Clinical and Translational Gastroenterology最新文献

{"title":"Clarifying Development and Validation Claims for a Bowel-Preparation Prediction Tool.","authors":"Anastasios Koulaouzidis, Ervin Toth, Wojciech Marlicz","doi":"10.14309/ctg.0000000000001080","DOIUrl":"10.14309/ctg.0000000000001080","url":null,"abstract":"","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677284","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":"Angiotensin-Converting Enzyme Inhibitors and Hepatocellular Carcinoma Risk in Patients With Chronic Hepatitis B and Hypertension: A Nationwide Dose-Response Cohort Study.","authors":"Jung-Min Yu, Wan-Ming Chen, Ming-Feng Chiang, Ming-Shun Wu, Szu-Yuan Wu","doi":"10.14309/ctg.0000000000001049","DOIUrl":"10.14309/ctg.0000000000001049","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic hepatitis B virus (HBV) infection is a leading cause of hepatocellular carcinoma (HCC). Angiotensin-converting enzyme inhibitors (ACEIs) may reduce HCC risk by modulating hepatic fibrogenesis, but population-level evidence remains limited.</p><p><strong>Methods: </strong>We conducted a nationwide cohort study using Taiwan's National Health Insurance Research Database (2010-2020), including adults with chronic HBV and hypertension. ACEI use was defined as ≥28 cumulative defined daily doses. We applied a new-user design, propensity score matching, time-varying Cox models, and competing risk analysis to assess incident HCC.</p><p><strong>Results: </strong>After 1:1 propensity score matching, 118,715 patients were included in each group. ACEI users had a significantly lower HCC risk than nonusers (adjusted hazard ratio [aHR], 0.66; 95% confidence interval, 0.64-0.69). A strong dose-dependent effect was observed, with the highest cumulative defined daily dose quartile demonstrating the greatest risk reduction (aHR, 0.29; 95% confidence interval, 0.26-0.32). This protective association persisted regardless of concurrent nucleos(t)ide analogues (NAs) therapy. Furthermore, treatment persistence (>1 year) was associated with lower HCC risk compared with early discontinuation (aHR, 0.62 vs 0.71).</p><p><strong>Discussion: </strong>ACEI use was associated with a robust, dose-dependent reduction in HCC risk among chronic HBV patients with hypertension. These findings highlight the translational potential of repurposing ACEIs for HCC chemoprevention, particularly for hypertensive HBV carriers currently ineligible for antiviral therapy.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e01049"},"PeriodicalIF":3.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147947889","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":"Esophageal Sonography: A Review of the Utility of Ultrasound in Clinical Esophagology.","authors":"Daniel L Cohen, Ayelet Wandel, Alla Khashper, Haim Shirin, Vered Richter","doi":"10.14309/ctg.0000000000001048","DOIUrl":"10.14309/ctg.0000000000001048","url":null,"abstract":"<p><p>The utility and availability of ultrasound (US) are increasing. While US has traditionally not been performed on the esophagus, as the entire length of the esophagus cannot be optimally viewed, it does allow for visualization of the cervical and intra-abdominal esophagus. There is growing evidence that esophageal US can be useful in clinical esophagology. This review summarizes the current knowledge concerning esophageal US in various esophageal disorders. Studies of patients with achalasia have shown that US can distinguish patients with achalasia from health controls and patients with esophagogastric cancer. US may be helpful as a screening test for esophageal varices in cirrhotic patients as esophageal wall thickness has been shown to correlate with the presence of varices. US has also been shown to identify the presence of esophageal foreign bodies in case reports in both the adult and pediatric population. In infants, numerous studies have shown its utility in diagnosing gastroesophageal reflux disease and its correlation with pH study results, although the data in adults are less convincing. Taken together, these results suggest that there is a role for US-a noninvasive, cost-effective, and widely available test-in evaluating esophageal disorders. Despite these promising results, it does not seem that esophageal US is frequently used in clinical practice. Barriers to its implementation, including the availability of US and the training required, are discussed, along with the lack of standardized US protocols, equipment, and normal values. Future high-quality studies on the utility of US in esophageal disorders are warranted and will accelerate the implementation of this promising technology.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e01048"},"PeriodicalIF":3.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148175507","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 Ileal Pouch-Anal Anastomosis Have Decreased Bowel Frequency on Glucagon-Like Peptide-1 Receptor Agonist Therapy.","authors":"Ezan Chaudhry, Payal Kakadiya, Hayden Vaughn, Simon Gray, Jonathan J Hansen, John P Haydek, Animesh Jain, Millie D Long, Hans H Herfarth, Edward L Barnes","doi":"10.14309/ctg.0000000000001070","DOIUrl":"10.14309/ctg.0000000000001070","url":null,"abstract":"<p><strong>Introduction: </strong>High bowel frequency after ileal pouch-anal anastomosis (IPAA) causes significant symptom burden. We aimed to evaluate the impact of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in this setting.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of patients with previous IPAA for ulcerative colitis who were treated with a GLP-1 RA (n = 20). Daily bowel frequency at baseline and 12 weeks after GLP-1 RA initiation was assessed. We also assessed the proportion of patients achieving ≥30% reduction in bowel frequency and ≤8 bowel movements per day.</p><p><strong>Results: </strong>The median daily bowel frequency decreased from 9.0 (interquartile range [IQR], 6.0-12.5) at baseline to 6.0 (IQR, 5.0-8.1) at the 12-week follow-up ( P < 0.01). Overall, 7 of 20 patients achieved a ≥30% reduction in bowel frequency, and 15 of 20 had ≤8 bowel movements per day.</p><p><strong>Discussion: </strong>In this retrospective cohort, we provide further evidence for the potential role of GLP-1 RAs in the management of high bowel frequency after IPAA.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e01070"},"PeriodicalIF":3.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148367638","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":"Plasma Phospholipids and Incident Ulcerative Colitis: A Prospective Cohort Study in the UK Biobank.","authors":"Jialu Tang, Dawei Zhou, Shaojun Liu","doi":"10.14309/ctg.0000000000001051","DOIUrl":"10.14309/ctg.0000000000001051","url":null,"abstract":"<p><strong>Introduction: </strong>To investigate the association between plasma levels of total phospholipids in lipoprotein particles and the risk of incident ulcerative colitis (UC).</p><p><strong>Methods: </strong>This prospective cohort study analyzed data from 254,921 participants in the UK Biobank (2006-2020), excluding those with preexisting UC or missing data. Phospholipid levels were measured by nuclear magnetic resonance spectroscopy. Cox proportional hazards models were adjusted for demographic, lifestyle, socioeconomic, and genetic factors. Dose-response and subgroup analyses were conducted using generalized additive models.</p><p><strong>Results: </strong>During a median follow-up duration of 15.78 years, 1,330 incident UC cases were identified. Higher phospholipid levels demonstrated a significant inverse association with UC risk. After full adjustment, each unit increase in phospholipids was associated with a 16% lower risk (hazard ratio 0.84, 95% confidence interval 0.75-0.95, P = 0.006). Quartile analyses showed lower risks in higher quartiles, with the risk reduction most evident by the third quartile and then generally stable (Q4 vs Q1: hazard ratio 0.83, 95% confidence interval 0.71-0.97, P = 0.020). Generalized additive and quartile analyses suggested a nonlinear plateau/threshold pattern rather than a strictly linear association. Subfraction analyses showed heterogeneous associations, with inverse patterns mainly observed for phospholipids carried by high-density lipoprotein cholesterol, intermediate-density lipoprotein, and low-density lipoprotein cholesterol particles, whereas chylomicron- and several very low-density lipoprotein-related phospholipids showed null or positive/nonprotective associations.</p><p><strong>Discussion: </strong>Higher plasma total phospholipid levels are independently associated with reduced UC risk, suggesting phospholipid metabolism may play a protective role in UC pathogenesis. However, this association is not uniform across lipoprotein subfractions. These findings highlight potential metabolic biomarkers and mechanistic pathways requiring further validation for UC prevention.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e01051"},"PeriodicalIF":3.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148162039","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":"Novel Technologies for Gastrointestinal Cancer Detection: A Systematic Review and Meta-Analysis of Diagnostic Accuracy.","authors":"Melissa Barlow, Sarah Bailey, Saleh Alessy, Badr Al-Bawardy, Sadeem Aldarweesh, Rowaedh A Bawaked, Heba Alharith, Amin Mahdi, Asrar Alaklabi, Mohammad Mawardi, Aldanah M Althwanay, Nora A Althumiri, Saleh Alabbad, Khalid I Bzeizi, Severin Rakic, Ahmed Allehebi, Predrag Zivotic, Volkan Cetinkaya, Bandar AlJudaibi, Saleh A Alqahtani","doi":"10.14309/ctg.0000000000001058","DOIUrl":"10.14309/ctg.0000000000001058","url":null,"abstract":"<p><strong>Introduction: </strong>Gastrointestinal (GI) cancers account for a quarter of all cancers and one-third of cancer-related deaths worldwide. Novel diagnostic approaches are crucial to enhance early detection and improve patient outcomes. This review systematically identified and evaluated novel GI cancer detection approaches.</p><p><strong>Methods: </strong>A systematic review was conducted using PubMed, EMBASE, Scopus, and the Cochrane Library on December 11, 2024, and updated on June 2, 2025. Cohort studies and randomized controlled studies, published in English, that evaluated a novel diagnostic approach for incident GI cancer in a clinical setting, included ≥300 participants, and reported diagnostic accuracy metrics were eligible for inclusion. Two reviewers independently screened studies and assessed risk of bias using the Quality Assessment of Diagnostic Accuracy Studies 2 tool.</p><p><strong>Results: </strong>Of 9,604 records screened, 72 studies were included: by site, 51 on colorectal, 1 on upper GI, 1 on esophageal, 7 on gastric, 9 on pancreatic, and 5 on hepatocellular carcinoma. Stool DNA testing in patients with a positive fecal immunochemical test showed the highest performance for colorectal cancer (area under the receiver operating characteristic curve [AUC] 0.94-0.98). The best performing technologies across other cancer types were Q-Cancer for pancreatic (AUC 0.89-0.92), the GALADUS model for hepatocellular carcinoma in cirrhotic patients (AUC 0.94), and an artificial intelligence model for esophageal cancer (AUC 0.87).</p><p><strong>Discussion: </strong>This review highlights several promising novel diagnostic approaches for GI cancer detection. External validation, population-level studies, and health economic evaluation are crucial to establish clinical utility across different settings and populations. Clinicians and policy makers must weigh the added value of novel technologies against current practice, regulatory requirements, clinical understanding, interpretation of results, and public trust.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e01058"},"PeriodicalIF":3.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148161947","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":"Role of Anxiety and Depression on the Interplay Between Disorders of Gut-Brain Interaction and Eating Disorders.","authors":"Stella-Maris C Egboh, Natasha A Koloski, Michael P Jones, Ayesha Shah, Gerald Holtmann, Nicholas J Talley","doi":"10.14309/ctg.0000000000001025","DOIUrl":"10.14309/ctg.0000000000001025","url":null,"abstract":"<p><strong>Introduction: </strong>Disorders of gut-brain interaction (DGBI) are frequently encountered among patients with eating disorders (ED). Underlying both ED and DGBI may be psychological comorbidities, but it is uncertain how often psychological disorder explains the development of either disorder. We hypothesized a DGBI may predispose to a new onset ED. We aimed to determine the associations and chronological presentation of DGBI, ED, and psychological comorbidities.</p><p><strong>Methods: </strong>Data were collected from a retrospective cohort of n = 1,256,331 patients attending general practices in the UK; 1,018 patients diagnosed with both a DGBI and an ED were included, with 777 also having data on anxiety and/or depression. Timing of order of onset and potential moderators of the sequence of occurrence were considered. Clinical significance level was set at P < 0.01 and odds ratio (OR) ≥ 2.0.</p><p><strong>Results: </strong>Prevalence of any ED was 0.7%. Chronic constipation was associated with anorexia nervosa (OR = 2.12; 95% confidence interval 1.84-2.45) and any ED (OR = 2.06; 95% confidence interval 1.79-2.36). Irritable bowel syndrome and functional dyspepsia were significantly associated with one or more ED. More patients in primary care were diagnosed with an ED (59.5%, n = 606) preceding a DGBI than vice versa (40.5%, n = 412, P < 0.001). Independent predictors of having a diagnosed DGBI preceding an ED were younger age at first diagnosis of DGBI ( P < 0.001), antecedent depression ( P < 0.003), and antecedent proton pump inhibitor use ( P < 0.001).</p><p><strong>Discussion: </strong>Psychological disorders, ED, and DGBI overlap. ED more frequently preceded the onset of a DGBI diagnosis; younger age, antecedent depression, and proton pump inhibitor use were independently associated with a DGBI predicting an ED.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e01025"},"PeriodicalIF":3.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148223756","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":"Clip Combined With Rubber Band vs Clip-Assisted Endoscopic Retrograde Cholangiopancreatography for Difficult Biliary Cannulation in Periampullary Diverticulum: A Propensity Score-Matched Analysis.","authors":"Longping Chen, Jin Zheng, Chuanshen Jiang, Junguo Chen, Zhiping Chen, Zanxuan Qiu, Dazhou Li, Wen Wang","doi":"10.14309/ctg.0000000000001054","DOIUrl":"10.14309/ctg.0000000000001054","url":null,"abstract":"<p><strong>Introduction: </strong>Successful biliary cannulation is critical to the success of endoscopic retrograde cholangiopancreatography (ERCP). While various devices and auxiliary techniques have been developed to manage difficult cannulation in patients with periampullary diverticulum (PAD), however, comparative studies on different traction methods remain understudied. The aim of this study was to compare the safety and efficacy of clip-assisted ERCP (C-ERCP) vs clip combined with rubber band-assisted ERCP (CRB-ERCP) for difficult biliary cannulation in patients with PAD.</p><p><strong>Methods: </strong>This study was a single-center retrospective analysis including 193 patients with difficult biliary cannulation and concomitant PAD. Using propensity score matching based on age, sex, and diverticulum type, 120 patients (60 per group) were selected for comparison. The primary outcomes assessed were cannulation success rate, procedure time, and incidence of procedure-related complications.</p><p><strong>Results: </strong>The cannulation success rate was significantly higher in the CRB-ERCP group than in the C-ERCP group (96.7% vs 73.3%, P < 0.001). The cannulation time was also markedly shorter in the CRB-ERCP group (52 ± 47 vs 106 ± 73 seconds, P < 0.001). To achieve successful cannulation, the C-ERCP group required additional techniques-such as the double-guidewire method or transpancreatic biliary sphincterotomy-more frequently than the CRB-ERCP group (38.3% vs 13.3%, P = 0.003). The overall incidence of adverse events was comparable between the 2 groups ( P = 0.632), all of which resolved with conservative management. No serious adverse events occurred in either group.</p><p><strong>Discussion: </strong>Both CRB-ERCP and C-ERCP are viable options for difficult biliary cannulation in PAD. However, CRB-ERCP shows superior advantages in shortening cannulation time, improving success rates, and reducing the need for additional rescue techniques, making it a safe, feasible, and highly effective approach.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e01054"},"PeriodicalIF":3.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155550","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":"Sarcopenia Predicts the Recompensation in Patients With Decompensated Cirrhosis.","authors":"Ning Wei, Minghui Liu, Li Gu, Yangyang Zhou, Haonan Gao, Xin Li, Dong Xu, Yuhu Song","doi":"10.14309/ctg.0000000000001050","DOIUrl":"10.14309/ctg.0000000000001050","url":null,"abstract":"<p><strong>Introduction: </strong>Sarcopenia is associated with increased mortality and poor clinical outcomes in patients with liver cirrhosis. However, the correlation between sarcopenia and recompensation has not been determined until now. In this study, we aimed to evaluate the performance of sarcopenia in predicting recompensation in patients with decompensated cirrhosis.</p><p><strong>Methods: </strong>A total of 258 patients with decompensated cirrhosis were enrolled in this retrospective study, and the data of enrolled patients were collected and analyzed.</p><p><strong>Results: </strong>Overall, 36.82% of patients with decompensated cirrhosis achieved recompensation. The etiology of liver cirrhosis in these patients included hepatitis B virus, hepatitis C virus, alcoholic liver disease, autoimmune liver diseases, schistosomiasis infection, and nonalcoholic fatty liver disease. The decompensating events in these patients included ascites (43.02%), esophagogastric variceal bleeding (42.25%), and hepatic encephalopathy (5.23%); 27.06% of decompensated patients with sarcopenia and 41.62% of patients without sarcopenia achieved recompensation. Univariate logistic analysis demonstrated several variables were associated with recompensation, including erythrocyte, hemoglobin, the third lumbar skeletal muscle index, sarcopenia, and subcutaneous fat area (all P < 0.05). Multivariate analysis demonstrated that sarcopenia (odds ratio = 0.52; P = 0.03) and hemoglobin (odds ratio = 1.02; P < 0.01) were independent predictors for recompensation.</p><p><strong>Discussion: </strong>Sarcopenia and hemoglobin were independent predictors for recompensation of decompensated patients, which helped to identify high-risk patients who have difficulty in achieving recompensation.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e01050"},"PeriodicalIF":3.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210224","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":"Phenotype-Specific Dose-Response Patterns of Systemic Inflammation With Hepatic Decompensation in Cirrhosis: A Cross-Sectional Study.","authors":"Shufang Zhang, Xiaowei Mo, Caiting Lai, Yuanfeng Lv, Xinjun Jiang, Yue Lin, Jiakun Liu, Wenting Li, Zan Liu","doi":"10.14309/ctg.0000000000001063","DOIUrl":"10.14309/ctg.0000000000001063","url":null,"abstract":"<p><strong>Introduction: </strong>Systemic inflammation is associated with hepatic decompensation in cirrhosis, but whether this association follows the same dose-response pattern across different decompensation phenotypes is unknown. We examined an inflammation burden index (IBI) against severity proxies (Child-Turcotte-Pugh [CTP], Model for End-Stage Liver Disease [MELD]), and clinical events (ascites, spontaneous bacterial peritonitis [SBP]).</p><p><strong>Methods: </strong>In 463 adults with cirrhosis, IBI integrated interleukin-6, high-sensitivity C-reactive protein, neutrophil-to-lymphocyte ratio, and procalcitonin (log1p, robust-z, equal-weight). A unified covariate set was applied; dose-response used restricted cubic splines; additive interaction with sarcopenia by relative excess risk due to interaction/attributable proportion/synergy index; internal validation by 1,000 bootstrap resamples.</p><p><strong>Results: </strong>Cronbach α was 0.65; max variance inflation factors 1.58. High IBI was associated with worse CTP (odds ratio [OR] 3.50, 2.43-5.06), higher MELD (β 4.88, 3.69-6.07), ascites (OR 3.67, 2.44-5.51), and SBP (OR 2.67, 1.45-4.93; all q < 0.05); bootstrap-corrected estimates differed by <0.04 log-odds or β units. Dose-response was phenotype-specific: CTP, MELD, and SBP rose monotonically, whereas ascites showed an inverted-U pattern ( P -nonlinearity < 0.001) confined to CTP C; ascitic high-IBI patients showed an immunoparalysis profile (lower white blood cell count [WBC], procalcitonin, high-sensitivity C-reactive protein, albumin). IBI - sarcopenia additive interaction was supra-additive for ascites only (relative excess risk due to interaction 0.192, attributable proportion 29.7%); sarcopenia had no independent main effect.</p><p><strong>Discussion: </strong>The IBI - decompensation association is phenotype-specific; the inverted-U for ascites likely reflects an artifact of advanced disease rather than a biological threshold. Findings are descriptive and require prospective validation.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":"e01063"},"PeriodicalIF":3.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148270472","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}