obesity

Hypovitaminosis D and metabolic syndrome

Editor , , , , ArticlesLRIOG 2022-1 , , , , , .
Hypovitaminosis D and metabolic syndrome

Martina Leoni1* – Orcid, Marco Infante 1,2,3,4,* – Orcid, Raffaele Infante 4 – Orcid, Massimiliano Caprio 5,6– Orcid, Andrea Fabbri1 – Orcid

1 – Transmural Complex Organizational Unit of Endocrinology & Diabetes Research Institute Federation (DRIF), Department of Systems Medicine, CTO A. Alesini & S.Eugenio Hospitals, Local Health Center Roma 2, University of Rome Tor Vergata (Rome, Italy)

2 – UniCamillus, Saint Camillus International University of Health Sciences (Roma, Italia)

3 – Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN) (Roma, Italia)

4 – Cardio Endocrino Metabolica (CEM) – Endocrine and Cardiometabolic Center (Salerno, Italia)

5 – Department of Human Sciences and Promotion of the Quality of Life, San Raffaele University of Rome (Rome, Italy)

6 – Cardiovascular Endocrinology Laboratory, Scientific Institute for Research, Hospitalization and Healthcare, San Raffaele Rome (Rome, Italy)

*Martina Leoni e Marco Infante hanno contribuito in egual misura alla stesura del presente articolo.

Autore di riferimento: Marco Infante

marco.infante@unicamillus.org

DOI: 10.53146/lriog1202162

Abstract

Metabolic syndrome is a complex disorder characterized by the co-occurrence of several known cardiovascular risk factors, including obesity, insulin resistance, atherogenic dyslipidemia and hypertension. As such, metabolic syndrome is associated with an increased risk of cardiovascular disease and type 2 diabetes mellitus. Of note, metabolic syndrome is defined by the presence of at least three of the following conditions: abdominal obesity (or central obesity), high blood pressure (≥130/≥85 mmHg), abnormal fasting plasma glucose (≥100 mg/dL), elevated serum triglycerides (≥150 mg/dL) and low high-density lipoprotein (HDL)-cholesterol level (<40 mg/dL in men, <50 mg/dL in women). Over the last years, the global prevalence of metabolic syndrome has progressively increased as a consequence of the increasing rates of overweight/obesity, population ageing, and lifestyle changes favoring sedentary behaviors, physical inactivity and unhealthy dietary habits. On the other hand, the global prevalence of vitamin D deficiency has concurrently increased. To date, vitamin D deficiency is regarded as a global pandemic afflicting more than one billion individuals across all age groups worldwide. Since growing evidence suggests that vitamin D exerts several pleiotropic extraskeletal actions beyond its well-established role in the regulation of bone homeostasis, researchers have proposed that vitamin D deficiency may be involved in the pathophysiology of metabolic syndrome. Therefore, this brief Report article aims to summarize the current scientific evidence regarding the possible causal relationship between vitamin D deficiency and metabolic syndrome, as well as the potential favorable effects Keywords: metabolic syndrome; obesity; vitamin D deficiency; insulin resistance; type 2 diabetes mellitus; cardiometabolic risk.

Available in LRIOG Nr.1 – 2022

e-ISSN: 1824-0283

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Weight excess and inflammation in menopause: pathophysyology of a dangerous liaison and role of lifestyles

Editor , , ArticlesLRIOG 2022-1 , , , , , .
Weight excess and inflammation in menopause: pathophysiology of dangerous liaison and role of lifestyles

Gabriella Pugliese1 – Orcid, Annamaria Colao1,2 – Orcid, Alessandra Graziottin3 – Orcid

1 – Department of Clinical Medicine and Surgery, Section of Endocrinology, University “Federico II” of Naples, Via Sergio Pansini, 5, Naples, Italy

2 – Unesco Chair “Health Education and Sustainable Development”, Federico II University, Naples, Italy

3 – Center for Gynecology and Medical Sexology – San Raffaele Resnati Hospital Milan, Italy; Graziottin Foundation for the treatment of pain in women, ONLUS, Italy

Corresponding Author: Gabriella Pugliese

robiniapugliese@gmail.com

DOI: 10.53146/lriog1202159

Abstract

Weight gain is a common condition in menopause. It recognizes both modifiable and non-modifiable multifactorial etiological mechanisms. They include age, climacteric hormonal changes, alteration of hunger and satiety circuits, sleep disorders, reduction of energy expenditure, sedentary lifestyle and nutrition, including the eating time (chrononutrition and chronotype). The redistribution of adipose tissue, mainly from the subcutaneous site to the visceral site, acts as a real endocrine organ capable of secreting adipokines and proinflammatory cytokines such as TNF-α, IL-1, IL-6 and leptin. This contributes to the menopausal chronic low-grade inflammation, that increases the risk of metabolic disorders, cardiovascular events and neurovegetative disorders. Lifestyles interventions are the first line approach to cope with this condition. To date there are no specific dietary and exercise recommendations to be prescribed in overweight/obese women at menopause. The purpose of this review is, first, to analyse the mechanisms that favour weight gain, with focus on the role of sleep disorders and of proinflammatory mediators produced by the adipose tissue; second, to provide practical recommendations focused on lifestyles, useful in the general clinical management of postmenopausal women. The potential role of bowel microbiota and chronotype will be finally briefly discussed.

Keywords: menopause; obesity; inflammation; sleep disorders; adipose tissue; adipokines.

Available in LRIOG Nr.1 – 2022

e-ISSN: 1824-0283

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Metabolic syndrome and birth risks

Editor , , ArticlesLRIOG 2022-1 , , , , , .
Metabolic syndrome and birth risks

Nicoletta Di Simone1 – Orcid, Gloria Lalli2 – Orcid, Greta Barbaro3 – Orcid

1 – MD, PhD at Humanitas University, Milan

2 – MD at Humanitas University, Milan

3 – MD at Università Cattolica del Sacro Cuore, Rome

Corresponding Author: Nicoletta Di Simone

nicoletta.disimone@hunimed.eu

DOI: 10.53146/lriog1202156

Abstract

Metabolic syndrome is a condition characterized by the simultaneous presence of a cluster of risk factors leading to an increased cardiovascular risk. During pregnancy this syndrome has important repercussions on the maternal and fetal well-being and can cause important risks at the time of delivery. Pregestational hypertension increases the risk of preeclampsia, intrauterine fetal growth restriction and abruptio placentae. Also type II diabetes is a risk factor for preeclampsia and hypodevelopment but may also involve the appearance of fetal macrosomia and polyamnios. Fetal macrosomia is responsible for an increased risk of shoulder dystonia and polyamnios can determine the umbilical cord prolapse at the time of rupture of the membranes. Obesity is another element of metabolic syndrome. The obese pregnant patient has an increased risk of premature childbirth, she has a lower probability of response to the medical induction of labor and requires higher doses of oxytocin. In addition, the management of these patients is also complicated from an anesthesiological point of view: the placement of the peridural catheter is more difficult and they have a higher risk that it will displace, therefore getting a good epidural analgesia in these patients is not always easy. In obese patients, the risk of performing an urgent cesarian section is higher and leads to increased anaesthetic complications (tough intubation and difficult mechanical ventilation), intraoperative complications (increased bleeding and difficult fetal extraction) and post-operative (increased risk of surgical site infection). Still unclear are the effects of a dyslipidic state on pregnancy, although the change in lipidic profile is, within certain limits, physiological. Metabolic syndrome is therefore a condition that must be intercepted before pregnancy arises, as all the factors that compose it are modifiable.

Keywords: metabolic syndrome; pregnancy; obesity; hypertension; diabetes; delivery.

Available in LRIOG Nr.1 – 2022

e-ISSN: 1824-0283

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Weight excess and inflammation in menopause: pathophysiology of a dangerous liaison and role of lifestyles

Editor , , ArticlesLRIOG 2021-4 , , , , , .
Weight excess and inflammation in menopause: pathophysiology of a dangerous liaison and role of lifestyles

Gabriella Pugliese1 – Orcid, Annamaria Colao1,2 – Orcid, Alessandra Graziottin3 – Orcid

1 – Department of Clinical Medicine and Surgery, Endocrinology Section, “Federico II” University of Naples, Naples, Italy

2 – Unesco Chair “Health Education and Sustainable Development”, Federico II University, Naples, Italy

3 – Center for Gynecology and Medical Sexology H. San Raffaele Resnati Milan, Italy; Graziottin Foundation for the treatment of pain in women, ONLUS, Italy

Corresponding Author: Gabriella Pugliese

robiniapugliese@gmail.com

DOI: 10.53146/lriog1202151

Abstract

Weight gain is a common condition in menopause. It recognizes both non- modifiable and modifiable multifactorial etiological mechanisms. The first include: age, climacteric hormonal changes, alteration of hunger and satiety circuits, reduction of energy expenditure and sleep disorders; while among non-modifiable factors: sedentary lifestyle and nutrition, including the ea- ting time (chrononutrition and chronotype). The redistribution of adipo- se tissue, mainly from the subcutaneous site to the visceral site, acts as a real endocrine organ capable of secreting adipokines and proinflammatory cytokines such as TNF-a, IL-1, IL-6 and leptin. This contributes to the meno- pausal chronic low-grade inflammation, that increases the risk of metabolic disorders, cardiovascular events and neurovegetative disorders. Lifestyles interventions are the first line approach to cope with this condition. To date there are no specific dietary and exercise recommendations to be prescribed in overweight/obese women at menopause. The purpose of this review is, first, to analyse the mechanisms that favour weight gain, with focus on the role of sleep disorders and of proinflammatory mediators produced by the adipose tissue; second, to provide practical recommendations focused on li- festyles, useful in the general clinical management of postmenopausal wo- men. The potential role of bowel microbiota and chronotype will be finally briefly discussed.

Keywords: menopause; obesity; inflammation; sleep disorders; adipose tissue; adipokines.

Available in LRIOG Nr.4 – 2021

e-ISSN: 1824-0283

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Endocrine-metabolic syndrome and nutritional aspects: polycystic ovary syndrome

Editor , , ArticlesLRIOG 2021-4 , , , .
Endocrine-metabolic syndrome and nutritional aspects: polycystic ovary syndrome

Luigi Barrea1,2 – Orcid, Ludovica Verde3 – Orcid, Giovanna Muscogiuri2,3,4 – Orcid

1 – Department of Humanities, Pegaso Telematic University, Naples, Italy

2 – Italian Center for the Care and Wellbeing of Patients with Obesity (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, Federico II University, Naples, Italy

3 – Department of Clinical Medicine and Surgery, Endocrinology Unit, Federico II University, Naples, Italy

4 – Unesco Chair “Education for health and sustainable development”, Federico II University, Naples, Italy

Corresponding Author: Luigi Barrea

luigi.barrea@unina.it

DOI: 10.53146/lriog1202150

Abstract

Polycystic ovary syndrome (PCOS) is the most common endocrine and me- tabolic disorders in women of reproductive age, defined by a combination of signs and clinical or biochemical symptoms of androgen excess and ova- rian dysfunction in the absence of other specific endocrine diagnoses. The aetiology of PCOS is largely unknown, but different evidence suggests that this syndrome might be a complex multifactorial disorder with strong envi- ronmental and epigenetic influences, including lifestyle factors, such as nutri- tion. Specific nutrients per sè or via weight loss improve endocrine features, cardiometabolic risk profile, and reproductive function. Different foods and a change in dietary habits are associated with the reduction of body weight and with improvement PCOS clinical severity. Of interest, beyond obesity se- veral comorbidities, including infertility, metabolic syndrome, impaired glu- cose tolerance, insulin resistance, type 2 diabetes, and increased cardiovascu- lar risk are associated with PCOS. In this context, specific recommendations on macronutrient intake should be provided to patients with obesity and PCOS. In particular, high intake of high glycemic index carbohydrate contributes to weight gain and metabolic alterations, including insulin resistance, dysli- pidemia and metabolic syndrome, and stimulates hunger and carbohydrate craving. The nutritional approach in PCOS must be to reach specific goals including as improving insulin resistance and metabolic disorders that will be possible through an hypocaloric diet reducing the intake of simple and refined carbohydrates with a high glycemic index, limiting of saturated fatty acids (<10% of total energy intake), and attention to possible deficiencies of several micronutrients, including vitamin D, chromium and omega-3. The main aim of this narrative review is to discuss the role of diet as therapeutic treatment in management of women with obesity and PCOS.

Keywords: polycystic ovary syndrome; obesity; nutrition; diet.

Available in LRIOG Nr.4 – 2021

e-ISSN: 1824-0283

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