OBJECTIVEIncreased very-low-density lipoprotein triglycerides (VLDL-TG) concentration is a central feature of diabetic dyslipidemia. The objective was to compare basal and insulin mediated VLDL-TG kinetics, oxidation, and adipose tissue storage in type 2 diabetic and healthy (nondiabetic) men.RESEARCH DESIGN AND METHODSEleven type 2 diabetic and 11 healthy men, matched for BMI and age, were included. Ex vivo-labeled VLDL-TG tracers, blood and breath samples, fat biopsies, indirect calorimetry, and body composition measures were applied to determine VLDL-TG kinetics, VLDL-TG fatty acids (FA) oxidation, and storage in regional adipose tissue before and during a hyperinsulinemic euglycaemic clamp.RESULTSVLDL-TG secretion was significantly greater in diabetic compared with healthy men (basal: 86.9 [31.0] vs. 61.9 [30.0] μmol/min, P = 0.03; clamp: 60.0 [26.2] vs. 34.2 [17.9] μmol · min−1, P = 0.01). The insulin mediated suppression of VLDL-TG secretion was significant in both groups. VLDL-TG clearance was lower in diabetic men (basal: 84.6 [32.7] vs. 115.4 [44.3] ml · min−1, P = 0.08; clamp: 76.3 [30.6] vs. 119.0 [50.2] ml · min−1, P = 0.03). During hyperinsulinemia fractional VLDL-TG FA oxidation was comparable, but in percentage of energy expenditure (EE), significantly higher in diabetic men. Basal VLDL-TG storage was similar, but significantly greater in abdominal compared with leg fat.CONCLUSIONSIncreased VLDL-TG in type 2 diabetic men is caused by greater VLDL-TG secretion and less so by lower VLDL-TG clearance. The ability of hyperinsulinemia to suppress VLDL-TG secretion appears preserved. During hyperinsulinemia VLDL-TG FA oxidation is significantly increased in proportion of EE in type 2 diabetic men. Greater basal abdominal VLDL-TG storage may help explain the accumulation of upper-body fat in insulin-resistant individuals.

Background The morphological changes seen during treatment with regorafenib represent challenges when evaluating treatment response using RECIST. Computed tomography texture analysis (CTTA) has potential as a non-invasive functional imaging biomarker during treatment with anti-angiogenetic therapies. Purpose To explore changes in three-dimensional tumor CTTA in colorectal liver metastases (CRLM) in a cohort of patients with metastatic colorectal cancer during treatment with regorafenib. Material and Methods Twenty-seven patients with CRLM were treated with regorafenib and evaluated using CTTA. Texture analysis was applied in the standard contrast-enhanced CT performed in the portal-venous phase (PVP-CT) and in two selected scan series derived from a dynamic contrast-enhanced CT (DCE-CT). A total of 269 scan series were analyzed. Results In the unfiltered dataset of the PVP-CT, all texture parameters, except for kurtosis, changed significantly during treatment. In the filtered PVP-CT dataset, the CTTA parameters entropy, uniformity, and standard deviation were markedly associated with overall survival (OS) at spatial scaling factors (SSF) of 1.0– 2.0, but did not change significantly during treatment. Skewness increased significantly during treatment and was evaluated at SSF ≥1.0. In general, the same trends in texture parameter changes were seen when analyzing DCE-CT datasets. However, these changes did not reach the same level of significance. Conclusions In this exploratory study, we demonstrated substantial changes in the texture parameters during treatment with regorafenib, most evident in the unfiltered dataset of the PVP-CT. Some texture parameters showed prognostic association with OS. Texture may potentially help evaluate the treatment response in patients treated with regorafenib.

Introduction: Distant metastases are found in the many of patients with lung cancer at time of diagnosis. Several diagnostic tools are available to distinguish between metastatic spread and benign lesions in the adrenal gland. However, all require additional diagnostic steps after the initial CT. The purpose of this study was to evaluate if texture analysis of CT-abnormal adrenal glands on the initial CT correctly differentiates between malignant and benign lesions in patients with confirmed lung cancer. Materials and methods: In this retrospective study 160 patients with endoscopic ultrasound-guided biopsy from the left adrenal gland and a contrast-enhanced CT in portal venous phase were assessed with texture analysis. A region of interest encircling the entire adrenal gland was used and from this dataset the slice with the largest cross section of the lesion was analyzed individually. Results: Several texture parameters showed statistically significantly difference between metastatic and benign lesions but with considerable between-groups overlaps in confidence intervals. Sensitivity and specificity were assessed using ROC-curves, and in univariate binary logistic regression the area under the curve ranged from 36 % (Kurtosis 0.5) to 69 % (Entropy 2.5) compared to 73 % in the best fitting model using multivariate binary logistic regression. Conclusion:In lung cancer patients with abnormal adrenal gland at imaging, adrenal gland texture analyses appear not to have any role in discriminating benign from malignant lesions.

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Men with type 2 diabetes have increased VLDL-TG storage in muscle tissue, potentially contributing to increased intramyocellular triglyceride and ectopic lipid deposition. Neither muscle nor adipose tissue storage rates were related to LPL activity. This argues against LPL as a rate-limiting step in the postabsorptive quantitative storage of VLDL-TG.