The mtDNA 15497 G/A polymorphism in cytochrome b in severe obese subjects from Southern Italy.

Background and aim: A large number of mitochondrial DNA (mtDNA) mutations have been implicated in degenerative diseases and aging. The aim of this study was to evaluate whether the 15497 G/A mtDNA polymorphism (G251S) in the cytochrome b subunit of respiratory complex III, which has been associated with obesity-related variables and lipid metabolism in a Japanese population, is associated with severe obesity also in adult Caucasians from southern Italy. Methods and results: Unrelated severely obese patients (n Z 317; BMI > 40 kg/m2) and controls (n Z 217; BMI < 25 kg/m2) from Southern Italy were genotyped by allelic discrimination TaqMan assay for the 15497 G/A mtDNA polymorphism. In obese patients fasting serum total cholesterol, triglycerides, HDL-cholesterol and glucose were measured enzymatically and sitting blood pressure and heart rate were also collected. Mean levels of total cholesterol, triglycerides and glucose were below the upper reference limit for healthy subjects. Female obese subjects showed lower levels of blood pressure and heart rate and higher levels of HDL cholesterol than male obese patients (P < 0.001). All the control subjects and 315/317 severely obese patients were homozygous for the G allele (wild type), whereas only 2/317, were females homozygous for the A allele. Conclusions: The mtDNA 15497 G/A polymorphism in cytochrome b was present in 0.6% obese subjects, two females whose lipid parameters and BMI were similar to those of the overall group. Therefore, this mutation may appear to contribute in rare instances to severe obesity but does not explain the majority of cases in our population. A more extensive genetic haplogroup characterization is required to identify associations to obesity in Caucasians

Fecal Short Chain Fatty Acids and Dietary Intake in Italian Women With Restrictive Anorexia Nervosa: A Pilot Study

Nutritional disorders such as Anorexia Nervosa (AN) can shape the composition of gut microbiota and its metabolites such as short chain fatty acid (SCFA). This study aims to compare fecal SCFA along with dietary intake of women with restrictive AN (r-AN = 10) and those of sex-matched lean controls (C = 8). The main fecal short chain fatty acids (SCFA) were assessed by gas chromatography equipped with a flame ionization detector. All participants completed 7-day food record and underwent indirect calorimetry for measuring resting energy expenditure (REE). Butyrate and propionate fecal concentrations were significantly reduced in r-AN patients compared to controls. The intake of carbohydrate and fat was significantly lower in r-AN patients than controls as well as energy intake and REE; whereas the amount of protein and fiber did not differ between groups. These preliminary results showed that r-AN patients had a reduced excretion of fecal SCFA, likely as a mechanism to compensate for the lower energy and carbohydrate intake observed between groups. Therefore, further studies need to be performed in patients with AN to explore the link between nutritional disorders, gut microbiota and its metabolites

Micronutrient content in enteral nutrition formulas: comparison with the dietary reference values for healthy populations

The micronutrient content in standard enteral mixtures should be closer to the dietary reference values for a healthy population since standard enteral diets are formulated for subjects with no special nutritional needs. This study compares the micronutrient content of the most common enteral nutrition (EN) formulas with European dietary reference values (DRVs) for healthy population

Iron Absorption following a Single Oral Dose of Ferrous Sulfate or Ferric Gluconate in Patients with Gastrectomy

Background: Iron deficiency anemia frequently occurs in gastrectomized patients. Methods: Serum iron levels following the ingestion of a single oral dose of 105 mg elemental iron, taken as ferrous sulfate (FeS) or ferric gluconate (FeG), have been evaluated in 20 gastrectomized patients (and 20 controls). All subjects participated on 2 different test days, 1 month apart: they took a single dose of 105 mg elemental iron as FeS or FeG after a night of fasting. Serum iron concentrations at baseline, 30, 60, 120 and 180 min after the oral dose administration were measured. Results: In patients and controls receiving FeG, serum iron levels did not significantly change. After oral ingestion of FeS, patients' serum iron levels gradually increased. The increase in serum iron levels was 148 and 168% at 120 and 180 min in patients (p < 0.0001 for both evaluations), whilst in controls, it was 216% at 120 min and 234% at 180 min, i.e. significantly higher than in gastrectomized patients (p < 0.001 for both evaluations). Conclusions: In gastrectomized patients, a single oral dose of FeS shows a significant increase in iron serum concentration, albeit lower than in controls. Further studies on a larger sample of patients will be necessary to confirm these results

Are Raw BIA Variables Useful for Predicting Resting Energy Expenditure in Adults with Obesity?

This study aimed to develop and validate new predictive equations for resting energy expenditure (REE) in a large sample of subjects with obesity also considering raw variables from bioimpedance-analysis (BIA). A total of 2225 consecutive obese outpatients were recruited and randomly assigned to calibration (n = 1680) and validation (n = 545) groups. Subjects were also split into three subgroups according to their body mass index (BMI). The new predictive equations were generated using two models: Model 1 with age, weight, height, and BMI as predictors, and Model 2 in which raw BIA variables (bioimpedance-index and phase angle) were added. Our results showed that REE was directly correlated with all anthropometric and raw-BIA variables, while the correlation with age was inverse. All the new predictive equations were effective in estimating REE in both sexes and in the different BMI subgroups. Accuracy at the individual level was high for specific group-equation especially in subjects with BMI > 50 kg/m². Therefore, new equations based on raw-BIA variables were as accurate as those based on anthropometry. Equations developed for BMI categories did not substantially improve REE prediction, except for subjects with a BMI > 50 kg/m². Further studies are required to verify the application of those formulas and the role of raw-BIA variables for predicting REE

Ureteroiliac Artery Fistula in a Young Woman with Short Bowel Syndrome for Radiation Enteritis

Ureteral-iliac artery fistula is a rare and potentially life-threatening complication, typically occurring after radiation therapy in already surgically treated cancer patients. This case report describes the diagnostic challenges and the successful management, with the positioning of an intra-arterial prosthesis, of a fistula between the internal iliac artery and the left ureter presenting as massive hematuria in a young woman with history of total colectomy and pelvic radiotherapy for rectal cancer and subsequent wide ileal resections and bilateral ureteral stent positioning for radiation enteritis. Ureteroiliac artery fistulas require a prompt diagnosis and intervention, to avoid life threatening clinical events