Pubblicazioni - Lafortuna Dott. Claudio

• Prevalence of the metabolic syndrome and its components among obese men and women in Italy.
  Obes Facts

  2012 ;5(1):127-37. doi: 10.1159/000336700.
  
  Lafortuna Claudio L, Agosti Fiorenza, De Col Alessandra, Pera Franca, Adorni Fulvio, Sartorio Alessandro
  
  Abstract
  
  OBJECTIVE:
  Assessment of the prevalence of the metabolic syndrome (MetS) and its components in Italian obese individuals.
  
  METHODS:
  Cross-sectional estimate of MetS prevalence using the IDF definition in 635 obese (BMI ? 35 kg/m(2)) individuals (286 men, 349 women) aged 19-78 years hospitalised for mass excess treatment.
  
  RESULTS:
  MetS prevalence was significantly (p < 0.001) higher in males (75.9%) than in females (61.9%), due to the increased prevalence of 4/5 involved abnormalities. A multivariate binary logistic regression analysis disclosed a contributory independent effect of ageing (p < 0.01-0.001), but not of BMI, whereas large waist circumference (p < 0.01) and high waist-to-hip ratio (p < 0.01) contributed to MetS prevalence only in women. Affected individuals were significantly older (males p = 0.022; females p < 0.001), affected men being younger than affected women (p < 0.01). The prevailing clinical picture included all abnormalities (21.2% in men, 22.2% in women); in minimal trait MetS (3/5 abnormalities), the prevailing combination was, beside central obesity, hypertension-hyperglycaemia in men (12.4%), and hypertension-dyslipidemia in women (19.4%).
  
  CONCLUSIONS:
  MetS is a highly prevalent condition among Italian obese individuals. Prevalence and combinations of involved abnormalities differ considerably between genders and suggest a different pathophysiology of the MetS in men and women, with possible relevance for prevention and treatment of the condition.
  
  Copyright © 2012 S. Karger AG, Basel.
  
  Guarda su PubMed

• Prevalence of the metabolic syndrome among extremely obese adolescents in Italy and Germany.
  Diabetes Res Clin Pract

  2010 Apr;88(1):14-21. doi: 10.1016/j.diabres.2010.01.008.
  
  Lafortuna Claudio L, Adorni Fulvio, Agosti Fiorenza, De Col Alessandra, Sievert Kolja, Siegfried Wolfgang, Sartorio Alessandro
  
  Abstract
  
  Juvenile metabolic syndrome (MetS) is a growing major medical problem in industrialised countries. We estimated its prevalence among two similar clinic-based sequentially recruited cohorts of extremely obese adolescents (age: 12-18 years) from Italy (N=665, males=271, females=394) and Germany (N=661, males=261, females=400) using the recent IDF paediatric criteria. The prevalence of the MetS was 23.3% among the Italians and 40.4% among the Germans. A multivariate logistic regression revealed an increased risk related to age (adjusted odd ratio (AOR): 2.24; 95% confidence interval (CI): 1.59-3.16; p<0.001), BMI SDS (AOR: 3.61; 95% CI: 2.33-5.60; p<0.001), male gender (AOR: 2.36; 95% CI: 1.80-3.10; p<0.001), and in German adolescents (AOR: 2.56; 95% CI: 1.98-3.31; p<0.001). Among Italian adolescents having the MetS, 83% had 3 abnormalities, 16% had 4 abnormalities while less than 1% had all the 5 abnormalities. In the German cohort, 67%, 28% and 5% of affected individuals had 3, 4 and 5 abnormalities, respectively. These results indicate that MetS is highly prevalent among extremely obese adolescents, and suggest that (besides age, obesity and gender) national sociocultural factors, as alimentary trends, could be important. Further tools should be developed to understand international epidemiological differences concerning obesity and its comorbidities in relation to lifestyles in the countries of European Union.
  
  Guarda su PubMed

• The energetic and cardiovascular response to treadmill walking and cycle ergometer exercise in obese women.
  Eur J Appl Physiol

  2008 Aug;103(6):707-17. doi: 10.1007/s00421-008-0758-y.
  
  Lafortuna Claudio L, Agosti Fiorenza, Galli Raffaela, Busti Carlo, Lazzer Stefano, Sartorio Alessandro
  
  Abstract
  
  Physical activity is essential in obesity management, but exercise capacity is compromised in obese individuals due to the excessive body mass, impacting on body movement's energetics, and to the dysfunctions of regulatory mechanisms, affecting cardiovascular responses. This study aims to compare the energetics and cardiovascular responses of walking and cycling in obese women, and to formulate recommendations regarding the most suitable type of exercise for obesity. Fifteen obese (OB) and six normal weight (NW) women exercised on treadmill (TM) and cycle ergometer (CE). During both exercise modalities, metabolic rate was higher in OB than in NW and correlated with measures of body mass. Leg movement metabolic rate during cycling depended upon individual adiposity, and when accounted for, mechanical efficiency was similar in the two groups. When accounting for extra mass, differences in metabolic rate among groups are abolished for CE, indicating no obesity impairment of muscle efficiency, but not for TM, suggesting that differences in biomechanics may explain the higher net cost of transport of OB. In both groups, HR was higher during CE than TM at the same oxygen uptake (VO(2)), but in OB the HR increment over VO(2) was greater for CE than for TM. Therefore, due to different cardiovascular responses to TM and CE in OB, walking is more convenient, enabling OB to attain target energy expenditure at lower HR or in a shorter time.
  
  Guarda su PubMed

• Factor analysis of metabolic syndrome components in obese women.
  Nutr Metab Cardiovasc Dis

  2008 Mar;18(3):233-41.
  
  Lafortuna Claudio L, Adorni Fulvio, Agosti Fiorenza, Sartorio Alessandro
  
  Abstract
  
  BACKGROUND AND AIM:
  Factor analysis is a multivariate correlation technique that is frequently employed to characterise the clustering of intercorrelated abnormalities, which underlie the metabolic syndrome in cohorts of individuals with different characteristics. To our knowledge, it has never been used to identify the components of this syndrome in obese subjects. The purpose of this study was to use factor analysis to investigate the clustering of features, which characterise the metabolic syndrome, in a cohort of 552 obese women aged 18-83 years (mean body mass index: 43.0 kg/m(2)+/-5.7 SD).
  
  METHODS AND RESULTS:
  Principal component analysis reduced ten correlated physiological variables, to four uncorrelated factors that explained 72.2% of the variance in the original parameters. These factors were interpreted as: (1) an insulin resistance factor, with positive loading of fasting serum insulin and homeostatic model assessment of insulin resistance; (2) a metabolic glucose/lipid factor, with positive loading of fasting plasma glucose, triglycerides, waist-to-hip ratio, and inverse loading of high density lipoprotein cholesterol; (3) a body mass factor, with positive loading of body mass and waist circumference; and (4) a blood pressure factor, with positive loading of systolic and diastolic blood pressure.
  
  CONCLUSION:
  The identification of four independent factors is consistent with previous findings among samples of different populations and may also support, in obese women, the hypothesis that multiple physiological determinants are responsible for the abnormalities underlying the metabolic syndrome. Nonetheless, findings in this cohort of obese women suggest that the absolute degree of adiposity is not correlated with any tested component of the metabolic syndrome, but that the relative fat distribution is highly correlated with the development of hyperglycaemic and dyslipidaemic phenomena. Furthermore, insulin resistance appears to be a major factor in obese individuals, independent of other metabolic and anthropometic abnormalities.
  
  Guarda su PubMed

• The energy cost of cycling in young obese women.
  Eur J Appl Physiol

  2006 May;97(1):16-25.
  
  Lafortuna Claudio L, Proietti Marco, Agosti Fiorenza, Sartorio Alessandro
  
  Abstract
  
  In order to evaluate the difference in the energy cost of submaximal cycling between normal weight (NW) and obese (OB) females, nine OB (age 23.2 years+/-1.6 SE, BMI 40.4+/-1.2 kg/m2) and nine NW (age 25.6 years+/-1.8, BMI 21.7+/-0.6 kg/m2) healthy young women were studied during a graded bicycle ergometer test at 40, 60, 80, 100 and 120 W. At rest and at all workloads, oxygen uptake VO2 was higher in OB than in NW women (Student's t test, P<0.05-0.01), as well as respiratory quotient during all exercise levels (P<0.05-0.01), while similar values of heart rate, pulmonary ventilation and breathing efficiency were found between the two groups. Maximal VO2 and anaerobic threshold were higher in OB women, and they also explained the higher oxygen pulse observed during submaximal exercise, but no difference was found when the values were adjusted for fat-free mass. While net mechanical efficiency (ME) was significantly lower in OB (ANOVA, P<0.05), delta ME was similar in both groups, indicating no substantial derangement of muscle intrinsic efficiency in obesity, but suggesting that the increased mass of body segments involved in cycling movements may be chiefly responsible for the higher energy cost of this type of exercise. Comparison of the actual VO2 presently measured with that predicted by available cycle ergometry equations at the different workloads indicated inaccuracy of various degrees ranging from 8.4 to -31.9%. It is concluded that the lower mechanical efficiency displayed by obese women in cycling has to be taken into account when prescribing exercise through methods predicting the metabolic load.
  
  Guarda su PubMed

• The regulation of respiratory resistance in exercising horses.
  Eur J Appl Physiol

  2003 Oct;90(3-4):396-404.
  
  Lafortuna Claudio L, Saibene Franco, Albertini Mariangela, Clement M Giovanna
  
  Abstract
  
  Horses display remarkable aerobic capabilities, attaining during muscular exercise a maximal rate of oxygen consumption about 30-fold higher than the resting value, and 2.5-fold higher than that of other mammals of similar body mass. Under these circumstances an enormous mechanical burden is expected to impinge on the equine respiratory pump and regulatory mechanisms aiming to minimize this load may play an important role in determining the adequacy of the respiratory system to the metabolic requirements. The behaviour of the respiratory system has been investigated in horses at rest and during treadmill locomotion at different velocities and gaits. During exercise hyperpnoea, horses exhibit a significant reduction in the lung viscous resistance not observed in other mammals, such as dogs and humans. Therefore, the exercise-dependent increase in the rate of mechanical work of breathing is lower in the horse than in other mammals. This increase in the equine airway patency during exercise appeared to be mainly determined by the pattern of laryngeal movements. In fact, during exercise, the laryngeal cross-sectional area, determined with a video-endoscopic imaging technique at the level of rima glottidis (CSArg), undergoes during inspiration an increase averaging up to over 4 times the resting expiratory values. Although a significant linear correlation was found between CSArg and minute ventilation (VE), the laryngeal activation contributes to increase lung conductance only when CSArg is narrower than the tracheal section. It appears therefore that in exercising horses pulmonary resistive features are finely controlled to reduce the mechanical load supported by the respiratory muscles and to counterbalance the increase in the ventilatory energetic requirements inherent in the remarkably enhanced aerobic performance observed in this species.
  
  Guarda su PubMed

• Locomotor behaviours and respiratory pattern of the Mediterranean fin whale (Balaenoptera physalus).
  Eur J Appl Physiol

  2003 Oct;90(3-4):387-95.
  
  Lafortuna Claudio L, Jahoda Maddalena, Azzellino Arianna, Saibene Franco, Colombini Angelo
  
  Abstract
  
  Twenty-four Mediterranean fin whales were tracked in open sea with a method based on the assessment of the animal differential position in respect of the observer's absolute position aboard a vessel, with the concomitant recording of the respiratory activity. Short distance video recording was also performed in two whales, permitting the simultaneous determination of single breath expiratory (TE) and inspiratory (TI) durations. In the 24 whales swimming at an average velocity of 1.39 (0.47) m.s(-1) [mean (SD), range: 0.62-2.44 m.s(-1)], 2068 breaths organized in 477 respiratory cycles were observed. Each cycle entailed a prolonged apnoea dive phase [225 (91) s, Tdive) followed by a period near the surface [62 (28) s, surfacing], during which a series of breaths [4.6 (1.8)] was performed at short intervals. On the basis of track length and swimming velocity, two groups of animals were devised differing for convolution of the course (p<0.001), extension of ranging territory (p<0.01) and horizontal swimming velocity (p<0.05), which may represent two distinct behaviours. A possibly general mechanism of control of breathing in cetaceans was found, consistent with a model of constant tidal volume and variable respiratory frequency. Coherently with this model, TE was independent of TI or Tdive, in line with a passive expiration, while TI appeared to be negatively correlated with Tdive (p<0.05), otherwise suggesting, similarly with terrestrial mammals, a significant role of hypercapnic stimulation. The estimated O2 consumption of about 150 l.min(-1) is in line with the general allometric regression for mammals and corresponds to an energetic expenditure of 85-95 kJ.kg(-1).day(-1).
  
  Guarda su PubMed