The potential prognostic novel markers PIV and PILE score to predict survival outcomes at hepatocellular cancer.

OBJECTIVE: We aimed at investigating the prognostic significance of a novel immune marker, PIV and PILE score (a score composite from PIV, LDH and ECOG PS), in patients with HCC in a single center. PATIENTS AND METHODS: 120 patients who met the criteria were included. PIV and PILE at the time of diagnosis were computed retrospectively. For PIV, the median value of 286.15 was taken as the cut-off. While <286.15 was considered low, ≥286.15 was considered high PIV. The PILE score included PIV (< median vs. ≥ median), lactate dehydrogenase level (

The easy way of evaluating exocrine pancreatic insufficiency in type 2 diabetes : listen to the patients' complaints and look in their eyes!

BACKGROUND AND STUDY AIMS: The objective of this study is to determine the prevalence of exocrine pancreatic insufficiency (EPI) in diabetic patients, and to investigate whether there is a relationship between EPI and diabetes period, gastrointestinal complaints and other diabetic microvascular complications. PATIENTS AND METHODS: A total of 93 participants, consisting of 57 type 2 diabetes patients and 36 healthy volunteers have been included in our cross-sectional study. Participants were questioned for abdominal complaints and weight loss. Fecal elastase-1 (FE-1) was determined in fecal spot samples received from participants. The relationship between EPI and blood glucose, HbA1c, and duration and complications of diabetes were investigated. RESULTS: FE-1 levels were significantly lower in diabetic group compared to control group (p=0.007). The number of patients with FE-1 levels of <200µg/g were significantly higher in diabetic group (p=0.002). A statistically significant negative correlation was determined between FE-1 levels and the duration of diabetes (r= -0.453 p<0.001). FE-1 levels were significantly lower in patients with retinopathy (p= 0.014). In the post-hoc analysis, this difference was due to patients in the proliferative retinopathy group. A significant negative correlation was determined between the presence of retinopathy and FE-1 levels (r=-0.32, p=0.02). Abdominal pain and distension complaints were independent predictive factors that estimate EPI. CONCLUSIONS: An important part of type 2 diabetes patients has EPI and it should be considered in diabetes patients upon abdominal pain and distension. Determination of proliferative retinopathy in the eye examination may also suggest an idea on the possible presence of EPI.

The role of insulin - like growth factor - 1 on steatohepatitis.

PURPOSE: Recent studies have revealed that growth hormone and STAT5 were related to hepatosteatosis in mice. Loss of signal transducer and activator of transcription factor-5 leads to hepatosteatosis and impaired liver regeneration. We aimed to investigate the role of IGF-1 in steatosis with normal (SNLFT) and disturbed liver function tests (SDLFT) in humans. METHODS: We included 272 NAFLD patients and 110 age, sex and body mass index (BMI)-matched healty controls. We measured routine blood biochemistry and complete blood count, IGF-1, insulin, c-peptide, ferritin, hsCRP, ESR and HOMA-IR. We subdivided NAFLD patients into SNLFT and SDLFT subgroups. RESULTS: ge, sex and BMI were similar between NAFLD and controls. IGF-1 levels were significantly lower in NAFLD patients (120,6±48,2) than controls (148,9±53,8), (<0,0001). IGF-1 levels were also lower in SDLFT subgroup (93,4±27,8) than SNLFT subgroup (123,1±49,0), (p:0,032). Waist circumference, fasting blood glucose, HbA1c, uric acid, hsCRP, AST, ALT, GGT, WBC, hemoglobin, hematocrit, ferritin, insulin, c-peptid and HOMA-IR measurements were significantly higher in NAFLD patients than controls (for all values: p<0,0001).Cholesterol (p:0,026), triglycerides (p<0,0001), ESR (p:0,006) were significantly higher in NAFLD patients than controls. HDL-chelesterol levels were significantly lower (p:0,002) in NAFLD patients than controls. CONCLUSION: This study supported previous findings of experi-mental studies in that, IGF-1 levels were lower in SNLFT and SDLFT. Growth hormone-IGF-1 system may be involved in the pathogenesis of NAFLD.