1
|
Ravà L, Fintini D, Mariani M, Deodati A, Inzaghi E, Pedicelli S, Bizzarri C, Cappa M, Cianfarani S, Manco M. High 1-h glucose in youths with obesity as marker of prediabetes and cardiovascular risk. J Endocrinol Invest 2023; 46:2555-2562. [PMID: 37204691 DOI: 10.1007/s40618-023-02111-6] [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: 01/30/2023] [Accepted: 05/09/2023] [Indexed: 05/20/2023]
Abstract
PURPOSE Testing 1-h glucose (1HG) concentration during oral glucose tolerance test is cost-effective to identify individuals at risk of incident type 2 diabetes. Aim of the study was to define 1HG cutoffs diagnostic of incident impaired glucose tolerance (IGT) in youths with obesity, and to evaluate prevalence and association of cutoffs identified in the cohort and from the literature (133 and 155 mg/dl) to cardiovascular disease (CVD) in a population of youths with obesity. METHODS This is a longitudinal study of 154 youths to identify 1HG cutoffs, and cross-sectional study of 2295 youths to estimate prevalence of high 1HG and association to CVD. Receiver-operating characteristic curves (ROC) were used to establish 1HG cutoffs, and univariate regression analyses to test association of 1HG to blood pressure, lipids and aminotransferases. RESULTS ROC analysis identified the 1HG cutoff of 159 mg/dl as having diagnostic accuracy of IGT with area under the ROC 0.82 (95% CI 0.66-0.98), sensitivity 0.86% and specificity 0.79%. In the cross-sectional population, prevalence of high 1HG was 36% and 15% for 133 and 155 mg/dl cutoffs, respectively, and 17% for the 159 mg/dl value. All the examined cutoffs were significantly associated with worse lipid profile, liver function test, reduced insulin sensitivity, secretion and disposition index. CONCLUSION High 1HG is marker of persistent IGT and increased risk of metabolic abnormalities in youths. The 155 mg/dl cutoff is a convenient estimate in young people but longitudinal studies with retinopathy and overt diabetes as end points are advised to verify the 1HG cutoff with the best diagnostic accuracy.
Collapse
Affiliation(s)
- L Ravà
- Clinical Epidemiology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - D Fintini
- Unit of Endocrinology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - M Mariani
- Unit of Endocrinology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - A Deodati
- Unit of Endocrinology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - E Inzaghi
- Unit of Endocrinology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - S Pedicelli
- Unit of Endocrinology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - C Bizzarri
- Unit of Endocrinology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - M Cappa
- Unit of Endocrinology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - S Cianfarani
- Department of Systems Medicine, University of Rome 'Tor Vergata', Rome, Italy
- Diabetes and Growth Disorders Unit, Bambino Gesù' Children's Hospital, IRCCS, Rome, Italy
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - M Manco
- Research Area for Multifactorial Diseases and Complex Phenotypes, Bambino Gesù Children's Hospital, IRCCS, Via F. Baldelli 38, 00146, Rome, Italy.
| |
Collapse
|
2
|
Inzaghi E, Deodati A, Loddo S, Mucciolo M, Verdecchia F, Sallicandro E, Catino G, Cappa M, Novelli A, Cianfarani S. Prevalence of copy number variants (CNVs) and rhGH treatment efficacy in an Italian cohort of children born small for gestational age (SGA) with persistent short stature associated with a complex clinical phenotype. J Endocrinol Invest 2022; 45:79-87. [PMID: 34255311 DOI: 10.1007/s40618-021-01617-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/14/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Multiple factors influence intrauterine growth and lead to low birth sizes. The impact of genetic alterations on both pre- and post-natal growth is still largely unknown. The aim of this study was to investigate the prevalence of CNVs in an Italian cohort of SGA children with persistent short stature and complex clinical phenotype. rhGH treatment efficacy was evaluated according to the different genotypes. SUBJECTS AND METHODS Twenty-four SGA children (10F/14M) with persistent short stature associated with dysmorphic features and/or developmental delay underwent CNV evaluation. RESULTS CNVs were present in 14/24 (58%) SGA children. Six patients had a microdeletion involving the following regions: 3q24q25.1, 8p21.2p12, 15q26, 19q13.11, 20q11.21q12, 22q11.2. In three females, the same microdeletion involving 17p13.3 region was identified. In two different patients, two microduplications involving 10q21.3 and Xp11.3 region were observed. A further female patient showed both an 11q12.1 and an Xq27.1 microduplication, inherited from her mother and from her father, respectively. In a boy, the presence of a 12p13.33 microdeletion and a 19q13.43 microduplication was found. GH treatment efficacy, expressed by height gain and height velocity in the first 12 months of therapy, was similar in subjects with and without CNVs. CONCLUSIONS These results show that pathogenic CNVs are common in SGA children with short stature associated with additional clinical features. Interestingly, the involvement of 17p13.3 region occurs with a relative high frequency, suggesting that genes located in this region could play a key role in pre- and post-natal growth. rhGH therapy has similar efficacy in the short term whether CNVs are present or not.
Collapse
Affiliation(s)
- E Inzaghi
- Dipartimento Pediatrico Universitario Ospedaliero, IRCCS "Bambino Gesù" Children's Hospital, Rome, Italy.
| | - A Deodati
- Dipartimento Pediatrico Universitario Ospedaliero, IRCCS "Bambino Gesù" Children's Hospital, Rome, Italy
| | - S Loddo
- Translational Cytogenomics Research Unit, IRCCS "Bambino Gesù" Children's Hospital, Rome, Italy
| | - M Mucciolo
- Translational Cytogenomics Research Unit, IRCCS "Bambino Gesù" Children's Hospital, Rome, Italy
| | - F Verdecchia
- Dipartimento Pediatrico Universitario Ospedaliero, IRCCS "Bambino Gesù" Children's Hospital, Rome, Italy
| | - E Sallicandro
- Translational Cytogenomics Research Unit, IRCCS "Bambino Gesù" Children's Hospital, Rome, Italy
| | - G Catino
- Translational Cytogenomics Research Unit, IRCCS "Bambino Gesù" Children's Hospital, Rome, Italy
| | - M Cappa
- Dipartimento Pediatrico Universitario Ospedaliero, IRCCS "Bambino Gesù" Children's Hospital, Rome, Italy
| | - A Novelli
- Translational Cytogenomics Research Unit, IRCCS "Bambino Gesù" Children's Hospital, Rome, Italy
| | - S Cianfarani
- Dipartimento Pediatrico Universitario Ospedaliero, IRCCS "Bambino Gesù" Children's Hospital, Rome, Italy
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Department of Women's and Children's Health, Karolinska Institute and University Hospital, Stockholm, Sweden
| |
Collapse
|
3
|
Marzano F, Faienza MF, Caratozzolo MF, Brunetti G, Chiara M, Horner DS, Annese A, D'Erchia AM, Consiglio A, Pesole G, Sbisà E, Inzaghi E, Cianfarani S, Tullo A. Pilot study on circulating miRNA signature in children with obesity born small for gestational age and appropriate for gestational age. Pediatr Obes 2018; 13:803-811. [PMID: 30160046 DOI: 10.1111/ijpo.12439] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [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: 11/20/2017] [Revised: 05/25/2018] [Accepted: 05/29/2018] [Indexed: 02/01/2023]
Abstract
BACKGROUND Children born small for gestational age (SGA) are at increased risk of metabolic dysfunction. Dysregulation of specific microRNAs (miRNAs) contributes to aberrant gene expression patterns underlying metabolic dysfunction. OBJECTIVE We aimed to determine and compare circulating miRNA (c-miRNA) profile of SGA and appropriate for gestational age (AGA) children with obesity and with normal weight, in order to identify biomarkers for early detection of increased risk of developing metabolic dysfunction in SGA and AGA children with obesity. METHODS Small non-coding RNAs from serum of 15 SGA children with obesity (OB-SGA), 10 SGA children with normal weight (NW-SGA), 17 AGA children with obesity (OB-AGA) and 12 AGA children with normal weight (NW-AGA) (mean age 11.2 ± 2.6) have been extracted and sequenced in order to detect and quantify miRNA expression profiles. RESULTS RNA-seq analyses showed 28 miRNAs dysregulated in OB-SGA vs. NW-SGA and 19 miRNAs dysregulated in OB-AGA vs. NW-AGA. Among these, miR-92a-3p, miR-122-5p, miR-423-5p, miR-484, miR-486-3p and miR-532-5p were up regulated, and miR-181b-5p was down regulated in both OB-SGA and OB-AGA compared with normal weight counterparts. Pathway analysis and miRNA target prediction suggested that these miRNAs were particularly involved in insulin signalling, glucose transport, insulin resistance, cholesterol and lipid metabolism. CONCLUSION We identified a specific profile of c-miRNAs in SGA and AGA children with obesity compared with SGA and AGA children with normal weight. These c-miRNAs could represent specific biomarkers for early detection of increased risk of developing metabolic dysfunction in SGA and AGA children with obesity.
Collapse
Affiliation(s)
- F Marzano
- Institute of Biomembranes, Bioenergetics and Molecular Biotechnologies-IBIOM, CNR, Bari, Italy
| | - M F Faienza
- Department of Biomedical Sciences and Human Oncology, Section of Pediatrics, University of Bari "A. Moro,", Bari, Italy
| | - M F Caratozzolo
- Institute of Biomembranes, Bioenergetics and Molecular Biotechnologies-IBIOM, CNR, Bari, Italy
| | - G Brunetti
- Department of Basic Medical Sciences, Neuroscience, and Sense Organs, Section of Human Anatomy and Histology, University of Bari "A. Moro", Bari, Italy
| | - M Chiara
- Department of Biosciences, University of Milan, Milan, Italy
| | - D S Horner
- Department of Biosciences, University of Milan, Milan, Italy
| | - A Annese
- Institute of Biomembranes, Bioenergetics and Molecular Biotechnologies-IBIOM, CNR, Bari, Italy
| | - A M D'Erchia
- Institute of Biomembranes, Bioenergetics and Molecular Biotechnologies-IBIOM, CNR, Bari, Italy.,Department of Bioscience, Biotechnology and Biopharmaceutics, University of Bari "Aldo Moro", Bari, Italy
| | - A Consiglio
- Institute for Biomedical Technologies of Bari - ITB, National Research Council, Bari, Italy
| | - G Pesole
- Institute of Biomembranes, Bioenergetics and Molecular Biotechnologies-IBIOM, CNR, Bari, Italy
| | - E Sbisà
- Institute for Biomedical Technologies of Bari - ITB, National Research Council, Bari, Italy
| | - E Inzaghi
- Dipartimento Pediatrico Universitario Ospedaliero, "Bambino Gesu`" Children's Hospital - Tor Vergata University, Rome, Italy
| | - S Cianfarani
- Dipartimento Pediatrico Universitario Ospedaliero, "Bambino Gesu`" Children's Hospital - Tor Vergata University, Rome, Italy.,Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - A Tullo
- Institute of Biomembranes, Bioenergetics and Molecular Biotechnologies-IBIOM, CNR, Bari, Italy
| |
Collapse
|
4
|
Brandt S, Roos J, Inzaghi E, Kotnik P, Kovac J, Battelino T, Cianfarani S, Nobili V, Colajacomo M, Kratzer W, Denzer C, Fischer-Posovszky P, Wabitsch M. Circulating levels of miR-122 and nonalcoholic fatty liver disease in pre-pubertal obese children. Pediatr Obes 2018; 13:175-182. [PMID: 29271122 DOI: 10.1111/ijpo.12261] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [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: 02/22/2017] [Revised: 10/20/2017] [Accepted: 10/31/2017] [Indexed: 01/23/2023]
Abstract
OBJECTIVES The liver-specific miR-122 was proposed as biomarker for NAFLD in adults. Here, we investigated the relationship between miR-122 levels, parameters of liver metabolism and NAFLD in pre-pubertal obese children. METHODS Parameters of liver metabolism (ALT, AST and GGT) of three European cohorts were included (German cohort [n = 71; age: 11.53 ± 1.29 years; BMI z-score: 2.96 ± 0.64], Italian cohort [n = 45; age: 9.60 ± 2.11 years; BMI z-score: 3.57 ± 1.16], Slovenian cohort [n = 31; age: 7.53 ± 1.47 years; BMI z-score: 3.66 ± 0.88]). MiR-122 levels and CK18 concentrations were measured in fasting blood samples. In the German and Italian cohort, the diagnosis of NAFLD and grading of NAFLD was assessed by ultrasound. RESULTS NAFLD was diagnosed in n = 50 patients of the German cohort (29.6%) and in n = 29 patients (72.5%) of the Italian cohort. In all three cohorts, miR-122 was positively correlated with ALT and AST as well as with CK18 concentrations. MiR-122 levels were higher in children with NAFLD compared with healthy controls. CONCLUSIONS MiR-122 levels in pre-pubertal obese children could be a potential biomarker for paediatric NAFLD.
Collapse
Affiliation(s)
- S Brandt
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| | - J Roos
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| | - E Inzaghi
- Dipartimento Pediatrico Universitario Ospedaliero, Bambino Gesù Children's Hospital, Tor Vergata University, Rome, Italy
| | - P Kotnik
- University Children's Hospital, Ljubljana, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - J Kovac
- University Children's Hospital, Ljubljana, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - T Battelino
- University Children's Hospital, Ljubljana, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - S Cianfarani
- Dipartimento Pediatrico Universitario Ospedaliero, Bambino Gesù Children's Hospital, Tor Vergata University, Rome, Italy.,Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - V Nobili
- Hepato-Metabolic Disease Unit, Bambino Gesù Children's Hospital, Rome, Italy
| | - M Colajacomo
- Dipartimento Diagnostica per Immagini, Bambino Gesù Children's Hospital, Rome, Italy
| | - W Kratzer
- Department of Internal Medicine I, University Hospital Ulm, Germany
| | - C Denzer
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| | - P Fischer-Posovszky
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| | - M Wabitsch
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| |
Collapse
|
5
|
Pampanini V, Inzaghi E, Germani D, Alterio A, Puglianiello A, Alisi A, Nobili V, Cianfarani S. Serum Fetuin-A levels in obese children with biopsy proven nonalcoholic fatty liver disease. Nutr Metab Cardiovasc Dis 2018; 28:71-76. [PMID: 29122442 DOI: 10.1016/j.numecd.2017.09.008] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 09/19/2017] [Accepted: 09/25/2017] [Indexed: 01/14/2023]
Abstract
BACKGROUND AND AIMS Fetuin-A has been proposed as a marker of liver damage in adults with obesity-related NAFLD. The aim of this study was to test serum fetuin-A concentrations in obese children with NAFLD diagnosed either by ultrasonography or by liver biopsy and to determine its applicability as predictive tool in pediatric NAFLD. METHODS AND RESULTS Metabolic parameters and fetuin-A levels were investigated in 81 obese children with NAFLD diagnosed by biopsy, 79 obese children with NAFLD defined by liver ultrasonography and 23 lean subjects. Serum fetuin-A correlated significantly with age, waist circumference, systolic blood pressure, fasting insulin and 2-h postload insulin during OGTT, HOMA-IR, ISI, CRP, and apo B levels. Obese children with NAFLD detected by ultrasonography had significantly higher fetuin-A levels compared to those with normal liver. In obese children who underwent liver biopsy, no significant differences were detected in fetuin-A levels between subject with nonalcoholic steatohepatitis and those with simple steatosis. Fetuin-A was not different between obese and lean children. CONCLUSION Fetuin-A is not related with the degree of liver damage in obese children with NAFLD and its routine measurement as marker of liver disease severity is therefore not recommended.
Collapse
Affiliation(s)
- V Pampanini
- Department of Women's and Children's Health, Pediatric Endocrinology Unit, Karolinska Institutet and University Hospital, 17176, Stockholm, Sweden.
| | - E Inzaghi
- Dipartimento Pediatrico Universitario Ospedaliero "Bambino Gesù" Children's Hospital - Tor Vergata University, 00165, Rome, Italy
| | - D Germani
- Department of Systems Medicine, Tor Vergata University, 00173, Rome, Italy
| | - A Alterio
- Hepato-Metabolic Disease Unit, "Bambino Gesù" Children's Hospital - IRCCS, Rome, Italy
| | - A Puglianiello
- Department of Systems Medicine, Tor Vergata University, 00173, Rome, Italy
| | - A Alisi
- Hepato-Metabolic Disease Unit, "Bambino Gesù" Children's Hospital - IRCCS, Rome, Italy
| | - V Nobili
- Hepato-Metabolic Disease Unit, "Bambino Gesù" Children's Hospital - IRCCS, Rome, Italy
| | - S Cianfarani
- Department of Women's and Children's Health, Pediatric Endocrinology Unit, Karolinska Institutet and University Hospital, 17176, Stockholm, Sweden; Dipartimento Pediatrico Universitario Ospedaliero "Bambino Gesù" Children's Hospital - Tor Vergata University, 00165, Rome, Italy
| |
Collapse
|
6
|
Fintini D, Inzaghi E, Colajacomo M, Bocchini S, Grugni G, Brufani C, Cappa M, Nobili V, Cianfarani S, Crinò A. Non-Alcoholic Fatty Liver Disease (NAFLD) in children and adolescents with Prader-Willi Syndrome (PWS). Pediatr Obes 2016; 11:235-8. [PMID: 26132376 DOI: 10.1111/ijpo.12052] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 01/30/2015] [Accepted: 05/20/2015] [Indexed: 01/21/2023]
Abstract
We tested the hypothesis that patients with Prader-Willi syndrome (PWS) may be at lower risk of developing non-alcoholic fatty liver disease (NAFLD) because of a higher insulin sensitivity. Twenty-one PWS patients and 42 control subjects closely similar for age, gender, pubertal stage and body mass index (CNT), were studied. Metabolic profile and body composition were assessed. NAFLD was established by a validated method of US grading (range from G0 to G3). PWS patients showed a significantly better metabolic profile (lower waist circumference, fasting glucose levels, HOMA-IR, cholesterol, transaminase levels and trunk fat mass/fat mass ratio). Furthermore, NAFLD G1stage was significantly more frequent in PWS subjects (P < 0.05), whereas G2 stage was significantly more frequent in control patients (P < 0.05). NAFLD grading seems to correlate with body composition in PWS, also after adjustment for sex and GH treatment. To our knowledge, this is the first report suggesting a reduced risk of NAFLD in PWS children.
Collapse
Affiliation(s)
- D Fintini
- Autoimmune Endocrine Diseases Unit, Bambino Gesù Children's Hospital, Research Institute, Palidoro, Rome, Italy
| | - E Inzaghi
- Endocrinology and Diabetic Unit, Bambino Gesù Children's Hospital, Research Institute, Palidoro, Rome, Italy.,D.P.U.O. 'Bambino Gesù' Children's Hospital, 'Tor Vergata' University, Rome, Italy
| | - M Colajacomo
- Radiology Dept., Bambino Gesù Children's Hospital, Research Institute, Palidoro, Rome, Italy
| | - S Bocchini
- Autoimmune Endocrine Diseases Unit, Bambino Gesù Children's Hospital, Research Institute, Palidoro, Rome, Italy
| | - G Grugni
- Italian Auxological Institute Foundation, Piancavallo, Verbania, Italy
| | - C Brufani
- Endocrinology and Diabetic Unit, Bambino Gesù Children's Hospital, Research Institute, Palidoro, Rome, Italy
| | - M Cappa
- Endocrinology and Diabetic Unit, Bambino Gesù Children's Hospital, Research Institute, Palidoro, Rome, Italy
| | - V Nobili
- Hepato-Metabolic Unit, Bambino Gesù Children's Hospital, Research Institute, Palidoro, Rome, Italy
| | - S Cianfarani
- D.P.U.O. 'Bambino Gesù' Children's Hospital, 'Tor Vergata' University, Rome, Italy.,Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - A Crinò
- Autoimmune Endocrine Diseases Unit, Bambino Gesù Children's Hospital, Research Institute, Palidoro, Rome, Italy
| |
Collapse
|