We evaluate the accuracy of whole body muscle mass (WBMM) and appendicular skeletal muscle mass (ASMM) assessed by bioelectrical impedance analysis (BIA) using an InBody770 machine (InBody, Seoul, Korea) referenced to dual-energy X-ray absorptiometry (DXA) in 507 people (mean age 63.7 ± 10.8 years, body mass index (BMI) 25.2 ± 3.5 kg/m2). Mean WBMMs measured by BIA and DXA were 49.3 ± 6.6 kg and 46.8 ± 6.5 kg in men and 36.1 ± 4.7 kg and 34.0 ± 4.8 kg in women, respectively. The respective effect sizes and 95% confidence intervals (CIs) for the difference were 2.49 (2.22–2.76) for men, and 2.12 (1.91–2.33) for women. Mean ASMMs measured by BIA and DXA were 22.1 ± 3.3 kg and 19.9 ± 3.2 kg in men, and 15.3 ± 2.5 kg and 13.5 ± 2.2 kg in women, respectively. The respective effect sizes and 95% CIs for the difference were 2.26 (2.10–2.41) for men and 1.75 (1.65–1.87) for women. The BIA clearly overestimated WBMM by 2.28 kg and ASMM by 1.97 kg compared with DXA. Using BMI, gender, and fat percentage, we derive equations that improved the residuals to <2 kg between methods from 38.29% to 85.91% for WBMM and 52.78% to 97.02% for ASMM.
Patients who have no tumor visible on MRI, have a nadir PRL level <1 ng/dL during drug treatment, and received drug treatment for >6 years may be the best candidates for DA withdrawal.
BackgroundType 2 diabetes is one of the most common diseases with devastating complications. However, genetic susceptibility of diabetic complications has not been clarified. The vitamin D endocrine system is related with calcification and lipolysis, insulin secretion, and may be associated with many complicated disease including diabetes and cardiovascular disease. Recent studies reported that single nucleotide polymorphisms of vitamin D receptor (VDR) gene were associated with diabetic complications.MethodsIn present study, we evaluated the association of BsmI polymorphism of VDR with diabetic complications in Korean diabetes patients. Total of 537 type 2 diabetic subjects from the Endocrinology Clinic of Chungbuk National University Hospital were investigated. Polymerase chain reaction-restriction fragment length polymorphism was used to test the genotype and allele frequency of BsmI (rs1544410; BB, Bb, bb) polymorphisms.ResultsMean age was 62.44±10.64 years and mean disease duration was 13.65±7.39 years. Patients with B allele (BB or Bb) was significantly associated with lower risk of diabetic retinopathy (severe non-proliferative diabetic retinopathy or proliferative retinopathy; 7.4%, 5/68) compared with patients without B allele (bb; 17.3%, 81/469; P=0.035). This association was also significant after adjusting for hemoglobin A1c level, body mass index, age, sex, and diabetes mellitus duration, concurrent dyslipidemia and hypertension (odds ratio, 2.99; 95% confidence interval, 1.08 to 8.29; P=0.035) in logistic regression analysis.ConclusionOur findings suggest that B allele of Bsm1 polymorphism in VDR gene is associated with lower risk of diabetic retinopathy in type 2 diabetic patients. Bsm1 genotype could be used as a susceptibility marker to predict the risk of diabetes complication.
A pyogenic pancreatic abscess mimicking pancreatic neoplasm in the absence of acute pancreatitis is rare. We report four patients who each presented with a pancreatic mass at the pancreas head or body without acute pancreatitis. The presenting symptoms were abdominal pain, fever, or weight loss. Abdominal CT scans showed low-density round masses at the pancreas head or body with/without lymphadenopathy. In each case, a PET-CT scan showed a mass with a high SUV, indicating possible malignancy. Comorbid diseases were identified in all patients: chronic pancreatitis and thrombus at the portal vein, penetrating duodenal ulcer, distal common bile duct stenosis, and diabetes mellitus. Diagnoses were performed by laparoscopic biopsy in two patients and via EUS fine needle aspiration in one patient. One patient revealed a multifocal microabscess at the pancreatic head caused by a deep-penetrating duodenal ulcer. He was treated with antibiotics and a proton-pump inhibitor. The clinical symptoms and pancreatic images of all the patients were improved using conservative management. Infective causes should be considered for a pancreatic mass mimicking malignancy. ( However, some cases manifest with abdominal pain or weight loss. A pyogenic pancreatic abscess mimicking pancreatic neoplasm in the absence of acute pancreatitis is rare and difficult to diagnose. 4 We report on four patients who each presented with a pancreatic mass at the pancreas head or body that mimicked malignancy but was diagnosed as a pancreatic abscess (Table 1). CASE REPORT Case 1A 51-year-old woman was admitted following two days of abdominal pain. There was no history of fever or weight loss. CA 19-9 was normal. An abdominal CT scan showed a 2.7-cm ill-defined low-density mass with peripancreatic fat infiltration located at the pancreatic body (Fig. 1A). An ill-defined soft tissue density lesion around the celiac axis, common hepatic artery, splenic artery, and portal vein was noted (Fig. 1B), which was suggestive of lymphadenopathy with vascular invasion. A PET-CT scan showed hot uptake (SUV 3.8) at the pancreatic body and peripancreatic lymph nodes, which indicated possible malignancy (Fig. 1C). Based on the image findings, borderline respectable pancreatic cancer was U/L, and CRP 24.44 mg/dL. CA 19-9 was normal. An abdominal CT scan showed a 5.0-cm well-defined low-density mass with heterogenous enhancement at the pancreas head and mild pancreatic duct dilatation with a calcifying stone ( Fig. 2A). The portal vein and common hepatic artery were encased by the mass (Fig. 2B). Based on the CT findings, the diagnosis was suspected pancreatic neoplasm against the background of chronic pancreatitis. A laparoscopy was per-
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