Elevated 1-h post-load plasma glucose levels in normal glucose tolerance children with obesity is associated with early carotid atherosclerosis

CONTEXT

Evidence suggests that the 1-h post-load plasma glucose (1-h PG) ≥155mg/dL during an oral glucose tolerance test (OGTT) predicts development of type 2 diabetes (T2DM) and associated complications, among adults with normal glucose tolerance (NGT), but relevant data on children is scarce.

OBJECTIVES

To investigate whether NGT children with obesity whose 1-h PG is ≥155mg/dL have an increased carotid intima-media thickness (IMT) and exhibit non-alcoholic fatty liver disease (NAFLD) diagnosed by ultrasonography, as compared with NGT subjects with 1-h PG <155mg/dL and impaired glucose tolerance (IGT).

METHODS

Cardio-metabolic profile, OGTT, measurements of carotid IMT and liver ultrasonography were analyzed in 171 non-diabetic children with obesity. Subjects were divided into 3 groups: NGT subjects with a 1-h PG <155mg/dL, NGT subjects with a 1-h PG ≥155mg/dL, and IGT subjects.

RESULTS

As compared with NGT individuals with a 1-h PG <155mg/dL, NGT individuals with a 1-h PG ≥155mg/dL exhibited higher carotid IMT (0.75±0.15mm vs. 0.68±0.15mm; p<0.05). No significant differences were observed in carotid IMT between IGT and NGT subjects with a 1-h PG ≥155mg/dL (0.75±0.18mm vs 0.75±0.15mm; p>0.05). Of the three glycemic parameters, 1-h and 2-h PG, but not fasting glucose, were significantly correlated with carotid IMT. There were no significant differences for increased risk of having NAFLD between the three groups.

CONCLUSIONS

These data suggest that a value of 1-h PG ≥155mg/dL in children and adolescents with obesity is as important as IGT with respect to cardiovascular risks.

Contribution of diffusion-weighted imaging to diagnosis and staging of cervical cancer

BACKGROUND

Cervical cancer is the second most common female malignancy worldwide. Although its incidence has decreased in developed countries due to screening with Papanicolaou test, it is still the leading cause of cancer-related female death in developing countries.

AIMS

The aim of this study was to determine whether the apparent diffusion coefficient (ADC) measurements calculated from diffusion-weighted imaging (DWI) images had any contribution in differentiation of normal cervical tissue from malignant lesions preoperatively, and whether there was a correlation between the mean ADC values and tumor type, grade, or stage in malignant lesions.

STUDY DESIGN

Case-control study.

METHODS

Mean ADC values in 25 patients who had cervical cancer proved histopathologically, and 20 patients with otherwise normal uterus were compared. Also in the study group, mean ADC values were compared between histopathologic subtypes, tumor grades, and stages.

RESULTS

In the study group the mean ADC values (0.96±0.15×10(-3) mm(2)/s) were statistically lower than that of the control group (1.67±0.17×10(-3) mm(2)/s) (p<0.05). According to histopathologic sub-types there was no significant difference between mean ADC values of squamous cell cancer and adenocarcinoma (0.95×10(-3) mm(2)/s and 0.91×10(-3) mm(2)/s, respectively) (p>0.05). There was also no significant difference between the mean ADC values of the tumor grades (p>0.05). The mean ADC values in early stage cervical cancer (0.86±0.05×10(-3) mm(2)/s) were significantly lower than the mean ADC values in late stage disease (0.98±0.06×10(-3) mm(2)/s) (p<0.05).

CONCLUSION

ADC value measurements may provide useful information in diagnosis of cervical cancer as well as in preoperative assessment of the tumor stage.

Is quantitative diffusion-weighted MRI a reliable method in the assessment of the inflammatory activity in ulcerative colitis?

PURPOSE

We investigated the relationship between the apparent diffusion coefficient (ADC) values of the colonic wall and the pathologic pericolonic lymph nodes (PCLNs) and inflammatory activity in ulcerative colitis patients by diffusion-weighted magnetic resonance imaging (DW-MRI).

MATERIALS AND METHODS

A total of 28 ulcerative colitis patients (9 endoscopically active, 10 subacute and 9 in remission) were evaluated by DW-MRI with 0, 500 and 1000 s/mm² b-values. The ADC values of the rectum and sigmoid colon walls and the adjacent PCLNs were obtained for quantitative analysis. The DW-MRI findings were compared to the disease activity.

RESULTS

The ADC values of the sigmoid colon were similar in patients with active, subacute and remissive ulcerative colitis (P = 0.472). The ADC values of the rectum were different (P = 0.009) between patients in the active (1.08 ± 0.14×10⁻³ mm²/s) and subacute phases (1.13 ± 0.23×10⁻³ mm²/s) of disease and those in remission (1.29 ± 0.17×10⁻³ mm²/s). The ADC values of the PCLNs (P = 0.899) did not differ with respect to disease activity.

CONCLUSION

DW-MRI is useful in identifying disease activity in ulcerative colitis patients, especially with respect to the rectum. The ADC values of the rectum increase during remission and decrease in patients with active distal colitis. The ADC values of the PCLNs were not useful in determining disease activity.