COVID-19 Vaccine Hesitancy among Unvaccinated Adults: A Cross-Sectional Exploratory Analysis of Vaccination Intentions in Italy Related to Fear of Infection

From the initial COVID-19 outbreak, Italy was the first Western country to be seriously affected by the pandemic. Understanding vaccine hesitancy can help efforts to achieve broad vaccination coverage. The objectives of this research were to determine the extent of vaccine hesitancy in Italy and to understand the characteristics of those segments of the population with some hesitancy. Between January and February 2021, 41,473 subjects answered the second questionnaire delivered in phase II of the web-based EPICOVID19 survey. Among the included adult volunteers living in Italy, 4653 (11.2%) reported having previously received at least one dose of the COVID-19 vaccine. In the sample of 36,820 respondents, all not vaccinated (age 51.1 ± 13.5; 59.7% female; 63.6% high level of education), the comparison between hesitant and inclined participants was accompanied by percentages and odds ratios. A total of 2449 individuals were hesitant (6.7% of the unvaccinated ones). Hesitancy was higher among women (OR = 1.48; 95%CI: 1.36-1.62); it was highest in the 50-59 and 40-49 age groups and among those with a lower educational level. A higher level of education was associated with a lower proportion of hesitancy (5.54%) compared with 9.44% among respondents with a low level of education (OR = 0.56; 95%CI: 0.46-0.68). Hesitancy was most common in subjects who did not report fear of infection (12.4%, OR = 4.0; 95%CI: 3.46-4.61). The results can guide the design of tailored information and communication campaigns through considering objective and subjective characteristics.

Ultrastructural and Molecular Investigation on Peripheral Leukocytes in Alzheimer's Disease Patients

Thriving literature underlines white blood cell involvement in the inflammatory processes of Alzheimer's Disease (AD). Among leukocytes, lymphocytes have been considered sentinels of neuroinflammation for years, but recent findings highlighted the pivotal role of neutrophils. Since neutrophils that infiltrate the brain through the brain vascular vessels may affect the immune function of microglia in the brain, a close investigation of the interaction between these cells is important in understanding neuroinflammatory phenomena and the immunological aftermaths that follow. This study aimed to observe how peripheral leukocyte features change at different stages of AD to identify potential molecular markers when the first features of pathological neurodegeneration arise. For this purpose, the examined patients were divided into Mild Cognitive Impairment (MCI) and severely impaired patients (DAT) based on their Cognitive Dementia Rating (CDR). The evaluation of the neutrophil-to-lymphocytes ratio and the morphology and function of leukocytes showed a close relationship between the ultrastructural and the molecular features in AD progression and suggested putative markers for the early stages of the disease.

Community Concern about the Health Effects of Pollutants: Risk Perception in an Italian Geothermal Area

Geothermal fluids for electricity and heat production have long been exploited in the Mt. Amiata area (Tuscany, Italy). Public concern about the health impact of geothermal plants has been present from the outset. Several factors influence the way people perceive risk; therefore, the objective of the present research is to develop indicators of risk perception and assess indices differences in relation to some questionnaire variables. A cross-sectional survey was conducted in the Amiata area on 2029 subjects aged 18-77. From the questionnaire section about risk perception from environmental hazards, four indicators were developed and analysed. A total of 64% of the subjects considered the environmental situation to be acceptable or excellent, 32% serious but reversible, and 4% serious and irreversible; as the values of the various perception indicators increased, an upward trend was observed in the averages. Risk perception was higher among women and young people, and was associated with higher education. Those who smelled bad odours in their surroundings reported higher risk perception. Furthermore, risk perception was higher in four municipalities. The results represent the basis for further investigations to analyse the link among risk perception indicators, exposure parameters, and health status.

Risk Associations between Vehicular Traffic Noise Exposure and Cardiovascular Diseases: A Residential Retrospective Cohort Study

Environmental noise can induce detrimental health effects such as cardiovascular disease (CVD). The relationship between vehicular traffic noise pollution and CVD was investigated through a retrospective residential cohort study in the city of Pisa. Four exposure classes were defined for noise pollution, using noise propagation maps. The association between noise exposures and cause-specific mortality or hospitalization of the subjects of the cohort was calculated using the hazard ratio (HR) for night and day through a multiple time-dependent and sex-specific Cox regression adjusting for age, the socio-economic deprivation index, and traffic air pollution. Mortality excess for CVD and risk trends for a 1 decibel noise increment were observed among the most exposed women (mortality: HRnight_class4 1.15 (1.03-1.28); Trend_night 1.007 (1.002-1.012); HRday_class4 1.14 (1.02-1.27); Trend_day 1.008 (1.003-1.013)), particularly for ischaemic disease (mortality: Trend_night 1.008 (0.999-1.017); Trend_day 1.009 (0.999-1.018)) and cerebrovascular disease (mortality: HRnight_class3 1.23 (1.02-1.48), HRday_class3 1.24 (1.03-1.49)). Hospitalization analyses confirm mortality results. A decreased risk for hospitalization was also observed among the most exposed men (HRday_class4 0.94 (0.88-1.01), particularly for ischaemic disease (HRnight_class4 0.90 (0.80-1.02); HRday_class4 0.86 (0.77-0.97)) and cerebrovascular disease (HRnight_class4 0.89 (0.78-1.01)). Authors recommend the adoption of prevention measures aimed at mitigating noise and the activation of a monitoring of the risk profile in the Pisa population updating both the residential cohort and health data.

Anorexia Nervosa, Body Image Perception and Virtual Reality Therapeutic Applications: State of the Art and Operational Proposal

Anorexia Nervosa (AN) patients exhibit distorted body representation. The purpose of this study was to explore studies that analyze virtual reality (VR) applications, related to body image issues, to propose a new tool in this field. We conducted a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, EMBASE, Scopus, and Web of Science databases were explored; the review included 25 studies. Research has increased over the last five years. The selected studies, clinical observational studies (n = 16), mostly concerning patients' population with AN (n = 14) or eating disorders (EDs) diagnosis, presented multiple designs, populations involved, and procedures. Some of these studies included healthy control groups (n = 7). Studies on community sample populations were also selected if oriented toward clinical applications (n = 9). The VR technologies in the examined period (about 20 years) have evolved significantly, going from very complex and bulky systems, requiring very powerful computers, to agile systems. The advent of low-cost VR devices has given a big boost to research works. Moreover, the operational proposal that emerges from this work supports the use of biofeedback techniques aimed at evaluating the results of therapeutic interventions in the treatment of adolescent patients diagnosed with AN.

Fear of COVID-19 for Individuals and Family Members: Indications from the National Cross-Sectional Study of the EPICOVID19 Web-Based Survey

The study analyzed the association of the fear of contagion for oneself and for family members (FMs) during the first wave of the COVID-19 pandemic, with demographic and socioeconomic status (SES) and health factors. The study was performed within the EPICOVID19 web-based Italian survey, involving adults from April-June 2020. Out of 207,341 respondents, 95.9% completed the questionnaire (60% women with an average age of 47.3 vs. 48.9 years among men). The association between fear and demographic and SES characteristics, contacts with COVID-19 cases, nasopharyngeal swab, self-perceived health, flu vaccination, chronic diseases and specific symptoms was analyzed by logistic regression model; odds ratios adjusted for sex, age, education and occupation were calculated (aORs). Fear for FMs prevailed over fear for oneself and was higher among women than men. Fear for oneself decreased with higher levels of education and in those who perceived good health. Among those vaccinated for the flu, 40.8% responded they had feelings of fear for themselves vs. 34.2% of the not vaccinated. Fear increased when diseases were declared and it was higher when associated with symptoms such as chest pain, olfactory/taste disorders, heart palpitations (aORs > 1.5), lung or kidney diseases, hypertension, depression and/or anxiety. Trends in fear by region showed the highest percentage of positive responses in the southern regions. The knowledge gained from these results should be used to produce tailored messages and shared public health decisions.

Lower gray matter volumes of frontal lobes and insula in adolescents with anorexia nervosa restricting type: Findings from a Brain Morphometry Study

BACKGROUND

Brain atrophy in anorexia nervosa (AN) is one of the most marked structural brain changes observed in mental disorders. In this study, we propose a whole brain analysis approach to characterize global and regional cerebral volumes in adolescents with restricting-type anorexia nervosa (AN-r).

METHODS

A total of 48 adolescent females (age range 13-18 years) were enrolled in the study (24 right-handed AN-r in the early stages of the illness and treated in the same clinical setting and 24 age-matched healthy controls [HC]). High-resolution T1-weighted magnetic resonance images were acquired. Cerebral volumes, including the total amounts of gray matter (GM), white matter (WM), and cerebrospinal fluid (CSF) were obtained with the Statistical Parametric Mapping software (SPM8); specific cortical regional volumes were computed by applying an atlas-based cortical parcellation to the SPM8 GM segments. Analysis of variance (ANOVA) was performed to identify any significant between-group differences in global and regional brain volumes.

RESULTS

The analyses revealed reduced total GM volumes (p = 0.02) and increased CSF (p = 0.05) in AN-r, compared with HC. No significant between-group difference was found in WM volumes. At the regional level, significantly lower GM volumes in both frontal lobes (p = 0.006) and in the left insula (p = 0.016) were detected. No significant relationships were found between cerebral volumes and duration of illness, psychiatric comorbidities, psychopharmacological treatment, prepubertal phase, or presence of amenorrhea.

CONCLUSIONS

The topographic distribution of GM reduction in a homogenous group of AN-r involves regions responsible for the emotional and cognitive deficits associated with the illness. These findings are discussed in relation to the roles of the insular cortex and the frontal lobes.

Transdiagnostic vs. disorder-focused perspective in children and adolescents with eating disorders: Findings from a large multisite exploratory study

BACKGROUND

The transdiagnostic model of eating disorders (ED) proposes common cognitive mechanisms in patients with ED psychopathology. Little is known about their role in the maintenance of ED in children and adolescents. This study aimed to determine whether the relationships between key factors (low self-esteem, weight and shape control, clinical perfectionism, interpersonal problems, distress and mood instability) and core maintaining mechanisms (binge-eating and restraint) would support a transdiagnostic theory in young patients.

METHODS

A total of 419 patients (mean age 14.7 ± 2.14 years; age range: 7-18 years; males 13.8%) diagnosed with an ED were assessed in six Italian clinical centers in 2013. Multiple comparisons between ED diagnosis, correlation analysis and principal component analysis (PCA) were performed.

RESULTS

Of the entire collective, 51.5% of patients were diagnosed with Anorexia Nervosa (AN), 12.3% were diagnosed with Bulimia Nervosa (BN) and 36.2% with Eating Disorder Not Otherwise Specified (EDNOS). In PCA, the core ED mechanisms, dietary restraint and binge eating, acted as poles of attraction of the other variables. The AN group was particularly linked to restraint and the BN group was particularly related to "Bulimia". Considering the diagnostic subtypes, there were no significant differences between the anorexic binge-purging group, bulimic purging group and bulimic non-purging group, which constituted a unique cluster related to affective, interpersonal problems and to perfectionism, indicating a very homogeneous subgroup. Restricting anorexic group (AN-R), related to shape concern and anxious-depressed mood, was not linked to the other subtypes. EDNOS appeared to be opposed to the AN-R group; the binge eating disorder group appeared to be independent from others.

CONCLUSION

Our results suggest the presence of both specific and transdiagnostic mechanisms in ED subtypes, whose knowledge is of relevance for clinical practice.

Feelings of uselessness and 3-year mortality in an Italian community older people: the role of the functional status

BACKGROUND

Sense of self-worth influences the health status of the elderly and may be associated with mortality. The aim of the study was to investigate whether the association between subjective feelings of uselessness and mortality was confounded or modified by functional limitation in non-institutionalized older people.

METHODS

Participants were community-dwelling older people, aged 70 years and older, who lived in neighbourhoods of Massa and Carrara municipalities in northern Tuscany, Italy. At baseline, 2335 non-institutionalized older people were assessed with a short self-administered questionnaire; the analysis included 2132 older persons for whom vital statistical data were available after a 3-year follow-up.

RESULTS

The feeling of uselessness was associated with an increased mortality at the 3-year follow-up, but only in older people who reported disability problems (adjusted hazard ratio = 1.97, 95% confidence interval = 1.48-2.63, P < 0.0001).

CONCLUSIONS

People who reported disability problems and a feeling of uselessness may be vulnerable to an increased risk for poor health outcomes in later life. This study outlined the importance of enquiring about feelings of uselessness, which is a relational variable that is linked to both psychological and physical health status, especially in older people who need help in daily activities.

The presence of anti-thyroglobulin (TgAb) and/or anti-thyroperoxidase antibodies (TPOAb) does not exclude the diagnosis of type 2 amiodarone-induced thyrotoxicosis

PURPOSE

It is widely accepted that type 2 amiodarone-induced thyrotoxicosis (AIT) generally occurs in patients with a normal thyroid gland without signs of thyroid autoimmunity. However, it is currently unknown if the presence of anti-thyroglobulin (TgAb) and/or anti-thyroperoxidase antibodies (TPOAb) in AIT patients without other signs of an underlying thyroid disease may impair the response to glucocorticoid therapy.

METHODS

We performed a pilot retrospective cohort study with matched-subject design and an equivalence hypothesis, comparing the response to glucocorticoid therapy between 20 AIT patients with a normal thyroid gland, low radioiodine uptake, undetectable TSH receptor antibodies and positive TgAb and/or TPOAb (Ab+ group), and 40 patients with the same features and absent thyroid antibodies (Ab- group).

RESULTS

The mean cure time was 54 ± 68 days in the Ab+ group and 55 ± 49 days in the Ab- group (p = 0.63). The equivalence test revealed an equivalent cure rate after 60, 90 and 180 days (p = 0.67, 0.88 and 0.278, respectively). The occurrence of permanent hypothyroidism was higher in the Ab+ group than in the Ab- group (26.3 vs 5.13 %, p = 0.032).

CONCLUSIONS

The presence of TgAb and/or TPOAb does not affect the response to glucocorticoid therapy, suggesting that the patients with features of destructive form of AIT should be considered as having a type 2 AIT irrespective of the presence of TGAb or TPOAb. These patients have a higher risk of developing hypothyroidism after the resolution of thyrotoxicosis and should be monitored accordingly.

Parent-child Interaction Treatment for Preschoolers with Feeding Disorders

BACKGROUND

This study examined the immediate outcome of Feeding Disorders (FD) in preschoolers referred to the family treatment program Cerco Asilo.

METHOD

21 children (mean age [SD=1]: 39 months [1]; range 9-65 months) with a diagnosis of FD were included in the treatment for 24 weeks. Specifically, seven subjects were diagnosed with Infantile Anorexia (IA), nine subjects with Sensory Food Aversion (SFA), and five subjects with Feeding Disorder of Caregiver-Infant Reciprocity (FDCIR).

RESULTS

The great majority of patients with SFA and with FDCIR resolved the FD, whereas children with IA did not respond well to the treatment.

LIMITATIONS

The study's main limitations are the relatively small sample size, and the lack of a control group.

CONCLUSIONS

Findings suggest that changes in the parentchild relationship could generally promote FD resolution, other than IA. These data may have implications for clinical practice suggesting the need to develop ad hoc intervention protocols tailored to children with IA and their families.

Assessment of mental disorders in preschoolers: the multiaxial profiles of diagnostic classification 0-3

A group of 291 preschoolers consecutively enrolled at the Early Childhood Mental Health Service of IRCSS Stella Maris (Italy) were assessed using the Diagnostic Classification Zero to Three (DC:0-3; ZERO TO THREE, 1994). All active variables were extracted from its five axes, and a multiple correspondence analysis was performed. This analysis evidenced four multiaxial clinical profiles: (a) Multisystem developmental disorders (Axis I) were correlated with the underinvolved quality of relationship (Axis II), medical conditions (Axis III), and a low level of emotional functioning (Axis V); (b) regulatory disorders (Axis I) were correlated with maladaptive or angry/hostile relationship (Axis II), medical conditions (Axis III), and an immature level of emotional functioning (Axis V); (c) affective disorders (Axis I) were correlated with anxious/tense relationship (Axis II), stress factors (Axis IV), and emotional functioning vulnerable to stress (Axis V); and (d) adjustment, feeding, and sleeping disorders (Axis I) were correlated with mild relationship disorders (Axis II) and important impact of stress factors (Axis IV). These findings support DC:0-3 as a valid tool to detect multiaxial profiles that could be useful to plan comprehensive treatments of the disorders.

[Anorexia nervosa and hyperactivity in adolescence: psychiatric and internal medicine features]

AIM

The aim of the present study was to verify the influence of hyperactivity on internistic and psychiatric parameters in early onset anorexia nervosa restricting type (ANR).

METHODS

Seventy-three adolescent females (mean age 13.5 years, SD: 2.27) with a diagnosis of ANR (DSM-IV-TR) were consecutively enrolled in the Child and Adolescent Eating Disorders Unit of the IRCCS-Stella Maris and assessed by an extensive clinical protocol. All patients completed: psychiatric evaluation for description of the DCA and comorbidities; pediatric assessment including complete auxological data, blood pressure, heart rate and other electro/echo cardiographic and biohumoral parameters. The hyperactivity was estimated by the application of the "Structured Interview for Anorexic and Bulimic Disorder-Expert Form" (Item 40) in the context of clinical observation. Subjects were identified according to their level of hyperactive (ANR+H) and non-hyperactive (ANR-H) activity.

RESULTS

In the ANR+H group heart rate, leptin, sodium, potassium and gamma plasma proteins significantly differ compared to the group ANR-H. Patients with hyperactivity also have a complete form of ANR in 94% of cases compared with 66.7% of non-hyperactive; significant differences were found also in thought and attention CBCL and YSR subscales, combined with major internalizing problems.

CONCLUSION

This study provides preliminary data which can orient research towards the development of specific treatments for the hyperactivity, in order to improve the prognosis and thus avoid the chronicity of the disorder and the development of complications in adult life.

Optimal scaling of the CAST and of SDS Scale in a national sample of adolescents

PURPOSE

Psychometric and screening properties of the Cannabis Abuse Screening Test (CAST) and of the Severity Dependence Scale (SDS) were investigated using DSM-IV diagnoses of cannabis dependence (CD) as external criteria. Performance of the SDS and of the CAST were compared.

METHODS

Cross-sectional European School Survey Project on Alcohol and Other Drugs (ESPAD) was carried out in Italy in 2009. The sample consisted of 5787 Italian adolescents aged 15-19 who reported cannabis last year use. Uni-dimensionality, internal reliability, external validity, and optimal scaling of the 6 items for CAST and 5 items for SDS were performed. The Munich Composite International Diagnostic Interview (M-CIDI) was used as a gold standard for DSM-IV diagnoses, and all outputs were assessed by 10-fold cross validation procedure.

RESULTS

Both scales were uni-dimensional and Cronbach's α was 0.74 for SDS and 0.78 for CAST. High and comparable area under curve (AUC) values indicate a good ability of both scales to discriminate between individuals with and without dependence diagnosis. Based on balanced sensitivity and specificity, the optimal cut-off scores for problematic use disorders were 7 for CAST MCA and 4 for SDS MCA. Both CAST and SDS overestimated CD prevalence.

CONCLUSIONS

The CAST and SDS are equally useful for screening for problematic cannabis use disorders. Both clinical and research applications of the scales are possible.

The effects of the macro-environment on treatment retention for problem cocaine users

BACKGROUND

Client dropout is commonly used as an indicator of quality and effectiveness of drug treatment. Following increasing cocaine use in recent years, research has attempted to identify predictors of retention in treatment for cocaine users but there is no consensus about how individual characteristics and system variables (referral source, treatment setting), what we term here as the "macro-environment" - effect risk of dropout. This study sought to identify macro-environmental factors and examine the way these impact upon treatment retention.

METHODS

A retrospective longitudinal study of an admission cohort among drug services in Vasta Romagna in Emilia Romagna Region, Italy (up to 8 years of treatment or until discharge) was conducted to determine the effect of macro-environmental variables on retention among first time admitted cocaine-dependent clients in different treatment settings. The sample consisted of 1178 clients meeting DSM-IV-R criteria for cocaine dependence.

RESULTS

The joint effect of individual and system factors had a significant impact on dropout rates. In particular, lower rates of dropout were observed for those treated in prison and those who had a stable home, HR: 0.09 (0.02-0.48), or lived in rehabilitation units, HR: 0.36 (0.15-0.88), and among clients referred by the local authority and those living with parents, HR: 0.60 (0.38-0.95).

CONCLUSION

The combined effect of individual and system factors on retention in treatment sets a critical background necessary to assess any impact of organizational dynamics and delineate the trajectory for future interventions.

Concordance and consistency of answers to the self-delivered ESPAD questionnaire on use of psychoactive substances

Considering the prevalence of drug use in Italy, it is crucial to develop a reproducible screening test. Test-retest reliability and internal consistency are important indicators of a measurement's temporal stability and are a necessary condition for validity. The aim of the study was to assess the consistency and concordance of the European School Survey Project on Alcohol and Other Drugs (ESPAD) questionnaire; participating students completed the questionnaire twice, with a three-week interval. To verify the concordance for variables relating to use of alcohol, cigarettes and illicit drugs, the original ordinal variables as well as the same dichotomically recodified variables were used. Data analysis was done using Kappa and weighted Kappa. The method proposed by Lipsitz was used to evaluate the influence of gender and age on concordance. Questions about drug use, examined in ordinal form, show a good test-retest concordance and an excellent concordance for answers relating to the use of cigarettes, alcohol and cannabis. Regarding the effect of age adjusted for gender, 15-year-old subjects showed a lower concordance than 19-year-olds. ESPAD is a tool with a good reproducibility. Results focus on the effect of gender and age covariates on the concordance of answers regarding drug use and suggest the importance of examining the concordance in relation to the covariate levels.

The application of observational data in translational medicine: analyzing tobacco-use behaviors of adolescents

Background

Translational Medicine focuses on “bench to bedside”, converting experimental results into clinical use. The “bedside to bench” transition remains challenging, requiring clinicians to define true clinical need for laboratory study. In this study, we show how observational data (an eleven-year data survey program on adolescent smoking behaviours), can identify knowledge gaps and research questions leading directly to clinical implementation and improved health care. We studied gender-specific trends (2000–2010) in Italian students to evaluate the specific impact of various anti-smoking programs, including evaluation of perceptions of access to cigarettes and health risk.

Methods

The study used, ESPAD-Italia® (European School Survey Project on Alcohol and other Drugs), is a nationally representative sample of high-school students. The permutation test for joinpoint regression was used to calculate the annual percent change in smoking. Changes in smoking habits by age, perceived availability and risk over a 11-year period were tested using a gender-specific logistic model and a multinomial model.

Results

Gender-stratified analysis showed 1) decrease of lifetime prevalence, then stabilization (both genders); 2) decrease in last month and occasional use (both genders); 3) reduction of moderate use (females); 4) no significant change in moderate use (males) and in heavy use (both genders). Perceived availability positively associates with prevalence, while perceived risk negatively associates, but interact with different effects depending on smoking patterns. In addition, government implementation of public policies concerning access to tobacco products in this age group during this period presented a unique background to examine their specific impact on behaviours.

Conclusion

Large observational databases are a rich resource in support of translational research. From these observations, key clinically relevant issues can be identified and form the basis for further clinical studies. The ability to identify patterns of behaviour and gaps in available data translates into new experiments, but also impacts development of public policy and reveals patterns of clinical reality. The observed global decrease in use is countered by stabilization in number of heavy smokers. Increased cigarette cost has not reduced use. While perceived risk of smoking may prevent initial experimentation, how government policies impact the perception of risk is not easily quantifiable.

Characteristics of alcoholics attending 'clubs of alcoholics in treatment' in Italy: a national survey

AIMS

To provide an overview of alcoholics attending a socio-ecological treatment programme [Clubs of Alcoholics in Treatment (CATs)] and to identify factors associated with abstinence and self-perceived improvement in lifestyle.

METHODS

A national sample of 7522 subjects (76% males and 24% females, mean age 53.2 ± 11.3 years ± SD) attending CATs was evaluated using a self-administered questionnaire completed at a weekly meeting in 2006.

RESULTS

Of participants, >70% reported no alcohol use in the last year and around 90% indicated no use in the previous month, whereas 4% of them declared no alcohol use before club attendance. Abstinence and lifestyle improvement were related positively to the number of years of club attendance but negatively to the presence of other problems in addition to the alcohol-related one. Moreover, being older or female was associated with more likely achievement of abstinence as well as with the perception of a better lifestyle. Finally, attending the club with one or more family members was associated with achievement of better lifestyle.

CONCLUSION

These data provide an overview of alcoholics attending the CAT programme and are a first step toward developing a surveillance system. In addition, on the basis of this preliminary picture further research (notably longitudinal studies) can be planned considering this method and its effectiveness.

Vitamin D status may contribute to serum insulin-like growth factor I concentrations in healthy subjects

OBJECTIVE

The aim of the study was to evaluate whether vitamin D [25-(OH) D3] status affects serum IGFI concentrations in healthy subjects.

DESIGN AND PATIENTS

Two hundred and forty-one consecutive healthy subjects were included in the present study.

MEASUREMENTS

Serum IGF-I and 25-(OH) D3 concentrations.

RESULTS

As expected, serum IGF-I concentrations progressively decreased with age (r=-0.55, p<0.0001); on the contrary, gender was not related to serum IGF-I levels. A positive relationship was identified between serum 25-(OH) D3 and IGF-I concentrations (r=0.33, p<0.0001); the 25-(OH) D3-dependent changes of serum IGF-I concentrations were observed also when subjects were divided on the basis of vitamin D deficiency; in fact, those with severe 25-(OH) D3 deficiency (<20 ng/ml) had lower (185 ± 83 μg/l) IGF-I values than those with mild-to absent 25-(OH) D3 deficit (225 ± 83 μg/l, p=0.0004).

CONCLUSIONS

25-(OH) D3 status may contribute to determine serum IGF-I levels in healthy population.