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  • ISSN: 2373-9487
    Volume 7, Issue 1
    Research Article
    Lars Lind, Ulf Riserus, Joel Kullberg, Hakan Ahlstrom, Jan W Eriksson, and Jan Oscarsson*
    Objective: Ectopic fat is associated with inflammation; whether ectopic fat in different tissues is differently associated with systemic inflammation is unclear. We compared the ectopic fat content of three tissues and investigated links with inflammation using inflammation-related proteins.
    Materials and methods: Overall, 310 individuals from two trials (NCT02354976; NCT02279407) with body mass index ≥25 kg/m2 and type 2 diabetes or serum triglycerides ≥1.7 mmol/L were included. Magnetic resonance imaging examinations included liver proton density fat fraction (PDFF), pancreatic fat percentage, and visceral adipose tissue (VAT) volume. Total body fat mass was evaluated by bioimpedance. Plasma levels of 74 inflammation related proteins were measured with the proximal extension assay.
    Results: Proteomic profiles differed between the tissues (P<0.0001) when adjusted for age, sex, fasting glucose, and total body fat mass. Using a split-sample discovery/validation approach, five proteins were significantly related to VAT and eight to liver PDFF; none were related to pancreatic fat. Fibroblast growth factor 21 and stem cell factor were related to VAT and liver PDFF. Oncostatin-M (P=0.001) was associated with VAT and the CUB domain-containing protein 1 with liver PDFF (P=0.00002).
    Conclusion: Inflammation-related proteins were differently related to ectopic fat depots. Liver and visceral fat were linked to distinct inflammatory pathways; pancreatic fat was weakly linked to systemic inflammation. 
    Serhat Ozer, Zeynep Altın, Sinem Namdaroglu*, Betul Koyuncu, Fatih Aslan, and Belkıs Unsal
    Introduction: It was aimed in this study to evaluate influence of uric acid levels on pegylated-interferon alpha (PEG-IFN-a) 2a/2b plus ribavirin therapy in patients with chronic hepatitis C.
    Methods: A total of 165 chronic hepatitis c patients with ages ranging from 20 to 75 years having pre- and post-treatment serum uric acid and HCV-RNA (0, 12, 24, 48 and 72 weeks) levels available were included in the study. These parameters were assessed according to the groups based on response to therapy (sustained virologic response -SVR, relapse and non-responders).
    Results: Of the 165 patients, 28 were excluded from hyperuricemia analyses owing to lack of uric acid levels and/or liver biopsies. Of the 137 included, 117 had no hyperuricemia while 20 did (cut-off levels were 7 and 6 mg/dL in males and female, respectively). In univariate analyses, no statistically significant association was established between hyperuricemia and age, waist circumference, HOMA-IR score, sustained virologic response, fibrosis and histologic activity index (p values were 0,61; 0,115; 0,437; 0,645; 0,235 and 0,166; respectively). However, significant association was found between hyperuricemia and body mass index, hypertension, existence of metabolic syndrome and grade of steatosis (p values were 0,045; 0,04; 0,045; 0,007; respectively). No significant relevance was noted between hyperuricemia and the parameters in multivariate analyses.
    Conclusion: There has been detected a significant association between hyperuricemia and steatosis in patients with chronic hepatitis C. However, no influence on therapy has been found with regard to uric acid levels. Multicenter studies are required to enlighten this metabolic chaos.
    Sebastiano Lacitignola*, Roberto Massafra, Marcello Bernardini, Manzo Fabio, and Taddeo Roccasalda
    The incidence of bile lesions after Laparoscopic Cholecystectomy (LC) remains high despite surgeons having crossed the learning curve. In fact, the data reported on bile and vascular injuries in the course of LC ranges from 0,3 to 1,4. Many of these lesions are not due to inexperience; they are the result of basic technical failure and misinterpretations.
    The purpose of this work is to make a contribution, based on our experience of over 40 years, to reduce the possibility of ongoing LC injuries by improving the possibilities of their prevention as well as a timely recognition that would favor a more suitable repair with more valid results in the future.
    Elaine Chiu1, Erin Wishart, Lorian M. Taylor, Brendan Cord Lethebe, Louisa Lam, Melanie Stapleton, Puneeta Tandon, Sandeep Kaur, Abdel-Aziz Shaheen, and Maitreyi Raman
    Background: This study aimed to explore longitudinal relationships between bedside nutrition assessment tools (NAT): hand grip strength (HGS), mid upper arm circumference (MAC), and subjective global assessment (SGA), and clinical outcomes including: liver related hospitalizations, and liver transplant-free survival (LTFS) in patients undergoing liver transplantation assessment.
    Methods: Cirrhosis patients, referred to a cirrhosis focused malnutrition clinic, (N=41) completed NAT during the baseline visit and received one follow-up visit with NAT reassessment and were then followed up 24-months post assessment (median 23.0 months (IQR: 10.5 -29.1)). Log rank Kaplan-Meier and Cox proportional-hazard regression models were used to assess associations between demographic, clinical characteristics and NAT with outcomes.
    Results: Neither baseline NAT assessment or improvements affected the risk of hospitalizations in our cohort. In univariate analyses, improvement of SGA status (Hazard ratio [HR]: 0.28, 95% confidence interval [CI] 0.09-0.88, p=0.03) HGS (HR: 0.91, 95%CI 0.83-1.00, p=0.05) and MAC (HR 0.85, 95% 0.72.1.00, p=0.05) were associated with LTFS. However, NAT did not independently predict LTFS in adjusted multivariate analyses.
    Conclusions: Prospective larger cohorts are needed to further evaluate the impact of temporal improvement of NAT on LTFS and hospitalizations.]
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