The FAT in the liver is measured by the Controlled Attenuation Parameter - CAP. 14(7), 837852 (2021). Correction to Lancet Gastroenterol Hepatol 2020; 5: 362-73. PubMed Hypertension prevalence and influence of basal metabolic rate on blood pressure among adult students in Bangladesh. CAPis a quantitative surrogate of liver steatosis expressed in decibel per meter (db/m). If you have more than one liver disease, you may not be able to use the table. Renal Physiol. 19(6), 802 (2013). Google Scholar. Bloodwork is perfect. Check cost defrayal conditions with paying bodies. Dial. For more resources, visit www.mskcc.org/pe to search our virtual library. endobj *CAP is not available on S+ probe in all countries. Liver stiffness measurement (LSM) by vibration-controlled transient elastography and controlled attenuation parameter (CAP) measured by FibroScan device were combined with aspartate aminotransferase (AST), alanine aminotransferase (ALT), or AST:ALT ratio. The serum levels of insulin, C-peptide and thyroid-stimulating hormone (TSH) were determined by using ELISA kit (Monobind Inc., USA). Resting energy expenditure and protein turnover are increased in patients with severe chronic obstructive pulmonary disease. /CreationDate (D:20230117053017Z) This cross sectional study was conducted in 30 to 53-year-old individuals with concurrent T2DM and NAFLD (controlled attenuation parameter score260dB/m). PubMed FibroScan is a special ultrasound technology that measures liver stiffness (hardness) and fatty changes in your liver. Clin. Clin. Utaka, S. et al. Advantages of CAP include its ease of measurement, operator-independence and simultaneous availability with LSM for fibrosis assessment. /MediaBox [0 0 612 792] Impaired glycemic control and elevated glucose output from the liver due to increased gluconeogenesis and glycogenolysis, which is caused by insulin inefficiency, as well as higher protein turnover, higher sympathetic nervous system activity, oxidative stress, visceral fat and altered body metabolism are potential mechanisms which have been suggested for the increased metabolism in diabetic subjects21,22,23. This is based on your diagnosis, liver stiffness, and fibrosis scores. Ther. Jouinot, A. et al. 7) In accordance with our findings, Ali et al.63 and Snodgrass et al.64 showed a direct relationship between BMR and blood pressure. Lee, P. H. et al. @Ev*B{p\Qk[Ll0T!]\3# Miele, L. et al. Biolo, G. et al. Your doctor may also order other tests to evaluate your liver, such as blood tests, other imaging scans, or biopsies. However, our study has some limitations. FibroScan will help your healthcare provider learn more about your liver disease. PubMed Central 2012 Feb;36(1):13-20. doi: 10.1016/j.clinre.2011.08.001. Circulatory and adipose tissue leptin and adiponectin in relationship to resting energy expenditure in patients with chronic obstructive pulmonary disease. (Lausanne) 12, 768850 (2021). Certain conditions can cause a liver stiffness result thats too high, which makes it incorrect. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The mean age of the participants was 44.695.47years, and 67.40% of them were males. Bethesda, MD 20894, Web Policies 73 to 1 using the dual cutoffs approach, with cutoffs derived in the derivation cohort. Factors related to hypermetabolism in individuals with type 2 diabetes They are sending me for an MRI with elastography on Friday to confirm the staging. 2020 Nov;5(11):970-985. doi: 10.1016/S2468-1253(20)30252-1. A fibrosis score of F0 to F1 ( 2 to 7 kPa) means there is little or no scarring on the liver. Sci. I had a fibroscan done last month with a 17 Kpa (cirrhosis). I am still having symptoms of right sided pain, nausea, itchy skin and extreme fatigue and light headed. Nat Rev Gastroenterol Hepatol. fibroscan cap; fibroscan score; . However, there is inadequate evidence regarding the threshold of blood glucose in which REE is increased38. If you do not see your disease listed, ask your healthcare provider to go over your results with you. Article Your fibrosis result is a measurement of the amount of scarring in your liver. -. The FibroScan test result will provide with: Cap Score: The amount of liver with fatty change is measured by CAP score in decibels per meter(dB/m) that corresponds to the stages of steatosis- S1, S2, or S3. It measures fibrosis (scarring) and steatosis (fatty change) in your liver. One study found that adiponectin concentration had no relationship with energy expenditure among non-diabetic subjects52. Operators are expressly recommended to carefully read the instructions given in the user manual and on the labelling of these products. Epub 2019 Jan 25. World J Gastroenterol. Then, look at the top of that column to see the fibrosis score.[3]. The CAP was significantly correlated with the percentage of steatosis ( = 0.47) and steatosis grade ( = 0.51; both P < 0.00005). Fibroscan Score Fatty Liver Cap - How To Cure A Fatty Liver (for good Am. Bica, C. et al. Fatty liver? : I had a fibroscan - British Liver Trust - HealthUnlocked Both LSM by VCTEand CAP are measured simultaneously without lengthening the examination time. Your CAP score is a measurement of fatty change in your liver. 2012 Jul;32(6):911-8. doi: 10.1111/j.1478-3231.2012.02820.x. Correlation between basal metabolic rate, visceral fat and insulin resistance among type 2 diabetes mellitus with peripheral neuropathy. To the best of our knowledge, this is the first study which evaluated hypermetabolism and its contributing factors in T2DM individuals with NAFLD. Front. Call your healthcare provider if you have any questions. For instance, Tarantino et al., showed that morbidly obese NAFLD patients with metabolic syndrome had higher BMR in comparison to NAFLD individuals with a similar weight but without metabolic syndrome17. According to the results of multivariable logistic regression analyses, hypermetabolism had a positive association with adiponectin (odds ratio [OR] 1.167, 95% confidence interval [CI] 1.0151.342, p=0.030), physical activity (OR 1.134, 95% CI 1.0021.284, p=0.046), alanine transaminase (OR 1.062, 95% CI 1.0061.122, p=0.031) and diastolic blood pressure (OR 1.067, 95% CI 1.0101.127, p=0.021). x}%q>00 h!h!,B.sGydUHHnno7/??kv=?mT//zI~n?nCOO5g=~|?|onnso1 O6VW/w0vc]!? The lower the percentage of your liver with fatty change, the healthier your liver is and the lower your CAP score and steatosis grade from your FibroScan. You will find your fibrosis score in the third column from the left. Stefan, N. et al. 678.750000 0] 91(4), 16001603 (2006). Curr. FibroScan works similarly to an ultrasound, emitting a small pulse of energy, called a shear wave. In addition, JFC has a patent pending for protein-based biomarkers of fatty liver disease. The elasticity modulus of liver in fatty liver rabbits of nonalcoholic and alcoholic groups showed a positive correlation with progression of liver fibrosis (P<0.01). Results of a FibroScan are available immediately following the scan. Controlled attenuation parameter (CAP): a new device for fast evaluation of liver fat? Filed Under: FibroScan Tagged With: FibroScan Testing, FibroScan Testing in California, FibroScan Testing near me, gastroenterologist clinic, gastroenterologist clinic in California, gastroenterologist clinic near me, gastroenterologist in California, gastroenterologist near me, inSite Digestive Health Care. KPa score 44.2 CAP score 309. 1 0 obj Comparison of portal vein hemodynamics with ultrasound-based CAP(Controlled Attenuation Parameter) is the non-invasive reference parameter to diagnose and monitor liver steatosis. Among anthropometric measures, including height, weight, BMI, fat mass, fat percent, fat free mass (FFM), total body water (TBW) and WC, only TBW was significantly higher in subjects with non-hypermetabolism, as compared with hypermetabolism subjects (46.158.09 vs. 42.098.47, p=0.027). A positive association between adiponectin concentrations and energy expenditure during hyperinsulinemia state among offspring of T2DM individuals49, in underweight patients with COPD50, and in elderly individuals after resistance exercise51 has been shown. 100(3), 10781087 (2015). eCollection 2023. Your healthcare provider will talk with you about your results during your appointment. Use of FAST in primary care will require investment in devices and personnel, although there are many examples of such models being introduced successfully. Follow the row that has your results. Tarantino, G., Savastano, S. & Colao, A. Hepatic steatosis, low-grade chronic inflammation and hormone/growth factor/adipokine imbalance. The cells become scarred and cannot divide. The median CAP was higher among patients with significant steatosis (317 [IQR 284-339] vs. 250 [227-279] dB/m with <10% steatosis; P < 0.0005) and the AUROC for this outcome was 0.81 (95% CI 0.74-0.88). It can be used alone or with other tests (such as blood tests, imaging scans, or biopsies) that also measure scarring or fatty change in your liver. The table below shows liver diseases, ranges of fibrosis results, and the matching fibrosis score. Why Your Doctor May Order a FibroScan - Northeast Digestive The nurse said we don't have the cap score. Here are some helpful terms to know related to your FibroScan results: Fibrosis (fy-BROH-sis): Scarring in your liver. Please do not write your name or any personal information on this feedback form. Exerc. Pratley, R. et al. There is a silent epidemic of fatty liver disease in the general population, called NAFLD/NASH. MathSciNet Non-alcoholic fatty liver disease: A major challenge in type 2 diabetes mellitus. Your result may be higher than the normal range if you have liver disease. FAST=FibroScan-aspartate aminotransferase. BMC Nephrol. 2023 Feb 19;13(4):788. doi: 10.3390/diagnostics13040788. Liver scarring is a serious condition and can lead to life-threatening complications if not addressed. Most patients with the presence of a metabolic syndrome. A score below 238 dB/m means the amount of fatty change in your liver is not higher than normal. Oxygen species in the microvascular environment: Regulation of vascular tone and the development of hypertension. Tanase, D. M. et al. 75(4), 18471853 (1993). -, Tsochatzis EA, Newsome PN. Most patients with the presence of a metabolic syndrome. Metab. A p-value<0.05 was considered statistically significant. Fatty change is when fat builds up in your liver cells. Google Scholar. Metab. Kao, C. C. et al. In contrast, FFM was negatively related to hypermetabolism (OR 0.93, 95% CI 0.880.99, p=0.023). FibroScan is a specialized ultrasound machine for your liver. J. Bitz, C. et al. W-KC reports personal fees from Boehringer Ingelheim, Echosens, and Mylan; grants from Sysmex and Resonance Health; and non-financial support from Endosurgery, outside the submitted work. s -w64'?*TM|_*>&7VZG|Ze~_-c\;7b 4+T*=P *xtocd~ _t~D8, AuA? Cap Score Liver - What Does Mean By Cap Score In Fibroscan Of | Practo Lombardo, M. et al. Endocrinol. Today, in most studies, as well as in clinical practice, resting energy expenditure (REE), also known as resting metabolic rate (RMR), is used as an estimate of BMR, because it requires less restrictive conditions18,20. Background and Aims: FibroScan is used to determine liver stiffness and controlled attenuation parameter (referred to as CAP) scores in patients, including those with chronic hepatitis B (CHB). The prevalence of NAFLD including liver steatosis and liver fibrosis in T2DM has been estimated to be more considerable3,7. Diabetes Care 32(12), 21612167 (2009). To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. FibroScan is a special ultrasound technology that measures liver stiffness (hardness) and fatty changes in your liver. N. Engl. pdf files. Ann. Kablawi D, Aljohani F, Palumbo CS, Restellini S, Bitton A, Wild G, Afif W, Lakatos PL, Bessissow T, Sebastiani G. Crohns Colitis 360. PMC The authors are thanks to the patients who participated in the study. PubMed Central Melby, C. et al. The results of measuring the stiffness of the liver after ultrasound of There is a positive association between diabetes and REE15,37. WP%n. $ #B :5AAs/8@lJ(V!GGc\ek5BiPlE~{;D[j1">2D(nPc=/OVE\A6xyQv xolK )E-M CWs]9P];&RL{y^|KnMTB%VO{ipgx;DG_v/@[iKc{39:Gq`%L,OHuNQ Xb+rL~ -9sR^I2= &L-tx\t1tpTj|TT;5Y5xaG>0C(n(\2*ynlXAm3??-q`]e~{Z4 dq`8l^ooA1zWQ,JEBudgdqGVR9J@y@yZG&y~X9 pxJTz|PN(u0[$2cRKm!t(!0COwPjv+WPP%8r Q Sampath Kumar, A. et al. Critical revision, M.A. If treated early with diet and lifestyle changes, the disease can be reversible. FibroScan with CAP for fatty liver disease assessment - ECHOSENS /ColorSpace << government site. If you're a patient at MSK and you need to reach a provider after. Echosens and UK National Institute for Health Research. FLF Launches a Public-Private Partnership to Combat the Silent Epidemic of NAFLD, FLF and Fibronostics form a patient education partnership, Echosens Aligns with FLF to Accelerate Screening for Undiagnosed NAFLD and NASH, Fatty Liver Foundation Launches the State of NAFLD/NASH Care in America Initiative to Support Improved Patient Care Experience, FATTY LIVER FOUNDATION TO MARK INTERNATIONAL NASH DAY WITH THREE INTERACTIVE PROGRAMS OFFERING INFORMATION, INSPIRATION, AND SUPPORT FOR PEOPLE AT-RISK OF OR LIVING WITH NAFLD/NASH. However, the literature represents diverse findings in regard to adiponectin levels and REE. Accuracy of FibroScan Controlled Attenuation Parameter and Liver Stiffness Measurement in Assessing Steatosis and Fibrosis in Patients With Nonalcoholic Fatty Liver Disease. Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. The exclusion criteria were as follows: being under insulin therapy, experiencing pregnancy or lactation, having the history of or currently drinking excessive alcohol (average drinking of alcohol over 20g/day26), viral hepatitis infection, having the history of thyroid disease or limb amputation, suffering from cardiovascular diseases, kidney diseases, cancer, mental disorders, cirrhosis and other chronic liver diseases, and currently consuming supplements including vitamin E and other antioxidants. The main causes of fatty liver disease are excessive alcohol consumption and/or poor diet and sedentary lifestyle. Publication Paul et al. Diagnostics (Basel). Liver Int. A body mass index (BMI) higher than 30 (obesity), A build-up of fluid in your abdomen (ascites), Too little bile flowing out of your liver (biliary obstruction). 85(1), 2634 (2007). Sugimoto K, Lee DH, Lee JY, Yu SJ, Moriyasu F, Sakamaki K, Oshiro H, Takahashi H, Kakegawa T, Tomita Y, Abe M, Yoshimasu Y, Takeuchi H, Choi BI, Itoi T. Radiology. 12 0 obj 2022;15(4):360-365. doi: 10.22037/ghfbb.v15i4.2480. PubMed Central Pursuing basic and translational research across 9 programs and 100+ labs, Focusing on clinical cancer research and population health, Bridging the lab and the clinic through translational research, Fostering interdisciplinary collaborations between laboratory scientists and clinicians, Partnering with other academic and research institutions, Offering state-of-the-art resources for our researchers, Offering a curriculum with a focus on cancer, Connecting college seniors to future careers in biomedicine. Changes in eating habits and physical activity after COVID-19 pandemic lockdowns in Italy. A fibroscan score is a numerical result between 2-75. Reddavide, R. et al. http://creativecommons.org/licenses/by/4.0/. The prevalence of T2DM among NAFLD and non-alcoholic steatohepatitis (NASH) cases has been reported to be 22.5% and 43.6%, respectively6. My partner has been diagnosed with cirrhosis and had a second fibro scan on the 02/11 - his previous and first fibroscan KPa result was 29 it has risen to 44.2 in a matter of months - i am not sure what his previous CAP score was - does anyone know what stage of liver disease this is? CAP provides a convenient and patient-friendly method to assess lipid turnover during lifestyle and dietary interventions to combat NAFLD. To ensure hydration and obtain a valid evaluation, subjects were asked to follow the instructions before the body composition assessment as previously described27. Monday to Friday, 8 a.m. to 6 p.m. (Eastern time), Monday to Friday, 9 a.m. to 5 p.m. (Eastern time). Deurenberg, P. Limitations of the bioelectrical impedance method for the assessment of body fat in severe obesity. Google Scholar. Kotronen, A. et al. FibroScan-AST (FAST) score for the non-invasive identification of 20(1), 18 (2020). References are available in ourbibliography. See this image and copyright information in PMC. Crit. Int. Anthropol. The CAP is a promising tool for the noninvasive detection of hepatic steatosis. By submitting a comment you agree to abide by our Terms and Community Guidelines. Rodrguez-Iturbe, B. et al. In non-alcoholic fatty liver disease (NAFLD), advanced liver fibrosis is excluded by normal liver stiffness, but a wide range of cutoffs have been used to predict advanced liver fibrosis or cirrhosis. A fibrosis score of F2 (7.5 to 10 kPa) indicates moderate scarring that has spread outside the liver. If you have more than one liver disease, this table may not apply to you. What to Expect with FibroScan Testing The measurement of fatty change in your liver is the CAP score, while the measurement of scarring is the fibrosis score. This information will help you understand your FibroScan results. Hypermetabolism was defined as an elevated measured REE>110% of the predicted REE. QMA reports grants from European Commission during the conduct of the study and speaker fees/advisory board fees from Acuitas Medical, E3Bio, Eli Lilly & Company, Galmed, Grunthal, Imperial Innovations, MedImmune, NewGene, Inventiva, Janssen, Raptor Farmer, NGMBio, Madriglal, and Servier; personal fees and speaker fees/advisory board fees from Allergan/Tobira, Genfit SA, Gilead, and Intercept Pharma Europe; personal fees from Kenes, Novartis Pharma AG, and Bristol-Myers Squibb; grants and speaker fees/advisory board fees from Pfizer; and grants from GlaxoSmithKline and AbbVie, outside the submitted work. 35(8), 19831991 (2015). The results of the present study showed a positive association between diastolic blood pressure and hypermetabolism. Article This is usually caused by heart failure. Zheng, Y., Ley, S. H. & Hu, F. B. Read across the rest of that row from left to right. It measures fibrosis (scarring) and steatosis (fatty change) in your liver. CAS Google Scholar. Careers. However, this cohort size is quite small (n=83). livers can have up to 5% of fatty changes in them. We use cookies to help provide and enhance our service and tailor content and ads. 6(1), 19 (2005). Independent sample t-test, MannWhitney U test or Chi-square (2) test was used for comparison between groups as appropriate. Get the latest news and updates on MSKs cancer care and research breakthroughs sent straight to your inbox with our e-newsletters. Med. At a cut-off of 283 dB/m, the CAP was 76% sensitive, 79% specific, and had positive and negative predictive values of 87% and 64%, respectively. Shear wave speed and stiffness, and CAP* may be used as an aid in the clinical management of pediatric patients with liver disease. To assess the health of your liver, your doctor may recommend a FibroScan test, which is an ultrasound of the liver. Sasso M, Miette V, Sandrin L, Beaugrand M. Clin Res Hepatol Gastroenterol. 26(12), 15471552 (2002). Nutr. Int. CAP value of 300 falls into S2/S3 stage. The CAP score is measured in decibels per meter (dB/m). Ciardullo, S. & Perseghin, G. Statin use is associated with lower prevalence of advanced liver fibrosis in patients with type 2 diabetes. Insulin resistance was estimated using the following formula: HOMA-IR=[Fasting insulin (U/mL)fasting glucose (mmol/L)/22.5]. These measurements help your healthcare provider learn more about your liver disease. You can keep reading to learn more about your results. 2020 The Author(s). 2014;29(7):1470-6. doi: 10.1111/jgh.12557. If treated early with diet and lifestyle changes, the disease can be reversible. Protein turnover is assumed to account for 20% of REE in healthy subjects41, and elevated protein turnover is associated with increased REE42,43 and loss of FFM43. Epub 2020 Aug 5. For instance, bioelectrical impedance can be affected by some factors including the level of body hydration, body geometry, etc., which could result in the incorrect estimation of body composition78. Curr. 8600 Rockville Pike Harrison SA, Ratziu V, Boursier J, Francque S, Bedossa P, Majd Z, Cordonnier G, Sudrik FB, Darteil R, Liebe R, Magnanensi J, Hajji Y, Brozek J, Roudot A, Staels B, Hum DW, Megnien SJ, Hosmane S, Dam N, Chaumat P, Hanf R, Anstee QM, Sanyal AJ. J. Clin. J. Mol. FibroScan - Fatty Liver Foundation Diagnostic performance in the derivation cohort of the FAST score for the diagnostic of NASH+NAS4+F2 (A) Receiver operating characteristic curve. Enhanced levels of whole-body protein turnover in patients with chronic obstructive pulmonary disease. >> 37(2), 558565 (2018). The following table shows ranges of CAP scores, and the matching steatosis grades. National Library of Medicine What it measures: fibrosis, steatosisWho should take it: undiagnosed and diagnosed NAFLD/NASH patientsWhere to get it: specialty care centers, hospitals, some primary care providers. Nonalcoholic fatty liver disease as trigger of cardiovascular and metabolic complication in metabolic syndrome. Not all diseases are listed in the table. Validity of the international physical activity questionnaire short form (IPAQ-SF): A systematic review. A FibroScan is usually ordered for patients with medical conditions that can affect liver health, such as hepatitis B, hepatitis C, type 2 diabetes, and obesity. It uses ultrasound technology to measure the stiffness of your liver tissue. Critical revision, R.J. Acquisition of data, S.M.S.J. (F) Malaysian NAFLD cohort (n=176). Metab. Metab. Your fibrosis result may be over-estimated (your liver may have less scarring than what your fibrosis result says) if you have: Your FibroScan results may also be less accurate if you have: Fibrosis score F0 to F1: No liver scarring or mild liver scarring, Fibrosis score F2: Moderate liver scarring, Fibrosis score F3: Severe liver scarring Fibrosis score. Our highly-specialized educational programs shape leaders to be at the forefront of cancer care and research. Association of adiponectin level and variants in the adiponectin gene with glucose metabolism, energy expenditure, and cytokines in offspring of type 2 diabetic patients. Calibration of the data is estimated using a smoothed regression line (dotted line) using locally estimated scatterplot smoothing (Loess) that allows inspection of the calibration across the range of predicted values and determination of whether there are segments of the range in which the model is poorly calibrated. Metabolism 60(10), 14491455 (2011). To find the predictive factors that affected hypermetabolism in subjects with both T2DM and NAFLD, parameters with a p-value<0.2 in univariate analysis (data not shown), including sex, age, physical activity, AST, ALT, cholesterol, TNF-, adiponectin and FFM, were enteredinto the multivariate model. Considering the progressive prevalence and co-occurrence of type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD), as well as the current evidence suggesting the elevated levels of basal metabolic rate (BMR) among these individuals, the present study aimed to identify factors determining hypermetabolism in such subjects. FAST=FibroScan-aspartate aminotransferase. de Ldinghen V, Vergniol J, Foucher J, Merrouche W, le Bail B. Liver Int. The calibration plot characterises the agreement between observed proportion and predicted probabilities. NASH=non-alcoholic steatohepatitis. If you have questions about your care, contact your healthcare provider. Diabetologia 35(10), 962966 (1992). To use the table, find the liver disease that you have on the left side of the table. [ ] Res. Metab. The highest possible result is 75 kPa. Products in the FibroScanrange are Class IIa medical devices as defined by Directive 93/42/EEC (EC 0459). Obes. Understanding NAFLD: From Case Identification to Interventions, Outcomes, and Future Perspectives. JFC was supported by the NIHR Oxford BRC. A healthy liver has a CAP score of 5% or lower. Both LSM by VCTEand CAP are measured simultaneously without lengthening the examination time. The rest of this resource explains your FibroScan results in more detail, including how your healthcare provider uses your results to determine your steatosis grade and fibrosis score. Clayton-Chubb D, Kemp W, Majeed A, Lubel JS, Hodge A, Roberts SK. Multiparametric US for Identifying Patients with High-Risk NASH: A Derivation and Validation Study. PubMed Ma, X. et al. Rehabil. Diabetes Care 40(3), 419430 (2017). >> Oxidative stress, renal infiltration of immune cells, and salt-sensitive hypertension: All for one and one for all. A CAP score of 5% or lower indicates a healthy liver, while a CAP score of 5% to 33% with a steatosis grade of S1 indicates a mild fatty liver. The Chinese Hong-Kong NAFLD cohort (C) has a zone in which the risk of being NASH+NAS4+F2 is overestimated using the FAST score (grey ribbon below the ideal calibration curve) and a zone in which the calibration seem adequate (grey ribbon zone includes the ideal calibration curve). In another study, intracerebroventricular administration of adiponectin in mice induced UCP1 mRNA expression and decreasing the body weight, while not affecting the food intake62. In addition, among biochemical markers, subjects with non-hypermetabolism had a significantly higher level of low-density lipoprotein cholesterol (LDL-C), as compared with hypermetabolic cases (98.00 [68.00118.00] vs. 71.00 [61.00105.00], p=0.041).
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