Low estradiol-to-testosterone ratio is associated with oligo-anovulatory cycles and atherogenic lipidic pattern in women with polycystic ovary syndrome

The estradiol-to-testosterone (E2/T) ratio has been investigated in different diseases but few in vivo data are available with regard to its role in women with ovary syndrome (PCOS). The aim of this study was to evaluate the role of the E2/T ratio in the ovulatory function and metabolic pattern in such women.We retrospectively evaluated hyperandrogenemia, clinical hyperandrogenism, ovarian morphology, hypothalamo-hypophyseal axis and metabolic syndrome parameters in a cohort of 202 consecutive women affected by PCOS. An oral glucose tolerance test measured areas under the curve for insulin (AUC(2hIRI)), for glucose (AUC(2hglucose)), and the HOMA-IR and Matsuda index of insulin resistance we…

Adrenal incidentaloma: a new contributing factor in metabolic syndrome

Visceral adiposity index is associated with significant fibrosis in patients with non-alcoholic fatty liver disease

Aliment Pharmacol Ther 2012; 35: 238–247 Summary Background  Metabolic factors have been associated with liver damage in patients with non-alcoholic fatty liver disease (NAFLD). Aims  To test a new marker of adipose dysfunction, the visceral adiposity index (VAI), in NAFLD patients to assess whether or not it is associated with host factors, and to investigate a potential correlation with histological findings. Methods  One hundred and forty-two consecutive NAFLD patients were evaluated by liver biopsy, and clinical and metabolic measurements, including insulin resistance with the homeostasis model assessment (HOMA), and VAI by using waist circumference, body mass index, triglycerides and H…

Serum visfatin levels in acromegaly: Correlation with disease activity and metabolic alterations

Objective: The studies that have extensively evaluated the relation between adipokines and metabolic parameters in acromegaly treatment are quite discordant. We aimed to evaluate and correlate a set of selected adipokines, known to have a metabolic role, with the disease activity, metabolic status and treatment modalities. Design: Data of 56 consecutive acromegalic patients (31 M and 25 F; aged 54 ± 12 years), admitted to the section of Endocrinology of the University of Palermo during the years 2005-2014, including 16 newly diagnosed untreated (ND), 21 during therapy with somatostatin analogues (SA), 12 with pegvisomant (PE) and 7 after surgical treatment (SU), grouped into uncontrolled (g…

Predictors of microvascular complications in type 1 diabetic patients at onset: The role of metabolic memory

Background Several epidemiological studies showed a close association between metabolic control and microvascular complications in type 1 Diabetes Mellitus (T1DM). The aim of our longitudinal observational study was to evaluate the predictive role of the main clinical and biochemical parameters in determining microvascular complications. Methods 376 T1DM patients, hospitalized in our division from 1991 to 2005 (mean follow-up = 10.93 ± 4.26 years) were studied. Stepwise Cox regression analysis was used to identify the influence of residual ß-cell function, ß-cell autoimmunity, HbA1c levels and other clinical and laboratory parameters in the development of microalbuminuria and retinopathy. R…

Metabolically healthy polycystic ovary syndrome (MH-PCOS) and metabolically unhealthy polycystic ovary syndrome (MU-PCOS): a comparative analysis of four simple methods useful for metabolic assessment.

Study question Is it possible to distinguish metabolically healthy polycystic ovary syndrome (MH-PCOS) from metabolically unhealthy PCOS (MU-PCOS) by simple diagnostic tools such as body mass index (BMI), waist/hip ratio (WHR), at-risk category suggested by Androgen Excess Society (AES) and visceral adiposity index (VAI)? Summary answer VAI could be an easy and useful tool in clinical practice and in population studies for assessment of MU-PCOS. What is known already VAI is a good indicator of insulin sensitivity and cardiometabolic risk in oligo-ovulatory women with PCOS. Study design, size, duration We conducted a cross-sectional study of 232 women with PCOS in a university hospital setti…

The evaluation of metabolic parameters and insulin sensitivity for a more robust diagnosis of the polycystic ovary syndrome

BACKGROUND: Insulin glargine is a once-daily basal insulin analog with prolonged duration of action and absence of an evident peak. Glargine is associated with reduced frequency of hypoglycemic episodes (mostly nocturnal) as well as effective glycemic control. Maintenance of good metabolic control before conception and throughout pregnancy is essential to lower the risk of fetal malformations. Glargine might be a valuable alternative in the management of pregnancies complicated by diabetes mellitus. However, because its clinical utility has not been established, the use of glargine is not currently recommended during pregnancy. OBJECTIVE: The aim of this study was to retrospectively evaluat…

Insulino sensibilità ed insulinosecrezione nell’acromegalia in fase attiva.

The relationship between metabolic syndrome and bone health: results of a retrospective gender specific female study.

Sviluppo di un sistema di supporto decisionale tipo Fuzzy per il controllo della glicemia post-prandiale nel diabete mellito tipo 1

Visceral adiposity index and DHEAS are useful markers of diabetes risk in women with polycystic ovary syndrome

ObjectiveOn the basis of the known diabetes risk in polycystic ovary syndrome (PCOS), recent guidelines of the Endocrine Society recommend the use of an oral glucose tolerance test (OGTT) to screen for impaired glucose tolerance (IGT) and type 2 diabetes (T2DM) in all women with PCOS. However, given the high prevalence of PCOS, OGTT would have a high cost–benefit ratio. In this study, we identified, through a receiver operating characteristic analysis, simple predictive markers of the composite endpoint (impaired fasting glucose (IFG) or IGT or IFG+IGT or T2DM) in women with PCOS according to the Rotterdam criteria.DesignWe conducted a cross-sectional study of 241 women with PCOS in a unive…

Effetti della terapia combinata (OHA+Insulina) su una casistica ambulatoriale di pazienti affetti da NIDDM.

Metabolic parameters and adipokine profile during GH replacement therapy in children with GH deficiency

Objective: GH replacement therapy in children with GH deficiency (GHD) mainly promotes linear growth. Not only have very few studies fully analyzed the metabolic consequences of GH therapy, but also the question as to whether GH may affect adipokine secretion has been insufficiently investigated. Our aim was to study the effects of GH replacement therapy on auxological data, lipid and glycemic profiles, insulin homeostasis (HOMA-IR) and serum adipokines in children. Methods: This was a 1-year prospective study. Thirty-four GHD children (11.6 ± 2.6 years) and thirty healthy matched controls were enrolled. Children affected by GHD were studied both before beginning continuous GH replacement t…

Prevalence and clinical features of polycystic ovarian syndrome in adolescents with previous childhood growth hormone deficiency.

AbstractGrowth hormone (GH) plays a role in the regulation of ovarian function but there are limited data in women with GH deficiency (GHD). Our aim was to evaluate the features of polycystic ovarian syndrome (PCOS) in women with previous GHD.Data of 22 adolescents previously GH-treated (group A) were compared with those of 22 women with classical PCOS (group B) and 20 controls (group C).: Group A showed higher testosterone (p=0.048) and prevalence of menstrual irregularities (p<0.001) than group C. Compared to the group B, group A showed lower diastolic blood pressure (p=0.004), degree of hirsutism (p=0.005), testosterone (p=0.003) and prevalence of polycsytic ovaries (POC) morphology (…

Polycistic ovary syndrome and antiepileptic drugs: a cross-sectional study

Visceral adiposity index is associated with histological findings and high viral load in patients with chronic hepatitis C due to genotype 1.

Metabolic factors have been associated with liver damage in patients with genotype 1 chronic hepatitis C (G1 CHC). We tested visceral adiposity index (VAI), a new marker of adipose dysfunction in G1 CHC, patients to assess its association with host and viral factors and its link to both histological findings and sustained virological response (SVR). Two hundred thirty-six consecutive G1 CHC patients were evaluated by way of liver biopsy and anthropometric and metabolic measurements, including insulin resistance (IR), homeostasis model assessment (HOMA), and VAI using waist circumference, body mass index, triglycerides, and high-density lipoprotein cholesterol. All biopsies were scored by on…

Increased central corneal thickness in acromegalic patients.

La valutazione retinica mediante Tomografia a Coerenza Ottica (OCT) nel diabete mellito tipo 1.

Use of antiepileptic drugs in women with polycystic ovary syndrome

Insulin sensitivity and visceral adiposity index (VAI) in women with functional secondary amenorrhea.

Disregolazione funzionale gonadotropinica nella sindrome dell’ovaio policistico: risultati di una two-step cluster analysis.

Insulin sensitività in women whit clinical features of hyperandrogenism.

Clinical indications and proper use of Visceral Adiposity Index.

L’obesità viscerale ed un aumentato rapporto ApoB/ApoA1 fanno perdere la protezione cardiovascolare di genere nelle donne diabetiche tipo 2.

L’uso del hrTSH nel follow up del microcarcinoma tiroideo in pazienti sottoposti a tiroidectomia totale

Valutazione morfologica e funzionale surrenalica nell’acromegalia

Valutazione dell'insulinoresistenza tramite un test pasto standard

Effetti di un’infusione insulinica di breve durata in diabetici tipo 2 non obesi in “secondary failure” alle sulfaniluree.

Low Estradiol-to-Testosterone ratio is associated with low progesterone levels and atherogenic lipidic pattern in women with policystic ovary syndrome (PCOS).

Il rischio cardiovascolare nella donna diabetica

Changes in lipid profile and adipokine levels in GH deficient children during GH replacement therapy.

Visceral adiposity index is associated with insulin sensitivity and adipocytokine levels in newly diagnosed acromegalic patients.

Complete biochemical control and pituitary adenoma disappearance in a child with gigantism: Efficacy of octreotide therapy

Adrenal incidentaloma: a new contributing factor in metabolic syndrome?

Cornea in acromegalic patients as a possible target of growth hormone action.

Background: GH exerts its effects on many organs and the eye also seems to be a target site, although few authors have investigated the corneal thickness in patients with acromegaly. Aim: To perform a detailed ophthalmological evaluation in acromegalic patients, in relation to disease activity. Material and methods: Twenty-eight acromegalic patients (11 males, 17 females) and 22 voluntary healthy subjects underwent complete metabolic and ophthalmological evaluation, including retinal thickness (RT), central corneal thickness (CCT), and intraocular pressure values (IOP). Results: Significantly greater CCT values were found in all acromegalic patients in comparison with controls (567 vs 528.5…

Detection of BRAFv600E mutation in papillary thyroid carcinoma using real time allele-specific amplification on fine needle aspiration biopsy specimens.

Visceral adiposity index is associated with insulin sensitivity and adipocytokine levels in newly diagnosed acromegalic patients.

Context: The visceral adiposity index (VAI) has proved to be a marker of visceral adipose dysfunction, strongly associated with insulin sensitivity in both the general and specific populations of patients at metabolic risk. Objective: The objective of the study was to test VAI as a useful tool to assess early metabolic risk in acromegaly. Patients: Twenty-four newly diagnosed acromegalic patients (11 women and 13 men, aged 54.9 ± 13.6 yr) were grouped into those with normal (group A, n = 13, 54.2%) and those with high VAI (group B, n = 11, 45.8%). Outcome Measures: Glucose, hemoglobin A1c, nadir and area under the curve (AUC) of GH (AUCGH) during the oral glucose tolerance test, AUCCpeptide…

Relazioni tra sindrome metabolica e carcinoma mammario: osservazioni da una casistica ambulatoriale

BRAFV600E mutation and timp-1 hyper-expression in classical variants of papillary thyroid carcinoma (PTC).

Alteration of the growth hormone axis, visceral fat dysfunction, and early cardiometabolic risk in adults: the role of the visceral adiposity index

The aim of the study is to clarify the relationship between adipose tissue dysfunction, metabolic profile and growth hormone (GH)/insulin-like growth factor (IGF)-I secretion in healthy adult subjects. We investigated the metabolic profile in a cohort of 231 consecutive healthy subjects in relation to GH, IGF-I levels, and visceral adiposity index (VAI). Anthropometric measures, lipid profile, and glucose and insulin levels during oral glucose tolerance test, Homa-IR and ISI Matsuda, IGF-I and GH peak after GHRH plus Arginine test were analyzed. The subjects with high VAI showed lower GH peak (22.8 ± 11.1 vs. 42.2 ± 21.3 µg/L; p = 0.049) and lower IGF-I (presented as IGF-I under normal rang…

No effect of GH/IGF-1 excess on adrenal glands in acromegalic patients

Hyperinsulinism and polycystic ovary syndrome (PCOS): role of insulin clearance.

PURPOSE: Insulin resistance and compensatory hyperinsulinism are the predominant metabolic defects in polycystic ovary syndrome (PCOS). However, hyperinsulinism, as well as being compensatory, can also express a condition of reduced insulin clearance. Our aim was to evaluate the differences in insulin action and metabolism between women with PCOS (with normal glucose tolerance) and age- and BMI-matched women with prediabetes (without hyperandrogenism and ovulatory disorders). METHODS: 22 women with PCOS and 21 age/BMI-matched women with prediabetes were subjected to a Hyperinsulinemic-euglycemic clamp and an Oral Glucose tolerance Test (OGTT). Insulin sensitivity was assessed by the glucose…

Adrenal morphology and function in acromegalic patients in relation to disease activity.

Visceromegaly is a common consequence of acromegaly. However, few studies investigated the chronic effects of growth hormone on adrenal glands. Our aim was to evaluate adrenal morphology and function in a cohort of acromegalic patients in relation to disease activity. Twenty-six acromegalics (10 males and 16 females) and 21 healthy subjects were investigated. Gland morphology was evaluated by computerized axial tomography, measuring central, lateral, and medial adrenal segments. Uncontrolled acromegalics showed increased volume of all adrenal segments, higher urinary free cortisol (UFC), and lower morning adrenocorticotropic hormone in comparison with healthy subjects. However, normal corti…

Marcatori di rischio diabetologico nella Sindrome dell’ovaio policistico (PCOS).

Visceral adiposity index is associated with histological findings and high viral load in patients with chronic hepatitis C due to genotype 1.

Metabolic factors have been associated with liver damage in patients with genotype 1 chronic hepatitis C (G1 CHC). We tested visceral adiposity index (VAI), a new marker of adipose dysfunction in G1 CHC, patients to assess its association with host and viral factors and its link to both histological findings and sustained virological response (SVR). Two hundred thirtysix consecutive G1 CHC patients were evaluated by way of liver biopsy and anthropometric and metabolic measurements, including insulin resistance (IR), homeostasis model assessment (HOMA), and VAI using waist circumference, body mass index, triglycerides, and highdensity lipoprotein cholesterol. All biopsies were scored by one …

The degree of urinary hypercortisolism is not correlated with the severity of cushing’s syndrome

Cushing syndrome (CS) is characterized by increased morbidity and mortality compared to the general population. However, there are patients who have more clinical aggressive forms than others. Aim of the study is to evaluate whether the degree of hypercortisolism, defined by the number of times urinary free cortisol (UFC) levels exceed the upper limit of the normal range (ULN), is related to the worsening of phenotypic features, as well as metabolic and cardiovascular parameters, in a cohort of CS patients. A cross-sectional study was conducted on 192 patients with active CS, consecutively presenting at the outpatients' clinic of the University Hospitals of Ancona, Naples, and Palermo. Pati…

Hypoxia inducible factor-1 alpha expression is increased in infected positive HPV16 DNA oral squamous cell carcinoma and positively associated with HPV16 E7 oncoprotein.

Abstract Background There is increasing evidence for the role of High Risk (HR) Human PapillomaVirus (HPV) in the pathogenesis of Oral Squamous Cell Carcinoma (OSCC). The E6 and E7 oncogenes from HR HPVs are responsible for the deregulation of p53 and pRB proteins involved in cell cycle and apoptotic pathways. In cell lines experiments, the HPV E7 protein seems to be able to enhance Hypoxia Inducible Factor-1 alpha (HIF-1α) activity, normally involved in the response to hypoxia and able to enhance angiogenesis. Results We studied tumor specimens from 62 OSCC; a higher prevalence of tumors in TNM stage II and also in pT2 class between OSCC infected positive HPV16 DNA than non-infected ones w…

Anaplastic Thyroid Carcinoma: A ceRNA Analysis Pointed to a Crosstalk between SOX2, TP53, and microRNA Biogenesis.

It has been suggested that cancer stem cells (CSC) may play a central role in oncogenesis, especially in undifferentiated tumours. Anaplastic thyroid carcinoma (ATC) has characteristics suggestive of a tumour enriched in CSC. Previous studies suggested that the stem cell factorSOX2has a preeminent hierarchical role in determining the characteristics of stem cells in SW1736 ATC cell line. In detail, silencing SOX2 in SW1736 is able to suppress the expression of the stem markers analysed, strongly sensitizing the line to treatment with chemotherapeutic agents. Therefore, in order to further investigate the role of SOX2 in ATC, a competing endogenous RNA (ceRNA) analysis was conducted in order…

BRAFV600E mutation, TIMP-1 upregulation, and NF-κB activation: closing the loop on the papillary thyroid cancer trilogy.

BRAFV600E is the most common mutation found in papillary thyroid carcinoma (PTC). Tissue inhibitor of metalloproteinases (TIMP-1) and nuclear factor (NF)-κB have been shown to play an important role in thyroid cancer. In particular, TIMP-1 binds its receptor CD63 on cell surface membrane and activates Akt signaling pathway, which is eventually responsible for its anti-apoptotic activity. The aim of our study was to evaluate whether interplay among these three factors exists and exerts a functional role in PTCs. To this purpose, 56 PTC specimens were analyzed for BRAFV600E mutation, TIMP-1 expression, and NF-κB activation. We found that BRAFV600E mutation occurs selectively in PTC nodules an…

Lower insulin sensitivity differentiates hirsute from non-hirsute Sicilian women with polycystic ovary syndrome

Objective: It is well known that hyperandrogenism and insulin-resistance with or without compensatory hyperinsulinism are closely associated, but the Rotterdam Consensus has concluded that principally obese women with polycystic ovary syndrome (PCOS) should be evaluated for the metabolic syndrome. Our aim was to study insulin sensitivity in PCOS women with hirsutism regardless of obesity. Methods: Clinical characteristics, sex hormones and fasting- and after OGTT-glycemia and insulinemia, homeostatic model of insulin resistance (HOMA IR), and Matsuda index of insulin sensitivity were analyzed in 130 women with PCOS. Hirsutism has been evaluated through the Ferriman–Gallwey (FG) map scoring …

In Vitro Identification and Characterization of CD133pos Cancer Stem-Like Cells in Anaplastic Thyroid Carcinoma Cell Lines

BackgroundRecent publications suggest that neoplastic initiation and growth are dependent on a small subset of cells, termed cancer stem cells (CSCs). Anaplastic Thyroid Carcinoma (ATC) is a very aggressive solid tumor with poor prognosis, characterized by high dedifferentiation. The existence of CSCs might account for the heterogeneity of ATC lesions. CD133 has been identified as a stem cell marker for normal and cancerous tissues, although its biological function remains unknown.Methodology/principal findingsATC cell lines ARO, KAT-4, KAT-18 and FRO were analyzed for CD133 expression. Flow cytometry showed CD133(pos) cells only in ARO and KAT-4 (64+/-9% and 57+/-12%, respectively). These …

The adipose visceral dysfunction plays an important role in diabetes in Cushing disease.

Background: Cushing disease (CD) is associated with increased morbidity and mortality caused by cardiometabolic alterations. Visceral Adiposity Index (VAI) expresses impaired adipose distribution and function which are related to the cardiometabolic risk. Aim: To evaluate in a cohort of CD patients the correlation between VAI and other parameters, such as gender, etiology, age, cortisol values measured in the morning (8 am) and at the midnight, urinary free cortisol (24h sample of urine, average of three samples) and glucose tolerance as normal glucose tolerance (NGT), impaired fasting glucose (IFG), impaired glucose tolerance (IGT), IFG+IGT and diabetes mellitus. Materials and methods: We …

The current version of the visceral adiposity index is not suitable for application in pediatric populations: comments on the article by Al-Daghri et al.

The current version of the visceral adiposity index is not suitable for application in pediatric populations: comments on the article by Al-Daghri et al .

PROPOSED OF A NEW SIMPLIFIED VISCERAL ADIPOSITY INDEX (VAI-2).

RELATIONSHIP BETWEEN GONADAL HOMEOSTASIS AND METABOLIC PARAMETERS IN A POPULATION OF HOSPITALIZED DIABETIC MALES.

Detection of BRAFV600 mutation in papillary thyroid carcinoma using real time allele-specific amplification on fine needle aspiration biopsy specimens

Leptina e adiponectina nella valutazione del compenso glicometabolico in corso di diabete mellito di tipo 1 normopeso.

No effect of GH/IGF-1 excess on adrenal gland in Acromegalic patients.

Transient chylomicronemia preceding the onset of insulin-dependent diabetes in a young girl with no humoral markers of islet autoimmunity

OBJECTIVE: We investigated the possible causes of diabetes in a young child who presented with hyperglycemia associated with severe hypertriglyceridemia (>166 mmol/l), hypercholesterolemia (>38 mmol/l) and fasting chilomicrons. RESULTS: The patient did not have any of the HLA and autoantibody markers typically associated with type 1 diabetes. A glucose clamp failed to demonstrate insulin resistance (peripheral glucose utilization rate (M)=4.3 mg/kg per min) and there was no family history of type 2 diabetes or maturity onset diabetes in youth. Both fasting and stimulated C-peptide levels, including those in response to i.v. glucagon, were below the limit of detection. This is consiste…

Subclinical ovulatory dysfunction (SOD): a frequent but underestimated phenomenon which may be useful for diagnosis of PCOS.

Efficacia e sicurezza della terapia con glargine in gravidanza: esperienza su una casistica di 15 donne diabetiche di tipo 1.

L’aumentata risposta dell’unità pilosebacea agli androgeni è correlata all’insulinoresistenza: valutazione di vari indici di sensibilità insulinica in donne con segni clinici di iperandrogenismo.

The Metabolic Profile in Active Acromegaly is Gender-Specific.

CONTEXT: The sexual dimorphism of the somatotroph axis has been documented, but whether the acromegaly-related metabolic alterations are gender-dependent has never been investigated. OBJECTIVE: The aim of the study was to evaluate the impact of gender on the metabolic parameters in acromegaly. DESIGN: We conducted a retrospective, comparative, multicenter study. PATIENTS: The 307 newly diagnosed acromegalic patients included in the study were grouped by gender: 157 men (aged 48.01 ± 14.28 yr), and 150 women (aged 48.67 ± 14.95 yr; of which 77 were premenopausal and 73 postmenopausal). OUTCOME MEASUREMENTS: We measured each component of the metabolic syndrome (MS), hemoglobin A1c, the areas …

Clinical and metabolic effects of first-line treatment with somatostatin analogues or surgery in acromegaly: a retrospective and comparative study.

To evaluate the metabolic effects of first-line somatostatin analogues or surgery in acromegaly. Retrospective, comparative, 12-month follow-up. Two hundred and thirty one patients (123 men, age 47.32 ± 14.63 years) with active acromegaly, first line treatments were somatostatin analogues in 151 (65.4%) and surgery in 80 (34.6%). Metabolic syndrome (MS) parameters, glucose, insulin and GH during oral glucose tolerance test, stimulated insulin sensitivity by insulin sensitivity index (ISI Matsuda), early and total insulin-secretion rate by insulinogenic index and AUC(INS), visceral adiposity function, expressed by visceral adipose index (VAI). Somatostatin analogues treatment improved all MS…

Espressione dei fattori di trascrizione di staminalità in cellule stromali (HASC) ottenute da tessuto adiposo viscerale e sottocutaneo

OCT is not useful for detection of minimal diabetic retinopathy in type 1 diabetes.

Optical coherence tomography (OCT) has been proven useful in measuring retinal thickness (RT) in patients with diabetes, although with discordant results in different studies. We examined RT in patients with type 1 diabetes (T1D) with or without minimal diabetic retinopathy (MDR) to test whether OCT is able to identify early retinal changes and potential correlations with metabolic parameters. RT of 102 patients with T1D (53 females, 49 males, aged 27.03 +/- 7.4 years) and of 42 healthy controls was examined, with analysis of nine different sectors (fovea, four pericentral and four peripheral sectors). According to the results of basal fundus photography, patients were divided into two grou…

Phenotyping of type 2 diabetes mellitus at onset on the basis of fasting incretin tone: Results of a two-step cluster analysis.

Aims/Introduction According to some authors, in type 2 diabetes there is a reduced postprandial action of glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). However, little is known about the role of fasting incretins in glucose homeostasis. Our aim was to evaluate, through a two-step cluster analysis, the possibility of phenotyping patients with type 2 diabetes at onset on the basis of fasting GLP-1, GIP and ghrelin. Materials and Methods A total of 96 patients with type 2 diabetes within 6 months of onset (mean age 62.40 ± 6.36 years) were cross-sectionally studied. Clinical, anthropometric and metabolic parameters were evaluated. At fasting the follow…

Variabili cliniche nella casistica del policlinico di Palermo nell’ambito del registro dei tumori della tiroide in Sicilia: Età, sesso, autoimmunità, tipo, dimensionilesionali e coinvolgimento delle stazioni linfonodali della tiroide

Complete biochemical control and oituitary adenoma disappearance in a child with gigantism: efficay of octreotide therapy

Effetti di una terapia con glucocorticoidi ev ad alte dosi sull'oftalmopatia di Graves moderata-severa:uno studio caso-controllo

Off-line control of the postprandial glycemia in type 1 diabetes patients by a fuzzy logic decision support

Il c-peptide come marker principale nella storia naturale del Diabete di tipo 1: ruolo della funzione b-cellulare pancreatica nelle complicanze.

Cut-off points of the visceral adiposity index (VAI) identifying a visceral adipose dysfunction associated with cardiometabolic risk in a Caucasian Sicilian population

Abstract Background The Visceral Adiposity Index (VAI) is a sex-specific mathematical index, based on Waist Circumference (WC), Body Mass Index (BMI), triglycerides (TG) and HDL cholesterol (HDL) levels, indirectly expressing visceral adipose function and insulin sensitivity. Our aim was to find the optimal cut-off points of VAI identifying a visceral adipose dysfunction (VAD) associated with cardiometabolic risk in a Caucasian Sicilian population. Methods Medical check-up data of 1,764 Primary Care patients (PC patients) were retrospectively and cross-sectionally examined using a receiver-operating characteristic (ROC) curve to determine appropriate stratified-for-age cut-off of VAI, for t…

Alte dosi di cabergolina migliorano i parametri metabolici in pazienti affetti da prolattinoma.

HYPERINSULINISM AND POLYCYSTIC OVARY SYNDROME (PCOS): ROLE OF INSULIN CLEARANCE.

Fine-Needle Aspiration (FNAB) Molecular Analysis for the Diagnosis of Papillary Thyroid Carcinoma through BRAFv600E mutation and RET/PTC rearrangement

Objective: To evaluate BRAFV600E mutation on consecutive fine-needle aspiration biopsy (FNAB) specimens in order to assess FNAB’s usefulness in preoperative papillary thyroid carcinoma (PTC) diagnosis with the contemporaneous analysis of RET=PTC1 and RET=PTC3 rearrangements obtained from ex vivo thyroid nodules. Design: Thyroid FNABs from 156 subjects with nodules and 49 corresponding surgical samples were examined for the presence of BRAF mutation by real-time allele-specific polymerase chain reaction, confirmed with the use of a laser pressure catapulting system. Samples were also examined for RET=PTC rearrangements. The results were compared with the cytological diagnosis and histopathol…

Rotterdam consensus, NIH and EAS: comparison among the three different diagnostic criteria for the diagnosis of PCOS.

Is diabetes in Cushing's syndrome only a consequence of hypercortisolism?

ObjectiveDiabetes mellitus (DM) is one of the most frequent complications of Cushing's syndrome (CS). The aim of this study was to define the changes in insulin sensitivity and/or secretion in relation to glucose tolerance categories in newly diagnosed CS patients.DesignCross-sectional study on 140 patients with CS.MethodsA total of 113 women (80 with pituitary disease and 33 with adrenal disease, aged 41.7±15.7 years) and 27 men (19 with pituitary disease and eight with adrenal disease, aged 38.1±20.01 years) at diagnosis were divided according to glucose tolerance into normal glucose tolerance (CS/NGT), impaired fasting glucose and/or impaired glucose tolerance (CS/prediabetes), and diabe…

Valutazione dell’insulinoresistenza tramite un test pasto standard.

Alterazioni del metabolismo glucidico determinate da eccesso di ormoni contro regolatori.

Visceral Adiposity Index

OBJECTIVE To individuate a novel sex-specific index, based on waist circumference, BMI, triglycerides, and HDL cholesterol, indirectly expressing visceral fat function. RESEARCH DESIGN AND METHODS Visceral adiposity index (VAI) was first modeled on 315 nonobese healthy subjects. Using two multiple logistic regression models, VAI was retrospectively validated in 1,498 primary care patients in comparison to classical cardio- and cerebrovascular risk factors. RESULTS All components of metabolic syndrome increased significantly across VAI quintiles. VAI was independently associated with both cardiovascular (odd ratio [OR] 2.45; 95% CI 1.52–3.95; P < 0.001) and cerebrovascular (1.63; 1.0…

INSULIN SECRETION AND SENSITIVITY DURING PASIREOTIDE TREATMENT IN PATIENTS WITH RECURRENT CUSHING DISEASE: A CASE SERIES

Visceral adiposity index (VAI) is predictive of an altered adipokine profile in patients with type 2 diabetes.

Aims Although there is still no clear definition of “adipose tissue dysfunction” or ATD, the identification of a clinical marker of altered fat distribution and function may provide the needed tools for early identification of a condition of cardiometabolic risk. Our aim was to evaluate the correlations among various anthropometric indices [BMI, Waist Circumference (WC), Hip Circumference (HC), Waist/Hip ratio (WHR), Body Adiposity Index (BAI) and Visceral adiposity Index (VAI)] and several adipocytokines [Visfatin, Resistin, Leptin, Soluble leptin receptors (sOB-R), Adiponectin, Ghrelin, Adipsin, PAI-1, vascular endothelial growth factor (VEGF), Hepatocyte growth factor (HGF) TNF-α, hs-CRP…

Correlation between severity of growth hormone deficiency and thyroid metabolism and effects of long-term growth hormone treatment on thyroid function in children with idiopathic growth hormone deficiency.

<b><i>Background/Aim:</i></b> The significance of changes in thyroid function in children during growth hormone (GH) treatment remains uncertain. We aimed to evaluate the impact of GH replacement on thyroid status in children with idiopathic GH deficiency (GHD). <b><i>Methods:</i></b> Data of 105 GHD children (82 M, 23 F; aged 11.13 years) during a 36-month follow-up were analyzed. At diagnosis the areas under the curve of GH (AUC<sub>GH</sub>) were calculated during a GH-releasing hormone + arginine (GHRH-Arg) and insulin tolerance test. <b><i>Results:</i></b> A significant ΔfT<sub>3</su…

BRAFV660E mutation and Timp-1 hyper-expression in classical variants of papyllary thyroid carcinoma.

Visceral Adiposity Index (VAI): A Reliable Indicator Of Visceral Fat Function Associated With Cardiometabolic Risk.

Objective: To individuate a novel sex-specific index, based on Waist Circumference (WC), Body Mass Index (BMI), Triglycerides (TG) and HDL cholesterol (HDL), indirectly expressing visceral fat function. Research design and Methods: Visceral Adiposity Index (VAI) was first modelled on 315 non-obese healthy subjects. Using two multiple logistic regression models, VAI was retrospectively validated in 1,498 primary care patients in comparison to classical cardio and cerebrovascular risk factors. Results: All components of metabolic syndrome increased significantly across VAI quintiles. VAI was independently associated with both cardiovascular (OR:2.45; 95%CI: 1.52-3.95; p<0.001) and cerebrov…

The oligomenorrhoic phenotypes of polycystic ovary syndrome are characterized by a high visceral adiposity index: a likely condition of cardiometabolic risk.

BACKGROUND: Women with polycystic ovary syndrome (PCOS) frequently exhibit central obesity, glucose intolerance, atherogenic dys- lipidemia and hypertension, which are characteristic features of a condition of cardiometabolic risk. Our objective was to investigate the relationship between visceral adiposity index (VAI) and phenotypic characteristics in women with PCOS. METHODS: We conducted a cross-sectional case-control study in our Endocrinology Outpatients Clinic. A total of 220 women with PCOS (Rotterdam definition) and I44 age- and BMI-matched healthy women were studied. We evaluated hyperandrogenemia and clinical hyperandrogenism, ovarian morphology, hypothalamic-hypophyseal axis and …

Safety of glargine therapy during pregnancy in women with type 1 diabetes mellitus.

Visceral adiposity index and metabolic profile in adult patients with congenital adrenal hyperplasia: hydrocortisone versus prednisone treatment.

Background: Patients with Congenital Adrenal Hypeplasia (CAH) due to 21-hydroxylase deficiency need a life-long therapy with glucocorticoids (GCs) and tend to have a cluster of metabolic risk factors, which are consistent with metabolic syndrome (MS). Most frequently used GCs are Hydrocortisone (HC) and Prednisone (P), different for both pharmacodynamic and pharmacokynetic characteristics. Aim: The aim of this study was to evaluate the impact of HC and P on VAI, a new indicator of visceral fat function, and on metabolic profile in CAH patients long term treated with GC. Materials and Methods: Thirty-two patients (22 F, 10 M, 18-46 yrs), among which 16 (11 F, 5 M) treated with HC (dose 10-45…

Maggior rischio cardiometabolico nelle donne affette da Cushing, anche in assenza di una franca Sindrome Metabolica.

Increased expression of transketolase-like-1 in papillary thyroid carcinomas smaller than 1.5 cm in diameter is associated with lymph-node metastases.

BACKGROUND. Patients with small papillary thyroid carcinoma (PTC) may have a high incidence of regional lymph-node (LN) metastases at presentation, and these are considered to be an independent risk factor for tumor recurrence. A mutated transketolase transcript (TKTL1) has been found up-regulated in different human malignancies, and strong TKTL1 protein expression has been associated with aggressiveness and poor patient survival in several epithelial cancers. METHODS. TKTL1 protein expression was analyzed in 256 consecutive cases of PTCs ≤1.5 cm by immunohistochemistry with a specific anti-TKTL1 antibody. RNA analysis was performed by real-time polymerase chain reaction (PCR) in all cases …

Endocrine and pro-inflammatory activity of visceral (VAT) and subcutaneous (SAT) adipose tissue in morbidly obese patients with and without metabolic syndrome.

Reduction in insulin sensitivity and inadequate β-cell capacity to counteract the increase in insulin resistance in children with idiopathic growth hormone deficiency during 12 months of growth hormone treatment

Purpose: To evaluate the performance of various indexes of insulin sensitivity and secretion and to identify the most useful indicator of deterioration of glucose metabolism in a cohort of children with growth hormone (GH) deficiency (GHD) during GH treatment. Methods: In 73 GHD children (55 M, 18 F; mean age 10.5 years) at baseline and after 12 months of treatment, we evaluated a number of surrogate indexes of insulin secretion and sensitivity. In a subgroup of 11 children we also performed an euglycemic hyperinsulinemic clamp. Results: After 12 months, a significant increase in fasting glucose (p < 0.001) and HbA1c levels (p < 0.001) was documented, despite all children remained with a no…

Clamp euglicemico iperinsulinemico e test al glucagone come utili strumenti di valutazione degli effetti metabolici della terapia sostitutiva con GH.

Visceral Adiposity Index (VAI) as a simple indicator of “adipose tissue dysfunction” in patients with type 2 diabetes.

Although still there is no a clear definition of “adipose tissue dysfunction”, the identification of clinical and biological markers of altered fat distribution and function may provide the needed tools to early identify a condition of cardiometabolic risk. Visceral Adiposity Index (VAI) is a mathematical gender-specific index estimated with the use of simple anthropometric [(BMI and Waist circumference (WC)] and biochemical parameters [HDL cholesterol (HDL) and Triglycerides (Tg)], that in recent studies has shown to reflect accurately the degree of visceral adiposity and insulin resistance. However, although VAI has been indirectly shown to be a marker of impaired fat distribution and fun…

Il c-peptide come marker principale nella storia naturale del Diabete tipo 1: ruolo della funzione b-cellulare pancreatica nelle complicanze

Insulin resistance and polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in humans, affecting approximately 7-8% of women of reproductive age. Despite the criteria adopted, PCOS is considered to be a predominantly hyperandrogenetic syndrome and the evaluation of metabolic parameters and insulin sensitivity is not mandatory. Most women with PCOS also exhibit features of the metabolic syndrome, including insulin resistance, obesity and dyslipidaemia. While the association with type 2 diabetes is well established, whether the incidence of cardiovascular disease is increased in women with PCOS remains unclear. Acknowledging the strong impact of insulin-resistance in the genesis of PCOS co…

Valutazione dell’insulino-sensibilità e della funzione adiposa viscerale nel diabete mellito tipo 1 autoimmune ed idiopatico.

Utilizzo dell’insulina detemir in una casistica di donne affette da diabete tipo 1 in gravidanza: uno studio caso-controllo retrospettivo.

Buon compenso glicemico nei pazienti acromegalici affetti da diabete secondario.

Corrigendum to “Off-line control of the postprandial glycemia in type 1 diabetes patients by a fuzzy logic decision support” [Expert Systems with Applications 39 (12) (2012) 10693–10699]

Oligomenorrhea in PCOS is characterized by a high visceral adiposity index (VAI): a likely condition of cardiometabolic risk.

BRAFV600E Mutation and p27kip1 Expression in Papillary Carcinomas of the Thyroid ≤1 cm and Their Paired Lymph Node Metastases

BACKGROUND. BRAFV600E mutation and p27kip1 expression have been introduced as novel indicators that may predict prognosis in different tumors, as well as in papillary thyroid carcinomas. METHODS. Tissue samples from 214 consecutive patients who underwent total or near-total thyroidectomy with histological diagnosis of papillary thyroid carcinoma (PTC) ≤1 cm were analyzed for BRAFV600E mutation by a real-time, allele-specific amplification and for p27kip1 expression by immunohistochemistry. RESULTS. The BRAFV600E mutation was detected in 88 of the tumors examined, with significant differences between groups with and without lymph node (LN) metastases; the mean age of patients with BRAFV600E …

Serum miRNAs in women affected by hyperandrogenic polycystic ovary syndrome: the potential role of miR-155 as a biomarker for monitoring the estroprogestinic treatment.

MicroRNAs can be used as very efficient circulating biomarkers. The role of microRNAs in polycystic ovary syndrome (PCOS) and the effects of antiandrogen therapy on microRNA expression is still not fully understood. A panel of serum microRNAs were retrotranscribed via looped reverse primer transcription specific for each miRNA and quantified via probe specific RT-PCR in 16 Caucasian hyperandrogenic PCOS women selected according to the Rotterdam criteria and in a subset of seven patients after four months of sequential reverse antiandrogenic therapy. All women recruited underwent an oral glucose tolerance test (OGTT) and a baseline total cholesterol, high density lipoproteins cholesterol, tr…

The use of rh-TSH in the follow-up of thyroid microcarcinoma after total thyroidectomy

AlKam Metabolic Syndrome Study (AlkaMeSy Study): Studio di prevalenza sulla sindrome metabolica.

Low hrTSH-Tg levels in patients affected by papillary thyroid microcarcinoma are influenced by pre-surgery L-thyroxine therapy.

Prevalenza del cancro del colon e di altre neoplasie in una casistica ambulatoriale di soggetti affetti da diabete mellito tipo 2.

Development of a fuzzy expert system for the control of glycemia in type 1 diabetic patients

Abstract The paper describes the structure and the characteristics of an expert system that allows the optimization of postprandial glycemia in type 1 diabetic patients. The expert system is able to provide patients with the number of rapid insulin units that must be taken in order to keep the blood glucose level close to the omeostatic condition in the hours following a meal.

Use of glargine in pregnant women with type 1 diabetes mellitus: a case-control study.

BACKGROUND: Insulin glargine is a once-daily basal insulin analog with prolonged duration of action and absence of an evident peak. Glargine is associated with reduced frequency of hypoglycemic episodes (mostly nocturnal) as well as effective glycemic control. Maintenance of good metabolic control before conception and throughout pregnancy is essential to lower the risk of fetal malformations. Glargine might be a valuable alternative in the management of pregnancies complicated by diabetes mellitus. However, because its clinical utility has not been established, the use of glargine is not currently recommended during pregnancy. OBJECTIVE: The aim of this study was to retrospectively evaluat…

Prevalenza del fenotipo oligoovulatorio non irsuto nelle donne diabetiche di tipo 1 normopeso affette da PCOS

Higher doses of cabergoline further improve metabolic parameters in patients with prolactinoma regardless of the degree of reduction in prolactin levels.

OBJECTIVE: Currently available studies that fully analyse the metabolic parameters in patients with prolactinoma are scarce and discordant. The aim of this study was to evaluate the metabolic effects of cabergoline (CAB) treatment in patients with newly diagnosed prolactinoma in relation to disease control and CAB dosage. DESIGN: This is a retrospective clinical-based therapy analysis. PATIENTS: Forty-three patients with prolactinoma (eight men, 35 women), aged 33·65 ± 11·23 years, were evaluated metabolically at baseline and after 12 months of CAB treatment. MEASUREMENTS: Body mass index (BMI), systolic and diastolic blood pressure, waist circumference (WC), lipid profile, haemoglobinA1c (…

Relative Hypoleptinemia in poor controlled patients with Type 1 Diabetes

LA TERAPIA CON GH PEGGIORA L'INSULINO-SENSIBILITA' SENZA UN'ADEGUATA RISPOSTA PANCREATICA COMPENSATORIA IN BAMBINI AFFETTI DA DEFICIT DI GH DURANTE IL PRIMO ANNO DI TERAPIA

Visceral Adiposity Index: An Indicator of Adipose Tissue Dysfunction

The Visceral Adiposity Index (VAI) has recently proven to be an indicator of adipose distribution and function that indirectly expresses cardiometabolic risk. In addition, VAI has been proposed as a useful tool for early detection of a condition of cardiometabolic risk before it develops into an overt metabolic syndrome. The application of the VAI in particular populations of patients (women with polycystic ovary syndrome, patients with acromegaly, patients with NAFLD/NASH, patients with HCV hepatitis, patients with type 2 diabetes, and general population) has produced interesting results, which have led to the hypothesis that the VAI could be considered a marker of adipose tissue dysfuncti…

The impact of insulin resistance, serum adipocytokines and visceral obesity on steatosis and fibrosis in patients with chronic hepatitis C.

Aims To assess whether host metabolic factors influence the degree of hepatic steatosis and fibrosis in patients infected with hepatitis C virus, and to evaluate the impact of anti-viral therapy on insulin resistance and serum levels of adipocytokines. Methods Clinical and biochemical features, anthropometrical characteristics, and levels of fasting insulin, leptin, adiponectin and resistin were measured in ‘naı¨ve’ patients with chronic hepatitis C, before, during and after therapy with Peg-Interferon-alpha 2a plus Ribavirin. Results Forty-eightpatientswereincluded(M/F28/20;meanage50.0 12.6years; 62.5% genotype-1). Body mass index was 26.4 4.0 kg/m2 , and visceral obesity was present in 24…

Variazioni plasmatiche del fattore di crescita insulino-simile (IGF-1) durante iperinsulinizzazione esogena (calmp euglicemico) in pazienti affetti da sindrome metabolica con e senza complicanze macrovascolari.

PTC REFRACTORY TO RADIOIODINE: A CROSS-SECTIONAL STUDY

Utilizzo del Visceral Adiposity Index per l’identificazione di donne con sindrome iperandrogenica a rischio cardiometabolico.

The sonographic pattern of neck lymph nodes in chronic autoimmune thyroiditis.

Background: Neck lymph nodes may be involved in the pathogenesis of chronic autoimmune thyroiditis (CAT).We hypothesized that the involvement of cervical lymph nodes in CAT may be associated with a different sonographic pattern of neck nodes in comparison to subjects without CAT. Methods: We included 106 patients (92 females and 14 males) with CAT and 70 control subjects (53 females andm17 males) without clinical, biochemical, and ultrasonographic evidence of thyroid and neck diseases. We performed laboratory tests (thyrotropin, antithyroperoxidase antibodies, antithyroglobulin antibodies, and ultrasonography) to evaluate in each group: (i) thyroid function, autoimmunity, and morphology; (i…

Revaluation of the clinical and metabolic behavior of children with isolated growth hormone deficiency during GH treatment according to newly proposed note 39 of the Italian Medicines Agency (AIFA).

Purpose To evaluate the clinical and metabolic behavior of children with isolated growth hormone (GH)-deficiency (GHD), grouped according to the new AIFA criteria for the appropriateness of use and reimbursement of GH treatment in children. Methods The clinical and metabolic data of 310 prepubertal children (220 M, 90 F; mean age 10.8 years) grouped, according to new AIFA note 39, into group A (No 181 with a peak of GH 10 µg/L) were retrospectively analyzed. Group A and B, diagnosed as having GHD, were treated with GH for at least 24 months, while group C was analyzed only at baseline. Results At baseline, group A showed higher waist circumference than B (p=0.031) and C (p=0.041), while no …

GH-suppression test in acromegaly: comparison between OGTT and chocolate test

IS THE DEGREE OF URINARY FREE CORTISOL AN EXHAUSTIVE PARAMETER FOR DEFINING CUSHING SYNDROME SEVERITY?

Alta prevalenza di Sindrome dell’ovaio policistico in donne diabetiche di tipo 1 in età fertile.

Hirsutism and oligomenorrhea are characterized by a different pathogenesis in women affected by PCOS

Poor diagnostic value of the euglycemic-hyperinsulinemic clamp in the clinical assessment of insulin resistant women with PCOS.

Insulin resistance (IR) per se and/or the ensuing compensatory hyperinsulinism, have been always considered as a key point in the pathogenesis of PCOS. Aim of our study was to evaluate which of these two aspects plays a key role in the pathogenesis of PCOS. Using a cross-sectional study design, 15 PCOS (Rotterdam criteria) and 16 age/BMI-matched control women (with suspect of IR) underwent clinical measures of IR after a 3-month withdrawal of insulin sensitizers and oral contraceptive pills. In an academic clinic setting, average glucose infusion rate (M-value) (during an euglycaemic–hyperinsulinaemic clamp), AUCinsulin and AUCglucose (during an Oral Glucose tolerance Test), HOMA-IR, ISI-Ma…

No phenotypic differences for polycystic ovary syndrome (PCOS) between women with and without type 1 diabetes mellitus.

Context: Women with type 1 diabetes mellitus (DM1) have a higher prevalence of polycystic ovary syndrome (PCOS) than the general population. Objective: The aim of this study was to clarify, in DM1 women with PCOS(PCOS-DM1), the influence of insulin therapy and glycemic control and evaluate the hormonal and phenotypic differences with age-matched and body mass index (BMI)-matched women with PCOS without diabetes. Design, Setting, and Patients: We evaluated 103 DM1 women with and without PCOS treated with intensive insulin therapy; 38 age-matched and BMI-matched women with PCOS without diabetes were compared in a cross-sectional study. Outcome Measurements: Clinical, anthropometric, and metab…

Disfunzione del tessuto adiposo e diabete mellito tipo 2: scarsa utilità diagnostica della quantificazione del grasso tramite RMN.