AIM: To investigate whether perinatal events, intrauterine or postpartum, are associated with the development of primary sclerosing cholangitis (PSC) later in life. METHODS: Birth records from 97 patients with adult P...AIM: To investigate whether perinatal events, intrauterine or postpartum, are associated with the development of primary sclerosing cholangitis (PSC) later in life. METHODS: Birth records from 97 patients with adult PSC in Sweden were reviewed. Information on perinatal events including medications and complications during pregnancy, gestation length, birth weight and length were collected. Two control children of the same sex were selected for each subject. Conditional multiple logistic regression was used to assess associations of the perinatal measures with development of PSC. RESULTS: No significant associations were found between gestational age, birth length, breastfeeding, and the majority of medical complications including infections or medication during pregnancy for the mothers or postpartum for the children. Vaginal bleeding and peripheral oedema showed associations with PSC, with matched odds ratios of 5.70 (95% CI, 1.13-28.83) and 2.28 (95% CI, 1.04-5.03), respectively. CONCLUSION: The associations of vaginal bleeding and oedema with subsequent PSC cannot readily beexplained, so our fi ndings do not strongly support the hypothesis of a signifi cant role of perinatal events as a risk for the development of PSC later in life.展开更多
Background: Our aim was to investigate the frequency of elevated liver enzymes and NAFLD in patients with known insulin resistance during 15 years of follow-up. Methods: Subjects with insulin resistance were identifie...Background: Our aim was to investigate the frequency of elevated liver enzymes and NAFLD in patients with known insulin resistance during 15 years of follow-up. Methods: Subjects with insulin resistance were identified from a population-based prospective cohort study in Sweden, Malm? Diet and Cancer Study, conducted in 1991-1996. Inall, 285 non-diabetic subjects with insulin resistance established by HOMA-IR (homeostasis model assessment) were invited to do the liver function testing and if elevated, they should be further assessed by radiological examination of the liver, anthropometric measures and blood testing. Results: 165 subjects (57.9%) agreed to do the liver function testing. Of these, 25 subjects (15%) had elevated liver enzymes. After exclusion of other diseases, 5 of the remaining 21 subjects (23.8%) had radiological signs of steatosis. Liver steatosis significantly correlated with ALT (alanine aminotransferase) (p = 0.04), HOMA-IR (p = 0.00) and the metabolic syndrome (p = 0.03). 80% of the subjects with NAFLD had either developed type 2 diabetes mellitus or had impaired fasting glucose and 80% fulfilled the WHO-criteria for the metabolic syndrome, which were of significant differences to the group without NAFLD. Conclusion: The risk of developing elevated liver enzymes and NAFLD at long-term follow-up in insulin resistant subjects is not insignificant, but mainly associated with the simultaneous development of impaired fasting glucose, established diabetes mellitus and/ or the metabolic syndrome.展开更多
文摘AIM: To investigate whether perinatal events, intrauterine or postpartum, are associated with the development of primary sclerosing cholangitis (PSC) later in life. METHODS: Birth records from 97 patients with adult PSC in Sweden were reviewed. Information on perinatal events including medications and complications during pregnancy, gestation length, birth weight and length were collected. Two control children of the same sex were selected for each subject. Conditional multiple logistic regression was used to assess associations of the perinatal measures with development of PSC. RESULTS: No significant associations were found between gestational age, birth length, breastfeeding, and the majority of medical complications including infections or medication during pregnancy for the mothers or postpartum for the children. Vaginal bleeding and peripheral oedema showed associations with PSC, with matched odds ratios of 5.70 (95% CI, 1.13-28.83) and 2.28 (95% CI, 1.04-5.03), respectively. CONCLUSION: The associations of vaginal bleeding and oedema with subsequent PSC cannot readily beexplained, so our fi ndings do not strongly support the hypothesis of a signifi cant role of perinatal events as a risk for the development of PSC later in life.
文摘Background: Our aim was to investigate the frequency of elevated liver enzymes and NAFLD in patients with known insulin resistance during 15 years of follow-up. Methods: Subjects with insulin resistance were identified from a population-based prospective cohort study in Sweden, Malm? Diet and Cancer Study, conducted in 1991-1996. Inall, 285 non-diabetic subjects with insulin resistance established by HOMA-IR (homeostasis model assessment) were invited to do the liver function testing and if elevated, they should be further assessed by radiological examination of the liver, anthropometric measures and blood testing. Results: 165 subjects (57.9%) agreed to do the liver function testing. Of these, 25 subjects (15%) had elevated liver enzymes. After exclusion of other diseases, 5 of the remaining 21 subjects (23.8%) had radiological signs of steatosis. Liver steatosis significantly correlated with ALT (alanine aminotransferase) (p = 0.04), HOMA-IR (p = 0.00) and the metabolic syndrome (p = 0.03). 80% of the subjects with NAFLD had either developed type 2 diabetes mellitus or had impaired fasting glucose and 80% fulfilled the WHO-criteria for the metabolic syndrome, which were of significant differences to the group without NAFLD. Conclusion: The risk of developing elevated liver enzymes and NAFLD at long-term follow-up in insulin resistant subjects is not insignificant, but mainly associated with the simultaneous development of impaired fasting glucose, established diabetes mellitus and/ or the metabolic syndrome.
