Clin Med
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Comparative Study
Low vitamin D levels are associated with increased risk for fatty liver disease among non-obese adults.
Recent data have revealed an inverse relationship between insulin resistance, which is associated with fatty liver disease, and blood 25-hydroxy-vitamin D (25(OH)D) levels. The aim of the present study was to determine the association of vitamin D levels with the presence and stage of fatty liver disease among non-obese subjects and to determine the effect of vitamin D status on fatty liver disease development. A total of 613 non-obese (body mass index <30 kg/m(2)) gastroenterology and internal medicine outpatients (472 women and 141 men) were enrolled in the study. ⋯ When the patients were evaluated as low or normal vitamin D groups, low vitamin D levels was determined to be a risk factor for fatty liver disease, with an odds ratio of -1.59 (confidence interval -1.22 to -1.97). The increased risk for fatty liver disease among patients with low vitamin D status may be suggestive of mechanisms promoting fat flow and accumulation in the liver. Molecular studies are warranted to elucidate the action of vitamin D on the liver with respect to fat metabolism.
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Acute colonic pseudo-obstruction (ACPO), or Ogilvie syndrome, is colonic bowel obstruction without a mechanical cause. Stroke is known to result in autonomic disturbance, which is one of the factors that can lead to ACPO, yet it has only rarely been described post stroke. There are several management options available, including conservative techniques, pharmacological therapies, endoscopic treatments and, finally, surgery. This case highlights effectively the refractory nature that this condition can take, and the different management options that can be used to help resolve it.