Hunting of Rare, Exotic Antelopes Now Limited under New U.S. Rule.


A new U.S. rule went into effect this week that—after years of legal wrangling—places limitations on hunting of three critically endangered African antelope species: the scimitar-horned oryx (Oryx dammah), addax (Addax nasomaculatus) and dama gazelle (Nanger dama). Although almost nonexistent in their homelands, thousands of these animals have been raised in captivity and now live on private ranches in Texas.

When the three species were first protected under the Endangered Species Act (ESA) in 2005, the U.S. Fish and Wildlife Service (FWS) added what is known as a “blanket exception” that allowed captive-bred animals to be hunted on private ranches. The animals are highly valued by hunters and routinely fetched prices of $5,000 or more from people looking for “exotic” trophies.

The logic behind the blanket exception was simple: the private hunting ranches had bred so many of the endangered antelopes over the years that they had, according to FWS, “contributed greatly to the conservation of these species.” Conservationists, however, argued that the blanket exception was a violation of the intentions of the ESA, which normally prohibits hunting of endangered animals. The courts, after much back and forth, eventually agreed, and in January the FWS published a new rule that requires individuals “who possess these three antelope species and wish to carry out otherwise prohibited activities, including interstate or foreign commerce, import, export, culling or other forms of take, [to] obtain a permit or other authorization.” That rule took effect on April 4.

Ranchers have been arguing for years that removal of the blanket exception would also remove any financial incentive for them to keep the antelopes alive on their lands. When I wrote about this subject in 2009, one rancher commented on my story: “Since we can’t hunt and eat them anymore, the ranch I work on will now be forced to stop its breeding program and exterminate the remaining stock as feral pests.” Many other ranchers have said that they would go so far as to kill off their stock or release them into the wild—actions FWS points out are illegal under the ESA.

The industry’s main spokesperson is Charly Seale, executive director of the Exotic Wildlife Association, who told the Associated Press that many ranches, his own included, have sold off their antelopes. Seale also said that the average price tag for hunting the animals has already dropped 50 percent and will further plummet now that the new rule has taken effect.

But that’s the thing: the new rule still allows hunting of these three endangered species. Ranches just need to apply for two permits first, one to register captive-born wildlife, which costs $200 and lasts for five years, and another allowing “culling” and interstate traffic, which costs $100, lasts one year and has a rapid-renewal process. It is still legal to own and breed the animals even without a permit. FWS has promised that the permit process will take fewer than 90 days, and the agency aims to reduce that to 60 days or fewer. (The full FWS’s FAQ on the process is here.

Unfortunately, that’s apparently too much government intrusion for some property rights–conscious Texans. Seale told the AP that only 10 percent of the ranches that currently hold these antelope species have applied for the permits. “Ranchers in this country are very private-property individuals,” Seale told McClatchy Newspapers. “We bought the animals with our own money and they’re telling us what to do with them. They are not anybody’s animals but ours.” FWS spokesperson Vanessa Kauffman told McClatchy that approximately 50 ranches out of the 400 that belong to the Exotic Wildlife Association have applied for permits, half of which have already been approved.

Yes, most ranches are purposefully getting out of the antelope business rather than paying a few hundred dollars and filling out a couple of forms. Seale told both the AP and McClatchy that this is the beginning of the end for exotic antelopes in Texas, saying the herds of thousands of animals will soon shrink to fewer than 1,000.

Ranchers and hunters accuse conservationists of dooming the three species to extinction in the name of ideals. Friends of Animals, the organization that filed the lawsuits that inspired the new FWS rule, says breeding rare animals solely to be hunted is not conservation. “It’s merely commercial exploitation in a strange, macabre touristy world,” Friends of Animals Vice President for Legal Affairs, Lee Hall, told McClatchy. In January the organization’s president, Priscilla Feral, told CBS’s 60 Minutes that she would rather see the animals not exist at all in Texas than have them living there only to be hunted.

One place the scimitar-horned Oryx won’t disappear is the same place where they started in Texas: Selah Bamberger Preserve, home of the Scimitar-Horned Oryx Survival Program. The preserve was founded by David Bamberger, who in 1980 devoted more than 240 hectares of his 2,225-hectare ranch to the animals, which were gathered there from zoos across the U.S. and Europe, in all likelihood saving the species from extinction in the process. Today, many zoos maintain captive breeding populations of these animals, but that might never have been possible if Bamberger had not stepped up first. Of course, Bamberger’s ranch also provided many of the animals raised there to brokers, who in turn sold them to Texas hunting ranches, which is how we ended up with this conundrum in the first place.

Meanwhile, some ranches will continue to allow hunting while also possibly going back to the courts to try to remove the new rule. “We’re not giving up on these species,” Kevin Reid, owner of Morani River Ranch in Texas, told McClatchy. “We’re not going to get rid of them. We’re continuing our plan to manage the herd and shoot the old males past breeding age. That’s what we hunt.”

Even though they still raise these endangered species to ultimately be hunted, not conserved, it’s people like Bamberger and Reid who blow holes in the arguments of ranchers like Seale, who would rather be possessive, stubborn and spiteful than lift a finger to do anything they don’t want to do. These ranchers claim to love the animals they raise and shoot. Their actions tell a different story.

Source: Scientific American.

 

What Can an Octopus Teach Us About National Security? A Q&A with Ecologist Rafe Sagarin.


Octopuses possess camouflage abilities that put some of our military’s best high-tech efforts to shame. And their flexible, intelligent arms are the envy of roboticists and artificial intelligence engineers worldwide.

But these animals, which have evolved over hundreds of millions of years, can teach us even more about security in the 21st century than camo and communications, Rafe Sagarin argues in his new book Learning from the Octopus: How secrets from nature can help us fight terrorist attacks, natural disasters and disease .

Sagarin suggests we take cues from octopuses and other organisms in the natural world to make our responses to all kinds of threats—from sophisticated terrorist cells to emerging infections—more robust and adaptable.

Sagarin is a research scientist at the University of Arizona’s Institute of the Environment. Trained as a marine ecologist, he has spent a lot of time gazing into the ocean, thinking about the marvels of animal adaptability in the face of danger, which is what got him thinking about these impressive cephalopods.

Octopuses lack a protective shell—as well as any internal skeleton. So they have developed a myriad of strategies for staying safe (which leads us to the first three lessons for improved security: redundancy, redundancy, redundancy).

When an octopus is out and about, “millions of cells on the surface of its skin are all sensing and responding to the world around, instantly changing shape and color to perfectly match their immediate surroundings,” he writes in his book.

Once, after staring at a tide pool in Baja California for a long time, I thought I spied an octopus, but the small waves cresting the tide pool walls riffled the surface too much to be sure. My eyes failing me, I reached my hand in to engage my tactile senses, and instantly a dark cloud of smoky ink filled the pool. By the time it cleared, I had confirmed my identification, but the beast was long gone.

It’s hard to imagine humans ever being quite this stealthy (read more about this research in Sagarin’s book). But what I really wanted to know was how he made this cool conceptual leap from thinking about slippery invertebrates to beefed up national security, anyway. I called him up just before he left for his book tour to find out.

What first got you thinking about the octopus as a good animal for thinking about security issues?
I first was thinking about nature in general as a good model because of the way all natural organisms have to deal with uncertainty and how they have to adapt to an uncertain world. I started to think about organisms as metaphors and octopuses kept coming to the top. They express their adaptability in so many different ways.

You already hinted at an answer to my next question—do you think of the octopus as an example to follow or more as a metaphor?
It’s both, really. In some cases, it’s just a metaphor because there are translational issues—because we have certain ethical norms and different political and economic realities where we can’t do exactly what nature does.

In some cases it does work well to decentralize observing [as the octopus does via its skin cells]. And those are some of the things it works to adopt almost verbatim from nature.

Why not squid or cuttlefish?
I’ve always had a fondness for octopuses. Even though squid and cuttlefish have some really remarkable abilities, octopuses really have it all. They’re probably more intelligent than squid or cuttlefish; they have the camouflage ability; they also think about things and plan out what they are going to do.

Another thing they do is they show is that a lot of the boundaries we’ve put up in the past between humans and other organisms in the living world have already been crossed. Octopuses already do things we were often told that non-humans just don’t do [such as use tools]. They’re a really good exemplar of this general point that humans and the rest of the animal world are different—but not that different.

You also mention in your book the ability of octopuses to use tools and plan for the future, which I think we consider ourselves pretty good at, as a species—is there still something more we can learn from that?
I think it’s that we have to not be so prejudiced against taking advice from the rest of the natural world. If we can get over that thinking that there’s a boundary [between us and it], then we can open our minds to the ideas that we can learn from these other organisms.

So you’re trained as a marine ecologist, but you also seem to dabble in policy and security issues. These seem like pretty different fields—how did you get into those areas?
I’ve always been interested in the interface between science and policy. I worked for Congresswoman Hilda Solis for a while, and that’s really where this particular project started. I was working in D.C. after 9/11, and I remember noticing all this extra security but not being very impressed by it, by its adaptability and ability to meet a changing threat.

If we could borrow one thing—one lesson—from the octopus what do you think it should be?
I think it’s this combination of having a lot of ways to see change in the world, combined with a lot of ways to respond to that change: Having redundancy in the way you see the world, as the skin cells of the octopus demonstrate, but then having a lot of ways to respond to that change.

If you can always try to make that combination in what you’re doing, you’re going to be a lot more successful, rather than relying on a small number of responders and a small number of “best practices.”

What lesson from the octopus do you think will be most difficult for us to integrate into our current way of thinking?
In talking to people it seems the most difficult is a fear of getting started, a feeling that: “We’re already stuck in these huge bureaucracies that are not at all like the decentralized concepts you’re talking about.” But what you find is that when people in these organizations start to do these things on their own, things start to fall into place. My big thing is: “Just get started.” Start by having people respond to unusual challenges.

Okay, so we both seem to agree that the octopus is awesome. But if you had to look to another animal for bio-inspiration—to help us learn how to respond to challenges better—what would you pick?
That’s a hard one. It really depends on the lesson. There are exemplary species for many lessons. Communicating with an enemy is an important one. It’s really interesting to see that ground squirrels send very direct messages to their predators that can hear—very loud noises. But for snakes that can’t hear, a squirrel puffs up its tail. But if it’s a rattlesnake that can sense heat, a squirrel will heat up its tail. That shows that the squirrel has learned to communicate with its predators in its predators’ own languages, rather than send out vague messages—like we do with airport security messages. Saying that we’re at “threat level orange” communicates to our enemies that we really don’t know anything.

Anything else?
Organisms in nature have survived and thrived for three and a half billion years, and they’ve done it without any kind of planning or predicting, or anything that we spend so much of our time doing. They have a very efficient process for dealing with unknown threats.

Source: Scientific American.

 

 

 

Long-Term Follow-Up of Gut-Directed Hypnotherapy vs. Standard Care in Children With Functional Abdominal Pain or Irritable Bowel Syndrome.


We previously showed that gut-directed hypnotherapy (HT) is highly effective in the treatment of children with functional abdominal pain (FAP) and irritable bowel syndrome (IBS). Aim of this follow-up study was to investigate the long-term effects of HT vs. standard medical treatment plus supportive therapy (SMT).

METHODS:

All 52 participants of our previous randomized controlled trial (RCT) were invited to complete a standardized abdominal pain diary, on which pain frequency and pain intensity were scored. Furthermore, the Children’s Somatization Inventory (CSI) and a general quality of life (QOL) questionnaire were filled out. Clinical remission was defined as >80% improvement in pain scores compared with baseline.

RESULTS:

All 27 HT patients and 22 out of 25 SMT patients participated in this study. Two patients of the SMT group were lost to follow-up and one refused to participate. After a mean duration of 4.8 years follow-up (3.4–6.7), HT was still highly superior to conventional therapy with 68 vs. 20% of the patients in remission after treatment (P=0.005). Pain intensity and pain frequency scores at follow-up were 2.8 and 2.3, respectively, in the HT group compared with 7.3 and 7.1 in the SMT group (P<0.01). Also, somatization scores were lower in the HT group (15.2 vs. 22.8; P=0.04). No differences were found in QOL, doctors’ visits, and missed days of school or work between the two groups.

CONCLUSIONS:

 

The beneficial effects of gut-directed HT are long lasting in children with FAP or IBS with two thirds still in remission almost 5 years after treatment, making it a highly valuable therapeutic option.

Source: American Journal of Gastroenterology.

Use of Antidiabetic Agents and the Risk of Pancreatic Cancer: A Case–Control Analysis.


The objective of this study was to explore the association between use of metformin or other antidiabetic drugs, diabetes, and the risk of pancreatic cancer.

METHODS:

We conducted a case–control study using the UK-based General Practice Research Database (GPRD). Cases had a first-time diagnosis of pancreatic cancer, and six controls per case were matched on age, sex, calendar time, general practice, and number of years of active history in the GPRD before the index date. Results were further adjusted in multivariate logistic regression analyses for potential confounders such as body mass index, smoking, alcohol consumption, and diabetes duration.

RESULTS:

In all, 2,763 case patients with a recorded diagnosis of pancreatic cancer were identified. Mean age±s.d. was 69.5±11.0 years. Long-term use (≥30 prescriptions) of metformin was not associated with a materially altered risk of pancreatic cancer (adjusted odds ratio (adj. OR): 0.87, 95% confidence interval (CI): 0.59–1.29), but there was a suggestion of effect modification by gender, as long-term use of metformin was linked to a decreased risk in women (adj. OR: 0.43, 95% CI: 0.23–0.80). Both use of sulfonylureas (≥30 prescriptions, adj. OR: 1.90, 95% CI: 1.32–2.74) and of insulin (≥40 prescriptions, adj. OR: 2.29, 95% CI: 1.34–3.92) were associated with an increased risk of pancreatic cancer.

CONCLUSIONS:

 

Use of metformin was associated with a decreased risk of pancreatic cancer in women only, whereas use of sulfonylureas and of insulin was associated with an increased risk of pancreatic cancer.

Source: American Journal of Gastroenterology.

 

 

 

A Comparative Evaluation of Radiologic and Clinical Scoring Systems in the Early Prediction of Severity in Acute Pancreatitis.


The early identification of clinically severe acute pancreatitis (AP) is critical for the triage and treatment of patients. The aim of this study was to compare the accuracy of computed tomography (CT) and clinical scoring systems for predicting the severity of AP on admission.

METHODS:

Demographic, clinical, and laboratory data of all consecutive patients with a primary diagnosis of AP during a two-and-half-year period was prospectively collected for this study. A retrospective analysis of the abdominal CT data was performed. Seven CT scoring systems (CT severity index (CTSI), modified CT severity index (MCTSI), pancreatic size index (PSI), extrapancreatic score (EP), ‘‘extrapancreatic inflammation on CT’’ score (EPIC), ‘‘mesenteric oedema and peritoneal fluid’’ score (MOP), and Balthazar grade) as well as two clinical scoring systems: Acute Physiology, Age, and Chronic Health Evaluation (APACHE)-II and Bedside Index for Severity in AP (BISAP) were comparatively evaluated with regard to their ability to predict the severity of AP on admission (first 24 h of hospitalization). Clinically severe AP was defined as one or more of the following: mortality, persistent organ failure and/or the presence of local pancreatic complications that require intervention. All CT scans were reviewed in consensus by two radiologists, each blinded to patient outcome. The accuracy of each imaging and clinical scoring system for predicting the severity of AP was assessed using receiver operating curve analysis.

RESULTS:

Of 346 consecutive episodes of AP, there were 159 (46%) episodes in 150 patients (84 men, 66 women; mean age, 54 years; age range, 21–91 years) who were evaluated with a contrast-enhanced CT scan (n=131 episodes) or an unenhanced CT scan (n=28 episodes) on the first day of admission. Clinically severe AP was diagnosed in 29/159 (18%) episodes; 9 (6%) patients died. Overall, the Balthazar grading system (any CT technique) and CTSI (contrast-enhanced CT only) demonstrated the highest accuracy among the CT scoring systems for predicting severity, but this was not statistically significant. There were no statistically significant differences between the predictive accuracies of CT and clinical scoring systems.

CONCLUSIONS:

The predictive accuracy of CT scoring systems for severity of AP is similar to clinical scoring systems. Hence, a CT on admission solely for severity assessment in AP is not recommended.

Source: American Journal of Gastroenterology.

Impaired Control of Effector T Cells by Regulatory T Cells: A Clue to Loss of Oral Tolerance and Autoimmunity in Celiac Disease?


Regulatory T cells (Tregs) are instrumental for tolerance to self-antigens and dietary proteins. We have previously shown that interleukin (IL)-15, a cytokine overexpressed in the intestine of patients with celiac disease (CD), does not impair the generation of functional Tregs but renders human T cells resistant to Treg suppression. Treg numbers and responses of intestinal and peripheral T lymphocytes to suppression by Tregs were therefore compared in CD patients and controls.

METHODS:

Intraepithelial lymphocytes (IELs) and lamina propria lymphocytes (LPLs) were isolated from duodenal biopsy specimens of CD patients and controls. Concomitantly, CD4+CD25+ T lymphocytes (Tregs) were purified from blood. Responses of IELs and of LPLs, and peripheral lymphocytes (PBLs) to suppression by Tregs were tested by analyzing anti-CD3-induced proliferation and interferon (IFN)-γ production in the presence or absence of peripheral Tregs. Lamina propria and peripheral CD4+CD25+FOXP3+ T cells were assessed by flow cytometry.

RESULTS:

Although percentages of CD4+CD25+FOXP3+ LPLs were significantly increased in patients with active CD, proliferation and IFN-γ production of intestinal T lymphocytes were significantly less inhibited by autologous or heterologous Tregs in CD patients than in controls (P<0.01). In all tested CD patients, IEL were unable to respond to Tregs. Resistance of LPLs and PBLs to Treg suppression was observed in patients with villous atrophy who had significantly enhanced serum levels of IL-15 compared with patients without villous atrophy and controls.

CONCLUSIONS:

 

Our results indicate that effector T lymphocytes from active CD become resistant to suppression by Tregs. This resistance might cause loss of tolerance to gluten, but also to self-antigens.

Source: American Journal of Gastroenterology.

 

 

 

Fecal Incontinence in Systemic Sclerosis Is Secondary to Neuropathy.


Systemic sclerosis (SSc) is a chronic multi-system autoimmune disorder with gastrointestinal tract (GIT) involvement in up to 90% of patients and anorectal involvement occurs in up to 50% of patients. The pathogenesis of gastrointestinal abnormalities may be both myogenic and neurogenic. We aimed to identify which anorectal physiological abnormalities correlate with clinical symptoms and thus understand the pathophysiology of anorectal involvement in SSc.

METHODS:

In total, 44 SSc patients (24 symptomatic (Sx) (fecal incontinence) and 20 asymptomatic (ASx)) and 20 incontinent controls (ICs) were studied. Patients underwent anorectal manometry, rectal mucosal blood flow (RMBF), rectal compliance (barostat), and rectoanal inhibitory reflex assessment (RAIR).

RESULTS:

Anal squeeze pressure was lower in the IC group compared with both the ASx and Sx groups (IC: 46.95 (30–63.9)) vs. ASx: 104.6 (81–128.3) vs. (Sx: 121.4 (101.3–141.6); P<0.05). Resting pressure was lower in the IC group. RMBF and rectal compliance did not differ between groups. Anal, but not rectal, sensory threshold, was significantly attenuated in Sx patients (Sx: 10.4 (8.8–11.4) vs. ASx: 6.7 (5.7–7.7) vs. IC: 8.5 (6.5–10.4); P<0.05). There was a positive correlation between anal sensory thresholds and incontinence score in SSc patients (r=0.54; P<0.05). RAIR was absent in 11/24 Sx patients but only in 2/20 ASx and in 1/20 IC patients.

CONCLUSIONS:

 

Fecal incontinence in SSc is related to neuropathy as suggested by absent RAIR and higher anal sensory threshold and is related less so to sphincter atrophy and rectal fibrosis.

Source: American Journal of Gastroenterology.

 

 

Clinical and Genetic Risk Factors for Perianal Crohn’s Disease in a Population-Based Cohort


Perianal Crohn’s disease (CD) affects around one-quarter of CD patients and represents a distinct disease phenotype. The objective of this study was to investigate a large population-based cohort of inflammatory bowel disease (IBD) patients to identify clinical and genetic risk factors for perianal CD.

METHODS:

Data were collected in the Canterbury IBD database, estimated to include 91% of all patients with IBD in Canterbury, New Zealand. Genotyping was performed for selected loci previously demonstrated to be associated with CD. Patients with perianal disease were then compared with both CD patients without perianal disease and healthy controls to assess the presence of potential phenotypic, environmental, and genetic risk factors.

RESULTS:

Of the 715 CD patients in the database, 190 (26.5%) had perianal disease. In all, 507 patients with genotype data available were analyzed. Perianal disease was associated with younger age at diagnosis (P<0.0001), complicated intestinal disease (P<0.0001), and ileal disease location (P=0.002). There was no association with gender, ethnicity, smoking, or breast feeding. Genotype analysis revealed an association with the neutrophil cytosolic factor 4 (NCF4) gene compared with both non-perianal CD patients (odds ratio (OR): 1.47; 95% confidence interval (CI): 1.08–1.99) and healthy controls (OR: 1.47; 95% CI: 1.10–1.95). There was no association identified with other genes, including IBD5 (OR: 0.91; 95% CI: 0.69–1.20), tumor necrosis factor α (OR: 1.04; 95% CI: 0.56–1.85), and IRGM (immunity-related guanosine triphosphatase protein type M) (OR: 1.21; 95% CI: 0.80–1.82).

CONCLUSIONS:

 

This study suggests that younger age at diagnosis, complicated disease behavior, and ileal disease location are risk factors for perianal CD. In addition, this paper represents the first report of an association of the NCF4 gene with perianal disease.

Source: American Journal of Gastroenterology.

 

Has There Been a Change in the Natural History of Crohn’s Disease? Surgical Rates and Medical Management in a Population-Based Inception Cohort from Western Hungary Between 1977–2009


Medical therapy for Crohn’s disease (CD) has changed significantly over the past 20 years with increasing use of immunosuppressives. In contrast, surgery rates are still high and there is little evidence that disease outcomes for CD have changed over the past decades. The objective of this study was to analyze the evolution of the surgical rates and medical therapy in the population-based Veszprem province database.

METHODS:

Data of 506 incident CD patients were analyzed (age at diagnosis: 31.5 years, s.d. 13.8 years). Both hospital and outpatient records were collected and comprehensively reviewed. The study population was divided into three groups by the year of diagnosis (cohort A: 1977–1989, cohort B: 1990–1998 and cohort C: 1999–2008).

RESULTS:

Overall, azathioprine (AZA), systemic steroid, and biological (only available after 1998) exposure was 45.8, 68.6, and 9.5%, respectively. The 1- and 5-year probability of AZA use were 3.2 and 6.2% in cohort A, 11.4 and 29.9% in cohort B, and 34.8 and 46.2% in cohort C. In a multivariate Cox-regression analysis, decade of diagnosis (P<0.001, hazard ratio (HR)cohorts B−C: 2.88–6.53), age at onset (P=0.008, HR: 1.76), disease behavior at diagnosis (P<0.001, HRcomplicated: 1.76–2.07), and need for systemic steroids (P<0.001, HR: 2.71) were significantly associated with the time to initiation of AZA therapy. Early AZA use was significantly associated with the time to intestinal surgery in CD patients; in a multivariate Cox analysis (HR: 0.43, 95% confidence interval (CI): 0.28–0.65) and after matching on propensity scores for AZA use (HR: 0.42, 95% CI: 0.26–0.67).

CONCLUSIONS:

This population-based inception cohort has shown that the recent reduction in surgical rates was independently associated with increased and earlier AZA use.

Source: American Journal of Gastroenterology.

Ultrasonographically Detected Non-Alcoholic Fatty Liver Disease Is an Independent Predictor for Identifying Patients With Insulin Resistance in Non-Obese, Non-Diabetic Middle-Aged Asian Adults


We assessed the association among ultrasonographically detected non-alcoholic fatty liver disease (US-NAFLD), metabolic syndrome (MetS), and insulin resistance (IR) in non-obese, non-diabetic middle-aged adults, to find out whether US-NAFLD is independently associated with IR in this population.

METHODS:

A total of 5,878 non-obese (body mass index, ≥18.5 and <25), non-diabetic individuals were analyzed. IR was estimated with the homeostasis model assessment index (HOMA2–IR) and defined when HOMA2–IR ≥1.5. MetS was defined by the Adult Treatment Panel III (ATP III) criteria.

RESULTS:

MetS was present in 381 (6.5%) participants, IR was present in 801 (13.6%) participants, and US-NAFLD was present in 1,611 (27.4%) participants. The increase in the prevalence of US-NAFLD closely followed the increase in the number of metabolic components diagnosed according to the ATP III criteria (15.2%, 28.5%, 48.0%, 65.7%, 71.4%, and 100% for 0, 1, 2, 3, 4, and 5 metabolic components, respectively, P<0.001). US-NAFLD showed a significantly higher odds ratio (OR) for IR, regardless of the number of metabolic components (OR (95% confidence interval) of 3.48 (2.45–4.94), 3.63 (2.74–4.82), 3.19 (2.29–4.44), and 2.43 (1.43–3.81) for 0, 1, 2, and ≥3 metabolic components, respectively, P<0.001 for all values). MetS showed a low sensitivity (0.22) for the identification of individuals with IR, and either US-NAFLD alone (0.60) or US-NAFLD with MetS (0.66) improved sensitivity with acceptable trade-off in specificity.

CONCLUSIONS:

US-NAFLD was an independent predictor for IR, irrespective of the number of metabolic components of MetS in the non-obese, non-diabetic middle-aged Asian adults. US-NAFLD could identify individuals with IR that cannot be identified by MetS in this population.

Source: American Journal of Gastroenterology.