Burden of Cardiometabolic Risk Factors on Cerebrovascular Events in a Southern Italian Population

Background: Stroke is the second leading cause of death in the world and the third due to disability. However, there are few data available that identify the risk factors associated with it and their weight in different populations (population risk). Aim: Contribute to the knowledge of burden risk factors in stroke in a large cohort of Southern Italy. Methods: The data refer to a randomized Campania cohort of 1200 subjects (35 - 74 years) enrolled in 2008-09. Ten years later (2018-19) they were re-evaluated. We analyzed data from 32 patients who reported a cerebrovascular event (stroke or TIA) with the event-free group of subjects (804 subjects: 378 men and 426 women). We evaluated: absolute risk, Odds Ratio (OR), Additional Risk (AR), Risk Attributable to the Population (PAR) and, finally, the Population Attributable risk Fraction (FAP). Results: In the comparison between the two groups (patients with events and patients without events) the risk factors with statistically significant differences were: age, Systolic Blood Pressure (SBP), BMI, cholesterol, triglycerides, glycemia and hyperinsulinemia. The ORs with the greatest impact were: blood glucose (5.1), BMI (3.3) and BPS (2.9). Linear regression analysis identified Glycemia and BMI as the only independent variables. The FAPs with the greatest impact were SBP (47.4%) and BMI (42.6%). Discussion and Conclusions: Our data confirm that the high incidence of stroke in Campania is particularly related to the high prevalence of obesity and hypertension. In the single patient, however, the risk factors with the greatest impact are: glycaemia BMI an SBP.

High-Lard and High-Fish Oil Diets Differ in Their Effects on Insulin Resistance Development, Mitochondrial Morphology and Dynamic Behaviour in Rat Skeletal Muscle

Fish oil (mainly omega 3 polyunsaturated fatty acids), differently from lard (mainly saturated fatty acids) has been suggested to have anti-inflammatory effects associated with amelioration of insulin sensibility. An important role in skeletal muscle insulin resistance development has been recently attributed to mitochondrial dynamic behavior. Mitochondria are dynamic organelles that frequently undergo fission/fusion processes and a shift toward fission process has been associated with skeletal muscle mitochondrial dysfunction and insulin resistance development. The present work aimed to evaluate if the replacement of lard with fish oil in high-fat diet positively affect skeletal muscle mitochondrial dynamic behavior in association with the improvement of insulin-resistance. Body weight gain, systemic insulin-resistance (glucose/insulin ratio), serum TNFα levels and skeletal muscle lipid content were assessed in rats fed a high-lard or high-fish-oil diet for 6 weeks. In skeletal muscle sections, immunohistochemical analysis were performed to detect the presence of insulin receptor substrate 1 (IRS1) and tyrosine phosphorylated IRS1 (key factor in insulin signalling pathway) as well as to detect the main proteins involved in mitochondrial fusion (MFN2 and OPA1) and fission (DRP1 and Fis1) processes. Skeletal muscle mitochondrial ultrastructural features were assessed by electron microscopy. High-fish oil feeding induced lower body weight gain, systemic inflammation and insulin-resistance development as well as skeletal muscle lipid accumulation compared to high-lard feeding. Skeletal muscle sections from high-fish oil fed rats exhibited a greater number of immunoreactive fibers for MFN2 and OPA1 proteins as well as weaker immunostaining for DRP1 and Fis1 compared to sections from high-lard fed rats. Electron microscopy observations suggested a prominent presence of fission events in L rats and fusion events in F rats. The positive effect of the replacement of lard with fish oil in high-fat diet on systemic and skeletal muscle insulin sensibility was associated to changes in mitochondrial dynamic behavior.