Examinando por Autor "De Cosmo, Salvatore"

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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 and Glomerular Filtration Rate in Patients with Type 2 Diabetes
(PlosOne, 2015) Ortega Moreno, Lorena; Salvemini, Lucia; Mendonca, Christine; Copetti, Massimiliano; De Bonis, Concetta; De Cosmo, Salvatore; Doria, Alessandro; Trischitta, Vincenzo; Menzaghi, Claudia
Background High serum levels of the pro-inflammatory adipokine resistin have been associated with decreased renal function in the general population. The goal of this study was to investigate whether such association is also present among diabetic subjects, who are at increased risk of renal function loss. Methods The cross-sectional association between serum resistin levels and estimated glomerular filtration rate (eGFR) was investigated in 1,560 type 2 diabetic (T2D) patients of European ancestry comprised in two different cohorts: 762 patients from San Giovanni Rotondo (SGR; Italy) and 798 patients from Boston (US). Results Serum resistin was inversely associated with eGFR in SGR [β (SE) for one SD of resistin increment = -1.01 (0.70) ml/min/1.73m2 , p = 0.019] and in Boston [β (SE) = -5.31 (0.74) ml/min/1.73m2 , p < 0.001] samples, as well as in the two studies combined [β (SE) = -3.42 (0.52) ml/min/1.73m2 , p < 0.001]. The association was unaffected by adjustment for smoking habits, BMI, waist circumference, diabetes duration, HbA1c, insulin treatment, hypertension and lipid-lowering therapy: β (SE) for one SD of resistin increment = -1.07 (0.70), p = 0.02; -5.50 (0.88), p < 0.001; and -2.81 (0.55) ml/min/1.73m2 , p < .001, in SGR, Boston and the two studies combined, respectively. The association was significantly stronger in men than in women (p for resistin-by-gender interaction = 0.003). For each resistin SD increment, the odds of having eGFR < 0 ml/min/1.73m2 increased by 22% (OR = 1.22; 95% CI 1.02–1.44; p = 0.025) in SGR sample, 69% (OR = 1.69; 95% CI 1.38–2.07; p < 0.001) in Boston sample, and 47% (OR = 1.47; 95% CI 1.29–1.68; p < 0.001) in the two studies considered together. Similar associations were observed in the adjusted model: OR 95% CI for each SD resistin increment being 1.23 (1.03–1.46), p = 0.021; 1.52 (1.20–1.92), p < 0.001; 1.33 (1.16–1.53), p < 0.001, in SGR, Boston and the two studies combined, respectively. Conclusions This is the first report of an association between high serum resistin and low eGFR in patients with T2D of European ancestry.
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 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