These limitations raise potential alternative players (Fig. 1). For instance, the phosphatase PP2A mediates insulin resistance by antagonizing AKT phosphorylation.14 Ethanol has been shown to increase Akt inhibitor ceramide levels in brain cells,15 and PP2A is one of the myriad signaling targets of ceramide action.16 Finally, the notion that binge drinking spared liver insulin signaling was examined in liver extracts, and not confirmed in isolated hepatocytes, raising the possibility of masking impaired

insulin signaling in parenchymal cells by the presence of nonparenchymal cells. Despite these limitations, the findings by Lindtner et al. are of potential relevance with important clinical implications. Insulin resistance is a cardinal feature

of the metabolic syndrome and type 2 diabetes, and hence the findings define binge drinking as an important risk habit for the development of diabetes, mediated by defective insulin signaling in the central nervous system. selleck chemicals llc In addition to the role of insulin resistance in hypertension and dislipidemia, obesity is associated with fatty liver disease and both engage in a vicious cycle.17 Moreover, considering the key role of brain insulin in feeding behavior, reward pathways and cognitive functions,18–20 the disturbance of brain insulin signaling by binge drinking may pave the way for neuropsychiatric and neurodegenerative disorders. Given these nefarious implications and risks for developing metabolic and neurologic disorders, the study of Lindtner et al. may help partying people to make the right choice in deciding whether to binge or not to binge. “
“Identifying patients with non-alcoholic steatohepatitis (NASH), a more aggressive form with a worse prognosis than for simple steatosis, is highly important. Liver biopsy still remains the gold standard for diagnosing

NASH, but with limitations. The diagnostic value of serum cytokeratin-18 (CK-18) in predicting NASH is still indefinite. We selected relevant studies by a literature search of the PubMed, Ovid Medline and Cochrane Library databases up to January 2012. A DerSimonian-Laird random effects model was used to compute the pooled estimates of sensitivity (SEN), specificity (SPE), and diagnostic odds ratio (DOR), and a summary receiver MCE operating characteristic (SROC) curve was constructed. Stratified analysis was performed to explore the heterogeneity in test accuracy. Funnel plot and Egger’s regression were performed to assess publication bias. A total of 10 studies with 838 patients were included (nine CK-18 fragments and five total CK-18 studies) in this meta-analysis. Among nine CK-18 fragment studies with a significant publication bias, the pooled results on SEN, SPE and DOR were 0.83 (95% CI, 0.80–0.86), 0.71 (95% CI, 0.66–0.76) and 11.90 (95% CI, 6.05–23.