Roberta Papa

Zinc, metallothioneins, and longevity--effect of zinc supplementation: zincage study.

Abstract:  Aging is an inevitable biological process that is associated with gradual and spontaneous biochemical and physiological changes and increased susceptibility to diseases. Because nutritional factors are involved in improving immune functions, metabolic harmony, and antioxidant defense, some nutritional factors, such as zinc, may modify susceptibility to disease and promote healthy aging. In vitro (human lymphocytes exposed to endotoxins) and in vivo (old or young mice fed with low zinc dietary intake) studies revealed that zinc is important for immune efficiency (innate and adaptive), antioxidant activity (supeoxide dismutase), and cell differentiation via clusterin/apolipoprotein J. Intracellular zinc homeostasis is regulated by metallothioneins (MT) via ion release through the reduction of thiol groups in the MT molecule. This process is crucial in aging because high MT levels are not able to release zinc, resulting in low intracellular free ion availability for biological functions. Improvement in these functions occurs in the elderly after physiological zinc supplementation. In this study, the selection of elderly subjects for zinc supplementation is discussed in relation to the genetic background of MT and pro‐inflammatory cytokines, such as interleukin‐6, because the latter is involved both in MT‐gene expression and in intracellular zinc homeostasis.

Use of the desmopressin test in the differential diagnosis of pseudo-Cushing state from Cushing's disease.

CONTEXT The desmopressin (DDAVP) test has been proposed to discriminate Cushings disease (CD) from pseudo-Cushing states (PC); however, current information on its value is scarce and contradictory. OBJECTIVE The aim of the study was to assess the ability of the DDAVP test in distinguishing between these conditions, with emphasis on subjects with mild hypercortisolism. DESIGN AND SETTING We conducted a retrospective/prospective study at the Division of Endocrinology, Polytechnic University of Marche, Ancona, Italy. PATIENTS The study included 52 subjects with CD, 28 with PC, and 31 control subjects (CT). INTERVENTION(S) We performed the DDAVP test and standard diagnostic procedures for the diagnosis of Cushings syndrome. MAIN OUTCOME MEASURE(S) The diagnosis/exclusion of CD was measured. RESULTS Interpretation of the DDAVP test based on percentage and absolute increment of cortisol and ACTH did not afford acceptable values of both sensitivity (SE) and specificity (SP). CD diagnosis based on simultaneous positivity for basal serum cortisol greater than 331 nmol/liter and absolute ACTH increment greater than 4 pmol/liter and its exclusion in subjects negative for one or both measures yielded an SE of 90.3% and an SP of 91.5%. The approach was also highly effective in distinguishing PC from: 1) CD with moderate values of urinary free cortisol (SE, 86.9%; SP, 92.8%); 2) CD with moderate values of serum cortisol after dexamethasone suppression (SE, 86.6%; SP, 92.8%); and 3) CD with moderate values of midnight serum cortisol (SE, 100%; SP, 92.8%). CONCLUSIONS Interpretation of the DDAVP test through a combination of parameters allowed effective discrimination of CD from PC, even in subjects with mild hypercortisolism.

Corticotrophin-releasing hormone and desmopressin tests in the differential diagnosis between Cushing's disease and pseudo- Cushing state: a comparative study

Background  We recently proposed a new and effective way of interpreting human corticotrophin‐releasing hormone (hCRH) and desmopressin (DDAVP) tests, for the differential diagnosis between Cushing’s disease (CD) and pseudo‐Cushing state (PC), based on the simultaneous analysis of ACTH and cortisol.

Associations of personal and mobility resources with subjective well-being among older adults in Italy and Germany.

The purpose of this study was to investigate the patterns of associations of personal and mobility resources with positive well-being in two sample populations of older adults from Germany (n=1518) and Italy (n=600). A correlation study showed which variables correlated the closest with the well-being components, then four logistic regression analyses were performed, one for each well-being component such as the positive and negative affect schedule (PANAS) positive scale, mobility satisfaction, health satisfaction and life satisfaction. High positive scores of PANAS and satisfaction scales were found both for Germany and Italy. As expected and in accordance with previous studies, components utilized as a measure of subjective well-being correlated significantly with each other in both countries, confirming their validity as instruments of evaluation for several different life domains. A considerable result of this study was that the driving car is an important predictor of well-being in both countries. The findings underlined a variety of associations among the mobility resources and the subjective perception of well-being. Our work supports the importance of being aware of the main variables influencing the positive dimension of well-being for creating a better understanding the needs and goals of older people. Moreover, the present study shows that individual-environment interaction should be considered in evaluating personal well-being, especially in older people.

Human corticotropin releasing hormone test performance in the differential diagnosis between Cushing's disease and pseudo-Cushing state is enhanced by combined ACTH and cortisol analysis

OBJECTIVE Corticotropin releasing hormone (CRH) test does not reliably distinguish Cushings disease (CD) from normality or pseudo-Cushing state (PC). We assessed whether this could be achieved with a novel approach while preserving the ability of the test to distinguish CD from ectopic ACTH syndrome (EAS). Design Retrospective/prospective study. SUBJECTS AND METHODS We studied 51 subjects with CD, 7 with EAS, 26 with PC, and 31 controls (CT). Human CRH (hCRH) test was performed at 0830 h by measuring plasma ACTH and serum cortisol at -15, 0, 15, 30, 45, 60, 90, and 120 min. RESULTS The area under the curve-ACTH exhibited a significant negative correlation with baseline serum cortisol in CT and PC, but not in CD or EAS patients. ACTH response to hCRH was blunted in PC compared with CT, whereas peak serum cortisol was higher in PC than in CT subjects. These findings suggested that ACTH-dependent Cushings syndrome can be diagnosed by the presence of two hCRH test parameters and excluded if either or both are absent. Application of i) basal serum cortisol >12 microg/dl and peak plasma ACTH >54 pg/ml, or ii) peak serum cortisol >21 microg/dl and peak plasma ACTH >45 pg/ml, had 91.3% (95% confidence intervals (CI) 81-97.1) and 94.8% (CI 85.6-98.9) sensitivity and 98.2% (CI 90.6-99.9) and 91.2% (CI 80.7-97) specificity respectively, in diagnosing ACTH-dependent Cushings syndrome. The >14% serum cortisol increase from mean baseline values to the mean of 15 and 30 min values in patients who were positive for the test completely discriminated between CD and EAS. CONCLUSIONS Simultaneous plasma ACTH and serum cortisol analysis enables the hCRH test to distinguish CD from PC and from normality, while preserving its ability to discriminate CD from EAS.

Predictors of participation in physical activity for community-dwelling elderly Italians

This paper analyses variables associated with community-dwelling older peoples engagement in physical activity (PA). Data were examined using the results from the European ZINCAGE study on 306 community-dwelling Italians aged 65 years and over. The lifestyle questionnaire was used to evaluate the data. Levels of regular/non-regular PA were based on ≥ 1 h of weekly exercise. Logistic regression analysis was used to analyze the predictors of PA. Participants reported the time they had spent per week engaging in PA over the last year. Overall, 56.2% of them engaged in regular physical exercise. PA levels decreased in subjects with probable cognitive decline, depression and high perceived stress levels (p<0.001). Lower age, a lower body mass index (BMI), better health status, absence of depression, being married, were all associated with regular PA. The importance of monitoring PA in the elderly emerged, in particular in those having some certain social-demographic characteristics.

OBESITY AND BODY MASS INDEX (BMI) IN RELATION TO LIFE-STYLE AND PSYCHO-SOCIAL ASPECTS

Obesity is increasing in middle-aged adults and the elderly. This multifactorial phenomenon may have different causes, such as incorrect nutritional and dietary habits, psycho-social aspects and sedentary life-style. It is becoming a serious problem, due also to the worlds ageing society. The aim of this study is to provide preliminary results on BMI, life-style and psycho-social aspects in a sample of Italian subjects, which also assesses the relationship between obesity and psychological health. We hypothesize that obesity is related to many factors, such as life-style, behavioral, socio-economic, and psychological aspects. The sample was made up of 107 obese and non-obese subjects, aged 50-74. All participants were given a multidimensional assessment, which included anthropometric, psycho-social and life-style evaluation. As per the protocol a structured life-style questionnaire designed to gather information on anthropometric measurements, socio-economic factors, physical activity, smoking, alcohol and food intake. The Symptom Checklist-90 (SCL-90) for the evaluation of a broad range of psychological problems and symptoms of psychopathology; the Binge Eating Scale (BES) for the assessment of disorders in the eating habits were administered. BMI was associated with age and education, socio-economic status and smoking in both genders. Psychological factors for obesity differed between overweight men and women. In conclusion, obesity and non-obesity appear as two different entities in some aspects. The increase in the prevalence of obesity in elderly subjects could lead to disability and age-related diseases. For this reason, greater insight of the factors related to the development of obesity is required to develop treatment strategies weight-loss prevention programs.

The Effects of Cognitive Training for Elderly: Results from My Mind Project

Abstract Cognitive decline and dementia represent very important public health problems that impact the ability to maintain social function and independent living. The aim of this study was to investigate the effects of a nonpharmacological intervention consisting of comprehensive cognitive training in elderly people having one of three different cognitive statuses. In all, 321 elderly people with a diagnoses of mild–moderate Alzheimers disease (AD), with mild cognitive impairment (MCI) and without cognitive decline were randomly assigned to two groups: experimental group (EG, who underwent intervention) and control group (CG), according to a prospective randomized intervention study. In the three groups, immediately after the end of the intervention, we observed a significant effect on some cognitive and noncognitive outcomes in the EGs. At the end of the intervention, we found an intermediate intervention effect on the Alzheimers Disease Assessment Scale (ADAS) score of subjects with AD, as well as on functional status, as measured by using the Instrumental Activities of Daily Living scale. A significant intervention effect was also observed on enhancement of auditory verbal short-term memory and subjective memory complaints of subjects with MCI. The group of subjects without cognitive decline obtained a significant intervention effect on subjective complaints outcomes. The obtained results demonstrated that participation in the intervention could improve performance with respect to specific cognitive functions and psychological statuses. The role of healthy lifestyle programs, such as the use of comprehensive interventions, has been shown to be efficient for enhancing memory and other abilities in aged individuals with and without cognitive decline.

Zinc in Elderly People: Effects of Zinc Supplementation on Psychological Dimensions in Dependence of IL-6 -174 Polymorphism: A Zincage Study

Zinc is relevant for psychological dimensions, which are altered in zinc deficiency, as in aging. Since zinc deficiency and the beneficial effect of zinc supplementation may be related to genotypes of IL-6 -174 polymorphism, the main goal was to examine psychological dimensions in relationship to plasma zinc and genetic background of IL-6 in healthy elderly subjects, recruited in Italy, Greece, and Poland, before and after zinc supplementation. On the basis of IL-6 -174 polymorphism, significant restoration occurs for PSS, especially in Greece and Poland, less for MMSE and GDS, after zinc supplementation, suggesting zinc is important in reducing stress in elderly people.

Social Support Networks and Depression of Women Suffering from Early-Stage Breast Cancer: A Case Control Study

The aim of this study was to investigate the areas of depression, anxiety, and social support using the structural model of the social network. By comparing the networks of two samples of breast cancer sufferers and healthy control participants, it was possible to identify differences in their relationships, in the shape of the networks themselves, and in the levels of depression and anxiety. Women with breast cancer described smaller and denser networks, including mainly kins whereas the healthy women included more friends, coworkers, and leisure companions. The levels of anxiety and depression were higher in women with breast cancer. Social network and social support measure correlated differently with depression and anxiety in the two groups.