Clinical and Translational Gastroenterology最新文献

{"title":"Splenic Elastography as a Predictor of Gastroesophageal Varices in Cirrhosis.","authors":"Jorge Pacheco Oliva, Ninoska Isamar Meléndez Rodríguez, Abel Alberto Sánchez Orozco","doi":"10.14309/ctg.0000000000001092","DOIUrl":"10.14309/ctg.0000000000001092","url":null,"abstract":"<p><strong>Introduction: </strong>Gastroesophageal varices are a major complication of portal hypertension in cirrhosis, associated with high morbidity and mortality. Noninvasive predictors are needed to reduce reliance on endoscopy. Splenic elastography has emerged as a potential tool to assess portal hypertension severity.</p><p><strong>Methods: </strong>We conducted prospective, descriptive cross-sectional study at Hospital Roosevelt, Guatemala, in 2024, including 78 patients with recent diagnosis of cirrhosis confirmed by ultrasonography. Patients with hepatocellular carcinoma, acute decompensation, or conditions interfering with splenic stiffness measurement were excluded. Splenic stiffness was measured using transient elastography with the M probe. Endoscopy was performed within 2 weeks. Diagnostic accuracy for gastroesophageal varices was assessed using receiver operating characteristic analysis.</p><p><strong>Results: </strong>The mean age was 56.1 years (SD 12.6), and 70.5% were female. The most frequent etiology was viral hepatitis (30.77%), followed by alcohol-related liver disease (19.23%) and metabolic dysfunction-associated steatotic liver disease (11.53%). Most patients were Child-Pugh class A (80.76%), with a mean model for end-stage liver disease (MELD)-Na score of 11.99 (SD 5.46). Gastroesophageal varices were present in 57.69% of patients and large varices in 26.92%. Splenic elastography showed an area under the curve of 0.72 (95% CI: 0.59-0.83), with sensitivity of 82.22% and specificity of 66.67% at ≥27 kPa. The median stiffness increased progressively with variceal size, from 25 kPa in absence of varices to 50 kPa in large varices ( P < 0.001). No significant correlation was found with Child-Pugh class ( P = 0.538) or MELD-Na score ( P = 0.121).</p><p><strong>Discussion: </strong>Splenic elastography demonstrated moderate accuracy for predicting gastroesophageal varices in cirrhosis. Stiffness values correlated significantly with variceal size, supporting its role as a noninvasive marker of variceal severity. Larger external validation studies are warranted.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891170","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}

{"title":"Impact of Hepatitis C Viremia on Overall Survival and Hepatic Decompensation Among Patients with Unresectable Hepatocellular Carcinoma Receiving Immunotherapy.","authors":"Eunice Y Lee, Willis Tang, Jennifer C Price, Robin K Kelley, John D Gordan, Jennifer C Lai, Lawrence Fong, Neil Mehta, Michael Li","doi":"10.14309/ctg.0000000000001093","DOIUrl":"10.14309/ctg.0000000000001093","url":null,"abstract":"<p><strong>Introduction: </strong>Hepatitis C (HCV) is associated with an immunosuppressive liver microenvironment, but whether HCV affects immune checkpoint inhibitor (ICI) outcomes in unresectable hepatocellular carcinoma (HCC) remains unknown.</p><p><strong>Methods: </strong>We performed a single-center retrospective cohort study of patients with unresectable HCC treated with ICIs. In patients with a history of HCV, viremia was defined as a detectable viral load before immunotherapy. The primary outcome was overall survival (OS); secondary outcomes were real-world progression-free survival (PFS), time on treatment, and time to hepatic decompensation.</p><p><strong>Results: </strong>Among 350 patients with unresectable HCC treated with ICIs, 135 (39%) had a history of HCV, of which 37 (27%) were viremic. Viremia was not associated with OS (hazard ratio [HR] 0.88, 95% CI 0.53-1.44, P = 0.600), but was associated with longer real-world PFS (HR 0.59, 95% CI 0.36-0.96, P = 0.033) and longer time on treatment (HR 0.63, 95% CI 0.40-0.99, P = 0.044). Compared with patients with non-HCV related unresectable HCC (n = 215), viremic patients had longer real-world PFS (HR 0.65, 95% CI 0.44-0.97, P = 0.037) but nonviremic patients did not (HR 0.87, 95% CI 0.66-1.17, P = 0.359). Viremia was not associated with time to hepatic decompensation (HR 1.11, 95% CI 0.61-2.04, P = 0.728), but in patients who survived at least 1 year without decompensating, viremia was associated with shorter time to decompensation (29.8 months vs median not reached, log-rank P = 0.010).</p><p><strong>Discussion: </strong>Viremia was not associated with OS among ICI-treated HCV patients with unresectable HCC, but was associated with longer real-world PFS and time on treatment. Further studies are needed to investigate these findings.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879464","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}

{"title":"Response to Khan et al.","authors":"Marco Vincenzo Lenti, Luca Gadaleta, Giorgio Civitarese, Antonio Di Sabatino","doi":"10.14309/ctg.0000000000001088","DOIUrl":"10.14309/ctg.0000000000001088","url":null,"abstract":"","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879440","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}

{"title":"Response to Jamalinia and Lonardo.","authors":"Omar Al Ta'ani, Yahya Alhalalmeh, Basile Njei, Nikki Duong","doi":"10.14309/ctg.0000000000001072","DOIUrl":"10.14309/ctg.0000000000001072","url":null,"abstract":"","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e01072"},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148367654","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":"Trajectory of Ascites Pressure and Outcomes of Patients With Cirrhosis Undergoing Paracentesis.","authors":"Nikhilesh R Mazumder, Max Macgregor, John D Rice, Elliot B Tapper, Anna S Lok","doi":"10.14309/ctg.0000000000001077","DOIUrl":"10.14309/ctg.0000000000001077","url":null,"abstract":"<p><strong>Introduction: </strong>Ascites severity is an important prognostic marker of liver disease. We hypothesize that ascites pressure correlates with outcomes of patients undergoing therapeutic paracentesis.</p><p><strong>Methods: </strong>Adults with portal hypertensive ascites (n = 87) undergoing therapeutic paracentesis (n = 261) had pressure measured during drainage using a noninvasive manometer setup and were followed for 365 days.</p><p><strong>Results: </strong>Pressure drop during paracentesis was associated with event-free survival after adjusting for Model for End Stage Liver Disease 3.0 and age (adjusted hazard ratio 0.43 per 5 cmH 2 O, 95% confidence interval [0.21, 0.90], P = 0.02), but volume drained was not.</p><p><strong>Discussion: </strong>Ascites pressure provides Model for End Stage Liver Disease-independent prognostic information in patients undergoing paracentesis.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e01077"},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548031","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":"Establishment and Evaluation of a Probe-Based Confocal Laser Endomicroscopy Training System for Gastric Cancerous Lesions Diagnosis: Evidence From a National Training Program.","authors":"Peng Pan, Jie Gao, Yu Zhang, Jin-Yan Pan, Wen-Hua Zhang, Nan-Nan Wang, Jiu-Long Zhao, Zhi-Xia Dong, Zhi-Hua Xiao, Zhen-Dong Jin, Zhao-Shen Li, Yu Bai","doi":"10.14309/ctg.0000000000001074","DOIUrl":"10.14309/ctg.0000000000001074","url":null,"abstract":"<p><strong>Introduction: </strong>The learning process for probe-based confocal laser endomicroscopy (pCLE) is challenging, and standardized training protocols are currently lacking. The main purpose of this study was to establish and evaluate a preliminary pCLE training system.</p><p><strong>Methods: </strong>This prospective diagnostic trial was performed based on the nationwide training program. The training system included online theoretical courses and a 2-day offline training. All patients underwent pCLE and magnifying endoscopy (ME). The diagnostic performances of baseline levels, pCLE trainees, pCLE experts, and ME experts were evaluated and compared. The primary outcomes were the diagnostic accuracy, sensitivity, and specificity of gastric cancerous lesions. Linear regression analysis was adopted to explore the influence factors on the accuracy of trainees.</p><p><strong>Results: </strong>A total of 150 lesions and 127 endoscopists were enrolled. All diagnostic indicators for pCLE trainees exhibited significant improvement versus baseline levels (all P < 0.001). pCLE trainees exhibited significantly lower accuracy than pCLE experts ( P = 0.036). There were no significant differences in accuracy, sensitivity, and specificity between pCLE trainees and ME experts. pCLE experts showed significantly higher accuracy ( P = 0.039) and specificity ( P = 0.022) than ME experts. Professional title, hospital level, gastroscopy experience, ME experience, and educational degree exerted no significant influence on the accuracy of pCLE trainees.</p><p><strong>Discussion: </strong>Short-term systematic pCLE training demonstrated significant efficacy, and the diagnostic performance of pCLE trainees was comparable with that of mature ME technology. pCLE can serve as an effective method to promptly enhance the diagnostic proficiency of endoscopists, especially novices, for gastric cancerous lesions.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e01074"},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148599659","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":"Measuring Perceived Goal Concordant Care Among Patients With Advanced Liver Diseases and Their Caregivers.","authors":"Manisha Verma, Victor Navarro, Bryce B Reeve, Li Lin, Simona Jakab, Marie Bakitas, Annette Totten, Michael Volk","doi":"10.14309/ctg.0000000000001079","DOIUrl":"10.14309/ctg.0000000000001079","url":null,"abstract":"<p><strong>Introduction: </strong>High-quality care in advanced chronic liver disease requires alignment between patients' goals and preferences and the care delivered. However, no validated instruments exist to measure perceived goal-concordant care (GCC), defined as patients' and caregivers' assessment of the extent to which received care aligns with their preferences.</p><p><strong>Methods: </strong>We developed a novel dyadic instrument with input from clinicians, researchers, patients with advanced chronic liver disease, and their caregivers. The measure includes 2 domains: (i) goals-of-care conversations (GoCC), a 7-item scale assessing the patients' and caregivers' perception of the extent to which clinicians engaged them in discussion of prognosis, and (ii) care concordant with preferences (CCPs), a 4-item scale measuring the perceived alignment of care with preferences. Patients and caregivers were enrolled as dyads in the Palliative Care for Liver Diseases (PAL-LIVER) trial. Baseline data were used for psychometric evaluation. Factor structure was examined using confirmatory factor analysis and reliability using the Cronbach coefficient. Construct validity was tested by associations with patient satisfaction, quality of life, and caregiver burden.</p><p><strong>Results: </strong>Eight hundred thirty patients and 490 caregivers completed the GCC instrument. Confirmatory factor analysis demonstrated acceptable fit for GoCC (patient: comparative fit index [CFI] = 0.95, Tucker-Lewis index [TLI] = 0.92, root mean square error of approximation [RMSEA] = 0.12; caregiver: CFI = 0.99, TLI = 0.98, RMSEA = 0.07) and CCP after item refinement (patient: CFI = 0.99, TLI = 0.98, RMSEA = 0.06; caregiver: CFI = 0.97, TLI = 0.91, RMSEA = 0.18). Internal consistency was good (GoCC α = 0.79-0.84; CCP α = 0.82-0.85). CCP scores demonstrated moderate positive correlations with patient satisfaction (r = 0.49; caregiver r = 0.35) and quality of life (r = 0.31; r = 0.25), and small inverse correlations with caregiver burden (r = -0.17; r = -0.22).</p><p><strong>Discussion: </strong>This novel instrument provides initial evidence supporting validity and reliability for measuring perceived GCC in chronic liver disease patients and their caregivers.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e01079"},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618729","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":"Evaluating the Reporting Transparency and Interpretability of OLGA and OLGIM Staging in Gastric Cancer Risk Stratification.","authors":"Jing Tian, Wenjie Xu, Shaofen Xu, Tingying Tang, Yimin Kang, Qiaoyu Peng, Fengbin Liu, Shaogang Huang, Xinlin Chen, Zhengkun Hou","doi":"10.14309/ctg.0000000000001068","DOIUrl":"10.14309/ctg.0000000000001068","url":null,"abstract":"<p><strong>Introduction: </strong>Operative Link on Gastritis Assessment (OLGA) and Operative Link on Gastric Intestinal Metaplasia Assessment (OLGIM) are widely used for gastric cancer risk stratification, but published studies vary in how clearly their implementation is reported. We assessed the interpretability of OLGA/OLGIM implementation reporting, focusing on reporting transparency rather than methodological correctness, study quality, or guideline adherence.</p><p><strong>Methods: </strong>We searched PubMed, Embase, and Cochrane CENTRAL from inception to March 20, 2026, with forward and backward citation tracking in Web of Science. Eligible studies applied OLGA and/or OLGIM and reported staging results. Two reviewers independently performed study selection and data extraction. Reporting interpretability was appraised using a prespecified framework based on 2 core components: biopsy sampling strategy and histological assessment with grading approach and stage derivation.</p><p><strong>Results: </strong>Among 155 included studies, 75 (48.4%) had high reporting interpretability, 72 (46.5%) had moderate interpretability, and 8 (5.2%) had low interpretability. Although staging outcomes were widely reported, key details needed to understand stage generation were often incomplete, particularly biopsy sampling, grading approach, and stage derivation. These gaps limited the interpretability, reproducibility, and comparability of published OLGA/OLGIM evidence.</p><p><strong>Discussion: </strong>Studies applying OLGA and OLGIM show substantial variability in implementation reporting. Limited interpretability often reflects incomplete reporting rather than demonstrable deficiencies in underlying methods. More consistent and transparent reporting may improve reproducibility, facilitate cross-study comparison, and support clinical translation.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e01068"},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148326984","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":"Identification of Estrogen-Related Biomarkers in Metabolic Dysfunction-Associated Steatotic Liver Disease Through Machine Learning and Single-Cell Analysis.","authors":"Jiajing Chao, Zhangmin Tan, Yiwen Zhang, Qian Gao, Zhe Li, Chengfang Xu","doi":"10.14309/ctg.0000000000001059","DOIUrl":"10.14309/ctg.0000000000001059","url":null,"abstract":"<p><strong>Introduction: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as nonalcoholic fatty liver disease (NAFLD), is a prevalent chronic liver disease linked to metabolic risk factors. Sex hormones, particularly estrogen, seem to influence MASLD development, as premenopausal women are relatively protected. The aim of this study was to identify estrogen-related biomarkers of MASLD using integrated bioinformatics, machine learning, and single-cell RNA sequencing (scRNA-seq) approaches.</p><p><strong>Methods: </strong>Six public transcriptomic data sets (5 training, 1 validation) were analyzed to find differentially expressed genes (DEGs) in MASLD vs controls. Estrogen-related genes (ERGs) were obtained from the Molecular Signatures Database (MSigDB) and intersected with DEGs to define estrogen-associated DEGs (DEERGs). Machine learning algorithms-Least Absolute Shrinkage and Selection Operator regression and Extreme Gradient Boosting (XGBoost)-were applied to select key feature genes, which were then validated in an independent cohort. Immune cell infiltration was evaluated by cell-type identification by estimating relative subsets of RNA transcripts (CIBERSORT) and single-sample gene set enrichment analysis. Consensus clustering based on feature genes defined molecular subtypes. In addition, a human liver scRNA-seq data set was analyzed to map cell-type-specific expression and pathway activity. A competing endogenous RNA (ceRNA) network of lncRNA-miRNA-mRNA interactions was constructed for the diagnostic genes.</p><p><strong>Results: </strong>Fourteen DEERGs were identified, and 2 diagnostic biomarkers -IGFBP2 and P4HA1- showed high diagnostic accuracy. Both genes were associated with immune infiltration and defined 2 estrogen-related molecular subtypes with distinct immune microenvironment features. Single-cell analysis localized IGFBP2 and P4HA1 to hepatocytes, implicating estrogen-related regulation in metabolic and fibrotic remodeling. CellChat analysis revealed weakened hepatocyte-centered signaling in MASLD. The ceRNA network suggested that multiple lncRNAs (e.g., NEAT1, MALAT1, XIST) may modulate these biomarkers through shared miRNAs.</p><p><strong>Discussion: </strong>Through integrated multicohort analysis, we identified IGFBP2 and P4HA1 as novel estrogen-related tissue biomarkers of MASLD. Preliminary exploration suggests their potential detectability in peripheral blood, though large-scale tissue and protein-level validations are required. Our findings provide insight into sex hormone-linked mechanisms in MASLD and propose candidate molecular targets for improved risk stratification and therapy.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e01059"},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216485","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":"The Impact of Obesity on Inflammatory Cytokines and 90-day and 180-day Survival in Patients With Alcohol-Associated Hepatitis.","authors":"Yun-Cheng Hsieh, Mrigya Babuta, Hannah Siegenberg, Prashanth Thevkar Nagesh, Yunpeng Yu, Wanzhu Tu, Richard K Sterling, Gyongyi Szabo","doi":"10.14309/ctg.0000000000001066","DOIUrl":"10.14309/ctg.0000000000001066","url":null,"abstract":"<p><strong>Introduction: </strong>Obesity is prevalent in patients with alcohol-associated hepatitis (AH), but its impact on clinical outcomes remains incompletely defined. We aimed to evaluate the association between body mass index (BMI)-defined obesity and 90-day and 180-day survival in AH, as well as its association with complications and circulating inflammatory mediators.</p><p><strong>Methods: </strong>We analyzed 778 patients with AH enrolled in the National Institute on Alcohol Abuse and Alcoholism-supported Alcohol-associated Hepatitis Network observational cohort and randomized clinical trial. Patients were categorized as normal weight, overweight, or obese by BMI. Multivariable Cox models were used to evaluate survival. Baseline serum cytokines were measured in a randomly selected subset of 168 patients.</p><p><strong>Results: </strong>Of the 778 patients, 255 (32.8%) were overweight and 310 (39.8%) were obese. Obese patients had higher baseline Model for End-Stage Liver Disease scores, higher rates of bacterial infection during hospitalization, and higher 90-day and 180-day mortality than overweight and normal-weight patients. In multivariable analysis, obesity was associated with reduced 180-day survival (hazard ratio 1.50; 95% confidence interval [CI] 1.03-2.23, P = 0.041). In adjusted logistic models among severe AH cases, obesity remained associated with infection (odds ratio 1.84; 95% CI 1.15-2.93; P = 0.011) and acute kidney injury (odds ratio 2.25; 95% CI 1.42-3.57; P = 0.0005) within 180 days. In the cytokine subset, obese patients showed higher levels of proinflammatory cytokines and chemokines and lower levels of growth factors.</p><p><strong>Discussion: </strong>Obesity in AH was associated with more severe disease at presentation, increased risk of complications, and worse survival, supporting obesity as an important adverse factor in AH.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e01066"},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148367033","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}