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62. Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes

Author

Mirijello, Antonio, Viazzi, Francesca, Fioretto, Paola, Giorda, Carlo, Ceriello, Antonio, Russo, Giuspina T., Guida, Pietro, Pontremoli, Roberto, De Cosmo, Salvatore, Cimino, Antonino, Fava, Danila, Giorda, Carlo Bruno, Meloncelli, Illidio, Nicolucci, Antonio, Pellegrini, Fabio, Rossi, Maria Chiara, Turco, Salvatore, Vespasiani, Giacomo, Pellegrini, F., Graziano, G., Lucisano, G., Memmo, R., Pellicciotta, E., Paciotti, V., Pupillo, M., Armentano, G., Giovannini, C., Armentano, V., Laudato, M., Turco, S., Acquati, S., Ciardullo, A. V., Laffi, G., Felace, G., Taboga, C., Tortul, C., Santantonio, G., Suraci, C., Ghisoni, G., Raffa, M., Genovese, S., Lovagnini-Scher, C. A., Rampini, P., Rocca, A., Ruggeri, P., Tortato, E., Cotti, L., Cristofaro, M. R., Tagliaferri, M., Comoglio, M., Fornengo, R., De Cosmo, S., Gentile, F. M., Gigante, A., Mastinu, F., Di Benedetto, A., Pata, P., Arcangeli, A., Orsini, P., Acler, P., De Blasi, G., Cicioni, G., Pocciati, S., Marangoni, A., Nogara, A., Lanero, M., Bertero, M. G., Damassino, R., Bergonzini, C., Schumtz, L., Seksich, L., Pipitone, A., Boaretto, M., Manfroi, I., Parmesan, L., Conte, B., Soccol, F., Pagano, A., Papini, E., Rinaldi, R., Petrucci, L., Graziano, F., Chianelli, M., Silvagni, S., Rosco, M., Ansaldi, E., Malvicino, F., Battezzati, M., Maresca, P., Palenzona, C., Boemi, M., Rabini, R. A., Brandoni, G., Lanari, L., Gatti, C., Testa, I., Cherubini, V., Doveri, G., Pecorelli, L., Ciccarelli, A., Gallardini, M. B., Courthoud, R., Sara Bredy, S., Ricciardi, G. P., Vitalone, G., Setti, D., Contrini, P., Corsi, A., Ghigliotti, V., Oddone, G., Ponzani, P., Valbonesi, G., Mazzini, V., Di Berardino, P., Colleluori, P., Montani, V., Trosini, V., Velussi, M., Alfidi, P., Verdecchia, B., Baliva, L., Di Pietro, A., Franchi, G., Luce, R. P., Pianta, A., Ferrari, M., Balzano, S., Beltranello, G., Dal Fabbro, S., Aricò, C. N., Cervo, L., Zanon, R., Rossa, S., Di Pace, M. C., Ciavarella, A., Giangiulio, S., Grimaldi, M., Mustacchio, A., Santacroce, G., Fattor, B., Monauni, T., Cristini, M., Orion, G., Crazzolara, D., Amor, F., Eisath, J. E., Lintner, S., Garavelli, S., Calari, T., Marini, P., Sandri, O., Scala, M., Stroppa, C., Trentin, A., Carlin, R., Carli, B., Sandonà, M., Zortea, C., Bonet, L., Pradel, L., Reato, S., Buschini, M., Bonfiglioli, D., Mones, D., Beldì, F., Morea, A., Bondesan, L., Perbellini, S., Cimino, A., Valentini, U., Agosti, B., Corsini, R., Girelli, A., Zarra, E., Rocca, L., Bergmann, M., Pradi, I., Unterkircher, S., Piok, M., Pichler, M., Trinchera, A., Palamà, G., Palma, P., Carboni, L., Murtas, M. G., Mudadu, T., Turco, M. P., Floris, M., Delogu, A., Farris, L., Songini, M., Piras, G., Seguro, R., Floris, R., Corona, G., Lai, M., Piras, E., Contini, P. P., Cocco, S., Pilosu, R. M., Sannia, M. C., Spanu, F., Busciantella Ricci, N., Cartechini, M. G., Agostinelli, G., Fiorelli, C., Nuzzi, A., Ballauri, C., Giorda, C. B., Lesina, A., Romeo, F., Giudici, G., Maciejewska, E. G., Deroma, A., Paduano, M., Rossi, L., Vagnini, C., Dolci, M., Mori, M., Baccetti, F., Gregori, G., Straface, E., Pozzuoli, G., Barone, M., Stasio, G. B., Tondini, S., Borgoni, F., Grosso, J., Scarsellato, C., Sciulli, A., De Marco, F., Confortin, L., Marin, N., Lamonica, M., Gialdino, S., Borzì, V., Gatta, C., Rapisard, R., Strano, S., Calabrò, M., Puccio, L., Zolli, M., Coracina, A., Starnone, V., Del Buono, A., Terracciano, A. M., Monda, M. V., Castro, F., Guaglianone, A., Maccari, V., Corsi, L., Versari, G., Falivene, M. R., Boletto, N., Corsi, S., Marafetti, L., Vitacolonna, E., Capani, F., Caputo, L., Di Nisio, L., Simonetti, F., Boscolo Bariga, A., Ballarin, G., De Boni, S., Di Benedetto, S., Chiambretti, A. M., Di Vito, L., Pascuzzo, M. D., Urli, P., Rumi, P., Balzarini, B., Galli, P., Castellan, M., Giannetti, A., Russotti, C., De Blasi, A., Perna, A., Campanelli, C., Ranchelli, A., Biccheri, D., Dadi, G., Massa, L., Baldi, G. P., Sciacca, F., Costanzo, E., Spada, M., Paolini, G., Ziller, P., Portolan, F., Pasolini, G., Ghilardi, G., Fiorina, P., Grata, M. L., Capretti, L., Speroni, G., Fugazza, L., Massafra, C., Lovagnini Scher, A., Cimicchi, M. C., Percudani, C., Risolo, T., Saccò, P., Gidoni Guarnieri, G. L., Piccolo, D., Bravin, C., De Noni, E., Scarpel, M., Marcon, M., Giacon, F., Panebianco, G., Tadiotto, F., Da Tos, V., D'Ambrosio, M., Pellizzola, D., Zampini, M. A., Frezzati, E., Mari, E., Raminelli, E., Gaiti, D., Bosi, E. A., Chierici, G., Pilla, S., Copelli, M., Zanichelli, P., Bertelli, L., Caretta, P., Vezzani, V., Bodecchi, S., Longobucco, A., Di Lembo, S., Spotti, E., Carrai, E., Degli Innocenti, A., Manini, L., Persico, R., Rossi, C., Magro, G., Marelli, G., Vilei, V., Andrioli, M., Bellato, L., Fedeli, M., Merlini, A., Pinelli, G., Marin, G., Contin, M. L., Gallo, A., Parlato, P., Pecchielan, W., Jacovacci, J., Placentino, G., Richini, D., Molinari, S., Strazzeri, R., Fabbri, T., Di Bartolo, P., Garrapa, G., D'Incau, F., Lagomanzini, P., Conte, P., Todesco, F., Foglini, P., Pantanetti, P., Bedetta, C., Maricotti, R., Tomasi, F., Monesi, M., Graziani, R., Beretta, F., Penna, L., Guberti, A., Dazzi, D., Forte, E., Gasbarrone, A., Marrocco, T., Moschetta, R., Tuccinardi, F., De Meo, F., Coppola, A., Pirolozzi, P., Placitelli, E., Vallefuoco, R., Catone, B., Ceschia, S., Urban, M., Fabbri, F., Torresani, M., Crovetto, R., Battistini, M., Carosia, P., Viviani, G. L., Durante, A., Pais, F., Lilliu, V., Quieto, C., D'Ugo, E., Squadrone, M., Amenduni, T., Iovannisci, M. M., Della Penna, L., Potente, F., Delle Donne, T., Massa, C., Ulisse, M. A., De Berardinis, S., Guarnieri, I., Pace, S., Splendiani, M., Di Giuseppe, R., Brunato, B., Assaloni, R., Muraro, R., Loro, R., Bucciol, S., Lavacca, C., Rossi, M., Sabbatini, G., Quadri, F., Sambuco, L., Santacroce, C., Paola Caretta, D., Marino, C., Micheletti, A., Petrelli, A., Corda, A., Pisano, L., Guaita, G., Deias, C., Trevisan, G., Coletti, I., Iannarelli, R., De Luca, A., Minnucci, A., Antenucci, D., Di Florio, C., Angelicola, G., Bosco, A., Fresco, R., Di Marco, G., Ugolotti, D., Cadossi, T., Di Caro, P., Mazzocchetti, M., Buzzetti, R., Leto, G., Gnessi, C., Cipolloni, L., Foffi, C., Moretti, C., Venditti, C., Meniconi, R., Bertoli, S., Cosimi, S., Di Cianni, G., Turco, A., Richini, A., Marconi, S., Sannino, C., Lemmi, P., Giuntoli, S., Manfrè, N., Giannini, F., Di Carlo, A., Casadidio, I., Melandri, P., Maolo, G., Polenta, B., Piccinini, N., Vincenti, C., Pastore, N., Mega, P., Magurano, E., Cananiello, A., Francescutto, C. A., Brussa Toi, E., Gaspardo, G., Angeli, L., Ronchese, L., Sciangula, L., Ciucci, A., Contartese, A., Banfi, E., Castelli, E., Tatti, P., Bloise, D., Di Mauro, P., Masselli, L., Lo Presti, A., Scarpitta, A. M., Gambina, F., Venezia, A., Morea, R., Lagonigro, G., Copeta, G., Iannucci, V., Milano, V., Trupo, M., Lochmann, A., Marchetto, P. E., Incelli, G., De Paola, G., Steiger, M. M., Gamper, M. A., Breitenberger, S., Holzner, M., Frischmann, J., Lambiase, C., Di Vece, T., D'Aniello, M., Fezza, M., Giordano, C., Leo, F., Saitta, G., Cucinotta, D., Di Vieste, G., Pintaudi, B., Mancuso, T., Musacchio, N., Giancaterini, A., Pessina, L., Salis, G., Schivalocchi, F., Testori, G., Rampini, P. A., Cerutti, N., Morpugo, P. S., Cavaletto, M. L., Bonino, G., Morreale, F., Mariani, G., Ragonesi, P. D., Bollati, P., Colapinto, P., Bosi, E., Falqui, L., Bortolato, L., Cosma, A., Pistolato, P., Centenaro, B., Ceccato, A., Campobasso, G., Zaurino, F., Mazzotta, G., Manti, R., Da Ros, R., Carlucci, S., Narduzzi, L., Bortolotto, D., D'Acunto, L., Stanic, L., Volpi, A., Cospite, A. M., Manicardi, V., Michelini, M., Finardi, L., Borghi, F., Manicardi, E., Lombardi, S., Tommasi, C., Iaccarino, M., Cozza, S., Binotto, M., Marini, F., Mecenero, I., Massignani, S., Stecco, P., Urbani, E., Massariol, W., Parolin, R., Gatti, A., Bonavita, M., Creso, E., Giannettino, R., Gobbo, M., Iovine, C., Turco, A. A., Riccardi, G., Iazzetta, N., Giannattasio, C., Egione, O., Galdieri, S., Velotti, A., Azzolina, A., Annicelli, G., Sorrentino, T., Gaeta, I., Zenari, L., Bertolini, L., Sorgato, C., Grippaldi, F., Stroppiana, M., Popolizio, R., Carbone, N., Grasso, S., Abate, S., Gaggero, G. C., Strazzabosco, M., Brun, E., Carlesi, G. P., Garrone, S., Cicalò, A. M., Clausi, C., Cau, R., Manconi, A., Carboni, A., Angius, M. F., Pinna, A. A., Caria, S., Filigheddu, G. D., Tonolo, G., Carta, I., Calebich, S., Burlotti, C., Saglietti, G., Schellino, A., Madau, G., Cossu, M., Mulas, F., Zoccheddu, S., Balsanelli, M., Fetonti, M., Rotolo, A., Sambo, P., Secchi, E., Angotzi, M. A., Loddoni, S., Brundu, I., Careddu, F., Becciu, A., Gabriella Piras, G., Novara, F., Cipro, F., Torchio, G., Palumbo, P., Bianchi, A., Colucci, G., La Motta, G., Tiengo, A., Avogaro, A., Bruttomesso, D., Crepaldi, C., Fadini, G., Guarnieri, G., Lavagnini, M. T., Maran, A., Vedovato, M., De Kreutzenberg, V., Fedele, D., Lapolla, A., Sartore, G., Bax, G., Cardone, C., Dalfrà, M. G., Masin, M., Toniato, R., Piarulli, Francesco, Mattina, G., Fulantelli, M. A., Gioia, D., Conti, M., Ridola, G., D'Agati, F., Grossi, G., De Berardinis, F., Zavaroni, I., Dei Cas, A., Franzini, L., Usberti, E., Antonimi, M., Anelli, N., Poli, R., Ridolfi, V., Michela, M., Haddoub, S., Prampolini, G., Muoio, A., Filippi, D., Bucci, F., Tardio, S. M., Calderini, M. C., Magotti, M. G., Quarantelli, C., Vernazza, M. A., Carolfi, A., Saracca, R., Picchio, E., Del Sindaco, P., Spalluto, A., Maggiulli, L., Torreggiani, V., Rastelletti, S., Ugolini, C., Pucci, N., Magi, S., Muratori, S., La Penna, G., Consoli, A., Galeone, F., Magiar, A. V., Gherardini, V., Moretti, L., Bientinesi, M., Landi, L., Bernardi, A., Del Prato, S., Miccoli, R., Bianchi, C., Penno, G., Venditti, F., Anichini, R., De Bellis, A., Bruschi, T., Butelli, L., Gioffredi, M., Gori, R., Picciafuochi, R., Malagoli, R., Bernini, A., Gelisio, R., Zanon, M., Del Bianco, A., Bamiston, A., Signorato, M., Citro, G., Calabrese, M., Ianni, L., Lorenzetti, M., Marsocci, A., Guizzotti, S., Memoli, G., Cabasino, F., Farci, F., Atzori, A., Sanna, A., Ghiani, M., Siotto, I., Sedda, M., Manis, A., Loddo, C., Loddo, I., Seguro, P., Cuomo, A., Orlando, L., Olanda, G. B., Pucci, A., Massenzo, M., Sardu, C., Perrone, G., Corazziere, F., La Puzza, I., Tripodi, P. F., Riggio, S., Giampaolo, A., Mannino, D., Aleandri, A. R., Guidi, M. V., Battisti, B., Faraglia, M. R., Lilli, V., Leotta, S., Visalli, N., Gagliardi, A., Fontana, L., Altomare, M., Carletti, S., Abbruzzese, S., Chiaramonte, F., Giordano, R., Rossini, M., Migneco, G., Cappelloni, D., Urbani, A., Piergiovanni, F., Fava, D., Simonetta, A., Massimiani, F., Bulzomì, R., Giuliano, M., Pennafina, M. G., Di Perna, P., D'Accinni, M. P., Paolucci, D., D'Ubaldi, A., D'Angelo, M. T., Masaro, G., Pietrantoni, M., Fratini, M., La Rosa, R., Poggi, M., Piccirilli, F., Pisano, R., Saponara, C., Conforti, I., Penza, A., Scalpone, R., Lo Pinto, S., Iacovella, L., Caccamo, C., Sposito, S., Teodonio, C., Restuccia, M. G., Mirto, G., Girardello, R., Gennaro, R., De Moliner, L., Bettini, E., Mattuzzi, A., Speese, K., Frisinghelli, F., Locatelli, F., Nicoletti, M., Trojan, N., Centis, R., L Volsi, P., Levis, E., Zanette, G., Comba, G., Ballatore, L., Cattaneo, A., Aglialoro, A., Guido, R., Patrone, M., Zecchini, M., Vespasiani, G., Meloncelli, I., Clementi, L., Galetta, M., Marconi, V., Bordin, P., Perale, L., Vinci, C., Sira Zanon, M., Geretto, L., Toffolo, C., Furlan, M. G., Mazzanti, G., Vinci, M., Sica, V., Armeni, M., Derai, R., Ennas, O., Mamusa, S., Pisano, M. A., Carreras, L., Rauseo, A., Cervone, S., Leggieri, A., Pontonio, M., Sturaro, R., Quattrocchi, F., Molinaro, M., Trasatti, M., Ferretti, B., Labarile, G., Baule, G. M., Gentilini, A., Spanu, M. A., Fancellu, A., Bianco, P., Lione, L., Massazza, G., Bocchio, G., Bosco, E., Monachesi, M., Carta, G., Boschetti, M., Ceresola, E., Venier, E., Calcaterra, F., Cataldi, F., Miola, M., Manfrini, S., Lai, A., Locci, B., Putzu, D., Tanganelli, I., Leonini, M., Egger, K., Marchiotto, W., Vincis, L., Orlandini, V., Pilloni, C., Farci, R., Pelligra, I., Renier, G., Mameli, M., Pala, A., Devigus, E., Fumagalli, I., Lalli, C., Leandri, M., Agliani, M., De Pascalis, L., Malci, F., De Ciocchis, A., Diodati, M. B., Macerola, B., Davì, S., Caccavale, A., Brocato, L., Pognant Gros, M., Borla, S., Lattanzi, E., Piersanti, C., Piersanti, A., Spinelli, I., Tuzzoli, L., Tulini, V., Quaranta, G., Iorio, V., Tirabovi, M., De Terlizi, Candia, Massarelli, M. G., Venturi, S., Travaglini, A., Draghi, P., Pomante, P., Richiardi, L., Clerico, A., Bruno, A., Cavallo Perin, P., Ghigo, E., Porta, M., Scuntero, P., Arcari, R., Bertaina, S., Bo, S., Broglio, F., Bruno, G., Degiovanni, M., Fornengo, P., Grassi, G., Inglese, V., Maccario, M., Maghenzani, G., Marena, S., Martina, V., Passera, P., Ruiu, G., Tagliabue, M., Zanone, M., Monge, M., Boffano, G. M., Macrì, K., Maio, P., Ozzello, A., Pergolizzi, E., Gaia, D., Gennari, P., Micali, G., Rossetto, E., Dalmazzo, C., Oreglia, M., Stefani, T., Dossena, C., Paglia, P., Bosoni, S., Romanelli, T., Inchiostro, S., Dauriz, M., Bossi, C. A., Meregalli, G., Balini, A., Berzi, D., Filippini, B., Crotto, G., Paccagnella, A., Orrasch, M., Sambataro, M., Citro, T., Kiwanuka, E., Bagolin, E., Almoto, B., Macchia, A., Branca, M. T., Filesi, M., Candido, R., Caroli, E., Manca, E., Petrucco, A., Tommasi, E., Jagodnik, G., Baskar, B., Daris, N., Dal Col, P., Pellegrini, M. A., Tonutti, L., Venturini, G., Andreani, M., Turchi, F., Fedrighelli, F., Martinelli, G., Rongioletti, R., Candidi, M., Pais, M., Moro, E., Cervellino, F., Sinisi, R., Zampino, A., Mingardi, R., Lora, L., Reitano, R., Stocchiero, C., Simoncini, M., Mesturino, C. A., Zen, F., Di Pietro, S., Scoponi, C., Tilaro, L., Pelliccioni, S., Slongo, R., Vita, E., Garofalo, A., Vitale, F., Campanella, B., Mastrilli, V., Borrelli, T., D'Avino, A., Perbellini, A., Mirijello, Antonio, Viazzi, Francesca, Fioretto, Paola, Giorda, Carlo, Ceriello, Antonio, Russo, Giuspina T, Guida, Pietro, Pontremoli, Roberto, and De Cosmo, Salvatore, Giordano, Carla

Subjects
Adult, Male, Nephrology, medicine.medical_specialty, endocrine system diseases, Renal function, 030209 endocrinology & metabolism, 030204 cardiovascular system & hematology, lcsh:RC870-923, Kidney, urologic and male genital diseases, GFR, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, Diabetes mellitus, medicine, Humans, Albuminuria, Diabetic kidney disease, Type 1 diabetes, urogenital system, business.industry, Incidence (epidemiology), Middle Aged, lcsh:Diseases of the genitourinary system. Urology, medicine.disease, female genital diseases and pregnancy complications, Albuminuria, Diabetic kidney disease, GFR, Nephrology, Diabetes Mellitus, Type 1, medicine.anatomical_structure, Italy, Disease Progression, Female, medicine.symptom, business, Research Article, Follow-Up Studies, Glomerular Filtration Rate, Kidney disease
Abstract

Background Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage ≥3 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage ≥3 CKD in a large cohort of patients affected by T1DM. Methods A total of 4284 patients affected by T1DM followed-up at 76 diabetes centers participating to the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD) initiative constitutes the study population. Urinary albumin excretion (ACR) and estimated GFR (eGFR) were retrieved and analyzed. The incidence of stage ≥3 CKD (eGFR 30% from baseline was evaluated. Results The mean estimated GFR was 98 ± 17 mL/min/1.73m2 and the proportion of patients with albuminuria was 15.3% (n = 654) at baseline. About 8% (n = 337) of patients developed one of the two renal endpoints during the 4-year follow-up period. Age, albuminuria (micro or macro) and baseline eGFR 90 ml/min/1.73m2 and normoalbuminuria, those with albuminuria at baseline had a 1.69 greater risk of reaching stage 3 CKD, while patients with mild eGFR reduction (i.e. eGFR between 90 and 60 mL/min/1.73 m2) show a 3.81 greater risk that rose to 8.24 for those patients with albuminuria and mild eGFR reduction at baseline. Conclusions Albuminuria and eGFR reduction represent independent risk factors for incident stage ≥3 CKD in T1DM patients. The simultaneous occurrence of reduced eGFR and albuminuria have a synergistic effect on renal function worsening. Electronic supplementary material The online version of this article (10.1186/s12882-018-1136-6) contains supplementary material, which is available to authorized users.

Published
2018

68. Short-term fasting abolishes the sex-related difference in GH and leptin secretion in humans

Author

MACCARIO, M., AIMARETTI, G., CORNELI, G., GAUNA, C., GROTTOLI, S., BIDLINGMAIER, M., STRASBURGER, C. J., DIEGUEZ, C., CASANUEVA, F. F., and GHIGO, E.

Subjects
Somatotropin -- Physiological aspects, Leptin -- Physiological aspects, Insulin-like growth factor 1 -- Physiological aspects, Glucose metabolism -- Physiological aspects, Fasting -- Physiological aspects, Biological sciences
Abstract

Maccario, M., G. Aimaretti, G. Corneli, C. Gauna, S. Grottoli, M. Bidlingmaier, C. J. Strasburger, C. Dieguez, F. F. Casanueva, and E. Ghigo. Short-term fasting abolishes the sex-related difference in GH and leptin secretion in humans. Am J Physiol Endocrinol Metab 279: E411-E416, 2000.--We studied growth hormone (GH) and leptin secretion in eight male (age 29.3 [+ or -] 1.2 yr, body mass index 22.2 [+ or -] 0.5 kg/[m.sup.2]) and seven female normal subjects (28.0 [+ or -] 0.8 yr, 20.1 [+ or -] 0.7 kg/[m.sup.2]) before and after 36 h of fasting. In the fed state, 8-h mean GH and leptin concentrations were higher in females (P [is less than] 0.05 and P [is less than] 0.0001, respectively). Fasting increased GH and decreased leptin in both sexes. There was significant interaction between gender and fasting (P [is less than] 0.05 for GH and P [is less than] 0.005 for leptin). Females showed a slighter increase in GH but a more marked decrease in leptin, so that there was no significant gender-related difference in GH and leptin after fasting. Fasting did not modify insulin-like growth factor (IGF) I, IGF binding protein (IGFBP)-3, acid-labile subunit, or GH binding protein; increased IGFBP-1 and free fatty acids (P [is less than] 0.0001) but decreased glucose (P [is less than] 0.001) and insulin levels (P [is less than] 0.05). In males, insulin levels were higher (P [is less than] 0.05) in the fed state and underwent deeper reduction after fasting (interaction P [is less than] 0.03). In conclusion, GH and leptin secretions are higher in women than in men in the fed but not in the fasting condition, which abolishes these gender-related differences in humans. gender; insulin-like growth factor I; insulin-like growth factor binding proteins; insulin; glucose

Published
2000

69. The aldosterone-renin ratio based on the plasma renin activity and the direct renin assay for diagnosing aldosterone-producing adenoma

Author

Rossi, G. P., Barisa, M., Belfiore, A., Desideri, G., Ferri, C., Letizia, C., Maccario, M., Morganti, A., Palumbo, G., Patalano, A., Roman, E., Seccia, T. M., Pessina, A. C., Mantero, F., Fabris, Bruno, PAPI study investigators, Rossi, G. P., Barisa, M., Belfiore, A., Desideri, G., Ferri, C., Letizia, C., Maccario, M., Morganti, A., Palumbo, G., Patalano, A., Roman, E., Seccia, T. M., Pessina, A. C., Mantero, F., Fabris, Bruno, and PAPI study, Investigators

Subjects
Adenoma, Adult, Male, medicine.medical_specialty, animal structures, Captopril, Physiology, medicine.drug_class, Secondary hypertension, urologic and male genital diseases, Plasma renin activity, renin assay, chemistry.chemical_compound, Primary aldosteronism, Internal medicine, Renin–angiotensin system, Hyperaldosteronism, Renin, Internal Medicine, medicine, secondary hypertension, Humans, Prospective Studies, Aldosterone, Aged, aldosteronism, aldosterone, business.industry, Reproducibility of Results, Middle Aged, medicine.disease, female genital diseases and pregnancy complications, Endocrinology, chemistry, ROC Curve, Mineralocorticoid, Hypertension, Female, Cardiology and Cardiovascular Medicine, business, hormones, hormone substitutes, and hormone antagonists, Blood Chemical Analysis, circulatory and respiratory physiology, medicine.drug
Abstract

Background The screening for primary aldosteronism is based on the aldosterone–renin ratio calculated with the plasma renin activity (PRA) value as denominator. A direct measurement of active renin (DRA) is being used as an alternative to PRA, but its diagnostic performance remains unclear. Method We, therefore compared, head-to-head, the aldosterone–renin ratio based on PRA with that based on DRA, at baseline and after captopril administration, for identifying aldosterone-producing adenoma (APA) in 251 patients of the Primary Aldosteronism Prevalence in hYpertension Study (PAPY). The area under the receiver operator characteristics curves was used for estimating the accuracy of the aldosterone–renin ratio based on either renin assay for identifying APA and for the comparison between tests. Results The rate of primary aldosteronism was 13.2%; 6.4% of the patients had an APA and 6.8% idiopathic hyperaldosteronism; 218 (86.8%) had primary hypertension. The area under the receiver operator characteristics curve for identifying APA was higher than 0.50 for the aldosterone–renin ratio based on both renin values (0.870W0.058 for DRA and 0.973W0.028 for PRA) (P

Published
2010

70. Within-patient reproducibility of the aldosterone: renin ratio in primary aldosteronism

Author

ANDRONICO, Giuseppe, CERASOLA, Giovanni, Rossi, GP, Seccia, TM, Palumbo, G, Belfiore, A, Bernini, G, Caridi, G, Desideri, G, Fabris, B, Ferri, C, Giacchetti, G, Letizia, C, Maccario, M, Mallamaci, F, Mannelli, M, Patalano, A, Rizzoni, D, Rossi, E, Pessina, AC, Mantero F, Andronico, G, Rossi, GP, Seccia, TM, Palumbo, G, Belfiore, A, Bernini, G, Caridi, G, Desideri, G, Fabris, B, Ferri, C, Giacchetti, G, Letizia, C, Maccario, M, Mallamaci, F, Mannelli, M, Patalano, A, Rizzoni, D, Rossi, E, Pessina, AC, Mantero F, and Cerasola, G

Subjects
Settore MED/09 - Medicina Interna, primary aldosteronism, HYPERTENSION, SCREENING, Settore MED/11 - Malattie Dell'Apparato Cardiovascolare, Settore MED/13 - Endocrinologia
Abstract

The plasma aldosterone concentration:renin ratio (ARR) is widely used for the screening of primary aldosteronism, but its reproducibility is unknown. We, therefore, investigated the within-patient reproducibility of the ARR in a prospective multicenter study of consecutive hypertensive patients referred to specialized centers for hypertension in Italy. After the patients were carefully prepared from the pharmacological standpoint, the ARR was determined at baseline in 1136 patients and repeated after, on average, 4 weeks in the patients who had initially an ARR > or =40 and in 1 of every 4 of those with an ARR

Published
2010

72. Thyroid function and anti-thyroid antibodies in MS patients screened for interferon treatment. A multicenter study

Author

Durelli, L, Oggero, A, Verdun, E, Isoardo, G. L, Barbero, P, Bergamasco, B, Brossa, P. C, Ghigo, E, Maccario, M, Faggiano, F, Inglese, MARIA MATILDE, and Betaferon Safety Trial Study Group

Subjects
Adult, Male, endocrine system, medicine.medical_specialty, Multiple Sclerosis, Adolescent, endocrine system diseases, Thyrotropin, Gastroenterology, Thyroid-stimulating hormone, Risk Factors, Internal medicine, 80 and over, medicine, Humans, Prospective Studies, Aged, Autoantibodies, Subclinical infection, Aged, 80 and over, business.industry, Multiple sclerosis, Thyroid, Odds ratio, Middle Aged, medicine.disease, Thyroid Diseases, Anti-thyroid autoantibodies, Causality, Thyroxine, medicine.anatomical_structure, Neurology, Immunology, Triiodothyronine, Female, Interferons, Neurology (clinical), Thyroid function, business, Hormone
Abstract

Interferon beta (IFNB) treatment for multiple sclerosis (MS) has been associated with thyroid disorders (TD), in particular in patients with subclinical TD or anti-thyroid (AT) autoantibodies (autoAb) before starting treatment. TD and AT autoAb frequency was reported increased in MS. To determine whether MS patients have subclinical thyroid function abnormalities or anti-thyroid autoimmunity predisposing to develop TD, we performed a prospective multicenter screening of thyroid function and autoimmunity in 152 relapsing-remitting (RR) MS patients selected to receive IFNB treatment and in 437 healthy normothyroidal controls. Thyroid-related hormones and anti-thyroid microsomal antigen (anti-TMA) autoAb were tested with sensitive immunoradiometric or chromatographic assays. Cases were stratified for different progressively decreasing or increasing cutoff values of thyroid-stimulating hormone (TSH) (0.3, 0.2, 0.1, 3 and 5 mIU/l), and odds ratios (OR) with 95% confidence intervals (CI) calculated using logistic regression adjusted for gender, age, and anti-TMA autoAb positivity. The frequency of cases below or above the TSH cutoff values was not significantly different in MS patients and controls, and the risk to have an abnormal TSH level was not significantly increased in MS patients (OR ranging 0.37-0.84; CI, 0.05-3.01), even if anti-TMA autoAb positive (OR ranging 0.35-0.85; CI, 0.04-3.00). Frequencies of subclinical hypothyroidism and of anti-TMA autoAb positivity were, however, trending higher in MS men (ranging 5-7%) than in controls (3%). MS patients do not have an increased risk of subtle thyroid function abnormalities, subclinical TD, or anti-TMA autoAb positivity that may predispose to develop thyroid dysfunction during IFNB treatment. The positive trend for subclinical hypothyroidism and anti-TMA autoAb positivity, however, advises a longitudinal study of thyroid function and autoimmunity during IFNB treatment to see whether patients with baseline subclinical thyroid dysfunction develop clinically significant alteration during treatment.

Published
2001
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73. Body mass index predicts plasma aldosterone concentrations in overweight-obese primary hypertensive patients

Author

Rossi, Gp, Belfiore, A, Bernini, Giampaolo, Desideri, G, Fabris, B, Caridi, G, Ferri, C, Giacchetti, G, Letizia, C, Maccario, M, Mannelli, M, Palumbo, G, Patalano, A, Rizzoni, D, Rossi, E, Pessina, Ac, Mantero, F, FOR THE PAPY STUDY INVESTIGATORS, Rossi, G. P., Belfiore, A., Bernini, G., Fabris, Bruno, Caridi, G., Ferri, C., Giacchetti, G., Letizia, C., Maccario, M., Mannelli, M., Palumbo, G., Patalano, A., Rizzoni, D., Rossi, E., Pessina, A. C., and Mantero F., Primary Aldosteronism Prevalence In Hypertension Study Investigators

Subjects
Male, medicine.medical_specialty, medicine.drug_class, Endocrinology, Diabetes and Metabolism, Clinical Biochemistry, Context (language use), Essential hypertension, Biochemistry, Plasma renin activity, Body Mass Index, chemistry.chemical_compound, Endocrinology, Primary aldosteronism, Obesity, overweight, aldosterone, essential hypertension, Internal medicine, Renin, medicine, Humans, Prospective Studies, Aldosterone, business.industry, Biochemistry (medical), Captopril, Middle Aged, Overweight, medicine.disease, chemistry, Mineralocorticoid, Hypertension, Female, business, Body mass index, medicine.drug
Abstract

CONTEXT: Body mass index (BMI) shows a direct correlation with plasma aldosterone concentration (PAC) and urinary aldosterone excretion in normotensive individuals; whether the same applies to hypertensive patients is unknown. OBJECTIVE: Our objective was to determine if BMI predicts PAC and the PAC/plasma renin activity ratio [aldosterone renin ratio (ARR)] in hypertensive patients, and if this affects the identification of primary aldosteronism (PA). DESIGN: This was a prospective evaluation of consecutive hypertensive patients referred nationwide to specialized hypertension centers. MAIN OUTCOME MEASURES: Sitting PAC, plasma renin activity, and the ARR, baseline and after 50 mg captopril orally with concomitant assessment of parameters, including BMI and daily sodium intake, were calculated. RESULTS: Complete biochemical data and a definite diagnosis were obtained in 1125 consecutive patients. Of them 999 had primary (essential) hypertension (PH) and 126 (11.2%) PA caused by an aldosterone-producing adenoma in 54 (4.8%). BMI independently predicted PAC (beta = 0.153; P < 0.0001) in PH, particularly in the overweight-obese, but not in the PA group. Covariance analysis and formal comparison of the raw, and the BMI-, sex-, and sodium intake-adjusted ARR with receiver operator characteristic curves, showed no significant improvement for the discrimination of aldosterone-producing adenoma from PH patients with covariate-adjusted ARR. CONCLUSIONS: BMI correlated with PAC independent of age, sex, and sodium intake in PH, but not in PA patients. This association of BMI is particularly evident in overweight-obese PH patients, and suggests a pathophysiological link between visceral adiposity and aldosterone secretion. However, it does not impact on the diagnostic accuracy of the ARR for discriminating PA from PH patients.

Published
2008

74. Analysis of risk factors for surgical wound infections following vascular surgery

Author

Richet, H.M., Chidiac, C., Prat, A., Pol, A., David, M., Maccario, M., Cormier, P., Bernard, E., and Jarvis, W.R.

Subjects
Surgical wound infections -- Risk factors, Blood vessels, Surgery -- Complications, Surgical wound infections -- Prevention, Health, Health care industry
Abstract

Although surgical wound infections (SWI) following implantation of prosthetic devices can be catastrophic and often require removal of the prosthesis, few studies have identified risk factors for these infections. We conducted a prospective multicenter study to identify risk factors for SWI. Of 561 vascular surgery patients enrolled in the study, 23 (4.1%) developed SWI. Multivariate analysis using logistic regression analyses identified surgery on lower extremities, delayed surgery, diabetes mellitus, past history of vascular surgery, and short antimicrobial prophylaxis (three doses of cefamandole) as independent risk factors for SWI. Consequences of SWI were serious; two (9%) died, 11 (48%) required reoperation, and five (22%) had their prosthesis removed. A risk index was developed using the independent risk factors for SWI identified by logistic regression analyses. When no risk factors were present, no SWI was observed (0 of 100), and the rate of SWI increased from 2.5% when one risk factor was present to 53.8% (7 of 13) when [is greater than or equal to] 4 risk factors were present., Surgical wound infections (SWI) are those that develop at the site were the surgery was performed. They are not very common following vascular surgery (surgery performed on blood vessels), but when they do occur they can result in death in 30 to 50 percent of the cases. This article describes the results of a study designed to identify risk factors for SWI in patients undergoing vascular surgery. The study included 561 patients from four different hospitals. The most common postoperative infections were urinary tract infections, SWI and lower respiratory tract infections. The incidence of SWI varied among the four different hospitals and ranged from 2 to 6 percent for all types of vascular surgery, and from 3 percent to 8 percent for vascular surgery performed on the legs and feet. Of the patients who developed SWI, 9 percent died, 22 percent had to have their prosthetic devices removed, and 48 percent had to have additional surgery. Risk factors that increase the likelihood of SWI include vascular surgery on the lower extremities, insulin-dependent diabetes, prior vascular surgery, delay in performing the surgery, and short-term treatment with antibiotics (three doses of cefamandole). The results of this study indicate that most of the risk factors for SWI in vascular surgery patients cannot be modified. Therefore, special precautions should be taken to identify and provide proper preventive treatment for patients with the greatest risk for SWI. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1991

75. Comparison of the captopril and the saline infusion test for excluding aldosterone-producing adenoma

Author

Rossi, Gp, Belfiore, A, Bernini, Giampaolo, Desideri, G, Fabris, B, Ferri, C, Giacchetti, G, Letizia, C, Maccario, M, Mallamaci, F, Mannelli, M, Palombo, G, Rizzoni, D, Rossi, E, AGABITI ROSEI, E, Pessina, Ac, Mantero, F, FOR THE PAPY STUDY INVESTIGATORS, Rossi, G. P., Belfiore, A., Bernini, G., Desideri, G., Fabris, Bruno, Ferri, C., Giacchetti, G., Letizia, C., Maccario, M., Mallamaci, F., Mannelli, M., Palumbo, G., Rizzoni, D., Rossi, E., Agabiti Rosei, E., Pessina, A. C., Mantero, F., and Primary Aldosteronism Prevalence In Italy Study, Investigators

Subjects
Male, Captopril, diagnosis, secondary hypertension, aldosterone, aldosteronism, clinical science, secondary, Secondary hypertension, Primary hyperaldosteronism, multiple tests, Sodium Chloride, chemistry.chemical_compound, Primary aldosteronism, Analysis of Variance Captopril/diagnostic use, Prospective Studies, Infusions, Intravenous, Aldosterone, Adrenocortical Adenoma, Captopril challenge test, Female, Intravenous, Adrenocortical Adenoma/diagnosis, medicine.drug, Infusions, medicine.medical_specialty, Adenoma, medicine.drug_class, Urology, Sensitivity and Specificity, Diagnosis, Differential, Internal medicine, Hyperaldosteronism, Adrenal Cortex Neoplasms/diagnosis, Diagnosis, Differential, Hyperaldosteronism/diagnosis, Probability, Sodium Chloride/diagnostic use, Internal Medicine, medicine, Humans, Analysis of Variance, business.industry, medicine.disease, Adrenal Cortex Neoplasms, Endocrinology, chemistry, Mineralocorticoid, ACE inhibitor, business
Abstract

We performed a prospective head-to-head comparison of the accuracy of the captopril test (CAPT) and the saline infusion test (SAL) for confirming primary aldosteronism due to an aldosterone-producing adenoma (APA) in patients with different sodium intake. A total of 317 (26.9%) of the 1125 patients screened in the Primary Aldosteronism Prevalence in Italy Study underwent both CAPT and SAL. They were composed of the patients with a high aldosterone/renin ratio baseline and 1 every 4 patients without such criterion. The accuracy of post-CAPT or post-SAL plasma aldosterone values for diagnosing APA was estimated with the area under the receiver operator characteristics curves. Primary aldosteronism was found in 120 patients, of which 46 had an APA. No untoward effect occurred with either test. The area under the receiver operator characteristics curve of plasma aldosterone for both tests was higher ( P P =0.054). The optimal aldosterone cutoff value for identifying APA was 13.9 and 6.75 ng/dL for the CAPT and SAL, respectively. Even at these cutoffs, sensitivity and specificity were moderate because of overlap of values between patients with and without APA. When examined in relation to sodium intake, the accuracy of the SAL surpassed that of the CAPT in the patients with a sodium intake ≤130 mEq per day; this difference waned at a higher Na + intake. Thus, both the CAPT and the SAL are safe and moderately accurate for excluding APA; at a sodium intake >7.6 g per day, the SAL offers no advantage over the easier-to-perform CAPT.

Published
2007

76. Prospective evaluation of the saline infusion test for excluding primary aldosteronism due to aldosterone-producing adenoma

Author

Rossi, Gp, Belfiore, A, Bernini, G, Desideri, Giovambattista, Fabris, B, Ferri, Claudio, Giacchetti, G, Letizia, C, Maccario, M, Mallamaci, F, Mannelli, M, Montemurro, D, Palumbo, G, Rizzoni, D, Rossi, E, Semplicini, A, AGABITI ROSEI, E, Pessina, Ac, Mantero, F, Papy, Study, Investigators, Rossi, Gp, Belfiore, A, Bernini, G, Desideri, G, Fabris, Bruno, Ferri, C, Giacchetti, G, Letizia, C, Maccario, M, Mallamaci, F, Mannelli, M, Montemurro, D, Palumbo, G, Rizzoni, D, Rossi, E, Semplicini, A, AGABITI ROSEI, E, Pessina, Ac, and Mantero, F.

Subjects
Adenoma, medicine.medical_specialty, Hydrocortisone, Physiology, medicine.drug_class, Urology, Adrenal Gland Neoplasms, Secondary hypertension, Sodium Chloride, Diagnosis, Differential, chemistry.chemical_compound, Primary aldosteronism, Internal medicine, Hyperaldosteronism, Renin, Internal Medicine, Medicine, Humans, Prospective Studies, Prospective cohort study, Infusions, Intravenous, Aldosterone, Aldosteronism, business.industry, Reproducibility of Results, Middle Aged, medicine.disease, Endocrinology, chemistry, ROC Curve, Mineralocorticoid, Hypertension, Differential diagnosis, Cardiology and Cardiovascular Medicine, business
Abstract

BACKGROUND: Data on the performance of the tests used to confirm the diagnosis of primary aldosteronism (PA) are limited. OBJECTIVE: To prospectively investigate the accuracy of the saline infusion test (SIT). METHODS: Three hundred and seventeen (26.9%) out of 1125 patients screened in the PAPY study underwent measurement of plasma aldosterone, cortisol and renin activity after infusion of 2 l of isotonic saline intravenously over 4 h. They comprised patients with a baseline aldosterone/renin ratio (ARR) > 40 and one every four patients not fulfilling such criterion. The area under the receiver-operator characteristic curves (AUC) of aldosterone values after SIT was used as a measure of accuracy for diagnosing PA, aldosterone-producing adenoma (APA) or idiopathic hyperaldosteronism (IHA). RESULTS: One hundred and twenty (37.9%) patients had PA that was due to an APA in 46 (38.3%) and to IHA in 74 (61.7%). No untoward effect occurred with the SIT. The AUC (0.811 ± 0.026, 0.878 ± 0.040 and 0.784 ± 0.034 for identification of PA, APA and IHA, respectively) was higher (P < 0.0001) than that under the diagonal. By sensitivity/specificity versus criterion values plot, the best aldosterone cut-off values for identifying APA and IHA were 6.75 and 6.91 ng/dl, respectively. However, even at these optimal cut-offs, sensitivity and specificity were moderate because of values overlapping between patients with and without the disease. Moreover, there were no differences of AUC and aldosterone cut-offs between APA and IHA. CONCLUSION: In a multicenter study the SIT was safe and specific for excluding PA, but had no place for discriminating between an APA and IHA.

Published
2007

80. The study of spontaneous GH secretion after 36-h fasting distinguishes between GH-deficient and normal adults

Author

Aimaretti G, Corneli G, MacCario M, Morrison K, Pflaum CD, Strasburger CJ, Ghigo E., COLAO, ANNAMARIA, PIVONELLO, ROSARIO, LOMBARDI, GAETANO, Aimaretti, G, Colao, Annamaria, Corneli, G, Pivonello, Rosario, Maccario, M, Morrison, K, Pflaum, Cd, Strasburger, Cj, Lombardi, Gaetano, and Ghigo, E.

Subjects
GH deficiency, Adult, Blood Glucose, Male, GH secretion, Fasting, Fatty Acids, Nonesterified, Hypopituitarism, Statistics, Nonparametric, Diagnosis, Differential, Insulin-Like Growth Factor Binding Protein 1, Insulin-Like Growth Factor Binding Protein 3, Case-Control Studies, Growth Hormone, Humans, Insulin, Female, Insulin-Like Growth Factor I, Carrier Proteins, Glycoproteins
Abstract

OBJECTIVE: Within an appropriate clinical context, GH deficiency (GHD) in adults can only be diagnosed biochemically by provocative testing. The evaluation of IGF-I, IGFBP-3 and even of spontaneous GH secretion do not establish the diagnosis of adult GHD. In fact, remarkable overlaps between normal and GHD adults have been reported for all these parameters. On the other hand, it is well known that even short-term fasting stimulates GH secretion in normal subjects. The aim of our study was to determine the effects of 36 h fasting on 8-h diurnal GH, insulin and glucose levels as well as on basal IGF-I, IGFBP-3, acid-labile subunit (ALS), IGFBP-1, GHBP and free fatty acid (FFA) levels. SUBJECTS: We studied 9 GHD adults (GHD, 8 males, 1 female; age, mean +/- SEM: 37.6 +/- 2.3 years, body mass index (BMI): 24.5 +/- 1.0 kg/m2) and 20 age-matched normal subjects (NS) as controls (13 males, 7 females; age: 28.9 +/- 0.6 years, BMI: 21.6 +/- 0.4 kg/m2). STUDY DESIGN: In all subjects we studied the effects of 36 h fasting on 8-h daytime GH, insulin and glucose levels (assay every 30 min from 0800 h to 1600 h) as well as on basal IGF-I, IGFBP-3, ALS, IGFBP-1, GHBP and FFA levels. RESULTS: Before fasting, basal mean IGF-I, IGFBP-3 and ALS levels in GHD were lower (P < 0. 0001) than in NS. IGFBP-1, GHBP and FFA levels were similar in both groups. Before fasting mean GH concentration (mGHc) in GHD was lower (P < 0.05) than in NS (0.4 +/- 0.2 vs. 2.2 +/- 0.6 mu/l) but with a clear overlap between the 2 groups (range 0.4-0.8 vs. 0.4-6.8 mu/l). After fasting, both in GHD and NS basal IGF-I, IGFBP-3, ALS and GHBP levels did not change significantly. On the other hand, in both GHD and in NS IGFBP-1 was increased (P < 0.0001) to a similar extent, while FFA increased in NS more (P < 0.01) than in GHD. Fasting significantly increased mGHc in NS (12.0 +/- 1.2 mu/l, P < 0.0001) but not in GHD (0.6 +/- 0.2 mu/l). After fasting, no overlap was present between GHD and NS (0.4-1.6 vs. 2.4-20.8 mu/l, respectively). Mean glucose and insulin concentrations over 8 h in GHD and NS in basal conditions were similar and were reduced to the same extent in both groups. CONCLUSIONS: Our findings demonstrate that after short-term fasting, the study of spontaneous GH secretion distinguishes between GH-deficient adults and normal subjects; this phenomenon occurs before significant changes in IGF-I and IGFBP-3 levels. These results suggest that the assessment of spontaneous GH secretion could be useful for the diagnosis of adult GH deficiency only after short-term fasting.

Published
1999

81. LB02.08

Author

Caprino, M. Parasiliti, primary, Lucatello, B., additional, Bima, C., additional, D’Angelo, V., additional, Burrello, J., additional, Piovesan, A., additional, La Grotta, A., additional, Giordano, R., additional, Mulatero, P., additional, Veglio, F., additional, Arvat, E., additional, Ghigo, E., additional, and Maccario, M., additional

Published
2015
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82. 9B.01

Author

Monticone, S., primary, Satoh, F., additional, Viola, A., additional, Fischer, E., additional, Vonend, O., additional, Bernini, G., additional, Quinkler, M., additional, Ronconi, V., additional, Morimoto, R., additional, Kudo, M., additional, Degenhart, C., additional, Gao, X., additional, Willenberg, H.S., additional, Riester, A., additional, Maccario, M., additional, Giacchetti, G., additional, Veglio, F., additional, Ito, S., additional, Reincke, M., additional, and Mulatero, P., additional

Published
2015
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89. Identifying patients at risk for microalbuminuria via interaction of the components of the metabolic syndrome: a cross-sectional analytic study

Author

Gentile, L., Cichero, P., Di Berardino, P., Di Petta, C., Montani, V., Poli, M., Grosso, J., De Marco, F., Perticone, F., Mattace, A., Vatrano, M., Ventura, G., Sprovieri, M., Spagnuolo, V., Mastropasqua, A., Marenco, P., Caruso, M., D’Ugo, E., Squadrone, M. R., Pupillo, M., Minnucci, A., De Luca, A., Tagliaferri, M., Vitale, C., Sciangula, L., Banfi, E., Cucinotta, D., Dibenedetto, A., Previti, M., Tiengo, A., Avogaro, A., Bettio, M., Dekreuzenberg, S., Galluzzo, A., Camilleri, C., Merlino, S., Sinagra, D., Provenzano, V., Fleres, M., Carnovali, M., Crespi, E., Sommariva, M., Vecchio, C., Consoli, A., Ciccarone, E., Devangelio, E., Formoso, G., Taraborrelli, M., Seghieri, G., Alviggi, L., Bardini, G., De Bellis, A., Porro, T., Bianchi, A., Dagani, R., Di Battista, R., Ferrario, A., Ottaviano, R., Gambardella, S., Bracaglia, D., Testa, G., Mancini, A., Giannini, D., Monesi, G., Mollo, F., Osti, M., Di Michele, D., Lattanzi, E., Piersanti, C., Ghigo, E., Camanni, F., Destefanis, S., Gaia, D., Gasco, V., Maccario, M., Carretta, R., Fiammengo, F., Gerloni, R., Macaluso, L., Donnini, P., Alvaro, S., Ambrosio, G. B., Leprotti, C., Moro, E., Pais, M., Pianetti, S., Garbin, A., Frascone, V., Marmo, P., Munari, G. F., Cataldi, B., Filiani, M. L., Ursini, G., Augello, M., Tassan, P., Giraldi, D., Berarducci, G., Braggion, M., Novelletto, B. F., Dell’Orco, R. L., Baj, A., Pardo, S., Persia, M., Bellini, F., Nistico, F., Rossi, C. L., Quinzii, G., Ferrigato, A., Zaramella, M. L., Crisante, E., Biundo, G., Serughetti, G., Sofra, D., Trono, L., Arduino, G., Chiappetta, S., Novarese, I., Monari, M., Cappello, I., Lipari, L., Bersani, G. P., Marcomini, G., Felici, M. G., Bragiotto, A., Felice, L., Caberletti, I., Vergani, P., Orecchia, E., Ferracin, F., Cavallo, G., Giardina, L., Felloni, L., Cesarone, L., Albanese, V., Bizzozero, L., Cerati, C., Mauri, L., Ratti, C., Alecci, U., Alibrando, A., Forastiere, G., Petrella, G., Di Mattia, Q., Grimaldi, N., Olivieri, I., Cardella, M. C., Duren, B., Falzone, A., Furlan, G., Nesladek, N., Novel, N., Pasquariello, M., Russo, M., Veglia, D., Fusello, M., Baldi, C., Seller, R., Tosi, G., Barberio, S., Tonon, R., Cardinale, G., Lombardo, F. P., Magliozzo, F., Merlino, G., Merlino, N., Quartetti, G., Bolognese, F., Baglieri, S., Giarrusso, P., Speciale, S., Buffone, M., Di Domizio, O., Panzieri, F., Perfetto, G., Granati, A., Lattari, P. R., Potenti, P. G., Quattrocchi, M., Vannucci, R., Daddi, L., Dallatorre, G., Guido, G. P., Orlando, F., Santoro, A., Zagni, R., Genova, O., Alaimo, A., Canfora, M., Cappelli, C., Caracciolo, F., Casimirri, R., Crestini, A. M., Daniele, G., De Lucia, L., Demarchis, A., Di Masi, A., Di Rosa, F., Filabozzi, A., Levati, M., Lucente, A., Manzo, G., Marchionne, M., Marino, G. A., Paolini, E., Quaresima, M., Scala, P., Scotto, M., Scotto, R., Simeoni, A., Chieregato, G., Sparesato, S., Cavallo, E., Ceglia, G., Chiarini, T., Visentini, E., Sammarone, R., Di Giambattista, P., Fumagalli, M. A., Milanese, F., Santoro, L., Giusti, P., Nafra, G., Romito, G., Balsamo, R., Rinaldi, M., Biondo, F., Consiglio, G., Arbore, G., Garione, I., Merlini, C., Pizzini, A., Titta, G., Vitali, S., Rotondo, G., Berardi, A., Castellani, G., Cova, L. V., Lamberti, C., Granzotto, S., Mazzi, P. A., Bergamasco, G., Autiero, V., and L. Ghiraldelli.

Subjects
Male, medicine.medical_specialty, Multivariate analysis, endocrine system diseases, Epidemiology, Population, urologic and male genital diseases, Critical Care and Intensive Care Medicine, Impaired glucose tolerance, Insulin resistance, Risk Factors, Diabetes mellitus, Internal medicine, medicine, Albuminuria, Humans, education, Aged, Metabolic Syndrome, Transplantation, education.field_of_study, business.industry, nutritional and metabolic diseases, Middle Aged, medicine.disease, female genital diseases and pregnancy complications, Endocrinology, Cross-Sectional Studies, Nephrology, Homogeneous, Microalbuminuria, Female, Metabolic syndrome, business
Abstract

The objective of this study was to investigate correlates of risk for having microalbuminuria in individuals with one or more cardiovascular risk factors.The study involved 1919 individuals who attended general practice settings, were aged 55 to 75 yr, and did not have a history of cardiovascular events or diabetes but had one or more cardiovascular risk factors. A tree-based regression technique and multivariate analysis were used to identify distinct, homogeneous subgroups of patients with different likelihood of having microalbuminuria; interaction between correlates of microalbuminuria and risk for microalbuminuria was also investigated.The prevalence of microalbuminuria was 5.9%. Patients who did not have hypertension and had postload glycemia140 mg/dl showed the lowest prevalence of microalbuminuria (1.9%) and represented the reference class. The likelihood of microalbuminuria was seven times higher in men with hypertension and homeostatic model assessment levels in the upper tertile and four times higher in women with the same characteristics. Individuals with hypertension and lower homeostatic model assessment levels and normotensive individuals with postload glycemiaor = 140 mg/dl had a more than three-fold increased likelihood of having microalbuminuria. Treatment with statins was associated with a 54% reduction in the likelihood of having microalbuminuria, whereas levels of triglycerides150 mg/dl and fibrinogen levels in the upper tertile were associated with a significantly higher risk for microalbuminuria.The likelihood of having microalbuminuria in a population-based study of elderly individuals is strongly related to the interaction between the components of the metabolic syndrome, particularly hypertension, insulin resistance, and impaired glucose tolerance.

Published
2007

92. Renal damage in primary aldosteronism: results of the PAPY Study

Author

Rossi, Gianpaolo, Bernini, G, Caliumi, C, Desideri, G, Fabris, B, Ferri, C, Ganzaroli, C, Giacchetti, G, Letizia, C, Maccario, M, Mallamaci, F, Mannelli, M, Mattarello, Mj, Moretti, A, Palumbo, G, Parenti, G, Porteri, E, Semplicini, A, Rizzoni, D, Rossi, E, Boscaro, Marco, Pessina, Ac, Mantero, Franco, and PAPY STUDY INVESTIGATORS

Published
2006

93. Renal damage in primary aldosteronism: results of the PAPY Study

Author

Rossi, Gp, Bernini, G, Desideri, G, Fabris, B, Ferri, C, Giacchetti, G, Letizia, C, Maccario, M, Mannelli, M, Matterello, Mj, Montemurro, D, Palumbo, G, Rizzoni, Damiano, Rossi, E, Pessina, Ac, Mantero, F, PAPY STUDY PARTICIPANTS, Rossi, Gian Paolo, Bernini, Giampaolo, Desideri, Giovambattista, Fabris, Bruno, Ferri, Claudio, Giacchetti, Gilberta, Letizia, Claudio, Maccario, Mauro, Mannelli, Massimo, Matterello, Mee Jung, Montemurro, Domenico, Palumbo, Gaetana, Rizzoni, Damiano, Rossi, Ermanno, Pessina, Achille Cesare, and Mantero, Franco

Subjects
Nephrology, Secondary hypertension, Blood Pressure, Comorbidity, Kidney Function Tests, Muscle hypertrophy, Cohort Studies, chemistry.chemical_compound, Primary aldosteronism, Fibrosis, Renin, Prevalence, mineralocorticoid, Prospective Studies, Kidney, education.field_of_study, Aldosterone, adrenal gland, aldosterone, hypertension, endocrine, hypertrophy, kidney, mineralocorticoids, Middle Aged, Hyperaldosteronism, Causality, medicine.anatomical_structure, Italy, Creatinine, endocrine hypertension, Cardiology, Kidney Diseases, Glomerular Filtration Rate, medicine.medical_specialty, Population, Urology, Renal function, Predictive Value of Tests, Internal medicine, Internal Medicine, medicine, Albuminuria, Humans, education, business.industry, medicine.disease, Endocrinology, Blood pressure, chemistry, Potassium, Microalbuminuria, business, Biomarkers, Kidney disease
Abstract

Introduction: Several studies have now revealed the direct deleterious effects of excess aldosterone, especially in cardiovascular disease, independent of the usual effect of aldosterone on electrolyte transport [1,2]. These new pathologic findings appear to be direct effects of aldosterone on cardiovascular and other tissues, leading to tissue remodeling and fibrosis. Interestingly, very little attention has been directed toward the kidney and renal damage in primary aldosteronism (PA). In fact, only two publications from the same institution have examined renal function in PA in a limited approach, noting early microalbuminuria when compared to subjects with primary hypertension (PH) [3,4]. In general, studies of renal pathology in PA are lacking. This omission is quite surprising for a disease involving often severe hypertension, and given the new information on the direct effects of aldosterone on tissue fibrosis [5]. Recent knowledge holds that PA is a much more frequent cause of secondary hypertension than previously thought, being as high as 12% of all the hypertensive population, thus involving millions of individuals in the world, further increasing the demand for world organization of screening and evaluation protocols and high-standard special centers [6]. Further information on PA and renal function is mandatory, especially with the newer screening tests to monitor progression of chronic kidney disease (CKD) and the renoprotective features indicating that PA be part of the new tests in nephrology, such as urinary albumin excretion (UAE) and estimated glomerular filtration rate (GFR). The Primary Aldosteronism Prevalence in Italy (PAPY) study is a prospective survey of 1180 consecutive newly diagnosed hypertensive patients referred to specialized hypertension centers in Italy to detect the prevalence of PA and intensely study several of its characteristic features [7]. In this study, 490 subjects were deemed justified for an intensified evaluation for PA, aldosterone-producing adenomas (APA) were found in 4.8% of subjects, and idiopathic hyperaldosteronism (IHA) in 6.4%, for a total incidence of PA of 11.2% in the Italian hypertensive population [7]. The main feature examined for renal function was the UAE, but previous renal function studies also showed serum and urine hyperfiltration and increased microalbuminuria in PA; however, these studies were limited by size and the fact that they studied only patients with APA. As is also well known, increased UAE is a key determinant for cardiovascular damage and endothelial dysfunction in high-risk patients. Thus, UAE would also serve an important role in patients with PA as a marker of their overall cardiovascular burden.

Published
2006

99. Use of the Diabetes Risk Score for Opportunistic Screening of Undiagnosed Diabetes and Impaired Glucose Tolerance: The IGLOO (Impaired Glucose Tolerance and Long-Term Outcomes Observational) study

Author

Muggeo, M., Caimi, V., Capani, F., Cucinotta, D., Grimaldi, N., Montanari, P., Mocarelli, P., Signorini, S., Dinardo, B., Ferrari, S., Piaggione, M., Gentile, L., Cichero, P., Di Berardino, P., Di Petta, C., Montani, V., Poli, M., Grosso, J., De Marco, F., Perticone, F., Mattace, A., Vatrano, M., Ventura, G., Sprovieri, M., Spagnuolo, V., Mastropasqua, A., Marenco, P., D’Ugo, E., Squadrone, M. R., Pupillo, M., De Luca, A., Mennucci, A., Tagliaferri, M., Vitale, C., Sciangula, L., Banfi, E., Di Benedetto, A., Previti, M., Tiengo, A., Avogaro, A., Bettio, De Kreuzenberg, S., Galluzzo, A., Camilleri, C., Merlino, S., Sinagra, D., Provenzano, V., Fleres, M., Spano, L., Carnovali, M., Crespi, E., Sommariva, M., Vecchio, C., Consoli, A., Ciccarone, E., Devangelio, E., Formoso, G., Seghieri, G., Alviggi, L., Bardini, G., De Bellis, A., Porro, T., Bianchi, A., Dagani, R., Di Battista, R., Ferrario, Gambardella, S., Bracaglia, D., Testa, G., Giannini, D., Mancini, A., Monesi, G., Mollo, F., Osti, M., Di Michele, D., Lattanzi, E., Piersanti, C., Ghigo, E., Camanni, F., Destefanis, S., Gaia, D., Gasco, V., Maccario, M., Carretta, R., Fiammengo, F., Gerloni, R., Macaluso, L., Donnini, P., Alvaro, S., Ambrosio, G. B., Leprotti, C., Moro, E., Pais, M., Pianetti, S., Garbin, A., Frascone, V., Marmo, P., Munari, G. F., Cataldi, B., Ursini, G., Augello, M., Braggion, M., Baj, A., Persia, M., Nistico’, F., Rossi, C. L., Quinzii, G., Ferrigato, A., Zaramella, M. L., Serughetti, G., Sofra, D., Arduino, G., Chiappetta, S., Novarese, I., Monari, M., Cappello, I., Lipari, L., Marcomini, G., Felice, L., Caberletti, I., Vergani, P., Orecchia, E., Ferracin, F., Cavallo, G., Giardina, L., Felloni, L., Cesarone, L., Bizzozero, L., Ratti, C., Alecci, U., Marino, S., Forastiere, G., Petrella, G., Olivieri, I., Cardella, M. C., Duren, B., Furlan, G., Novel, N., Pasquariello, M., Russo, M., Baldi, C., Seller, R., Tosi, G., Barberio, S., Cardinale, G., Lombardo, F. P., Magliozzo, F., Merlino, G., Merlino, N., Quartetti, G., Bolognese, F., Baglieri, S., Speciale, S., Buffone, M., Di Domizio, O., Panzieri, F., Perfetto, G., Potenti, P. G., Quattrocchi, M., Vannucci, R., Daddi, L., Guido, G. P., Orlando, F., Santoro, A., Zagni, R., Canfora, M., Cappelli, C., Caracciolo, F., Casimirri, R., Crestini, A. M., De Marchis, A., Di Masi, A., Lucente, A., Manzo, G., Marchionne, M., Marino, G. A., Paolini, E., Scala, P., Scotto, M., Scotto, R., Simeoni, A., Chieregato, G., Cavallo, E., Ceglia, G., Chiarini, T., Visentini, E., Sammarone, R., Fumagalli, M. A., Milanese, F., Giusti, P., Balsamo, R., Rinaldi, M., Biondo, F., Consiglio, G., Garione, I., Merlini, C., Pizzini, A., Titta, G., Vitali, S., Rotondo, G., Cova, L. V., Lamberti, C., Granzotto, S., Mazzi, P. A., and Ghiraldelli, L.

Published
2005

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