Evaluation and prevention of type II diabetes mellitus and cardiovascular diseases in obese children and adolescents: a public health intervention in a local health organisation in Rome (Italy) [Un intervento di sanità pubblica per la valutazione e la prevenzione del diabete di tipo 2 e delle malattie cardiovascolari in bambini e adolescenti obesi.]

INTRODUCTION: Prevention of childhood obesity and of its complications is an increasingly important public health priority. During 2002-2003 a network of family paediatricians working in the territory of a local health organisation in Rome (Italy) was created, in order to evaluate the health status of obese children. A preferential diagnostic and therapeutic management workup procedure was then developed for these patients at the Paediatrics department of the "Policlinico Tor Vergata" (PTV) university teaching hospital in Rome (Italy). METHODS: Family paediatricians invited children aged 6-14 years with a body mass index (BMI) above the 95th percentile, to a clinical consultation at PTV where each child then underwent a clinical evaluation (including blood pressure measurement and evaluation of family history of cardiovascular disease and type 2 diabetes mellitus) and laboratory testing (including oral glucose tolerance testing-OGTT, measurement of cholesterol and trygliceride levels). The BMI z score and insulin resistance index (HOMA-IR) were also calculated and pubertal stage was assessed. RESULTS: Overall, 168 children, with a mean age of 11 years, were evaluated; 53% were males. The mean BMI z score was 2.43+/-0.45. Forty-four percent of children were found to be hypertensive and 28.3% had a positive family history for type 2 diabetes mellitus. Fifteen children (9%) were found to have Impaired Glucose Tolerance (IGT) while one child was frankly diabetic. Thirty-six children (23.4%) were diagnosed with a metabolic syndrome (MS). Systolic blood pressure was significantly correlated with BMI z score and with 2 hour glucose levels. Obese children with either hypertension or a family history of diabetes were significantly more likely to have glucose intolerance or metabolic syndrome (GI, OR= 4.7 ; MS, OR= 6.8) CONCLUSIONS: A high percentage of obese children and adolescents develop metabolic complications. The percentage of children with such complications is greater when other risk factors such as hypertension and family history of type 2 diabetes are present. Family paediatricians play a fundamental role in the prevention, evaluation and treatment of child obesity. This study underscores the importance of performing routine evaluations of BMI and blood pressure in children aged 6-14 years, eventually by extending well-child visits to this age group

[Evaluation and prevention of type II diabetes mellitus and cardiovascular diseases in obese children and adolescents: a public health intervention in a local health organisation in Rome (Italy)]

Prevention of childhood obesity and of its complications is an increasingly important public health priority. During 2002-2003 a network of family paediatricians working in the territory of a local health organisation in Rome (Italy) was created, in order to evaluate the health status of obese children. A preferential diagnostic and therapeutic management workup procedure was then developed for these patients at the Paediatrics department of the "Policlinico Tor Vergata" (PTV) university teaching hospital in Rome (Italy)

Hunting For Extreme Blazars In The Tev Band

<p>Blazars are a particular class of active galactic nuclei with their relativistic jets pointing close to the line of sight of the observer. Their spectral energy distributions are dominated by non-thermal emission from the jet, consisting of two main bumps. For the so-called extreme blazars, these components each peak in the X-ray and GeV-TeV bands.<br> Recent observations have revealed that in a few of these objects, the energy of the second peak exceeds several TeV (e.g. 1ES 0229+200). These intriguing objects have been suggested as sources of hadronic gamma-ray emission as well as high-energy neutrinos. Their hard TeV spectra are also valuable for indirectly probing the extragalactic background light and the intergalactic magnetic field.<br> In this contribution, we present the results of our observing campaign on ten promising targets performed in very-high-energy gamma rays with the MAGIC telescopes. Modelling of their broadband spectra is also discussed. Furthermore, we propose new targets for current and future TeV gamma-ray telescopes, selected on the basis of hard X-ray and GeV gamma-ray emission.</p

[Evaluation and prevention of type II diabetes mellitus and cardiovascular diseases in obese children and adolescents: a public health intervention in a local health organisation in Rome (Italy)]

Prevention of childhood obesity and of its complications is an increasingly important public health priority. During 2002-2003 a network of family paediatricians working in the territory of a local health organisation in Rome (Italy) was created, in order to evaluate the health status of obese children. A preferential diagnostic and therapeutic management workup procedure was then developed for these patients at the Paediatrics department of the "Policlinico Tor Vergata" (PTV) university teaching hospital in Rome (Italy)

Genotypes of p53 codon 72 correlate with age at onset of type 1 diabetes in a sex-specific manner

In type 1 diabetes mellitus (T1D) p53 pathways are up-regulated and there is an increased susceptibility to apoptosis. The hypothesis is that p53 codon 72 polymorphism could be associated with T1D. A total of 286 children with T1D and a control sample of 730 subjects were studied. p53 codon 72 polymorphism was analysed by polymerase chain reaction. A large increase of p53 *Arg/*Arg was observed in T1D patients with age at onset < 6 years. A strong linear correlation between *Arg/*Arg genotype and age at onset was observed in females. The involvement of the *Arg/*Arg genotype in apoptosis suggests that during the autoimmune process leading to T1D, genetic factors that favor apoptosis may contribute to the onset of overt disease

Genotypes of p53 codon 72 correlate with age at onset of type 1 diabetes in a sex-specific manner

In type 1 diabetes mellitus (T1D) p53 pathways are up-regulated and there is an increased susceptibility to apoptosis. The hypothesis is that p53 codon 72 polymorphism could be associated with T1D. A total of 286 children with T1D and a control sample of 730 subjects were studied. p53 codon 72 polymorphism was analysed by polymerase chain reaction. A large increase of p53 *Arg/*Arg was observed in T1D patients with age at onset < 6 years. A strong linear correlation between *Arg/*Arg genotype and age at onset was observed in females. The involvement of the *Arg/*Arg genotype in apoptosis suggests that during the autoimmune process leading to T1D, genetic factors that favor apoptosis may contribute to the onset of overt disease

A variable degree of autoimmunity in the pedigree of a patient with type 1 diabetes homozygous for the PTPN22 1858T variant

We investigated whether the PTPN22 C1858T polymorphism is associated with the autoimmune conditions present in the family of a child affected by type 1 diabetes (T1D) carrying the TT genotype (index patient) and the potential immunological effect of the variant. We found that nine family members carried the CT genotype and five suffered from autoimmunity. Interestingly, anti-ZnT8 antibodies were detected in T1D patients and in three healthy relatives. In the TT patient, we showed diminished T-cell proliferation and reduced interleukin-2 (IL-2) and interferon-gamma (IFN-γ) production. A marked reduction of IL-2 was also observed for all CT relatives with autoimmunity and a lack of IFN-γ production was observed for the younger brother of the index patient, heterozygous for the polymorphism. In this family, the C1858T variant might confer a high risk of autoimmunity. Moreover, our data confirm that impaired IL-2 production upon T-cell receptor stimulation is associated with autoimmunity in the carriers of the polymorphism. This study might prompt to extend the panel of risk markers in relatives of subjects affected by T1D

Metabolic control and complications in Italian people with diabetes treated with continuous subcutaneous insulin infusion

The objective of this cross-sectional study was to evaluate the degree of glycaemic control and the frequency of diabetic complications in Italian people with diabetes who were treated with continuous subcutaneous insulin infusion (CSII)