TY  - JOUR
AB  - In cystic fibrosis (CF), 85% to 90% of patients develop exocrine pancreatic insufficiency. Despite enzyme substitution, low pancreatic phospholipase A2 (sPLaseA2-IB) activity causes fecal loss of bile phosphatidylcholine and choline deficiency. We report on a female patient who has CF and progressive hepatosteatosis from 4.5 y onward. At 22.3 y, the liver comprised 27% fat (2385 mL volume) and transaminases were strongly increased. Plasma choline was 1.9 µmol/L (normal: 8-12 mol/L). Supplementation with 3 ×  1g/d choline chloride decreased liver fat and volume (3 mo: 8.2%; 1912 mL) and normalized transaminases. Plasma choline increased to only 5.6 µmol/L upon supplementation, with high trimethylamine oxide levels (12-35 µmol/L; normal: 3 ± 1 mol/L) proving intestinal microbial choline degradation. The patient was homozygous for rs12325817, a frequent single-nucleotide polymorphism in the PEMT gene, associated with severe hepatosteatosis in response to choline deficiency. Resolution of steatosis required 2 y (4.5% fat). Discontinuation/resumption of choline supplementation resulted in rapid relapse/resolution of steatosis, increased transaminases, and abdominal pain.
AU  - Bernhard, W.*
AU  - Shunova, A.*
AU  - Machann, J.
AU  - Grimmel, M.*
AU  - Haack, T.B.*
AU  - Utz, P.*
AU  - Graepler-Mainka, U.*
C1  - 62422
C2  - 50840
CY  - Ste 800, 230 Park Ave, New York, Ny 10169 Usa
TI  - Resolution of severe hepatosteatosis in a cystic fibrosis patient with multifactorial choline deficiency: A case report.
JO  - Nutrition
VL  - 89
PB  - Elsevier Science Inc
PY  - 2021
SN  - 0899-9007
ER  - 

TY  - JOUR
AB  - OBJECTIVE: This review aims to put an economic perspective on childhood and adolescent obesity by providing an overview on the latest literature on obesity-related costs and the cost effectiveness of interventions to prevent or manage the problem. METHODS: The review is based on a comprehensive PubMed/Medline search performed in October 2011. RESULTS: Findings on the economic burden of childhood obesity are inconclusive. Considering the different cost components and age groups, most but not all studies found excess health care costs for obese compared with normal-weight peers. The main limitations relate to short study periods and the strong focus on health care costs, neglecting other components of the economic burden of childhood obesity. The results of the economic evaluations of childhood and adolescent obesity programs support the expectation that preventive and management interventions with acceptable cost effectiveness do exist. Some interventions may even be cost saving. However, owing to the differences in various methodologic aspects, it is difficult to compare preventive and treatment approaches in their cost effectiveness or to determine the most cost-effective timing of preventive interventions during infancy and adolescence. CONCLUSION: To design effective public policies against the obesity epidemic, a better understanding and a more precise assessment of the health care costs and the broader economic burden are necessary but, critically, depend on the collection of additional longitudinal data. The economic evaluation of childhood obesity interventions poses various methodologic challenges, which should be addressed in future research to fully use the potential of economic evaluation as an aid to decision making.
AU  - John, J.
AU  - Wolfenstetter, S.B.
AU  - Wenig, C.M.
C1  - 7290
C2  - 29650
SP  - 829-839
TI  - An economic perspective on childhood obesity: Recent findings on cost of illness and cost effectiveness of interventions.
JO  - Nutrition
VL  - 28
IS  - 9
PB  - Elsevier
PY  - 2012
SN  - 0899-9007
ER  - 

TY  - JOUR
AB  - OBJECTIVE: To determine if the Geriatric Nutritional Risk Index (GNRI), an index for the risk of nutrition-related complications, is associated with healthcare costs and risk of hospitalization at baseline and after 10 y. METHODS: Data from a German population-based cohort of 1999 subjects 55 to 74 y of age at baseline were used. Self-reported physician visits, length of hospital stay, and drug intake were used to estimate costs. The GNRI is based on serum albumin values and the discrepancy between real and ideal body weights. Low GNRI values were defined as mean minus 2 times standard deviation. Mean GNRI values were regarded as normal. RESULTS: Low baseline GNRI was consistently associated with increased total costs, probability of hospitalization, inpatient costs, and pharmaceutical costs at baseline and follow-up, after adjustment for socioeconomic characteristics, lifestyle factors, and coexisting conditions. Subjects with low GNRI at baseline had approximately 47% higher total costs, 50% higher risk of hospitalization, 62% higher inpatient costs and 27% higher pharmaceutical costs at follow-up than subjects with normal GNRI values. CONCLUSION: The GNRI risk predicted increased future healthcare costs and higher risk of hospitalization in independent-living older adults. The GNRI is a rapid and low-cost tool that might be routinely used in population-based settings.
AU  - Baumeister, S.E.*
AU  - Fischer, B.*
AU  - Döring, A.
AU  - Koenig, W.*
AU  - Zierer, A.
AU  - John, J.
AU  - Heier, M.
AU  - Meisinger, C.
C1  - 621
C2  - 28019
SP  - 534-542
TI  - The Geriatric Nutritional Risk Index predicts increased healthcare costs and hospitalization in a cohort of community-dwelling older adults: Results from the MONICA/KORA Augsburg cohort study, 1994-2005.
JO  - Nutrition
VL  - 27
IS  - 5
PB  - Elsevier
PY  - 2011
SN  - 0899-9007
ER  -