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Biomedical subjects

E Farinaro

Publications and source records attributed to E Farinaro.

At least 19 recordsLinked to original sources

The PEA15 gene is overexpressed and related to insulin resistance in healthy first-degree relatives of patients with type 2 diabetes.

AIMS/HYPOTHESIS: Overexpression of the gene encoding phosphoprotein enriched in astrocytes 15 (PEA15), also known as phosphoprotein enriched in diabetes (PED), causes insulin resistance and diabetes in transgenic mice and has been observed in type 2 diabetic individuals. The aim of this study was to investigate whether PEA15 overexpression occurs in individuals at high risk of diabetes and whether it is associated with specific type 2 diabetes subphenotypes. SUBJECTS AND METHODS: We analysed PEA15 expression in euglycaemic first-degree relatives (FDR) of type 2 diabetic subjects. RESULTS: The expression of PEA15 in peripheral blood leucocytes (PBLs) paralleled that in fat and skeletal muscle tissues. In PBLs from the FDR, PEA15 expression was two-fold higher than in euglycaemic individuals with no family history of diabetes (control subjects), both at the protein and the mRNA level (p < 0.001). The expression of PEA15 was comparable in FDR and type 2 diabetic subjects and in each group close to one-third of the subjects expressed PEA15 levels more than 2 SD higher than the mean of control subjects. Subjects with IFG with at least one type 2 diabetes-affected FDR also overexpressed PEA15 (p < 0.05). In all the groups analysed, PEA15 expression was independent of sex and unrelated to age, BMI, waist circumference, systolic and diastolic BP, and fasting cholesterol, triacylglycerol and glucose levels. However, in euglycaemic FDR of type 2 diabetic subjects, PEA15 expression was inversely correlated with insulin sensitivity (r = -557, p = 0.01). CONCLUSIONS/INTERPRETATION: We conclude that PEA15 overexpression represents a common defect in FDR of patients with type 2 diabetes and is correlated with reduced insulin sensitivity in these individuals.

Adult↗

Self-rated measures of physical activity and cardiovascular risk in a sample of Southern Italian male workers: the Olivetti heart study.

BACKGROUND AND AIM: The number of people who are overweight, obese and/or lead a sedentary lifestyle is increasing, and numerous studies have shown that physical activity has beneficial cardiovascular effects. METHODS: The aim of this study was to evaluate the relationship between physical activity and the anthropometric, cardiovascular and metabolic variables involved in coronary risk. The study population consisted of 1075 adult men aged 25-75 years, all of whom were workers in Olivetti factories. Physical activity was assessed by means of a questionnaire and the sample was divided into two groups: those practising sport and those who said they were sedentary. RESULTS: Age-adjusted BMI was higher in the participants practising sport, whereas the values of all of the remaining variables (i.e. abdominal circumference, skinfolds, heart rate, blood pressure, serum cholesterol, triglyceride, glucose, insulin and HOMA) were lower; however, the only statistically significant differences were in heart rate and blood pressure. After the subjects were classified as being normal weight, overweight or obese on the basis of BMI, the active participants tended to have lower values for all of the parameters than their sedentary counterparts in each BMI category. In a subgroup undergoing OGTT, glucose and insulin levels at T0 and T60 were significantly lower in the active participants. CONCLUSIONS: These findings confirm the usefulness of physical activity in preventing cardiovascular disease.

Adult↗

Natural history of chronic viral hepatitis in southern Italy: epidemiological changes since the introduction of the anti-HCV test.

We investigated whether there are differences between the natural history of B and C chronic hepatitis in a southern Italian population, and whether the chronic viral hepatitis population was modified by the introduction of the anti-HCV test in 1989. We examined clinical charts of 1120 patients consecutively admitted to our division from January 1979 to December 1998 with the histological diagnosis of chronic viral hepatitis (304 from 1979 to 1988; 816 from 1989 to 1998). We found significant differences only in age at diagnosis (higher in the second decade, P = 0.001), and in aetiology (HBV decreased in the second decade, P < 0.0001). We were able to follow up 449 patients for 2-20 years (311 with HCV and 138 with HBV infection), and found that chronic HCV evolved to cirrhosis more frequently than did chronic HBV; but in both types time to development of cirrhosis and the incidence of death were similar. Our data confirm that a higher onset age of HBV and of HCV is frequently observed in those subjects who have a faster disease progression.

Adult↗

Altered renal sodium handling and hypertension in men carrying the glucagon receptor gene (Gly40Ser) variant.

A higher prevalence of hypertension has been associated with the G-->A/GT (Gly40Ser) polymorphism of the glucagon receptor gene (GCGR) in two population studies. As the mutated receptor is less responsive to glucagon, it has been speculated that the increased susceptibility to hypertension is due to deprivation of the recognized natriuretic effect of the hormone. To test this hypothesis we determined the frequency of the polymorphic variant and evaluated the segmental renal sodium handling by the clearances of uric acid and of exogenous lithium in the Olivetti Heart Study participants (n=971). The polymorphic variant was present only in heterozygous form in 37 individuals (3.8%). After controlling for age and body mass index, the carriers of the variant were twice more likely to be hypertensive and almost three times more likely to be on antihypertensive treatment at the time of examination. Compared to participants carrying the wild type, those carrying the Gly40Ser allele had higher serum uric acid and lower fractional excretion of uric acid and exogenous lithium, independently of age, body mass, and current pharmacological treatment. We conclude that the Gly40Ser polymorphism of the GCGR gene is associated with higher risk of hypertension and with enhanced proximal tubular sodium reabsorption, a factor possibly contributing to hypertension in this group.

Adult↗

Past history of nephrolithiasis and incidence of hypertension in men: a reappraisal based on the results of the Olivetti Prospective Heart Study.

BACKGROUND: We have previously reported that in the Olivetti Prospective Heart Study cohort the incidence of nephrolithiasis was higher in hypertensive participants than in normotensive ones. As the time sequence and the mechanisms underlying the association between nephrolithiasis and hypertension remain controversial, we further tested the hypothesis that in a cohort of normotensive males a history of nephrolithiasis predicts the development of future hypertension. METHODS: The analysis was conducted in 381 male workers at Olivetti who were normotensive at the baseline examination and who were re-examined 8 years later. RESULTS: A past history of nephrolithiasis is associated with an increased risk of hypertension of 1.96 (95% CI=1.25-3.07) relative to subjects with a negative history, after adjusting for age. CONCLUSION: In this 8-year follow-up study, a history of nephrolithiasis resulted in an increased risk of developing hypertension in the future. As the reverse was also true, as previously reported, a clear-cut time sequence, as well as the mechanisms linking these two conditions, remain to be identified.

Adult↗

Relationship of the Trp64Arg polymorphism of the beta3-adrenoceptor gene to central adiposity and high blood pressure: interaction with age. Cross-sectional and longitudinal findings of the Olivetti Prospective Heart Study.

METHODS: The association of the Trp64Arg polymorphism of the beta3-adrenoceptor (beta3-AR) gene with high blood pressure, central adiposity and other features of the metabolic syndrome was investigated in a large unselected sample of a white male working population in Southern Italy (n = 979). RESULTS: In the whole population, subjects heterozygous for the Trp64Arg mutation (11.2%) were not different from the homozygous Trp64Trp for any of the variables investigated. However, upon stratification for age, among men in the upper tertile of age (> 53 years), the Trp64Arg genotype was associated with higher waist: hip ratio (0.992 +/- 0.021 versus 0.982 +/- 0.037, P< 0.05), serum uric acid (6.34 +/- 1.50 versus 5.75 +/- 1.30 micromol/l, P < 0.05) and systolic blood pressure (144.3 +/- 19.4 versus 136.9 +/- 18.9 mmHg, P< 0.05) compared with the wild-type homozygotes. Accordingly, in the same age group, the carriers of Trp64Arg genotype were more often in the upper tertile of abdominal adiposity (69.7 versus 43.7%, P< 0.02) and serum uric acid (56.3 versus 34.8%, P < 0.02) and were more often hypertensive (68.6 versus 57.6%, P< 0.058) than the Trp64Trp homozygotes. No such differences were observed in younger age groups. No association was found with fasting serum insulin and the homeostasis model assessment (HOMA) index of insulin resistance. Furthermore, in a subgroup of 457 men for whom retrospective 20-year follow-up data were available, the variant genotype was associated with a higher probability of developing overweight (44.7 versus 27.0%, P < 0.05) and a trend to higher blood pressure (52.6 versus 38.4%, P = 0.09) over 20 years. CONCLUSION: We conclude that the Trp64Arg variant of the beta3-AR receptor predicts a greater tendency to develop abdominal adiposity and high blood pressure with advancing age.

Adipose Tissue↗

Altered renal sodium handling in men with abdominal adiposity: a link to hypertension.

OBJECTIVES: Central adiposity, insulin resistance and hypertension are clearly interrelated but the mechanisms underlying this association have not been thoroughly elucidated. As renal sodium handling plays a central role in salt-sensitive forms of hypertension, we investigated the relation of renal tubular sodium handling to abdominal adiposity, blood pressure and insulin sensitivity. DESIGN: Population-based study. PARTICIPANTS: Five hundred and fifty-five untreated Olivetti male workers, aged 25-75 years. SETTING: Olivetti factory medical centers in Pozzuoli and Marcianise (Naples, Italy) MAIN OUTCOME MEASURES: Anthropometric indices, serum insulin, homeostatic model assessment index of insulin sensitivity, blood pressure, fractional excretions of uric acid and exogenous lithium (as markers of renal tubular sodium handling). RESULTS: In univariate analysis, measures of central adiposity (i.e. sagittal abdominal diameter and umbilical circumference) were directly correlated with serum insulin (P < 0.001) and blood pressure levels (P < 0.001) and inversely associated with the fractional excretions of uric acid and lithium (P = 0.01-0.001). In multiple linear regression analysis, the same anthropometric indices but not the measures of peripheral adiposity (arm circumference and tricipital skinfold thickness), were significant predictors of the fractional excretion of uric acid and lithium, independently of age, blood pressure and serum insulin levels (P = 0.01-0.001). CONCLUSIONS: Abdominal adiposity was associated with altered renal tubular sodium handling apart from insulin resistance and high blood pressure. The data indicate that men with prevalent abdominal adiposity have an enhanced rate of tubular sodium reabsorption, mainly at proximal sites. These findings provide a possible mechanistic link between central adiposity and salt-dependent hypertension.

Abdomen↗

Long term relations between earthquake experiences and coronary heart disease risk factors.

The authors analyzed the relations between a variety of earthquake-related experiences incurred in 1983-1984 (financial loss, evacuation, indices of disruption of social networks) and coronary heart disease risk factors (heart rate, blood pressure, total serum cholesterol) assessed in 1987 among 693 Italian male factory workers. Multivariate analyses (adjusting for age, body mass index, smoking, and educational level) revealed no long term relations between the quake-related experiences and blood pressure or cholesterol level. However, higher resting heart rates were observed for individuals who reported financial loss, increased distance from family/friends, or decreased visiting as a result of relocation after the quakes. Findings were unchanged after further adjustment for self-reported psychological distress (assessed using the global symptom index of the Symptom Checklist). These findings, while limited by the cross-sectional nature of the data, suggest that a number of psychosocial consequences of relocation due to a natural disaster are unrelated in the long term to coronary heart disease risk factors, except for small but significant differences in heart rate among individuals who have experienced financial loss and/or social network disruptions.

Adult↗

Intestinal fatty acid binding protein polymorphism at codon 54 is not associated with postprandial responses to fat and glucose tolerance tests in healthy young Europeans. Results from EARS II participants.

UNLABELLED: Polymorphism Ala54Thr of the intestinal fatty acid-binding protein 2 (FABP2) has been reported to have an effect on the protein's affinity for long chain fatty acids and to be associated with serum lipid and insulin levels in fasting and especially postprandial states. We wanted to test whether this genetic variation is associated with fasting and postprandial glucose, insulin or lipid levels in 666 male university students participating in the second European Atherosclerosis Study (EARS II). We also studied whether the subgroup of 330 students with paternal history of myocardial infarction (MI) before the age of 55 have different genotype distribution than 336 matched controls. RESULTS: No difference in genotype distribution was observed between offspring with and without paternal history of MI or between populations from 11 European countries. The frequency of the threonine encoding allele was 0.276 in cases and 0.266 in controls. There were no differences in fasting or postprandial serum lipid, glucose or insulin levels between subjects having different genotypes. CONCLUSIONS: In this study FABP2 Ala54Thr polymorphism was not associated with lipid or glucose metabolism. In addition to environmental and genetic factors, selection of study population also may explain the difference between this and earlier studies.

Adolescent↗

Increasing evidence for the role of salt and salt-sensitivity in hypertension.

The paper focuses on some aspects of the complex relationship between dietary salt intake and blood pressure. The first part is a short review of the evidence available from epidemiological and clinical studies, indicating that a moderate reduction in dietary salt intake represents an effective non-pharmacological measure for the treatment of hypertension and for the prevention of hypertension-related cardiovascular complications, namely stroke and ischemic heart disease. The second part deals with the role of inherited and acquired factors in the phenotypic expression of the salt-sensitivity of blood pressure. In particular, the influence of sympathetic nervous system hyperactivity, of insulin resistance and of alterations of endothelial function in the pathogenesis of salt-related forms of hypertension are discussed.

Age Factors↗

A prospective study of hypertension and the incidence of kidney stones in men.

OBJECTIVE: To examine whether hypertension predicts the incidence of kidney stone disease. DESIGN: Prospective cohort study (the Olivetti Prospective Heart Study). SETTING: The Olivetti factory in Southern Italy. SUBJECTS: Five hundred and three male workers, aged 21 - 68 years, with no evidence of kidney stone disease at baseline. Follow-up 8 years. MAIN OUTCOME MEASURES: Anthropometry, blood pressure, biochemistry and history of kidney stone disease were evaluated at the baseline examination in 1987. Occurrence of kidney stone disease was evaluated again in 1994-1995. Hypertension was defined as systolic blood pressure > or = 160 or diastolic blood pressure, > or = 95 mmHg or both, or being on drug therapy for hypertension. Occurrence of kidney stone disease was defined as radiological or echographic evidence of calculi or documented passage of one or more stones. RESULTS: At baseline, 114/503 men (22.7%) had hypertension and 32 were on drug treatment. After 8 years, 52 (10.3%) incident cases of kidney stone disease were detected. The majority (n = 45) had a documented passage of one or more stones. The incidence of kidney stone disease was higher in hypertensive than in normotensive men (19/114 (16.7%) versus 33/389 (8.5%); P = 0.011). Hypertensive men had a greater risk of developing kidney stones than normotensive ones (RR 1.96; 95% confidence interval 1.16-3.32). The risk was unaffected by the exclusion of treated hypertensives (2.01; 1.13-3.59) and after adjustment for age (1.89; 1.12-3.18), body weight (1.78; 1.05-3.00) or height (2.00; 1.19-3.38). CONCLUSIONS: Hypertension in middle-aged men is a significant predictor of kidney stone disease rather than a consequence of renal damage caused by the kidney stones.

Adult↗

Heart rate as a risk factor in hypertensive individuals. The Italian TensioPulse Study.

BACKGROUND AND AIM: The predictive role of heart rate as a new, independent risk factor for the development of high blood pressure and cardiovascular diseases (CVD) has been investigated in recent years and many studies have demonstrated a significant and independent association between heart rate, blood pressure and cardiovascular (CV) endpoints. Various pathogenic pathways can be postulated to explain this association and the role of heart rate as a plausible risk factor. Previous studies have been limited to the examination of small samples of general populations. By contrast, our study is based on a large cohort (38,145) of hypertensive patients. METHODS AND RESULTS: The Italian TensioPulse Study is a detailed investigation of the relation between heart rate (HR) and other CV risk factors in a large cohort of hypertensives. A strong, positive relationship was found between heart rate and both systolic and diastolic blood pressure: r = 0.21 for SBP in both sexes, and r = 0.21 and r = 0.24 for DBP in men and women respectively. Smoking and drinking habits seem to be associated with higher heart rate, SBP and DBP values. CONCLUSIONS: These findings and the observation that more than one out of three hypertensives had a relatively high heart rate could assist in the organisation of prevention programmes. Correction of certain lifestyle factors must precede the decision to use drugs to reduce the global CVD risk.

Adult↗

Red blood cell sodium-lithium countertransport and risk of future hypertension: the Olivetti Prospective Heart Study.

An elevated red blood cell (RBC) sodium-lithium countertransport (Na-Li CT) is associated with high blood pressure (BP) in cross-sectional investigations; however, its value as a predictor of future hypertension, and thus of cardiovascular risk, has not been defined. The present study evaluated the association between Na-Li CT and risk of future hypertension in a sample of 106 untreated normotensive middle-aged men participating in the Olivetti Prospective Heart Study in southern Italy. BP, anthropometric and metabolic variables, and RBC Na-Li CT were measured at baseline in 1987 and at a follow-up visit in 1994 through 1995. Na-Li CT was stable over time (r=0.85) and was significantly associated to systolic BP in both visits. Of the 106 initially normotensive participants, 14 were found to be hypertensive at the 8-year follow-up examination. Eleven of these 14 hypertensives were in the highest tertile of systolic BP at baseline, and 9 of 11 also had an elevated baseline Na-Li CT. In multiple logistic regression analysis, baseline BP, Na-Li CT, and age were all significant predictors of the risk of future hypertension. Individuals with baseline systolic BP in the highest tertile had a 60% risk of developing hypertension if their Na-Li CT was also high, whereas their risk was only 5% if Na-Li CT was in the two lowest tertiles (P=0.003). RBC Na-Li CT was a valuable predictor of subsequent hypertension in middle-aged men with a high-normal BP level for their age.

Age Factors↗

Social network disturbances and psychological distress following earthquake evacuation.

The relationship between social network disturbances following earthquake evacuation and self-reported psychological distress (reduced version of the SCL-90-R) 3 to 4 years later was studied among 817 Italian male factory workers. Increased distress was reported by permanently relocated men, while those who were evacuated, but returned to their original homes, reported distress levels comparable to their nonevacuated co-workers. Additionally, among evacuated men, only those whose relocation placed them at an increased distance from family and/or friends reported distress levels higher than the nonevacuated. Change in visiting frequency with family and/or friends following evacuation was not related to distress. Although these data are correlational and cross-sectional, they are consistent with the hypothesis that disaster related distress is, in part, a function of resulting social network disruption.

Adult↗

Sodium lithium countertransport and blood pressure. Longitudinal findings.

A significant and positive association between red blood cell sodium lithium countertransport (Na-Li CT) and blood pressure has been found in numerous studies. However, the majority of the studies presented to date are cross-sectional in nature and limited information exists on the longitudinal association between Na-Li CT and blood pressure. The present study analyzes the longitudinal association between Na-Li CT and blood pressure in 124 men participants in the Olivetti Heart Study and normotensives at the baseline examination. The Na-Li CT measured at the 12 year follow-up examination was analyzed in regard to the blood pressure changes over time during the 12 year follow-up. Na-Li CT (measured at follow-up examination) was positively related to changes over time in systolic pressure (r = 0.16) and diastolic pressure (r = 0.07) and changes in body mass index (r = 0.18). When blood pressure changes over time were analyzed by tertiles of Na-Li CT, the highest tertile group exhibited on the average significantly higher increases in systolic blood pressure compared with participants of the lowest tertile of the Na-Li CT distribution. This difference remained statistically significant after adjusting for the changes in weight observed during the 12 years follow-up. These findings indicate that the Na-Li CT distribution is related to blood pressure changes over time. However, the usefulness of Na-Li CT as a predictor of incidence of hypertension remains to be established.

Adult↗

Blood pressure in young adults with and without a paternal history of premature coronary heart disease in Europe: the EARS Study. European Arteriosclerosis Study.

OBJECTIVE: The European Arteriosclerosis Study (EARS) was designed to identify variables which discriminate subjects with a paternal history of premature coronary heart disease (CHD) from controls and to study the distribution of these variables across Europe. In this article we report on the blood pressure (BP) data. DESIGN: Comparison of young individuals (18 to 26 years) from 14 different European universities with and without paternal history of premature (before 55) myocardial infarction (MI). SUBJECTS AND METHODS: 1994 university students were recruited, 682 with a positive paternal history of premature MI (cases) and 1312 age and sex-matched controls. Following a rigid fieldwork and analyses protocol, data on life style, BP, anthropometric and analytical measurements were obtained. RESULTS: Only diastolic BP in female patients was different between cases and controls (P < 0.05). A significantly higher prevalence of high BP personal history in male cases than in controls was observed (P < 0.02). BP means showed significant regional differences with higher values in the northern and middle European countries respect to southern regions (P < 0.0001). BP values were positively correlated to body mass index (BMI) and waist to hip (W/H) ratio, no correlations were observed with alcohol consumption in this age group. Tobacco showed a negative independent correlation with both systolic and diastolic BP (P < 0.0001). The use of contraceptive pills was associated with higher systolic (P < 0.0001) and diastolic (P < 0.05) BP levels. After adjustment for covariants, only weak correlations were observed between BP, lipids and apolipoproteins. Apo E showed a positive correlation with BP. Lp(a) and fibrinogen showed no significant regression coefficients with BP. Among cholesterylesters, oleic acid percentages were negatively correlated to BP values (mainly diastolic BP: P < 0.001), while the correlation with linoleic acid was positive (P < 0.001). Fasting glucose levels showed an independent correlation with systolic BP (P < 0.0001) in a multiple regression analysis. CONCLUSIONS: In the group with paternal history of premature MI, the higher prevalence of personal history of high BP in males and the higher diastolic BP values in females suggest that high BP could play a role in the elevated CHD risk of this group. Epidemiological observations on BP distribution and its relation with anthropometric and biochemical covariants in a young group of age from different European countries are reported.

Adolescent↗

[PLasma lipids and cardiovascular risk: lesions in the community].

We examined serum cholesterol levels and lipoprotein profiles as possible risk factors for the development of coronary heart disease by means of a review of epidemiological studies. At present a great body of literature reinforces the evidence of the etiologic role of total and LDL cholesterol and the magnitude of benefits deriving from its treatment. No convincing evidence has been put forward to indicate that the undoubtedly favourable effects of cholesterol lowering on coronary heart disease risk are offset by untoward effect on non-cardiovascular disease rates.

Cardiovascular Diseases↗