PubMed Health⌕ Search

Biomedical subjects

Giampiero I Baroncelli

Publications and source records attributed to Giampiero I Baroncelli.

9 recordsLinked to original sources
PubMed2006

Analysis of bone mineral density and turnover in patients with cystic fibrosis: associations between the IGF system and inflammatory cytokines.

BACKGROUND: Cystic fibrosis (CF) patients present an increased risk of osteoporosis, and increased fracture rate. Several factors have been identified as modulators of bone metabolism and bone mineral density (BMD). AIMS: To evaluate BMD and serum markers of bone turnover and establish their relationships with serum concentrations of interleukin (IL)-1beta, IL-6, tumour necrosis factor (TNF)-alpha, IGF-I, IGF-II, IGF binding protein (IGFBP)-2, IGFBP-3, and parathyroid hormone (PTH) in young adult CF patients. METHODS: Seventeen young adult CF patients (4 M, 13 F; mean age: 26.6 +/- 1.1 years) were enrolled in the study and analysed as a whole and as two subgroups according to the Shwachman-Kulczycki score. BMD was assessed at the lumbar spine (L1-L4) by dual energy X-ray absorptiometry (DXA Hologic QDR 2000). Bone turnover was assessed by measuring serum levels of osteocalcin (OC) and serum carboxyterminal propeptide of type I collagen (PICP) as markers of bone formation, and serum cross-linked carboxyterminal telopeptide of type I collagen (ICTP) as a marker of bone resorption. Serum IGFs, IGFBPs, and cytokines were assayed using special commercial kits. Daily calcium intake and weekly physical activity were estimated by questionnaires. Forced expiratory volume in one second was used to assess pulmonary function. RESULTS: Lumbar BMD was normal, although there was a tendency to be lower in the patients with a lower clinical score. Both OC and PICP were increased, whereas ICTP was normal. Lumbar BMD was positively correlated with pulmonary function. IL-6 and C-reactive protein (markers of inflammation) were inversely correlated with PICP. Serum ICTP levels were correlated with serum IGF-I levels. No significant relationship was detected among lumbar BMD, markers of bone turnover and PTH, IGF-I, IGF-II, IGFBP-2, IGFBP-3, TNF-alpha, IL-1beta, and body mass index Z-score. CONCLUSIONS: Bone turnover is abnormal in CF patients. Young adult CF patients with satisfying clinical status and nutritional conditions have normal BMD and increased serum OC and PICP levels.

Adult↗
PubMed2006

Cross-sectional reference data for phalangeal quantitative ultrasound from early childhood to young-adulthood according to gender, age, skeletal growth, and pubertal development.

Bone mineral status by phalangeal quantitative ultrasound (QUS, DBM Sonic, IGEA, Carpi, Modena, Italy) was examined in 3044 (1513 males and 1531 females) healthy subjects, aged 2-21 years. The aim of the study was to provide a reference database for phalangeal QUS parameters, amplitude-dependent speed of sound (AD-SoS) and bone transmission time (BTT), both expressed as centiles and Z score, according to gender, age, height, weight, body mass index (BMI), and pubertal stage to be used for estimating bone mineral status in patients with disorders of growth or of bone and mineral metabolism. In both sexes, AD-SoS and BTT increased significantly (P<0.0001) according to all the anthropometric variables. Females showed higher values than males in the age groups 9-14 for AD-SoS (P<0.04-P<0.0001) and in the age groups 11-13 for BTT (P<0.02). Males had higher BTT values than females in the age groups 6-8 and 15-21 (P<0.04-P<0.0001). AD-SoS was higher (P<0.02-P<0.0001) in females than in males at pubertal stages 2, 3, and 4, but it was higher (P=0.001) in males compared with females at pubertal stage 5. BTT was higher in males than females at pubertal stages 1 (P<0.0001), 2 (P<0.01), and 5 (P<0.0001). In both sexes, AD-SoS and BTT were significantly correlated between them (r=0.92, P<0.0001) and with all the anthropometric variables (r=0.53-r=0.85, P<0.0001). Age, weight, BMI, and pubertal stage were independent predictors of AD-SoS in males; age and pubertal stage were independent predictors of AD-SoS in females. In both sexes, height and pubertal stage, and also age only in females, were independent predictors of BTT. In conclusion, our data show that gender, age, height, and timing of sexual maturation are main determinants of bone structure and geometry, and that both these two processes may be captured by phalangeal QUS. It may be a useful tool to assess bone mineral status from early childhood to young-adulthood with a very small confounding effect related to bone sizes and without exposing the subjects to a source of radiation.

Adolescent↗
PubMed2006

Effects of sports training in adolescence on growth, puberty and bone health.

Athletic training in adolescent females is important for their well-being; indeed, it may have both positive and negative effects on some physiological processes, as growth, reproductive axis and bone health. Adequate physical activity likely exerts neither a positive nor a negative effect on growth. By contrast, intensive training and insufficient diet may have a negative influence on growth, probably due to energy deficiency and impairment of the growth hormone-insulin-like growth factor-I axis; net long term-effects of such alterations remain to be established. Adolescents who perform regular athletic training present with normal or slightly advanced sexual maturation, because increased strength and power associated with earlier maturation advantage them. However, intensive training and inadequate energy intake may induce delayed menarche and menstrual dysfunctions. The consequent hypoestrogenism, in association with the nutritional deficiencies, may affect bone health. On the contrary, regular physical activity increases the amount of bone mass gained during childhood and adolescence mainly at the bone sites which are trained. Since the number of adolescent females involved in strenuous sports from an early age is increasing, physicians must be aware of such effects, explain to girls and their parents the 'right' sports training and appropriate dietary regimens, and recognize problems due to excessive training as soon as possible. These issues should not be a cause of lesser involvement in athletic participation of young people.

Adolescent↗
PubMed2003

Pubertal changes in biochemical markers of growth.

Puberty is a crucial period of life during which dramatic hormonal changes induce notable modifications in linear growth, bone mass and body composition. These changes are associated with variations in some biochemical parameters such as markers of bone turnover and leptin, which may reflect changes in bone growth and fat mass, respectively. Children with growth hormone (GH) deficiency have reduced concentrations of bone markers, which increase during GH administration, while the levels of leptin decrease. There have been few studies analysing the behaviour of bone markers during puberty in GH-treated GH-deficient patients and no studies analysing the behaviour of leptin. Results from a longitudinal study showed that there was no change in serum osteocalcin, carboxy-terminal propeptide of type I procollagen, and cross-linked carboxy-terminal telopeptide of type I collagen levels during puberty in GH-treated GH-deficient children. Some studies have shown that changes in markers of bone turnover and leptin after short-term GH treatment may predict the growth response (at 6-12 months) to GH administration in GH-deficient children. At present, insufficient data are available for the clinical use of these parameters as markers of growth response during pubertal development and as predictors of long-term growth response to GH treatment in children with GH deficiency. Nevertheless, the use of more and possibly new markers might improve the accuracy of growth prediction models in the future.

Adolescent↗
PubMed2003

Growth and puberty in Turner's syndrome.

Turner's syndrome is the commonest sex chromosome abnormality in females, resulting from the absence of an X chromosome or the presence of a structurally abnormal X chromosome. Short stature and ovarian failure are the most consistent clinical features and require specific and co-ordinated medical approaches in order to improve final height and well-being in adulthood. High doses of growth hormone (GH) are able to improve adult height in comparison with untreated patients. GH therapy should be started during childhood as soon as the growth curve declines below the 5th percentile and doses adjusted according to clinical response. Some studies reported that combined therapy with GH and an anabolic steroid--oxandrolone--is also beneficial at lower GH doses. Ovarian failure should be treated by appropriate substitutive estrogen therapy. Since estrogen administration may impair growth of patients with Turner's syndrome, the age at beginning of therapy should be individualized taking into consideration potential growth, the need for feminization, bone mineral density and the psychological well-being of each patient. Well co-ordinated endocrine interventions can permit better long-term outcome in adulthood.

Anabolic Agents↗
PubMed2003

Acquisition of bone mass in normal individuals and in patients with growth hormone deficiency.

Children and adolescents with growth hormone (GH) deficiency (GHD) have reduced bone turnover and bone mass in comparison with normal individuals. GH replacement therapy stimulates bone turnover and improves bone mass during childhood and adolescence. At final height, patients with GHD treated with GH have normal mean values of bone mass, but some patients have reduced lumbar BMD (Z score <1) with an increased susceptibility to fractures. Children and adolescents with GHD have approximately a fourfold decreased fracture frequency during treatment in comparison with controls. The changes of bone mass during the transition to adulthood in patients with GHD who discontinued GH treatment after final height are not defined. An increase of lumbar BMD after final height has been reported until 2 years after discontinuation of GH treatment; this could be the result of a spontaneous progression towards peak bone mass or of a persisting effect of GH treatment on bone mass accumulation. GH has an important role in the accrual of bone mass during childhood and adolescence, but the impact of GHD on bone mass during the transiton to adulthood is unknown.

Aging↗
PubMed2003

Effects of thalassemia major on bone mineral density in late adolescence.

Management of thalassemia major has shown substantial clinical and prognostic improvement, suggesting the need for major attention to quality of life. We studied bone health in 25 patients (13 males, 12 females; 15-23 years old) affected by beta-thalassemia major. In all patients, bone mineral density (BMD), biochemical markers of bone and calcium metabolism (calcium, phosphate, magnesium, alkaline phosphatase, urinary calcium, 25-hydroxyvitamin D [25OH-D], 1,25-dihydroxyvitamin D [1,25(OH)2D], parathyroid hormone [PTH]), hematological parameters and gonadal steroids status were assessed and related to each other and to auxological parameters (chronological, statural and bone ages, height, weight, stage of puberty). BMD of the lumbar spine (L1-L4) (g/cm2) and expressed as Z-scores, was assessed by dual energy X-ray absorptiometry. PTH levels were low in seven patients (28%), and in the normal range in 18 (72%). 25OH-D serum levels were normal in 16 patients (64%) and low in nine (36%). 1,25(OH)2D values were reduced in 19 patients (76%) and normal in six (24%). Alkaline phosphatase correlated with bone age delay (r = 0.414; p = 0.039); no other statistically significant correlation was found. Mean BMD values in patients with thalassemia were significantly reduced in comparison with that of age- and sex-matched controls (Z-score: -2.8 +/- 2.0, p <0.001; -3.3 +/- 2.1 in males, and -2.2 +/- 1.9 in females). Twenty-one patients (84%) showed reduced BMD. Overall, BMD reduction was in the osteopenia range in five patients (20%) and in the osteoporosis range in 16 patients (64%). Our data indicate that low BMD is often present in patients with thalassemia, although recognized late, as in the present series. Early diagnosis should be done during childhood, in order to improve the quality of life in adulthood.

Adolescent↗