Carla Lubrano - Academia.edu (original) (raw)
Papers by Carla Lubrano
International Journal of Obesity, Jul 21, 2023
BACKGROUND: Despite obesity being well known to be associated with several pituitary hormone imba... more BACKGROUND: Despite obesity being well known to be associated with several pituitary hormone imbalances, pituitary appearance in magnetic resonance imaging (MRI) in patients with obesity is understudied. OBJECTIVE: To evaluate the pituitary volume and signal intensity at MRI in patients with obesity. METHODS: This is a prospective study performed in an endocrine Italian referral center (ClinicalTrial.gov Identifier: NCT03458533). Sixty-nine patients with obesity (BMI > 30 kg/m 2) and twenty-five subjects without obesity were enrolled. Thirty-three patients with obesity were re-evaluated after 3 years of diet and lifestyle changes, of whom 17 (51.5%) achieved a > 5% loss of their initial body weight, whereas the remaining 16 (48.5%) had maintained or gained weight. Evaluations included metabolic and hormone assessments, DEXA scan, and pituitary MRI. Pituitary signal intensity was quantified by measuring the pixel density using ImageJ software. RESULTS: At baseline, no difference in pituitary volume was observed between the obese and non-obese cohorts. At the 3-year follow-up, pituitary volume was significantly reduced (p = 0.011) only in participants with stable-increased body weight. Furthermore, a significant difference was noted in the mean pituitary intensity of T1-weighted plain and contrast-enhanced sequences between the obese and non-obese cohorts at baseline (p = 0.006; p = 0.002), and a significant decrease in signal intensity was observed in the subgroup of participants who had not lost weight (p = 0.012; p = 0.017). Insulin-like growth factor-1 levels, following correction for BMI, were correlated with pituitary volume (p = 0.001) and intensity (p = 0.049), whereas morning cortisol levels were correlated with pituitary intensity (p = 0.007). The T1-weighted pituitary intensity was negatively correlated with truncal fat (p = 0.006) and fibrinogen (p = 0.018). CONCLUSIONS: The CHIASM study describes a quantitative reduction in pituitary intensity in T1-weighted sequences in patients with obesity. These alterations could be explained by changes in the pituitary stromal tissue, correlated with low-grade inflammation.
PubMed, 1992
ABSTRACT The receptor for epidermal growth factor (EGF-R) was characterized on membrane fractions... more ABSTRACT The receptor for epidermal growth factor (EGF-R) was characterized on membrane fractions from human benign prostatic hyperplasia (BPH). Specific binding of [125I]EGF reached equilibrium after 40 min at 25 degrees C and was stable for up to 120 min. Saturation analysis of EGF-R, performed by incubating the membranes with 0.0156-15 nM [125I]EGF in the presence and in the absence of 100-fold excess of cold EGF for 60 min, revealed the presence of two classes of binding sites with high and low affinities (Kd = 0.35 +/- 0.23 and 9.60 +/- 2.87 nM respectively). Competition experiments revealed that FSH, insulin and calcitonin did not compete with [125I]EGF. The simultaneous determination of EGF-R and that of estradiol (ER), progesterone (PR) and androgen receptors (AR) was performed using the same buffer to homogenate the tissues and to obtain cellular membranes. The steroid receptors (SR) were determined by means of the dextran-coated charcoal method. There was a significant negative correlation between nuclear SR and binding capacity of EGF-R. The presence of specific and high affinity binding sites for EGF and the modulation of the level of these sites by steroid receptors suggest a possible role of EGF in prostatic hyperplasia.
PubMed, 2004
This case report documents the treatment of a female patient, 37 years 6 months of age, with a Cl... more This case report documents the treatment of a female patient, 37 years 6 months of age, with a Class II open bite malocclusion with severe osteoarthritis of the temporomandibular joint associated with Hashimoto disease, a chronic inflammatory disease of the thyroid in which autoimmune factors play a prominent role. The simultaneous treatment of both pathologies (malocclusion and thyroiditis) led to the cessation of pain and dysfunctional symptoms in both temporomandibular joints.
Nutrition, Jun 1, 2022
Growing evidence suggests that changes in muscle mass and function may further contribute to heal... more Growing evidence suggests that changes in muscle mass and function may further contribute to health risk assessment in individuals who are obese. As numbers for both obese and aged population subgroups are increasing worldwide, sarcopenic obesity is emerging as a relevant factor associated with higher risk for adverse events and outcomes in several clinical settings, including cancer. Recent reports showing that prevalence of sarcopenic obesity may involve up to one-third of patients with cancer despite body mass index strongly support the need for its evaluation in oncological clinical practice. In fact, in several cancer types, sarcopenic obesity is associated with poorer outcomes that include metabolic and surgical complications, longer hospitalization, physical disability, and shorter survival. Importantly, sarcopenic obesity may also have an effect on chemotherapy, as it may induce a higher risk for dose-limiting-toxicity. The aim of this review was to present an updated overview on the definition, effects, mechanisms, and clinical relevance of sarcopenia in this setting.
Journal of the Endocrine Society, May 1, 2021
Abstract Background: In sarcopenic obese subjects it is essential to reduce body weight and to pr... more Abstract Background: In sarcopenic obese subjects it is essential to reduce body weight and to preserve lean mass, in order to avoid a worsening of muscle function (1). Several studies have shown that leucine supplementation can be useful to improve skeletal muscle mass in sarcopenic patients (2). Aim: Evaluate the effectiveness of a short-term low calorie diet (LCD) combined with combined supplementation with whey protein, leucine and vitamin D on weight loss, lean mass and muscle strength in sarcopenic, obese, hyperinsulinemic and menopause women. Materials and methods: 16 female with mean age: 58.1 years (range: 47–69 years), BMI 37.6 Kg/m2 (range: 31,7 - 44,1 Kg/m2), HOMA-index ≥ 2.5, were assigned to an LCD regimen (1000 kcal/day) with supplementation of 18 g protein, 4 g leucine and 5 mcg vitamin D for 45 days. Anthropometric indexes, blood and urine chemistry, body composition by DEXA, muscle strength by handgrip test and Short Physical Performance Battery (SPPB) were assessed at baseline and at the end of the treatment. Results: A significant reduction of BMI (35,7 vs 37,6 Kg/m2), waist circumference (102,4 vs 107 cm), HOMA index (2,3 vs 4,8) and fasting insulin (10,4 vs 17,4 μIU/ml) was observed in all patients. Women preserved total lean body mass (57 vs 55 %) and improved significantly muscle strength, as measured by handgrip (22,2 vs 18,6 Kg) and SPPB (8,9 vs 7,5). Conclusion: We conclude that LCD with adequate protein intake and a supplementation with whey protein, leucine and vitamin D should be promoted to maintain muscle mass and improve muscle strength in menopause women with sarcopenic obesity. References: 1. Batsis JA, Villareal DT. Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies. Nat Rev Endocrinol. 2018 Sep;14(9):513–5372. Bauer JM, Verlaan S, Bautmans I, Brandt K, Donini LM, Maggio M, McMurdo ME, Mets T, Seal C, Wijers SL, Ceda GP, De Vito G, Donders G, Drey M, Greig C, Holmbäck U, Narici M, McPhee J, Poggiogalle E, Power D, Scafoglieri A, Schultz R, Sieber CC, Cederholm T. Effects of a vitamin D and leucine-enriched whey protein nutritional supplement on measures of sarcopenia in older adults, the PROVIDE study: a randomized, double-blind, placebo-controlled trial. J Am Med Dir Assoc. 2015 Sep 1;16(9)
Journal of Endocrinological Investigation, Nov 2, 2017
Purpose Patients with cystic fibrosis (CF) present with signs and symptoms that overlap with thos... more Purpose Patients with cystic fibrosis (CF) present with signs and symptoms that overlap with those of adult growth hormone deficiency (GHD) syndrome: loss of muscle mass, bone fragility and lower stress tolerance. In literature, the prevalence of GHD in pediatric CF patients ishigher than general population, but these studies have been performed on children with growth delay. To our knowledge, there are no studies on adult patients. The aim of this paper is to evaluate GH-IGF1 axis in an adult CF population. Methods Fifty clinically stable adult patients, 30 males; age 36 ± 2 years; BMI 21.39 ± 0.22 kg/m 2 and FEV 1 67 ± 4% were studied. Data regarding glycometabolic status and results of pituitary, thyroid, parathyroid, gonadal and adrenal function tests were recorded. All patients underwent a GH releasing hormone (GHRH) + Arginine stimulation test to confirm a GHD. Results GHRH + Arginine test revealed the presence of GHD in 16 patients (32%); specifically 7 patients had a severe deficiency and 9 a partial deficiency. Conclusions Adult patients with CF may show GHD. These patients should be followed over time to assess if the GHD could impact the clinical progression of CF.
Nutrients, Apr 29, 2022
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
Journal of Infection, Mar 1, 2021
The Journal of Steroid Biochemistry and Molecular Biology, Mar 1, 1992
Benign prostatic hyperplasia (BPH) is a sex steroid dependent disease. Estrogens and androgens ca... more Benign prostatic hyperplasia (BPH) is a sex steroid dependent disease. Estrogens and androgens can modulate in different mammalian tissues epidermal growth factor (EGF) production and/or secretion. In order to clarify the relationships between estrogen and androgen receptor concentrations and those of immunoreactive EGF (irEGF), we have evaluated these parameters in 14 human BPH samples, by means of a dextran-coated charcoal method and radioimmunoassay, respectively. Cytosolic steroid receptors did not seem to correlate with irEGF. A linear significative relationship was evident between nuclear androgen receptor (ARn) levels and endogenous irEGF but not between nuclear estrogen receptors and irEGF: in ARn negative BPH samples, irEGF levels were lower than in ARn positive ones. Therefore, it is possible that androgens act at prostatic tissue level, through their own receptors, by modulating EGF production and/or secretion.
International Journal of Immunopathology and Pharmacology, 1996
5a reductase is a key enzyme in androgen metabolism. Altered enzyme function and/or regulation is... more 5a reductase is a key enzyme in androgen metabolism. Altered enzyme function and/or regulation is responsible for numerous human pathologies such as benign prostatic hyperplasia, acne, hirsutism and male pattern baldness. In order to block androgen action through inhibition of this enzyme, numerous compounds have been synthesized during the past two decades. Among them, 4-azasteroids and in particular finasteride have been extensively studied and used in the treatment of human diseases.
Clinical Endocrinology, Feb 1, 1992
OBJECTIVE Because of continued debate about the role of insulin In the development of hirsutlsm a... more OBJECTIVE Because of continued debate about the role of insulin In the development of hirsutlsm and in the Induction of the polycystlc ovary syndrome, we have evaluated the hormonal pattern in a group of hirsute patients. PATIENTS Fifty-four hirsute patients (age range 18-39 years) of whom 26 patlents were obese (0) (BMI 28-53 kgt m2 and W/H > 0.85), 12 with ultrasonographlc evidence of polycystlc ovaries (0 PCO) and 14 with normal ovaries. Twenty-eight patients were within normal weight range, and, of these, 14 presented ultrasonographlc evidence of polycystlc ovaries and 14 had normal ovaries. Two groups of age-matched subjects (obese and normal weight), normally menstruating, without hirsutism or history of endocrlnopathies or ultrasonographic evidence of polycystic ovaries, served as controls. MEASUREMENTS Androstenedlone and testosterone were evaluated In all patlents by RIA, followlng ether extraction, DHEAS, LH, FSH and insulin were evaluated directly by RIA. SHBG was evaluated by the concanavalin method. Free testosterone (FT%) was calculated eccording to the formula FT=4.038-1.607 log SHBG. integrated areas under the response curve were calculated for LH and insulin respectively followlng i.v. administration of GnRH (100 pg) or oral administration of glucose (75 g). RESULTS Results (mean f standard deviation) showed comparable values of androstenedlone In all groups of obese patients and in obese controls (7-3 f 2.6 in patients with polycystic ovaries, 7.1 f 2.9 in non-polycystic ovary patients and 7.4f2.6 nmolll in obese controls, respectively), regardless of baseline and area insulin, the presence or absence of polycystic ovaries, or hirsutlsm. SHBG
Journal of Endocrinological Investigation, Mar 13, 2018
Purpose To examine differences in effects according to growth hormone (GH) treatment duration in ... more Purpose To examine differences in effects according to growth hormone (GH) treatment duration in adult GH-deficient patients. Methods In the Italian cohort of the observational Hypopituitary Control and Complications Study, GH-treated adults with GH deficiency (GHD) were grouped by duration of treatment; ≤ 2 years (n = 451), > 2 to ≤ 6 years (n = 387) and > 6 years (n = 395). Between-group differences in demographics, medical history, physical characteristics, insulin-like growth factor-I standard deviation score (IGF-I SDS) and lipid profile at baseline, last study visit and changes from baseline to last study visit were assessed overall, for adult-and childhood-onset GHD and by gender using ANOVA for continuous variables and Chi-squared test for categorical variables. Results At baseline, treatment duration groups did not differ significantly for age, gender, body mass index, GHD onset, IGF-I SDS, lipid profile, and quality of life. Mean initial GH dose did not differ significantly according to treatment duration group in any subgroup, except female patients, with highest mean dose seen in the longest duration group. In the longest duration group for patients overall, adult-onset patients and male patients, there were significant decreases in GH dose from baseline to last visit, and in total and low-density lipoprotein (LDL)-cholesterol concentrations. IGF-I SDS increased, to a greater extent, in the longest duration group for patients overall and female patients. Conclusions The results show that long-term GH treatment is associated with decreasing GH dose, increased IGF-I, decreased LDL-cholesterol and the presence of surrogate markers that help to give confidence in a diagnosis of GHD.
Journal of Cellular Physiology, Nov 23, 2015
Low-grade chronic inflammation is a salient feature of obesity and many associated disorders. Thi... more Low-grade chronic inflammation is a salient feature of obesity and many associated disorders. This condition frequently occurs in central obesity and is connected to alterations of the visceral adipose tissue (AT) microenvironment. Understanding how obesity is related to inflammation may allow the development of therapeutics aimed at improving metabolic parameters in obese patients. To achieve this aim, we compared the features of 2 subpopulations of adipose-derived stem cells (ASC) isolated from both subcutaneous and visceral AT of obese patients with the features of 2 subpopulations of ASC from the same isolation sites of non-obese individuals. In particular, the behavior of ASC of obese vs non-obese subjects during hypoxia, which occurs in obese AT and is an inducer of the inflammatory response, was evaluated. Obesity deeply influenced ASC from visceral AT (obV-ASC); these cells appeared to exhibit clearly distinguishable morphology and ultrastructure as well as reduced proliferation, clonogenicity and expression of stemness, differentiation and inflammation-related genes. These cells also exhibited a deregulated response to hypoxia, which induced strong tissue-specific NF-kB activation and an NF-kB-mediated increase in inflammatory and fibrogenic responses. Moreover, obV-ASC, which showed a less stem-like phenotype, recovered stemness features after hypoxia. Our findings demonstrated the peculiar behavior of obV-ASC, their influence on the obese visceral AT microenvironment and the therapeutic potential of NF-kB inhibitors. These novel findings suggest that the deregulated hyperresponsiveness to hypoxic stimulus of ASC from visceral AT of obese subjects may contribute via paracrine mechanisms to low-grade chronic inflammation, which has been implicated in obesity
Urology, Feb 1, 1993
Based on the reported sex difference in the incidence of acquired cystic kidney disease (ACKD) in... more Based on the reported sex difference in the incidence of acquired cystic kidney disease (ACKD) in patients with chronic renal failure, it is hypothesized that the hormonal derangement, well documented in male and female uremic patients on long-term dialysis, could be responsible for the pathogenesis of ACKD. The decreased androgen/estrogen ratio, and the increased estrogen value could be responsible for an estrogen receptor mediated effect on the tubular epithelial cell proliferation, an event further potentiated by the action of regulatory peptides like epidermal growth factor (EGF). The epithelial stimulation is more pronounced in men because male tissues are less adapted than female tissues to high estrogen values. Furthermore the androgen reduction, more remarkable in male than female patients, is responsible for an up-regulation of EGF-R. Therefore hormones and growth factors, by means of their own receptor in renal tissue (homologous to the two oncogenes c-erb A and c-erb B), may be responsible for the development of ACKD, and may play an important role in the pathogenesis of multiple adenomas and renal carcinomas reported with high incidence among uremic patients with ACKD.
L'Endocrinologo, Sep 15, 2021
Sommario La Non-Alcoholic Fatty Liver Disease (NA-FLD) comprende diversi stadi di patologia epati... more Sommario La Non-Alcoholic Fatty Liver Disease (NA-FLD) comprende diversi stadi di patologia epatica che vanno dalla steatosi alla cirrosi epatica. È considerata la manifestazione epatica della patologia metabolica e alcune alterazioni endocrinologiche possono concorrere a determinarne l'insorgenza o la progressione. È quindi di fondamentale importanza che l'endocrinologo sia consapevole dell'importanza clinica e prognostica della NAFLD correlata alle patologie endocrine, al fine di offrire al paziente il trattamento adeguato. Parole chiave NAFLD • Steatosi epatica • Ormoni • Metabolismo Introduzione La Non-Alcoholic Fatty Liver Disease (NAFLD) è considerata la manifestazione epatica della patologia metabolica, e consiste in uno spettro di patologie epatiche che comprendono l'accumulo epatico di lipidi in più del 5% degli epatociti (steatosi), l'infiammazione epatica (steatoepatite), la fibrosi, la cirrosi e lo sviluppo di epatocarcinoma (Figura 1), in assenza di consumo alcolico maggiore o uguale a 20 g nelle donne e 30 g negli uomini, e di altre cause secondarie [1].
British Journal of Dermatology, 1995
Pachydermoperiostosis is a rare osteo-cutaneous disease characterized by hypertrophy of bones and... more Pachydermoperiostosis is a rare osteo-cutaneous disease characterized by hypertrophy of bones and surrounding soft tissues. The cutaneous manifestations include coarsening of facial features, cutis verticis gyrata. digital clubbing, hyperhidrosis and seborrhoea. The pathogenetic mechanism of the disease is still debated, and proposed aetiological factors include genetic influences, anomalies in fibroblast activity, or alteration in peripheral blood flow. We studied a patient with the incomplete form of pachydermoperiostosis. assessing epidermal growth factor receptor (EGF-R) and sex hormone steroid receptors (SR) in the affected skin, and also evaluating the urinary excretion of EGF. The results showed high levels of nuclear steroid receptors, increased cytosolic oestrogen receptors, and no detectable progesterone and androgen cytosoiic receptors. EGF-R was also undetectable, and the urinary excretion of EGF was elevated. These findings suggest that the increased tissue sensitivity to circulating sex-steroids could induce enhanced tissue EGF/transforming growth factor a (TGF-a) production and utilization. The SR-EGF-R system could therefore be involved in determining hypertrophy of the affected tissues.
Viruses, Feb 9, 2023
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
European Urology, 1992
A double-blind placebo-controlled study was performed in 35 benign prostatic hypertrophy (BPH) pa... more A double-blind placebo-controlled study was performed in 35 benign prostatic hypertrophy (BPH) patients never treated before. The patients were randomized into two groups, the 1st (18 cases) receiving Serenoa repens extract (160 mg t.d.) for 3 months up to the day before the operation of transvesical adenomectomy and the 2nd (17 cases) receiving placebo. Steroid receptors were evaluated in the nuclear (n) and cytosolic (c) fraction using the saturation analysis technique (Scatchard analysis or single saturating-dose assay) for androgen (AR) and estrogen (ER) receptors and the enzyme immunoassay (EIA) for ER and progesterone receptors (PgR). Scatchard analysis of ERc and ERn revealed the presence of two classes of binding sites, one with high-affinity low-capacity binding and the other with low-affinity high-capacity binding. In the untreated BPH group, ER were higher in the n than in the c fraction: ERn were positive in 14 cases and ERc in 12 of 17 cases. In the BPH group treated with S. repens extract on the contrary, ERn were negative for both binding classes in 17 cases and ERc in 6 of 18 cases. Using EIA, ERn and ERc were detected in all 15 samples examined, but in the treated group, ERn were significantly (p less than 0.01) lower than in the untreated group, whilst ERc remained almost unchanged. Similar results were obtained measuring PgR: the n fraction of the treated group prostatic samples was significantly (p less than 0.01) lower than that of the untreated group.(ABSTRACT TRUNCATED AT 250 WORDS)
Results of the HYPOCCS Study focusing on the role of the duration of r-hGH treatment on several p... more Results of the HYPOCCS Study focusing on the role of the duration of r-hGH treatment on several parameter
International Journal of Obesity, Jul 21, 2023
BACKGROUND: Despite obesity being well known to be associated with several pituitary hormone imba... more BACKGROUND: Despite obesity being well known to be associated with several pituitary hormone imbalances, pituitary appearance in magnetic resonance imaging (MRI) in patients with obesity is understudied. OBJECTIVE: To evaluate the pituitary volume and signal intensity at MRI in patients with obesity. METHODS: This is a prospective study performed in an endocrine Italian referral center (ClinicalTrial.gov Identifier: NCT03458533). Sixty-nine patients with obesity (BMI > 30 kg/m 2) and twenty-five subjects without obesity were enrolled. Thirty-three patients with obesity were re-evaluated after 3 years of diet and lifestyle changes, of whom 17 (51.5%) achieved a > 5% loss of their initial body weight, whereas the remaining 16 (48.5%) had maintained or gained weight. Evaluations included metabolic and hormone assessments, DEXA scan, and pituitary MRI. Pituitary signal intensity was quantified by measuring the pixel density using ImageJ software. RESULTS: At baseline, no difference in pituitary volume was observed between the obese and non-obese cohorts. At the 3-year follow-up, pituitary volume was significantly reduced (p = 0.011) only in participants with stable-increased body weight. Furthermore, a significant difference was noted in the mean pituitary intensity of T1-weighted plain and contrast-enhanced sequences between the obese and non-obese cohorts at baseline (p = 0.006; p = 0.002), and a significant decrease in signal intensity was observed in the subgroup of participants who had not lost weight (p = 0.012; p = 0.017). Insulin-like growth factor-1 levels, following correction for BMI, were correlated with pituitary volume (p = 0.001) and intensity (p = 0.049), whereas morning cortisol levels were correlated with pituitary intensity (p = 0.007). The T1-weighted pituitary intensity was negatively correlated with truncal fat (p = 0.006) and fibrinogen (p = 0.018). CONCLUSIONS: The CHIASM study describes a quantitative reduction in pituitary intensity in T1-weighted sequences in patients with obesity. These alterations could be explained by changes in the pituitary stromal tissue, correlated with low-grade inflammation.
PubMed, 1992
ABSTRACT The receptor for epidermal growth factor (EGF-R) was characterized on membrane fractions... more ABSTRACT The receptor for epidermal growth factor (EGF-R) was characterized on membrane fractions from human benign prostatic hyperplasia (BPH). Specific binding of [125I]EGF reached equilibrium after 40 min at 25 degrees C and was stable for up to 120 min. Saturation analysis of EGF-R, performed by incubating the membranes with 0.0156-15 nM [125I]EGF in the presence and in the absence of 100-fold excess of cold EGF for 60 min, revealed the presence of two classes of binding sites with high and low affinities (Kd = 0.35 +/- 0.23 and 9.60 +/- 2.87 nM respectively). Competition experiments revealed that FSH, insulin and calcitonin did not compete with [125I]EGF. The simultaneous determination of EGF-R and that of estradiol (ER), progesterone (PR) and androgen receptors (AR) was performed using the same buffer to homogenate the tissues and to obtain cellular membranes. The steroid receptors (SR) were determined by means of the dextran-coated charcoal method. There was a significant negative correlation between nuclear SR and binding capacity of EGF-R. The presence of specific and high affinity binding sites for EGF and the modulation of the level of these sites by steroid receptors suggest a possible role of EGF in prostatic hyperplasia.
PubMed, 2004
This case report documents the treatment of a female patient, 37 years 6 months of age, with a Cl... more This case report documents the treatment of a female patient, 37 years 6 months of age, with a Class II open bite malocclusion with severe osteoarthritis of the temporomandibular joint associated with Hashimoto disease, a chronic inflammatory disease of the thyroid in which autoimmune factors play a prominent role. The simultaneous treatment of both pathologies (malocclusion and thyroiditis) led to the cessation of pain and dysfunctional symptoms in both temporomandibular joints.
Nutrition, Jun 1, 2022
Growing evidence suggests that changes in muscle mass and function may further contribute to heal... more Growing evidence suggests that changes in muscle mass and function may further contribute to health risk assessment in individuals who are obese. As numbers for both obese and aged population subgroups are increasing worldwide, sarcopenic obesity is emerging as a relevant factor associated with higher risk for adverse events and outcomes in several clinical settings, including cancer. Recent reports showing that prevalence of sarcopenic obesity may involve up to one-third of patients with cancer despite body mass index strongly support the need for its evaluation in oncological clinical practice. In fact, in several cancer types, sarcopenic obesity is associated with poorer outcomes that include metabolic and surgical complications, longer hospitalization, physical disability, and shorter survival. Importantly, sarcopenic obesity may also have an effect on chemotherapy, as it may induce a higher risk for dose-limiting-toxicity. The aim of this review was to present an updated overview on the definition, effects, mechanisms, and clinical relevance of sarcopenia in this setting.
Journal of the Endocrine Society, May 1, 2021
Abstract Background: In sarcopenic obese subjects it is essential to reduce body weight and to pr... more Abstract Background: In sarcopenic obese subjects it is essential to reduce body weight and to preserve lean mass, in order to avoid a worsening of muscle function (1). Several studies have shown that leucine supplementation can be useful to improve skeletal muscle mass in sarcopenic patients (2). Aim: Evaluate the effectiveness of a short-term low calorie diet (LCD) combined with combined supplementation with whey protein, leucine and vitamin D on weight loss, lean mass and muscle strength in sarcopenic, obese, hyperinsulinemic and menopause women. Materials and methods: 16 female with mean age: 58.1 years (range: 47–69 years), BMI 37.6 Kg/m2 (range: 31,7 - 44,1 Kg/m2), HOMA-index ≥ 2.5, were assigned to an LCD regimen (1000 kcal/day) with supplementation of 18 g protein, 4 g leucine and 5 mcg vitamin D for 45 days. Anthropometric indexes, blood and urine chemistry, body composition by DEXA, muscle strength by handgrip test and Short Physical Performance Battery (SPPB) were assessed at baseline and at the end of the treatment. Results: A significant reduction of BMI (35,7 vs 37,6 Kg/m2), waist circumference (102,4 vs 107 cm), HOMA index (2,3 vs 4,8) and fasting insulin (10,4 vs 17,4 μIU/ml) was observed in all patients. Women preserved total lean body mass (57 vs 55 %) and improved significantly muscle strength, as measured by handgrip (22,2 vs 18,6 Kg) and SPPB (8,9 vs 7,5). Conclusion: We conclude that LCD with adequate protein intake and a supplementation with whey protein, leucine and vitamin D should be promoted to maintain muscle mass and improve muscle strength in menopause women with sarcopenic obesity. References: 1. Batsis JA, Villareal DT. Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies. Nat Rev Endocrinol. 2018 Sep;14(9):513–5372. Bauer JM, Verlaan S, Bautmans I, Brandt K, Donini LM, Maggio M, McMurdo ME, Mets T, Seal C, Wijers SL, Ceda GP, De Vito G, Donders G, Drey M, Greig C, Holmbäck U, Narici M, McPhee J, Poggiogalle E, Power D, Scafoglieri A, Schultz R, Sieber CC, Cederholm T. Effects of a vitamin D and leucine-enriched whey protein nutritional supplement on measures of sarcopenia in older adults, the PROVIDE study: a randomized, double-blind, placebo-controlled trial. J Am Med Dir Assoc. 2015 Sep 1;16(9)
Journal of Endocrinological Investigation, Nov 2, 2017
Purpose Patients with cystic fibrosis (CF) present with signs and symptoms that overlap with thos... more Purpose Patients with cystic fibrosis (CF) present with signs and symptoms that overlap with those of adult growth hormone deficiency (GHD) syndrome: loss of muscle mass, bone fragility and lower stress tolerance. In literature, the prevalence of GHD in pediatric CF patients ishigher than general population, but these studies have been performed on children with growth delay. To our knowledge, there are no studies on adult patients. The aim of this paper is to evaluate GH-IGF1 axis in an adult CF population. Methods Fifty clinically stable adult patients, 30 males; age 36 ± 2 years; BMI 21.39 ± 0.22 kg/m 2 and FEV 1 67 ± 4% were studied. Data regarding glycometabolic status and results of pituitary, thyroid, parathyroid, gonadal and adrenal function tests were recorded. All patients underwent a GH releasing hormone (GHRH) + Arginine stimulation test to confirm a GHD. Results GHRH + Arginine test revealed the presence of GHD in 16 patients (32%); specifically 7 patients had a severe deficiency and 9 a partial deficiency. Conclusions Adult patients with CF may show GHD. These patients should be followed over time to assess if the GHD could impact the clinical progression of CF.
Nutrients, Apr 29, 2022
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
Journal of Infection, Mar 1, 2021
The Journal of Steroid Biochemistry and Molecular Biology, Mar 1, 1992
Benign prostatic hyperplasia (BPH) is a sex steroid dependent disease. Estrogens and androgens ca... more Benign prostatic hyperplasia (BPH) is a sex steroid dependent disease. Estrogens and androgens can modulate in different mammalian tissues epidermal growth factor (EGF) production and/or secretion. In order to clarify the relationships between estrogen and androgen receptor concentrations and those of immunoreactive EGF (irEGF), we have evaluated these parameters in 14 human BPH samples, by means of a dextran-coated charcoal method and radioimmunoassay, respectively. Cytosolic steroid receptors did not seem to correlate with irEGF. A linear significative relationship was evident between nuclear androgen receptor (ARn) levels and endogenous irEGF but not between nuclear estrogen receptors and irEGF: in ARn negative BPH samples, irEGF levels were lower than in ARn positive ones. Therefore, it is possible that androgens act at prostatic tissue level, through their own receptors, by modulating EGF production and/or secretion.
International Journal of Immunopathology and Pharmacology, 1996
5a reductase is a key enzyme in androgen metabolism. Altered enzyme function and/or regulation is... more 5a reductase is a key enzyme in androgen metabolism. Altered enzyme function and/or regulation is responsible for numerous human pathologies such as benign prostatic hyperplasia, acne, hirsutism and male pattern baldness. In order to block androgen action through inhibition of this enzyme, numerous compounds have been synthesized during the past two decades. Among them, 4-azasteroids and in particular finasteride have been extensively studied and used in the treatment of human diseases.
Clinical Endocrinology, Feb 1, 1992
OBJECTIVE Because of continued debate about the role of insulin In the development of hirsutlsm a... more OBJECTIVE Because of continued debate about the role of insulin In the development of hirsutlsm and in the Induction of the polycystlc ovary syndrome, we have evaluated the hormonal pattern in a group of hirsute patients. PATIENTS Fifty-four hirsute patients (age range 18-39 years) of whom 26 patlents were obese (0) (BMI 28-53 kgt m2 and W/H > 0.85), 12 with ultrasonographlc evidence of polycystlc ovaries (0 PCO) and 14 with normal ovaries. Twenty-eight patients were within normal weight range, and, of these, 14 presented ultrasonographlc evidence of polycystlc ovaries and 14 had normal ovaries. Two groups of age-matched subjects (obese and normal weight), normally menstruating, without hirsutism or history of endocrlnopathies or ultrasonographic evidence of polycystic ovaries, served as controls. MEASUREMENTS Androstenedlone and testosterone were evaluated In all patlents by RIA, followlng ether extraction, DHEAS, LH, FSH and insulin were evaluated directly by RIA. SHBG was evaluated by the concanavalin method. Free testosterone (FT%) was calculated eccording to the formula FT=4.038-1.607 log SHBG. integrated areas under the response curve were calculated for LH and insulin respectively followlng i.v. administration of GnRH (100 pg) or oral administration of glucose (75 g). RESULTS Results (mean f standard deviation) showed comparable values of androstenedlone In all groups of obese patients and in obese controls (7-3 f 2.6 in patients with polycystic ovaries, 7.1 f 2.9 in non-polycystic ovary patients and 7.4f2.6 nmolll in obese controls, respectively), regardless of baseline and area insulin, the presence or absence of polycystic ovaries, or hirsutlsm. SHBG
Journal of Endocrinological Investigation, Mar 13, 2018
Purpose To examine differences in effects according to growth hormone (GH) treatment duration in ... more Purpose To examine differences in effects according to growth hormone (GH) treatment duration in adult GH-deficient patients. Methods In the Italian cohort of the observational Hypopituitary Control and Complications Study, GH-treated adults with GH deficiency (GHD) were grouped by duration of treatment; ≤ 2 years (n = 451), > 2 to ≤ 6 years (n = 387) and > 6 years (n = 395). Between-group differences in demographics, medical history, physical characteristics, insulin-like growth factor-I standard deviation score (IGF-I SDS) and lipid profile at baseline, last study visit and changes from baseline to last study visit were assessed overall, for adult-and childhood-onset GHD and by gender using ANOVA for continuous variables and Chi-squared test for categorical variables. Results At baseline, treatment duration groups did not differ significantly for age, gender, body mass index, GHD onset, IGF-I SDS, lipid profile, and quality of life. Mean initial GH dose did not differ significantly according to treatment duration group in any subgroup, except female patients, with highest mean dose seen in the longest duration group. In the longest duration group for patients overall, adult-onset patients and male patients, there were significant decreases in GH dose from baseline to last visit, and in total and low-density lipoprotein (LDL)-cholesterol concentrations. IGF-I SDS increased, to a greater extent, in the longest duration group for patients overall and female patients. Conclusions The results show that long-term GH treatment is associated with decreasing GH dose, increased IGF-I, decreased LDL-cholesterol and the presence of surrogate markers that help to give confidence in a diagnosis of GHD.
Journal of Cellular Physiology, Nov 23, 2015
Low-grade chronic inflammation is a salient feature of obesity and many associated disorders. Thi... more Low-grade chronic inflammation is a salient feature of obesity and many associated disorders. This condition frequently occurs in central obesity and is connected to alterations of the visceral adipose tissue (AT) microenvironment. Understanding how obesity is related to inflammation may allow the development of therapeutics aimed at improving metabolic parameters in obese patients. To achieve this aim, we compared the features of 2 subpopulations of adipose-derived stem cells (ASC) isolated from both subcutaneous and visceral AT of obese patients with the features of 2 subpopulations of ASC from the same isolation sites of non-obese individuals. In particular, the behavior of ASC of obese vs non-obese subjects during hypoxia, which occurs in obese AT and is an inducer of the inflammatory response, was evaluated. Obesity deeply influenced ASC from visceral AT (obV-ASC); these cells appeared to exhibit clearly distinguishable morphology and ultrastructure as well as reduced proliferation, clonogenicity and expression of stemness, differentiation and inflammation-related genes. These cells also exhibited a deregulated response to hypoxia, which induced strong tissue-specific NF-kB activation and an NF-kB-mediated increase in inflammatory and fibrogenic responses. Moreover, obV-ASC, which showed a less stem-like phenotype, recovered stemness features after hypoxia. Our findings demonstrated the peculiar behavior of obV-ASC, their influence on the obese visceral AT microenvironment and the therapeutic potential of NF-kB inhibitors. These novel findings suggest that the deregulated hyperresponsiveness to hypoxic stimulus of ASC from visceral AT of obese subjects may contribute via paracrine mechanisms to low-grade chronic inflammation, which has been implicated in obesity
Urology, Feb 1, 1993
Based on the reported sex difference in the incidence of acquired cystic kidney disease (ACKD) in... more Based on the reported sex difference in the incidence of acquired cystic kidney disease (ACKD) in patients with chronic renal failure, it is hypothesized that the hormonal derangement, well documented in male and female uremic patients on long-term dialysis, could be responsible for the pathogenesis of ACKD. The decreased androgen/estrogen ratio, and the increased estrogen value could be responsible for an estrogen receptor mediated effect on the tubular epithelial cell proliferation, an event further potentiated by the action of regulatory peptides like epidermal growth factor (EGF). The epithelial stimulation is more pronounced in men because male tissues are less adapted than female tissues to high estrogen values. Furthermore the androgen reduction, more remarkable in male than female patients, is responsible for an up-regulation of EGF-R. Therefore hormones and growth factors, by means of their own receptor in renal tissue (homologous to the two oncogenes c-erb A and c-erb B), may be responsible for the development of ACKD, and may play an important role in the pathogenesis of multiple adenomas and renal carcinomas reported with high incidence among uremic patients with ACKD.
L'Endocrinologo, Sep 15, 2021
Sommario La Non-Alcoholic Fatty Liver Disease (NA-FLD) comprende diversi stadi di patologia epati... more Sommario La Non-Alcoholic Fatty Liver Disease (NA-FLD) comprende diversi stadi di patologia epatica che vanno dalla steatosi alla cirrosi epatica. È considerata la manifestazione epatica della patologia metabolica e alcune alterazioni endocrinologiche possono concorrere a determinarne l'insorgenza o la progressione. È quindi di fondamentale importanza che l'endocrinologo sia consapevole dell'importanza clinica e prognostica della NAFLD correlata alle patologie endocrine, al fine di offrire al paziente il trattamento adeguato. Parole chiave NAFLD • Steatosi epatica • Ormoni • Metabolismo Introduzione La Non-Alcoholic Fatty Liver Disease (NAFLD) è considerata la manifestazione epatica della patologia metabolica, e consiste in uno spettro di patologie epatiche che comprendono l'accumulo epatico di lipidi in più del 5% degli epatociti (steatosi), l'infiammazione epatica (steatoepatite), la fibrosi, la cirrosi e lo sviluppo di epatocarcinoma (Figura 1), in assenza di consumo alcolico maggiore o uguale a 20 g nelle donne e 30 g negli uomini, e di altre cause secondarie [1].
British Journal of Dermatology, 1995
Pachydermoperiostosis is a rare osteo-cutaneous disease characterized by hypertrophy of bones and... more Pachydermoperiostosis is a rare osteo-cutaneous disease characterized by hypertrophy of bones and surrounding soft tissues. The cutaneous manifestations include coarsening of facial features, cutis verticis gyrata. digital clubbing, hyperhidrosis and seborrhoea. The pathogenetic mechanism of the disease is still debated, and proposed aetiological factors include genetic influences, anomalies in fibroblast activity, or alteration in peripheral blood flow. We studied a patient with the incomplete form of pachydermoperiostosis. assessing epidermal growth factor receptor (EGF-R) and sex hormone steroid receptors (SR) in the affected skin, and also evaluating the urinary excretion of EGF. The results showed high levels of nuclear steroid receptors, increased cytosolic oestrogen receptors, and no detectable progesterone and androgen cytosoiic receptors. EGF-R was also undetectable, and the urinary excretion of EGF was elevated. These findings suggest that the increased tissue sensitivity to circulating sex-steroids could induce enhanced tissue EGF/transforming growth factor a (TGF-a) production and utilization. The SR-EGF-R system could therefore be involved in determining hypertrophy of the affected tissues.
Viruses, Feb 9, 2023
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
European Urology, 1992
A double-blind placebo-controlled study was performed in 35 benign prostatic hypertrophy (BPH) pa... more A double-blind placebo-controlled study was performed in 35 benign prostatic hypertrophy (BPH) patients never treated before. The patients were randomized into two groups, the 1st (18 cases) receiving Serenoa repens extract (160 mg t.d.) for 3 months up to the day before the operation of transvesical adenomectomy and the 2nd (17 cases) receiving placebo. Steroid receptors were evaluated in the nuclear (n) and cytosolic (c) fraction using the saturation analysis technique (Scatchard analysis or single saturating-dose assay) for androgen (AR) and estrogen (ER) receptors and the enzyme immunoassay (EIA) for ER and progesterone receptors (PgR). Scatchard analysis of ERc and ERn revealed the presence of two classes of binding sites, one with high-affinity low-capacity binding and the other with low-affinity high-capacity binding. In the untreated BPH group, ER were higher in the n than in the c fraction: ERn were positive in 14 cases and ERc in 12 of 17 cases. In the BPH group treated with S. repens extract on the contrary, ERn were negative for both binding classes in 17 cases and ERc in 6 of 18 cases. Using EIA, ERn and ERc were detected in all 15 samples examined, but in the treated group, ERn were significantly (p less than 0.01) lower than in the untreated group, whilst ERc remained almost unchanged. Similar results were obtained measuring PgR: the n fraction of the treated group prostatic samples was significantly (p less than 0.01) lower than that of the untreated group.(ABSTRACT TRUNCATED AT 250 WORDS)
Results of the HYPOCCS Study focusing on the role of the duration of r-hGH treatment on several p... more Results of the HYPOCCS Study focusing on the role of the duration of r-hGH treatment on several parameter