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Flore G, Deledda A, Lombardo M, Armani A, Velluzzi F. Effects of Functional and Nutraceutical Foods in the Context of the Mediterranean Diet in Patients Diagnosed with Breast Cancer. Antioxidants (Basel) 2023; 12:1845. [PMID: 37891924 PMCID: PMC10603973 DOI: 10.3390/antiox12101845] [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: 09/19/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
Several studies report that breast cancer survivors (BCS) tend to have a poor diet, as fruit, vegetable, and legume consumption is often reduced, resulting in a decreased intake of nutraceuticals. Moreover, weight gain has been commonly described among BCS during treatment, increasing recurrence rate and mortality. Improving lifestyle and nutrition after the diagnosis of BC may have important benefits on patients' general health and on specific clinical outcomes. The Mediterranean diet (MD), known for its multiple beneficial effects on health, can be considered a nutritional pool comprising several nutraceuticals: bioactive compounds and foods with anti-inflammatory and antioxidant effects. Recent scientific advances have led to the identification of nutraceuticals that could amplify the benefits of the MD and favorably influence gene expression in these patients. Nutraceuticals could have beneficial effects in the postdiagnostic phase of BC, including helping to mitigate the adverse effects of chemotherapy and radiotherapy. Moreover, the MD could be a valid and easy-to-follow option for managing excess weight. The aim of this narrative review is to evaluate the recent scientific literature on the possible beneficial effects of consuming functional and nutraceutical foods in the framework of MD in BCS.
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Affiliation(s)
- Giovanna Flore
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.F.); (A.D.); (F.V.)
| | - Andrea Deledda
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.F.); (A.D.); (F.V.)
| | - Mauro Lombardo
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy;
| | - Andrea Armani
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy;
- Laboratory of Cardiovascular Endocrinology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele, 00166 Rome, Italy
| | - Fernanda Velluzzi
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.F.); (A.D.); (F.V.)
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Flore G, Deledda A, Fosci M, Lombardo M, Moroni E, Pintus S, Velluzzi F, Fantola G. Perioperative Nutritional Management in Enhanced Recovery after Bariatric Surgery. Int J Environ Res Public Health 2023; 20:6899. [PMID: 37835169 PMCID: PMC10573058 DOI: 10.3390/ijerph20196899] [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] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 10/01/2023] [Accepted: 10/06/2023] [Indexed: 10/15/2023]
Abstract
Obesity is a crucial health problem because it leads to several chronic diseases with an increased risk of mortality and it is very hard to reverse with conventional treatment including changes in lifestyle and pharmacotherapy. Bariatric surgery (BS), comprising a range of various surgical procedures that modify the digestive tract favouring weight loss, is considered the most effective medical intervention to counteract severe obesity, especially in the presence of metabolic comorbidities. The Enhanced Recovery After Bariatric Surgery (ERABS) protocols include a set of recommendations that can be applied before and after BS. The primary aim of ERABS protocols is to facilitate and expedite the recovery process while enhancing the overall effectiveness of bariatric procedures. ERABS protocols include indications about preoperative fasting as well as on how to feed the patient on the day of the intervention, and how to nourish and hydrate in the days after BS. This narrative review examines the application, the feasibility and the efficacy of ERABS protocols applied to the field of nutrition. We found that ERABS protocols, in particular not fasting the patient before the surgery, are often not correctly applied for reasons that are not evidence-based. Furthermore, we identified some gaps in the research about some practises that could be implemented in the presence of additional evidence.
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Affiliation(s)
- Giovanna Flore
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.F.); (A.D.); (M.F.)
| | - Andrea Deledda
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.F.); (A.D.); (M.F.)
| | - Michele Fosci
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.F.); (A.D.); (M.F.)
| | - Mauro Lombardo
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Open University, Via di Val Cannuta, 247, 00166 Rome, Italy;
| | - Enrico Moroni
- Obesity Surgery Unit, Department of Surgery, Azienda di Rilievo Nazionale ed Alta Specializzazione G. Brotzu, 09134 Cagliari, Italy; (E.M.); (S.P.); (G.F.)
| | - Stefano Pintus
- Obesity Surgery Unit, Department of Surgery, Azienda di Rilievo Nazionale ed Alta Specializzazione G. Brotzu, 09134 Cagliari, Italy; (E.M.); (S.P.); (G.F.)
| | - Fernanda Velluzzi
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.F.); (A.D.); (M.F.)
| | - Giovanni Fantola
- Obesity Surgery Unit, Department of Surgery, Azienda di Rilievo Nazionale ed Alta Specializzazione G. Brotzu, 09134 Cagliari, Italy; (E.M.); (S.P.); (G.F.)
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Rodia R, Meloni PE, Mascia C, Balestrieri C, Ruggiero V, Serra G, Conti M, Loi M, Pes F, Onali S, Perra A, Littera R, Velluzzi F, Mariotti S, Chessa L, Boi F. Direct-acting antivirals used in HCV-related liver disease do not affect thyroid function and autoimmunity. J Endocrinol Invest 2023; 46:359-366. [PMID: 36048357 PMCID: PMC9859881 DOI: 10.1007/s40618-022-01909-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/19/2022] [Indexed: 01/25/2023]
Abstract
PURPOSE It is well known that interferon-α (IFN-α), used for long time as the main therapy for HCV-related disease, induces thyroid alterations, but the impact of the new direct-acting antivirals (DAAs) on thyroid is not established. Aim of this prospective study was to evaluate if DAAs therapy may induce thyroid alterations. METHODS A total of 113 HCV patients, subdivided at the time of the enrollment in naïve group (n = 64) and in IFN-α group (n = 49) previously treated with pegylated interferon-α and ribavirin, were evaluated for thyroid function and autoimmunity before and after 20-32 weeks of DAAs. RESULTS Before starting DAAs, a total of 8/113 (7.1%) patients showed Hashimoto's thyroiditis (HT) all belonging to IFN-α group (8/49, 16.3%), while no HT cases were found in the naïve group. Overall, 7/113 (6.2%) patients were hypothyroid: 3/64 (4.7%) belonging to naïve group and 4/49 (8.2%) to IFN-α group. Furthermore, a total of 8/113 patients (7.1%) showed subclinical hyperthyroidism: 2/64 (3.1%) were from naïve group and 6/49 (12.2%) from IFN-α group. Interestingly, after DAAs therapy, no new cases of HT, hypothyroidism and hyperthyroidism was found in all series, while 6/11 (54.5%) patients with non-autoimmune subclinical thyroid dysfunction became euthyroid. Finally, the only association between viral genotypes and thyroid alterations was genotype 1 and hypothyroidism. CONCLUSIONS This study supports evidence that DAAs have a limited or missing influence on thyroid in patients with HCV-related diseases. Moreover, it provides preliminary evidence that subclinical non-autoimmune thyroid dysfunction may improve after HCV infection resolution obtained by DAAs.
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Affiliation(s)
- R Rodia
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - P E Meloni
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - C Mascia
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - C Balestrieri
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - V Ruggiero
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - G Serra
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - M Conti
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - M Loi
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - F Pes
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - S Onali
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - A Perra
- Unit of Oncology and Molecular Pathology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - R Littera
- Complex Structure of Medical Genetics, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - F Velluzzi
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - S Mariotti
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - L Chessa
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - F Boi
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy.
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Velluzzi F, Deledda A, Lombardo M, Fosci M, Crnjar R, Grossi E, Sollai G. Application of Artificial Neural Networks (ANN) to Elucidate the Connections among Smell, Obesity with Related Metabolic Alterations, and Eating Habit in Patients with Weight Excess. Metabolites 2023; 13:metabo13020206. [PMID: 36837824 PMCID: PMC9959568 DOI: 10.3390/metabo13020206] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/19/2023] [Accepted: 01/27/2023] [Indexed: 01/31/2023] Open
Abstract
Obesity is a severe health problem linked to an increased risk of comorbidity and mortality and its etiopathogenesis includes genetic, epigenetic, microbiota composition, and environmental factors, such as dietary habits. The olfactory system plays an important role in controlling food intake and meal size, influencing body weight and energy balance. This study aims to identify the connection between olfactory function and clinical and nutritional aspects related to weight excess in a group of 68 patients with overweight or obesity. All participants underwent the evaluation of olfactory function, anthropometric data (weight, height, BMI, waist circumference), clinical data (hypertension, disglycemia, dyslipidemia, metabolic syndrome), and adherence to the Mediterranean diet (Mediterranean Diet Score). A fourth-generation artificial neural network data mining approach was used to uncover trends and subtle associations between variables. Olfactory tests showed that 65% of patients presented hyposmia. A negative correlation was found between olfactory scores and systolic blood pressure, fasting plasma glucose, and triglycerides levels, but a positive correlation was found between olfactory scores and the Mediterranean diet score. The methodology of artificial neural networks and the semantic connectivity map "Auto-Contractive Map" highlighted the underlying scheme of the connections between the variables considered. In particular, hyposmia was linked to obesity and related metabolic alterations and the male sex. The female sex was connected with normosmia, higher adherence to the Mediterranean diet, and normal values of blood pressure, lipids, and glucose levels. These results highlight an inverse correlation between olfactory skills and BMI and show that a normosmic condition, probably because of greater adherence to the Mediterranean diet, seems to protect not only from an excessive increase in body weight but also from associated pathological conditions such as hypertension and metabolic syndrome.
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Affiliation(s)
- Fernanda Velluzzi
- Obesity Unit, Department of Medical Sciences and Public Health, University Hospital of Cagliari, 09124 Cagliari, Italy
| | - Andrea Deledda
- Obesity Unit, Department of Medical Sciences and Public Health, University Hospital of Cagliari, 09124 Cagliari, Italy
| | - Mauro Lombardo
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy
| | - Michele Fosci
- Obesity Unit, Department of Medical Sciences and Public Health, University Hospital of Cagliari, 09124 Cagliari, Italy
| | - Roberto Crnjar
- Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy
| | - Enzo Grossi
- Autism Research Unit, Villa Santa Maria Foundation, 22038 Tavernerio, Italy
| | - Giorgia Sollai
- Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy
- Correspondence: ; Tel.: +39-070-6754160
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5
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Deledda A, Palmas V, Heidrich V, Fosci M, Lombardo M, Cambarau G, Lai A, Melis M, Loi E, Loviselli A, Manzin A, Velluzzi F. Dynamics of Gut Microbiota and Clinical Variables after Ketogenic and Mediterranean Diets in Drug-Naïve Patients with Type 2 Diabetes Mellitus and Obesity. Metabolites 2022; 12:1092. [PMID: 36355175 PMCID: PMC9693465 DOI: 10.3390/metabo12111092] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 10/29/2022] [Accepted: 11/08/2022] [Indexed: 07/30/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM), the most common form of diabetes, is a progressive chronic metabolic disease that has increasingly spread worldwide, enhancing the mortality rate, particularly from cardiovascular diseases (CVD). Lifestyle improvement through diet and physical activity is, together with drug treatment, the cornerstone of T2DM management. The Mediterranean diet (MD), which favors a prevalence of unprocessed vegetable foods and a reduction in red meats and industrial foods, without excluding any food category, is usually recommended. Recently, scientific societies have promoted a very low-calorie ketogenic diet (VLCKD), a multiphasic protocol that limits carbohydrates and then gradually re-introduces them, with a favorable outcome on body weight and metabolic parameters. Indeed, gut microbiota (GM) modifications have been linked to overweight/obesity and metabolic alterations typical of T2DM. Diet is known to affect GM largely, but only a few studies have investigated the effects of VLCKD on GM, especially in T2DM. In this study, we have compared anthropometric, biochemical, lifestyle parameters, the quality of life, and the GM of eleven patients with recently diagnosed T2DM and overweight or obesity, randomly assigned to two groups of six and five patients who followed the VLCKD (KETO) or hypocaloric MD (MEDI) respectively; parameters were recorded at baseline (T0) and after two (T2) and three months (T3). The results showed that VLCKD had more significant beneficial effects than MD on anthropometric parameters, while biochemical improvements did not statistically differ. As for the GM, despite the lack of significant results regarding the alpha and beta diversity, and the Firmicutes/Bacteroidota ratio between the two groups, in the KETO group, a significant increase in beneficial microbial taxa such as Verrucomicrobiota phylum with its members Verrucomicrobiae, Verrucomicrobiales, Akkermansiaceae, and Akkermansia, Christensenellaceae family, Eubacterium spp., and a reduction in microbial taxa previously associated with obesity (Firmicutes and Actinobacteriota) or other diseases (Alistipes) was observed both at T2 and T3. With regards to the MEDI group, variations were limited to a significant increase in Actinobacteroidota phylum at T2 and T3 and Firmicutes phylum at T3. Moreover, a metagenomic alteration linked to some metabolic pathways was found exclusively in the KETO group. In conclusion, both dietary approaches allowed patients to improve their state of health, but VLCKD has shown better results on body composition as well as on GM profile.
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Affiliation(s)
- Andrea Deledda
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Vanessa Palmas
- Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy
| | - Vitor Heidrich
- Departamento de Bioquímica, Instituto de Química, Universidade de São Paulo, São Paulo 05508-900, Brazil
- Centro de Oncologia Molecular, Hospital Sírio-Libanês, São Paulo 01308-050, Brazil
| | - Michele Fosci
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09042 Monserrato, Italy
| | - Mauro Lombardo
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy
| | - Giulia Cambarau
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Alessio Lai
- Diabetologia, P.O. Binaghi, ASSL Cagliari, 09126 Cagliari, Italy
| | - Marietta Melis
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Elisabetta Loi
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Andrea Loviselli
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09042 Monserrato, Italy
| | - Aldo Manzin
- Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy
| | - Fernanda Velluzzi
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
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Velluzzi F, Pisanu S, Galletta M, Fosci M, Secci G, Deledda A, Boi F, Rodia R, Fanciulli G, Delitala AP, Sainas G, Loviselli A. Association between High Normal TSH Levels and Obesity in Women with Anti-Thyroid Autoantibodies (ATAs). J Clin Med 2022; 11:jcm11175125. [PMID: 36079055 PMCID: PMC9457091 DOI: 10.3390/jcm11175125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/06/2022] [Accepted: 08/27/2022] [Indexed: 11/16/2022] Open
Abstract
A positive correlation between Thyroid-Stimulating Hormone (TSH) and Body Mass Index (BMI) has been reported in many studies, but data on this topic remain controversial, especially when TSH values are in the normal range. Moreover, few studies have evaluated the co-existence of thyroid autoimmunity. This study investigated the role of thyroid autoimmunity in the interconnection between TSH, BMI, and waist circumference (WC) in euthyroid patients with overweight or obesity. We enrolled 902 patients (213 males; mean age ± SD: 45 ± 14 years; mean BMI ± SD: 35.8 ± 6.5 kg/m2), with normal serum TSH concentration; anti-thyroid autoantibodies (ATAs) were evaluated in 752 patients (186 males). Patients were divided into four BMI classes, based on WHO criteria, and the relationship between BMI, WC, and TSH was evaluated in the whole sample and compared to ATAs positivity, observed in 235 patients (44 males). No significant difference was found between TSH levels in the BMI classes. A statistically significant correlation between TSH and BMI was found only in ATAs-positive females (N = 191, Spearman rho: 0.149; p-value: 0.040). However, this finding was not confirmed when considering the WC. Our study shows a positive correlation only between TSH and BMI in obese women with positive ATAs, suggesting that in these patients, the high normal levels of TSH could be attributed to a mild thyroid failure with a possible worsening obesity-related effect, and both need a careful evaluation.
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Affiliation(s)
- Fernanda Velluzzi
- Endocrinology, and Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Silvia Pisanu
- Endocrinology, and Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Maura Galletta
- Hygiene Section, Department of Medical Sciences and Public Health, University of Cagliari, 09042 Cagliari, Italy
| | - Michele Fosci
- Endocrinology, and Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
- Correspondence:
| | - Gianni Secci
- Endocrinology, and Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Andrea Deledda
- Endocrinology, and Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Francesco Boi
- Endocrinology, and Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Rossella Rodia
- Endocrinology, and Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Giuseppe Fanciulli
- Department of Surgical, Medical and Experimental Sciences, University of Sassari-Endocrine Unit, AOU Sassari, 07100 Sassari, Italy
| | - Alessandro Palmerio Delitala
- Department of Surgical, Medical and Experimental Sciences, University of Sassari-Endocrine Unit, AOU Sassari, 07100 Sassari, Italy
| | - Gianmarco Sainas
- Endocrinology, and Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Andrea Loviselli
- Endocrinology, and Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
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Velluzzi F, Cossu G, Fosci M, Montisci R, Zaccheddu R, Minerba L, Musu M, Pintus E, Fortin D, Romano F, Aviles Gonzalez CI, Melis P, Deledda A, Loviselli A, Carta MG. Effect of a Low-Moderate Exercise Program on Dysmetabolism in Older Adults: Results of a Randomized Controlled Trial. Nutrients 2022; 14:nu14163337. [PMID: 36014843 PMCID: PMC9413492 DOI: 10.3390/nu14163337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 08/10/2022] [Accepted: 08/11/2022] [Indexed: 12/11/2022] Open
Abstract
Physical exercise has been shown to improve dysmetabolism in older adults, reducing cardiovascular risk, while its role in preventing dysmetabolism is less known. Moreover, most of the trials use exercise programs that are difficult to put into daily practice. The purpose of this Randomized Controlled Trial (RCT) was to evaluate the effectiveness of a 3-month moderate exercise program in improving or preventing dysmetabolism in 120 older adults, randomly selected for the exercise program (experimental group) or cultural activities (control group). None of the subjects were following a hypocaloric diet, and all of them reported healthy eating habits. Anthropometric (Body Mass Index (BMI) and Waist Circumference (WC)) and metabolic variables (fasting plasma glucose (FPG), High-Density Lipoprotein Cholesterol (HDL-C), and triglycerides (TG)) were assessed at baseline (T0) and at the end of the trial (T1). Dysmetabolism was defined by the presence of an increased WC plus at least two metabolic alterations. At T0, the two groups did not differ by sex, age, education, BMI, WC, FPG, HDL-C levels, and prevalence of dysmetabolism. The mean BMI value indicated overweight, and WC values were higher than the cut-off. At T1, a slight reduction in the number of people with dysmetabolism was found only in the experimental group. However, none of the individuals without dysmetabolism at T0 in the experimental group developed it at T1, while 11.4% developed it in the control group (p = 0.032). This study highlights that a moderate exercise program, accessible in daily practice, can prevent dysmetabolism in older adults, even while being overweight, while if dysmetabolism is already present, more prolonged combined nutritional and exercise interventions will be needed.
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Affiliation(s)
- Fernanda Velluzzi
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
- Correspondence:
| | - Giulia Cossu
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Michele Fosci
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Roberta Montisci
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Rosanna Zaccheddu
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Luigi Minerba
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Mario Musu
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Elisa Pintus
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Dario Fortin
- Department of Psychology and Cognitive Science, University of Trento, 38123 Trento, Italy
| | - Ferdinando Romano
- Department of Public Health and Infectious Diseases, Unitelma Sapienza University, 00185 Rome, Italy
| | - Cesar Ivan Aviles Gonzalez
- Departamento de Facultad de Ciencias de la Salud, Universidad Popular del Cesar, Valledupar 200002, Colombia
| | - Paola Melis
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Andrea Deledda
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Andrea Loviselli
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
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8
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Carta MG, Sancassiani F, Melis P, Aviles-Gonzales CI, Urban A, Minerba L, D'Oca S, Atzeni M, Velluzzi F, Ferreli C, Serrentino R, Coghe F, Cossu G. The perception of professionals and users of the quality of care and respect for human rights in four outpatient care facilities of an Italian hospital during the Covid-19 pandemic. J Public Health Res 2022; 11:22799036221119026. [PMID: 36172597 PMCID: PMC9511322 DOI: 10.1177/22799036221119026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/21/2022] [Indexed: 12/02/2022] Open
Abstract
Background: During the Covid-19 pandemic, delays in providing medical services, dissatisfaction, criticism toward health workers (HW) and the risk of burnout of HW in Italy have been documented. No studies have contrasted the point of view of HW and users on the quality of care and respect for human rights in health facilities. Objective: To compare the perception of users of their satisfaction with the care provided with the perception of HW of their satisfaction with work as well as the perception of the respect of HW “s and users” human rights. Methods: The “Well-Being at work and respect for human rights questionnaire” (WWRR) was administered on a sample of users (142) and HW (154) in four outpatient health care facilities of a hospital in Sardinia, Italy. Results: Users showed higher scores than HW on their satisfaction with the care received (p < 0.0001), the perception of respect for their human rights (p < 0.0001), and availability of resources for care (p < 0.0001). The HW scores were higher than 50% of the maximum in all items, but a relatively low score was reported on the HW’s satisfaction of the resources and the respect for their rights. Conclusion: The satisfaction for care and respect for human rights in the outpatient health services was higher than expected. The relatively low score by the HWs in relation to the satisfaction with the resources and perception of respect for their human rights could be a wake-up call. The study does not involve emergency rooms, wards, or Covid units.
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Affiliation(s)
- Mauro G Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy
| | - Federica Sancassiani
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Paola Melis
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy
| | - Cesar I Aviles-Gonzales
- Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy.,Popular Universidad del Cesar, Valledupar, Colombia
| | - Antonio Urban
- Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy
| | - Luigi Minerba
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy
| | - Silvia D'Oca
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Michela Atzeni
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Fernanda Velluzzi
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy
| | - Caterina Ferreli
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy
| | - Roberta Serrentino
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Giulia Cossu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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9
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Carta MG, Orrù G, Peracchia A, Cossu G, Velluzzi F, Atzori L, Ferreli C, Ivan Aviles Gonzalez C, Romano F, Littera R, Puxeddu R, Chessa L, Firinu D, Del Giacco S, Restivo A, Deidda S, Scano A, Coghe F, Minerba L, Manconi M, Saba L. Differences in lethality and diffusion of Covid-19 in countries using different kinds of vaccines. J Public Health Res 2022; 11:22799036221107062. [PMID: 36105780 PMCID: PMC9465600 DOI: 10.1177/22799036221107062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 05/19/2022] [Indexed: 11/17/2022] Open
Abstract
To verify if lethality and diffusivity of Covid-19 correlated with percentage of
people vaccinated in different countries and whether results on these indicators
were comparable under different types of vaccines. A linear regression analysis
was conducted between vaccines/inhabitant, new cases/inhabitants and ratio
deaths/cases. A comparison between the three indicators was carried out in
countries subdivided by kind of vaccine. The proportion of
vaccinations/inhabitants correlates negatively with proportion of deaths × 100
cases (R = −3.90, p < 0.0001), but didn’t
on incidence of new cases. Countries with prevalence of mRNA vaccines were
similar to others on incidence of new cases; but a lower lethality of Sars-Cov2
was found than in countries with prevalence of viral vehicle vaccines
(F = 6.064, p = 0.0174) but didn’t against
countries with prevalence of inactivated vaccines. The higher is the proportion
of vaccine/inhabitant in a given country, the less is the fraction of infected
people who die.
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Affiliation(s)
- Mauro Giovanni Carta
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Germano Orrù
- Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Ambra Peracchia
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Giulia Cossu
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Fernanda Velluzzi
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Laura Atzori
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Caterina Ferreli
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Ferdinando Romano
- Department of Hygiene and Preventive Medicine, Sapienza University of Rome, Rome, Italy
| | - Roberto Littera
- Department of Medical Genetic, R. Binaghi Hospital of Cagliari, Cagliari, Italy
| | - Roberto Puxeddu
- Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Luchino Chessa
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Davide Firinu
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Stefano Del Giacco
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Angelo Restivo
- Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Simona Deidda
- Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Alessandra Scano
- Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | | | - Luigi Minerba
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Maria Manconi
- Department of Life and Environmental Sciences, University of Cagliari, Cagliari, Italy
| | - Luca Saba
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
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10
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Palmas V, Pisanu S, Madau V, Casula E, Deledda A, Cusano R, Uva P, Loviselli A, Velluzzi F, Manzin A. Gut Microbiota Markers and Dietary Habits Associated with Extreme Longevity in Healthy Sardinian Centenarians. Nutrients 2022; 14:nu14122436. [PMID: 35745166 PMCID: PMC9227524 DOI: 10.3390/nu14122436] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 12/13/2022] Open
Abstract
This study was aimed at characterizing the gut microbiota (GM) and its functional profile in two groups of Sardinian subjects with a long healthy life expectancy, overall named Long-Lived Subjects (LLS) [17 centenarians (CENT) and 29 nonagenarians (NON)] by comparing them to 46 healthy younger controls (CTLs). In addition, the contribution of genetics and environmental factors to the GM phenotype was assessed by comparing a subgroup of seven centenarian parents (CPAR) with a paired cohort of centenarians’ offspring (COFF). The analysis was performed through Next Generation Sequencing (NGS) of the V3 and V4 hypervariable region of the 16S rRNA gene on the MiSeq Illumina platform. The Verrucomicrobia phylum was identified as the main biomarker in CENT, together with its members Verrucomicrobiaceae, Akkermansia and Akkermansia muciniphila. In NON, the strongest associations concern Actinobacteria phylum, Bifidobacteriaceae and Bifidobacterium, while in CTLs were related to the Bacteroidetes phylum, Bacteroidaceae, Bacteroides and Bacteroides spp. Intestinal microbiota of CPAR and COFF did not differ significantly from each other. Significant correlations between bacterial taxa and clinical and lifestyle data, especially with Mediterranean diet adherence, were observed. We observed a harmonically balanced intestinal community structure in which the increase in taxa associated with intestinal health would limit and counteract the action of potentially pathogenic bacterial species in centenarians. The GM of long-lived individuals showed an intrinsic ability to adapt to changing environmental conditions, as confirmed by functional analysis. The GM analysis of centenarians’ offspring suggest that genetics and environmental factors act synergistically as a multifactorial cause in the modulation of GM towards a phenotype similar to that of centenarians, although these findings need to be confirmed by larger study cohorts and by prospective studies.
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Affiliation(s)
- Vanessa Palmas
- Department of Biomedical Sciences, Microbiology and Virology Unit, University of Cagliari, 09042 Monserrato, Italy; (V.P.); (S.P.); (V.M.); (E.C.)
| | - Silvia Pisanu
- Department of Biomedical Sciences, Microbiology and Virology Unit, University of Cagliari, 09042 Monserrato, Italy; (V.P.); (S.P.); (V.M.); (E.C.)
| | - Veronica Madau
- Department of Biomedical Sciences, Microbiology and Virology Unit, University of Cagliari, 09042 Monserrato, Italy; (V.P.); (S.P.); (V.M.); (E.C.)
| | - Emanuela Casula
- Department of Biomedical Sciences, Microbiology and Virology Unit, University of Cagliari, 09042 Monserrato, Italy; (V.P.); (S.P.); (V.M.); (E.C.)
| | - Andrea Deledda
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (A.D.); (A.L.); (F.V.)
| | - Roberto Cusano
- Interdisciplinary Center for Advanced Studies, Research and Development in Sardinia (CRS4), Science and Technology Park Polaris, Piscina Manna, 09134 Pula, Italy;
| | - Paolo Uva
- Clinical Bioinformatics Unit, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy;
| | - Andrea Loviselli
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (A.D.); (A.L.); (F.V.)
| | - Fernanda Velluzzi
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (A.D.); (A.L.); (F.V.)
| | - Aldo Manzin
- Department of Biomedical Sciences, Microbiology and Virology Unit, University of Cagliari, 09042 Monserrato, Italy; (V.P.); (S.P.); (V.M.); (E.C.)
- Correspondence:
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11
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Carta MG, Moro MF, Sancassiani F, Ganassi R, Melis P, Perra A, D’Oca S, Atzeni M, Velluzzi F, Ferreli C, Atzori L, Gonzalez CIA, Serrentino MR, Angermeyer MC, Cossu G. Respect for service users’ human rights, job satisfaction, and wellbeing are higher in mental health workers than in other health workers: A study in Italy at time of the Covid pandemic. J Public Health Res 2022. [DOI: 10.1177/22799036221107060] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: This study aimed to evaluate the respect for users’ rights, job satisfaction, and well-being between mental health workers (MHWs) compared to non-mental health care workers (nMHWs) from the same Italian region. Methods: The sample was recruited from community mental health and non-mental health outpatient centers in Sardinia. Participants fulfilled the WellBeing at work and respect for human-rights questionnaire (WWRR). The sample included 240 MHWs and 154 nMHWs. Results: MHWs were more satisfied with their work and workplace compared to nMHWs. MHWs had stronger beliefs that users were satisfied with the care received, and both workers and users’ human rights were respected in their workplace. MHWs reported to need more rehabilitation therapists and psychologists in their services, while nMHWs needed more nurses and professionals for users’ personal care. Italian MHWs are more satisfied with their work and workplace, and more convinced that users are satisfied with the care received and that users’ and staff human rights are respected in their workplaces, compared to nMHWs. Conclusions: The historic link between the community mental health network and other support networks in Italy and the consequent perception of proximity to the citizens of the care network may be the reason for this optimal situation of Italian MHWs.
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Affiliation(s)
- Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato (Cagliari), Italy
| | | | - Federica Sancassiani
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato (Cagliari), Italy
| | - Ruben Ganassi
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato (Cagliari), Italy
| | - Paola Melis
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato (Cagliari), Italy
| | - Alessandra Perra
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato (Cagliari), Italy
| | - Silvia D’Oca
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato (Cagliari), Italy
| | - Michela Atzeni
- International Ph.D. in Innovation Sciences and Technologies, University of Cagliari, Cagliari, Italy
| | - Fernanda Velluzzi
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato (Cagliari), Italy
| | - Caterina Ferreli
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato (Cagliari), Italy
| | - Laura Atzori
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato (Cagliari), Italy
| | | | - Maria Roberta Serrentino
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato (Cagliari), Italy
| | | | - Giulia Cossu
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato (Cagliari), Italy
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12
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Carta MG, Orrù G, Cossu G, Velluzzi F, Atzori L, Aviles Gonzalez CI, Romano F, Littera R, Chessa L, Firinu D, Del Giacco S, Restivo A, Deidda S, Scano A, Onali S, Kalcev G, Coghe F, Minerba L. Covid-19 vaccines work but other factors play a relevant role: a data analysis on spread and mortality in 24 countries. J Public Health Res 2022; 11. [PMID: 35322646 PMCID: PMC8996068 DOI: 10.4081/jphr.2022.2665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 12/11/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The aim was to outline a methodology to monitor the impact of vaccinations in different countries comparing at two different times within countries and between countries the frequency of new cases and Covid-19 related deaths and the percentage of vaccinations conducted. DESIGN AND METHODS The 25 countries with the largest increase in SARS-CoV-2 cases on 8 August 2021 were evaluated. In each nation was calculated the proportion of Covid-19 deaths divided per new cases x 100 and the proportion of new cases per 1.000 inhabitants on 10 January 2021 (before vaccinations' distribution) and 8 August 2021 (when large percentage of the population had been vaccinated in many countries). RESULTS The study shows that in the countries with the highest number of cases as of 8 August 2021, the proportion of vaccinations carried out in the population correlates negatively with both the proportion between Covid-19 dead people x100 infected people and with the rate of new cases. However, the proportion of vaccinations does not correlate with the differences in the two same indicators considered in the weeks observed, thus additional factors seem to play an important role. CONCLUSIONS This work indicates that mass vaccination is associated with a lower spread of the pandemic and, to greater extent, with a lowering of mortality in infected people.
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Affiliation(s)
| | - Germano Orrù
- Department of Medical Sciences and Public Health, University of Cagliari.
| | - Giulia Cossu
- Department of Medical Sciences and Public Health, University of Cagliari.
| | - Fernanda Velluzzi
- Department of Medical Sciences and Public Health, University of Cagliari.
| | - Laura Atzori
- Department of Medical Sciences and Public Health, University of Cagliari.
| | | | | | - Roberto Littera
- Department of Medical Sciences and Public Health, University of Cagliari.
| | - Luchino Chessa
- Department of Medical Sciences and Public Health, University of Cagliari.
| | - Davide Firinu
- Department of Medical Sciences and Public Health, University of Cagliari.
| | - Stefano Del Giacco
- Internal Medicine, Allergy and Clinical Immunology, Department of Medical Sciences, University of Cagliari.
| | - Angelo Restivo
- Colorectal Surgery Unit, Department of Surgical Science, University of Cagliari.
| | - Simona Deidda
- Colorectal Surgery Unit, Department of Surgical Science, University of Cagliari.
| | | | - Simona Onali
- Department of Biomedical Sciences, University of Cagliari.
| | - Goce Kalcev
- Department of Medical Sciences and Public Health, University of Cagliari.
| | - Ferinando Coghe
- Department of Medical Sciences and Public Health, University of Cagliari.
| | - Luigi Minerba
- Department of Medical Sciences and Public Health, University of Cagliari.
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13
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Flore G, Preti A, Carta MG, Deledda A, Fosci M, Nardi AE, Loviselli A, Velluzzi F. Weight Maintenance after Dietary Weight Loss: Systematic Review and Meta-Analysis on the Effectiveness of Behavioural Intensive Intervention. Nutrients 2022; 14:nu14061259. [PMID: 35334917 PMCID: PMC8953094 DOI: 10.3390/nu14061259] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/07/2022] [Accepted: 03/14/2022] [Indexed: 02/04/2023] Open
Abstract
After a low-calorie diet, only 25% of patients succeed in maintaining the result of weight loss for a long time. This systematic review and meta-analysis aims to explore whether patients undergoing intensive intervention during the maintenance phase have a greater preservation of the weight achieved during the previous slimming phase than controls. A bibliographic search was conducted using PubMed, Scopus, and Cochrane databases for clinical trials and randomised, controlled trials investigating the role of choice in weight-loss-maintenance strategies. Only studies with a follow-up of at least 12 months were considered. A total of eight studies, for a total of 1454 patients, was identified, each comparing a group that followed a more intensive protocol to a control group. Our metanalysis highlighted that an intensive approach even in the maintenance phase could be important to ensure greater success in the phase following the weight-loss period. However, it should be pointed out that the improvement was not so different from the trend of the respective controls, with a non-statistically significant mean difference of the effect size (0.087; 95% CI −0.016 to 0.190 p = 0.098). This finding, along with the observation of a weight regain in half of the selected studies, suggests this is a long work that has to be started within the weight-loss phase and reinforced during the maintenance phase. The problem of weight control in patients with obesity should be understood as a process of education to a healthy lifestyle and a balanced diet to be integrated in the context of a multidisciplinary approach.
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Affiliation(s)
- Giovanna Flore
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (A.D.); (M.F.); (A.L.); (F.V.)
- Correspondence: ; Tel.: +39-070-6754230
| | - Antonio Preti
- Department of Neuroscience, University of Turin, 10124 Torino, Italy;
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy;
| | - Andrea Deledda
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (A.D.); (M.F.); (A.L.); (F.V.)
| | - Michele Fosci
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (A.D.); (M.F.); (A.L.); (F.V.)
| | - Antonio Egidio Nardi
- Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-901, Brazil;
| | - Andrea Loviselli
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (A.D.); (M.F.); (A.L.); (F.V.)
| | - Fernanda Velluzzi
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (A.D.); (M.F.); (A.L.); (F.V.)
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14
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Carta MG, Fornaro M, Minerba L, Pau M, Velluzzi F, Atzori L, Aviles Gonzalez CI, Romano F, Littera R, Chessa L, Firinu D, Del Giacco S, Restivo A, Deidda S, Orrù G, Scano A, Onali S, Coghe F, Kalcev G, Cossu G. Previous functional social and behavioral rhythms affect resilience to COVID-19-related stress among old adults. J Public Health Res 2022; 11. [PMID: 35299585 PMCID: PMC8973204 DOI: 10.4081/jphr.2022.2768] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 01/10/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Functioning of Social Behavioral Rhythms (SBRs) may affect resilience toward stressful events across different age groups. However, the impact of SBRs on the coronavirus disease of 2019 (COVID-19) in elder people is yet to ascertain, representing the aim of the present report. DESIGN AND METHODS Follow-up of a peer-reviewed randomized controlled trial on exercise on old adults (³65 years), concurrent to the onset of the pandemic-related lockdown. Post-RCT evaluations occurred after further 12 and 36 weeks since the beginning of the lockdown phase. People with Major Depressive Episode (MDE) at week-48 (follow-up endpoint) were deemed as cases, people without such condition were considered controls. MDE was ascertained using the Patient Health Questionnaire-9 (PHQ-9); SBRs functioning at week 12 onward, through the Brief Symptom Rating Scale (BSRS). RESULTS Seventy-nine individuals (53.2%, females) entered the RCT-follow-up phase. The frequency of MDE did not significantly change before versus during lockdown (OR 2.60, CI95%=0.87-9.13). People with BSRS>1 standard deviation of the whole sample score at week-12 had an inflated risk of DE during lockdown (OR=5.6, 95%CI: 1.5-21.4) compared to those with lower BSRS scores. Such odd hold after excluding individuals with MDD at week-12. The post-hoc analysis could be potentially affected by selection bias. CONCLUSIONS Overall, older adults were resilient during the first phase of the pandemic when functioning of pre-lockdown was still preserved, in contrast to the subsequent evaluations when the impairment of daily rhythms was associated with impaired reliance.
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Affiliation(s)
| | | | - Luigi Minerba
- Department of Medical Science and Public Health, University of Cagliari.
| | - Massimiliano Pau
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari.
| | - Fernanda Velluzzi
- Department of Medical Science and Public Health, University of Cagliari.
| | - Laura Atzori
- Department of Medical Science and Public Health, University of Cagliari.
| | | | | | - Roberto Littera
- Unit of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari.
| | - Luchino Chessa
- Department of Medical Science and Public Health, University of Cagliari.
| | - Davide Firinu
- Department of Medical Science and Public Health, University of Cagliari.
| | - Stefano Del Giacco
- Department of Medical Science and Public Health, University of Cagliari.
| | - Angelo Restivo
- Department of Surgical Sciences, University of Cagliari.
| | - Simona Deidda
- Department of Surgical Sciences, University of Cagliari.
| | - Germano Orrù
- Department of Surgical Sciences, University of Cagliari.
| | | | - Simona Onali
- Department of Medical Science and Public Health, University of Cagliari.
| | - Ferdinando Coghe
- Clinical Chemical and Microbiology Laboratory, University Hospital of Cagliari.
| | - Goce Kalcev
- International Ph.D in Innovation Sciences and Technologies, University of Cagliari.
| | - Giulia Cossu
- Department of Medical Science and Public Health, University of Cagliari.
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15
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Velluzzi F, Deledda A, Onida M, Loviselli A, Crnjar R, Sollai G. Relationship between Olfactory Function and BMI in Normal Weight Healthy Subjects and Patients with Overweight or Obesity. Nutrients 2022; 14:nu14061262. [PMID: 35334919 PMCID: PMC8955602 DOI: 10.3390/nu14061262] [Citation(s) in RCA: 12] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/08/2022] [Accepted: 03/14/2022] [Indexed: 02/07/2023] Open
Abstract
Smell plays a critical role in food choice and intake by influencing energy balance and body weight. Malnutrition problems or modified eating behaviors have been associated with olfactory impairment or loss. The obesity epidemic is a serious health problem associated with an increased risk of mortality and major physical comorbidities. The etiopathogenesis of obesity is complex and multifactorial, and one of the main factors contributing to the rapid increase in its incidence is the environment in which we live, which encourages the overconsumption of foods rich in energy, such as saturated fats and sugars. By means of the “Sniffin’ Sticks” test, we measured the olfactory threshold, discrimination and identification score (TDI score) in patients of the Obesity Center of the University Hospital (OC; n = 70) and we compared them with that of healthy normal weight controls (HC; n = 65). OC patients demonstrated a significantly lower olfactory function than HC subjects both general and specific for the ability to discriminate and identify odors, even when they were considered separately as females and males. For OC patients, a negative correlation was found between body mass index (BMI) and olfactory scores obtained by each subject, both when they were divided according to gender and when they were considered all together. Besides, normosmic OC patients showed a significantly lower BMI than hyposmic ones. A reduced sense of smell may contribute to obesity involving the responses of the cephalic phase, with a delay in the achievement of satiety and an excessive intake of high-energy foods and drinks.
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Affiliation(s)
- Fernanda Velluzzi
- Obesity Center, Department of Medical Sciences and Public Health, University of Cagliari, Presidio Ospedaliero San Giovanni di Dio, 09124 Cagliari, Italy; (F.V.); (A.D.); (M.O.); (A.L.)
| | - Andrea Deledda
- Obesity Center, Department of Medical Sciences and Public Health, University of Cagliari, Presidio Ospedaliero San Giovanni di Dio, 09124 Cagliari, Italy; (F.V.); (A.D.); (M.O.); (A.L.)
| | - Maurizio Onida
- Obesity Center, Department of Medical Sciences and Public Health, University of Cagliari, Presidio Ospedaliero San Giovanni di Dio, 09124 Cagliari, Italy; (F.V.); (A.D.); (M.O.); (A.L.)
| | - Andrea Loviselli
- Obesity Center, Department of Medical Sciences and Public Health, University of Cagliari, Presidio Ospedaliero San Giovanni di Dio, 09124 Cagliari, Italy; (F.V.); (A.D.); (M.O.); (A.L.)
| | - Roberto Crnjar
- Department of Biomedical Sciences, University of Cagliari, Monserrato, 09042 Cagliari, Italy;
| | - Giorgia Sollai
- Department of Biomedical Sciences, University of Cagliari, Monserrato, 09042 Cagliari, Italy;
- Correspondence: ; Tel.: +39-070-6754160
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16
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Carta MG, Aviles Gonzalez CI, Minerba L, Pau M, Musu M, Velluzzi F, Ferreli C, Pintus E, Machado S, Romano F, Vacca V, Preti A, Cossu G, Atzori L. Exercise in Older Adults to Prevent Depressive Symptoms at the Time of Covid-19: Results of a Randomized Controlled Trial with Follow-Up. Clin Pract Epidemiol Ment Health 2022; 18:e174501792112231. [PMID: 37274849 PMCID: PMC10156046 DOI: 10.2174/17450179-v18-e2112231] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 10/18/2021] [Accepted: 11/19/2021] [Indexed: 06/07/2023]
Abstract
Background This study aimed to verify, through a randomized controlled trial, whether a medium-intensity mixing/aerobic/anaerobic exercise (accessible to older adults even with mild chronic diseases) can effectively counteract depressive episodes. A characteristic of the trial was that the follow-up coincided (unscheduled) with the lockdown due to Covid-19. Methods Participants (N=120) were randomized into an intervention group, performing physical exercise, and a control group. Participants, aged 65 years and older, belonged to both genders, living at home, and cleared a medical examination, were evaluated with a screening tool to detect depressive episodes, the PHQ9, at pre-treatment, end of the trial (12-week), and follow-up (48-week). Results A decrease in the frequency of depressive episodes after the trial (T1) was found in both groups; however, a statistically significant difference was observed only in the control group (p=0.0039). From T1 to follow-up (conducted during the lockdown), the frequency of depressive episodes increased in the control group, reaching a frequency equal to the time of study entry (p=0.788). In the experimental group, the frequency of depressive episodes did not change at the end of the trial but reached a statistically significant difference compared to the start of the study (p = 0.004) and was higher than the control group (p=0.028). Conclusion Moderate-intensity physical exercise can be conducted safely, benefitting older adults even suffering from mild chronic disorders. Physical exercise seems to guarantee a long-term preventive effect towards depressive symptoms, especially in serious stressful situations such as the lockdown due to the Covid-19 pandemic. Clinical Trial Registration Number NCT03858114
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Affiliation(s)
- Mauro Giovanni Carta
- Department Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Cesar Ivan Aviles Gonzalez
- Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy
- Universidad del Cesar, Valledupar, Colombia
| | - Luigi Minerba
- Department Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Massimiliano Pau
- Dipartimento di Ingegneria Meccanica, Chimica e dei Materiali, Università degli Studi di Cagliari, Cagliari, Italy
| | - Mario Musu
- Department Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Fernanda Velluzzi
- Department Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Caterina Ferreli
- Department Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Elisa Pintus
- Department Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Sergio Machado
- Department of Sports and Methods Techniques, Federal University of Santa Maria (UFSM), Brazil
- Laboratory of Physical Activity Neuroscience, Neurodiversity Institute, Queimados-RJ, Brazil
| | - Ferdinando Romano
- Department of Public Health and Infectious Diseases, Università Roma Sapienza, Roma, Italy
| | - Veronica Vacca
- Department Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Antonio Preti
- Department of Medical Sciences and Public Health, University of Turin, Turin, Italy
| | - Giulia Cossu
- Department Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Laura Atzori
- Department Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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17
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Rodia R, Pani F, Caocci G, La Nasa G, Simula MP, Mulas O, Velluzzi F, Loviselli A, Mariotti S, Boi F. Thyroid autoimmunity and hypothyroidism are associated with deep molecular response in patients with chronic myeloid leukemia on tyrosine kinase inhibitors. J Endocrinol Invest 2022; 45:291-300. [PMID: 34283388 PMCID: PMC8783879 DOI: 10.1007/s40618-021-01613-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 06/13/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE Thyroid alterations including de novo appearance of thyroid autoimmunity are adverse effects of tyrosine kinase inhibitors, used in solid and hematologic cancer therapy, but the relationship between thyroid alterations during this treatment and the outcome of chronic myeloid leukemia remains unclear. Aim of this study was to investigate whether the presence of thyroid alterations may affect the clinical outcome of chronic myeloid leukemia on tyrosine kinase inhibitors. METHODS We evaluated thyroid function and autoimmunity in 69 chronic myeloid leukemia patients on long-term therapy looking at the association between thyroid abnormalities and disease molecular response. RESULTS Overall, 24 of 69 (34.8%) had one or more thyroid abnormalities during therapy. A high percentage of patients (21/69, 30.4%) showed thyroid autoimmunity (positive thyroid autoantibodies with ultrasound hypoechogenicity), while clinical and subclinical hypothyroidism and subclinical hyperthyroidism were, respectively, found in 4 of 69 (5.8%) and 3 of 69 (4.3%) of cases. Second-generation tyrosine kinase inhibitors resulted significantly associated (14/32, 43.7%) with Hashimoto's thyroiditis, compared to first generation (7/37, 18.9%; p = 0.03). Interestingly, we also found a significant association between euthyroid (14/26, 53.8%) and hypothyroid Hashimoto's thyroiditis (4/26, 15.4%) in patients with deep molecular response, as compared to euthyroid (3/43, 7%; p = 0.0001) and hypothyroid (0/43, 0%; p = 0.02) Hashimoto's thyroiditis patients with major molecular response. CONCLUSIONS Our study confirms and extends our knowledge on the tyrosine kinase inhibitors effects on thyroid, showing that thyroid autoimmunity is frequently observed in chronic myeloid leukemia patients on long-term therapy and is associated with a better oncological response.
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Affiliation(s)
- R Rodia
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, Monserrato, 09042, Cagliari, Italy
| | - F Pani
- Division of Immunology, Department of Pathology, The Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - G Caocci
- Ematology and CTMO, Businco Hospital, Azienda Ospedaliera Brotzu, Cagliari, Italy
| | - G La Nasa
- Ematology and CTMO, Businco Hospital, Azienda Ospedaliera Brotzu, Cagliari, Italy
| | - M P Simula
- Ematology and CTMO, Businco Hospital, Azienda Ospedaliera Brotzu, Cagliari, Italy
| | - O Mulas
- Ematology and CTMO, Businco Hospital, Azienda Ospedaliera Brotzu, Cagliari, Italy
| | - F Velluzzi
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, Monserrato, 09042, Cagliari, Italy
| | - A Loviselli
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, Monserrato, 09042, Cagliari, Italy
| | - S Mariotti
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, Monserrato, 09042, Cagliari, Italy
| | - F Boi
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, Monserrato, 09042, Cagliari, Italy.
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18
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Pinna F, Suprani F, Deiana V, Lai L, Manchia M, Paribello P, Somaini G, Diana E, Nicotra EF, Farci F, Ghiani M, Cau R, Tuveri M, Cossu E, Loy E, Crapanzano A, Grassi P, Loviselli A, Velluzzi F, Carpiniello B. Depression in Diabetic Patients: What Is the Link With Eating Disorders? Results of a Study in a Representative Sample of Patients With Type 1 Diabetes. Front Psychiatry 2022; 13:848031. [PMID: 35782445 PMCID: PMC9243395 DOI: 10.3389/fpsyt.2022.848031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 05/25/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND PURPOSE Comorbidity between diabetes and depression, and diabetes and eating disorders (ED) conveys significant diagnostic, clinical and therapeutic implications. The present study was conducted on a sample of adult outpatients affected by Type 1 Diabetes (T1DM) to assess lifetime prevalence of ED; current prevalence of depression and Disturbed Eating Behaviors (DEB) and their impact on glycemic control. We hypothesized that patients with depression would have higher rates of lifetime ED and current DEB. We hypothesized a significant and independent association between DEB and the prevalence of depression. MATERIALS AND METHODS The study was carried out using a cross-sectional design in a sample of 172 diabetic patients with T1DM aged from 17 to 55 years. Lifetime prevalence of ED according to DSM-5 criteria was assessed by means of the Module H modified of the Structured Clinical Interview for DSM-IV Axis I Disorder (SCID-I). The following questionnaires were used: Beck Depression Inventory-IA version (BDI-IA) and Diabetes Eating Problems Survey-Revised (DEPS-R), to assess respectively the current presence of depression and DEB. Socio-demographic, clinical, and laboratory data were also collected. RESULTS High rates of depression (35.5%) and DEB (19.2%) were observed in our sample of 172 adult outpatients with T1DM. Lifetime history of ED was present in 20.9% of the sample and was more frequently diagnosed in patients with current depression (34.4% vs. 13.9%, p = 0.002). Higher levels of DEB at DEPS-R significantly increased the odds of depression (adjOR: 1.09; 95% CI: 1.03-1.15; p = 0.003). The presence of DEB was associated with poor glycemic control. On the other hand, no association was found between depression and metabolic compensation. CONCLUSION Adult patients with T1DM and depression should be screened for ED and DEB. Treating DEB could positively impact both mood and glycemic control in this population. Further studies should be carried out on a larger patient population using a longitudinal design and an accurate method of evaluation to explore the complex relationship between diabetes, depression, ED, and DEB. Future research should investigate treatment strategies for DEB in T1DM patients and their impact on both psychopathological and metabolic outcomes.
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Affiliation(s)
- Federica Pinna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Federico Suprani
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Valeria Deiana
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Lorena Lai
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy.,Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
| | - Pasquale Paribello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Giulia Somaini
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Enrica Diana
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | | | - Fernando Farci
- Unit of Diabetology, Azienda Sanitaria Locale Cagliari, Quartu Sant'Elena, Italy
| | - Mariangela Ghiani
- Unit of Diabetology, Azienda Sanitaria Locale Cagliari, Quartu Sant'Elena, Italy
| | - Rossella Cau
- Unit of Diabetology, Azienda Sanitaria Locale Cagliari, Quartu Sant'Elena, Italy
| | - Marta Tuveri
- Endocrinology and Diabetes Unit, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Efisio Cossu
- Endocrinology and Diabetes Unit, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Elena Loy
- Endocrinology and Diabetes Unit, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Andrea Crapanzano
- Department of Counseling, San Francisco State University, San Francisco, CA, United States
| | - Paola Grassi
- Department of Education, Psychology and Philosophy, University of Cagliari, Cagliari, Italy
| | - Andrea Loviselli
- Endocrinology and Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Fernanda Velluzzi
- Endocrinology and Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Bernardo Carpiniello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
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Velluzzi F, Anedda J, Pisanu S, Dell'Antonia M, Deledda A, Boi A, Ferreli C, Atzori L. Mediterranean diet, lifestyle and quality of life in Sardinian patients affected with Hidradenitis suppurativa. J Public Health Res 2021; 11. [PMID: 34850622 PMCID: PMC8958440 DOI: 10.4081/jphr.2021.2706] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 11/11/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Hidradenitis Suppurativa is a chronic inflammatory skin disease with a strong negative impact on physical and psychological health. Obesity, especially visceral adiposity, but also smoking or unhealthy nutritional habits, have been reported to be significantly associated with hidradenitis suppurativa. Design and methods: Case-control study in 35 patients of both sexes affected with hidradenitis suppurativa, and 35 healthy subjects matched for sex, age, and geographic origin (Sardinia, Italy). Results: Several anthropometric measures (body mass index, waist circumference, body composition), lifestyle (Mediterranean diet adherence, and physical activity level), and the perceived physical and mental health status were evaluated in case and controls. Hidradenitis patients showed significantly higher values of body mass index, waist circumference, body composition, fat mass, and lower values of physical and mental health status compared to controls, while both groups showed a similar moderate physical activity level which can be assumed to counteract the negative effects of obesity or poor nutritional pattern in hidradenitis patients. However, none of the evaluated variables were correlated with the severity of the disease, assessed by means of the Hurley stage system or the Sartorius score. Instead, the Sartorius score showed a positive correlation with the duration of hidradenitis, mainly imputable to the diagnostic delay and the consequent long lasting inflammatory status. Conclusions: Although nutritional factors and lifestyle can be important and modifiable factors in the hidradenitis suppurativa course, the detrimental effect of chronic inflammation and delayed management are clearly prevalent and heavily influence the disease burden. Significance for public health The negative impact of Hidradenitis Suppurativa on physical and psychological health is incontrovertibly high, especially in young adults, in the midst of their social and working life. Modifiable negative attitude and lifestyles are an important field of study and intervention, which remain controversial. Although smoking and unhealthy nutritional habits, have been reported to be significantly associated with Hidradenitis Suppurativa, main studies were performed in geographical areas with a high prevalence of obesity. Present case-control study is conducted in a sample of Sardinian population, which confirm a lower obesity rate, a certain relevance of altered anthropometric measures (body mass index, waist circumference, body composition), lower Mediterranean diet adherence, and perceived physical and mental health status in hidradenitis cases. However, none of these factors resulted statistically associated with the severity of the disease, as opposed to the diagnostic and consequent management delay, which confirms is prominent role on the disease burden.
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Affiliation(s)
- Fernanda Velluzzi
- Department of Medical Sciences and Public Health, Obesity Unit, University of Cagliari.
| | - Jasmine Anedda
- Department of Medical Sciences and Public Health, Dermatology Unit, University of Cagliari.
| | - Silvia Pisanu
- Department of Medical Sciences and Public Health, Obesity Unit, University of Cagliari.
| | - Massimo Dell'Antonia
- Department of Medical Sciences and Public Health, Dermatology Unit, University of Cagliari.
| | - Andrea Deledda
- Department of Medical Sciences and Public Health, Obesity Unit, University of Cagliari.
| | - Alessandro Boi
- Department of Medical Sciences and Public Health, Obesity Unit, University of Cagliari.
| | - Caterina Ferreli
- Department of Medical Sciences and Public Health, Dermatology Unit, University of Cagliari.
| | - Laura Atzori
- Department of Medical Sciences and Public Health, Dermatology Unit, University of Cagliari.
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Carta MG, Cossu G, Pintus E, Zaccheddu R, Callia O, Conti G, Pintus M, Aviles Gonzalez CI, Massidda MV, Mura G, Sardu C, Contu P, Minerba L, Demontis R, Pau M, Finco G, Cocco E, Penna MP, Orr G, Kalcev G, Cabras F, Lorrai S, Loviselli A, Velluzzi F, Monticone M, Cacace E, Musu M, Rongioletti F, Cauli A, Ruggiero V, Scano A, Crisafulli A, Cosentino S, Atzori L, Massa E, Mela Q, Fortin D, Migliaccio G, Machado S, Romano F, Preti A. Moderate Exercise Improves Cognitive Function in Healthy Elderly People: Results of a Randomized Controlled Trial. Clin Pract Epidemiol Ment Health 2021; 17:75-80. [PMID: 34733346 PMCID: PMC8493830 DOI: 10.2174/1745017902117010075] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 01/10/2023]
Abstract
Background Physical activity in the elderly is recommended by international guidelines to protect against cognitive decline and functional impairment. Objective This Randomized Controlled Trial (RCT) was set up to verify whether medium-intensity physical activity in elderly people living in the community is effective in improving cognitive performance. Design RCT with parallel and balanced large groups. Setting Academic university hospital and Olympic gyms. Subjects People aged 65 years old and older of both genders living at home holding a medical certificate for suitability in non-competitive physical activity. Methods Participants were randomized to a 12-week, 3 sessions per week moderate physical activity program or to a control condition focused on cultural and recreational activities in groups of the same size and timing as the active intervention group. The active phase integrated a mixture of aerobic and anaerobic exercises, including drills of "life movements", strength and balance. The primary outcome was: any change in Addenbrooke's Cognitive Examination Revised (ACE-R) and its subscales. Results At the end of the trial, 52 people completed the active intervention, and 53 people completed the control condition. People in the active intervention improved on the ACE-R (ANOVA: F(1;102)=4.32, p=0.040), and also showed better performances on the memory (F(1;102)=5.40 p=0.022) and visual-space skills subscales of the ACE-R (F(1;102)=4.09 p=0.046). Conclusion A moderate-intensity exercise administered for a relatively short period of 12 weeks is capable of improving cognitive performance in a sample of elderly people who live independently in their homes.Clinical Trials Registration No: NCT03858114.
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Affiliation(s)
- Mauro Giovanni Carta
- Dipartimento di Sanità Pubblica, Università degli studi di Cagliari, Cagliari, Italy
| | - Giulia Cossu
- Dipartimento di Sanità Pubblica, Università degli studi di Cagliari, Cagliari, Italy
| | - Elisa Pintus
- Dipartimento di Sanità Pubblica, Università degli studi di Cagliari, Cagliari, Italy
| | - Rosanna Zaccheddu
- Dipartimento di Sanità Pubblica, Università degli studi di Cagliari, Cagliari, Italy
| | - Omar Callia
- Dipartimento di Sanità Pubblica, Università degli studi di Cagliari, Cagliari, Italy
| | - Giuliana Conti
- Dipartimento di Sanità Pubblica, Università degli studi di Cagliari, Cagliari, Italy
| | - Mirra Pintus
- Dipartimento di Sanità Pubblica, Università degli studi di Cagliari, Cagliari, Italy
| | | | - Maria Valeria Massidda
- Dipartimento di Sanità Pubblica, Università degli studi di Cagliari, Cagliari, Italy.,Department of Medical Sciences and Publcic Health, University of Cagliari, Cagliari, Italy.,Dipartimento di Ingegneria Meccanica, Università degli studi di Cagliari, Chimica e Dei Materiali, Cagliari, Italy.,Department of Education, University of Cagliari, Psychology and Philosophy, Cagliari, Italy.,Department of Psychology and Cognitive Science, University of Trento, Trento, Italy.,Comitato Olimpico Nazionale Italiano, Sezione Sardegna, Rome, Italy.,Departament of Sports Methods and Techniques, Federal University of Santa Maria (UFSM), Santa Maria, Brazil.,Laboratory of Physical Activity Neuroscience, Neurodiversity Institute, Queimados-RJ, Brazil.,Department of Public Health and Infectious Diseases, University of Rome "La Sapienza", Rome, Italy.,Dipartimento di Neuroscienze, Università degli studi di Torino, Turin, Italy
| | - Gioia Mura
- Dipartimento di Sanità Pubblica, Università degli studi di Cagliari, Cagliari, Italy
| | - Claudia Sardu
- Dipartimento di Sanità Pubblica, Università degli studi di Cagliari, Cagliari, Italy
| | - Paolo Contu
- Dipartimento di Sanità Pubblica, Università degli studi di Cagliari, Cagliari, Italy
| | - Luigi Minerba
- Department of Medical Sciences and Publcic Health, University of Cagliari, Cagliari, Italy
| | - Roberto Demontis
- Dipartimento di Sanità Pubblica, Università degli studi di Cagliari, Cagliari, Italy
| | - Massimiliano Pau
- Dipartimento di Ingegneria Meccanica, Università degli studi di Cagliari, Chimica e Dei Materiali, Cagliari, Italy
| | - Gabriele Finco
- Dipartimento di Sanità Pubblica, Università degli studi di Cagliari, Cagliari, Italy
| | - Eleonora Cocco
- Dipartimento di Sanità Pubblica, Università degli studi di Cagliari, Cagliari, Italy
| | | | - Germano Orr
- Department of Psychology and Cognitive Science, University of Trento, Trento, Italy
| | - Goce Kalcev
- Comitato Olimpico Nazionale Italiano, Sezione Sardegna, Rome, Italy
| | - Federico Cabras
- Dipartimento di Sanità Pubblica, Università degli studi di Cagliari, Cagliari, Italy
| | - Stefano Lorrai
- Dipartimento di Sanità Pubblica, Università degli studi di Cagliari, Cagliari, Italy
| | - Andrea Loviselli
- Dipartimento di Sanità Pubblica, Università degli studi di Cagliari, Cagliari, Italy
| | - Fernanda Velluzzi
- Dipartimento di Sanità Pubblica, Università degli studi di Cagliari, Cagliari, Italy
| | - Marco Monticone
- Dipartimento di Sanità Pubblica, Università degli studi di Cagliari, Cagliari, Italy
| | - Enrico Cacace
- Dipartimento di Sanità Pubblica, Università degli studi di Cagliari, Cagliari, Italy
| | - Mario Musu
- Dipartimento di Sanità Pubblica, Università degli studi di Cagliari, Cagliari, Italy
| | - Franco Rongioletti
- Dipartimento di Sanità Pubblica, Università degli studi di Cagliari, Cagliari, Italy
| | - Alberto Cauli
- Dipartimento di Sanità Pubblica, Università degli studi di Cagliari, Cagliari, Italy
| | - Valeria Ruggiero
- Dipartimento di Sanità Pubblica, Università degli studi di Cagliari, Cagliari, Italy
| | - Alessandra Scano
- Dipartimento di Sanità Pubblica, Università degli studi di Cagliari, Cagliari, Italy
| | - Antonio Crisafulli
- Dipartimento di Sanità Pubblica, Università degli studi di Cagliari, Cagliari, Italy
| | - Sofia Cosentino
- Dipartimento di Sanità Pubblica, Università degli studi di Cagliari, Cagliari, Italy
| | - Laura Atzori
- Dipartimento di Sanità Pubblica, Università degli studi di Cagliari, Cagliari, Italy
| | - Elena Massa
- Dipartimento di Sanità Pubblica, Università degli studi di Cagliari, Cagliari, Italy
| | - Quirico Mela
- Department of Medical Sciences and Publcic Health, University of Cagliari, Cagliari, Italy
| | - Dario Fortin
- Department of Psychology and Cognitive Science, University of Trento, Trento, Italy
| | | | - Sergio Machado
- Departament of Sports Methods and Techniques, Federal University of Santa Maria (UFSM), Santa Maria, Brazil.,Laboratory of Physical Activity Neuroscience, Neurodiversity Institute, Queimados-RJ, Brazil
| | - Ferdinando Romano
- Department of Public Health and Infectious Diseases, University of Rome "La Sapienza", Rome, Italy
| | - Antonio Preti
- Dipartimento di Neuroscienze, Università degli studi di Torino, Turin, Italy
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21
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Cossu G, Abbile Gonzalez CI, Minerba L, Demontis R, Pau M, Velluzzi F, Ferreli C, Atzori L, Machado S, Fortin D, Romano F, Carta MG. Exercise improves long-term social and behavioral rhythms in older adults: Did it play a role during the COVID-19 lockdown? J Public Health Res 2021; 11. [PMID: 34351101 PMCID: PMC8847954 DOI: 10.4081/jphr.2021.2432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 06/22/2021] [Indexed: 11/27/2022] Open
Abstract
The study aimed to verify whether exercise training in older adults can improve social behavioral rhythms (SBR) and if any modification is maintained over time. Older adults (n=120) from a previous randomized controlled trial (RCT), were randomly allocated to either a moderate-intensity exercise group or a control group. SBR was evaluated at t0, t26, and t48 weeks (during the COVID-19 lockdown), using the brief social rhythms scale (BSRS). Seventy-nine participants completed the follow-up (age 72.3±4.7, women 55.3%). An improvement in the BSRS score was found in the exercise group at 26 weeks (p=0.035) when the exercise program was concluded, and it was still maintained at 48 weeks (p=0.013). No improvements were observed in the control group. To conclude, social behavioral rhythms (SBR), previously found as a resilience factor in older adults during Covid-19, appear to improve after a moderate 12 weeks exercise program, and the improvement persisted even after stopping exercise during the COVID-19 lockdown. Significance for public health The pandemic condition, requiring community containment and social distancing has widely affected the population, especially older adults. However, improvement of social and behavioral rhythms (SBR) in the year before the Covid-19 lockdown were found as an important resilience factor, especially against the risk of depression. Current study suggests that a moderate 12 weeks exercise program improved SBR and that the benefits persisted even after stopping exercise during the COVID-19 lockdown.
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Affiliation(s)
- Giulia Cossu
- Department of Medical Sciences and Public Health, University of Cagliari.
| | | | - Luigi Minerba
- Department of Medical Sciences and Public Health, University of Cagliari.
| | - Roberto Demontis
- Department of Medical Sciences and Public Health, University of Cagliari.
| | - Massimiliano Pau
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari.
| | - Fernanda Velluzzi
- Department of Medical Sciences and Public Health, University of Cagliari.
| | - Caterina Ferreli
- Department of Medical Sciences and Public Health, University of Cagliari.
| | - Laura Atzori
- Department of Medical Sciences and Public Health, University of Cagliari.
| | - Sergio Machado
- Department of Sports and Methods Techniques, Federal University of Santa Maria (UFSM).
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22
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Pugliese F, Salcuni AS, Battista C, Carnevale V, Guglielmi G, Columbu C, Velluzzi F, Giovanelli L, Eller-Vainicher C, Scillitani A, Chiodini I. Prevalence of less severe hypercortisolism in fractured patients admitted in an outpatient clinic for metabolic bone diseases. Endocrine 2021; 73:203-208. [PMID: 33484412 DOI: 10.1007/s12020-021-02616-1] [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: 11/24/2020] [Accepted: 01/08/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE To evaluate the prevalence of less severe hypercortisolism (LSH) in fractured patients, and its association with hypertension, hyperglicemia, dyslipidemia, and obesity. METHOD From July 2015 to October 2018 we enrolled all fractured patients admitted in our outpatient center for metabolic bone diseases, after exclusion of patients with secondary osteoporosis apart from diabetes and taking drugs known to affect bone metabolism. In all enrolled patients we collected data regarding gonadal status, history of diabetes, high blood pressure, dyslipidemia, and measured blood pressure, lipid profile, fasting glycaemia. Bone mass was measured with DXA at lumbar spine and femoral neck and the presence of fractures was evaluated with X-ray of thoracic and lumbar spine. All patients performed twice, 1 mg overnight dexametasone suppression test (DST) and, as confirmatory, 2day low-dose DST for diagnosing hypercortisolism. RESULTS We enrolled 101 fractured patients (75 females, 26 males), aged 65 ± 10.3 years. Five out of 101 (5.0%) patients were diagnosed as LSH. Fifty-five (54.5%) out of 101 were hypertensive, 57 (56.4%) dyslipidemic, 17 (16.8%) hyperglicaemic, 28(27.7%) obese patients. LSH tended to be associated to blood hypertension [5/5 vs 50/96 (Fisher exact test, p = 0.06) hypertensive patients]. Four out five LSH patients were hypogonadic. CONCLUSIONS Our study confirms that a nonnegligible percentage of fractured subjects actually presents an unrecognized hypercortisolism. Accordingly, regardless of age, we suggest to screen for hypercortisolism all patients with established osteoporosis and in particular hypertensive subjects.
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Affiliation(s)
- F Pugliese
- Units of Endocrinology, Ospedale "Casa Sollievo della Sofferenza", IRCCS, San Giovanni Rotondo, FG, Italy
| | - A S Salcuni
- Units of Endocrinology, Ospedale "Casa Sollievo della Sofferenza", IRCCS, San Giovanni Rotondo, FG, Italy
| | - C Battista
- Units of Endocrinology, Ospedale "Casa Sollievo della Sofferenza", IRCCS, San Giovanni Rotondo, FG, Italy
| | - V Carnevale
- Unit of Internal Medicine, Ospedale "Casa Sollievo della Sofferenza", IRCCS, San Giovanni Rotondo, FG, Italy
| | - G Guglielmi
- Unit of Radiology, Ospedale "Casa Sollievo della Sofferenza", IRCCS, San Giovanni Rotondo, FG, Italy
| | - C Columbu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - F Velluzzi
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - L Giovanelli
- Department of Endocrine and Metabolic Diseases, IRCCS, Istituto Auxologico Italiano, Milan, Italy
| | - C Eller-Vainicher
- Unit of Endocrinology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - A Scillitani
- Units of Endocrinology, Ospedale "Casa Sollievo della Sofferenza", IRCCS, San Giovanni Rotondo, FG, Italy.
| | - I Chiodini
- Department of Endocrine and Metabolic Diseases, IRCCS, Istituto Auxologico Italiano, Milan, Italy
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
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23
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Carta MG, Cossu G, Pintus E, Zoccheddu R, Callia O, Conti G, Pintus M, Gonzalez CIA, Massidda MV, Mura G, Sardu C, Contu P, Minerba L, Demontis R, Pau M, Finco G, Cocco E, Penna MP, Orrù G, Kalcev G, Cabras F, Lorrai S, Loviselli A, Velluzzi F, Monticone M, Cacace E, Musu M, Rongioletti F, Cauli A, Ruggiero V, Scano A, Crisafulli A, Cosentino S, Atzori L, Massa E, Mela Q, Fortin D, Migliaccio G, Nardi AE, Angermeyer M, Preti A. Active elderly and health-can moderate exercise improve health and wellbeing in older adults? Protocol for a randomized controlled trial. Trials 2021; 22:331. [PMID: 33962664 PMCID: PMC8103665 DOI: 10.1186/s13063-021-05278-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 04/16/2021] [Indexed: 12/16/2022] Open
Abstract
Background Aging is marked by a progressive rise in chronic diseases with an impact on social and healthcare costs. Physical activity (PA) may soothe the inconveniences related to chronic diseases, has positive effects on the quality of life and biological rhythms, and can prevent the decline in motor functions and the consequent falls, which are associated with early death and disability in older adults. Methods We randomized 120 over-65 males and females into groups of similar size and timing and will give each either moderate physical activity or cultural and recreational activities. Being younger than 65 years, inability to participate in physical activity for any medical reason, and involvement in a massive program of physical exercise are the exclusion criteria. The primary outcome measures are: quality of life, walking speed, and postural sway. Participants are tested at baseline, post-treatment, and 6-month (24 weeks) and 12-month (48 weeks) follow-ups. Discussion This study aims at improving the quality of life, wellness, and cognitive functioning in the elderly through a low-cost affordable program of moderate physical activity. Given the growing aging of the world population and the social and economic burden of disability in the elderly, our results might have a major impact on future practices. Trial registration ClinicalTrials.gov NCT03858114. Registered on 28 February 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05278-6.
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Affiliation(s)
- Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
| | - Giulia Cossu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Elisa Pintus
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Rosanna Zoccheddu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Omar Callia
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Giuliana Conti
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Mirra Pintus
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | | | - Gioia Mura
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Claudia Sardu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Paolo Contu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Luigi Minerba
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Roberto Demontis
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Massimiliano Pau
- Dipartimento di Ingegneria meccanica, chimica e dei materiali, Università degli Studi di Cagliari, Cagliari, Italy
| | - Gabriele Finco
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Eleonora Cocco
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Maria Petronilla Penna
- Dipartimento di Pedagogia, psicologia, filosofia, Università degli Studi di Cagliari, Cagliari, Italy
| | - Germano Orrù
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Goce Kalcev
- International PhD in Innovation Sciences and Technologies, University of Cagliari, Cagliari, Italy
| | - Federico Cabras
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Stefano Lorrai
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Andrea Loviselli
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Fernanda Velluzzi
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Marco Monticone
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Enrico Cacace
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Mario Musu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Franco Rongioletti
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Vita-Salute - S. Raffaele University, Milan, Italy
| | - Alberto Cauli
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Valeria Ruggiero
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Alessandra Scano
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Antonio Crisafulli
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Sofia Cosentino
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Laura Atzori
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Elena Massa
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Quirico Mela
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Dario Fortin
- Department of Psychology and Cognitive Sciences, University of Trento, Rovereto, Italy
| | | | | | | | - Antonio Preti
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Department of Neuroscience, University of Turin, Turin, Italy
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24
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Palmas V, Pisanu S, Madau V, Casula E, Deledda A, Cusano R, Uva P, Vascellari S, Loviselli A, Manzin A, Velluzzi F. Gut microbiota markers associated with obesity and overweight in Italian adults. Sci Rep 2021; 11:5532. [PMID: 33750881 PMCID: PMC7943584 DOI: 10.1038/s41598-021-84928-w] [Citation(s) in RCA: 145] [Impact Index Per Article: 48.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 02/22/2021] [Indexed: 02/06/2023] Open
Abstract
In the present study, we characterized the distinctive signatures of the gut microbiota (GM) from overweight/obese patients (OB), and normal-weight controls (NW), both of Sardinian origin. Fecal bacterial composition of 46 OB patients (BMI = 36.6 ± 6.0; F/M = 40/6) was analyzed and compared to that of 46 NW subjects (BMI = 21.6 ± 2.1; F/M = 41/5), matched for sex, age and smoking status, by using 16S rRNA gene sequencing on MiSeq Illumina platform. The gut microbial community of OB patients exhibited a significant decrease in the relative abundance of several Bacteroidetes taxa (i.e. Flavobacteriaceae, Porphyromonadaceae, Sphingobacteriaceae, Flavobacterium, Rikenella spp., Pedobacter spp., Parabacteroides spp., Bacteroides spp.) when compared to NW; instead, several Firmicutes taxa were significantly increased in the same subjects (Lachnospiraceae, Gemellaceae, Paenibacillaceae, Streptococcaceae, Thermicanaceae, Gemella, Mitsuokella, Streptococcus, Acidaminococcus spp., Eubacterium spp., Ruminococcus spp., Megamonas spp., Streptococcus, Thermicanus, Megasphaera spp. and Veillonella spp.). Correlation analysis indicated that body fatness and waist circumference negatively correlated with Bacteroidetes taxa, while Firmicutes taxa positively correlated with body fat and negatively with muscle mass and/or physical activity level. Furthermore, the relative abundance of several bacterial taxa belonging to Enterobacteriaceae family, known to exhibit endotoxic activity, was increased in the OB group compared to NW. The results extend our knowledge on the GM profiles in Italian OB, identifying novel taxa linking obesity and intestine.
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Affiliation(s)
- Vanessa Palmas
- Microbiology and Virology Unit, Department of Biomedical Sciences, Azienda Ospedaliero-Universitaria Cagliari, University of Cagliari, Strada Statale 554- bivio Sestu, 09042, Monserrato, Cagliari, Italy
| | - Silvia Pisanu
- Microbiology and Virology Unit, Department of Biomedical Sciences, Azienda Ospedaliero-Universitaria Cagliari, University of Cagliari, Strada Statale 554- bivio Sestu, 09042, Monserrato, Cagliari, Italy
| | - Veronica Madau
- Microbiology and Virology Unit, Department of Biomedical Sciences, Azienda Ospedaliero-Universitaria Cagliari, University of Cagliari, Strada Statale 554- bivio Sestu, 09042, Monserrato, Cagliari, Italy
| | - Emanuela Casula
- Microbiology and Virology Unit, Department of Biomedical Sciences, Azienda Ospedaliero-Universitaria Cagliari, University of Cagliari, Strada Statale 554- bivio Sestu, 09042, Monserrato, Cagliari, Italy
| | - Andrea Deledda
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Roberto Cusano
- CRS4, Science and Technology Park Polaris, Piscina Manna, Pula, Cagliari, Italy
| | - Paolo Uva
- CRS4, Science and Technology Park Polaris, Piscina Manna, Pula, Cagliari, Italy
| | - Sarah Vascellari
- Microbiology and Virology Unit, Department of Biomedical Sciences, Azienda Ospedaliero-Universitaria Cagliari, University of Cagliari, Strada Statale 554- bivio Sestu, 09042, Monserrato, Cagliari, Italy
| | - Andrea Loviselli
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Aldo Manzin
- Microbiology and Virology Unit, Department of Biomedical Sciences, Azienda Ospedaliero-Universitaria Cagliari, University of Cagliari, Strada Statale 554- bivio Sestu, 09042, Monserrato, Cagliari, Italy.
| | - Fernanda Velluzzi
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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25
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Fosci M, Pigliaru F, Salcuni AS, Ghiani M, Cherchi MV, Calia MA, Loviselli A, Velluzzi F. Diabetes insipidus secondary to nivolumab-induced neurohypophysitis and pituitary metastasis. Endocrinol Diabetes Metab Case Rep 2021; 2021:EDM200123. [PMID: 33522491 PMCID: PMC7849457 DOI: 10.1530/edm-20-0123] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 01/07/2021] [Indexed: 12/03/2022] Open
Abstract
SUMMARY A 62-year-old patient with metastatic hypopharyngeal carcinoma underwent treatment with nivolumab, following which he developed symptoms suggestive of diabetes insipidus. Nivolumab was stopped and therapy with methylprednisolone was started. During corticosteroid therapy, the patient presented himself in poor health condition with fungal infection and glycemic decompensation. Methylprednisolone dose was tapered off, leading to the resolution of mycosis and the restoration of glycemic compensation, nevertheless polyuria and polydipsia persisted. Increase in urine osmolarity after desmopressin administration was made diagnosing central diabetes insipidus as a possibility. The neuroradiological data by pituitary MRI scan with gadolinium was compatible with coexistence of metastatic localization and infundibulo-neurohypophysitis secondary to therapy with nivolumab. To define the exact etiology of the pituitary pathology, histological confirmation would have been necessary; however, unfortunately, it was not possible. In the absence of histological confirmation, we believe it is likely that both pathologies coexisted. LEARNING POINTS A remarkable risk of endocrine immune-related adverse events (irAEs) during therapy with checkpoint inhibitors exsists. In order to ensure maximum efficiency in the recognition and treatment of endocrine iRAes related to immune checkpoint inhibitors, multidisciplinary management of oncological patients is critical. The pituitary syndrome in oncological patients who underwent immunotherapy represents a challenge in the differential diagnosis between pituitary metastasis and drug-induced hypophysitis. This is the first case, described in the literature of diabetes insipidus in a patient suffering from nivolumab-induced infundibulo-neurohypophysitis and anterohypophyseal metastasis.
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Affiliation(s)
- Michele Fosci
- Department of Medical Sciences, University of Cagliari, Azienda Universitaria-Ospedaliera of Cagliari, Cagliari, Sardegna, Italy
| | - Francesca Pigliaru
- Department of Medical Sciences, University of Cagliari, Azienda Universitaria-Ospedaliera of Cagliari, Cagliari, Sardegna, Italy
| | - Antonio Stefano Salcuni
- Department of Medical Sciences, University of Cagliari, Azienda Universitaria-Ospedaliera of Cagliari, Cagliari, Sardegna, Italy
| | - Massimo Ghiani
- Department of Medical Oncology, Azienda Ospedaliera Brotzu, Cagliari, Sardegna, Italy
| | - Maria Valeria Cherchi
- Department of Radiology, University of Cagliari, Azienda Universitaria-Ospedaliera of Cagliari, Cagliari, Sardegna, Italy
| | | | - Andrea Loviselli
- Department of Medical Sciences, University of Cagliari, Azienda Universitaria-Ospedaliera of Cagliari, Cagliari, Sardegna, Italy
| | - Fernanda Velluzzi
- Department of Medical Sciences, University of Cagliari, Azienda Universitaria-Ospedaliera of Cagliari, Cagliari, Sardegna, Italy
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26
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Dell’Osa AH, Battacone G, Pulina G, Fois A, Tocco F, Loviselli A, Concu A, Velluzzi F. Electrical Impedance to Easily Discover Undeclared Freeze-thaw Cycles in Slaughtered Bovine Meat. J Electr Bioimpedance 2021; 12:3-10. [PMID: 34413917 PMCID: PMC8336310 DOI: 10.2478/joeb-2021-0002] [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] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Indexed: 06/13/2023]
Abstract
A portable electrical impedance spectroscopy device was developed to monitor the bioimpedance resistive component of bovine meat by injecting a sinusoidal current of 1 mA at 65 kHz. Both right and left longissimus dorsi muscles were trimmed from 4 slaughtered cows. The left muscle portions were frozen to -18 °C for 7 days while the right ones were meantime maintained at 5 °C. Mean value of impedance per length (Ω/cm) of frozen and thawed left samples was 31% lower than that of right non-frozen one (P = 0.0001). It was concluded that the device is reliable for monitoring the maturation of beef meat in situ with the possibility of revealing undeclared freeze-thaw cycles.
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Affiliation(s)
- A. H. Dell’Osa
- Instituto de Desarrollo Económico e Innovación, Universidad Nacional de Tierra del Fuego, Ushuaia, Argentina
| | - G. Battacone
- Department of Agricultural Science, University of Sassari, Sassari, Italy
| | - G. Pulina
- Department of Agricultural Science, University of Sassari, Sassari, Italy
| | - A. Fois
- Nomadyca Ltd, Kampala, Uganda
| | - F. Tocco
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - A. Loviselli
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - A. Concu
- 2C Technologies Ltd, Academic Spin-Off, University of Cagliari, Cagliari, Italy
| | - F. Velluzzi
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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27
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Niccolini G, Manuello A, Capone A, Marongiu G, Dell'Osa AH, Fois A, Velluzzi F, Concu A. Possible Assessment of Calf Venous Pump Efficiency by Computational Fluid Dynamics Approach. Front Physiol 2020; 11:1003. [PMID: 33013438 PMCID: PMC7510250 DOI: 10.3389/fphys.2020.01003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 07/23/2020] [Indexed: 11/24/2022] Open
Abstract
Three-dimensional simulations of peripheral, deep venous flow during muscular exercise in limbs of healthy subjects and in those with venous dysfunction were carried out by a computational fluid-dynamics (CFD) approach using the STAR CCM + platform. The aim was to assess the effects of valvular incompetence on the venous calf pump efficiency. The model idealizes the lower limb circulation by a single artery, a capillary bed represented by a porous region and a single vein. The focus is on a segment of the circuit which mimics a typical deep vein at the level of the calf muscle, such as the right posterior tibial vein. Valves are idealized as ball valves, and periodic muscle contractions are given by imposing time-dependent boundary conditions to the calf segment wall. Flow measurements were performed in two cross-sections downstream and upstream of the calf pump. Model results demonstrate a reduced venous return for incompetent valves during calf exercise. Two different degrees of valvular incompetence are considered, by restricting the motion of one or both valves. Model results showed that only the proximal valve is critical, with a 30% reduction of venous return during calf exercise in case of valvular incompetence: the net flow volume ejected by the calf in central direction was 0.14 mL per working cycle, against 0.2 mL for simulated healthy limbs. This finding appeared to be consistent with a 25% reduction of the calf ejection fraction, experimentally observed in chronic venous disease limbs compared with healthy limbs.
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Affiliation(s)
- Gianni Niccolini
- Department of Structural, Geotechnical and Building Engineering, Politecnico di Torino, Turin, Italy
| | - Andrea Manuello
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Antonio Capone
- Orthopedic Clinic, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Giuseppe Marongiu
- Orthopedic Clinic, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Antonio Hector Dell'Osa
- Instituto de Desarrollo Economico e Innovación, Universidad Nacional de Tierra del Fuego, Antartida e Islas del Atlantico Sur, Ushuaia, Argentina
| | - Andrea Fois
- Biosignal Acquisition System, Nomadyca Ltd., Kampala, Uganda
| | - Fernanda Velluzzi
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Alberto Concu
- 2C Technologies Ltd., Academic Spin-Off, University of Cagliari, Cagliari, Italy
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28
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Pisanu S, Palmas V, Madau V, Casula E, Deledda A, Cusano R, Uva P, Vascellari S, Boi F, Loviselli A, Manzin A, Velluzzi F. Impact of a Moderately Hypocaloric Mediterranean Diet on the Gut Microbiota Composition of Italian Obese Patients. Nutrients 2020; 12:nu12092707. [PMID: 32899756 PMCID: PMC7551852 DOI: 10.3390/nu12092707] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 08/21/2020] [Accepted: 08/31/2020] [Indexed: 12/12/2022] Open
Abstract
Although it is known that the gut microbiota (GM) can be modulated by diet, the efficacy of specific dietary interventions in determining its composition and diversity in obese patients remains to be ascertained. The present work aims to evaluate the impact of a moderately hypocaloric Mediterranean diet on the GM of obese and overweight patients (OB). The GM of 23 OB patients (F/M = 20/3) was compared before (T0) and after 3 months (T3) of nutritional intervention (NI). Fecal samples were analyzed by Illumina MiSeq sequencing of the 16S rRNA gene. At baseline, GM characterization confirmed typical obesity-associated dysbiosis. After 3 months of NI, patients presented a statistically significant reduction in body weight and fat mass, along with changes in the relative abundance of many microbial patterns. In fact, an increase in the abundance of several Bacteroidetes taxa (i.e., Sphingobacteriaceae, Sphingobacterium, Bacteroides spp., Prevotella stercorea) and a depletion of many Firmicutes taxa (i.e., Lachnospiraceae members, Ruminococcaceae and Ruminococcus, Veillonellaceae, Catenibacterium, Megamonas) were observed. In addition, the phylum Proteobacteria showed an increased abundance, while the genus Sutterella, within the same phylum, decreased after the intervention. Metabolic pathways, predicted by bioinformatic analyses, showed a decrease in membrane transport and cell motility after NI. The present study extends our knowledge of the GM profiles in OB, highlighting the potential benefit of moderate caloric restriction in counteracting the gut dysbiosis.
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Affiliation(s)
- Silvia Pisanu
- Department of Biomedical Sciences, University of Cagliari, 09124 Cagliari, Italy; (S.P.); (V.P.); (V.M.); (E.C.); (S.V.); (A.M.)
| | - Vanessa Palmas
- Department of Biomedical Sciences, University of Cagliari, 09124 Cagliari, Italy; (S.P.); (V.P.); (V.M.); (E.C.); (S.V.); (A.M.)
| | - Veronica Madau
- Department of Biomedical Sciences, University of Cagliari, 09124 Cagliari, Italy; (S.P.); (V.P.); (V.M.); (E.C.); (S.V.); (A.M.)
| | - Emanuela Casula
- Department of Biomedical Sciences, University of Cagliari, 09124 Cagliari, Italy; (S.P.); (V.P.); (V.M.); (E.C.); (S.V.); (A.M.)
| | - Andrea Deledda
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (A.D.); (F.B.); (F.V.)
| | - Roberto Cusano
- CRS4, Science and Technology Park Polaris, Piscina Manna, Pula, 09010 Cagliari, Italy; (R.C.); (P.U.)
| | - Paolo Uva
- CRS4, Science and Technology Park Polaris, Piscina Manna, Pula, 09010 Cagliari, Italy; (R.C.); (P.U.)
| | - Sarah Vascellari
- Department of Biomedical Sciences, University of Cagliari, 09124 Cagliari, Italy; (S.P.); (V.P.); (V.M.); (E.C.); (S.V.); (A.M.)
| | - Francesco Boi
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (A.D.); (F.B.); (F.V.)
| | - Andrea Loviselli
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (A.D.); (F.B.); (F.V.)
- Correspondence: ; Tel.: +39-070-675-4268
| | - Aldo Manzin
- Department of Biomedical Sciences, University of Cagliari, 09124 Cagliari, Italy; (S.P.); (V.P.); (V.M.); (E.C.); (S.V.); (A.M.)
| | - Fernanda Velluzzi
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (A.D.); (F.B.); (F.V.)
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Pisanu S, Deledda A, Loviselli A, Huybrechts I, Velluzzi F. Validity of Accelerometers for the Evaluation of Energy Expenditure in Obese and Overweight Individuals: A Systematic Review. J Nutr Metab 2020; 2020:2327017. [PMID: 32832147 PMCID: PMC7424495 DOI: 10.1155/2020/2327017] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 05/16/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Even though the validity of accelerometers for the measurement of energy expenditure (EE) has been demonstrated for normal-weight individuals, the applicability of this instrument in obese individuals remains controversial. This review aims to summarize the level of agreement between accelerometers and the gold standards (indirect calorimetry and doubly labelled water) for the measurement of energy expenditure (EE) in obese or overweight individuals. METHODS The literature search was limited to comparison studies assessing agreement in EE determination between accelerometers and indirect calorimetry (IC) or doubly labelled water (DLW). We searched in PubMed and in Scopus until March 1, 2019. The analysis was restricted to obese or overweight adult individuals. The following descriptive information was extracted for each study: sample size, characteristics of participants (sex, age, BMI, fat mass percentage, any pathological conditions, modality of recruitment in the study, and exclusion criteria), accelerometer description (model, type and body position), and type of gold standard and validity protocol (duration, conditions, and requirements during and before the experiment). Three review authors independently screened the obtained results, and the quality of the selected articles was assessed by the QUADAS-2 tool. RESULTS We obtained seventeen eligible articles, thirteen of which showed concerns for the applicability section, due to the patient selection. Regarding the accelerometers, nine devices were validated in the included studies with the BodyMedia SenseWear® (SWA) being the most frequently validated. Although correlations between accelerometers and the gold standard were high in some studies, agreement between the two methods was low, as shown by the Bland-Altman plots. CONCLUSIONS Most accelerometer estimations of EE were inaccurate for obese/overweight subjects, and authors advise to improve the accuracy of algorithms for SWA software, or the predicted equations for estimating EE from other accelerometers.
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Affiliation(s)
- Silvia Pisanu
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Andrea Deledda
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Andrea Loviselli
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Inge Huybrechts
- International Agency for Research on Cancer, Nutrition and Metabolism Section, Lyon, France
| | - Fernanda Velluzzi
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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Bocchetta A, Ambrosiani L, Baggiani G, Pisanu C, Chillotti C, Ardau R, Velluzzi F, Piras D, Loviselli A, Pani A. Circulating antithyroid antibodies contribute to the decrease of glomerular filtration rate in lithium-treated patients: a longitudinal study. Int J Bipolar Disord 2018; 6:3. [PMID: 29492700 PMCID: PMC6161986 DOI: 10.1186/s40345-017-0114-4] [Citation(s) in RCA: 9] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 12/19/2017] [Indexed: 12/20/2022] Open
Abstract
Background Concerns about the adverse effects of long-term treatment with lithium include reduced renal function. In the present study, we examined comorbidities which may be associated with chronic kidney disease in a cohort of patients treated with lithium for up to 41 years. Methods We studied 394 patients who were treated with lithium for ≥ 5 years. The potential role of comorbidities (diabetes, concurrent antihypertensive medication, treatment with l-thyroxine, and presence of antithyroid peroxidase/microsomes, anti-thyroglobulin, and/or anti-thyrotropin-receptor antibodies) was analysed. We focused on the categories of patients with an estimated glomerular filtration rate (eGFR) lower than 60 or 45 mL/min/1.73 m2 as calculated from serum creatinine according to the Modification of Diet in Renal Disease Study Group. We applied multivariate regression analysis and Cox survival analysis to study the effects exerted by sex, age, duration of lithium treatment, and comorbidities using eGFR categories as the dependent variable. Kaplan–Meier curves were generated to measure the time to decline to an eGFR lower than 45 mL/min/1.73 m2 in patients with positive or negative thyroid antibodies. Results Age was associated with a decline to an eGFR lower than 60 mL/min/1.73 m2 after controlling for sex, duration of lithium treatment, and comorbidities. Circulating thyroid antibodies were associated with a decline to an eGFR lower than 45 mL/min/1.73 m2. Conclusions The present study is the first to suggest a potential role of circulating thyroid antibodies in the severe decline of eGFR in lithium-treated patients.
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Affiliation(s)
- Alberto Bocchetta
- Section of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Via Ospedale 54, 09124, Cagliari, Italy. .,Unit of Clinical Pharmacology, Cagliari University Hospital, Cagliari, Italy.
| | - Luca Ambrosiani
- Section of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Via Ospedale 54, 09124, Cagliari, Italy
| | - Gioia Baggiani
- Section of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Via Ospedale 54, 09124, Cagliari, Italy
| | - Claudia Pisanu
- Section of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Via Ospedale 54, 09124, Cagliari, Italy
| | - Caterina Chillotti
- Unit of Clinical Pharmacology, Cagliari University Hospital, Cagliari, Italy
| | - Raffaella Ardau
- Unit of Clinical Pharmacology, Cagliari University Hospital, Cagliari, Italy
| | - Fernanda Velluzzi
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Doloretta Piras
- Nephrology, Dialysis and Transplantation Unit, 'Giuseppe Brotzu' Hospital, Cagliari, Italy
| | - Andrea Loviselli
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Antonello Pani
- Nephrology, Dialysis and Transplantation Unit, 'Giuseppe Brotzu' Hospital, Cagliari, Italy
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Pinna F, Sardu C, Orrù W, Velluzzi F, Loviselli A, Contu P, Carpiniello B. Psychopathology, psychosocial factors and obesity. Riv Psichiatr 2017; 51:30-6. [PMID: 27030347 DOI: 10.1708/2168.23450] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
AIMS The aims of this study were to evaluate the association between obesity and socio-demographic and psychopathological variables in a clinical sample of patients referred to a center for the diagnosis and treatment of obesity, compared with a homogeneous sample of normal-weight subjects. METHODS In the context of a research project regarding obesity and psychopathology, a multivariate logistic regression analysis was used to examine the association between obesity and the demographic and clinical variables, on the basis of the dataset of a consecutive sample of 293 obese patients (48 males, 245 females, mean age: 45.41±13.55, mean body mass index [BMI] 35.6±6.2)compared with a control group of 293 non-obese subjects (48 males, 245 females, mean age 45.66±13.86, mean BMI 21.8±2.06). All subjects were assessed by structured clinical interview, the Structured Clinical Interview for Diagnosis for axis I DSM-IV (SCID-I) and for axis II DSM-IV(SCID-II). RESULTS Multivariate statistical analysis showed that the status of housewife and the presence of lifetime axis I and II psychiatric diagnosis in general, and of depressive, anxiety, eating and some personality disorders in particular, significantly increased the likelihood of being overweight/obese. The likelihood for different combinations of risk factors increased from a value of 32.3% for an individual not exposed to any risk factor, to a value of 86.7% for those exposed to all risk factors considered. CONCLUSIONS The presence of an axis I and/or II diagnosis and housewife status are both independently associated with an increased likelihood of being overweight/obese. The interaction of these factors increases this likelihood. Even taking into account the limits of the study, in particular of its cross-sectional nature, these findings may have important implications in both prevention and treatment of obesity.
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Affiliation(s)
- Federica Pinna
- Department of Public Health, Clinical and Molecular Medicine, Unit of Psychiatry, University of Cagliari, Italy
| | - Claudia Sardu
- Department of Public Health, Clinical and Molecular Medicine, Unit of Epidemiology, University of Cagliari, Italy
| | - Walter Orrù
- Department of Public Health, Clinical and Molecular Medicine, Unit of Psychiatry, University of Cagliari, Italy - H. Shultz Institute, Cagliari, Italy
| | - Fernanda Velluzzi
- Centre for Diagnosis and Treatment of Obesity, University Hospital, Cagliari, Italy
| | - Andrea Loviselli
- Centre for Diagnosis and Treatment of Obesity, University Hospital, Cagliari, Italy
| | - Paolo Contu
- Department of Public Health, Clinical and Molecular Medicine, Unit of Epidemiology, University of Cagliari, Italy
| | - Bernardo Carpiniello
- Department of Public Health, Clinical and Molecular Medicine, Unit of Psychiatry, University of Cagliari, Italy
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Velluzzi F, Secci G, Sepe V, Klersy C, Shattock M, Foxon R, Songini M, Mariotti S, Locatelli M, Bottazzo GF, Loviselli A. Prediction of type 1 diabetes in Sardinian schoolchildren using islet cell autoantibodies: 10-year follow-up of the Sardinian schoolchildren type 1 diabetes prediction study. Acta Diabetol 2016; 53:73-9. [PMID: 25896008 DOI: 10.1007/s00592-015-0751-y] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Accepted: 03/29/2015] [Indexed: 01/12/2023]
Abstract
AIMS Stable genetic background makes individuals from the Mediterranean island of Sardinia ideal to define the predictive power of islet-related autoantibodies (IRAs): glutamic acid decarboxylase antibodies (GADA), tyrosine phosphatase-like antibodies (IA-2A), islet cell antibodies (ICA) to identify T1DM progressors. The aims of the present study were: (1) determination of IRAs reference limits in healthy non-diabetic Sardinian schoolchildren (SSc). (2) Predictive power evaluation of IRAs as single or combined determination to identify islet to identify T1DM progressors. METHODS Between 1986 and 1994, 8448 SSc were tested for IRAs. All were followed up for 10 years. The predictive power of single or combination of IRAs was determined as hazard ratio (HR), sensitivity, specificity, area under the ROC curve, negative and positive predictive value (NPV, PPV). RESULTS All 43 progressors to T1DM, but three showed at least one autoantibody positivity. HR for any single-autoantibody positivity was 55.3 times greater when compared to SSc negative for all IRAs. Any single autoantibody performed at least 64.9 % sensitivity with PPV always lower than 16 %. The best performing combination was ICA, plus IA-2A (showing 52.6 % sensitivity, 99.8 % specificity, 0.76 area under the ROC curve, 51.3 % PPV and 99.8 % NPV. CONCLUSIONS Determination of IRAs reference limits in healthy SSc by standard statistical methods is crucial to establish the power of IRAs as progression markers to T1DM. Our data offer a solid rationale for future testing of ICA and IA-2A as routine laboratory markers to identify individuals at high risk of T1DM in the general population.
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Affiliation(s)
- Fernanda Velluzzi
- Department of Medical Sciences "Mario Aresu", University of Cagliari, AOU, SS 554, Monserrato, Cagliari, Italy
| | - Gianni Secci
- Department of Medical Sciences "Mario Aresu", University of Cagliari, AOU, SS 554, Monserrato, Cagliari, Italy
| | - Vincenzo Sepe
- Unit of Nephrology, Dialysis, Transplantation, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Catherine Klersy
- Service of Biometry and Clinical Epidemiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marion Shattock
- Department of Immunology, St Bartholomew's and the Royal London School of Medicine and Dentistry, London, UK
| | - Richard Foxon
- School of Biomedical and Health Science, King's College, London, UK
| | | | - Stefano Mariotti
- Department of Medical Sciences "Mario Aresu", University of Cagliari, AOU, SS 554, Monserrato, Cagliari, Italy
| | - Mattia Locatelli
- Scientific Directorate, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | | | - Andrea Loviselli
- Department of Medical Sciences "Mario Aresu", University of Cagliari, AOU, SS 554, Monserrato, Cagliari, Italy.
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Tocco F, Crisafulli A, Milia R, Marongiu E, Mura R, Roberto S, Todde F, Concu D, Melis S, Velluzzi F, Loviselli A, Concu A, Melis F. Nervous Facilitation in Cardiodynamic Response of Exercising Athletes to Superimposed Mental Tasks: Implications in Depressive Disorder. Clin Pract Epidemiol Ment Health 2015; 11:166-73. [PMID: 26535050 PMCID: PMC4627388 DOI: 10.2174/1745017901511010166] [Citation(s) in RCA: 7] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Revised: 02/15/2015] [Accepted: 02/16/2015] [Indexed: 12/03/2022]
Abstract
Introduction : Motor commands to perform exercise tasks may also induce activation of cardiovascular centres to supply the energy needs of the contracting muscles. Mental stressors per se may also influence cardiovascular homeostasis. We investigated the cardiovascular response of trained runners simultaneously engaged in mental and physical tasks to establish if aerobically trained subjects could develop, differently from untrained ones, nervous facilitation in the brain cardiovascular centre. Methods : Cardiovascular responses of 8 male middle-distance runners (MDR), simultaneously engaged in mental (colour-word interference test) and physical (cycle ergometer exercise) tasks, were compared with those of 8 untrained subjects. Heart rate, cardiac (CI) and stroke indexes were assessed by impedance cardiography while arterial blood pressures were assessed with a brachial sphygmomanometer. Results : Only in MDR simultaneous engagement in mental and physical tasks induced a significant CI increase which was higher (p<0.05) than that obtained on summing CI values from each task separately performed. Conclusion : Aerobic training, when performed together with a mental effort, induced a CI oversupply which allowed a redundant oxygen delivery to satisfy a sudden fuel demand from exercising muscles by utilizing aerobic sources of ATP, thus shifting the anaerobic threshold towards a higher work load. From data of this study it may also be indirectly stated that, in patients with major depressive disorder, the promotion of regular low-intensity exercise together with mental engagement could ameliorate the perceived physical quality of life, thus reducing their heart risk associated with physical stress.
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Affiliation(s)
- Filippo Tocco
- Laboratory of Sports Physiology, Department of Medical Sciences, University of Cagliari, Italy
| | - Antonio Crisafulli
- Laboratory of Sports Physiology, Department of Medical Sciences, University of Cagliari, Italy
| | - Raffaele Milia
- Laboratory of Sports Physiology, Department of Medical Sciences, University of Cagliari, Italy
| | - Elisabetta Marongiu
- Laboratory of Sports Physiology, Department of Medical Sciences, University of Cagliari, Italy
| | - Roberto Mura
- Laboratory of Sports Physiology, Department of Medical Sciences, University of Cagliari, Italy
| | - Silvana Roberto
- Laboratory of Sports Physiology, Department of Medical Sciences, University of Cagliari, Italy
| | - Francesco Todde
- Laboratory of Sports Physiology, Department of Medical Sciences, University of Cagliari, Italy
| | - Daniele Concu
- 2C Technologies Inc., Academic Spinoff, University of Cagliari, Italy
| | - Salvatore Melis
- Laboratory of Sports Physiology, Department of Medical Sciences, University of Cagliari, Italy
| | - Fernanda Velluzzi
- Obesity Units, Department of Medical Sciences, University of Cagliari, Italy
| | - Andrea Loviselli
- Obesity Units, Department of Medical Sciences, University of Cagliari, Italy
| | - Alberto Concu
- Laboratory of Sports Physiology, Department of Medical Sciences, University of Cagliari, Italy ; 2C Technologies Inc., Academic Spinoff, University of Cagliari, Italy
| | - Franco Melis
- Laboratory of Sports Physiology, Department of Medical Sciences, University of Cagliari, Italy
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Milia R, Velluzzi F, Roberto S, Palazzolo G, Sanna I, Sainas G, Pusceddu M, Mulliri G, Loviselli A, Crisafulli A. Differences in hemodynamic response to metaboreflex activation between obese patients with metabolic syndrome and healthy subjects with obese phenotype. Am J Physiol Heart Circ Physiol 2015; 309:H779-89. [DOI: 10.1152/ajpheart.00250.2015] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 06/30/2015] [Indexed: 01/07/2023]
Abstract
Patients suffering from obesity and metabolic syndrome (OMS) manifest a dysregulation in hemodynamic response during exercise, with an exaggerated systemic vascular increase. However, it is not clear whether this is the consequence of metabolic syndrome per se or whether it is due to concomitant obesity. The aim of the present investigation was to discover whether OMS and noncomplicated obesity resulted in different hemodynamic responses during the metaboreflex. Twelve metabolically healthy but obese subjects (MHO; 7 women), 13 OMS patients (5 women), and 12 normal age-matched controls (CTL; 6 women) took part in this study. All participants underwent a postexercise muscle ischemia protocol to evaluate the metaboreflex activity. Central hemodynamics were evaluated by impedance cardiography. The main result shows an exaggerated increase in systemic vascular resistance from baseline during the metaboreflex in the OMS patients as compared with the other groups (481.6 ± 180.3, −0.52 ± 177.6, and −60.5 ± 58.6 dynes·s−1·cm−5 for the OMS, the MHO, and the CTL groups, respectively; P < 0.05). Moreover, the MHO subjects and the CTL group showed an increase in cardiac output during the metaboreflex (288.7 ± 325.8 and 703.8 ± 276.2 ml/m increase with respect to baseline), whereas this parameter tended to decrease in the OMS group (−350 ± 236.5 ml/m). However, the blood pressure response, which tended to be higher in the OMS patients, was not statistically different between groups. The results of the present investigation suggest that OMS patients have an exaggerated vasoconstriction in response to metaboreflex activation and that this fact is not due to obesity per se.
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Affiliation(s)
- Raffaele Milia
- From the Sports Physiology Laboratory, University of Cagliari, Cagliari, Italy; and
| | - Fernanda Velluzzi
- The Obesity Center of the Department of Medical Sciences of the University of Cagliari, Cagliari, Italy
| | - Silvana Roberto
- From the Sports Physiology Laboratory, University of Cagliari, Cagliari, Italy; and
- The Obesity Center of the Department of Medical Sciences of the University of Cagliari, Cagliari, Italy
| | - Girolamo Palazzolo
- From the Sports Physiology Laboratory, University of Cagliari, Cagliari, Italy; and
| | - Irene Sanna
- From the Sports Physiology Laboratory, University of Cagliari, Cagliari, Italy; and
| | - Gianmarco Sainas
- From the Sports Physiology Laboratory, University of Cagliari, Cagliari, Italy; and
- The Obesity Center of the Department of Medical Sciences of the University of Cagliari, Cagliari, Italy
| | - Matteo Pusceddu
- From the Sports Physiology Laboratory, University of Cagliari, Cagliari, Italy; and
| | - Gabriele Mulliri
- From the Sports Physiology Laboratory, University of Cagliari, Cagliari, Italy; and
- The Obesity Center of the Department of Medical Sciences of the University of Cagliari, Cagliari, Italy
| | - Andrea Loviselli
- From the Sports Physiology Laboratory, University of Cagliari, Cagliari, Italy; and
- The Obesity Center of the Department of Medical Sciences of the University of Cagliari, Cagliari, Italy
| | - Antonio Crisafulli
- From the Sports Physiology Laboratory, University of Cagliari, Cagliari, Italy; and
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Crisafulli A, Roberto S, Velluzzi F, Palazzolo G, Sanna I, Sainas G, Pusceddu M, Mulliri G, Loviselli A, Milia R. Altered Metaboreflex Activity In Patients With Metabolic Syndrome. Med Sci Sports Exerc 2015. [DOI: 10.1249/01.mss.0000477148.64780.c2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Carpiniello B, Pinna F, Velluzzi F, Loviselli A. Mental disorders in patients with metabolic syndrome. The key role of central obesity. Eat Weight Disord 2012; 17:e259-66. [PMID: 23299201 DOI: 10.3275/8809] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The Authors sought to evaluate current prevalence of mental disorders in patients affected by metabolic syndrome compared with patients affected by central obesity alone. METHODS 186 (63.5%) patients affected by central obesity and 107 (36.5%) affected by metabolic syndrome according to ICF criteria were interviewed by means of SCID I. RESULTS Axis I current prevalence was respectively 45.7% and 44.9% among patients with central obesity and patients with metabolic syndrome, differences which were not significant. No statistically significant differences were found between groups as far as each single axis I diagnostic category was concerned. Moreover, current prevalence of any axis I, anxiety and mood disorders were independent of the number of components of metabolic syndrome. CONCLUSION metabolic syndrome is associated to an higher risk for current mental disorders, which seems to be mainly due to the strong association of central obesity to psychopathology.
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Affiliation(s)
- B Carpiniello
- Department of Public Health, Clinical and Molecular Medicine-Section of Psychiatry and Psychiatric Clinic, University of Cagliari, Cagliari, Italy.
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Massidda M, Satta G, Attene G, Steri G, Santus S, Velluzzi F, Cugusi L. Energy expenditure and intensity of physical activity during a training session in obese pre-diabetic women. J Sci Med Sport 2012. [DOI: 10.1016/j.jsams.2012.11.364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Cugusi L, Satta G, Velluzzi F, Steri G, Santus S, Attene G, Massidda M. Type 2 Diabetes incidence, physical activity levels and quality of life in a group of pre-diabetic and overweight subjects. J Sci Med Sport 2012. [DOI: 10.1016/j.jsams.2012.11.360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
OBJECTIVE The authors sought to evaluate lifetime prevalence of mental disorders in patients affected by metabolic syndrome compared with patients affected by central obesity alone. METHODS One hundred eighty-six (63.5%) patients affected by central obesity and 107 (36.5%) affected by metabolic syndrome according to ICF criteria were interviewed by means of SCID I and SCID II. RESULTS Axis I and axis II lifetime prevalence were respectively 53.8% and 30.1% among patients with central obesity, 50.5% and 28% among patients with metabolic syndrome, differences which were not significant. No statistically significant differences were found between groups as far as each single axis I and II diagnostic category was considered. CONCLUSION Metabolic syndrome is not associated with a higher risk of mental disorders compared to central obesity alone.
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Affiliation(s)
- B Carpiniello
- Dept. of Public Health-Section of Psychiatry and Psychiatric Clinic, University of Cagliari, Italy.
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Pinna F, Lai L, Pirarba S, Orrù W, Velluzzi F, Loviselli A, Carpiniello B. Obesity, alexithymia and psychopathology: a case-control study. Eat Weight Disord 2011; 16:e164-70. [PMID: 21330781 DOI: 10.3275/7509] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE The relationship between psychopathology and alexithymia in obese patients is uncertain. The present study was performed to evaluate this relationship in a clinical sample of patients attending a centre for the diagnosis and treatment of obesity compared to a matched sample of non-obese subjects. METHODS 293 consecutive obese patients (48 males, 245 females, mean age 45, 41±13.55 yrs; mean BMI 35.60±6.20) were compared with a control group made of 293 non-obese subjects (48 males, 245 females, mean age 45, 66±13.86 yrs; mean BMI 21.8±2.06); all subjects were interviewed by means of SCID I and SCID II together with several self-evaluation instruments including the TAS-20 (Toronto Alexithymia Scale) and SCL-90 (Symptom Check List, Revised). RESULTS Alexithymia was significantly more frequent among obese patients compared to "normal" controls (12.9% vs 6.9%, p=0.010); moreover obese patients achieved significantly higher mean scores on subscales 1 and 2 and on overall scale of the Toronto Alexithymia Scale; comorbidity with axis I/II disorders, in particular Binge Eating Disorder, was associated with a significantly higher frequency of alexithymic traits and higher scores at TAS. CONCLUSIONS Alexithymia and psychopathology are strongly correlated among obese patients seeking treatment. Routine evaluation of personality traits and comorbid psychopathology may be relevant in treatment of obesity.
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Affiliation(s)
- F Pinna
- Department of Public Health, Section of Psychiatry, University of Cagliari, Via Liguria 13, 09127 Cagliari, Italy
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Olivieri A, De Angelis S, Dionisi S, D'Annunzio G, Locatelli M, Marinaro M, Bonato V, Amendola A, Songini M, Velluzzi F, Schirru C, Cotichini R, Stazi MA, Dotta F, Lorini R, Bottazzo GF, Boirivant M. Serum transforming growth factor β1 during diabetes development in non-obese diabetic mice and humans. Clin Exp Immunol 2010; 162:407-14. [PMID: 20819089 DOI: 10.1111/j.1365-2249.2010.04253.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Recent data show that regulatory cells with transforming growth factor (TGF)-β1-dependent activity are able to restore self-tolerance in overtly diabetic non-obese diabetic (NOD) mice. Thus, TGF-β1 seems to have a relevant role in protection from autoimmune diabetes. Our aim was to investigate the possible significance of serum TGF-β1 measurement in the natural history of diabetes in NOD mice, as well as in children positive for at least one islet-related antibody. Serum TGF-β1 (both total and active) was measured by enzyme-linked immunosorbent assay at monthly intervals in 26 NOD mice during the spontaneous development of diabetes and, on a yearly basis, in nine siblings of patients with type 1 diabetes (T1D) with a follow-up of 4 years. Diabetes appeared between the 12th week of age and the end of the study period (36 weeks) in 17 mice. TGF-β1 serum level variations occurred in the prediabetic period in both NOD mice and humans and diabetes diagnosis followed a continuing reduction of active TGF-β1 (aTGF-β1) serum levels. In mice, aTGF-β1 serum levels measured at 4 weeks of age correlated positively with severity of insulitis, and negatively with percentage of insulin-positive cells. Our findings suggest that in NOD mice serum TGF-β1 levels during the natural history of the diabetes reflect the course of islet inflammation. The measurement of aTGF-β1 in islet-related antibody-positive subjects may provide insights into the natural history of prediabetic phase of T1D.
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Affiliation(s)
- A Olivieri
- Department of Cell Biology and Neuroscience, Istituto Superiore di Sanità, Roma, Italy
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Carpiniello B, Pinna F, Pillai G, Nonnoi V, Pisano E, Corrias S, Orrù MG, Orrù W, Velluzzi F, Loviselli A. Psychiatric comorbidity and quality of life in obese patients. Results from a case-control study. Int J Psychiatry Med 2009; 39:63-78. [PMID: 19650530 DOI: 10.2190/pm.39.1.e] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The authors sought to evaluate psychiatric comorbidity, subjective quality of life, and impact of psychopathology on quality of life measures in a clinical sample of patients attending a center for the diagnosis and treatment of obesity compared to a matched sample of non-obese subjects. METHODS Two hundred ninety-three consecutive obese patients (48 males, 245 females, mean age 45.41 +/- 13.55 yrs; mean BMI 35.60 +/- 6.20) were compared with a control group made of 293 non obese subjects (48 males, 245 females, mean age 45.66 +/- 13.86 yrs; mean BMI 21.8 +/- 2.06); all subjects were interviewed by means of SCID I and SCID II and completed the WHO-QoL-Bref, a self-administered instrument for evaluation of subjective quality of life. RESULTS Obesity was associated with a significant lifetime major risk both for axis I (OR = 3.47, p = 0.000) and axis II disorders (OR = 2.27, p = 0.000); obesity was also associated with significantly lower measures of subjective quality of life on physical, social, and psychological domains; comorbidity with axis I/II disorders was associated with lower QoL measures on WHO-QoL-Bref, in particular among obese patients. CONCLUSIONS Obesity is significantly associated with a significant major risk of psychiatric comorbidity and poor quality of life; comorbid mental disorders play a significant role in worsening quality of life of obese patients; a multimodal approach to the treatment of obesity, including psychiatric evaluation and intervention, is needed to improve quality of life of patients.
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Affiliation(s)
- Bernardo Carpiniello
- Department of Public Health, Section of Psychiatry, University of Cagliari, Italy.
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Carpiniello B, Pinna F, Pillai G, Nonnoi V, Pisano E, Corrias S, Orrù MG, Orrù W, Velluzzi F, Loviselli A. Obesity and psychopathology. A study of psychiatric comorbidity among patients attending a specialist obesity unit. Epidemiol Psichiatr Soc 2009; 18:119-127. [PMID: 19526743] [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: 05/27/2023]
Abstract
AIMS The study aims to evaluate the frequency of association between Axis I and II disorders according to DSMIVTR criteria and obesity, and use of mental health services in a clinical sample of patients attending a centre for the diagnosis and treatment of Obesity. METHODS 150 consecutive patients (32 Males, 118 females, mean age 44.6 +/- 14.3 yrs; mean BMI 35.4 +/- 6.2) were interviewed by means of SCID I and SCID II. RESULTS Lifetime Prevalence of Axis I disorders was 58% (males 50%; females 61%); the highest prevalence rate was found for Anxiety Disorders (approx 35%), whilst 30% of subjects were affected by Mood disorders, chiefly Major Depression (20%), and 18% by Eating Disorders. 28% of obese patients presented a Personality Disorder, 23% of patients being affected both by an Axis I and Axis II disorder. Mood Disorders, in particular Major Depression, were significantly prevalent among female obese. 50% of females and approx 37% males included in the sample had contacted mental health units for treatment. CONCLUSION Data obtained in the present study confirm the high prevalence rates of mental disorders in obese patients seeking treatment. Specialist units should therefore include thorough psychiatric evaluation of patients as a routine practice.
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Affiliation(s)
- Bernardo Carpiniello
- Department of Public Health, Section of Psychiatry, University of Cagliari, Cagliari, Italy.
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Velluzzi F, Lai A, Secci G, Mastinu R, Pilleri A, Cabula R, Rizzolo E, Cocco PL, Fadda D, Binaghi F, Mariotti S, Loviselli A. Prevalence of overweight and obesity in Sardinian adolescents. Eat Weight Disord 2007; 12:e44-50. [PMID: 17615488 DOI: 10.1007/bf03327590] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND To estimate the prevalence of overweight and obesity among adolescents in Sardinia and to examine the association with several biological and geographic factors. METHODOLOGY A cross-sectional study was performed in 3,946 unselected adolescents (2,011 boys, 1,935 girls; aged 11-15 years) attending the public secondary schools in 33 Sardinian municipalities: 28 semi-rural, 5 urban, sub-grouped according to their geographic location (mountain, hillside and plain). Oversized children were measured and their BMI defined as being above normal values according to parameters provided by the International Obesity Task Force (IOFT) by Cole et al. (BMI for age > or = 95th percentile). Relative risk for overweight and obesity was calculated using Poisson regression analysis: risks associated to each covariate were reciprocally adjusted. The 95% confidence interval (CI) of the estimated risk was calculated using Wald's formula (RR, RR = log(n) beta +/- 1.96 se(beta)). MAIN FINDINGS The overall prevalence rate found for overweight and obesity was 14.9% (95% C.I.: 13.7-16.1%) and 3.7% (95% C.I. 3.1-4.3%), respectively. Overweight rate showed no association with gender, whereas belonging to the female sex constituted a significant protection against obesity. Increasing age in the range 12-14 years was protective against both overweight and obesity in the whole sample. A similar finding however was not observed for obesity in girls or overweight in boys, when considered separately. Boys, but not girls, living in urban areas displayed a modest though significant 20% increase in overweight and a 40% decrease in obesity risk. Living in a mountainous area conveyed a 30% decrease in risk of overweight and a 50% decrease in risk of obesity, when compared to living on the plains and hillside combined. However, the small sample size of study subjects living in mountainous areas generated extremely wide 95% confidence intervals, thereby preventing the drawing of any significant conclusions. CONCLUSION In comparison with other surveys performed by the IOFT, Sardinian adolescents show a low prevalence rate for oversize, emphasizing a marked discrepancy with the general north-south rising trend of oversize observed throughout Europe. Geographic location, aesthetic or other age related factors seem to exert a different gender-specific influence on overweight and obesity. SIGNIFICANCE The present report is cross sectional and the consequences of overweight and obesity on individuals over time are not traceable. However, the outcome of the study suggests the need to implement suitable policies and public health programs leading to increased awareness.
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Affiliation(s)
- F Velluzzi
- Department of Medical Science Mario Aresu, University of Cagliari, Cagliari, Italy
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Abstract
OBJECTIVE To study prospectively the course of clinically relevant thyroid dysfunction in a cohort of patients on long-term lithium treatment. METHOD Patients (no.=150) who had undergone a cross-sectional evaluation of their thyroid function in 1989, when they were at different stages of lithium treatment, were followed up for thyroid circulating thyroid antibodies, hypothyroidism, hyperthyroidism, and thyroidectomy, during a further period of lithium exposure of up to 15 yr. RESULTS Annual rates of newly developed circulating thyroid antibodies and hypothyroidism were 1.7 and 1.5%, respectively. Subjects with thyroid antibodies had a higher chance of requiring substitution treatment with levothyroxine for hypothyroidism compared with subjects with no evidence of thyroid antibodies (6.4% annual rate compared to 0.8%; relative risk: 8.4; 95% confidence interval: 2.9-24.0). One case of hyperthyroidism was observed over 976 patient-yr. Three patients underwent thyroidectomy during followup (two for multinodular goiter and one for multicentric papillary carcinoma). CONCLUSIONS Lithium may be associated with hypothyroidism in particular in the presence of circulating thyroid antibodies. Incidence of thyroid antibodies is comparable with that reported for the general population. Hyperthyroidism and thyroid cancer are rare.
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Affiliation(s)
- A Bocchetta
- Section of Clinical Pharmacology, Bernard B. Brodie Department of Neurosciences, University of Cagliari, Cagliari, Italy.
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Loviselli A, Secci G, Lai A, Velluzzi F. [Mechanisms of regulation of the food intake: recent advances]. Recenti Prog Med 2007; 98:1-6. [PMID: 17345872] [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
The mechanisms deputed to energetic control have been selected by ancestral diets resulting from the nutrient disposal during the evolution. Discovery of the leptin and its downstream peptidergic pathways has increased our understanding of the physiological system that regulate food intake in the last decade. Hypothalamus plays a key role in the regulation of the peripheral and central signals of energy requirements. Insulin and leptin, that reflect the adipose status, are able to long term influence these circuits. Gut hormones acutely modulated the pathways, resulting in a stimulation effects by ghreline, or in a inhibition effects by PYY and oxintomoduline. Moreover, brain centres signal energy homeostasis by monoamine release and endocannabinoid system. This review discusses the network of neuronal and hormonal signals, which contribute to the energetic control.
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Affiliation(s)
- Andrea Loviselli
- Dipartimento di Scienze Mediche M. Aresu, Policlinico Universitario, Cagliari.
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Abstract
Recently, concentrations of serum carboxy-terminal-1-telopeptide (ICTP), a marker of bone collagen resorption, were found to be more sensitive than sex hormone-binding globulin (SHBG) in identifying peripheral overexposure to thyroid hormones in exogenous subclinical hyperthyroidism. The aim of the present study was to assess serum ICTP and SHBG in multinodular goiter with (pretoxic goiter) or without biochemical evidence of endogenous subclinical hyperthyroidism. Forty-five women affected by multinodular goiter were enrolled in this study. They were subdivided into two groups: group 1, consisting of 27 patients affected by pretoxic goiter; group 2, consisting of 18 patients affected by non toxic goiter; group 3, consisting of thirty-six euthyroid women matched with the other groups for age and lifestyle. In group 1, serum ICTP (mean +/- SD: 5.8 +/- 2.9 microg/l) concentrations were significantly higher when compared either to group 2 (3.6 +/- 1.2 microg/l; p < 0.02) or controls (2.7 +/- 0.7 microg/l; p < 0.0001); serum ICTP concentrations were also slightly but significantly higher in patients of group 2 compared to controls (p < 0.003). In contrast, mean serum SHBG concentrations did not show any difference among the three groups. No significant correlation was found between serum TSH and ICTP concentrations, while a weak positive correlation (p < 0.05) was only found between serum FT 3 and ICTP concentrations when data from the two patient groups were analyzed together. Moreover, when we subdivided patients into pre- and postmenopausal patients, we observed that SHBG but not ICTP serum concentrations were influenced by estrogenic status. In summary, the measurement of serum ICTP seems to be more suitable than SHBG for identifying those with a higher degree of peripheral thyroid hormone exposure in women affected by endogenous subclinical hyperthyroidism.
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Affiliation(s)
- A Loviselli
- Endocrinology, Department of Medical Sciences, University of Cagliari, Italy.
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Abstract
The objective of this paper was to study prospectively the course of clinically relevant thyroid dysfunction in a cohort of patients on long-term lithium treatment. Patients (N = 150) who had undergone a cross-sectional evaluation of their thyroid function in 1989, when they were at different stages of lithium treatment, were followed up for the presence of thyroid autoimmunity, hypothyroidism, and goiter during a further period of lithium exposure of up to ten years. The following annual rates of newly developed thyroid dysfunction were observed: autoimmunnity (1.4%), subclinical hypothyroidism (1.7%), and goiter (2.1%). Subjects with thyroid autoimmunity had a higher chance of requiring substitution treatment with levothyroxine for subclinical hypothyroidism compared with subjects with no evidence of thyroid autoimmunity (13/32 = 41% versus 7/118 = 6%). Subjects (N = 15) who were prescribed carbamazepine in addition to lithium showed a significant decrease of TSH concentrations. In patients already being treated with lithium for several years, the overall incidence of hypothyroidism, goiter, and thyroid autoimmunity were comparable with those reported for the general population. However, lithium exposure may represent an additional risk factor for hypothyroidism in women and/or in the presence of thyroid autoimmunity.
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Affiliation(s)
- A Bocchetta
- Bernard B. Brodie Department of Neurosciences, School of Medicine, University of Cagliari, Italy.
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Loviselli A, Velluzzi F, Mossa P, Cambosu MA, Secci G, Atzeni F, Taberlet A, Balestrieri A, Martino E, Grasso L, Songini M, Bottazzo GF, Mariotti S. The Sardinian Autoimmunity Study: 3. Studies on circulating antithyroid antibodies in Sardinian schoolchildren: relationship to goiter prevalence and thyroid function. Thyroid 2001; 11:849-57. [PMID: 11575854 DOI: 10.1089/105072501316973109] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The relationship among iodine intake, goiter prevalence, and thyroid autoimmunity remains controversial. In the present article, we report the prevalence of antithyroid antibodies (ATA) in relation to iodine intake, frequency of goiter, and thyroid function in a large group of Sardinian schoolchildren living in areas with borderline iodine sufficiency, or mild to moderate iodine deficiency. A total of 8,040 schoolchildren (4,194 males, 3,846 females, ages 6-15 years) from 29 communities were examined between 1986-1994. Thyroid size was assessed by palpation, according to the Pan American Health Organization (PAHO) criteria. In all cases antimicrosomal (MAb) or antithyroid peroxidase antibodies (TPOAb) and thyrotropin (TSH) were assayed. Urinary iodine was determined in a subgroup of 820 children. ATA was detected in 235 (2.92%) sera (88 males, 2.12%; 147 females, 3.82%; chi2 = 20.41, p < 0.0001). ATA prevalence ranged between 0.0%-7.3% in the 29 communities without any geographical correlation with goiter prevalence and urinary iodine excretion. However, ATA was more frequently detected in goitrous children, especially in females. The presence of ATA was not age-dependent in males, whereas a significant increase of ATA was observed in females older than 11 years of age. Seventy-seven (0.96%) children showed borderline to slightly increased serum TSH (>5.2-32 mU/L). Increased serum TSH concentration was more frequently found in children with ATA, especially at higher titers. In summary, our study in Sardinian schoolchildren indicates: (1) ATA display geographical heterogeneity, which seems to be unrelated to goiter prevalence and/or to iodine supply; (2) ATA are more frequently detected in females older than 11 years of age, suggesting that puberty has a role in determining the predominance in females of thyroid autoimmunity; (3) although most goitrous children are ATA-negative, the prevalence of ATA is increased in children with enlarged glands; (4) ATA is associated with an increased prevalence of subclinical hypothyroidism.
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Affiliation(s)
- A Loviselli
- Department of Medical Sciences M. Aresu, University of Cagliari, Italy.
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Olivieri A, Pinna G, Lai A, Velluzzi F, Pilo A, Atzeni F, Guaita G, Cirillo R, Sorcini M, Carta S, Bottazzo GF, Mariotti S. The sardinian autoimmunity study. 4. Thyroid and islet cell autoantibodies in sardinian pregnant women at delivery: a cross-sectional study. J Endocrinol Invest 2001; 24:570-4. [PMID: 11686538 DOI: 10.1007/bf03343896] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A high incidence of autoimmune Type 1 diabetes mellitus (DM) has been clearly established in Sardinia. Although systematic epidemiological studies are still not available, an increased prevalence of thyroid autoantibodies (ATA) has been documented in the Sardinian adult population as compared to other Italian regions, suggesting that thyroid autoimmune disease may also have increased. We carried out a preliminary study with the aim of determining the prevalence of serological markers of thyroid (anti-thyroperoxydase antibodies, TPOAb) and islet cell (ICA) autoimmunity in a large number (no.=2249) of sera obtained from cord-blood of Sardinian pregnant women at delivery. The prevalence of TPOAb was 11.9%, while ICA were detected in 59 cases (2.6%). A higher prevalence of TPOAb (6/17=35.3%) was found in sera with high ICA titers (> or = 20 JDF-U), as compared to sera with low ICA titers (5-19 JDF-U) and to ICA-negative sera (3/42=7,1%; chi2=5.4, p=0.02 and 258/2190=11,8%; chi2=6.8, p=0.009 respectively). Fourteen women (all ICA-negative) were diabetic: 4 had Type 1 and 10 had gestational DM; due to the low number, no correlation could be established between DM type and TPOAb prevalence and/or titer. These preliminary data indicate that ATA are frequently observed in the general population of Sardinian pregnant women at term. As a consequence, even the frequency of postpartum thyroiditis is expected to be high. Although ATA were not increased in women with clinical overt diabetes, a higher prevalence of ATA was found in women with high titers of circulating ICA. Our results also confirm that Sardinia represents, perhaps for its peculiar genetic characteristics, an ideal place to study organ-specific autoimmunity.
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Affiliation(s)
- A Olivieri
- Laboratory of Metabolism and Pathological Biochemistry, Istituto Superiore di Sanità, Rome, Italy
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