F. De Vita

The relationship between sex hormones, sex hormone binding globulin and peripheral artery disease in older persons

OBJECTIVE The prevalence of peripheral artery disease (PAD) increases with aging and is higher in persons with metabolic syndrome and diabetes. PAD is associated with adverse outcomes, including frailty and disability. The protective effect of testosterone and sex hormone binding globulin (SHBG) for diabetes in men suggests that the biological activity of sex hormones may affect PAD, especially in older populations. METHODS Nine hundred and twenty-one elderly subjects with data on SHBG, testosterone (T), estradiol (E2) were selected from InCHIANTI study. PAD was defined as an Ankle-Brachial Index (ABI) < 0.90. Logistic regression models adjusted for age (Model 1), age, BMI, insulin, interleukin-6, physical activity, smoking, chronic diseases including metabolic syndrome (Model 2), and a final model including also sex hormones (Model 3) were performed to test the relationship between SHBG, sex hormones and PAD. RESULTS The mean age (±SD) of the 419 men and 502 women was 75.0 ± 6.8 years. Sixty two participants (41 men, 21 women) had ABI < 0.90. Men with PAD had SHBG levels lower than men without PAD (p = 0.03). SHBG was negatively and independently associated with PAD in men (p = 0.028) but not in women. The relationship was however attenuated after adjusting for sex hormones (p = 0.07). The E2 was not significantly associated with PAD in both men and women. In women, but not in men, T was positively associated with PAD, even after adjusting for multiple confounders, including E2 (p = 0.01). CONCLUSIONS Low SHBG and high T levels are significantly and independently associated with the presence of PAD in older men and women, respectively.

Relationship between use of proton pump inhibitors and igf system in older subjects

Objectivesto investigate the effects of proton pump inhibitors (PPIs) on the insulin-like-growth factor 1(IGF-1) system in the elderly.Designcross-sectional.SettingInCHIANTI study.Participants938 older subjects (536 women, 402 men, mean age 75.7±7.4 years).Measurementscomplete data on age, sex, BMI, liver function, medications, dietary intake, IGF-1, IGF-binding protein-1 and -3 (IGFBP-1, IGFBP-3).ResultsParticipants were categorized by PPI use, identifying 903 PPI non users and 35 users. After adjusting for age, male PPI users (107.0 ± 69.6 vs 127.1 ± 55.8, p<0.001) and female PPI users (87.6 ± 29.1 vs 107.6 ± 52.3, p=0.03) had lower IGF-1 levels than non-users. IGFBP-1 levels were similar in the two groups in both sexes. In whole population, after adjustment for age and sex, PPI users had lower IGF-1 levels 81.9 [61.1–113.8] than nonusers 110 [77.8–148.6], p=0.02. After further adjustment for BMI, albumin, liver function, C-reactive protein, Interleukin-6, number of medications, ACE-inhibitors use, caloric intake, protein intake, physical activity, glycemia, and IGFBP-1, the use of PPIs remained significantly and negatively associated with IGF-1 levels (β±SE=−19.60±9.83, p=0.045).ConclusionUse of PPIs was independently and negatively associated with IGF-1 levels.

PP096-SUN: Inverse Relationship Between Carotenoids and Estradiol Levels in Older Women: Implication for Estrogen-Dependent Cancers?

Rationale: The HSCT patients have a tendency to lower serum vitamin D (VD). There is an important role in the regulation of VD and lymphocyte function T. The VD has an immunomodulatory effect that correlates with an increased incidence of Chronic GVHD and may increase mortality in this group of patients. Additionally, serum vitamin D levels are related to bacterial infection, ICU and relapse after HSCT. Objective: Analyse the relationship between disability and serum levels of vitamin D and risk of developing Acute GVHD. Methods: Retrospective study in Oncology and Hematology Department of the Albert Einstein Hospital (HIAE), with 19 patients (10 women, 9 men), adults (>18 years) who underwent HSCT, 42% of allogeneic related, 37% of unrelated allogeneic and 21% haploidential. The mean age was 46 years (±16) and weight 67 kg (±17). Of these patients, 59% had normal body mass index (BMI) (kg/m2), 21% overweight, 5% obese and 16% malnutrition. The exam for measurement of serum vitamin D (25-hydroxyvitamin D) was requested at the time of admission of the patient before the start of HSCT. The results of serum VD were classified into 50 nmol/ml normal. Results: There was a significant and negative correlation between BMI and serum levels of VD (rp = 0.5). 53% of patients had GVHD, but there was no significant relationship of the same with the other variables. There was a trend GVHD in the presence of low serum vitamin D also present in 53% of cases. Conclusion: GVHD is a disease with a high risk for patients undergoing HSCT, having great impact on the quality of life. Overweight and obese patients who have lower levels of VD should be better monitored, as tending to a higher risk of developing this complication.