Perirenal Fat and Association With Metabolic Risk Factors

Abstract

Incidence of esophageal adenocarcinoma (EAC) has risen rapidly over the past decades in Western countries. As a premalignant lesion, Barrett's esophagus (BE) is an established risk factor of EAC. This study estimated the impact of surveillance endoscopy for BE on population's survival upon EAC by a whole-population cost-effectiveness analysis among modeled Western population.Possibilities and survival payoffs were retrieved through literature searching based on PubMed database. Patients with BE were classified as adequate surveillance (AS), inadequate surveillance (IAS), and no surveillance groups. Direct cost of endoscopy per person-year was estimated from diagnosis of BE to before diagnosis of EAC in the whole-population model, whereas the payoff was 2-year disease-specific survival rate of EAC.AS for patients with BE had lower cost-effectiveness ratio (CER) than that of IAS group, as well as lower incremental cost-effectiveness ratio (6116 €/% vs 118,347 €/%). Prolonging the surveillance years could decrease the yearly cost in whole population and also relevant CERs, despite increased total cost. Increasing the proportion of participants in AS group could improve the survival benefit. The maximal payoff was up to 2-year mortality reduction of 2.7 per 100,000 persons by spending extra €1,658,913 per 100,000 person-years.A longer endoscopic surveillance among BE subpopulation plan can reduce yearly budget. Attempt to increase the proportion of AS participants can induce decline in population mortality of EAC, despite extra but acceptable expenditure. However, regarding optimal cost-effectiveness, further studies are still required to identify a high-risk subpopulation out of BE patients for endoscopic surveillance.

Para‐perirenal distribution of body fat is associated with reduced glomerular filtration rate regardless of other indices of adiposity in hypertensive patients

“…In recent studies, PUFT has demonstrated a close association with several cardiovascular and metabolic risk factors such as fasting plasma glucose, uric acid, HDL‐C, or tryglicerides, and our data seem to confirm these results (see Table ). Moreover, PUFT has been shown to correlate with visceral fat and with total adiposity better than anthropometric parameters of obesity, so the relationship between PUFT and eGFR could be more accurate and less affected by the abovementioned bias.…”

“…Like BMI or WC, PUFT has shown a close relationship with microalbuminuria and reduced glomerular filtration rate in animal models . A few studies on diabetic or obese patients would seem to confirm this finding even in humans . No data are available about nondiabetic patients or in hypertensive patients.…”

Major risk factors for atherosclerosis and metabolic syndrome: The UHS

“…The high prevalence of MetS and risk factors for atherosclerosis may be associated with an increase in the accumulation of visceral and perirenal fat deposits in this population [26][27][28]. In a recent study in Ecuador, the prevalence of MetS was 66.0% in women and 47.1% in men.…”

“…The MetS and risk factors for atherosclerosis may be associated with an increase in the accumulation of visceral and perirenal fat deposits in this population [26][27][28]. The high prevalence of MetS and risk factors for atherosclerosis may be associated with an increase in the accumulation of visceral and perirenal fat deposits in this population [26][27][28].…”

Pancreatic Steatosis: Is it Related to Obesity, Diabetes Mellitus and Metabolic Syndrome?

“…Obesity is associated with a large number of diseases such as hypertension, diabetes, heart disease, brain disease, sleep disorders, cancer, infertility, pain, skin infections, metabolic syndrome (MetS), gastric ulcers and gallstones [1][2][3][4][5][6].…”