Clinical and Translational Gastroenterology最新文献

{"title":"Real-World Trends and Future Projections of the Prevalence of Cirrhosis and Hepatic Encephalopathy Among Commercially and Medicare-Insured Adults in the United States.","authors":"Robert J Wong, Patrick Gagnon-Sanschagrin, Zeev Heimanson, Jessica Maitland, Remi Bellefleur, Annie Guérin, Aaron Samson, Olamide Olujohungbe, Brock Bumpass","doi":"10.14309/ctg.0000000000000823","DOIUrl":"10.14309/ctg.0000000000000823","url":null,"abstract":"<p><strong>Introduction: </strong>Describing cirrhosis and hepatic encephalopathy (HE) burden over time can inform clinical management and resource allocation. Using healthcare claims data, this observational study examined recent trends in the prevalence of cirrhosis and HE and associated healthcare resource utilization among commercially and Medicare-insured adults in the United States.</p><p><strong>Methods: </strong>Data from the MarketScan Commercial Claims and Encounters Database and 100% Medicare Research Identifiable Files were analyzed (2007-2020). Annual prevalence of cirrhosis, HE, overt HE (OHE) hospitalizations, and rifaximin ± lactulose use, and costs per hospitalization per year were calculated. Average year-over-year changes in prevalence of cirrhosis, and HE were estimated. Trends were extrapolated to 2030 using ordinary least-squares regression.</p><p><strong>Results: </strong>From 2007 to 2020, the prevalence of cirrhosis increased by an average of 4.6% year-over-year in the Commercial population and 8.1% in the Medicare population; the prevalence of HE increased by 4.3% and 2.5%, respectively. Rates of OHE hospitalizations decreased from 27.5% to 5.5% (Commercial) and from 26.2% to 9.5% (Medicare), and rates of liver transplantation increased. Average payer costs (Commercial) and provider charges (Medicare) per OHE hospitalization increased (from $40,881 to $77,699 and from $45,913 to $74,894, respectively). Use of rifaximin ± lactulose showed an increasing trend during the observation period, whereas lactulose use declined steadily.</p><p><strong>Discussion: </strong>The healthcare burden of cirrhosis and HE in the United States is increasing. Trends are projected to continue unless action is taken, such as improving medication access and developing policies addressing the contributing factors.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e00823"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Patterns of Opioid Use in Chronic Pancreatitis.","authors":"Anna Evans Phillips, Darwin L Conwell, Shuang Li, Jami L Saloman, Phil A Hart, Evan L Fogel, Santhi Swaroop Vege, Dana K Andersen, William E Fisher, Christopher E Forsmark, Stephen Pandol, Walter G Park, Mark D Topazian, Stephen K Van Den Eeden, Jose Serrano, Liang Li, Dhiraj Yadav","doi":"10.14309/ctg.0000000000000807","DOIUrl":"10.14309/ctg.0000000000000807","url":null,"abstract":"<p><strong>Introduction: </strong>Opioids are used to treat pain in chronic pancreatitis (CP), but little is known about current use patterns. The aim of this study was to characterize the utilization of opioids and associations with clinical characteristics in adult patients with CP.</p><p><strong>Methods: </strong>This cross-sectional analysis used baseline data from participants with definite CP enrolled in a cohort study in the United States (PROspective Evaluation of CP for EpidEmiologic and Translational StuDies). Data on demographics, pain medication use, healthcare utilization, disability, and pain patterns were systematically collected in case report forms while quality of life was assessed with patient-reported outcome instruments. Opioid use was classified according to strength (weak or strong) and frequency (scheduled or as-needed).</p><p><strong>Results: </strong>A total of 681 participants (n = 364, 53% male) were included: 299 (44%) were current opioid users (22% only weak opioids and 22% at least 1 strong opioid). Increasing frequency and severity of pain was associated with increase of weak, strong, as-needed, or scheduled opioids. Neuromodulators were used by ∼40% of participants; increasing use was associated with increasing frequency and severity of pain. On multivariate analysis, independent predictors associated with strength and frequency of current opioid use were pain patterns (odds ratios [ORs] 1.84-8.32 and ORs 1.92-8.52, respectively, P < 0.001) and prior celiac plexus block (OR 3.54, 95% confidence intervals 1.82-6.87 and OR 3.42, 95% confidence intervals 1.76-6.64, respectively). Participants using opioids had higher prevalence of disability, healthcare utilization, and poorer quality of life.</p><p><strong>Discussion: </strong>Opioid use in CP is common and associated with increased pain severity and constancy. These data provide foundational estimates for future trials that can elucidate the complex interactions between patient factors, pain, and interventions.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e00807"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiographic Identification of Visceroptosis in Patients With Hypermobile Ehlers-Danlos Syndrome With Functional Gastrointestinal Symptoms Compared With Healthy Subjects.","authors":"Yin Chan, Bianca W Chang, Amrit K Kamboj, Yaniv Raphael, Richard Sukov, Ali Rezaie","doi":"10.14309/ctg.0000000000000834","DOIUrl":"10.14309/ctg.0000000000000834","url":null,"abstract":"<p><strong>Introduction: </strong>Visceroptosis is a potential cause of gastrointestinal symptoms in hypermobile Ehlers-Danlos syndrome (hEDS).</p><p><strong>Methods: </strong>We systematically examined the prolapse of abdominal organs below their natural supine position (visceroptosis) during the upright small bowel barium study in healthy and hEDS subjects with irritable bowel syndrome.</p><p><strong>Results: </strong>Comparison of age- and sex-matched healthy (n = 20) and hEDS (n = 10) subjects did not show any significant difference in dynamic movement of the viscera. Subgroup analysis did not demonstrate any correlation between the degree of prolapse, clinical symptoms, and hypermobility clinical (Beighton) scores. The interobserver reliability for 3 of the 4 anatomic landmarks showed \"moderate\" or \"good\" correlation based on their interclass correlation coefficients.</p><p><strong>Discussion: </strong>Patients with hEDS do not appear to have a significantly increased incidence of visceroptosis.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e00834"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nomogram Prediction for Gastric Cancer Development.","authors":"Joo Hyun Lim, Areum Han, Soo-Jeong Cho, Seokyung Hahn, Sang Gyun Kim","doi":"10.14309/ctg.0000000000000833","DOIUrl":"10.14309/ctg.0000000000000833","url":null,"abstract":"<p><strong>Introduction: </strong>Helicobacter pylori ( Hp ) and gastric atrophy represent significant risk factors for gastric cancer (GC). Nevertheless, to date, no nomogram has been developed to predict GC based on the specific combination of risk factors present in individual cases.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using health screening data collected between 2003 and 2018. Subjects with positive results for anti- Hp antibody were enrolled. Individuals were classified into 4 groups: low-B (low titer without atrophy), high-B (high titer without atrophy), high-C (high titer with atrophy), and low-C (low titer with atrophy). Nomogram prediction models were developed for overall GCs as well as intestinal and diffuse cancers, with each type considered a competing event, by using both Cox proportional and subdistribution hazard models. Prediction performance was evaluated using the concordance index (c-index) and the area under the curve through 10-fold cross-validation.</p><p><strong>Results: </strong>During a median follow-up period of 5.7 years, 231 new GC cases developed among the total cohort of 28,311 subjects, including 159 intestinal type, 68 diffuse type, and 4 cases of unknown type. Multivariable analyses indicated that age, body mass index, family history, smoking, and classification into the high-C or low-C group were significant predictors of GC. The nomograms for intestinal type, diffuse type, and total GC demonstrated area under the curve values of 0.82, 0.62, and 0.75, respectively, and c-indices of 0.85, 0.54, and 0.76, respectively.</p><p><strong>Discussion: </strong>The nomograms for GC prediction would be useful in identifying high-risk individuals, particularly for intestinal type. This would facilitate the implementation of personalized eradication and intensive screening strategies to target those at higher risk for GC.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e00833"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Double Band Ligation-Assisted Endoscopic Submucosal Resection for Rectal Neuroendocrine Tumors: Comparison With Conventional Endoscopic Mucosal Resection With Ligation (With Video).","authors":"Yuan Gao, Liansong Ye, Xu Li, Long He, Bin Yu, Wei Liu, Yuwan Cao, Liuxiang Chen, Yi Mou, Ou Chen, Jia Xie, Jiang Du, Qiongying Zhang, Bing Hu","doi":"10.14309/ctg.0000000000000830","DOIUrl":"10.14309/ctg.0000000000000830","url":null,"abstract":"<p><strong>Introduction: </strong>Based on endoscopic mucosal resection with ligation (EMR-L), we developed double band ligation-assisted endoscopic submucosal resection (ESR) for complete resection of small submucosal rectal neuroendocrine tumors (NETs). Both procedures use a multiband device to perform resection, with the only difference being that ESR adds an additional band to obtain deeper resection margin. The aim of this retrospective study was to validate its feasibility, safety, and effectiveness compared with EMR-L.</p><p><strong>Methods: </strong>This retrospective study included consecutive patients with small (≤10 mm) suspected submucosal rectal NETs who underwent ESR (n = 45) or EMR-L (n = 26) between June 2018 and October 2023 at West China Hospital. En bloc resection rate, complete resection rate, procedure time, margin distance, and adverse events were compared between 2 groups.</p><p><strong>Results: </strong>En bloc resections were achieved in all patients. The complete resection rate of ESR was higher than EMR-L (100% vs 88.5%, P = 0.045). The vertical margin distance and lateral margin distance were significantly longer in ESR group than EMR-L group (vertical margin distance 782.31 ± 359.45 μm vs 363.84 ± 222.78 μm, P < 0.001; and lateral margin distance 4,205.75 ± 2,167.43 μm vs 3,162.94 ± 1,419.22 μm, P = 0.008, respectively). There were no significant differences in procedure time, adverse events, postprocedural hospital stay, or medical cost between 2 groups. In addition, there was no evidence of recurrence or metastasis during the follow-up.</p><p><strong>Discussion: </strong>ESR seems to be safe and effective for complete resection of small submucosal rectal NETs. Larger, multicenter, prospective studies are needed to further assess this technique.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e00830"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Whole Transcriptome-wide Analysis Combined With Summary Data-Based Mendelian Randomization Identifies High-Risk Genes for Cholelithiasis Incidence.","authors":"Xuxu Liu, Heming Wang, Zhihong Xie, Lianghao Li, Yuanhang He, Ziang Meng, Jiachen Li, Jingjing Yu, Zhiwei Du, Yi Zheng, Tianming Liu, Chenjun Hao, Dongbo Xue, Liyi Wang, Enjun Gao","doi":"10.14309/ctg.0000000000000800","DOIUrl":"10.14309/ctg.0000000000000800","url":null,"abstract":"<p><strong>Introduction: </strong>Cholelithiasis is influenced by various factors, including genetic elements identified in genomewide association studies, but their biological functions are not fully understood.</p><p><strong>Methods: </strong>Analyzing data from the Finngen database with 37,041 cholelithiasis cases and 330,903 controls, this study combined SNP data from GTEx v8 and linkage disequilibriums data from the 1000 Genomes Project. Using the Transcriptomewide Association Studies FUSION protocol and summary data-based Mendelian randomization analysis, it investigated the relationship between gene expression and cholelithiasis, using colocalization tests and conditional analyses to explore causality.</p><p><strong>Results: </strong>The study identified genes associated with cholelithiasis in the liver and whole blood, such as LINC01595, TTC39B, and UGT1A3, with several showing colocalization traits. Notably, RP11-378A13.1 and adenosine deaminase acting on RNA (ADAR) were significantly associated with the disease in both tissues.</p><p><strong>Discussion: </strong>This research provides insights into the genetic underpinnings of cholelithiasis, highlighting the significant role of gene expression in its development. It establishes new gene associations and identifies potential genetic markers for the disease.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e00800"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients With Inflammatory Bowel Disease Are at Increased Risk of Respiratory Syncytial Virus Infections After Severe Acute Respiratory Syndrome Coronavirus 2 Infection: A Propensity-Matched Cohort Analysis.","authors":"Saqr Alsakarneh, Oscar Ramirez Ramirez, Mary S Hayney, Jana G Hashash, Francis A Farraye, Freddy Caldera","doi":"10.14309/ctg.0000000000000840","DOIUrl":"10.14309/ctg.0000000000000840","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with inflammatory bowel disease (IBD) are at an increased risk of infections. Before the COVID-19 pandemic, respiratory syncytial virus (RSV) followed predictable seasonal patterns, which have been recently disrupted. This study aimed to investigate whether severe acute respiratory syndrome (SARS) coronavirus 2 (CoV-2) infection is associated with an increased risk of RSV infection in patients with IBD compared with those without a history of SARS-CoV-2 infection.</p><p><strong>Methods: </strong>This retrospective cohort study used the TriNetX database to identify patients aged 18 years and older with IBD and SARS-CoV-2 infection (IBD-SARS-CoV-2 cohort) during the 2022 and 2023 RSV seasons. A 1:1 propensity score matching was used to compare patients with IBD but no history of SARS-CoV-2 infection (IBD non-SARS-CoV-2 cohort).</p><p><strong>Results: </strong>In the 2022 IBD-SARS-CoV-2 cohort (mean age: 53.7 ± 17.6 years; 59% female; 77% White), the RSV infection risk was 0.47%, higher than 0.19% in the matched IBD non-SARS-CoV-2 cohort (adjusted odds ratio [aOR]: 2.4; 95% CI: 1.5-3.6). The risk was highest 30-60 days after SARS-CoV-2 infection (aOR: 2.9; 95% CI: 1.7-4.9), particularly in those aged 60 years and older (aOR: 2.5; 95% CI: 1.3-4.5). The use of systemic corticosteroids (aOR: 2.3; 95% CI: 1.1-4.6) or immune-modifying therapies (aOR: 3.9; 95% CI: 2-7.1) was associated with higher RSV infection risk. Similar trends were observed during the 2023 RSV season, with no significant differences in RSV-related hospitalizations.</p><p><strong>Discussion: </strong>Adults with IBD have a higher risk of RSV infection after SARS-CoV-2 infection, particularly those receiving steroids or immune therapies. SARS-CoV-2 infection may have contributed to the recent RSV infection surge in this population, warranting further research.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e00840"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secondary Spontaneous Bacterial Peritonitis Prophylaxis Is Associated With a Higher Rate of Infections other than Spontaneous Bacterial Peritonitis in 2 US-Based National Cirrhosis Cohorts.","authors":"Scott Silvey, Nilang Patel, Jacqueline G O'Leary, Sofia S Jakab, Heather Patton, Shari Rogal, John D Markley, Ramsey Cheung, Arpan Patel, Timothy R Morgan, Jasmohan S Bajaj","doi":"10.14309/ctg.0000000000000837","DOIUrl":"10.14309/ctg.0000000000000837","url":null,"abstract":"<p><strong>Introduction: </strong>Antibiotic overuse and subsequent antibiotic resistance lead to worse infection outcomes in cirrhosis. Secondary spontaneous bacterial peritonitis prophylaxis (SecSBBPr) is associated with higher SBP recurrence, but impact on non-SBP infections is unclear.</p><p><strong>Methods: </strong>We studied patients with cirrhosis and SBP who were given SecSBPPr or not between 2009 and 2019 in 2 complementary national cohorts (Veterans Affairs Corporate Data Warehouse [VA-CDW] and non-VA TriNetX). Development of total non-SBP infections and specifically urinary tract infections (UTIs), bacteremia, pneumonia, and C. difficile using validated codes over 2 years was compared between those on SecSBPPr vs not. Multivariable regression for non-SBP infections was performed.</p><p><strong>Results: </strong>VA-CDW: Of 4,673 veterans with index SBP, 2,539 (54.3%) were started on SecSBPPr. In total, 1,406 (30.1%) developed non-SBP infections (13.5% UTI, 12.4% pneumonia, 8.5% bacteremia, and 6.8% C. difficile ). On multivariable regression, SecSBPPr was significantly associated with any non-SBP infection (odds ratio [OR] 1.26, 95% confidence interval [CI] 1.10-1.44, P < 0.0001) and UTI (OR 1.21, 95% CI 1.01-1.45, P = 0.036). TriNetX: Of 6,708 patients with index SBP, 3,261 (48.6%) were started on SecSBPPr. In total, 1,932 (28.8%) patients developed non-SBP infections (13.4% UTI, 12.9% pneumonia, 8.6% bacteremia, and 5.9% C. difficile ). On multivariable regression, SecSBPPr was significantly associated with any non-SBP infection (OR 1.33, 95% CI 1.12-1.59, P < 0.0001), UTI (OR 1.35, 95% CI 1.07-1.71, P = 0.010), pneumonia (OR 1.35, 95% CI 1.06-1.72, P = 0.017), and bacteremia (OR 1.47, 95% CI 1.10-1.97, P = 0.009).</p><p><strong>Discussion: </strong>In 2 diverse US-based national cohorts of patients with cirrhosis and SBP, use of SecSBPPr was associated with a higher risk of non-SBP infections, especially urinary tract infections.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e00837"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mucin 5AC as a Biomarker for Sessile Serrated Lesions: Results From a Systematic Review and Meta-Analysis.","authors":"Kevin Liu, Moniyka Sachar, Violeta Popov, Ziheng Pei, Giulio Quarta","doi":"10.14309/ctg.0000000000000831","DOIUrl":"10.14309/ctg.0000000000000831","url":null,"abstract":"<p><strong>Introduction: </strong>Sessile serrated lesions (SSLs) are a class of colon polyps challenging to detect through current screening methods but highly associated with colon cancer. To improve detection, we sought a biomarker sensitive for SSLs. Recent endoscopic and histopathologic studies suggest that SSLs are associated with alterations in intestinal mucin expression, but the frequency with which this occurs is not known.</p><p><strong>Methods: </strong>We performed a meta-analysis of available pathologic studies comparing mucin expression on SSLs to normal colonic mucosa, tubular adenomas, villous adenomas, traditional serrated adenomas (TSAs), and hyperplastic polyps (HPs). We searched Medline, Pubmed, and Embase and found 440 publications in this topic, and 18 total studies met inclusion.</p><p><strong>Results: </strong>We found that MUC5AC expression was more common in SSLs compared to normal colonic mucosa (OR = 82.9, P < 0.01), tubular adenoma (OR = 11, P < 0.01), and TSAs (OR = 3.6, P = 0.04). We found no difference in MUC5AC expression between SSLs versus HPs (OR = 2.1, P = 0.09) and no difference in MUC5AC expression between left colon and right colon HPs, with an OR = 1.8, P = 0.23.</p><p><strong>Discussion: </strong>We found that MUC5AC expression was found commonly on villous adenoma, SSLs, and TSAs while the frequency on colon cancers declined. MUC5AC is also upregulated in inflammatory bowel disease and in response to intestinal infections. MUC5AC expression highlights the potential of mucins as useful biomarkers, though not specific to SSLs. Further research into the clinical utility of MUC5AC as a pathologic or fecal biomarker could enhance SSL detection.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e00831"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pruritus and Fatigue in Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease: A Study of Turkish Patients From the Global NASH/MASH Registry.","authors":"Yusuf Yilmaz, Caglayan Keklikkiran, Andrei Racila, Maria Stepanova, Zobair M Younossi","doi":"10.14309/ctg.0000000000000844","DOIUrl":"10.14309/ctg.0000000000000844","url":null,"abstract":"<p><strong>Introduction: </strong>Despite being underappreciated, pruritus and fatigue are not uncommon in metabolic dysfunction-associated steatotic liver disease (MASLD). In this prospective registry-based study, we sought to evaluate the prevalence, predictors, and impact of these symptoms on patient-reported outcomes (PROs) in patients with MASLD from Türkiye, a country with one of the highest burdens of MASLD globally.</p><p><strong>Methods: </strong>A total of 1,874 Turkish patients from the Global Liver Registry were included. Significant pruritus and fatigue were defined using the Chronic Liver Disease Questionnaire-nonalcoholic steatohepatitis and the Functional Assessment of Chronic Illness Therapy-Fatigue, respectively. PROs were assessed using the Chronic Liver Disease Questionnaire-nonalcoholic steatohepatitis, Functional Assessment of Chronic Illness Therapy-Fatigue, and the Work Productivity and Activity Impairment: Specific Health Problem questionnaire.</p><p><strong>Results: </strong>The prevalence of significant pruritus and fatigue was 37% and 33%, respectively. Both symptoms were significantly associated with female sex, type 2 diabetes, depression, abdominal pain, and lack of regular exercise. Patients with these symptoms had significantly worse PROs, with impairments up to 31% (all P < 0.0001). Over 1-2 years, symptoms persisted in 47%-52% of patients with baseline pruritus and 33%-39% with baseline fatigue. Independent predictors of a higher likelihood of resolution of pruritus included the absence of fatigue at baseline and the lack of abdominal pain, with odds ratios of 0.36 (95% confidence interval: 0.22-0.59) and 0.60 (95% confidence interval: 0.39-0.91), respectively (both P < 0.05).</p><p><strong>Discussion: </strong>Pruritus and fatigue are common in MASLD, significantly impairing PROs and often persisting over time. Regular assessment and management are essential to improve patients' well-being and functioning.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}