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Gazzaruso C Bruno R Garzaniti A Giordanetti S Fratino P Sacchi P Filice G 《Journal of hypertension》2003,21(7):1377-1382
OBJECTIVES: Metabolic syndrome is a cluster of risk factors, such as central obesity, dyslipidemia, glucose intolerance, hypertension, related to insulin resistance. In HIV patients insulin resistance and several metabolic abnormalities of the metabolic syndrome have been described, but few and conflicting studies have investigated the behaviour of blood pressure. The aims of the present study were to evaluate the prevalence of hypertension in a large group of HIV-patients on highly active antiretroviral therapy (HAART) and to investigate the relationship between hypertension, metabolic syndrome and insulin resistance. DESIGN: Case control study. METHODS: We enrolled 287 HIV-positive patients on HAART (mean age 41.1 +/- 7.5 years) and 287 age- and sex-matched controls. Insulin resistance was estimated by the homeostasis model insulin resistance assessment (HOMA) index. Metabolic syndrome was defined according to the European Group for the Study of Insulin Resistance. RESULTS: HIV patients showed a prevalence of subjects with hypertension (34.2 versus 11.9%; P < 0.0001) and metabolic syndrome (33.1 versus 2.4%; P < 0.0001) higher than controls. HOMA was higher in HIV-patients than controls (3.3 +/- 1.2 versus 2.0 +/- 0.9; P < 0.0001). HOMA (3.7 +/- 1.0 versus 3.1 +/- 1.2; P < 0.001) and the prevalence of subjects with the metabolic syndrome (64.3 versus 16.9%; P < 0.0001) were greater in HIV-patients with than in those without hypertension. Multiple logistic regression analysis showed that family history of hypertension (odds ratio [(OR): 8.73; 95% confidence interval (CI): 4.31-17.70; P < 0.0001], metabolic syndrome (OR: 6.79; 95% CI: 3.27-14.10; P < 0.0001), lipodystrophy (OR: 4.80; 95% CI: 2.43-9.85; P < 0.0001) and HOMA (OR: 4.13; 95% CI: 1.14-14.91; P < 0.05) were predictors of hypertension in HIV-patients. CONCLUSIONS: The present study shows that hypertension is frequent in HIV patients on HAART and that hypertension appears to be linked to insulin resistance; in particular, hypertension seems to be a part of the metabolic syndrome. 相似文献
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Bellazzi R Arcelloni M Bensa G Blankenfeld H Brugués E Carson E Cobelli C Cramp D D'Annunzio G De Cata P De Leiva A Deutsch T Fratino P Gazzaruso C Garcìa A Gergely T Gómez E Harvey F Ferrari P Hernando E Boulos MK Larizza C Ludekke H Maran A Nucci G Pennati C Ramat S Roudsari A Rigla M Stefanelli M 《Diabetes technology & therapeutics》2003,5(4):621-629
Recent advances in information and communication technology allow the design and testing of new models of diabetes management, which are able to provide assistance to patients regardless of their distance from the health care providers. The M2DM project, funded by the European Commission, has the specific aim to investigate the potential of novel telemedicine services in diabetes management. A multi-access system based on the integration of Web access, telephone access through interactive voice response systems, and the use of palmtops and smart modems for data downloading has been implemented. The system is based on a technological platform that allows a tight integration between the access modalities through a middle layer called the multi-access organizer. Particular attention has been devoted to the design of the evaluation scheme for the system: A randomized controlled study has been defined, with clinical, organizational, economic, usability, and users' satisfaction outcomes. The evaluation of the system started in January 2002. The system is currently used by 67 patients and seven health care providers in five medical centers across Europe. After 6 months of usage of the system no major technical problems have been encountered, and the majority of patients are using the Web and data downloading modalities with a satisfactory frequency. From a clinical viewpoint, the hemoglobin A1c (HbA1c) of both active patients and controls decreased, and the variance of HbA1c in active patients is significantly lower than the control ones. The M2DM system allows for the implementation of an easy-to-use, user-tailored telemedicine system for diabetes management. The first clinical results are encouraging and seem to substantiate the hypothesis of its clinical effectiveness. 相似文献
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Tiziana Montalcini Gaetano Gorgone Carmine Gazzaruso Adriana Garzaniti Arturo Pujia 《Atherosclerosis》2010,210(2):458-460
Objective
To investigate on Brachial Artery Diameter enlargement in postmenopausal women with Metabolic Syndrome.Methods
294 women were admitted and classified in two groups according to the presence of Metabolic Syndrome. Serum glucose, insulin, lipid profile, carotid arteries and Brachial Artery Diameter were measured.Results
Subjects with Metabolic Syndrome had the following different parameters in comparison to subjects without Metabolic Syndrome: Brachial Artery Diameter, Common Carotid Artery Diameter, IMT, and age. In a multivariate regression analysis Brachial Artery Diameter resulted correlated to age and presence of Metabolic Syndrome, among the Metabolic Syndrome components HDL was the only one to be associated to artery diameter. Furthermore, artery diameters increased with the increasing number of Metabolic Syndrome components.Conclusion
Brachial Artery Diameter enlargement was found in postmenopausal women with Metabolic Syndrome. Arterial enlargement seems to be a systemic process occurring in response to some factors involved in atherosclerosis and not a focal change. 相似文献36.
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C. Gazzaruso A. Garzaniti P. Buscaglia G. D'Annunzio A. Porta G. Vandelli R. Lorini G. Finardi P. Fratino D. Geroldi 《Acta diabetologica》1998,35(1):13-18
To investigate plasma concentrations of lipoprotein(a) [Lp(a)] and apolipoprotein(a) [apo(a)] polymorphism in relation to
the presence of microvascular and neurological complications in type 1 diabetes mellitus, 118 young diabetic patients and
127 age-matched controls were recruited. Lp(a) levels were higher in patients than in controls, but the apo(a) isoforms distribution
did not differ between the two groups [higher prevalence of isoforms of high relative molecular mass (RMM) in both groups].
Microalbuminuric patients had Lp(a) levels significantly greater than normoalbuminuric patients, and normoalbuminuric patients
showed higher Lp(a) levels than controls. Patients with retinopathy or neuropathy showed similar Lp(a) levels to those without
retinopathy or neuropathy. No differences in apo(a) isoforms frequencies were observed between subgroups with and without
complications (higher prevalence of isoforms of high RMM in every subgroup). However, among patients with retinopathy, those
with proliferative retinopathy had higher Lp(a) levels and a different apo(a) isoforms distribution (higher prevalence of
isoforms of low RMM) than those with non-proliferative and background retinopathy (higher prevalence of isoforms of high RMM).
Our data suggest that young type 1 diabetic patients without microalbuminuria have Lp(a) levels higher than healthy subjects
of the same age. Lp(a) levels are further increased in microalbuminuric patients. High Lp(a) levels and apo(a) isoforms of
low RMM seem to be associated with the presence of proliferative retinopathy, but have no relation to neuropathy.
Received: 23 June 1997 / Accepted in revised form: 27 November 1997 相似文献
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Gazzaruso C Garzaniti A Falcone C Geroldi D Turpini C Fratino P 《International journal of cardiology》2003,87(1):91-98
BACKGROUND: The relationship between lipoprotein(a) and restenosis after intracoronary stent implantation has been analysed by two specific studies, but the role of apoliprotein(a) polymorphism was not considered. The aim of the present prospective study was to evaluate whether lipoprotein(a) levels and apolipoprotein(a) phenotypes are predictors of restenosis after elective stent implantation in patients with de novo lesions of coronary arteries. METHODS: We recruited 182 patients with a new lesion successfully treated with elective placement of one or two Palmaz-Schatz stents. Follow-up angiography was scheduled at 6 months or earlier if clinically indicated. Nine patients were lost to the follow up. Among 173 patients enrolled, restenosis was present in 52 (30.0%) and absent in 121 (70.0%). RESULTS: Lipoprotein(a) levels were higher in the restenosis than in the nonrestenosis group (29.5+/-17.2 versus 27.4+/-20.2 mg/dl), even if the difference did not attain statistical significance (P=0.067). The restenosis group had a percentage of subjects with at least one apolipoprotein(a) isoform of low molecular weight significantly greater than the nonrestenosis group (82.7 versus 66.9%; P=0.035). A multiple logistic regression analysis showed that multiple stenting (RR: 4.01; CI 95%: 1.65-13.91; P=0.004), presence of diabetes (RR: 3.96; CI 95%: 1.67-9.37; P=0.002) and presence of multivessel disease (RR: 2.71; CI 95%: 1.19-6.16; P=0.017) were predictors of restenosis after stent placement. Lipoprotein(a) and apolipoprotein(a) polymorphism did not enter the model as predictive variables. CONCLUSIONS: Our study confirms that multiple stenting, diabetes and multivessel disease are powerful predictors of restenosis after intracoronary stent implantation. On the contrary, lipoprotein(a) and apolipoprotein(a) polymorphism do not appear to be reliable markers of restenosis in patients with stent implantation. 相似文献