Lipid deposition in various sites of the skeletal muscles and liver exhibits a positive correlation with visceral fat accumulation in middle-aged Japanese men with metabolic syndrome.

Objective In addition to excess visceral fat, lipid deposition in the liver and skeletal muscle has been implicated in the pathophysiology of type 2 diabetes and metabolic syndrome. This study was designed to explore the relationship between hepatic and muscular lipid deposition and visceral fat accumulation in 105 middle-aged men with metabolic syndrome. Methods Abdominal computed tomography (CT) was used to simultaneously evaluate the visceral fat area (VFA) and CT Hounsfield unit (HU) values of three different portions of skeletal muscle and the liver. Results A significant inverse correlation was observed between the VFA and the CT HU values of the iliopsoas muscle, back muscle, rectus abdominis muscle and liver. Three types of interventions, i.e., lifestyle modification and treatment with antidiabetic drugs, such as Pioglitazone or Miglitol, caused significant decreases in visceral fat accumulation. The extent of lipid deposition in the liver was strongly correlated with the levels of glucose-lipid metabolic markers, which decreased significantly following Pioglitazone treatment. On the other hand, the amount of lipid deposition in the three skeletal muscles and the liver did not decrease after Miglitol treatment. Conclusion Visceral fat accumulation is accompanied by excess lipid deposition in skeletal muscle and the liver in patients with metabolic syndrome. The CT-based simultaneous, concise evaluations of ectopic lipid deposition and visceral fat mass used in the present study may provide unique information for assessing cardiometabolic risks and the therapeutic impact in patients with diabetes-obesity syndrome.

False-positive 123I-metaiodobenzylguanidine (MIBG) scan in a patient with angiomyolipoma; positive MIBG scan does not necessarily indicate the presence of pheochromocytoma.

123I-Metaiodobenzylguanidine (123I-MIBG)-accumulation in angiomyolipoma (AML) is demonstrated. A 24-year-old Japanese woman presented with tumors in the right retroperitoneal space. The tumors, which accumulated 123I-MIBG, had been thought to be adrenal pheochromocytoma before surgery. They were removed, and were found to be AML. 123I-MIBG was accumulated in AML. 123I-MIBG-accumulation in AML led to a false-positive diagnosis of adrenal pheochromocytoma. Catecholamine levels had been normal. No chromaffin cells were found in the histological examination of the tumors. MIBG accumulation does not necessarily indicate the presence of pheochromocytoma.