Antonino Scarinci

Università degli Studi G. d'Annunzio Chieti e Pescara, Chieta, Abruzzo, Italy

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Publications (6)26.36 Total impact

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    ABSTRACT: Objective: To investigate the presence of possible early atherosclerotic changes in a group of prepubertal children with juvenile idiopathic arthritis (JIA) and to establish the potential beneficial effects of 1-year treatment. Materials and methods: Inflammatory markers (C-reactive protein, erythrocyte sedimentation rate), proinflammatory cytokines (IL-1β, IL-6, IFN-γ, TNF-α), lipid profile and oxidant-antioxidant status (urinary isoprostanes [PGF-2α]) were assessed in 38 JIA children (12M/26F, mean age 7.05 ± 2.39 years) and compared with 40 controls (18M/22F, mean age 6.34 ± 2.25 years). Carotid intima-media wall thickness (cIMT) was obtained and blood pressure was measured. All parameters were reassessed in JIA children after 1 year of therapy. Results: At baseline JIA children presented compared to controls higher levels of inflammatory markers, proinflammatory cytokines, total cholesterol, LDL cholesterol, and PGF-2α (all p ≤ 0.01). Furthermore, blood pressure and cIMT were significantly increased (both p ≤ 0.01). After a 1-year treatment with non-steroid anti-inflammatory (NSAIDs) and disease-modifying antirheumatic drugs (DMARDs), a significant reduction of all parameters was detected (all p ≤ 0.01). This was associated with a significant reduction in blood pressure and cIMT (both p ≤ 0.01). Within the JIA group, patients requiring etanercept presented worse laboratory values and cIMT measurements at baseline. Nevertheless, the same improvement of all parameters was obtained after a 1-year treatment. In stepwise multiple regression, LDL cholesterol and IL-1β were mainly related to cIMT. Conclusion: Chronic and systemic inflammation seems to lead to early atherosclerotic abnormalities even in pre-pubertal JIA children. Substantial improvement can be obtained with 1-year of appropriate therapy.
    Clinical Research in Cardiology 08/2012; 102(1). DOI:10.1007/s00392-012-0496-3 · 4.56 Impact Factor
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    ABSTRACT: Early development of increased cardiovascular risk in obese children and the possible related cardiovascular diseases into adulthood have been shown; however, the underling pathogenetic mechanisms implicated are not yet completely defined. Receptors for advanced glycation end products (RAGE) pathway play a pivotal role in the genesis of abnormality of arterial wall. However, whether obese prepubertal children present impaired levels of endogenous and soluble secretory receptor for advanced glycation end products (esRAGE/sRAGE) and whether an association exists between RAGE levels and carotid intima media thickness (cIMT) are not yet evaluated in this age group. We note that esRAGE and sRAGE were significantly lower in obese children than controls and were independently related to cIMT. Our findings lead to the hypothesis that RAGE system seems to be related to the development of atherosclerosis even in obese prepubertal children.
    Antioxidants & Redox Signaling 02/2012; 17(2):187-91. DOI:10.1089/ars.2012.4525 · 7.41 Impact Factor
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    ABSTRACT: The aim of this study was to evaluate carotid intima-media thickness (cIMT) in children with a positive family history of premature cardiovascular disease (PFHPCD) and the relationship between cIMT and other known risk factors (insulin resistance, oxidant status and lipid profile) involved in structural vascular changes. Anthropometric measurements and inflammatory markers [isoprostanes (prostaglandin F-2alpha)] were evaluated in 24 prepubertal children (10 boys, 14 girls, mean age 7.9 +/- 2.37 years) with PFHPCD and compared with 25 healthy prepubertal children (11 boys, 14 girls). Fasting insulin and glycemia levels were evaluated and homeostasis model assessment of insulin resistance and fasting glucose-insulin ratio were calculated in all children. High-resolution ultrasound technique was used to evaluate cIMT. Children with PFHPCD had an increased cIMT (P = 0.001) in comparison with healthy controls. No significant differences were found in terms of fasting insulin levels (P = 0.416), glucose-insulin ratio (P = 0.454) and homeostasis model assessment of insulin resistance (P = 0.317) between children with PFHPCD and controls. Prostaglandin F-2alpha levels were significantly higher in children with PFHPCD than in controls (P = 0.003). In order to evaluate the relationship between cIMT and other known risk factors, a multiple linear regression analysis was performed. A direct correlation was found between cIMT and prostaglandin F-2alpha (beta = 0.905; P = 0.002; r2, 0.63) even after adjusting for confounding factors (age, sex, BMI). Signs of precocious cardiovascular risk are detectable in children with PFHPCD already during prepuberty. Furthermore, impaired oxidant-antioxidant status would be implicated in the detected abnormalities of the vascular wall, suggesting a pivotal role of hereditary and genetic predisposition in the pathogenesis of increased cIMT.
    Journal of Hypertension 05/2009; 27(4):822-8. DOI:10.1097/HJH.0b013e328325d81b · 4.72 Impact Factor
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    ABSTRACT: In order to characterize whether different degrees of adipose tissue storage may be associated with markers of early atherosclerosis, we evaluated oxidant-antioxidant status and inflammatory markers and determined carotid intima-media thickness (cIMT) in healthy constitutional lean and obese pre-pubertal children. Eighty healthy pre-pubertal lean and obese children were recruited and compared with 40 age, gender, and pubertal stage-matched normal controls. Anthropometric measurements, oxidant (urinary isoprostanes (PGF-2alpha), lag phase, and malondialdehyde (MDA)) and antioxidant status (vitamin E), inflammatory markers (high sensitive C-reactive protein (hs-CRP)), and insulin sensitivity (fasting glucose-insulin ratio, homeostasis model assessment of insulin resistance (HOMA-IR)) were investigated. Furthermore, cIMT was measured by high-resolution ultrasound. hs-CRP was not different between lean and control subjects (P=0.45), while higher values were found in obese compared with lean and control children (P<0.001 and P<0.001 respectively). PGF-2alpha and MDA were higher while lag phase shorter in lean and obese subjects compared with controls (lean P<0.001; P<0.001; P<0.001 and obese P<0.001; P<0.001; P<0.001 respectively), while no differences were documented between lean and obese subjects (P=0.78, P=0.019, and P=0.53 respectively). Compared with controls, cIMT was increased in lean and in obese subjects (P=0.001; P=0.004), while no differences were documented between obese and lean subjects (P=0.1). In a multiple stepwise linear regression analysis, cIMT was related with PGF-2alpha (beta=0.641, P<0.001) and HOMA-IR (beta=0.307; P<0.001). Pre-pubertal lean and obese children present increased oxidative stress and impaired inflammation and insulin sensitivity, which in turn seem to result in similar impaired endothelial dysfunction and early signs of atherosclerosis, already in childhood.
    European Journal of Endocrinology 05/2009; 161(1):73-80. DOI:10.1530/EJE-09-0042 · 4.07 Impact Factor
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    L Breda · D Di Marzio · A Scarinci · M Nozzi · K Falasca · F Chiarelli
    Pediatric Rheumatology 09/2008; 6:1-1. DOI:10.1186/1546-0096-6-S1-P59 · 1.61 Impact Factor
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    ABSTRACT: Obesity in children appears to be associated with increased risk of cardiovascular and metabolic diseases later in life. Early development of insulin resistance and impaired oxidant-antioxidant status may lead to endothelial dysfunction and increased carotid intima media thickness (IMT) even in childhood. The aim of this study was to measure IMT and the relationship between IMT, insulin resistance and oxidant status in obese pre-pubertal children. In 53 obese pre-pubertal children (27M/26F, mean age 8+/-2 years), anthropometric measurements and inflammatory markers (hs-CRP and PGF-2 alpha), were evaluated compared with 41 healthy pre-pubertal subjects (21M/20F, mean age 7+/-2 years). OGTT was performed and insulin resistance (IR) indices (HOMA-IR, WBISI, G/I and QUICKI) were calculated in all patients. High-resolution ultrasound techniques were used to evaluate IMT. Obese children had higher levels of PGF-2 alpha and hs-CRP compared to healthy subjects (p=0.001 and p=0.005). Furthermore, fasting insulin levels and HOMA-IR were higher in obese children than in controls (p=0.001 and p=0.001) while WBISI was significantly lower (p=0.002). In addition, obeses had an increased IMT (p=0.001). In obese children there was a significant correlation between IMT and indices of IR (HOMA-IR: beta=-1.233, p=0.002; WBISI: beta=-0.921, p=0.008; G/I: beta=-0.811, p=0.003) and between IMT and PGF-2 alpha (beta=0.505, p=0.004). After categorizing subjects according to tertiles of body mass index (BMI) (<or=21.42, 21.42-26.23 and >or=26.23 kg/m(2)) and to waist circumference (WC) (<or=68.28, 68.28-79.04 and >or=79.04 cm), no influence of BMI or WC on IMT were found in the three groups. In conclusion, early changes in glucose metabolism and an alteration of oxidant-antioxidant status may be present in obese pre-pubertal children; this could lead to increase IMT and early cardiovascular disease.
    Atherosclerosis 03/2008; 197(1):448-56. DOI:10.1016/j.atherosclerosis.2007.06.023 · 3.99 Impact Factor