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Pintaudi B, Gironi I, Mion E, Di Vieste G, Meneghini E, Disoteo O, Pani A, Bonomo M, Bertuzzi F. The Effectiveness of Superbolus on Postprandial Blood Glucose Management of Pregnant Women With Type 1 Diabetes. J Diabetes Sci Technol 2024; 18:402-406. [PMID: 35787016 PMCID: PMC10973862 DOI: 10.1177/19322968221109262] [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] [Indexed: 11/16/2022]
Abstract
AIM Pregnancies of women with pregestational diabetes are at risk of after-meal glucose peaks and late after-meal hypoglycemia, particularly at breakfast. We aimed to explore the effectiveness of a specific feature of insulin pump therapy called superbolus in preventing these glucose swings. METHODS In this retrospective observational study, we analyzed continuous glucose monitoring data of patients with type 1 diabetes in pregnancy who were advised to use superbolus to manage their breakfast. Some of the postprandial basal insulin delivery was partially reduced and delivered instead as additional insulin bolus on top of a normal bolus. Outcomes of interest were one hour after breakfast glucose levels, the time in glucose range for after breakfast period, the number of late hypoglycemic episodes. RESULTS Overall, 21 consecutive pregnant women with type 1 diabetes (mean age 34.3 ± 5.5 years, mean pregestational body mass index 23.7 ± 4.7 kg/m2, HbA1c levels during pregnancy 6.1 ± 0.6%) were studied. Superbolus reduced after breakfast glucose peaks (one hour after breakfast glucose levels 130 ± 17 mg/dL vs 123 ± 10 mg/dL before and after superbolus use, respectively, P = .01), improved the time in glucose range for after breakfast period (70.4% vs 50.8%, P = .001), and reduced the number of late hypoglycemic episodes (3 [1-5] vs 1 [0-2], P< .0001). CONCLUSION Superbolus was effective in avoiding after-meal glucose peaks, increased postprandial glucose time in target, without late hypoglycemia occurrence. It represents a valid option for the treatment of pregnant women with type 1 diabetes using insulin pump.
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Affiliation(s)
- Basilio Pintaudi
- Diabetes Unit, Interdisciplinary Diabetes and Pregnancy Center, Niguarda CàGranda Hospital, Milan, Italy
| | - Ilaria Gironi
- Diabetes Unit, Interdisciplinary Diabetes and Pregnancy Center, Niguarda CàGranda Hospital, Milan, Italy
| | - Elena Mion
- Diabetes Unit, Interdisciplinary Diabetes and Pregnancy Center, Niguarda CàGranda Hospital, Milan, Italy
| | | | - Elena Meneghini
- Diabetes Unit, Interdisciplinary Diabetes and Pregnancy Center, Niguarda CàGranda Hospital, Milan, Italy
| | - Olga Disoteo
- Diabetes Unit, Interdisciplinary Diabetes and Pregnancy Center, Niguarda CàGranda Hospital, Milan, Italy
| | - Arianna Pani
- Department of Clinical Pharmacology and Toxicology, University of Milan, Milan, Italy
| | - Matteo Bonomo
- Diabetes Unit, Interdisciplinary Diabetes and Pregnancy Center, Niguarda CàGranda Hospital, Milan, Italy
| | - Federico Bertuzzi
- Diabetes Unit, Interdisciplinary Diabetes and Pregnancy Center, Niguarda CàGranda Hospital, Milan, Italy
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Chiereghin F, Pianazzola S, Mion E, Fumagalli G, Conti M, Vergani M, Gironi I, Di Vieste G, Bertuzzi F, Pintaudi B. Real-world effectiveness of an ethnic diet plan for the management of gestational diabetes in females at high-risk ethnicity: An observational, prospective, case-control study. Diabet Med 2024:e15311. [PMID: 38356191 DOI: 10.1111/dme.15311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/05/2024] [Accepted: 02/06/2024] [Indexed: 02/16/2024]
Affiliation(s)
- Francesca Chiereghin
- Department of Human Sciences and Quality of Life Promotion, San Raffaele University, Rome, Italy
| | | | - Elena Mion
- Diabetes Unit, Niguarda Cà Granda Hospital, Milan, Italy
| | | | - Matteo Conti
- Department of Endocrinology, Bicocca University, Milan, Italy
| | - Michela Vergani
- Department of Endocrinology, Bicocca University, Milan, Italy
| | - Ilaria Gironi
- Diabetes Unit, Niguarda Cà Granda Hospital, Milan, Italy
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Pintaudi B, Gironi I, Meneghini E, Conti M, Guidoni C, Di Vieste G, Grattieri A, Disoteo O, Mion E, Bertuzzi F. Advanced hybrid closed loop system use in elderly with type 1 diabetes: effectiveness and safety in a prospective, observational, one year follow-up real-world study. Diabetes Obes Metab 2023. [PMID: 36932827 DOI: 10.1111/dom.15055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/11/2023] [Accepted: 03/12/2023] [Indexed: 03/19/2023]
Affiliation(s)
| | - Ilaria Gironi
- Diabetes Unit, Niguarda Cà Granda Hospital, 20162, Milan, Italy
| | - Elena Meneghini
- Diabetes Unit, Niguarda Cà Granda Hospital, 20162, Milan, Italy
| | - Matteo Conti
- Diabetes Unit, Niguarda Cà Granda Hospital, 20162, Milan, Italy
- Bicocca University, Milan, Italy
| | - Chiara Guidoni
- Diabetes Unit, Niguarda Cà Granda Hospital, 20162, Milan, Italy
| | | | - Anna Grattieri
- Diabetes Unit, Niguarda Cà Granda Hospital, 20162, Milan, Italy
| | - Olga Disoteo
- Diabetes Unit, Niguarda Cà Granda Hospital, 20162, Milan, Italy
| | - Elena Mion
- Diabetes Unit, Niguarda Cà Granda Hospital, 20162, Milan, Italy
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De Giglio R, Di Vieste G, Mondello T, Balduzzi G, Masserini B, Formenti I, Lodigiani S, Pallavicini D, Pintaudi B, Mazzone A. Efficacy and Safety of Bioactive Glass S53P4 as a Treatment for Diabetic Foot Osteomyelitis. J Foot Ankle Surg 2021; 60:292-296. [PMID: 33358382 DOI: 10.1053/j.jfas.2020.06.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 05/03/2020] [Accepted: 06/22/2020] [Indexed: 02/03/2023]
Abstract
Osteomyelitis represents a challenging condition in the diabetic foot with an associated high risk of major amputation. S53P4 Bioactive Glass (BG) has bacterial inhibiting properties on the market and indicated to be used in osteomyelitis. The objective of the study was to test the efficacy and safety of BG in treating diabetic foot osteomyelitis. This was an observational, retrospective, single-centre study involving subjects with diabetes affected by osteomyelitis of the foot who underwent surgical debridement from 01/2016 to 10/2018. Overall, 44 diabetic patients (14 [31.8%] female, aged 68.0 ± 10.2 years, diabetes duration 26.8 ± 11.9 years) were studied: 22 (50%) treated with surgical debridement and a local application of BG; 22 (50%) treated by means of surgical debridement. The primary outcome was the osteomyelitis resolution. Revascularization was performed before surgical procedure in 31 (70.5%) of patients. Systemic antibiotics were used in both groups. The osteomyelitis resolution rate was significantly higher in subjects treated with BG than in subjects treated with traditional procedure (18 [90%] vs 13 [61.9%], respectively p = .03). The odds of BG to reach osteomyelitis resolution was 5.54 times greater than for traditional treatment (odds ratio 5.54, 95% confidence interval 1.10-30.5). The use of BG was associated with an 81% lower probability to need additional antibiotic therapy compared to subjects treated with traditional procedure (odds ratio 0.19, 95% confidence interval 0.04-0.87). The debridement of osteomyelitis followed by application of BG could be an effective and safe option in the treatment of osteomyelitis of the diabetic foot.
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Affiliation(s)
- Roberto De Giglio
- Chief, Diabetic Foot Unit, ASST OVEST Milanese, Abbiategrasso Hospital, Milan, Italy.
| | - Giacoma Di Vieste
- Associate Physician, Diabetic Foot Unit, ASST OVEST Milanese, Abbiategrasso Hospital, Milan, Italy
| | - Teresa Mondello
- Associate Physician, Diabetic Foot Unit, ASST OVEST Milanese, Abbiategrasso Hospital, Milan, Italy
| | - Gianmario Balduzzi
- Doctor of Podiatric Medicine, Diabetic Foot Unit, ASST OVEST Milanese, Abbiategrasso Hospital, Milan, Italy
| | - Benedetta Masserini
- Associate Physician, Diabetic Foot Unit, ASST OVEST Milanese, Abbiategrasso Hospital, Milan, Italy
| | - Ilaria Formenti
- Associate Physician, Diabetic Foot Unit, ASST OVEST Milanese, Abbiategrasso Hospital, Milan, Italy
| | - Sara Lodigiani
- Associate Physician, Diabetic Foot Unit, ASST OVEST Milanese, Abbiategrasso Hospital, Milan, Italy
| | - Dario Pallavicini
- Associate Physician, Department of Radiology, Unit, ASST OVEST Milanese, Abbiategrasso Hospital, Milan, Italy
| | - Basilio Pintaudi
- Associate Physician, Diabetes Unit, Niguarda Hospital, Milan, Italy
| | - Antonino Mazzone
- Associate Professor and Director of Department of Internal Medicine, ASST OVEST Milanese, Legnano General Hospital, Milan, Italy
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Balduzzi G, De Giglio R, Masserini B, Formenti I, Lodigiani S, Mondello T, Mumoli N, Pintaudi B, Di Vieste G. Effectiveness, Safety, and Acceptance of an Interim Orthosis in Patients with Diabetes in the Immediate Postoperative Chopart Surgery. INT J LOW EXTR WOUND 2021:15347346211023041. [PMID: 34096795 DOI: 10.1177/15347346211023041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Chopart amputation is the consequence of severe diabetes-related foot complications. A new interim orthosis allowing the patient a greater degree of mobility after Chopart surgery than currently used systems is now available. The aim of this study was to evaluate the effectiveness of the new orthosis compared with traditional treatment. Safety and level of patient acceptance of the device were also investigated. We performed a retrospective case-control observational study involving people with diabetes who underwent Chopart amputation between January 2016 and January 2018. The sample of subjects treated with the innovative orthosis was compared with consecutive patients, who were treated with traditional management. The main study outcomes include major amputation occurrence, ulcer recurrence, healing time, and patient acceptance of the orthosis. Patient satisfaction was evaluated using the Italian validated version of the Orthotic Prosthetic User's Survey (OPUS) questionnaire. Overall, 27 subjects were enrolled using the new device (mean age 68.7 ± 8.4 years, 70.4% males, mean diabetes duration 22.7 ± 15 years). Clinical baseline characteristics were comparable between the cases and the controls. There was no difference between the groups in the healed wound rate (81.5% vs 80.0% for cases and the control group, respectively, P = .53). The ulcer recurrence rate was higher in the control group compared with subjects using the new orthosis (62.5% vs 24.0%, respectively, P = .04). The use of the innovative orthosis was associated with an 81% lower probability to have ulcer recurrence (odds ratio 0.19, 95% confidence interval 0.04-1.04). No between groups difference was detected for a major amputation rate. The wound healing time was faster for cases compared with controls (160.4 ± 114.1 vs 256.5 ± 112.9 days, P = .05). No adverse events related to the use of the new orthosis were recorded. Patient acceptance of the new orthosis was high. This orthosis can be recommended as an efficient, safe, and well-accepted device after Chopart amputation.
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Affiliation(s)
| | | | | | - Ilaria Formenti
- Abbiategrasso Hospital, 9338ASST Ovest Milanese, Milan, Italy
| | - Sara Lodigiani
- Abbiategrasso Hospital, 9338ASST Ovest Milanese, Milan, Italy
| | - Teresa Mondello
- Abbiategrasso Hospital, 9338ASST Ovest Milanese, Milan, Italy
| | - Nicola Mumoli
- Magenta Hospital, 472668ASST Ovest Milanese, Milan, Italy
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Pani A, Gironi I, Di Vieste G, Mion E, Bertuzzi F, Pintaudi B. From Prediabetes to Type 2 Diabetes Mellitus in Women with Polycystic Ovary Syndrome: Lifestyle and Pharmacological Management. Int J Endocrinol 2020; 2020:6276187. [PMID: 32587614 PMCID: PMC7298266 DOI: 10.1155/2020/6276187] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 05/13/2020] [Indexed: 12/20/2022] Open
Abstract
AIMS Despite the very clear association between polycystic ovary syndrome (PCOS) and dysglycemia, few studies have explored the continuum of glycemic alterations leading from minor glucose abnormalities to overt diabetes. The purpose of this review is to trace the natural history of glycemic alteration in women with PCOS. METHODS We performed a literature review without time limit until August 2019. Inclusion criteria were studies addressing the association between impaired glucose tolerance or impaired fasting glucose or type 2 diabetes (T2D) and PCOS with at least an English abstract. The exclusion criteria were no PCOS or impaired glucose tolerance or impaired fasting glucose or T2D as outcome. The outcomes of interest were the onset of impaired glucose tolerance, impaired fasting glucose, T2D, and the progression from impaired glucose tolerance or impaired fasting glucose to T2D. RESULTS Healthy diet and physical activity are the first-line therapy for PCOS. Treatment with metformin was associated with significant lower 2-hour postload glucose levels and with reduction in fasting glucose when compared to placebo. Thiazolidinediones were more effective in reducing fasting glucose levels compared to placebo. Metformin and pioglitazone treatments showed similar effects on fasting glucose levels. The sodium-glucose cotransporter-2 inhibitor empagliflozin did not show differences in metabolic parameters when compared to metformin. The combination therapy with metformin plus the glucagon-like peptide-1 receptor agonist liraglutide was associated with significant improvements in basal and postload glucose levels compared with only liraglutide. Likewise, a combination therapy with the dipeptidyl peptidase-4 inhibitor saxagliptin and metformin demonstrated superiority versus metformin in fasting glucose and oral glucose tolerance test normalization. Myo-inositol supplementation was associated with lower insulin levels, glucose levels, and insulin resistance when compared with placebo, metformin, or estrogen treatments. CONCLUSIONS The use of insulin-sensitizing agents, such as metformin and inositols, along with lifestyle interventions may improve the metabolic profile in PCOS women.
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Affiliation(s)
- Arianna Pani
- Postgraduate School of Clinical Pharmacology and Toxicology, University of Milan, Milan, Italy
| | | | | | - Elena Mion
- Diabetes Unit, Niguarda Cà Granda Hospital, Milan, Italy
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Fraticelli F, Celentano C, Zecca IA, Di Vieste G, Pintaudi B, Liberati M, Franzago M, Di Nicola M, Vitacolonna E. Effect of inositol stereoisomers at different dosages in gestational diabetes: an open-label, parallel, randomized controlled trial. Acta Diabetol 2018; 55:805-812. [PMID: 29774465 DOI: 10.1007/s00592-018-1157-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [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: 02/01/2018] [Accepted: 05/06/2018] [Indexed: 12/20/2022]
Abstract
AIMS Gestational diabetes mellitus (GDM) is the most common metabolic disorder of pregnancy. The aim of the study is to compare the effect of different dosages of inositol stereoisomers supplementation on insulin resistance levels and several maternal-fetal outcomes in GDM women. METHODS Participants were randomly allocated to receive daily: 400 mcg folic acid (control treatment), 4000 mg myo-inositol plus 400 mcg folic acid (MI treatment), 500 mg D-chiro-inositol plus 400 mcg folic acid (DCI treatment) or 1100/27.6 mg myo/D-chiro-inositol plus 400 mcg folic acid (MI plus DCI treatment). The homeostasis model assessment of insulin resistance (HOMA-IR) was measured at the diagnosis of GDM and after 8 weeks of treatment. Secondary outcomes, obstetric outcomes and any maternal or fetal complication at delivery were also collected. RESULTS Eighty GDM women were assigned to one of the four arms of study (20 per arm). A significant delta decrease in HOMA-IR index was found in subjects of MI group without insulin therapy compared to control group (p < 0.001). A lower variation in average weight gain (at delivery vs pre-pregnancy and OGTT period) was detected in MI group vs control group (p = 0.001 and p = 0.019, respectively). Moreover, women exposed to MI and MI plus DCI required a significantly lower necessity of an intensified insulin treatment. Women of the control group had newborns with higher birth weight compared with women treated with inositol (p = 0.032). CONCLUSIONS Our study provides interesting but preliminary results about the potential role of inositol stereoisomers supplementation in the treatment of GDM on insulin resistance levels and several maternal-fetal outcomes. Further studies are required to examine the optimal and effective dosages of different inositol supplements. CLINICAL TRIAL REG. NO.: NCT02097069, ClinicalTrial.gov.
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Affiliation(s)
- Federica Fraticelli
- Department of Medicine and Aging, School of Medicine and Health Sciences, "G. d'Annunzio" University Chieti-Pescara, Via dei Vestini, 66100, Chieti, Italy
| | - Claudio Celentano
- Department of Medicine and Aging, School of Medicine and Health Sciences, "G. d'Annunzio" University Chieti-Pescara, Via dei Vestini, 66100, Chieti, Italy
| | - Isaia Al Zecca
- Department of Medicine and Science of Ageing, School of Hygiene and Preventive Medicine, "G. D'Annunzio" University Chieti-Pescara, Chieti, Italy
| | | | | | - Marco Liberati
- Department of Medicine and Aging, School of Medicine and Health Sciences, "G. d'Annunzio" University Chieti-Pescara, Via dei Vestini, 66100, Chieti, Italy
| | - Marica Franzago
- Department of Medicine and Aging, School of Medicine and Health Sciences, "G. d'Annunzio" University Chieti-Pescara, Via dei Vestini, 66100, Chieti, Italy
| | - Marta Di Nicola
- Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, "G. D'Annunzio" University Chieti-Pescara, Chieti, Italy
| | - Ester Vitacolonna
- Department of Medicine and Aging, School of Medicine and Health Sciences, "G. d'Annunzio" University Chieti-Pescara, Via dei Vestini, 66100, Chieti, Italy.
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Pintaudi B, Di Vieste G. Comment on Farren et al. The Prevention of Gestational Diabetes Mellitus With Antenatal Oral Inositol Supplementation: A Randomized Controlled Trial. Diabetes Care 2017;40:759-763. Diabetes Care 2017; 40:e172. [PMID: 29162587 DOI: 10.2337/dc17-0847] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Muscatello MRA, Troili GM, Pandolfo G, Mento C, Gallo G, Lanza G, Pintaudi B, Di Vieste G, Di Benedetto A, Zoccali RA, Bruno A. [Depression, anxiety and anger in patients with type 1 diabetes mellitus.]. Recenti Prog Med 2017; 108:77-82. [PMID: 28287201 DOI: 10.1701/2636.27098] [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: 11/05/2022]
Abstract
INTRODUCTION The aim of this study is to evaluate the influence of negative emotions such as depression, anxiety and anger on clinical expression of type 1 diabetes, also assessing possible gender differences. MATERIALS AND METHODS 75 subjects with type 1 diabetes mellitus afferent to Diabetology Unit of the University Hospital in Messina underwent the following psychodiagnostic tests: Hamilton Rating Scale For Depression (HDRS), State-Trait Anxiety Inventory form Y (STAI-Y), State-Trait Anger Expression Inventory-2 (STAXI-2). Continuous data were expressed as mean ± standard deviation, and the comparison between groups was performed using T Student test; the data not continuous were expressed as a percentage and the differences between groups were evaluated using Chi-square test. We considered the results for values of p<0.05. RESULTS The mean age of 75 subjects (49.3% males) was 41.0±11.4 years, age of disease onset was 21.1 ± 11.8 years and mean duration of disease was 19.9±11.9 years; 30.7% of subjects were treated with CSII (Subcutaneus Insulin Infusion). Mild levels of depression (HDRS= 10.71±7.9) and anxiety (STAI-Y= 52.37±6.11) were found, whereas STAXI-2 subscales scores were within the normal range. Statistical analysis did not show significant gender differences. DISCUSSION Our results, according to data from literature, confirm the association between negative emotions, particularly anxiety, and diabetes. No gender differences were found. CONCLUSIONS Our results suggest the importance of investigating the association between diabetes and negative emotional states and the psychological and psychopathological dimensions which may have a potential role in the therapeutic management of diabetes.
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Affiliation(s)
- Maria Rosaria Anna Muscatello
- Dipartimento di Scienze biomediche, odontoiatriche e delle immagini morfologiche e funzionali, Università di Messina
| | - Giulia Maria Troili
- Dipartimento di Scienze biomediche, odontoiatriche e delle immagini morfologiche e funzionali, Università di Messina
| | - Gianluca Pandolfo
- Dipartimento di Scienze biomediche, odontoiatriche e delle immagini morfologiche e funzionali, Università di Messina
| | - Carmela Mento
- Dipartimento di Scienze biomediche, odontoiatriche e delle immagini morfologiche e funzionali, Università di Messina
| | - Giuseppa Gallo
- Dipartimento di Scienze biomediche, odontoiatriche e delle immagini morfologiche e funzionali, Università di Messina
| | - Giulia Lanza
- Dipartimento di Scienze biomediche, odontoiatriche e delle immagini morfologiche e funzionali, Università di Messina
| | - Basilio Pintaudi
- Dipartimento di Medicina Clinica e Sperimentale, Università di Messina
| | - Giacoma Di Vieste
- Dipartimento di Medicina Clinica e Sperimentale, Università di Messina
| | | | - Rocco Antonio Zoccali
- Dipartimento di Scienze biomediche, odontoiatriche e delle immagini morfologiche e funzionali, Università di Messina
| | - Antonio Bruno
- Dipartimento di Scienze biomediche, odontoiatriche e delle immagini morfologiche e funzionali, Università di Messina
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Pintaudi B, Di Vieste G, Bonomo M. The Effectiveness of Myo-Inositol and D-Chiro Inositol Treatment in Type 2 Diabetes. Int J Endocrinol 2016; 2016:9132052. [PMID: 27807448 PMCID: PMC5078644 DOI: 10.1155/2016/9132052] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 08/14/2016] [Accepted: 09/20/2016] [Indexed: 12/16/2022] Open
Abstract
Inositol has been used as a supplement in treating several pathologies such as PCOS, metabolic syndrome, and gestational diabetes. Both myo-inositol and its isomer d-chiro-inositol showed insulin mimetic effects in conditions of insulin resistance. Type 2 diabetes (T2DM) is a condition typically caused by insulin resistance. There is a lack of evidence of inositol use in T2DM. We evaluated the effectiveness and safety of myo-inositol and d-chiro-inositol treatment in T2DM. This was a pilot study involving a consecutive sample of patients with T2DM with suboptimal glycemic control (HbA1c 7.0-10.0%) already treated with glucose-lowering agents. Patients (23.1% males, mean age of 60.8 ± 11.7 years) took for three months a combination of myo-inositol (550 mg) and d-chiro-inositol (13.8 mg) orally twice a day as add-on supplement to their glucose-lowering drugs. Possible occurrence of side effects was investigated. After three months of treatment fasting blood glucose (192.6 ± 60.2 versus 160.9 ± 36.4; p = 0.02) and HbA1c levels (8.6 ± 0.9 versus 7.7 ± 0.9; p = 0.02) significantly decreased compared to baseline. There was no significant difference in blood pressure, lipid profile, and BMI levels. None of the participants reported side effects. In conclusion, a supplementation with a combination of myo- and d-chiro-inositol is an effective and safe strategy for improving glycemic control in T2DM.
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Affiliation(s)
- Basilio Pintaudi
- Diabetes Unit, Niguarda Cà Granda Hospital, 20162 Milan, Italy
- *Basilio Pintaudi:
| | | | - Matteo Bonomo
- Diabetes Unit, Niguarda Cà Granda Hospital, 20162 Milan, Italy
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Abstract
CONTEXT Autoimmune thyroid diseases (AITDs) can be associated with type 1 diabetes (DM1). The prevalence of serum antibodies against thyroid hormones (THAb) in subjects with autoimmune diseases other than DM1 is increasing. No data are available for DM1. OBJECTIVE The objectives were evaluate the rate of associated AITD; the rate of positiveness for serum THAb; the panel of THAb based on thyroid hormone interaction and on Ig class; and the association of AITD alone, THAb alone, or AITD plus THAb with diabetes-related complications. DESIGN This was an observational, prospective study with 6-year (2005-2011) follow-up. SETTING The setting was an outpatient diabetes clinic. PATIENTS Fifty-two consecutive subjects (53.8% males; mean age, 37.4 ± 7.4 y; diabetes duration, 19.9 ± 8.2 y) with DM1. All participants completed the study. MAIN OUTCOME MEASURES Main outcome measures were AITD rate; THAb positivity according to hormone interaction and Ig class; association of AITD and THAb with diabetes-related complications. RESULTS AITD rate increased from baseline (34.6%) to follow-up (38.5%). Subjects with DM1 had a high prevalence of THAb (92.3%). The presence of AITD at baseline was associated with subsequent development of macroangiopathy (0 vs 33% at baseline and follow-up, respectively; P = .029). Some THAb patterns, the majority having T3 binding in common, were associated with the progression and development of diabetes-related complications. CONCLUSIONS THAb synthesis in DM1 might be driven by increased glycosylation of thyroglobulin. Anti T3-THAb may cause a relative "tissue hypothyroidism" by sequestering thyroid hormone, this at least partially contributing to worsening diabetes-related vascular complications. In a clinical setting THAb positivity could identify subjects more likely to develop diabetes complications.
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Affiliation(s)
- Salvatore Benvenga
- Department of Clinical and Experimental Medicine (R.V.), Master Program on Childhood, Adolescent and Women's Endocrine Health (S.B.), University of Messina School of Medicine, 98125 Messina, Italy; Interdepartmental Program on Molecular & Clinical Endocrinology (S.B.) and Women's Endocrine Health, University Hospital, University of Messina, 98125 Messina, Italy; Department of Clinical Pharmacology and Epidemiology (B.P.), Fondazione Mario Negri Sud, 66030 Santa Maria Imbaro (CH), Italy; and Department of Clinical and Experimental Medicine (G.D.V., A.D.B.), University of Messina, 98125 Messina, Italy
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Marchetti D, Fraticelli F, Polcini F, Lato R, Pintaudi B, Nicolucci A, Fulcheri M, Mohn A, Chiarelli F, Di Vieste G, Vitacolonna E. Preventing Adolescents' Diabesity: Design, Development, and First Evaluation of "Gustavo in Gnam's Planet". Games Health J 2015; 4:344-51. [PMID: 26287925 PMCID: PMC4545704 DOI: 10.1089/g4h.2014.0107] [Citation(s) in RCA: 18] [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] [Indexed: 11/13/2022] Open
Abstract
Objective: The goal of this study was to design, develop, and evaluate a game for health, “Gustavo in Gnam's Planet” (“Gustavo”), aimed to improve knowledge on healthy foods and to increase consumption of healthy foods. Subjects and Methods: Eighty-three high school students were enrolled in the study. The game was designed and developed by a multidisciplinary team. Behavioral change theories were adopted to guide the design of the health messages. Participants were assessed about food frequency, healthy food knowledge, and the game's interest. Results: Forty-seven subjects (mean age, 14.9±1.0 years; 72.3 percent males) completed the study. At posttest, participants showed significant higher scores (i.e., increased knowledge) in the questionnaire on knowledge of healthy foods (70.0±9.2 versus 71.3±10.0 for pretest and posttest, respectively; P<0.05). Improvements in healthy eating habits were also detected: higher frequency of consumption during a week of white meat (1 [1–2] versus 2 [1–2]; P=0.01), eggs (1 [1–1] versus 1 [1–2]; P=0.01], and legumes (1 [0–1] versus 1 [1–2]; P=0.03) and lower frequency of consumption of sugar-containing packaged snacks (1 [0–1] versus 0 [0–1]; P=0.009). Most of the participants found the game easy to use and clear in its content. Half of the participants found the game interesting. Conclusions: Our study shows that “Gustavo” is a promising tool for health education, in schools or in other environments. Limitations of the study and future directions are discussed.
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Affiliation(s)
- Daniela Marchetti
- 1 Department of Psychological Sciences, Humanities and the Territory, "G. d'Annunzio" University , Chieti-Pescara, Chieti, Italy
| | - Federica Fraticelli
- 2 Department of Medicine and Aging, "G. d'Annunzio" University , Chieti-Pescara, Chieti, Italy
| | | | - Roberto Lato
- 3 "G. d'Annunzio" University , Chieti-Pescara, Chieti, Italy
| | - Basilio Pintaudi
- 4 Department of Clinical Pharmacology and Epidemiology, Fondazione Mario Negri Sud, S. Maria Imbaro, Chieti, Italy
| | - Antonio Nicolucci
- 4 Department of Clinical Pharmacology and Epidemiology, Fondazione Mario Negri Sud, S. Maria Imbaro, Chieti, Italy
| | - Mario Fulcheri
- 1 Department of Psychological Sciences, Humanities and the Territory, "G. d'Annunzio" University , Chieti-Pescara, Chieti, Italy
| | - Angelika Mohn
- 2 Department of Medicine and Aging, "G. d'Annunzio" University , Chieti-Pescara, Chieti, Italy .,5 Center of Excellence on Aging, "G. d'Annunzio" University Foundation , Chieti-Pescara, Chieti, Italy
| | - Francesco Chiarelli
- 2 Department of Medicine and Aging, "G. d'Annunzio" University , Chieti-Pescara, Chieti, Italy .,5 Center of Excellence on Aging, "G. d'Annunzio" University Foundation , Chieti-Pescara, Chieti, Italy
| | - Giacoma Di Vieste
- 5 Center of Excellence on Aging, "G. d'Annunzio" University Foundation , Chieti-Pescara, Chieti, Italy
| | - Ester Vitacolonna
- 2 Department of Medicine and Aging, "G. d'Annunzio" University , Chieti-Pescara, Chieti, Italy .,5 Center of Excellence on Aging, "G. d'Annunzio" University Foundation , Chieti-Pescara, Chieti, Italy
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Pintaudi B, Lucisano G, Pellegrini F, D'Ettorre A, Lepore V, De Berardis G, Scardapane M, Di Vieste G, Rossi MC, Sacco M, Tognoni G, Nicolucci A. The long-term effects of stillbirth on women with and without gestational diabetes: a population-based cohort study. Diabetologia 2015; 58:67-74. [PMID: 25312813 DOI: 10.1007/s00125-014-3403-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [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] [Received: 07/23/2014] [Accepted: 09/09/2014] [Indexed: 11/30/2022]
Abstract
AIMS/HYPOTHESIS The aim of this study was to estimate the incidence of type 2 diabetes (primary objective) and hospitalisation for cardiovascular events (secondary objective) in women with previous gestational diabetes mellitus (GDM) and in those with normal glucose tolerance (NGT) in pregnancy, and to evaluate the role of stillbirth in differentiating the risks. METHODS This was a population-based cohort study using administrative data and involving 12 local health authorities. Women with GDM (n = 3,851) during the index period from 2002 to 2010 were propensity matched with women with NGT (n = 11,553). Information was collected on type 2 diabetes development and hospitalisation for cardiovascular events. RESULTS During a median follow-up of 5.4 years, the incidence rate per 1,000 person-years of type 2 diabetes was 2.1 (95% CI 1.8, 2.5) in women without GDM and 54.0 (95% CI 50.2, 58.0) among women with GDM and pregnancy at term (incidence rate ratio [IRR] 26.9; 95% CI 22.1, 32.7 compared with NGT and pregnancy at term). A history of stillbirth increased the risk of type 2 diabetes development by about twofold, irrespective of GDM status. No significant interaction between stillbirth and GDM on type 2 diabetes risk was found. GDM was associated with a significantly higher risk of cardiovascular events compared with NGT (IRR 2.4; 95% CI 1.5, 3.8). CONCLUSIONS/INTERPRETATION Pregnancy complicated by GDM and ending in stillbirth represents an important contributory factor in determining type 2 diabetes development. Women with GDM are at a high risk of future cardiovascular events. Women with pregnancy complicated by GDM and stillbirth deserve careful follow-up.
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Affiliation(s)
- Basilio Pintaudi
- Department of Clinical Pharmacology and Epidemiology, Fondazione Mario Negri Sud, Via Nazionale, 66030, S. Maria Imbaro (CH), Italy
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Catalano A, Pintaudi B, Morabito N, Di Vieste G, Giunta L, Bruno ML, Cucinotta D, Lasco A, Di Benedetto A. Gender differences in sclerostin and clinical characteristics in type 1 diabetes mellitus. Eur J Endocrinol 2014; 171:293-300. [PMID: 24891138 DOI: 10.1530/eje-14-0106] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [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: 11/08/2022]
Abstract
BACKGROUND Sclerostin is an osteocyte-derived inhibitor of the Wnt/β-catenin signaling pathway, which acts as a negative regulator of bone formation. Published data on sclerostin levels in type 1 diabetes mellitus (T1DM) are few. OBJECTIVE To evaluate gender differences in sclerostin serum levels and the association among sclerostin, bone mass, bone metabolism, and the main clinical characteristics of subjects with T1DM. DESIGN AND METHODS A total of 69 patients with T1DM (mean age, 33.7±8.1; 49% males) were enrolled in this cross-sectional study in a clinical research center. Bone mineral density was measured by phalangeal quantitative ultrasound (QUS); bone turnover markers (urinary pyridinoline, deoxypyridinoline (D-PYR), and urine hydroxyproline (OH-PRO) to evaluate bone resorption; serum bone alkaline phosphatase and BGP to evaluate bone formation) and sclerostin were assessed. RESULTS D-PYR and sclerostin were significantly higher in women when compared with men (P=0.04). A disease duration >15 years was associated with higher sclerostin levels (P=0.03). Bone turnover markers and QUS parameters were not correlated with sclerostin. A significant negative correlation was observed among QUS parameters, BMI, and OH-PRO. Sclerostin serum levels were correlated with homocysteine (r=-0.34, P=0.005) and vitamin B12 (r=-0.31, P=0.02). Generalized linear model showed that macroangiopathy was the only predictor of sclerostin serum levels (β=-11.8, 95% CI from -21.9 to -1.7; P=0.02). CONCLUSIONS Our data demonstrate that women with T1DM exhibit higher sclerostin levels than men and that circulating sclerostin is not associated with bone turnover markers and phalangeal QUS measurements. Macroangiopathy was associated with sclerostin levels.
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Affiliation(s)
- Antonino Catalano
- Department of Clinical and Experimental MedicineUniversity Hospital of Messina, A.O.U. Policlinico 'G.Martino', Via C. Valeria, 98125 Messina, ItalyDepartment of Clinical Pharmacology and EpidemiologyFondazione Mario Negri Sud, Santa Maria Imbaro (CH), Italy
| | - Basilio Pintaudi
- Department of Clinical and Experimental MedicineUniversity Hospital of Messina, A.O.U. Policlinico 'G.Martino', Via C. Valeria, 98125 Messina, ItalyDepartment of Clinical Pharmacology and EpidemiologyFondazione Mario Negri Sud, Santa Maria Imbaro (CH), Italy
| | - Nancy Morabito
- Department of Clinical and Experimental MedicineUniversity Hospital of Messina, A.O.U. Policlinico 'G.Martino', Via C. Valeria, 98125 Messina, ItalyDepartment of Clinical Pharmacology and EpidemiologyFondazione Mario Negri Sud, Santa Maria Imbaro (CH), Italy
| | - Giacoma Di Vieste
- Department of Clinical and Experimental MedicineUniversity Hospital of Messina, A.O.U. Policlinico 'G.Martino', Via C. Valeria, 98125 Messina, ItalyDepartment of Clinical Pharmacology and EpidemiologyFondazione Mario Negri Sud, Santa Maria Imbaro (CH), Italy
| | - Loretta Giunta
- Department of Clinical and Experimental MedicineUniversity Hospital of Messina, A.O.U. Policlinico 'G.Martino', Via C. Valeria, 98125 Messina, ItalyDepartment of Clinical Pharmacology and EpidemiologyFondazione Mario Negri Sud, Santa Maria Imbaro (CH), Italy
| | - Maria Lucia Bruno
- Department of Clinical and Experimental MedicineUniversity Hospital of Messina, A.O.U. Policlinico 'G.Martino', Via C. Valeria, 98125 Messina, ItalyDepartment of Clinical Pharmacology and EpidemiologyFondazione Mario Negri Sud, Santa Maria Imbaro (CH), Italy
| | - Domenico Cucinotta
- Department of Clinical and Experimental MedicineUniversity Hospital of Messina, A.O.U. Policlinico 'G.Martino', Via C. Valeria, 98125 Messina, ItalyDepartment of Clinical Pharmacology and EpidemiologyFondazione Mario Negri Sud, Santa Maria Imbaro (CH), Italy
| | - Antonino Lasco
- Department of Clinical and Experimental MedicineUniversity Hospital of Messina, A.O.U. Policlinico 'G.Martino', Via C. Valeria, 98125 Messina, ItalyDepartment of Clinical Pharmacology and EpidemiologyFondazione Mario Negri Sud, Santa Maria Imbaro (CH), Italy
| | - Antonino Di Benedetto
- Department of Clinical and Experimental MedicineUniversity Hospital of Messina, A.O.U. Policlinico 'G.Martino', Via C. Valeria, 98125 Messina, ItalyDepartment of Clinical Pharmacology and EpidemiologyFondazione Mario Negri Sud, Santa Maria Imbaro (CH), Italy
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Pintaudi B, Di Vieste G, Corrado F, Lucisano G, Pellegrini F, Giunta L, Nicolucci A, D'Anna R, Di Benedetto A. Improvement of selective screening strategy for gestational diabetes through a more accurate definition of high-risk groups. Eur J Endocrinol 2014; 170:87-93. [PMID: 24114434 DOI: 10.1530/eje-13-0759] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [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: 12/25/2022]
Abstract
OBJECTIVE This study aimed to assess the predictive value of risk factors (RFs) for gestational diabetes mellitus (GDM) established by selective screening (SS) and to identify subgroups of women at a higher risk of developing GDM. DESIGN A retrospective, single-center study design was employed. METHODS Data of 1015 women screened for GDM at 24-28 weeks of gestation and diagnosed according to the International Association of Diabetes and Pregnancy Study Groups criteria were evaluated. Information on RFs established by SS was also collected and their association with GDM was determined. To identify distinct and homogeneous subgroups of patients at a higher risk, the RECursive Partitioning and AMalgamation (RECPAM) method was used. RESULTS Overall, 113 (11.1%) women were diagnosed as having GDM. The application of the SS criteria would result in the execution of an oral glucose tolerance test (OGTT) in 58.3% of women and 26 (23.0%) cases of GDM would not be detected due to the absence of any RF. The RECPAM analysis identified high-risk subgroups characterized by fasting plasma glucose values >5.1 mmol/l (odds ratio (OR)=26.5; 95% CI 14.3-49.0) and pre-pregnancy BMI (OR=7.0; 95% CI 3.9-12.8 for overweight women). In a final logistic model including RECPAM classes, previous macrosomia (OR=3.6; 95% CI 1.1-11.6), and family history of diabetes (OR=1.8; 95% CI 1.1-2.8), but not maternal age, were also found to be associated with an increased risk of developing GDM. A screening approach based on the RECPAM model would reduce by over 50% (23.0 vs 10.6%) the number of undiagnosed GDM cases when compared with the current SS approach, at the expense of 50 additional OGTTs required. CONCLUSIONS A screening approach based on our RECPAM model results in a significant reduction in the number of undetected GDM cases compared with the current SS procedure.
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Affiliation(s)
- Basilio Pintaudi
- Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, Via Nazionale, 66030 S. Maria Imbaro (CH), Italy
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Lacquaniti A, Donato V, Pintaudi B, Di Vieste G, Chirico V, Buemi A, Di Benedetto A, Arena A, Buemi M. "Normoalbuminuric" diabetic nephropathy: tubular damage and NGAL. Acta Diabetol 2013; 50:935-42. [PMID: 23754672 DOI: 10.1007/s00592-013-0485-7] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [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] [Received: 12/08/2012] [Accepted: 05/21/2013] [Indexed: 12/11/2022]
Abstract
The aim of this study was to demonstrate that neutrophil gelatinase-associated lipocalin (NGAL) increased before the onset of microalbuminuria in patients with type 1 diabetes mellitus (T1DM), representing an important biochemical parameter with high sensitivity and specificity to make a precocious diagnosis of "normoalbuminuric" diabetic nephropathy (DN). Serum NGAL (sNGAL) and urinary NGAL (uNGAL) levels were evaluated in a cohort of fifty patients affected by T1DM. They had no signs of clinical nephropathy. Thirty-five healthy subjects (HS) were recruited. sNGAL levels were significantly higher compared with those measured in HS [193.7 (103.2-405.4) vs. 46.4 (39.8-56.2) ng/ml; p < 0.0001], as were uNGAL levels [25.5 (14.2-40.2) vs. 6.5 (2.9-8.5) ng/ml; p < 0.0001]. sNGAL was found to be directly correlated with glycated hemoglobin. uNGAL also positively correlated with albuminuria, whereas an inverse correlation was found with uric acid. After multivariate analysis, significance was maintained for the correlation between uNGAL and microalbuminuria. In ROC analysis, sNGAL showed a good diagnostic profile such as uNGAL. NGAL increases in patients with T1DM, even before diagnosis of microalbuminuria representing an early biomarker of "normoalbuminuric" DN with a good sensitivity and specificity. NGAL measurement could be useful for the evaluation of early renal involvement in the course of diabetes.
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Irace C, Marini H, Bitto A, Altavilla D, Polito F, Adamo EB, Arcoraci V, Minutoli L, Di Benedetto A, Di Vieste G, de Gregorio C, Gnasso A, Corrao S, Licata G, Squadrito F. Genistein and endothelial function in postmenopausal women with metabolic syndrome. Eur J Clin Invest 2013; 43:1025-31. [PMID: 23899172 DOI: 10.1111/eci.12139] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 07/06/2013] [Indexed: 12/24/2022]
Abstract
BACKGROUND Previous data have suggested that genistein could exert beneficial effects on endothelial function and on predictors of cardiovascular risk in healthy postmenopausal women. In a randomized clinical trial, we studied the effects of genistein on endothelial function in postmenopausal women with metabolic syndrome (MS). METHODS Twenty postmenopausal women with MS, according to modified NCEP-ATP III criteria were randomly assigned to receive placebo or genistein (54 mg/day) for 6 months, along with a Mediterranean-style diet. Postmenopausal women without MS (n = 15), served as controls. The primary goal was the assessment of endothelial function by flow-mediated vasodilation (FMD) of brachial artery; moreover, time-to-peak dilation in the FMD response has been evaluated. Secondary outcomes were fasting glucose, fasting insulin, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, visfatin, adiponectin and homocysteine blood levels. Data on adverse events were also recorded. RESULTS After 6 months of treatment, FMD at 50s and peak FMD significantly increased in genistein recipients compared with placebo. Moreover, genistein significantly decreased the blood levels of total cholesterol, triglycerides, homocysteine and visfatin compared with placebo, while blood adiponectin levels were increased. Genistein recipients neither experienced more side-adverse effects than placebo nor discontinued the study. CONCLUSIONS Six months of treatment with genistein effectively improves brachial artery flow-mediated vasodilation in postmenopausal women with metabolic syndrome.
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Affiliation(s)
- Concetta Irace
- Department of Experimental and Clinical Medicine, University "Magna Graecia", Catanzaro, Italy
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Squadrito F, Marini H, Bitto A, Altavilla D, Polito F, Adamo EB, D'Anna R, Arcoraci V, Burnett BP, Minutoli L, Di Benedetto A, Di Vieste G, Cucinotta D, de Gregorio C, Russo S, Corrado F, Saitta A, Irace C, Corrao S, Licata G. Genistein in the metabolic syndrome: results of a randomized clinical trial. J Clin Endocrinol Metab 2013; 98:3366-74. [PMID: 23824420 DOI: 10.1210/jc.2013-1180] [Citation(s) in RCA: 112] [Impact Index Per Article: 10.2] [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: 12/11/2022]
Abstract
CONTEXT This study was performed to evaluate the effects of genistein on metabolic and cardiovascular risk factors in Caucasian postmenopausal subjects with metabolic syndrome (MetS). OBJECTIVE Our objective was to assess the effects of genistein on surrogate endpoints associated with diabetes and cardiovascular disease. DESIGN AND SETTING This was a randomized, double-blind, placebo-controlled trial at 3 university medical centers in Italy. PATIENTS Patients included 120 postmenopausal women with MetS according to modified Third Report of the National Cholesterol Education Program (NCEP), Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) criteria. INTERVENTION After a 4-week stabilization period, postmenopausal women with MetS were randomly assigned to receive placebo (n = 60) or 54 mg genistein daily (n = 60) for 1 year. MAIN OUTCOME MEASURES The primary outcome was homeostasis model assessment for insulin resistance (HOMA-IR) at 1 year. Secondary outcomes were fasting glucose, fasting insulin, total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, visfatin, adiponectin, and homocysteine levels. Data on adverse events were also recorded. RESULTS At 1 year in genistein recipients, fasting glucose, fasting insulin, and HOMA-IR (mean from 4.5 to 2.7; P < .001) decreased and were unchanged in placebo recipients. Genistein statistically increased HDL-C (mean from 46.4 to 56.8 mg/dL) and adiponectin and decreased total cholesterol, LDL-C (mean from 108.8 to 78.7 mg/dL), triglycerides, visfatin, and homocysteine (mean from 14.3 to 11.7 μmol/L) blood levels. Systolic and diastolic blood pressure was also reduced in genistein recipients. Genistein recipients neither experienced more side adverse effects than placebo nor discontinued the study. CONCLUSION One year of treatment with genistein improves surrogate endpoints associated with risk for diabetes and cardiovascular disease in postmenopausal women with MetS.
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Affiliation(s)
- Francesco Squadrito
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy.
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