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Pioglitazone does not modify ANP levels of type 2 diabetic patients

World Journal of Cardiovascular Diseases 2012年第4期2卷 277-282页

作者： Stefano Benedini Paolo Villa livio luzi Maurizio Bevilacqua Dipartimento di Scienze Biomediche per la Salute University of Milan Milan Italy Endocrinology and Diabetes Unit Department of Medicine Luigi Sacco (Vialba) University of Milan Milan Italy Metabolism Research Center Policlinico San Donato IRCCS San Donato Milanese Milan Italy

Background: The atrial natriuretic peptide (ANP) regulates fluid volume redistribution between heart and the pulmonary vessels. In diabetic patients the physiological action of ANP appears to be seriously altered. Methods: 12 subjects (gender 6M/6F, age 47 ± 2 years, BMI 29.1 ± 0.1 kg/m2), with type 2 diabetes and under stable conditions, were studied after one month of pioglitazione treatment (30 mg/die) by means of isotonic blood volume expansion. Results: After one month of pioglitazone treatment the meta- bolic profile of the subjects improved (decrease dia- stolic blood pressure: p = 0.05, total cholesterol: p = 0.01, triglycerides: p = 0.03 and blood glucose: p = 0.01) as the expansion of their plasma volume was found associated with the decrease of hematocrit (p < 0.05). The statistical comparison before versus after pioglitazone showed a significant decrease in the ba- sal aldosterone levels post-treatment (p < 0.04). Nonetheless ANP plasma levels were similar before and after therapy. Conclusions: The inappropriately high concentrations of ANP induced by hyperglyce-mia and the abnormal responses to a physiological sti- mulus like an isotonic blood volume expansion are not reverted by one month of pioglitazone. This is in contrast with the brisk improvement of the metabolic profile seen for the same period of treatment. ANP secretion is modified by fluid load in diabetic patients. This anomaly is not reverted by pioglitazone.

关键词： Atrial Natriuretic Peptide Pioglitazone Insulin Resistance Blood Glucose

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Immunosuppressive therapy in pancreas and islet transplant: Need for simultaneous assessment of insulin sensitivity and secretion

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Journal of Diabetes Mellitus 2013年第3期3卷 156-160页

作者： Stefano Benedini Andrea Caumo leana Terruzzi livio luzi Department of Biomedical and Health Sciences University of Milan Milan Italy Division of Metabolic and Cardiovascular Sciences San Raffaele Scientific Institute Milan Italy Research Center of Metabolism IRCCS Policlinico San Donato Milanese Milan Italy

Diabetes mellitus is a metabolic disease possible to treat via pancreas/islet transplantation but most immunosuppressive drugs are diabetogenic. In this letter, we review current up to date methods to assess insulin action and secretion (using the surrogate indexes) suggesting their use in large studies in populations of pancreas/ islets transplanted patients.

关键词： Pancreas-Islets Transplantation Insulin Sensitivity Insulin Secretion HOMA (The Homeostasis Model Assessment) QUICKI (The Quantitative Insulin-Sensitivity Check Index) Hyperinsulinemic Clamp

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Plasma Citrulline: A New Marker of Gut Epithelium Alteration in Obese Patients?

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Journal of Diabetes Mellitus 2015年第4期5卷 233-237页

作者： Stefano Benedini Isabella Fermo Andrea Caumo Ileana Terruzzi livio luzi Department of Biomedical Sciences and Health Università degli Studi di Milano Milan Italy Metabolism Research Center IRCCS Policlinico San Donato Milan Italy Division of Immunology Transplantation & Infectious disease San Raffaele Scientific Institute Milan Italy Diabetes Research Institute Metabolism Nutrigenomics and Cellular Differentiation Unit San Raffaele Scientific Institute Milan Italy

Objectives: In the last decade gut microbial diversity was associated with the pathogenesis of obesity in humans. Plasma citrulline was a simple and accurate biomarker for the severity of intestinal failure and was associated with short bowel syndrome and alteration of gut permeability, being developed as an alternative to D-xylose tolerance test for the diagnosis of an abnormal small intestinal absorption of nutrients. This study was performed to ascertain whether obesity might be associated with dysregulation of epithelial gut function. Methods: Fifteen obese individuals (5 M/10 F;BMI 37.4 ± 6.1 Kg/m2;42 ± 6 yrs) and 15 healthy gender- and age-matched controls (6 M/9 F BMI: 22.7 ± 2.1 Kg/m2;39 ± 7 yrs) underwent D-xylose load (25 g) and plasma citrulline, plasma insulin, glucose and lipid profile testing. Results: Plasma citrulline was significantly lower in the obese group (p = 0.045) with respect to controls, whilst total cholesterol, LDL and trygliceri- des concentration, insulin level and HOMA-IR were significantly higher in obese patients. In contrast, after D-xylose load no difference in serum xylose was found between the two groups (p = ns). Conclusions: Obese patients show a decreased citrulline concentration with respect to lean subjects. Since citrulline is a known marker of intestinal health, alterations in the gut epithelium are likely to be associated with the obesity syndrome. We propose to measure citrulline level in obese patients on a routine basis.

关键词： Citrulline Obesity HOMA-IR Gut

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Erectile dysfunction as a predictor of asymptomatic coronary artery disease in elderly men with type 2 diabetes

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Journal of Geriatric Cardiology 2016年第6期13卷 552-556页

作者： Carmine Gazzaruso Adriana Coppola Arturo Pujia Colomba Falcone Silvia Collaviti Mariangela Fodaro Pietro Gallotti Sebastiano B Solerte Andrea Giustina Gabriele Pelissero livio luzi Tiziana Montalcini Internal medicine diabetes endocrine-metabolic diseases Unit and the Centre for Applied Clinical Research (Ce.R.CA.) Clinical Institute 'Beato Matteo Vigevano Italy Department of Clinical and Experimental Medicine University of Catanzaro Catanzaro Italy Cardiology Unit Clinical Institute 'Citta di Pavia ' University of Pavia Pavia Italy Department of lnternal Medicine University of Pavia Pavia Italy Department of Medical and Surgical Sciences University of Brescia Brescia Italy IRCCS Policlinico San Donato and University of Pavia Pavia Italy IRCCS Policlinico San Donato and University of Milan Milan Italy

1 Introduction Erectile dysfunction （ED） and coronary artery disease （CAD） are closely linked, as both conditions share the same cardiovascular risk factors. Indeed, these risk factors can determine endothelial dysfunction that represents the common underlying mechanism of both ED and CAD. The prevalence of ED is about three-fold higher among diabetic patients than in the general population and a higher prevalence of CAD has been observed in people with diabetes when compared to non-diabetic *** studies showed that ED can be a powerful marker of silent CAD and a strong predictor of cardiovascular events in apparently uncomplicated type 2 diabetic patients Therefore ED is now considered as a sentinel symptom of silent CAD, as ED often precedes the onset of myocardial ischemia itself by many years.

关键词： Aging male Diabetes mellitus Erectile dysfunction Silent coronary artery disease

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