Giorgio Bedogni | Università di Bologna (original) (raw)

Papers by Giorgio Bedogni

The American Journal of Gastroenterology, Sep 6, 2022

INTRODUCTION: We assessed the impact of long-term albumin administration to hyponatremic patients... more INTRODUCTION: We assessed the impact of long-term albumin administration to hyponatremic patients with ascites enrolled in the ANSWER trial. METHODS: The normalization rate of baseline hyponatremia and the 18-month incidence rate of at least moderate hyponatremia were evaluated. RESULTS: The hyponatremia normalization rate was higher with albumin than with standard medical treatment (45% vs 28%, P = 0.042 at 1 month). Long-term albumin ensured a lower incidence of at least moderate hyponatremia than standard medical treatment (incidence rate ratio: 0.245 [CI 0.167–0.359], P < 0.001). DISCUSSION: Long-term albumin administration improves hyponatremia and reduces episodes of at least moderate hyponatremia in outpatients with cirrhosis and ascites.

Translational Research, 2022

The differential diagnosis of psoriatic arthritis (PsA) and rheumatoid arthritis (RA) is difficul... more The differential diagnosis of psoriatic arthritis (PsA) and rheumatoid arthritis (RA) is difficult because of the lack of diagnostic clinical signs and reliable biomarkers. This study investigated miRNA and adipokines as potential additional markers to discriminate PsA from RA. The expression profile of miRNA (miR-21, miR-140, miR-146a, miR-155, miR-181b, miR-223, miR-let-7e) and inflammatory cytokines (IL-1β, IL-6, IL-17a, IL-23a, TNF-α) from peripheral blood mononuclear cells of PsA and RA patients compared to healthy controls (HC) were evaluated by real-time PCR, and serum adipokines (adiponectin, chemerin, leptin, resistin, visfatin) and cytokines by ELISA. Univariable binary logistic regression was used to find the association between PsA and potential predictors. The gene expression of miRNA and cytokines and the serum levels of adipokines were found significantly different in PsA and RA patients compared to HC, as well as in PsA versus RA. MiR-140 gene expression resulted up-regulated in PsA patients and reduced in RA in comparison to HC, and, first, significantly higher in PsA compared with RA. Serum levels of IL-23a and leptin were significantly increased in PsA and RA populations than in HC, as well as in PsA versus RA. Furthermore, circulating TNF-α was up-regulated in PsA and RA in comparison to controls, while resulted higher in RA than in PsA. Univariable binary logistic regression analysis found the above mentioned markers associated to PsA versus RA. Our results demonstrated for the first time increased expression of circulating miR-140 and serum leptin in PsA patients compared to RA, which were identified as potential additional biomarkers to discriminate PsA from RA. Since the differential diagnosis of PsA and RA poses challenges in clinical practice, our data may help to enhance the diagnostic performance of PsA in daily practice.

Fatty liver (FL) is the most common wide-world liver disease that is nowadays demonstrating an in... more Fatty liver (FL) is the most common wide-world liver disease that is nowadays demonstrating an increasing prevalence trend. In sharp contrast, the most common causes of liver diseases, such as viral causes, are decreasing thanks to advances in antiviral therapies. Non-alcoholic fatty liver disease (NAFLD) is characterized by hepatic fat accumulation, often associated with insulin resistance (IR), and defined by the presence of steatosis in at least 5% of hepatocytes in absence of relevant alcohol intake. [1] The prevalence of FL is variable, ranging from 17 to 46% in adults and is dependent on the diagnostic method besides varying with the ethnicity, sex and age [2]. Many studies have been carried out in primary, secondary and tertiary care centers and few studies of FL are still available in the general population [3]. Taking into account the "ecology of medical care model", according to which only a minority of citizens with a given illness will actually search for and get medical care, the real burden of disease attributable to FL can be estimated only from data obtained from the general population.

A novel Body Shape Index (ABSI, waist circumference (WC)/BMI 2/3 Height 1/2) has been recently id... more A novel Body Shape Index (ABSI, waist circumference (WC)/BMI 2/3 Height 1/2) has been recently identified as a risk factor for premature mortality in the NHANES population. However, limited research on the association of ABSI with the metabolic syndrome (MS) components is available. We investigated the contribution of ABSI to high fasting glucose and other MS components, independently of sex, age and BMI, with a cross-sectional analysis of 6081 Caucasians (18-87 yr, 72% females) followed as outpatients at a Nutritional Research Centre in Milan (ICANS). Biochemical parameters of MS were measured enzymatically. MS was diagnosed using the harmonized international definition. ABSI association with binary outcomes (high triglycerides, blood pressure, fasting glucose and low HDL) were analyzed by generalized linear models (GLMs). Median BMI was 28.7 kg -2 (25.4-32.7), 20.4%, 39.7% and 39,9% subjects were normal weight, overweight and obese, respectively. High WC, triglycerides, blood pressure, fasting glucose and low HDL were detected in 63.6%, 17.4%, 17,0%, 44.3% and 28.7%, respectively. MS was present in 27.0%. ABSI was independently associated to all the outcomes of interest. In conclusion, high fasting glucose and the other MS components are independently associated with ABSI in a large population at different levels of nutritional status

Multivariable logistic regression models developed for studying the association between the 4 par... more Multivariable logistic regression models developed for studying the association between the 4 parameters of interest and the 8 outcomes considered. Describe how to calculate the probability of the outcome from each model. (PDF 370Â kb)

Cancer Biomarkers, Oct 9, 2020

BACKGROUND: The role of serum biomarkers in the surveillance of hepatocellular carcinoma (HCC) is... more BACKGROUND: The role of serum biomarkers in the surveillance of hepatocellular carcinoma (HCC) is controversial. OBJECTIVE: We assessed the diagnostic performances of alpha-fetoprotein (AFP) and protein-induced by vitamin-Kabsence/antagonist-II (PIVKA-II) in 388 cirrhotic patients with chronic liver disease (CLD). METHODS: Biomarkers were quantified by automated chemiluminescent-enzyme-immunoassays (Fujirebio, Tokyo, Japan) at HCC diagnosis in 258 patients (204 males; median age 66.9 years) and in 130 cirrhotics without HCC (104 males; median-age 60.6 years). CLD etiology in HCC/non-HCC was CHB in 48/35, CHC in 126/56 and Non-Viral in 84/39.

Annals of Hepatology, Sep 1, 2014

Definitions, Apr 19, 2018

A Definition is a new piece of knowledge produced by researchers which represents one of the buil... more A Definition is a new piece of knowledge produced by researchers which represents one of the building blocks at the base of research. By its very nature, the Definition is suited to be evaluated through simple parameters such as numeric rating scale, direct comment and number of reuses in new research. T he entire researchers' community has the power to take part in the evaluation process of Definitions.

Nutrients, Sep 13, 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 Hepatology, Jun 1, 2023

Journal of Personalized Medicine, Mar 3, 2023

Definitions, Apr 19, 2018

EFSA Supporting Publications, 2018

The present document refers to the project GP/EFSA/NUTRI/2014/01. This document aims at describin... more The present document refers to the project GP/EFSA/NUTRI/2014/01. This document aims at describing the methods used to retrieve and to critically analyse the scientific data pertinent to this project, besides giving information about the scheduled meetings and reports. EFSA Scientific Opinions, guidance documents and comments received during public consultation were used to select the outcome variables and the methods of measurement that were evaluated by the Experts on the basis of an extensive research of the scientific literature. Purposely developed databases were used by the Experts to perform a critical analysis of the outcome variables and their methods of measurement. The project was performed in 3 blocks, each including 2 categories of claims: Block 1: 1a) Protection against oxidative damage and cardiovascular health and; 1b) Post-prandial blood glucose responses/blood glucose control, weight management; Block 2: 2a) Bone, joints, oral and skin health and; 2b) Neurological and psychological functions; Block 3: 3a) Gut and immune function and; 3b) Physical performance. Project GP/EFSA/NUTRI/2014/01 www.efsa.europa.eu/publications 2 EFSA Supporting publication 2018:EN-1272 An additional Block ("Miscellaneous") was added and refers to all the claimed effects, outcome variables and methods of measurement that did not fall in any of the other blocks.

Digestive Diseases, 2010

Access to full text and tables of contents, including tentative ones for forthcoming issues: www.... more Access to full text and tables of contents, including tentative ones for forthcoming issues: www.karger.com/ddi_issues

British Journal of Nutrition, Sep 1, 1996

We assessed total body water (TBW) and extracellular water (ECW) in thirty-four non-ascitic cirrh... more We assessed total body water (TBW) and extracellular water (ECW) in thirty-four non-ascitic cirrhotics and twenty healthy controls by *H,O and Br dilution. In the same subjects, bioelectric impedance (BI) was recorded at multiple frequencies. Body hydration was similar for controls (mean 55.6 (SD 67)), lesssevere cirrhotics (Child-Pugh classification A; CPA; n 21, mean 56.2 (SD 6.2)) and moderately-severe cirrhotics (Child-Pugh classification B; CPB; n 13, mean 57.2 (SD 5.4)). However, intracellular water standardized per litre TBW was significantly higher in CPB subjects (mean 27.0 (SD 7-5); P c 0.01) compared with CPA (mean 21.3 (SD 10.6)) and control subjects (mean 18.0 (SD 9%)). Published formulas for predicting TBW and ECW from BI at multiple frequencies were applied to the cirrhotics. These formulas gave accurate predictions of TBW and ECW, although standard errors of estimates were higher for CPB subjects (TBW < 2 5 and ECW < 2-1 1) than those for CPA (TBW < 2-0 and ECW < 1.8 I) and control (TBW 1.4 and ECW 0.9 1) subjects. Liver cirrhosis: Total body water: Extracellular water: Bioelectric impedance * For reprints.

Nutrients, Feb 24, 2023

European Journal of Pediatrics, Jun 17, 2014

The aim of this study was to analyse the relationship between insulin-glucose metabolism, nocturn... more The aim of this study was to analyse the relationship between insulin-glucose metabolism, nocturnal blood pressure dipping and nonalcoholic fatty liver disease (NAFLD) in obese adolescents without diabetes. One hundred one consecutive children, with biopsy-proven NAFLD, were included in this study. Blood samples were drawn for the analyses of liver function tests, insulin-glucose metabolism and lipid profile appraisal. An ambulatory blood pressure measurement (ABPM) was performed. Seventy-six children (75.3 %) were systolic nondippers, and 23 of them were diastolic nondippers (30.3 %). No differences were found in the anthropometric parameters between the two groups. When compared to the systolic dippers, the systolic nondippers had higher medians of mean nocturnal blood pressure, glucose at 0, 60 and 120 min in the oral glucose tolerance test (OGTT), OGTT insulin at all time points and insulin-resistance values. No correlation of histopathological features with dipping/ nondipping statuses was found. Conclusions: We found an association between a nocturnal blood pressure fall and measures of insulin levels, independent of obesity, or daytime blood pressure levels, among the obese patients with NAFLD. Although no association between nondipping pro-with a longer term follow-up are needed, to better elucidate the complex link between these particular entities. Keywords Dipping. Hypertension. NAFLD. Children. Obesity Abbreviations ALT Alanine transferases AST Aspartate transferases ABPM Ambulatory blood pressure measurement BP Blood pressure GGT Gamma-glutamyl-transpeptidase HSC Hepatic stellate cells HOMA Homeostatic model assessment IQR Interquartile range ISI OGTT-derived insulin sensitivity index LDL Low-density lipoprotein HDL High-density lipoprotein NAFLD Nonalcoholic fatty liver disease OGTT Oral glucose tolerance test RAAS Renin-angiotensin-aldosterone system NASH Steatohepatitis SNS Sympathetic nervous system TG Total triglycerides

European Journal of Clinical Nutrition, Jul 25, 2007

To evaluate air-displacement plethysmography (ADP) and bioelectrical impedance analysis (BIA) vs ... more To evaluate air-displacement plethysmography (ADP) and bioelectrical impedance analysis (BIA) vs dual-energy X-ray absorptiometry (DXA) for the assessment of fat-free mass (FFM) in healthy elderly subjects. Subjects: Forty-two women and twenty-six men aged 60-84 years. Methods: FFM was measured by DXA and ADP. Body impedance (Z) was measured by four-polar BIA and the impedance index (ZI) was calculated as stature 2 /Z. Selection of predictors (gender, age, weight and ZI at 5, 50 and 100 kHz) for BIA algorithms was carried out using bootstrapped stepwise linear regression on 1000 samples of 68 subjects. Limits of agreement were used as measures of interchangeability of ADP and BIA with DXA. Results: The limits of agreement of ADP vs DXA were À11.0 to 2.4 kg in males and À4.8 to 2.2 kg in females. Gender, weight and ZI 100 were selected as predictors of FFM by bootstrapped stepwise linear regression. In males, ZI 100 (À12.2 to 12.2 kg) was much less accurate than weight (À6.0 to 6.0 kg) at predicting FFM and their combination did not improve the estimate (À6.0 to 6.0 kg). In females, ZI 100 (À6.8 to 6.8 kg) was less accurate than weight (À5.6 to 5.6 kg) at predicting FFM and their combination improved the estimate only slightly (À5.0 to 5.0 kg). Conclusions: In healthy elderly subjects, (1) ADP and DXA are not interchangeable for the assessment of FFM, especially in males; and (2) ZI 100 is not superior to weight for the prediction of FFM and their combination is of little advantage and only in females.

Alimentary Pharmacology & Therapeutics, Aug 23, 2021

LINKED CONTENTThis article is linked to Nocerino et al and Philips & Abraham papers. To v... more LINKED CONTENTThis article is linked to Nocerino et al and Philips & Abraham papers. To view these articles, visit https://doi.org/10.1111/apt.16404 and https://doi.org/10.1111/apt.16474

The American Journal of Gastroenterology, Sep 6, 2022

Translational Research, 2022

Cancer Biomarkers, Oct 9, 2020

Annals of Hepatology, Sep 1, 2014

Definitions, Apr 19, 2018

Nutrients, Sep 13, 2022

Journal of Hepatology, Jun 1, 2023

Journal of Personalized Medicine, Mar 3, 2023

Definitions, Apr 19, 2018

EFSA Supporting Publications, 2018

Digestive Diseases, 2010

British Journal of Nutrition, Sep 1, 1996

Nutrients, Feb 24, 2023

European Journal of Pediatrics, Jun 17, 2014

European Journal of Clinical Nutrition, Jul 25, 2007

Alimentary Pharmacology & Therapeutics, Aug 23, 2021

The present study has assessed the composition of the food distributed by a University canteen (C... more The present study has assessed the composition of the food distributed by a University canteen (CORIS, Modena, Italy) analyzing the principal nutrients of both winter and summer menus for a period of one week. The analysis of the principal nutrients (carbohydrates, lipids and proteins) contained in the food was carried out by laboratory methods and by using a computerized data bank of food composition tables. The computerized data were compared with the laboratory data and both with LARN (italian RDA, recommended daily allowance) {\ldots

Total body electrical conductivity (TOBEC) is a simple and non-invasive method for the assessment... more Total body electrical conductivity (TOBEC) is a simple and non-invasive method for the assessment of body composition in vivo. Information regarding the applicability of TOBEC in the condition of abnormal fluid balance is scarce. In the present paper we give the results of the comparison between TOBEC and total body water (TBW; assessed by the tritium dilution technique) in three groups of animals: (1) healthy (n 17), (2) expanded fluid volume by secondary biliary cirrhosis (SBC; n 9) and (3) Furosemide-treated rats (n 9). The TOBEC score and TBW by tritium dilution were found to be highly correlated in the pooled sample (r 0.90) and in normal (r 0.87), SBC (r 0.73) and Furosemide-treated (r 0.89) rats. However, the relationship between TOBEC and TBW, described by least-squares regression analysis, was found to be similar for SBC and normal rats but was significantly different for Furosemide-treated and normal rats. These findings suggest that TOBEC is unable to track TBW accurately when the ratio between intracellular and extracellular water is chronically or acutely altered.

This study reports total body hydration and water distribution between the extracellular water (E... more This study reports total body hydration and water distribution between the extracellular water (ECW) and the intracellular water (ICW) of a group of 15 elite male athletes compared with a group of 15 male subjects practising the same sport at `amateur' level. Total body water (TBW) and ECW were assessed by means of deuterium and bromide dilution techniques respectively. Both TBW and body hydration were significantly higher in elite athletes than in non-competitive subjects (52.3 +/- 5.0 vs 46.1 +/- 4.2 litres p < 0.001 and 63.2 +/- 1.9 vs 60.2 +/- 1.9% body weight, p < 0.003 respectively). Likewise, both ECW the ratio of ECW to TBW were significantly higher in athletes than in control subjects (20.7 +/- 2.9 vs 16.1 +/- 1.8 litres, p < 0.0001 and 0.40 +/- 0.06 vs 0.35 +/- 0.03, p < 0.005 respectively). ICW was similar in both groups but the ICW to ECW ratio was significantly higher in the athletes compared to the recreational sportsmen (0.67 +/- 0.16 vs 0.54 +/- 0.07, p < 0.01). These data suggest that assumptions regarding the chemical composition of the standard human body may not be valid in elite athletes.

World Health Organization has suggested that American standards may be adopted for use in countri... more World Health Organization has suggested that American standards may be adopted for use in countries where no local reference data are available. Since no locally accepted growth standard is available in Italy, this study investigated if American growth curves for weight, height and triceps skinfold (TSF) provide reliable values for Italian children. Weight, height and TSF were measured in 1273 Italian children (boys: 656, girls: 617) ranging in age from 6 to 12 years and their percentiles were compared with that provided by NCHS for American children. Despite some minor differences, it is shown that American standards can be used safely in Italian children aged from 6 to 12 years.

The availability of only a small number of studies on bioelectric impedance analysis (BIA) in non... more The availability of only a small number of studies on bioelectric impedance analysis (BIA) in non-Caucasian ethnic groups appears to limit reliable utilization of this method in anthropological field studies. In this study, 28 male Turkish-Mongolian subjects native of Kazakhstan (Central Asia) underwent total body water (TBW) and extracellular water (ECW) assessment by deuterium oxide (D2O) and sodium bromide (NaBr) dilution respectively. Bioelectric impedance (BI) was recorded at multiple frequencies. ECW and TBW were calculated from BI at 1 and 100 kHz respectively by applying formulae developed on a sample of Caucasian subjects with a hydration status similar to that of the study population. TBW predicted from BI at 1 and 100 kHz (37.5 +/- 3.31) was highly correlated and not significantly different from that obtained by D2O dilution (39.0 +/- 4.11, r = 0.894, p < 0.0001, SEE = 1.91). Similarly, ECW predicted from BI at 1 kHz (15.1 +/- 1.21) was highly correlated and not significantly different from that obtained by NaBr dilution (15.0 +/- 1.61, r = 0.847, p < 0.0001, SEE = 0.81). It is concluded that selected predictive formulae developed on Caucasian subjects may provide a precise and accurate assessment of ECW and TBW in Turkish-Mongolian populations.

Total body water (TBW) was measured by deuterium oxide dilution (D2O) and predicted by bioelectri... more Total body water (TBW) was measured by deuterium oxide dilution (D2O) and predicted by bioelectric impedance analysis (BIA) (Deurenberg, Schouten, Andreoli and De Lorenzo 1993) in 21 subjects with Schistosoma mansoni infection and 17 healthy controls of similar age (32.8 +/- 13.7 years, n=38). Patients were selected to have no visible fluid retention and no cardiac or renal abnormalities. Body hydration (TBW per kg of body weight) was significantly higher in patients with schistosomiasis than in controls (62.9 +/- 3.6 vs 57.4 +/- 4.3%, p < 0.0005). A significant correlation was found between albumin levels and TBW% on the pooled sample (n=38; r=0.660, p < 0.0001). This relationship was not influenced by the presence of disease, as determined by ANCOVA. Values of TBW predicted by BIA were highly correlated and not significantly different (p=n.s., ANOVA) from those measured by D2O in both controls and patients (r=0.854, p < 0.001, SEE = 2.3 1, CV=5.9% and r=0.848, p < 0.001, SEE=4.0 1, CV=9.3%, respectively). The bias (TBW by BIA - TBW by D2O) was of 0.9 +/- 3.7 in controls and of -1.3 +/- 4.2 1 in patients. This bias was significantly correlated to TBW% in patients (r=0.575, p < 0.05) but not in controls (p=n.s.). It is concluded that subjects with schistosomiasis show an apparent subclinical increase in body hydration which could affect the prediction of TBW from BIA.

Acute exposure to high altitude produces characteristic changes in body water distribution from w... more Acute exposure to high altitude produces characteristic changes in body water distribution from which acclimatized individuals seem to be spared. However, it has been suggested that body water distribution may be different in highlanders (HL) as compared to lowlanders (LL). We studied the distribution of total body water (TBW) between extracellular water (ECW) and intracellular water (ICW) in a group of 20 HL (3200 m above sea level) versus one of 20 LL (900 m above sea level). Subjects were matched for ethnic group (Kirghiz), sex (male), weight (Wt), height and body mass index. TBW:Wt and ECW:TBW were not different in HL as compared to LL (mean +/- SD, 58.5 +/- 5.0% versus 56.0 +/- 4.2% and 40.5 +/- 4.2% versus 40.7 +/- 2.2%; p = n.s. for both). This study does not support the hypothesis that body water distribution is different in HL as compared to LL.

OBJECTIVES: To assess the reliability of bioelectric impedance analysis (BIA) for predicting tota... more OBJECTIVES: To assess the reliability of bioelectric impedance analysis (BIA) for predicting total body water (TBW) and extracellular water (ECW) in obese children. DESIGN: Comparison of five prediction models based on: (i) body weight (Wt), (ii) the impedance (Z) index (ZI = height2/Z), (iii) the association of Wt and ZI, (iv) the body surface area (SA) to impedance ratio (SA:Z) and, (v) the body volume (V) to impedance ratio (V:Z). SUBJECTS: Thirty obese and 25 control children of 11.2 +/- 1.8 y of age. MEASUREMENTS: TBW and ECW were assessed by deuterium and bromide dilution; Z was measured at frequencies of 5,50 and 100 kHz. RESULTS: In controls, Wt explained 11% more variance of TBW than ZI (r2 = 0.977, SEE = 0.9 I, CV = 3.8%) and the association of Wt and ZI improved the prediction of TBW only slightly (r2 = 0.982, SEE = 0.8 I, CV = 3.5%). The SA:Z and V:Z indexes explained 6 and 33% less variance of TBW respectively as compared to Wt alone. In obese subjects, ZI explained 4% more variance of TBW than Wt (r2 = 0.914, SEE = 1.8 I, CV = 6.4%) and the SA:Z ratio was the most accurate predictor of TBW (r2 = 0.959, SEE = 1.2 I, CV = 4.4%). However, the increase in the explained variance of TBW associated to the use of the SA:Z ratio was of only 1% as compared to the association of ZI and Wt. The V:Z ratio explained 9% less of variance of TBW as compared to ZI. In both control and obese subjects, the association of Wt and ZI offered the best prediction of ECW (r2 = 0.807, SEE = 1.564 I and r2 = 0.826, SEE = 1.035 I, respectively). However, the values of CV were much higher in controls than in obese children (17.5% vs 8.4%) owing to their lower ECW and greater variability in ECW%. ZI was the most accurate predictor of TBW on the pooled sample (n = 55; r2 = 0.910, SEE = 1.932 I; CV = 7.4%). However, it was a poor predictor of ECW on the same sample owing to its high CV (n = 55; r2 = 0.866, SEE = 1.806 I, CV = 17.0%). CONCLUSIONS: The body surface area to impedance ratio is the most accurate predictor of TBW in obese children but the association of ZI and Wt may be of more interest when BIA is used to estimate both TBW and ECW. The impedance index offers a good prediction of TBW but not of ECW in children with different levels of fatness.

Total body water (TBW) was measured by deuterium oxide (D2O) dilution and predicted from bioelect... more Total body water (TBW) was measured by deuterium oxide (D2O) dilution and predicted from bioelectrical impedance (Z) in nineteen anorexic and twenty-seven control women. The equation of Kushner et al. (1992) based on the impedance index (ZI = height2/Z) gave biases of 0.9 (SD 2.5) and 0.8 (SD 2.5) litres in controls and patients respectively (NS, ANOVA). The ZI-based equation of Deurenberg et al. (1993) gave biases of 1.5 (SD 2.4) litres (NS) and 3.0 (SD 2.1) litres (P < 0.001) in controls and patients respectively. Despite the fact that weight was the most powerful predictor of TBW on the study sample (n 46, r2 0.90, P < 0.0001, SE of the estimate 1.6 litres, CV 5.7%), the formulas of Segal et al. (1991) and Kushner et al. (1992) based on the association of weight and ZI gave an inaccurate prediction of TBW in both control and anorexic subjects, with a bias ranging from -3.2 (SD 2.4) to 2.9 (SD 2.1) litres (P < or = 0.001). Population-specific formulas based on ZI (n 46) gave a more accurate prediction of TBW by bioelectrical impedance analysis on the study subjects, with biases of -0.1 (SD 1.8) and 0.5 (SD 1.7) litres in controls and patients respectively (NS). However, the individual bias was sometimes high. It is concluded that bioelectrical impedance analysis can be used to predict TBW in anorexic women at a population level, but the predictions are less good than those based on body weight alone.

Validation studies of bioelectric impedance analysis (BIA) were performed in children with obesit... more Validation studies of bioelectric impedance analysis (BIA) were performed in children with obesity, Duchenne muscle dystrophy and juvenile rheumatoid arthritis. BIA allowed an accurate assessment of total body water in all groups (CV from 4.1 to 5.1%). However, the prediction of extracellular water by BIA was not always satisfactory (CV from 8.5 to 12.5%), being better in the groups of children with the lowest variability in body water distribution.

This study tested two hypotheses: (1) that simple anthropometric parameters can be used to identi... more This study tested two hypotheses: (1) that simple anthropometric parameters can be used to identify patients at risk of decreased bone mineral content and (2) that an inverse relationship exists between waist:hip ratio (WHR) and bone mineral density (BMD). Bone mineral content (BMC) and BMD were evaluated by dual-energy X-ray absorptiometry in 1873 free-living women. Of these, 1819 (97%) were post-menopausal. One thousand and thirteen women (54%) had normal BMD, 705 (38%) osteopenia and 155 (8%) osteoporosis. Body weight (Wt), body mass index and arm muscle and fat areas were significantly lower in osteoporotics than osteopenics (p < 0.0001) and in these latter than controls (p < 0.0001). However, values of WHR were similar in all groups (p = ns). Body weight was the anthropometric parameter better correlated with BMC (rho = 0.650, p < 0.0001) and only Wt and age were identified as significant predictors of bone mineral status (normal-BMD/osteopenic/osteoporotic) at polytomous logistic regression (p = 0.0001 for each). However, Wt could not be employed as an indicator of bone mineral status at the individual level because of high variations in BMC for the same level of Wt. Under- (< 5th percentile) and normal-Wt (5th-95th percentile) women had the same frequency of osteopenia (39%) while it was lower in over-Wt (> 95th) women (13%). The frequency of osteoporosis was higher in under- than normal-Wt women (37 vs 7%) and none of the over-Wt women had osteoporosis. This study shows that: (1) simple anthropometric measurements cannot be used to select subjects at risk of decreased BMC and, (2) BMD does not vary with WHR.

Food composition tables (FCT) were validated against chemical analysis (CA) to assess energy, car... more Food composition tables (FCT) were validated against chemical analysis (CA) to assess energy, carbohydrate, lipid, protein and fibre content of the food consumed by Italian Army cadets. The absolute difference between FCT and CA in 2 separate weeks was < or = 0.7% for energy, < or = 4.1% for carbohydrates, < or = 2.9% for lipids, < or = 6.2% for proteins and < or = 31.6% for fibre. It is concluded that FCT can be used to assess energy, carbohydrate, lipid and protein but not fibre intake in this military community.

We used bioelectrical impedance analysis (BIA) as an exploratory tool to monitor the changes in b... more We used bioelectrical impedance analysis (BIA) as an exploratory tool to monitor the changes in body composition induced by a short-term (3-wk) weight reduction (energy-restricted diet, moderate aerobic exercise conditioning and psychological counselling) in 175 highly obese subjects (body mass index, BMI=41.7+/-5.8 kg/m2). The decrease in weight and BMI after the weight reduction program was 3.4% (geometric mean, p<0.0001) and 3.7+/-1.3 kg/m2 (mean+/-SD, p<0.0001), respectively. Bioelectrical impedance (Z) increased of about the same value at each of the measured frequencies (from 6+/-10% at 5 kHz to 5+/-9% at 100 kHz, mean+/-SD, p<0.0001). A statistically significant increase in Z5:Z100 was also seen (p<0.0001), but its clinical significance is questionable owing to its low absolute value (<1%). Taken together, these data suggest that no clinically relevant change in body water distribution occurred in our subjects as a result of the weight reduction program. However, the changes in Z did not satisfactorily predict the changes in anthropometric dimensions despite the evidence of a substantial association between Z and anthropometry both before and after the weight reduction program. Thus, accurate predictions of body composition changes in obese subjects may require more than two BIA measurements so as to have a better description of the weight-losing process.

BACKGROUND AND OBJECTIVES: Folate deficiency in the general population is associated with a risk ... more BACKGROUND AND OBJECTIVES: Folate deficiency in the general population is associated with a risk of cardiovascular disease and various cancers. The aim of this study was to evaluate folate status in Italian blood donors and its relationship with gender and smoking habit. DESIGN AND METHODS: A prospective study of 201 first visit donors (99 males and 102 females) was undertaken to evaluate folate status by measuring serum folate (SF) and red blood cell folate (RCF) levels and relating those with gender and smoking habit (100 smokers and 101 non-smokers). RESULTS: The rates of SF level less than 6.8 nmol/L and RCF less than 340 nmol/L were 9.9% and 25.3%, respectively in Italian blood donors. Mean RCF level was significantly lower (p<0.05) in females than in males and in smokers compared to non-smokers (p<0.001). The risk of reduced RCF levels in smokers was related to the number of cigarettes smoked per day, more than nine cigarettes increased the relative risk (RR) of low RCF level to 2.93 (95% C.I.: 1.34-6.41). INTERPRETATION AND CONCLUSIONS: This study suggests that folate deficiency, evaluated by RCF and SF levels, is widespread in Italian blood donors. Moreover, RCF values seem related to gender in non-smokers and modified by smoking habit, according to the cigarettes number smoked per day.

PRIMARY OBJECTIVE: We tested whether fasting insulin levels are associated with blood pressure in... more PRIMARY OBJECTIVE: We tested whether fasting insulin levels are associated with blood pressure in a large sample of obese children. SUBJECTS AND METHODS: Three hundred and fifty obese children (F:M ratio = 1.03) of 10.1 +/- 2.7 y of age (mean +/- SD) were consecutively enrolled at an Outpatient Paediatric Clinic. Obesity was diagnosed on the basis of a relative weight for age > 120% and hypertension on the basis of a systolic (SBP) or diastolic (DBP) blood pressure > 95th percentile for age after adjustment for height (Ht). MAIN OUTCOME AND RESULTS: Insulin was significantly higher in hypertensive (n = 202, 58%) than normotensive (n = 148, 42%) children (16 vs 14 microU mL(-1), geometric mean, p < 0.01, ANOVA) but the difference was not clinically relevant. Moreover, (log-transformed) insulin explained only 7 and 4% of SBP and DBP variance, respectively (p < 0.0001 for both) and this contribution disappeared after the confounding effects of age, weight or other anthropometric dimensions were taken into account (p = ns, ANCOVA). CONCLUSIONS: This study does not support the hypothesis of a clinically relevant association between fasting insulin and blood pressure in obese children.

Some applications of indirect calorimetry to sports medicine are discussed and exemplified by cas... more Some applications of indirect calorimetry to sports medicine are discussed and exemplified by case reports. In particular, it is suggested that oxigen consumption can be employed to assess the effects of physical activity on fat-free tissues and that the respiratory quotient may offer some insights into the food habits of athletes.