Radiotherapy as well as endoscopic laser surgery as the most widely used treatment modalities for T1a glottic carcinoma cause minor morbidity and negligible mortality and result in more or less comparable, excellent cure and larynx preservation rates. Therefore, other outcome measures such as voice-related problems and health status are important factors in the choice of treatment for T1a glottic cancer. The present study focuses on voice-related problems in the daily life of patients treated by radiotherapy or endoscopic laser surgery for T1a glottic cancer. Self ratings on health status assessed by means of COOP/WONCA health status charts and voice problems evaluated with a validated voice-specific questionnaire (the Voice Handicap Index) and overall judgment on voice quality were obtained. A total of 102 patients (56 treated by endoscopic laser surgery and 46 treated by radiotherapy) with at least 1-year follow-up were included. Response scores were high: 52 (93%) patients after endoscopic laser surgery versus 40 (87%) patients after radiation therapy completed and returned the questionnaires. A high percentage of patients reported voice problems in daily life: 58% of the patients following radiotherapy and 40% of the patients following endoscopic treatment had abnormal VHI scores. The difference between both treatment modalities proved to be significant. No significant differences were found concerning health status or overall judgment of voice quality. Moderate correlations were found between total VHI score and voice quality judgment and the COOP/WONCA social activities chart. This study reveals that treatment for T1a glottic cancer often does result in voice problems in daily life, negatively influencing patients social activities. Patients selected for endoscopic laser surgery on average report fewer voice-related problems than those who underwent radiotherapy.

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We conclude that endoscopic cordectomy is an efficient alternative for radiotherapy for these patients.

The sirtuin SIRT1 is an important regulator of energy metabolism through its impact on glucose and lipid metabolism and therefore we tested the hypothesis that genetic variation in SIRT1 may have an effect on adiposity in a Belgian case/control association study. This study included 1,068 obese patients (BMI > or = 30 kg/m(2)) from the outpatient obesity clinic and 313 lean controls (BMI between 18.5 and 25 kg/m(2)). Anthropometrics were assessed by classical methods and visceral (VFA), subcutaneous (SFA) and total abdominal (TFA) fat areas were determined by a CT scan. The extent of linkage disequilibrium in SIRT1 allowed us to reduce the number of SNPs to two, sufficient to cover the entire gene. The two tagSNPs (rs7069102 and rs3818292) were analyzed by LightSNiP assays in all subjects. Rs3818292 genotypes were similarly distributed in cases and controls, whereas rs7069102 was different for the additive (P = 0.007) and dominant (P = 0.01) model. The variant C-allele of rs7069102 reduced obesity risk with an OR of 0.74 (P = 0.025; 95% CI 0.57-0.96) under a dominant model. In obese male subjects, this variant allele was associated with increased waist circumference (P = 0.04), WHR (P = 0.02), TFA (P = 0.03) and VFA (P = 0.005) (dominant model; adjusted for age and BMI). Rs3818292 was related to VFA (P = 0.005; adjusted for age and BMI) in obese males while in obese women, no significant associations were detected. Our data suggest that genetic variation in SIRT1 increases the risk for obesity, and that SIRT1 genotype correlates with visceral obesity parameters in obese men.

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Since recent data suggest that the endocannabinoid system controls food intake through central, and lipogenesis via peripheral CB1 receptors, we hypothesized that genetic variation at the cannabinoid receptor-1 (CNR1) locus could have an effect on adiposity. We investigated, whether a specific CNR1 G1422A genotype is associated with anthropometric markers of obesity and fat distribution in adult obese individuals. A total of 1,064 obese subjects (BMI > or = 30 kg/m2) without diabetes, impaired glucose tolerance or other endocrine diseases and 251 healthy control persons were genotyped for the G1422A variant (rs1049353) with a TaqMan assay. Anthropometric measures as body weight, BMI, waist and waist-to-hip ratio (WHR) were assessed by classical methods. Fat mass (FM) was measured by bio-impedance. The prevalence of the G1422A variant was not significantly different between cases and controls (OR = 1.056; P = 0.626). In obese women, no meaningful associations between CNR1 genotype and anthropometric parameters were found. In obese men, CNR1 1422 A/A genotype was significantly associated with higher WHR (P = 0.009) and waist circumference (P = 0.008) after adjusting for age and BMI. Fat mass percentage showed an association (P = 0.011) which disappeared after adjusting for age and BMI. A trend for an association was seen for fat mass (unadjusted P = 0.099; adjusted P = 0.033). Our data indicate that the G1422A polymorphism in the CNR1 gene is associated with increased abdominal adiposity in obese men.