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Non-alcoholic fatty liver disease connections with fat-free tissues: A focus on bone and skeletal muscle

World Journal of Gastroenterology 2017年第10期23卷 1747-1757页

作者： eleonora poggiogalle Lorenzo Maria Donini Andrea Lenzi Claudio Chiesa Lucia Pacifico Department of Experimental Medicine-Medical Pathophysiology Food Science and Endocrinology SectionSapienza University of Rome Institute of Translational Pharmacology National Research Council Policlinico Umberto I Hospital Sapienza University of Rome

The estimates of global incidence and prevalence of non-alcoholic fatty liver disease(NAFLD) are worrisome, due to the parallel burden of obesity and its metabolic complications. Indeed, excess adiposity and insulin resistance represent two of the major risk factors for NAFLD; interestingly, in the last years a growing body of evidence tended to support a novel mechanistic perspective, in which the liver is at the center of a complex interplay involving organs and systems, other than adipose tissue and glucose homeostasis. Bone and the skeletal muscle are fat- free tissues which appeared to be independently associated with NAFLD in several cross-sectional studies. The deterioration of bone mineral density and lean body mass, leading to osteoporosis and sarcopenia, respectively, are age-related processes. The prevalence of NAFLD also increases with age. Beyond physiological aging, the three conditions share some common underlying mechanisms, and their elucidations could be of paramount importance to design more effective treatment strategies for the management of NAFLD. In this review, we provide an overview on epidemiological data as well as on potential contributors to the connections of NAFLD with bone and skeletal muscle.

关键词： Non-alcoholic fatty liver disease Bone Skeletal muscle Osteoporosis Sarcopenia

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Pediatric nonalcoholic fatty liver disease:A clinical and laboratory challenge

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World Journal of Hepatology 2010年第7期2卷 275-288页

作者： Lucia Pacifico eleonora poggiogalle Vito Cantisani Guendalina Menichini Paolo Ricci Flavia Ferraro Claudio Chiesa Departments of 1 Pediatrics Sapienza University of Rome National Research Council Institute of Neurobiology and Molecular Medicine Departments of Radiological Sciences Sapienza University of Rome

The true prevalence of pediatric nonalcoholic fatty liver disease (NAFLD) is unknown. Challenges in determin ing the population prevalence of NAFLD include the type of test (and the reference intervals used to define normal and abnormal), the type of population (general population, hospital series), the demographic characteristics of the population sampled, and the nat ure of the study design. The natural history of pediat ric NAFLD remains uncertain. The issue of when to perform a liver biopsy in children with suspected NAFLD remains controversial. Children with NAFLD but normal alanine aminotransferase are rarely investigated. However, evidence of alterations in glucose metabolism parameters should prompt a better understanding of the natural history of pediatric NAFLD not only in terms of the progression of liver disease but also regarding its potential relationship with other health outcomes such as type 2 diabetes mellitus and cardiovascular disease. This evidence could make liver biopsy mandatory in the majority of cases at risk of progressive and severe hepatic and extrahepatic disease. This conclusion, however, raises the question of the feasibility of liver biopsy assessment in an extremely large at risk popul ation, and of the cost/effectiveness of this policy. There is a considerable, continuous interest in reliable, noninv asive alternatives that will allow the prognosis of pediat ric NAFLD to be followed in large community or populat ionbased studies.

关键词： Nonalcoholic fatty liver disease Children Insulin resistance Ultrasound Magnetic resonance imaging

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Sarcopenic Obesity: Correlation with Clinical, Functional, and Psychological Status in a Rehabilitation Setting

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Food and Nutrition Sciences 2014年第20期5卷 2020-2031页

作者： Lorenzo M. Donini eleonora poggiogalle Silvia Migliaccio Alessandro Pinto Carla Lubrano Andrea Lenzi Food Science and Human Nutrition Research Unit Medical Physiopatology Food Science and Endocrinology Section Department of Experimental Medicine Sapienza University of Rome Rome Italy Unit of Endocrinology Department of Movement Human and Health Sciences ForoItalico University of Rome Rome Italy

Obesity and sarcopenia combination, appropriately defined as sarcopenic obesity (SO), due to disproportionally reduced/low lean body mass compared to excess fat mass, may lead to disability. Aims: The aim of our study was to investigate the relationship among sarcopenic obesity, physical performance, disability, and quality of life in a rehabilitation setting. Methods: Participants were recruited among obese patients (BMI > 30 kg/m2) admitted to the rehabilitation facility at the Department of Experimental Medicine, Medical Physiopatology, Food Science and Endocrinology Section during a 1-year period. A multidimensional evaluation was performed through bioelectrical impedance analysis and anthropometry, handgrip strength test, Short Physical Performance Battery (SPPB), 6-minute walk test (6MWT) and blood chemistry parameters. Psychological status (SCL-90 questionnaire), quality of life, and comorbidity (Charlson comorbidity index score) were also evaluated. Obesity was diagnosed as increased fat mass by 35% in women and by 25% in men. Sarcopenia was defined if lean body mass (LBM) was <90% of the subject’s ideal LBM. Results: 79 patients (48 women and 31 men;mean age: 60.1 ± 11.5 years, and 58.6 ± 10.8 years, respectively) were enrolled. Results showed a high prevalence of SO (54.4%) in our samples of obese subjects. Sarcopenia was present not only among older obese adults but also among younger obese subjects, and was related to reduced functional performance, to inflammatory status and to worse psychological status and quality of life.

关键词： Sarcopenic Obesity Disability

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Indirect calorimetry in obese female subjects: Factors influencing the resting metabolic rate

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World Journal of Experimental Medicine 2012年第3期2卷 58-64页

作者： Theresa Hagedorn eleonora poggiogalle Claudia Savina Cecilia Coletti Maddalena Paolini Luciano Scavone Barbara Neri Lorenzo Maria Donini Rehabilitation Clinical Institute "Villadelle Querce" Nemi 00040 Rome Italy Department of Experimental Medicine Medical Physiopathology Food Science and Endocrinology Section Food Science and Human Nutrition Research Unit Sapienza University of Rome

AIM: To evaluate selected factors influencing resting energy expenditure(REE) in obese female ***: Seventy seven 61 obese Caucasian women [mean age of 52.93 ± 13.45 years, and mean body mass index(BMI) of 41.78 ± 11.54 kg/m2] were enrolled; measurements of resting metabolic rate(RMR) by a ventilated, open-circuit system, indirect calorimeter were performed after an overnight fast. Body composition as well as medications, physical parameters, blood samples, disease pattern, and smoking were considered. RESULTS: RMR was significantly associated with body weight(r = 0.732, P < 0.001), body height(r = 0.401,P = 0.008), BMI(r = 0.504, P < 0.001), waist circumference(r = 0.602, P < 0.001), mid-upper arm circumference(r = 0.417, P = 0.006), mid-upper arm muscle circumference(r = 0.344, P = 0.028), total body water(r = 0.339, P = 0.035), body temperature(r = 0.409, P = 0.007), smoking(P = 0.031), serum T4 levels(r = 0.331, P = 0.036), obstructive sleep apnoea syndrome(OSAS; P = 0.023), impaired glucose tolerance(IGT; P = 0.017) and impaired glycaemic status, including hyperinsulinism, IGT and diabetes mellitus(P = 0.003).CONCLUSION: Future research should be prompted to optimize the procedure of indirect calorimetry to achieve clinical benefits in obese subjects.

关键词： Indirect calorimetry Obesity Resting metabolic rate Resting energy expenditure

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