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Article: An update of the consensus statement on insulin resistance in children 2010.

Tagi, Veronica Maria / Samvelyan, Sona / Chiarelli, Francesco

2022 Volume 13, Page(s) 1061524

Abstract: In our modern society, where highly palatable and calorie-rich foods are readily available, and sedentary lifestyle is common among children and adolescents, we face the pandemic of obesity, nonalcoholic fatty liver disease, hypertension, atherosclerosis, ...

Abstract	In our modern society, where highly palatable and calorie-rich foods are readily available, and sedentary lifestyle is common among children and adolescents, we face the pandemic of obesity, nonalcoholic fatty liver disease, hypertension, atherosclerosis, and T2D. Insulin resistance (IR) is known to be the main underlying mechanism of all these associated health consequences; therefore, the early detection of IR is fundamental for preventing them.A Consensus Statement, internationally supported by all the major scientific societies in pediatric endocrinology, was published in 2010, providing all the most recent reliable evidence to identify the definition of IR in children, its measurement, its risk factors, and the effective strategies to prevent and treat it. However, the 2010 Consensus concluded that further research was necessary to assess some of the discussed points, in particular the best way to measure insulin sensitivity, standardization of insulin measurements, identification of strong surrogate biomarkers of IR, and the effective role of lifestyle intervention and medications in the prevention and treatment of IR.The aim of this review is to update each point of the consensus with the most recent available studies, with the goal of giving a picture of the current state of the scientific literature regarding IR in children, with a particular regard for issues that are not yet fully clarified.
MeSH term(s)	Adolescent ; Child ; Humans ; Insulin Resistance ; Consensus ; Non-alcoholic Fatty Liver Disease ; Obesity ; Atherosclerosis
Language	English
Publishing date	2022-11-16
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2592084-4
ISSN	1664-2392
ISSN	1664-2392
DOI	10.3389/fendo.2022.1061524
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Treatment Options for Lipodystrophy in Children.

Mainieri, Francesca / Tagi, Veronica Maria / Chiarelli, Francesco

Frontiers in endocrinology

2022 Volume 13, Page(s) 879979

Abstract: Lipodystrophy includes a heterogeneous group of rare diseases characterized by different amounts of adipose tissue loss and several metabolic complications, including hypertriglyceridemia, steatohepatitis and particularly insulin resistance, that may ... ...

Abstract	Lipodystrophy includes a heterogeneous group of rare diseases characterized by different amounts of adipose tissue loss and several metabolic complications, including hypertriglyceridemia, steatohepatitis and particularly insulin resistance, that may lead to severe morbidity and, sometimes, mortality. Therefore, therapy for lipodystrophy primarily consists of a conventional approach that involves standard treatments of metabolic abnormalities. Given the evidence of leptin deficiency in lipodystrophy syndromes, leptin replacement therapy has been considered as a treatment option. Long-term studies on the use of therapy with a methionylated analog of human leptin, metreleptin, first on animals and subsequently on human patients, demonstrated enormous improvements of patients' clinical features and metabolic conditions. Recently, metreleptin was approved by Food and Drug Administration (FDA) for the treatment of generalized lipodystrophy and by European Medicines Agency (EMA) for the treatment of both generalized and partial lipodystrophy. However, further research is being conducted for new and different therapeutic agents, especially helpful for the treatment of patients with partial lipodystrophy, as some of them do not have access to metreleptin therapy or show poor response.
MeSH term(s)	Animals ; Humans ; Insulin Resistance ; Leptin/therapeutic use ; Lipodystrophy/drug therapy ; Lipodystrophy, Congenital Generalized/drug therapy ; United States
Chemical Substances	Leptin
Language	English
Publishing date	2022-05-04
Publishing country	Switzerland
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	2592084-4
ISSN	1664-2392
ISSN	1664-2392
DOI	10.3389/fendo.2022.879979
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Article: Recent Advances on Familial Hypercholesterolemia in Children and Adolescents.

Mainieri, Francesca / Tagi, Veronica Maria / Chiarelli, Francesco

Biomedicines

2022 Volume 10, Issue 5

Abstract: Familial hypercholesterolemia is a common autosomal hereditary disorder characterized by elevated concentrations of low-density lipoprotein cholesterol and the development of premature atherosclerosis and cardiovascular disease. Early diagnosis, as well ... ...

Abstract	Familial hypercholesterolemia is a common autosomal hereditary disorder characterized by elevated concentrations of low-density lipoprotein cholesterol and the development of premature atherosclerosis and cardiovascular disease. Early diagnosis, as well as prompt and aggressive treatment, are fundamental steps to prevent cardiovascular complications and a high rate of premature mortality in children and adolescents. Clinics and genetics are the two main aspects on which diagnosis is based. Widespread screening programs are a respectable option for the early detection of familial hypercholesterolemia. Different types of screening have been proposed so far; however, the optimal screening program has not yet been found. The treatment approach for both heterozygous and homozygous familial hypercholesterolemia in the pediatric population is multidisciplinary, including lifestyle modifications, standard lipid-lowering medications, and novel pharmacological agents. The latter show promising results, especially for patients who experience intolerance to other treatment or present with more severe conditions. Our purpose is to focus on the importance of the early detection of familial hypercholesterolemia, and to highlight the best therapeutic strategies, including the recent approaches based on current clinical evidence, that need to be adopted from the earliest stages of life.
Language	English
Publishing date	2022-04-30
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2720867-9
ISSN	2227-9059
ISSN	2227-9059
DOI	10.3390/biomedicines10051043
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Article ; Online: Hypertension in Patients with Insulin Resistance: Etiopathogenesis and Management in Children.

Tagi, Veronica Maria / Mainieri, Francesca / Chiarelli, Francesco

International journal of molecular sciences

2022 Volume 23, Issue 10

Abstract: Insulin resistance (IR) is a key component in the etiopathogenesis of hypertension (HS) in patients with diabetes mellitus (DM). Several pathways have been found to be involved in this mechanism in recent literature. For the above-mentioned reasons, ... ...

Abstract	Insulin resistance (IR) is a key component in the etiopathogenesis of hypertension (HS) in patients with diabetes mellitus (DM). Several pathways have been found to be involved in this mechanism in recent literature. For the above-mentioned reasons, treatment of HS should be specifically addressed in patients affected by DM. Two relevant recently published guidelines have stressed this concept, giving specific advice in the treatment of HS in children belonging to this group: the European Society of HS guidelines for the management of high blood pressure in children and adolescents and the American Academy of Pediatrics Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents. Our aim is to summarize the main pathophysiological mechanisms through which IR causes HS and to highlight the specific principles of treatment of HS for children with DM.
MeSH term(s)	Adolescent ; Child ; Humans ; Hypertension/complications ; Hypertension/therapy ; Insulin Resistance ; Mass Screening ; United States
Language	English
Publishing date	2022-05-22
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms23105814
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Article ; Online: Insulin resistance in children.

Mainieri, Francesca / Tagi, Veronica Maria / Chiarelli, Francesco

Current opinion in pediatrics

2022 Volume 34, Issue 4, Page(s) 400–406

Abstract: Purpose of review: Insulin resistance (IR) is a clinical condition due to the decline in the efficiency of insulin promoting glucose uptake and utilization. The aim of this review is to provide an overview of the current knowledge on IR in children, ... ...

Abstract	Purpose of review: Insulin resistance (IR) is a clinical condition due to the decline in the efficiency of insulin promoting glucose uptake and utilization. The aim of this review is to provide an overview of the current knowledge on IR in children, focusing on its physiopathology, the most appropriate methods of measurement of IR, the assessment of risk factors, the effects of IR in children, and finally giving indications on screening and treatment. Recent findings: IR has evolved more and more to be a global public health problem associated with several chronic metabolic diseases. Summary: Detecting a correct measurement method and specific risk predictors, in order to reduce the incidence of IR, represents a challenging goal.
MeSH term(s)	Blood Glucose/metabolism ; Body Mass Index ; Child ; Humans ; Incidence ; Insulin/therapeutic use ; Insulin Resistance ; Risk Factors
Chemical Substances	Blood Glucose ; Insulin
Language	English
Publishing date	2022-07-05
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1049374-8
ISSN	1531-698X ; 1040-8703
ISSN (online)	1531-698X
ISSN	1040-8703
DOI	10.1097/MOP.0000000000001151
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Article ; Online: Cardiovascular risk in children: a burden for future generations.

Candelino, Maria / Tagi, Veronica Maria / Chiarelli, Francesco

Italian journal of pediatrics

2022 Volume 48, Issue 1, Page(s) 57

Abstract: Cardiovascular diseases are the main causes of death and health costs in developed countries. Although cardiovascular diseases are thought to affect only adulthood, the underlying process of atherosclerosis begins in the first decade of life. ... ...

Abstract	Cardiovascular diseases are the main causes of death and health costs in developed countries. Although cardiovascular diseases are thought to affect only adulthood, the underlying process of atherosclerosis begins in the first decade of life. Epidemiological studies show that severity of atherosclerosis depends both on the number and intensity of risk factors. Early detection of cardiovascular risk in childhood is the most powerful tool to prevent cardiovascular accidents in adulthood and possibly reduce its consequent burden for the future.A large amount of cardiovascular risk factors is already detectable in childhood and include non-modifiable elements, among which genetic factors and congenital heart diseases, and modifiable elements, which depend on environmental effects (e.g. lifestyle and nutrition). Regardless of the possibility to intervene on these factors, an early diagnosis is fundamental to ensure an optimal life expectancy in adulthood. The most important cardiovascular risk factors in the paediatric age and adolescence are excess weight, arterial hypertension, glucose metabolism and lipid metabolism alterations.In this review we will discuss the main risk factors strictly correlated with cardiac and vessels diseases, focusing on their pathogenesis, diagnosis, and treatments.
MeSH term(s)	Adolescent ; Adult ; Atherosclerosis/complications ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/etiology ; Child ; Heart Disease Risk Factors ; Humans ; Risk Factors ; Social Responsibility
Language	English
Publishing date	2022-04-11
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2088556-8
ISSN	1824-7288 ; 1720-8424
ISSN (online)	1824-7288
ISSN	1720-8424
DOI	10.1186/s13052-022-01250-5
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Article ; Online: Obesity and insulin resistance in children.

Tagi, Veronica Maria / Chiarelli, Francesco

Current opinion in pediatrics

2020 Volume 32, Issue 4, Page(s) 582–588

Abstract: Purpose of review: It is well known that obesity represents the main modifiable risk factor for insulin resistance in children and adolescents; obesity-induced insulin resistance in children is the most important risk factor for developing ... ...

Abstract	Purpose of review: It is well known that obesity represents the main modifiable risk factor for insulin resistance in children and adolescents; obesity-induced insulin resistance in children is the most important risk factor for developing cardiovascular diseases and type 2 diabetes in adulthood. The mechanisms through which obesity causes insulin resistance are complex and not completely known to date. Recent findings: In children, global adiposity is the main factor determining insulin resistance. Excessive fatty acids play a determinant role in the pathogenesis of insulin resistance in obese children, inducing an increased production of acetyl-CoA in the liver and enhancing inflammation in adipose tissue. The aetiology of insulin resistance in polycystic ovary syndrome is multifactorial and still debated. Summary: The aim of this review is to present an updated frame and new insights of the numerous pathways involved in the development of insulin resistance in obese patients, focusing on the peculiarities of children and adolescents. Improving the knowledge of mechanisms through which obesity leads to insulin resistance is fundamental in order to recommend particular follow-up and possible treatment to specific categories of obese children and adolescents.
MeSH term(s)	Adiposity/physiology ; Adolescent ; Adult ; Body Composition ; Child ; Diabetes Mellitus, Type 2/complications ; Female ; Glucose Intolerance/complications ; Humans ; Insulin Resistance ; Obesity/complications ; Polycystic Ovary Syndrome/complications
Language	English
Publishing date	2020-06-08
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1049374-8
ISSN	1531-698X ; 1040-8703
ISSN (online)	1531-698X
ISSN	1040-8703
DOI	10.1097/MOP.0000000000000913
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Article ; Online: Glycomacropeptide-Based Protein Substitutes for Children with Phenylketonuria in Italy: A Nutritional Comparison.

Tosi, Martina / Fiori, Laura / Tagi, Veronica Maria / Gambino, Mirko / Montanari, Chiara / Bosetti, Alessandra / Zuccotti, Gianvincenzo / Verduci, Elvira

Nutrients

2024 Volume 16, Issue 7

Abstract: Advancements in food science technology have allowed the development of new products for the therapeutic management of inherited metabolic diseases such as phenylketonuria (PKU). Glycomacropeptide (GMP), a peptide derived from casein, is naturally low in ...

Abstract	Advancements in food science technology have allowed the development of new products for the therapeutic management of inherited metabolic diseases such as phenylketonuria (PKU). Glycomacropeptide (GMP), a peptide derived from casein, is naturally low in phenylalanine (Phe) and, thus, adequate for protein substitutes (PSs) for the management of PKU in children. This review aims primarily to analyse the differences in the nutritional composition of GMP-based protein substitutes in different formulations (ready to drink, powdered, and bars), and secondarily to assess the quality of these products, comparing their nutritional composition with that of standard amino acid (L-AA) mixtures. Thirty-five GMP-based PSs produced by six different companies were included in this review: twenty-one powdered PSs, eight ready to drink, and six bars. The analysis revealed great heterogeneity not only among the different formulations (powdered, ready to drink, and bars) but also within the same group, in terms of energy content and nutritional composition. GMP-based PSs were shown to have higher contents of sugars and saturated fatty acids compared to L-AA PSs, especially in ready-to-drink formulations and bars. The latter also provided the highest amounts of energy among the GMP-based products. This finding may be related to a higher risk of developing overweight and obesity. The greater palatability of these GMP-based PSs, combined with improved nutritional quality, could not only improve adherence to diet therapy but also reduce the incidence of obesity-related comorbidities in PKU.
MeSH term(s)	Child ; Humans ; Caseins ; Phenylketonurias ; Italy ; Obesity ; Peptide Fragments
Chemical Substances	caseinomacropeptide ; Caseins ; Peptide Fragments
Language	English
Publishing date	2024-03-27
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2518386-2
ISSN	2072-6643 ; 2072-6643
ISSN (online)	2072-6643
ISSN	2072-6643
DOI	10.3390/nu16070956
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Article ; Online: Treatment of Metabolic Syndrome in Children.

Tagi, Veronica Maria / Samvelyan, Sona / Chiarelli, Francesco

Hormone research in paediatrics

2020 Volume 93, Issue 4, Page(s) 215–225

Abstract: Although metabolic syndrome (MetS) in children and adolescents is a frequently discussed topic in the literature, uniform guidelines on its definition and treatment are still lacking. Insulin resistance, central obesity, dyslipidaemia, and hypertension ... ...

Abstract	Although metabolic syndrome (MetS) in children and adolescents is a frequently discussed topic in the literature, uniform guidelines on its definition and treatment are still lacking. Insulin resistance, central obesity, dyslipidaemia, and hypertension are commonly considered the main components of MetS. The first recommended approach to all these pathological conditions in children and adolescents is lifestyle intervention (diet and physical exercise); however, in some selected cases, a pharmacological or surgical treatment might prove useful for the prevention of metabolic and cardiovascular complications. The aim of this review is to present the more recent evidence about the treatment of the major components of MetS in children and adolescents, focussing on the current recommendations concerning lifestyle changes, available drugs, and bariatric surgery.
MeSH term(s)	Adolescent ; Child ; Female ; Humans ; Male ; Metabolic Syndrome/therapy ; Pediatric Obesity/therapy ; Risk Factors
Language	English
Publishing date	2020-10-05
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2537278-6
ISSN	1663-2826 ; 1663-2818
ISSN (online)	1663-2826
ISSN	1663-2818
DOI	10.1159/000510941
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Article ; Online: Stress and Diabetes Mellitus: Pathogenetic Mechanisms and Clinical Outcome.

Ingrosso, Diletta Maria Francesca / Primavera, Marina / Samvelyan, Sona / Tagi, Veronica Maria / Chiarelli, Francesco

Hormone research in paediatrics

2022 Volume 96, Issue 1, Page(s) 34–43

Abstract: Evidence suggests that psychological and physical stress are relevant triggering factors for the onset of type 1 diabetes (T1D) and type 2 diabetes (T2D). The underlying mechanisms involve a complex neuroendocrine structure, involving the central nervous ...

Abstract	Evidence suggests that psychological and physical stress are relevant triggering factors for the onset of type 1 diabetes (T1D) and type 2 diabetes (T2D). The underlying mechanisms involve a complex neuroendocrine structure, involving the central nervous system and the periphery. Psychological stress leads to an increase of serum glucocorticoid concentrations and catecholamines release increasing the insulin need and the insulin resistance. According to the β-cell stress hypothesis, also causes of increased insulin demand, such as rapid growth, overweight, puberty, low physical activity, trauma, infections, and glucose overload, are potentially relevant factors in development of T1D. It has also been demonstrated that chronic stress and obesity form a vicious circle which leads to a definitive metabolic failure, increasing the risk of developing T2D. In this review, we will provide the most recent data concerning the role of stress in the outcomes of T1D and T2D, with a focus on the role of physical and psychological stress on the onset of T1D.
MeSH term(s)	Humans ; Diabetes Mellitus, Type 1/etiology ; Diabetes Mellitus, Type 1/metabolism ; Diabetes Mellitus, Type 2/etiology ; Insulin ; Insulin Resistance/physiology ; Glucose
Chemical Substances	Insulin ; Glucose (IY9XDZ35W2)
Language	English
Publishing date	2022-02-04
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2537278-6
ISSN	1663-2826 ; 1663-2818
ISSN (online)	1663-2826
ISSN	1663-2818
DOI	10.1159/000522431
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