Small intestinal bacterial overgrowth prevalence in hypothyroidism

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Abstracts

a leucine to valine substitution (L162V), and a G/C nt396 transversion (intron 7). The aim of this study was to verify the etiopathogenic relevance of PPAR-alpha in gallstone disease, by PPARA haplotype analysis. Material and methods: PPARA polymorphisms and haplotypes were screened in a group of 130 patients (59 males, 71 females) admitted to the hospital for the treatment of gallstone disease. The control group was composed of 114 age matched hospital workers and university students (57 males, 57 females). Following genomic DNA extraction from peripheral blood leukocytes, exon 5 and intron 7 regions were PeR amplified. Denaturing-high performance liquid chromatography (D-HPLC) was used to screen the PCR products for the presence of polymorphisms, which were further characterized by automated sequencing. Statistical analysis was performed by the chi-square test. Results: Exon 5 L162V polymorphism displayed a similar overall carrier frequency in the control population (11%) and in the gallstone group (13.4%) (p=NS). The total carrier frequency for intron 7 polymorphism was 25% in the control population, while in male and female lithiasic patients it was 43% and 37%, respectively (p= 0.03). Homozygote carriers of the intron 7 polymorphism were found only in the male gallstone group. The contemporary presence of both exon 5 and intron 7 polymorphism was significantly more frequent in male patients than in controls (p=0.04). The haplotype characterized byexon 5 L162V, in the absence of intron 7 polymorphism, was absent in male gallstone patients, while a 11 % frequency was observed in male controls (p=0.02). Conclusions: These data characterize putative PPARA haplotypes associated with protection or increased risk of gallstone disease. Gender strongly influences theses associations, with a stronger effect in males than in females. Further analyses will be necessary to characterize the genetic and environmental factors which modulate the risk of gallstone development in presence of specific PPARA haplotypes.

OC3.4.6 GALLSTONES AND LIVER STEATOSIS DO NOT SHARE THE SAME RISK FACTORS: RESULTS OF THE "ARSITA I" OPEN POPULATION SURVEY I. Petridis *,1, E Lattanzi 1, B. Marraccini 1 , I. Carderi 1 , E Claar 1 , C. Liani 1, S. Lobello 1, O. Di Andrea 2, M. Chiaramonte 1

lHepato-Gastroenterology and Nutrition Unit, L'Aquila 2Family Doctor, Arsita Background and aim: Liver steatosis and gallstones share some risk factors such as obesity, diabetes and hyperlipidemia. However, simultaneous prevalence of both these liver diseases are poor known. As part of an epidemiological study, in a central Italian open popUlation, we studied the prevalence of liver steatosis and gallstone disease Material and methods: All subjects over 18 years, were invited to have liver ultrasound (US) and blood liver tests. Liver steatosis was classified as none, mild, moderate and severe. Diagnosis of choledocolithiasis was made every time gallstones were detected by ultrasound exam, and when gallbladder was surgically removed Results: Moderate/severe steatosis was found in 89/253 (35%) males and 75/288 (26%) females and was steadily increasing with age in both sexes. It was correlated with BMI in females and with alcohol in males. Gallstones were present in 11% of males and 21,5% of females (p60 yrs (vs 2,7% <60 yrs) and 29% in females >60 yrs (vs 14,4% <60 yrs). Out of 288 females, 20 had both steatosis and gallstones (26.6% of 75 steatosis carriers and 38.5% of 52 gallstones carriers) without differences in the under or over 60 yrs aged subgroups. Out of 253 males, 9 subjects over 60 yrs vs 1 in the group under 60 yrs had both steatosis and gallstones. High BMI (>30) was correlated with gallstones mostly in the subgroup aged under 60 yrs, in both males and females

Conclusions: Gallstones and liver steatosis are simultaneously present in a minority of subjects, in both males and females, suggesting that the impact of risk factors is different in these two liver diseases

OC3.5.1 SMALL INTESTINAL BACTERIAL OVERGROWTH PREVALENCE IN PARKINSON'S DISEASE A. Lupascu, EC. Lauritano, E Scarpellini, P Bentivoglio, F. Soleti, M. Gabrielli, G. Nucera, G. D'Antona, R. Flore, P Tondi, G. Cammarota, G. Gasbarrini, PA. Tonali, A. Gasbarrini Ospedale Gemelli, Roma Background and aim: Patients with idiopathic Parkinson's disease often show autonomic disturbances related to the disease itself or to its progression, the more frequent being dysphagia, delayed gastric emptying and constipation. These motility abnormalities could predispose to small intestinal bacterial overgrowth (SIBO). SIBO is a clinical condition characterized by a malabsorption syndrome due to an increase in microrganisms to a level exceeding 105 bacteria per milliter of jejunal juice. The aim of our study was to assess the prevalence of SIBO, by glucose BT, in a population of Parkinson pts with respect to an healthy subjects' control group. Material and methods: Thirty-six (36) pts affected by idiopathic Parkinson's disease (mean age 60±5; 24 male, 12 female) were enrolled. The control population consisted of 30 healthy subjects, matched for sex and age. All subjects underwent glucose BT to detect SIBO under standard conditions. The presence of SIBO was based on the occurrence of a peak of H2 values more than> 10 ppm above the basal value after 75 gr glucose ingestion. Differences between groups were assessed by the chi square 2 Yates test. A p value <0.05 was considered to be statistically significant. Results: A total of 20 out of 36 Parkinson pts resulted to be positive to glucose BT (55.5%) with respect to 2 out of 30 control subjects (6.6%). The difference between groups resulted to be statistically significant (p
OC3.5.2 SMALL INTESTINAL BACTERIAL OVERGROWTH PREVALENCE IN HYPOTHYROIDISM E.C. Lauritano, A. Bilotta, A. Lupascu, E. Scarpellini, M. Gabrielli, G. Nucera, R. La Mura, G. Cammarota, G. Gasbarrini, A. Pontecorvi, A. Gasbarrini Gemelli Hospital, Rome Background and aim: Hypothyroidism is a disorder in which there is a lack of normal thyroid production or secretion of thyroid hormone. Hypothyroidism is often associated to chronic constipation due to an altered intestinal motility. This bowel dysfunction could predispose to small intestinal bacterial overgrowth (SIBO). SIBO is a clinical condition characterized by a malabsorption syndrome due to an increase in microrganisms to a level exceeding 105 bacteria per milliter of jejunal juice. The aim of our study was to assess the prevalence of SIBO, by glucose BT, in a population of pts with hypothyroidism with respect to an healthy subjects' control group. Material and methods: Thirty (30) pts affected by hypothyroidism (mean age 35±5; 9 male, 21 female) were enrolled. The control population consisted of 30 healthy subjects, matched for sex and age. All

Abstracts subjects underwent glucose BT to detect smo under standard conditions. The presence of smo was based on the occurrence of a peak of H2 values more than> 10 ppm above the basal value after 75 gr glucose ingestion. Differences between groups were assessed by the chi square 2 Yates test. A p value <0.05 was considered to be statistically significant. Results: A total of 17 out of 30 pts resulted to be positive to glucose BT (56.6%) with respect to lout of 30 control subjects (3.3%). The difference between groups resulted to be statistically significant (p
OC3.5.3 PATIENTS WITH FUNCTIONAL DYSPEPSIA AND HEADACHE ARE CHARACTERIZED BY A MEAL·INDUCED REDUCTION OF DISCOMFORT THRESHOLD M. Di Stefano *,1, E. Pucci 2 , E. Miceli 1, P. Tana 1, S. Mazzocchi 1, G. Sandrini 2, G. Nappi 2, G.R. Corazza 1

If Department ofMedicine, fRCCS "S.Matteo" Hospital, University of Pavia, Pavia 2 University Centre for Adaptive Disorders and Headache, fRCCS "C.Mondino", University ofPavia, Pavia Background and aim: Several patients with functional dyspepsia very often present headache. Up to now, no data are available on the putative pathophysiological mechanism responsible for this association. Therefore, the aim of the present study was to assess whether headache represents a symptom associated with a peculiar pathophysiological mechanism of functional dyspepsia. Material and methods: Thirty-five HP-ve patients (22 F, mean age 33±9 yrs) with functional dyspepsia, diagnosed according to Rome II criteria took part in the study. Eighteen patients also suffered from migraine without aura depending on HIS criteria. As a control group, ten age- and sex-matched healthy volunteers were also enrolled. In all patients presence and severity of dyspeptic symptoms (epigastric discomfort, bloating, fullness, early satiety, nausea, vomiting, belching, epigastric burning, epigastric pain) and headache was evaluated by a 0-3 score where O=absence of symptom, l=mild, 2=relevant, and 3=severe. All subjects underwent gastric barostat test according to previous studies in order to evaluate whether an alteration of gastric accommodation (1) or hypersensitivity to gastric distention (2) was present. Discomfort threshold was also determined postprandially to evaluate whether postprandial sensitisation occurs, and a relevant reduction, according to results in healthy volunteers, was defined as a threshold reduction higher than 4 mmHg. Finally, gastric emptying for solids was evaluated by BC-octanoic acid breath test. Results: The prevalence of relevant (score=2 or 3) symptoms was not different between patients with impaired accommodation (8/35; 22%) and patients with normal accommodation, between patients with hypersensitivity (10/35; 28%) or normal sensitivity to gastric distention, and between patients with delayed gastric emptying (25/35; 71%) and normal gastric emptying. On the contrary, patients with postprandial reduction of discomfort threshold (15/35; 43%) showed a significantly higher prevalence of headache (73% vs 35%; p=0.040). Stepwise multiple logistic analysis confirmed the significant association (p=O.OI) between relevant headache and the risk of postprandial hypersensitivity to gastric distention. Conclusions: Among patients with functional dyspepsia, the subgroup showing an association with migraine is characterized by postprandial hypersensitivity to gastric distension.

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OC3.5.4 COMPUTER·ASSISTED ANALYSIS OF ENDOSCOPIC CAPSULE IMAGES FOR THE STUDY OF THE INTESTINAL MOTILITY F. De Iorio *,1, P. Spyridonos 2, F. Azpiroz 3, R. Petia 2, C. Malagelada 3 , J.R. Malagelada 3

lPoliclinico G.B. Rossi, Verona Vision Centre, Barcelona 3 Vall Hebron Hospital, Barcelona 2 Computer

Background and aim: Conventional methods for the study of intestinal motility, particularly the fed pattern, are complex and invasive. We studied whether no-invasive endoluminal image and displacement analysis, using new capsule technologies, allows correlation of wall motion and propulsion. Material and methods: Intestinal motor activity was recorded using the M2A Given capsule specially fitted with a localizer device that measure displacement over time. External detectors wer fixed on the abdominal wall, and the capsule was ingested. Just immediately after the capsule entered the duodenum, a test meal was administred and small bowel passage was recorded for a maximum of 6 hours. In a group of 8 healthy subjects we studied, first, the effect of a meal on intestinal motility (fed vs fast). In another group of 8 healthy subjects we tested the effect of single nutrient solutions administred directly into the duodenum (carbohydrate vs lipids vs proteins) in random order and on separate days. Semiautomated analysis of endoluminal images and displacement was performed by a specifically developed computer program. Results: Meal ingestion stimulated intestinal contractile activity (3,7 ± 0,3 contraction/min vs 1,7 ±0,2 during fast; p
OC3.5.5 HLA CLASS I AND II IN PATIENTS WITH WHIPPLE'S DISEASE F. Biagi *, M. Martinetti, C. Badulli, J. Campanella, M. Di Stefano, G.R. Corazza

University ofPavia, Pavia Background and aim: Whipple's disease (WD) is a systemic chronicrelapsing disorder due to both environmental and host factors. Although Tropheryma Whipplei is known to be the enviromental factor, the host factors are still unknown. Probably due to the rarity of this condition, the association between HLA and WD was studied in ouly small samples of patients. The few papers that have been published so far have given conflicting results [1,2]. Material and methods: The EU funded European Study Group on WD (QRLT-2001-01049) collected DNA and tissue samples from 60 western European WD patients. HLA class I and II alleles were identified, at low resolution level, with sequence specific primers and PeR