2D Shear Wave Elastography, a promising screening tool for Cystic Fibrosis liver disease, shows a correlation between vitamin D and liver stiffness.

BACKGROUND: Liver disease in Cystic Fibrosis (CFLD) is an early complication of CF. Evidence of CFLD is often subclinical and screening is recommended. Screening includes a biochemical work-up and an ultrasound investigation. Non-invasive methods measuring liver stiffness such as shear wave elastography could be beneficial. This study describes the use of 2D Shear Wave Elastography (2D SWE) in screening for CFLD in a clinical setting and explores its correlation to other indicators of CFLD. Furthermore, a relationship between liver stiffness and nutritional status, lung function and glucose tolerance was explored. MATERIAL AND METHODS: A retrospective cohort study was performed at a pediatric CF center. Information was gathered from the patients' charts and the Swedish national CF registry. The patients included had been evaluated for the presence of CFLD by ultrasound and 2D SWE during 2018-2020. Demographic data as well as data concerning nutritional status, lung function and glucose tolerance were collected. RESULTS: Fifty-one subjects were included with a median age of 11 years. Four children who had biopsy confirmed liver cirrhosis had significantly increased liver stiffness. There was a statistically significant negative correlation between liver stiffness and vitamin D levels and FEV1% predicted respectively. Children with abnormal glucose tolerance had increased liver stiffness compared to their normal glucose tolerant counterparts. CONCLUSION: Measuring liver stiffness by 2D SWE is a reliable addition to CFLD screening with data comparable to the more conventional ultrasound investigation. Increased liver stiffness is associated with lower vitamin D levels, lower FEV1% predicted and abnormal glucose tolerance.

Prevalence of self-reported stroke in association with ethnic background within a multi-ethnic population in Paramaribo, Suriname: Results from the HeliSur study

Background:Suriname is a middle-income country with a multi-ethnic population. Urbanization and ethnicity may be associated with incidence of cerebrovascular disease, but so far this has not been documented for Suriname. The objective of this study was to examine the prevalence of stroke in the capital of Suriname, and its association with ethnicity. Methods: Using the self-reported data from the ‘Healthy life in Suriname’ (HeliSur) study, we determined the prevalence of stroke in 1,478 subjects. The odds for having suffered from stroke in Javanese, Maroons and Creoles were separately compared to the odds in Hindustani. Odds ratios were adjusted for traditional risk factors including age, sex, diabetes, hypertension, dyslipidemia, and smoking, by use of multiple logistic regression analysis. Results:The overall prevalence of stroke in urban Surinameis 3.2% (95% CI 2.3 to 4.0%). Hindustani reported the highest prevalence of stroke (4.1%, 95% CI 2.4 to 5.8%) compared to the Javanese (2.0%, 95% CI 0 to 4.0%), Creoles (3.6%, 95% CI 2.7 to 4.5%) and Maroons (1.8%, 95% CI 0.5 to 3.1%). Adjusted odds ratios showed no significant association between ethnic background and stroke. Conclusions: Stroke prevalence is high in urban Suriname, and there seems to be ethnic difference in its prevalence. However, with and without adjustments for traditional risk factors, no significant association between stroke and ethnicity could be shown