre- and postoperatively in all patients undergoing bariatric surgery. Regardless of the type of procedure, high-dose supplementation is recommended in patients after bariatric surgery.
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Affiliation(s)
- Andrea Giustina
- Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy.
| | - Luigi di Filippo
- Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy
| | - Antonio Facciorusso
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Robert A Adler
- Richmond Veterans Affairs Medical Center and Virginia Commonwealth University, Richmond, VA, USA
| | | | | | - Roger Bouillon
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, 3000 KU, Leuven, Belgium
| | - Felipe F Casanueva
- Molecular Endocrinology Group, Instituto de Investigacion Sanitaria (IDIS), Complejo Hospitalario Universitario de Santiago (CHUS/SERGAS). CIBER de Fisiopatologia de La Obesidad y Nutricion (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Giulia Martina Cavestro
- Gastroenterology and Gastrointestinal Endoscopy Unit, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Marlene Chakhtoura
- Calcium Metabolism and Osteoporosis Program, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Caterina Conte
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Via Di Val Cannuta 247, 00166, Rome, Italy
| | - Lorenzo M Donini
- Experimental Medicine Department, Sapienza University, Rome, Italy
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Australia
| | - Angelo Fassio
- Rheumatology Unit, University of Verona, Verona, Italy
| | - Stefano Frara
- Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy
| | - Claudia Gagnon
- Department of Medicine, Université Laval, Quebec City, Canada
| | - Giovanni Latella
- Gastroenterology, Hepatology and Nutrition Division, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Claudio Marcocci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Jeffrey I Mechanick
- Kravis Center for Clinical Cardiovascular Health at Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | | | - René Rizzoli
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Ferruccio Santini
- Obesity and Lipodystrophy Center, University Hospital of Pisa, Pisa, Italy
| | - Joseph L Shaker
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Fabio Massimo Ulivieri
- Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy
| | - Jyrki K Virtanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Nicola Napoli
- Department of Medicine and Surgery, Research Unit of Endocrinology and Diabetes, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21 - 00128, Roma, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128, Roma, Italy
| | - Anne L Schafer
- University of California, San Francisco and the San Francisco Veterans Affairs Health Care System, San Francisco, USA
| | - John P Bilezikian
- Department of Medicine, Endocrinology Division, Vagelos College of Physicians and Surgeons Columbia University, New York, NY, USA
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Guglielmi V, Capoccia D, Russo B, Lubrano C, Mariani S, Poggiogalle E, Furia G, Alizadeh AH, Patrizi C, Sapienza M, Damiani G, Tarsitano MG, Conte C, Frontoni S. Knowledge, experiences, and perceptions relating to obesity management among primary care physicians in the Lazio Region, Italy. Front Endocrinol (Lausanne) 2023; 14:1249233. [PMID: 38027122 PMCID: PMC10668048 DOI: 10.3389/fendo.2023.1249233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 09/25/2023] [Indexed: 12/01/2023] Open
Abstract
Background Primary care providers (PCPs) play an essential role in obesity care as they represent the first contact for patients seeking weight loss interventions. Objective This study explored the knowledge, experiences, and perceptions of PCPs in the Lazio Region of Italy in the management of obesity. Design and subjects We conducted an anonymous survey delivered from March to July 2022 via the newsletter of Rome Provincial Order of Physicians and Dentists and at the annual meeting of the regional section of the Italian Obesity Society. Approach The survey consisted of 24 closed-ended questions grouped into 5 sections: sociodemographic and work information; assessment of obesity; management of obesity; connections with regional Centres for Obesity Management; attitudes towards obesity. Key results A total of 92 PCPs accessed the survey. Of those, 2.2% were excluded because they did not see any patients with obesity. A total of 68 PCPs (75.6%) had complete questionnaires and were included in this analysis. All participants reported asking their patients about their eating habits, lifestyle, and clinical complications at the first assessment. Body weight and blood pressure were measured by 98.5% of participants and 82% calculate body mass index (BMI), while a small proportion of PCPs analysed body composition and fat distribution. Over 80% prescribed laboratory tests and ECG. Approximately 40% of PCPs did not refer patients for nutritional counselling, and most prescribed a low-calorie diet. Sixty-three percent referred patients to an endocrinologist, 48.5% to a psychotherapist, and a minority to specialists for obesity complications. Twenty-three percent prescribed anti-obesity medications and 46.5% referred patients for bariatric surgery only in severe cases. Ninety-one percent stated that obesity is "a complex and multifactorial disease" and 7.4% considered obesity to be secondary to other conditions. Conclusions Despite most PCPs adopt a correct approach to manage patients with obesity, many aspects could be improved to ensure optimal and multidisciplinary management.
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Affiliation(s)
- Valeria Guglielmi
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Internal Medicine Unit - Obesity Center, University Hospital Policlinico Tor Vergata, Rome, Italy
- Italian Obesity Society (SIO), Pisa, Italy
| | - Danila Capoccia
- Italian Obesity Society (SIO), Pisa, Italy
- Department of Medical Surgical Sciences and Biotechnologies, Sapienza University of Rome, Santa Maria Goretti Hospital, Latina, Italy
| | - Benedetta Russo
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Italian Obesity Society (SIO), Pisa, Italy
- Unit of Endocrinology, Diabetes and Metabolism, Fatebenefratelli Gemelli Isola Hospital, Rome, Italy
| | - Carla Lubrano
- Italian Obesity Society (SIO), Pisa, Italy
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Stefania Mariani
- Italian Obesity Society (SIO), Pisa, Italy
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Eleonora Poggiogalle
- Italian Obesity Society (SIO), Pisa, Italy
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Furia
- Directive Council of Order of Physicians and Dentists of the Province of Rome, Rome, Italy
- Local Health Authority Roma 1, Hospital Management Area, Rome, Italy
| | - Aurora Heidar Alizadeh
- Directive Council of Order of Physicians and Dentists of the Province of Rome, Rome, Italy
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Cristina Patrizi
- Directive Council of Order of Physicians and Dentists of the Province of Rome, Rome, Italy
| | - Martina Sapienza
- Directive Council of Order of Physicians and Dentists of the Province of Rome, Rome, Italy
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gianfranco Damiani
- Directive Council of Order of Physicians and Dentists of the Province of Rome, Rome, Italy
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario “A. Gemelli” Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Maria Grazia Tarsitano
- Directive Council of Order of Physicians and Dentists of the Province of Rome, Rome, Italy
- Department of Medical and Surgical Science, University Magna Grecia, Catanzaro, Italy
| | - Caterina Conte
- Italian Obesity Society (SIO), Pisa, Italy
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
- Department of Endocrinology, Nutrition and Metabolic Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) MultiMedica, Sesto San Giovanni, Italy
| | - Simona Frontoni
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Italian Obesity Society (SIO), Pisa, Italy
- Unit of Endocrinology, Diabetes and Metabolism, Fatebenefratelli Gemelli Isola Hospital, Rome, Italy
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Lampignano L, Tatoli R, Donghia R, Bortone I, Castellana F, Zupo R, Lozupone M, Panza F, Conte C, Sardone R. Nutritional patterns as machine learning predictors of liver health in a population of elderly subjects. Nutr Metab Cardiovasc Dis 2023; 33:2233-2241. [PMID: 37541928 DOI: 10.1016/j.numecd.2023.07.009] [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: 03/03/2023] [Revised: 06/14/2023] [Accepted: 07/07/2023] [Indexed: 08/06/2023]
Abstract
BACKGROUND AND AIMS Non-alcoholic hepatic steatosis affects 25% of adults worldwide and its prevalence increases with age. There is currently no definitive treatment for NAFLD but international guidelines recommend a lifestyle-based approach, including a healthy diet. The aim of this study was to investigate the interactions between eating habits and the risk of steatosis and/or hepatic fibrosis, using a machine learning approach, in a non-institutionalized elderly population. METHODS AND RESULTS We recruited 1929 subjects, mean age 74 years, from the population-based Salus in Apulia Study. Dietary habits and the risk of steatosis and hepatic fibrosis were evaluated with a validated food frequency questionnaire, the Fatty Liver Index (FLI) and the FIB-4 score, respectively. Two dietary patterns associated with the risk of steatosis and hepatic fibrosis have been identified. They are both similar to a "western" diet, defined by a greater consumption of refined foods, with a rich content of sugars and saturated fats, and alcoholic and non-alcoholic calorie drinks. CONCLUSION This study further supports the concept of diet as a factor that significantly influences the development of the most widespread liver diseases. However, longitudinal studies are needed to better understand the causal effect of the consumption of particular foods on fat accumulation in the liver.
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Affiliation(s)
| | - Rossella Tatoli
- National Institute of Gastroenterology IRCCS "Saverio de Bellis", Research Hospital, Castellana Grotte, Italy
| | - Rossella Donghia
- National Institute of Gastroenterology IRCCS "Saverio de Bellis", Research Hospital, Castellana Grotte, Italy
| | - Ilaria Bortone
- Department of Translational Biomedicine and Neuroscience "DiBraiN", University of Bari Aldo Moro, Bari, Italy
| | | | - Roberta Zupo
- Department of Interdisciplinary Medicine, University "Aldo Moro", Bari, Italy
| | - Madia Lozupone
- Department of Translational Biomedicine and Neuroscience "DiBraiN", University of Bari Aldo Moro, Bari, Italy
| | - Francesco Panza
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Caterina Conte
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy; Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milan, Italy
| | - Rodolfo Sardone
- Unit of Statistics and Epidemiology, Local Health Authority of Taranto, Taranto, Italy
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7
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De Lorenzo R, Di Filippo L, Scelfo S, Merolla A, Giustina A, Conte C, Rovere-Querini P. Longitudinal Changes in Physical Function and Their Impact on Health Outcomes in COVID-19 Patients. Nutrients 2023; 15:4474. [PMID: 37892549 PMCID: PMC10610243 DOI: 10.3390/nu15204474] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/18/2023] [Accepted: 10/20/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Coronavirus disease (COVID-19) is correlated with a variety of long-term sequelae that affect different aspects of health, including physical function. This study investigated the longitudinal changes in handgrip strength (HGS) over six months post-hospital discharge in COVID-19 patients and explores the associations between HGS, health-related quality of life, dyspnoea, exercise capacity, and body mass index (BMI). METHODS Adult COVID-19 patients were followed up at one, three, and six months after hospital discharge. HGS, BMI, exercise capacity, and health-related quality of life were assessed. Data from patients with HGS measurements at all three time points were analysed. RESULTS Low HGS was prevalent one month post-discharge (35%). Participants with low HGS exhibited more severe disease (30.5% vs. 5.9% were admitted to the intensive care unit, p < 0.01), longer hospital stays (median [IQR] 21 [10.0; 40.5] vs. 12.0 [8.0; 20.0] days, p < 0.01), greater weight loss (-5.7 [-9.1; -0.6] vs. -3.2 [-5.7; -0.0] kg, p = 0.004), and reduced exercise capacity (6 min walking test [6 MWT], 95.7 [84.0; 102.0] vs. 100.0 [92.9; 105.0]% predicted, p = 0.007). Those with persistently low HGS (40% of the initial low HGS group) had worse exercise capacity (6-MWT 93.3 [78.3; 101.0] vs. 101.0 [95.0; 107.0]% predicted, p < 0.001), more dyspnoea (29.0% vs. 2.0% of participants, p < 0.001), poorer quality of life (visual analogue scale score, 75 [50; 75] vs. 85 [75; 95], p < 0.001), and higher rates of problems in various health dimensions. HGS at 1 month was the only significant predictor of HGS improvement from 1 month to 6 months (odds ratio [95% CI] 1.11 [1.03; 1.20], p = 0.008). CONCLUSIONS This study highlights the prevalence of reduced physical function among COVID-19 survivors and emphasises the importance of early identification and intervention to optimise their long-term health. Monitoring HGS, a simple and reliable tool, can provide valuable insights into patients' overall physical function, aiding in tailored care and improved outcomes.
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Affiliation(s)
- Rebecca De Lorenzo
- School of Medicine and Surgery, Vita-Salute San Raffaele University, 20132 Milan, Italy; (R.D.L.); (L.D.F.); (A.M.); (A.G.); (P.R.-Q.)
| | - Luigi Di Filippo
- School of Medicine and Surgery, Vita-Salute San Raffaele University, 20132 Milan, Italy; (R.D.L.); (L.D.F.); (A.M.); (A.G.); (P.R.-Q.)
- Institute of Endocrine and Metabolic Sciences, Vita-Salute San Raffaele University, IRCCS Hospital, 20132 Milan, Italy
| | - Sabrina Scelfo
- Division of Immunology, Transplantation, and Infectious Diseases, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy;
| | - Aurora Merolla
- School of Medicine and Surgery, Vita-Salute San Raffaele University, 20132 Milan, Italy; (R.D.L.); (L.D.F.); (A.M.); (A.G.); (P.R.-Q.)
| | - Andrea Giustina
- School of Medicine and Surgery, Vita-Salute San Raffaele University, 20132 Milan, Italy; (R.D.L.); (L.D.F.); (A.M.); (A.G.); (P.R.-Q.)
- Institute of Endocrine and Metabolic Sciences, Vita-Salute San Raffaele University, IRCCS Hospital, 20132 Milan, Italy
| | - Caterina Conte
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, 20099 Milan, Italy
| | - Patrizia Rovere-Querini
- School of Medicine and Surgery, Vita-Salute San Raffaele University, 20132 Milan, Italy; (R.D.L.); (L.D.F.); (A.M.); (A.G.); (P.R.-Q.)
- Innate Immunity and Tissue Remodeling Unit, Division of Immunology, Transplantation, and Infectious Diseases, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
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Vigna L, Speciani MC, Tirelli AS, Bravi F, La Vecchia C, Conte C, Gori F. Vitamin D and Metabolic Syndrome in Working Age Subjects from an Obesity Clinic. Nutrients 2023; 15:4354. [PMID: 37892428 PMCID: PMC10609594 DOI: 10.3390/nu15204354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 09/28/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
Serum vitamin D (VitD) levels have been inversely related with metabolic syndrome (MetS), although the direct impact of VitD is still debated. This study examined 879 subjects of working age from an obesity and occupational clinic in Milan, Italy. Among these participants, 316 had MetS, while 563 did not. A multiple logistic regression analysis was conducted to determine the odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) for MetS in relation to serum VitD levels. After controlling for age, sex, leisure time physical activity, and body mass index (BMI), individuals with VitD levels between 20 and 29.9 ng/dL, or at least 30 ng/dL, had approximately half the risk of developing MetS (OR: 0.52, 95% CI: 0.32-0.86 and OR: 0.50, 95% CI: 0.25-0.99, respectively) compared to those with VitD levels below 10 ng/dL. This study presents further evidence of the beneficial effect of adequate VitD levels on the risk of MetS in a population of overweight/obese workers, even after adjusting for BMI. This study supports the importance of testing for and-if required-supplementing VitD in individuals with metabolic risk factors.
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Affiliation(s)
- Luisella Vigna
- Centro Obesità e Lavoro, Unità di Salute Occupazionale, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy;
| | - Michela Carola Speciani
- Laboratorio di Statistica Medica, Dipartimento di Scienze Cliniche e di Comunità, Biometria ed Epidemiologia “G.A. Maccacaro”, Università degli Studi di Milano, 20133 Milan, Italy; (M.C.S.); (F.B.); (C.L.V.)
| | - Amedea Silvia Tirelli
- Centro Obesità e Lavoro, Unità di Salute Occupazionale, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy;
| | - Francesca Bravi
- Laboratorio di Statistica Medica, Dipartimento di Scienze Cliniche e di Comunità, Biometria ed Epidemiologia “G.A. Maccacaro”, Università degli Studi di Milano, 20133 Milan, Italy; (M.C.S.); (F.B.); (C.L.V.)
| | - Carlo La Vecchia
- Laboratorio di Statistica Medica, Dipartimento di Scienze Cliniche e di Comunità, Biometria ed Epidemiologia “G.A. Maccacaro”, Università degli Studi di Milano, 20133 Milan, Italy; (M.C.S.); (F.B.); (C.L.V.)
| | - Caterina Conte
- Dipartimento di Promozione delle Scienze Umane e della Qualità della Vita, Università Telematica San Raffaele Roma, 00166 Rome, Italy;
- Dipartimento di Endocrinologia, Nutrizione e Malattie Metaboliche, IRCCS MultiMedica, Sesto S. Giovanni, 20900 Milan, Italy
| | - Francesca Gori
- Dipartimento di Anestesia, Rianimazione ed Emergenza Urgenza, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy;
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9
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Conte C, De Luca P. Editorial: Impact of diet-related disorders on musculoskeletal health. Front Nutr 2023; 10:1301837. [PMID: 37876612 PMCID: PMC10591309 DOI: 10.3389/fnut.2023.1301837] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 10/26/2023] Open
Affiliation(s)
- Caterina Conte
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
- Department of Endocrinology, Nutrition and Metabolic Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) MultiMedica, Sesto San Giovanni, Italy
| | - Paola De Luca
- IRCCS Istituto Ortopedico Galeazzi, Laboratorio di Biotecnologie Applicate all'Ortopedia, Milan, Italy
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10
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Conte C, Camajani E, Lai A, Caprio M. Not all very-low-carbohydrate diets are created equal. Diabetologia 2023; 66:1752-1753. [PMID: 37402834 DOI: 10.1007/s00125-023-05961-0] [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: 05/12/2023] [Accepted: 05/18/2023] [Indexed: 07/06/2023]
Affiliation(s)
- Caterina Conte
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy.
- IRCCS MultiMedica, Milan, Italy.
| | - Elisabetta Camajani
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
- Laboratory of Cardiovascular Endocrinology, San Raffaele Research Institute, IRCCS San Raffaele, Rome, Italy
| | - Alessio Lai
- Ospedale Roberto Binaghi - ASSL Cagliari, Cagliari, Italy
| | - Massimiliano Caprio
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
- Laboratory of Cardiovascular Endocrinology, San Raffaele Research Institute, IRCCS San Raffaele, Rome, Italy
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11
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DE Lorenzo R, Cinel E, Cilla M, Compagnone N, Ferrante M, Falbo E, Patrizi A, Castellani J, Magnaghi C, Calvisi SL, Arcidiacono T, Lanzani C, Canti V, Mazza MG, Martinenghi S, Vitali G, Benedetti F, Ciceri F, Conte C, Rovere Querini P. Physical and psychological sequelae at three months after acute illness in COVID-19 survivors. Panminerva Med 2023; 65:312-320. [PMID: 34060280 DOI: 10.23736/s0031-0808.21.04399-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) may leave behind an altered health status early after recovery. We evaluated the clinical status of COVID-19 survivors at three months after hospital discharge. METHODS In this prospective observational cohort study, hospitalized patients aged ≥18 years, evaluated at one (M1) and three (M3) months post-discharge were enrolled. 251 patients (71.3% males, median [IQR] age 61.8 [53.5-70.7] years) were included. Median (IQR) time from discharge to M3 was 89 (79.5-101) days. Primary outcome was residual respiratory dysfunction (RRD), defined by tachypnea, moderate to very severe dyspnea, or peripheral oxygen saturation ≤95% on room air at M3. RESULTS RRD was found in 30.4% of patients, with no significant difference compared with M1. Chronic obstructive pulmonary disease and length of stay were independent predictors of RRD at multivariable logistic regression (OR [95% CI]: 4.13 [1.17-16.88], P=0.033; OR [95% CI]: 1.02 [1.00-1.04], P=0.047, respectively). Obesity and C-reactive protein levels upon admission were additional predictors at regression tree analysis. Impaired quality of life (QoL) was reported by 53.2% of patients. Anxiety and insomnia were each present in 25.5% of patients, and PTSD in 22.4%. No difference was found between M1 and M3 in QoL, anxiety or PTSD. Insomnia decreased at M3. Current major psychiatric disorder as well as anxiety, insomnia and PSTD at M1 independently predicted PTSD at M3. CONCLUSIONS Clinical damage may persist at three months after discharge in COVID-19 survivors. Post-recovery follow-up is an essential component of patient management.
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Affiliation(s)
| | - Elena Cinel
- Vita-Salute San Raffaele University, Milan, Italy
| | - Marta Cilla
- Vita-Salute San Raffaele University, Milan, Italy
| | | | | | | | | | | | - Cristiano Magnaghi
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Hospital, Milan, Italy
| | - Stefania L Calvisi
- Unit of General Medicine and Advanced Care, IRCCS San Raffaele Scientific Hospital, Milan, Italy
| | - Teresa Arcidiacono
- Unit of Nephrology, IRCCS San Raffaele Scientific Hospital, Milan, Italy
| | - Chiara Lanzani
- Unit of Nephrology, IRCCS San Raffaele Scientific Hospital, Milan, Italy
| | - Valentina Canti
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Hospital, Milan, Italy
| | - Mario G Mazza
- Unit of Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Hospital, Milan, Italy
| | - Sabina Martinenghi
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Hospital, Milan, Italy
| | - Giordano Vitali
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Hospital, Milan, Italy
| | - Francesco Benedetti
- Unit of Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Hospital, Milan, Italy
| | - Fabio Ciceri
- Vita-Salute San Raffaele University, Milan, Italy
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Hospital, Milan, Italy
| | - Caterina Conte
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Hospital, Milan, Italy
| | - Patrizia Rovere Querini
- Vita-Salute San Raffaele University, Milan, Italy -
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Hospital, Milan, Italy
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12
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Conte C, Molfino A. Editorial: Obesity and chronic kidney disease: complexities, clinical impact, and challenges in nutritional management. Front Nutr 2023; 10:1212700. [PMID: 37599691 PMCID: PMC10433202 DOI: 10.3389/fnut.2023.1212700] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/21/2023] [Indexed: 08/22/2023] Open
Affiliation(s)
- Caterina Conte
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milan, Italy
| | - Alessio Molfino
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
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13
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Leanza G, Conte C, Cannata F, Isgrò C, Piccoli A, Strollo R, Quattrocchi CC, Papalia R, Denaro V, Maccarrone M, Napoli N, Sardanelli AM. Oxidative Stress in Postmenopausal Women with or without Obesity. Cells 2023; 12:cells12081137. [PMID: 37190046 DOI: 10.3390/cells12081137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/23/2023] [Accepted: 04/10/2023] [Indexed: 05/17/2023] Open
Abstract
Oxidative stress, a key mediator of cardiovascular disease, metabolic alterations, and cancer, is independently associated with menopause and obesity. Yet, among postmenopausal women, the correlation between obesity and oxidative stress is poorly examined. Thus, in this study, we compared oxidative stress states in postmenopausal women with or without obesity. Body composition was assessed via DXA, while lipid peroxidation and total hydroperoxides were measured in patient's serum samples via thiobarbituric-acid-reactive substances (TBARS) and derivate-reactive oxygen metabolites (d-ROMs) assays, respectively. Accordingly, 31 postmenopausal women were enrolled: 12 with obesity and 19 of normal weight (mean (SD) age 71.0 (5.7) years). Doubled levels of serum markers of oxidative stress were observed in women with obesity in women with obesity compared to those of normal weight (H2O2: 32.35 (7.3) vs. 18.80 (3.4) mg H2O2/dL; malondialdehyde (MDA): 429.6 (138.1) vs. 155.9 (82.4) mM in women with or without obesity, respectively; p < 0.0001 for both). Correlation analysis showed that both markers of oxidative stress increased with an increasing body mass index (BMI), visceral fat mass, and trunk fat percentage, but not with fasting glucose levels. In conclusion, obesity and visceral fat are associated with a greater increase in oxidative stress in postmenopausal women, possibly increasing cardiometabolic and cancer risks.
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Affiliation(s)
- Giulia Leanza
- Department of Medicine and Surgery, Unit of Endocrinology and Diabetes, Campus Bio-Medico University of Rome, 00128 Rome, Italy
| | - Caterina Conte
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy
- Department of Endocrinology, Nutrition and Metabolic Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) MultiMedica, 20900 Milan, Italy
| | - Francesca Cannata
- Department of Medicine and Surgery, Unit of Endocrinology and Diabetes, Campus Bio-Medico University of Rome, 00128 Rome, Italy
| | - Camilla Isgrò
- Department of Medicine and Surgery, Unit of Endocrinology and Diabetes, Campus Bio-Medico University of Rome, 00128 Rome, Italy
- Department of Translational Biomedicine and Neuroscience 'DiBraiN', University of Bari "Aldo Moro", Pi-azza G. Cesare 11, 70124 Bari, Italy
| | - Alessandra Piccoli
- Department of Medicine and Surgery, Unit of Endocrinology and Diabetes, Campus Bio-Medico University of Rome, 00128 Rome, Italy
| | - Rocky Strollo
- Department of Science and Technology for Sustainable Environment and One Health, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 21, 00128 Rome, Italy
| | - Carlo Cosimo Quattrocchi
- Department of Medicine, Unit of Diagnostic Imaging and Interventional Medicine, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Rocco Papalia
- Department of Medicine, Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Vincenzo Denaro
- Department of Medicine, Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Mauro Maccarrone
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio snc, 67100 L'Aquila, Italy
- European Center for Brain Research, Santa Lucia Foundation IRCCS, 00164 Rome, Italy
| | - Nicola Napoli
- Department of Medicine and Surgery, Unit of Endocrinology and Diabetes, Campus Bio-Medico University of Rome, 00128 Rome, Italy
| | - Anna Maria Sardanelli
- Department of Translational Biomedicine and Neuroscience 'DiBraiN', University of Bari "Aldo Moro", Pi-azza G. Cesare 11, 70124 Bari, Italy
- Department of Medicine and Surgery, Unit of Biochemistry and Molecular Biology, Campus Bio-Medico University of Rome, 00128 Roma, Italy
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Falbo E, Porchetti G, Conte C, Tarsitano MG. Adherence to Mediterranean Diet in Individuals on Renal Replacement Therapy. Int J Environ Res Public Health 2023; 20:4040. [PMID: 36901049 PMCID: PMC10002197 DOI: 10.3390/ijerph20054040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 02/15/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
Patients on renal replacement therapy are typically subject to several dietary restrictions; however, this approach has been questioned in recent years, with some suggesting that the Mediterranean diet might be beneficial. Data on the adherence to this diet and factors that influence it are scarce. We conducted a web survey among individuals on renal replacement therapy (dialysis or kidney transplant, KT) using the MEDI-LITE questionnaire to assess adherence to the Mediterranean diet and dietary habits in this population. Adherence to the Mediterranean diet was generally low, and significantly lower among participants on dialysis versus KT recipients (19.4% vs. 44.7%, p < 0.001). Being on dialysis, adopting fluid restrictions, and having a basic level of education were predictors of low adherence to the Mediterranean diet. Consumption of foods typically included in the Mediterranean diet, including fruit, legumes, fish, and vegetables, was generally low, particularly among those on dialysis. There is a need for strategies to improve both the adherence to and the quality of the diet among individuals on renal replacement therapy. This should be a shared responsibility between registered dietitians, physicians, and the patient.
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Affiliation(s)
- Elisabetta Falbo
- Azienda Sanitaria Provinciale di Catanzaro, Centro di Medicina del Viaggiatore e delle Migrazioni, 88100 Catanzaro, Italy
| | - Gabriele Porchetti
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Via di Val Cannuta 247, 00166 Rome, Italy
| | - Caterina Conte
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Via di Val Cannuta 247, 00166 Rome, Italy
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Via Milanese 300, Sesto San Giovanni, 20900 Milan, Italy
| | - Maria Grazia Tarsitano
- Department of Medical and Surgical Science Nutrition Unit, University Magna Grecia, 88100 Catanzaro, Italy
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15
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Conte C. Is Sleep the Best Medicine? J Clin Endocrinol Metab 2023; 108:e17-e18. [PMID: 36330649 DOI: 10.1210/clinem/dgac647] [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: 10/27/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Caterina Conte
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166, Rome, Italy
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, 20099, Milan, Italy
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16
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Lampignano L, Niro A, Castellana F, Bortone I, Zupo R, Tirelli S, Tatoli R, Griseta C, De Nucci S, Sila A, De Pergola G, Conte C, Alessio G, Boscia F, Sborgia G, Giannelli G, Sardone R. Liver fibrosis and retinal features in an older Mediterranean population: Results from the Salus in Apulia study. Front Neurosci 2022; 16:1048375. [PMID: 36590297 PMCID: PMC9798127 DOI: 10.3389/fnins.2022.1048375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/25/2022] [Indexed: 12/23/2022] Open
Abstract
Background Age is a leading contributor to the liver fibrosis rate and a gradual deterioration of optical function, but this association in older populations is still under-explored. The present study aimed to explore the link between vascular and neural retinal characteristics and the risk of liver fibrosis in 731 older adults from the population-based Salus in Apulia study. Methods Retinal features were obtained using optical coherence tomography (OCT) and OCT-angiography (OCT-A). Liver fibrosis risk was taken as the fibrosis-4 (FIB-4) score. Generalized linear models (logistic regression) were used to estimate the association effect between each unit increase of OCT and OCT-A parameters as independent variables and a FIB-4 ≥ 2.67 score as an outcome. Generalized additive models were used to assess the non-linear association between OCT-A features and the linear FIB-4 score. Results Increased gangliar cell complex (GCC) thickness was inversely associated with a FIB-4 score above the cut-off in both the raw model (OR: 0.98; 95% CI: 0.96-0.99; SE: 0.01) and after adjustment for age, sex, education, hypertension, diabetes, total cholesterol, and triglycerides (OR: 0.98; 95% CI: 0.97-0.99; SE: 0.01). Conclusion Our findings add to the growing volume of scientific literature demonstrating that liver fibrosis is associated with retinal neurodegeneration. This study raises a number of new questions, including whether OCT-A may be used to track the progression of metabolic abnormalities and define exact thresholds for predicting and classifying liver disease.
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Affiliation(s)
- Luisa Lampignano
- Unit of Research Methodology and Data Sciences for Population Health, “Salus in Apulia Study”, National Institute of Gastroenterology Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) “Saverio de Bellis”, Research Hospital, Castellana Grotte, Italy
| | - Alfredo Niro
- Eye Clinic, Hospital “SS. Annunziata”, Azienda Sanitaria Locale (ASL) Taranto, Taranto, Italy
| | - Fabio Castellana
- Unit of Research Methodology and Data Sciences for Population Health, “Salus in Apulia Study”, National Institute of Gastroenterology Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) “Saverio de Bellis”, Research Hospital, Castellana Grotte, Italy
| | - Ilaria Bortone
- Unit of Research Methodology and Data Sciences for Population Health, “Salus in Apulia Study”, National Institute of Gastroenterology Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) “Saverio de Bellis”, Research Hospital, Castellana Grotte, Italy
| | - Roberta Zupo
- Unit of Research Methodology and Data Sciences for Population Health, “Salus in Apulia Study”, National Institute of Gastroenterology Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) “Saverio de Bellis”, Research Hospital, Castellana Grotte, Italy
| | - Sarah Tirelli
- Unit of Research Methodology and Data Sciences for Population Health, “Salus in Apulia Study”, National Institute of Gastroenterology Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) “Saverio de Bellis”, Research Hospital, Castellana Grotte, Italy
| | - Rossella Tatoli
- Unit of Research Methodology and Data Sciences for Population Health, “Salus in Apulia Study”, National Institute of Gastroenterology Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) “Saverio de Bellis”, Research Hospital, Castellana Grotte, Italy
| | - Chiara Griseta
- Unit of Research Methodology and Data Sciences for Population Health, “Salus in Apulia Study”, National Institute of Gastroenterology Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) “Saverio de Bellis”, Research Hospital, Castellana Grotte, Italy
| | - Sara De Nucci
- Unit of Research Methodology and Data Sciences for Population Health, “Salus in Apulia Study”, National Institute of Gastroenterology Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) “Saverio de Bellis”, Research Hospital, Castellana Grotte, Italy
| | - Annamaria Sila
- Unit of Research Methodology and Data Sciences for Population Health, “Salus in Apulia Study”, National Institute of Gastroenterology Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) “Saverio de Bellis”, Research Hospital, Castellana Grotte, Italy
| | - Giovanni De Pergola
- Unit of Geriatrics and Internal Medicine, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Bari, Italy
| | - Caterina Conte
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy,Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milan, Italy
| | - Giovanni Alessio
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Francesco Boscia
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Giancarlo Sborgia
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | | | - Gianluigi Giannelli
- Scientific Direction, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, Research Hospital, Castellana Grotte, Italy
| | - Rodolfo Sardone
- Unit of Research Methodology and Data Sciences for Population Health, “Salus in Apulia Study”, National Institute of Gastroenterology Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) “Saverio de Bellis”, Research Hospital, Castellana Grotte, Italy,*Correspondence: Rodolfo Sardone, ; orcid.org/0000-0003-1383-1850
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Conte C, Muscaritoli M. Editorial: Muscle mass and function in COVID-19. Front Nutr 2022; 9:1012742. [DOI: 10.3389/fnut.2022.1012742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 11/07/2022] [Indexed: 11/17/2022] Open
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18
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Conte C. Waist circumference and dysglycaemia: new insights and additional questions, but do not miss the opportunity to measure it! Intern Emerg Med 2022; 17:1859-1861. [PMID: 36040676 DOI: 10.1007/s11739-022-03088-5] [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: 08/13/2022] [Accepted: 08/19/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Caterina Conte
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Via di Val Cannuta 247, 00166, Rome, Italy.
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Via Milanese 300, Sesto San Giovanni, 20900, Milan, Italy.
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19
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Conte C, Princi G, D’Amario D, Sanna T, Pedicino D, Liuzzo G. Incessant pericarditis following the second dose of SARS-CoV-2 mRNA vaccine successfully treated with anakinra: a case report. Eur Heart J Case Rep 2022; 6:ytac357. [PMID: 36111072 PMCID: PMC9470051 DOI: 10.1093/ehjcr/ytac357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 03/11/2022] [Accepted: 08/25/2022] [Indexed: 11/15/2022]
Abstract
Background The SARS-CoV-2 pandemic has led to the development of the first mRNA vaccines used in humans. These vaccines are well tolerated, safe, and highly effective; however, post-marketing surveillance is revealing potential rare adverse effects. We report a case of incessant pericarditis following administration of the second dose of mRNA-1273 SARS-CoV-2 vaccine, unresponsive to conventional therapy, and successfully treated with anakinra. Case summary A 30-year-old man presented to the Emergency Department for incessant pericarditis unresponsive to evacuative pericardiocentesis and conventional first-line anti-inflammatory therapy. Given the typical ‘inflammatory phenotype’ clinically characterized by fever, C-reactive protein (CRP) elevation, and leucocytosis, we decided, in agreement with the rheumatologist team, to avoid glucocorticoid and to administer anakinra. A sudden clinical and echocardiographic improvement was observed, with complete resolution of the symptoms and of the pericardial effusion; similarly, CRP values progressively decreased. The patient was discharged at home; no recurrences of pericarditis were described at clinical and instrumental follow-up made 3 months later. Discussion Several cases of pericarditis have been described in patients who received the COVID-19 vaccination, especially with the mRNA vaccine that can induce a non-adaptive immunity response against the viral spike protein, triggering cardiac damage for a molecular mimicry mechanism; however, defined pathogenesis of pericarditis associated with mRNA vaccine is still missing. The clinical scenario described is characterized by the typical ‘inflammatory phenotype’, triggered by a disproportionate and uncontrolled activation of the inflammasome based on an interleukin-1 (IL-1) overproduction. We administered anakinra, an IL-1 blocking drug, with a sharp clinical, echocardiographic and laboratoristic improvement. The complete response observed in this case suggests that vaccine-related pericarditis could be triggered by an auto-inflammatory pathway based on IL-1 overproduction. Further research is, therefore, warranted to determine the mechanisms by which the mRNA vaccine may cause pericarditis in order to choose the most targeted therapy.
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Affiliation(s)
- C Conte
- Department of Cardiovascular and Thoracic Sciences, Catholic University of Sacred Heart , Largo Francesco Vito 1, 00168, Rome , Italy
| | - G Princi
- Department of Cardiovascular and Thoracic Sciences, Catholic University of Sacred Heart , Largo Francesco Vito 1, 00168, Rome , Italy
| | - D D’Amario
- Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS , Largo Francesco Vito, 1–00168 Rome , Italy
| | - T Sanna
- Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS , Largo Francesco Vito, 1–00168 Rome , Italy
| | - D Pedicino
- Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS , Largo Francesco Vito, 1–00168 Rome , Italy
| | - G Liuzzo
- Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS , Largo Francesco Vito, 1–00168 Rome , Italy
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20
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Cribari F, Conte C, Ruggio A, Narducci ML, D'Aiello A, Pedicino D, Biasucci LM, Liuzzo G. Levosimendan for acute right heart failure in COVID-19: another arrow in our quiver? Eur Rev Med Pharmacol Sci 2022; 26:5596-5600. [PMID: 35993658 DOI: 10.26355/eurrev_202208_29432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE SARS-CoV-2 infection is associated with a higher risk of acute right heart failure (RHF) due to primary right ventricle (RV) dilation and systemic inflammatory response, which in turn lead to microvascular and cardiomyocytes dysfunction, local hypoxia and multi-organ failure. In this clinical setting, levosimendan could be a viable therapy thanks to its right-heart tropism and its additional pleiotropic properties. CASE REPORT We present the case of a 72 years-old man with positive nasopharyngeal swab for SARS-CoV-2 infection, mild pulmonary involvement and clinical signs of new-onset RHF. We started a 12-hour levosimendan cycle to improve RV performance and reduce cardiac filling pressures. RESULTS We obtained a net clinical benefit in terms of acute RHF-related signs and symptoms, progressive renal and liver function improvement and concomitant reduction of high-sensitivity C-Reactive Protein and Interleukin-6 (IL-6) levels. CONCLUSIONS Acute RHF during SARS-CoV-2 infection could be related to a convergent widespread systemic inflammatory response. Thanks to its anti-inflammatory and anti-remodeling properties, levosimendan might represent a viable therapy in this clinical setting, contributing to the dampening of the inflammatory response.
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Affiliation(s)
- F Cribari
- Catholic University of the Sacred Heart, Rome, Italy.
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21
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Napoli N, Conte C. Bone fragility in type 1 diabetes: new insights and future steps. Lancet Diabetes Endocrinol 2022; 10:475-476. [PMID: 35576954 DOI: 10.1016/s2213-8587(22)00137-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 04/21/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Nicola Napoli
- Operative Research Unit of Osteo-metabolic diseases, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy; Research Unit of Endocrinology and Diabetes, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy.
| | - Caterina Conte
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy; Department of Endocrinology, Nutrition and Metabolic Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCSS) MultiMedica, Milan, Italy
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22
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Bonanni A, Pedicino D, D'aiello A, Vinci R, Severino A, Russo G, Cribari F, Conte C, Filomia S, Bruno P, Burzotta F, Trani C, Massetti M, Crea F, Liuzzo G. Transcatheter versus surgical aortic valve replacement in patients with aortic stenosis: characterization of molecular pathways before and after treatment. Cardiovasc Res 2022. [DOI: 10.1093/cvr/cvac066.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background/Introduction
Recently, the transcatheter aortic valve replacement (TAVR) has reformed the management of Aortic Stenosis (AS), providing a valid therapeutic alternative to surgical aortic valve replacement (SAVR). Although optimizing the timing of surgery is a crucial aspiration, the introduction of innovative pharmacological therapies able to modify disease evolution might help clinicians to treat patients in a non-invasive way. Several evidences pointed out the role of inflammation, oxidative stress, and pathological remodelling in AS natural history.
Purpose
The aim of this study is to assess biological pathways modifications after aortic valve replacement, comparing the transcatheter and the surgical approach.
Methods
We enrolled a total of 35 consecutive patients with severe symptomatic aortic stenosis undergoing aortic valve replacement with transcatheter (n = 19) or surgical (n = 16) approach. Biological samples were collected and stored before (T0) and 72 hours after the procedure (T1). We firstly performed gene expression arrays for a total of 132 genes, on two groups of pooled cDNA from peripheral blood mononuclear cells of TAVR (n = 10) and SAVR (n = 10) patients. Then, taking into account the most relevant result of the arrays, we selected 15 genes for validation.
Results
Our preliminary data showed several differences in the gene expression levels of the two groups under examination for a large number of molecules, mostly associated with the oxidative balance. More in detail, after procedure, TAVR patients showed higher levels of glutathione peroxidase 1 (GPX1, TAVR p = 0.029; SAVR p = 0.031) and glutathione reductase (GSR, p = 0.029), while SAVR patients showed higher expression of GPX1, catalase (CAT, p = 0.019) and NADPH oxidase 2 (NOX2, p = 0.008), thus confirming an intense post-operative oxidative stress particularly for patients undergoing surgery. Moreover, Caspase 3 (CASP3, p = 0.013), involved in apoptotic pathway and myocyte enhancer factor 2C (MEF2C, p = 0.036), implicated in overload induced hypertrophy genes showed a significantly reduction in their expression after TAVR.
Conclusions
In our study, we describe different gene expression signatures in patients with an AS diagnosis and their recalibration after AV replacement with two kinds of procedure, TAVR and SAVR. Our data describe for the first time an altered oxidative balance in patient undergoing aortic valve replacement, that is particularly evident for patients undergoing SAVR. A clearer understanding of biological processes taking place in the first hours post AV replacement lays the ground to a more efficient management of post-operative status and, in the incessant research for a tailored therapy, the results of our study add a little piece of information to assist clinicians in selecting the optimal procedure for each patient.
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Affiliation(s)
- A Bonanni
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - D Pedicino
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - A D'aiello
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - R Vinci
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - A Severino
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - G Russo
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - F Cribari
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - C Conte
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - S Filomia
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - P Bruno
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - F Burzotta
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - C Trani
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - M Massetti
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - F Crea
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - G Liuzzo
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
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Faraldi M, Mangiavini L, Conte C, Banfi G, Napoli N, Lombardi G. A novel methodological approach to simultaneously extract high-quality total RNA and proteins from cortical and trabecular bone. Open Biol 2022; 12:210387. [PMID: 35506206 PMCID: PMC9065961 DOI: 10.1098/rsob.210387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Molecular differences between cortical and trabecular bone, of relevance to understanding the pathophysiological basis of bone diseases, can be determined only through effective isolation methods for RNA and proteins. Here we present a TRIzol-based method, which combines bone pulverization and homogenization to extract simultaneously total RNA and proteins from human cortical and trabecular bone from the same carrot. RNA integrity and purity were determined as the 260/280 nm and 260/230 nm absorbance ratios and the 28S/18S rRNA ratio. Protein integrity and quality were evaluated by Coomassie blue staining. Reverse transcription quantitative polymerase chain reaction and immunoblotting for bone-specific genes and proteins were performed to verify the suitability of the isolated material in downstream applications. The 260/280 nm and 260/230 nm absorbance ratios were, on average, less than or equal to 1.8. Bands on agarose gel were consistent with intact RNA, with mean 28S/18S ratios of 1.68 ± 0.35 and 1.88 ± 0.10 for cortical and trabecular bone, respectively. Band patterns after Coomassie blue staining confirmed protein integrity. Successful gene and protein expression analysis, with relevant differences between the two compartments, highlighted the suitability of the material in downstream applications. The method presented here is appropriate and effective for the study of human bone.
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Affiliation(s)
- Martina Faraldi
- Laboratory of Experimental Biochemistry and Molecular Biology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Laura Mangiavini
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy,Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Caterina Conte
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy,Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milan, Italy
| | - Giuseppe Banfi
- Laboratory of Experimental Biochemistry and Molecular Biology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy,Vita-Salute San Raffaele University, Milan, Italy
| | - Nicola Napoli
- Unit of Endocrinology and Diabetes, Departmental Faculty of Medicine and Surgery, Campus Bio-Medico University of Rome, Rome, Italy,Division of Bone and Mineral Diseases, Washington University in St Louis, St Louis, MO, USA
| | - Giovanni Lombardi
- Laboratory of Experimental Biochemistry and Molecular Biology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy,Department of Athletics, Strength and Conditioning, Poznań University of Physical Education, Poznań, Poland
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Di Filippo L, De Lorenzo R, Giustina A, Rovere-Querini P, Conte C. Vitamin D in Osteosarcopenic Obesity. Nutrients 2022; 14:1816. [PMID: 35565781 PMCID: PMC9100750 DOI: 10.3390/nu14091816] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 04/24/2022] [Accepted: 04/25/2022] [Indexed: 02/07/2023] Open
Abstract
Osteosarcopenic obesity is a unique clinical condition where low bone and muscle mass coexist in individuals with obesity. Alterations in adipose tissue, skeletal muscle and bone are strictly interconnected, and vitamin D plays key roles in several metabolic pathways that are involved in maintaining musculoskeletal health and glucose homeostasis. We reviewed the available literature on mechanisms underlying osteosarcopenic obesity, with a focus on the role of vitamin D in the pathogenesis and treatment of the condition. We found that, although evidence from large observational studies and pre-clinical experiments strongly supports a role of vitamin D deficiency in the pathogenesis of osteosarcopenic obesity, the common belief that vitamin D improves musculoskeletal health lacks solid clinical evidence, as trials specifically aimed at assessing the effects of vitamin D supplementation in patients with osteosarcopenic obesity are not available, and trials that investigated the role of vitamin D on muscle and bone health in other patient populations either showed no or even detrimental effects. We conclude that large observational and interventional studies including individuals with osteosarcopenic obesity representative of different sex, age and race are needed to better define the role of vitamin D in the pathogenesis and treatment of this condition.
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Affiliation(s)
- Luigi Di Filippo
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 00132 Milan, Italy; (L.D.F.); (R.D.L.); (A.G.); (P.R.-Q.)
- Institute of Endocrine and Metabolic Sciences, IRCCS San Raffaele Hospital, Via Olgettina 60, 00132 Milan, Italy
| | - Rebecca De Lorenzo
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 00132 Milan, Italy; (L.D.F.); (R.D.L.); (A.G.); (P.R.-Q.)
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Hospital, Via Olgettina 60, 00132 Milan, Italy
| | - Andrea Giustina
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 00132 Milan, Italy; (L.D.F.); (R.D.L.); (A.G.); (P.R.-Q.)
- Institute of Endocrine and Metabolic Sciences, IRCCS San Raffaele Hospital, Via Olgettina 60, 00132 Milan, Italy
| | - Patrizia Rovere-Querini
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 00132 Milan, Italy; (L.D.F.); (R.D.L.); (A.G.); (P.R.-Q.)
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Hospital, Via Olgettina 60, 00132 Milan, Italy
| | - Caterina Conte
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Via di Val Cannuta 247, 00166 Rome, Italy
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Via Milanese 300, Sesto San Giovanni, 20900 Milan, Italy
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De Lorenzo R, Palmisano A, Esposito A, Gnasso C, Nicoletti V, Leone R, Vignale D, Falbo E, Ferrante M, Cilla M, Magnaghi C, Martinenghi S, Vitali G, Molfino A, Rovere-Querini P, Muscaritoli M, Conte C. Myosteatosis Significantly Predicts Persistent Dyspnea and Mobility Problems in COVID-19 Survivors. Front Nutr 2022; 9:846901. [PMID: 35464004 PMCID: PMC9024358 DOI: 10.3389/fnut.2022.846901] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 12/31/2021] [Accepted: 03/10/2022] [Indexed: 11/22/2022] Open
Abstract
Background Persistent symptoms including dyspnea and functional impairment are common in COVID-19 survivors. Poor muscle quality (myosteatosis) associates with poor short-term outcomes in COVID-19 patients. The aim of this observational study was to assess the relationship between myosteatosis diagnosed during acute COVID-19 and patient-reported outcomes at 6 months after discharge. Methods Myosteatosis was diagnosed based on CT-derived skeletal muscle radiation attenuation (SM-RA) measured during hospitalization in 97 COVID-19 survivors who had available anthropometric and clinical data upon admission and at the 6-month follow-up after discharge. Dyspnea in daily activities was assessed using the modified Medical Research Council (mMRC) scale for dyspnea. Health-related quality of life was measured using the European quality of life questionnaire three-level version (EQ-5D-3L). Results Characteristics of patients with (lowest sex- and age-specific tertile of SM-RA) or without myosteatosis during acute COVID-19 were similar. At 6 months, patients with myosteatosis had greater rates of obesity (48.4 vs. 27.7%, p = 0.046), abdominal obesity (80.0 vs. 47.6%, p = 0.003), dyspnea (32.3 vs. 12.5%, p = 0.021) and mobility problems (32.3 vs. 12.5%, p = 0.004). Myosteatosis diagnosed during acute COVID-19 was the only significant predictor of persistent dyspnea (OR 3.19 [95% C.I. 1.04; 9.87], p = 0.043) and mobility problems (OR 3.70 [95% C.I. 1.25; 10.95], p = 0.018) at 6 months at logistic regression adjusted for sex, age, and BMI. Conclusion Myosteatosis diagnosed during acute COVID-19 significantly predicts persistent dyspnea and mobility problems at 6 months after hospital discharge independent of age, sex, and body mass. Clinical Trial Registration [www.ClinicalTrials.gov], identifier [NCT04318366].
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Affiliation(s)
- Rebecca De Lorenzo
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Anna Palmisano
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Antonio Esposito
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Gnasso
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Valeria Nicoletti
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Riccardo Leone
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Davide Vignale
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Elisabetta Falbo
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Marica Ferrante
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Marta Cilla
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Cristiano Magnaghi
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sabina Martinenghi
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giordano Vitali
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alessio Molfino
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Patrizia Rovere-Querini
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Maurizio Muscaritoli
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Caterina Conte
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milan, Italy
- *Correspondence: Caterina Conte,
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De Lorenzo R, Magnaghi C, Cinel E, Vitali G, Martinenghi S, Mazza MG, Nocera L, Cilla M, Damanti S, Compagnone N, Ferrante M, Conte C, Benedetti F, Ciceri F, Rovere-Querini P. A Nomogram-Based Model to Predict Respiratory Dysfunction at 6 Months in Non-Critical COVID-19 Survivors. Front Med (Lausanne) 2022; 9:781410. [PMID: 35280880 PMCID: PMC8904385 DOI: 10.3389/fmed.2022.781410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 01/28/2022] [Indexed: 12/12/2022] Open
Abstract
Objective To assess the prevalence of respiratory sequelae of Coronavirus disease 2019 (COVID-19) survivors at 6 months after hospital discharge and develop a model to identify at-risk patients. Patients and Methods In this prospective cohort study, hospitalized, non-critical COVID-19 patients evaluated at 6-month follow-up between 26 August, 2020 and 16 December, 2020 were included. Primary outcome was respiratory dysfunction at 6 months, defined as at least one among tachypnea at rest, percent predicted 6-min walking distance at 6-min walking test (6MWT) ≤ 70%, pre-post 6MWT difference in Borg score ≥ 1 or a difference between pre- and post-6MWT oxygen saturation ≥ 5%. A nomogram-based multivariable logistic regression model was built to predict primary outcome. Validation relied on 2000-resample bootstrap. The model was compared to one based uniquely on degree of hypoxemia at admission. Results Overall, 316 patients were included, of whom 118 (37.3%) showed respiratory dysfunction at 6 months. The nomogram relied on sex, obesity, chronic obstructive pulmonary disease, degree of hypoxemia at admission, and non-invasive ventilation. It was 73.0% (95% confidence interval 67.3–78.4%) accurate in predicting primary outcome and exhibited minimal departure from ideal prediction. Compared to the model including only hypoxemia at admission, the nomogram showed higher accuracy (73.0 vs 59.1%, P < 0.001) and greater net-benefit in decision curve analyses. When the model included also respiratory data at 1 month, it yielded better accuracy (78.2 vs. 73.2%) and more favorable net-benefit than the original model. Conclusion The newly developed nomograms accurately identify patients at risk of persistent respiratory dysfunction and may help inform clinical priorities.
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Affiliation(s)
- Rebecca De Lorenzo
- Medical Residency Program, Vita-Salute San Raffaele University, Milan, Italy
| | - Cristiano Magnaghi
- Division of Immunology, Transplantation and Infectious Diseases, San Raffaele Hospital, Milan, Italy
| | - Elena Cinel
- Medical Residency Program, Vita-Salute San Raffaele University, Milan, Italy
| | - Giordano Vitali
- Division of Immunology, Transplantation and Infectious Diseases, San Raffaele Hospital, Milan, Italy
| | - Sabina Martinenghi
- Division of Immunology, Transplantation and Infectious Diseases, San Raffaele Hospital, Milan, Italy
| | - Mario G Mazza
- Medical Residency Program, Vita-Salute San Raffaele University, Milan, Italy.,Unit of Psychiatry and Clinical Psychobiology, Division of Neuroscience, San Raffaele Hospital, Milan, Italy
| | - Luigi Nocera
- Medical Residency Program, Vita-Salute San Raffaele University, Milan, Italy
| | - Marta Cilla
- Division of Immunology, Transplantation and Infectious Diseases, San Raffaele Hospital, Milan, Italy
| | - Sarah Damanti
- Unit of General Medicine and Advanced Care, San Raffaele Hospital, Milan, Italy
| | - Nicola Compagnone
- Medical Residency Program, Vita-Salute San Raffaele University, Milan, Italy
| | - Marica Ferrante
- Medical Residency Program, Vita-Salute San Raffaele University, Milan, Italy
| | - Caterina Conte
- Division of Immunology, Transplantation and Infectious Diseases, San Raffaele Hospital, Milan, Italy
| | - Francesco Benedetti
- Medical Residency Program, Vita-Salute San Raffaele University, Milan, Italy.,Unit of Psychiatry and Clinical Psychobiology, Division of Neuroscience, San Raffaele Hospital, Milan, Italy
| | - Fabio Ciceri
- Medical Residency Program, Vita-Salute San Raffaele University, Milan, Italy.,Division of Immunology, Transplantation and Infectious Diseases, San Raffaele Hospital, Milan, Italy
| | - Patrizia Rovere-Querini
- Medical Residency Program, Vita-Salute San Raffaele University, Milan, Italy.,Division of Immunology, Transplantation and Infectious Diseases, San Raffaele Hospital, Milan, Italy
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Compagnone N, Palumbo D, Cremona G, Vitali G, De Lorenzo R, Calvi MR, Del Prete A, Baiardo Redaelli M, Calamarà S, Belletti A, Steidler S, Conte C, Zangrillo A, De Cobelli F, Rovere‐Querini P, Monti G. Residual lung damage following ARDS in COVID-19 ICU survivors. Acta Anaesthesiol Scand 2022; 66:223-231. [PMID: 34758108 PMCID: PMC8652634 DOI: 10.1111/aas.13996] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 10/13/2021] [Accepted: 10/26/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Coronavirus disease 2019 acute respiratory distress syndrome (COVID-19 ARDS) is a disease that often requires invasive ventilation. Little is known about COVID-19 ARDS sequelae. We assessed the mid-term lung status of COVID-19 survivors and investigated factors associated with pulmonary sequelae. METHODS All adult COVID-19 patients admitted to the intensive care unit from 25th February to 27th April 2020 were included. Lung function was evaluated through chest CT scan and pulmonary function tests (PFT). Logistic regression was used to identify predictors of persisting lung alterations. RESULTS Forty-nine patients (75%) completed lung assessment. Chest CT scan was performed after a median (interquartile range) time of 97 (89-105) days, whilst PFT after 142 (133-160) days. The median age was 58 (52-65) years and most patients were male (90%). The median duration of mechanical ventilation was 11 (6-16) days. Median tidal volume/ideal body weight (TV/IBW) was 6.8 (5.71-7.67) ml/Kg. 59% and 63% of patients showed radiological and functional lung sequelae, respectively. The diffusion capacity of carbon monoxide (DLCO ) was reduced by 59%, with a median per cent of predicted DLCO of 72.1 (57.9-93.9) %. Mean TV/IBW during invasive ventilation emerged as an independent predictor of persistent CT scan abnormalities, whilst the duration of mechanical ventilation was an independent predictor of both CT and PFT abnormalities. The extension of lung involvement at hospital admission (evaluated through Radiographic Assessment of Lung Edema, RALE score) independently predicted the risk of persistent alterations in PFTs. CONCLUSIONS Both the extent of lung parenchymal involvement and mechanical ventilation protocols predict morphological and functional lung abnormalities months after COVID-19.
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Affiliation(s)
- Nicola Compagnone
- Vita‐Salute San Raffaele UniversityMilanItaly
- Division of Immunology, Transplantation and Infectious DiseasesIRCCS San Raffaele HospitalMilanItaly
| | - Diego Palumbo
- Vita‐Salute San Raffaele UniversityMilanItaly
- Clinical and Experimental Radiology UnitExperimental Imaging CenterIRCCS San Raffaele Scientific InstituteMilanItaly
| | - George Cremona
- Unit of Respiratory MedicineIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Giordano Vitali
- Division of Immunology, Transplantation and Infectious DiseasesIRCCS San Raffaele HospitalMilanItaly
| | - Rebecca De Lorenzo
- Vita‐Salute San Raffaele UniversityMilanItaly
- Division of Immunology, Transplantation and Infectious DiseasesIRCCS San Raffaele HospitalMilanItaly
| | - Maria Rosa Calvi
- Department of Anesthesia and Intensive CareIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Andrea Del Prete
- Clinical and Experimental Radiology UnitExperimental Imaging CenterIRCCS San Raffaele Scientific InstituteMilanItaly
| | | | - Sabrina Calamarà
- Clinical and Experimental Radiology UnitExperimental Imaging CenterIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Alessandro Belletti
- Department of Anesthesia and Intensive CareIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Stephanie Steidler
- Clinical and Experimental Radiology UnitExperimental Imaging CenterIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Caterina Conte
- Division of Immunology, Transplantation and Infectious DiseasesIRCCS San Raffaele HospitalMilanItaly
| | - Alberto Zangrillo
- Vita‐Salute San Raffaele UniversityMilanItaly
- Department of Anesthesia and Intensive CareIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Francesco De Cobelli
- Vita‐Salute San Raffaele UniversityMilanItaly
- Clinical and Experimental Radiology UnitExperimental Imaging CenterIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Patrizia Rovere‐Querini
- Vita‐Salute San Raffaele UniversityMilanItaly
- Division of Immunology, Transplantation and Infectious DiseasesIRCCS San Raffaele HospitalMilanItaly
| | | | - Giacomo Monti
- Department of Anesthesia and Intensive CareIRCCS San Raffaele Scientific InstituteMilanItaly
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Pindozzi F, Socci C, Bissolati M, Marchi M, Devecchi E, Saibene A, Conte C. Role of nutritional ketosis in the improvement of metabolic parameters following bariatric surgery. World J Diabetes 2022; 13:54-64. [PMID: 35070059 PMCID: PMC8771267 DOI: 10.4239/wjd.v13.i1.54] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/29/2021] [Accepted: 01/05/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Ketone bodies (KB) might act as potential metabolic modulators besides serving as energy substrates. Bariatric metabolic surgery (BMS) offers a unique opportunity to study nutritional ketosis, as acute postoperative caloric restriction leads to increased lipolysis and circulating free fatty acids.
AIM To characterize the relationship between KB production, weight loss (WL) and metabolic changes following BMS.
METHODS For this retrospective study we enrolled male and female subjects aged 18-65 years who underwent BMS at a single Institution. Data on demographics, anthropometrics, body composition, laboratory values and urinary KB were collected.
RESULTS Thirty-nine patients had data available for analyses [74.4% women, mean age 46.5 ± 9.0 years, median body mass index 41.0 (38.5; 45.4) kg/m2, fat mass 45.2% ± 6.2%, 23.1% had diabetes, 43.6% arterial hypertension and 74.4% liver steatosis]. At 46.0 ± 13.6 d post-surgery, subjects had lost 12.0% ± 3.6% of pre-operative weight. Sixty-nine percent developed ketonuria. Those with nutritional ketosis were significantly younger [42.9 (37.6; 50.7) years vs 51.9 (48.3; 59.9) years, P = 0.018], and had significantly lower fasting glucose [89.5 (82.5; 96.3) mg/dL vs 96.0 (91.0; 105.3) mg/dL, P = 0.025] and triglyceride levels [108.0 (84.5; 152.5) mg/dL vs 152.0 (124.0; 186.0) mg/dL, P = 0.045] vs those with ketosis. At 6 mo, percent WL was greater in those with postoperative ketosis (-27.5% ± 5.1% vs 23.8% ± 4.3%, P = 0.035). Urinary KBs correlated with percent WL at 6 and 12 mo. Other metabolic changes were similar.
CONCLUSION Our data support the hypothesis that subjects with worse metabolic status have reduced ketogenic capacity and, thereby, exhibit a lower WL following BMS.
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Affiliation(s)
- Fioralba Pindozzi
- Unità di Chirurgia Generale Provinciale, Ospedale del Delta, Lagosanto (FE) 44023, Italy
| | - Carlo Socci
- Transplant and Metabolic/Bariatric Surgery Unit, IRCCS Ospedale San Raffaele, Milan 20132, Italy
| | - Massimiliano Bissolati
- Transplant and Metabolic/Bariatric Surgery Unit, IRCCS Ospedale San Raffaele, Milan 20132, Italy
| | - Monica Marchi
- Department of General Medicine, Diabetes and Endocrinology, IRCCS Ospedale San Raffaele, Milan 20132, Italy
| | - Elisabetta Devecchi
- Department of General Medicine, Diabetes and Endocrinology, IRCCS Ospedale San Raffaele, Milan 20132, Italy
| | - Alessandro Saibene
- Department of General Medicine, Diabetes and Endocrinology, IRCCS Ospedale San Raffaele, Milan 20132, Italy
| | - Caterina Conte
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Open University, Rome 00166, Italy
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milan 20099, Italy
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Loverro M, Ergasti R, Conte C, Gallitelli V, Nachira D, Scaglione G, Fagotti A, Scambia G, Gallotta V. Minimally Invasive Secondary Cytoreductive Surgery for Superficial Celiac and Cardio-Phrenic Isolated Nodal Recurrence of Ovarian Cancer. Ann Surg Oncol 2022; 29:2603-2604. [DOI: 10.1245/s10434-021-11267-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 12/12/2021] [Indexed: 11/18/2022]
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30
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Damanti S, Cilla M, Tuscano B, De Lorenzo R, Manganaro G, Merolla A, Pacioni G, Pomaranzi C, Tiraferri V, Martinenghi S, Vitali G, Bosi E, Conte C, Giustina A, Tresoldi M, Rovere Querini P. Evaluation of Muscle Mass and Stiffness with Limb Ultrasound in COVID-19 Survivors. Front Endocrinol (Lausanne) 2022; 13:801133. [PMID: 35250860 PMCID: PMC8892603 DOI: 10.3389/fendo.2022.801133] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 01/25/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND acute illnesses, like COVID-19, can act as a catabolic stimulus on muscles. So far, no study has evaluated muscle mass and quality through limb ultrasound in post-COVID-19 patients. METHODS cross sectional observational study, including patients seen one month after hospital discharge for SARS-CoV-2 pneumonia. The patients underwent a multidimensional evaluation. Moreover, we performed dominant medial gastrocnemius ultrasound (US) to characterize their muscle mass and quality. RESULTS two hundred fifty-nine individuals (median age 67, 59.8% males) were included in the study. COVID-19 survivors with reduced muscle strength had a lower muscle US thickness (1.6 versus 1.73 cm, p =0.02) and a higher muscle stiffness (87 versus 76.3, p = 0.004) compared to patients with normal muscle strength. Also, patients with reduced Short Physical Performance Battery (SPPB) scores had a lower muscle US thickness (1.3 versus 1.71 cm, p = 0.01) and a higher muscle stiffness (104.9 versus 81.07, p = 0.04) compared to individuals with normal SPPB scores. The finding of increased muscle stiffness was also confirmed in patients with a pathological value (≥ 4) at the sarcopenia screening tool SARC-F (103.0 versus 79.55, p < 0.001). Muscle stiffness emerged as a significant predictor of probable sarcopenia (adjusted OR 1.02, 95% C.I. 1.002 - 1.04, p = 0.03). The optimal ultrasound cut-offs for probable sarcopenia were 1.51 cm for muscle thickness (p= 0.017) and 73.95 for muscle stiffness (p = 0.004). DISCUSSION we described muscle ultrasound characteristics in post COVID-19 patients. Muscle ultrasound could be an innovative tool to assess muscle mass and quality in this population. Our preliminary findings need to be confirmed by future studies comparing muscle ultrasound with already validated techniques for measuring muscle mass and quality.
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Affiliation(s)
- Sarah Damanti
- Unit of General Medicine and Advanced Care, Instituto di Ricovero e Cura a Carattere Scientifico (IRCSS) San Raffaele Institute, Milan, Italy
- *Correspondence: Sarah Damanti,
| | - Marta Cilla
- Unit of General Medicine and Advanced Care, Instituto di Ricovero e Cura a Carattere Scientifico (IRCSS) San Raffaele Institute, Milan, Italy
| | - Bruno Tuscano
- Unit of Radiology, IRCCS San Raffaele Institute, Milan, Italy
| | | | | | | | | | | | | | - Sabina Martinenghi
- San Raffaele Diabetes Research Institute, Instituto di Ricovero e Cura a Carattere Scientifico (IRCSS) Ospedale San Raffaele, Milan, Italy
| | - Giordano Vitali
- San Raffaele Diabetes Research Institute, Instituto di Ricovero e Cura a Carattere Scientifico (IRCSS) Ospedale San Raffaele, Milan, Italy
| | - Emanuele Bosi
- Vita-Salute San Raffaele University, Milan, Italy
- San Raffaele Diabetes Research Institute, Instituto di Ricovero e Cura a Carattere Scientifico (IRCSS) Ospedale San Raffaele, Milan, Italy
| | - Caterina Conte
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
- Department of Endocrinology, Nutrition and Metabolic Diseases, Instituto di Ricovero e Cura a Carattere Scientifico (IRCSS) MultiMedica, Milan, Italy
| | - Andrea Giustina
- Institute of Endocrine and Metabolic Sciences, San Raffaele Vita-Salute University, Instituto di Ricovero e Cura a Carattere Scientifico (IRCSS) San Raffaele Hospital, Ospedale San Raffaele, Milan, Italy
| | - Moreno Tresoldi
- Unit of General Medicine and Advanced Care, Instituto di Ricovero e Cura a Carattere Scientifico (IRCSS) San Raffaele Institute, Milan, Italy
| | - Patrizia Rovere Querini
- Unit of Radiology, IRCCS San Raffaele Institute, Milan, Italy
- Department of Immunology, Transplantation and Infectious Diseases, Instituto di Ricovero e Cura a Carattere Scientifico (IRCSS) Ospedale San Raffaele, Milan, Italy
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Bonanni A, Pedicino D, Vinci R, D'Aiello A, Ponzo M, Ciampi P, Pisano E, Canonico F, Di Sario M, Conte C, Cribari F, Grimaldi MC, Severino A, Crea F, Liuzzo G. Takotsubo syndrome: a way to reach a straightforward diagnosis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1392] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background/Introduction
Acute stress-induced cardiomyopathy, also known as Takotsubo Syndrome (TTS), was originally classified as a benign disease. Nowadays, this assumption has changed, especially in its long-term outcome, due to TTS clinical presentation, that often mirrors the acute myocardial infarction (MI) phenotype. Current knowledge already delineate clinical features distinctive of TTS and MI patients, however, diagnosis requires multiple, expansive, and invasive medical examinations. Moreover, concerning the biological panorama, very slight is known and the lack of a tailored therapy is resented. Therefore, a biological profile for this clinical category could provide easier and less invasive diagnostic tools, leading edge towards novel therapeutic pathways.
Purpose
The aim of the study is to perform a biological profile of the TTS group compared to the ST Segment Elevation Myocardial Infarction (STEMI) in order to explore the molecular peculiarities attendant the pathophysiologic mechanisms.
Methods
We performed a gene expression array on two groups of pooled cDNA from peripheral blood mononuclear cells, from TTS (n=11) and STEMI (n=19) patients. We conducted gene expression validations for each enrolled patient through qPCR.
Results
Our preliminary data displayed several differences in gene expression levels of a grand number of cell adhesion signaling molecule between the two groups. As shown in figure 1, three gene were more expressed in TTS group: Nitric Oxide Synthase 3, also known as endothelial NOS (NOS3; p=0.002), Superoxide dismutase 1 (SOD1; p=0.03) and transferrin receptor (TFRC; p=0.005). Meanwhile, five gene displayed a higher expression in STEMI patients compared to TTS: phospholipase A2 Group 7 (PLA2G7; p=0.04), Galectin 8 (LGALS8; p=0.02), Intercellular Adhesion Molecule 1 (ICAM1; p=0.002), Hyaluronidase 2 (HYAL2; p=0.01) and Hyaluronan Receptor (CD44; p=0.0002).
Conclusions
The earliest results of this study led us to focus on fewer genes related to endothelial and oxidative stress pathways. TTS is habitually triggered by intense emotional or physical stress. Indeed, our results showed how TTS patients present higher expression of NOS3, SOD1 and TFRC, all components involved in the oxidative stress pathways. In STEMI patients, top expressed genes, such as HYAL2, CD44 and ICAM1, are all associated with extracellular matrix turnover, likely due to the presence of a stenotic plaque and the consequent endothelial derangement. The uncovering of diagnostic biomarkers in TTS might improve the early, non-invasive, stratification of this group of patients, thus facilitating novel and personalized therapeutics design.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The present study was supported by the Italian National Project Grant PRIN 2017.
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Affiliation(s)
- A Bonanni
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - D Pedicino
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - R Vinci
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - A D'Aiello
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - M Ponzo
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - P Ciampi
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - E Pisano
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - F Canonico
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - M Di Sario
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - C Conte
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - F Cribari
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - M C Grimaldi
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - A Severino
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - F Crea
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - G Liuzzo
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Landstra CP, Andres A, Chetboun M, Conte C, Kelly Y, Berney T, de Koning EJP, Piemonti L, Stock PG, Pattou F, Vantyghem MC, Bellin MD, Rickels MR. Examination of the Igls Criteria for Defining Functional Outcomes of β-cell Replacement Therapy: IPITA Symposium Report. J Clin Endocrinol Metab 2021; 106:3049-3059. [PMID: 34061967 PMCID: PMC8571711 DOI: 10.1210/clinem/dgab386] [Citation(s) in RCA: 12] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Indexed: 11/19/2022]
Abstract
CONTEXT The Igls criteria were developed to provide a consensus definition for outcomes of β-cell replacement therapy in the treatment of diabetes during a January 2017 workshop sponsored by the International Pancreas & Islet Transplant Association (IPITA) and the European Pancreas & Islet Transplant Association. In July 2019, a symposium at the 17th IPITA World Congress was held to examine the Igls criteria after 2 years in clinical practice, including validation against continuous glucose monitoring (CGM)-derived glucose targets, and to propose future refinements that would allow for comparison of outcomes with artificial pancreas system approaches. EVIDENCE ACQUISITION Utilization of the criteria in various clinical and research settings was illustrated by population as well as individual outcome data of 4 islet and/or pancreas transplant centers. Validation against CGM metrics was conducted in 55 islet transplant recipients followed-up to 10 years from a fifth center. EVIDENCE SYNTHESIS The Igls criteria provided meaningful clinical assessment on an individual patient and treatment group level, allowing for comparison both within and between different β-cell replacement modalities. Important limitations include the need to account for changes in insulin requirements and C-peptide levels relative to baseline. In islet transplant recipients, CGM glucose time in range improved with each category of increasing β-cell graft function. CONCLUSIONS Future Igls 2.0 criteria should consider absolute rather than relative levels of insulin use and C-peptide as qualifiers with treatment success based on glucose assessment using CGM metrics on par with assessment of glycated hemoglobin and severe hypoglycemia events.
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Affiliation(s)
- Cyril P Landstra
- Division of Endocrinology & Division of Nephrology, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Axel Andres
- Divison of Transplantation and Visceral Surgery, Department of Surgery, Geneva University Hospital, Geneva, Switzerland
| | - Mikael Chetboun
- Department of General and Endocrine Surgery, Centre Hospitalier Universitaire de Lille, and Inserm, Translational Research for Diabetes, Université de Lille, Lille, France
| | - Caterina Conte
- Diabetes Research Institute, IRCCS San Raffaele Scientific Institute, and Vita-Salute San Raffaele University, Milan, Italy
| | - Yvonne Kelly
- Division of Transplantation, Department of Surgery, University of California at San Francisco, San Francisco, CA, USA
| | - Thierry Berney
- Divison of Transplantation and Visceral Surgery, Department of Surgery, Geneva University Hospital, Geneva, Switzerland
| | - Eelco J P de Koning
- Division of Endocrinology & Division of Nephrology, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Lorenzo Piemonti
- Diabetes Research Institute, IRCCS San Raffaele Scientific Institute, and Vita-Salute San Raffaele University, Milan, Italy
| | - Peter G Stock
- Division of Transplantation, Department of Surgery, University of California at San Francisco, San Francisco, CA, USA
| | - François Pattou
- Department of General and Endocrine Surgery, Centre Hospitalier Universitaire de Lille, and Inserm, Translational Research for Diabetes, Université de Lille, Lille, France
| | - Marie-Christine Vantyghem
- Department of Endocrinology, Diabetology and Metabolism, Centre Hospitalier Universitaire de Lille, and Inserm, Translational Research for Diabetes, Université de Lille, Lille, France
| | - Melena D Bellin
- Division of Endocrinology, Department of Pediatrics, and the Schulze Diabetes Institute, University of Minnesota, Minneapolis, MN, USA
| | - Michael R Rickels
- Division of Endocrinology, Diabetes & Metabolism, Department of Medicine, and Institute for Diabetes, Obesity & Metabolism, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Correspondence: Michael R. Rickels, MD, MS, Institute for Diabetes, Obesity & Metabolism, University of Pennsylvania Perelman School of Medicine, 12-134 Smilow Center for Translational Research, 3400 Civic Center Boulevard, Philadelphia, PA, USA 19104-5160.
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Filippo LD, De Lorenzo R, Sciorati C, Capobianco A, Lorè NI, Giustina A, Manfredi AA, Rovere-Querini P, Conte C. Adiponectin to leptin ratio reflects inflammatory burden and survival in COVID-19. Diabetes Metab 2021; 47:101268. [PMID: 34333093 PMCID: PMC8320244 DOI: 10.1016/j.diabet.2021.101268] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/01/2021] [Accepted: 07/25/2021] [Indexed: 12/16/2022]
Abstract
Aim Obesity is a risk factor for COVID-19, but the underlying mechanisms are unclear. We investigated the role of adiponectin (an anti-inflammatory adipokine), leptin (a pro-inflammatory adipokine) and their ratio (Adpn/Lep) in this context. Design Single-centre, prospective observational study. Methods. Adiponectin and leptin were measured in 60 COVID-19 patients with mild (not hospitalised, n=11), moderate (hospitalised but not requiring intensive care, n=25) and severe (admission to the intensive care unit [ICU] or death, n=24) disease. Results Adiponectin and leptin levels were similar across severity groups, but patients with moderate severity had the highest Adpn/Lep ratio (1.2 [0.5; 2.0], 5.0 [1.6; 11.2], 2.1 [1.0; 3.6] in mild, moderate and severe disease; P = 0.019). Adpn/Lep, but not adiponectin or leptin alone, correlated with systemic inflammation (C reactive protein, CRP: Spearman's rho 0.293, P = 0.023). When dividing patients into Adpn/Lep tertiles, adiponectin was highest, whereas leptin was lowest in the third (highest) tertile. Patients in the highest Adpn/Lep tertile had numerically lower rates of obesity, diabetes and hypertension, and lower rates of death or admission to ICU versus other tertiles. At linear regression in the whole cohort, CRP significantly predicted Adpn/Lep (β 0.291, P = 0.022), while female gender (β -0.289, P = 0.016), diabetes (β -0.257, P = 0.028), and hypertension (β -239, P = 0.043) were negative predictors. Conclusions We speculate that the rise in Adpn/Lep, due to increased adiponectin and reduced leptin, is a compensatory response to systemic inflammation. In patients with worse cardiometabolic health (e.g. diabetes, hypertension) this mechanism might be blunted, possibly contributing to higher mortality.
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Affiliation(s)
- Luigi Di Filippo
- Vita-Salute San Raffaele University, Milan, Italy; Institute of Endocrine and Metabolic Sciences, IRCCS San Raffaele Hospital, Milan, Italy
| | - Rebecca De Lorenzo
- Vita-Salute San Raffaele University, Milan, Italy; Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Clara Sciorati
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Annalisa Capobianco
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Nicola I Lorè
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy; Emerging Bacterial Pathogens Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Giustina
- Vita-Salute San Raffaele University, Milan, Italy; Institute of Endocrine and Metabolic Sciences, IRCCS San Raffaele Hospital, Milan, Italy
| | - Angelo A Manfredi
- Vita-Salute San Raffaele University, Milan, Italy; Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Patrizia Rovere-Querini
- Vita-Salute San Raffaele University, Milan, Italy; Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Caterina Conte
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.
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34
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Conte C, Esposito A, De Lorenzo R, Di Filippo L, Palmisano A, Vignale D, Leone R, Nicoletti V, Ruggeri A, Gallone G, Secchi A, Bosi E, Tresoldi M, Castagna A, Landoni G, Zangrillo A, De Cobelli F, Ciceri F, Camici P, Rovere-Querini P. Epicardial adipose tissue characteristics, obesity and clinical outcomes in COVID-19: A post-hoc analysis of a prospective cohort study. Nutr Metab Cardiovasc Dis 2021; 31:2156-2164. [PMID: 34059384 PMCID: PMC8091800 DOI: 10.1016/j.numecd.2021.04.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 04/19/2021] [Accepted: 04/19/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND AND AIMS Obesity-related cardiometabolic risk factors associate with COVID-19 severity and outcomes. Epicardial adipose tissue (EAT) is associated with cardiometabolic disturbances, is a source of proinflammatory cytokines and a marker of visceral adiposity. We investigated the relation between EAT characteristics and outcomes in COVID-19 patients. METHODS AND RESULTS This post-hoc analysis of a large prospective investigation included all adult patients (≥18 years) admitted to San Raffaele University Hospital in Milan, Italy, from February 25th to April 19th, 2020 with confirmed SARS-CoV-2 infection who underwent a chest computed tomography (CT) scan for COVID-19 pneumonia and had anthropometric data available for analyses. EAT volume and attenuation (EAT-At, a marker of EAT inflammation) were measured on CT scan. Primary outcome was critical illness, defined as admission to intensive care unit (ICU), invasive ventilation or death. Cox regression and regression tree analyses were used to assess the relationship between clinical variables, EAT characteristics and critical illness. One-hundred and ninety-two patients were included (median [25th-75th percentile] age 60 years [53-70], 76% men). Co-morbidities included overweight/obesity (70%), arterial hypertension (40%), and diabetes (16%). At multivariable Cox regression analysis, EAT-At (HR 1.12 [1.04-1.21]) independently predicted critical illness, while increasing PaO2/FiO2 was protective (HR 0.996 [95% CI 0.993; 1.00]). CRP, plasma glucose on admission, EAT-At and PaO2/FiO2 identified five risk groups that significantly differed with respect to time to death or admission to ICU (log-rank p < 0.0001). CONCLUSION Increased EAT attenuation, a marker of EAT inflammation, but not obesity or EAT volume, predicts critical COVID-19. TRIAL REGISTRATION NCT04318366.
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Affiliation(s)
- Caterina Conte
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.
| | - Antonio Esposito
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Experimental Imaging Center, Unit of Experimental and Clinical Radiology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Luigi Di Filippo
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Anna Palmisano
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Experimental Imaging Center, Unit of Experimental and Clinical Radiology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Davide Vignale
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Experimental Imaging Center, Unit of Experimental and Clinical Radiology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Riccardo Leone
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Experimental Imaging Center, Unit of Experimental and Clinical Radiology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Valeria Nicoletti
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Experimental Imaging Center, Unit of Experimental and Clinical Radiology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Annalisa Ruggeri
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Guglielmo Gallone
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, Turin, Italy
| | - Antonio Secchi
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Emanuele Bosi
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Moreno Tresoldi
- Unit of General Medicine and Advanced Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Antonella Castagna
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Giovanni Landoni
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alberto Zangrillo
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesco De Cobelli
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Experimental Imaging Center, Unit of Experimental and Clinical Radiology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Fabio Ciceri
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Paolo Camici
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Patrizia Rovere-Querini
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
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Napoli N, Incalzi RA, De Gennaro G, Marcocci C, Marfella R, Papalia R, Purrello F, Ruggiero C, Tarantino U, Tramontana F, Conte C. Bone fragility in patients with diabetes mellitus: A consensus statement from the working group of the Italian Diabetes Society (SID), Italian Society of Endocrinology (SIE), Italian Society of Gerontology and Geriatrics (SIGG), Italian Society of Orthopaedics and Traumatology (SIOT). Nutr Metab Cardiovasc Dis 2021; 31:1375-1390. [PMID: 33812734 DOI: 10.1016/j.numecd.2021.01.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 01/24/2021] [Accepted: 01/25/2021] [Indexed: 02/08/2023]
Abstract
Bone fragility is one of the possible complications of diabetes, either type 1 (T1D) or type 2 (T2D). Bone fragility can affect patients of different age and with different disease severity depending on type of diabetes, disease duration and the presence of other complications. Fracture risk assessment should be started at different stages in the natural history of the disease depending on the type of diabetes and other risk factors. The risk of fracture in T1D is higher than in T2D, imposing a much earlier screening and therapeutic intervention that should also take into account a patient's life expectancy, diabetes complications etc. The therapeutic armamentarium for T2D has been enriched with drugs that may influence bone metabolism, and clinicians should be aware of these effects. Considering the complexity of diabetes and osteoporosis and the range of variables that influence treatment choices in a given individual, the Working Group on bone fragility in patients with diabetes mellitus has identified and issued recommendations based on the variables that should guide screening of bone fragility and management of diabetes and bone fragility: (A)ge, (B)MD, (C)omplications, (D)uration of disease, & (F)ractures (ABCD&F). Consideration of these parameters may help clinicians identify the best time for screening, the appropriate glycaemic target and anti-osteoporosis drug for patients with diabetes at risk of or with bone fragility.
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Affiliation(s)
- Nicola Napoli
- Unit of Endocrinology and Diabetes, Departmental Faculty of Medicine and Surgery, Campus Bio-Medico University of Rome, Rome, Italy; Division of Bone and Mineral Diseases, Washington University in St. Louis, St. Louis, MO, USA.
| | - Raffaele A Incalzi
- Unit of Geriatrics, Departmental Faculty of Medicine and Surgery, Campus Bio-Medico University of Rome, Rome, Italy.
| | - Giovanni De Gennaro
- Diabetes Center, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Claudio Marcocci
- Endocrinology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Raffaele Marfella
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Rocco Papalia
- Unit of Orthopedic and Trauma Surgery, Departmental Faculty of Medicine and Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Francesco Purrello
- Department of Clinical and Experimental Medicine, University of Catania, 95100 Catania, Italy; Department of Clinical and Experimental Medicine, Internal Medicine, Garibaldi-Nesima Hospital, University of Catania, Catania, Italy
| | - Carmelinda Ruggiero
- Institute of Gerontology and Geriatrics, Department of Medicine, University of Perugia, Perugia, Italy
| | - Umberto Tarantino
- Department of Clinical Sciences and Translational Medicine, Faculty of Medicine and Surgery, "Tor Vergata" University of Rome, Rome, Italy; Department of Orthopaedics and Traumatology, "Policlinico Tor Vergata" Foundation, Rome, Italy
| | - Flavia Tramontana
- Unit of Endocrinology and Diabetes, Departmental Faculty of Medicine and Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Caterina Conte
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy; Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milan, Italy
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Potenza S, Marella GL, Mauriello S, Milano F, Mancuso A, Conte C, Marsella LT. An unusual case of death using a compacting machine. Clin Ter 2021; 172:186-189. [PMID: 33956033 DOI: 10.7417/ct.2021.2310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
In the large series of forensic injury, death from accidental me-chanical asphyxiation in adults is rare and is usually secondary to suffocation, aspiration, strangulation caused by entrapment of clothing in machinery (deaths at work) or asphyxiation in the course of erotic maneuvers. Compression asphyxia is a form of violent mechanical asphyxia in which the asphyxiated insult is produced by means of a compression and constriction mechanism of the thoracic cage. The authors report an unusual case of asphyxiated death from chest com-pression resulting from the action of a compacting machine, which occurred in a person who had fallen asleep in a waste bin.
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Affiliation(s)
- S Potenza
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - G L Marella
- Department of Surgical Sciences, Univer-sity of Rome "Tor Vergata", Rome, Italy
| | - S Mauriello
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - F Milano
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - A Mancuso
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - C Conte
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - L T Marsella
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
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Conte C, Terruzzi I, Ambrosio G. Metabolic memory in diabetes: Permanent scar, legacy, or ongoing domino effect? Cardiovasc Res 2021; 118:4-6. [PMID: 33744936 DOI: 10.1093/cvr/cvab104] [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: 03/12/2021] [Accepted: 03/18/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Caterina Conte
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy.,Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milan, Italy
| | - Ileana Terruzzi
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milan, Italy.,Department of Biomedical Sciences and Health, Università degli Studi di Milano, Milan, Italy
| | - Giuseppe Ambrosio
- Division of Cardiology, University of Perugia School of Medicine, Perugia, Italy
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38
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Gaspardone C, Meloni C, Preda A, Romagnolo D, Brugliera L, Castellazzi P, Tettamanti A, Conte C, Secchi A, Maranta F, Iannaccone S, Cianflone D. Lung Ultrasound in COVID-19 A Role Beyond the Acute Phase? J Ultrasound Med 2021; 40:503-511. [PMID: 32770687 DOI: 10.1002/jum.15425] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 06/22/2020] [Indexed: 05/08/2023]
Abstract
OBJECTIVES Coronavirus disease 2019 (COVID-19) is a viral illness caused by severe acute respiratory syndrome coronavirus 2. With the increasing number of improved and discharged patients with COVID-19, the definition of an adequate follow-up strategy is needed. The purpose of this study was to assess whether lung ultrasound (LUS) is an effective indicator of subclinical residual lung damage in patients with COVID-19 who meet discharge criteria. METHODS We prospectively enrolled 70 consecutive patients with COVID-19 who had a prolonged hospitalization with inpatient rehabilitation between April 6 and May 22, 2020. All of the patients underwent an LUS evaluation at discharge. Data of patients with more severe disease during the acute phase (ie, required ventilatory support) were compared to those of patients with milder disease. RESULTS Among the 70 patients with COVID-19 (22 women and 48 men; mean age ± SD, 68 ± 13 years), the LUS score before discharge was still frankly pathologic and higher in patients who had more severe disease during the acute phase compared to patients with milder disease (median [interquartile range], 8.0 [5.5-13.5] versus 2.0 [1.0-7.0]; P < .001), even when both categories met internationally defined discharge criteria. CONCLUSIONS Lung ultrasound can identify the persistence of subclinical residual lung damage in patients with severe COVID-19 even if they meet discharge criteria. Considering the low cost, easy application, and lack of radiation exposure, LUS seems the ideal tool to be adopted in outpatient and primary care settings for the follow-up of patients with COVID-19.
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Affiliation(s)
| | - Carlo Meloni
- Cardiac Rehabilitation Unit, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Scientific Institute, Milan, Italy
| | | | | | - Luigia Brugliera
- Department of Rehabilitation and Functional Recovery, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Scientific Institute, Milan, Italy
| | - Paola Castellazzi
- Department of Rehabilitation and Functional Recovery, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Tettamanti
- Department of Rehabilitation and Functional Recovery, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Scientific Institute, Milan, Italy
| | - Caterina Conte
- Vita-Salute San Raffaele University, Milan, Italy
- Department of Internal Medicine, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Scientific Institute, Milan, Italy
| | - Antonio Secchi
- Vita-Salute San Raffaele University, Milan, Italy
- Department of Internal Medicine, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Scientific Institute, Milan, Italy
| | - Francesco Maranta
- Cardiac Rehabilitation Unit, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Scientific Institute, Milan, Italy
| | - Sandro Iannaccone
- Department of Rehabilitation and Functional Recovery, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Scientific Institute, Milan, Italy
| | - Domenico Cianflone
- Vita-Salute San Raffaele University, Milan, Italy
- Cardiac Rehabilitation Unit, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Scientific Institute, Milan, Italy
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Fominskiy EV, Scandroglio AM, Monti G, Calabrò MG, Landoni G, Dell'Acqua A, Beretta L, Moizo E, Ravizza A, Monaco F, Campochiaro C, Pieri M, Azzolini ML, Borghi G, Crivellari M, Conte C, Mattioli C, Silvani P, Mucci M, Turi S, Tentori S, Baiardo Redaelli M, Sartorelli M, Angelillo P, Belletti A, Nardelli P, Nisi FG, Valsecchi G, Barberio C, Ciceri F, Serpa Neto A, Dagna L, Bellomo R, Zangrillo A. Prevalence, Characteristics, Risk Factors, and Outcomes of Invasively Ventilated COVID-19 Patients with Acute Kidney Injury and Renal Replacement Therapy. Blood Purif 2021; 50:102-109. [PMID: 32659757 PMCID: PMC7445373 DOI: 10.1159/000508657] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 05/11/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND There is no information on acute kidney injury (AKI) and continuous renal replacement therapy (CRRT) among invasively ventilated coronavirus disease 2019 (COVID-19) patients in Western healthcare systems. OBJECTIVE To study the prevalence, characteristics, risk factors and outcome of AKI and CRRT among invasively ventilated COVID-19 patients. METHODS Observational study in a tertiary care hospital in Milan, Italy. RESULTS Among 99 patients, 72 (75.0%) developed AKI and 17 (17.7%) received CRRT. Most of the patients developed stage 1 AKI (33 [45.8%]), while 15 (20.8%) developed stage 2 AKI and 24 (33.4%) a stage 3 AKI. Patients who developed AKI or needed CRRT at latest follow-up were older, and among CRRT treated patients a greater proportion had preexisting CKD. Hospital mortality was 38.9% for AKI and 52.9% for CRRT patients. CONCLUSIONS Among invasively ventilated COVID-19 patients, AKI is very common and CRRT use is common. Both carry a high risk of in-hospital mortality.
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Affiliation(s)
- Evgeny V Fominskiy
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Anna Mara Scandroglio
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giacomo Monti
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Maria Grazia Calabrò
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giovanni Landoni
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy,
- Faculty of Medicine, Vita-Salute San Raffaele University, Milan, Italy,
| | - Antonio Dell'Acqua
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Luigi Beretta
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Elena Moizo
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alfredo Ravizza
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Fabrizio Monaco
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Corrado Campochiaro
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Marina Pieri
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Maria Luisa Azzolini
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giovanni Borghi
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Martina Crivellari
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Caterina Conte
- Faculty of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Department of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Cristina Mattioli
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paolo Silvani
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Milena Mucci
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Stefano Turi
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Stefano Tentori
- Transplant Medicine, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Martina Baiardo Redaelli
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Marianna Sartorelli
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Piera Angelillo
- Department of Hematology and Stem Cell Transplantation, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alessandro Belletti
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Pasquale Nardelli
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesco Giuseppe Nisi
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Gabriele Valsecchi
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Cristina Barberio
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Fabio Ciceri
- Faculty of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Department of Hematology and Stem Cell Transplantation, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Ary Serpa Neto
- Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Critical Care Medicine, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
- Data Analytics Research & Evaluation Centre, Austin Hospital and University of Melbourne, Melbourne, Victoria, Australia
| | - Lorenzo Dagna
- Faculty of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Rinaldo Bellomo
- Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Intensive Care, Austin Hospital, Melbourne, Victoria, Australia
- Department of Intensive Care, Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Centre for Integrated Critical Care, School of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
- Data Analytics Research & Evaluation Centre, Austin Hospital and University of Melbourne, Melbourne, Victoria, Australia
| | - Alberto Zangrillo
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Faculty of Medicine, Vita-Salute San Raffaele University, Milan, Italy
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40
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De Cobelli F, Palumbo D, Ciceri F, Landoni G, Ruggeri A, Rovere-Querini P, D'Angelo A, Steidler S, Galli L, Poli A, Fominskiy E, Calabrò MG, Colombo S, Monti G, Nicoletti R, Esposito A, Conte C, Dagna L, Ambrosio A, Scarpellini P, Ripa M, Spessot M, Carlucci M, Montorfano M, Agricola E, Baccellieri D, Bosi E, Tresoldi M, Castagna A, Martino G, Zangrillo A. Pulmonary Vascular Thrombosis in COVID-19 Pneumonia. J Cardiothorac Vasc Anesth 2021; 35:3631-3641. [PMID: 33518461 PMCID: PMC7836419 DOI: 10.1053/j.jvca.2021.01.011] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/04/2021] [Accepted: 01/06/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVES During severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, dramatic endothelial cell damage with pulmonary microvascular thrombosis have been was hypothesized to occur. The aim was to assess whether pulmonary vascular thrombosis (PVT) is due to recurrent thromboembolism from peripheral deep vein thrombosis or to local inflammatory endothelial damage, with a superimposed thrombotic late complication. DESIGN Observational study. SETTING Medical and intensive care unit wards of a teaching hospital. PARTICIPANTS The authors report a subset of patients included in a prospective institutional study (CovidBiob study) with clinical suspicion of pulmonary vascular thromboembolism. INTERVENTIONS Computed tomography pulmonary angiography and evaluation of laboratory markers and coagulation profile. MEASUREMENTS AND MAIN RESULTS Twenty-eight of 55 (50.9%) patients showed PVT, with a median time interval from symptom onset of 17.5 days. Simultaneous multiple PVTs were identified in 22 patients, with bilateral involvement in 16, mostly affecting segmental/subsegmental pulmonary artery branches (67.8% and 96.4%). Patients with PVT had significantly higher ground glass opacity areas (31.7% [22.9-41] v 17.8% [10.8-22.1], p < 0.001) compared with those without PVT. Remarkably, in all 28 patients, ground glass opacities areas and PVT had an almost perfect spatial overlap. D-dimer level at hospital admission was predictive of PVT. CONCLUSIONS The findings identified a specific radiologic pattern of coronavirus disease 2019 (COVID-19) pneumonia with a unique spatial distribution of PVT overlapping areas of ground-glass opacities. These findings supported the hypothesis of a pathogenetic relationship between COVID-19 lung inflammation and PVT and challenged the previous definition of pulmonary embolism associated with COVID-19 pneumonia.
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Affiliation(s)
- Francesco De Cobelli
- Vita-Salute San Raffaele University, Milan, Italy; Radiology Department, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Diego Palumbo
- Vita-Salute San Raffaele University, Milan, Italy; Radiology Department, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Fabio Ciceri
- Vita-Salute San Raffaele University, Milan, Italy; Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giovanni Landoni
- Vita-Salute San Raffaele University, Milan, Italy; Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
| | - Annalisa Ruggeri
- Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Patrizia Rovere-Querini
- Vita-Salute San Raffaele University, Milan, Italy; Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Armando D'Angelo
- Vita-Salute San Raffaele University, Milan, Italy; Coagulation Service and Thrombosis Research Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Stephanie Steidler
- Radiology Department, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Laura Galli
- Unit of Infectious Diseases, IRCCS, San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Poli
- Unit of Infectious Diseases, IRCCS, San Raffaele Scientific Institute, Milan, Italy
| | - Evgeny Fominskiy
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Maria Grazia Calabrò
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sergio Colombo
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giacomo Monti
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Roberto Nicoletti
- Radiology Department, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Antonio Esposito
- Vita-Salute San Raffaele University, Milan, Italy; Radiology Department, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Caterina Conte
- Vita-Salute San Raffaele University, Milan, Italy; Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Lorenzo Dagna
- Vita-Salute San Raffaele University, Milan, Italy; Unit of Immunology, Rheumatology, Allergy, and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alberto Ambrosio
- Clinical Governance, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paolo Scarpellini
- Unit of Infectious Diseases, IRCCS, San Raffaele Scientific Institute, Milan, Italy
| | - Marco Ripa
- Unit of Infectious Diseases, IRCCS, San Raffaele Scientific Institute, Milan, Italy
| | - Marzia Spessot
- Unit of General Medicine and Advanced Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Matteo Montorfano
- Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Eustachio Agricola
- Vita-Salute San Raffaele University, Milan, Italy; Cardiovascular Imaging Unit, Cardio-Thoracic-Vascular Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Domenico Baccellieri
- Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy
| | - Emanuele Bosi
- Vita-Salute San Raffaele University, Milan, Italy; Unit of General Medicine, Endocrine and Metabolic Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Moreno Tresoldi
- Unit of General Medicine and Advanced Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Antonella Castagna
- Vita-Salute San Raffaele University, Milan, Italy; Unit of Infectious Diseases, IRCCS, San Raffaele Scientific Institute, Milan, Italy
| | - Gianvito Martino
- Vita-Salute San Raffaele University, Milan, Italy; Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alberto Zangrillo
- Vita-Salute San Raffaele University, Milan, Italy; Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Di Filippo L, De Lorenzo R, Cinel E, Falbo E, Ferrante M, Cilla M, Martinenghi S, Vitali G, Bosi E, Giustina A, Rovere-Querini P, Conte C. Weight trajectories and abdominal adiposity in COVID-19 survivors with overweight/obesity. Int J Obes (Lond) 2021; 45:1986-1994. [PMID: 34002039 PMCID: PMC8127478 DOI: 10.1038/s41366-021-00861-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 04/30/2021] [Accepted: 05/06/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND COVID-19 is associated with unintentional weight loss. Little is known on whether and how patients regain the lost weight. We assessed changes in weight and abdominal adiposity over a three-month follow-up after discharge in COVID-19 survivors. METHODS In this sub-study of a large prospective observational investigation, we collected data from individuals who had been hospitalized for COVID-19 and re-evaluated at one (V1) and three (V2) months after discharge. Patient characteristics upon admission and anthropometrics, waist circumference and hunger levels assessed during follow-up were analyzed across BMI categories. RESULTS One-hundred-eighty-five COVID-19 survivors (71% male, median age 62.1 [54.3; 72.1] years, 80% with overweight/obesity) were included. Median BMI did not change from admission to V1 in normal weight subjects (-0.5 [-1.2; 0.6] kg/m2, p = 0.08), but significantly decreased in subjects with overweight (-0.8 [-1.8; 0.3] kg/m2, p < 0.001) or obesity (-1.38 [-3.4; -0.3] kg/m2, p < 0.001; p < 0.05 vs. normal weight or obesity). Median BMI did not change from V1 to V2 in normal weight individuals (+0.26 [-0.34; 1.15] kg/m2, p = 0.12), but significantly increased in subjects with overweight (+0.4 [0.0; 1.0] kg/m2, p < 0.001) or obesity (+0.89 [0.0; 1.6] kg/m2, p < 0.001; p = 0.01 vs. normal weight). Waist circumference significantly increased from V1 to V2 in the whole group (p < 0.001), driven by the groups with overweight or obesity. At multivariable regression analyses, male sex, hunger at V1 and initial weight loss predicted weight gain at V2. CONCLUSIONS Patients with overweight or obesity hospitalized for COVID-19 exhibit rapid, wide weight fluctuations that may worsen body composition (abdominal adiposity). CLINICALTRIALS. GOV REGISTRATION NCT04318366.
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Affiliation(s)
- Luigi Di Filippo
- grid.15496.3fVita-Salute San Raffaele University, Milan, Italy ,grid.18887.3e0000000417581884Institute of Endocrine and Metabolic Sciences, IRCCS San Raffaele Hospital, Milan, Italy
| | - Rebecca De Lorenzo
- grid.15496.3fVita-Salute San Raffaele University, Milan, Italy ,grid.18887.3e0000000417581884Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Hospital, Milan, Italy
| | - Elena Cinel
- grid.15496.3fVita-Salute San Raffaele University, Milan, Italy ,grid.18887.3e0000000417581884Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Hospital, Milan, Italy
| | - Elisabetta Falbo
- grid.15496.3fVita-Salute San Raffaele University, Milan, Italy ,grid.18887.3e0000000417581884Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Hospital, Milan, Italy
| | - Marica Ferrante
- grid.15496.3fVita-Salute San Raffaele University, Milan, Italy ,grid.18887.3e0000000417581884Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Hospital, Milan, Italy
| | - Marta Cilla
- grid.18887.3e0000000417581884Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Hospital, Milan, Italy
| | - Sabina Martinenghi
- grid.18887.3e0000000417581884Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Hospital, Milan, Italy
| | - Giordano Vitali
- grid.18887.3e0000000417581884Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Hospital, Milan, Italy
| | - Emanuele Bosi
- grid.15496.3fVita-Salute San Raffaele University, Milan, Italy ,grid.18887.3e0000000417581884Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Hospital, Milan, Italy
| | - Andrea Giustina
- grid.15496.3fVita-Salute San Raffaele University, Milan, Italy ,grid.18887.3e0000000417581884Institute of Endocrine and Metabolic Sciences, IRCCS San Raffaele Hospital, Milan, Italy
| | - Patrizia Rovere-Querini
- grid.15496.3fVita-Salute San Raffaele University, Milan, Italy ,grid.18887.3e0000000417581884Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Hospital, Milan, Italy
| | - Caterina Conte
- grid.18887.3e0000000417581884Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Hospital, Milan, Italy ,Present Address: Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open, University, Rome, Italy
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Napoli N, Conte C, Eastell R, Ewing SK, Bauer DC, Strotmeyer ES, Black DM, Samelson EJ, Vittinghoff E, Schwartz AV. Bone Turnover Markers Do Not Predict Fracture Risk in Type 2 Diabetes. J Bone Miner Res 2020; 35:2363-2371. [PMID: 32717111 DOI: 10.1002/jbmr.4140] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [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: 11/18/2019] [Revised: 07/14/2020] [Accepted: 07/18/2020] [Indexed: 12/11/2022]
Abstract
Type 2 diabetes (T2D) is characterized by increased fracture risk despite higher BMD and reduced bone turnover. BMD underestimates fracture risk in T2D, but the predictive role of bone turnover markers (BTMs) on fracture risk in T2D has not been explored. Thus, we sought to determine whether BTMs predict incident fractures in subjects with T2D. For this case-cohort study, we used data from the Health, Aging, and Body Composition (Health ABC) Study of well-functioning older adults, aged 70 to 79 years at baseline (April 1997-June 1998). The case-cohort sample consisted of (i) the cases, composed of all 223 participants who experienced incident fractures of the hip, clinical spine, or distal forearm within the first 9 years of study follow-up; and (ii) the subcohort of 508 randomly sampled participants from three strata at baseline (T2D, prediabetes, and normoglycemia) from the entire Health ABC cohort. A total of 690 subjects (223 cases, of whom 41 were in the subcohort) were included in analyses. BTMs (C-terminal telopeptide of type I collagen [CTX], osteocalcin [OC], and procollagen type 1 N-terminal propeptide [P1NP]) were measured in archived baseline serum. Cox regression with robust variance estimation was used to estimate the adjusted hazard ratio (HR) for fracture per 20% increase in BTMs. In nondiabetes (prediabetes plus normoglycemia), fracture risk was increased with higher CTX (HR 1.10; 95% confidence interval [CI], 1.01 to 1.20 for each 20% increase in CTX). Risk was not increased in T2D (HR 0.92; 95% CI, 0.81 to 1.04; p for interaction .045). Similarly, both OC and P1NP were associated with higher risk of fracture in nondiabetes, but not in T2D, with p for interaction of .078 and .109, respectively. In conclusion, BTMs did not predict incident fracture risk in T2D but were modestly associated with fracture risk in nondiabetes. © 2020 American Society for Bone and Mineral Research.
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Affiliation(s)
- Nicola Napoli
- Division of Endocrinology and Diabetes, University Campus Bio-Medico di Roma, Rome, Italy.,Department of Internal Medicine, Division of Bone and Mineral Diseases, Musculoskeletal Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Caterina Conte
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Open University, Rome, Italy
| | - Richard Eastell
- Metabolic Bone Centre, Northern General Hospital, Sheffield, UK
| | - Susan K Ewing
- Department Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Douglas C Bauer
- Departments of Medicine and Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Elsa S Strotmeyer
- Center for Aging and Population Health, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Dennis M Black
- Departments of Medicine and Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Elizabeth J Samelson
- Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA.,Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Eric Vittinghoff
- Department Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Ann V Schwartz
- Department Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
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Chen Z, Boxwell A, Conte C, Haas T, Harley A, Terman DH, Travers SP, Travers JB. Kv4 channel expression and kinetics in GABAergic and non-GABAergic rNST neurons. J Neurophysiol 2020; 124:1727-1742. [PMID: 32997557 DOI: 10.1152/jn.00396.2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The rostral nucleus of the solitary tract (rNST) serves as the first central relay in the gustatory system. In addition to synaptic interactions, central processing is also influenced by the ion channel composition of individual neurons. For example, voltage-gated K+ channels such as outward K+ current (IA) can modify the integrative properties of neurons. IA currents are prevalent in rNST projection cells but are also found to a lesser extent in GABAergic interneurons. However, characterization of the kinetic properties of IA, the molecular basis of these currents, as well as the consequences of IA on spiking properties of identified rNST cells is lacking. Here, we show that IA in rNST GABAergic (G+) and non-GABAergic (G-) neurons share a common molecular basis. In both cell types, there was a reduction in IA following treatment with the specific Kv4 channel blocker AmmTx3. However, the kinetics of activation and inactivation of IA in the two cell types were different with G- neurons having significantly more negative half-maximal activation and inactivation values. Likewise, under current clamp, G- cells had significantly longer delays to spike initiation in response to a depolarizing stimulus preceded by a hyperpolarizing prepulse. Computational modeling and dynamic clamp suggest that differences in the activation half-maximum may account for the differences in delay. We further observed evidence for a window current under both voltage clamp and current clamp protocols. We speculate that the location of Kv4.3 channels on dendrites, together with a window current for IA at rest, serves to regulate excitatory afferent inputs.NEW & NOTEWORTHY Here, we demonstrate that the transient outward K+ current IA occurs in both GABAergic and non-GABAergic neurons via Kv4.3 channels in the rostral (gustatory) solitary nucleus. Although found in both cell types, IA is more prevalent in non-GABAergic cells; a larger conductance at more negative potentials leads to a greater impact on spike initiation compared with GABAergic neurons. An IA window current further suggests that IA can regulate excitatory afferent input to the nucleus.
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Affiliation(s)
- Z Chen
- Division of Biosciences, Ohio State University, Columbus, Ohio
| | - A Boxwell
- College of Medicine, Ohio State University, Columbus, Ohio
| | - C Conte
- Department of Statistics, Ohio State University, Columbus, Ohio
| | - T Haas
- Division of Biosciences, Ohio State University, Columbus, Ohio
| | - A Harley
- Division of Biosciences, Ohio State University, Columbus, Ohio
| | - D H Terman
- Department of Mathematics, Ohio State University, Columbus, Ohio
| | - S P Travers
- Division of Biosciences, Ohio State University, Columbus, Ohio
| | - J B Travers
- Division of Biosciences, Ohio State University, Columbus, Ohio
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Piccoli A, Cannata F, Strollo R, Pedone C, Leanza G, Russo F, Greto V, Isgrò C, Quattrocchi CC, Massaroni C, Silvestri S, Vadalà G, Bisogno T, Denaro V, Pozzilli P, Tang SY, Silva MJ, Conte C, Papalia R, Maccarrone M, Napoli N. Sclerostin Regulation, Microarchitecture, and Advanced Glycation End-Products in the Bone of Elderly Women With Type 2 Diabetes. J Bone Miner Res 2020; 35:2415-2422. [PMID: 32777114 PMCID: PMC8143610 DOI: 10.1002/jbmr.4153] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [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: 04/15/2020] [Revised: 07/21/2020] [Accepted: 08/02/2020] [Indexed: 12/21/2022]
Abstract
Increased circulating sclerostin and accumulation of advanced glycation end-products (AGEs) are two potential mechanisms underlying low bone turnover and increased fracture risk in type 2 diabetes (T2D). Whether the expression of the sclerostin-encoding SOST gene is altered in T2D, and whether it is associated with AGEs accumulation or regulation of other bone formation-related genes is unknown. We hypothesized that AGEs accumulate and SOST gene expression is upregulated in bones from subjects with T2D, leading to downregulation of bone forming genes (RUNX2 and osteocalcin) and impaired bone microarchitecture and strength. We obtained bone tissue from femoral heads of 19 T2D postmenopausal women (mean glycated hemoglobin [HbA1c] 6.5%) and 73 age- and BMI-comparable nondiabetic women undergoing hip replacement surgery. Despite similar bone mineral density (BMD) and biomechanical properties, we found a significantly higher SOST (p = .006) and a parallel lower RUNX2 (p = .025) expression in T2D compared with non-diabetic subjects. Osteocalcin gene expression did not differ between T2D and non-diabetic subjects, as well as circulating osteocalcin and sclerostin levels. We found a 1.5-fold increase in total bone AGEs content in T2D compared with non-diabetic women (364.8 ± 78.2 versus 209.9 ± 34.4 μg quinine/g collagen, respectively; p < .001). AGEs bone content correlated with worse bone microarchitecture, including lower volumetric BMD (r = -0.633; p = .02), BV/TV (r = -0.59; p = .033) and increased trabecular separation/spacing (r = 0.624; p = .023). In conclusion, our data show that even in patients with good glycemic control, T2D affects the expression of genes controlling bone formation (SOST and RUNX2). We also found that accumulation of AGEs is associated with impaired bone microarchitecture. We provide novel insights that may help understand the mechanisms underlying bone fragility in T2D. © 2020 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Alessandra Piccoli
- Unit of Endocrinology and Diabetes, Departmental Faculty of Medicine and Surgery, Campus Bio-Medico University of Rome, Rome, Italy.,Unit of Biochemistry and Molecular Biology, Departmental Faculty of Medicine and Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Francesca Cannata
- Unit of Endocrinology and Diabetes, Departmental Faculty of Medicine and Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Rocky Strollo
- Unit of Endocrinology and Diabetes, Departmental Faculty of Medicine and Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Claudio Pedone
- Unit of Geriatrics, Departmental Faculty of Medicine and Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Giulia Leanza
- Unit of Endocrinology and Diabetes, Departmental Faculty of Medicine and Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Fabrizio Russo
- Unit of Orthopedic and Trauma Surgery, Departmental Faculty of Medicine and Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Valentina Greto
- Unit of Endocrinology and Diabetes, Departmental Faculty of Medicine and Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Camilla Isgrò
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari "Aldo Moro", Bari, Italy
| | | | - Carlo Massaroni
- Research Unit of Measurements and Biomedical Instrumentation, Departmental Faculty of Bioengineering, Campus Bio-Medico di Roma University, Rome, Italy
| | - Sergio Silvestri
- Research Unit of Measurements and Biomedical Instrumentation, Departmental Faculty of Bioengineering, Campus Bio-Medico di Roma University, Rome, Italy
| | - Gianluca Vadalà
- Unit of Orthopedic and Trauma Surgery, Departmental Faculty of Medicine and Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Tiziana Bisogno
- Endocannabinoid Research Group, Institute of Translational Pharmacology, National Research Council, (CNR), Rome, Italy
| | - Vincenzo Denaro
- Unit of Orthopedic and Trauma Surgery, Departmental Faculty of Medicine and Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Paolo Pozzilli
- Unit of Endocrinology and Diabetes, Departmental Faculty of Medicine and Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Simon Y Tang
- Unit of Orthopedics, Washington University in St. Louis, St. Louis, MO, USA
| | - Matt J Silva
- Unit of Orthopedics, Washington University in St. Louis, St. Louis, MO, USA
| | - Caterina Conte
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Rocco Papalia
- Unit of Orthopedic and Trauma Surgery, Departmental Faculty of Medicine and Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Mauro Maccarrone
- Unit of Biochemistry and Molecular Biology, Departmental Faculty of Medicine and Surgery, Campus Bio-Medico University of Rome, Rome, Italy.,European Center for Brain Research (CERC)/Santa Lucia Foundation, Rome, Italy
| | - Nicola Napoli
- Unit of Endocrinology and Diabetes, Departmental Faculty of Medicine and Surgery, Campus Bio-Medico University of Rome, Rome, Italy.,Division of Bone and Mineral Diseases, Washington University in St. Louis, St. Louis, MO, USA
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Farina N, Ramirez GA, De Lorenzo R, Di Filippo L, Conte C, Ciceri F, Manfredi AA, Rovere-Querini P. COVID-19: Pharmacology and kinetics of viral clearance. Pharmacol Res 2020; 161:105114. [PMID: 32758635 PMCID: PMC7834389 DOI: 10.1016/j.phrs.2020.105114] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/26/2020] [Accepted: 07/27/2020] [Indexed: 02/06/2023]
Abstract
Coronavirus Disease 2019 (COVID-19) is a pandemic disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The clinical spectrum of COVID-19 is broad and varies from mild to severe forms complicated by acute respiratory distress and death. This heterogeneity might reflect the ability of the host immune system to interact with SARS-CoV2 or the characteristics of the virus itself in terms of loads or persistence. Information on this issue might derive from interventional studies. However, results from high-quality trials are scarce. Here we evaluate the level of evidence of available published interventional studies, with a focus on randomised controlled trials and the efficacy of therapies on clinical outcomes. Moreover, we present data on a large cohort of well-characterized patients hospitalized at a single University Hospital in Milano (Italy), correlating viral clearance with clinical and biochemical features of patients.
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Affiliation(s)
- Nicola Farina
- Vita - Salute San Raffaele University, via Olgettina 60, 20132 Milano, Italy
| | - Giuseppe A Ramirez
- Vita - Salute San Raffaele University, via Olgettina 60, 20132 Milano, Italy
| | - Rebecca De Lorenzo
- Vita - Salute San Raffaele University, via Olgettina 60, 20132 Milano, Italy
| | - Luigi Di Filippo
- Vita - Salute San Raffaele University, via Olgettina 60, 20132 Milano, Italy
| | - Caterina Conte
- Vita - Salute San Raffaele University, via Olgettina 60, 20132 Milano, Italy; Division of Immunology, Transplantation and Infectious Diseases, via Olgettina 60, 20132 Milano, Italy
| | - Fabio Ciceri
- Vita - Salute San Raffaele University, via Olgettina 60, 20132 Milano, Italy; Division of Immunology, Transplantation and Infectious Diseases, via Olgettina 60, 20132 Milano, Italy
| | - Angelo A Manfredi
- Vita - Salute San Raffaele University, via Olgettina 60, 20132 Milano, Italy; Division of Immunology, Transplantation and Infectious Diseases, via Olgettina 60, 20132 Milano, Italy
| | - Patrizia Rovere-Querini
- Vita - Salute San Raffaele University, via Olgettina 60, 20132 Milano, Italy; Division of Immunology, Transplantation and Infectious Diseases, via Olgettina 60, 20132 Milano, Italy.
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Di Filippo L, De Lorenzo R, D'Amico M, Sofia V, Roveri L, Mele R, Saibene A, Rovere-Querini P, Conte C. COVID-19 is associated with clinically significant weight loss and risk of malnutrition, independent of hospitalisation: A post-hoc analysis of a prospective cohort study. Clin Nutr 2020; 40:2420-2426. [PMID: 33160700 PMCID: PMC7598735 DOI: 10.1016/j.clnu.2020.10.043] [Citation(s) in RCA: 107] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 10/18/2020] [Accepted: 10/21/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND & AIMS Coronavirus disease 2019 (COVID-19) may associate with clinical manifestations, ranging from alterations in smell and taste to severe respiratory distress requiring intensive care, that might associate with weight loss and malnutrition. We aimed to assess the incidence of unintentional weight loss and malnutrition in COVID-19 survivors. METHODS In this post-hoc analysis of a prospective observational cohort study, we enrolled all adult (age ≥18 years) patients with a confirmed diagnosis of COVID-19 who had been discharged home from either a medical ward or the Emergency Department of San Raffaele University Hospital, and were re-evaluated after remission at the Outpatient COVID-19 Follow-Up Clinic of the same Institution from April 7, 2020, to May 11, 2020. Demographic, anthropometric, clinical and biochemical parameters upon admission were prospectively collected. At follow-up, anthropometrics, the mini nutritional assessment screening and a visual analogue scale for appetite were assessed. RESULTS A total of 213 patients were included in the analysis (33% females, median age 59.0 [49.5-67.9] years, 70% overweight/obese upon initial assessment, 73% hospitalised). Sixty-one patients (29% of the total, and 31% of hospitalised patients vs. 21% of patients managed at home, p = 0.14) had lost >5% of initial body weight (median weight loss 6.5 [5.0-9.0] kg, or 8.1 [6.1-10.9]%). Patients who lost weight had greater systemic inflammation (C-reactive protein 62.9 [29.0-129.5] vs.48.7 [16.1-96.3] mg/dL; p = 0.02), impaired renal function (23.7% vs. 8.7% of patients; p = 0.003) and longer disease duration (32 [27-41] vs. 24 [21-30] days; p = 0.047) as compared with those who did not lose weight. At multivariate logistic regression analysis, only disease duration independently predicted weight loss (OR 1.05 [1.01-1.10] p = 0.022). CONCLUSIONS COVID-19 might negatively impact body weight and nutritional status. In COVID-19 patients, nutritional evaluation, counselling and treatment should be implemented at initial assessment, throughout the course of disease, and after clinical remission. CLINICALTRIALS. GOV REGISTRATION NCT04318366.
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Affiliation(s)
- Luigi Di Filippo
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | | | - Marta D'Amico
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Valentina Sofia
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Luisa Roveri
- IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Roberto Mele
- IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Patrizia Rovere-Querini
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; IRCCS San Raffaele Scientific Institute, Milan, Italy
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Rovere-Querini P, Tresoldi C, Conte C, Ruggeri A, Ghezzi S, De Lorenzo R, Di Filippo L, Farina N, Ramirez GA, Ripa M, Mancini N, Cantarelli E, Galli L, Poli A, De Cobelli F, Bonini C, Manfredi AA, Franchini S, Spessot M, Carlucci M, Dagna L, Scarpellini P, Ambrosio A, Di Napoli D, Bosi E, Tresoldi M, Lazzarin A, Landoni G, Martino G, Zangrillo A, Poli G, Castagna A, Vicenzi E, Clementi M, Ciceri F. Biobanking for COVID-19 research. Panminerva Med 2020; 64:244-252. [PMID: 33073557 DOI: 10.23736/s0031-0808.20.04168-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Biobanks are imperative infrastructures, particularly during outbreaks, when there is an obligation to acquire and share knowledge as quick as possible to allow for implementation of science-based preventive, diagnostic, prognostic and therapeutic strategies. METHODS We established a COVID-19 biobank with the aim of collecting high-quality and well-annotated human biospecimens, in the effort to understand the pathogenic mechanisms underlying COVID-19 and identify therapeutic targets (COVID-BioB, NCT04318366). Here we describe our experience and briefly review the characteristics of the biobanks for COVID-19 that have been so far established. RESULTS A total of 46,677 samples have been collected from 913 participants (63.3% males, median [IQR] age 62.2 [51.2 - 74.0] years) since the beginning of the program. Most patients (66.9%) had been admitted to hospital for COVID-19, with a median length of stay of 15.0 (9.0 - 27.0) days. A minority of patients (13.3% of the total) had been admitted for other reasons and subsequently tested positive for SARS-CoV-2. The remainder were managed at home after being seen at the Emergency Department. CONCLUSIONS Having a solid research infrastructure already in place, along with flexibility and adaptability to new requirements, allowed for the quick building of a COVID-19 biobank that will help expand and share the knowledge of SARS-CoV-2.
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Affiliation(s)
- Patrizia Rovere-Querini
- Vita-Salute San Raffaele University, Milan, Italy - .,Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy -
| | - Cristina Tresoldi
- Molecular Hematology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Caterina Conte
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Annalisa Ruggeri
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Ghezzi
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | | | | | - Giuseppe A Ramirez
- Vita-Salute San Raffaele University, Milan, Italy.,Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Marco Ripa
- Vita-Salute San Raffaele University, Milan, Italy.,Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Nicasio Mancini
- Vita-Salute San Raffaele University, Milan, Italy.,Laboratory of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Elisa Cantarelli
- Diabetes Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Laura Galli
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Poli
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesco De Cobelli
- Vita-Salute San Raffaele University, Milan, Italy.,Experimental Imaging Center, Radiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Bonini
- Vita-Salute San Raffaele University, Milan, Italy.,Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Angelo A Manfredi
- Vita-Salute San Raffaele University, Milan, Italy.,Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Stefano Franchini
- Emergency Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Marzia Spessot
- Emergency Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Michele Carlucci
- Emergency Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Lorenzo Dagna
- Vita-Salute San Raffaele University, Milan, Italy.,Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paolo Scarpellini
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alberto Ambrosio
- Clinical Governance Division, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Davide Di Napoli
- Clinical Governance Division, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Emanuele Bosi
- Vita-Salute San Raffaele University, Milan, Italy.,Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Moreno Tresoldi
- Unit of General Medicine and Advanced Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Adriano Lazzarin
- Vita-Salute San Raffaele University, Milan, Italy.,Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giovanni Landoni
- Vita-Salute San Raffaele University, Milan, Italy.,Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Gianvito Martino
- Vita-Salute San Raffaele University, Milan, Italy.,Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alberto Zangrillo
- Vita-Salute San Raffaele University, Milan, Italy.,Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Guido Poli
- Vita-Salute San Raffaele University, Milan, Italy.,Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Antonella Castagna
- Vita-Salute San Raffaele University, Milan, Italy.,Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Elisa Vicenzi
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Clementi
- Vita-Salute San Raffaele University, Milan, Italy.,Laboratory of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Fabio Ciceri
- Vita-Salute San Raffaele University, Milan, Italy.,Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
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48
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Conte C, Maggiore U, Cappelli G, Ietto G, Lai Q, Salis P, Marchetti P, Piemonti L, Secchi A, Capocasale E, Caldara R. Supporting physicians in the management of metabolic alterations in adult kidney transplant recipients: a comment on the joint position statement of the Italian Society of Nephrology (SIN), the Italian Society for Organ Transplantation (SITO) and the Italian Diabetes Society (SID). J Nephrol 2020; 33:887-893. [PMID: 32876937 DOI: 10.1007/s40620-020-00839-5] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Caterina Conte
- IRCCS San Raffaele Hospital, Milan, Italy
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Umberto Maggiore
- Dipartimento di Medicina e Chirurgia, University Hospital of Parma, Parma, Italy
| | - Gianni Cappelli
- University of Modena and Reggio Emilia, Azienda Ospedaliero, Universitaria Policlinico, Modena, Italy
| | - Giuseppe Ietto
- Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy
| | - Quirino Lai
- Hepato-Biliary Surgery and Organ Transplantation Unit, Sapienza University of Rome, Umberto I Polyclinic of Rome, Rome, Italy
| | - Paola Salis
- IRCCS ISMETT (Istituto Mediterraneo per I Trapianti e Terapie ad alta Specializzazione), Palermo, Italy
| | - Piero Marchetti
- Dipartimento di Medicina Clinica e Sperimentale, Università di Pisa, Pisa, Italy
| | - Lorenzo Piemonti
- Università Vita-Salute San Raffaele, Milan, Italy
- Diabetes Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Antonio Secchi
- IRCCS San Raffaele Hospital, Milan, Italy
- Diabetes Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
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49
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Battisti S, Pedone C, Napoli N, Russo E, Agnoletti V, Nigra SG, Dengo C, Mughetti M, Conte C, Pozzilli P, Giampalma E, Strollo R. Computed Tomography Highlights Increased Visceral Adiposity Associated With Critical Illness in COVID-19. Diabetes Care 2020; 43:e129-e130. [PMID: 32753457 DOI: 10.2337/dc20-1333] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [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: 06/02/2020] [Accepted: 07/10/2020] [Indexed: 02/03/2023]
Affiliation(s)
- Sofia Battisti
- Radiology Department, AUSL Romagna M. Bufalini Hospital, Cesena, Italy.,Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.,Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale (DIMES), Alma Mater Studiorum-Università di Bologna, Bologna, Italy
| | - Claudio Pedone
- Unit of Geriatrics, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy
| | - Nicola Napoli
- Unit of Endocrinology and Diabetes, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy.,Division of Bone and Mineral Diseases, Washington University in St. Louis, St. Louis, MO
| | - Emanuele Russo
- Anesthesia and Intensive Care Unit, AUSL Romagna M. Bufalini Hospital, Cesena, Italy
| | - Vanni Agnoletti
- Anesthesia and Intensive Care Unit, AUSL Romagna M. Bufalini Hospital, Cesena, Italy
| | - Stefano Geniere Nigra
- Emergency Department, Dipartimento Chirurgico e Grandi Traumi, AUSL Romagna M. Bufalini Hospital, Cesena, Italy
| | - Caterina Dengo
- Radiology Department, AUSL Romagna M. Bufalini Hospital, Cesena, Italy
| | - Martina Mughetti
- Radiology Department, AUSL Romagna M. Bufalini Hospital, Cesena, Italy
| | - Caterina Conte
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Paolo Pozzilli
- Unit of Endocrinology and Diabetes, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy.,Centre for Immunobiology, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, U.K
| | | | - Rocky Strollo
- Unit of Endocrinology and Diabetes, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy
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50
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Mazza MG, De Lorenzo R, Conte C, Poletti S, Vai B, Bollettini I, Melloni EMT, Furlan R, Ciceri F, Rovere-Querini P, Benedetti F. Anxiety and depression in COVID-19 survivors: Role of inflammatory and clinical predictors. Brain Behav Immun 2020; 89:594-600. [PMID: 32738287 PMCID: PMC7390748 DOI: 10.1016/j.bbi.2020.07.037] [Citation(s) in RCA: 832] [Impact Index Per Article: 208.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 02/07/2023] Open
Abstract
Infection-triggered perturbation of the immune system could induce psychopathology, and psychiatric sequelae were observed after previous coronavirus outbreaks. The spreading of the Severe Acute Respiratory Syndrome Coronavirus (COVID-19) pandemic could be associated with psychiatric implications. We investigated the psychopathological impact of COVID-19 in survivors, also considering the effect of clinical and inflammatory predictors. We screened for psychiatric symptoms 402 adults surviving COVID-19 (265 male, mean age 58), at one month follow-up after hospital treatment. A clinical interview and a battery of self-report questionnaires were used to investigate post-traumatic stress disorder (PTSD), depression, anxiety, insomnia, and obsessive-compulsive (OC) symptomatology. We collected sociodemographic information, clinical data, baseline inflammatory markers and follow-up oxygen saturation levels. A significant proportion of patients self-rated in the psychopathological range: 28% for PTSD, 31% for depression, 42% for anxiety, 20% for OC symptoms, and 40% for insomnia. Overall, 56% scored in the pathological range in at least one clinical dimension. Despite significantly lower levels of baseline inflammatory markers, females suffered more for both anxiety and depression. Patients with a positive previous psychiatric diagnosis showed increased scores on most psychopathological measures, with similar baseline inflammation. Baseline systemic immune-inflammation index (SII), which reflects the immune response and systemic inflammation based on peripheral lymphocyte, neutrophil, and platelet counts, positively associated with scores of depression and anxiety at follow-up. PTSD, major depression, and anxiety, are all high-burden non-communicable conditions associated with years of life lived with disability. Considering the alarming impact of COVID-19 infection on mental health, the current insights on inflammation in psychiatry, and the present observation of worse inflammation leading to worse depression, we recommend to assess psychopathology of COVID-19 survivors and to deepen research on inflammatory biomarkers, in order to diagnose and treat emergent psychiatric conditions.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Anxiety/epidemiology
- Anxiety/immunology
- Anxiety/psychology
- Anxiety Disorders/epidemiology
- Anxiety Disorders/immunology
- Anxiety Disorders/psychology
- Betacoronavirus
- C-Reactive Protein/immunology
- COVID-19
- Coronavirus Infections/epidemiology
- Coronavirus Infections/immunology
- Coronavirus Infections/psychology
- Depression/epidemiology
- Depression/immunology
- Depression/psychology
- Depressive Disorder/epidemiology
- Depressive Disorder/immunology
- Depressive Disorder/psychology
- Depressive Disorder, Major/epidemiology
- Depressive Disorder, Major/immunology
- Depressive Disorder, Major/psychology
- Emergency Service, Hospital
- Female
- Humans
- Inflammation
- Italy/epidemiology
- Length of Stay/statistics & numerical data
- Leukocyte Count
- Lymphocyte Count
- Male
- Mental Disorders/epidemiology
- Mental Disorders/immunology
- Mental Disorders/psychology
- Middle Aged
- Monocytes
- Neutrophils
- Obsessive-Compulsive Disorder/epidemiology
- Obsessive-Compulsive Disorder/immunology
- Obsessive-Compulsive Disorder/psychology
- Pandemics
- Pneumonia, Viral/epidemiology
- Pneumonia, Viral/immunology
- Pneumonia, Viral/psychology
- SARS-CoV-2
- Severity of Illness Index
- Sex Factors
- Sleep Initiation and Maintenance Disorders/epidemiology
- Sleep Initiation and Maintenance Disorders/immunology
- Sleep Initiation and Maintenance Disorders/psychology
- Stress Disorders, Post-Traumatic/epidemiology
- Stress Disorders, Post-Traumatic/immunology
- Stress Disorders, Post-Traumatic/psychology
- Suicidal Ideation
- Survivors/psychology
- Survivors/statistics & numerical data
- Young Adult
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Affiliation(s)
- Mario Gennaro Mazza
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy.
| | - Rebecca De Lorenzo
- Vita-Salute San Raffaele University, Milano, Italy; Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Caterina Conte
- Vita-Salute San Raffaele University, Milano, Italy; Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sara Poletti
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy
| | - Benedetta Vai
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy
| | - Irene Bollettini
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy
| | - Elisa Maria Teresa Melloni
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy
| | - Roberto Furlan
- Vita-Salute San Raffaele University, Milano, Italy; Clinical Neuroimmunology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Fabio Ciceri
- Vita-Salute San Raffaele University, Milano, Italy; Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Patrizia Rovere-Querini
- Vita-Salute San Raffaele University, Milano, Italy; Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesco Benedetti
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy
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