Liver fat in adults with GH deficiency: comparison to matched controls and the effect of GH replacement

CONTEXT: Existing data regarding the association between growth hormone deficiency (GHD) and liver fat content are conflicting. OBJECTIVE: We aimed i) to assess intrahepatocellular lipid (IHCL) content in hypopituitary adults with GHD compared to matched controls and ii) to evaluate the effect of growth hormone (GH) replacement on IHCL content. DESIGN: Cross-sectional comparison and controlled intervention study. PATIENTS, PARTICIPANTS: Cross-sectional comparison: 22 hypopituitary adults with GHD and 44 healthy controls matched for age, BMI, gender and ethnicity. Intervention study: 9 GHD patients starting GH replacement (GH Rx group), 9 GHD patients not starting replacement therapy (non-GH Rx group). INTERVENTION: Intervention study:GH replacement for 6 months in the GH Rx group, dosage was titrated to achieve normal IGF-1 levels. MAIN OUTCOME MEASURES: IHCL content determined by proton magnetic resonance spectroscopy (1 H MRS). RESULTS: Cross-sectional comparison: There was no difference in IHCL content between GHD patients and healthy controls (1.89% (0.30, 4.03) vs. 1.14% (0.22, 2.32); p=0.2), the prevalence of patients with hepatic steatosis (IHCL of ≥ 5.56%) was similar in the two groups (22.7% vs. 15.9%; chi square probability = 0.4). Intervention study: The change in IHCL content over 6 months did not differ between the GH Rx group and the non-GH Rx group (-0.63 ± 4.53% vs. +0.11 ± 1.46%; p=0.6). CONCLUSIONS: In our study liver fat content and the prevalence of hepatic steatosis did not differ between hypopituitary adults with GHD and matched controls. In GHD patients GH replacement had no effect on liver fat content.

Considering the relationship between freight transport and urban form

There has been much discussion since the mid-1980s about the relationship between transport and urban form. However, all of this body of research has concerned itself with passenger transport (i.e. the movement of people). This report is intended as an initial investigation into the relationship between road freight transport and urban form. Important trends in road freight transport and logistics and the land use associated with these activities are discussed. Data about road freight transport activity by heavy goods vehicles (HGVs) in Britain that has been disaggregated from a UK government survey is analysed to investigate the nature of urban freight operations in sixteen selected urban areas. This includes analysis of the efficiency and transport intensity of these operations on journeys to, from and within each urban area. Scenarios concerning urban freight operations based on reductions in length of haul, and improvements in vehicle lading factors, vehicle carrying capacities and empty running are constructed in order to investigate the potential effect of such changes on the vehicle kilometres performed on journeys to, from and within the sixteen urban areas.

Investigating relationships between road freight transport, facility location, logistics management and urban form

This paper examines road freight transport activity and its relationship with facility location, logistics management and urban form through an analysis of 14 selected urban areas in the UK. Improved understanding of this relationship will assist planners when making transport and land use decisions. The findings suggest that several geographical, spatial and land use factors have important influences on freight activity in urban areas. Commercial and industrial land use patterns affect the types and quantities of goods produced, consumed, and hence the total quantity of freight transport handled. This also influences the distances over which goods are moved and by what specific mode. There has been relatively low growth in warehousing in many of the selected areas over the last decade compared to the national average as well suburbanisation of warehousing in some locations. This affects the origin and destination of journeys visiting these facilities and typically increases the distance of such journeys. A greater proportion of road freight has been shown to be lifted on internal journeys in large urban areas than in smaller ones. Journeys within urban areas have been shown to be less efficient than journeys to and from the urban area in the 14 locations studied due to the much smaller average vehicle carrying capacities and lower lading factors for journeys within urban areas. The length of haul on journeys to and from urban areas studied was found to be greatest for those areas with a major seaport and/or which were geographically remote. This affects the road freight transport intensity of goods transport journeys.

Sustainable freight: impacts of the London congestion charge and low emissions zone

This paper assesses whether two sustainability policies currently in effect in London, a congestion charge zone and a low emission zone, have affected freight operations and reduced vehicle kilometers travelled. It investigates responses by freight operators, including re-timing, re-routing, or reducing the number of trips, or replacing vehicles. Freight traffic trends from 1994 to 2012 were identified using road traffic estimates, cordon counts, and vehicle speed data and supplemented by interviews with freight industry experts and operators. Findings indicate that freight traffic increased throughout London during this timeframe, but declined in the central boroughs partly within the congestion charge zone. The congestion charge may have time-shifted some light goods trips, but most freight trips face a variety of constraints on operators’ delivery window. No evidence was found of re-routing of freight traffic or avoidance traffic around the charged zone. The low emission zone spurred higher levels of operational change than the congestion charge zone, and it was effective at spurring freight vehicle replacement. The paper also discusses freight operators’ perceptions of these policies and how they could be improved.

Light goods vehicles in urban areas

The paper provides a review of the light goods vehicle (LGV) fleet and its activity, with specific reference to operations in urban areas, and sustainability issues associated with the ever-growing use of LGVs. Traditionally these vehicles have received little attention but are becoming an ever-more important element of urban freight transport both for goods collection and delivery and for the provision of a wide range of critical services. Relevant literature from the UK and elsewhere pertaining to LGV operations and their impacts has been identified and utilised. The paper identifies the impacts of LGV operations in terms of economic, social and environmental impacts and presents the range of measures being taken by policy makers and companies to address negative impacts.