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Spleen:A new role ffoorr an old player?

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World Journal of Gastroenterology 2011年第33期17卷 3776-3784页

作者： Giovanni Tarantino silvia savastano Domenico Capone Annamaria Colao Department of Clinical and Experimental Medicine Federico Ⅱ University Medical School of NaplesVia S.Pansini 580131 NaplesItaly Department of Molecular and Clinical Endocrinology and Oncology Division of EndocrinologyFederico Ⅱ University Medical School of NaplesVia S.Pansini 580131 NaplesItaly Department of Neurosciences Unit of Clinical PharmacologyFederico Ⅱ University Medical School of Naples80131 NaplesItaly

The spleen could be considered a neglected *** date,it has been deemed an ancillary organ in portal hypertension or an organ localization in lymphoproliferative diseases,even though it has had significant attention in infectious diseases for some ***,it is thought to be central in regulating the immune system,a metabolic asset and involved in endocrine function with regard to nonalcoholic fatty liver *** main mechanisms involved in this complex network will be critically discussed in this article.

关键词： Endocrine function Immune system Metabolic asset Nonalcoholic fatty liver disease Spleen

Serum Bcl-2 concentrations in overweight-obese subjects with nonalcoholic fatty liver disease

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World Journal of Gastroenterology 2011年第48期17卷 5280-5288页

作者： Giovanni Tarantino Francesco Scopacasa Annamaria Colao Domenico Capone Marianna Tarantino Ernesto Grimaldi silvia savastano Department of Clinical and Experimental Medicine Federico Ⅱ University Medical School of Naples Department of Biochemistry and Medical Biotechnology Federico Ⅱ University Medical School of Naples Department of Molecular and Clinical Endocrinology and Oncology Endocrinology UnitFederico Ⅱ University Medical School of Naples Department of Neurosciences Unit of Clinical Pharmacology Federico Ⅱ University Medical School of Naples Department of Biomorphological and Functional Sciences Federico Ⅱ University Medical School of Naples

AIM： To shed some light on the relationship between anti-apoptotic serum Bcl-2 concentrations and metabolic status, anthropometric parameters, inflammation indi- ces, and non-alcoholic fatty liver disease severity were investigated in 43 young individuals with fatty liver （FL） and 41 with nonalcoholic steatohepatitis （NASH）. METHODS： Circulating levels of Bcl-2 were detected in 84 patients with ultrasonographic findings of ＂bright liver＂ and/or hyper-transaminasemia of unknown origin and/or increase in T-glutamyl-transpeptidase （T-GT） strictly in the absence of other acute or chronic liver disease, whose age was not advanced, who gave consent to liver biopsy and were then divided on the basis of the histological results into two groups （43 with FL and 41 with NASH）. Twenty lean subjects, apparently healthy and young, were chosen as ***： Serum Bcl-2 concentrations were significantly higher in the FL group than in the NASH group. Insulin resistance and γ-GT activity were significantly higher in NASH subjects. Apoptotic hepatocytes were significantly more numerous in NASH patients. NASH patients presented with larger spleens and augmented C-reactive protein （CRP） concentrations than healthy subjects. Steatosis grade at histology was similar in both NASH and FL populations. The number of apoptotic cells was significantly related to anti-apoptotic Bcl-2 protein values in FL patients. Bcl-2 serum levels positively correlated to body mass index （BMI） values （P ~ 0.0001） but not to age of the population. Triglycerides/HDL ratio correlated well to waist circumference in males （P = 0.0008）. γ-GT activity was associated with homeostatic metabolic assessment （HOMA）（P = 0.0003） and with serum ferritin （P = 0.02）. Bcl-2 concentrations were not related to either spleen size or CRP values. NASH patients pre- sented a weak negative correlation between Iobular inflammation and Bcl-2 levels. A prediction by low values of serum Bcl-2 towards a greater presence of metaboli

关键词： Bcl-2 Nonalcoholic fatty liver disease Meta-bolically unhealthy overweight/obese

Hepatic steatosis in overweight/obese females: New screening method for those at risk

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World Journal of Gastroenterology 2009年第45期15卷 5693-5699页

作者： Giovanni Tarantino Genoveffa Pizza Annamaria Colao Fabrizio Pasanisi Paolo Conca Patrizia Colicchio Carmine Finelli Franco Contaldo Carolina Di Somma silvia savastano Department of Clinical and Experimental Medicine Federico Ⅱ University Medical School of Naples Department of Molecular and Clinical Endocrinology and Oncology Section of Endocrinology Federico Ⅱ University Medical School of Naples

AIM: To identify which parameters could help to distinguish the "metabolically benign obesity", which is not accompanied by insulin resistance (IR) and early ***: Eighty two of 124 overweight/obese females formed the study population, which was divided into two groups (52 and 30 subjects, respectively) with and without IR according to a HO meostatic Metabolic Assessment (HOMA) cut-off of 2, and were studied in a cross-sectional manner. The main outcome measures were waist circumference, serum uric acid, high-density lipoprotein-cholesterol and triglycerides, alanine amino-transferase, blood pressure and the two imaging para-meters, hepatic steatosis and longitudinal diameter of the spleen, which were measured in relation to the presence/absence of IR. RESULTS: A variable grade of visceral obesity was observed in all subjects with the exception of *** of a severe grade was represented more in the group of IR individuals (P = 0.01). Hepatic steatosis, revealed at ultrasound, was more pronounced in IR than in non-IR subjects (P = 0.005). The two groups also demonstrated a clear difference in longitudinal spleen diameter and blood pressure, with raised and signif icant values in the IR group. Metabolic syndrome was frequent in the IR group, and was not modified when adjusted for menopause (P = 0.001). At linear regression, the β values of waist circumference and body mass index predicting HOMA were 0.295, P = 0.007 and 0.41, P = 0.0001, respectively. Measures of spleen longitudinal diameter were well predicted by body mass index (BMI) values, β = 0.35, P = 0.01, and by HOMA, β = 0.41, P = 0.0001. Blood pressure was predicted by HOMA values, β = 0.39, P = 0.0001). HOMA and hepatic steatosis were highly associated (rho = 0.34, P = 0.002). Interestingly, IR patients were almost twice as likely to have hepatic steatosis as non-IR patients. Among the MS criteria, blood pressure was very accurate in identifying the presence of IR (AUROC for systo

关键词： Body mass index Cardiovascular disease Fatty liver Insulin resistance Metabolic f itness Obesity

Bariatric surgery and diabetes remission: Sleeve gastrectomy or mini-gastric bypass?

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World Journal of Gastroenterology 2013年第39期19卷 6590-6597页

作者： Marco Milone Matteo Nicola Dario Di Minno Maddalena Leongito Paola Maietta Paolo Bianco Caterina Taffuri Dario Gaudioso Roberta Lupoli silvia savastano Francesco Milone Mario Musella Department of Advanced Biomedical Science University of Naples "Federico Ⅱ"80131 NaplesItaly

AIM:To investigate the weight loss and glycemic control status[blood glucose,hemoglobin A1c(HbA1c)and hypoglycaemic treatment].METHODS:The primary risk factor for type 2 diabetes is obesity,and 90%of all patients with type 2 diabetes are overweight or *** a remarkable effect of bariatric surgery is the profound and durable resolution of type 2 diabetes clinical manifestations,little is known about the difference among various weight loss surgical procedures on diabetes *** from patients referred during a 3-year period(from January2009 to December 2011)to the University of Naples"FedericoⅡ"diagnosed with obesity and diabetes were retrieved from a prospective *** patients were split into two groups according to the surgical intervention performed[sleeve gastrectomy(SG)and mini-gastric bypass(MGB)].Weight loss and glycemic control status(blood glucose,HbA1c and hypoglycaemic treatment)were ***:A total of 53 subjects who underwent sleeve gastrectomy or mini-gastric bypass for obesity and diabetes were screened for the inclusion in this *** these,4 subjects were excluded because of surgical complications,7 subjects were omitted because young surgeons conducted the operations and 11 subjects were removed because of the lack of *** obese patients were recruited for this study.A total of 15 subjects underwent SG(48.4%),and 16underwent MGB(51.6%).After adjusting for various clinical and demographic characteristics in a multivariate logistic regression analysis,high hemoglobin A1c was determined to be a negative predictor of diabetes remission at 12 mo(OR=0.366,95%CI:0.152-0.884).Using the same regression model,MGB showed a clear trend toward higher diabetes remission rates relative to SG(OR=3.780,95%CI:0.961-14.872).CONCLUSION:Although our results are encouraging regarding the effectiveness of mini-gastric bypass on diabetes remission,further studies are needed to provide definitive conclusions in selecting th

关键词： Bariatric surgery Sleeve Bypass Obesity and diabetes