Background: The current definition of lean is based on body mass index (BMI). However, BMI is an imperfect surrogate for adiposity and provides no information on central obesity (CO). Hence, we explored the differences in clinical profile and liver disease severity in lean patients with nonalcoholic fatty liver disease (NAFLD) with and without CO.
Methods: One hundred seventy lean patients with NAFLD (BMI <23 kg/m) were divided into two groups depending upon the presence or absence of CO (waist circumference ≥80 cm in females and ≥90 cm in males). Noninvasive assessment of steatosis was done by ultrasound and controlled attenuation parameter (CAP), while fibrosis was assessed with FIB-4 and liver stiffness measurement (LSM). FibroScan-AST (FAST) score was used for non-invasive prediction of NASH with significant fibrosis.
Results: Of 170 patients with lean NAFLD, 96 (56.5%) had CO. Female gender (40.6% vs. 17.6%, = 0.001), hypertriglyceridemia (58.3% vs. 39.2%, = 0.01) and metabolic syndrome (23.9% vs. 4.1%, < 0.001) were more common in the CO group. There was a poor correlation between BMI and waist circumference (r = 0.24, 95% CI: 0.09-0.38). Grade 2-3 steatosis on ultrasound was significantly more common in CO patients (30% vs. 12.3%, = 0.007). CAP [312.5 (289.8-341) dB/m vs. 275 (248-305.1) dB/m, = 0.002], FAST score [0.42 (0.15-0.66) vs. 0.26 (0.11-0.39), = 0.04], FIB-4 and LSM were higher in those with CO. Advanced fibrosis was more prevalent among CO patients using FIB-4 (19.8% vs 8.1%, = 0.03) and LSM (9.5% vs. 0, = 0.04). CO was independently associated with advanced fibrosis after adjusting for BMI and metabolic risk factors (aOR: 3.11 (1.10-8.96), = 0.03). Among these 170 patients, 142 fulfilled metabolic dysfunction associated steatotic liver disease (MASLD) criteria. CO was also an independent risk factor for advanced fibrosis in MASLD (3.32 (1.23-8.5), = 0.02).
Conclusion: Lean patients with NAFLD or MASLD and CO have more severe liver disease compared to those without CO.
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http://dx.doi.org/10.1016/j.jceh.2024.102400 | DOI Listing |
Arthroscopy
December 2024
American Hip Institute Research Foundation, Chicago, IL 60018; American Hip Institute, Chicago, IL 60018. Electronic address:
Purpose: The purpose of this study is to assess the effect of perioperative testosterone supplementation on orthopedic surgical outcomes.
Methods: Three online databases were searched from database inception until September 2024. Three reviewers independently screened all titles, abstracts, and full-texts of articles investigating perioperative testosterone use in orthopedic surgery.
PLoS One
December 2024
CHU Clermont Ferrand, Plateforme d'Exploration de la Mobilité, Pôle MOBEX, Université Clermont Auvergne, Clermont-Ferrand, France.
Background: In osteoarthritis quadriceps strength is an important outcome to assess exercise capacity and recovery after arthroplasty. However, its measurement is limited due to lack of time and the need for trained personnel and equipment whose accuracy is verified.
Objectives: To find out the determinants of a reduced quadriceps strength and to establish a score to screen for it.
J Cardiovasc Dev Dis
November 2024
Health and Movement Consultation, Pediatric Cardiology Unit, Service of Pediatric Specialties, Department of Woman, Child and Adolescent Medicine, Geneva University Hospitals and Faculty of Medicine, University of Geneva, 1211 Geneva 14, Switzerland.
: In adults, epicardial adipose tissue (EAT) is associated with metabolic syndrome (MS) and coronary artery disease. EAT thickness is increased in obese youth, but total EAT volume and its correlation with cardiovascular risk factors have not been studied. : To determine EAT volume in adolescents and its association with obesity and cardiovascular risk factors.
View Article and Find Full Text PDFCurr Oncol
December 2024
Freelance Surgeon Oncologist, Residenza Querce, Milanodue, 20054 Segrate, Italy.
Design: The purpose of this review is the analysis of the literature concerning the effects of physical exercise in cancer patients undergoing medical oncologic treatment. Papers were retrieved from the scrutiny of 15 reviews/meta-analyses published in the last 2 years, which, however, pooled different populations of patients (surgical and medical patients, receiving or not an oncologic therapy, harboring a cancer, or being survivors).
Results: We reviewed the data of 35 RCTs on the use of physical exercise in cancer patients, distinguishing well-nourished from malnourished patients.
Pediatr Nephrol
December 2024
Department of Physical Medicine and Rehabilitation, Medical Faculty, Ondokuz Mayis University, Samsun, Turkey.
Background: The study evaluated the relationship between balance function and skeletal muscle mass index (ASMI), physical function, and fatigue in children with chronic kidney disease (CKD).
Methods: A cross-sectional study of 83 children with CKD (stages 1-4, dialysis, transplant) and 71 healthy controls was conducted. Functional performance tests, including gait speed, 6-min walk distance (6MWD), five-repetition sit-to-stand (5RST), and timed up-and-go (TUG) tests, were administered.
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