BackgroundPreliminary evidence suggests an association between obesity and gut inflammation.AimsTo evaluate the frequency of glucose abnormalities and their correlation with systemic and intestinal inflammation in severely obese children.Patients and MethodsThirty-four children (25 males; median age 10.8 ± 3.4 yrs) with severe obesity (BMI >95%) were screened for diabetes with oral glucose tolerance test (OGTT), systemic inflammation with C-reactive protein (CRP) and gut inflammation with rectal nitric oxide (NO) and faecal calprotectin.ResultsBMI ranged from 23 to 44 kg/m2, and BMI z-score between 2.08 e 4.93 (median 2.69 ± 0.53). Glucose abnormalities were documented in 71% of patients: type 2 diabetes in 29%, impaired fasting glucose (IFG) in 58%, and impaired glucose tolerance (IGT) in 37.5%. Thirty-one patients (91%) were hyperinsulinemic. CRP was increased in 73.5% with a correlation between BMI z-score and CRP (p 0.03). Faecal calprotectin was increased in 47% patients (mean 77 ± 68), and in 50% of children with abnormal glucose metabolism (mean 76 ± 68 μg/g), with a correlation with increasing BMI z-score. NO was pathological in 88%, and in 87.5% of glucose impairment (mean 6.8 ± 5 μM).ConclusionsIn this study, the prevalence of glucose abnormalities in obese children is higher than in other series; furthermore, a correlation is present between markers of systemic and intestinal inflammation and glucose abnormalities.
IntroductionSchizophrenia patients experience severe difficulties in a range of common activities, defined 'functional milestones' (i.e. marriage, employment, self-supported living).Objectives/AimsThis study investigated the impairment in functional milestones in treatment resistant schizophrenia (TRS), compared to other severe disabling psychiatric conditions. Moreover, we evaluated whether multiple clinical and psychopathological features may be predictors of outcome in such functional milestones.Methods157 patients were enrolled and subdivided in four groups by diagnosis: anxious-depressive spectrum, bipolar disorder spectrum, schizophrenia responder patients, TRS patients. Demographic, clinical and social data were collected. Patients underwent psychopathological, psychosocial and cognitive functioning assessments. Positive and Negative Syndrome Scale (PANSS), Personal and Social Performance (PSP) scale, Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), List Learning task for Verbal Memory, Digit Sequencing task for Working Memory, Category Instances task for Verbal Fluency and Tower of London task for Problem Solving were administered. Data were analyzed by ×2 test, ANOVA test and Kruskal-Wallis test. Stepwise multivariate regression was used to correlate functional outcomes to clinical and psychopathological variables.ResultsTRS patients were more severely impaired in all psychosocial areas explored, were exposed to higher antipsychotic doses, had a higher number of hospitalizations, had higher scores on psychopathological rating scales and performed worse on the verbal memory task. Outcomes in functional milestones were more correlated to clinical/psychopathological variables in TRS than in the other groups.ConclusionsPsychosocial impairment, clinical, and psychopathological features generate a vicious circle in TRS, which is less evident in other disabling psychiatric conditions.
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