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Da Porto A, Varisco E, Antonello M, Casarsa V, Sechi LA. Semaglutide Treatment in Adult-Onset Autoimmune Diabetes: A Case Study With Long-Term Follow-Up and Periodic Evaluation of Beta-Cell Function. Cureus 2024; 16:e55771. [PMID: 38586652 PMCID: PMC10999013 DOI: 10.7759/cureus.55771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2024] [Indexed: 04/09/2024] Open
Abstract
Latent autoimmune diabetes of adults (LADA) is a form of autoimmune diabetes that typically occurs in adulthood and has intermediate characteristics between type 1 and type 2 diabetes. To optimize the diagnostic and therapeutic approach, recently, a subclassification of LADA has been proposed based on some clinical features, antibodies, and beta cellular function at onset. In this paper, we expose an interesting case showing the effectiveness of early treatment with a glucagon-like peptide receptor agonist (semaglutide) in maintaining long-term good glycemic control and associated with the preservation of beta-cell function over a five-year observation period in a young woman with LADA.
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Da Porto A, Donnini D, Vanin F, Romanin A, Antonello M, Toritto P, Varisco E, Brosolo G, Catena C, Sechi LA, Soardo G. Effects of Monacolin K in Nondiabetic Patients with NAFLD: A Pilot Study. Nutrients 2023; 15:nu15081887. [PMID: 37111106 PMCID: PMC10144054 DOI: 10.3390/nu15081887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/01/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is a common chronic liver condition with significant risk of progression to steatohepatitis and cirrhosis. Therapeutic strategies in NAFLD include lifestyle changes mainly related to dietary interventions and use of drugs or nutritional components that could improve plasma lipid profiles and insulin sensitivity and decrease the local inflammatory response. In this study, we tested the effects of monacolin K, an inhibitor of HMCoA reductase. In a prospective, uncontrolled, open study, we treated 24 patients with NAFLD and mild hypercholesterolemia with 10 mg/day of monacolin K. At baseline and after 26 weeks, we measured in plasma liver tests, lipids, malondialdehyde, and oxidized glutathione, and assessed biochemical steatosis scores, liver elastography, and body composition with bioimpedance analysis. Monacolin K significantly reduced plasma alanine aminotransferase, cholesterol, triglycerides and the homeostatic model assessment (HOMA) index that indicated improved insulin sensitivity. No significant changes were found in body fat mass and visceral fat, nor in liver elastography, while the fatty liver index (FLI) was significantly decreased. Plasma levels of both malondialdehyde and oxidized glutathione were markedly reduced by monacolin K treatment, suggesting a reduction in oxidative stress and lipid peroxidation. In summary, this pilot study suggests possible benefits of monacolin K use in NAFLD patients that could be linked to a reduction in oxidative stress. This hypothesis should be further investigated in future studies.
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Affiliation(s)
- Andrea Da Porto
- Clinica Medica, Department of Medicine, University of Udine, 33100 Udine, Italy
- Diabetes and Metabolism Unit, Department of Medicine, University of Udine, 33100 Udine, Italy
| | - Debora Donnini
- Clinica Medica, Department of Medicine, University of Udine, 33100 Udine, Italy
- Liver Unit, Department of Medicine, University of Udine, 33100 Udine, Italy
| | - Fabio Vanin
- Clinica Medica, Department of Medicine, University of Udine, 33100 Udine, Italy
- Liver Unit, Department of Medicine, University of Udine, 33100 Udine, Italy
| | - Arianna Romanin
- Clinica Medica, Department of Medicine, University of Udine, 33100 Udine, Italy
- Liver Unit, Department of Medicine, University of Udine, 33100 Udine, Italy
| | - Martina Antonello
- Clinica Medica, Department of Medicine, University of Udine, 33100 Udine, Italy
- Diabetes and Metabolism Unit, Department of Medicine, University of Udine, 33100 Udine, Italy
| | - Paolo Toritto
- Clinica Medica, Department of Medicine, University of Udine, 33100 Udine, Italy
- Liver Unit, Department of Medicine, University of Udine, 33100 Udine, Italy
| | - Eleonora Varisco
- Clinica Medica, Department of Medicine, University of Udine, 33100 Udine, Italy
- Liver Unit, Department of Medicine, University of Udine, 33100 Udine, Italy
| | - Gabriele Brosolo
- Clinica Medica, Department of Medicine, University of Udine, 33100 Udine, Italy
| | - Cristiana Catena
- Clinica Medica, Department of Medicine, University of Udine, 33100 Udine, Italy
| | - Leonardo A Sechi
- Clinica Medica, Department of Medicine, University of Udine, 33100 Udine, Italy
| | - Giorgio Soardo
- Clinica Medica, Department of Medicine, University of Udine, 33100 Udine, Italy
- Liver Unit, Department of Medicine, University of Udine, 33100 Udine, Italy
- Italian Liver Foundation, Area Science Park, Basovizza, 34149 Trieste, Italy
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Monti B, Varisco E, Cortese M, Calienno C, Iedà N. [Fertility after surgery for rAFS stage III and IV endometriosis]. Minerva Ginecol 2007; 59:27-34. [PMID: 17353871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
AIM The aim of this paper was to assess the impact on fertility of surgery to eradicate endometriosis. METHODS One-hundred and twenty-six patients aged between 20 and 40 were observed. All wished to have offspring after the operation and were subjected to conservative surgery for stage III and IV endometriosis (rAFS score > 16) in the period 1992-2002. The type of surgical approach was chosen in consideration of the patient's clinical condition and on the basis of the experience of the surgeon, with the aim of radically removing the disease and, where necessary, restoring fertility. RESULTS Fifty-six of 126 patients (44.4%) conceived after the operation; 55 spontaneously and 1 with assisted fecundation. Of the patients observed who became pregnant, about 1/3 (32%) conceived within 6 months of the operation and 1/3 (31%) after 12 months. Forty-four (78.5%) pregnancies reached term with a positive outcome, 7 (12.5%) were in progress at the moment of follow-up, 4 (7.1%) suffered a miscarriage and 1 (1.7%) was extrauterine; 48.2% (27/56 patients) of the pregnancies were stage III, 40% (28/70 patients) were stage IV. CONCLUSIONS It emerges clearly from the data extrapolated from our series that surgery to eradicate endometriosis increases the fertility of the patients affected, without being resolutive: more than half the patients in fact remained sterile in spite of the operation.
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Affiliation(s)
- B Monti
- Clinica Ostetrica e Ginecologica, Istituto di Scienze Biomediche San Gerardo, Via Solferino 16, 20052 Monza, Milan, Italy
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