Assunta Santonati - Academia.edu (original) (raw)

Papers by Assunta Santonati

Current oncology, Feb 6, 2024

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Endocrine, Oct 3, 2019

Purpose Hypoparathyroidism (hypoPT) results in an impairment of quality of life (QoL), an increas... more Purpose Hypoparathyroidism (hypoPT) results in an impairment of quality of life (QoL), an increase in fatigue and a higher risk of mortality. Cardiovascular autonomic neuropathy (CAN) is an impairment of the cardiovascular autonomic system and is associated with increased mortality and fatigability. Patients with hypoPT show an increased risk of CAN. However, no previous studies have investigated the association between CAN and QoL in hypoPT. To test whether CAN is associated with fatigue and impaired QOL in hypoPT patients. Methods We enrolled 48 subjects with postsurgical hypoPT treated with calcium and calcitriol and 38 healthy subjects who underwent thyroidectomy. Subjects completed the RAND 36-Item Short Form (SF-36) Health Survey, evaluating physical (PCS) and mental (MCS) health, and fatigue score. CAN was assessed using cardiovascular autonomic reflex tests (CARTs). Participants were considered to have "early CAN" (EC) if they had one abnormal CART and "definite CAN" (DC) with two or more abnormal CARTs. Results Compared with controls, hypoPT population had lower fatigue scores (44.5 IQRː9 vs 38.5 IQRː12.3, P = 0.031). In the hypoPT group, only participants with DC had a lower fatigue score than subjects without CAN (DC: β: −9.55, P = 0.005) after adjusting for age, duration of disease, calcium concentration, TSH, calcitriol and calcium supplementation. No differences were found in the PCS and MCS scores in the hypoPT group. Conclusions CAN may explain fatigue, a common complaint of postsurgical hypoPT patients. Further larger and prospective investigations are needed to confirm our findings.

Bone reports, Oct 1, 2020

PubMed, Sep 1, 2015

Imbalance of bone resorption and bone formation is responsible for osteoporosis that is character... more Imbalance of bone resorption and bone formation is responsible for osteoporosis that is characterized by decreased bone mass and mineral density. The aim of this study was to evaluate the available data that could clarify the effectiveness and safety of supplementations with calcium and vitamin D, alone or in combination, to slow down bone loss in postmenopausal and elderly women. Using search key words, we performed a research both in the PubMed and Cochrane Library in order to find all meta-analysis, prospective and randomized clinical studies published from 2000 to 2014 that had investigated the effectiveness of calcium and vitamin D in the treatment of osteoporosis. At the moment it is not possible either to provide reassurance that calcium supplements given with vitamin D do not cause adverse cardiovascular events or to link them with certainty to increased cardiovascular risk. According to the data now available, vitamin D, at dosage of at least 800 IU/day, alone or in combination with antiresorptive drugs, should be administered in osteoporotic and osteopenic patients for a primary and secondary prevention. Further studies are needed and the debate remains ongoing. However, every administration needs the calculation of the absolute fracture risk of the patient. Especially considering the high cost of osteoporosis prevention, more studies are mandatory to clarify indications and contraindications.

The Journal of Clinical Endocrinology and Metabolism, Sep 1, 2015

Endocrine Abstracts, May 7, 2022

The Journal of Clinical Endocrinology and Metabolism, Nov 1, 2017

Journal of the Endocrine Society, Apr 1, 2019

Abstract Background: Post-surgical hypoparathyroidism (hypoPT) increases fatigue and seems to aff... more Abstract Background: Post-surgical hypoparathyroidism (hypoPT) increases fatigue and seems to affect the risk of mortality. Hypoparathyroid patients on conventional treatment with calcium and vitamin D supplementation show a reduction of Quality of life (QoL). Cardiovascular autonomic neuropathy (CAN) is an impairment of the cardiovascular autonomic system and it represents a cause of increased mortality and fatigability. Recently, we have demonstrated that patient with chronic post-surgical hypoparathyroidism show an increased risk of CAN. No previous studies have investigated the association between CAN and QoL in hypoparathyroidism. Aim: We tested the hypothesis that CAN would be associated with impaired QOL measures in subjects with chronic post-surgical hypoparathyroidism. Study population and design: We enrolled 49 post-surgical hypoparathyroid patients treated with calcium and calcitriol. Subjects completed the RAND 36-Item Short Form (SF-36) Health Survey, a measure of health-related QOL covering eight domains of physical and mental health. QOL has also been evaluated using Fatigue score (version 4). CAN was assessed by heart rate (HR) response to deep breathing, HR response to the lying-to-standing test, HR response to the Valsalva maneuver and blood pressure response to standing. Participants were considered to have “early CAN” (EC) if they had one abnormal result in the HR tests and “definite CAN” (DC) with two or more abnormal results. Results: the prevalence of EC was 39% (n=19), the prevalence of DC was 39% (n=19), the prevalence of patients without CAN (WC) was 22% (n=11). Only DC subjects had a statistically significant lower fatigue score compared to WC(35.1±5.8 vs 44.4±4.6, P=0.004). These results have been confirmed after adjustment for age, calcium concentration, calcitriol and calcium supplementation (β:-9.31, P=0.004). No statistically significant differences between groups were found for mental and physical component summary scores. Role limitation due to physical problem represents the only domain that showed a significant reduction between groups (WC: 82.6±33.4, EC: 72.4±33.2, DC: 50±38.2, ANOVA P=0.044). Conclusion: definite CAN may represent a cause of impaired QoL in patient with chronic post-surgical hypoparathyroidism. The presence of cardiovascular autonomic neuropathy could explain the fatigue, a common complaint in patient with hypoparathyroidism.

Journal of Bone and Mineral Research, Dec 14, 2018

The use of recombinant human PTH (1-84) [rhPTH(1-84)] is approved as hormonal replacement therapy... more The use of recombinant human PTH (1-84) [rhPTH(1-84)] is approved as hormonal replacement therapy in patients with hypoparathyroidism not adequately controlled with conventional therapy. The objective of this study was to investigate the effects of 12 months of rhPTH (1-84) treatment in a cohort of patients selected according to the indications of recent hypoparathyroidism guidelines. It is a multicenter, observational, retro-prospective, open label study. Eleven Italian Endocrinological centers were involved. Fourteen adult subjects with chronic hypoparathyroidism treated with rhPTH (1-84) for 12 months were enrolled. Main outcome measures included serum and urinary parameters of mineral metabolism, renal function, oral calcium and vitamin D doses, and clinical manifestations. At 12 months, 61.5% of patients discontinued calcium supplement and 69.2% calcitriol. Mean serum calcium levels quickly normalized after initiation of rhPTH (1-84) treatment compared to baseline (p=0.009). Ra...

The Journal of Clinical Endocrinology & Metabolism, 2020

Context The clinical and radiological aspects of normocalcemic hyperparathyroidism (NHPT) are con... more Context The clinical and radiological aspects of normocalcemic hyperparathyroidism (NHPT) are confounded by the differing methods used to rule out secondary hyperparathyroidism and by the small sample size. Objective To assess the clinical, biochemical, and radiological profile of NHPT compared with primary hyperparathyroidism (PHPT) and control subjects Design Multicentric cross-sectional study Setting Outpatient clinic Patients 47 NHPT, 41 PHPT, and 39 age- and sex-matched control subjects. Main Outcome Measures Calcium metabolism and bone turnover markers (BTMs). Lumbar spine, total hip, femoral neck, one-third distal radius bone mineral density (BMD). Morphometric vertebral fracture (VF) assessed by dual-energy X-ray absorptiometry. Results NHPT patients had significantly higher parathyroid hormone, 25(OH)-vitamin D levels and lower calcium × phosphorus product than controls (P < .001). Compared with PHPT, the NHPT group had significantly higher 25(OH) vitamin D levels (P = ....

Journal of Ultrasound, 2019

Endocrine Abstracts, 2019

Journal of the Endocrine Society, 2019

Journal of Bone and Mineral Research, 2018

ABSTRACTPostsurgical hypoparathyroidism (hypoPT) increases fatigue and seems to affect the risk o... more ABSTRACTPostsurgical hypoparathyroidism (hypoPT) increases fatigue and seems to affect the risk of mortality. Cardiovascular autonomic neuropathy (CAN) is an impairment of the cardiovascular autonomic system, a cause of increased mortality, and associated with increased fatigability. The aim of this study is to evaluate CAN in hypoPT and its relationship with hypocalcemia, PTH levels, and hyperphosphatemia. This is a cross‐sectional study comparing 51 postsurgical hypoPT patients treated with calcium and calcitriol and 43 control subjects without any PTH/calcium/phosphate disorders who underwent thyroidectomy. CAN was assessed by heart rate (HR) response to deep breathing, HR response to the lying‐to‐standing test, HR response to the Valsalva maneuver, and blood pressure response to standing. Participants were considered to have “early CAN” if they had one abnormal result in the HR tests and “definite CAN” with two or more abnormal results. The prevalence of CAN was 23% in the contr...

Minerva endocrinologica