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Objective@#To investigate the quantitative relationship between liver fat content and bone mineral density (BMD) in middle-aged and elderly people.@*Methods@#Totally 184 middle-aged and elderly community residents were recruited from March to June 2016, including 68 males and 116 females. MRI mDIXON-Quant and quantitative CT (QCT) examinations were performed to determine the content of liver fat and L1-L3 vertebral BMD. The subjects were divided into four groups according to the quartiles of liver fat content, and the baseline characteristics and other variables of different groups were were identified by using one-way analysis of Variance. The relationship between liver fat content and lumbar vertebral BMD was assessed with Spearman correlation and partial correlation analysis.@*Result@#Subjects with higher hepatic fat content had lower spine BMD and higher body mass index (BMI), waist circumference. Liver fat content was negatively correlated with BMD (r=-0.203, P=0.003). After age and body weight were controlled, the negative correlation between liver fat content and BMD was still significant (r=-0.291, P<0.001), in males (r=-0.283, P=0.021) and in females (r=-0.210, P=0.025).@*Conclusion@#Liver fat content is negatively correlated with lumbar vertebral BMD in middle-aged and elderly people.
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Objective:To investigate the quantitative relationship between liver fat content and bone mineral density (BMD) in middle-aged and elderly people.Methods:Totally 184 middle-aged and elderly community residents were recruited from March to June 2016, including 68 males and 116 females. MRI mDIXON-Quant and quantitative CT (QCT) examinations were performed to determine the content of liver fat and L1-L3 vertebral BMD. The subjects were divided into four groups according to the quartiles of liver fat content, and the baseline characteristics and other variables of different groups were were identified by using one-way analysis of Variance. The relationship between liver fat content and lumbar vertebral BMD was assessed with Spearman correlation and partial correlation analysis.Result:Subjects with higher hepatic fat content had lower spine BMD and higher body mass index (BMI), waist circumference. Liver fat content was negatively correlated with BMD ( r=-0.203, P=0.003). After age and body weight were controlled, the negative correlation between liver fat content and BMD was still significant ( r=-0.291, P<0.001), in males ( r=-0.283, P=0.021) and in females ( r=-0.210, P=0.025). Conclusion:Liver fat content is negatively correlated with lumbar vertebral BMD in middle-aged and elderly people.
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Objective@#To evaluate the application value of quantitative computed tomography for evaluation of changes in abdominal fat after laparoscopic Roux-en-Y gastric bypass in obese patients.@*Methods@#The retrospective and descriptive study was conducted. The clinical data of 52 obese patients who underwent laparoscopic Roux-en-Y gastric bypass in the Third Medical Center of Chinese PLA General Hospital from March 2011 to February 2012 were collected. There were 24 males and 28 females, aged (43±9)years, with the range of 23-62 years. All the 52 patients underwent laparoscopic Roux-en-Y gastric bypass. Observation indicators: (1) surgical and postoperative conditions; (2) changes in anthropometric indices; (3) follow-up. Follow-up using outpatient examination was performed to detect complications of patients at 1, 3, 6, 12 months after surgery up to February 2013. Measurement data with normal distribution were represented as Mean±SD, repeated measurement data were analyzed using repeated ANOVA. Count data were represented as absolute numbers.@*Results@#(1) Surgical and postoperative conditions: all the patients underwent laparoscopic Roux-en-Y gastric bypass successfully, without conversion to open surgery. The volume of intraoperative blood loss, operation time, and duration of hospital stay were (25±11)mL, (78±14)minutes, and (11±2)days. (2) Changes in anthropometric indices: the body mass index (BMI), fat mass, free fat mass, total abdominal fat volume (TAFV), total subcutaneous fat volume (TSFV), and total visceral fat volume (TVFV) of all the 52 patients were (31.8±1.8)kg/m2, (39.4±4.1)kg, (50.2±6.0)kg, (11 703±3 899)cm3, (7 418±2 969)cm3, and (4 314±1 692)cm3 before surgery, (28.5±1.4)kg/m2, (33.0±1.1)kg, (49.7±4.6)kg, (11 016±3 713)cm3, (7 044±2 970)cm3, (3 969±1 443)cm3 at 3 months after surgery, (27.1±1.7)kg/m2, (30.2±1.3)kg, (45.4±3.1)kg, (9 406±4 452)cm3, (6 442±3 307)cm3, and (2 964±1 694)cm3 at 6 months after surgery, (24.4±2.4)kg/m2, (32.6±1.1)kg, (48.6±2.7)kg, (7 612±3 029)cm3, (5 623±2 650)cm3, and (1 826±360)cm3 at 12 months after surgery, respectively, there were significant differences in the changes of these indices (F=130.2, 30.3, 4.9, 25.6, 11.9, 16.5, P<0.05). The BMI, fat mass, and TAFV at 3 months after surgery had significant differences compared with those before surgery (P<0.05), but free fat mass, TSFV, and TVFV had no significant difference (P>0.05). The BMI, fat mass, TAFV, and TVFV at 6 months after surgery had significant differences compared with those before surgery (P<0.05), but free fat mass and TSFV had no significant difference (P>0.05). The BMI, fat mass, TAFV, TSFV, and TVFV at 12 months after surgery had significant differences compared with those before surgery (P<0.05), but free fat mass had no significant difference (P>0.05). (3) Follow-up: all the 52 patients have completed the follow-up after surgery and the remission number of obesity was 35. No complications such as anastomotic hemorrhage, obstruction, or anastomotic leakage occured in all the 52 patients.@*Conclusion@#Laparoscopic Roux-en-Y gastric bypass can reduce abdominal visceral fat significantly, while quantitative computed tomography can help to evaluate the distribution of abdominal visceral fat accurately.
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Objective To evaluate the application value of quantitative computed tomography for evaluation of changes in abdominal fat after laparoscopic Roux-en-Y gastric bypass in obese patients.Methods The retrospective and descriptive study was conducted.The clinical data of 52 obese patients who underwent laparoscopic Roux-en-Y gastric bypass in the Third Medical Center of Chinese PLA General Hospital from March 2011 to February 2012 were collected.There were 24 males and 28 females,aged (43±9)years,with the range of 23-62 years.All the 52 patients underwent laparoscopic Roux-en-Y gastric bypass.Observation indicators:(1) surgical and postoperative conditions;(2) changes in anthropometric indices;(3) follow-up.Follow-up using outpatient examination was performed to detect complications of patients at 1,3,6,12 months after surgery up to February 2013.Measurement data with normal distribution were represented as Mean±SD,repeated measurement data were analyzed using repeated ANOVA.Count data were represented as absolute numbers.Results (1) Surgical and postoperative conditions:all the patients underwent laparoscopic Roux-en-Y gastric bypass successfully,without conversion to open surgery.The volume of intraoperative blood loss,operation time,and duration of hospital stay were (25± 11) mL,(78± 14) minutes,and (11±2) days.(2) Changes in anthropometric indices:the body mass index (BMI),fat mass,free fat mass,total abdominal fat volume (TAFV),total subcutaneous fat volume (TSFV),and total visceral fat volume (TVFV) of all the 52 patients were (31.8 ± 1.8)kg/m2,(39.4±4.1)kg,(50.2±6.0)kg,(l1 703±3 899)cm3,(7 418±2 969)cm3,and (4 314± 1 692)cm3 before surgery,(28.5±1.4)kg/m2,(33.0±1.1)kg,(49.7±4.6)kg,(11 016±3 713) cm3,(7 044± 2970)cm3,(3969±1 443)cm3 at 3 months after surgery,(27.1±1.7)kg/m2,(30.2±1.3)kg,(45.4± 3.1)kg,(9 406±4 452)cm3,(6 442±3 307)cm3,and (2 964±1 694) cm3 at 6 months after surgery,(24.4± 2.4)kg/m2,(32.6±1.1)kg,(48.6±2.7)kg,(7 612±3 029)cm3,(5 623±2 650)cm3,and (1 826±360) cm3 at 12 months after surgery,respectively,there were significant differences in the changes of these indices (F=130.2,30.3,4.9,25.6,11.9,16.5,P＜0.05).The BMI,fat mass,and TAFV at 3 months after surgery had significant differences compared with those before surgery (P＜0.05),but free fat mass,TSFV,and TVFV had no significant difference (P＞0.05).The BMI,fat mass,TAFV,and TVFV at 6 months after surgery had significant differences compared with those before surgery (P ＜ 0.05),but free fat mass and TSFV had no significant difference (P＞0.05).The BMI,fat mass,TAFV,TSFV,and TVFV at 12 months after surgery had significant differences compared with those before surgery (P＜0.05),but free fat mass had no significant difference (P＞ 0.05).(3) Follow-up:all the 52 patients have completed the follow-up after surgery and the remission number of obesity was 35.No complications such as anastomotic hemorrhage,obstruction,or anastomotic leakage occured in all the 52 patients.Conclusion Laparoscopic Roux-en-Y gastric bypass can reduce abdominal visceral fat significantly,while quantitative computed tomography can help to evaluate the distribution of abdominal visceral fat accurately.
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Objective To explore the change patterns in the lumbar vertebral bone marrow fat content with age, analyze the interactions between lumbar vertebral bone marrow fat content, bone mineral density (BMD), and age, and compare the difference of lumbar vertebral bone marrow fat content between males and females in the same age groups. Methods According to the statistical sample size requirements that the minimum sample size of each group was 18, thus, we prospectively recruited healthy volunteers who met the inclusion criteria. Among them, there were 139 males and females, with age range of 21-70 years old. According to age, the patients were divided into group 1 (21-30-yr), group 2 (31-40-yr), group 3 (41-50-yr), group 4 (51-60-yr), and group 5 (61-70-yr). Quantitative computed tomography (QCT) was used to measure the lumbar vertebral BMD, and MR mDIXON-Quant technique was used to measure the marrow fat content of L3 lumbar vertebra. We compared the difference of lumbar vertebral bone marrow fat content and BMD between different age groups in males and females using one-way ANOVA, and compared the difference of lumbar vertebral bone marrow fat content and BMD between males and females in the same age groups using t-test. Correlation analysis was conducted between bone marrow fat content, BMD and age. Results Lumbar vertebral bone marrow fat content was generally increasing with the age. There were significant differences in the fat content of bone marrow at different age groups (male, F=13.598, P=0.000;female, F=73.419, P=0.000). Before the age of 50 years, lumbar vertebral bone marrow fat content in females was lower than one in males, and there was a significant difference between group 2 [females,(29.7± 7.1)%-(36.1 ± 6.6)%, males,(34.1 ± 8.4)%-(39.9 ± 5.9)%;21-30-yr, t=1.984, P=0.053;31-40-yr, t=5.699, P=0.000;41-50-yr, t=2.017, P=0.050]. Females older than 50 years had a higher marrow fat content than males, and there was a significant difference between group 5 [females,(48.3±8.8)%-(52.5±8.2)%, males, (45.5 ± 8.1)%-(46.2 ± 7.4)%;51-60-yr, t=-0.914, P=0.365;61-70-yr, t=-3.400, P=0.001]. For males, bone marrow fat content was positively correlated with age (r=0.527, P<0.05), and negatively correlated with BMD (r=-0.730, adjusted for age r=-0.584, P<0.05). For females, bone marrow fat content was positively correlated with age (r=0.761, P<0.05), and negatively correlated with BMD (r=-0.809, adjusted for age r=-0.473, P<0.05). Conclusions Lumbar vertebral bone marrow fat content was generally increasing with the age. Bone marrow fat content was positively correlated with age and negatively correlated with BMD for males and females.
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Objective To investigate the influence of abdominal adipose tissue on insulin resistance and other metabolic indicators in the patients with type 2 diabetes mellitus(T2DM)complicating obesity.Methods Fifty-one patients with newly diagnosed T2DM complicating obesity (T2DM group) and 50 cases of simple obesity(control group) in Jishuitan Hospital were enrolled.The two groups were performed QCT for measuring the total abdominal adipose tissue volume (TAV),subcutaneous adipose tissue volume (SAV),visceral adipose tissue volume (VAV),and then the VAV/SAV ratio was calculated.Meanwhile the waist circumference,body mass index(BMI),blood uric acid (UA),total cholesterol (C H O),triglycerides (TG),high-density lipo protein cholesterol (HDL),low density lipoprotein cholesterol(LDL),homocysteine(HCY),dosage of basal insulin(DBIns),dosage of prandial insulin (DPIns),fasting plasma glucose(FBG),fasting blood insulin (FIns) and HbA1c levels were also measured.The relationship between TAV,SAV and VAV with HOMA-RI and other indicators was investigated.The influence of abdominal adipose tissue on insulin resistance and other metabolic indicators was determined.Results The UA,TG,LDL,FPG and HbA1c levels in the T2DM group were increased compared with the control group(P＜0.05).Compared with the control group,the SAV level in the T2DM group was decreased(P＜0.05),the VAV and VAV/SAV levels were increased(P＜0.05).The multivariate regression analysis showed that VAV was the natural logarithm affecting In (HOMA-RI),UA,CHO,TG,LDL,HCY,DBIns (β=0.399,0.398,0.389,0.447,0.440,0.372,0.307;P＜ 0.05).TAV was the main factor affecting the waist circumference and BMI (β=0.868,0.639;P＜0.05).Conclusion The visceral adipose tissue volume has larger influences on insulin resistance,blood lipids,UA,HCY and DBIns.
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Objective To explore the change patterns in the lumbar vertebral bone marrow fat content with age, analyze the interactions between lumbar vertebral bone marrow fat content, bone mineral density (BMD), and age, and compare the difference of lumbar vertebral bone marrow fat content between males and females in the same age groups. Methods According to the statistical sample size requirements that the minimum sample size of each group was 18, thus, we prospectively recruited healthy volunteers who met the inclusion criteria. Among them, there were 139 males and females, with age range of 21-70 years old. According to age, the patients were divided into group 1 (21-30-yr), group 2 (31-40-yr), group 3 (41-50-yr), group 4 (51-60-yr), and group 5 (61-70-yr). Quantitative computed tomography (QCT) was used to measure the lumbar vertebral BMD, and MR mDIXON-Quant technique was used to measure the marrow fat content of L3 lumbar vertebra. We compared the difference of lumbar vertebral bone marrow fat content and BMD between different age groups in males and females using one-way ANOVA, and compared the difference of lumbar vertebral bone marrow fat content and BMD between males and females in the same age groups using t-test. Correlation analysis was conducted between bone marrow fat content, BMD and age. Results Lumbar vertebral bone marrow fat content was generally increasing with the age. There were significant differences in the fat content of bone marrow at different age groups (male, F=13.598, P=0.000;female, F=73.419, P=0.000). Before the age of 50 years, lumbar vertebral bone marrow fat content in females was lower than one in males, and there was a significant difference between group 2 [females,(29.7± 7.1)%-(36.1 ± 6.6)%, males,(34.1 ± 8.4)%-(39.9 ± 5.9)%;21-30-yr, t=1.984, P=0.053;31-40-yr, t=5.699, P=0.000;41-50-yr, t=2.017, P=0.050]. Females older than 50 years had a higher marrow fat content than males, and there was a significant difference between group 5 [females,(48.3±8.8)%-(52.5±8.2)%, males, (45.5 ± 8.1)%-(46.2 ± 7.4)%;51-60-yr, t=-0.914, P=0.365;61-70-yr, t=-3.400, P=0.001]. For males, bone marrow fat content was positively correlated with age (r=0.527, P<0.05), and negatively correlated with BMD (r=-0.730, adjusted for age r=-0.584, P<0.05). For females, bone marrow fat content was positively correlated with age (r=0.761, P<0.05), and negatively correlated with BMD (r=-0.809, adjusted for age r=-0.473, P<0.05). Conclusions Lumbar vertebral bone marrow fat content was generally increasing with the age. Bone marrow fat content was positively correlated with age and negatively correlated with BMD for males and females.
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Objective To investigate the influence of abdominal adipose tissue on insulin resistance and other metabolic indicators in the patients with type 2 diabetes mellitus(T2DM)complicating obesity.Methods Fifty-one patients with newly diagnosed T2DM complicating obesity (T2DM group) and 50 cases of simple obesity(control group) in Jishuitan Hospital were enrolled.The two groups were performed QCT for measuring the total abdominal adipose tissue volume (TAV),subcutaneous adipose tissue volume (SAV),visceral adipose tissue volume (VAV),and then the VAV/SAV ratio was calculated.Meanwhile the waist circumference,body mass index(BMI),blood uric acid (UA),total cholesterol (C H O),triglycerides (TG),high-density lipo protein cholesterol (HDL),low density lipoprotein cholesterol(LDL),homocysteine(HCY),dosage of basal insulin(DBIns),dosage of prandial insulin (DPIns),fasting plasma glucose(FBG),fasting blood insulin (FIns) and HbA1c levels were also measured.The relationship between TAV,SAV and VAV with HOMA-RI and other indicators was investigated.The influence of abdominal adipose tissue on insulin resistance and other metabolic indicators was determined.Results The UA,TG,LDL,FPG and HbA1c levels in the T2DM group were increased compared with the control group(P＜0.05).Compared with the control group,the SAV level in the T2DM group was decreased(P＜0.05),the VAV and VAV/SAV levels were increased(P＜0.05).The multivariate regression analysis showed that VAV was the natural logarithm affecting In (HOMA-RI),UA,CHO,TG,LDL,HCY,DBIns (β=0.399,0.398,0.389,0.447,0.440,0.372,0.307;P＜ 0.05).TAV was the main factor affecting the waist circumference and BMI (β=0.868,0.639;P＜0.05).Conclusion The visceral adipose tissue volume has larger influences on insulin resistance,blood lipids,UA,HCY and DBIns.
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<p><b>OBJECTIVE</b>To compare the short-term outcomes between transrectal specimen extraction during laparoscopic sigmoid radical resection and conventional laparoscopy-assisted sigmoid radical resection.</p><p><b>METHODS</b>Sixteen patients(transrectal specimen extraction group,4 females and 12 males), who were planned to undergo laparoscopically assisted sigmoid radical resection with BMI<28 kg/mand were evaluated as T1-T3 tumor by iconography without distant metastasis, were selected to undergo transrectal specimen extraction during laparoscopic sigmoid radical resection from December 2015 to April 2016 in the Department of Anorectal Surgery of Changhai Hospital. The procedure of specimen extraction was as follows: Perineal anal expansion was performed. The rectum was cut in rectal distal ligature within the abdominal cavity. Telescope cover was placed through Trocar hole in right low abdomen and rectal stump was pulled out of the body through the anus to form an access tunnel. Planned resected bowel was placed in the tunnel and the specimen was dissociated and removed completely from anus. Each patient in transrectal specimen extraction group was individually matched with two patients who underwent laparoscopically assisted sigmoid radical resection by gender, age, BMI and date of surgery. The perioperative outcomes and pathological evaluation of surgical specimen of two groups were retrospectively collected and compared.</p><p><b>RESULTS</b>The differences of baseline data (gender, age, BMI, distance from tumor to anal verge measured by colonoscopy and clinical tumor category) between two groups were not significant (all P>0.05). Compared to laparoscopy-assisted group, transrectal specimen extraction group presented longer operation time [(140.6±8.3) minutes vs. (122.2±26.2) minutes, t=-3.629, P=0.001], and more blood loss[(43.8±9.2) ml vs. (35.3±10.2) ml, t=-2.795, P=0.008], but shorter time to first flatus [(43.1±8.3) hours vs. (52.0±11.4) hours, t=2.756, P=0.008] and lower pain score at operative day and the first postoperative day (3.8±0.8 vs. 4.8±1.1, t=3.558, P=0.001; 2.6±0.6 vs. 3.8±0.8, t=5.165, P=0.000). The case ratio of additional analgesia [6.3%(1/16) ns. 18.8%(6/32)], postoperative hospital stay [(6.8±3.4) days vs. (5.6±0.8) days] and postoperative morbidity of complication [12.5%(2/16) vs. 9.4%(3/32)] were not significantly different between the two groups (all P>0.05). Within postoperative 30-day follow-up, transrectal specimen extraction group had ileus in one patient and anastomotic leakage in one patient, and laparoscopy-assisted group had fat necrosis of assisted incision in two patients and gastric retention in one patient. There were also no significant differences in specimen length[(18.2±4.8) cm vs. (19.8±5.7) cm, P>0.05], tumor size [(4.0±1.2) cm vs. (4.4±1.5) cm, P>0.05] and number of harvested lymph node (14.6±2.6 vs. 16.0±3.0, P>0.05] between two groups. During follow-up of 7-10(mean 9) months of transrectal specimen extraction group and 2-16 (mean 7) months of laparoscopically assisted group, no tumor local relapse and distant metastasis were found in the both groups.</p><p><b>CONCLUSION</b>As compared to laparoscopy-assisted sigmoid radical resection, transrectal specimen extraction laparoscopic sigmoid radical resection has better short-term efficacy, meanwhile they have comparable oncologic clearance.</p>
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Objective Currently , the targeted therapy is the first-choice treatment of advanced non-small cell lung cancer (NSCLC) in with epidermal growth factor receptor (EGFR) mutations, but few studies have been reported on the relationship between immunohistochemical markers and the EGFR mutation.The aim of this study is to analyze the relationship of the EGFR mutation with the ex-pressions of thymidylate synthetase (TS), excision repair cross-com-plementation group 1 ( ERCC1 ) , β-tubulin-III, and ribonucleofide reductase large subunit-l ( RRM1) in NSCLC. Methods We retro-spectively analyzed 336 cases of NSCLC treated in the Department of Medical Oncology , the Affiliated Hospital of Inner Mongolia Medical University, from June 2014 to December 2015 and examined 29 EGFR mutations.We divided the patients into a mutation and a non-mutation group, performed immunohistochemical staining of the TS, ERCC1,β-tubulin-III and RRM1 proteins and compared their expressions in the NSCLC tissue between the two groups . Results EGFR mutations were found in 138 ( 41.07%) of the 336 NSCLC patients but not in the other 198 ( 58.93%) .The expression of TS was significantly lower in the mutation than in the non-mutation group (9.42%vs 39.39%, P<0.05), and so was that of β-tubulin-III (44.2%vs 60.1%, P<0.05).EGFR mutations were correlated with decreased expressions of TS (r=-0.332, P<0.05) andβ-tubulin-III (r=-0.157, P<0.05).Multivariate regression analysis showed that the risk of EGFR mutations was 2.109 times higher in the fe-male patients than in the males (OR=2.109, 95%CI:1.268-3.509), 24.265 times higher in the adenocarcinoma than in the adeno-squamous carcinoma patients (OR=24.265, 95%CI:3.508-167.845), 15.2 times higher in the squamous carcinoma than in the ade-nocarcinoma patients (OR=15.200, 95%CI:4.480-51.569), 2.364 times higher in the lung biopsy specimens than in the surgically treated patients (OR=2.364, 95%CI:1.266-4.413), and 6.171 times higher in the patients with lowly expressed than in those with highly expressed TS (OR=6.171, 95%CI: 3.145-12.109). Conclusion The decreased expressions of TS and β-tubulin-Ⅲ in NSCLC indicate the mutation of the EGFR gene.
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OBJECTIVE: To investigate the bone mineral density (BMD) of cervical vertebrae in a population-stratified manner and correlate with that of the lumbar vertebrae. MATERIALS AND METHODS: Five hundred and ninety-eight healthy volunteers (254 males, 344 females), ranging from 20 to 64 years of age, were recruited for volumetric BMD (vBMD) measurements by quantitative computed tomography. Basic information (age, height, weight, waistline, and hipline), and vBMD of the cervical and lumbar vertebrae (C2-7 and L2-4) were recorded. Comparisons among sex, age groups and different levels of vertebrae were analyzed using analysis of variance. Linear regression was performed for relevance of different vertebral levels. RESULTS: The vBMD of cervical and lumbar vertebrae was higher in females than males in each age group. The vBMD of the cervical and lumbar vertebrae in males and the vBMD of lumbar vertebrae in females decreased with aging. In each age group, the vBMD of the cervical vertebrae was higher than that of the lumbar vertebrae with gradual decreases from C2 to C7 except for C3; moreover, the vBMD of C6 and C7 was significantly different from that of C2-5. Correlations of vBMD among different cervical vertebrae (females: r = 0.62-0.94; males: r = 0.63-0.94) and lumbar vertebrae (males: r = 0.93-0.98; females: r = 0.82-0.97) were statistically significant at each age group. CONCLUSION: The present study provided normative data of cervical vertebrae in an age- and sex-stratified manner. Sex differences in vBMD prominently vary with age, which can be helpful to design a more comprehensive pre-operative surgical plan.