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Simonetta C, Bissacco J, Conti M, Bovenzi R, Salimei C, Cerroni R, Pierantozzi M, Stefani A, Mercuri NB, Schirinzi T. Motor cortex transcranial direct current stimulation improves non-motor symptoms in early-onset Parkinson's disease: a pilot study. J Neural Transm (Vienna) 2024; 131:189-193. [PMID: 38104296 DOI: 10.1007/s00702-023-02726-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/08/2023] [Indexed: 12/19/2023]
Abstract
Early-onset Parkinson's Disease (EOPD) demands tailored treatments. The younger age of patients might account for a higher sensitivity to transcranial direct current stimulation (tDCS) based non-invasive neuromodulation, which may raise as an integrative therapy in the field. Accordingly, here we assessed the safety and efficacy of the primary left motor cortex (M1) anodal tDCS in EOPD. Ten idiopathic EOPD patients received tDCS at 2.0 mA per 20 min for 10 days within a crossover, double-blind, sham-controlled pilot study. The outcome was evaluated by measuring changes in MDS-UPDRS part III, Non-Motor Symptoms Scale (NMSS), PD-cognitive rating scale, and PD Quality of Life Questionnaire-39 scores. We showed that anodal but not sham tDCS significantly reduced the NMSS total and "item 2" (sleep/fatigue) scores. Other parameters were not modified. No adverse events occurred. M1 anodal tDCS might thus evoke plasticity changes in cortical-subcortical circuits involved in non-motor functions, supporting the value as a therapeutic option in EOPD.
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Affiliation(s)
- Clara Simonetta
- Unit of Neurology, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier, 00133, Rome, Italy
| | - Jacopo Bissacco
- Unit of Neurology, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier, 00133, Rome, Italy
| | - Matteo Conti
- Unit of Neurology, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier, 00133, Rome, Italy
| | - Roberta Bovenzi
- Unit of Neurology, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier, 00133, Rome, Italy
| | - Chiara Salimei
- Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Rocco Cerroni
- Unit of Neurology, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier, 00133, Rome, Italy
| | - Mariangela Pierantozzi
- Unit of Neurology, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier, 00133, Rome, Italy
- UOSD Parkinson Centre, Tor Vergata University Hospital, Rome, Italy
| | - Alessandro Stefani
- Unit of Neurology, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier, 00133, Rome, Italy
- UOSD Parkinson Centre, Tor Vergata University Hospital, Rome, Italy
| | - Nicola Biagio Mercuri
- Unit of Neurology, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier, 00133, Rome, Italy
| | - Tommaso Schirinzi
- Unit of Neurology, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier, 00133, Rome, Italy.
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Al-Wardat M, Grillo P, Schirinzi T, Pavese C, Salimei C, Pisani A, Natoli S. Constipation and pain in Parkinson's disease: a clinical analysis. J Neural Transm (Vienna) 2024; 131:165-172. [PMID: 37897509 DOI: 10.1007/s00702-023-02696-5] [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: 07/29/2023] [Accepted: 09/06/2023] [Indexed: 10/30/2023]
Abstract
Parkinson's Disease (PD) is a neurodegenerative disorder characterized by both motor and non-motor symptoms (NMS). Among NMS, constipation and pain are both highly prevalent and debilitating affecting up to 80% of PD patients and impairing their quality of life. Here, we investigated the relationship between constipation and pain in PD patients. This is a retrospective study assessing the relationship between pain and constipation in a PD patient population from a clinical database of patients attending the outpatient clinic of the movement disorders division, Neurology Unit of Policlinico Tor Vergata, in Rome. Subjects were assessed with the Unified Parkinson's Disease Rating Scale (UPDRS) part III, Hoehn and Yahr (H&Y) stage, King's Parkinson's Disease Pain Scale (KPPS), Brief Pain Inventory (BPI), Non-Motor Symptoms Scale (NMSS) and Beck Depression Inventory (BDI). Patients were further divided in two groups (Group 1, 32 patients with constipation and Group 2, 35 PD patients without constipation) ANOVA and ANCOVA analysis were used to compare the two groups. PD patients with constipation had significantly higher pain severity and pain interference, as measured by the BPI scale and higher total KPPS score, fluctuation-related pain, nocturnal pain, and radicular pain when compared to PD patients without constipation. This study highlights for the first time a possible interplay between constipation and pain in PD that deserves further investigations.
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Affiliation(s)
- Mohammad Al-Wardat
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Piergiorgio Grillo
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- IRCCS Fondazione Mondino, Pavia, Italy
| | - Tommaso Schirinzi
- Unit of Neurology, Department of Systems Medicine, Tor Vergata University of Rome, 00133, Rome, Italy
| | - Chiara Pavese
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation and Spinal Unit of Pavia Institute, Pavia, Italy
| | - Chiara Salimei
- Deptartment of Clinical Science and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Antonio Pisani
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- IRCCS Fondazione Mondino, Pavia, Italy
| | - Silvia Natoli
- Deptartment of Clinical Science and Translational Medicine, University of Rome Tor Vergata, Rome, Italy.
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Bovenzi R, Conti M, Degoli GR, Cerroni R, Simonetta C, Liguori C, Salimei C, Pisani A, Pierantozzi M, Stefani A, Mercuri NB, Schirinzi T. Shaping the course of early-onset Parkinson's disease: insights from a longitudinal cohort. Neurol Sci 2023; 44:3151-3159. [PMID: 37140831 PMCID: PMC10415517 DOI: 10.1007/s10072-023-06826-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 09/22/2022] [Accepted: 04/20/2023] [Indexed: 05/05/2023]
Abstract
INTRODUCTION Early -onset Parkinson's disease (EOPD) labels those cases with onset earlier than fifty. Although peculiarities emerged either in clinical or pathological features, EOPD is managed alike typical, late-onset PD. A customized approach would be, instead, better appropriate. Accordingly, a deeper characterization of the clinical course, with an estimation of the disease progression rate, the therapy flow, and the main motor and non-motor complications occurrence, is needed. METHODS A longitudinal cohort of 193 EOPD patients (selected on a single-centre population of 2000 PD cases) was retrospectively analysed, providing descriptive statics on a series of clinical parameters (genetics, phenotype, comorbidities, therapies, motor and non-motor complications, marital and gender issues) and modelling the trajectories from diagnosis to 10 years later of both Hoehn and Yahr (H&Y) stage and levodopa equivalent daily dose (LEDD). RESULTS EOPD had a prevalence of 9.7%, including few monogenic cases. It mostly appeared as a motor syndrome, with asymmetric, rigid-akinetic presentation. H&Y linearly progressed with an increment of 0.92 points/10 years; LEDD flow had a non-linear trend, increasing of 526.90 mg/day in 0-5 years, and 166.83 mg/day in 5-10 years. Motor fluctuations started 6.5 ± 3.2 years from onset, affecting up to 80% of the cohort. Neuropsychiatric troubles interested the 50%, sexual complaints the 12%. Gender-specific motor disturbances emerged. CONCLUSION We shaped EOPD course, modelling a "brain-first" PD subtype, slowly progressive, with non-linear dopaminergic requirement. Major burden mostly resulted from motor fluctuations, neuropsychiatric complications, sexual and marital complaints, with a considerable gender-effect.
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Affiliation(s)
- Roberta Bovenzi
- Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Via Montpellier, 00133, Rome, Italy
| | - Matteo Conti
- Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Via Montpellier, 00133, Rome, Italy
| | - Giulia Rebecca Degoli
- Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Via Montpellier, 00133, Rome, Italy
| | - Rocco Cerroni
- Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Via Montpellier, 00133, Rome, Italy
| | - Clara Simonetta
- Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Via Montpellier, 00133, Rome, Italy
| | - Claudio Liguori
- Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Via Montpellier, 00133, Rome, Italy
| | - Chiara Salimei
- Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Via Montpellier, 00133, Rome, Italy
| | - Antonio Pisani
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
- IRCCS Mondino Foundation, Pavia, Italy
| | - Mariangela Pierantozzi
- Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Via Montpellier, 00133, Rome, Italy
| | - Alessandro Stefani
- Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Via Montpellier, 00133, Rome, Italy
- UOSD Parkinson Centre, Tor Vergata University Hospital, Rome, Italy
| | - Nicola Biagio Mercuri
- Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Via Montpellier, 00133, Rome, Italy
- IRCCS Fondazione Santa Lucia, European Centre for Brain Research, Rome, Italy
| | - Tommaso Schirinzi
- Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Via Montpellier, 00133, Rome, Italy.
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Gualtieri P, Al-Wadart M, De Santis GL, Alwadart N, Della Morte D, Clarke C, Best T, Salimei C, Bigioni G, Cianci R, De Lorenzo A, Di Renzo L. The role of MTHFR polymorphisms in the risk of lipedema. Eur Rev Med Pharmacol Sci 2023; 27:1625-1632. [PMID: 36876707 DOI: 10.26355/eurrev_202302_31407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
OBJECTIVE This study examines the role of MTHFR gene polymorphism (rs1801133) in women with lipedema (LIPPY) body composition parameters compared to a control group (CTRL). SUBJECTS AND METHODS We carried out a study on a sample of 45 LIPPY and 50 women as a CTRL. Body composition parameters were examined by Dual-energy X-ray Absorptiometry (DXA). A genetic test was performed for the MTHFR polymorphism (rs1801133, 677C>T) using a saliva sample for LIPPY and CTRL groups. Mann-Whitney tests evaluated statistically significant differences between four groups (carriers and non-carriers of the MTHFR polymorphism for LIPPY and CTRL groups) on anthropometric/body composition parameters to identify patterns. RESULTS LIPPY showed significantly higher (p<0.05) anthropometric parameters (weight, BMI, waist, abdominal, hip circumferences) and lower waist/hip ratio (p<0.05) compared to the CTRL group. The association between the polymorphism alleles related to the rs1801133 MTHFR gene and the body composition values LIPPY carriers (+) showed an increase in fat tissue of legs and fat region of legs percentage, arm's fat mass (g), leg's fat mass (g), and leg's lean mass (g) (p<0.05) compared to CTRL (+). Lean/fat arms and lean/fat legs were lower (p<0.05) in LIPPY (+) than in CTRL (+). In the LIPPY (+), the risk of developing the lipedema disease was 2.85 times higher (OR=2.85; p<0.05; 95% confidence interval = 0.842-8.625) with respect to LIPPY (-) and CTRL. CONCLUSIONS The presence or absence of MTHFR polymorphism offers predictive parameters that could better characterize women with lipedema based on the association between body composition and MTHFR presence.
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Affiliation(s)
- P Gualtieri
- Department of Biomedicine and Prevention, Section of Clinical Nutrition and Nutrigenomics, University of Tor Vergata, Rome, Italy.
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Al-Wardat M, Clarke C, Alwardat N, Kassab M, Salimei C, Gualtieri P, Marchetti M, Best T, Di Renzo L. The Difficulties in Emotional Regulation among a Cohort of Females with Lipedema. Int J Environ Res Public Health 2022; 19:13679. [PMID: 36294260 PMCID: PMC9602978 DOI: 10.3390/ijerph192013679] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/30/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Lipedema is a chronic and progressive adipose tissue disorder that causes significant morbidity and negatively influences mental health and quality of life, and increases the risk of depression, anxiety, and eating disorders. One construct of relevance to better understanding psychological disorders is emotion regulation (ER). Therefore, the aim of this study is to investigate the difficulties in ER among lipedema patients compared to healthy people without lipedema. METHODS This cross-sectional study assessed differences in ER and anxiety between two groups: 26 female patients with lipedema and 26 sex- and age-matched healthy controls. The Difficulties in Emotion Regulation Scale (DERS) assessed emotional regulation across six dimensions: Impulse control, goal-directed behavior, awareness, clarity, non-acceptance, and strategies. Anxiety was assessed by the Hamilton Anxiety Scale (HAM-A). ANOVA assessed differences in measures between lipedema and healthy control groups. RESULTS Lipedema patients presented with significantly more difficulties in ER and a higher level of anxiety than those without lipedema. Specifically, the lipedema group showed higher and significant differences in total DERS and anxiety scores and all DERS subscales scores compared to those without lipedema. CONCLUSIONS Lipedema patients showed significant difficulties with ER, and were associated with anxiety symptoms, indicating that ER difficulties may play a role in developing emotional disorders, such as anxiety, for patients with lipedema. The health care provider should pay more attention to ER difficulties and psychological status among lipedema patients.
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Affiliation(s)
- Mohammad Al-Wardat
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid P.O. Box 3030, Jordan
| | - Chantelle Clarke
- NeuroHealth Lab, Appleton Institute, School of Health, Medical and Applied Sciences, CQUniversity Australia, Brisbane 4000, Australia
| | - Nuha Alwardat
- Faculty of Applied Medical Sciences, Jerash University, Jerash P.O. Box 311, Jordan
| | - Manal Kassab
- Department of Maternal and Child Health, Faculty of Nursing, Jordan University of Science and Technology, Irbid P.O. Box 3030, Jordan
| | - Chiara Salimei
- Department of Clinical Sciences and Translational Medicine, University of Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Paola Gualtieri
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Marco Marchetti
- Department of Clinical Sciences and Translational Medicine, University of Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
- PhD School of Applied Medical-Surgical Sciences, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Talitha Best
- NeuroHealth Lab, Appleton Institute, School of Health, Medical and Applied Sciences, CQUniversity Australia, Brisbane 4000, Australia
| | - Laura Di Renzo
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
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Perrone MA, Feola A, Pieri M, Donatucci B, Salimei C, Lombardo M, Perrone A, Parisi A. The Effects of Reduced Physical Activity on the Lipid Profile in Patients with High Cardiovascular Risk during COVID-19 Lockdown. Int J Environ Res Public Health 2021; 18:ijerph18168858. [PMID: 34444607 PMCID: PMC8393411 DOI: 10.3390/ijerph18168858] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/18/2021] [Accepted: 08/19/2021] [Indexed: 12/11/2022]
Abstract
Background: The COVID-19 pandemic is a serious global health problem. In Italy, to limit the infections, the government ordered lockdown from March 2020. This measure, designed to contain the virus, led to serious limitations on the daily life of the individuals it affected, and in particular in the limitation of physical exercise. The aim of this study was to evaluate the effects of reduced physical activity on the lipid profile in patients with high cardiovascular risk. Methods: We enrolled 38 dyslipidemic patients, 56% male, with an age range of 44-62 years, considered to be at high cardiovascular risk. All patients were prescribed statin drug therapy (atorvastatin 40 mg) and a vigorous physical activity program four times a week, 1 h per session. In addition, a personalized Mediterranean diet was prescribed to all the patients. Total cholesterol, LDL, HDL and triglycerides were measured in patients at T0 before lockdown and at T1 during lockdown. Results: Data showed a significant increase (p < 0.01) in total cholesterol (+6,8%) and LDL (+15,8%). Furthermore, the analysis of the data revealed a reduction in HDL (-3%) and an increase in triglycerides (+3,2%), although both were not significant (p > 0.05). Conclusions: Our study showed that the reduction in physical activity during lockdown led to an increase in LDL levels, and therefore, in the risk of ischemic heart disease in dyslipidemic patients with high cardiovascular risk.
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Affiliation(s)
- Marco Alfonso Perrone
- Department of Systems Medicine, University of Roma Tor Vergata, 00133 Rome, Italy;
- University Sports Centre, University of Rome Tor Vergata, 00133 Rome, Italy;
- Correspondence:
| | - Alessandro Feola
- Department of Experimental Medicine, University of Campania Luigi Vanvitelli, 80138 Naples, Italy;
| | - Massimo Pieri
- Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Bruno Donatucci
- University Sports Centre, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Chiara Salimei
- Department of Systems Medicine, University of Roma Tor Vergata, 00133 Rome, Italy;
| | - Mauro Lombardo
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy;
| | - Andrea Perrone
- Department of Management Engineering, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Attilio Parisi
- Department of Movement, Human and Health Science, University of Rome Foro Italico, 00135 Rome, Italy;
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Sancesario GM, Di Lazzaro G, Alwardat M, Biticchi B, Basile V, Salimei C, Colona VL, Sinibaldi Salimei P, Bernardini S, Mercuri NB, Pisani A, Schirinzi T. Amyloid-β42/Neurogranin Ratio as a Potential Index for Cognitive Impairment in Parkinson's Disease. J Alzheimers Dis 2021; 76:1171-1178. [PMID: 32597810 DOI: 10.3233/jad-200344] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Synaptopathy is critical in pathophysiology of Parkinson's disease (PD). Cerebrospinal fluid (CSF) levels of neurogranin (NG) and amyloid-β42 (Aβ42) are considered markers of synaptic dysfunction in neurodegenerative diseases. OBJECTIVE To evaluate the CSF synaptopathy-related biomarkers, especially the novel Aβ42/NG ratio, in PD, establishing possible associations with cognitive level and other clinical parameters. METHODS Levels of NG, Aβ42, amyloid-β40, total and phosphorylated tau, and Aβ42/NG ratio were measured in 30 PD patients and 30 controls and correlated with cognitive and motor parameters. The accuracy in distinguishing the cognitive status was determined. RESULTS NG and Aβ42 were significantly reduced in PD, with higher NG levels in patients with worse cognition. The Aβ42/NG ratio showed a direct correlation with Mini-Mental State Examination, independently from age and sex, and differentiated cognitively impaired patients with 92% sensitivity and 71.4% specificity, accuracy higher than NG alone. No correlations resulted with motor disturbances or therapy. CONCLUSIONS The novel Aβ42/NG ratio couples either presynaptic or postsynaptic markers of synaptic dysfunction, representing a potential global index of synaptopathy, useful to track cognitive functions in PD.
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Affiliation(s)
- Giulia Maria Sancesario
- IRCCS Fondazione Santa Lucia, Rome, Italy.,Department of Experimental Medicine and Surgery, University of Roma Tor Vergata, Rome, Italy
| | - Giulia Di Lazzaro
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Mohammad Alwardat
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Benedetta Biticchi
- Department of Experimental Medicine and Surgery, University of Roma Tor Vergata, Rome, Italy
| | - Valerio Basile
- Department of Experimental Medicine and Surgery, University of Roma Tor Vergata, Rome, Italy
| | - Chiara Salimei
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Vito Luigi Colona
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | | | - Sergio Bernardini
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Nicola Biagio Mercuri
- IRCCS Fondazione Santa Lucia, Rome, Italy.,Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Antonio Pisani
- IRCCS Fondazione Santa Lucia, Rome, Italy.,Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Tommaso Schirinzi
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
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Di Renzo L, Cinelli G, Dri M, Gualtieri P, Attinà A, Leggeri C, Cenname G, Esposito E, Pujia A, Chiricolo G, Salimei C, De Lorenzo A. Mediterranean Personalized Diet Combined with Physical Activity Therapy for the Prevention of Cardiovascular Diseases in Italian Women. Nutrients 2020; 12:E3456. [PMID: 33187188 PMCID: PMC7697155 DOI: 10.3390/nu12113456] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 12/12/2022] Open
Abstract
Cardiovascular diseases (CVDs) and inflammatory risk indexes are used to calculate the exposure to morbidity. Most of them are suggested by the American College of Cardiology/American Heart Association to predict the risk of CVDs diagnosis in primary prevention, instead of treating the ongoing pathology. Prevention starts from habit changes with the prescription of diet and physical activity (PA). The aim of the study is to investigate the effectiveness of a personalized Mediterranean Diet (MD) and a PA intervention, on the risk indexes Atherogenic Index of Plasma (AIP), Lipid Accumulation Product (LAP) and Fatty Liver Index (FLI) in a population of women at risk of CVDs with different pathological conditions. After treatment, patients achieved the best results in body composition (BC) and laboratory tests. The BC analysis showed a significant reduction of total body Fat Mass (FM). CVDs risk indexes significantly decreased, except for Neutrophil/Lymphocyte (NLR) and Platelet/Lymphocyte Ratios (PLR). The reduction of the CVDs indexes associated with lipid profile was linked to both weight and FM decrease. AIP and LAP were significantly reduced when losing fat mass and body weight, respectively. A personalized MD therapy plus a PA program led to body weight loss, BC remodelling and risk indexes reduction.
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Affiliation(s)
- Laura Di Renzo
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (P.G.); (A.D.L.)
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (A.P.); (G.C.)
| | - Giulia Cinelli
- School of Specialization in Food Sciences, University of Rome Tor Vergata, 00133 Rome, Italy; (G.C.); (A.A.); (C.L.)
- Predictive and Preventive Medicine Research Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Maria Dri
- Department of Surgical Sciences, School of Applied Medical-Surgical Sciences, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Paola Gualtieri
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (P.G.); (A.D.L.)
| | - Alda Attinà
- School of Specialization in Food Sciences, University of Rome Tor Vergata, 00133 Rome, Italy; (G.C.); (A.A.); (C.L.)
| | - Claudia Leggeri
- School of Specialization in Food Sciences, University of Rome Tor Vergata, 00133 Rome, Italy; (G.C.); (A.A.); (C.L.)
| | - Giuseppe Cenname
- Comando Generale Arma Carabinieri, Direzione di Sanità, 00197 Rome, Italy;
| | - Ernesto Esposito
- Department of Human Policies (General Directorate) of Basilicata Region, 85100 Potenza, Italy;
| | - Alberto Pujia
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (A.P.); (G.C.)
| | - Gaetano Chiricolo
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (A.P.); (G.C.)
| | - Chiara Salimei
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Antonino De Lorenzo
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (P.G.); (A.D.L.)
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Schirinzi T, Di Lazzaro G, Salimei C, Cerroni R, Liguori C, Scalise S, Alwardat M, Mercuri NB, Pierantozzi M, Stefani A, Pisani A. Physical activity changes and correlate effects in patients with Parkinson's disease during COVID-19 lockdown. Mov Disord Clin Pract 2020; 7:797-802. [PMID: 32837960 PMCID: PMC7404747 DOI: 10.1002/mdc3.13026] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [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: 05/14/2020] [Revised: 07/01/2020] [Accepted: 07/13/2020] [Indexed: 01/06/2023] Open
Abstract
Background COVID‐19 outbreak profoundly affected health systems and people's daily life worldwide. Parkinson's disease (PD) patients lost their normal routine and interrupted regular physical activity, either as physiotherapy or sport, with inevitable consequence on their daily‐life and well‐being. Objectives To evaluate the changes in physical activity due to COVID‐19 emergency, including self‐management strategies or technology‐assisted activities, and the subsequent clinical implications in PD patients. Methods Seventy‐four patients from an Italian center have been remotely examined during the lockdown (April–May 2020) by an e‐mail structured survey, including self‐administered scales. We collected and analyzed data on changes, modalities and amount of physical active practice, on the use of technology‐based tools, and on self‐perceived clinical condition. Results Sixty percent of patients reported a significant worsening of their general conditions during the lockdown, the reduction of physical activity being the main risk factor for such change. However, patients found ways to practice physical activity, using satisfactorily technology assistance in 50% of cases (mostly women). Conclusions The COVID‐19 emergency has been an ordeal for PD patients. Nevertheless, patients adapted their habits to continue practicing physical activity that resulted a main determinant of their well‐being; as well, they successfully approached technology‐based assistance. Education, communication, and networking emerge as critical for a constructive reaction to the emergency's challenges.
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Affiliation(s)
- Tommaso Schirinzi
- Department of Systems Medicine University of Roma Tor Vergata Rome Italy
| | - Giulia Di Lazzaro
- Department of Systems Medicine University of Roma Tor Vergata Rome Italy
| | - Chiara Salimei
- Department of Systems Medicine University of Roma Tor Vergata Rome Italy
| | - Rocco Cerroni
- Department of Systems Medicine University of Roma Tor Vergata Rome Italy.,UOSD Parkinson's Center, Department of Systems Medicine University of Roma Tor Vergata Rome Italy
| | - Claudio Liguori
- Department of Systems Medicine University of Roma Tor Vergata Rome Italy
| | - Simona Scalise
- Department of Systems Medicine University of Roma Tor Vergata Rome Italy.,UOSD Parkinson's Center, Department of Systems Medicine University of Roma Tor Vergata Rome Italy
| | - Mohammad Alwardat
- Department of Systems Medicine University of Roma Tor Vergata Rome Italy.,Department of Physical Therapy Aqaba University of Technology Aqaba Jordan
| | - Nicola Biagio Mercuri
- Department of Systems Medicine University of Roma Tor Vergata Rome Italy.,IRCCS Fondazione Santa Lucia Rome Italy
| | - Mariangela Pierantozzi
- Department of Systems Medicine University of Roma Tor Vergata Rome Italy.,UOSD Parkinson's Center, Department of Systems Medicine University of Roma Tor Vergata Rome Italy
| | - Alessandro Stefani
- Department of Systems Medicine University of Roma Tor Vergata Rome Italy.,UOSD Parkinson's Center, Department of Systems Medicine University of Roma Tor Vergata Rome Italy
| | - Antonio Pisani
- Department of Systems Medicine University of Roma Tor Vergata Rome Italy.,IRCCS Fondazione Santa Lucia Rome Italy
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10
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Imbriani P, D'Angelo V, Platania P, Di Lazzaro G, Scalise S, Salimei C, El Atiallah I, Colona VL, Mercuri NB, Bonsi P, Pisani A, Schirinzi T, Martella G. Ischemic injury precipitates neuronal vulnerability in Parkinson's disease: Insights from PINK1 mouse model study and clinical retrospective data. Parkinsonism Relat Disord 2020; 74:57-63. [PMID: 32335490 DOI: 10.1016/j.parkreldis.2020.04.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [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: 12/27/2019] [Revised: 04/07/2020] [Accepted: 04/07/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Increasing evidence demonstrates the relevant association between Parkinson's disease (PD) and vascular diseases/risk factors, as well as a worse clinico-pathological progression in those patients with vascular comorbidity. The mechanisms underlying this relationship have not been clarified yet, although their comprehension is critical in a perspective of disease-modifying treatments development or prevention. METHODS We performed an experimental protocol of ischemic injury (glucose-oxygen deprivation, OGD) on PTEN-induced kinase 1 knockout (PINK1-/-) mice, a well-established PD model, looking at both electrophysiological and morphological changes in basal ganglia. In addition, 253 PD patients were retrospectively analysed, to estimate the prevalence of vascular risk factors. RESULTS In PINK1-/- mice, the OGD protocol induced electrophysiological (prolonged depolarization) and morphological alterations (picnotic cells, cellular loss and swelling, thickening of nuclear chromatin) in striatal medium spiny neurons and nigral dopaminergic neurons. Vascular comorbidity occurred in 75% of PD patients. CONCLUSIONS The ischemic injury precipitates neuronal vulnerability in basal ganglia of PINK1-/- mice, probably through an impairment of mitochondrial metabolism and higher oxidative stress. These experimental data may provide a potential mechanistic explanation for both the association between vascular diseases and PD and their reciprocal interactions in determining the clinico-pathological burden of PD patients.
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Affiliation(s)
- Paola Imbriani
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy; IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Vincenza D'Angelo
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Paola Platania
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Giulia Di Lazzaro
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Simona Scalise
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Chiara Salimei
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Ilham El Atiallah
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy; IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Vito Luigi Colona
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Nicola Biagio Mercuri
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy; IRCCS Fondazione Santa Lucia, Rome, Italy
| | | | - Antonio Pisani
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy; IRCCS Fondazione Santa Lucia, Rome, Italy.
| | - Tommaso Schirinzi
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Giuseppina Martella
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy; IRCCS Fondazione Santa Lucia, Rome, Italy
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11
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Ricci M, Di Lazzaro G, Pisani A, Scalise S, Alwardat M, Salimei C, Giannini F, Saggio G. Wearable Electronics Assess the Effectiveness of Transcranial Direct Current Stimulation on Balance and Gait in Parkinson's Disease Patients. Sensors (Basel) 2019; 19:E5465. [PMID: 31835822 PMCID: PMC6960759 DOI: 10.3390/s19245465] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 11/29/2019] [Accepted: 12/08/2019] [Indexed: 12/17/2022]
Abstract
Currently, clinical evaluation represents the primary outcome measure in Parkinson's disease (PD). However, clinical evaluation may underscore some subtle motor impairments, hidden from the visual inspection of examiners. Technology-based objective measures are more frequently utilized to assess motor performance and objectively measure motor dysfunction. Gait and balance impairments, frequent complications in later disease stages, are poorly responsive to classic dopamine-replacement therapy. Although recent findings suggest that transcranial direct current stimulation (tDCS) can have a role in improving motor skills, there is scarce evidence for this, especially considering the difficulty to objectively assess motor function. Therefore, we used wearable electronics to measure motor abilities, and further evaluated the gait and balance features of 10 PD patients, before and (three days and one month) after the tDCS. To assess patients' abilities, we adopted six motor tasks, obtaining 72 meaningful motor features. According to the obtained results, wearable electronics demonstrated to be a valuable tool to measure the treatment response. Meanwhile the improvements from tDCS on gait and balance abilities of PD patients demonstrated to be generally partial and selective.
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Affiliation(s)
- Mariachiara Ricci
- Department of Electronic Engineering, University of Rome “Tor Vergata”, 00133 Rome, Italy; (M.R.); (F.G.)
| | - Giulia Di Lazzaro
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (G.D.L.); (A.P.); (S.S.); (M.A.); (C.S.)
| | - Antonio Pisani
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (G.D.L.); (A.P.); (S.S.); (M.A.); (C.S.)
| | - Simona Scalise
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (G.D.L.); (A.P.); (S.S.); (M.A.); (C.S.)
| | - Mohammad Alwardat
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (G.D.L.); (A.P.); (S.S.); (M.A.); (C.S.)
| | - Chiara Salimei
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (G.D.L.); (A.P.); (S.S.); (M.A.); (C.S.)
| | - Franco Giannini
- Department of Electronic Engineering, University of Rome “Tor Vergata”, 00133 Rome, Italy; (M.R.); (F.G.)
| | - Giovanni Saggio
- Department of Electronic Engineering, University of Rome “Tor Vergata”, 00133 Rome, Italy; (M.R.); (F.G.)
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12
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Pacifici F, Di Cola D, Pastore D, Abete P, Guadagni F, Donadel G, Bellia A, Esposito E, Salimei C, Sinibaldi Salimei P, Ricordi C, Lauro D, Della-Morte D. Proposed Tandem Effect of Physical Activity and Sirtuin 1 and 3 Activation in Regulating Glucose Homeostasis. Int J Mol Sci 2019; 20:ijms20194748. [PMID: 31557786 PMCID: PMC6801856 DOI: 10.3390/ijms20194748] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 09/17/2019] [Accepted: 09/21/2019] [Indexed: 12/19/2022] Open
Abstract
Sirtuins (SIRTs) are seven nicotinamide adenine dinucleotide (NAD+)-dependent protein deacetylases enzymes (SIRT1–7) that play an important role in maintaining cellular homeostasis. Among those, the most studied are SIRT1 and SIRT3, a nuclear SIRT and a mitochondrial SIRT, respectively, which significantly impact with an increase in mammals’ lifespan by modulating metabolic cellular processes. Particularly, when activated, both SIRT1 and 3 enhance pancreatic β-cells’ insulin release and reduce inflammation and oxidative stress pancreatic damage, maintaining then glucose homeostasis. Therefore, SIRT1 and 3 activators have been proposed to prevent and counteract metabolic age-related diseases, such as type 2 diabetes mellitus (T2DM). Physical activity (PA) has a well-established beneficial effect on phenotypes of aging like β-cell dysfunction and diabetes mellitus. Recent experimental and clinical evidence reports that PA increases the expression levels of both SIRT1 and 3, suggesting that PA may exert its healthy contribute even by activating SIRTs. Therefore, in the present article, we discuss the role of SIRT1, SIRT3, and PA on β-cell function and on diabetes. We also discuss the possible interaction between PA and activation of SIRTs as a possible therapeutic strategy to maintain glucose hemostasis and to prevent T2DM and its complications, especially in the elderly population.
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Affiliation(s)
- Francesca Pacifici
- Department of Systems Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy.
| | - Davide Di Cola
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy.
| | - Donatella Pastore
- Department of Systems Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy.
| | - Pasquale Abete
- Department of Translational Medical Sciences, University of Naples "Federico II", 80138 Naples, Italy.
| | - Fiorella Guadagni
- Department of Human Sciences and Quality of Life Promotion, San Raffaele Roma Open University, 00166 Rome, Italy.
| | - Giulia Donadel
- Department of Systems Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy.
| | - Alfonso Bellia
- Department of Systems Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy.
| | - Eleonora Esposito
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy.
| | - Chiara Salimei
- University of Rome Tor Vergata, Neuroscience, 00133 Rome, Italy.
| | - Paola Sinibaldi Salimei
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy.
| | - Camillo Ricordi
- Diabetes Research Institute (DRI) and Clinical Cell Transplant Program, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
| | - Davide Lauro
- Department of Systems Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy.
| | - David Della-Morte
- Department of Systems Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy.
- Department of Human Sciences and Quality of Life Promotion, San Raffaele Roma Open University, 00166 Rome, Italy.
- Department of Neurology and Evelyn F. McKnight Brain Institute, Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
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Perrone MA, Capria G, Belfiore C, Salimei C, Parrettini S, Fantozzi I, Nicoletti F, Donatucci B, Salvati A, Romeo F, Bernardini S, De Lorenzo A. Influence of physical activity and lifestyle on nutritional status and cardiovascular prevention of countryside school adolescents in Italy. MED SPORT 2019. [DOI: 10.23736/s0025-7826.19.03479-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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14
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Costa de Miranda R, Di Renzo L, Cupertino V, Romano L, De Lorenzo A, Salimei C, De Lorenzo A. Secular trend of childhood nutritional status in Calabria (Italy) and the United States: the spread of obesity. Nutr Res 2018; 62:23-31. [PMID: 30803504 DOI: 10.1016/j.nutres.2018.10.008] [Citation(s) in RCA: 5] [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] [Received: 03/21/2018] [Revised: 09/05/2018] [Accepted: 10/26/2018] [Indexed: 12/31/2022]
Abstract
The number of children who are overweight has been increasing worldwide, including in Mediterranean countries. Based on this, we hypothesized that the weights of Italian children from Calabria have also increased across the years, approaching even the levels of their North American counterparts. This cross-sectional study, which was conducted at 3 time points (1992, 2004, and 2013/2014) with Calabrian children between the ages of 9 and 10 years, aimed to (1) examine a 20-year trend of growth and weight in Calabrian children and (2) compare these trends to those of children from the United States within a similar period. Data from the National Health and Nutrition Examination Survey were used for comparing Calabrian and American children at similar time points. Height and weight were measured, and body mass index was calculated. Nutritional status was defined by International Obesity Task Force cutoffs. Across 20 years, a positive trend was observed in the height and weight of Calabrian children. Trends of preobesity and obesity increased significantly in Calabria from 10.7% (95% confidence interval [CI] 7.1-15.3) to 30.5% (95% CI 26.4-34.8) and from 2.1% (95% CI 0.7-4.8) to 13.8% (95% CI 10.9-17.2), respectively. Although a cessation was observed between 2004 and 2013/2014, from 2003 to 2004, childhood overweight rates in Calabria were as high as those seen in the United States. There was no significant difference between boys from Calabria and the United States in 2013/2014. Over time, odds to become overweight were significant for most of the children from both populations but higher for those from Calabria. Therefore, inducting a reform in the political, environmental, and societal systems may protect children from becoming overweight by increasing quality of diet and physical activity.
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Affiliation(s)
- Renata Costa de Miranda
- PhD School of Applied Medical-Surgical Sciences, University of Rome Tor Vergata, 00133 Rome, Italy; CAPES Scholarship (Proc No. BEX 13264/13-3), CAPES Foundation, Ministry of Education of Brazil, 70040-020 Brasília-DF, Brazil
| | - Laura Di Renzo
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Vita Cupertino
- Pediatrics of Provincial Health Authority of Cosenza, 87100 Cosenza, Italy
| | - Lorenzo Romano
- Specialization School of Food Science, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Antonino De Lorenzo
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Chiara Salimei
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
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15
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De Lorenzo A, Romano L, Di Renzo L, Gualtieri P, Salimei C, Carrano E, Rampello T, de Miranda RC. Triponderal mass index rather than body mass index: An indicator of high adiposity in Italian children and adolescents. Nutrition 2018; 60:41-47. [PMID: 30529185 DOI: 10.1016/j.nut.2018.09.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 08/08/2018] [Accepted: 09/15/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aims of this study were to compare body mass index (BMI) and triponderal mass index (TMI) as predictors of fat mass percentage (FM%) and to develop TMI cutoffs for screening high adiposity. Therefore, TMI- and BMI-based references against FM% criterion for indicating adiposity in Italian children and adolescents were compared. METHODS This was a cross-sectional study conducted at the University of Rome Tor Vergata, Human Nutrition Unit, from 2008 to 2015. The sample included 485 children and adolescents from 8 to 17 y of age from central-southern Italy. Body weight (kg) and height (m) were assessed to calculate BMI and TMI. FM% was assessed by dual-energy x-ray absorptiometry. The prevalence of high adiposity was based on the 75th percentile of FM%, according to Ogden et al. curves. Statistical tests such as Mann-Whitney, Kruskal-Wallis, polynomial regression, receiver operating characteristics curve, and Cohen's κ, were performed using SPSS version 24 and MedCalc version 18. RESULTS Prevalence of high adiposity according to FM% was 50.2% (95% confidence interval [CI], 43.2-57.2) in boys and 43.2% (95% CI, 37.3-49.2) in girls. TMI rather than BMI could better predict FM% for both sexes (boys R2 = 0.67 and girls R2 = 0.79 versus boys R2 = 0.44 and girls R2 = 0.74, respectively). TMI was found to present a significantly higher area under the curve than BMI for indicating high adiposity in children and adolescents. TMI sex- and age-specific cutoffs were responsible by better classification of adiposity, followed by the International Obesity Task Force, World Health Organization, and Cacciari reference curves. CONCLUSION TMI is a useful screening tool in pediatric clinical practice and epidemiologic studies concerning childhood obesity.
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Affiliation(s)
- Antonino De Lorenzo
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
| | - Lorenzo Romano
- Specialization School of Food Science, University of Rome Tor Vergata, Rome, Italy
| | - Laura Di Renzo
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Paola Gualtieri
- PhD School of Applied Medical-Surgical Sciences, University of Rome Tor Vergata, Rome, Italy
| | - Chiara Salimei
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | | | - Tiziana Rampello
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Renata Costa de Miranda
- PhD School of Applied Medical-Surgical Sciences, University of Rome Tor Vergata, Rome, Italy; CAPES Scholarship, CAPES Foundation, Ministry of Education of Brazil, Brasilia, Brazil
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