Intra-pancreatic fat deposition and its relation to obesity: a magnetic resonance imaging study.

OBJECTIVES: Intra-pancreatic fat deposition (IPFD) is suspected to be associated with various medical conditions. This study aimed to assess pancreatic fat content in lean and obese individuals, characterize obese individuals with and without IPFD, and explore the underlying mechanisms. MATERIALS AND METHODS: Sixty-two obese individuals without diabetes and 35 lean controls underwent magnetic resonance imaging (MRI) using proton density fat fraction (PDFF) maps to evaluate pancreatic and hepatic fat content, and visceral adipose tissue (VAT) content. Pancreatic fibrosis was explored by T1 relaxation time and MR elastography (MRE) measurements. Associations between pancreatic fat, measures of obesity and metabolic syndrome were examined using uni- and multivariate regression analyses. RESULTS: Pancreatic PDFF was higher in obese than in lean controls (median 8.0%, interquartile range (6.1;13.3) % vs 2.6(1.7;3.9)%, p < 0.001). Obese individuals with IPFD (PDFF ≥6.2%) had higher waist circumference (114.0 ± 12.5 cm vs 105.2 ± 8.7 cm, p = 0.007) and VAT (224.9(142.1; 316.1) cm2 vs 168.2(103.4; 195.3) cm2, p < 0.001) than those without. In univariate analysis, pancreatic PDFF in obese individuals correlated with BMI (r = 0.27, p = 0.03), waist circumference (r = 0.44, p < 0.001), VAT (r = 0.37, p = 0.004), hepatic PDFF (r = 0.25, p = 0.046) and diastolic blood pressure (r = 0.32, p = 0.01). However, in multivariate analysis, only VAT was associated to pancreatic fat content. MRI measures of pancreatic fibrosis indicated no evident fibrosis in relation to increased pancreatic fat content. CONCLUSIONS: Pancreatic fat content was increased in obese individuals compared with lean controls and predominantly correlated with the amount of visceral adipose tissue. Pancreatic fat content was not clearly linked to measures of pancreatic fibrosis.

Cognitive function in individuals with and without painful and painless diabetic polyneuropathy-A cross-sectional study in type 1 diabetes.

INTRODUCTION: Previous studies suggest that cognitive impairment is more prevalent in individuals with painful and painless diabetic peripheral neuropathy (DPN). However, the current evidence is not well described. This study investigated cognitive function in adults with type 1 diabetes mellitus (T1DM) and the association to painful/painless DPN and clinical parameters. METHODS: This cross-sectional, observational, case-control study included 58 participants with T1DM, sub-grouped into 20 participants with T1DM and painful DPN, 19 participants with T1DM and painless DPN, 19 participants with T1DM without DPN, and 20 healthy controls were included. The groups were matched for sex and age. The participants performed Addenbrooke's examination III (ACE-III), which assesses attention, memory, verbal fluency, language and visuospatial skills. Working memory was evaluated using an N-back task. Cognitive scores were compared between the groups and correlated to age, diabetes duration, HbA1c and nerve conduction measurements. RESULTS: Compared to healthy controls, T1DM participants showed lower total ACE-III (p = .028), memory (p = .013) and language scores (p = .028), together with longer reaction times in the N-back task (p = .041). Subgroup analyses demonstrated lower memory scores in those with painless DPN compared with healthy controls (p = .013). No differences were observed between the three T1DM subgroups. Cognitive scores and clinical parameters were not associated. CONCLUSIONS: This study supports the notion of cognitive alterations in T1DM and indicates that cognitive function is altered in T1DM regardless of underlying neuropathic complications. The memory domain appears altered in T1DM, particularly in those with painless DPN. Further studies are needed to verify the findings.

MRI-based quantification of renal fat in obese individuals using different image analysis approaches.

PURPOSE: The purpose of this study was to evaluate different renal proton density fat fraction (PDFF) analysis approaches. Additionally, we assessed renal fat in obese individuals and lean individuals. METHODS: This was a retrospective observational case-control study. Twenty-eight obese individuals and 14 lean controls underwent MRI with multi-point Dixon technique for PDFF maps. The following renal PDFF image analysis approaches were performed and compared: (1) five circular regions of interest (ROIs) in six slices, (2) three circular ROIs in one slice, (3) freehand segmentation of renal parenchyma in one slice, and (4) freehand segmentation of renal parenchyma avoiding the renal border in one slice. Furthermore, renal PDFF was compared between obese and lean individuals. RESULTS: Methods 1, 2, and 4 were positively correlated (r ≥ 0.498, p ≤ 0.001). Renal PDFF values varied more with regards to ROI placement within slices than mean PDFF between slices. Using all methods, the obese individuals had significantly higher renal PDFF values compared with the lean controls. CONCLUSION: Renal PDFF should be measured covering large areas of the kidney while excluding artifacts. This can be achieved using multiple circular ROIs. Increased lipid accumulation in the kidneys was related to obesity.

Patterns and characteristics of polypharmacy among elderly residents in Danish nursing homes.

AIM: To identify patterns and characteristics of polypharmacy among elderly residents in Danish nursing homes in the Northern region of Denmark. MATERIALS & METHODS: Twenty-five nursing homes were contacted, where each supplied 20 randomly selected anonymized residents' information. Residents were 65 years or older, concurrently taking five or more medications. Drug-drug interactions and potential adverse effects were investigated. RESULTS: One hundred residents (68% females; 32% males) were included. The most prevalent co-morbid condition was cardiovascular disease, and the most prevalent medications were for gastrointestinal- and metabolism-related conditions. Age influenced the number of drugs (p = 0.013) and drug-drug interactions per resident (p = 0.039), with a positive correlation. CONCLUSION: Elderly residents of the studied nursing homes were potentially affected by an inappropriate polypharmacy.