Michele Cioffi

Evidence for Anti-Inflammatory Effects of Combined Administration of Vitamin E and C in Older Persons with Impaired Fasting Glucose: Impact on Insulin Action

Objective: Vitamin E and C given separately improve insulin sensitivity due to an inhibitory effect on oxidative stress and inflammation, however their combined effect on glucose control and inflammation is unknown. To investigate combined effect of Vitamin E and C in elderly with Impaired Fasting Glucose (IFG) on insulin action and substrate oxidation. Design: Controlled-trial administration of Vitamin E (1000 mg/day) and Vitamin C (1000 UI/day) for four weeks. Hyperinsulinemic euglycemic glucose clamp was performed before and following supplementation. Setting: Out-patient clinic. Participants: Thirteen older men with IFG. Main Outcome Parameters: Variations in whole body glucose disposal (WBGD), anti-oxidant, and inflammatory cytokines plasma levels. Results: An increase in plasma Vitamin E (8.3 + 0.8 vs. 64.9 + 2.1 μmol/l; p < 0.001] and C (35.9 + 5.4 vs. 79.4 + 7.4 μmol/l; p < 0.001) was found. Vitamin administration reduced insulin, glucose, lipid, TNF-α and [8-]isoprostane levels. Increase in plasma vitamin E levels correlated with decline in both plasma [8-]isoprostane levels (r = −0.58; p = 0.048) and TNF-α levels (r = − 0.62; p = 0.025), while no correlations were found for Vitamin C. Whole body glucose disposal (WBGD) (22.7 + 0.6 vs. 30.4 + 0.8 mmol × kg-1 × min-1; p = 0.001) and non-oxidative glucose metabolism rose after supplementation. Rise in plasma levels of Vitamin C and E correlated with WBGD. Multivariate linear regression models showed independent associations among the change in Vitamin E and the decline in TNF-α and [8-]isoprostane levels. Conclusions: Combined administration of Vitamin E and C lowered inflammation and improved insulin action through a rise in non-oxidative glucose metabolism.

Association between vitamin D receptor gene polymorphisms and tubular citrate handling in calcium nephrolithiasis

Abstract. Mossetti G, Vuotto P, Rendina D, Numis FG, Viceconti R, Giordano F, Cioffi M, Scopacasa F, Nunziata V (Federico II University Medical School, Naples, Italy). Association between vitamin D receptor gene polymorphisms and tubular citrate handling in calcium nephrolithiasis. J Intern Med 2003; 253: 194–200.

Current Insights and Future Advances in Endometriosis Diagnostics

Endometriosis is a benign gynaecological disease characterized by the presence of endometrial glands and stroma outside the uterine cavity. This condition is mainly found in women of reproductive age, from all ethnic and social groups and it is associated with pelvic pain and infertility. Endometriosis is typically present in the pelvis such as on the ovaries and pelvic peritoneum, but may also involve the bowel, ureter or bladder. It regresses after menopause or ovariectomy, suggesting it could depend on the production and metabolism of sex steroids: high concentrations of estrogens were found in the endometriotic lesions, which grow and regress in an oestrogen-dependent way. Nevertheless, the pathogenesis and the molecular mechanism that underlie the development of endometriosis have troubled the investigators through many years, remaining an enigma. The disease is widely accepted to result from the ectopic implantation of refluxed menstrual tissues. In addition, immunologic changes, environmental, hormonal and genetic factors contribute to the multifactorial etiology of endometriosis.