Clinical Gastroenterology and Hepatology最新文献

{"title":"Noninvasive Hepatic Steatosis and Fibrosis Indices Differentially Predict Mortality in the Adult Korean Population.","authors":"Young-Gyun Seo, Stergios A Polyzos, Kyung-Hee Park, Christos S Mantzoros","doi":"10.1016/j.cgh.2024.10.006","DOIUrl":"10.1016/j.cgh.2024.10.006","url":null,"abstract":"<p><strong>Background & aims: </strong>Because the association of hepatic fibrosis and steatosis non-invasive indices with mortality remain controversial, their association with all-cause, cardiovascular-, cancer-, and liver-related mortality was evaluated in the Korean population.</p><p><strong>Methods: </strong>In this registry-based, cohort study, data were retrieved from the Korea National Health and Nutrition Examination Survey and mortality data from the Korean Cause of Death data registry; 40,491 individuals followed-up for a median of 8.6 years. Hepatic fibrosis was evaluated with alanine aminotransferase (AST)-to-platelet ratio index (APRI), body mass index-AST-to-alanine aminotransferase (ALT) ratio-diabetes mellitus (BARD), and metabolic dysfunction-associated fibrosis-5 (MAF-5) score, and steatosis was evaluated with liver fat score (LFS) and lipid accumulation product (LAP).</p><p><strong>Results: </strong>Cox regression analysis showed that APRI (<1.0 vs ≥1.0) was independently associated with all-cause (hazard ratio [HR], 3.84; 95% confidence interval [CI], 2.30-6.43; C-index, 0.870), cancer (HR, 4.21; 95% CI, 1.88-9.45; C-index, 0.866), and liver-related (HR, 25.36; 95% CI, 11.02-58.38; C-index 0.909) mortality. MAF-5 (<1.0 vs ≥1.0) was independently associated with all-cause mortality (HR, 1.50; 95% CI, 1.10-2.03; C-index, 0.868) and liver-related mortality (HR, 8.35; 95% CI, 3.58-19.46; C-index, 0.911). LFS (<1.257 vs ≥1.257) was independently associated with all-cause (HR, 1.55; 95% CI, 1.14-2.12; C-index, 0.872) and liver-related (HR, 7.00; 95% CI, 1.63-29.96; C-index, 0.887) mortality. LAP (<38.05 vs ≥38.05) was independently associated with cardiovascular mortality (HR, 2.23; 95% CI, 1.40-3.58; C-index, 0.898). BARD was not associated with mortality.</p><p><strong>Conclusions: </strong>APRI, MAF-5, and LFS were independently associated with all-cause mortality, LAP (cutoff, 38.05) with cardiovascular mortality, APRI with cancer mortality, and APRI, MAF-5, and LFS with liver-related mortality in the adult Korean population.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Gastroparesis in Chronic Pancreatitis and Predictive Factors: A Machine Learning Prediction Model.","authors":"Daryl Ramai, Chun-Wei Pan, David M Troendle, Marcello Maida, Antonio Facciorusso, Jorge D Machicado","doi":"10.1016/j.cgh.2024.09.023","DOIUrl":"10.1016/j.cgh.2024.09.023","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-integrin αvβ6 Autoantibodies are Increased in Primary Sclerosing Cholangitis Patients With Concomitant Inflammatory Bowel Disease and Correlate With Liver Disease Severity.","authors":"Hannah Bloemen, Alexandra E Livanos, Adrielly Martins, Richard Dean, Ana Catarina Bravo, Arno R Bourgonje, Michael Tankelevich, Jake Herb, Judy Cho, André Anastácio Santos, Cecília M P Rodrigues, Francesca Petralia, Jean-Frederic Colombel, Christopher L Bowlus, Thomas Schiano, Joana Torres, Cynthia Levy, Saurabh Mehandru","doi":"10.1016/j.cgh.2024.10.005","DOIUrl":"10.1016/j.cgh.2024.10.005","url":null,"abstract":"<p><strong>Background & aims: </strong>Anti-integrin αvβ6 autoantibodies (anti-αvβ6) are found in more than 50% of individuals with ulcerative colitis (UC). We aimed to determine the prevalence of anti-αvβ6 in patients with primary sclerosing cholangitis (PSC) and their association with liver disease severity.</p><p><strong>Methods: </strong>Four cohorts of pre-liver transplant patients with PSC were recruited. Patients with inflammatory bowel disease (IBD) and healthy controls (HCs) served as comparators. Total IgG and anti-αvβ6 levels were measured using enzyme-linked immunosorbent assay. Olink inflammation panel was run on a subset of samples. Multivariable linear regression analysis was performed to assess the association between anti-αvβ6 and indices of liver disease severity.</p><p><strong>Results: </strong>A total of 137 patients with PSC (including 76 with PSC-UC, 33 with PSC-Crohn's disease (CD), and 28 with PSC alone) and 160 controls (including 91 with IBD and 69 HCs) were enrolled. Anti-αvβ6 levels were significantly higher in PSC-UC and PSC-CD compared with PSC alone (P < .0001 and P < .003) and HCs (P < .0001 and P < .0001). However, anti-αvβ6 levels in PSC alone were not increased compared with HCs. In patients with PSC-IBD, anti-αvβ6 levels correlated with markers of liver disease severity, including alkaline phosphatase level (r = 0.32; P = .004), the revised Mayo PSC risk score (r = 0.25; P = .02), and liver stiffness measurement (r = 0.43; P = .008) after adjusting for age, gender, race/ethnicity, and IBD subtype. Additionally, anti-αvβ6 levels were associated with markers of systemic inflammation and tissue remodeling.</p><p><strong>Conclusion: </strong>Anti-αvβ6 autoantibodies identify a subset of patients with PSC with concomitant IBD.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term Effectiveness and Safety of Risankizumab in Patients with Crohn's Disease.","authors":"Adar Zinger, David Choi, Natalie Choi, Evan Fear, Zachary Fine, Russell D Cohen, David T Rubin","doi":"10.1016/j.cgh.2024.09.027","DOIUrl":"10.1016/j.cgh.2024.09.027","url":null,"abstract":"<p><strong>Background & aims: </strong>Risankizumab is a selective interleukin-23 inhibitor approved for the treatment of Crohn's disease (CD). We report a large long-term real-world experience with risankizumab in CD.</p><p><strong>Methods: </strong>We performed a prospective monitoring of clinical outcomes in patients at a large tertiary center who started treatment with risankizumab. Patients with active luminal disease who had at least 12 weeks of follow-up were included in the effectiveness analysis. Harvey-Bradshaw Index, as well as C-reactive protein and fecal calprotectin, were used to monitor disease activity. Primary outcomes were clinical remission and steroid-free clinical remission rates at weeks 12, 26, and 52. Univariate analysis followed by a multivariate analysis using a logistic regression model was performed to identify predictors of steroid-free clinical remission at 1 year. All patients who started treatment with risankizumab for any indication were included in the safety analysis.</p><p><strong>Results: </strong>A total of 134 patients were included in the effectiveness analysis. Seventy (52%) were ustekinumab-experienced. Clinical remission rates were 69%, 64%, and 54% at weeks 12, 26, and 52, respectively. Steroid-free clinical remission rates at 12, 26, and 52 weeks were 58%, 58%, and 50%, respectively. Remission rates in ustekinumab-experienced patients were not statistically lower compared with naïve patients, and in a multivariate analysis, prior ustekinumab treatment was not associated with lower odds of achieving steroid-free clinical remission at 1 year. Adverse effects were assessed in 243 patients and were consistent with previous literature.</p><p><strong>Conclusions: </strong>This large real-world experience with risankizumab with long-term follow-up demonstrates effectiveness and safety in patients with CD; there was comparable effectiveness in ustekinumab-naïve and ustekinumab-experienced patients.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply.","authors":"Amrit K Kamboj, Dhyanesh A Patel, Rena Yadlapati","doi":"10.1016/j.cgh.2024.09.017","DOIUrl":"10.1016/j.cgh.2024.09.017","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Future of Inflammatory Bowel Disease Care.","authors":"Edward V Loftus, Joana Torres, Jason K Hou, Charles Kahi, Siddharth Singh","doi":"10.1016/j.cgh.2024.10.004","DOIUrl":"10.1016/j.cgh.2024.10.004","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidimensional Patient-Reported Outcomes and Quality of Life at Diagnosis of IBD: A Population-Based Inception Cohort Study.","authors":"Mohamed Attauabi, Gorm Roager Madsen, Flemming Bendtsen, Jakob Benedict Seidelin, Johan Burisch","doi":"10.1016/j.cgh.2024.08.047","DOIUrl":"10.1016/j.cgh.2024.08.047","url":null,"abstract":"<p><strong>Background and aims: </strong>Patient-reported outcomes (PROs) are pivotal in assessing treatment efficacy and estimating the burden of inflammatory bowel diseases (IBDs). We investigated PROs at the time of IBD diagnosis.</p><p><strong>Methods: </strong>The Short Inflammatory Bowel Disease Questionnaire (SIBDQ), IBD Disability Index (IBD-DI), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), and disease activity-related PROs were assessed in the Copenhagen IBD Inception Cohort, a prospective, population-based cohort of patients newly diagnosed with IBD between May 2021 and May 2023.</p><p><strong>Results: </strong>A total of 203 ulcerative colitis (UC) and 116 Crohn's disease (CD) patients were recruited. At diagnosis, 160 (78.8%) and 99 (85.3%) patients with UC and CD, respectively, reported moderate-to-severe impairment in at least 1 PRO (P = .18), with 89 (43.8%) and 74 (63.8%), respectively, reporting moderate-to-severe impairment in at least 2 PROs (P < .01). Being female, the disease extent of UC, and extraintestinal manifestations were associated with impaired PROs. There were no differences found according to CD phenotype. FACIT-F, IBD-DI, and SIBDQ scores showed weak, but significant, correlations with the Mayo endoscopic score in UC, and the FACIT-F score with C-reactive protein. In CD, SIBDQ, IBD-DI, and FACIT-F correlated moderately with C-reactive protein and fecal calprotectin but not with the endoscopic severity of CD. None of the PROs correlated with iron, ferritin, or vitamin D levels. Among the most prevalent symptoms reported were fatigue, abdominal pain, urgency, and passing of blood in both CD and UC.</p><p><strong>Conclusions: </strong>We found a substantial patient-reported disease burden in newly diagnosed IBD, underscoring the importance of vigilant PRO monitoring in clinical practice.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Natural History of Clinically Suspected Isolated Perianal Fistulizing Crohn's Disease.","authors":"Lodoe Sangmo, Baseer Quraishi, Palak Rajauria, Elisabeth Giselbrecht, Jean-Frederic Colombel, Ryan Ungaro, Serre-Yu Wong","doi":"10.1016/j.cgh.2024.09.016","DOIUrl":"10.1016/j.cgh.2024.09.016","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Long-term Tumor Necrosis Factor Alpha Inhibitor Therapy Beyond 10 Years in Inflammatory Bowel Disease.","authors":"Quinten Dicken, Mmeyeneabasi Omede, Ashwin N Ananthakrishnan","doi":"10.1016/j.cgh.2024.09.018","DOIUrl":"10.1016/j.cgh.2024.09.018","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter Response to: Hernandez-Rocha C et al, Clin Gastroenterol Hepatol 2024.","authors":"Emily K Wright, Michael A Kamm","doi":"10.1016/j.cgh.2024.09.026","DOIUrl":"10.1016/j.cgh.2024.09.026","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}