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Biomedical subjects

E Mannucci

Publications and source records attributed to E Mannucci.

At least 55 records · Page 3Linked to original sources
PubMed1998

Relationship between leptin and oestrogens in healthy women.

OBJECTIVE: Leptin. a protein secreted by white adipocytes, plays a relevant role in the regulation of body weight and food intake. A possible role for sex hormones in the regulation of leptin secretion has been suggested; however, the effect of variations in oestrogen concentration on serum leptin levels has not been described so far. METHODS: In study 1, serum leptin concentrations were measured on days 3, 10, 17 and 24 of the menstrual cycle in 18 healthy, lean, regularly menstruating women, aged 18-35 years. Serum oestradiol, progesterone, testosterone. Delta4-androstenedione, dehydroepiandrosterone sulphate (DHEAS). LH and FSH concentrations were also determined. In study 2, serum leptin and oestradiol levels were measured on the 5th and 7th day of ovarian stimulation with human FSH (225 IU daily) during an in vitro fertilisation programme for infertility in 20 women aged 25-45 years. RESULTS: The results from study 1 show a physiological fluctuation of leptin levels during the menstrual cycle, which has not been described previously. Leptin levels are significantly lower in the early follicular phase. The results of study 2 show a parallel increase in serum oestrogen and leptin concentrations during FSH administration. CONCLUSIONS: The fluctuation in leptin levels during the menstrual cycle observed in study 1 is compatible with the hypothesis of a stimulatory effect of oestrogen on leptin secretion. The results of study 2 support the hypothesis of a relevant role for oestrogen in the regulation of leptin secretion. Leptin fluctuations during the menstrual cycle are consistent with reported perimenstrual variations in food craving and consumption.

Adolescent↗
PubMed1998

[Gliclazide and metformin combination in patients with type 2 diabetes. Preliminary data].

BACKGROUND: This preliminary study is aimed at the evaluation of the efficacy and tolerability of combined therapy with gliclazide and metformin in the treatment of patients with type 2 diabetes mellitus inadequately controlled with maximal doses of gliclazide. METHODS: A prospective, uncontrolled study, with a follow-up of 3 months, was performed in two Outpatient Diabetes Care Units. Fifty-seven patients affected by type 2 diabetes for at least 5 years, aged 61.0 +/- 3.4 years, with a duration of diabetes of 9.2 +/- 3.9 years, Body Mass Index (BMI) 30.5 +/- 3.7 kg/m2, previously treated with gliclazide 240 mg/day, and with HbA1c > 8.5%, were studied. The patients were treated with gliclazide 120 mg/day and metformin 1500 mg/day for 3 months; HbA1c, 24-hour glycosuria, and fasting and post-prandial glycaemia, were determined at the beginning and at the end of the study. RESULTS: After a 3-month treatment, a reduction of fasting and post-prandial glycaemia, glycosuria (15.0 +/- 5.3 versus 5.7 +/- 4.0 g/l, p < 0.01), and HbA1c (9.9 +/- 1.1 versus 8.4 +/- 1.0%, p < 0.01) was observed, while no significant changes occurred in body weight. The treatment was generally well tolerated. CONCLUSIONS: In conclusion, the combination of gliclazide and metformin, which could theoretically show some advantages over the association of glibenclamide and metformin with regards to lipid and haemorheologic profiles, resulted to be effective and well tolerated in patients with type 2 diabetes inadequately controlled with sulphonylurea monotherapy.

Diabetes Mellitus, Type 2↗
PubMed1997

Clinical features of binge eating disorder in type I diabetes: a case report.

Eating disorders in patients with type I diabetes show some peculiar clinical features. We report the case of a young type I diabetic woman with binge eating disorder and dysthymic disorder. The patient shows a poor metabolic control and her body mass index is within the normal range. The eating disorder has been present for 3 years, and it developed after recurrent nocturnal hypoglycemic episodes. The authors discuss the complex relationships between binge eating disorder and hypoglycemic reactions and underline the diagnostic problems typical of comorbidity between type I diabetes and binge eating disorder.

Adult↗
PubMed1997

Cognitive-behavioral therapy versus combined treatment with group psychoeducation and fluoxetine in bulimic outpatients.

A series of 51 female bulimic outpatients, aged 23.4+/-3.9, were assigned either to Cognitive-Behavioral Therapy (CBT) or combined Group Psychoeducation and Fluoxetine (GPF) treatment. The Eating Disorder Examination (EDE) was performed at the beginning of treatment and after 6 months, together with the administration of self reported questionnaires for depression (BDI) and Anxiety (STAI). A significant (p<0.001) reduction of the number of monthly binge episodes (from 25.0+/-12.9 to 6.2+/-3.8 and from 24.8+/-9.1 to 8.0+/-4.3) for CBT and GPF respectively were observed. Similar reductions were obtained in the number of episodes of compensatory behaviors. Both treatments reduced depression and anxiety (p<0.001) while CBT only determined a significative improvement of EDE scores. The data obtained suggest that GPF is as effective as CBT in reducing bulimic symptomatology but its long-term efficacy should be evaluated in a follow-up study.

Adult↗
PubMed1997

Psychometric properties of EDE 12.0D in obese adult patients without binge eating disorder.

The aim of the present study is to assess the psychometric properties of the Eating Disorder Examination (EDE) 12.0D in obese adult patients without Binge Eating Disorder (BED). A consecutive series of 115 obese patients without BED (23 M; 92 F), seeking treatment for obesity at the Outpatient Clinic of the Section of Metabolic Diseases and Diabetology of the University of Florence was studied using the EDE 12.0D. Patients had a mean (+/- SD) age of 40.8 +/- 15.1 years, and a Body Mass Index (BMI) of 36.3 +/- 5.9 Kg/m2. Internal consistency of EDE and its scales was evaluated through Cronbach's alpha; factor structure of EDE 12.0D was studied with factor analysis. EDE total and Shape Concern (SC) scores were found to be higher in females than in males. EDE total, SC and Eating Concern (EC) scores were inversely correlated to age, but not BMI. Factor analysis suggested the grouping of items in two subscales. The first scale includes all the items from EC, Weight Concern (WC) and SC except reaction to prescribed weighing; the second scale consists of all the items from Restraint. Data obtained show that items from EC, WC and SC all converge into the same factor analysis derived scale in obese patients without BED. EDE 12.0D provides relevant information about psychopathological features of obese patients, but a grouping of items into subscales different from those originally described could be indicated.

Adolescent↗
PubMed1997

Assessment of basic symptoms in schizophrenia, schizoaffective and bipolar disorders.

In order to evaluate the basic symptoms differences of schizophrenics, schizoaffectives and bipolar patients, a consecutive series of 72 outpatients participated in the study. According to DSM III-R criteria, 28 had a diagnosis of schizophrenia, 29 of bipolar disorder and 15 of schizoaffective disorder. The assessment of basic symptoms was performed using the Frankfurter Beschwerde-Fragebogen (FBF). Data obtained suggest that perception and thought disturbances are the most characteristic experiences of schizophrenic patients in comparison with bipolar patients. The FBF questionnaire did not highlight a characteristic basic symptoms profile of schizoaffective disorder, when compared with bipolar affective disorder and schizophrenia.

Adult↗
PubMed1996

Sertraline enhances the effects of cognitive-behavioral treatment on weight reduction of obese patients.

Serotonin reuptake inhibitors, such as dexfenfluramine, fluoxetine and fluvoxamine, have been proposed as therapeutical tools for the treatment of eating disorders and obesity. Sertraline, a SSRI used in the treatment of depression, interferes with eating behavior in animal models, but it has not been tested in obese humans. Aim of this study is the assessment of the effects of sertraline on eating attitudes and body weight in obese patients with and without mood disorders. A consecutive series of 65 obese out-patients aged 18-65 years, with a body mass index (BMI) > 30 kg/m2, was treated for 6 months with sertraline 150 mg/day per os, in addition to a cognitive-behavioral treatment (CBT). A consecutive series of 60 obese patients with similar characteristics, who were treated with CBT only, were used as control group. A greater reduction of BMI (mean +/- SD) was observed in sertraline-treated patients when compared to controls (from 35.3 +/- 5.7 to 32.0 +/- 5.4 kg/m2 in sertraline-treated patients, from 37.1 +/- 7.0 to 36.0 +/- 7.1 kg/m2 in controls; 6.5 +/- 5.4% vs. 3.0 +/- 6.3%; p < 0.01), while a similar change in eating attitudes (evaluated through the BITE questionnaire) was observed in both groups. Effects of sertraline on eating attitude and body weight were similar in patients with and without mood disorders. In conclusion, sertraline, administered together with CBT, seems to be more effective in inducing weight loss in obese patients when compared with CBT alone, and therefore it could be a useful tool in the first months of CBT for severe obesity.

1-Naphthylamine↗
PubMed1996

[Psychopathological and clinical features among the ambulatory population of obese patients].

Aim of the present study is the evaluation of psychopathological and clinical features of these outpatients followed by the Outpatient Clinic of the Section of Metabolic Diseases and Diabetes, University of Florence. 84 obese patients and 217 non-obese control subjects were studied using the Structured Clinical Interview for DSM-III-R (SCID), and applying DSM-IV criteria for Binge Eating Disorder. BITE self-reported questionnaire, STAI inventory and Ham-D rating scale were also used. Lifetime prevalence of Binge Eating Disorder in obese patient was 11.9%, markedly lower than that reported in studies on North American samples. Prevalence of depressive disorder (Major Depression and Dysthymia) was significantly higher (p < 0.005) in obese patients than in control subjects. This confirms the important relationships between eating and mood disorders. The prevalence of subclinical eating disorders resulted to be significantly higher in obese patients (p < 0.01) when compared with control subjects. Significant correlations (p < 0.01) of BITE scores were observed with STAI and Ham-D scores, but not with body mass index. These results underline the need for an accurate psychopathological assessment in obese patients, in order to formulate a correct diagnosis and plan adequate therapeutical interventions.

Adolescent↗
PubMed1994

Short cycles of very low calorie diet in the therapy of obese type II diabetes mellitus.

Very Low Calorie Diet (VLCD) is known to induce not only weight loss, but also an improvement of metabolic control, in obese type II diabetics. In order to evaluate the therapeutical efficacy of cycles of VLCD shorter than those previously described, 29 obese type II diabetics and 31 obese nondiabetic subjects were entered as inpatients and prescribed a 450 kcal/day diet for 15 days. Metabolic results obtained were similar to those achieved with longer cycles of VLCD, showing that 15 days are sufficient to induce a BMI decrease in diabetic (BMI from 35.3 +/- 4.8 to 33.3 +/- 4.6 after VLCD) and nondiabetic patients (BMI from 40.5 +/- 7.4 to 38.1 +/- 7.2 after VLCD), a desired fall of blood glucose levels and the decrease of daily insulin needs in insulin-treated patients. Glucagon tests were performed before and after VLCD in order to study possible modifications of insulin secretion. Although we did not observe any significant increase of C-peptide basal or peak levels (nM/ml) either in diabetic (basal levels before VLDC: 1.2 +/- 0.4 and peak levels 2.4 +/- 0.7; basal after VLCD 1.23 +/- 0.6 and peak 2.6 +/- 0.7) and nondiabetic patients (basal levels before VLDC 1.0 +/- 0.3 and peak levels 2.5 +/- 0.4; basal after VLCD 0.9 +/- 0.3 and peak 2.4 +/- 0.6). The rise of the C-peptide/glycemia ratio is an index of an improvement of insulin biological activity, which could be partly responsible for the therapeutical effects of VLCD.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Release of extracellular matrix components by bovine bone endothelial cells in continuous culture.

Production of collagen type I (pIp), type III (pIIIp), type IV (CIV), type VI (CVI), fibronectin (FN), laminin and glycosaminoglycans (GAGs) has been investigated in a clonal line of Bovine Bone Endothelial (BBE) cells continuously growing in culture. BBE cells produced pIp, pIIIp and FN, whereas they did not synthetize significant amounts of CIV, CVI and laminin. pIp, pIIIp and FN syntheses were influenced by cell density:pIp secretory activity reached its maximum just after cell seeding, whereas pIIIp and FN production increased later, when cells were subconfluent. Furthermore, BBE cells produced and released significant amounts of GAGs into medium.

Animals↗
PubMedDate not supplied

Fasting and post-prandial glycemia and their correlation with glycated hemoglobin in Type 2 diabetes.

OBJECTIVE: The relative contribution of fasting and post-prandial glucose to glycated hemoglobin (HbA1c) is controversial. In the present study, we assessed the relationship with HbA1c of fasting and post-prandial glucose measured in a more naturalistic setting, through home glucose self-monitoring or with a continuous glucose monitoring system (CGM). MATERIALS AND METHODS: A consecutive series of 300 patients with Type 2 diabetes were enrolled in the study, provided that they performed blood glucose self-monitoring. HbA1c and fasting plasma glucose (FPG) were measured at enrolment. RESULTS: Both fasting plasma and capillary glucose showed a significant correlation with HbA1c (r=0.66 and 0.61, respectively; p<0.001). When home glucose monitoring was considered, both mean fasting and post-prandial glucose showed a significant correlation with HbA1c (r=0.71 and 0.73, respectively). In patients in the lower tertile of body mass index (BMI), HbA1c showed a significant correlation at multivariate analysis with post-prandial glucose, but not with fasting glucose. In patients with HbA1c >7%, both fasting and post-prandial glucose showed a significant correlation, after adjustment for age and BMI, with HbA1c (both p<0.01); conversely, in those with HbA1c < or =7%, such a correlation could be observed for fasting (p<0.01), but not for post-prandial glucose. CONCLUSION: In conclusion, both fasting and post-prandial glucose contribute to the determination of HbA1c . Home glucose self-monitoring appears to provide a more accurate assessment of metabolic control than a single plasma glucose measurement in experimental conditions. Fasting glucose could provide a greater contribution to HbA1c in patients with lower HbA1c, while post-prandial glucose seems to play a major role in leaner Type 2 diabetic subjects.

Aged↗
PubMedDate not supplied

Screening for binge eating disorder in obese outpatients.

The prevalence of binge eating disorder (BED) in clinical samples of obese patients is controversial, and sensitive diagnostic protocols for use in routine clinical practice need to be further defined. Three hundred forty-four obese (body mass index [BMI] > or =30 kg/m2) patients were studied with the Structured Clinical Interview for DSM-III-R to investigate the lifetime prevalence of mental disorders. The current prevalence of BED was assessed using DSM-IV criteria. Eating attitudes and behavior were investigated with the Bulimic Investigation Test, Edinburgh (BITE) and the Binge Eating Scale (BES). The Beck Depression Inventory (BDI) and Spielberg's State-Trait Anxiety Inventory (STAI) were also applied. The prevalence of BED was 7.5%. Patients with BED had a higher BMI compared with obese patients without BED. Differences in the lifetime prevalence of mental disorders in patients with and without BED were not statistically significant. Using the BES as a screening instrument for BED with a threshold of 17, the sensitivity was 84.8%, specificity 74.6%, positive predictive value 26.2%, and negative predictive value 97.9%. Using the BITE with a threshold of at least 10, the sensitivity was 91%, specificity 51.4%, positive predictive value 71.8%, and negative predictive value 98.2%. The BITE can be a valid alternative to the BES as a screening method for BED in obese patients.

Adult↗
PubMedDate not supplied

Quality of life and overweight: the obesity related well-being (Orwell 97) questionnaire.

The development and validation of a self-reported measure of obesity-related quality of life, the Obesity Related Well-Being (ORWELL 97), were undertaken to examine the intensity and the subjective relevance of physical and psychosocial distress. The questionnaire was validated in a sample of 147 obese patients (99 females, 48 males). The Eating Disorder Examination 12.0D interview, a structured diagnostic interview for DSM-III-R (DSM-IV criteria for binge eating disorder), Beck Depression Inventory, Binge Eating Scale, and the State-Trait Anxiety Inventory 1 and 2 scales were also applied. Internal consistency and test-retest reliability were satisfactory. Factor analysis allowed the identification of two subscales: ORWELL 97-1 related to psychological status and social adjustment, and ORWELL 97-2 related to physical symptoms impairment. Obese female patients showed a lower quality of life, and the severity of obesity appeared to interfere with physical functioning rather than psychological status and social adjustment. The ORWELL 97 questionnaire appears to be a simple and reliable measure of obesity-related quality of life, which can be used in current clinical practice.

Adolescent↗
PubMedDate not supplied

Difficulties in achieving vs maintaining erection: organic, psychogenic and relational determinants.

Achieving and maintaining a penile erection are two essential components of the male sexual response. It has recently been suggested that distinct molecular mechanism could underlie the two disturbances. The aim of the present study is to verify possible clinical differences on pathogenetic factors underlying difficulties of achieving and maintaining an erection. We studied a consecutive series of 560 patients (aged 51.9+/-12.8 y old) reporting erectile dysfunction (ED), using SIEDY structured interview. Patients were classified into two distinct categories: those with difficulties in maintaining, rather than achieving, an erection (sample A) and those with main problems in achieving an erection (sample B). A complete physical examination and a series of metabolic, biochemical, hormonal, psychometric, penile vascular tests and nocturnal penile tumescence and rigidity evaluations (NPT) were also performed. Sample B patients showed a higher prevalence of organic conditions related to ED, when compared with sample A as confirmed by higher SIEDY scale 1 scores (3[1-5] vs 1[0.1-3] for sample B vs sample A, respectively; P < 0.0001) which explores organic component of ED and higher prevalence of pathological instrumental parameters. No difference among groups was observed for SIEDY scale 2 (relational component) and SIEDY scale 3 (intrapsychic component) of ED. In conclusion, this study shows for the first time that patients with difficulties in maintaining erection are less likely to be affected by organic disturbances interfering with sexual function, when compared with those unable to achieve a valid erection.

Adult↗