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Biomedical subjects

G Di Biase

Publications and source records attributed to G Di Biase.

At least 19 recordsLinked to original sources
PubMed1997

The prediction of total body water from bioelectrical impedance in patients with anorexia nervosa.

Total body water (TBW) was measured by deuterium oxide (D2O) dilution and predicted from bioelectrical impedance (Z) in nineteen anorexic and twenty-seven control women. The equation of Kushner et al. (1992) based on the impedance index (ZI = height2/Z) gave biases of 0.9 (SD 2.5) and 0.8 (SD 2.5) litres in controls and patients respectively (NS, ANOVA). The ZI-based equation of Deurenberg et al. (1993) gave biases of 1.5 (SD 2.4) litres (NS) and 3.0 (SD 2.1) litres (P < 0.001) in controls and patients respectively. Despite the fact that weight was the most powerful predictor of TBW on the study sample (n 46, r2 0.90, P < 0.0001, SE of the estimate 1.6 litres, CV 5.7%), the formulas of Segal et al. (1991) and Kushner et al. (1992) based on the association of weight and ZI gave an inaccurate prediction of TBW in both control and anorexic subjects, with a bias ranging from -3.2 (SD 2.4) to 2.9 (SD 2.1) litres (P < or = 0.001). Population-specific formulas based on ZI (n 46) gave a more accurate prediction of TBW by bioelectrical impedance analysis on the study subjects, with biases of -0.1 (SD 1.8) and 0.5 (SD 1.7) litres in controls and patients respectively (NS). However, the individual bias was sometimes high. It is concluded that bioelectrical impedance analysis can be used to predict TBW in anorexic women at a population level, but the predictions are less good than those based on body weight alone.

Adult↗
PubMed1994

Cardiac abnormalities in young women with anorexia nervosa.

OBJECTIVE: To identify the characteristics of cardiac involvement in the self-induced starvation phase of anorexia nervosa. METHODS: Doppler echocardiographic indices of left ventricular geometry, function, and filling were examined in 21 white women (mean (SD) 22 (5) years) with anorexia nervosa according to the DSMIII (Diagnostic and Statistical Manual of Mental Disorders) criteria, 19 women (23 (2) years) of normal weight, and 22 constitutionally thin women (21 (4) years) with body mass index < 20. RESULTS: 13 patients (62%) had abnormalities of mitral valve motion compared with one normal weight woman and two thin women (p < 0.001) v both control groups). Left ventricular chamber dimension and mass were significantly less in women with anorexia nervosa than in either the women of normal weight or the thin women, even after standardisation for body size or after controlling for blood pressure. There were no substantial changes in left ventricular shape. Midwall shortening as a percentage of the values predicted from end systolic stress was significantly lower in the starving patients than in women of normal weight: when endocardial shortening was used as the index this difference was overestimated. The cardiac index was also significantly reduced in anorexia nervosa because of a low stroke index and heart rate. The total peripheral resistance was significantly higher in starving patients than in both control groups. The left atrial dimension was significantly smaller in anorexia than in the women of normal weight and the thin women, independently of body size. The transmitral flow velocity E/A ratio was significantly higher in anorexia than in both the control groups because of the reduction of peak velocity A. When data from all three groups were pooled the flow velocity E/A ratio was inversely related to left atrial dimension (r = -0.43, p < 0.0001) and cardiac output (r = -0.64, p < 0.0001) independently of body size. CONCLUSIONS: Anorexia nervosa caused demonstrable abnormalities of mitral valve motion and reduced left ventricular mass and filling associated with systolic dysfunction.

Adult↗
PubMed1993

Predicted and measured resting energy expenditure in healthy young women.

Basal energy expenditure (BEE) was either measured by indirect calorimetry or predicted by different formulae in 104 young women: 74 lean and overweight subjects (normal weight, NWt) and 30 obese subjects. The predictive equations were based on weight alone (Owen, FAO-1, Schofield-1) or on weight and height (Harris-Benedict, Mifflin, Kleiber, and again FAO-2 and Schofield-2). With the exception of the Owen equation all the equations over-estimated measured BEE in both study groups. The ratio between measured and predicted value (% MP) varied between 102.3 (Owen) and 87.7 (Kleiber) in the NWt subjects and between 113.2 (Owen) and 89.3 (Schofield-1) in the obese subjects. The range including 95% of the predicted-measured differences (PMdiff) was larger than 1700 kJ/d in the NWt group and 2300 kJ/d in the obese group. In both study groups most of the equations showed a significant relationship between PMdiff and/or % MP with body weight and the magnitude of BEE. In conclusion, these equations are of little help in predicting BEE in a single subject and should be used with caution when assessing energy requirements in populations or groups of subjects.

Journal Article↗
PubMed1993

Bioimpedance analysis and resting energy expenditure in undernourished and refed anorectic patients.

Anthropometry, bioimpedance analysis (BIA) and resting energy expenditure (REE) were evaluated in young female patients affected by anorexia nervosa who were either severely malnourished (MnA) or already refed (RfA) and in a control group of healthy young women (WnC). Fat-free mass (FFM) and fat mass (FM), evaluated from skinfold thickness, were severely decreased in the MnA group while they were very similar in the RfA group and in the WnC group. With respect to BIA parameters, impedance (Z) was significantly higher in absolute terms in the MnA but lower than in the other groups when expressed as specific impedance, i.e. after normalization for both FFM and height. Phase angle significantly differed between the three groups, being significantly (P < 0.01) lower in the MnA (3.70 +/- 0.83 degrees) and the RfA (4.36 +/- 0.82) than in the WnC (5.17 +/- 0.40). REE was comparable in RfA subjects and WnC subjects, while it was sharply decreased (P < 0.01) in the MnA patients both in absolute value and after adjustment for body composition (FFM and FM) or body weight. This cross-sectional study shows that marked changes in BIA parameters occur in undernourished anorectic patients and also in the anorectic subjects who were previously very underweight but studied only after having already regained a normal body size. REE was deeply decreased in the undernourished anorectic women even when the differences in body composition or Wt were taken into account, indicating the occurrence of a significant adaptation of energy expenditure to chronic underfeeding.

Adipose Tissue↗
PubMed1990

Androgenicity in relation to body fat distribution and metabolism in 38-year-old women--the European Fat Distribution Study.

We studied fat distribution and metabolic risk factors in 434 38-year old women selected from population registrars in 5 cities in different parts of Europe. In the present study we focussed on the geographical variation in serum concentrations of free testosterone and its relation to measures of obesity, fat distribution and indicators of cardiovascular risk (serum lipids, insulin, and blood pressure). There were significant differences in free testosterone levels (F = 5.4, p less than 0.001) with lowest levels in Polish women (mean +/- SEM: 1.56 +/- 0.08 pg/ml) and highest in women from Italy (2.07 +/- 0.12 pg/ml). In the pooled data, free testosterone levels were correlated with several anthropometric variables (strongest with subscapular/triceps ratio r = 0.27, with subscapular skinfold and waist/thigh circumference ratio r = 0.25 p-values less than 0.001). In addition, free testosterone was positively correlated with serum total cholesterol (r = 0.11), HDL/total cholesterol fraction (r = 0.12), serum insulin (r = 0.20) and diastolic blood pressure (r = 0.15). These associations remained significant after adjustment for body mass index and waist/thigh ratio (not for diastolic blood pressure) but were no longer significant after further adjustment for insulin levels. There were considerable differences in strength of the associations mentioned between the 5 centers. We conclude that degree of obesity, fat distribution and serum levels of free testosterone all, to a limited degree, contribute to the metabolic profile of randomly selected 38-year old women but that adjustment for such variables increases the differences in metabolic profiles between women from different centers of Europe.

Adipose Tissue↗
PubMed1990

[Hypopotassemia and prolongation of the Q-T interval in a patient with severe malnutrition caused by bulimia and post-prandial vomiting].

Patient L.A. (f., 20 yrs), affected by bulimia and self-induced vomiting, was hospitalized because of severe malnutrition (BMI 13.1), hypopotassemia (2.8 mEq/l) and prolonged QTc interval (0.469"). Intensive care treatment aimed to normalize mineral balance mainly serum potassium, consisted of administering e.v. potassium (mg 2346/day), magnesium (mg 72/day), calcium (mg 80/day), phosphorus (mg 769/day), chloride (mg 710/day), iron (mg 40/day). Dietary treatment was deliberately chosen to be slightly above minimum energy requirements in order to avoid possible side effects of forced hyperalimentation. The patient, immediately after hospitalization, interrupted vomiting and 2 wks later weight increased by 5 kg (from 34.9 kg to 40.0 kg). On the other hand normalization of serum potassium levels was slow and QTc interval reached normal range only after the 10th day of treatment (0.447"). This case supports the hypothesis that major ECG abnormalities may be present in severe malnutrition due to anorexia nervosa or bulimia with self-induced vomiting. The dangers of these complications were substantiated by the fact that intensive care treatment allowed prompt body weight recovery but normalization of electrolytic balance and cardiac function was very slow. For such patients, electrocardiographic monitoring should be routine.

Adult↗
PubMed1989

Indicators of fat distribution, serum lipids, and blood pressure in European women born in 1948--the European Fat Distribution Study.

In the spring of 1986, the authors studied the relation between body mass index and anthropometric indicators of fat distribution to cardiovascular risk factors (serum lipids and blood pressure) in approximately 450 women aged 38 years randomly selected from population registers in five European centers. Waist circumference was, in univariate analysis, more strongly related to triglycerides (positive association) and high density lipoprotein (HDL) cholesterol (negative association) than to body mass index or any other anthropometric measurement. Among the centers, we observed considerable variation in the strength of the associations between anthropometric measurements and risk factors. After adjustment for body mass index, most associations between skinfolds and circumferences and risk factors were reduced to statistically nonsignificant levels, but in some centers there were independent contributions of circumferences or circumference ratios to serum lipids, but not to blood pressures. Adjustment for differences in body mass index and fat distribution between the centers did not reduce the differences in cardiovascular risk factors between the different centers but instead revealed that serum cholesterol levels were lowest in the centers of southern Europe (Italy) and that HDL cholesterol levels were higher. Blood pressure was highest in the Swedish women. We conclude that in some female populations, but not in others, indicators of fat distribution are related to serum lipids but not to blood pressure, independent of body mass index.

Adipose Tissue↗
PubMed1989

Some statistical considerations on dietary assessment methods.

Dietary intake for 18 nutrients in a sample of 230 free-living elderly people in Naples was assessed by three dietary assessment methods (diet history, 24-h recall and 3-d record). Different statistical criteria (the correlation coefficient, the mean difference and the proportion of individuals placed in the same thirds of distribution) were used to evaluate the agreement among different methods. Theoretical considerations are shown demonstrating the uselessness of the correlation coefficient in evaluating the agreement. In analysing the mean differences, diet history gave higher estimates of nutrient intake and 24-h recall gave lower estimates, when compared to the 3-d record. Large standard errors for the mean differences and small proportions of individuals placed in the same thirds of the distribution, for nearly all the nutrients examined, showed poor agreement among the three different methods. These findings strongly suggest the presence of bias in, at least, two of the three dietary assessment methods. Some statistical techniques for improving the diet record method in epidemiological studies are discussed: the need to transform nutrient intake data to achieve normality in the distribution; the number of days of recording required to produce a valid study; and the need to evaluate the bias in the diet record.

Aged↗
PubMed1988

Cardiovascular risk factors and age of onset of obesity in severely obese patients.

Aim of this study was to evaluate whether the age of onset of obesity might affect the prevalence of CV risk factors in severely obese patients. Five hundred forty-five (385 F aged 42.3 +/- 7.1 yrs, BMI 47.3 +/- 5.1 w/h2 and 160 M of 39.0 +/- 1.1 yrs and BMI of 41.8 +/- 5.3 w/h2) severely obese patients hospitalized in the Metabolic Unit between 1972 and 1985 were subdivided in four classes according to the age of onset of obesity. Severely obese women with maturity onset obesity (i.e. onset greater than or equal to 20 yrs) (MOO) had higher (p less than or equal to .01) serum glucose (118 vs 103 mg/dl) and triglyceride (167 vs 126 mg/dl) than those with early onset obesity (EOO) (i.e. onset less than or equal to 3 yrs) with the same age, BMI and smoking habits. Similar trend was also found in men. In males arterial blood pressure was found to be higher (p less than or equal to .01) in EOO than in MOO (SBP = 152 vs 133 mmHg and DBP = 92 vs 83 mmHg). Similar trend was found in females. In conclusion age of onset of obesity may, at least in part, affect the prevalence of cardiovascular risk factors in severe obesity.

Adult↗
PubMed1988

Mortality rate, causes and predictive factors of death in severely obese patients.

Several studies have investigated the relationship between obesity and mortality or cardiovascular disease (CVD) reporting conflicting results. The very few data collected on extremely obese patients have shown an increased mortality in these patients compared to the general population. Two hundred and sixtyfour (182 f, 82 m) severely obese patients (BMI greater than or equal to 35 w/h2) living in Southern Italy (hospitalized from 1972 to 1985 in our Metabolic Unit for a weight reduction program) were followed-up for a mean period of 7.1 years. Twentynine (20f, 9m) deaths were recorded during the follow-up. Higher mortality was found at all ages and in both sexes in these patients when compared to the general italian population. The excess mortality reached its peak in the age range 25-54 yrs (observed/expected mortality rate was 6.9 in females and 4.32 in males) diminishing by aging in both sexes (3.52 in females and 1.56 in males in age range 55-72 yrs). Death from CV disease was found more frequent than in the general italian population but it was unable to fully explain the excess mortality. Predictive factors of mortality were: in females age, BMI, and serum glucose and in males only age. In conclusion severely obese patients living in Southern Italy have a very high mortality rate. The excess mortality is not fully explained by cardiovascular disease.

Actuarial Analysis↗
PubMed1987

Nutritional status of the elderly in Naples.

Nutritional status (anthropometry, food habits, thiamin and riboflavin status) has been evaluated in 136 (70 males and 66 females) free living healthy elderly individuals (age range 65-69 yrs) from the district of San Carlo Arena that can be considered representative of the sociocultural and economic level of the city of Naples. By assuming as reference values those of middle aged individuals, 50 percent of elderly men and 85 percent of elderly women showed different degree of excess body fat. As far as food habits are concerned legumes, vegetables and fruit daily intake was quite high whilst alcohol consumption was low. Furthermore milk and eggs intake was low and infrequent. Although prevalence of excess body weight was high, total daily energy intake was found to be equal or slightly above dietary recommendations for the elderly. Diet composition showed a high protein intake whilst CHO and fat intake was slightly below recommendations. Micronutrients' intake was insufficient for calcium in 10 percent of both males and females and for iron in 20 percent of men and 40 percent of women. Niacin intake was low in about 50 percent of both men and women. Thiamin nutritional status was found low in 20 percent of men and women and riboflavin status in 40 percent of men and 20 percent of women. In conclusion obesity and overweight are very frequent in an urbanized sample of free living healthy elderly individuals of Naples. On the other hand serum calcium and iron and some vitamin deficiency is not uncommon. The composition of the diet seems to be also poor in some micronutrients.

Aged↗
PubMed1986

Body fat distribution and cardiovascular risk in middle-aged people in southern Italy.

Skinfold thickness, % body fat content, body mass index, systolic and diastolic blood pressure, plasma glucose, serum cholesterol and triglycerides have been measured in 132 middle-aged men (mean age 39.8 +/- 9.9, range 20-59 yr) and in 114 middle-aged women (mean age 39.1 +/- 9.3, range 20-59 yr). Anthropometric data were related to blood pressure and biochemical parameters by using a straight-line regression analysis. Body mass index, % body fat content, subscapular and suprailiac skinfold thickness, consideral as indicative of splanchnic fat distribution, were positively correlated to blood pressure, plasma glucose, cholesterol and triglycerides. Triceps skinfold thickness, an index of peripheral fat distribution, showed weaker or no correlation with these parameters. These preliminary observations in the Neapolitan area support the hypothesis that, in addition to body mass index and % body fat content, preferential splanchnic fat distribution is associated with cardiovascular risk factors.

Adipose Tissue↗
PubMed1983

Evaluation of the hypocholesterolemic effect of vegetable proteins.

The hypocholesterolemic effect of dietary vegetable proteins was studied by comparing egg-white protein and fava bean protein concentrate in one normal and seven hypercholesterolemic (six type II A, one II B) persons; five completed the crossover design. To maintain stable body weight, subjects were kept on an isocaloric diet (20% protein, 48% carbohydrate (CH), 32% fat, P/S = 2) for 1 month and then hospitalized for two consecutive 18-day periods while receiving an isocaloric diet of different composition (15% protein, 50% CH, 26% fat, P/S = 2). Women were provided 50 g and men 70 g daily of egg-white or fava bean protein concentrate during the two crossover periods. Hematocrit and fasting plasma or serum were analyzed every 3 days for glucose, insulin, uric acid, creatinine, total and low-density lipoprotein (LDL), very low-density lipoprotein (VLDL), and high-density lipoprotein (HDL) cholesterols, and for total and VLDL triglyceride. Dietary adequacy of both proteins was evaluated by measuring plasma concentration of prealbumin, transferrin, and retinol-binding globulin. Insulin and hematocrit did not show any change, nor did any other biochemical variables show significant differences when results were compared at the end of each crossover period. Compared with baseline, fasting plasma glucose significantly decreased on the fava bean diet. Serum total and LDL cholesterol decreased during both diets but were statistically significant only on the egg-white diet. Serum HDL cholesterol significantly decreased only on the fava bean diet. Serum total and VLDL triglyceride did not show any significant change. Labile plasma protein concentration was significantly reduced only on the fava bean diet. In conclusion, the fava bean diet did not show a significant effect on lowering serum total and LDL cholesterol. Such an effect was mild but significant on the egg-white diet, compared with baseline.

Adult↗