EVALUATION OF INFLAMMATORY-OXIDATIVE PARAMETERS AND CAROTID ARTERY INTIMA-MEDIA THICKNESS IN OVERWEIGHT/OBESE SUBJECTS
Tesi di Dottorato
Data di Pubblicazione:
2012
Citazione:
EVALUATION OF INFLAMMATORY-OXIDATIVE PARAMETERS AND CAROTID ARTERY INTIMA-MEDIA THICKNESS IN OVERWEIGHT/OBESE SUBJECTS / R. De Giuseppe ; tutor: V. Chigorno ; coordinatore: F. Bonomi. Universita' degli Studi di Milano, 2012 Feb 10. 24. ciclo, Anno Accademico 2011.
Abstract:
Introduction:
Obesity is a rapidly growing health problem, conferring substantial excess risk for morbidity and mortality, especially for type 2 diabetes and atherosclerotic cardiovascular disease (CVD). Obesity is frequently associated with various metabolic disorders defined altogether as Metabolic Syndrome (MS), whose incidence is high and increasing; MS refers to a constellation of disturbances including glucose intolerance, central obesity, dyslipidemia (hypertriglyceridemia, decreased high-density lipoprotein (HDL cholesterol) and hypertension. It can present in several forms, according to the combination of the different components of the syndrome, and it is well established that it increases the risk for the development of cardiovascular disease and type 2 diabetes. Obesity and MS are characterized by oxidative stress (OS), defined as unbalance between Reactive Oxygen Species (ROS) and Total Antioxidant Capacity (TAC), and by subclinical inflammation, both responsible for the development of atherosclerosis.
In addition, in the diabetic condition, oxidative stress impairs glucose uptake in muscle and adipose tissue and decreases insulin secretion from pancreatic β cells.
Elevated levels of proinflammatory proteins are found in blood and metabolically relevant tissues of obese individuals. In fact adipose tissue, which is considered as an active endocrine and paracrine organ, releases a variety of biologically active molecules collectively known as adipocytokines or adipokines, that influence body weight homeostasis and induce changes in cardiovascular structure and function, glucose metabolism, blood pressure, lipid metabolism, coagulation, fibrinolysis and inflammation; these changes lead to endothelial dysfunction and atherosclerosis.
Aims of the study:
The first aim of this study was to evaluate, in overweight/obese subjects, the classical risk factors (such as dyslipidemia) and less conventional mechanisms, such as oxidative stress, involved in the development of endothelial dysfunction, increasing cardiovascular risk. Several inflammatory markers (C Reactive Protein, fibrinogen), associated with abdominal obesity, were also assessed.
Secondly, because carotid artery intima-media thickness (IMT), which is significantly associated with prevalent and incident carotid plaques, is a convenient marker of atherosclerosis, we studied the association between IMT and oxidative stress, inflammatory markers (cytokines) and others biochemical parameters in a subgroup of our overweight/obese population.
Subjects, Material and Methods:
Three-hundred and sixty consecutive overweight-obese subjects (99 males and 261 females; mean age 48.912.1 years; mean BMI 34.25.6 Kg/m2; mean waist circumference 99.7±12.4 cm for females and 111.5 ±10.3 cm for males) were enrolled at the ‘‘Obesity and Work’’ outpatient clinic of the Clinica del Lavoro L. Devoto, Fondazione IRCCS, Cà Granda Ospedale Maggiore Policlinico Milano.
Each participant signed informed consent and was interviewed about the general health, life-style and smoking habit.
Exclusion criteria were: Body Mass Index (BMI)<26 Kg/m2, any previous cardiovascular and pregnancy.
Each subject was evaluated by standard routine examination including Complete Blood Count (CBC), lipid panel (Triglycerides, TG; Total Cholesterol, T-Chol; LDL Cholesterol, LDL-Chol; HDL Cholesterol, HDL-Chol), glycemic status (glucose concentration; insulin and glycated haemoglobin, HbA1c), creatinine, high sensitive C Reactive Protein (hsCRP), fibrinogen, uric acid.
Oxidative status was evaluated by measuring Serum Reactive Oxygen Species (ROS) concentrations and Total Antioxidant Capacity (TAC) with spectrophotometric method, using commercial ki
Tipologia IRIS:
Tesi di dottorato
Elenco autori:
R. DE GIUSEPPE
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