Thiopurines are an independent risk factor for active tuberculosis in inflammatory bowel disease patients

The use of thiopurines is an independent risk factor for active tuberculosis in patients with inflammatory bowel disease.

Prevalence of sarcopenia using different methods in patients with non-alcoholic fatty liver disease

BACKGROUND Sarcopenia is a clinical condition associated with several liver diseases and it includes non-alcoholic fatty liver disease(NAFLD)in its broad spectrum as steatosis,steatohepatitis and fibrosis.However,the criteria to define sarcopenia are diverse,and even those established in consensus have been discussed regarding their performance in making an accurate diagnosis.AIM To evaluate the prevalence of sarcopenia,using different methods,in patients with NAFLD,and its association with clinical-anthropometric parameters.METHODS This was an observational study of outpatients with NAFLD.Sarcopenia was defined by the European Working Group Consensus on Sarcopenia in Older People of 2010(EWGSOP1)and 2018(EWGSOP2).The skeletal muscle index was used to estimate muscle mass,handgrip strength was assessed using the dynamometer and physical performance by walking a distance of four meters at usual walking speed.The non-invasive fibrosis scores,fibrosis-4(FIB-4)index and Aspartate aminotransferase to platelet ratio index(APRI),were used to assess the absence and presence of fibrosis.RESULTS Fifty-seven individuals with NAFLD were evaluated,the mean age(SD)was 52.7(11.3)years and 75.4%were female.Fibrosis assessed by FIB-4 and APRI was observed in 3.7%and 16.6%of patients with NAFLD,respectively.The diagnosis of sarcopenia was identified only by EWGSOP1 in 3.5%of NAFLD patients,and the prevalence of probable/pre-sarcopenia was higher using the EWGSOP2 consensus at 26.3%,when compared to 1.8%with EWGSOP1.Sarcopenia defined by EWGSOP1,was associated with grade I steatosis,but without overweight(P<0.05).An association between sarcopenia and fibrosis was not observed(P>0.05).EWGSOP2 showed a greater number of patients with probable sarcopenia,and who were overweight(12(80.0%)),with a higher degree of steatosis[11(73.3%)and presence of fibrosis(1(6.7%),FIB-4 and 3(20.0%),APRI]compared to EWGSOP1[1(100%),0(0.0%),0(0.0%),FIB-4 and 0(0.0%),APRI,respectively].CONCLUSION The present study showed that sarcopenia in NAFLD was not predominant in patients without fibrosis,by both diagnostic methods.In addition,the prevalence of probable sarcopenia also depends on the method applied.

Overweight and abdominal fat are associated with normal bone mineral density in patients with ulcerative colitis

BACKGROUND Low bone mineral density(BMD)is common in patients with inflammatory bowel disease.However,nutritional risk factors for low BMD in the ulcerative colitis(UC)population are still poorly understood.AIM To investigate the association of anthropometric indicators and body composition with BMD in patients with UC.METHODS This is a cross-sectional study on adult UC patients of both genders who were followed on an outpatient basis.A control group consisting of healthy volunteers,family members,and close people was also included.The nutritional indicators evaluated were body mass index(BMI),total body mass(TBM),waist circumference(WC),body fat in kg(BFkg),body fat in percentage(BF%),trunk BF(TBF),and also lean mass.Body composition and BMD assessments were performed by dual-energy X-ray absorptiometry.RESULTS The sociodemographic characteristics of patients with UC(n=68)were similar to those of healthy volunteers(n=66)(P>0.05).Most patients(97.0%)were in remission of the disease,58.8%were eutrophic,33.8%were overweight,39.0%had high WC,and 67.6%had excess BF%.However,mean BMI,WC,BFkg,and TBF of UC patients were lower when compared to those of the control group(P<0.05).Reduced BMD was present in 41.2%of patients with UC(38.2%with osteopenia and 2.9%with osteoporosis)and 3.0%in the control group(P<0.001).UC patients with low BMD had lower BMI,TBM,and BFkg values than those with normal BMD(P<0.05).Male patients were more likely to have low BMD(prevalence ratio[PR]=1.86;95%confidence interval[CI]:1.07-3.26).Those with excess weight(PR=0.43;95%CI:0.19-0.97)and high WC(PR=0.44;95%CI:0.21-0.94)were less likely to have low BMD.CONCLUSION Patients with UC in remission have a high prevalence of metabolic bone diseases.Body fat appears to protect against the development of low BMD in these patients.

Coffee protection against the development of hepatocellular carcinoma: review article

Coffee, a popular drink around the world, is composed of a complex mix of biologically active molecules, including caffeine, chlorogenic acid, and diterpenes. These compounds have antioxidant, anti-inflammatory, antifibrotic, and anticarcinogenic properties, which may explain observational data showing that coffee drinkers have lower rates of chronic liver disease, including cirrhosis and hepatocellular carcinoma (HCC). Recent studies have also shown that coffee consumption may also increase patient survival before and after liver transplantation. The mechanism by which coffee consumption protects against HCC is not clear;however, its relevant role has been demonstrated. This literature review article focuses on the role of coffee consumption in protecting against the development of HCC. Methodology: Scientific articles indexed through PubMed, including Medline, Scielo, and Lilacs, published in English were used as search methods. The terms used in English were: "hepatocellular carcinoma" or "Liver cancer" or "HCC" and "coffee". According to the study design or review article, cross-sectional, longitudinal, or descriptive investigations were included, showing site and year of publication until 2019.