G. Receputo

Serum Carnitine Levels in Centenarians

AbstractObjective and Study Participants: We evaluated serum carnitine concentrations in a group of 17 centenarians (six males, 11 females: mean age 102.35 ±2.21 years), and compared them with a control group that comprised 20 elderly volunteers (age range: 66 to 75 years). Results: The mean serum carnitine level in the centenarian group was 8.99 ±5.1 mg/L compared with 7.71 ±0.92 mg/L in the control group (p = NS). Serum carnitine levels were not significantly correlated with lipid pattern, kidney function, daily activity, body mass index and daily diet in the centenarians. Analysis of the lipid pattern revealed that the mean serum total cholesterol, low density lipoprotein (LDL) cholesterol, apoprotein B100 and triglyceride concentrations were higher in the controls than in the centenarians (p = 0.01 for total cholesterol, LDL cholesterol, and apoprotein B100; p = 0.05 for triglycerides). High density lipoprotein (HDL) cholesterol and apoprotein A levels were significantly lower in the controls than in the centenarians (p = 0.01). We postulated that an endogenous synthesis is responsible for the increased serum carnitine levels observed in the centenarians. Conclusion: In our study series, the association between a good lipid profile and elevated serum carnitine levels, although nonsignificant, might be considered an important factor in achieving longevity.

Multiple pathologies and drug consumption in a group of centenarians from Eastern Sicily

Multiple pathologies are characteristic for the elderly. We evaluated the prevalence of multiple pathologies in 28 randomly selected centenarians living in Eastern Sicily and compared the data with those obtained in another random group of 28 control subjects over 80 years of age. It has been revealed that 25% of the centenarians suffered from 0-3 pathologies, while the remaining 75% displayed more than 3 pathologies. The control subjects had 0-3 pathologies in 50% of over 80 years, while 50% were affected by more than 3 pathologies. In centenarians the most prevalent pathologies involved the sensorial apparatus (sight and hearing), followed by the digestive, urogenital and cardiovascular systems. In the control group the rank of occurrence was as follows: cardiovascular system, osteoarticular and respiratory apparatuses, and sensorium. We compared drug consumption in the two age groups. In the centenarians, 71.43% took 0-3 drugs, while 28.57% took more than 3 drugs. In the control group, 53.57% took 0-3 drugs, whereas 46.43% took more than 3 drugs.

Thyroid function in healthy centenarians.

Seven thyroid function parameters (total T3, TT3; total T4, TT4; free T3, FT3; free T4, FT4; TSH; anti-thyroglobulin antibodies, TGAb; and anti-microsomal antibodies, TMAb) were studied in a series of 20 healthy centenarians in order to evaluate their thyroid function status. Our results showed that all the parameters were within normal range, with the exception of TT4 values which were reduced in 60% of centenarians examined. Therefore, the authors believe that the production of thyroid hormones seems to decrease in advanced years, but that this may not solely depend on thyroid parenchyma involution, but also on a lower demand by the hormone sensitive tissues. Centenarians seem to be adapted euthyroid subjects who present low, nonetheless adequate, levels of circulating thyroid hormone (T4).

Study on the sense of taste in a group of sicilian centenarians

The sense of taste was studied in a group of 20 centenarians from Eastern Sicily, displaying a mini mental state examination (MMSE) score higher than 19. Control subjects were 20 adult (mean age 27.7 +/- 3.2 years) and 20 elderly subjects (mean age 71.3 +/- 5.5 years). Although it has been revealed that centenarians retain considerably the capacity to perceive tastes, they displayed statistically significant reductions (p < 0.001) in taste functions for sweet, sour, salty and bitter, as compared to both the adult and elderly controls.

LIPOPROTEIN(a) LEVELS IN CENTENARIANS

In elderly subjects (above 65 years), cardio- and cerebrovascular diseases are known to contribute to the death rate. Serum lipoprotein(a) = Lp(a), a low density lipoprotein, is involved in the atherogenic processes, as confirmed by several clinical trials. We evaluated serum Lp(a) levels in a group of centenarians (15 females and 7 males, mean age 102.81 +/- 2.5 years) compared to 25 healthy control subjects (10 males and 15 females, mean age 51.12 +/- 15.34 years). In all subjects Lp(a) serum levels were determined by ELISA method (EIA mod. 2550 reader). Statistical analysis of the results was performed by using the Students t test. In centenarians the mean Lp(a) level increased (39.6 +/- 23.53 mg/dl) compared to that of the control group (16.78 +/- 16.24 mg/dl) (p < 0.005). The elevated Lp(a) values observed in centenarians may be attributed to the presence of low molecular weight lipoprotein isoforms which are known to be associated with cardio-cerebrovascular risk. Therefore, it seems that elevated Lp(a) levels alone are not risk factors for the onset of acute acute vascular accidents and do not influence longevity.

Diabetes in the elderly: Remarks from an epidemiological study carried out in a town in south-eastern sicily (militello V.C.)

SummaryLonger mean life span and life expectancy of diabetics and increased factors that favor onset of type II diabetes have determined greater prevalence of diabetes in the elderly population. According to HANES II, it is 17% in the elderly in U.S.A. We carried out an epidemiological study on the over 65 year olds in Militello V.C. and examined 910 elderly subjects (72.05% of the total elderly population). All were tested for peripheral fasting blood glucose, body weight and height and filled out a questionnaire with general and diabetological questions. The values recommended by the NDDG were used to diagnose diabetes. One hundred and sixty-one diabetics (25 newly diagnosed) were observed (17.69%). Onset had occurred before age 65 (aged diabetics) in 72 cases and after 65 in 89 (senile diabetics). Mean blood glucose was 152.91±55.56 mg/dl. Our results indicated that sulfonylureas and/or biguanides are first choice treatment. By grouping the diabetics on the basis of age at onset and duration of disease, a fall in the number of cases treated with diet alone and hypoglycemic drugs and an increase in patients on insulin were seen in aged diabetics as the disease evolves. On the contrary, there was a rise in the number of senile diabetics on hypoglycemic drugs.

Functional evaluation of a group of centenarians in Eastern Sicily by means of the activity of daily living scale.

A random sample of 28 centenarians was studied (32.56% of all centenarians in Eastern Sicily) within the framework of the Italian Multicenter Study on Centenarians. The activity of daily living (ADL) scale was applied to evaluate their capacity to perform everyday tasks autonomously. The study sample consisted of 8 males (28.57%) and 20 females (71.43%), overall mean age was 102.57 +/- 2.1 years. The patients fell into 3 groups according to their ADL scores independent group (with score A) 5 persons, 17.86% (2 males and 3 females); partially independent group (with scores B and C) 5 persons, 17.86% (1 male and 4 females); dependent group (with scores D-E-F-G and other) 18 persons, 64.29% (5 males and 13 females). We compared the results with a control study sample of 28 elderly patients (8 males, 20 females) over 85 years of age resident in a small village in Eastern Sicily (Graniti) and observed that the centenarians presented greater independence, especially the women.

Alterations of blood and plasma viscosity and erythrocyte filtration in senile osteoporosis

Blood and plasma viscosity, as well as erythrocyte filtration rates were studied in 44 osteopenic (20 men and 24 women) and in 40 non-osteopenic (20 men and 20 women) patients, all over 65 years of age. Pathological hemorheological parameters were observed only in 12 subject of the osteopenic group, and 10 controls. The results indicate that although the hemorheological parameters do not show a direct correlation with the osteopenia, it is worthwhile following these parameters, among others, in order to optimize the treatment with anti-osteoporotic drugs which are able to regulate them.

Lipid Profile in Centenarians

SummaryIn human epidemiological studies the levels of plasma lipids are related to the incidence of atherosclerotic cardiovascular disease. In this study we evaluated and compared lipid profiles in a group of healthy centenarians and a control group of adults. The study included 22 healthy centenarians (mean age 102.81 ± 2.5 years) and a control group of 20 elderly volunteers (mean age 70.35 ± 4.12 years). Total cholesterol (TC), high-density lipoprotein cholesterol (HDLC) and triglycerides were determined by enzymatic methods in all subjects. Low-density lipoprotein cholesterol (LDLC) was determined according to Friede wald’s formula; apolipoproteins A and B (Apo A and B) were determined using the nephelometric method, while lipoprotein (a) [Lp(a)] was determined by the ELISA method. The following ratios, which are considered indices of cardiovascular risk, were calculated: TC/HDLC; LDLC/HDLC; Apo B/Apo A. The lipid profile in centenarians was characterised by a lower total cholesterol level (4.36 ± 0.93 mmol/L), LDLC (974.1 ± 288 mg/L), triglycerides (1.14 ± 0.51 g/L), Apo B (0.92 ± 0.26 g/L), Apo B/Apo A ratio (0.63 ±0.1), TC/HDLC ratio (3.52 ± 0.77), and LDLC/HDLC ratio (2.04 ± 0.66) than that observed in controls. Conversely, Lp(a) [39.04 ± 13.44 mg/dl], HDLC (483.1 ± 73 mg/L) and Apo A (1.47 ± 0.28 g/L) were greater in centenarians than in controls.

The efficacy of interferon alfa in chronic hepatitis B: a review and meta-analysis

Abstract Since 1976, treatment with interferon alfa (IFN-α) has been shown to inhibit viral replication and obtain sustained normalization of biohumoral indices in patients with chronic hepatitis B. The present investigators performed a meta-analysis to evaluate the effectiveness of IFN-α. This was done by examining 26 controlled trials (including 773 treated subjects and 532 control subjects) in which patients with chronic hepatitis B and mutant B virus were treated with IFN-α and which had a posttreatment follow-up period of at least 12 months. The Mantel-Haenszel-Peto method was applied to the extrapolated data. Of the 773 patients treated with IFN-α, 306 (39.6%) were complete responders; spontaneous remission was seen in 74 of the 532 control patients (13.9%). The computed odds ratio was 4.0 (95% confidence interval = 3.09 to 5.18). A heterogeneity test furnished a chi-square value of 44.01. Studies of treatment with lymphoblastoid IFN-α reported the highest remission rate (40.8%). Encouraging results were observed in trials of recombinant IFN-α-2a and recombinant IFN-α-2b (remission rates were 38.3% and 36.4%, respectively). A 5-megaunits schedule was more efficacious than a 3-megaunits schedule (remission rate was 47.5% vs 30.7%, respectively). Even if the efficacy of IFN-α in patient with chronic hepatitis B has been confirmed, more prolonged follow-up periods are needed to obtain more reliable results. Furthermore, the results of IFN-α treatment in patients with mutant B virus can be considered poor. Relapse occurred in 70% to 90% of the responders and the remission rate was low compared with the results observed in the 26 trials examined (mean remission rates were 10.0% to 25.0% vs 39.6%, respectively).