Journal of investigative medicine : the official publication of the American Federation for Clinical Research
-
The liver is a principal metabolic organ within the human body and has a major role in regulating carbohydrate, fat, and protein metabolism. With increasing rates of obesity, the prevalence of non-alcoholic fatty liver disease (NAFLD) is growing. It remains unclear why NAFLD, which is now defined as the hepatic manifestation of the metabolic syndrome, develops but lifestyle factors such as diet (ie, total calorie and specific nutrient intakes), appear to play a key role. ⋯ In contrast, a hypocaloric diet decreases liver fat content. Findings from both hyper- and hypo-caloric feeding studies provide some suggestion that macronutrient composition may also play a role in regulating liver fat content and this is supported by data from isocaloric feeding studies; fatty acid composition and/or carbohydrate content/type appear to influence whether there is accrual of liver fat or not. The mechanisms by which specific macronutrients, when consumed as part of an isocaloric diet, cause a change in liver fat remain to be fully elucidated.
-
Nephropathy is a major microvascular complication of diabetes mellitus and often leads to terminal renal failure in addition to contributing significantly to cardiovascular morbidity and mortality. Despites continuous advances, the pathogenesis of diabetic nephropathy remains poorly understood. ⋯ The role of podocytes in health and diabetic nephropathy and abnormalities including podocyte hypertrophy, effacement, and apoptosis, and a detailed discussion on the role played by the Wnt-β-catenin signaling pathway in podocyte injury and dysfunction are the focus of this review. In addition, the role played by Wnt signaling in mediating the effects of known therapeutic strategies for diabetic nephropathy is also discussed.
-
Karyotype (KT) aberrations are important prognostic factors for acute myeloid leukemia (AML); however, around 50% of cases present normal results. Single nucleotide polymorphism array can detect chromosomal gains, losses or uniparental disomy that are invisible to KT, thus improving patients' risk assessment. However, when both tests are normal, important driver mutations can be detected by the use of next-generation sequencing (NGS). ⋯ All patients could be reclassified based on genomic status and nine had their prognosis modified. In summary, NGS offers insights into the molecular pathogenesis and biology of cytogenetically normal AML in Brazilian patients, indicating that the prognosis could be further stratified by different mutation combinations. This study shows a different frequency of mutations in Brazilian population that should be confirmed.
-
This study aimed to evaluate the association of ascending aortic diameter (AAD) measured by low-dose chest CT (LDCT) and metabolic syndrome (MS) in Korean men. AAD was measured with LDCT in 1046 healthy Korean men (mean age 50.7±9.7 years, range 28 to 69 years) participating in medical health check-up in a university health promotion center. AAD was defined as the longest length measured from the left main coronary ostium to the level of the right pulmonary artery in the axial plane in LDCT. ⋯ Logistic regression with AAD showed that ORs and 95% CI of MS in Q2 (1.72, 95% CI 1.23 to 2.53), Q3 (2.59, 95% CI 1.85 to 5.81) and Q4 (4.71, 95% CI 1.63 to 8.79) were significantly higher compared with Q1 (the lowest quartile). In variable (age, body surface area, total cholesterol, alanine aminotransferase, gamma-glutamyl transferase, smoking, alcohol intake and exercise) adjusted multiple linear regression analysis, Q4 (the highest quartile of AAD) was significantly associated with MS compared with Q1 (OR 4.52, 95% CI 1.67 to 9.87). In conclusion, AAD measured by LDCT is significantly associated with the prevalence of MS in Korean men.
-
Review Meta Analysis
Efficacy of interventions for adherence to the immunosuppressive therapy in kidney transplant recipients: a meta-analysis and systematic review.
Immunosuppressive treatment regimens are complex and require ongoing self-management. Medication adherence can be difficult to achieve for several reasons. The current meta-analysis and systematic review investigated whether adherence interventions improved immunosuppressive treatment adherence in kidney transplant recipients. ⋯ Sensitivity analysis indicated that findings for adherence rate were robust. However, for adherence score, the significance of the association disappeared after removing one of the studies indicating the findings may have been overly influenced by this one study. Intervention programs designed to increase immunosuppressive adherence in patients with kidney transplant improve treatment adherence.