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Pozzuoli, Italy

Di Bonito P.,Pozzuoli Hospital | Sanguigno E.,Pozzuoli Hospital | Forziato C.,Pozzuoli Hospital | Saitta F.,Pozzuoli Hospital | And 2 more authors.
Diabetes Care | Year: 2011

OBJECTIVE - To evaluate whether fasting plasma glucose (FPG) within a normoglycemic range is associated with cardiometabolic risk factors (CMRF) among children and adolescents in an outpatient setting. RESEARCH DESIGN AND METHODS - Subjects (780; age 6-16 years) with FPG<100 mg/dL were divided into tertiles of FPG. RESULTS - BMI, waist circumference, homeostasis model assessment-insulin resistance, systolic blood pressure, and white blood cell (WBC) count (P < 0.0001) increased across tertiles of FPG. Subjects with high-normal FPG (89-99 mg/dL) showed a higher risk of insulin resistance, hypertension, and high WBC count compared with subjects with low-normal FPG, independent of BMI z score. CONCLUSIONS - In outpatient children and adolescents, higher FPG within the normal range is associated with several CMRF, independent of obesity. Thus the simple measurement of FPG may help identify subjects who warrant some monitoring in relation to cardiovascular risk. © 2011 by the American Diabetes Association.

Di Bonito P.,Pozzuoli Hospital | Forziato C.,Pozzuoli Hospital | Sanguigno E.,Pozzuoli Hospital | Di Fraia T.,Pozzuoli Hospital | And 4 more authors.
Journal of Endocrinological Investigation | Year: 2010

Objective: To analyze the prevalence of the metabolic syndrome (MetS) defined by three sets of Adult Treatment Panel 111 (ATPIII)-derived criteria, and the ability of each definition to identify insulin-resistance (IR) in a wide cohort of outpatient children. Subjects and methods: Seven hundred and twenty-four children consecutively observed in the Outpatient Pediatric Clinic of Pozzuoli Hospital during the period 2004-2009 were included in the study. Diagnosis of the MetS was made using three definitions: Cook, Jolliffe (which adopt age- and gender-specific cut-points) and de Ferranti. Insulin sensitivity was evaluated by homeostasis model assessment of insulin resistance (HOMA-IR). IR was defined by the 90 th percentile of HOMA-IR in healthy non-obese Italian children grouped by gender and Tanner stage. The ability of each definition to identify IR was evaluated in terms of sensitivity and specificity. Results: The prevalence of the MetS in the overall cohort was 11,12 and 24% using Cook, Jolliffe and de Ferranti criteria, respectively. Sensitivity and specificity in relation to IR were 19 and 94% with Cook criteria, 21 and 92% with Jolliffe criteria, and 39 and 84% with de Ferranti criteria. Conclusions: The prevalence of the MetS in children increases with increasing body weight. Among the three definitions analyzed, de Ferranti identifies a larger number of children with the MetS. The prediction of IR is weak with all definitions; on the contrary, the absence of MetS identifies fairly well children with low degree of IR. ©2010, Editrice Kurtis.

Di Bonito P.,S. Maria delle Grazie | Moio N.,S. Maria delle Grazie | Scilla C.,S. Maria delle Grazie | Cavuto L.,S. Maria delle Grazie | And 7 more authors.
Diabetes Care | Year: 2012

OBJECTIVE - To evaluate whether the high triglyceride-to-HDL cholesterol (TG-to-HDL-C) ratio is associated with cardiometabolic risk (CMR) factors and preclinical signs of organ damage in an outpatient population of white children and adolescents. RESEARCH DESIGN AND METHODS - The study population included 884 subjects (aged 6-16 years), of whom 206 (23%) were normal weight, 135 (15%) were overweight, and 543 (61%) were obese. Biochemical variables were analyzed in the whole sample, whereas homocysteine and left ventricular (LV) geometry and function were evaluated in 536 and 258 children, respectively. RESULTS - The percentage of pubertal children (P < 0.001), as well as measurements of BMI, waist circumference, homeostasis model assessment of insulin resistance, white blood cell count, alanine aminotransferase (ALT), systolic blood pressure (P < 0.0001, for all), creatinine (P < 0.001), and diastolic blood pressure (P < 0.02), increased from the lowest to the highest tertile of the TG-to-HDL-C ratio. Age, sex, homocysteine, and glomerular filtration rate did not change. Moreover, interventricular septum thickness, relative wall thickness, and LV mass index (P = 0.01 to P < 0.0001) increased across tertiles of the TG-to-HDL-C ratio. Children with a TG-to-HDL-C ratio ≥2.0 showed a two- to threefold higher risk of elevated ALT levels and concentric LV hypertrophy than those with a TG-to-HDL-C ratio <2.0, independent of confounding factors. CONCLUSIONS - The high TG-to-HDL-C ratio is associated with several CMR factors and preclinical signs of liver and cardiac abnormalities in the outpatient, white pediatric population. Thus, a TG-to-HDL-C ratio ≥2.0 may be useful in clinical practice to detect children with a worsened CMR profile who need monitoring to prevent cardiovascular disease in adulthood. © 2012 by the American Diabetes Association.

Di Bonito P.,S. Maria delle Grazie | Sanguigno E.,S. Maria delle Grazie | Forziato C.,S. Maria delle Grazie | Di Fraia T.,S. Maria delle Grazie | And 6 more authors.
Obesity | Year: 2014

Objective To evaluate the relationship between estimated glomerular filtration rate (eGFR) and cardiometabolic risk factors (CMRF) in an outpatient pediatric population with high prevalence of obesity. Design and Methods eGFR was evaluated in 901 children unselected for chronic kidney disease of whom 694 were overweight/obese (6-16 years) and 207 were age- and sex-matched normal weight (NW). We generated three categories of eGFR: mild-low eGFR (< 20th percentile), high eGFR (>80th percentile) and intermediate eGFR (20-80th percentile), considered as the reference category Results Children with either mild-low or high eGFR category showed a 2-4 fold higher Odds ratio of high blood pressure, left ventricular hypertrophy, and microalbuminuria compared with children of the intermediate eGFR category. In addition, children with mild-low eGFR levels showed a 1.5-2 fold higher Odds ratio of impaired fasting glucose and high white blood cell count compared with children with intermediate eGFR levels. Conclusions In outpatient children with high prevalence of obesity, children with either mildly reduced or high eGFR have an increased burden of CMRF. Children with eGFR < 97 mL/min/1.73 m2 show a worse CMR profile. This finding supports the usefulness to assess eGFR to identify children with unfavorable CMR profile. © 2013 The Obesity Society.

Miraglia Del Giudice M.,The Second University of Naples | Saitta F.,S. Maria delle Grazie | Leonardi S.,University of Catania | Capasso M.,The Second University of Naples | And 5 more authors.
International Journal of Immunopathology and Pharmacology | Year: 2012

The objective of the study is to verify effects of nebulized 3% saline hypertonic solution (HS) in comparison to normal saline (NS) in addition to epinephrine in hospitalized children with bronchiolitis. Infants were randomly assigned either to receive every 6 hours nebulized NS (group I) or 3% HS (group II) in addition to epinephrine (1.5 mg) and to conventional treatment. The main endpoints of this study were the length of stay (LOS) in hospital and the clinical response score (CSS). Patients presented a significant decrease in CSS from the first through the third day of treatment, present in the first group but even more evident in the second group (p=0.0001). Comparison between group I and II data shows significant decrease in CSS in the 3% HS-treated patients both at the second (p<0.005) and at the third day of treatment (p<0.005). Infants in the NS control group had a mean LOS of 5.6±1.6 days, whereas children treated with 3% HS were discharged with a LOS of 4.9±1.3 days, reaching a significant decrease in stay (p<0.05). In hospitalized patients bronchiolitis nebulized 3% HS and epinephrine significantly decreased symptoms and LOS as compared to 0.9% NS and epinephrine. Copyright © by BIOLIFE, s.a.s.

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