BACKGROUND Obesity is a risk factor for non-alcoholic fatty liver disease(NAFLD),although obese patients with NAFLD do not always develop significant fibrosis.The distribution of body fat could predict the risk of NAF...BACKGROUND Obesity is a risk factor for non-alcoholic fatty liver disease(NAFLD),although obese patients with NAFLD do not always develop significant fibrosis.The distribution of body fat could predict the risk of NAFLD progression.AIM To investigate the role of bioelectrical impedance-estimated visceral fat(VF)in assessing NAFLD severity.METHODS In this cross-sectional study,patients with biopsy-proven NAFLD were prospectively included.All patients underwent anthropometric evaluation,blood tests and bioelectrical impedance analysis.RESULTS Between 2017 and 2020,119 patients were included[66.4%male,56 years(SD 10.7),62.2%obese,61.3%with metabolic syndrome].Sixty of them(50.4%)showed significant fibrosis(≥F2)in liver biopsy.Age,VF and metabolic syndrome were associated with significant fibrosis(61 years vs 52 years,16.4 vs 13.1,73.3%vs 49.2%,respectively;P<0.001 for all).In the multivariate analysis,VF and age were independently associated with significant fibrosis(VF,OR:1.11,95%CI:1.02-1.22,P=0.02;age,OR:1.08,95%CI:1.03-1.12,P<0.01).A model including these variables showed and area under the receiver operating characteristic curve(AUROC)of 0.75,which was not inferior to transient elastography or NAFLD fibrosis score AUROCs.We developed a nomogram including age and VF for assessing significant fibrosis in routine practice.CONCLUSION VF is a surrogate marker of liver fibrosis in patients with NAFLD.Bioelectrical impedance analysis is an inexpensive and simple method that can be combined with age to guide patient referral when other resources may be unavailable.展开更多
BACKGROUND Meckel’s diverticulum is a common asymptomatic congenital gastrointestinal anomaly.However,its presentation as an inverted Meckel's diverticulum is a rare complication,of which few cases have been repo...BACKGROUND Meckel’s diverticulum is a common asymptomatic congenital gastrointestinal anomaly.However,its presentation as an inverted Meckel's diverticulum is a rare complication,of which few cases have been reported in the literature.CASE SUMMARY Here,we report the case of a 33-year-old man with iron deficiency anemia without manifestation of gastrointestinal bleeding.An upper gastrointestinal endoscopy and total colonoscopy were performed,but no abnormalities were found within the observed area.Finally,a capsule endoscopy was performed and offered us a clue to subsequently confirm the diagnosis of inverted Meckel's diverticulum via computed tomography scan.Laparoscopic intestinal resection surgery was performed.The final pathology report described a Meckel’s diverticulum.CONCLUSION Since inverted Meckel's diverticulum is an uncommon disease and its clinical presentation is not specific,it may go undetected by capsule endoscopy.Successful diagnosis and treatment of this disease requires a high index of clinical suspicion.展开更多
文摘BACKGROUND Obesity is a risk factor for non-alcoholic fatty liver disease(NAFLD),although obese patients with NAFLD do not always develop significant fibrosis.The distribution of body fat could predict the risk of NAFLD progression.AIM To investigate the role of bioelectrical impedance-estimated visceral fat(VF)in assessing NAFLD severity.METHODS In this cross-sectional study,patients with biopsy-proven NAFLD were prospectively included.All patients underwent anthropometric evaluation,blood tests and bioelectrical impedance analysis.RESULTS Between 2017 and 2020,119 patients were included[66.4%male,56 years(SD 10.7),62.2%obese,61.3%with metabolic syndrome].Sixty of them(50.4%)showed significant fibrosis(≥F2)in liver biopsy.Age,VF and metabolic syndrome were associated with significant fibrosis(61 years vs 52 years,16.4 vs 13.1,73.3%vs 49.2%,respectively;P<0.001 for all).In the multivariate analysis,VF and age were independently associated with significant fibrosis(VF,OR:1.11,95%CI:1.02-1.22,P=0.02;age,OR:1.08,95%CI:1.03-1.12,P<0.01).A model including these variables showed and area under the receiver operating characteristic curve(AUROC)of 0.75,which was not inferior to transient elastography or NAFLD fibrosis score AUROCs.We developed a nomogram including age and VF for assessing significant fibrosis in routine practice.CONCLUSION VF is a surrogate marker of liver fibrosis in patients with NAFLD.Bioelectrical impedance analysis is an inexpensive and simple method that can be combined with age to guide patient referral when other resources may be unavailable.
文摘BACKGROUND Meckel’s diverticulum is a common asymptomatic congenital gastrointestinal anomaly.However,its presentation as an inverted Meckel's diverticulum is a rare complication,of which few cases have been reported in the literature.CASE SUMMARY Here,we report the case of a 33-year-old man with iron deficiency anemia without manifestation of gastrointestinal bleeding.An upper gastrointestinal endoscopy and total colonoscopy were performed,but no abnormalities were found within the observed area.Finally,a capsule endoscopy was performed and offered us a clue to subsequently confirm the diagnosis of inverted Meckel's diverticulum via computed tomography scan.Laparoscopic intestinal resection surgery was performed.The final pathology report described a Meckel’s diverticulum.CONCLUSION Since inverted Meckel's diverticulum is an uncommon disease and its clinical presentation is not specific,it may go undetected by capsule endoscopy.Successful diagnosis and treatment of this disease requires a high index of clinical suspicion.
