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51. TOP-085 Final results from the italian real-world experience on lusutrombopag treatment in cirrhotic patients with severe thrombocytopenia: insights from the reality study

Author

Gallo, Paolo, De Vincentis, Antonio, Pace Palitti, Valeria, Russello, Maurizio, Vignone, Anthony, Alvaro, Domenico, Tortora, Raffaella, biolato, marco, Pompili, Maurizio, Calvaruso, Vincenza, Veneziano, Marzia, Tizzani, Marco, Frigo, Francesco, Caneglias, Alessandro, Marcantonio, Gesualdo, Marzano, Alfredo, Rosato, Valerio, Claar, Ernesto, Villani, Rosanna, Izzi, Antonio, Cozzolongo, Raffaele, Airoldi, Aldo, Mazzarelli, Chiara, Distefano, Marco, Iegri, Claudia, Fagiuoli, Stefano, Messina, Vincenzo, Ragone, Enrico, Sacco, Rodolfo, Cacciatore, Pierluigi, Masutti, Flora, Saveria Crocè, Lory, Moretti, Alessandra, Terracciani, Francesca, Falcomata, Andrea, Di Pasquale, Giulia, Flagiello, Valentina, Picardi, Antonio, and Vespasiani-Gentilucci, Umberto

Published
2024
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52. A Genetic and Metabolic Staging System for Predicting the Outcome of Nonalcoholic Fatty Liver Disease

Author

Pennisi, Grazia, primary, Pipitone, Rosaria Maria, additional, Enea, Marco, additional, De Vincentis, Antonio, additional, Battaglia, Salvatore, additional, Di Marco, Vito, additional, Di Martino, Vincenzo, additional, Spatola, Federica, additional, Tavaglione, Federica, additional, Vespasiani‐Gentilucci, Umberto, additional, Zito, Rossella, additional, Romeo, Stefano, additional, Cammà, Calogero, additional, Craxì, Antonio, additional, Grimaudo, Stefania, additional, and Petta, Salvatore, additional

Published
2022
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54. Sarcopenia in Hepatocellular Carcinoma: Pathogenesis and Management

Author

Gallo, Paolo, primary, Silletta, Marianna, additional, De Vincentis, Antonio, additional, Lo Prinzi, Federica, additional, Terracciani, Francesca, additional, Di Fazio, Giuseppina, additional, Flagiello, Valentina, additional, Vespasiani Gentilucci, Umberto, additional, Antonelli Incalzi, Raffaele, additional, and Picardi, Antonio, additional

Published
2021
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55. Accuracy of controlled attenuation parameter for assessing liver steatosis in individuals with morbid obesity before bariatric surgery

Author

Tavaglione, Federica, primary, De Vincentis, Antonio, additional, Bruni, Vincenzo, additional, Gallo, Ida Francesca, additional, Carotti, Simone, additional, Tuccinardi, Dario, additional, Spagnolo, Giuseppe, additional, Ciociola, Ester, additional, Mancina, Rosellina Margherita, additional, Jamialahmadi, Oveis, additional, D’Alessio, Rossella, additional, Bottazzi, Bruna, additional, Manfrini, Silvia, additional, Picardi, Antonio, additional, Perrone, Giuseppe, additional, Pozzilli, Paolo, additional, Caricato, Marco, additional, Vespasiani‐Gentilucci, Umberto, additional, and Romeo, Stefano, additional

Published
2021
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57. Metabolic and genetic determinants for progression to severe liver disease in subjects with obesity from the UK Biobank

Author

De Vincentis, Antonio, primary, Tavaglione, Federica, additional, Spagnuolo, Rocco, additional, Pujia, Roberta, additional, Tuccinardi, Dario, additional, Mascianà, Gianluca, additional, Picardi, Antonio, additional, Antonelli Incalzi, Raffaele, additional, Valenti, Luca, additional, Romeo, Stefano, additional, and Vespasiani-Gentilucci, Umberto, additional

Published
2021
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59. Predictors of serious adverse events and non‐response in cirrhotic patients with primary biliary cholangitis treated with obeticholic acid.

Author

De Vincentis, Antonio, D'Amato, Daphne, Cristoferi, Laura, Gerussi, Alessio, Malinverno, Federica, Lleo, Ana, Colapietro, Francesca, Marra, Fabio, Galli, Andrea, Fiorini, Cecilia, Coco, Barbara, Brunetto, Maurizia, Niro, Grazia Anna, Cotugno, Rosa, Saitta, Carlo, Cozzolongo, Raffaele, Losito, Francesco, Giannini, Edoardo Giovanni, Labanca, Sara, and Marzioni, Marco

Subjects
*ESOPHAGEAL varices, *CHOLANGITIS, *ALBUMINS, *BILIRUBIN, *CONFIDENCE intervals, *JAUNDICE
Abstract

Background & Aims: Obeticholic acid (OCA) has recently been restricted in patients with primary biliary cholangitis (PBC) with "advanced cirrhosis" because of its narrow therapeutic index. We aimed to better define the predicting factors of hepatic serious adverse events (SAEs) and non‐response in cirrhotic patients undergoing OCA therapy. Methods: Safety and efficacy of treatment were evaluated in a cohort of consecutive PBC cirrhotic patients started with OCA. OCA response was evaluated according to the Poise criteria. Risk factors for hepatic SAEs and non‐response were reported as risk ratios (RR) with 95% confidence intervals (CIs). Results: One hundred PBC cirrhotics were included, 97 Child‐Pugh class A and 3 class B. Thirty‐one had oesophageal varices and 5 had a history of ascites. Thirty‐three per cent and 32% of patients achieved a biochemical response at 6 and 12 months respectively. Male sex (adjusted‐RR 1.75, 95%CI 1.42–2.12), INR (1.37, 1.00–1.87), Child‐Pugh score (1.79, 1.28–2.50), MELD (1.17, 1.04–1.30) and bilirubin (1.83, 1.11–3.01) were independently associated with non‐response to OCA. Twenty‐two patients discontinued OCA within 12 months: 10 for pruritus, 9 for hepatic SAEs (5 for jaundice and/or ascitic decompensation; 4 for upper digestive bleeding). INR (adjusted‐RR 1.91, 95%CI 1.10–3.36), lower albumin levels (0.18, 0.06–0.51), Child‐Pugh score (2.43, 1.50–4.04), history of ascites (3.5, 1.85–6.5) and bilirubin (1.30, 1.05–1.56), were associated with hepatic SAEs. A total bilirubin≥1.4 mg/dl at baseline was the most accurate biochemical predictor of hepatic SAEs under OCA. Conclusions: An accurate baseline assessment is crucial to select cirrhotic patients who can benefit from OCA. Although OCA is effective in one third of cirrhotics, bilirubin level ≥1.4 mg/dl should discourage from its use. [ABSTRACT FROM AUTHOR]

Published
2022
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60. Gut Microbiota and Related Electronic Multisensorial System Changes in Subjects With Symptomatic Uncomplicated Diverticular Disease Undergoing Rifaximin Therapy

Author

De Vincentis, Antonio, primary, Santonico, Marco, additional, Del Chierico, Federica, additional, Altomare, Annamaria, additional, Marigliano, Benedetta, additional, Laudisio, Alice, additional, Reddel, Sofia, additional, Grasso, Simone, additional, Zompanti, Alessandro, additional, Pennazza, Giorgio, additional, Putignani, Lorenza, additional, Guarino, Michele Pier Luca, additional, Cicala, Michele, additional, and Antonelli Incalzi, Raffaele, additional

Published
2021
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61. Orthogeriatric co-management for the care of older subjects with hip fracture: recommendations from an Italian intersociety consensus

Author

De Vincentis, A, Behr, A, Bellelli, G, Bravi, M, Castaldo, A, Galluzzo, L, Iolascon, G, Maggi, S, Martini, E, Momoli, A, Onder, G, Paoletta, M, Pietrogrande, L, Roselli, M, Ruggeri, M, Ruggiero, C, Santacaterina, F, Tritapepe, L, Zurlo, A, Antonelli Incalzi, R, De Vincentis, Antonio, Behr, Astrid Ursula, Bellelli, Giuseppe, Bravi, Marco, Castaldo, Anna, Galluzzo, Lucia, Iolascon, Giovanni, Maggi, Stefania, Martini, Emilio, Momoli, Alberto, Onder, Graziano, Paoletta, Marco, Pietrogrande, Luca, Roselli, Mauro, Ruggeri, Mauro, Ruggiero, Carmelinda, Santacaterina, Fabio, Tritapepe, Luigi, Zurlo, Amedeo, Antonelli Incalzi, Raffaele, De Vincentis, A, Behr, A, Bellelli, G, Bravi, M, Castaldo, A, Galluzzo, L, Iolascon, G, Maggi, S, Martini, E, Momoli, A, Onder, G, Paoletta, M, Pietrogrande, L, Roselli, M, Ruggeri, M, Ruggiero, C, Santacaterina, F, Tritapepe, L, Zurlo, A, Antonelli Incalzi, R, De Vincentis, Antonio, Behr, Astrid Ursula, Bellelli, Giuseppe, Bravi, Marco, Castaldo, Anna, Galluzzo, Lucia, Iolascon, Giovanni, Maggi, Stefania, Martini, Emilio, Momoli, Alberto, Onder, Graziano, Paoletta, Marco, Pietrogrande, Luca, Roselli, Mauro, Ruggeri, Mauro, Ruggiero, Carmelinda, Santacaterina, Fabio, Tritapepe, Luigi, Zurlo, Amedeo, and Antonelli Incalzi, Raffaele

Abstract

Background: Health outcomes of older subjects with hip fracture (HF) may be negatively influenced by multiple comorbidities and frailty. An integrated multidisciplinary approach (i.e. the orthogeriatric model) is, therefore, highly recommended, but its implementation in clinical practice suffers from the lack of shared management protocols and poor awareness of the problem. The present consensus document has been implemented to address these issues. Aim: To develop evidence-based recommendations for the orthogeriatric co-management of older subjects with HF. Methods: A 20-member Expert Task Force of geriatricians, orthopaedics, anaesthesiologists, physiatrists, physiotherapists and general practitioners was established to develop evidence-based recommendations for the pre-, peri-, intra- and postoperative care of older in-patients (≥ 65 years) with HF. A modified Delphi approach was used to achieve consensus, and the U.S. Preventive Services Task Force system was used to rate the strength of recommendations and the quality of evidence. Results: A total of 120 recommendations were proposed, covering 32 clinical topics and concerning preoperative evaluation (11 topics), perioperative (8 topics) and intraoperative (3 topics) management, and postoperative care (10 topics). Conclusion: These recommendations should ease and promote the multidisciplinary management of older subjects with HF by integrating the expertise of different specialists. By providing a convenient list of topics of interest, they might assist in identifying unmet needs and research priorities.

Published
2021

63. Management of hip fracture in the older people: rationale and design of the Italian consensus on the orthogeriatric co-management

Author

De Vincentis, A, Behr, A, Bellelli, G, Bravi, M, Castaldo, A, Cricelli, C, Galluzzo, L, Iolascon, G, Maggi, S, Martini, E, Momoli, A, Onder, G, Paoletta, M, Roselli, M, Ruggeri, M, Santacaterina, F, Tritapepe, L, Zurlo, A, Antonelli Incalzi, R, De Vincentis, Antonio, Behr, Astrid Ursula, Bellelli, Giuseppe, Bravi, Marco, Castaldo, Anna, Cricelli, Claudio, Galluzzo, Lucia, Iolascon, Giovanni, Maggi, Stefania, Martini, Emilio, Momoli, Alberto, Onder, Graziano, Paoletta, Marco, Roselli, Mauro, Ruggeri, Mauro, Santacaterina, Fabio, Tritapepe, Luigi, Zurlo, Amedeo, Antonelli Incalzi, Raffaele, De Vincentis, A, Behr, A, Bellelli, G, Bravi, M, Castaldo, A, Cricelli, C, Galluzzo, L, Iolascon, G, Maggi, S, Martini, E, Momoli, A, Onder, G, Paoletta, M, Roselli, M, Ruggeri, M, Santacaterina, F, Tritapepe, L, Zurlo, A, Antonelli Incalzi, R, De Vincentis, Antonio, Behr, Astrid Ursula, Bellelli, Giuseppe, Bravi, Marco, Castaldo, Anna, Cricelli, Claudio, Galluzzo, Lucia, Iolascon, Giovanni, Maggi, Stefania, Martini, Emilio, Momoli, Alberto, Onder, Graziano, Paoletta, Marco, Roselli, Mauro, Ruggeri, Mauro, Santacaterina, Fabio, Tritapepe, Luigi, Zurlo, Amedeo, and Antonelli Incalzi, Raffaele

Abstract

Background Hip fracture (HF) is a burdening health problem in older people. The orthogeriatric approach has been shown to favour functional recovery and reduce mortality, but its implementation in clinical practice cannot rely upon shared management protocols and greatly varies among different healthcare systems. Here, we present the rationale and design of the Italian consensus document on the management of HF in older people. Methods A panel of multidisciplinary experts from ten Italian scientific societies involved in the care of HF and including geriatricians, orthopaedics, anaesthesiologists, physiatrists and general practitioners, will join to establish the content validity of a list of statements. A Delphi consensus methodology will be applied to obtain the opinions of the panel and to provide the final recommendations. Objectives The document will include indications on the following relevant topics: (1) optimal care path of older subjects with HF; (2) management of comorbidities and pre-operative alteration of physiological parameters; (3) management of selected categories of patients at expected increased risk of adverse outcomes; (4) continuity of care out of hospital; (5) screening and correction of risk factors for HF in older subjects; (6) information and divulgation of shared management strategies. The objective of the consensus will be to inform clinicians, patients, researchers, and health policy makers about the best management strategies for HF in older people and their inherent limitations, thus facilitating communication between stakeholders and promoting the most cost/effective models of care.

Published
2020

65. OS-070 - Development and validation of a score predicting response to obeticholic acid in primary biliary cholangitis: the OCA response score (ORS)

Author

De Vincentis, Antonio, Terracciani, Francesca, D’Amato, Daphne, Invernizzi, Pietro, Morgando, Anna, Pellicano, Rinaldo, Vanni, Ester, Viganò, Mauro, Alvaro, Domenico, Venere, Rosanna, Lleo, Ana, Colapietro, Francesca, Degasperi, Elisabetta, Viganò, Raffaella, Giannini, Edoardo Giovanni, Labanca, Sara, Feletti, Valentina, Mussetto, Alessandro, Cozzolongo, Raffaele, Losito, Francesco, Pompili, Maurizio, Ponziani, Francesca, Niro, Grazia, Cotugno, Rosa, Pozzoni, Pietro, Chessa, Luchino, Cuccorese, Giuseppe, Palitti, Valeria Pace, Russello, Maurizio, Cannavò, Maria Rita, Frazzetto, Evelise, Bertino, Gaetano, Marzioni, Marco, Terreni, Natalia, Zolfino, Teresa, Saitta, Carlo, Pellicelli, Adriano, Coco, Barbara, Brunetto, Maurizia, Cazzagon, Nora, Floreani, Annarosa, Muratori, Luigi, Rosina, Floriano, Distefano, Marco, Scifo, Gaetano, Baiocchi, Leonardo, Grassi, Giuseppe, Sacco, Rodolfo, Izzi, Antonio, Croce’, Saveria Lory, Fiorini, Cecilia, Marra, Fabio, Simone, Loredana, Morelli, Olivia, Abenavoli, Ludovico, Pizzolante, Fabrizio, De Matthaeis, Nicoletta, Scaravaglio, Miki, Gimignani, Giancarlo, Boano, Valentina, Francesca, Giulia, Marignani, Massimo, Fanella, Silvia, Giaccetto, Marco, Castellaneta, Antonino, Poggi, Guido, Buzzanca, Valerio, Scivetti, Paolo, Tortora, Annalisa, Casella, Silvia, Bellia, Valentina, Omazzi, Barbara, Alagna, Giuliano, Ricci, Chiara, Poisa, Paolo, Rigamonti, Cristina, Calvaruso, Vincenza, Gentilucci, Umberto Vespasiani, and Carbone, Marco

Published
2023
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66. OS-045 - Long-term real-world experience with obeticholic acid in primary biliary cholangitis: the Italian recapitulate study

Author

Terracciani, Francesca, De Vincentis, Antonio, D’Amato, Daphne, Morgando, Anna, Vanni, Ester, Viganò, Mauro, Alvaro, Domenico, Venere, Rosanna, Lleo, Ana, Colapietro, Francesca, Degasperi, Elisabetta, Viganò, Raffaella, Giannini, Edoardo Giovanni, Labanca, Sara, Feletti, Valentina, Mussetto, Alessandro, Cozzolongo, Raffaele, Losito, Francesco, Pompili, Maurizio, Ponziani, Francesca, Niro, Grazia, Cotugno, Rosa, Pozzoni, Pietro, Chessa, Luchino, Cuccorese, Giuseppe, Palitti, Valeria Pace, Russello, Maurizio, Cannavò, Maria Rita, Frazzetto, Evelise, Bertino, Gaetano, Marzioni, Marco, Terreni, Natalia, Zolfino, Teresa, Saitta, Carlo, Pellicelli, Adriano, Coco, Barbara, Brunetto, Maurizia, Cazzagon, Nora, Floreani, Annarosa, Muratori, Luigi, Rosina, Floriano, Distefano, Marco, Scifo, Gaetano, Baiocchi, Leonardo, Grassi, Giuseppe, Sacco, Rodolfo, Izzi, Antonio, Croce‘, Saveria Lory, Fiorini, Cecilia, Marra, Fabio, Simone, Loredana, Morelli, Olivia, Abenavoli, Ludovico, Pizzolante, Fabrizio, De Matthaeis, Nicoletta, Scaravaglio, Miki, Gimignani, Giancarlo, Boano, Valentina, Francesca, Giulia, Marignani, Massimo, Fanella, Silvia, Giaccetto, Marco, Castellaneta, Antonino, Poggi, Guido, Buzzanca, Valerio, Scivetti, Paolo, Tortora, Annalisa, Casella, Silvia, Bellia, Valentina, Omazzi, Barbara, Alagna, Giuliano, Ricci, Chiara, Poisa, Paolo, Invernizzi, Pietro, Rigamonti, Cristina, Calvaruso, Vincenza, Carbone, Marco, and Gentilucci, Umberto Vespasiani

Published
2023
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67. OS-036 - Efficacy and safety of lusutrombopag in a real-world Italian series of cirrhotic patients with severe thrombocytopenia undergoing invasive procedures: the Reality study

Author

Gallo, Paolo, De Vincentis, Antonio, Palitti, Valeria Pace, Russello, Maurizio, Vignone, Anthony, Alvaro, Domenico, Tortora, Raffaella, Biolato, Marco, Pompili, Maurizio, Calvaruso, Vincenza, Veneziano, Marzia, Rosato, Valerio, Claar, Ernesto, Villani, Rosanna, Izzi, Antonio, Cozzolongo, Raffaele, Distefano, Marco, Messina, Vincenzo, Ragone, Enrico, Sacco, Rodolfo, Cacciatore, Pierluigi, Moretti, Alessandra, Terracciani, Francesca, Picardi, Antonio, and Gentilucci, Umberto Vespasiani

Published
2023
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68. Sarcopenia in Hepatocellular Carcinoma: Pathogenesis and Management.

Author

Gallo, Paolo, Silletta, Marianna, De Vincentis, Antonio, Lo Prinzi, Federica, Terracciani, Francesca, Di Fazio, Giuseppina, Flagiello, Valentina, Vespasiani Gentilucci, Umberto, Antonelli Incalzi, Raffaele, and Picardi, Antonio

Subjects
HEPATOCELLULAR carcinoma, SARCOPENIA, LIVER diseases, DISEASE management, AMINO acids
Abstract

Background: Sarcopenia is almost constantly observed in patients with cirrhosis and hepatocellular carcinoma (HCC). Summary: Chronic liver disease represents a unique pathophysiological scenario in which sarcopenia develops and all factors involved in the pathogenesis should be taken into account for an appropriate management of the disease. No properly designed intervention studies on this topic are available and, thus, no effective strategies have been developed for clinical practice. Apart from any targeted intervention, treatment, and optimization of liver disease is crucial. Key Messages: In patients with cirrhosis and HCC, nutritional support to maintain and restore nutrition status, a targeted use of branched-chain amino acids and a guided physical exercise, should all be an integral part of the multidimensional assessment and tailored interventions. [ABSTRACT FROM AUTHOR]

Published
2022
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69. Reply

Author

Tavaglione, Federica, De Vincentis, Antonio, Jamialahmadi, Oveis, Vespasiani-Gentilucci, Umberto, and Romeo, Stefano

Published
2023
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72. Genetic variants in the MTHFR are not associated with fatty liver disease

Author

De Vincentis, Antonio, primary, Mancina, Rosellina Margherita, additional, Pihlajamäki, Jussi, additional, Männistö, Ville, additional, Petta, Salvatore, additional, Dongiovanni, Paola, additional, Fracanzani, Anna Ludovica, additional, Valenti, Luca, additional, Tavaglione, Federica, additional, Romeo, Stefano, additional, and Vespasiani‐Gentilucci, Umberto, additional

Published
2020
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74. Return to Sport after Anatomic and Reverse Total Shoulder Arthroplasty in Elderly Patients: A Systematic Review and Meta-Analysis

Author

Papalia, Rocco, primary, Ciuffreda, Mauro, additional, Albo, Erika, additional, De Andreis, Chiara, additional, Diaz Balzani, Lorenzo Alirio, additional, Alifano, Anna Maria, additional, Fossati, Chiara, additional, Macaluso, Andrea, additional, Borzuola, Riccardo, additional, De Vincentis, Antonio, additional, and Denaro, Vincenzo, additional

Published
2020
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75. Voltammetric analysis for distinguishing portal hypertension-related from malignancy-related ascites: A proof of concept study

Author

Muley, Moises, primary, Vespasiani-Gentilucci, Umberto, additional, De Vincentis, Antonio, additional, Santonico, Marco, additional, Pennazza, Giorgio, additional, Sanguedolce, Simona, additional, De Luca, Cristiana, additional, Plotti, Francesco, additional, Picardi, Antonio, additional, and Antonelli-Incalzi, Raffaele, additional

Published
2020
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77. Accuracy of controlled attenuation parameter for assessing liver steatosis in individuals with morbid obesity before bariatric surgery.

Author

Tavaglione, Federica, De Vincentis, Antonio, Bruni, Vincenzo, Gallo, Ida Francesca, Carotti, Simone, Tuccinardi, Dario, Spagnolo, Giuseppe, Ciociola, Ester, Mancina, Rosellina Margherita, Jamialahmadi, Oveis, D'Alessio, Rossella, Bottazzi, Bruna, Manfrini, Silvia, Picardi, Antonio, Perrone, Giuseppe, Pozzilli, Paolo, Caricato, Marco, Vespasiani‐Gentilucci, Umberto, and Romeo, Stefano

Subjects
*MORBID obesity, *BARIATRIC surgery, *FATTY degeneration, *FATTY liver, *LIVER, *GASTRIC bypass, *LIVER histology
Abstract

Background & Aims: The ultrasound‐based controlled attenuation parameter (CAP) is a non‐invasive tool widely validated for assessing liver steatosis across different etiologies. However, few studies, with liver biopsy available, have investigated its performance in individuals with morbid obesity. Herein, we aimed to evaluate the diagnostic accuracy of CAP in participants with morbid obesity from the MAFALDA study before bariatric surgery. Methods: A total of 120 individuals with valid examinations within three months from bariatric surgery were included. Clinical, laboratory, FibroScan® (XL probe), and liver biopsy data were collected using standardized procedures. The overall accuracy of CAP for detecting liver steatosis was estimated by the area under the receiver‐operating characteristics curve (AUROC). Optimal cut‐offs were chosen at points with the highest Youden index. Results: The AUROCs of CAP for detecting S ≥ S1, S ≥ S2, and S = S3 were 0.91 (95% CI 0.86–0.97), 0.83 (95% CI 0.76–0.90), and 0.86 (95% CI 0.79–0.94), respectively. The best CAP cut‐offs for S ≥ S1, S ≥ S2, and S = S3 were 300 dB/m (95% CI 275–316), 328 dB/m (95% CI 296–345), and 344 dB/m (95% CI 343–352), respectively. CAP values were independently influenced by steatosis grade (estimate 20.60, 95% CI 12.70–28.40, P = 1.05 × 10−6). The AUROC of FibroScan‐AST (FAST) score for detecting progressive non‐alcoholic steatohepatitis was 0.76 (95% CI 0.66–0.86). Conclusions: In individuals with morbid obesity, CAP measured by XL probe is an accurate non‐invasive tool for grading liver steatosis. Measurement of liver fat content by CAP may help identify those eligible for bariatric procedures and estimate the effect of bariatric surgery on hepatic steatosis. Lay Summary: The ultrasound‐based controlled attenuation parameter (CAP) by using the XL probe has an excellent performance for grading liver steatosis among individuals with morbid obesity. CAP may represent an accurate tool for the non‐invasive assessment of liver steatosis among individuals with morbid obesity before and after bariatric surgery. [ABSTRACT FROM AUTHOR]

Published
2022
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78. Orthogeriatric co-management for the care of older subjects with hip fracture: recommendations from an Italian intersociety consensus.

Author

De Vincentis, Antonio, Behr, Astrid Ursula, Bellelli, Giuseppe, Bravi, Marco, Castaldo, Anna, Galluzzo, Lucia, Iolascon, Giovanni, Maggi, Stefania, Martini, Emilio, Momoli, Alberto, Onder, Graziano, Paoletta, Marco, Pietrogrande, Luca, Roselli, Mauro, Ruggeri, Mauro, Ruggiero, Carmelinda, Santacaterina, Fabio, Tritapepe, Luigi, Zurlo, Amedeo, and Antonelli Incalzi, Raffaele

Abstract

Background: Health outcomes of older subjects with hip fracture (HF) may be negatively influenced by multiple comorbidities and frailty. An integrated multidisciplinary approach (i.e. the orthogeriatric model) is, therefore, highly recommended, but its implementation in clinical practice suffers from the lack of shared management protocols and poor awareness of the problem. The present consensus document has been implemented to address these issues. Aim: To develop evidence-based recommendations for the orthogeriatric co-management of older subjects with HF. Methods: A 20-member Expert Task Force of geriatricians, orthopaedics, anaesthesiologists, physiatrists, physiotherapists and general practitioners was established to develop evidence-based recommendations for the pre-, peri-, intra- and postoperative care of older in-patients (≥ 65 years) with HF. A modified Delphi approach was used to achieve consensus, and the U.S. Preventive Services Task Force system was used to rate the strength of recommendations and the quality of evidence. Results: A total of 120 recommendations were proposed, covering 32 clinical topics and concerning preoperative evaluation (11 topics), perioperative (8 topics) and intraoperative (3 topics) management, and postoperative care (10 topics). Conclusion: These recommendations should ease and promote the multidisciplinary management of older subjects with HF by integrating the expertise of different specialists. By providing a convenient list of topics of interest, they might assist in identifying unmet needs and research priorities. [ABSTRACT FROM AUTHOR]

Published
2021
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83. Frequency of Left Ventricular Hypertrophy in Non-Valvular Atrial Fibrillation

Author

Proietti M, Marra AM, Tassone EJ, De Vuono S, Corrao S, Gobbi P, Perticone F, Corazza GR, Basili S, Lip GY, Violi F, Raparelli V, ARAPACIS Study Investigators, GIS Group, Alessandri Cesare, Serviddio Gaetano, Fascetti Stefano, Serra Pietro, Palange Paolo, Greco Eleonora, Bruno Graziella, Averna Maurizio, Giammanco Antonina, Sposito Pietro, De Cristofaro Raimondo, De Gennaro Leonardo, Loria Paola, Pellegrini Elisa, Cominacini Luciano, Mozzini Chiara, Sprovieri Mario, Spagnuolo Vitaliano, Cerqua Giannantonio, Cerasola Giovanni, Mulé Giuseppe, Barbagallo Mario, Lo Sciuto Salvatore, Monteverde Alfredo, Saitta Antonino, Lo Gullo Alberto, Malatino Lorenzo, Cilia Chiara, Licata Giuseppe, Tuttolomondo Antonino, Conigliaro Roberta, Pinto Antonio, Di Raimondo Domenico, Signorelli Santo, Anzaldi Massimiliano, De Palma Daniela, Galderisi Maurizio, Cudemo Giuseppe, Galletti Ferruccio, Fazio Valeria, De Luca Nicola, Meccariello Alfonso, Caputo Dario, De Donato Maria Teresa, Iannuzi Arcangelo, Bresciani Alessandro, Giunta Riccardo, Cimini Claudia, Durante Mangoni Emanuele, Agrusta Federica, Iorio Federica, Adinolfi Luigi E, Sellitto Ausilia, Restivo Luciano, Bellis Paolo, Tirelli Paolo, Sacerdoti David, Pesce Paola, Vanni Dino, Iuliano Luigi, Ciacciarelli Marco, Pacelli Antonio, Palazzuoli Alberto, Cacciafesta Mauro, Gueli Nicola, Capeci William, Tarquinio Nicola, Pellegrini Francesco, Vincentelli Giovanni Maria, Ravallese Ferdinando, Santini Claudio, Letizia Claudio, Petramala Luigi, Zinnamosca Laura, Cilli Mirella, Savoriti Claudio, Falaschi Paolo, Martocchia Antonio, Stefanelli Manuela, Marigliano Vincenzo, Lo Iacono Cristina, Brusco Simona, Bertazzoni Giuliano, Attalla El Halabieh Elias, Paradiso Michele, Lizzi Eugenio Maria, Timmi Stefano, Battisti Paola, Cerci Sabina, Ciavolella Massimo, Di Veroli Claudio, Malci Francesco, De Ciocchis Anita, Abate Damiano, Castellino Pietro, Curto Irene, Vecchio Claudia, Mannarino Elmo, Pasqualini Leonella, Fattori Chiara, Pende Aldo, Denegri Andrea, Artom Nathan, Ricchio Roberto, Fimognari Filippo Luca, Alletto Maurizio, Messina Simona, Sesti Giorgio, Arturi Franco, Grembiale Alessandro, Perticone Francesco, Maio Raffaele, Scarpino Paola Elisa, Carullo Giuseppe, Sciacqua Angela, Frugiuele Pierluigi, Battaglia Giuseppe, Vidili Gianpaolo, Atzori Sebastiana, Delitala Giuseppe, Davì Giovanni, Angelucci Ermanno, Sestili Simona, Traisci Giancarlo, De Feudis Lucrezia, Di Michele Dario, Fava Alessandra, Balsano Clara, De Ciantis Pierpaolo, Desideri Giovambattista, Camerota Antonio, Migliacci Rino, Porciello Giovanni, Mezzetti Matteo, Gresele Paolo, Vedovati Cristina, Fierro Tiziana, Puccetti Luca, Scarpini Francesca, Bertolotti Marco, Mussi Chiara, Boddi Maria, Savino Andrea, Contri Silvia, Saller Alois, Fabris Fabrizio, Pesavento Raffaele, Filippi Lucia, Vedovetto Valentina, Puato Massimo, Treleani Martina, De Luca Elisabetta, De Zaiacomo Francesca, Giantin Valter, Semplicini Andrea, Minuz Pietro, Calabria Stefano, Romano Simone, Fantin Francesco, Manica Angela, Stockner Ingrid, Pattis Peter, Gutmann Bernhard, Catena Cristiana, Colussi GianLuca, Annoni Giorgio, Bruni Adriana Antonella, Castagna Alberto, Spinelli Diana, Corazza Gino Roberto, Miceli Emanuela, Padula, Schinco Giuseppina, Spreafico Sibilla, Secchi Beatrice, Vanoli Massimo, Casella Gianluca, Serra Maria Grazia, Longo Stefania, Antonaci Salvatore, Belfiore Anna, Ricci Lara, Ventrella Francesco, Iamele Luigi, Bianco Cesare, Santovito Donato, Cipollone Francesco, Nicolai Salvatore, Salvati Filippo, Rini Giovan Battista, Scozzari Francesca, Muiesan Maria Lorenza, Salvetti Massimo, Bazza Abramo, Picardi Antonio, De Vincentis Antonio, Cosio Paolo, Terzolo Massimo, Madaffari Bruno, Parasporo Bruno, Fenoglio Luigi, Bracco Christian, Melchio Remo, Gentili Tamira, Salvi Aldo, Nitti Cinzia, Falsetti L, Gabrielli Armando, Paglione Ivano, Capucci Alessandro, Brambatti Michela, Sparagna Armando, Tirotta Daniela, Andreozzi Paola, Ettorre Evaristo, Viscogliosi Giovanni, Rossi Fanelli Fillippo, Delfino Massimo, Glorioso Nicola, Melis Giada, Marras Gianfranca, Matta Michela, Sacco Andrea, Stellitano Elio, Scordo Anna, Russo Franco, Caruso Assunta Antonietta, Porreca Ettore, Santilli Francesca, Tana Marco, Ferri Claudio, Grassi Davide, Cheli Paola, Portincasa Piero, Muscianisi Giuseppe, Giordani Sara, Stanghellini Vincenzo, Sabbà Carlo, Suppressa Patrizia, Mancuso Gerardo, Bartone Mosè, Calipari Daniela, Arcidiacono Giuseppe, Bellanuova Ignazio, Ferraro Maria, Scalzo Antonio, Marigliano Giampietro, Cozzolino Domenico, Lampitella Antonio, Acri Vera, Galasso Domenico, Mazzei Francesca, Galasso Salvatore, Buratti Alberto, Porta Massimo, Brizzi Maria Felice, Fattorini Annalisa, Sampietro Francesca, D’Angelo Armando, Pala Marco, Fabbian Fabio, Manfredini Roberto, Moroni Carlo, Valente Lucia, Lopreiato Francesco, Parente Fernando, Moia Marco, Braham Simon, Rossi Marco, Pesce Margherita, Gentile Adelina, Catozzo Vania, Di Napoli Mariarosaria, Baciarello Giacinto, Rancan Elena, Ageno Walter, Guasti Luigina, Ciccaglioni Antonio, Negri Silvia, Polselli Marco, Abbate Rosanna, Marcucci Rossella, Cangemi Roberto, Pignataro Francesca Serena, Marco Proietti, Pastori Daniele, Ferro Domenico, Loffredo Lorenzo, Perri Ludovica, Catasca Elisa, Raparelli Valeria, Napoleone Laura, Talerico Giovanni, Calvieri Camilla, Vicario Tommasa, Russo Roberta, Saliola Mirella, Del Ben Maria, Angelico Francesco, Bucci Tommaso, Baratta Francesco, DATA AND SAFETY MONITORING BOARD (DSMB): Vestri Anna Rita, Farcomeni Alessio, Di Tanna Gianluca, STUDY COORDINATORS: Basili Stefania, Davi’ Giovanni, STEERING COMMITTEE OF ARAPACIS STUDY: Violi Francesco, Lip Gregory YH, Hiatt William R, Vestri Anna Rita, Mannucci Pier Mannuccio, Proietti Marco, Bazzini Cristina, Bianchi Paola Ilaria, Boari Benedetta, Buonauro Agostino, Buttà Carmelo, Buzzetti Elena, Carleo Pietro, Carrabba Maria Domenica, Castorani Luigi, Cecchetto Lara, Colombo Barbara Maria, De Giorgi Alfredo, De Vuono Stefano, Del Corso Lisette, Di Giosia Paolo, Falsetti Lorenzo, Forgione Alessandra, Hijazi Daniel, Lorusso Giusi, Marra Alberto Maria, Masala Maristella, Montebianco Abenavoli Ludovico, Murgia Giuseppe, Naccarato Paola, Pattoneri Paolo, Perego Francesca, Pinto Daniela, Pinna Miriam Pretti Vincenzo, Pucci Giacomo, Salinaro Francesco, Sirico Domenico, Tassone Eliezer Joseph, Torres Daniele, Vazzana Natale, Vecchio Claudia Rita, Vitale Francesco, Proietti M, Marra AM, Tassone EJ, De Vuono S, Corrao S, Gobbi P, Perticone F, Corazza GR, Basili S, Lip GY, Violi F, Raparelli V, ARAPACIS Study Investigators, GIS Group, Alessandri Cesare, Serviddio Gaetano, Fascetti Stefano, Serra Pietro, Palange Paolo, Greco Eleonora, Bruno Graziella, Averna Maurizio, Giammanco Antonina, Sposito Pietro, De Cristofaro Raimondo, De Gennaro Leonardo, Loria Paola, Pellegrini Elisa, Cominacini Luciano, Mozzini Chiara, Sprovieri Mario, Spagnuolo Vitaliano, Cerqua Giannantonio, Cerasola Giovanni, Mulé Giuseppe, Barbagallo Mario, Lo Sciuto Salvatore, Monteverde Alfredo, Saitta Antonino, Lo Gullo Alberto, Malatino Lorenzo, Cilia Chiara, Licata Giuseppe, Tuttolomondo Antonino, Conigliaro Roberta, Pinto Antonio, Di Raimondo Domenico, Signorelli Santo, Anzaldi Massimiliano, De Palma Daniela, Galderisi Maurizio, Cudemo Giuseppe, Galletti Ferruccio, Fazio Valeria, De Luca Nicola, Meccariello Alfonso, Caputo Dario, De Donato Maria Teresa, Iannuzi Arcangelo, Bresciani Alessandro, Giunta Riccardo, Cimini Claudia, Durante Mangoni Emanuele, Agrusta Federica, Iorio Federica, Adinolfi Luigi E, Sellitto Ausilia, Restivo Luciano, Bellis Paolo, Tirelli Paolo, Sacerdoti David, Pesce Paola, Vanni Dino, Iuliano Luigi, Ciacciarelli Marco, Pacelli Antonio, Palazzuoli Alberto, Cacciafesta Mauro, Gueli Nicola, Capeci William, Tarquinio Nicola, Pellegrini Francesco, Vincentelli Giovanni Maria, Ravallese Ferdinando, Santini Claudio, Letizia Claudio, Petramala Luigi, Zinnamosca Laura, Cilli Mirella, Savoriti Claudio, Falaschi Paolo, Martocchia Antonio, Stefanelli Manuela, Marigliano Vincenzo, Lo Iacono Cristina, Brusco Simona, Bertazzoni Giuliano, Attalla El Halabieh Elias, Paradiso Michele, Lizzi Eugenio Maria, Timmi Stefano, Battisti Paola, Cerci Sabina, Ciavolella Massimo, Di Veroli Claudio, Malci Francesco, De Ciocchis Anita, Abate Damiano, Castellino Pietro, Curto Irene, Vecchio Claudia, Mannarino Elmo, Pasqualini Leonella, Fattori Chiara, Pende Aldo, Denegri Andrea, Artom Nathan, Ricchio Roberto, Fimognari Filippo Luca, Alletto Maurizio, Messina Simona, Sesti Giorgio, Arturi Franco, Grembiale Alessandro, Perticone Francesco, Maio Raffaele, Scarpino Paola Elisa, Carullo Giuseppe, Sciacqua Angela, Frugiuele Pierluigi, Spagnuolo Vitaliano, Battaglia Giuseppe, Vidili Gianpaolo, Atzori Sebastiana, Delitala Giuseppe, Davì Giovanni, Angelucci Ermanno, Sestili Simona, Traisci Giancarlo, De Feudis Lucrezia, Di Michele Dario, Fava Alessandra, Balsano Clara, De Ciantis Pierpaolo, Desideri Giovambattista, Camerota Antonio, Migliacci Rino, Porciello Giovanni, Mezzetti Matteo, Gresele Paolo, Vedovati Cristina, Fierro Tiziana, Puccetti Luca, Scarpini Francesca, Bertolotti Marco, Mussi Chiara, Boddi Maria, Savino Andrea, Contri Silvia, Saller Alois, Fabris Fabrizio, Pesavento Raffaele, Filippi Lucia, Vedovetto Valentina, Puato Massimo, Fabris Fabrizio, Treleani Martina, De Luca Elisabetta, De Zaiacomo Francesca, Giantin Valter, Semplicini Andrea, Minuz Pietro, Calabria Stefano, Romano Simone, Fantin Francesco, Manica Angela, Stockner Ingrid, Pattis Peter, Gutmann Bernhard, Catena Cristiana, Colussi GianLuca, Annoni Giorgio, Bruni Adriana Antonella, Castagna Alberto, Spinelli Diana, Corazza Gino Roberto, Miceli Emanuela, Padula, Schinco Giuseppina, Spreafico Sibilla, Secchi Beatrice, Vanoli Massimo, Casella Gianluca, Serra Maria Grazia, Longo Stefania, Antonaci Salvatore, Belfiore Anna, Ricci Lara, Ventrella Francesco, Iamele Luigi, Bianco Cesare, Santovito Donato, Cipollone Francesco, Nicolai Salvatore, Salvati Filippo, Rini Giovan Battista, Scozzari Francesca, Muiesan Maria Lorenza, Salvetti Massimo, Bazza Abramo, Picardi Antonio, De Vincentis Antonio, Cosio Paolo, Terzolo Massimo, Madaffari Bruno, Parasporo Bruno, Fenoglio Luigi, Bracco Christian, Melchio Remo, Gentili Tamira, Salvi Aldo, Nitti Cinzia, Falsetti L, Gabrielli Armando, Paglione Ivano, Capucci Alessandro, Brambatti Michela, Sparagna Armando, Tirotta Daniela, Andreozzi Paola, Ettorre Evaristo, Viscogliosi Giovanni, Rossi Fanelli Fillippo, Delfino Massimo, Glorioso Nicola, Melis Giada, Marras Gianfranca, Matta Michela, Sacco Andrea, Stellitano Elio, Scordo Anna, Russo Franco, Caruso Assunta Antonietta, Porreca Ettore, Santilli Francesca, Tana Marco, Ferri Claudio, Grassi Davide, Cheli Paola, Portincasa Piero, Muscianisi Giuseppe, Giordani Sara, Stanghellini Vincenzo, Sabbà Carlo, Suppressa Patrizia, Mancuso Gerardo, Bartone Mosè, Calipari Daniela, Arcidiacono Giuseppe, Bellanuova Ignazio, Ferraro Maria, Scalzo Antonio, Marigliano Giampietro, Cozzolino Domenico, Lampitella Antonio, Acri Vera, Galasso Domenico, Mazzei Francesca, Galasso Salvatore, Buratti Alberto, Porta Massimo, Brizzi Maria Felice, Fattorini Annalisa, Sampietro Francesca, D’Angelo Armando, Pala Marco, Fabbian Fabio, Manfredini Roberto, Moroni Carlo, Valente Lucia, Lopreiato Francesco, Parente Fernando, Moia Marco, Braham Simon, Rossi Marco, Pesce Margherita, Gentile Adelina, Catozzo Vania, Di Napoli Mariarosaria, Baciarello Giacinto, Rancan Elena, Ageno Walter, Guasti Luigina, Ciccaglioni Antonio, Negri Silvia, Polselli Marco, Abbate Rosanna, Marcucci Rossella, Cangemi Roberto, Pignataro Francesca Serena, Marco Proietti, Pastori Daniele, Ferro Domenico, Loffredo Lorenzo, Perri Ludovica, Catasca Elisa, Raparelli Valeria, Napoleone Laura, Talerico Giovanni, Calvieri Camilla, Vicario Tommasa, Russo Roberta, Saliola Mirella, Del Ben Maria, Angelico Francesco, Bucci Tommaso, Baratta Francesco, DATA AND SAFETY MONITORING BOARD (DSMB): Vestri Anna Rita, Farcomeni Alessio, Di Tanna Gianluca, STUDY COORDINATORS: Basili Stefania, Davi’ Giovanni, STEERING COMMITTEE OF ARAPACIS STUDY: Violi Francesco, Perticone Francesco, Lip Gregory YH, Hiatt William R, Vestri Anna Rita, Corazza Gino Roberto, Mannucci Pier Mannuccio, Licata Giuseppe, Moroni Carlo, Proietti Marco, Anzaldi Massimiliano, Bazzini Cristina, Bianchi Paola Ilaria, Boari Benedetta, Bracco Christian, Buonauro Agostino, Buttà Carmelo, Buzzetti Elena, Calabria Stefano, Capeci William, Carleo Pietro, Carrabba Maria Domenica, Castorani Luigi, Cecchetto Lara, Cimini Claudia, Colombo Barbara Maria, De Giorgi Alfredo, De Vuono Stefano, Denegri Andrea, Del Corso Lisette, Di Giosia Paolo, Durante Mangoni Emanuele, Falsetti Lorenzo, Forgione Alessandra, Grassi Davide, Grembiale Alessandro, Hijazi Daniel, Iamele Luigi, Lorusso Giusi, Marra Alberto Maria, Masala Maristella, Montebianco Abenavoli Ludovico, Murgia Giuseppe, Naccarato Paola, Pattoneri Paolo, Perego Francesca, Pesce Paola, Petramala Luigi, Pinto Daniela, Pinna Miriam Pretti Vincenzo, Pucci Giacomo, Raparelli Valeria, Salinaro Francesco, Santilli Francesca, Scarpini Francesca, Sirico Domenico, Suppressa Patrizia, Tassone Eliezer Joseph, Torres Daniele, Vazzana Natale, Vecchio Claudia Rita, Vidili Gianpaolo, Vitale Francesco, Proietti, M., Marra, A., Tassone, E., De Vuono, S., Corrao, S., Gobbi, P., Perticone, F., Corazza, G., Basili, S., Lip, G., Violi, F., Raparelli, V., Marra, A. M., Tassone, E. J., Corazza, G. R., and Lip, G. Y. H.

Subjects
Registrie, Male, Cross-sectional study, Myocardial Infarction, Longitudinal Studie, Left ventricular hypertrophy, Cohort Studies, non-valvular atrial fibrillation, Atrial Fibrillation, 80 and over, Prevalence, echocardiography, Myocardial infarction, Longitudinal Studies, Prospective Studies, Registries, Prospective cohort study, Ultrasonography, Aged, 80 and over, education.field_of_study, Medicine (all), Atrial fibrillation, Diabetes Mellitu, Middle Aged, Left Ventricular, left ventricular hypertrophy, Italy, Hypertension, Cardiology, Age Distribution, Aged, Ankle Brachial Index, Cross-Sectional Studies, Diabetes Mellitus, Female, Humans, Hypertrophy, Left Ventricular, Logistic Models, Peripheral Arterial Disease, Cardiology and Cardiovascular Medicine, Human, medicine.medical_specialty, Logistic Model, Population, Concentric hypertrophy, Socio-culturale, non-valvular atrial fibrillation, left ventricular hypertrophy, echocardiography, cardiovascular diseases, Internal medicine, medicine, cardiovascular diseases, education, Cross-Sectional Studie, business.industry, Odds ratio, Hypertrophy, medicine.disease, Prospective Studie, Cohort Studie, business
Abstract

Left ventricular hypertrophy (LVH) is significantly related to adverse clinical outcomes in patients at high risk of cardiovascular events. In patients with atrial fibrillation (AF), data on LVH, that is, prevalence and determinants, are inconsistent mainly because of different definitions and heterogeneity of study populations. We determined echocardiographic-based LVH prevalence and clinical factors independently associated with its development in a prospective cohort of patients with non-valvular (NV) AF. From the "Atrial Fibrillation Registry for Ankle-brachial Index Prevalence Assessment: Collaborative Italian Study" (ARAPACIS) population, 1,184 patients with NVAF (mean age 72 ± 11 years; 56% men) with complete data to define LVH were selected. ARAPACIS is a multicenter, observational, prospective, longitudinal on-going study designed to estimate prevalence of peripheral artery disease in patients with NVAF. We found a high prevalence of LVH (52%) in patients with NVAF. Compared to those without LVH, patients with AF with LVH were older and had a higher prevalence of hypertension, diabetes, and previous myocardial infarction (MI). A higher prevalence of ankle-brachial index ≤0.90 was seen in patients with LVH (22 vs 17%, p = 0.0392). Patients with LVH were at significantly higher thromboembolic risk, with CHA2DS2-VASc ≥2 seen in 93% of LVH and in 73% of patients without LVH (p

Published
2015
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84. Combining Genetic Variants to Improve Risk Prediction for NAFLD and Its Progression to Cirrhosis: A Proof of Concept Study

Author

Vespasiani-Gentilucci, Umberto, primary, Dell’Unto, Chiara, additional, De Vincentis, Antonio, additional, Baiocchini, Andrea, additional, Delle Monache, Marco, additional, Cecere, Roberto, additional, Pellicelli, Adriano Maria, additional, Giannelli, Valerio, additional, Carotti, Simone, additional, Galati, Giovanni, additional, Gallo, Paolo, additional, Valentini, Francesco, additional, Del Nonno, Franca, additional, Rosati, Davide, additional, Morini, Sergio, additional, Antonelli-Incalzi, Raffaele, additional, and Picardi, Antonio, additional

Published
2018
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89. Rate of non-response to ursodeoxycholic acid in a large real-world cohort of primary biliary cholangitis patients in Italy.

Author

Vespasiani-Gentilucci, Umberto, Rosina, Floriano, Pace-Palitti, Valeria, Sacco, Rodolfo, Pellicelli, Adriano, Chessa, Luchino, De Vincentis, Antonio, Barlattani, Michela, Barlattani, Angelo, Feletti, Valentina, Mussetto, Alessandro, Zolfino, Teresa, Russello, Maurizio, Cozzolongo, Raffaele, Garrucciu, Giovanni, Niro, Grazia, Bacca, Donato, Bertino, Gaetano, Claar, Ernesto, and Ascione, Antonio

Subjects
CHOLANGITIS, URSODEOXYCHOLIC acid, ALKALINE phosphatase, CHRONIC active hepatitis, LIVER diseases, AUTOIMMUNE diseases
Abstract

Background and aim: Response to ursodeoxycholic acid (UDCA) is crucial for the prediction of primary biliary cholangitis (PBC) prognosis, and different response criteria were validated and proposed by reference centers for PBC. To date, rates of non-response to UDCA from real-world series are lacking. Methods: Hepatology/Gastroenterology centers belonging to 'Club Epatologi Ospedalieri' (CLEO) and 'Associazione Italiana Gastroenterologi Ospedalieri' (AIGO) were invited to participate in the study, and asked to extract all patients followed for PBC, without any selection or exclusion, and fill in the database provided. Results: Thirty-four centers were enrolled throughout Italy, for a total of 713 patients. None of these centers, except one, had a hepatology outpatient clinic devoted to the care of patients with autoimmune liver diseases. After excluding 79 cases of PBC/autoimmune hepatitis overlaps, 634 patients were analyzed: mean age, 64.4 ± 12.0 years; 91.2% females; F/M 10.3/1. For patients with at least 1 year of UDCA treatment (583), rates of non-response to UDCA were evaluated according to the Paris-I/-II, Toronto and GLOBE criteria, and compared with those in the original cohorts: 27% vs 39% in Paris-I cohort; 39.6% vs 52% in Paris-II; 20.1% vs 43.5% in Toronto; 15.7% vs 30% in GLOBE (age-specific cutoffs). Mean alkaline phosphatase levels on UDCA treatment, and the age-adjusted prevalence of F3/F4 fibrosis, appeared lower in this PBC population than in reference cohorts. Conclusions: A mean ∼15% better response to UDCA is observed in a real-world PBC population, probably due to migration of some of most severe/advanced cases to PBC referral centers. [ABSTRACT FROM AUTHOR]

Published
2019
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93. Lysosomal Acid Lipase Activity Is Reduced Both in Cryptogenic Cirrhosis and in Cirrhosis of Known Etiology

Author

Vespasiani-Gentilucci, Umberto, primary, Gallo, Paolo, additional, Piemonte, Fiorella, additional, Riva, Elisabetta, additional, Porcari, Aldostefano, additional, Vorini, Ferruccio, additional, Tozzi, Giulia, additional, Piccioni, Livia, additional, Galati, Giovanni, additional, De Vincentis, Antonio, additional, Carotti, Simone, additional, Morini, Sergio, additional, D’Amico, Jessica, additional, Angeletti, Silvia, additional, Pedone, Claudio, additional, and Picardi, Antonio, additional

Published
2016
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94. The PNPLA3 rs738409 C > G polymorphism is associated with the risk of progression to cirrhosis in NAFLD patients

Author

Vespasiani-Gentilucci, Umberto, primary, Gallo, Paolo, additional, Porcari, Aldostefano, additional, Carotti, Simone, additional, Galati, Giovanni, additional, Piccioni, Livia, additional, De Vincentis, Antonio, additional, Dell’Unto, Chiara, additional, Vorini, Ferruccio, additional, Morini, Sergio, additional, Riva, Elisabetta, additional, and Picardi, Antonio, additional

Published
2016
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96. Prevalence of peripheral artery disease by abnormal ankle-brachial index in atrial fibrillation: implications for risk and therapy

Author

Violi, Francesco, Daví, Giovanni, Hiatt, William, Lip, Gregory Y. H., Corazza, Gino R., Perticone, Francesco, Proietti, Marco, Pignatelli, Pasquale, Vestri, Anna R., Basili, Stefania, Desideri, ARAPACIS Study Investigators Alessandri Cesare (Dipartimento di Scienze e Biotecnologie Medico-Chirurgiche, G., Sapienza-Università di Roma), Serviddio Gaetano (Department of Medical and Surgical Sciences, University of Foggia), Fascetti Stefano (UOC Medicina Generale, USL 12 Viareggio, Toscana), Serra, Pietro, Palange Paolo(UOC Medicina Interna, I, Dipartimento di Sanità Pubblica, e Malattie Infettive, Greco, Eleonora, Bruno Graziella (Medicina, 3, Department of Medical Sciences, Città della Salute e della Scienza, A. O., University of Turin), Averna, Maurizio, Giammanco Antonina (Dipartimento Biomedico di Medicina Interna, e Specialistica (DIBIMIS), Università di Palermo), Sposito Pietro (Azienda Ospedaliera Ospedali Riuniti Papardo Piemonte, Messina), De Cristofaro Raimondo, De Gennaro Leonardo(Istituto di Medicina Interna, e Geriatria, Centro Emostasi, e Trombosi, Gemelli, Policlinico A., Roma), Loria, Paola, Pellegrini Elisa(Medicina Interna ad Indirizzo Metabolico, – NOCSAE Baggiovara, Department of Internal Medicine, Endocrinology, Metabolism and Geriatrics, Università degli Studi di Modena, e Reggio Emilia), Cominacini, Luciano, Mozzini Chiara (Dipartimento di Medicina, Sezione di Medicina Interna, D, Università di Verona), Sprovieri, Mario, Spagnuolo Vitaliano (UOC Medicina d'Urgenza, e PS, Stabilimento Ospedaliero dell'Annunziata, Cosenza), Cerqua Giannantonio (UOC Medicina Interna per l'Urgenza, S Giovanni Addolorata, Ao, Cerasola Giovanni, Mulé Giuseppe (Università degli Studi di Palermo), Barbagallo, Mario, Lo Sciuto Salvatore, Monteverde Alfredo(UOC di Geriatria, e Lungodegenza, Azienda Ospedaliera Universitaria Policlinico, Aoup, Palermo), Saitta, Antonino, Lo Gullo Alberto (UOC Medicina Interna, Università di Messina), Malatino, Lorenzo, Cilia Chiara (Clinica Medica, Ospedale, Cannizzaro, Università degli Studi di Catania), Licata, Giuseppe, Tuttolomondo, Antonino, Conigliaro Roberta (UOC Medicina Interna, e Cardioangiologia, Dipartimento Biomedico di Medicina Interna, e Specialistica, Università degli Studi di Palermo), Pinto, Antonio, Di Raimondo Domenico (UOC Medicina Vascolare, Dipartimento Biomedico di Medicina Interna e Specialistica, (Di. Bi. M. I. S. )., Signorelli, Santo, Anzaldi Massimiliano (Dipartimento di Medicina Interna, e Patologia, Università degli studi di Catania), De Palma Daniela, Galderisi, Maurizio, Cudemo Giuseppe (Dipartimento di Medicina Clinica, e Sperimentale, AUP Federico II di Napoli), Galletti, Ferruccio, Fazio Valeria(Dipartimento di Medicina Clinica, e Chirurgia, Università di Napoli Federico II), De Luca Nicola, Meccariello Alfonso (Centro Ipertensione, AUO Federico II, Napoli), Caputo, Dario, De Donato Maria Teresa (UO Medicina Interna, Azienda Ospedaliera Universitaria San Giovanni di Dio, e Ruggi D'Aragona, Salerno), Iannuzi, Arcangelo, Bresciani Alessandro (Divisione di Medicina Interna, Cardarelli, Osp. A., Giunta, Riccardo, Cimini Claudia (V Divisione Medicina Interna ed Immunoallergologia, Policlinico, Sun, Utili, Riccardo, Durante Mangoni Emanuele, Agrusta Federica (Medicina Infettivologica, e dei Trapianti, Monaldi, Ao, Sun, Napoli), Adinolfi Luigi, E., Sellitto, Cristiana, Restivo Luciano (Medicina Interna, Seconda Università di Napoli, Ospedale di Marcianise), Bellis, Paolo, Tirelli Paolo (UOC Medicina Interna e di Urgenza, e Pronto Soccorso, del Loreto Nuovo, P. O. S. M., Loreto, Mare), Sacerdoti, David, Pesce Paola (Clinica Medica, 5, Dipartimento di Medicina DIMED, Università degli Studi di Padova), Vanni Dino (UO Medicina Interna Arezzo, Ospedale San Donato, Azienda USL, 8 Arezzo), Iuliano, Luigi, Ciacciarelli, Marco, Pacelli Antonio (Department of Medico-Surgical Sciences and Biotechnology, Vascular Biology, Mass Spectrometry Lab, Sapienza-University of Rome), Palazzuoli Alberto (Sezione Cardiologia, Dipartimento di Medicina Interna, e Malattie Metaboliche, Università di Siena, Ospedale Le Scotte), Cacciafesta, Mauro, Gueli Nicola (UOC di Medicina Geriatrica, e Riabilitazione, Sapienza- Università di Roma, Capeci, William, Tarquinio, Nicola, Pellegrini Francesco (UO Medicina 'SS Benvenuto, e Rocco', Dipartimento di Medicina Interna, Asur, Marche, Area Vasta, n. 2., ex ZT 7), Vincentelli Giovanni Maria (UOS Breve Osservazione, Calibita 'Fatebenefratelli' Isola Tiberina, Ospedale S. 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Murri'-Direttore Prof., Ventrella, Francesco, Iamele Luigi (Struttura Complessa di Medicina Interna, Cerignola, Asl, Foggia), Bianco Cesare (UOC Medicina Interna, Tropea), Santovito, Donato, Mezzetti, Andrea, Cipollone Francesco (Centro di Eccellenza Europeo, e di Riferimento Regionale per l'Aterosclerosi, l'Ipertensione Arteriosa, e le Dislipidemie, Università, Chieti), Nicolai, Salvatore, Salvati Filippo (UO Medicina Interna, Ospedale di Ortona, ASL 02 Abruzzo), Rini Giovan Battista, Scozzari Francesca (UOC Medicina Interna ed Ipertensione, Dipartimento Biomedico di Medicina Interna e Specialistica (Di. Bi. M. 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(Clinica di Cardiologia, Ospedale, Torrette, Tirotta Daniela (UO Medicina Generale IV, Ospedale, Cervesi, Cattolica), Andreozzi, Paola, Ettorre, Evaristo, Cipriani Elisa (Area Geriatria, DAI Medicina Interna, Sapienza-Università di Roma, Rossi Fanelli Fillippo, Delfino Massimo (UOC Medicina Interna, H, Immunologia, Clinica, Nutrizione, Clinica, Endocrinologia, Glorioso, Nicola, Melis, Giada, Marras, Gianfranca, Matta Michela (Ambulatorio Ipertensione Arteriosa, e Patologie Correlate, Aou, Sassari, Sassari), Sacco Andrea (UOC Medicina Interna, PO Madonna delle Grazie, Matera), Stellitano, Elio, Scordo Anna (UO Medicina, PO 'Tiberio Evoli', Melito Porto Salvo), Russo, Franco, Caruso Assunta Antonietta (UOC Medicina Generale di Rogliano, AO di Cosenza), Porreca, Ettore, Santilli, Francesca, Tana Marco (UO Medicina Interna, e Geriatria, Ospedale Clinicizzato Colle Dell'Ara, D'Annunzio, Università G., Chieti-Pescara), Ferri, Claudio, Grassi, Davide, Di Giosia Paolo (Divisione di Medicina Interna Universitaria, - Ospedale San Salvatore, Dipartimento, Mesva, Università, Dell'Aquila, L'Aquila), Portincasa Piero (Clinica Medica 'Murri', Dipartimento di Scienze Mediche, e Oncologia Umana, Università degli Studi di Bari), Muscianisi Giuseppe (ASP Reggio Calabria, Saline Joniche), Giordani, Sara, Stanghellini Vincenzo (Dipartimento di Scienze Mediche, e Chirurgiche, Università degli Studi di Bologna), Sabbà, Carlo, Suppressa Patrizia (UOC Geriatria e Centro di assistenza, e ricerca sovraziendale per le malattie rare, Mancuso, Giuseppe, Bartone, Mosè, Calipari Daniela (UOC Medicina Interna, Presidio, Ospedaliero, ASP di Catanzaro), Arcidiacono, Giuseppe, Bellanuova Ignazio (UOC Cardiologia, e UTIC, Catania), Ferraro, Maria, Scalzo, Antonio, Marigliano Giampietro (ASP Cosenza), Cozzolino, Domenico, Lampitella, Antonio, Acri Vera (Dipartimento di Internistica Clinica, e Sperimentale, Galasso, Domenico, Mazzei, Francesca, Galasso Salvatore (RSA Madonna di Porto Gimigliano, Catanzaro), Buratti Alberto (Azienda Ospedaliera della Provincia di Pavia, UO Medicina Interna, Ospedale, Civile, Casorate, Primo, Porta, Massimo, Brizzi Maria Felice (SC Medicina Interna 1U, Azienda, Ospedaliera, Torino), Fattorini, Annalisa, Sampietro, Francesca, D’Angelo Armando (Coagulation Service and Thrombosis Research Unit, IRCCS Ospedale San Raffaele, Pala, Marco, Fabbian, Fabio, Manfredini Roberto (UOC Clinica Medica, Anna, Azienda Ospedaliera-Universitaria S., Ferrara), Moroni, Carlo, Valente, Lucia, Lopreiato Francesco (Laboratorio di Ecocardiografia-Cardiologia Preventiva, DAI Cuore, e Grossi Vasi, Parente Fernando (UOC Medicina Interna, Granata Massimo (Immunologia Clinica, A, Moia, Marco, Braham Simon (Fondazione IRCCS Ca'Granda, Ospedale Maggiore Policlinico, Rossi, Marco, Pesce Margherita (Dipartimento di Medicina Clinica, e Sperimentale, Università di Pisa), Gentile, Adelina, Catozzo Vania (UO Medicina, Ldp, Loreto, Ferranti, Edoardo, Soldini, Maurizio, Di Napoli Mariarosaria, Baciarello Giacinto (UOC Cardiologia Preventiva, e Riabilitativa, Rancan, Elena, Ageno, Walter, Guasti Luigina (Dipartimento di Medicina Clinica, e Sperimentale, Università, Dell'Insubria, Varese), Ciccaglioni, Antonio, Negri, Silvia, Polselli Marco (Centro Elettro-Stimolazione Cardiaca, Prisco Domenico (SOD Patologia Medica, Aou, Careggi, Firenze), Pignataro Francesca Serena, Pastori, Daniele, Ferro, Domenico, Loffredo, Lorenzo, Cangemi, Roberto, Perri, Ludovica, Polimeni, Licia, Catasca, Elisa, Raparelli, Valeria, Napoleone, Laura, Schillizzi, Marianna, Vicario, Tommasa, Russo, Roberta, Gentile Maria Cristina, Saliola, Mirella, Del Ben Maria, Angelico Francesco (I Clinica Medica, Sapienza-Università di, Roma)., Violi F, Daví G, Hiatt W, Lip GY, Corazza GR, Perticone F, Proietti M, Pignatelli P, Vestri AR, Basili S, ARAPACIS Study Investigators: […, Alessandri C, Serviddio G, Fascetti S, Serra P, Palange P, Greco E, Bruno G, Averna M, Giammanco A, Sposito P, De Cristofaro R, De Gennaro L, Loria P, Pellegrini E, Cominacini L, Mozzini C, Spovieri M, Spagnuolo V, Cerqua G, Cerasola G, Mulé G, Barbagallo M, Lo Sciuto S, Monteverde A, Saitta A, Lo Gullo A, Malatino L, Cilia C, Licata G, Tuttolomondo A, Conigliaro R, Pinto A, Di Raimondo D, Signorelli S, Anzaldi M, De Palma D, Galderisi M, Cudemo G, Galletti F, Fazio V, De Luca N, Meccariello A, Caputo D, De Donato MT, Iannuzi A, Bresciani A, Giunta R, Cimini C, Utili R, Durante M, Emanuele AF, Adinolfi LE, Cristiana S, Restivo L, Bellis P, Tirelli P, Sacerdoti D, Pesce P, Vanni D, Iuliano L, Palazzuoli A, Cacciafesta M, Gueli N, Capeci W, Tarquino N, Pellegrini F, Vincentelli GM, Ravallese F, Santini C, Letizia C, Petramala L, Zinnamosca L, Cilli M, Savoriti C, Falaschi P, Martocchia A, Stefanelli M, Marigliano V, Lo Iacono C, Brusco S, Bertazzoni G, El Halabieh Elias A, Paradiso M, Lizzi EM, Stefano T, Paola B, Cerci S, Ciavolella M, Di Veroli C, Malci F, De Ciocchis A, Abate D, Castellino P, Curto I, Vecchio C, Mannarino E, Pasqualini L, Fattori C, Pende A, Denegri A, Nathan A, Ricchio R, Fimognari FL, Alletto M, Messina S, Sesti G, Arturi F, Gembiale A, Scarpino PE, Carullo G, Pierluigi F, Battaglia G, Vadili G, Atzori S, Delitala G, Davì G, Angelucci E, Simona S, Giancarlo T, De Feudis L, Di Michele D, Fava A, Balsano C, De Ciantis P, Giovambattista D, Camerota A, Migliacci R, Porciello G, Mezzetti M, Gresele P, Vedovati C, Fierro T, Puccetti L, Scarpini F, Bertolotti M, Mussi C, Boddi M, Savino A, Contri S, Saller A, Fabris F, Pesavento R, Filippi L, Vedovetto V, Puato M, Treleani M, Maselli M, Corradin ML, Giantin V, Semplicini A, Minuz P, Calabria S, Romano S, Fantin F, Manica A, Stockner I, Pattis P, Guttman B, Catena C, Colussi GL, Annoni G, Bruni AA, Castagna A, Miceli E, Padula D, Schinco G, Spreafico S, Secchi B, Vanoli M, Casella G, Serra MG, Longo S, Antonaci S, Belfiore A, Frualdo M, Francesco V, Iamele L, Bianco C, Santovito D, Mezzetti A, Cipollone F, Nicolai S, Salvati F, Battista RG, Scozzari F, Muiesan ML, Salvetti M, Bazza A, Picardi A, De Vincentis A, Cosio P, Terzolo M, Fenoglio L, Bracco C, Melchio R, Gentili T, Salvi A, Nitti C, Falsetti L, Gabrielli A, Paglione I, Capucci A, Brambatti M, Sparagna A, Tirotta D, Andreozzi P, Ettorrre E, Cipriani E, Fanelli Fillippo R, Delfino M, Glorioso N, Melis G, Marras G, Matta M, Sacco A, Stellitano E, Scordo A, Russo F, Caruso Assunta A, Porreca E, Santilli F, Tana M, Ferri C, Grassi D, Di Giosia P, Portincasa P, Muscianisi G, Giordani S, Stanghellini V, Sabbà C, Supressa P, Mancuso G, Bartone M, Calipari D, Arcidiacono G, Bellanuova I, Ferraro M, Scalzo A, Marigliano G, Cozzolina D, Lampitella A, Acri V, Galasso D, Mazzei F, Galasso S, Buratti A, Porto M, Brizzi MF, Fattorini A, Sampietro F, D'Angelo A, Pala M, Fabbian F, Manfredini R, Moroni C, Valente L, Lopreiato F, Parente F, Granata M, Moia M, Braham S, Rossi M, Pesce M, Gentile A, Catozzzo V, Ferranti E, Soldini M, Di Napoli M, Baciarello G, Rancan E, Ageno W, Guasti L, Ciccaglioni A, Negri S, Polselli M, Prisco D, Pignataro FS, Pastori D, Ferro D, Loffredo L, Cangemi R, Perri L, Polimeni L, Catasca E, Raparelli V, Napoleone L, Schillizzi M, Vicario T, Russo R, Gentile MC, Saliola M, Del Ben M, Angelico F, Farcomeni A, Di Tanna G, Davi' G, Traisci G, Montebianco Abenavoli L, Grembiale A, Di Minno G, Durante ME, Pattoneri P, Boari B, Fabio G, Perego F, Bianchi Paola I, Angeli A, Colombo BM, Giannelli G, Vidili G, Torres D, Hijazl D, Gatta A, Mannucci Mannuccio P, Licata G., and …]

Subjects
Adult, Male, Risk, therapy, atrial fibrillation, cardiovascular disease, peripheral vascular disease, Aged, Atrial Fibrillation, Female, Humans, Internal Medicine, Italy, Middle Aged, Peripheral Arterial Disease, Prevalence, Registries, Societies, Medical, Ankle Brachial Index, ATRIAL FIBRILLATION, Cardiology and Cardiovascular Medicine, Medical, RISK FACTORS, cardiovascular diseases, Societies
Abstract

To the Editor: Nonvalvular atrial fibrillation (NVAF) is the most common sustained arrhythmia encountered in clinical practice and is associated with a 5-fold increased risk for stroke (1). Moreover, patients with NVAF often suffer from atherosclerotic complications such as acute myocardial infarction (AMI) (2). Peripheral artery disease (PAD) is an established marker of systemic atherosclerosis but its prevalence in NVAF is still unclear. We reasoned that inclusion of ankle-brachial index (ABI), which is an established tool for diagnosis of PAD (3), in the CHA2DS2-VASc (4) score would better define the prevalence of vascular disease. To address this issue, the Italian Society of Internal Medicine (SIMI) established an Italian registry documenting ABI in NVAF patients. The Atrial Fibrillation Registry for the ARAPACIS (Ankle-brachial Index Prevalence Assessment: Collaborative Italian Study) study is an independent research project involving all Regional Councils of SIMI. The first objective of the study was to estimate the prevalence of ABI ≤0.90 in NVAF patients. Consecutive patients with NVAF referred to internal medicine wards were eligible for the enrollment. Enrollment started in October 2010 and continued until October 30, 2012. Patients were enrolled if they were 18 years or older and had a diagnosis of NVAF, recording during the qualifying admission/consultation or in the preceding 12 months, and if it was possible to obtain the ABI measurement. Exclusion criteria included the following: acquired or congenital valvular AF, active cancer, disease with life expectancy 0.90 (93% vs. 82%; p < 0.0001). Logistic regression analysis demonstrated that ABI ≤0.90 was significantly associated with a smoking habit (odds ratio [OR]: 1.99; 95% confidence interval [CI]: 1.48 to 2.66; p < 0.0001), diabetes (OR: 1.93; 95% CI: 1.51 to 2.46; p < 0.0001), age class 65 to 74 years (OR: 2.05; 95% CI: 1.40 to 3.07; p < 0.0001), age class ≥75 years (OR: 3.12; 95% CI: 2.16 to 4.61; p < 0.0001), and history of previous transient ischemic attack/stroke (OR: 1.64; 95% CI: 1.20 to 2.24; p = 0.002). Vascular disease, as assessed by the history elements of CHA2DS2VASc score, was recorded in 17.3% of patients; inclusion of ABI ≤0.90 in the definition of vascular disease yielded a total prevalence of 33%. A higher prevalence of vascular disease was detected if ABI ≤0.90 was included in the CHA2DS2VASc score (Fig. 1). CHA2DS2VASc including ABI ≤0.90 was more associated with previous stroke (43%; OR: 1.85; 95% CI: 1.41 to 2.44; p < 0.0001) compared to CHA2DS2VASc with ABI 0.91 to 1.39 (23%; OR: 1.52; 95% CI: 1.10 to 2.11; p = 0.0117). To the best of our knowledge, there is no large-scale study that specifically examined the prevalence of ABI ≤0.90 in NVAF. In our population, 21% had ABI ≤0.90 indicating that NVAF is often associated with systemic atherosclerosis. The CHADS2 has been recently refined with the CHA2DS2-VASc score, which includes vascular disease as documented by a history of AMI, symptomatic PAD, or detection of atherosclerotic plaque in the aortic arch (4). Comparison of vascular prevalence as assessed by CHA2DS2-VASc score and/or ABI ≤0.90 is of interest to define the potentially positive impact of measuring ABI in the management of NVAF patients. Inclusion of ABI ≤0.90 in the definition of vascular disease greatly increased the prevalence of vascular disease, which increased from 17.3% (based on history alone) to 33% (based on ABI) in the entire population. If ABI ≤0.90 was encompassed in the definition of vascular disease of CHA2DS2-VASc score the prevalence of vascular disease increased in every risk class. Inclusion of ABI ≤0.90 in the CHA2DS2-VASc score allowed us to better define the risk profile of NVAF patients with an up-grading of the risk score in each CHA2DS2-VASc score category. This may have important therapeutic implications if the new score could be tested prospectively, as a higher number of NVAF patients would potentially be candidates for an anticoagulant treatment by measuring ABI. A prospective study is, therefore, necessary to validate the risk score of this new definition of vascular disease. In conclusion, this study provides the first evidence that one-fifth of NVAF patients had an ABI ≤0.90, indicating that it may represent a simple and cheap method to better define the prevalence of vascular disease in NVAF.

Published
2013

97. Low Alanine Aminotransferase Levels in the Elderly Population: Frailty, Disability, Sarcopenia, and Reduced Survival.

Author

Vespasiani-Gentilucci, Umberto, De Vincentis, Antonio, Ferrucci, Luigi, Bandinelli, Stefania, Incalzi, Raffaele Antonelli, Picardi, Antonio, and Antonelli Incalzi, Raffaele

Subjects
*HEALTH of older people, *AMINOTRANSFERASES, *SARCOPENIA, *MUSCULOSKELETAL diseases in old age, *CARDIOVASCULAR development, *LIVER diseases
Abstract

Background: Although low alanine aminotransferase (ALT) levels have been associated with poor outcomes in the elderly population, the determinants subtending this association have been poorly explored. To gain insight into this topic, we analyzed data from a prospective population-based database (InCHIANTI study) in which frailty, disability, sarcopenia, and pyridoxine levels were systematically assessed.Methods: Data are from 765 participants aged more than 65 years (mean age 75.3 years, women 61.8%), without chronic liver disease, malignancies, or alcohol abuse. Frailty was defined according to Fried criteria, sarcopenia through peripheral Quantitative-Computed-Tomography (lowest gender-specific tertile of the residuals of a linear regression of muscle mass from height and fat mass), and disability as self-reported need for help in at least one basic daily living activity. Associations of ALT with overall and cardiovascular mortality were assessed by Cox-models with time-dependent covariates.Results: ALT activity was inversely associated with frailty, sarcopenia, disability, and pyridoxine deficiency; however, higher ALT was confirmed to be protective with respect of overall and cardiovascular mortality even in multiple-adjusted models including all these covariates (overall: hazard ratio [HR] 0.98 [0.96-1], p = .02; cardiovascular: 0.94 [0.9-0.98], p < .01). The association between ALT activity and mortality was nonlinear (J-shaped), and subjects in the lower quintiles of ALT levels showed a sharply increased overall and cardiovascular mortality.Conclusions: These results suggest that reduced ALT levels in older individuals can be considered as a marker of frailty, disability, and sarcopenia, and as an independent predictor of adverse outcomes. The possible relationship between reduced ALT and impaired hepatic metabolic functions should be explored. [ABSTRACT FROM AUTHOR]

Published
2018
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100. Effect of Sibutramine on Plasma C-Reactive Protein, Leptin and Adipon ectin Concentrations: A Systematic Review and Meta-Analysis of Randomized Contr olled Trials

Author

De Vincentis, Antonio, Pedone, Claudio, Vespasiani-Gentilucci, Umberto, Picardi, Antonio, Derosa, Giuseppe, Maffioli, Pamela, and Sahebkar, Amirhossein

Abstract

Sibutramine is an anti-obesity medication whose effects on weight loss have been widely explored. Moreover, limited number of studies also evidenced its correlates on adipokines and proinflammatory markers; however, their results have not been conclusive. Hence, a systematic review and meta-analysis of available evidence was conducted in order to calculate the effect size of sibutramine therapy on C-reactive protein (CRP), leptin and adiponectin concentrations. Seven randomized clinical trials with a total of 601 subjects met the eligibility criteria. Random effect meta-analysis evidenced a significant decrease in plasma levels of CRP and leptin (weighted mean difference [WMD] -15.58%, 95% confidence interval [95%CI]: -28.84, -2.33, p=0.021 and WMD -9.25, 95%CI: -15.73, -2.78, p=0.005, respectively) and increase of adiponectin (WMD 9.86%, 95%CI: 1.76, 17.96, p=0.017) following sibutramine therapy. Subgroup analysis showed a greater CRP-lowering effect of sibutramine with doses <15 mg/day (WMD -17.26%, 95%CI: -31.02, -3.5, p=0.014) compared with doses ≥15 mg/day (WMD 6.01%, 95%CI: -43.38, 55.40, p=0.811). In meta-regression analysis, changes in CRP were found to be independent of baseline or percentage change in body mass index. These results suggest a significant improvement of plasma CRP, leptin and adiponectin levels following treatment with sibutramine. Possible impacts and relevance of these alterations on cardiovascular risk profile remain to be clarified, especially in post-hoc analyses of sibutramine outcome trials among people without pre-existing cardiovascular disease.

Published
2017

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