Giovanni Misciagna - Academia.edu (original) (raw)
Papers by Giovanni Misciagna
Lifestyle genomics, 2012
Background: Cannabinoid type 1 receptor (CB1-R) is a key mediator in the control of food intake a... more Background: Cannabinoid type 1 receptor (CB1-R) is a key mediator in the control of food intake and is linked to obesity. Aim: To evaluate the relationship between CB1-R gene polymorphism and dietary macronutrient intake in elderly subjects. Methods: This study included 118 subjects (60 males, 58 females) from a population survey carried out in southern Italy in 1992-1993 who were older than 65 years and previously characterized for CB1-R polymorphism (75 with GG wild-type genotype, 41 with heterozygous polymorphic allele AG, and 2 with genotype AA). All subjects completed a validated semi-quantitative food frequency questionnaire. Statistical methods included multiple logistic regression to model macronutrient intake to genotype, controlling for potential confounders. Results: When controlled for age, gender, and body mass index, the intake of dietary cholesterol and saturated fats corrected for calories was inversely associated with the CB1-R 1359 G/A polymorphism, while the intake of starchy carbohydrates was directly associated with this polymorphism. Conclusion: In our unselected elderly population, the 1359 G/A polymorphism is linked with a specific macronutrient intake. This could be explained by the role of the cannabinoid system as a determinant of food intake and eating behavior.
Frontiers in Oncology
BackgroundArtificial neural networks (ANNs) and logistic regression (LR) are the models of chosen... more BackgroundArtificial neural networks (ANNs) and logistic regression (LR) are the models of chosen in many medical data classification tasks. Several published articles were based on summarizing the differences and similarities of these models from a technical point of view and critically assessing the quality of the models. The aim of this study was to compare ANN and LR the statistical techniques to predict gastrointestinal cancer in an elderly cohort in Southern Italy (ONCONUT study).MethodIn 1992, ONCONUT was started with the aim of evaluating the relationship between diet and cancer development in a Southern Italian elderly population. Patients with gastrointestinal cancer (ICD-10 from 150.0 to 159.9) were included in the study (n = 3,545).ResultsThis cohort was used to train and test the ANN and LR. LR was evaluated separately for macro- and micronutrients, and the accuracy was evaluated based on true positives and true negatives versus the total (97.15%). Then, ANN was trained...
International Journal of Epidemiology, 2020
Background The Mediterranean diet (MedDiet) is associated with good health. We aimed to estimate ... more Background The Mediterranean diet (MedDiet) is associated with good health. We aimed to estimate the effect of levels of adherence to the MedDiet on lifespan by performing treatment effects survival analysis. Methods A sample of 5250 subjects aged ≥18 years were randomly selected from the electoral list of Castellana Grotte and Putignano (Apulian Region, Italy). Cohorts were enrolled in 2005–06 and followed-up until December 2018. The adherence to the MedDiet was measured by the relative Mediterranean score (rMED) and categorized as high, medium and low. Time-to-death (all-causes) as estimated by average treatment effect on the treated (ATET), potential outcome mean (POM) and relative efficiency of exposure were the outcomes. Results A total of 4896 subjects were included. The median follow-up time was 12.82 (inter quartile range (IQR) 12.22–13.05), 12.91 (IQR 12.21–13.27) and 12.84 (IQR 12.19–13.03) years for high, medium and low rMED subjects respectively. By December 2018, 453 (9...
International Journal of Obesity, 2021
Weight change is associated with all causes of death, cardiovascular, and cancer mortality and a ... more Weight change is associated with all causes of death, cardiovascular, and cancer mortality and a heterogeneous group of other causes of death. We aimed to estimate the effect of weight change on all causes and cause-specific mortality in a cohort with a high prevalence of deaths due to diseases of the digestive system.MethodsIn this prospective cohort study, 2230 subjects aged 30 to 50 years were examined. The study consisted of a 32-year longitudinal study period (January 1985 to December 2017) and mortality follow-up. Outcomes were mortality from all causes and deaths from gastrointestinal disease. Root Mean Squared Error (RMSE) was evaluated to capture individual residual variation in Body Mass Index (BMI) after adjustment for baseline BMI, and the relationship of residual variation with mortality was calculated as cumulative incidence function and cause-specific hazard (CSH) rate.ResultsIn total, 793 participants died during the follow-up, 96 of them due to Digestive system causes. Magnitude of residual variation weight in the last quintile was associated with all-cause mortality (relative risk, 2.00; 95% CI, 1.54–2.59) and Digestive system causes (relative risk, 3.82; 95% CI, 1.86–7.81).ConclusionThe findings suggest an association between weight change and gastrointestinal disease mortality. Epidemiological works studying the correlation between weight change and mortality should consider this aspect.
Nutrition, Metabolism and Cardiovascular Diseases, 2019
Background and aims: Increasing literature data show that adherence to the Mediterranean diet is ... more Background and aims: Increasing literature data show that adherence to the Mediterranean diet is undergoing profound changes in recent years, albeit with marked differences across nations. In Italy, one of the cradles of the Mediterranean diet, the literature regarding the trend for Mediterranean diet adherence is conflicting. Thus, we aimed to explore the trends of adherence to the Mediterranean diet in a large cohort of participants living in South Italy, over 20 years from 1985e86 to 2005e06. Methods and results: Cross-sectional study with two evaluations, one made in 1985e86 and another in 2005e06; all participants were adults aged 30e70 years of age. The adherence to the Mediterranean diet was evaluated using the score proposed by Panagiotakos et al. This score features values ranging from 0 to 55, higher scores reflecting a greater adherence. The data are reported by age (30e49 vs. 50e69 years). Overall, 2451 subjects were included in 1985e86 and 2375 in 2005e06. A significant reduction was observed in the adherence to the Mediterranean diet (age 30e49 years: 31.82 AE 4.18 in 1985e86 vs. 29.20 AE 4.48 in 2005e06, reduction by 8.2%, p < 0.0001; age 50e69: 32.20 AE 4.09 in 1985e86 vs.30.15 AE 4.27 in 2005e06, reduction by 6.3%, p < 0.0001). Among all these items, the most dramatic change was observed for olive oil consumption, that decreased by 2.35 points in younger and 0.89 in older people. The adherence to the Mediterranean diet decreased from 1985e86 to 2005e06 in South Italy, particularly in younger people, above all due to a decreased olive oil consumption.
BMJ Open, 2019
ObjectiveAlcoholic fatty liver (AFLD) and non-alcoholic fatty liver (NAFLD) are two common condit... more ObjectiveAlcoholic fatty liver (AFLD) and non-alcoholic fatty liver (NAFLD) are two common conditions. However, if they can increase the risk of death is poorly explored. We therefore aimed to investigate the potential association between the presence and severity of liver steatosis and mortality in a large sample of older people.DesignProspective.SettingCommunity.ParticipantsWomen and men randomly sampled from the electoral rolls of the population of Castellana Grotte, a town in Southern Italy (Apulia region) between 2005 and 2006. Among 1942 initially contacted, 1708 (=87.9%) participated to the baseline survey (Multicentrica Colelitiasi III (MICOL III)). This specific study included 1445 older participants (mean age=65.2 years, females=44.2%).ExposureNAFLD or AFLD.Primary and secondary outcomesMortality (all-cause and specific-cause).ResultsAfter a median of 12 years, 312 participants (=21.6%) died. After adjusting for nine potential confounders, the presence of steatosis was not...
The journal of nutrition, health & aging, 2016
Introduction: Health benefits associated with Mediterranean diet (MD) are well-established in non... more Introduction: Health benefits associated with Mediterranean diet (MD) are well-established in non-Mediterranean population settings, while less is known on the potential health advantages associated with non-Mediterranean dietary (MD) patterns among Mediterranean populations. Objectives: To establish the association between the traditional MD and non-MD patterns with mortality in a sample of the Italian general population, through a longitudinal analysis on 22,849 men and women from the Moli-sani study (2005e2010). A traditional MD was assessed by the Mediterranean diet score (MDS); the dietary approach to stop hypertension (DASH), the Palaeolithic diet and the Nordic diet were chosen as non-MD patterns. Hazard ratios (HR) with 95% confidence intervals (95%CI) were calculated by multivariable Cox regression and competing risk models. Results: During follow-up (median 8.2 y), 1,237 subjects died. Higher MDS was associated with lower risk of allecause (HR ¼ 0.77;95%CI 0.66e0.90, highest vs lowest quartile) and CVD (HR ¼ 0.77;0.59e1.00) death risk and a downward trend was found with cancer death (HR ¼ 0.88; 0.68e1.12). Closer adherence to the DASH diet was associated with reduced all-cause but not with CVD mortality; risk reduction associated with the Palaeolithic diet was limited to non CVD-non cancer death, whereas the Nordic diet was not associated with any death risk modification. Conclusions: A traditional MD lowers the risk of all-cause and CVD mortality in an adult general Mediterranean population; a DASH diet was associated with improved survival but not with a reduction of CVD mortality, while other non-MD diets were not associated with substantial health benefits.
Handbook of Anthropometry, 2012
Non-alcoholic fatty liver disease is a spectrum of disorders characterized by an abnormal accumul... more Non-alcoholic fatty liver disease is a spectrum of disorders characterized by an abnormal accumulation of triglycerides in the liver, and is recognized as the most common hepatic lesion, with an estimated prevalence of 15–39% in more industrialized countries. Many potential risk factors for non-alcoholic fatty liver disease have been identified, such as obesity, insulin resistance, hyperlipidemia and diabetes. Visceral adiposity seems to be the major contributor to a fatty liver in the insulin-resistant state. In fact, epidemiological evidence suggests that visceral adiposity is more associated with a fatty liver than the body mass. Direct assessment of hepatic fat obtained by biopsy is considered the gold standard, but it is a very invasive method. Fatty infiltration of the liver and abdominal fat can also be measured by Computerized Tomography, Magnetic Resonance Imaging, and 1H Magnetic Resonance Spectroscopy. Unfortunately, these accurate methods for measuring fat mass are very sophisticated and expensive and have limited applicability in routine clinical settings. Ultrasound has been proposed as an alternative non-invasive technique for measuring fatty liver and subcutaneous and visceral fat thickness, because it may overcome some limitations of skinfold thickness and more sophisticated anthropometric methods.
Gastroentérologie clinique et biologique, 1992
The authors carried out a prospective study to evaluate variations with time in postcholecystecto... more The authors carried out a prospective study to evaluate variations with time in postcholecystectomy duodenogastric reflux (expressed as "fasting bile reflux" in mumol/h) and in gastric mucosal damage. Ten patients underwent (before cholecystectomy, 6 months after surgery and after a median period of 4 years from surgery) a gastric drainage to assess total (enzymatic method) and single (high performance liquid chromatography) intragastric bile acids, and a gastroscopy with biopsies of the antrum and gastric body to assess histological damage to the mucosa. The results showed that there was a progressive increase in the fasting bile reflux of total bile acids with time (precholecystectomy median value 0.295 mumol/h; 6 months control median value 12.045 mumol/h; late control medial value 19.9 mumol/h; Friedman test, P = 0.0022). Examination of the gastric mucosa at the three moments of the study showed that histological damage worsened progressively. In fact chronic atrophic ...
Epidemiologia e prevenzione, 1992
In Italy there are eight tumor Population-Based Registries (PBRs) that publish incidence data, an... more In Italy there are eight tumor Population-Based Registries (PBRs) that publish incidence data, and only one of them (Ragusa) provides data for Southern Italy. Usually, PBRs are based on data collection from Pathologists and medical records. Our integrated system differentiates from traditional PBRs because the information comes from the General Practitioners (GPs) and is completed with the diagnosis provided by the Pathologists (Ps). During two years we have registered 1,057 new cancers on a middle period population of 212,644. GPs and Ps signed 395 and 879 incident cases, respectively. GPs alone provided 16.8%, Ps alone 62.6%, and either source 20.6% of total cases. After excluding non melanotic skin cancers and bladder carcinoma, the GPs-Ps integrated system counted 828 new cases in two years. These incidence data are the first in our region (Puglia). The 178 cases signed by GPs alone should have been lost if the informations of our PBR had been based only on local Ps' records...
Recenti progressi in medicina, 1992
The aim of this work was to detect, in patients with chronic hypertransaminasemia (CH), the facto... more The aim of this work was to detect, in patients with chronic hypertransaminasemia (CH), the factors associated with the changes of ALT serum levels after one year of 10 mg/Kg/die ursodeoxycholic acid (UDCA). One hundred and twenty two consecutive patients with ALT values more than twice the normal upper limit for at least six months were admitted to the study. At the liver biopsy 82 patients were affected by liver cirrhosis (LC), 7 by chronic persistent hepatitis (CPH), and 14 by chronic active hepatitis (CAH). Nineteen patients were classified as unspecified chronic liver disease (UCLD) due to biopsy refusal. Five patients (4 LC and 1 UCLD) did not finish the study. Before and after the beginning of the treatment ALT and the other routine tests of liver function were determined in serum by routine laboratory methods. In all the diagnosis a decrease of ALT was observed after one year UDCA therapy. Particularly, in cirrhotic patients a reduction of 40% in the ALT serum levels was det...
American Journal of Gastroenterology, 2013
The relationship between hepatitis C virus (HCV) infection and type 2 diabetes mellitus (DM 2) is... more The relationship between hepatitis C virus (HCV) infection and type 2 diabetes mellitus (DM 2) is still uncertain. The objective of this study was to evaluate the association between HCV infection, measured as positivity to anti-HCV antibodies, and the incidence of DM 2 in a cohort of subjects sampled from the general population and followed up for 20 years. At baseline, the cohort consisted of a random sample of 2,472 subjects (72% response rate, age range 30-69 years) from the electoral register of a town in Southern Italy. The cohort subjects were examined three times: in 1985 (M1), in 1992 (M2), and in 2005 (M3). At M1, M2, and M3, each participant filled in a questionnaire and had a blood sample taken to measure blood glucose and other serum variables including glutamic pyruvic alanine aminotransferase (ALT). Anti-HCV antibodies were analyzed with standard techniques at M1 and M2. Diabetes type 2 diagnosis was a history of diabetes and/or serum glucose ≥126 mg/dl and/or treatment with insulin or hypoglycemic drugs. Logistic regression was used for multivariable data analysis. Diabetes prevalence was higher in subjects with positive anti-HCV antibodies at M1 and M2, and diabetes incidence was higher in subjects with baseline positive anti-HCV antibodies at M1-M2 and lower at M2-M3. In multivariable models, controlling for gender, age, and body mass index (BMI), there was no association between incident cases of diabetes and positive anti-HCV antibodies at baseline, either at M1-M2 (odds ratio (OR) 0.73, 95% confidence interval (CI) 0.43-1.22) or at M2-M3 (0.65, 0.41-1.04). HCV was associated with DM 2 only in subjects with elevated ALT (OR 0.58, 95% CI 0.31-1.08, if ALT normal; OR 1.47, 95% CI 1-2.16, if ALT elevated, controlling for age, gender, and BMI). Our findings, in a cohort study at population level, support an association between the presence of anti-HCV antibodies at baseline and a higher incidence of type 2 diabetes in the following 20 years only in subjects with elevated ALT.
Lipids in health and disease, Jan 30, 2012
Lipid metabolism is altered in subjects with liver steatosis. FAS is a key enzyme in de novo lipo... more Lipid metabolism is altered in subjects with liver steatosis. FAS is a key enzyme in de novo lipogenesis and both FAS gene expression and enzymatic activity are primarily regulated by metabolic signals in the liver. Lipoprotein lipase (LPL), the rate-limiting enzyme for the hydrolysis of core triglycerides, plays a pivotal role in lipid metabolism. This study aims to investigate if circulating levels of FAS and LPL could be clinically associated with liver steatosis. In this work, we present data obtained from a subsample of 94 subjects with liver steatosis enrolled by NUTRIEPA study, a nutritional trial in subjects with liver steatosis. Serum levels of FAS protein and LPL activity were evaluated by ELISA test and by a fluorescent method, respectively. The diagnosis and the degree of liver steatosis were based on laboratory and ecographic measurements. Statistical methods included Kruskal-Wallis analysis of variance and Wilcoxon signed-rank test, where appropriate. The χ2 test has b...
Oncology, 2007
Objective: Spontaneous non-enzymatic reaction of protein amino groups with glucose and other redu... more Objective: Spontaneous non-enzymatic reaction of protein amino groups with glucose and other reducing sugars, known as glycation or Maillard reaction, has long been considered irreversible and inevitably followed by slow conversion of fructosamines and advanced glycation end products. Instead, recent identification of fructosamine 3 kinase (FN3K) has unveiled that fructosamines can be physiologically repaired, so that the FN3K enzyme could be considered a new form of protein repair. Methods: Thirty-one consecutive patients with colorectal cancer were enrolled in the study. FN3K gene expression was determined using quantitative RT-PCR. Results: The mean level of FN3K gene expression was significantly lower in cancer tissue than in the corresponding normal colorectal mucosa, and FN3K gene was under-expressed most particularly in the tumours located on the left side of the colon. Conclusions: Low mRNA levels of this enzyme in colon cancer tissue with respect to normal surrounding mucos...
Nutrition and Cancer, 1994
Many epidemiological studies have focused on the relationships between diet and colorectal cancer... more Many epidemiological studies have focused on the relationships between diet and colorectal cancer, but only a few have been conducted in the Mediterranean area. A population-based case-control study was carried out from July 1987 to June 1989 in a low-risk area in Southern Italy. By means of an &amp;quot;ad hoc&amp;quot; tumor registry, 132 diagnosed colorectal cancers were detected during the two years of study. One hundred nineteen of these 132 colorectal cancer cases were interviewed about their personal dietary habits with use of a questionnaire concerning the frequency of consumption of 70 foods or beverages. An equal number of controls was randomly selected from the lists of general practitioners of the area during the same period and interviewed with the same food frequency questionnaire. In a multivariate analysis, the relative risks (RRs) of developing colorectal cancer were estimated according to the different levels of consumption of food groups and selected food items. All RRs were adjusted for age, sex, education, smoking status, and modifications in diet in the previous 10 years. The risk of colorectal cancer increased nearly threefold for the highest level of consumption of foods with a high content of refined sugar [RR = 2.75, 95% confidence interval (CI) 1.26-5.97] and for the consumption of wine (&amp;gt; 1 l/day) (RR = 3.22, 95% CI 1.05-9.88). An inverse relationship was revealed for the highest consumption of raw and cooked vegetables (RR = 0.51, 95% CI 0.25-1.04) and diary products (RR = 0.46, 95% CI 0.22-0.98) and for the consumption of more than two cups of coffee per day (RR = 0.38, 95% CI 0.16-0.89). In this Mediterranean area, the main source of calories, cereals, did not show a significant relationship with colorectal cancer. These findings support the hypothesis that the local Mediterranean dietary pattern could explain the low risk of colorectal cancer.
Journal of the American College of Nutrition, 2005
To evaluate in non diabetic subjects the association of dietary carbohydrates with fructosamine, ... more To evaluate in non diabetic subjects the association of dietary carbohydrates with fructosamine, a measure of total non enzymatic glycated proteins in the blood associated with mortality, particularly from cardiovascular diseases. A population sample of 252 subjects (137 men and 115 women, mean age 57) without diabetes and with fasting serum glucose &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;126 mg/100 mL, participated in the study. Diet and dietary glycemic load were measured with a validated food frequency questionnaire. Fructosamine was measured with a standard colorimetric method. Multiple linear regression was used to analyze the data. Serum fructosamine was positively associated with dietary glycemic load. Moreover, it was positively associated with intake of polyunsaturated fats and alcohol; and negatively with intake of monounsaturated fats, and with physical activity. The quality of carbohydrate and fat, as well as physical activity, may explain the variation of non enzymatic glycated serum proteins in non diabetic subjects.
Journal of Clinical Gastroenterology, 1995
European Journal of Epidemiology, 1993
The risk of colo-rectal cancer (CRC) in subjects with a positive family history (FH+) for maligna... more The risk of colo-rectal cancer (CRC) in subjects with a positive family history (FH+) for malignancy has been assessed by means of a case-control study carried out between 1987-89 in an area of about 215,000 inhabitants in Southern Italy. One hundred and nineteen CRC cases were compared with 119 sex -and age -frequency matched population controls. Detailed pedigrees were collected at the family homes of both cases and controls. The odds ratio (OR) of CRC, adjusted by means of logistic regression for age, sex and number of first-degree relatives, increased with the number of any kinds of cancers in first-degree relatives with a significant linear trend (p = 0.042), while there was no risk with a FH+ for digestive cancer excluding CRC or for other cancers excluding large bowel and digestive organs. The OR (and 95% confidence interval) for CRC was 5.9 (1.64-21.23) for at least one first-degree relative with CRC. After a mutual adjustment between CRC and the other cancers in the families of cases and controls, the risk of CRC with a FH+ for other cancers did not change, revealing a strong association (p = 0.002) for CRC alone. From the analysis of the family history of cancer in the case group, the relative frequency of families that satisfied the criteria for so-called hereditary non-polyposic colo-rectal cancer (HNPCC) was 2.6%. The increased relative risk of CRC observed only in families with FH+ for CRC is a supportive finding for organizing and planning prevention and genetic counselling for these families, whose members should be referred for further assessment.
Lifestyle genomics, 2012
Background: Cannabinoid type 1 receptor (CB1-R) is a key mediator in the control of food intake a... more Background: Cannabinoid type 1 receptor (CB1-R) is a key mediator in the control of food intake and is linked to obesity. Aim: To evaluate the relationship between CB1-R gene polymorphism and dietary macronutrient intake in elderly subjects. Methods: This study included 118 subjects (60 males, 58 females) from a population survey carried out in southern Italy in 1992-1993 who were older than 65 years and previously characterized for CB1-R polymorphism (75 with GG wild-type genotype, 41 with heterozygous polymorphic allele AG, and 2 with genotype AA). All subjects completed a validated semi-quantitative food frequency questionnaire. Statistical methods included multiple logistic regression to model macronutrient intake to genotype, controlling for potential confounders. Results: When controlled for age, gender, and body mass index, the intake of dietary cholesterol and saturated fats corrected for calories was inversely associated with the CB1-R 1359 G/A polymorphism, while the intake of starchy carbohydrates was directly associated with this polymorphism. Conclusion: In our unselected elderly population, the 1359 G/A polymorphism is linked with a specific macronutrient intake. This could be explained by the role of the cannabinoid system as a determinant of food intake and eating behavior.
Frontiers in Oncology
BackgroundArtificial neural networks (ANNs) and logistic regression (LR) are the models of chosen... more BackgroundArtificial neural networks (ANNs) and logistic regression (LR) are the models of chosen in many medical data classification tasks. Several published articles were based on summarizing the differences and similarities of these models from a technical point of view and critically assessing the quality of the models. The aim of this study was to compare ANN and LR the statistical techniques to predict gastrointestinal cancer in an elderly cohort in Southern Italy (ONCONUT study).MethodIn 1992, ONCONUT was started with the aim of evaluating the relationship between diet and cancer development in a Southern Italian elderly population. Patients with gastrointestinal cancer (ICD-10 from 150.0 to 159.9) were included in the study (n = 3,545).ResultsThis cohort was used to train and test the ANN and LR. LR was evaluated separately for macro- and micronutrients, and the accuracy was evaluated based on true positives and true negatives versus the total (97.15%). Then, ANN was trained...
International Journal of Epidemiology, 2020
Background The Mediterranean diet (MedDiet) is associated with good health. We aimed to estimate ... more Background The Mediterranean diet (MedDiet) is associated with good health. We aimed to estimate the effect of levels of adherence to the MedDiet on lifespan by performing treatment effects survival analysis. Methods A sample of 5250 subjects aged ≥18 years were randomly selected from the electoral list of Castellana Grotte and Putignano (Apulian Region, Italy). Cohorts were enrolled in 2005–06 and followed-up until December 2018. The adherence to the MedDiet was measured by the relative Mediterranean score (rMED) and categorized as high, medium and low. Time-to-death (all-causes) as estimated by average treatment effect on the treated (ATET), potential outcome mean (POM) and relative efficiency of exposure were the outcomes. Results A total of 4896 subjects were included. The median follow-up time was 12.82 (inter quartile range (IQR) 12.22–13.05), 12.91 (IQR 12.21–13.27) and 12.84 (IQR 12.19–13.03) years for high, medium and low rMED subjects respectively. By December 2018, 453 (9...
International Journal of Obesity, 2021
Weight change is associated with all causes of death, cardiovascular, and cancer mortality and a ... more Weight change is associated with all causes of death, cardiovascular, and cancer mortality and a heterogeneous group of other causes of death. We aimed to estimate the effect of weight change on all causes and cause-specific mortality in a cohort with a high prevalence of deaths due to diseases of the digestive system.MethodsIn this prospective cohort study, 2230 subjects aged 30 to 50 years were examined. The study consisted of a 32-year longitudinal study period (January 1985 to December 2017) and mortality follow-up. Outcomes were mortality from all causes and deaths from gastrointestinal disease. Root Mean Squared Error (RMSE) was evaluated to capture individual residual variation in Body Mass Index (BMI) after adjustment for baseline BMI, and the relationship of residual variation with mortality was calculated as cumulative incidence function and cause-specific hazard (CSH) rate.ResultsIn total, 793 participants died during the follow-up, 96 of them due to Digestive system causes. Magnitude of residual variation weight in the last quintile was associated with all-cause mortality (relative risk, 2.00; 95% CI, 1.54–2.59) and Digestive system causes (relative risk, 3.82; 95% CI, 1.86–7.81).ConclusionThe findings suggest an association between weight change and gastrointestinal disease mortality. Epidemiological works studying the correlation between weight change and mortality should consider this aspect.
Nutrition, Metabolism and Cardiovascular Diseases, 2019
Background and aims: Increasing literature data show that adherence to the Mediterranean diet is ... more Background and aims: Increasing literature data show that adherence to the Mediterranean diet is undergoing profound changes in recent years, albeit with marked differences across nations. In Italy, one of the cradles of the Mediterranean diet, the literature regarding the trend for Mediterranean diet adherence is conflicting. Thus, we aimed to explore the trends of adherence to the Mediterranean diet in a large cohort of participants living in South Italy, over 20 years from 1985e86 to 2005e06. Methods and results: Cross-sectional study with two evaluations, one made in 1985e86 and another in 2005e06; all participants were adults aged 30e70 years of age. The adherence to the Mediterranean diet was evaluated using the score proposed by Panagiotakos et al. This score features values ranging from 0 to 55, higher scores reflecting a greater adherence. The data are reported by age (30e49 vs. 50e69 years). Overall, 2451 subjects were included in 1985e86 and 2375 in 2005e06. A significant reduction was observed in the adherence to the Mediterranean diet (age 30e49 years: 31.82 AE 4.18 in 1985e86 vs. 29.20 AE 4.48 in 2005e06, reduction by 8.2%, p < 0.0001; age 50e69: 32.20 AE 4.09 in 1985e86 vs.30.15 AE 4.27 in 2005e06, reduction by 6.3%, p < 0.0001). Among all these items, the most dramatic change was observed for olive oil consumption, that decreased by 2.35 points in younger and 0.89 in older people. The adherence to the Mediterranean diet decreased from 1985e86 to 2005e06 in South Italy, particularly in younger people, above all due to a decreased olive oil consumption.
BMJ Open, 2019
ObjectiveAlcoholic fatty liver (AFLD) and non-alcoholic fatty liver (NAFLD) are two common condit... more ObjectiveAlcoholic fatty liver (AFLD) and non-alcoholic fatty liver (NAFLD) are two common conditions. However, if they can increase the risk of death is poorly explored. We therefore aimed to investigate the potential association between the presence and severity of liver steatosis and mortality in a large sample of older people.DesignProspective.SettingCommunity.ParticipantsWomen and men randomly sampled from the electoral rolls of the population of Castellana Grotte, a town in Southern Italy (Apulia region) between 2005 and 2006. Among 1942 initially contacted, 1708 (=87.9%) participated to the baseline survey (Multicentrica Colelitiasi III (MICOL III)). This specific study included 1445 older participants (mean age=65.2 years, females=44.2%).ExposureNAFLD or AFLD.Primary and secondary outcomesMortality (all-cause and specific-cause).ResultsAfter a median of 12 years, 312 participants (=21.6%) died. After adjusting for nine potential confounders, the presence of steatosis was not...
The journal of nutrition, health & aging, 2016
Introduction: Health benefits associated with Mediterranean diet (MD) are well-established in non... more Introduction: Health benefits associated with Mediterranean diet (MD) are well-established in non-Mediterranean population settings, while less is known on the potential health advantages associated with non-Mediterranean dietary (MD) patterns among Mediterranean populations. Objectives: To establish the association between the traditional MD and non-MD patterns with mortality in a sample of the Italian general population, through a longitudinal analysis on 22,849 men and women from the Moli-sani study (2005e2010). A traditional MD was assessed by the Mediterranean diet score (MDS); the dietary approach to stop hypertension (DASH), the Palaeolithic diet and the Nordic diet were chosen as non-MD patterns. Hazard ratios (HR) with 95% confidence intervals (95%CI) were calculated by multivariable Cox regression and competing risk models. Results: During follow-up (median 8.2 y), 1,237 subjects died. Higher MDS was associated with lower risk of allecause (HR ¼ 0.77;95%CI 0.66e0.90, highest vs lowest quartile) and CVD (HR ¼ 0.77;0.59e1.00) death risk and a downward trend was found with cancer death (HR ¼ 0.88; 0.68e1.12). Closer adherence to the DASH diet was associated with reduced all-cause but not with CVD mortality; risk reduction associated with the Palaeolithic diet was limited to non CVD-non cancer death, whereas the Nordic diet was not associated with any death risk modification. Conclusions: A traditional MD lowers the risk of all-cause and CVD mortality in an adult general Mediterranean population; a DASH diet was associated with improved survival but not with a reduction of CVD mortality, while other non-MD diets were not associated with substantial health benefits.
Handbook of Anthropometry, 2012
Non-alcoholic fatty liver disease is a spectrum of disorders characterized by an abnormal accumul... more Non-alcoholic fatty liver disease is a spectrum of disorders characterized by an abnormal accumulation of triglycerides in the liver, and is recognized as the most common hepatic lesion, with an estimated prevalence of 15–39% in more industrialized countries. Many potential risk factors for non-alcoholic fatty liver disease have been identified, such as obesity, insulin resistance, hyperlipidemia and diabetes. Visceral adiposity seems to be the major contributor to a fatty liver in the insulin-resistant state. In fact, epidemiological evidence suggests that visceral adiposity is more associated with a fatty liver than the body mass. Direct assessment of hepatic fat obtained by biopsy is considered the gold standard, but it is a very invasive method. Fatty infiltration of the liver and abdominal fat can also be measured by Computerized Tomography, Magnetic Resonance Imaging, and 1H Magnetic Resonance Spectroscopy. Unfortunately, these accurate methods for measuring fat mass are very sophisticated and expensive and have limited applicability in routine clinical settings. Ultrasound has been proposed as an alternative non-invasive technique for measuring fatty liver and subcutaneous and visceral fat thickness, because it may overcome some limitations of skinfold thickness and more sophisticated anthropometric methods.
Gastroentérologie clinique et biologique, 1992
The authors carried out a prospective study to evaluate variations with time in postcholecystecto... more The authors carried out a prospective study to evaluate variations with time in postcholecystectomy duodenogastric reflux (expressed as "fasting bile reflux" in mumol/h) and in gastric mucosal damage. Ten patients underwent (before cholecystectomy, 6 months after surgery and after a median period of 4 years from surgery) a gastric drainage to assess total (enzymatic method) and single (high performance liquid chromatography) intragastric bile acids, and a gastroscopy with biopsies of the antrum and gastric body to assess histological damage to the mucosa. The results showed that there was a progressive increase in the fasting bile reflux of total bile acids with time (precholecystectomy median value 0.295 mumol/h; 6 months control median value 12.045 mumol/h; late control medial value 19.9 mumol/h; Friedman test, P = 0.0022). Examination of the gastric mucosa at the three moments of the study showed that histological damage worsened progressively. In fact chronic atrophic ...
Epidemiologia e prevenzione, 1992
In Italy there are eight tumor Population-Based Registries (PBRs) that publish incidence data, an... more In Italy there are eight tumor Population-Based Registries (PBRs) that publish incidence data, and only one of them (Ragusa) provides data for Southern Italy. Usually, PBRs are based on data collection from Pathologists and medical records. Our integrated system differentiates from traditional PBRs because the information comes from the General Practitioners (GPs) and is completed with the diagnosis provided by the Pathologists (Ps). During two years we have registered 1,057 new cancers on a middle period population of 212,644. GPs and Ps signed 395 and 879 incident cases, respectively. GPs alone provided 16.8%, Ps alone 62.6%, and either source 20.6% of total cases. After excluding non melanotic skin cancers and bladder carcinoma, the GPs-Ps integrated system counted 828 new cases in two years. These incidence data are the first in our region (Puglia). The 178 cases signed by GPs alone should have been lost if the informations of our PBR had been based only on local Ps' records...
Recenti progressi in medicina, 1992
The aim of this work was to detect, in patients with chronic hypertransaminasemia (CH), the facto... more The aim of this work was to detect, in patients with chronic hypertransaminasemia (CH), the factors associated with the changes of ALT serum levels after one year of 10 mg/Kg/die ursodeoxycholic acid (UDCA). One hundred and twenty two consecutive patients with ALT values more than twice the normal upper limit for at least six months were admitted to the study. At the liver biopsy 82 patients were affected by liver cirrhosis (LC), 7 by chronic persistent hepatitis (CPH), and 14 by chronic active hepatitis (CAH). Nineteen patients were classified as unspecified chronic liver disease (UCLD) due to biopsy refusal. Five patients (4 LC and 1 UCLD) did not finish the study. Before and after the beginning of the treatment ALT and the other routine tests of liver function were determined in serum by routine laboratory methods. In all the diagnosis a decrease of ALT was observed after one year UDCA therapy. Particularly, in cirrhotic patients a reduction of 40% in the ALT serum levels was det...
American Journal of Gastroenterology, 2013
The relationship between hepatitis C virus (HCV) infection and type 2 diabetes mellitus (DM 2) is... more The relationship between hepatitis C virus (HCV) infection and type 2 diabetes mellitus (DM 2) is still uncertain. The objective of this study was to evaluate the association between HCV infection, measured as positivity to anti-HCV antibodies, and the incidence of DM 2 in a cohort of subjects sampled from the general population and followed up for 20 years. At baseline, the cohort consisted of a random sample of 2,472 subjects (72% response rate, age range 30-69 years) from the electoral register of a town in Southern Italy. The cohort subjects were examined three times: in 1985 (M1), in 1992 (M2), and in 2005 (M3). At M1, M2, and M3, each participant filled in a questionnaire and had a blood sample taken to measure blood glucose and other serum variables including glutamic pyruvic alanine aminotransferase (ALT). Anti-HCV antibodies were analyzed with standard techniques at M1 and M2. Diabetes type 2 diagnosis was a history of diabetes and/or serum glucose ≥126 mg/dl and/or treatment with insulin or hypoglycemic drugs. Logistic regression was used for multivariable data analysis. Diabetes prevalence was higher in subjects with positive anti-HCV antibodies at M1 and M2, and diabetes incidence was higher in subjects with baseline positive anti-HCV antibodies at M1-M2 and lower at M2-M3. In multivariable models, controlling for gender, age, and body mass index (BMI), there was no association between incident cases of diabetes and positive anti-HCV antibodies at baseline, either at M1-M2 (odds ratio (OR) 0.73, 95% confidence interval (CI) 0.43-1.22) or at M2-M3 (0.65, 0.41-1.04). HCV was associated with DM 2 only in subjects with elevated ALT (OR 0.58, 95% CI 0.31-1.08, if ALT normal; OR 1.47, 95% CI 1-2.16, if ALT elevated, controlling for age, gender, and BMI). Our findings, in a cohort study at population level, support an association between the presence of anti-HCV antibodies at baseline and a higher incidence of type 2 diabetes in the following 20 years only in subjects with elevated ALT.
Lipids in health and disease, Jan 30, 2012
Lipid metabolism is altered in subjects with liver steatosis. FAS is a key enzyme in de novo lipo... more Lipid metabolism is altered in subjects with liver steatosis. FAS is a key enzyme in de novo lipogenesis and both FAS gene expression and enzymatic activity are primarily regulated by metabolic signals in the liver. Lipoprotein lipase (LPL), the rate-limiting enzyme for the hydrolysis of core triglycerides, plays a pivotal role in lipid metabolism. This study aims to investigate if circulating levels of FAS and LPL could be clinically associated with liver steatosis. In this work, we present data obtained from a subsample of 94 subjects with liver steatosis enrolled by NUTRIEPA study, a nutritional trial in subjects with liver steatosis. Serum levels of FAS protein and LPL activity were evaluated by ELISA test and by a fluorescent method, respectively. The diagnosis and the degree of liver steatosis were based on laboratory and ecographic measurements. Statistical methods included Kruskal-Wallis analysis of variance and Wilcoxon signed-rank test, where appropriate. The χ2 test has b...
Oncology, 2007
Objective: Spontaneous non-enzymatic reaction of protein amino groups with glucose and other redu... more Objective: Spontaneous non-enzymatic reaction of protein amino groups with glucose and other reducing sugars, known as glycation or Maillard reaction, has long been considered irreversible and inevitably followed by slow conversion of fructosamines and advanced glycation end products. Instead, recent identification of fructosamine 3 kinase (FN3K) has unveiled that fructosamines can be physiologically repaired, so that the FN3K enzyme could be considered a new form of protein repair. Methods: Thirty-one consecutive patients with colorectal cancer were enrolled in the study. FN3K gene expression was determined using quantitative RT-PCR. Results: The mean level of FN3K gene expression was significantly lower in cancer tissue than in the corresponding normal colorectal mucosa, and FN3K gene was under-expressed most particularly in the tumours located on the left side of the colon. Conclusions: Low mRNA levels of this enzyme in colon cancer tissue with respect to normal surrounding mucos...
Nutrition and Cancer, 1994
Many epidemiological studies have focused on the relationships between diet and colorectal cancer... more Many epidemiological studies have focused on the relationships between diet and colorectal cancer, but only a few have been conducted in the Mediterranean area. A population-based case-control study was carried out from July 1987 to June 1989 in a low-risk area in Southern Italy. By means of an &amp;quot;ad hoc&amp;quot; tumor registry, 132 diagnosed colorectal cancers were detected during the two years of study. One hundred nineteen of these 132 colorectal cancer cases were interviewed about their personal dietary habits with use of a questionnaire concerning the frequency of consumption of 70 foods or beverages. An equal number of controls was randomly selected from the lists of general practitioners of the area during the same period and interviewed with the same food frequency questionnaire. In a multivariate analysis, the relative risks (RRs) of developing colorectal cancer were estimated according to the different levels of consumption of food groups and selected food items. All RRs were adjusted for age, sex, education, smoking status, and modifications in diet in the previous 10 years. The risk of colorectal cancer increased nearly threefold for the highest level of consumption of foods with a high content of refined sugar [RR = 2.75, 95% confidence interval (CI) 1.26-5.97] and for the consumption of wine (&amp;gt; 1 l/day) (RR = 3.22, 95% CI 1.05-9.88). An inverse relationship was revealed for the highest consumption of raw and cooked vegetables (RR = 0.51, 95% CI 0.25-1.04) and diary products (RR = 0.46, 95% CI 0.22-0.98) and for the consumption of more than two cups of coffee per day (RR = 0.38, 95% CI 0.16-0.89). In this Mediterranean area, the main source of calories, cereals, did not show a significant relationship with colorectal cancer. These findings support the hypothesis that the local Mediterranean dietary pattern could explain the low risk of colorectal cancer.
Journal of the American College of Nutrition, 2005
To evaluate in non diabetic subjects the association of dietary carbohydrates with fructosamine, ... more To evaluate in non diabetic subjects the association of dietary carbohydrates with fructosamine, a measure of total non enzymatic glycated proteins in the blood associated with mortality, particularly from cardiovascular diseases. A population sample of 252 subjects (137 men and 115 women, mean age 57) without diabetes and with fasting serum glucose &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;126 mg/100 mL, participated in the study. Diet and dietary glycemic load were measured with a validated food frequency questionnaire. Fructosamine was measured with a standard colorimetric method. Multiple linear regression was used to analyze the data. Serum fructosamine was positively associated with dietary glycemic load. Moreover, it was positively associated with intake of polyunsaturated fats and alcohol; and negatively with intake of monounsaturated fats, and with physical activity. The quality of carbohydrate and fat, as well as physical activity, may explain the variation of non enzymatic glycated serum proteins in non diabetic subjects.
Journal of Clinical Gastroenterology, 1995
European Journal of Epidemiology, 1993
The risk of colo-rectal cancer (CRC) in subjects with a positive family history (FH+) for maligna... more The risk of colo-rectal cancer (CRC) in subjects with a positive family history (FH+) for malignancy has been assessed by means of a case-control study carried out between 1987-89 in an area of about 215,000 inhabitants in Southern Italy. One hundred and nineteen CRC cases were compared with 119 sex -and age -frequency matched population controls. Detailed pedigrees were collected at the family homes of both cases and controls. The odds ratio (OR) of CRC, adjusted by means of logistic regression for age, sex and number of first-degree relatives, increased with the number of any kinds of cancers in first-degree relatives with a significant linear trend (p = 0.042), while there was no risk with a FH+ for digestive cancer excluding CRC or for other cancers excluding large bowel and digestive organs. The OR (and 95% confidence interval) for CRC was 5.9 (1.64-21.23) for at least one first-degree relative with CRC. After a mutual adjustment between CRC and the other cancers in the families of cases and controls, the risk of CRC with a FH+ for other cancers did not change, revealing a strong association (p = 0.002) for CRC alone. From the analysis of the family history of cancer in the case group, the relative frequency of families that satisfied the criteria for so-called hereditary non-polyposic colo-rectal cancer (HNPCC) was 2.6%. The increased relative risk of CRC observed only in families with FH+ for CRC is a supportive finding for organizing and planning prevention and genetic counselling for these families, whose members should be referred for further assessment.