31 research outputs found
Effects of hypocaloric diets with different glycemic indexes on endothelial function and glycemic variability in overweight and in obese adult patients at increased cardiovascular risk
Background & aims: The role of glycemic index of the diet in glucose control and cardiovascular
prevention is still not clear. The aim of this study was to determine the effects of hypocaloric diets with
different glycemic indexes and glycemic loads on endothelial function and glycemic variability in
nondiabetic participants at increased cardiovascular risk.
Methods: Forty nondiabetic obese participants were randomly assigned to a three-month treatment with
either a low glycemic index (LGI; n ¼ 19) or high glycemic index (HGI; n ¼ 21) hypocaloric diet with
similar macronutrient and fiber content. Endothelial function was measured as flow-mediated dilatation
(FMD) of the brachial artery before and after dieting. In addition, 48-h continuous subcutaneous glucose
monitoring was done before and after dieting in a subgroup of 24 participants.
Results: The amount of weight loss after dieting was similar in both groups. The glycemic index of the diet
significantly influenced the FMD (P < 0.005). In particular, the change of FMD was 2.3 2.6% following
the LGI diet, and 0.9 3.6% after the HGI diet (P < 0.005). The mean 48-h glycemia decreased significantly
after dietary treatment (P< 0.05), but no significant effect of the glycemic index of the diet on
results was observed. The glycemic index of the diet significantly influenced the 48-h glycemic variability
measured as coefficient of variability (CV%; P< 0.001). The CV% decreased after the LGI diet (from 23.5 to
20.0%) and increased after the HGI diet (from 23.6 to 26.6%). The change in percentage of FMD was
inversely correlated with the change in the 48-h glycemic CV% (r¼ 0.45; P < 0.05).
Conclusions: Endothelial function and glycemic variability ameliorate in association with the adherence
to an LGI hypocaloric diet in nondiabetic obese persons.
Clinical trial registration number: ISRCTN56834511
Osteonecrosis of the jaws in patients assuming oral bisphosphonates for osteoporosis: a retrospective multi-hospital-based study of 87 Italian cases
BACKGROUND:
Bisphosphonates (BPs) are currently the chief drugs for the prevention/treatment of osteoporosis; one of their adverse effects is the osteonecrosis of the jaw (BRONJ). The primary endpoints of this multi-center cross-sectional study are: i) an observation of the clinical features of BRONJ in 87 osteoporotic, non-cancer patients; and ii) an evaluation of their demographic variables and comorbidities.
METHODS:
87 BRONJ patients in therapy for osteoporosis with BPs from 8 participating clinical Italian centers were consecutively identified and studied. After BRONJ diagnosis and staging, comorbidities and data relating to local and drug-related risk factors for BRONJ were collected.
RESULTS:
77/87 (88.5%) patients in our sample used alendronate as a BP type; the duration of bisphosphonate therapy ranged from 2 to 200 months, and 51.7% of patients were in treatment for ≤ 38 months (median value). No comorbidities or local risk factors were observed in 17 (19.5%) patients, indicating the absence of cases belonging to BRONJ forms triggered by surgery. BRONJ localization was significantly associated with age: an increased risk of mandible localization (p=0.002; OR=6.36, 95%CI=[1.89; 21.54]) was observed for those over 72 yrs. At multivariate analysis, the increased risk of BRONJ in the mandible for people over 72 yrs (OR'=6.87, 95%CI=[2.13; 2.21]) was confirmed for a BP administration >56 months (OR'=4.82, 95%CI=[2.13; 22.21]).
CONCLUSION:
Our study confirms the fundamental necessity of applying protocols of prevention in order to reduce the incidence of BRONJ in osteoporotic, non-cancer patients in the presence of comorbidities and/or local risk factor as well as, less frequently, in their absence
Osteonecrosis of the jaws in patients assuming oral bisphosphonates for osteoporosis: a retrospective multi-hospital-based study of 87 Italian cases
BACKGROUND:
Bisphosphonates (BPs) are currently the chief drugs for the prevention/treatment of osteoporosis; one of their adverse effects is the osteonecrosis of the jaw (BRONJ). The primary endpoints of this multi-center cross-sectional study are: i) an observation of the clinical features of BRONJ in 87 osteoporotic, non-cancer patients; and ii) an evaluation of their demographic variables and comorbidities.
METHODS:
87 BRONJ patients in therapy for osteoporosis with BPs from 8 participating clinical Italian centers were consecutively identified and studied. After BRONJ diagnosis and staging, comorbidities and data relating to local and drug-related risk factors for BRONJ were collected.
RESULTS:
77/87 (88.5%) patients in our sample used alendronate as a BP type; the duration of bisphosphonate therapy ranged from 2 to 200 months, and 51.7% of patients were in treatment for ≤ 38 months (median value). No comorbidities or local risk factors were observed in 17 (19.5%) patients, indicating the absence of cases belonging to BRONJ forms triggered by surgery. BRONJ localization was significantly associated with age: an increased risk of mandible localization (p=0.002; OR=6.36, 95%CI=[1.89; 21.54]) was observed for those over 72 yrs. At multivariate analysis, the increased risk of BRONJ in the mandible for people over 72 yrs (OR'=6.87, 95%CI=[2.13; 2.21]) was confirmed for a BP administration >56 months (OR'=4.82, 95%CI=[2.13; 22.21]).
CONCLUSION:
Our study confirms the fundamental necessity of applying protocols of prevention in order to reduce the incidence of BRONJ in osteoporotic, non-cancer patients in the presence of comorbidities and/or local risk factor as well as, less frequently, in their absence
Psychological and behavioural factors associated with long-term weight maintenance after a multidisciplinary treatment of uncomplicated obesity
Obesity is a multifactorial syndrome and the likelihood of success of a medical nutritional treatment (MNT) over the long term is low. As psychological and behavioural factors have an important role in both pathogenesis and the treatment of obesity, these issues were
investigated in individuals with obesity who reported a long-term success or a failure in terms of weight loss following a MNT. Eighty-eight individuals of an original
cohort of 251 subjects were re-evaluated 10 years after a
MNT with cognitive-behavioural approach for uncomplicated obesity. Fifty-three participants were classified as
failure (body weight change C0.5 kg) and 35 as a success (10-year body weight change\0.5 kg) of the MNT. Prior
to the beginning of the weight-management program, both the Dieting Readiness Test (DRT) and the Hospital Anxiety and Depression Scale (HADS) were administered. At a 10-year follow-up after the MNT, self-reported questionnaires were administered: quality of life was assessed by
the Obesity Related Well-Being (ORWELL 97) questionnaire, eating attitudes and behaviours by the Eating Disorder
Examination Questionnaire (EDE-Q), the Binge Eating Scale (BES) investigated the presence and severity of binge
eating and the Symptom Checklist (SCL 90-R) was used to identify the psychopathological distress. The scores of the ORWELL 97 items concerning symptoms (P = 0.005), discomfort (P = 0.03) and the total score (P = 0.02) were significantly lower in the success group. The depression score of the HADS was positively correlated with the percentage of body weight change observed 10 years after the
MNT (r = 0.22; P = 0.045). The scores of the shape concern (EDE-Q) (r = 0.35; P = 0.013) and of the discomfort
(ORWELL 97) (r = 0.36; P = 0.012) were significantly correlated with the percentage of body weight
change 10 years after the MNT. In conclusion, this study is
in agreement with the possibility that the psychological quality of life is associated even with modest amounts of
weight loss in the long run. Further research should support identifying successful predictors of weight loss