alterazioni del grasso corporeo: il ritorno di antichi ... · raffaele 3, mastrangelo andrea 1,...
TRANSCRIPT
![Page 1: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/1.jpg)
Alterazioni del grasso corporeo:
Il ritorno di antichi fantasmi?
Antonella Castagna
![Page 2: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/2.jpg)
David Lowery, 2017
![Page 3: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/3.jpg)
Diagnosis and treatment of lipodistrophy: a step-by-step
approach
D. Araujo-Vilar
![Page 4: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/4.jpg)
ENDOCRINOL METABOL CLIN N AM 2016
![Page 5: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/5.jpg)
![Page 6: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/6.jpg)
![Page 7: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/7.jpg)
Potential causes of inflammageing
Ferrucci F, NrC, 2018
![Page 8: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/8.jpg)
Inflammageing is a risk factor for multiple chronic diseases
Ferrucci F, NrC, 2018
![Page 9: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/9.jpg)
Heart Fat in HIV: marker or mediator of risk?
Curr Opin HIV AIDS, 2017
![Page 10: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/10.jpg)
WHAT ABOUT TAF ?
![Page 11: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/11.jpg)
Fletcher C, CROI 2019
![Page 12: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/12.jpg)
What is LDL Cholesterol?
Holmes MV, NrC , 2019
![Page 13: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/13.jpg)
Mills A, et al. JAIDS 2015
![Page 14: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/14.jpg)
Switch study (TANGO)
Phase III, randomised, multicentre, parallel-group, non-inferiority study
• Objective: To demonstrate the non-inferior antiviral activity of switching to DTG/3TC QD
compared with continuation of current ARV regimen over 48 weeks in HIV-1-infected
ART-experienced subjects
• Primary endpoint: The proportion of participants who meet the snapshot virological failure
criteria at week 48 using the ITT-E population
– Non-inferiority margin = 4%; week 48 primary endpoint
TAF-based
regimens
TAF-based
regimens
Randomisation
1:1N=600
Randomisation
1:1N=600
DTG/3TC
Primary
endpoints
Secondary
endpoints
Baseline Week 24 Week 48 Week 96 Week 144
TAF-based regimensTAF-based regimens
North America + EU + international
![Page 15: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/15.jpg)
![Page 16: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/16.jpg)
JA LAKE, CROI 2019
![Page 17: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/17.jpg)
Bernardino J, 2019
![Page 18: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/18.jpg)
![Page 19: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/19.jpg)
Homeostatic model assessment for insulin resistance (HOMA-IR) index trajectories in HIV-infected patients treated with first-line
antiretroviral regimens based on non-nucleoside reverse transcriptase inhibitors (NNRTIs), ritonavir-boosted protease
inhibitors (PIs/r) or on integrase strand transfer inhibitors (InSTIs)
Muccini Camilla1, Gianotti Nicola2, Galli Laura2, Poli Andrea2, Galizzi Nadia1, Dell’Acqua
Raffaele3, Mastrangelo Andrea1, Messina Emanuela2, Piatti Pier Marco4, Lazzarin
Adriano2, Castagna Antonella1,2
1Vita-Salute San Raffaele University, Milan, Italy;
2IRCCS San Raffaele Scientific Institute, Milan, Italy;
3University Hospital Policlinico, Bari, Italy;
4Cardiometabolic Clinical Trials Unit, Internal Medicine Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
ICAR 10° congresso nazionale, Roma 22-24 maggio 2018
OC64
Submitted, JMV
![Page 20: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/20.jpg)
• Retrospective analysis on a cohort of HIV-1 infected patients followed at the Infectious Diseases Unit of the San Raffaele Hospital of Milan:
• who started antiretroviral therapy (ART) since 2007;
• with 2 NRTIs (tenofovir, abacavir, lamivudine or emtricitabine) and 1 anchor drug [ritonavir-boosted PI, non-NRTI or integrase strand transfer inhibitor (InSTI)];
• with 1 HOMA-IR determination before starting ART and ≥1 determination after starting ART;
• Patients with known diabetes were excluded;
• Follow-up accrued from the start of ART (=baseline, BL) up to the stop of any drug of the regimen or lost to follow-up or data freezing (January, 22, 2018);
• Univariate and multivariate mixed linear models with random slope and intercept for each patient were fitted to estimate HOMA-IR changes according to the anchor drug.
Material and methods
![Page 21: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/21.jpg)
Changes from baseline in HOMA-IR index according to the type of the initial ART regimen
Type of ART regimen
Univariate mixed linear model
Crude mean (95%CI) change in
HOMA-IR, units per yearP-value
INSTI 0.149 (0.012, 0.287) 0.034
NNRTI -0.071 (-0.174, 0.031) 0.174
PI/r 0.041 (-0.052, 0.134) 0.387
![Page 22: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/22.jpg)
![Page 23: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/23.jpg)
![Page 24: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/24.jpg)
![Page 25: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/25.jpg)
![Page 26: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/26.jpg)
![Page 27: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/27.jpg)
![Page 28: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/28.jpg)
![Page 29: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/29.jpg)
![Page 30: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/30.jpg)
Inflammageing induces a catabolic state.
L Ferrucci, NrC 2019
![Page 31: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/31.jpg)
![Page 32: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/32.jpg)
![Page 33: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/33.jpg)
![Page 34: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/34.jpg)
![Page 35: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/35.jpg)
![Page 36: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/36.jpg)
LT Fourman, AIDS
2017
![Page 37: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/37.jpg)
![Page 38: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/38.jpg)
Ogni difficoltà su cui si sorvola diventa un fantasma che
turba il nostro sonnoF. Chopin
![Page 39: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/39.jpg)
Tom’s Selfies
![Page 40: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/40.jpg)
15
368
586
757
680
598 609635
660
588
101
15
145
207
253 261
215 203 215 218203
89
0
100
200
300
400
500
600
700
800
2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019
N° VISITE N° pazienti
Accessi al servizio di chirurgia plastica _ Data on File_ 180319_OSR
![Page 41: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/41.jpg)
Normale
100 mg/dL
126 mg/dL 7,0 mmol/L
5,6 mmol/L
Normale
140 mg/dL
200 mg/dL 11,1 mmol/L
7,8 mmol/L
Adattamento dal rapporto di follow-up di The Expert Committee on the Diagnosis and Classification of
Diabetes Mellitus. Diabetes Care 2003;26:3160–3167
IFG IGT
Diabetemellito
Diabetemellito
Glicemiaa digiuno
Glicemia 2 ore dopoil carico di glucosio all’OGTT
PRE-DIABETE
About 50% of cases convert from NFG/NGT to diabetes
in less than 5 years
![Page 42: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/42.jpg)
![Page 43: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/43.jpg)
![Page 44: Alterazioni del grasso corporeo: Il ritorno di antichi ... · Raffaele 3, Mastrangelo Andrea 1, Messina Emanuela 2, Piatti Pier Marco 4, Lazzarin Adriano 2 , Castagna Antonella 1,2](https://reader035.vdocuments.us/reader035/viewer/2022080721/5f7a6d0a8bfe0114b21da7f2/html5/thumbnails/44.jpg)