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1.
Liver Int ; 36(3): 427-33, 2016 Mar.
Article in English | MEDLINE | ID: mdl-26346413

ABSTRACT

BACKGROUND & AIMS: Fatty liver is associated with alcohol habits and/or overweight/obesity. We challenged several lifestyle features associated with fatty liver and, particularly, with non-alcoholic fatty liver disease (NAFLD). Among them, sleep shortage as a result of nightlife habits and a preference for plus-size fashion were assessed. The latter consists of fashionable plus-sized clothing for actual individuals' size and reflects a frequent attitude of some social or age groups, conceivably indicating more global and widespread trend and behaviour. METHODS: We studied a group of 708 non-diabetic youngsters, 458 women and 250 men, 21.72 Ā± 3.71 years old (range 15-35 years), referred for minor digestive ailments for clinical assessment, ultrasound detection of fatty liver and nutritional counselling. Details of personal history regarding lifestyle, food intake frequency and alcohol intake, dietary and physical exercise profile, sleep duration and clothing preferences were recorded. RESULTS: The prevalence of NAFLD in this cohort of youngsters is 67/708 (9.4%). Even if it is quantitatively very low in both groups, the average alcohol intake, always below 20 g/day, is greater in NAFLD subjects (5.83 Ā± 4.32 g) vs. subjects with normal liver (2.02 Ā± 3.20 g). The number of meals/day and adherence to a Mediterranean diet profile are smaller in NAFLD subjects. By multiple regression, BMI, sedentary life, plus-sized clothing for their actual size, sleep shortage and lower frequency of daily food intake are associated with the presence of NAFLD. CONCLUSIONS: Onset and continuation of fatty liver disease, beyond food and exercise quantity and quality, with their effects on obesity, may also be associated with other aspects of lifestyle.


Subject(s)
Clothing , Diet , Exercise , Feeding Behavior , Life Style , Meals , Non-alcoholic Fatty Liver Disease/epidemiology , Sleep Wake Disorders/epidemiology , Sleep , Adolescent , Adolescent Behavior , Adult , Age Factors , Appetite Regulation , Body Mass Index , Diet/adverse effects , Diet, Mediterranean , Female , Health Behavior , Humans , Italy/epidemiology , Male , Non-alcoholic Fatty Liver Disease/diagnosis , Non-alcoholic Fatty Liver Disease/prevention & control , Nutritional Status , Obesity/diagnosis , Obesity/epidemiology , Prevalence , Prospective Studies , Risk Factors , Risk Reduction Behavior , Sedentary Behavior , Sleep Wake Disorders/diagnosis , Sleep Wake Disorders/physiopathology , Sleep Wake Disorders/prevention & control , Young Adult
3.
Acta Radiol ; 56(7): 798-805, 2015 Jul.
Article in English | MEDLINE | ID: mdl-24951615

ABSTRACT

BACKGROUND: Despite the usefulness of elastography in assessing the stiffness/elasticity of tissues, and its proven diagnostic accuracy in thyroid, breast, and prostate cancers, among others, it is not yet applied in transthoracic ultrasound (TUS) scans to investigate lung nodules. PURPOSE: To investigate the potential clinical utility of TUS elastography in diagnosing lung cancer proven by fine-needle aspiration biopsy (FNAB). MATERIAL AND METHODS: TUS elastography was performed in 95 consecutive patients (71 men, 24 women; age, 62.84 Ā± 7.37 years) with lesions suspected of involving the chest wall or the pleura detected on chest X-ray or computed tomography (CT). Patients with pleural effusions were not enrolled, but were further evaluated by pleural fluid cytology. Patients were excluded from the study if a diagnosis had already been made based on sputum cytology and/or bronchoscopic histology (making TUS biopsy unnecessary) or if their lung lesions could not be visualized under standard US. Under FNAB, 34 consolidations were ascribed to pneumonia and 65 to cancer. Under TUS, tissue stiffness, detected using a convex multifrequency 2-8-mHz probe and a MyLab™Twice - ElaXto, was scored from 1 (greatest elasticity) to 5 (no elasticity). Subpleural solid masses (2-5 cm) were initially detected by TUS and subsequently assessed by FNAB. RESULTS: Histological diagnoses were: small cell lung cancer (4/61), adenocarcinoma (29/61), squamous cell carcinoma (SCC) (12/61), large cell lung carcinoma (12/61), and lymphomas (4/61). Patients' age and mass sizes (3.06 Ā± 0.88 cm) were not significantly associated with any histological type. A significant lower elasticity of SCC (4.67 Ā± 0.492) was observed versus other types of lung cancer (P < 0.005), and versus pneumonia (2.35 Ā± 0.48). CONCLUSION: Since only squamous cell lung carcinoma displays the feature of significantly reduced elasticity, and since no clear-cut diagnostic key is yet available, the clinical usefulness of TUS elastography is currently limited with a view to characterizing tumors. Nevertheless, it does enable good non-invasive imaging of lung nodules, providing information on their stiffness, and can improve the accuracy and yield of FNAB.


Subject(s)
Carcinoma/diagnostic imaging , Elasticity Imaging Techniques/methods , Lung Neoplasms/diagnostic imaging , Lymphoma/diagnostic imaging , Small Cell Lung Carcinoma/diagnostic imaging , Ultrasonography, Interventional , Biopsy, Fine-Needle , Carcinoma/pathology , Female , Humans , Lung/diagnostic imaging , Lung/pathology , Lung Neoplasms/pathology , Lymphoma/pathology , Male , Middle Aged , Reproducibility of Results , Small Cell Lung Carcinoma/pathology
4.
Radiol Med ; 119(10): 729-40, 2014 Oct.
Article in English | MEDLINE | ID: mdl-24496592

ABSTRACT

Interest in transthoracic ultrasound (US) procedures increased after the availability of portable US equipment suitable for use at the patient's bedside. It is possible to detect space-occupying lesions of the pleura, pleural effusion, focal or diffuse pleural thickening and subpleural lesions of the lung, even in emergency settings. Transthoracic US is useful as a guidance system for thoracentesis and peripheral lesion biopsy, where it minimises the occurrence of pneumothorax and haemorrhage. Transthoracic US imaging is strongly influenced by physical interaction of the ultrasonic beam at the tissue/air interface, which gives rise to reverberations classified as simple (A-line), "comet tail" and "ring down"(B-line) artifacts. Although these artifacts can be suggestive of a disease condition, they are essentially imaging errors present even in normal subjects and in empty-pleura post-pneumonectomy patients. In order to clarify some confusion and to report on the state of the art, we present a review of the literature on transthoracic US in diseases of the pleura and peripheral lung regions and our own clinical experience over 3 decades. The review focuses on quality assurance procedures and their value in diagnostic imaging and patient monitoring and warns against possible inappropriate indications and misleading information. Thoracic US is much more than "fishing for the moon in the well".


Subject(s)
Endoscopic Ultrasound-Guided Fine Needle Aspiration , Lung Diseases/diagnostic imaging , Lung Diseases/pathology , Pleural Diseases/diagnostic imaging , Pleural Diseases/pathology , Artifacts , Humans , Predictive Value of Tests , Pulmonary Disease, Chronic Obstructive/diagnostic imaging , Reproducibility of Results , Sensitivity and Specificity , Ultrasonography/methods , Ultrasonography, Interventional/methods
5.
Ren Fail ; 35(5): 615-23, 2013.
Article in English | MEDLINE | ID: mdl-23534584

ABSTRACT

BACKGROUND: Association of methylenetetrahydrofolate reductase (MTHFR) 677C>T gene polymorphism with hyperhomocysteinemia, renal failure, and cardiovascular events is controversial. We investigated the relationship of MTHFR 677C>T polymorphisms with left ventricular hypertrophy (LVH) and renal insufficiency. METHODS: Glomerular filtration rate (GFR) and left myocardial ventricular mass/m2 were assessed in 138 non-diabetic subjects (age, 50.93 Ā± 14.85 years; body mass index, 27.95 Ā± 5.98 kg/m(2)), 38 no-mutation wild MTHFR C677CC, 52 heterozygous MTHFR C677CT, and 48 homozygous MTHFR C677TT, all with adequate adherence to current international healthy dietary guidelines. Serum homocysteine, insulin resistance, high-sensitivity C-reactive-protein (hsCRP), parathyroid hormone, and renal artery resistive index (RRI) were challenged by odds ratio analysis and multiple linear regression models. RESULTS: MTHFR 677C>T polymorphism showed higher GFR (73.8 Ā± 27.99 vs. 58.64 Ā± 29.95; p= 0.001) and lower renal failure odds (OR, 0.443; 95% confidence interval, 0.141-1.387) in comparison with wild MTHFR genotype. A favorable effect on GFR of MTHFR polymorphism is presented independently by the negative effects of LVH, increased intra-renal arterial resistance, and hyperparathyroidism; GFR is the significant predictive factor to LVH. CONCLUSIONS: Renal insufficiency in non-diabetic subjects is explained by interactions of MTHFR C677T polymorphism mutation with LVH, hsCRP, intact parathyroid hormone (iPTH), and RRI. Sign of these predictive effects is opposite: subjects with MTHFR 677C>T polymorphism have lower likelihood of renal insufficiency; differently, wild-type MTHFR genotype subjects have lower GFR and greater hsCRP, iPTH, RRI, and LVH.


Subject(s)
Hypertrophy, Left Ventricular/genetics , Methylenetetrahydrofolate Reductase (NADPH2)/genetics , Renal Insufficiency/genetics , Adult , Aged , C-Reactive Protein/metabolism , Diet , Female , Glomerular Filtration Rate , Humans , Insulin Resistance , Linear Models , Male , Middle Aged , Parathyroid Hormone/blood , Polymorphism, Single Nucleotide
6.
J Clin Gastroenterol ; 46(6): e46-54, 2012 Jul.
Article in English | MEDLINE | ID: mdl-22476041

ABSTRACT

OBJECTIVE: Adenoviruses Ad36 and Ad37 increase adiposity in animals and are associated with obesity in humans; effects on the liver have been reported. The association of Adenovirus Ad36 seropositivity (Ad36+) with obesity but not with the severity of nonalcoholic fatty liver disease (NAFLD) has been previously shown. We investigate whether nondiabetic Ad37+ patients show a different prevalence of NAFLD and ultrasound Bright Liver score. PATIENTS: A total of 268 adult nondiabetic patients (146 men, 122 women) were included after lifestyle counseling including a personalized Mediterranean diet, increase in physical activity, and smoking withdrawal. After an Ad37+/Ad36+ assay, overweight obesity, insulin resistance, C-reactive protein, and bright liver prevalence and severity were compared according to Ad37+. RESULTS: Sixty-five of 268 patients were Ad37+ and 82/268 patients were both Ad37 seronegative (Ad37-) and Ad36-. The prevalence of obesity, defined as body mass index≥30, was not significantly different in Ad37+ (11/65; 16.9%) vs. Ad37- (15/82; 18.2%) patients; Bright Liver was present in 22/65 (33.8%) Ad37+ patients vs. 13/82 (15.8%) Ad37- patients (P<0.019). By odds ratio (OR), a consistent risk for NAFLD was associated with Ad37+, greater insulin resistance, and C-reactive protein. By a predictive multiple linear regression model, 40.0% of variance toward NAFLD and 50.4% toward the severity of Bright Liver score was explained significantly and independently by Ad37+ and by body mass index. CONCLUSIONS: Ad37+ status in nondiabetic patients on an appropriate diet is significantly associated with NAFLD; because fatty liver improves even without weight loss by a "healthy" diet, and not only by lower food caloric intake, Ad37+ may be an adjunctive hallmark of an unfavorable clinical-metabolic profile, if not a causative factor of NAFLD.


Subject(s)
Adenovirus Infections, Human/complications , Fatty Liver/physiopathology , Life Style , Obesity/epidemiology , Adenovirus Infections, Human/virology , Adenoviruses, Human/isolation & purification , Adult , Body Mass Index , C-Reactive Protein/metabolism , Diet, Mediterranean , Fatty Liver/etiology , Fatty Liver/virology , Female , Humans , Insulin Resistance , Linear Models , Male , Middle Aged , Motor Activity , Non-alcoholic Fatty Liver Disease , Obesity/virology , Prevalence , Severity of Illness Index , Smoking Cessation
7.
Dig Dis Sci ; 57(2): 535-44, 2012 Feb.
Article in English | MEDLINE | ID: mdl-21953137

ABSTRACT

BACKGROUND: Obesity and liver steatosis are both currently attributed to inappropriate lifestyle and nutrition. Higher prevalence of human adenovirus Ad36 seropositivity (Ad36+) is reported only in obesity. AIMS: To investigate whether a lifestyle-nutritional intervention achieves different outcomes in NAFLD patients, i.e., if is blunted or enhanced according to Ad36 seropositivity status. METHODS: One-year nutritional intervention was planned and accomplished for 62 non-alcoholic fatty liver disease overweight-obese patients, studied by liver ultrasound, evaluating Bright Liver Score (BLS), by Homeostatic Model assessment of Insulin Resistance (HOMA), by body composition and Ad36+ assay. Lower salt/lower calories Mediterranean diet, physical activity increase, smoking withdrawal and lifestyle counseling, provided by a health psychologist, were given. RESULTS: Ad36 seropositive patients have baseline greater BMI with the same level of BLS. Different prevalence of post-interventional response, significantly greater among Ad36+ patients, is observed: greater decrease of obesity, assessed by BMI, greater reduction of insulin resistance, assessed by HOMA and higher prevalence of bright liver disappearance. A BMI-adjusted multiple linear regression model explains significantly 23.8% (p < 0.04) of the variance; significant predictive variables are Ad36 seropositivity (p < 0.012) and fat mass loss (p < 0.011) accounting for the variance of the occurrence of bright liver disappearance. CONCLUSIONS: Ad36 previous infection is significantly associated with enhanced weight loss, bright liver disappearance, and recovery of insulin sensitivity through the chosen tailored nutritional interventional treatment. Nonetheless, Ad36 seronegative NAFLD patients' fatty liver pattern improves, at a lower extent, also without significant weight loss: an effect of dietary changes profile, Mediterranean diet, not only of lowered food caloric intake, is conceivably operating.


Subject(s)
Adenovirus Infections, Human/immunology , Adenoviruses, Human/immunology , Fatty Liver/immunology , Obesity/virology , Adenovirus Infections, Human/epidemiology , Adenoviruses, Human/pathogenicity , Adult , Body Mass Index , Comorbidity , Diet, Mediterranean , Fatty Liver/epidemiology , Fatty Liver/virology , Female , Health Behavior , Humans , Insulin Resistance/physiology , Life Style , Male , Middle Aged , Non-alcoholic Fatty Liver Disease , Nutrition Assessment , Obesity/epidemiology , Obesity/prevention & control , Seroepidemiologic Studies
8.
Endocr Res ; 37(2): 47-58, 2012.
Article in English | MEDLINE | ID: mdl-22007967

ABSTRACT

INTRODUCTION: The renal resistive index (RRI) reflects intrarenal vascular resistance and stiffness, which are associated with chronic kidney disease. The links connecting renal function, intrarenal arterial resistance, and parathyroid hormone (PTH) with hypertension and metabolic factors remain elusive. The aim of this study is to investigate the possible relationship of RRI with glomerular filtration rate, PTH, hypertension, obesity (body mass index and waist-to-hip ratio), bioelectrical impedance analysis in body composition assessment, serum lipids, and insulin resistance assessed by homoeostasis model insulin resistance index. PATIENTS AND METHODS: This study was carried out on 387 (246 women, 141 men) nondiabetic patients, between >25 and <75 years, referred to an Internal Medicine Clinic and Day Hospital for essential hypertension, overweightness-obesity, and/or dyslipidemia. Lower salt/lower calorie Mediterranean diet, physical activity increase, smoking withdrawal, and lifestyle counseling, provided by a health psychologist support, were prescribed. RESULTS: Higher hypertension risk, present in 42.5% of the overall group of eligible patients (164/387), is associated with high PTH and high RRI, along with greater renal insufficiency, insulin resistance, and obesity. There is a straight linear relationship of RRI to PTH (0.202; p=0.009) in arterial hypertension, which is not observed in normal blood pressure patients. By gender-adjusted multiple linear regression analysis, it was found that fat mass, waist-to-hip ratio, and PTH account significantly for 62.3% of the variance to RRI in hypertensive patients. CONCLUSION: Increased arterial stiffness and intrarenal arterial resistance are associated with higher PTH in arterial hypertension; obesity (defined by greater fat mass and waist-to-hip ratio) and PTH are the independent conditions that account significantly for higher RRI.


Subject(s)
Kidney/physiopathology , Obesity/complications , Parathyroid Hormone/blood , Renal Insufficiency, Chronic/etiology , Vascular Resistance/physiology , Vascular Stiffness/physiology , Adult , Aged , Body Mass Index , Female , Glomerular Filtration Rate , Humans , Hypertension/complications , Insulin Resistance , Kidney/diagnostic imaging , Male , Middle Aged , Obesity/physiopathology , Ultrasonography , Waist-Hip Ratio
9.
Front Med (Lausanne) ; 8: 709402, 2021.
Article in English | MEDLINE | ID: mdl-34513877

ABSTRACT

The pandemic spread of the new severe acute respiratory syndrome coronavirus 2 has raised the necessity to identify an appropriate imaging method for early diagnosis of coronavirus disease 2019 (COVID-19). Chest computed tomography (CT) has been regarded as the mainstay of imaging evaluation for pulmonary involvement in the early phase of the pandemic. However, due to the poor specificity of the radiological pattern and the disruption of radiology centers' functionality linked to an excessive demand for exams, the American College of Radiology has advised against CT use for screening purposes. Lung ultrasound (LUS) is a point-of-care imaging tool that is quickly available and easy to disinfect. These advantages have determined a "pandemic" increase of its use for early detection of COVID-19 pneumonia in emergency departments. However, LUS findings in COVID-19 patients are even less specific than those detectable on CT scans. The scope of this perspective article is to discuss the great number of diseases and pathologic conditions that may mimic COVID-19 pneumonia on LUS examination.

11.
Liver Int ; 30(2): 184-90, 2010 Feb.
Article in English | MEDLINE | ID: mdl-19840251

ABSTRACT

AIMS: Infection with specific pathogens may lead to increased adiposity. The human adenovirus 36 (Ad36) is a relatively new factor in promoting adipogenesis. It seems to improve the metabolic profile, expanding adipose tissue and enhancing insulin sensitivity in animal models. The aim of this study was to investigate whether any association or predictor effect of Ad36 seropositivity is present in non-alcoholic fatty liver disease (NAFLD), a condition associated with obesity and insulin resistance (IR). METHODS: Sixty-five NAFLD patients and 114 controls were investigated. Ultrasound bright liver score (BLS), body composition, IR evaluated by homeostasis model assessment of insulin resistance index (HOMA or HOMA-IR) and serum neutralization assay for antibodies to Ad36 were assessed. RESULTS: Ad36-seropositive patients have a lower risk of bright liver [OR 0.505 (95% confidence interval (CI) 0.265-0.962)]; greater IR leads to a higher risk of bright liver [OR 9.673 (95% CI 4.443-21.058)]. Among NAFLD, Ad36-seropositive vs. Ad36-seronegative patients did not show a significant IR difference. Ad36-seropositive NAFLD patients, with the same levels of HOMA and BLS, had greater body mass index and body fat mass, in comparison with seronegative NAFLD patients. By a multiple linear regression model, BLS was explained by HOMA (beta 0.513; P<0.0001), high density lipoprotein cholesterol (beta-0.219, P<0.006) and Ad36 seropositivity (beta-0.202, P<0.005); Ad36 seropositivity did not explain HOMA in the other multiple logistic regression model. CONCLUSIONS: Ad36 seropositivity is not associated with a significant difference of IR in NAFLD patients, but is associated with a greater adiposity. Ad36 seropositivity is associated with a lower occurrence of NAFLD and bright liver, which, conceivably, is not directly mediated by IR.


Subject(s)
Adenovirus Infections, Human/virology , Adenoviruses, Human/pathogenicity , Adipogenesis/physiology , Fatty Liver/virology , Insulin Resistance/physiology , Obesity/virology , Adenovirus Infections, Human/blood , Adenoviruses, Human/immunology , Adenoviruses, Human/isolation & purification , Antibodies, Viral/blood , Body Mass Index , Comorbidity , Fatty Liver/blood , Female , Humans , Italy/epidemiology , Male , Middle Aged , Obesity/metabolism , Seroepidemiologic Studies
12.
Dig Dis Sci ; 55(11): 3200-6, 2010 Nov.
Article in English | MEDLINE | ID: mdl-20165979

ABSTRACT

AIM: The benefits of coffee on abnormal liver biochemistry, cirrhosis and hepatocellular carcinoma have been reported, but there is a lack of satisfactory explanation. Thus, this study aims to investigate if coffee use has any relationship with bright liver, measured by ultrasound bright liver score (BLS), in patients with non-alcoholic fatty liver disease (NAFLD), and which relationship, if any, is present with BMI and insulin resistance. METHODS: This study was performed on 245 patients, 137 with NAFLD and 108 controls. Coffee drinking was defined according to the absolute number of cups of coffee (only espresso coffee), and also graded as 1 (0 cups of coffee/day), 2 (1-2 cups of coffee/day) 3 (≥3 cups of coffee/day). Insulin resistance was assessed by homoeostasis model-insulin resistance index (HOMA). RESULTS: Less fatty liver involvement is present in coffee vs. non-coffee drinkers. Odds ratios show that obesity, higher insulin resistance, lower HDL cholesterol, older age and arterial hypertension are associated with a greater risk of more severe BLS; to the contrary, coffee drinking is associated with less severe BLS. In the multiple logistic regression (MLR) model, number of cups of coffee, HOMA and BMI account for 35.8% of the variance to BLS. Coffee use is inversely associated with the degree of bright liver, along with insulin resistance and obesity, which, to the contrary, are directly associated with greater likelihood and severity of bright liver appearance. CONCLUSIONS: A possible opposite, if not antagonistic, role of coffee with regard to overweightness and insulin resistance, similar to that reported in hepatocarcinoma and cirrhosis, is envisaged in the natural history of NAFLD.


Subject(s)
Coffee , Fatty Liver/prevention & control , Adult , Body Mass Index , Body Weight/physiology , Chi-Square Distribution , Fatty Liver/diagnosis , Fatty Liver/diagnostic imaging , Fatty Liver/physiopathology , Female , Humans , Insulin Resistance/physiology , Life Style , Liver/diagnostic imaging , Logistic Models , Male , Middle Aged , Odds Ratio , Ultrasonography
13.
Heart Vessels ; 25(2): 82-6, 2010 Mar.
Article in English | MEDLINE | ID: mdl-20339967

ABSTRACT

The functional status of ischemic heart disease (IHD) is currently assessed using the Seattle Angina Questionnaire (SAQ), a tool for monitoring and predicting the patient's prognosis. Illness perceptions (IP) are associated with IHD behavioral risk factors. The aim of the study was to find whether different IP, as evaluated by the IP Questionnaire (IPQr), can predict any of the features of the SAQ, i.e., to determine whether the SAQ is influenced and/or biased by illness perceptions. Moreover, whether New York Heart Association class and Ejection Fraction (EF%) are predictors of IHD severity measured as need of subsequent stenting procedures was also assessed. Eighty IHD patients eligible for percutaneous coronary intervention (PCI) and drug-eluting stent implant were asked to complete the IPQr and the SAQ. Laboratory analyses, echocardiography, and coronary diagnostic and interventional procedures were performed concurrently. Physical limitations of the SAQ are predicted by IPQr emotional representation. Ischemic heart disease functional status is regulated by illness perceptions and beliefs. Thus, some of the inferences drawn from the SAQ regarding IHD prognosis and even interventional indications may be biased and compromise the prognostic reliability of the SAQ information on physical function. This can also have consequences for therapeutic indications.


Subject(s)
Angioplasty, Balloon, Coronary/instrumentation , Drug-Eluting Stents , Myocardial Ischemia/diagnosis , Surveys and Questionnaires , Aged , Emotions , Female , Health Knowledge, Attitudes, Practice , Heart Function Tests , Humans , Linear Models , Male , Middle Aged , Myocardial Ischemia/physiopathology , Myocardial Ischemia/psychology , Myocardial Ischemia/therapy , Perception , Predictive Value of Tests , Prognosis , Self Efficacy , Severity of Illness Index , Stroke Volume , Ventricular Function, Left
17.
Clin Exp Hypertens ; 32(5): 262-9, 2010.
Article in English | MEDLINE | ID: mdl-20662726

ABSTRACT

The study investigates lifestyle and effective anti-hypertensive intervention in overweight-obese patients can influence insulin-resistance (HOMA-IR) and US Renal-Resistive-Index (RRI). After a 1-year interventional program (including a personalized Mediterranean diet, physical activity increase, smoking withdrawal counseling), 156 Essential Hypertension (EH) patients still have abnormal HOMA-IR, significantly higher in comparison to 159 control group patients. Body mass index (BMI) and cholesterol-high-density-lipoprotein improvement are the best predictors of a HOMA-IR decrease; RRI improves in EH according to lifestyle interventions, but no predictor to RRI is identified. Persistence of IR can be tentatively assumed as a steady sign, persistent also after extended lifestyle intervention in EH, further warranting more intensive dietary interventions.


Subject(s)
Elasticity/physiology , Hypertension/physiopathology , Hypertension/therapy , Insulin Resistance/physiology , Life Style , Renal Artery/physiology , Adult , Blood Pressure/physiology , Diet , Follow-Up Studies , Humans , Middle Aged , Motor Activity , Smoking Cessation , Treatment Outcome
18.
Ren Fail ; 32(10): 1137-47, 2010.
Article in English | MEDLINE | ID: mdl-20954972

ABSTRACT

BACKGROUND: The relationship between nutrition and atherosclerosis is known, even dissociated from protein malnutrition. Cardiovascular impact of several nutrients is known; among them the action of coffee is still debated and cardiovascular effect of caffeine has been investigated without definite results. OBJECTIVE: The aim of this study is to investigate whether coffee habits, and/or quantity of coffee consumption, have any relationship with renal resistive index (RRI), a hallmark of arterial stiffness (AS). The relationship of AS with nutritional status assessed by body composition and serum albumin, insulin resistance (assessed by HOMA), and renal function assessed by glomerular filtration rate (GFR) is concurrently investigated. METHODS: This study was done with 221 consecutive patients, without diabetes, cancer, liver, renal, and heart disease, referred for clinical noninvasive assessment and nutritional counseling: 124 essential hypertensive and 97 nonhypertensive patients were eligible. Personalized Mediterranean diet, physical activity increase, and smoking withdrawal counseling were provided. RESULTS: By multiple linear regression, fat-free mass (FFM), HOMA (positive relationship), and number of cups of coffee/day (negative relationship) account for 17.2% of the variance to RRI. By odds ratios lower risk to increased RRI is associated with higher serum albumin, higher hemoglobin, and FFM; greater risk is associated with hypertension, insulin resistance (HOMA ≥ 3.0), and renal insufficiency (GFR ≤ 90); coffee, assessed by number of cups/day, reduces risk. CONCLUSION: Coffee use is inversely associated with RRI. Habitual coffee users have risk protection to higher RRI; lower serum albumin, insulin resistance, and renal insufficiency are associated with greater RRI.


Subject(s)
Coffee , Feeding Behavior , Nutritional Status , Renal Artery/physiology , Aged , Body Composition , Elasticity , Electric Impedance , Female , Glomerular Filtration Rate , Hemorheology , Humans , Insulin Resistance , Male , Middle Aged , Renal Artery/physiopathology , Serum Albumin/analysis
19.
World J Gastrointest Pathophysiol ; 11(3): 57-63, 2020 May 12.
Article in English | MEDLINE | ID: mdl-32435522

ABSTRACT

Atherosclerosis (ATH) and non-alcoholic fatty liver disease (NAFLD) are medical conditions that straddle a communal epidemiology, underlying mechanism and a clinical syndrome that has protean manifestations, touching every organ in the body. These twin partners, ATH and NAFLD, are seemingly straightforward and relatively simple topics when considered alone, but their interdependence calls for more thought. The study of the mutual relationship of NAFLD and ATH should involve big data analytics approaches, given that they encompass a constellation of diseases and are related to several recognized risk factors and health determinants and calls to an explicit theory of change, to justify intervention. Research studies on the "association between aortic stiffness and liver steatosis in morbidly obese patients", published recently, sparsely hypothesize new mechanisms of disease, claiming the "long shadow of NAFLD" as a risk factor, if not as a causative factor of arterial stiffness and ATH. This statement is probably overreaching the argument and harmful for the scientific credence of this area of medicine. Despite the verification that NAFLD and cardiovascular disease are strongly interrelated, current evidence is that NAFLD may be a useful indicator for flagging early arteriosclerosis, and not a likely causative factor. Greater sustainable contribution by precision medicine tools, by validated bioinformatics approaches, is needed for substantiating conjectures, assumptions and inferences related to the management of big data and addressed to intervention for behavioral changes within an explicit theory of change.

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