The serum leptin levels were significantly higher in patients with NASH, while they were not affected by chronic hepatitis. This elevation is out of proportion to BMI of these patients and may be related to hyperlipidemia in most. Elevated serum leptin levels, therefore, may promote hepatic steatosis and steatohepatitis.

Background: Neck circumference (NC) measurement is one of the simple screening measurements which can be used as an index of upper body fat distribution to identify obesity. Objectives: The aim of this study was to determine the relationship between neck circumferences and obesity. Methods:A total 411 volunteer adults participated in this study (174 men, 237 women). A questionnaire which consisted of anthropometric measurements and demographic features was used. Patients with NC ≥37 cm for men and ≥34 cm for women require evaluation of overweight status. Results: The percentages of the men and women with BMI ≥ 25kg/m 2 were 55.2% and 27.0% respectively and with high neck circumferences were 85.1% and 38.8%, respectively. The percentages of the men and women with high waist circumference were 31.6% and 79.3%, respectively. In both gender there were positive significant correlations between neck circumference, body weight (men, r=0.576; women, r=0.702; p=0.000), waist circumferences (men, r=0.593; women r=0.667; p=0.000), hip circumferences (men, r=0.568; women, r=0.617; p=0.000) and BMI (men, r=0.587; women, r=0.688; p=0.000). Conclusions: This study indicates that NC was associated with body weight, BMI, waist and hip circumferences and waist/ hip ratio for men and women. A significant association was found between NC and conventional overweight and obesity indexes. NC was associated with waist/hip ratio for men and women.

Percutaneous endoscopic gastrostomy is a minimally invasive gastrostomy method with low morbidity and mortality rates, is easy to follow up and easy to replace when clogged.

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