Prospective dietary polyunsaturated fatty acid intake is associated with trajectories of fatty liver disease: an 8 year follow-up study from adolescence to young adulthood.

BACKGROUND AND AIM: Dietary fat intake has long been associated with fatty liver. Our study aimed to determine the effect of dietary fats on longitudinal fatty liver index (FLI) trajectories from adolescence to young adulthood. METHODS: Nine hundred eighty-five participants in the Raine Study, Perth, Western Australia, Australia, had cross-sectional assessments at ages 14, 17, 20 and 22 years, during which anthropometric measurements and blood tests were obtained. FLI trajectories were derived from the longitudinal FLI results. Dietary fat intake was measured with a semi-quantitative food frequency questionnaire at 14 years and log multinominal regression analyses were used to estimate relative risks. RESULTS: Three FLI trajectories were identified and labelled as stable-low (79.1%, N = 782), low-to-high (13.9%, N = 132), and stable-high (7%, N = 71). The low-to-high group associated with an increased intake of the long-chain polyunsaturated fatty acids EPA, DPA and DHA (RR 1.27, 95% CI 1.10-1.48) relative to the stable-low group. Compared to the stable-low group, omega-6 and the ratio of omega-6 to omega-3 in the stable-high group were associated with an increased relative risk of 1.34 (95% CI 1.02-1.76) and 1.10 (95% CI 1.03-1.16), respectively. CONCLUSION: For those at high risk of fatty liver in early adolescence, high omega-6 fatty acid intake and a high ratio of omega-6 to omega-3 fatty acids are associated with increased risk of fatty liver. There should be caution in assuming these associations are causal due to possible undetected and underestimated confounding factors.

Asia's Growing Contribution to Obesity Surgery Research: A 40-year Bibliometric Analysis.

Bariatric metabolic surgery's global research interest is growing, particularly in Asia due to its high obesity rates. This study focuses on Asia, especially China, analyzing 3904 publications (1221 from China) from 1980 to 2022. Research output accelerated until the COVID-19 pandemic, driven by economic growth and rising obesity rates. China led contributions from 2010, but Western Asia led when adjusted for population. An intra-regional research collaboration network emerged, driven by geographic proximity and similar economic environments. Keyword analysis highlighted emerging topics like "laparoscopic sleeve gastrectomy" and "non-alcoholic fatty liver disease," indicating a shift in focus. The study recommends disseminating research in top-tier journals to enhance visibility and impact.

Relationship between dietary intake and erythrocyte PUFA in adolescents from a Western Australian cohort.

BACKGROUND: Population-based studies show that the intake of omega-3 (n-3) and omega-6 (n-6) polyunsaturated fatty acids (PUFA) are associated with a range of health conditions. Therefore, the reliability of food frequency questionnaires (FFQ) as rapid and easily accessible screening tools for PUFA intake deserve investigation. OBJECTIVE: We aimed to assess the relationship between erythrocyte fatty acids and fatty acid intake collected using the Commonwealth Scientific and Industrial Research Organisation (CSIRO) food frequency questionnaire in an adolescent cohort. DESIGN: A cross-sectional study using data from 1155 young adolescents participating in the 14-year follow-up of the Raine Study. Bland-Altman plots were used to determine the agreement between dietary intake and erythrocyte levels of each fatty acid. RESULTS: The main dietary source of n-3 long-chain (LC) PUFA was 'fresh fish' (53% of total n-3 LC-PUFA). Docosahexaenoic acid (DHA) showed the strongest correlation between erythrocyte and diet assessment (r = 0.274; p < 0.001), whilst linoleic acid (LA) (r = 0.103; p < 0.001) and arachidonic acid (AA) (r = -0.06; p = 0.042) showed weaker correlations, with limits of agreement relatively narrow. Bland-Altman plots showed a dose-dependent bias between the FFQ fatty acid data and corresponding erythrocyte data. CONCLUSIONS: For the major n-3 and n-6 PUFA, dietary intakes derived from the FFQ showed weaker correlations and poorer agreement with erythrocyte levels, and the deviation between the two increased with higher intake levels.

A predictive model for postthrombotic syndrome in proximal deep vein thrombosis patients.

BACKGROUND: Postthrombotic syndrome (PTS) is the most common long-term complication of deep vein thrombosis (DVT). Predictive models for PTS after hospitalized DVT patients, especially those with proximal DVT for whom preventative intervention decisions need to be made, are rare. We aimed to develop and externally validate a clinical predictive model for PTS in patients with proximal DVT. METHODS: This study was a retrospective, single-center, case-control study. The data used in our model were retrospectively collected from a prospective registry database in which 210 (derivation) and 90 (validation) consecutive patients were first diagnosed with proximal DVT. We developed a nomogram using the multivariate logistic regression model. External validation of our predictive model and previous predictive models in our validation set was assessed by discrimination, calibration, and clinical utility. RESULTS: Of the 30 candidate predictors, 5 were significantly associated with PTS in our final multivariable model, including the number of signs and symptoms (OR 1.33, 95% CI: 1.17 to 1.53, P<0.001), male sex (OR 1.79, 95% CI: 1.07 to 3.06, P=0.028), varicose vein history (OR 3.02, 95% CI: 1.04 to 7.60, P<0.001), BMI (OR 1.06, 95% CI: 1.00 to 1.12, P=0.052), and chronic DVT (OR 2.66, 95% CI: 1.49 to 4.79, P<0.001). The area under the curve was 0.724 in our predictive model, indicating suitable external performance. CONCLUSIONS: A simple-to-use nomogram effectively predicts the risk of PTS in patients with proximal DVT. This predictive model may be considered for use in clinical care.

Validation of fatty liver disease scoring systems for ultrasound diagnosed non-alcoholic fatty liver disease in adolescents.

BACKGROUND AND AIMS: The incidence of non-alcoholic fatty liver disease (NAFLD) is increasing in young populations. However, there are inadequate data regarding diagnosis of NAFLD. We aimed to validate three scoring systems against a previous standard of suprailiac skinfold thickness for diagnosing NAFLD in population-based adolescents. METHODS: Seventeen-year-old adolescents (n = 899), participating in the Raine Study, attended a cross-sectional follow-up. NAFLD was diagnosed using liver ultrasound. Scores for Fatty liver index (FLI), Hepatic Steatosis Index (HSI) and Zhejiang University index (ZJU index) were calculated. Diagnostic accuracy of these diagnostic tests was evaluated through discrimination and calibration. RESULTS: NAFLD was diagnosed 9% in males and 15% in females. The three scoring systems demonstrated better discrimination performance for NAFLD in males (AUC was FLI:0.82, HSI: 0.83 and ZJU index: 0.83) compared to females (AUC was FLI: 0.67, HSI: 0.67 and ZJU index: 0.67). Suprailiac skinfold performed better than the scoring systems (overall AUC: 0.82; male AUC:0.88; female AUC:0.73). FLI had best calibration performance. CONCLUSION: Suprailiac skinfold thickness was a better predictor of ultrasound-diagnosed NAFLD than the three diagnostic scoring systems investigated. The higher performance characteristics of the algorithmic scoring systems in males compared with females may have implications for use in population assessments.