1,720,991 research outputs found
Determinants of plasma aminothiols levels in renal transplant recipients
No full textElevated homocysteine (Hcys) plasma levels is a common finding in renal transplant recipients (RTRs) and may represent a risk factor for vascular disease in these subjects. Recently, an atherogenic role has also been hypotesized for Cysteine (Cys) a thiol-containing amino acid with a structure similar to Hcys. The aim of this study was to analyze 1) Hcys and Cys plasma levels in a group of stable RTRs; 2) the relationship among total Hcys and Cys, renal function and serum vitamin B12 and folate levels; 3) the influence of the 5,10-methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms on both thiols.
Methods. One hundred-eight stable RTRs already evaluated for routine follow-up during 2000 were included in the study (56 men, 52 women, mean age 46.3 ± 11.9 years;) as well as 93 healthy control subjects [1]. Plasma Hcys and Cys were measured by HPLC with fluorescent detection. Plasma folate and vitamin B12 were measured by ion capture assay and microparticle enzyme immunoassay, respectively (Abbott AxSYM automatic analyzer). MTHFR C677T and A1298C gene polymorphisms were genotyped by PCR-RFLP.
Results. Hcys levels were slightly increased in RTRs compared to controls although not significantly (11.4±8.2 vs 8.9±5.4 μmol/L; p>.05) whereas Cys levels were significantly increased (273± 49 μmol/L vs 210 ± 35, p0.05) and vitamin B12 (r=-0.18; P>0.05). A significant correlation of Cys levels with the age of the patients (r=0.31;p<0.01) was observed in RTRs. Patients carrying the MTHFR 677TT genotype had significantly higher Hcys levels than those with other genotypes, although this difference disappeared when Hcys was adjusted for glomerular filtration rate. Cys levels were unaffected by either MTHFR polymorphisms.
Conclusions. The only strong determinant of plasma Hcys in RTRs is glomerular filtration rate whereas folate, vitamin B12 and MTHFR polymorphisms have a minor effect. Cys levels were increased in older patients but no association with renal function, vitamin levels or MTHFR genotype was found
Does Mini Nutritional Assessment predict disability among elderly people?
No full textIntroduction: Nutritional status has been hypotesized to be a major predictor of functional ability in elderly people. Assessment of nutritional
status in clinical practice is obtained by the Mini-Nutritional Assessment (MNA) questionnaire. However, the reliability of MNA
for predicting functional decline and disability in older persons needs further evidence. The aim of this study was to assess whether MNA
(30-items) in subjects aged 80 and over correlates with functional status measured by the Activities of Daily Living (ADL) score.
Methods:We recruited 562 Sardinian subjects (227 men, 335 women, aged 80 and older). Age, ADL, Body Mass Index (BMI), MNA, Mini-
Mental State Examination (MMSE), Geriatric Depression Scale (GDS) were collected in each participant. The association of predictors with
disability was performed by multiple linear regression analysis with ADL as dependent variable.
Results: Mean value of ADL score was 4.12 ± 2.0. Mean value of MNA score was 18.9 ± 5.6. Multiple regression analysis gave the following
coefficients: Age (r = −0.127, p = 0.043) BMI (r = −0.250. p < 0.0001); MNA (r = 0.352, p < 0.0001); MMSE (r = 0.299, p < 0.0001) and GDS
(r = −0.274, p < 0.0001). Conclusions: Nutrition is a key determinant of geriatric health, and MNA is useful for nutritional assessment. Our analysis in subjects over 80 confirmed that MNA score is among the strongest predictors of disability when compared to similar indicators. However, our data do
not allow to determine whether there is a real cause-effect releationship between nutritional status and ADL, and which one is the primary determinant
Sociodemographic, Clinical and Functional Profile of Nonagenarians from Two Areas of Sardinia Characterized by Distinct Longevity Levels
No full textIntroduction: Among the world's longest-lived communities the so-called Longevity Blue Zone (LBZ) of Sardinia, Italy, has attracted a lot of interest. In the present study, health profile and functional characteristics of LBZ oldest-old were compared with an age-matched sample from Northern Sardinia (NSS) with a lower longevity level.
Methods: Cognitive status, symptomatic depression, disability, and nutritional status were assessed by standardized instruments. In addition, the proportion of escapers (illness-free medical history), delayers (illness only after age 80), and survivors (at least one disease before age 80) was calculated.
Results: Three hundred individuals, 150 from the LBZ (age range 89-101, 89 women), and 150 from NSS (age range 89-101, 101 women) were enrolled. The proportion of married individuals in the LBZ cohort was significantly greater compared with the NSS (55% vs. 32%, p = 0.0001). The educational level among nonagenarians in the LBZ was almost half compared with NSS (p < 0.0001). Unskilled workers, shepherds, and peasants prevailed in the LBZ (79% vs. 21%, p < 0.0001). Institutionalized subjects were 1% in the LBZ and 14% in the NSS (p < 0.0001). Disability, comorbidity, and daily physical activity were more represented in LBZ. There was a significantly higher percentage of delayers (37% vs. 18%, p < 0.0002), and a reduction in the number of survivors (30% vs. 44%, p = 0.012) in the LBZ compared with the NSS group. The proportion of escapers was similar in both groups (33% vs. 38%, n.s.).
Conclusion: These findings suggest that in the LBZ there are factors enabling frail individuals to live longer despite a greater burden of comorbidity
Effect of traditional Sardinian bread (“pistokku”) on post-prandial glucose and insulin response in subjects with normal or impaired glucose tolerance
No full textAssociation between Mild Overweight and Survival: A Study of an Exceptionally Long-Lived Population in the Sardinian Blue Zone
No full textBackground/Objectives: Overweight and obesity are generally considered risk factors for premature mortality. However, scientific evidence suggests that among older populations, mild conditions of overweight might be associated with reduced comorbidity and longer survival. This study investigates the potential association between anthropometric parameters and survival among a cohort of nonagenarians in Sardinia, Italy. Methods: This study included 200 subjects (50% females) aged 89 and older, enrolled in 2018 in the Sardinian Blue Zone—a population known for longevity—and followed for up to six years. Anthropometric variables such as body height, weight, age, sex, comorbidity, disability, and food group intake were collected using validated questionnaires and analyzed through multivariable analysis. Results: Out of 200 participants at baseline, 28 (14%) were still alive after six years of follow-up (females 10%, males 18%). Mean survival was 3.36 years (range 0.1–6.9 years) for males and 3.03 years (range 0.2–6.6 years) for females. Participants with a Body Mass Index (BMI) in the range of 25.0–27.0 kg/m2 among males and 25.0–27.2 kg/m2 among females had longer survival compared to those who were underweight (p = 0.002) or obese (p < 0.0001). The Cox proportional hazards regression model, adjusted for age, sex, and comorbidity, revealed a statistically significant association between the BMI and survival, demonstrating an inverted–U relationship. This indicates that mild overweight was associated with a survival advantage compared to both normal weight and obesity. Conclusions: Our study indicates that mild, but not severe, overweight in nonagenarians is associated with extended lifespan. Therefore, primary care physicians and geriatricians should exercise caution before recommending calorie-restricted diets for mildly overweight elderly patients
The Cholesterol Paradox in Long-Livers from a Sardinia Longevity Hot Spot (Blue Zone)
No full textBackground/Objectives: Hypercholesterolemia is commonly viewed as a risk factor for coronary heart disease; however, several studies have reported an inverse relationship between cholesterol levels and cardiovascular mortality, particularly in older adults. This “cholesterol paradox” challenges the conventional understanding of lipid metabolism. Despite often being dismissed as a result of reverse causality, the precise causes of this paradox remain poorly understood. This study aimed to investigate the potential existence of the cholesterol paradox in a long-lived population from central Sardinia, Italy. Methods: We recruited 168 baseline nonagenarians (81 males, 87 females) from the longevity Blue Zone area in 2018 and followed them until December 2024. The lipid profile was determined for all participants according to current guidelines, and its impact on survival was analyzed with Kaplan–Meier curves and Cox proportional hazards regression models. Results: The median total cholesterol was 199.5 (range 89–314) mg/dL in males and 202.5 (range 89–324) mg/dL in females. Survival time was significantly longer in participants with LDL cholesterol (LDL-C) above 130 mg/dL compared to that in nonagenarians with LDL-C lower than 130 mg/dL (3.82 ± 1.88 years vs. 2.79 ± 1.56 years, p < 0.0001). Cox regression analysis revealed a significant reduction in the hazard ratio (HR) for mortality in participants with mild hypercholesterolemia (LDL-C ≥ 130 mg/dL) compared to that in those with normal cholesterol (OR 0.600, 95%CI 0.405–0.891). Conclusions: In the long-lived population examined, the cholesterol paradox was unlikely to be a reflection of reverse causality. Our results challenge the common view that longevity is invariably associated with low cholesterol levels. Furthermore, moderate hypercholesterolemia does not preclude the oldest adult from attaining advanced ages, contrary to common belief
Role of ACE1, ACE2, and CCR5-Δ32 Polymorphisms in the Transmission of SARS-CoV-2 to Intimate Contacts
No full textBackground. Despite the high transmissibility of SARS-CoV-2, some individuals remain uninfected despite prolonged exposure to a high viral load, suggesting the involvement of an innate resistance mechanism, possibly underpinned by the host’s genetic factors. The angiotensin-converting enzyme-1 (ACE1), ACE2, and C-C Chemokine Receptor 5 (CCR5) polymorphisms have been shown to influence susceptibility to the infection. In this study, the role of ACE1, ACE2, and CCR5 gene polymorphisms in modulating susceptibility to SARS-CoV-2 infection within the context of intimate contact was evaluated. Methods. A cohort of heterosexual couples from Northern Sardinia, characterized by a homogenous genetic background, was recruited during the initial pandemic wave (March–June 2020). In each couple, one partner (index case) tested positive for SARS-CoV-2 by at least two consecutive independent molecular tests (real-time polymerase chain reaction: RT-PCR) on nasopharyngeal swabs. Bed-sharing partners of SARS-CoV-2 positive index cases, resistant and susceptible to the infection, were genotyped for ACE1 287 bp Alu repeat insertion/deletion (I/D) polymorphism, ACE2 G8790A (rs2285666) variant, and a 32-base pair deletion (Δ32) of CCR5. Resistant and susceptible partners to the infection were compared for polymorphisms. Results. Out of 63 couples, 30 partners acquired SARS-CoV-2 infection, while 33 remained uninfected despite intimate exposure. Clinical history was minimal for current or past illnesses. SARS-CoV-2-infected index spouses and partners who acquired the infection developed a mild disease, not requiring hospitalization. The observed distribution of ACE1 I/D and ACE2 G8790A genotypes was consistent with previously reported frequencies in Sardinia and across European populations. None of the study participants carried the CCR5-Δ32 variant. No statistically significant differences (p > 0.05) in the allelic or genotypic frequencies of these polymorphisms were observed between the infected and resistant partners. Conclusions. No differences in the distribution of ACE1, ACE2, and CCR5 polymorphisms between the two groups were detected. These findings suggest that resistance is likely multifactorial, involving a complex interplay of genetic, immunological, and environmental factors
Effect of age, period and birth–cohort on the frequency of glucose-6-phosphate dehydrogenase deficiency in Sardinian adults
No full textBackground: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an inherited disorder common in Sardinia. In this study, the frequency variation of G6PD-deficiency across age groups and birth cohorts was investigated using Age-Period-Cohort analysis. Methods: Data were collected from the clinical records of 11,252 patients (6975 women, age range 17-94 years) who underwent endoscopy between 2000 and 2016 at a teaching hospital (University of Sassari), Italy. G6PD status was assessed by enzymatic assay based on G6PD/6GPD ratio. A Poisson log-linear regression model was used to identify age and time trend in G6PD deficiency. Results: Enzyme deficiency was detected in 11.4% of the entire cohort (men: 7.9%; women: 13.6%). Age-Periodâ-Cohort analysis showed no inflection points across age groups, especially after age 80. The effects of time period and birth cohorts on G6PD deficiency were negligible (frequencies before and after 1950 were 11.0% and 11.8%, respectively). Conclusions: These findings indicate that the frequency of G6PD deficiency does not vary significantly in oldest subjects. The lack of evidence for selection across the malaria eradication time may be explained by other factors, including somatic cell selection or misclassification of heterozygotes women as G6PD normal in the older birth cohorts. Additional molecular studies may help clarify these issues.Key messageThe frequency of glucose-6-phosphate dehydrogenase deficiency is stable across age groups and does not vary in generations born before or after malaria eradication
Glucose-6-Phosphate Dehydrogenase Deficiency Reduces Susceptibility to Cancer of Endodermal Origin
No full textBackground. Glucose‒6‒phosphate dehydrogenase (G6PD) deficiency is the most common inherited enzyme defect worldwide. There is a growing scientific evidence for a protective role of G6PD deficiency against carcinogenesis. In this retrospective analysis we tested the hypothesis that G6PD deficiency may reduce the risk of developing cancer in a tissue‒specific manner.
Material and Methods. The study was conducted using data from 11,708 subjects undergoing gastrointestinal endoscopic procedures between 2002 and 2018 and tested for G6PD status in a teaching hospital of Northern Sardinia, Italy.
Results. A 40% reduction of risk for cancer of endodermal origin was observed among G6PD‒deficient patients compared with subjects with normal enzyme activity [Relative Risk (RR) 0.61, 95% Confidence Interval (CI) 0.47‒0.80] in both genders, confirmed by multivariable generalized linear regression after adjusting for age, sex, smoking habits, body mass index, diabetes and socio−economic status. The “protective” effect of G6PD deficiency was larger for gastric cancer (RR 0.41, 95% CI 0.18 ‒ 0.99), hepatocellular carcinoma (RR 0.48, 95% CI 0.26 ‒ 0.92), and colorectal cancer (RR 0.72, 95% CI 0.53 ‒ 0.98), while a non‒significant risk was observed for breast, prostate, lung, hematopoietic and metastases (primary site unknown).
Conclusion. Our results suggest a reduced susceptibility to develop cancers, mostly of endodermal origin (stomach, colon, and liver), but not of ectodermal/mesodermal origin, in carriers of G6PD deficiency. The effects of G6PD deficiency on carcinogenesis need further studies to better understand how cancer cells originating from different germ layers make use of pentose phosphate pathway to proliferate
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