Liver involvement in rheumatic diseases may occur as a primary liver disease, primary rheumatic disease with hepatic manifestations or antirheumatic drug-induced liver disease. The aim of our article is to underline the importance of monitoring and control of the level of aminotransferases and cholestatic enzymes in rheumatic disorders. Some of the rheumatic diseases with constantly elevated liver enzymes need to be investigated in consideration of concomitant primary autoimmune liver disease (such as autoimmune hepatitis, primary biliary cholangitis, primary sclerosing cholangitis) or drug hepatotoxicity. Also, we should be aware of hepatitis B reactivation or hepatitis C flare when immunosuppressants are used.

Introduction.According to the World Health Organization (WHO), about 15 million people worldwide suffer from stroke each year, which makes it the second leading cause of death and the leading cause of acquired disability in adults. Obesity is considered to be a great risk factor for stroke. It appears to play a role in the functional outcome and mortality. Obesity can be expressed by many indicators. Most commonly used is Body Mass Index (BMI). Objective. The aim of the study is to determine whether obesity increases the risk of stroke and present the recent state of knowledge about predictors for stroke incidence. Brief description of the state of knowledge. It seems that BMI cannot be taken into consideration as an isolated risk factor for stroke. BMI limitations create a need for better obesity indicators. Recently, it was highlighted that abdominal obesity and its indicators might be a better predictor for stroke incidence compared to BMI. This seems reasonable if recent studies are taken into account in which it was found that abdominal fat has more metabolic activity than subcutaneous fat. Conclusions. The use of the alternative obesity measurements, such as waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR), could help to correct limitations linked to the BMI, especially regarding patients with visceral type of obesity. All three obesity markers (BMI, WHR and WHtR) should be considered for use in every day practice. Key wordsstroke, abdominal obesity, risk factors, body mass index Streszczenie Wprowadzenie. Według Światowej Organizacji Zdrowia każdego roku ok. 15 mln ludzi na całym świecie cierpi z powodu udaru, co czyni go drugą najczęstszą przyczyną śmierci i główną przyczyną nabytej niepełnosprawności u dorosłych. Otyłość jest uważana za istotny czynnik ryzyka udaru mózgu, prawdopodobnie mający również wpływ na rokowanie oraz śmiertelność poudarową. Otyłość można zmierzyć za pomocą wielu wskaźników, przy czym najczęściej stosowanym jest wskaźnik masy ciała (ang. Body Mass Index, BMI). Cel pracy. Celem pracy jest określenie, czy otyłość zwiększa ryzyko wystąpienia udaru, i przedstawienie aktualnego stanu wiedzy na temat wskaźników ryzyka wystąpienia udaru. Opis stanu wiedzy. Wydaje się, że BMI nie może być brane pod uwagę jako izolowany czynnik ryzyka udaru. Ograniczenia związane ze stosowaniem BMI stwarzają potrzebę poszukiwania lepszych wskaźników otyłości. W ostatnich latach podkreśla się, że otyłość brzuszna i jej markery mogą stanowić bardziej wiarygodne wskaźniki ryzyka udaru mózgu w porównaniu do BMI. Uzasadniają to ostatnie badania, w których stwierdzono, że tłuszcz brzuszny ma większą aktywność metaboliczną niż podskórna tkanka tłuszczowa. Podsumowanie. Zastosowanie innych wskaźników otyłości, takich jak stosunek obwodu talii do obwodu bioder (ang. waist-to-hip ratio, WHR) oraz stosunek obwodu talii do wzrostu (ang. waist-to-height ratio, WHtR), może pomóc w skorygowaniu ograniczeń BMI, szczególnie w przypadku pacjentów z otyłością brzuszną. Wydaje się, że w celu najdokładniejszego określ...

Aim of the study: The aim of our study was to analyse the obesity indicators [body mass index (BMI), waist-to-hip ratio (WHR), waist circumference (WC), and the less-known body adiposity index (BAI)] to assess their influence on the severity and short-term outcome in both females and males after ischaemic stroke admitted over a period of 9 successive months to the Department of Neurology at the Medical University of Bialystok, Poland. Materials and methods: Based on the BMI, we divided the patients into the following groups: underweight, normal weight, overweight, and obese. The severity of stroke was evaluated by the National Institute of Health Stroke Scale (NIHSS). STATA 15 software (StataCorp, 2017) was used for statistical analysis. Results: The results demonstrated that there was no association between the BMI and changes in patient condition during hospitalisation in the stroke unit. The BAI had no clear correlation with the short-term outcome. However, a comparison of accuracy revealed that the BAI was a more precise indicator, and could better predict NIHSS improvement over treatment than the BMI. Among the analysed indicators, only the WC correlated with the difference between the NIHSS scores on admission and at hospital discharge. Conclusions: The BMI, used in clinical practice for decades, is far from a precise predictor of functional outcome after ischaemic stroke. This is the first study that takes into account the obesity indicator BAI in patients after acute ischaemic stroke. According to our results, in the future we should focus more attention on abdominal adiposity indicators such as the BAI or WC.