RESUMO
BACKGROUND: The presence of active brown adipose tissue (BAT) has been associated with a reduced risk of obesity in adult humans. AIM: To examine whether the presence and activity of BAT in patients undergoing PET-CT examinations is related to the presence of fatty liver. METHOD: We retrospectively analysed 3666 consecutive PET-CT whole-body scans performed on a total of 1832 patients who were referred for suspected malignancies. BAT-positive subjects (BAT+) were defined as subjects who showed substantial amounts of brown adipose tissue on PET-CT scans. In areas where uptake of [(18)F]FDG was identified by CT for BAT, the maximal standardised uptake values (SUVmax), defined as the maximum activity per millilitre within the region of interest divided by the injected dose in megabecquerels per gram of body weight, were determined. A ratio of mean liver attenuation to spleen attenuation <0.8 on CT scans was considered to indicate NAFLD. RESULTS: Thirty patients of the 1832 screened individuals (2%) demonstrated brown fat uptake (BAT+ subjects). Ninety matched individuals without evidence of BAT on PET scans (BAT- subjects) were enrolled for comparison purposes. After adjustment for potential confounders, the odds ratio for having NAFLD was significantly higher for BAT- subjects (3.12, 95% confidence interval = 1.03-9.88, P < 0.05). The SUVmax for brown fat tissue was significantly correlated with the ratio of mean liver attenuation to spleen attenuation (P < 0.05). CONCLUSION: The presence of brown adipose tissue in adulthood is independently associated with a lower likelihood of NAFLD diagnosed by CT findings.
Assuntos
Tecido Adiposo Marrom/metabolismo , Fígado Gorduroso/metabolismo , Adulto , Glicemia/metabolismo , Índice de Massa Corporal , Fígado Gorduroso/diagnóstico por imagem , Fluordesoxiglucose F18 , Humanos , Fígado/diagnóstico por imagem , Pessoa de Meia-Idade , Imagem Multimodal/métodos , Hepatopatia Gordurosa não Alcoólica , Razão de Chances , Tomografia por Emissão de Pósitrons , Estudos Retrospectivos , Fatores de Risco , Tomografia Computadorizada por Raios XAssuntos
Hemorragia Gastrointestinal/tratamento farmacológico , Fitoterapia , Extratos Vegetais/uso terapêutico , Proctite/tratamento farmacológico , Lesões por Radiação/tratamento farmacológico , Idoso , Endoscopia Gastrointestinal , Feminino , Hemorragia Gastrointestinal/etiologia , Humanos , Fotocoagulação a Laser , Lasers de Gás/uso terapêutico , Masculino , Pessoa de Meia-Idade , Extratos Vegetais/administração & dosagem , Proctite/complicações , Proctite/etiologia , Lesões por Radiação/complicações , Doenças Retais/tratamento farmacológico , Reto/efeitos da radiação , Recidiva , Falha de Tratamento , Úlcera/tratamento farmacológicoAssuntos
Doadores de Sangue , Hepatite B Crônica/diagnóstico , Hepatite B/diagnóstico , Reação Transfusional , Viremia/diagnóstico , Doença Aguda , Adulto , Doença de Crohn/complicações , Doença de Crohn/tratamento farmacológico , DNA Viral/sangue , Diagnóstico Diferencial , Reações Falso-Negativas , Hepatite B/transmissão , Anticorpos Anti-Hepatite B/sangue , Antígenos do Núcleo do Vírus da Hepatite B/imunologia , Antígenos de Superfície da Hepatite B/sangue , Vírus da Hepatite B/fisiologia , Humanos , Hospedeiro Imunocomprometido , Imunossupressores/farmacologia , Imunossupressores/uso terapêutico , Masculino , Ativação ViralAssuntos
Colestase Extra-Hepática/diagnóstico , Colonoscopia , Neoplasias dos Ductos Biliares/diagnóstico , Ductos Biliares Intra-Hepáticos , Colangiocarcinoma/complicações , Colangiocarcinoma/diagnóstico , Colestase Extra-Hepática/etiologia , Doença Crônica , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
We present here the case of a 31-year-old man that developed facial petechiae after unsedated upper gastrointestinal endoscopy. The lesions disappeared completely after 5 days. In English literature, only one patient similar to ours has been reported. The most likely explanation of this condition is a Valsalva maneuver that raised the intrathoracic or abdominal pressure and resulted in a rupture of capillaries in the skin. Endoscopists should therefore be aware of this rare and reversible complication.