Overweight and Obesity in Southern Italy: their association with social and life-style characteristics and their effect on levels of biologic markers.

BACKGROUND: In the last decades, overweight and obesity have been transformed from minor public health issues to a major threat to public health affecting the most affluent societies and also the less developed ones. OBJECTIVES: To estimate overweight-obesity prevalence in adults, their association with some social determinants and to assess the effect of these two conditions on levels of biologic and biochemical characteristics, by means of a population-based study. METHODS: A random sample of the general population of Putignano was drawn. All participants completed a general pre-coded and a Food Frequency questionnaire; anthropometric measures were taken and a venous blood sample was drawn. All subjects underwent liver ultra-sonography. Data description was done by means of tables and then Quantile Regression was performed. RESULTS: Overall prevalence of overweight and obesity were 34.5% and 16.1% respectively. Both overweight and obesity were more frequent among male, married and low socio-economic position subjects. There were increasing frequencies of normal weight with higher levels of education. Overweight and obese subjects had more frequently Nonalcoholic Fatty Liver Disease, Hypertension and altered biochemical markers. Quantile regression showed a statistically significant association of age with overweight and obesity (maximum about 64.8 yo), gender (female) and low levels of education in both overweight and obesity. More than 10 gr/day of wine intake was associated with overweight. CONCLUSIONS: The prevention and treatment of overweight/obesity on a population wide basis are needed. Population-based strategies should also improve social and physical environmental contexts for healthful lifestyles.

Overweight and Obesity in Southern Italy: their association with social and life-style characteristics and their effect on levels of biologic markers / Overweight and Obesity in Southern Italy: their association with social and life-style characteristics and their effect on levels of biologic markers.

BACKGROUND: In the last decades, overweight and obesity have been transformed from minor public health issues to a major threat to public health affecting the most affluent societies and also the less developed ones. OBJECTIVES: To estimate overweight-obesity prevalence in adults, their association with some social determinants and to assess the effect of these two conditions on levels of biologic and biochemical characteristics, by means of a population-based study. METHODS: A random sample of the general population of Putignano was drawn. All participants completed a general pre-coded and a Food Frequency questionnaire; anthropometric measures were taken and a venous blood sample was drawn. All subjects underwent liver ultra-sonography. Data description was done by means of tables and then Quantile Regression was performed. RESULTS: Overall prevalence of overweight and obesity were 34.5

respectively. Both overweight and obesity were more frequent among male, married and low socio-economic position subjects. There were increasing frequencies of normal weight with higher levels of education. Overweight and obese subjects had more frequently Nonalcoholic Fatty Liver Disease, Hypertension and altered biochemical markers. Quantile regression showed a statistically significant association of age with overweight and obesity (maximum about 64.8 yo), gender (female) and low levels of education in both overweight and obesity. More than 10 gr/day of wine intake was associated with overweight. CONCLUSIONS: The prevention and treatment of overweight/obesity on a population wide basis are needed. Population-based strategies should also improve social and physical environmental contexts for healthful lifestyles.

Manganese superoxide dismutase activity and incidence of hepatocellular carcinoma in patients with Child-Pugh class A liver cirrhosis: a 7-year follow-up study.

AIMS: To evaluate possible modifications in the manganese superoxide dismutase (MnSOD) activity during neoplastic transformation of a cirrhotic liver and to find out whether its assessment may have predictive value to identify cirrhotic patients at a higher risk of hepatocellular carcinoma (HCC). METHODS: Seventy-one consecutive subjects with Child-Pugh class A liver cirrhosis were recruited. At the time of enrolment, HCC was diagnosed in 20 cirrhotic patients. The 51 cirrhotic patients without HCC were followed up for the occurrence of tumour by 6-monthly screening for 7 years. During follow-up, 16 patients developed HCC. Seventy healthy subjects formed the control group. MnSOD activity was assayed spectrophotometrically. RESULTS: Serum MnSOD activity was significantly lower in 70 healthy subjects compared with 51 cirrhotic patients and 20 cirrhotic patients with HCC. Cirrhotic patients who developed HCC during follow-up showed significantly higher values of MnSOD activity than HCC-free patients. The best cut-off of MnSOD activity was 0.40 U/ml. At this cut-off, chi2 analysis revealed that MnSOD activity was significantly different between the HCC-free cirrhotic patients and cirrhotic patients who developed HCC. CONCLUSION: The present findings suggest that during neoplastic transformation of cirrhotic liver, an increase in MnSOD activity may occur already during the precancerous phase, making this enzyme a probable malignancy-associated parameter.

Characteristics at presentation and outcome of hepatocellular carcinoma (HCC) in the elderly. A study of the Cancer of the Liver Italian Program (CLIP).

PURPOSE: To describe the characteristics at presentation and the outcome of elderly patients (> or =70 years old) with HCC, a retrospective analysis using a CLIP database was performed. PATIENTS AND METHODS: The database included 650 patients. Chi2-test, logistic and Cox model were applied. RESULTS: Baseline characteristics and stage were similarly among elderly (n=158) and non-elderly (n=492) patients. More elderly patients did not receive any local treatment (56% versus 38%, p<0.0001). Age and CLIP score were independently predictive of the odds of locoregional treatment. Prognosis was worse for elderly patients with a hazard ratio of death of 1.49 (95% CI 1.20-1.86) at multivariable analysis. The survival difference disappeared when patients were compared within each treatment group, suggesting a close link between undertreatment and shorter survival. CONCLUSION: Elderly patients with HCC have a worse prognosis compared to non-elderly ones. Such difference seems the consequence of undertreatment.

Serum retinol and risk of hepatocellular carcinoma in patients with child-Pugh class A cirrhosis.

Liver cirrhosis is the main risk factor for the development of human hepatocellular carcinoma (HCC). In this condition, the liver and plasma suffer a drastic depletion of retinoids. This study was conducted to investigate whether any relation exists between serum retinol levels and HCC development in cirrhotics. Seventy child-Pugh class A cirrhotic patients, 16 child-Pugh class A cirrhotic patients with HCC, and 140 age- and sex-matched subjects were included in this study. At the time of enrollment, fasting blood samples were taken to determine serum retinol levels. For the following 7 years, the 70 cirrhotic patients were also followed up for the occurrence of HCC by periodic screening with ultrasonography and serum alpha-fetoprotein assays. The serum retinol levels in both cirrhotic patients and HCC patients were significantly lower than those in healthy subjects. Among the 70 cirrhotic patients, 14 HCC were detected during follow-up. The prediagnostic retinol levels were significantly lower in cirrhotic patients who developed HCC compared with patients who did not. The odds ratio of cirrhotic patients who developed HCC in the lowest tertile to highest tertile of retinol status was 6.75 (95% CI=1.26--36.0; P=0.015). Our results suggest that a state of retinoid deficiency may promote hepatocarcinogenesis in patients at high risk such as cirrhotics.