The novel predictor of metabolic risk in patients with polycystic ovary syndrome: could it be the visceral adiposity index?

OBJECTIVE: Polycystic ovary syndrome (PCOS) is the most common endocrinological disorder in women of reproductive age, often accompanied by high androgen levels, irregular menstrual cycles and polycystic ovaries. In addition, patients with PCOS also present with an increase in abdominal adipose tissue and insulin resistance. Recently, the gender-specific mathematical formulation called visceral adiposity index (VAI) has been widely used in assessing cardiometabolic risk. This study aimed at comparing the VAI values of patients with PCOS, patients with idiopathic hirsutism (IH) and a control group. PATIENTS AND METHODS: We obtained demographic data, laboratory results and anthropometric measurements of patients from the hospital database. We retrospectively grouped all cases included in the study as PCOS (n = 52), IH (n = 57) and control (n = 58) according to the diagnoses. We also took venous samples for hormone and biochemical tests in the early follicular phase of the menstrual cycle, at least 8-10 hours after fasting in the early morning hours. Finally, we evaluated the variables using SPSS 22.0 software (IBM Corp., Armonk, NY, USA). RESULTS: We included 167 female individuals in the study. Of these, 57 (34.1%) were diagnosed with IH, while 52 (31.1%) were diagnosed with PCOS. The control group comprised 58 (34.8%) healthy female individuals. The median age of the study group was 25 years [interquartile range (IQR) = 8 years]. The age, height, weight, body mass index (BMI) and waist circumference values of the groups were similar. We found that the VAI values among the groups were significantly different (p = 0.028). Post-hoc analysis determined that this was due to the difference between the group with PCOS and the control group. In addition, we found significantly high HOMA-IR, fasting insulin and androgen levels in the group with PCOS (p < 0.001). CONCLUSIONS: After comparing data in groups with similar BMI levels, we found significantly high VAI values in patients with PCOS. The results reinforce the idea that VAI is a useful marker easily obtained in daily practice for assessing the cardiometabolic risk of patients with PCOS.

Quantitative and visual analysis of idiopathic pulmonary fibrosis with different methods: the relationship between clinical correlation and mortality risk model.

OBJECTIVE: To test the correlation between the visual semi-quantitative score (VSQS) and different quantitative computed tomography (QCT) analyses and pulmonary physiology variables, and to determine the performance of these types of analyses on the Gender, Age, and Physiology (GAP) model for the prediction of mortality risk of idiopathic pulmonary fibrosis (IPF). PATIENTS AND METHODS: High-resolution computed tomography (HRCT) images of IPF patients were reviewed and the VSQS was calculated. Evaluations were made of the QCT score of interstitial lung disease (ILD) using four different previously defined methods. Respiratory function tests (RFT) and the 6-minute walk test (6MWT) were applied to all the patients. The GAP model was used to evaluate the mortality risk. The performance of the VSQS score and QCT methods on the GAP model to predict the mortality risk of the disease was calculated with ROC analysis. RESULTS: The study included 40 patients who met the criteria. A statistically significant correlation was determined between all the quantitative and semi-quantitative measurement results (p<0.001). A significant correlation was determined between the VSQS and QCT parameters and the RFT and 6MWT. In the ROC analysis, method 4 of the QCT parameters (a value of the voxels between -700 and -950 HU) and the VSQS showed the best performance in the differentiation of stage I, stage II, and stage III, according to the GAP model. CONCLUSIONS: The selection of a quantitative method was useful in the evaluation of spread in patients with IPF. According to the GAP model, VSQS performed best in predicting mortality risk. Furthermore, method 4 of the QCT parameters, which shows well-aerated lungs, were deemed to have good potential for the estimation of mortality risk.

Evaluation of neurologic complications by brain MRI in kidney and liver transplant recipients.

The aim of this study was to retrospectively analyze brain magnetic resonance imaging (MRI) findings in patients who developed neurologic complications after liver and kidney transplantation. The results in 216 organ transplant recipients, who had brain MRI were evaluated retrospectively. We performed 187 brain MRI on kidney recipients and 29 liver recipients. Neuroradiologic findings were classified in three groups: group 1 findings were related to transplantation; group 2 findings, to chronic parenchymal disease; and group 3 to neither transplantation nor chronic parenchymal disease. In group 1, six patients (20.6%) after liver and three (1.6%) after kidney transplantation had posterior reversible encephalopathy syndrome; two patients (1.1%) after renal and one (3.4%) after liver transplantation had tuberculosis granulomas; one patient (0.5%) after renal transplantation had osmotic demyelination syndrome; one patient (0.5%) had a Nocardia abcess and one (0.5%) focal cerebritis after renal transplantation. Among group 2, 38 patients (20.3%) had brain atrophy; 37 (20%), white matter changes; 3 (1.6%), sinus thrombosis; 8 (4.3%), lacunar infarct; 1 (0.5%), had renal osteodystrophy in the cranial bones; and 4 (2.2%), had intracranial hemorrhage secondary to end-stage renal disease. Brain atrophy in nine patients (31%), hyperintensity in the globus pallidus on T1-weighted MR images owing to manganese deposits in nine patients (31%), hyperintensity in basal ganglia on T2-weighted MR images owing to copper depositions in one patient (3.4%) were seen secondary to chronic liver disease. In group 3, three patients (1.6%) had intracranial lipomas; one (0.5%), mesial temporal sclerosis; and one (0.5%), an anterior cerebral artery aneurysm in renal transplant patients. Periventricular and subcortical white matter hyperintensities were observed on T2-weighted MR images in six liver transplant patients (20.7%). Neurologic complications after organ transplantation may be secondary to transplantation itself, to chronic parenchymal disease, or to neither transplantation nor chronic parenchymal disease.