PubMed Health⌕ Search

Biomedical subjects

A Capurso

Publications and source records attributed to A Capurso.

At least 37 records · Page 2Linked to original sources
PubMed2000

[Age-related cognitive decline: evaluation and prevention strategy].

The age-related decline of cognitive functions generally refers to a mild deterioration in memory performance, executive functions, and speed of cognitive processing. The terms "age-related cognitive decline" (ARCD) and "aging-associated cognitive decline" have been proposed recently to indicate an objective decline in cognitive functioning associated to the ageing process but within normal limits given the person's age. Whether ARCD is expression of a normal ageing process or represents a distinct clinical entity or, eventually, is a continuum with dementia is, at present, difficult to establish. The causes of ARCD are unknown, but some studies have suggested that it may be prevented. Avoidance of cardiovascular and other chronic diseases, high educational level, and maintenance of vision and hearing have been identified as protective factors from ARCD. On the contrary, hypertension, effects of altered metabolism of steroid hormones, smoking, low-complexity occupation, higher density of persons/bedroom in home, and low level of physical activity have been identified as risk factors for ARCD. Recent findings suggest a possible role of diet in the ARCD. In fact, in an elderly population of Southern Italy with a typical Mediterranean diet, high monounsaturated fatty acids energy intake appeared to be associated with a high protection against cognitive decline. Dietary antioxidants, specific macronutrients, estrogens, and anti-inflammatory drugs, may act synergistically with other protective factors, opening new therapeutic interventions for cognitive decline.

Age Factors↗
PubMed1999

Decreased frequency of apolipoprotein E epsilon4 allele from Northern to Southern Europe in Alzheimer's disease patients and centenarians.

Apolipoprotein E (apoE) polymorphism was studied in 79 sporadic late onset Alzheimer's disease (LOAD) patients, 125 unrelated caregivers or volunteers (19-80 years), and 67 centenarians from Apulia, Southern Italy. The frequency of apoE epsilon2 allele was higher in centenarians than in LOAD patients, while epsilon4 was lower. In middle-aged adults, the epsilon4 allele frequency was higher than in centenarians. The epsilon4 allele frequency was lower in healthy adults than in LOAD patients, while epsilon2 was higher. Compared with the allele frequencies of Northern and Central European countries, a geographic trend for epsilon3 and epsilon4 alleles in LOAD and middle-aged adults was observed. The frequency of epsilon3 increased from Northern to Southern Europe, while epsilon4 decreased significantly. In centenarians, epsilon2 showed a North-South increasing pattern, while epsilon4 was in opposite trend.

Aged↗
PubMed1999

High monounsaturated fatty acids intake protects against age-related cognitive decline.

OBJECTIVE: To study the relationships between dietary macronutrient intakes and age-related changes in cognitive functions. METHODS: We investigated these associations in the prevalence survey (1992 through 1993) of the Italian Longitudinal Study on Aging (ILSA). The population-based sample of 5,632 subjects of the ILSA, age 65 to 84 years, was identified from the electoral rolls of eight Italian municipalities. In this study, standardized test batteries assessing global cognitive functions (Mini-Mental State Examination [MMSE]), selective attention (Digit Cancellation Test [DCT]), and episodic memory (Babcock Story Recall Test), and a semi-quantitative food frequency questionnaire evaluating macronutrient energy intakes, were performed on 278 nondemented elderly subjects from the randomized cohort of Casamassima, Bari (n = 704). RESULTS: There was an inverse relationship between monounsaturated fatty acids (MUFAs) energy intake and cognitive decline (MMSE < 24). The effect of education on the odds of having a MMSE score <24 decreased exponentially with the increase of MUFA intakes (over 2,400 kJ; odds ratio, 0.69). Moreover, a significant inverse association was observed between MUFA intakes and DCT score (odds ratio, 0.99). No association was found between nutritional variables and episodic memory. CONCLUSIONS: In an elderly population of Southern Italy with a typical Mediterranean diet, high MUFA intakes appeared to be protective against age-related cognitive decline. Prospective clinical trials are needed to evaluate the impact of specific dietary macronutrient intakes on the age-related changes of cognitive functions.

Age Distribution↗
PubMed1999

Increased bile acid excretion and reduction of serum cholesterol after crenotherapy with salt-rich mineral water.

The effect of a spring mineral water from Montecatini (Italy) on bile acid excretion, and lipid and apolipoprotein serum levels was evaluated. The study was conducted in subjects with serum total cholesterol (TC) level > 240 mg/dL and LDL cholesterol (LDL-C) > 170 mg/dL, over a 9-week period, with 3 weeks of dietary stabilization, 3 weeks of active treatment, and 3 weeks of tap-water treatment as a control period. Serum lipids and apolipoproteins, total and fractionated bile acid excretion, gallbladder motility, and safety parameters were evaluated. Active treatment with mineral water significantly reduced serum TC by 7.5%, LDL-C by 12.5%, TC/HDL-cholesterol ratio by 6.3%, and apolipoprotein B by 6.3%; total fecal bile acid excretion was increased by 98.9%, and gallbladder volume was reduced by 40%. The reduction in serum and LDL-cholesterol levels observed during the active treatment period ran parallel to the increased excretion of bile acids in the stools. We suggest that salt-rich spring water treatment reduces serum and LDL-cholesterol levels in subjects with mild hypercholesterolemia through a mechanism of increased excretion of fecal bile acid sterols.

Aged↗
PubMed1998

In search of a biological pattern for human longevity: impact of apo A-IV genetic polymorphisms on lipoproteins and the hyper-Lp(a) in centenarians.

We studied centenarians to investigate the biological basis of human longevity focusing on the apolipoprotein A-IV and lipoprotein(a), potentially involved in the susceptibility to atherogenic mechanisms. We analyzed two restriction polymorphisms, HinfI347 (alleles +, -) and Fnu4HI360 (alleles 1, 2), and a VNTR (alleles 3, 4) at the 3' region of the apo A-IV gene. The allele frequencies, the lipoprotein concentrations and their association in centenarians and adults have been compared. In centenarians, the HinfI genotype distribution is different (P < 0.05) and the (+13) haplotype is prevalent (0.54 vs. 0.39), with a greater association of (+3), indicating the selection of a favourable allele. The lipoprotein modulation by the apo A-IV polymorphisms is suggested by significant associations in adults ((+/+) homozygotes have lower LDL-cholesterol and apo B than heterozygotes; (1/1) homozygotes have higher TG and apo B than heterozygotes), that in centenarians still exists as a trend. Centenarians show peculiar lipoprotein features: lower LDL-cholesterol (mean 103 vs. 115 mg/dl; P < 0.02), and higher lipoprotein(a) (median 17.5 vs. 4.5; P < 0.002). Large part of them (47%), especially the Hinf(+/+) and the (+13) homozygotes, have a lipoprotein(a) > 20 mg/dl, value considered as the threshold for atherogenic risk, surprisingly compatible with healthy longevity.

Adult↗
PubMed1997

Preserved antilipolytic insulin action is associated with a less atherogenic plasma lipid profile in healthy centenarians.

OBJECTIVE: Recent studies have demonstrated that centenarians have a preserved glucose tolerance and insulin action and a more favorable body composition and fat distribution than aged subjects. The strong relationship among glucose tolerance, insulin action, plasma lipid concentration, and lipoprotein metabolism would lead to the hypothesis that healthy centenarians may also have a less atherogenic profile than aged subjects less than 100 years old. DESIGN: Investigation of the relationship between insulin action and lipid metabolism in healthy centenarians. PARTICIPANTS: Fifty-six subjects were categorized into three groups: Adults (< or = 50 years old; n = 20); Aged (> or = 75 years old; n = 22); Centenarians (> or = 100 years old; n = 14). The latter represented a select group of individuals free of major age-related diseases. MEASUREMENTS: Anthropometric measurements were made in all subjects, fasting blood samples were drawn for metabolite determinations, and an euglycemic glucose clamp was performed. RESULTS: Compared with aged subjects, healthy centenarians appeared to have a less atherogenic plasma lipid profile. Fasting plasma LDL cholesterol (2.4 +/- 0.6 vs 3.7 +/- .6 mmol/L P < .010) was significantly higher in aged subjects than in centenarians, whereas fasting plasma HDL cholesterol (1.0 +/- 0.4 vs 1.7 +/- .4 mmol/L P < .005) had an opposite trend. In centenarians, insulin-mediated glucose uptake was greater (34.6 +/- 0.5 vs 23.3 +/- .05 mumol/Kg FFM x min P < .010) than in aged subjects and correlated with fasting plasma triglycerides, FFA, LDL, and HDL cholesterol, Apo B, and Apo A1 concentrations. Finally, insulin infusion suppressed plasma FFA concentration in similar ways in adults and centenarians. CONCLUSION: Our study demonstrates that centenarians have a less atherogenic plasma lipid and lipoprotein profile than aged subjects.

Aged↗
PubMed1995

[Mixed dyslipoproteinemias: new therapeutic opportunities].

Familial combined hyperlipoproteinemia (FCHL) is a dyslipidemic syndrome prevalent in patients with coronary artery disease and characterized by variable expression of hypercholesterolemia, hypertriglyceridemia in a given family, with either or both present in affected individuals. Efforts to refine the phenotype of FCHL have led to the observation that elevated levels of apolipoprotein (apo) B are commonly observed in individuals with FCHL. An increased rate of hepatic secretion of apo B associated with very low density lipoproteins in subjects with FCHL has been clearly documented. The predominance of small, dense LDL, as determined by gradient gel electrophoresis, denoted LDL subclass phenotype B, has been associated with increased apo B levels. Two genetic traits have been implicated in FCHL. The first is the predominance of small dense LDL, which segregates as a mendelian trait. The second is a mendelian locus with large effects on apo B levels. Therapy of FCHL is based on statins and fibrates, as monotherapy or given in combination.

Humans↗
PubMed1994

A new Italian case of lipoprotein lipase deficiency: a Leu365- > Val change resulting in loss of enzyme activity.

We describe a second Italian family with primary Lipoprotein Lipase deficiency. A new mutation in exon 8 causes a Leu365- > Val change resulting in severe mass reduction and loss of enzyme activity. We suggest that this change interferes with the correct folding and stability of the protein and impairs the assembly of the active homodimer. The procedures applied are useful to screen a large sample of population for genetic variants and allow the clear identification of asymptomatic heterozygous subjects at risk from atherosclerosis disease.

Adult↗
PubMed1992

A G----C change at the donor splice site of intron 1 causes lipoprotein lipase deficiency in a southern-Italian family.

We describe a new case of lipoprotein lipase deficiency in a proband from a Southern-Italian family. Enzyme activity and mass were absent. Amplification and sequencing of individual exons, intron boundaries and the regulatory region revealed only one homozygous G----C transversion at the first nucleotide of intron 1. The single strand conformation polymorphism analysis proved to be a helpful tool for the identification of the single base mutation. Northern hybridization failed to reveal the presence of mature lipoprotein lipase mRNA. The mutation, which destroys the conserved dinucleotide at the junction site of intron 1, causes defective mRNA splicing and it is responsible for the deficiency.

Adult↗
PubMed1992

Apo C-II deficiency type Bari.

We formerly studied an Italian family with apo C-II deficiency. Two probands were homozygous for the defect (unmeasurable circulating apolipoprotein C-II and absence of C-II bands on immunoelectrophoresis). We documented the synthesis of the protein at the intestinal level in the probands with immunohistological techniques. With the purpose of investigating the molecular basis of the defect, Southern analysis, polymerase chain reaction (PCR) amplification and sequence analysis were carried out on one of the two cases. We identified a point mutation C to G transversion in the third exon of the gene causing a premature stop codon. Our hypothesis is that the truncated protein of 36 aa., instead of 79 aa., lacks its functional domain. This causes inefficiency in the activation of lipoprotein lipase (LPL) and the instability of the circulating molecule, which could have an higher catabolic rate compared to a normal protein. The faster disappearance from the circulating compartment make it unmeasurable. The mutation destroys a Rsa I site, present in the normal gene sequence. We suggest the use of this site for a rapid Restriction Fragment Length Polymorphism (RFLP) on PCR amplification products to screen this defect in the Italian population.

Apolipoprotein C-II↗
PubMed1992

[Epidemiologic study on the effectiveness and safety of dihydroergocristine in impaired memory and behavioral functions in aged humans].

Aim of the study was to assess the activity of dihydroergocristine (DHEC, CAS 17479-19-5) in aged patients with impaired cognitive function. Twenty-five university hospital centres and 250 physicians participated in the study. 2,600 patients (1,104 males and 1,496 females, age range 50-80 years) were admitted to the study. Each patient was administered 6 mg/d DHEC for 120 days. Clinical evaluation was made through the SCAG Rating Scale registered at basal time, after 60 and 120 days. Responsivity to treatment was considered high when the final score was reduced by 30% and none if less than 10%. Analysis of results demonstrated that at the end of the study responsivity was high in 73% of cases, moderate in 20.4% and absent in 6.5%. Tolerability was very good as side effects were reported only in 3.16% of patients. Most frequent side effects were: nausea (1.23%), gastralgia (1.11%), headache (0.29%), hypotension (0.12%), vertigo (0.12%) and rash (0.08%). Drop-outs for gastralgia were reported only in 0.53% of the patients.

Aged↗
PubMed1992

Lipid metabolism and cardiovascular risk: should hypercholesterolemia be treated in the elderly?

PURPOSE: It is not clear whether an elevated serum cholesterol level is as important a risk factor for coronary heart disease in the elderly as it is in middle-aged men. This review highlights some aspects of this issue. OBSERVATIONAL STUDIES: The Framingham study showed that after the age of 65 years, serum cholesterol levels are associated with coronary heart disease only in women. The Honolulu (Hawaii) Heart Program, however, found that the same association also occurred in men aged over 65 years. INTERVENTION STUDIES: The Lipid Research Clinics trial and the Helsinki Heart Study both aimed to reduce coronary heart disease mortality by a drug-induced reduction in serum cholesterol levels. Each produced a significant reduction in coronary morbidity and mortality, of 20 and 30%, respectively, but failed to reduce total mortality significantly. Moreover, an increase in violent death (accident or suicide) was reported by the Helsinki study. LENGTH OF SURVIVAL AND CANCER MORTALITY: Elderly patients with moderate hypercholesterolemia have been reported to survive longer than those with a lower cholesterol level. Further, a significant increase in the cancer mortality rate has been observed in hypocholesterolemic subjects. These data have aroused concern about reducing serum cholesterol levels in patients aged over 65 years. CONCLUSIONS: At present, it seems that a moderate reduction of elevated serum cholesterol levels in elderly patients at risk of coronary heart disease may reduce the incidence of this disease and improve the quality of life in the elderly. The proposal needs to be tested by a randomly allocated controlled trial. The longer survival of patients with moderate hypercholesterolemia and the increase in cancer mortality or violent death seen among hypercholesterolemic subjects need to be further evaluated.

Aged↗
PubMed1991

Drugs affecting triglycerides.

Nicotinic acid and clofibrate derivatives are the main triglyceride-metabolism-affecting drugs. Nicotinic acid and its derivatives block adipose tissue lipolysis thus reducing the FFA flux of free fatty acids to the liver and the synthesis of very-low-density lipoproteins (VLDL). VLDL removal rate is also enhanced. Disturbing side effects (mostly flushing) limit the use of this compound. Clofibrate and its derivatives decrease the synthesis of VLDL and increase their catabolism. Lipoprotein lipase activity as well as VLDL fractional catabolic rate are increased by fibrates. Triglyceride synthesis is also reduced.

Benzhydryl Compounds↗
PubMed1991

Pravastatin vs gemfibrozil in the treatment of primary hypercholesterolemia. The Italian Multicenter Pravastatin Study I.

This study compared the efficacy and safety of pravastatin and gemfibrozil in the treatment of primary hypercholesterolemia. Three hundred eighty-five outpatients from 13 lipid clinics in Italy participated in this randomized double-blind study. Patients were assigned to receive either 40 mg once daily of pravastatin or 600 mg of gemfibrozil twice daily after an initial diet lead-in period. After 24 weeks, mean reductions from baseline values of plasma total and low-density lipoprotein cholesterol were, respectively, 23% and 30% with pravastatin and 14% and 17% with gemfibrozil. Significant lipid-lowering effects were noted within 4 weeks. Apolipoprotein B decrease was 21% with pravastatin and 13% with gemfibrozil. A statistically significant increase of high-density lipoprotein cholesterol of 5% was achieved with pravastatin compared with a 13% increase for gemfibrozil. Serum triglyceride values decreased 5% with pravastatin and 37% with gemfibrozil. Familial and polygenic hypercholesterolemic patients were also examined separately. Pravastatin effectiveness in reducing low-density lipoprotein cholesterol was greater by 6% in polygenic than in familial hypercholesterolemic patients. Treatment for 25 patients (eight treated with pravastatin and 17 treated with gemfibrozil) was discontinued during the study. The incidence of clinical symptoms and laboratory alterations was low for both treatment groups. Pravastatin and gemfibrozil were well tolerated, but pravastatin was significantly more effective in reducing total and low-density lipoprotein cholesterol levels in primary (either familial or polygenic) hypercholesterolemias than gemfibrozil.

Adult↗
PubMed1990

Identification of the mutation responsible for a case of plasmatic apolipoprotein CII deficiency (Apo CII-Bari).

We studied a case of familial Apolipoprotein CII deficiency. By Southern hybridization, amplification and sequence analysis, the genetic defect was identified. It consists in a point mutation C- greater than G in the third exon of the gene causing a premature stop codon. Truncated at the aa. 36 of the mature form, the protein loses its functional domains, becomes inefficient and cannot be detected in the plasma, because of its high instability. The mutation destroys an RsaI site, present in the normal gene sequence. This point mutation is useful in the diagnosis of this Apolipoprotein CII deficiency.

Amino Acid Sequence↗
PubMed1990

Nimodipine in the treatment of old age dementias.

1. In a multicenter, placebo-controlled, double-blind clinical study in 178 elderly patients with cognitive decline, nimodipine, a calcium antagonist was found to be a therapeutically effective agent in the treatment of old age dementias. 2. Treatment with 90 mg of nimodipine administered orally in divided doses for 12 weeks was significantly superior to an inactive placebo on all outcome measures including the Wechsler Memory Scale, the Mini Mental State Examination, the Global Deterioration Scale, the Sandoz Clinical Assessment Geriatric Scale, the Plutchik Geriatric Rating Scale, the Severity of Illness and Global Improvement Scales of Clinical Global Impression, and the Hamilton Psychiatric Rating Scale for Depression. 3. Adverse effects with nimodipine were few and mild. The drug was equally well tolerated and equally effective in the two major dementias of old age, i.e., primary degenerative and multi-infarct. The number of abnormal laboratory test readings remained essentially unchanged from pre-treatment to post-treatment.

Aged↗