Association between neck circumference and non-alcoholic fatty liver disease: cross-sectional analysis from ELSA-Brasil

Abstract BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) has become a public health problem worldwide. Neck circumference (NC) is a simple anthropometric adiposity parameter that has been correlated with cardiometabolic disorders like NAFLD. OBJECTIVES: To investigate the association between NC and NAFLD, considering their obesity-modifying effect, among participants from the Longitudinal Study of Adult Health (ELSA-Brasil) baseline study. DESIGN AND SETTINGS: Cross-sectional study at the ELSA-Brasil centers of six public research institutions. METHODS: This analysis was conducted on 5,187 women and 4,270 men of mean age 51.8 (± 9.2) years. Anthropometric indexes (NC, waist circumference [WC] and body mass index [BMI]), biochemical and clinical parameters (diabetes, hypertension and dyslipidemia) and hepatic ultrasound were measured. The association between NC and NAFLD was estimated using multinomial logistic regression, considering potential confounding effects (age, WC, diabetes, hypertension and dyslipidemia). Effect modification was investigated by including the interaction term NC x BMI in the final model. RESULTS: The frequency of NAFLD and mean value of NC were 33.6% and 33.9 (± 2.5) cm in women, and 45.8% and 39.4 (± 2.8) cm in men, respectively. Even after all adjustments, larger NC was associated with a greater chance of moderate/severe NAFLD (1.16; 95% confidence interval [CI] for women; 1.05, 95% CI for men; P < 0.001). Presence of multiplicative interaction between NC and BMI (P < 0.001) was also observed. CONCLUSION: NC was positively associated with NAFLD in both sexes, regardless of traditional adiposity indexes such as BMI and WC. The magnitude of the association was more pronounced among women.

Reemplazo graso total idiopático del páncreas: Reporte de un caso

La lipomatosis pancreática difusa o focal es una entidad que puede ser secundaria a patologías sistémicas (como el síndrome de Shwachman-Diamond, la fi brosis quística u otras) o ser idiopática. Se han reportado algunos casos con ausencia de síntomas clínicos o alteraciones en el laboratorio y otros en los que la funcionalidad del páncreas se encontraba comprometida. Aquí presentamos un caso en el cual el hallazgo de reemplazo graso total fue incidental, debido a que se visualizó en una tomografía computada (TC) solicitada por otras razones.

Fat replacement of pancreas is a condition that may be secondary to systemic diseases (such as Shwachman-Diamond syndrome or cystic fi brosis), or may be idiopathic. There are some reported cases in which there are no clinic symptoms or laboratory changes, and others where the pancreatic function is compromised. We present a case with an incidental finding of fat replacement, after a computed tomography (CT) performed for others reasons.

Band-Like Interposing Fat along Large Vessels: Ultrasonographic Pseudolesions of the Breast

OBJECTIVE: The aim of this study is to evaluate the clinical characteristics and ultrasonographic findings of band-like interposing fat as well as to identify additional approaches for its diagnosis. MATERIALS AND METHODS: This study included 26 confirmed cases of band-like interposing fat from June 2008 to June 2010. A retrospective analysis was performed to evaluate the clinical characteristics and ultrasonographic findings in these cases. Five radiologists analyzed the ultrasonographic findings, which correlated with the mammographic and MRI findings when available, according to Breast Imaging Reporting and Data System classification. RESULTS: None of the 26 patients had any symptoms. In 92.3% of the patients, the lesion was located in the upper outer quadrant of the breast. The mean distance of the lesion from the nipple was 2.4 +/- 0.7 cm (1.1-4.5). The mean depth of the lesion from the skin was 1.3 +/- 0.3 cm (0.8-2.1). The mean maximal length of the lesion was 0.8 +/- 0.4 cm (0.3-1.8). The following were the most frequent ultrasonographic findings of lesions: irregular shape, not parallel orientation, indistinct margins, abrupt interface, hypoechogenicity, no posterior feature, no calcification, and presence of vascularity. The most frequent BI-RADS category was 4a. There were no suspicious findings on the mammography or MRI. CONCLUSION: Ultrasonographic findings may lead to misclassification of band-like interposing fat as a malignancy. A better understanding of the clinical and ultrasonographic characteristics of band-like interposing fat would facilitate its differentiation from a true mass.

Study on the relationship between echocardiographic epicardial fat thickness and the severity of coronary heart disease / 中国基层医药

Objective To investigate the correlation between epicardial fat thickness (EAT) and the risk factors of coronary artery disease (CAD) as well as the severity of coronary lesions with echocardiography,Methods According to the results of coronary angiography,80 patients underwent coronary angiography were divided into coronary heart disease group (CHD group,4 6 cases) and without coronary heart disease group (control group,34cases),and according to coronary artorrythe severity,CHD goup was divided into subgroups of single-vessel disease (24 cases) and multivessel disease subgroup(22 cases).Tho epioardial fat thickness on the free wall of the right ventricle was measured at end-systole from the para-sterna,long-axis vlews.The relationship between EAT and the risk factors of CAD (such as age,gender,hypercholesterolemia,hypertenston,diabetes,smoking,family CAD history) as well as the severity of coronary lesions were analyzed.Results EAT in multivessel disease CAD group [(8.85 ± 1.44)mm] was significantly higher than that in single vessel CAD group[(6.86 ± 1.09) mm] and control group [(4.58 ± 1.12) mm] (all P ＜ 0.01).EAT was significantly related with the risk factors of CAD.Although the risk factors of CAD such as age,blood glucose,blood pressure were adjusted,EAT was still independently associated with CAD (OR:5.394,95 ％ CI:1.700 ～ 17.1 12,P =0.004).Concluslon The level of EAT is significantly correlated with CAD and the severity of coronary lesions.

Novel mutations in arrhythmogenic right ventricular cardiomyopathy from Indian population.

BACKGROUND: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a progressive condition with right ventricular myocardium being replaced by fibro-fatty tissue. The spectrum of the expression may range from benign palpitations to the most malignant sudden death. Most of the mutations identified for the condition are localized in desmosomal proteins although three other nondesmosomal genes (cardiac ryanodine receptor-2, TGF-β3, and TMEM43) have also been implicated in ARVC. Both desmosomal and nondesmosomal genes were screened in a set of patients from local population. MATERIALS AND METHODS: A set of 34 patients from local population were included in this study. Diagnosis was based on the criteria proposed by task force of European Society of Cardiology/International Society and Federation of Cardiology. Polymerase chain reaction-based single-strand conformation polymorphism analysis was carried out, and samples with abnormal band pattern were commercially sequenced. RESULTS: Screening of cardiac ryanodine receptor revealed an insertion of a base in the intronic region of exon-28 in a patient, leading to a creation of a cryptic splice site. Screening of plakohilin-2 for mutations revealed an abnormal band pattern in three patients. Two of them had similar abnormal band pattern for exon-3.1. Sequencing revealed a novel 2 base pair deletion (433_434 delCT), which would lead to premature truncation of the protein (L145EfsX8). Another patient showed abnormal band pattern for exon-3.2 and sequencing revealed a missense mutation C792T leading to amino acid change P244L, in N-terminal, and this substitution may cause disturbances in the various protein–protein interactions. CONCLUSION: This study reports novel cardiac ryanodine receptor (RyR-2) mutations and Pkp-2 for the first time from Indian population.

Traumatic Dissection of Subcutaneous Fatty Tissue: Ultrasonographic Findings and Treatment

PURPOSE: To evaluate the imaging findings of a traumatic dissection of subcutaneous fatty tissue and the treatment. MATERIALS AND METHODS: Fifteen lesions from 13 patients treated by sonography were investigated in our study. The lesions were treated by aspiration only, aspiration followed by steroid injection, and by surgical procedure. Based on the treatment, five factors such as location, size and extent of the lesions, nature of the contents, and treatment effectiveness were assessed. RESULTS: A total of 6 lesions in the thigh, 4 in the leg, 3 in the knee, and 1 each in proximal forearm and flank. All lesions were found in subcutaneous fatty tissue with an average size of 8.9 cm. The nature of the contents was serous (n = 2), hemorrhaging (n = 9), and an abscess (n = 1). Without treatment, three lesions disappeared. Five of the 7 lesions vanished after being treated by aspiration. Only one out of three lesions disappeared when they were treated by steroid injection after aspiration. The three hemorrhaging lesions disappeared after operation, but one serous lesion remained. CONCLUSION: Dissection of subcutaneous fatty tissue represents a cystic mass with serous fluid or hemorrhage. The effectiveness of lesion treatment may relate to the location, size, and content of the lesion.