37 results on '"Mazziotti, G."'
Search Results
2. Prediction of fragility fractures in men with prostate cancer under androgen deprivation therapy: the importance of a multidisciplinary approach using a mini-invasive diagnostic tool
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Mazziotti, G., Lania, A. G., Laganà, Marta, and Berruti, Alfredo
- Abstract
Bone fragility in men who are treated with androgen deprivation therapy (ADT) has a complex pathophysiology that differs from that of primary and post-menopausal osteoporosis. Fracture risk assessment based on bone mineral density (BMD) and Fracture Risk Assessment Tool (FRAX) score might not be effective in this patient setting, since high frequency of fragility fractures has been reported even in subjects with low FRAX risk and normal BMD. In this paper we want to emphasize the importance in the individual assessment of bone fragility and prediction of fractures by measuring parameters of bone quality, assessing morphometric vertebral fractures and evaluating body composition that in subjects under hormone-deprivation therapies can play a crucial role. Noteworthy, a single mini-invasive diagnostic tool, i.e., the dual energy x-ray absorptiometry (DXA) scan, offers the opportunity to evaluate reliably parameters of bone quality (e.g., trabecular bone score) and body composition, besides measurement of BMD and assessment of vertebral fractures by a morphometric approach. This article highlights the values and cost-effectiveness of this mini-invasive tool in the context of multidisciplinary approach to subjects with prostate cancer under ADTs.
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- 2024
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3. New understanding and treatments for osteoporosis
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Mazziotti, G., Bilezikian, J., Canalis, E., Cocchi, D., and Giustina, A.
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- 2012
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4. Molecular basis of pharmacological therapy in Cushing’s disease
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Ferone, Diego, Pivonello, Claudia, Vitale, Giovanni, Zatelli, Maria Chiara, Colao, Annamaria, Pivonello, Rosario, Albiger, ABC Group: N., Ambrogio, A., Arnaldi, G., Arvat, E., Baldelli, R., Berardelli, R., Boscaro, M., Cannavo', Salvatore, Cavagnini, F., Corsello, S. M., Cozzolino, A., De Bartolomeis, A., De Leo, M., Di Minno, G., Di Somma, C., Esposito, K., Fabbrocini, G., Foresta, C., Galderisi, M., Giordano, C., Giugliano, D., Giustina, A., Grimaldi, F., Isidori, A. M., Jannini, E., F. Lombardo, L. Manetti, Mannelli, M., Mantero, F., Marone, G., Mazziotti, G., Moretti, S., Nazzari, E., Paragliola, R. M., Pasquali, R., Pecorelli, S., Pecori Giraldi, F., Reimondo, G., Scaroni, C., Scillitani, A., Simeoli, C., Stigliano, A., Toscano, V., Trementino, L., Ferone, D, Pivonello, Claudia, Vitale, G, Zatelli, Mc, Colao, Annamaria, and Pivonello, Rosario
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business.industry ,Endocrinology, Diabetes and Metabolism ,Humans ,Hypothalamus ,Pituitary ACTH Hypersecretion ,Pituitary Gland ,Receptors, Glucocorticoid ,Disease ,Cushing's disease ,medicine.disease ,Bioinformatics ,Clinical trial ,Endocrinology ,Pituitary adenoma ,Diabetes mellitus ,Immunology ,medicine ,Endocrine system ,business ,Receptor ,Glucocorticoid ,medicine.drug - Abstract
Cushing's disease (CD) is a severe endocrine condition caused by an adrenocorticotropin (ACTH)-pro- ducing pituitary adenoma that chronically stimulates adrenocortical cortisol production and with potentially serious complications if not or inadequately treated. Active CD may produce a fourfold increase in mortality and is associated with significant morbidities. Moreover, excess mortality risk may persist even after CD treatment. Although predictors of risk in treated CD are not fully understood, the importance of early recognition and ade- quate treatment is well established. Surgery with resection of a pituitary adenoma is still the first line therapy, being successful in about 60-70 % of patients; however, recur- rence within 2-4 years may often occur. When surgery fails, medical treatment can reduce cortisol production and ameliorate clinical manifestations while more definitive therapy becomes effective. Compounds that target hypo- thalamic-pituitary axis, glucocorticoid synthesis or adre- nocortical function are currently used to control the deleterious effects of chronic glucocorticoid excess. In this review we describe and analyze the molecular basis of the drugs targeting the disease at central level, suppressing ACTH secretion, as well as at peripheral level, acting as adrenal inhibitors, or glucocorticoid receptor antagonists. Understanding of the underlying molecular mechanisms in CD and of glucocorticoid biology should promote the development of new targeted and more successful therapies in the future. Indeed, most of the drugs discussed have been tested in limited clinical trials, but there is potential ther- apeutic benefit in compounds with better specificity for the class of receptors expressed by ACTH-secreting tumors. However, long-term follow-up with management of per- sistent comorbidities is needed even after successful treatment of CD.
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- 2013
5. Impact of age on postsurgical outcomes of nonfunctioning pituitary adenomas
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Biamonte, E., Betella, N., Milani, D., Lasio, G. B., Ariano, S., Radice, S., Lavezzi, E., Mazziotti, G., and Lania, A.
- Abstract
Purpose: The management of pituitary adenomas in the elderly has become a relevant clinical issue, in relationship with improved life expectancy and spreading use of imaging techniques. In this single-center and retrospective study, we investigated the impact of age on peri- and postsurgical outcomes in patients undergoing transnasal sphenoidal (TNS) surgery for pituitary adenomas. Methods: One-hundred-sixty-nine patients (62% males) undergoing endoscopic transphenoidal (TNS) surgery for nonfunctioning pituitary adenomas (NFPAs) were enrolled. Patients were subdivided into three groups according to age tertiles: ≤56 (group 1), 57–69 (group 2), and ≥70 (group 3) years. Postsurgical and endocrinological outcomes were evaluated and compared among the three age groups. Results: 37/169 patients (21.9%) developed at least one perisurgical complication, without significant association with the patients’ age (P= 0.838), Charlson co-morbidity score (P= 0.326), and American Society of Anesthesiologist score (P= 0.616). In the multivariate regression analysis, the adenoma size resulted the only determinant of perisurgical complication (odds ratio [OR] 1.07, 95% confidence interval [C.I.] 1.00–1.13; P= 0.044). The development and the recovery of at least one pituitary hormone deficiency were observed in 12.2% and 14.2% of patients, respectively. The risk of developing new pituitary hormone deficiencies was correlated with cavernous sinus invasion as evaluated by magnetic resonance imaging (hazard ratio [HR] 4.19, 95% C.I. 1.39–12.66; P= 0.010), whereas the probability to normalize at least one pituitary hormone deficiency was significantly correlated with younger age of patients (HR 0.27, 95% CI 0.12–0.61; P= 0.002). Conclusions: The results of this study reinforce the concept that endoscopic TNS surgery is a safe therapeutic option in the elderly patients with NFPA, even in presence of comorbidities and high anesthetic risk.
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- 2021
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6. Primary hyperparathyroidism in prostate cancer: guilty or not guilty?
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Mazziotti, G., primary, Frara, S., additional, and Mosca, A., additional
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- 2018
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7. Real-life management and outcome of thyroid carcinoma-related bone metastases: results from a nationwide multicenter experience
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Mazziotti, G., primary, Formenti, A. M., additional, Panarotto, M. B., additional, Arvat, E., additional, Chiti, A., additional, Cuocolo, A., additional, Dottorini, M. E., additional, Durante, C., additional, Agate, L., additional, Filetti, S., additional, Felicetti, F., additional, Filice, A., additional, Pace, L., additional, Pellegrino, T., additional, Rodari, M., additional, Salvatori, M., additional, Tranfaglia, C., additional, Versari, A., additional, Viola, D., additional, Frara, S., additional, Berruti, A., additional, Giustina, A., additional, and Giubbini, R., additional
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- 2017
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8. Prevalence of morphometric vertebral fractures in “difficult” patients with acromegaly with different biochemical outcomes after multimodal treatment
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Chiloiro, S., primary, Mormando, M., additional, Bianchi, A., additional, Giampietro, A., additional, Milardi, D., additional, Bima, C., additional, Grande, G., additional, Formenti, A. M., additional, Mazziotti, G., additional, Pontecorvi, A., additional, Giustina, A., additional, and De Marinis, L., additional
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- 2017
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9. Vitamin D-binding protein: one more piece in the puzzle of acromegalic osteopathy?
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Mazziotti, G., primary, Maffezzoni, F., additional, and Giustina, A., additional
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- 2016
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10. Prevalence of morphometric vertebral fractures in “difficult” patients with acromegaly with different biochemical outcomes after multimodal treatment
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Chiloiro, S., Mormando, M., Bianchi, A., Giampietro, A., Milardi, D., Bima, C., Grande, G., Formenti, A., Mazziotti, G., Pontecorvi, A., Giustina, A., and De Marinis, L.
- Abstract
Skeletal fragility with high risk of vertebral fractures is an emerging complication of acromegaly in close relationship with duration of active disease. The aim of this cross-sectional study was to evaluate the prevalence and determinants of vertebral fractures in males and females with a history of long-standing active acromegaly undergoing treatment with Pegvisomant. Thirty-eight patients (25 females, 13 males) with acromegaly under Pegvisomant therapy were evaluated for vertebral fractures and bone mineral density at lumbar spine and femoral neck. Gonadal status, serum IGF1 levels and growth hormone receptor genotype were also assessed. Vertebral fractures were detected in 12 patients (31.6%). Fractured patients had longer duration of active disease (p= 0.01) with higher frequency of active acromegaly (p= 0.04), received higher dose of Pegvisomant (p= 0.008), and were more frequently hypogonadic (p= 0.02) as compared to patients who did not fracture. Stratifying the patients for gender, vertebral fractures were significantly associated with Pegvisomant dose (p= 0.02) and untreated hypogonadism (p= 0.02) in males and with activity of disease (p= 0.03), serum insulin-like growth factor-I values (p= 0.01) and d3GHRpolymorphism (p= 0.005) in females. No significant association was found between vertebral fractures and bone mineral density at either skeletal site. Vertebral fractures are a frequent complication of long-standing active acromegaly. When patients are treated with Pegvisomant, vertebral fractures may occur in close relationship with active acromegaly and coexistent untreated hypogonadism.
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- 2018
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11. Real-life management and outcome of thyroid carcinoma-related bone metastases: results from a nationwide multicenter experience
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Mazziotti, G., Formenti, A., Panarotto, M., Arvat, E., Chiti, A., Cuocolo, A., Dottorini, M., Durante, C., Agate, L., Filetti, S., Felicetti, F., Filice, A., Pace, L., Pellegrino, T., Rodari, M., Salvatori, M., Tranfaglia, C., Versari, A., Viola, D., Frara, S., Berruti, A., Giustina, A., and Giubbini, R.
- Abstract
The M.O.S.CA.TI. (Metastases of the Skeleton from CArcinoma of the ThyroId) is a multicenter, retrospective study investigating the real-life outcome and management of bone metastases (BM) in 143 patients (63 M, 80 F; median age 64 years, range 11–87) with differentiated thyroid carcinoma (DTC). Radio-active iodine (RAI) treatment was performed in 131 patients (91.6%), surgical approach and/or external radiotherapy in 68 patients (47.6%), and anti-resorptive bone-active drugs in 32 patients (22.4%; in 31 zoledronate and in one denosumab). At the start of treatment, 24 patients (75.0%) receiving anti-resorptive bone-active drugs had at least one clinical skeletal-related event (SRE) (p < 0.001). One or more clinical SREs (pathological fractures and/or malignant hypercalcemia and/or spinal cord compression) developed in 53 patients (37.1%). Development of SREs was significantly associated with metachronous BM (hazard ratio (HR) 2.04; p = 0.04), localization of BM to cervical spine (HR 3.89; p = 0.01), and lack of avid RAI uptake (HR 2.66; p = 0.02). Thirty-nine patients (27.3%) died in correlation with development of SREs (HR 6.97; p = 0.006) and localization of BM to the hip (HR 3.86; p = 0.02). Moreover, overall mortality was significantly decreased by RAI therapy (HR 0.10; p = 0.02), whereas no significant effects were induced by bone-active drugs (p = 0.36), external radiotherapy (p = 0.54), and surgery (p = 0.43) of BM. SREs are very frequent in BM from DTC and they impact patient survival. In the real life, the use of bone-active drugs is currently limited to zoledronate in patients with pre-existing SREs. In this clinical setting, RAI therapy, but not zoledronate, decreased mortality.
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- 2018
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12. New understanding and treatments for osteoporosis
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Mazziotti, G., primary, Bilezikian, J., additional, Canalis, E., additional, Cocchi, D., additional, and Giustina, A., additional
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- 2011
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13. The benefit of statins in SARS-CoV-2 patients: further metabolic and prospective clinical studies are needed
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Michele Ciccarelli, Andrea Lania, Gherardo Mazziotti, Patrizia Gazzerro, Maurizio Bifulco, Andrea Dipasquale, Dario Bruzzese, Bifulco, M., Ciccarelli, M., Bruzzese, D., Dipasquale, A., Lania, A. G., Mazziotti, G., and Gazzerro, P.
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Male ,medicine.medical_specialty ,2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,Endocrinology, Diabetes and Metabolism ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Treatment outcome ,MEDLINE ,Aged ,Aged, 80 and over ,COVID-19 ,Female ,Hospital Mortality ,Humans ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,Middle Aged ,Retrospective Studies ,Treatment Outcome ,Hospital mortality ,Endocrinology ,Diabetes mellitus ,Internal medicine ,80 and over ,Research Letter ,medicine ,business.industry ,Retrospective cohort study ,medicine.disease ,COVID-19 Drug Treatment ,business - Published
- 2020
14. Prevalence of morphometric vertebral fractures in 'difficult' patients with acromegaly with different biochemical outcomes after multimodal treatment
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Giuseppe Grande, Anna Maria Formenti, Chiara Bima, Sabrina Chiloiro, Antonio Bianchi, Antonella Giampietro, Alfredo Pontecorvi, L. De Marinis, Domenico Milardi, Marilda Mormando, Gherardo Mazziotti, Andrea Giustina, Chiloiro, S., Mormando, M., Bianchi, A., Giampietro, A., Milardi, D., Bima, C., Grande, G., Formenti, A. M., Mazziotti, G., Pontecorvi, A., Giustina, Andrea, and De Marinis, L.
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Adult ,Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Pegvisomant ,030209 endocrinology & metabolism ,Growth hormone receptor ,Disease ,Growth hormone receptor isoforms ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Absorptiometry, Photon ,Bone Density ,Growth hormone receptor isoform ,Diabetes mellitus ,Acromegaly ,medicine ,Prevalence ,Humans ,Bone ,Femoral neck ,Aged ,Bone mineral ,Lumbar Vertebrae ,business.industry ,Femur Neck ,Human Growth Hormone ,Settore MED/13 - ENDOCRINOLOGIA ,Middle Aged ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Fracture ,Cross-Sectional Studies ,030220 oncology & carcinogenesis ,Spinal Fractures ,Female ,business ,Complication ,medicine.drug - Abstract
Introduction: Skeletal fragility with high risk of vertebral fractures is an emerging complication of acromegaly in close relationship with duration of active disease. The aim of this cross-sectional study was to evaluate the prevalence and determinants of vertebral fractures in males and females with a history of long-standing active acromegaly undergoing treatment with Pegvisomant. Subjects and methods: Thirty-eight patients (25 females, 13 males) with acromegaly under Pegvisomant therapy were evaluated for vertebral fractures and bone mineral density at lumbar spine and femoral neck. Gonadal status, serum IGF1 levels and growth hormone receptor genotype were also assessed. Results: Vertebral fractures were detected in 12 patients (31.6%). Fractured patients had longer duration of active disease (p = 0.01) with higher frequency of active acromegaly (p = 0.04), received higher dose of Pegvisomant (p = 0.008), and were more frequently hypogonadic (p = 0.02) as compared to patients who did not fracture. Stratifying the patients for gender, vertebral fractures were significantly associated with Pegvisomant dose (p = 0.02) and untreated hypogonadism (p = 0.02) in males and with activity of disease (p = 0.03), serum insulin-like growth factor-I values (p = 0.01) and d3GHR polymorphism (p = 0.005) in females. No significant association was found between vertebral fractures and bone mineral density at either skeletal site. Conclusion: Vertebral fractures are a frequent complication of long-standing active acromegaly. When patients are treated with Pegvisomant, vertebral fractures may occur in close relationship with active acromegaly and coexistent untreated hypogonadism.
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- 2017
15. Vitamin D-binding protein: one more piece in the puzzle of acromegalic osteopathy?
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Andrea Giustina, Gherardo Mazziotti, Filippo Maffezzoni, Mazziotti, G, Maffezzoni, F, and Giustina, Andrea
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medicine.medical_specialty ,Vitamin D-binding protein ,business.industry ,Endocrinology, Diabetes and Metabolism ,Vitamin D-Binding Protein ,030209 endocrinology & metabolism ,Bioinformatics ,Vitamin D Deficiency ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Osteopathy ,030220 oncology & carcinogenesis ,Acromegaly ,medicine ,Physical therapy ,Bone Diseases ,Vitamin D ,business - Published
- 2016
16. New understanding and treatments for osteoporosis
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J. P. Bilezikian, Ernesto Canalis, Andrea Giustina, Gherardo Mazziotti, Daniela Cocchi, Mazziotti, G, Bilezikian, J, Canalis, E, Cocchi, D, and Giustina, Andrea
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Drug ,Endocrinology, Diabetes and Metabolism ,media_common.quotation_subject ,Osteoporosis ,Pharmacology ,Bioinformatics ,Bone and Bones ,Bone remodeling ,chemistry.chemical_compound ,Endocrinology ,Anabolic Agents ,Osteogenesis ,medicine ,Teriparatide ,Animals ,Humans ,media_common ,Bone Density Conservation Agents ,Diphosphonates ,business.industry ,medicine.disease ,Disease Models, Animal ,Denosumab ,chemistry ,Sclerostin ,Secondary osteoporosis ,Bone Remodeling ,business ,Odanacatib ,medicine.drug - Abstract
To summarize promising areas of investigation in osteoporosis and to stimulate further research in this area, as discussed in a recent international conference. Over the recent years, there has been an improvement in the knowledge of molecular pathways involved in bone formation and resorption with the development of new drugs to treat osteoporosis. Intact parathyroid hormone, teriparatide, and anti-sclerostin monoclonal antibody are anabolic drugs, whereas denosumab and odanacatib are anti-resorptive drugs with more reversible effects as compared to bisphosphonates. Anabolic and anti-resorptive agents have different effects on bone, and research in this area includes the efficacy of combination and sequential therapies with them. New insights in the molecular pathways of bone remodeling have clarified the mechanisms responsible for skeletal fragility in several forms of secondary osteoporosis, such as that occurring in type 2 diabetes, following drug exposure and systemic inflammatory diseases. Future research is needed to address the efficacy of anti-osteoporotic drugs in these more recently recognized conditions of skeletal fragility. Osteoporosis continues to be an important field of biomedical research.
- Published
- 2011
17. High prevalence of radiological vertebral fractures in HIV-infected males
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Daria Gotti, Roberto Maroldi, Andrea Giustina, Carlo Torti, Emanuele Focà, Giampiero Carosi, Gherardo Mazziotti, Pier Antonio Soldini, Torti, C, Mazziotti, G, Soldini, Pa, Focà, E, Maroldi, R, Gotti, D, Carosi, G, and Giustina, Andrea
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Cart ,Adult ,Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Population ,Osteoporosis ,HIV Infections ,Comorbidity ,Overweight ,Severity of Illness Index ,Thoracic Vertebrae ,Body Mass Index ,Endocrinology ,Diabetes mellitus ,Internal medicine ,medicine ,Diabetes Mellitus ,Prevalence ,Electronic Health Records ,Humans ,education ,Aged ,Retrospective Studies ,education.field_of_study ,business.industry ,virus diseases ,Middle Aged ,medicine.disease ,Antiretroviral therapy ,Surgery ,Radiography ,Cross-Sectional Studies ,Anti-Retroviral Agents ,Italy ,Radiological weapon ,Spinal Fractures ,Drug Therapy, Combination ,medicine.symptom ,business ,Body mass index - Abstract
Age-related co-morbidities including osteoporosis are relevant in patients responding to combination antiretroviral therapy (cART). Vertebral fractures are common osteoporotic fractures and their diagnosis is useful for managing at-risk individuals. However, there are few data from HIV-infected patients. Therefore, the aim of this study was to determine the prevalence of and factors associated with vertebral fractures in a population of HIV-infected males. A cross-sectional study of 160 HIV-infected patients with available chest X-rays was conducted from 1998 to 2010. One hundred and sixty-three males with comparable age and with no history of HIV infection were recruited as controls. Semi-quantitative evaluation of vertebral heights in lateral chest X-rays and quantitative morphometry assessment of centrally digitized images using dedicated morphometry software were utilized to detect prevalent vertebral fractures. The result showed that the vertebral fractures were detected in 43/160 (26.9%) HIV-infected patients and in 21/163 (12.9%) controls (P = 0.002). In HIV-infected patients with fractures, 27 had two or more fractures and ten patients had severe fractures. The prevalence of any fractures and multiple fractures in HIV-infected patients receiving cART (29.6 and 20.0%) was slightly higher than in HIV-infected patients not exposed to cART (17.1 and 5.7%), but significantly higher than control subjects (12.9 and 3.7%). At multivariable analyses, body mass index and diabetes mellitus were independently correlated with vertebral fractures in HIV-infected patients. We concluded that a significant proportion of HIV-infected males receiving cART showed vertebral fractures. Furthermore, proactive diagnosis of vertebral fragility fractures is particularly relevant in patients who are overweight or suffer from diabetes.
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- 2011
18. DXA-derived lumbar bone strain index corrected for kyphosis is associated with vertebral fractures and trabecular bone score in acromegaly.
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Jaafar S, Cristofolini G, Morenghi E, Rinaudo L, Birtolo MF, Sala E, Ferrante E, Mungari R, Lavezzi E, Leonardi L, Ragucci P, Ulivieri FM, Balzarini L, Mantovani G, Lania AG, and Mazziotti G
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- Humans, Male, Female, Middle Aged, Aged, Adult, Acromegaly complications, Acromegaly physiopathology, Acromegaly diagnostic imaging, Spinal Fractures diagnostic imaging, Spinal Fractures etiology, Lumbar Vertebrae diagnostic imaging, Absorptiometry, Photon, Cancellous Bone diagnostic imaging, Kyphosis diagnostic imaging, Bone Density
- Abstract
Purpose: The bone strain index (BSI) is a marker of bone deformation based on a finite element analysis inferred from dual X-ray absorptiometry (DXA) scans, that has been proposed as a predictor of fractures in osteoporosis (i.e., higher BSI indicates a lower bone's resistance to loads with consequent higher risk of fractures). We aimed to investigate the association between lumbar BSI and vertebral fractures (VFs) in acromegaly., Methods: Twenty-three patients with acromegaly (13 males, mean age 58 years; three with active disease) were evaluated for morphometric VFs, trabecular bone score (TBS), bone mineral density (BMD) and BSI at lumbar spine, the latter being corrected for the kyphosis as measured by low-dose X-ray imaging system (EOS®-2D/3D)., Results: Lumbar BSI was significantly higher in patients with VFs as compared to those without fractures (2.90 ± 1.46 vs. 1.78 ± 0.33, p = 0.041). BSI was inversely associated with TBS (rho -0.44; p = 0.034), without significant associations with BMD (p = 0.151), age (p = 0.500), BMI (p = 0.957), serum IGF-I (p = 0.889), duration of active disease (p = 0.434) and sex (p = 0.563)., Conclusions: Lumbar BSI corrected for kyphosis could be proposed as integrated parameter of spine arthropathy and osteopathy in acromegaly helping the clinicians in identifying patients with skeletal fragility possibly predisposed to VFs., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
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- 2024
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19. Alteration of the immunophenotype and cytokine profiles in patients affected by neuroendocrine neoplasms.
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Boemi I, Piccini S, Colombo FS, Smiroldo V, Zerbi A, Capretti G, Alloisio M, Trivellin G, Lavezzi E, Mazziotti G, Vitali E, and Lania AG
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- Humans, Somatostatin, Neuroendocrine Tumors pathology, Carcinoma, Neuroendocrine, Lung Neoplasms, Pancreatic Neoplasms pathology, Gastrointestinal Neoplasms pathology
- Abstract
Purpose: Neuroendocrine neoplasms (NENs) are tumors that arise from cells of the endocrine system and are most common in the gastrointestinal tract, the pancreas, and the lungs. Their incidence is rapidly increasing and the therapeutic options available are limited., Methods: Since the immune system can interfere with tumor growth and response to therapy, using flow cytometry we investigated the immunophenotype in samples of peripheral blood leukocytes from patients with pancreatic (Pan-NENs) and pulmonary NENs (Lung-NENs). Moreover, we performed a multiplex analysis of 13 key cytokines and growth factors essential for the immune response in the plasma of NEN patients and controls., Results: Patients presented with a higher percentage of granulocytes, a lower percentage of lymphocytes, and an increase in the granulocytes to lymphocytes ratio compared to healthy donors. These alterations were more marked in patients with metastasis. Somatostatin analogs (SSAs) restored the immunophenotype of patients to that seen in healthy donors. Finally, Pan-NEN patients showed a higher plasma concentration of IP-10, MCP-1, and IL-8 compared to healthy donors, suggesting a potential role for these cytokines as diagnostic biomarkers., Conclusion: This study highlighted differences in the immunophenotype of patients with Pan- and Lung-NENs compared to healthy individuals; these alterations were partially restored by therapy., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
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- 2024
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20. Trabecular bone score, bone marrow fat and vertebral fractures in cushing syndrome.
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Ferraù F, Giovinazzo S, Alessi Y, Catalano A, Tessitore A, Mormina E, Bellone F, Giuffrida G, Paola G, Cotta OR, Ragonese M, Granata F, Lania AG, Mazziotti G, and Cannavò S
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- Humans, Adult, Middle Aged, Cancellous Bone diagnostic imaging, Cancellous Bone pathology, Bone Marrow diagnostic imaging, Cross-Sectional Studies, Bone Density, Lumbar Vertebrae diagnostic imaging, Glucocorticoids, Absorptiometry, Photon methods, Cushing Syndrome complications, Cushing Syndrome diagnostic imaging, Cushing Syndrome pathology, Spinal Fractures diagnostic imaging, Spinal Fractures epidemiology, Spinal Fractures complications, Osteoporotic Fractures diagnostic imaging, Osteoporotic Fractures epidemiology, Osteoporotic Fractures etiology
- Abstract
Objective: Prediction of fragility fractures in Cushing syndrome (CS) is a challenge since dual energy X-ray absorptiometry (DXA) measurement of bone mineral density (BMD) does not capture all the alterations in bone microstructure induced by glucocorticoid excess. In this study we investigated the relationship between trabecular bone score (TBS), bone marrow fat (BMF) and vertebral fractures (VFs) in endogenous CS., Design: Cross-sectional., Methods: Thirty subjects (7 M and 23 F, mean age 44.8 ± 13.4 yrs, range: 25-71) with active hypercortisolism were evaluated for VFs by quantitative morphometry, BMD and TBS by lumbar spine DXA and BMF by single-voxel magnetic resonance spectroscopy of vertebral body of L3., Results: Subjects with VFs (17 cases; 56.7%) had higher BMF (P = 0.014) and lower BMD T-score (P = 0.012) and TBS (P = 0.004) as compared to those without VFs. Prevalence of VFs resulted to be significantly higher in individuals with impaired TBS as compared to those with normal TBS (77.8% vs. 25.0%; P = 0.008). Among patients with VFs, only 6 (35.3%) had either osteoporosis or "low BMD for age". In logistic regression analysis, impaired TBS maintained the significant association with VFs [odds ratio (OR) 6.60, 95% C.I. 1.07-40.61; P = 0.042] independently of BMF (OR 1.03, 95% C.I. 0.99-1.08; P = 0.152)., Conclusions: TBS might be more accurate than BMF in identifying subjects with active CS and skeletal fragility at risk of VFs., Significance Statement: Excess in glucocorticoids is associated with alterations in bone remodeling and metabolism, leading to fragility fractures regardless of bone mineral density, making more challenging for the clinician the identification of high-risk population and the definition of preventing strategies. In this context, instrumental parameters suggestive of bone quality alterations and predictive of increased fracture risk are needed. In this study, we found CS patients to have bone quality alterations as indicated by the decreased trabecular bone score and increased bone marrow fat, as measured by DEXA and MRI respectively. Both parameters were associated with high risk of VFs, and were inversely correlated, although TBS seems to be more accurate than BMF in fractures prediction in this clinical setting., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
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- 2023
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21. Looking at the spine in controlled Acromegaly.
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Birtolo MF, Antonini S, Lania AG, and Mazziotti G
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- Humans, Quality of Life, Bone Density physiology, Acromegaly therapy, Acromegaly drug therapy, Spinal Fractures complications, Spinal Fractures diagnostic imaging, Human Growth Hormone therapeutic use
- Abstract
Skeletal fragility with high risk of vertebral fractures (VFs) is an emerging complication of growth hormone (GH) hypersecretion. VFs often coexist with spine arthropathy and both clinical conditions negatively impact on quality of life of acromegalic subjects. Management of spine osteopathy and arthropathy in acromegaly could be challenging since both complications can persist or even progress after biochemical control of disease. This article analyzes the latest evidence about possible pathophysiological links between VFs and spine arthropathy in active and controlled acromegaly, as well as the diagnostic and therapeutic aspects concerning the holistic management of acromegalic osteo-arthropathy., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
- Published
- 2023
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22. Outcome of Sars-COV-2-related thyrotoxicosis in survivors of Covid-19: a prospective study.
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Pizzocaro A, Colombo P, Vena W, Ariano S, Magnoni P, Reggiani F, Favacchio G, Mirani M, Lavezzi E, Voza A, Calatroni M, Mazziotti G, and Lania A
- Subjects
- Autoantibodies, Female, Humans, Male, Middle Aged, Prospective Studies, SARS-CoV-2, Survivors, Thyrotropin, Thyroxine, COVID-19, Thyrotoxicosis epidemiology, Thyrotoxicosis etiology
- Abstract
Purpose: To evaluate the post- coronavirus disease-19 (COVID-19) outcome of thyroid function in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related thyrotoxicosis., Methods: This was a single-center prospective study involving 29 patients (11 females, 18 males; median age 64 years, range: 43-85) with thyrotoxicosis diagnosed after hospitalization for COVID-19 and then followed-up for a median period of 90 days (range: 30-120) after hospital discharge. At follow-up, patients were evaluated for serum thyrotropin (TSH), free-thyroxine (FT4), free-triiodiothyronine (FT3), TSH receptor antibodies (TRAb), thyroglobulin antibodies (TgAb), thyroperoxidase antibodies (TPOAb) and ultrasonographic thyroid structure., Results: After recovery of COVID-19, serum TSH values significantly increased (P < 0.001) and FT4 values significantly decreased (P = 0.001), without significant change in serum FT3 (P = 0.572). At follow-up, 28 subjects (96.6%) became euthyroid whereas overt hypothyroidism developed in one case. At the ultrasound evaluation of thyroid gland, hypoecogenicity was found in 10 patients (34.5%) and in these cases serum TSH values tended to be higher than those without thyroid hypoecogenity (P = 0.066). All subjects resulted to be negative for TgAb, TPOAb and TRAb., Conclusion: In a short-term follow-up, thyroid function spontaneously normalized in most subjects with SARS-CoV-2-related thyrotoxicosis. However, thyroid hypoecogenicity was found in a remarkable number of them and future longer-term studies are needed to clarify whether this ultrasonographic alteration may predispose to develop late-onset thyroid dysfunction.
- Published
- 2021
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23. Weight change and glycemic control in type 2 diabetes patients during COVID-19 pandemic: the lockdown effect.
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Biamonte E, Pegoraro F, Carrone F, Facchi I, Favacchio G, Lania AG, Mazziotti G, and Mirani M
- Subjects
- Aged, Blood Glucose, Communicable Disease Control, Glycated Hemoglobin analysis, Glycemic Control, Humans, Italy, Male, Pandemics, Retrospective Studies, SARS-CoV-2, COVID-19, Diabetes Mellitus, Type 2 drug therapy, Diabetes Mellitus, Type 2 epidemiology
- Abstract
Purpose: The aim of this study was to evaluate the impact of the COVID-19 lockdown occurred in Italy from March 9th to May 18th, 2020 on anthropometric parameters and glycemic control in patients with type 2 diabetes mellitus (T2DM)., Methods: One hundred twenty-eight consecutive patients with T2DM (median age 70 years, 74 males) were retrospectively evaluated at the end of the lockdown period. Data on metabolic control were collected at different time: within three months before the lockdown (visit 0) and within the first six weeks after it (visit 1)., Results: During the lockdown, a significant increase in body weight (from 79.7 ± 18.7 kg to 81.4 ± 19.4 kg, p < 0.001), body mass index (BMI, from 29.5 ± 6 kg/m
2 to 30.1 ± 6.3 kg/m2 , p < 0.001), waist circumference (from 103.8 ± 13 cm to 105 ± 13.6 cm, p < 0.001), fasting plasma glucose (FPG; from 138.1 ± 29.4 mg/dL to 146.6 ± 36.4 mg/dL) and glycated hemoglobin (HbA1c; from 7 ± 0.8 to 7.3 ± 0.9%, p < 0.001) was observed. Weight gain was directly associated with HbA1c increase (β 0.085, C.I. 95% 0.05-0.121; p < 0.001) while insulin therapy resulted to be the only significant independent predictor of HbA1c worsening at the multivariate logistic regression analysis (OR 2.40, C.I. 1.06-5.45; p = 0.035)., Conclusions: The lockdown due to COVID-19 pandemic had a negative impact on body weight and glucose control in T2DM patients, in particular in those on insulin treatment. This finding provides a further rationale to optimize the diabetes management during eventually new period of home confinement.- Published
- 2021
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24. The benefit of statins in SARS-CoV-2 patients: further metabolic and prospective clinical studies are needed.
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Bifulco M, Ciccarelli M, Bruzzese D, Dipasquale A, Lania AG, Mazziotti G, and Gazzerro P
- Subjects
- Aged, Aged, 80 and over, COVID-19 mortality, Female, Hospital Mortality, Humans, Male, Middle Aged, Retrospective Studies, Treatment Outcome, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use, COVID-19 Drug Treatment
- Published
- 2021
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25. Morphometric vertebral fractures in patients with castration-resistant prostate cancer undergoing treatment with radium-223: a longitudinal study in the real-life clinical practice.
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Mazziotti G, Rodari M, Gelardi F, Tosi G, Zucali PA, Pepe G, and Chiti A
- Subjects
- Androgen Antagonists, Humans, Longitudinal Studies, Male, Positron Emission Tomography Computed Tomography, Radium, Retrospective Studies, Bone Neoplasms radiotherapy, Prostatic Neoplasms, Castration-Resistant
- Abstract
Purpose: Radium-223 was associated with high incidence of non-vertebral fractures in patients with castration-resistant prostate cancer (CRPC). However, it is still unclear whether radium-223 may induce skeletal fragility regardless of other therapies for CRPC. We aimed at evaluating the prevalence, incidence, and determinants of vertebral fractures (VFs), i.e., the most frequent complication of skeletal fragility, in CRCP patients undergoing radium-223 therapy in the real-life clinical practice., Methods: We retrospectively reviewed 49 CRPC patients with symptomatic bone metastases treated with radium-223. Patients received median number of four radium-223 doses (range: 2-6) and were followed-up for a median period of 11 months (range: 6-44). VFs were assessed by a quantitative morphometry using lateral images of spine 11C-Choline PET/CT, excluding from the analysis the vertebral bodies affected by bone metastases., Results: Before radium-223 administration, 24 patients (49%) had VFs significantly associated with duration of androgen deprivation therapy (ADT; odds ratio 1.29) and previous abiraterone therapy (odds ratio 3.80). During radium-223 therapy, incident VFs occurred in 25% of patients, in relationship with prevalent VFs (hazard ratio 6.89) and change in serum total alkaline phosphatase values (hazard ratio 0.97), whereas the correlations with ADT and abiraterone therapy were lost. Noteworthy, the risk of VFs did not correlate with the therapeutic end points of radium-223., Conclusions: This study provides a first evidence that in real-life clinical practice, radium-223 therapy may induce skeletal fragility with high risk of VFs, likely by inhibition of bone formation and independently of ADT and abiraterone therapy.
- Published
- 2020
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26. High bone marrow fat in patients with Cushing's syndrome and vertebral fractures.
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Ferraù F, Giovinazzo S, Messina E, Tessitore A, Vinci S, Mazziotti G, Lania A, Granata F, and Cannavò S
- Subjects
- Absorptiometry, Photon, Adult, Bone Density, Bone Marrow diagnostic imaging, Cross-Sectional Studies, Humans, Middle Aged, Cushing Syndrome complications, Cushing Syndrome diagnostic imaging, Spinal Fractures diagnostic imaging, Spinal Fractures epidemiology, Spinal Fractures etiology
- Abstract
Purpose: The evaluation of skeletal fragility in Cushing's syndrome (CS) is a clinical challenge, since dual-energy X-ray absorptiometry (DXA) does not capture abnormalities in bone microstructure induced by glucocorticoid excess. Hypercortisolism was shown to increase bone marrow adiposity, but it is still unknown whether high bone marrow fat (BMF) as measured by vertebral magnetic resonance spectroscopy may predict fracture risk in this clinical setting. In this cross-sectional study, we evaluated the association between BMF and vertebral fractures (VFs) in patients with CS., Methods: Twenty patients (5 M, age 44 ± 13 years) with active CS were evaluated for morphometric VFs, lumbar spine BMF, and bone mineral density (BMD). Fifteen healthy volunteers (4 M, age 43 ± 12 years) acted as control group for BMF evaluation., Results: BMF was significantly higher in CS patients vs. controls (52.0% vs. 27.0%, p < 0.01), and was directly correlated with patients' age (p = 0.03), 24-hours urine-free cortisol (p = 0.03), midnight serum cortisol (p = 0.02), and serum CTX (p = 0.01). Patients with VFs (13 cases) showed significantly higher BMF vs. patients without VFs (65.0% vs. 24.0%, p = 0.03). Fractured patients with either normal BMD or osteopenia showed comparable BMF to fractured patients with either osteoporosis or low BMD for age (p = 0.71). When the analysis was restricted to patients with normal BMD or osteopenia, VFs were still significantly associated with higher BMF (p = 0.05)., Conclusions: This study provides a first evidence that vertebral adiposity may be a marker of hypercortisolism-induced skeletal fragility and measurement of spine BMF could have a role in the diagnostic work-up for the assessment of fracture risk in CS.
- Published
- 2020
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- View/download PDF
27. Medullary thyroid carcinoma treated with percutaneous ultrasound-guided radiofrequency ablation.
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Biamonte E, Solbiati L, Ierace T, Colombo P, Lavezzi E, Mazziotti G, and Lania A
- Subjects
- Biopsy, Fine-Needle, Calcitonin blood, Female, Humans, Middle Aged, Neck diagnostic imaging, Thyroid Gland diagnostic imaging, Thyroid Nodule diagnostic imaging, Treatment Outcome, Ultrasonography, Interventional, Carcinoma, Medullary diagnostic imaging, Carcinoma, Medullary radiotherapy, Catheter Ablation methods, Thyroid Neoplasms diagnostic imaging, Thyroid Neoplasms radiotherapy
- Abstract
Purpose: Minimally invasive image-guided thermal ablation has been proposed as alternative to surgery for treatment of benign thyroid nodules and recurrent differentiated thyroid carcinoma. Here, we report for the first time the use of radiofrequency ablation (RFA) in a patient with non-metastatic medullary thyroid carcinoma (MTC) who did not undergo surgery due to high anesthesiological risk., Methods and Results: A 64-year-old woman was referred to our institution for a routine endocrinological visit. No thyroid-related symptoms were present. She had a history of metabolic, cardiovascular and neurological diseases. On clinical examination, a nodular lesion of about 10 mm was palpable in the right thyroid lobe; ultrasonography (US) confirmed the presence of a 13 mm thyroid nodule in the lower pole of the right lobe, that was hypoechoic and with regular margins. Serum calcitonin (Ctn) level was significantly high (647 pg/mL). Fine-needle aspiration (FNA) of the thyroid nodule was negative for malignant cells, but the marked increase of Ctn level in the FNA wash-out fluid confirmed the diagnostic suspicion of MTC. Since patient refused surgery due to high anesthesiological risk, percutaneous US-guided RFA in single session was performed. At 6-months follow-up the serum Ctn level decreased from the initial value of 647 pg/mL, reaching near-normal range (15 pg/mL), and neck ultrasound showed a complete necrosis of the tumour. Afterward, serum Ctn slowly increased to 49 pg/mL at 15-month follow-up. The US performed at 6 and 12 months of follow-up revealed fibrotic tissue in place of the thyroid nodule, without evidence of cervical lymph-node metastases., Conclusions: This clinical case suggests that RFA may be effective and safe for treatment of MTC when surgery cannot be performed.
- Published
- 2019
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28. Bone safety of dual-release hydrocortisone in patients with hypopituitarism.
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Frara S, Chiloiro S, Porcelli T, Giampietro A, Mazziotti G, De Marinis L, and Giustina A
- Subjects
- Adult, Aged, Female, Humans, Hydrocortisone therapeutic use, Male, Middle Aged, Hydrocortisone adverse effects, Hypopituitarism drug therapy, Osteoporosis chemically induced
- Published
- 2018
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29. Glucocorticoid-induced osteoporosis: pathophysiological role of GH/IGF-I and PTH/VITAMIN D axes, treatment options and guidelines.
- Author
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Mazziotti G, Formenti AM, Adler RA, Bilezikian JP, Grossman A, Sbardella E, Minisola S, and Giustina A
- Subjects
- Bone Density Conservation Agents therapeutic use, Growth Hormone metabolism, Humans, Insulin-Like Growth Factor I metabolism, Osteoporosis drug therapy, Osteoporosis metabolism, Parathyroid Hormone metabolism, Vitamin D metabolism, Glucocorticoids adverse effects, Osteoporosis chemically induced
- Abstract
Glucocorticoid-induced osteoporosis is the most frequent form of secondary osteoporosis caused by chronic exposure to glucocorticoid excess. Pathogenesis of glucocorticoid-induced osteoporosis is multifactorial including direct effects of glucocorticoids on bone cells and indirect effects of glucocorticoids on several neuroendocrine and metabolic pathways. Fragility fractures occur early in glucocorticoid-induced osteoporosis and anti-osteoporotic drugs along with calcium and vitamin D should be started soon after exposure to glucocorticoid excess. This paper summarizes some of the main topics discussed during the 9th Glucocorticoid-Induced Osteoporosis Meeting (Rome, April 2016) with a specific focus on the role of growth hormone/insulin-like growth factor-1 and parathyroid hormone/vitamin D axes in the pathogenesis of glucocorticoid-induced osteoporosis and the controversial aspects concerning therapeutic approach to skeletal fragility in this clinical setting.
- Published
- 2016
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30. High-resolution-cone beam tomography analysis of bone microarchitecture in patients with acromegaly and radiological vertebral fractures.
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Maffezzoni F, Maddalo M, Frara S, Mezzone M, Zorza I, Baruffaldi F, Doglietto F, Mazziotti G, Maroldi R, and Giustina A
- Subjects
- Absorptiometry, Photon, Adult, Aged, Female, Femur Neck diagnostic imaging, Humans, Lumbar Vertebrae diagnostic imaging, Male, Middle Aged, Radius diagnostic imaging, Acromegaly diagnostic imaging, Bone Density physiology, Cancellous Bone diagnostic imaging, Cone-Beam Computed Tomography methods, Spinal Fractures diagnostic imaging
- Abstract
Vertebral fractures are an emerging complication of acromegaly but their prediction is still difficult occurring even in patients with normal bone mineral density. In this study we evaluated the ability of high-resolution cone-beam computed tomography to provide information on skeletal abnormalities associated with vertebral fractures in acromegaly. 40 patients (24 females, 16 males; median age 57 years, range 25-72) and 21 healthy volunteers (10 females, 11 males; median age 60 years, range: 25-68) were evaluated for trabecular (bone volume/trabecular volume ratio, mean trabecular separation, and mean trabecular thickness) and cortical (thickness and porosity) parameters at distal radius using a high-resolution cone-beam computed tomography system. All acromegaly patients were evaluated for morphometric vertebral fractures and for mineral bone density by dual-energy X-ray absorptiometry at lumbar spine, total hip, femoral neck, and distal radius. Acromegaly patients with vertebral fractures (15 cases) had significantly (p < 0.05) lower bone volume/trabecular volume ratio, greater mean trabecular separation, and higher cortical porosity vs. nonfractured patients, without statistically significant differences in mean trabecular thickness and cortical thickness. Fractured and nonfractured acromegaly patients did not have significant differences in bone density at either skeletal site. Patients with acromegaly showed lower bone volume/trabecular volume ratio (p = 0.003) and mean trabecular thickness (p < 0.001) and greater mean trabecular separation (p = 0.02) as compared to control subjects, without significant differences in cortical thickness and porosity. This study shows for the first time that abnormalities of bone microstructure are associated with radiological vertebral fractures in acromegaly. High-resolution cone-beam computed tomography at the distal radius may be useful to evaluate and predict the effects of acromegaly on bone microstructure.
- Published
- 2016
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31. Treatment of hypothyroidism: all that glitters is gold?
- Author
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Formenti AM, Mazziotti G, Giubbini R, and Giustina A
- Subjects
- Drug Compounding, Humans, Standard of Care, Tablets, Thyroxine administration & dosage, Hormone Replacement Therapy methods, Hormone Replacement Therapy standards, Hypothyroidism drug therapy, Medical Futility
- Published
- 2016
- Full Text
- View/download PDF
32. Incidence of morphometric vertebral fractures in adult patients with growth hormone deficiency.
- Author
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Mazziotti G, Doga M, Frara S, Maffezzoni F, Porcelli T, Cerri L, Maroldi R, and Giustina A
- Subjects
- Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Bone Density, Bone Diseases, Metabolic complications, Bone Diseases, Metabolic epidemiology, Cross-Sectional Studies, Endpoint Determination, Female, Follow-Up Studies, Human Growth Hormone therapeutic use, Humans, Hypopituitarism complications, Hypopituitarism drug therapy, Incidence, Lumbar Vertebrae injuries, Male, Middle Aged, Osteoporosis complications, Osteoporosis epidemiology, Prospective Studies, Recombinant Proteins therapeutic use, Risk Factors, Vitamin D Deficiency complications, Young Adult, Human Growth Hormone deficiency, Spinal Fractures epidemiology
- Abstract
Cross-sectional studies showed an elevated prevalence of clinical and morphometric vertebral fractures (VFs) in adult patients with growth hormone deficiency (GHD). However, no data are available on incidence and determinants of radiological VFs in this clinical setting. In this prospective study, we investigated the incidence and risk factors of radiological VFs in adults with GHD. Forty patients with GHD (28 males, 12 females; median age 44 years, range 19-82) were studied for incident VFs using quantitative morphometric approach on spine X-ray at baseline and after 6 years of follow-up. GHD patients were also studied for bone mineral density (BMD) measured by DXA at lumbar spine. After 6 years of follow-up, 12 patients (30 %) experienced incident VFs. Patients with incident VFs had more frequently untreated GHD and prevalent VFs at baseline, as compared to patients who did not experience incident VFs. Untreated GHD patients were significantly older as compared to treated GHD (50 years, range 19-82 vs. 36 years, range 19-75; p = 0.003), but the correlation between high risk of VFs and untreated GHD remained significant even after adjustment for the age of patients (odds ratio 6.8, CI 95 % 1.1-41.8; p = 0.037). In GHD patients experiencing incident VFs, lumbar spine BMD decreased significantly whereas it did not change in patients not developing VFs. This is the first prospective study confirming the hypothesis suggested by cross-sectional studies that untreated GHD may cause high risk of VFs in adult patients and that recombinant human GH treatment may effectively decrease such a risk.
- Published
- 2016
- Full Text
- View/download PDF
33. In memoriam: Dr. Irene Claudia Floriani (1964-2016).
- Author
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Torri V, Hollander L, and Mazziotti G
- Subjects
- Biostatistics history, History, 20th Century, History, 21st Century, Italy, Research Design, Endocrinology history
- Published
- 2016
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34. Impaired growth hormone secretion associated with low glucocorticoid levels: an experimental model for the Giustina effect.
- Author
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Giustina A and Mazziotti G
- Subjects
- Animals, Female, Male, Pregnancy, Adrenocorticotropic Hormone blood, Corticosterone blood, Fetal Growth Retardation chemically induced, Fetus drug effects, Maternal Exposure, Polychlorinated Dibenzodioxins
- Published
- 2014
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- View/download PDF
35. High prevalence of radiological vertebral fractures in HIV-infected males.
- Author
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Torti C, Mazziotti G, Soldini PA, Focà E, Maroldi R, Gotti D, Carosi G, and Giustina A
- Subjects
- Adult, Aged, Anti-Retroviral Agents adverse effects, Anti-Retroviral Agents therapeutic use, Body Mass Index, Comorbidity, Cross-Sectional Studies, Diabetes Mellitus epidemiology, Drug Therapy, Combination adverse effects, Electronic Health Records, HIV Infections drug therapy, Humans, Italy epidemiology, Male, Middle Aged, Overweight epidemiology, Prevalence, Radiography, Retrospective Studies, Severity of Illness Index, Spinal Fractures chemically induced, Spinal Fractures diagnostic imaging, Spinal Fractures pathology, Thoracic Vertebrae diagnostic imaging, Thoracic Vertebrae drug effects, Thoracic Vertebrae pathology, HIV Infections epidemiology, Spinal Fractures epidemiology, Thoracic Vertebrae injuries
- Abstract
Age-related co-morbidities including osteoporosis are relevant in patients responding to combination antiretroviral therapy (cART). Vertebral fractures are common osteoporotic fractures and their diagnosis is useful for managing at-risk individuals. However, there are few data from HIV-infected patients. Therefore, the aim of this study was to determine the prevalence of and factors associated with vertebral fractures in a population of HIV-infected males. A cross-sectional study of 160 HIV-infected patients with available chest X-rays was conducted from 1998 to 2010. One hundred and sixty-three males with comparable age and with no history of HIV infection were recruited as controls. Semi-quantitative evaluation of vertebral heights in lateral chest X-rays and quantitative morphometry assessment of centrally digitized images using dedicated morphometry software were utilized to detect prevalent vertebral fractures. The result showed that the vertebral fractures were detected in 43/160 (26.9%) HIV-infected patients and in 21/163 (12.9%) controls (P = 0.002). In HIV-infected patients with fractures, 27 had two or more fractures and ten patients had severe fractures. The prevalence of any fractures and multiple fractures in HIV-infected patients receiving cART (29.6 and 20.0%) was slightly higher than in HIV-infected patients not exposed to cART (17.1 and 5.7%), but significantly higher than control subjects (12.9 and 3.7%). At multivariable analyses, body mass index and diabetes mellitus were independently correlated with vertebral fractures in HIV-infected patients. We concluded that a significant proportion of HIV-infected males receiving cART showed vertebral fractures. Furthermore, proactive diagnosis of vertebral fragility fractures is particularly relevant in patients who are overweight or suffer from diabetes.
- Published
- 2012
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36. Influence of diabetes mellitus on vertebral fractures in men with acromegaly.
- Author
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Mazziotti G, Gola M, Bianchi A, Porcelli T, Giampietro A, Cimino V, Doga M, Gazzaruso C, De Marinis L, and Giustina A
- Subjects
- Absorptiometry, Photon, Acromegaly blood, Adult, Aged, Aged, 80 and over, Bone Density physiology, Case-Control Studies, Comorbidity, Cross-Sectional Studies, Diabetes Mellitus, Type 2 physiopathology, Humans, Insulin-Like Growth Factor I metabolism, Male, Middle Aged, Osteoporosis etiology, Prevalence, Spinal Fractures blood, Acromegaly complications, Diabetes Mellitus, Type 2 complications, Lumbar Vertebrae injuries, Spinal Fractures epidemiology, Thoracic Vertebrae injuries
- Abstract
Acromegaly is frequently complicated by fragility vertebral fractures and diabetes mellitus. Since type 2 diabetes mellitus is a cause of secondary osteoporosis in the general population, in this cross-sectional study we aimed at investigating the association between diabetes mellitus and vertebral fractures in males with acromegaly. Fifty-seven patients (median age 47 years, range: 24-85) with active (21 cases) and controlled (36 cases) acromegaly and 57 control subjects were evaluated for bone mineral density (BMD) by DXA and vertebral fractures by a quantitative morphometric analysis. Diabetes mellitus was found in 18 patients and 18 control subjects. The prevalence of vertebral fractures was higher in acromegalic patients as compared with the control subjects (50.9 vs. 10.5%; χ(2): 21.8; P < 0.001). Acromegalic patients with fractures had serum IGF-I values significantly higher (P = 0.009), longer duration of active disease (P < 0.001) and higher prevalence of active acromegaly (P = 0.007) and diabetes mellitus (P = 0.04) as compared to patients who did not fracture. When acromegaly was active, the prevalence of vertebral fractures was high independently of the coexistent diabetes mellitus. On the contrary, when acromegaly was controlled the prevalence of vertebral fractures was significantly higher in patients with diabetes as compared to patients without diabetes (62.6 vs. 28.0%; P = 0.04). In both diabetic and non diabetic patients, vertebral fractures occurred independently of BMD. In conclusion, this study suggests that diabetes mellitus may be associated with an increased prevalence of vertebral fractures in males with acromegaly. However, this effect seems to be relatively attenuated in the presence of persistent GH hypersecretion.
- Published
- 2011
- Full Text
- View/download PDF
37. Vertebral fractures in males with prolactinoma.
- Author
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Mazziotti G, Porcelli T, Mormando M, De Menis E, Bianchi A, Mejia C, Mancini T, De Marinis L, and Giustina A
- Subjects
- Absorptiometry, Photon, Adult, Aged, Bone Density, Humans, Hyperprolactinemia complications, Hypogonadism complications, Lumbar Vertebrae, Male, Middle Aged, Osteoporosis etiology, Testosterone blood, Pituitary Neoplasms complications, Prolactinoma complications, Spinal Fractures epidemiology
- Abstract
Data on osteoporotic fractures in hyperprolactinemia are limited. An increased prevalence of radiological vertebral fractures was recently observed in women with prolactin (PRL)-secreting adenoma, whereas it is unknown whether this observation may reflect a more general increased risk of fractures in this disease and whether the prevalence of fractures in males is affected by gonadal status. Thirty-two males (median age 47 years, range: 22-79) with PRL-secreting pituitary adenoma (10 with microadenoma and 22 with macroadenoma) and 64 control males, with normal PRL values and with comparable age to patients with hyperprolactinemia, were evaluated for vertebral fractures by a morphometric approach and for bone mineral density (BMD) by a dual-energy X-ray absorptiometry at lumbar spine. Vertebral fractures were shown in 12 patients with PRL-secreting adenoma (37.5%) and in 5 controls (7.8%, P < 0.001). Fractured patients had lower BMD T-score (P = 0.007) and longer duration of disease (P < 0.001) as compared to patients who did not fracture. Fractures occurred more frequently (P = 0.03) in patients with untreated hyperprolactinemia versus patients treated with cabergoline whose frequency of vertebral fractures was still higher than control subjects. The prevalence of vertebral fractures was not significantly different between eugonadal and hypogonadal patients (33.3% vs. 38.5%; P = 0.8). Moreover, no significant (P = 0.4) difference in serum testosterone values was found between fractured and not fractured males. Hyperprolactinemia is associated with high prevalence of radiological vertebral fractures in men with PRL-secreting adenoma. These findings would also suggest that PRL excess may produce negative skeletal effects independently of hypogonadism.
- Published
- 2011
- Full Text
- View/download PDF
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