Examinando por Autor "Cignarelli, Mauro"

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Serum Adiponectin and Glomerular Filtration Rate in Patients with Type 2 Diabetes
(PlosOne, 2015) Ortega Moreno, Lorena; Lamacchia, Olga; Copetti, Massimiliano; Salvemini, Lucia; De Bonis, Concetta; De Cosmo, Salvatore; Cignarelli, Mauro; Trischitta, Vincenzo; Menzaghi, Claudia
High serum adiponectin has been increased in several conditions of kidney disease. Only sparse and conflicting results have been reported in patients with type 2 diabetes (T2D), a subgroup of individuals who are at high risk for renal dysfunction. The aim of this study was to fill up this gap of knowledge by investigating such association in a large sample of Italian diabetic patients. The association between serum adiponectin levels and estimated glomerular filtration rate (eGFR by Chronic Kidney Disease-Epidemiology Collaboration CKD-EPI equation) was investigated in 1,243 patients with T2D from two cross-sectional Italian studies: 878 from San Giovanni Rotondo (SGR) and 365 from Foggia (FG). Serum adiponectin was inversely associated with eGFR in SGR [β (standard error, SE) for 1 standard deviation (SD) of adiponectin = -3.26 (0.64)] and in FG [β(SE)=-5.70(1.28)] sample, as well as in the two studies combined [β(SE)=-3.99(0.59)];(p<0.0001 for all). In this combined analysis, the association was still significant after adjusting for sex, smoking habits, body mass index (BMI), waist circumference, diabetes duration, glycated hemoglobin (HbA1c), albumin creatinine ratio (ACR) and anti-hyperglycemic, anti-hypertensive and anti-dyslipidemic treatments [β (SE)= -2.19 (0.59), p = 0.0001]. A stronger association between each SD adiponectin increment and low eGFR was observed among patients with micro-/macro-albuminuria, as compared to those with normo-albuminuria [adjusted β(SE)=-4.42(1.16) ml/min/ 1.73m2 vs. -1.50 (0.67) ml/min/1.73m2 , respectively; p for adiponectin-by-albuminuric status = 0.022]. For each adiponectin SD increment, the odds of having eGFR < 60 ml/min/1.73m2 increased by 41% (odds ratio, OR = 1.41; 95% confidence interval, CI 1.21–1.64) in SGR sample, 53% (OR = 1.53; 95% CI 1.21–1.94) in FG sample, and 44% (OR = 1.44; 95%CI 1.27–1.64) in the two studies considered together (p<0.0001 for all). In the combined sample, further adjustment for the above mentioned covariates did not change the observed association (OR = 1.36; 95%CI 1.16–1.60; p<0.0001). Our study, so far the largest addressing the relationship between serum adiponectin and GFR in T2D, strongly suggests that the paradoxical inverse association, previously reported in different clinical sets, is also observed in diabetic patients. Further studies are needed to unravel the biology underlying this counterintuitive relationship.
Serum resistin is causally related to mortality risk in patients with type 2 diabetes: preliminary evidences from genetic data
(2017) Ortega Moreno, Lorena; Fontana, Andrea; Lamacchia, Olga; De Bonis, Concetta; Salvemini, Lucia; De Cosmo, Salvatore; Cignarelli, Mauro; Copetti, Massimiliano; Trischitta, Vincenzo; Menzaghi, Claudia
Resistin has been firmly associated with all-cause mortality. We investigated, whether, in patients with type 2 diabetes (T2D), this association is sustained by a cause-effect relationship. A genotype risk score (GRS), created by summing the number of resistin increasing alleles of two genome-wide association studies (GWAS)-derived single nucleotide polymorphisms (SNPs), serum resistin measurements and allcause death records were obtained in 1,479 (403 events/12,454 person-years), patients with T2D from three cohorts, Gargano Heart Study-prospective design (n=350), Gargano Mortality Study (n=698) and Foggia Mortality Study (n=431), from Italy. GRS was strongly associated with serum resistin in a non-linear fashion (overall p=3.5*10−7) with effect size modest for GRS=1 and 2 and much higher for GRS >3, with respect to GRS=0. A significant non-linear association was observed also between GRS and all-cause mortality (overall p=3.3*10−2), with a low effect size for GRS=1 and 2, and nearly doubled for GRS≥3, with respect to GRS=0. Based on the above-reported associations, each genetic equivalent SD increase in log-resistin levels showed a causal hazard ratio of all-cause mortality equal to 2.17 (95%CI: 1.22–3.87), thus providing evidence for a causal role of resistin in shaping the risk of mortality in diabetic patients.
The combined effect of adiponectin and resistin on all-cause mortality in patients with type 2 diabetes: Evidence of synergism with abdominal adiposity
(2016) Ortega Moreno, Lorena; Lamacchia, Olga; Fontana, Andrea; Copetti, Massimiliano; Salvemini, Lucia; De Bonis, Concetta; Cignarelli, Mauro; Trischitta, Vincenzo; Menzaghi, Claudia
Background and aims While elevated serum adiponectin and resistin levels have been singly associated with all-cause mortality in patients with type 2 diabetes (T2D), their combined effect has never been studied. We investigated such joint effect in patients with T2D and its possible modulation by several demographic and clinical conditions, known to affect per se mortality rate. Methods Patients with T2D from the Gargano Mortality Study (GMS; N = 895, follow-up = 10.5 ± 3.7 years; 290 events) and the Foggia Mortality Study (FMS; N = 519, follow-up = 7.1 ± 2.5 years; 140 events) were examined. Results As singly considered, adiponectin and resistin were independently associated with mortality rate in GMS and FMS (p < 0.0001 for both). The two studies were then pooled, for investigating the nature of the joint effect of the two adipokines. In such sample, both adipokines were associated with death, independent of each other and of several additional covariates (p = 0.01–4.58 × 10−12). Of note, no adiponectin-by-resistin interaction was observed (p = 0.40), thus pointing to an additive effect of the two adipokines. As compared to individuals with low levels of both adiponectin and resistin (i.e. below median values), those with high levels of both adipokines had an HR (95%CI) for death of 3.02 (2.26–4.03). Such increased risk was more pronounced in individuals with relatively low abdominal adiposity (p for HR heterogeneity below or above the median value of waist circumference = 0.03). Conclusions Adiponectin and resistin show an additive independent effect on all-cause mortality in patients with T2D. Such effect is modified by abdominal adiposity.
The paradoxical association of adiponectin with mortality rate in patients with type 2 diabetes: evidence of synergism with kidney function
(Elseiver, 2016) Ortega Moreno, Lorena; Lamacchia, Olga; Salvemini, Lucia; De Bonis, Concetta; De Cosmo, Salvatore; Cignarelli, Mauro; Trischitta, Vincenzo; Menzaghi, Claudia