Sex differences in the relationship between hepatic steatosis, mood and anxiety disorders.

OBJECTIVE: To investigate the association between non-alcoholic fatty liver disease (NAFLD), alcoholic liver disease (ALD), mental symptoms (mood, anxiety disorders and distress) by sex. METHODS: This a cross-sectional study performed in working-age adults from a Health Promotion Center (primary care) in São Paulo, Brazil. Self-reported mental symptoms from rating scales (21-item Beck Anxiety Inventory, Patient Health Questionnaire-9, and K6 distress scale) were evaluated by hepatic steatosis (NAFLD and ALD). Logistic regression models estimated the association between hepatic steatosis subtypes and mental symptoms by Odds ratios (OR) adjusted by confounders in the total sample and sex stratified. RESULTS: Among 7241 participants (70.5% men, median age: 45 years), the frequency of steatosis was of 30.7% (25.1% NAFLD), being higher in men than women (70.5% vs. 29.5%, p < 0.0001), regardless of the steatosis subtype. Metabolic risk factors were similar in both subtypes of steatosis, but not mental symptoms. Overall, NAFLD was inversely associated with anxiety (OR = 0.75, 95%CI 0.63-0.90) and positively associated with depression (OR = 1.17, 95%CI 1.00-1.38). On the other hand, ALD was positively associated with anxiety (OR = 1.51; 95%CI 1.15-2.00). In sex-stratified analyses, only men presented an association of anxiety symptoms with NAFLD (OR = 0.73; 95%CI 0.60-0.89) and ALD (OR = 1.60; 95%CI 1.18-2.16). CONCLUSIONS: The complex association between different types of steatosis (NAFLD and ALD), mood and anxiety disorders indicates the need for a deeper understanding of their common causal pathways.

Neck circumference as a marker of body adiposity in young to middle-aged adults.

OBJECTIVE: Neck circumference (NC) is a straightforward method for quantifying upper body adiposity without the limitations that other indices can have. Thus, this study aimed to analyze the relationship between NC, overall (body mass index [BMI]) and central obesity (waist circumference [WC]), and percentage of body fat (BF%) in men and women. METHODS: The associations with NC quartiles (first quartile: reference group), BMI ≥30 kg/m2, WC (>102 cm for men and >88 cm for women), and high BF% (≥21 for men and ≥29 for women) were compared and analyzed by logistic regression models adjusted for demographic characteristics, cardiovascular risk factors, and lean mass. RESULTS: In 4283 adults (mean age: 44 y, 71.8% of men), the mean NC was higher in men (40.5 cm, range: 32-55 cm) than women (34.5 cm, range: 28.5-46 cm). Among men, the fourth quartile of NC (42.5-55 cm) was positively associated with obesity (multivariable odds ratio [OR]: 2.28, 95% confidence interval [CI]: 1.1-4.48). Among women, the fourth quartile of NC (36.5-46 cm) was associated with increased WC (multivariable OR: 2.98; 95% CI: 1.59-5.60). Progressive increases in the ORs were noticed across the associations between NC quartiles (second to fourth) and high BF% in men and women. The highest ORs were observed for the associations between high BF% and the fourth quartiles of NC in men (multivariable OR: 2.42; 95% CI: 1.49-3.93) and in women (multivariable OR: 29.19; 95% CI: 14.01-60.84). CONCLUSIONS: The utility of NC as a measurement of obesity in clinical practice was demonstrated in this large sample of young to middle-aged adults. The highest NC values were positively associated with overall obesity in men and central obesity in women. Moreover, NC was closely associated with high BF% in both sexes, particularly in women.

The Th17 pathway in the peripheral lung microenvironment interacts with expression of collagen V in the late state of experimental pulmonary fibrosis.

BACKGROUND: Myofibroblasts derived from fibroblasts in the pathogenesis of pulmonary fibrosis causes excessive and disordered deposition of matrix proteins, including collagen V, which can cause a Th17-mediated immune response and lead to apoptosis. However, whether the intrinsic ability of lung FBs to produce the matrix depends on their site-specific variations is not known. AIM: To investigate the link between Th17 and collagen V that maintains pulmonary remodeling in the peripheral lung microenvironment during the late stage of experimental pulmonary fibrosis. METHODS: Young male mice including wild Balb/c mice (BALB, n=10), wild C57 Black/6J mice (C57, n=10) and IL-17 receptor A knockout mice (KO, n=8), were sacrificed 21 days after treatment with bleomycin. Picrosirius red staining, immunohistochemistry for IL-17-related markers and "in situ" detection of apoptosis, immunofluorescence for collagen types I and V, primary cell cultures from tissue lung explants for RT-PCR and electron microscopy were used. RESULTS: The peripheral deposition of extracellular matrix components by myofibroblasts during the late stage is maintained in C57 mice compared with that in Balb mice and is not changed in the absence of IL-17 receptor A; however, the absence of IL-17 receptor A induces overexpression of type V collagen, amplifies the peripheral expression of IL-17 and IL-17-related cytokines and reduces peripheral lung fibroblast apoptosis. CONCLUSION: A positive feedback loop between the expression patterns of collagen V and IL-17 may coordinate the maintenance of peripheral collagen I in the absence of IL-17 receptor A in fibrosis-susceptible strains in a site-specific manner.