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PubMedDate not supplied

A molecular epidemiology project on diet and cancer: the EPIC-Italy Prospective Study. Design and baseline characteristics of participants.

EPIC-Italy is the Italian section of a larger project known as EPIC (European Prospective Investigation into Cancer and Nutrition), a prospective study on diet and cancer carried out in 10 European countries. In the period 1993-1998, EPIC-Italy completed the recruitment of 47,749 volunteers (15,171 men, 32,578 women, aged 35-65 years) in 4 different areas covered by cancer registries: Varese (12,083 volunteers) and Turin (10,604) in the Northern part of the country; Florence (13,597) and Ragusa (6,403) in Central and Southern Italy, respectively. An associate center in Naples enrolled 5,062 women. Detailed information for each individual volunteer about diet and life-style habits, anthropometric measurements and a blood sample was collected, after signing an informed consent form. A food frequency questionnaire specifically developed for the Italian dietary pattern was tested in a pilot phase. A computerized data base with the dietary and life-style information of each participant was completed. Blood samples were processed in the same day of collection, aliquoted (RBC, WBC, serum and plasma) and stored in liquid nitrogen containers. Follow-up procedures were validated and implemented for the identification of newly diagnosed cancer cases. Cancer incidence was related to dietary habits and biochemical markers of food consumption and individual susceptibility in order to test the role of diet-related exposure in the etiology of cancer and its interaction with other environmental or genetic determinants. The comparability of information in a prospective study design is much higher than in other studies. The availability of such a large biological bank linked to individual data on dietary and life-style exposures also provides the unique opportunity of evaluating the role of selected genotypes involved in the metabolism of chemical compounds and DNA repair, potentially related to the risk of cancer, in residents of geographic areas of Italy characterized by specific cancer risk and different dietary patterns. Baseline characteristics of participants are briefly described.

Adult↗
PubMed2000

Molecular characterisation of HCV genotype 4 isolates circulating in Italy.

The characteristics of genotype 4 subtype variability of HCV isolates circulating in Italy were studied. The viral isolates were identified from 736 HCV-RNA positive sera originated from seroepidemiological studies undertaken in 4 different regions of North, South Italy and Sardinia. 24 out of 28 genotype 4 isolates (86%) were classified by phylogenetic analysis of E1 genome region (915-1128) as belonging to subtype 4d (Neighbour Joining Method). Three isolates classified as subtype 4a were detected in haemophilic patients, possibly related to infections from blood products. One isolate classified as a new subtype derived from an Eritrean patient subjected to haemodialysis. Very high genome homogeneity (mean 4.3%) was shown by genetic comparisons (DNA dist programs Phylip Package) for all the 4d isolates relative to the studies performed in Veneto, Calabria and Sardinia and originated from subjects from the general population and outpatients (19 subtype 4d isolates out of 24). In the 3 studies different prevalence rates of HCV genotype 4 (3.1%, 1. 3%, 14% respectively) were found. In contrast a considerable degree of heterogeneity, both intragroup and with the other groups (mean 8. 2% and 8.7%, respectively) was observed among subtype 4d isolates identified in the patients of a haemodialysis centre in Apulia region. In conclusion the subtype 4d of genotype 4 was highly prevalent and endemic in Italy. An elevated level of viral heterogeneity was observed in one study carried out in a region of Southern Italy. This can be related to a longer period of past endemicity of this genotype and to a high level of exposure to reinfections in particular categories of patients such as haemodialysis patients.

Genotype↗
PubMed2007

No signature of Y chromosomal resemblance between possible descendants of the Cimbri in Denmark and Northern Italy.

Two European populations are believed to be related to the ancient Germanic tribe Cimbri: one living in Northern Italy, the other living in Jutland, Denmark. The people called Cimbri are documented in the ancient Roman historical record. Arriving from the far north their movements can be tracked from successive battles with the Romans. The Cimbri finally entered Italy from the northeast and were defeated at Vercellae (present day Vercelli) in 101 BC by Gaius Marius and his professional legions. Classical sources from the first centuries AD relate the homeland of the Cimbri to the coasts around the Elb estuary (northern Germany) or specifically towards the north (Himmerland in northern Jutland). In the alpine parts of Veneto, northeast of the historical battlefield, local traditions dating back to late medieval time, identify a local population as Cimbri living in Terra dei Cimbri. They are considered the descendents of the Germanic combatants that fled the battlefield at Vercelli. As the defeated Cimbri that possibly fled to the mountains of Northern Italy most likely would have been male (warriors), the present study investigated the possible Y chromosomal diversity of the two present populations using microsatellite markers and single nucleotide polymorphisms. While Cimbri from Himmerland resembled their geographical neighbors from Denmark for the Y-chromosome markers, Cimbri from Italy were significantly differentiated both from Cimbri from Himmerland and from Danes. Therefore, we were not able to show any biological relationship for uniparentally transmitted markers.

Chromosomes, Human, Y↗
PubMed2005

The importance of HCV on the burden of chronic liver disease in Italy: a multicenter prevalence study of 9,997 cases.

Knowledge of the current epidemiology of chronic liver disease in Italy is mostly obsolete and fragmentary for the lack of up-to-date consistent data. In 2001, a 6-month prevalence study was undertaken in 79 hospitals to assess the characteristics of chronic liver disease in Italy. Both prevalent and incident cases were enrolled. A total of 9,997 patients were recruited, of whom 939 (9.4%) had normal liver biochemistry, 6,210 (62.1%) had chronic hepatitis, 1,940 (19.4%) had liver cirrhosis, and 341 (3.4%) had hepatocellular carcinoma (HCC). In 567 patients (5.7%) the diagnosis was not established. Hepatitis C virus (HCV) was found in 69.9% of the patients and was the only etiological factor in 56.3% of all the patients. Hepatitis B surface antigen (HBsAg) was present in the serum of 13.4% of the cases (in 10% it was the only etiological factor). A history of alcohol abuse was found in 23% of the cases (9.4% without viral infection). The prevalence of HCV-related cases was significantly lower in incident than in prevalent cases (44.9% vs. 59.9%, P < 0.0001), while the proportion of patients with alcohol abuse was much higher in incident than in prevalent cases (18.1% vs. 6.6%, P < 0.0001). These findings indicate that nearly one quarter of patients with chronic liver diseases in Italy have a severe disease such as liver cirrhosis and HCC represents a not negligible burden for the national health system. Hepatitis B fell in importance as an etiological factor. Hepatitis C is the important pathogenic factor for chronic liver disease in Italy. However, a comparison between the prevalent and incident cases suggests that in future HCV infection will also play a progressively decreasing role, in part as a consequence of treatment.

Adult↗
PubMed1982

Alpha-1-antitrypsin (alpha 1AT) phenotypes and PiM subtypes in Italy. Evidence of considerable geographic variability.

Genetic typing of alpha 1AT was performed in 3751 individuals from Italian towns. The following was observed: (a) The pathologic phenotypes (SZ, MZ, ZZ) appeared to decrease progressively from northern to southern Italy; (b) the distribution of the PiM suballeles showed considerable geographic variability, but the suballele M2 was more frequently encountered in southern Italy; and (c) in the large cities of southern Italy, the frequency of the deficiency more closely resembled that found in northern Italy than that of the remaining populations of the south.

Electrophoresis, Polyacrylamide Gel↗
PubMed1994

AIDS as a leading cause of death among young adults in Italy.

The objective of this study is to describe the impact of AIDS on the mortality of young adult (aged 25 to 44 years) in Italy, at both the national and regional level. We analyzed the official mortality data for Italy: the most recent data available being from 1990. General mortality trends show that while mortality among young women is still decreasing (i.e. from a standardized rate of 83.8 per 100,000 in 1980 to 68.4 in 1990), mortality among young men began to rise in the mid-1980s, after a steady decrease over many years. Among the 25-34 year olds, however, this reversal in trend is more marked, notwithstanding a decrease or stabilization in most major causes of death. In fact it coincides with the appearance and spread of AIDS in Italy, which has affected young men in particular. (The peak age group for AIDS deaths is the 25-34 year olds). Mortality data from 1990 reveal that AIDS is the fourth leading cause of death in Italy among men between the ages of 25 and 44 years. Among 25-34 year-old men, however, AIDS is the second leading cause of death, after road accidents. AIDS also contributes greatly to the general mortality in individual regions, both among 25-44 year-old men (Lombardy, Liguria, Lazio, Emilia-Romagna, Tuscany), and especially among 25-34 year-old men (Lombardy, Liguria, Lazio, Sardinia, where it is the number one cause of death, Emilia-Romagna, Tuscany, and Veneto, where it is the number two cause of death).

AIDS-Related Complex↗
PubMed1981

Multiple sclerosis in northern Italy. Prevalence in the province of Ferrara in 1978.

Most available Italian studies indicate that the prevalence of multiple sclerosis (MS) in Italy is lower than 20 per 100,000. Much higher prevalence figures, however, have been recently found in small communities in Sicily. On this basis, it has been suggested that the frequency the MS in Italy has been seriously underestimated and that the true prevalence for MS is probably similar to that established for northern European countries. This paper reports the results of a survey of MS in the various public health districts of the province of Ferrara. The public health districts are homogeneous medical units serving small populations and therefore represent ideal areas for epidemiological purposes. The total prevalence rate of probable MS for the whole province has been found to be at least 26.9 per 100,000. This result supports the view that the frequency of MS in Italy is higher than that indicated by most published studies, but not that Italy is an area of high risk for MS.

Adolescent↗
PubMed1993

Liver transplantation in Italy and the scarcity of donors: causative factors and ethical considerations.

We analyze the current state of liver transplantation (OLTx) in Italy that in the last few years had reached approximately 150 OLTx per year for a population of 58 millions of inhabitants. The need for OLTx in Italy is high and mainly due to the incidence of post-hepatitis and post-alcoholic liver cirrhosis, which are the prevalent indication for OLTx. On the contrary the availability of donor organs in Italy is very low as compared with other European countries, and as a consequence the gap between need and performed OLTx is widening. The reasons for poor donations are multifactorial among which; lack of organization, insufficient ICU care beds, poor knowledge of health personnel. General attitudes of the society and brain death concepts are also involved as a recent survey has demonstrated. Under certain circumstances the patient who cannot be transplanted on time in Italy is allowed to seek for care abroad under the local government economical assistance. Finally some ethical considerations and the proposal for better education of both population and health care providers are advocated.

Adult↗
PubMed2002

The costs of multiple sclerosis: a cross-sectional, multicenter cost-of-illness study in Italy.

OBJECTIVES: To estimate the socio-economic impact of multiple sclerosis (MS) in Italy. METHODS: Outpatients with MS were enrolled at 44 centres across Italy. Socio-demographic, clinical and resource utilization data were collected using a validated questionnaire. Each patient completed a weekly diary of expenses due to MS over a three-month period. Direct health care costs and indirect costs (lack of productivity for the patient and for caregivers) were assessed for the whole population and were compared among five groups, categorised by disease severity (EDSS score). An analysis of variance was carried out on socio-demographic variables. RESULTS: For the total population of 566 patients, the mean direct cost over three months was ITL 2,134,000, the mean indirect cost was ITL 7,775,000. Costs were significantly higher for male patients (p < 0.05) and showed a significant increase with increasing age (p < 0.0005), disease duration (p < 0.0005) and disease severity (p < 0.0005). Costs for patients in a progressive phase were significantly higher (p < 0.0005). There were no significant geographical differences among the regions of Italy. CONCLUSIONS: This study confirms that MS represents a high economic burden, with indirect costs greatly exceeding direct costs. Unpaid caregivers remain the culturally accepted mode of care for MS patients in Italy and this study illustrates the impact of their loss of earnings. As costs increase with disease progression, these findings suggest that treatment efforts should focus on patients in the early stages of MS, in order to slow down disease progression.

Adolescent↗
PubMed2003

Prevalence of hypovitaminosis D in elderly women in Italy: clinical consequences and risk factors.

In order to evaluate the prevalence, risk factors, and clinical consequences of hypovitaminosis D in elderly Italian women a multicenter study of 43 osteoporosis centers from all regions of Italy was carried out. Study population included 700 women aged 60-80 years in whom blood was taken for 25-hydroxyvitamin D (25OHD) and parathyroid hormone (PTH) measurements. All subjects were also questioned to assess the prevalence of several risk factors for hypovitaminosis D, osteoporotic fractures and activities of daily living (ADL). Values of 25OHD lower than 5 ng/ml were found in 27% of the women and lower than 12 ng/ml in 76%. 25OHD and PTH levels were negatively correlated ( r=-0.38, after logarithmic transformation of both variables). 25OHD levels significantly declined with advancing age and number of pregnancies and were positively correlated with educational level (years spent at school), dairy calcium intake, and days spent on holiday by the sea. In a multivariate model including all these variables, the only one that remained significant was the level of education. The lowest age-adjusted 25OH D levels were found in smokers or in women living in central Italy as compared with those living in northern or southern Italy. The mean (+/-SD) age-adjusted 25OH D values were significantly lower in women who sustained a hip fracture (7.1+/-2.2 versus 11.0+/-9.9). Women with low 25OHD levels (<12 ng/ml) had worse scores for ADL and mobility ADL (move outdoors, use stairs, walk at least 400 m, carry a heavy object). Vitamin D deficiency is extremely common among elderly Italian women. Women with lower educational level, living in central Italy, smokers or with lower intake of dairy products are at greater risk. Hypovitaminosis D is associated with worsening of the ability to perform activities of daily living and higher hip fracture prevalence. This finding should lead to an urgent population-based strategy to remedy this condition.

25-Hydroxyvitamin D 2↗
PubMed2003

Prevalence of osteoporosis and fractures in a migrant population from southern to northern Italy: a cross-sectional, comparative study.

The purpose of this study was to assess whether a migrant population from southern regions of Italy showed differences in osteoporosis (OP) and fracture prevalence in comparison to a population born and living in Milan, a city in northern Italy. The study group consisted of 1764 postmenopausal women born in southern Italy who migrated after age 20 to Milan, where they had lived for at least 15 years. This group was compared with a sample of 4018 postmenopausal women born, raised and living in Milan. Bone mineral density (BMD) was measured at lumbar spine by dual-energy X-ray absorptiometry. Univariate analysis showed a significantly higher BMI, a greater parity, a lower postmenopausal estrogen (HRT) usage and a lower calcium intake in the Southern group (SG). Densitometric values showed a mean lumbar BMD significantly lower in SG ( P<0.001), resulting in a greater prevalence of OP (30.5% versus 24.9%; P<0.001). Consistent with this result, the number of women reporting low energy fractures after menopause was higher in SG (4.8% versus 3.6%; P=0.01). Multiple logistic regression analyses showed that OP was predicted by well-recognized variables, such as age, age at menopause, BMI, HRT, calcium intake together to belonging to SG, which independently increased the risk for OP by 42%. Age, age at menopause, BMI and belonging to SG significantly influenced the fracture risk, but the last variable was no longer associated with an increased fracture risk when BMD was entered in the model. Despite the results of previous epidemiological studies and protective anthropometric measures, a higher OP and fracture prevalence was found in the migrant group from southern Italy to Milan in comparison with the native sample. These differences are not solely explained by lifestyle variables. Our data suggest that changing environmental exposures can influence bone mass and fracture risk.

Adult↗
PubMed1999

Amyotrophic lateral sclerosis among the migrant population to Piemonte, northwestern Italy.

Recent surveys indicate a decreasing north-to-south gradient in the mortality and incidence rates of amyotrophic lateral sclerosis (ALS) in Italy, possibly indicating a different susceptibility to ALS in these populations. Piemonte, a region of northwestern Italy, experienced a considerable migration from other regions in Italy between 1940 and 1975; we therefore analyzed the effects of place of birth and migration upon the risk of developing ALS. Data on all ALS cases occurring in Piemonte during the period 1971-1990 were collected. Standardized incidence ratios (SIRs) for patients born outside Piemonte were calculated, using the Piemonte-born population as reference. A total of 962 ALS cases were identified during the study period, corresponding to a mean annual crude incidence rate of 1.37/100,000 population (95% confidence interval, 1.29-1.46). The SIRs of patients born in three southern Italian regions and of foreign-born persons were significantly higher than those of persons born in Piemonte and or other regions in Italy, and increased with age. This observation may be explained by an interaction between environmental and genetic factors or by selective migration.

Adult↗
PubMedDate not supplied

Antibodies to the E2 protein of GB virus C/hepatitis G virus: prevalence and risk factors in different populations in Italy.

BACKGROUND: Many aspects of the epidemiology of GB virus C/hepatitis G virus (GBV-C) infection have not been fully elucidated. The purpose of this study was to assess the prevalence of GBV-C antibodies and risk factors in different subjects living in Italy. MATERIALS AND METHODS: A total of 1,005 sera were tested for the presence of antibodies to the of GBV-C E2 protein using a recently developed enzyme immunoassay. RESULTS: A high prevalence of GBV-C antibodies was found in healthy blood donors (12.6%). Hemodialysis patients and drug users showed higher rates of GBV-C seropositivity (22% and 39%, respectively). Immigrants from sub-Saharan Africa and South Asia had anti-GBV-C prevalence comparable to that found in Italian blood donors, whereas higher and lower rates were detected in immigrants from Latin America and the Caribbean (19.5%) and from Mediterranean Africa (5.6%). CONCLUSION: GBV-C infections are widespread in the general population in Italy and particularly common in risk groups. The different prevalence of GBV-C antibodies detected in third world immigrants is likely to reflect the prevalence in the countries of origin. However, the observation that the length of residency in Italy is a significant risk factor may suggest that at least some GBV-C infections are contracted in Italy.

Adolescent↗
PubMed1989

Is Italy losing the "Mediterranean advantage?" Report on the Gubbio population study: cardiovascular risk factors at baseline. Gubbio Collaborative Study Group.

The coronary heart disease mortality rate in Italy--lower than in many other industrialized countries--has changed little in the last 20 years, whereas in the United States, a major decline in deaths resulting from coronary heart disease has occurred. These differing trends have reduced considerably the gap between the two countries in coronary mortality rates. Several recent population studies in Italy have found a change in the previously more favorable risk factor profile. In the northern hill town of Gubbio, studied in 1983-1985, median serum cholesterol level of men ages 40-59 was 223 mg/dl, considerably higher than was found in the 1960 Italian population samples of the Seven Countries Study (197-206 mg/dl). In the earlier study, the cholesterol levels in the Italian men who were still mainly consuming the traditional Mediterranean diet were 30-40 mg/dl lower than in the U.S. sample. The 1980 Gubbio levels, however, were at least as high as those of their U.S. contemporaries. Cigarette smoking was much higher among the middle-aged men of Gubbio than among a similar U.S. population sample (56% vs 36%). Hypertension prevalence was high, and several risk factors for hypertension--obesity, high salt intake, and alcohol--were common in the Gubbio as well as in other recent Italian population studies. The changing coronary risk profile in Italy, which now includes higher population levels of serum cholesterol as well as the other major coronary heart disease risk factors of cigarette smoking and hypertension, threatens to reduce markedly the "Mediterranean advantage" enjoyed by Italy in the past.

Adult↗
PubMed1988

Mortality from liver cirrhosis in Italy: proportion associated with consumption of alcohol.

A descriptive analysis of the features of mortality from cirrhosis in Italy suggests that it is made up of two components which are characterized by different age trends. On the basis of this hypothesis, a model has been postulated and applied to the data for the 94 Italian provinces in order to identify the two components. When considering alcoholic drinking data, it appears that only one of these components is associated with the consumption of alcohol, both for men and for women. In this way an estimate can be made of the proportion of mortality in Italy which can be linked to alcohol consumption. For males, this is 40.4% (47.1% for the North, 29.7% for Central Italy, and 33% for the South/Islands). For females, the average is 24.6% (36.6% for the North, 16.2% for Central Italy, and 12.3% for the South/Islands). In absolute terms, these figures represent approx 5000 of the 13,000 deaths per year among males and around 1200 of the 5000 deaths from cirrhosis among females.

Adult↗
PubMed2004

Characteristics of liver cirrhosis in Italy: results from a multicenter national study.

BACKGROUND: In 1992, the characteristics of liver cirrhosis in Italy were assessed in a cross-sectional study among 1829 cirrhosis patients attending 21 tertiary centres. AIM: To evaluate the characteristics of cirrhosis patients 9 years later. PATIENTS: A total of 2185 consecutive cirrhosis patients were enrolled over a 6-month period in 79 hospitals located throughout Italy, randomly selected by means of systematic cluster sampling. RESULTS: The main agent associated with cirrhosis was hepatitis C virus, which was found in 69.9% of the patients and was the only etiologic factor in 51.1% of the patients. Hepatitis B surface antigen was present in the serum of 13.0% of the cases (in 7.3%, it was the only etiologic factor). A history of alcohol abuse was found in 31.9% of the cases (12.4% without viral infection). Patients with hepatitis C virus-related cirrhosis were older (mean age of 64.4 years) and more likely to be female (male:female ratio of 0.7), compared to patients with other pathogenic factors. Virus-related cirrhosis was more likely to be observed in southern Italy, whereas alcohol-related cirrhosis was prevalent in the North. CONCLUSIONS: As found in the 1992 study, the results of the present study show that in Italy, liver cirrhosis is mainly associated with hepatitis C virus infection, reflecting the high prevalence of this infection in the general population.

Aged↗
PubMed2004

Frequency of NOD2/CARD15 variants in both sporadic and familial cases of Crohn's disease across Italy. An Italian Group for Inflammatory Bowel Disease Study.

BACKGROUND: Three variants of the NOD2/CARD15 gene are strongly associated with susceptibility to Crohn's disease; however, striking racial and geographic differences of their frequency have been described. AIMS: We have compared the allele frequencies of familial cases of Crohn's disease recruited in a multicentre study across Italy, in order to disclose possible geographic heterogeneity. Moreover, we also compared the allele frequencies in sporadic cases of Crohn's disease and healthy controls from Southern Italy with those reported in other two populations from Central and Northern Italy. SUBJECTS AND METHODS: A total of 731 subjects were genotyped for the polymorphism of three main variants (R702W, G908R and 1007 fs): 152 patients were familial cases of Crohn's disease, 183 were healthy first-degree relatives, 180 were sporadic cases of Crohn's disease, and 216 were unrelated healthy subjects. RESULTS: The frequency of the frameshift mutation (1007 fs) was significantly higher in both familial and sporadic cases of Crohn's disease (P = 0.000001), and healthy first-degree relatives (P = 0.0001) compared to controls. At least one risk allele was found in 44% of familial Crohn's disease patients, compared to 7% of healthy controls (OR = 4; CI = 2-6.5). Two risk alleles were found in 14% of familial Crohn's disease, compared to less than 1% of controls (OR = 26: CI = 4-129). CONCLUSIONS: Our data confirm the strong correlation between the 1007 fs variant and Crohn's disease, in both familial and sporadic cases. Moreover, no significant difference of allele frequencies was detected in familial cases, sporadic cases and healthy controls among different geographic areas of Italy.

Adult↗
PubMed2004

The aetiology of chronic hepatitis in Italy: results from a multicentre national study.

BACKGROUND: No recent national-level data on the aetiology of chronic hepatitis are available in Italy. AIM: To evaluate the current aetiology of chronic hepatitis in Italy. PATIENTS: A total of 6210 chronic hepatitis patients (both prevalence and incident cases) consecutively admitted to 79 hospitals located throughout Italy were enrolled over a 6-month period in 2001. The hospitals were randomly selected through systematic cluster sampling. RESULTS: The main agent associated with chronic hepatitis was hepatitis C virus, which was found in 76.5% of the patients (in 62.6% it was the only aetiologic factor). Hepatitis B surface antigen was present in the serum of 12.2% of the cases (in 9.2% it was the only aetiologic factor). Hepatitis B e antigen and hepatitis Delta were detected in 16.6% and 7.0%, respectively, of hepatitis B surface antigen-positive patients. A history of alcohol abuse was found in 19.2% of the cases (5.5% without viral infection). Autoimmune hepatitis and inborn metabolic disorders were extremely rare. The prevalence of hepatitis C virus-related cases was significantly lower in incident cases, compared to prevalent cases (55.1% versus 65.0%; p < 0.01). The mean alanine aminotransferase level was significantly higher in hepatitis B surface antigen-positive patients, compared to hepatitis B surface antigen-negative patients. The histology was less severe in non-viral-related cases. CONCLUSIONS: Hepatitis C virus is the most important pathogenic factor for chronic hepatitis in Italy; however, the comparison between prevalent and incident cases suggests that this infection will play a less important role in the future. A comparison with previous reports shows that both hepatitis B virus-related and hepatitis Delta virus-related cases are decreasing.

Adult↗