Inflammation as a Link between Obesity and Metabolic Syndrome

The metabolic syndrome is a complex of clinical features leading to an increased risk for cardiovascular disease and type 2 diabetes mellitus in both sexes. Visceral obesity and insulin resistance are considered the main features determining the negative cardiovascular profile in metabolic syndrome. The aim of this paper is to highlight the central role of obesity in the development of a chronic low-grade inflammatory state that leads to insulin resistance, endothelial and microvascular dysfunctions. It is thought that the starting signal of this inflammation is overfeeding and the pathway origins in all the metabolic cells; the subsequent increase in cytokine production recruits immune cells in the extracellular environment inducing an overall systemic inflammation. This paper focuses on the molecular and cellular inflammatory mechanisms studied until now

Intracellular absorption of transdermal magnesium demonstrated by ESEM-EDS

Magnesium, the second most abundant intracellular cation in human body, plays a fundamental role in intracellular metabolism. As a cofactor in a huge number of key enzimatic reactions, magnesium is especially important for those enzymes that use nucleotides as cofactors or substrates (phosphotransferases, phosphohydrolases, etc.). The majority of magnesium studies were performed by detecting serum magnesium concentration, measure that doesn’t consider the intracellular uptake. In the present study, a different approach has been carried out. By means of an Environmental Scanning Electron Microscope (ESEM) equipped with an Energy Dispersive Spectroscopy (EDS) detector, the intracellular magnesium presence and uptake has been measured in a semiquantitative approach on samples of exfoliating epithelial cells from the oral mucosa [1]. The intracellular magnesium uptake has been experimentally induced by applying, twice a day and for 4 months, on the skin of healthy volunteers, a spray of a magnesium chlorate supersaturated solution. Epithelial cells and blood samples were collected at time zero and every 2 months of treatment. Despite the constant serum concentration of magnesium along the treatment and in absence of any side effect, the EDS analysis reveals a progressive and regular intracellular magnesium increasing of about 100% of the values at each experimental step. Results can confirm the high specificity and, more in general, the high reliability of the EDS analysis about a parameter that can result neglect utilizing only the serum concentration. Moreover, transdermal absorption of magnesium can represent an efficient way of magnesium administration, low dose and side effect free, to be utilize in chronic clinical magnesium deficiency [2]

Human corticotropin releasing hormone test performance in the differential diagnosis between Cushing's disease and pseudo-Cushing state is enhanced by combined ACTH and cortisol analysis.

none8Abstract OBJECTIVE: Corticotropin releasing hormone (CRH) test does not reliably distinguish Cushing's disease (CD) from normality or pseudo-Cushing state (PC). We assessed whether this could be achieved with a novel approach while preserving the ability of the test to distinguish CD from ectopic ACTH syndrome (EAS). Design Retrospective/prospective study. SUBJECTS AND METHODS: We studied 51 subjects with CD, 7 with EAS, 26 with PC, and 31 controls (CT). Human CRH (hCRH) test was performed at 0830 h by measuring plasma ACTH and serum cortisol at -15, 0, 15, 30, 45, 60, 90, and 120 min. RESULTS: The area under the curve-ACTH exhibited a significant negative correlation with baseline serum cortisol in CT and PC, but not in CD or EAS patients. ACTH response to hCRH was blunted in PC compared with CT, whereas peak serum cortisol was higher in PC than in CT subjects. These findings suggested that ACTH-dependent Cushing's syndrome can be diagnosed by the presence of two hCRH test parameters and excluded if either or both are absent. Application of i) basal serum cortisol >12 microg/dl and peak plasma ACTH >54 pg/ml, or ii) peak serum cortisol >21 microg/dl and peak plasma ACTH >45 pg/ml, had 91.3% (95% confidence intervals (CI) 81-97.1) and 94.8% (CI 85.6-98.9) sensitivity and 98.2% (CI 90.6-99.9) and 91.2% (CI 80.7-97) specificity respectively, in diagnosing ACTH-dependent Cushing's syndrome. The >14% serum cortisol increase from mean baseline values to the mean of 15 and 30 min values in patients who were positive for the test completely discriminated between CD and EAS. CONCLUSIONS: Simultaneous plasma ACTH and serum cortisol analysis enables the hCRH test to distinguish CD from PC and from normality, while preserving its ability to discriminate CD from EAS.ARNALDI G.; TIRABASSI G.; PAPA R.; FURLANI G.; TREMENTINO L.; CARDINALETTI M.; FALOIA E.; BOSCARO M.Arnaldi, G.; Tirabassi, G.; Papa, R.; Furlani, G.; Trementino, L.; Cardinaletti, M.; Faloia, Emanuela; Boscaro, Marc