Search PubMed⌕ Search

Biomedical subjects

G Iacobellis

Publications and source records attributed to G Iacobellis.

At least 19 recordsLinked to original sources
PubMed2007

Obesity and the heart: redefinition of the relationship.

Although obesity is an important cardiovascular risk factor, growing evidence shows that obesity is not always related to an unfavourable cardio-metabolic profile or poor cardiac outcomes. Recent studies show that excess fat even in the absence of comorbidities (uncomplicated obesity) can lead to adaptive cardiac morphological and functional changes. Uncomplicated obesity represents a well-defined clinical entity that should be carefully considered and followed up. The existence of metabolically healthy subjects presenting a lower prevalence of cardiac modifications and risk factors strongly suggests that a redefinition of obesity based on regional fat distribution indices like waist-to-hip ratio instead of body mass index is warranted.

Adaptation, Physiological↗
PubMed2005

Acute hyperinsulinemia is associated with increased plasma adrenomedullin concentrations in uncomplicated obesity.

OBJECTIVE: Adrenomedullin (AM) is a potent hypotensive peptide which may be implicated in the insulin regulatory system. Acute hyperinsulinemia exerts no influence on plasma AM in normal subjects while no data on obese subjects has been reported. PURPOSE: The aim of the study was to investigate the effect of acute hyperinsulinemia on the plasma AM concentration in patients with uncomplicated obesity. RESEARCH METHODS: We measured the plasma AM levels in 23 obese subjects (BMI 41.9 +/- 9.8 kg/m2), 21 females and 2 males (mean age 31 +/- 7.2 years), before and during a euglycemic hyperinsulinemic clamp. The control group consisted of 43 healthy subjects (HS) (22 males and 21 females; mean age 38 +/- 12 years; BMI 23.3 +/- 3.2 kg/m2). RESULTS: Baseline plasma AM was found to be higher in obese subjects (20.4 +/- 8.4 pg/ml) than in normal subjects (11.3 +/- 0.8 pg/ml) (p < 0.001). A significant increase in the plasma AM levels was observed in obese subjects during acute hyperinsulinemia (from 20.4 +/- 8.4 pg/ml at 0 min to 26 +/- 8.9 pg/ml at 120 min, p < 0.02). Plasma AM concentrations were significantly correlated with insulin levels at 30 min (r = 0.44; p = 0.04) and 120 min (r = 0.40, p = 0.05) during the clamp. DISCUSSION: In conclusion, acute hyperinsulinemia induced a significant increase in the plasma levels of AM in uncomplicated obese subjects. Hyperinsulinemia may, at least in part, regulate levels of AM in obesity, explaining the high levels of the peptide in these subjects.

Acute Disease↗
PubMed2005

Imaging of visceral adipose tissue: an emerging diagnostic tool and therapeutic target.

Several lines of evidence support the contention that excess visceral fat plays a significant role in the development of an unfavourable metabolic and cardiovascular risk profile. Hence, estimation of visceral adipose tissue (VAT), that is, the fat surrounding the internal organs, might be important for cardiovascular risk stratification. Classically, anthropometric measures have been employed to assess body fat distribution for risk assessment. But more recently, imaging methods for visceral fat quantitation have become a focus of attention particularly in a clinical research setting. Several imaging methods have evolved for estimation of VAT mass. Among these, magnetic resonance imaging (MRI) is fairly well established, but ultrasound and magnetic resonance spectroscopy (MRS) are also emerging as useful methods for quantitation of VAT and fat tissue content in vivo. Ultrasound is the most cost-effective and a convenient imaging tool whereas MRS is still in its infancy but it is highly promising because of its high sensitivity and specificity. There is a compelling need to quantify VAT not only for diagnostic purposes, but also for therapeutic interventions with weight reduction drugs or pharmaceuticals targeted to with adipose tissue. For example, changes in regional fat distribution can be used to estimate drugs effectiveness and their mechanism of action. Therefore, in this review I shall present briefly latest and main imaging techniques to detect the visceral adiposity, including the new ultrasound measurements of different visceral adipose tissue compartments. Some visceral adipose tissues which are not traditionally assessed, such as intraperitoneal, mediastinal and the relatively small depots, such as epicardial adipose tissue have also been recently studied and are now proposed as new markers of visceral adiposity.

Adipose Tissue↗
PubMed2004

Insulin sensitivity assessment in uncomplicated obese women: comparison of indices from fasting and oral glucose load with euglycemic hyperinsulinemic clamp.

BACKGROUND AND AIM: Obesity is associated with a great variability to insulin sensitivity degree. Several formulae developed from measurements in the fasting state and during the oral glucose tolerance test (OGTT) have been proposed to assess insulin sensitivity. AIM: In this work we sought to compare the published insulin sensitivity indices with the metabolized glucose index obtained by hyperinsulinemic euglycemic clamp in uncomplicated obese subjects. Uncomplicated obesity provides a good model in order to study insulin sensitivity per se. METHODS AND RESULTS: In this protocol, 65 obese women affected by uncomplicated obesity (without impaired glucose tolerance, diabetes, hypertension and dyslipidemia) underwent 2 h OGTT and euglycemic hyperinsulinemic clamp. Common formulae obtained in the fasting state and from a 2h OGTT were calculated. Simple linear regression analysis showed that ISI (r=0.592, p=0.01), 2 h OGIS (r=0.576, p=0.02), MCRest (r=0.507, p=0.02), 120 insulin (r=-0.494, p=0.03) and fasting insulin (r=-0.382, p =0.02) are significantly correlated to the M index obtained from the hyperinsulinemic euglycemic clamp. The Bland-Altman plot confirmed the good agreement between indices from OGTT and the clamp. CONCLUSION: OGTT-derived indices provide a good assessment of insulin sensitivity in obesity. OGTT could easily be applied in a large number of obese patients in order to obtain information on both glucose tolerance and insulin sensitivity.

Adult↗
PubMed2003

Importance of premeal injection time in insulin therapy: Humalog Mix25 is convenient for improved post-prandial glycemic control in type 2 diabetic patients with Italian dietary habits.

We investigated the use, in a short period, of Humalog Mix25 (Mix25) in a twice-daily administration regimen compared to a twice-daily injection therapy with Humulin 30/70 (30/70) in diabetic patients with Italian dietary habits. We studied 33 type 2 diabetic patients aged 59.1 +/- 8.1 years, BMI 29.8 +/- 2.7 kg/m2, duration of diabetes and insulin therapy of 14.4 +/- 9.8 and 4.2 +/- 4.6 years, respectively. After a 4-day lead-in period of twice-daily human insulin 30/70 treatment, patients were randomized to one of two treatment sequences: (1) a twice-daily regimen with Mix25 just 5 minutes before the morning and evening meals for 12 days, followed by a twice-daily therapy with human insulin 30/70 given 30 minutes before the morning and evening meals for an additional 12 days; or (2) the alternate sequence. Each patient underwent a mixed meal test: Humulin 30/70 was administered 30 minutes before the meal, while Mix25 was given 5 minutes before. The 2-hour post-prandial glucose concentration after breakfast was significantly lower during treatment with Mix25 than with Humulin 30/70 (157 +/- 43.2 vs. 180 +/- 43.2 mg/dl, p<0.05). The glycemic excursion after dinner on Mix25 treatment was significantly lower than with Humulin 30/70 (12.2 +/- 48.01 vs. 35.5 +/- 36.92 mg/dl, p<0.05). AUCglucose after Mix25 was lower than after Humulin 30/70. Glycemia after test meal was significantly lower with Mix25 than with Humulin 30/70. Insulin and free insulin concentrations after the test meal were significantly higher with Mix25 in comparison to Humulin 30/70. AUC serum insulin and free insulin curves after Mix25 were significantly higher than after Humulin 30/70 (p=0.028 and p=0.005, respectively). Twice-daily injections of Humalog Mix25, compared to human insulin 30/70 in type 2 diabetic patients with Italian dietary habits, provide improved and lasting post-prandial glycemic control, with the great convenience of the injection just before the meal.

Biphasic Insulins↗
PubMed2002

Clinical, physiopathological and dietetic aspects of metabolic syndrome.

Hypertriglyceridaemia, diabetes, hypertension and obesity are the deadly quartet indicating a syndrome at high risk for cardiovascular disease for which, in 1998, WHO proposed the definition of Metabolic Syndrome, related to an elevated degree of insulin resistance. Treatment will often include behavioural changes that reduce body weight and increase physical activity A high-carbohydrate/low-fat diet with complex carbohydrates and mainly unsaturated fat is recommended. Replacing refined grain products and potatoes with minimally processed plant-based foods such as whole grains, fruit, and vegetables, and reducing the intake of high glycaemic load beverages may offer a simple strategy for reducing the incidence of coronary heart disease.

Diet↗
PubMed1999

Cardiac effects of slow-release lanreotide, a slow-release somatostatin analog, in acromegalic patients.

Cardiac involvement, mostly characterized by left ventricular hypertrophy associated with various degrees of cardiac dysfunction, greatly contributes to the increased mortality and morbidity observed in acromegaly. Lanreotide is a new SRIF analog characterized by a slow-release (SR) formulation with the peculiarity of a 30-mg im administration every 10-14 days. In this study, 13 patients with postoperative active acromegaly (9 females, 4 males, 45.9 +/- 16.3 yr old) underwent an echo-Doppler and hormonal study before and during a 12-month period of treatment with SR-lanreotide. GH and insulin-like growth factor I plasma levels (mean +/- SD) decreased significantly throughout the study period (from 10.1 +/- 2.2 to 3.9 +/- 0.9 ng/mL for GH, P < 0.005; and from 511.0 +/- 33.0 to 305.0 +/- 34.2 ng/mL for insulin-like growth factor I, P < 0.0001). Left ventricular mass index (mean +/- SD, 137.1 +/- 7.5 g/m2 at baseline) decreased after 3 months (120.0 +/- 5.4 g/m2), 6 months (111.7 +/- 5.7 g/m2), and 12 months (110.3 +/- 5.2 g/m2) of treatment (P < 0.005 at each time-point). This reduction in left ventricular mass index was accompanied by an improvement in some indexes of left ventricular diastolic function, especially the isovolumetric relaxation time (mean +/- SD, 109.1 +/- 4.6 m/sec at baseline), which decreased after 3 months (91.9 +/- 2.8 m/sec), 6 months (92.3 +/- 3.2 m/sec), and 12 months (92.2 +/- 3.0 m/sec) of treatment (P < 0.005 at each time-point). We conclude that SR-lanreotide is able to improve cardiac morphology and functional abnormalities in acromegaly; whether such beneficial effects on cardiac parameters will contribute to improve life expectancy in these patients should be further investigated.

Acromegaly↗
PubMed1993

[Primary malignant melanoma of the vagina].

We report two cases of primary malignant melanoma of the vagina explaining the essential clinical pathological and therapeutic features. They themselves, added those represented in literature, might constitute a further contribution to best definition of the unusual genital pathology, especially as regards prognostic and therapeutic aspects.

Aged↗
PubMed1992

[Vulvar papillary hidrocystadenoma. Description of a case].

Papillary hidradenoma of the vulva is a benign neoplasm arising from apocrine sweat glands of the skin. The treatment of choice is local excision. The prognosis for the patient is excellent. We present one case observed recently.

Adenoma, Sweat Gland↗
PubMed1990

5-Fluorouracil cardiotoxicity.

The authors report a case of cardiotoxicity secondary to 5-FU, the 67th in literature in a 46-year-old woman subjected to adjuvant therapy with a CMF protocol after surgical treatment for carcinoma of the breast, and presenting onset of clinical symptoms 16 hours after administration of the first dose. Analysis of previous cases reported in literature revealed no evidence of age or sex as risk factors. Doubts exist as to whether or not pre-existing heart disease and thoraco-mediastinic radiotherapy increase the risk. With regard to the causes of the syndrome, the authors are inclined to attribute its onset to an auto-immune mechanism. 5-FU-induced cardiotoxicity, though rare, should be borne in mind and the use of the drug should be discontinued at the first signs of cardiotoxicity.

Angina Pectoris↗