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Objective: This study evaluated whether sarcopenic obesity is closely associated with muscle quality using abdominal computed tomography. Methods: This cross‐sectional study included 13,612 participants who underwent abdominal computed tomography. The cross‐sectional area of the skeletal muscle was measured at the L3 level (total abdominal muscle area [TAMA]) and segmented into normal attenuation muscle area (NAMA, +30 to +150 Hounsfield units), low attenuation muscle area (−29 to +29 Hounsfield units), and intramuscular adipose tissue (−190 to −30 Hounsfield units). The NAMA/TAMA index was calculated by dividing NAMA by TAMA and multiplying by 100, and the lowest quartile of NAMA/TAMA index was defined as myosteatosis (<73.56 in men and <66.97 in women). Sarcopenia was defined using BMI‐adjusted appendicular skeletal muscle mass. Results: The prevalence of myosteatosis was found to be significantly higher in participants with sarcopenic obesity (17.9% vs. 54.2%, p < 0.001) than the control group without sarcopenia or obesity. Compared with the control group, the odds ratio (95% CI) for having myosteatosis was 3.70 (2.87–4.76) for participants with sarcopenic obesity after adjusting for age, sex, smoking, drinking, exercise, hypertension, diabetes, low‐density lipoprotein cholesterol, and high‐sensitivity C‐reactive protein. Conclusions: Sarcopenic obesity is significantly associated with myosteatosis, which is representative of poor muscle quality. [ABSTRACT FROM AUTHOR]

Background: The association of the risk of colorectal cancer (CRC) with obesity or obesity‐induced metabolic disturbances remains controversial. We assessed the association of metabolic health status with incident CRC among subjects with obesity. Methods: This study included 319,397 subjects from the Korean National Health Insurance Service‐National Health Screening Cohort. Transitions in metabolic health status and obesity were examined during 2009–2010 and 2011–2012. We categorized subjects with obesity into four separate groups according to their dynamic metabolic health status: metabolically healthy obesity (MHO), MHO to metabolically unhealthy obesity (MUO), MUO to MHO, and stable MUO. Subjects were followed up from 2009 to 2015 for incident CRC. Results: The stable MHO group showed no increased risk of incident CRC (hazard ratio [HR], 0.97; 95% confidence interval [CI], 0.83–1.14). However, the MHO to MUO group had a higher risk of incident CRC than the stable metabolically healthy nonobese (MHNO) group (HR, 1.34; 95% CI, 1.15–1.57). Among patients with MUO at baseline, those in the subgroup who transitioned to MHO group were not at increased risk of CRC (HR, 1.06; 95% CI, 0.91–1.25), whereas those who remained in the stable MUO group had a higher risk of incident CRC than those in the stable MHNO group (HR, 1.29; 95% CI, 1.19–1.41). Conclusions: The transition of metabolic health was a determining factor for CRC among subjects with obesity. Hence, maintenance or recovery of metabolic health should be addressed to prevent CRC in individuals with obesity. [ABSTRACT FROM AUTHOR]

Keywords: digenic inheritance; hypogonadotropic hypogonadism; maturity-onset diabetes of the young EN digenic inheritance hypogonadotropic hypogonadism maturity-onset diabetes of the young 554 557 4 05/14/20 20200601 NES 200601 Normosmic congenital hypogonadotropic hypogonadism (NHH) denotes Kallmann syndrome without anosmia or hyposmia. The WES of the proband revealed heterozygous missense mutations in the I PCSK1 i (c.239G > A, p.Arg80Gln, rs1799904) and I CHD7 i (c.6107C > T, p.Pro2036Leu, rs369543203) genes. Furthermore, the proband had a homozygous missense mutation in the I PAX4 i gene (c.575G > A, p.Arg192His, rs2233580), which is also known as the MODY 9 gene.[3] Interestingly, both parents were heterozygous for this mutation. [Extracted from the article]

Objectives: The hemoglobin glycation index (HGI) quantifies interindividual variations in glycated hemoglobin (HbA1c) and is associated with diabetic complications and metabolic diseases. However, information on the association between HGI and non‐alcoholic fatty liver disease (NAFLD) in healthy subjects is limited, particularly in Asian populations. This study aimed to investigate the association between HGI and NAFLD in a healthy Korean cohort. Design: Subjects were stratified in quartiles according to their HGI level. NAFLD was diagnosed by hepatic ultrasonography, hepatic steatosis index and fatty liver index. Multiple logistic regression analysis was performed to evaluate the association between HGI quartiles and the risk of NAFLD. Patients: Data from subjects without diabetes who underwent liver ultrasonography during routine health examinations were retrospectively reviewed. Results: Data from 14 465 subjects were included in the analysis. The prevalence of NAFLD increased significantly with each HGI quartile (24.8%, 29.7%, 32.6% and 40.6% in quartiles 1‐4, respectively; P < 0.001). In comparison with the lowest HGI quartile group, the highest quartile exhibited worse metabolic parameters, including body weight, waist circumference, body mass index and lipid profiles. Multiple logistic regression analysis adjusted for multiple factors showed that the odds ratio of having NAFLD was 1.564 (95% CI: 1.350‐1.813, P < 0.001) in the highest HGI quartile. Conclusions: Elevated HGI levels are independently associated with NAFLD in a healthy Asian population. [ABSTRACT FROM AUTHOR]

Abstract: Aims/Introduction: We aimed to evaluate the efficacy and safety of pioglitazone (PIO) and sodium–glucose cotransporter 2 inhibitors (SGLT2i) as additions to insulin therapy for the management of type 2 diabetes mellitus. Materials and Methods: We searched PubMed, EMBASE, the Cochrane Central Register of Controlled Trials and ClinicalTrials.gov through December 2016. Randomized controlled trials published in English that compared SGLT2i plus insulin (SGLT2i/INS) or PIO plus insulin (PIO/INS) with placebo plus insulin (PCB/INS) in type 2 diabetes mellitus patients were included. We compared the efficacy and safety between SGLT2i/INS and PIO/INS indirectly. Results: A total of 14 randomized controlled trials comparing 7,226 participants were included (8 SGLT2i and 6 PIO studies). SGLT2i/INS achieved similar reductions in hemoglobin A1c (weighted mean difference [WMD] −0.01% [−0.1 mmol/mol], 95% confidence interval [CI] −0.25 to 0.22% [−2.7 to −2.4 mmol/mol]; P = 0.896) and fasting plasma glucose (WMD −0.90 mg/dL, 95% CI: −15.50 to 13.71 mg/dL; P = 0.904), and a similar proportion of participants achieved hemoglobin A1c <7.0% (<53.0 mmol/mol; relative risk 0.98, 95% CI: 0.73 to 1.33; P = 0.917) as compared with the PIO/INS group, with greater weight reduction (WMD −4.54 kg, 95% CI: −5.67 to −3.41 kg; P < 0.001). PIO/INS showed non‐significant trends toward a higher risk of hypoglycemia (relative risk 1.15, 95% CI: 0.97 to 1.35; P = 0.102) and higher reduction of total daily insulin doses (WMD −2.45 IU/day, 95% CI: −7.30 to 2.40 IU/day; P = 0.438). Conclusions: Both PIO and SGLT2i are feasible adjunctive oral agents to pre‐existing insulin therapy in individuals with inadequately controlled type 2 diabetes mellitus. [ABSTRACT FROM AUTHOR]