obesity

Ipovitaminosi D e sindrome metabolica

Editor , , , , ArticoliLRIOG 2022-1 , , , , , .
Ipovitaminosi D e sindrome metabolica

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

1 – UOC transmurale di Endocrinologia & Diabetes Research Institute Federation (DRIF), Dipartimento di Medicina dei Sistemi, Ospedali CTO A. Alesini & S.Eugenio, ASL Roma 2, Università di Roma Tor Vergata (Roma, Italia)

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 – Dipartimento di Scienze Umane e Promozione della Qualità della Vita, Università San Raffaele Roma (Roma, Italia)

6 – Laboratorio di Endocrinologia Cardiovascolare, IRCCS San Raffaele Roma (Roma, Italia)

*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 (

Keywords: metabolic syndrome; obesity; vitamin D deficiency; insulin resistance; type 2 diabetes mellitus; cardiometabolic risk.

Presente in LRIOG Nr.1 – 2022

e-ISSN: 1824-0283

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Eccesso ponderale e infiammazione in menopausa: fisiopatologia di un binomio pericoloso e ruolo degli stili di vita

Editor , , ArticoliLRIOG 2022-1 , , , , , .
Eccesso ponderale e infiammazione in menopausa: fisiopatologia di un binomio pericoloso e ruolo degli stili di vita 

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

1 – Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università “Federico II” di Napoli, Via Sergio Pansini, 5, Napoli, Italia

2 – Cattedra Unesco “Educazione alla salute e allo sviluppo sostenibile”, Federico II University, Napoli, Italia

3 – Centro di Ginecologia e Sessuologia Medica – H. San Raffaele Resnati Milano, Italia; Fondazione Graziottin per la cura del dolore nella donna, ONLUS, Italia

Autore di riferimento: 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.

Presente in LRIOG Nr.1 – 2022

e-ISSN: 1824-0283

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Sindrome endocrino-metabolica e rischi per il parto

Editor , , ArticoliLRIOG 2022-1 , , , , , .
Sindrome endocrino-metabolica e rischi per il parto

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

1 – MD, PhD presso Humanitas University, Milano

2 – MD presso Humanitas University, Milano

3 – MD presso Università Cattolica del Sacro Cuore, Roma

Autore di riferimento: 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.

Presente in LRIOG Nr.1 – 2022

e-ISSN: 1824-0283

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Eccesso ponderale e infiammazione in menopausa: fisiopatologia di un binomio pericoloso e ruolo degli stili di vita

Editor , , ArticoliLRIOG 2021-4 , , , , , .
Eccesso ponderale e infiammazione in menopausa: fisiopatologia di un binomio pericoloso e ruolo degli stili di vita

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

1 – Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università “Federico II” di Napoli, Napoli, Italia

2 – Cattedra Unesco “Educazione alla salute e allo sviluppo sostenibile”, Federico II University, Napoli, Italia

3 – Centro di Ginecologia e Sessuologia Medica H. San Raffaele Resnati Milano, Italia; Fondazione Graziottin per la cura del dolore nella donna, ONLUS, Italia

Autore di riferimento: 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.

Presente in LRIOG Nr.4 – 2021

e-ISSN: 1824-0283

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Sindrome endocrino-metabolica e aspetti nutrizionali: la sindrome dell’ovaio policistico

Editor , , ArticoliLRIOG 2021-4 , , , .
Sindrome endocrino-metabolica e aspetti nutrizionali: la sindrome dell’ovaio policistico

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

1 – Dipartimento di Scienze Umanistiche, Università Telematica Pegaso, Napoli, Italia

2 – Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Università Federico II, Napoli, Italia

3 – Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Università Federico II, Napoli, Italia

4 – Cattedra Unesco “Educazione alla salute e allo sviluppo sostenibile”, Università Federico II, Napoli, Italia

Autore di riferimento: 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.

Presente in LRIOG Nr.4 – 2021

e-ISSN: 1824-0283

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