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Yegurla J, Qamar S, Gopi S, Madhusudhan KS, Agarwal S, Sati HC, Mani K, Tandon N, Gunjan D, Saraya A. Opportunistic screening for osteopathy with routine abdominal computed tomography scan in chronic pancreatitis. Pancreatology 2024; 24:41-47. [PMID: 38072684 DOI: 10.1016/j.pan.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/28/2023] [Accepted: 11/13/2023] [Indexed: 01/27/2024]
Abstract
BACKGROUND AND AIMS Lumbar vertebral bone attenuation, measured in Hounsfield units (HU) can indirectly indicate the bone mineral density (BMD). The aim of this study is to determine the optimal HU threshold on abdominal computed tomography (CT) scans to detect osteopathy in patients with chronic pancreatitis (CP). METHODS This cross-sectional study included patients with CP who underwent CT scans to measure HU at L1 to L4 vertebrae. The mean lumbar vertebral attenuation of female renal transplant donors, aged 20-30 years was utilized to calculate the T-scoreHU of all patients at each vertebral level. Receiver operator characteristic analysis was used to determine the HU and T-scoreHU for diagnosis of osteopathy in patients with CP. Dual-energy X-ray absorptiometry value was used to categorize osteopenia and osteoporosis. RESULTS A total of 175 patients (mean age, 34.5 ± 10.9 years; 72 % males) and 33 female renal transplant donors (mean age, 28 ± 2.4 years) were included. A threshold HU value 212 or T scoreHU of -1.80 at L1 vertebra was found to have a 78 % sensitivity and 70 % specificity for differentiating between osteoporosis and non-osteoporosis (osteopenia and normal BMD). Similarly, a threshold HU value of 254 or a T-scoreHU of -0.46 at L1 vertebra had 78 % sensitivity and 71 % specificity for distinguishing between normal and low BMD (osteoporosis and osteopenia). CONCLUSION Abdominal CT images, which are routinely performed in chronic pancreatitis, can be used for opportunistic screening of osteoporosis and osteopenia without additional cost or radiation exposure.
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Affiliation(s)
- Jatin Yegurla
- Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, India
| | - Sumaira Qamar
- Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, India
| | - Srikanth Gopi
- Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, India
| | - K S Madhusudhan
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Samagra Agarwal
- Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, India
| | - Hem Chandra Sati
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Kalaivani Mani
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Nikhil Tandon
- Department of Endocrinology, All India Institute of Medical Sciences, New Delhi, India
| | - Deepak Gunjan
- Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, India.
| | - Anoop Saraya
- Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, India.
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Chen KH, Chou LF, Hung CC, Tang HY, Cheng ML, Yang HY, Hsu HH, Tian YC, Yang CW. Integrated Metabolomic and Transcriptomic Analysis of Acute Kidney Injury Caused by Leptospira Infection. Pathogens 2022; 11:pathogens11070764. [PMID: 35890009 PMCID: PMC9316537 DOI: 10.3390/pathogens11070764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/06/2022] [Accepted: 07/01/2022] [Indexed: 11/16/2022] Open
Abstract
Renal leptospirosis caused by leptospiral infection is characterised by tubulointerstitial nephritis and tubular dysfunction, resulting in acute and chronic kidney injury. Metabolomic and transcriptomic data from a murine model of Leptospira infection were analysed to determine whether metabolomic data from urine were associated with transcriptome changes relevant to kidney injury caused by Leptospira infection. Our findings revealed that 37 metabolites from the urine of L. interrogans-infected mice had significantly different concentrations than L. biflexa-infected and non-infected control mice. Of these, urinary L-carnitine and acetyl-L-carnitine levels were remarkably elevated in L. interrogans-infected mice. Using an integrated pathway analysis, we found that L-carnitine and acetyl-L-carnitine were involved in metabolic pathways such as fatty acid activation, the mitochondrial L-carnitine shuttle pathway, and triacylglycerol biosynthesis that were enriched in the renal tissues of the L. interrogans-infected mice. This study highlights that L-carnitine and acetyl-L-carnitine are implicated in leptospiral infection-induced kidney injury, suggesting their potential as metabolic modulators.
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Affiliation(s)
- Kuan-Hsing Chen
- Kidney Research Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (K.-H.C.); (L.-F.C.); (C.-C.H.); (H.-Y.Y.); (H.-H.H.); (Y.-C.T.)
- Healthy Aging Research Center, Chang Gung University, Taoyuan 333, Taiwan; (H.-Y.T.); (M.-L.C.)
- Metabolomics Core Laboratory, Chang Gung University, Taoyuan 333, Taiwan
| | - Li-Fang Chou
- Kidney Research Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (K.-H.C.); (L.-F.C.); (C.-C.H.); (H.-Y.Y.); (H.-H.H.); (Y.-C.T.)
| | - Cheng-Chieh Hung
- Kidney Research Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (K.-H.C.); (L.-F.C.); (C.-C.H.); (H.-Y.Y.); (H.-H.H.); (Y.-C.T.)
| | - Hsiang-Yu Tang
- Healthy Aging Research Center, Chang Gung University, Taoyuan 333, Taiwan; (H.-Y.T.); (M.-L.C.)
- Metabolomics Core Laboratory, Chang Gung University, Taoyuan 333, Taiwan
- Department of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Clinical Phenome Center, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan
| | - Mei-Ling Cheng
- Healthy Aging Research Center, Chang Gung University, Taoyuan 333, Taiwan; (H.-Y.T.); (M.-L.C.)
- Metabolomics Core Laboratory, Chang Gung University, Taoyuan 333, Taiwan
- Department of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Clinical Phenome Center, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan
| | - Huang-Yu Yang
- Kidney Research Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (K.-H.C.); (L.-F.C.); (C.-C.H.); (H.-Y.Y.); (H.-H.H.); (Y.-C.T.)
| | - Hsiang-Hao Hsu
- Kidney Research Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (K.-H.C.); (L.-F.C.); (C.-C.H.); (H.-Y.Y.); (H.-H.H.); (Y.-C.T.)
| | - Ya-Chung Tian
- Kidney Research Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (K.-H.C.); (L.-F.C.); (C.-C.H.); (H.-Y.Y.); (H.-H.H.); (Y.-C.T.)
| | - Chih-Wei Yang
- Kidney Research Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (K.-H.C.); (L.-F.C.); (C.-C.H.); (H.-Y.Y.); (H.-H.H.); (Y.-C.T.)
- Correspondence:
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