Could semiquantitative analysis of real-time ultrasound elastography distinguish more liver parenchyma alterations of nonalcoholic fatty liver disease in patients with polycystic ovary syndrome?

ABSTRACT Objective: Nonalcoholic fatty liver disease is the commonest diffuse liver disease, of which women with polycystic ovary syndrome are at an increased risk. The aim of the present study was to assess the diagnostic value of the semiquantitative strain parameters of real-time ultrasound elastography for nonalcoholic fatty liver disease in patients with polycystic ovary syndrome. Subjects and methods: Thirty-five polycystic ovary syndrome patients with nonalcoholic fatty liver disease, 70 polycystic ovary syndrome patients without nonalcoholic fatty liver disease, and 70 healthy female controls of reproductive age were included. All participants underwent ultrasonic examination and semiquantitative analysis of real-time ultrasound elastography of the liver. Results: Main semi quantitative strain parameters, such as average strain value, differed significantly among groups polycystic ovary syndrome with nonalcoholic fatty liver disease, polycystic ovary syndrome without nonalcoholic fatty liver disease, and control (87.02 ± 10.16 vs. 96.31 ± 11.44 vs. 104.49 ± 7.28, p < 0.001). Clinical and laboratory parameters differed significantly between the two subgroups with low or high average strain value. For diagnostic value of average strain value for elevated aminotransferase, the area under the curve was 0.808 (range 0.721-0.895). In multiple linear regression analysis, polycystic ovary syndrome, waist circumference, and metabolic syndrome were stand-alone independent factors associated with average strain value among subjects without nonalcoholic fatty liver disease. Conclusion: Semiquantitative real-time ultrasound elastography analysis could distinguish liver parenchyma alterations in patients with polycystic ovary syndrome more sensitively. The diagnostic value of the proposed method for nonalcoholic fatty liver disease need further research.

Research progress on protective effects and mechanism of Dendrobii Caulis on metabolic disturbances / 中草药

Life style changes with economic and social development, including a improper diet, cause diabetes, dyslipidemia, hypertension and other metabolic disturbances, which has become a major threat to the health of people around the world. Dendrobii Caulis, a traditional Chinese herbal medicine with various medicinal and health-care effects, is derived from different species of Dendrobium, which is traditionally used for “consumptive thirst syndrom”. In recent years, its preventive effects on metabolic disturbances have been attracting more and more attention with the high incidence of metabolic disturbances. This paper aims to review the recent achievements of different Dendrobium species in preventive and therapeutic effects and its traditional functions on metabolic disturbances, mainly in diabetes, hypertension and dyslipidemia. Furthermore, probable mechanisms were summarized based on its traditional functions. Dendrobii Caulis was effective on metabolic disturbances primarily relevant to its conventional functions including replenishing yin for maintaining gastric tonicity, promoting body fluid production, nourishing yin and clearing heat, which is helpful for treatment of spleen impediment with abdominal flatulence and interior heat, the source of various metabolic disturbances in traditional medicine. This review provids reference for mechanism research and clinical application of Dendrobium in metabolic disturbances prevention and treatment.

Biochemical disturbances, nutritional assessment, and interventions in patients with glycogen storage disease in a Beijing-based general hospital / 中华临床营养杂志

Objective To investigate the biochemical disturbances,nutritional assessment and nutritional interventions in hospitalized patients with glycogen storage disease (GSD) in a general hospital in Beijing and provide examples of advanced nutritional management for these patients.Methods We retrospectively reviewed 22 consecutive hospitalized patients with GSD diagnosed from January 1,2013 to January 1,2016 in Peking Union Medical College Hospital and analyzed their medical data,nutritional assessments,and interventions.Results These 22 GSD patients included 2 cases with GSD-Ⅰa,3 cases with GSD-Ⅰb,and 17 cases with GSD-Ⅲ.They were composed of 21 children (including a 6-month old infant and a 7-month old infant) and one 18-yearold man.Biochemical abnormalities:hypoglycemia (5/5),hyperlactacidemia (4/5),hyperlipidemia (4/5),hyperuricemia (4/5) were common in GSD-Ⅰ patients,while hypoglycemia (17/17),hyperlactacidemia (5/17),hyperlipidemia (7/17),and hyperuricemia (3/17) were also present among patients with GSD-Ⅲ.Growth and development assessments:among 5 patients with GSD-Ⅰ,the body weight was below the 10th percentile in of 4 patients and the height was below the 3rd percentile in 5 patients;among 17 patients with GSD-Ⅲ,the body weight was below the 10th percentile in 4 patients and the height was below the 10th percentile in 9 patients.Nutritional management condition:all the patients received nutritional assessment,dietary modulation and nutritional support.Twenty children or adolescents were prescribed with raw corn starch (RCS) every 4-6 hours,with a mean initial dose of (1.58±0.28) g and (1.21±0.33) g for patients with GSD-Ⅰ and GSD-Ⅲ,respectively;the other 2 infant aged 6-month old and 7-month old were regularly administered amino acid-based enteral nutritional agents.In addition,all the patients with GSD-Ⅲ were recommended high protein intake of 3 g/(kg · d) and received dietary guidance and modulation.Follow-up condition:5 cases with GSD-Ⅰ and 2 cases with GSD-Ⅲ stayed in track after discharge from our hospital.The mean follow-up duration was (480.40±246.16) d and (373.00± 108.89) d for patients with GSD-Ⅰ and GSD-Ⅲ,respectively.All the patients reported alleviated symptom of hypoglycemia,and the examinations also indicated improved fasting blood glucose,uric acid,lipid profile,and growth status.Conelusions Hypoglycemia,metabolic disturbances,and growth retardation are prevalent in both GSD-Ⅰ and GSD-Ⅲ patients.Potential biochemical abnormalities should not be ignored in GSD-Ⅲ patients,especially in young patients.Comprehensive nutrition assessment,regular administration of RCS,sufficient protein intake,and continuous patient follow-up and surveillance can help to alleviate symptoms,correct metabolic disturbances,and improve growth status of patients with GSD.

Effects of bixin in high-fat diet-fed-induced fatty liver in C57BL/6J mice

Objective To evaluate the anti-obesity activity of bixin (BIX) on C57BL/6J mice which were fed a high-fat diet (HFD) and to determine the mechanism of this effect. Methods C57BL/6J mice were separately fed a high-calorie diet or a normal diet for 8 weeks, then they were treated with BIX for another 13 weeks. After administration for 13 weeks, the animals were sacrificed. Body adiposity, serum lipid level, and insulin resistance were evaluated. In addition, a histological assay of pancreas and liver, an evaluation of the inhibitory properties on pancreatic lipase, and α-amylase were conducted. Results Administration of BIX significantly decreased the body weight gain, adipocyte size, fat pad weights, hepatic lipid levels in HFD-induced obese mice. In addition, reduced liver weight exhibited decreased serum leptin levels, malic enzyme, glucose-6-phosphate dehydrogenase, hepatic fatty acid synthase, aspartate aminotransferase, alanine aminotransferase and hepatic phosphatidate phosphohydrolase activity. However, superoxide dismutase, catalase, glutathione peroxidase, and glutathione levels were increased in hepatic tissue. BIX also decreased lipid and carbohydrates absorption due to inhibition of pancreatic lipase and α-amylase. Long term supplementation of BIX significantly decreased hyperlipidemia, insulin resistance and glucose level. Decreased levels of hepatic steatosis and the islets of Langerhans appeared less shrunken in HFD-fed mice. Conclusions The antiobesity effect of BIX appears to be associated at least in part, to its inhibitory effect on lipids and carbohydrate digestion enzymes such as pancreatic lipase, α-glucosidase, and α-amylase. The results suggested that BIX also act as an antioxidant and may treat visceral obesity normalizing glucose levels, improving insulin resistance and increasing energy expenditure. Therefore, achiote which has a main component, the carotenoid BIX, could be a viable food for the treatment of obesity and diabetes.

Metabolic Disturbances in Schizophrenia Patients With Positive, Negative and Cognitive Symptoms.

Elevated cholesterol, triglycerides and glucose are known independent risk factors for coronary heart disease. This study examines the status of cholesterol, triglycerides and glucose of schizophrenia patients with positive, negative and cognitive symptoms and to investigate the association between these levels and obesity. This was a prospective observational study involving samples of patients who met established criteria for schizophrenia and were admitted to the mental health care center, Coimbatore. Glucose, total cholesterol and triglycerides levels increased when schizophrenia patients are treated with anti-psychotic drugs. Although mean changes in glucose and cholesterol levels remained within clinically normal ranges, about one patient in eight studied developed abnormally high glucose, and also one in five patients assessed has abnormal cholesterol levels. The obesity and metabolic disorders observed in the patients were higher than the prevalence in the control group and confirms that there are deregulations of metabolic pathways in schizophrenic patients. The rate of obesity and metabolic disorders observed in this study were higher than the prevalence in the control group sugesting that more attention should be paid to the metabolic condition of psychiatric patients.

Ganho de peso e alterações metabólicas em esquizofrenia / Weight gain and metabolic disorders in schizophrenia

CONTEXTO: Após cinco décadas de síntese e disseminação de uso de drogas para o tratamento da esquizofrenia, foi possível observar a disponibilidade de drogas com diferentes perfis farmacológicos e um largo perfil de efeitos adversos que se estendem além dos originalmente descritos em área endocrinológica e neurológica, se expandindo para aumento de peso, transtornos metabólicos, transtornos cardiovasculares e morte prematura associada a doenças comuns. Estas evidências, agravadas com a relativa ausência de diretrizes e orientações para o clínico, apontam para a necessidade de se produzir orientações claras e sintéticas para uso pelo clínico, orientando para a seleção de drogas e medidas de prevenção e tratamento de transtornos de peso e metabolismo. OBJETIVO: Identificar a freqüência e o tipo de alterações de peso e metabolismo em pessoas diagnosticadas com esquizofrenia, antes e depois do uso de diferentes antipsicóticos, e sintetizar as medidas preventivas e paliativas adequadas para a redução desses desfechos desfavoráveis. MÉTODOS: Efetuada breve revisão em PubMed e Scielo nos últimos cinco anos com os descritores weight, metabolic syndrome AND schizophrenia, e a partir dos artigos encontrados, selecionados artigos com dados clínicos. RESULTADO: Foram identificados aumento de peso, dislipidemia e síndrome metabólica em pacientes portadores do diagnóstico de esquizofrenia, antes, durante e após o uso de antipsicóticos, especialmente em drogas de nova geração, com taxas perto de duas vezes maiores do que na população geral, que resultam de redução de cerca de 20 por cento na expectativa de vida desses pacientes. CONCLUSÃO: Devido a estes riscos elevados e à inexistência de critérios claros de definição de risco de ganho de peso antes da exposição a antipsicóticos (apesar do maior risco associado a uso de clozapina e olanzapina), recomenda-se seguimento ativo de pacientes em regime de drogas antipsicóticas, com troca logo que observado...

BACKGROUND: Five decades after use and dissemination of use of drugs for the treatment of schizophrenia, with different pharmacologic profiles, it has been evidenced that these drugs display a large profile of adverse events other than endocrinological and neurological, including weight gain, metabolic disorders, increased frequency of cardiovascular disorders and premature death associated to common disorders. These evidences, aggravated by the lack of synthetic and clear description of guidelines for the clinical practitioner, points to the need of comprehensive studies about weight gain and metabolic disturbances followed by clear and simple guidelines orienting drug selection and measures for prevention and treatment of weight and metabolic disturbances. OBJECTIVE: Identification of frequency and type of weight and metabolic disturbances in people diagnosed with schizophrenia, before and after the use of different antipsychotics. METHODS: A PubMed and Scielo review of the last 5 years using descriptors such as weight, metabolic syndrome AND schizophrenia, and after that, the authors selected articles with clinical data. RESULT: Increased weight, dislipidemia and metabolic syndrome in subjects with schizophrenia, before, was evidenced during and after drug use, especially new-generation drugs, with overall rates around 2 times the general population, resulting in a 20 percent reduction of life expectancy in these patients. CONCLUSION: The evidence of elevated risk for overweight and metabolic syndrome and the lack of defined criteria for risk assessment for weight gain before drug use (despite of increased pre-drug use risk with clozapine and olanzapine) it is recommended active follow-up of patients under antipsychotic drug use, with drug change when observed 5 percent or more weight gain, with maintenance of active care of nutritional, lifestyle and activity level. There is also a need of systematic reviews for controlling selection...