Clinics and research in hepatology and gastroenterology最新文献

{"title":"BEND3 is associated with poor prognosis and treatment response in Hepatocellular Carcinoma","authors":"Valbert Oliveira Costa Filho , Pedro Robson Costa Passos , Márcia Valéria Pitombeira Ferreira , Silvia Helena Barem Rabenhorst","doi":"10.1016/j.clinre.2026.102759","DOIUrl":"10.1016/j.clinre.2026.102759","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"50 2","pages":"Article 102759"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-assisted endoscopic submucosal dissection in gastrointestinal lesions: A systematic review and meta-analysis","authors":"Amany Mahmoud Genidy ,&nbsp;Abdelaziz Awad ,&nbsp;Omar Khaled Abdelsalam ,&nbsp;Belal Mohamed Hamed ,&nbsp;Nesma Mahmoud Ibrahim ,&nbsp;Ahmed K.M. Khaled ,&nbsp;Omar Saeed ,&nbsp;May Mahmoud Elgamal ,&nbsp;Manar A Balouz ,&nbsp;Ahmed Abdelgayed M Hussein ,&nbsp;Fatma S Mohamed ,&nbsp;Ahmed L. Youseif ,&nbsp;Jawad Mahmood","doi":"10.1016/j.clinre.2025.102752","DOIUrl":"10.1016/j.clinre.2025.102752","url":null,"abstract":"<div><h3>Introduction</h3><div>Endoscopic submucosal dissection (ESD) is an increasingly effective endoscopic technique worldwide. Robot-assisted ESD is a novel technique that enables complex movements by providing an extended range of motions to improve the visualization of the surgical field and provide better cosmetic surgical outcomes. We aim to systematically review and meta-analyze the efficacy and safety of robot-assisted ESD.</div></div><div><h3>Methods</h3><div>We followed the PRISMA guidelines for meta-analysis. We included studies reporting on patients with GI tumors or masses who underwent robot-assisted ESD. Our primary outcomes were en bloc resection rates, recurrence rates, and complications like bleeding and perforation. Secondary outcomes encompassed the length of the procedure, lesion size, complete resection rates, and duration of hospital stay. We used Joanna Briggs Institute's (JBI) Critical Appraisal Tool and the ROBINS-I tool for quality assessment. Continuous data were pooled as means, while dichotomous data were pooled as proportions with a 95 % confidence interval (95 % CI).</div></div><div><h3>Results</h3><div>Eight studies consisting of two clinical trials, three cohort studies, and three case reports with 115 participants were included. The en bloc resection rate was 97.400 %, 95 % CI (0.901, 0.993). According to the complete resection outcome, the rate was 82.900 %, 95 % CI (0.722, 0.900). Procedure time and Hospital Stay were 82.030 min 95 % CI: 48.130, 115.940), 1.640 days 95 % CI (-0.180, 3.740), respectively. The intraoperative bleeding rate was 1.800 %, 95 % CI (0.004, 0.068).</div></div><div><h3>Conclusion</h3><div>Our systematic review and meta-analysis demonstrated robot-assisted endoscopic submucosal dissection's potential efficacy and safety. However, future high-quality studies with larger sample sizes and extended follow-up periods are needed to support our initial findings further. Robot-assisted ESD may be promising in dealing with larger lesions, which are often challenging with conventional ESD.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"50 2","pages":"Article 102752"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145848919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liver gains beyond glycemic control: GLP-1 vs. SGLT2 in metabolic dysfunction–associated steatohepatitis (MASH): A real-world data analysis","authors":"Elizabeth Beyene ,&nbsp;Lakshmi Chirumamilla ,&nbsp;Mekdem Bisrat ,&nbsp;Allan Bowen ,&nbsp;Yonas Fetle ,&nbsp;Brandon Wilkerson ,&nbsp;Addishiwot Wudeneh ,&nbsp;Syed Fahad Gillani ,&nbsp;Daniel Larbi ,&nbsp;Miriam Michael","doi":"10.1016/j.clinre.2026.102760","DOIUrl":"10.1016/j.clinre.2026.102760","url":null,"abstract":"<div><h3>Background</h3><div>Metabolic dysfunction associated steatohepatitis (MASH) is a progressive liver disease associated with metabolic syndrome. While both GLP-1 receptor agonists and SGLT2 inhibitors offer cardiometabolic benefits, their comparative impact on liver-related outcomes in MASH remains unclear.</div></div><div><h3>Objective</h3><div>To compare the incidence of cirrhosis, hepatocellular carcinoma (HCC), and changes in liver enzyme profiles in patients with MASH treated with GLP-1 receptor agonists versus SGLT2 inhibitors.</div></div><div><h3>Methods</h3><div>This retrospective cohort study used de-identified electronic health records from the TriNetX network. Adults with MASH were grouped into GLP-1 receptor agonist users (n=19,421) or SGLT2 inhibitor users (n=12,772). After 1:1 propensity score matching on demographics, BMI, diabetes, liver enzymes, and substance use, 10,803 patients remained in each cohort. Patients with overlapping use of both drug classes or with preexisting cirrhosis, fibrosis, HCC, viral hepatitis, or alcoholic liver disease were excluded. Outcomes included incidence of cirrhosis, HCC, and liver enzyme normalization (ALT &lt;60 U/L, AST &lt;60 U/L, GGT ≤140 U/L). Risk estimates and hazard ratios were calculated using TriNetX analytics; p&lt;0.05 was considered significant.</div></div><div><h3>Results</h3><div>After matching, 10,803 patients were included in each cohort. Compared to SGLT2 inhibitors, the GLP-1 cohort showed significantly lower risks of cirrhosis (5.8 %¦vs. 17.3 %; HR: 0.31, 95 % CI: 0.29–0.34), HCC (0.4 %¦vs. 1.8 %; HR: 0.25, 95 % CI: 0.18–0.34), and elevated GGT (5.4 %¦vs. 6.8 %; HR: 0.80, 95 % CI: 0.72–0.89). Liver enzyme control (ALT and AST &lt; 60 U/L) was also more favorable in the GLP-1 group (p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>In this large real-world cohort of patients with MASH, GLP-1 receptor agonists were associated with significantly better liver-related outcomes compared to SGLT2 inhibitors. These findings support the potential hepatoprotective role of GLP-1 agents and highlight their promise in managing MASH beyond glycemic control.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"50 2","pages":"Article 102760"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hematologic focal hepatic lesions in the absence of liver cirrhosis: Consider lymphoma and myeloma","authors":"Daniela Tirotta ,&nbsp;Claudia Lena ,&nbsp;Mario Torre ,&nbsp;Paolo Muratori","doi":"10.1016/j.clinre.2025.102749","DOIUrl":"10.1016/j.clinre.2025.102749","url":null,"abstract":"<div><h3>Background</h3><div>Solitary liver lesions in patients without underlying liver disease or elevated tumor markers (AFP, CEA, CA19-9) are uncommon and can represent hematologic malignancies, including primary hepatic lymphoma (PHL) and, more rarely, hepatic involvement by multiple myeloma. Early recognition is crucial to guide appropriate management and avoid unnecessary surgery.</div></div><div><h3>Methods</h3><div>A systematic literature review was conducted using PubMed, Scopus, and Google Scholar up to August 2025. Search terms included “primary hepatic lymphoma,” “hepatic plasmacytoma,” “multiple myeloma liver involvement,” and “solitary liver lesion.” Articles reporting epidemiology, clinical presentation, imaging characteristics, histopathology, and management of solitary hepatic lesions due to lymphoma or myeloma were included.</div></div><div><h3>Results</h3><div>Hematologic hepatic solitary lesions typically present as hypodense lesions on CT or hypointense on T1-weighted MRI with variable enhancement. Clinical manifestations are often nonspecific, including mild hepatomegaly or abdominal discomfort, while liver function tests are frequently normal. Definitive diagnosis relies on histopathology via biopsy. Management strategies differ: chemotherapy is first-line for lymphoma, whereas myeloma-related hepatic lesions may require systemic therapy or, rarely, surgical resection if diagnosis is uncertain.</div></div><div><h3>Conclusions</h3><div>In patients with solitary liver lesions, normal tumor markers, and no chronic liver disease, clinicians should maintain a high index of suspicion for hematologic malignancies. Accurate imaging assessment and tissue diagnosis are essential for optimal treatment planning.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"50 2","pages":"Article 102749"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145780552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of episodic and tonic appetite-related signals with malnutrition and appetite dysregulation in end-stage liver disease","authors":"François Le Calvez ,&nbsp;James King ,&nbsp;Alexis Couret ,&nbsp;Armand Abergel ,&nbsp;David Thivel ,&nbsp;Gaël Ennequin","doi":"10.1016/j.clinre.2026.102765","DOIUrl":"10.1016/j.clinre.2026.102765","url":null,"abstract":"<div><div>Malnutrition is highly prevalent in end-stage liver disease (ESLD), while being strongly associated with sarcopenia and poor prognosis in this population. The physiological regulation of energy intake is influenced by tonic signals, reflecting body composition and metabolic demands, and episodic signals, arising from gastrointestinal peptides, that remain to be better explored in the context of ESLD. The present narrative review analyzed 94 studies that characterises circulating concentrations of ghrelin, CCK, PYY, GLP-1 and leptin in cirrhosis and hepatocellular carcinoma. Overall, in patients with ESLD, orexigenic signaling, particularly from ghrelin and Fat-Free Mass (FFM) appears blunted, while anorexigenic peptides (CCK, PYY, GLP-1) are frequently elevated, prolonging satiety. Leptin regulation is inconsistent, reflecting both inflammation-driven increases and fat mass-related decreases. These disturbances converge toward a mismatch between elevated metabolic requirements and insufficient energy intake. Understanding how ESLD disrupts appetite-regulating pathways may help design new strategies to restore nutritional balance and improve clinical outcomes.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"50 2","pages":"Article 102765"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145974722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rifaximin for Primary prophylaxis of overt hepatic encephalopathy after transjugular intrahepatic portosystemic shunt: A cohort analysis","authors":"Chuanfu Ding ,&nbsp;Youwei Xing ,&nbsp;Siwei Liang ,&nbsp;Chunxiang Wang ,&nbsp;Wei Zhang ,&nbsp;Huan Chen ,&nbsp;Xueqian Li ,&nbsp;Yuyun Jia ,&nbsp;Zihao Cai ,&nbsp;Wei Li ,&nbsp;Yang Cheng ,&nbsp;Song Zhang ,&nbsp;Jiangqiang Xiao ,&nbsp;Lei Wang ,&nbsp;Qin Yin ,&nbsp;Yuzheng Zhuge ,&nbsp;Feng Zhang","doi":"10.1016/j.clinre.2025.102751","DOIUrl":"10.1016/j.clinre.2025.102751","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Transjugular intrahepatic portosystemic shunt (TIPS) is linked to an elevated risk of overt hepatic encephalopathy (OHE), yet evidence supporting primary prophylaxis for post-TIPS OHE remains limited. This study aimed to evaluate whether rifaximin reduces the incidence of post-TIPS OHE in cirrhotic patients.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 72 patients who received rifaximin (400 mg twice daily) for 6 months after TIPS (rifaximin group). A matched control group (<em>n</em> = 72) was recruited from a randomized clinical trial (ChiCTR-INR-17,012,479). The primary endpoint was the occurrence of OHE within 6 months. Secondary endpoints included 1-year mortality, rebleeding episodes, stent dysfunction, and improvements in liver function.</div></div><div><h3>Results</h3><div>The 6-month incidence of OHE was significantly lower in the rifaximin group (21%, 15/72) than in the control group (40%, 29/72; <em>P</em> = 0.011). The risk difference was -19.5% (95% confidence interval [CI]: -34.2% to -4.7%), with an odds ratio (OR) of 0.39 (95% CI: 0.19–0.82). Kaplan-Meier analysis demonstrated a significantly reduced cumulative risk of OHE in the rifaximin group (log-rank <em>P</em> = 0.009). No significant differences were observed between groups in terms of mortality, rebleeding, or stent dysfunction (all <em>P</em> &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>Six-month rifaximin prophylaxis following TIPS significantly reduced the incidence of early OHE in patients with cirrhosis.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"50 2","pages":"Article 102751"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145843058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Muricholic acids and autotaxin in intrahepatic cholestasis of pregnancy: A case-control study","authors":"Katharina Köstenbauer ,&nbsp;Theresa Bauer ,&nbsp;Patrick Greimel ,&nbsp;Tanja Strini ,&nbsp;Axel Schlagenhauf ,&nbsp;Jörg Jahnel","doi":"10.1016/j.clinre.2026.102769","DOIUrl":"10.1016/j.clinre.2026.102769","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"50 2","pages":"Article 102769"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Five-year effectiveness of either ustekinumab or vedolizumab in 239 patients with Crohn's disease refractory to anti-tumour necrosis factor","authors":"Aurélien Amiot ,&nbsp;Julien Kirchgesner ,&nbsp;Hadrien Alric ,&nbsp;Xavier Tréton ,&nbsp;Mathieu Uzzan ,&nbsp;Nassim Hammoudi ,&nbsp;Matthieu Allez ,&nbsp;Clément Bresteau ,&nbsp;Yoram Bouhnik ,&nbsp;Philippe Seksik ,&nbsp;Franck Carbonnel ,&nbsp;Antoine Meyer","doi":"10.1016/j.clinre.2025.102741","DOIUrl":"10.1016/j.clinre.2025.102741","url":null,"abstract":"<div><h3>Background</h3><div>There are still conflicting data about superiority of ustekinumab over vedolizumab in patients with Crohn’s disease (CD) who failed anti-tumour necrosis factor (anti-TNF).</div></div><div><h3>Aim</h3><div>To compare the 5-year effectiveness and safety of ustekinumab and vedolizumab in patients with CD who failed anti-TNF in a multicentre retrospective observational cohort.</div></div><div><h3>Methods</h3><div>This is a retrospective cohort study including all consecutive patients with CD refractory or intolerant to anti-TNF who initiated either vedolizumab or ustekinumab between May 2014 and August 2018. Steroid-free clinical remission, clinical remission and treatment persistence were assessed at year 2, 3 and 5 with intention-to-treat analysis and propensity scores weighted logistic models.</div></div><div><h3>Results</h3><div>A total of 239 patients were included, 107 received ustekinumab and 132 vedolizumab. At year 5, ustekinumab was associated with a higher rate of steroid-free clinical remission (41.2% vs 20.5%; odds ratio 2.72 [1.43–5.18]) and treatment persistence (46.8% vs 22.5%; OR 3.03 [1.63–5.63]) than vedolizumab but not the rate of CD-related intestinal surgery. Superiority of ustekinumab was more pronounced in patients with ileal CD, stricturing or penetrating behaviour, and history of intestinal CD-related surgery. Patients treated with ustekinumab, were associated with higher treatment persistence compared to patients treated with vedolizumab with low (<em>p</em> &lt; 0.001) or intermediate (<em>p</em> &lt; 0.001) but not with those with high vedolizumab CDST (<em>p</em> = 0.95).</div></div><div><h3>Conclusion</h3><div>In this study, ustekinumab was associated with higher rate of steroid-free clinical remission and treatment persistence than vedolizumab after 5 years of follow-up, particularly in patients with ileal CD, stricturing or penetrating behaviour and history of CD-related intestinal surgery.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"50 1","pages":"Article 102741"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145699534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of rectal indomethacin and diclofenac for post ERCP pancreatitis prophylaxis: A single center study","authors":"Hüseyin Köseoğlu ,&nbsp;Berkant Bebek ,&nbsp;Tolga Düzenli","doi":"10.1016/j.clinre.2025.102742","DOIUrl":"10.1016/j.clinre.2025.102742","url":null,"abstract":"<div><h3>Background</h3><div>Endoscopic retrograde cholangiopancreatography (ERCP) is a commonly performed invasive procedure, with post-ERCP pancreatitis (PEP) being the most frequent and clinically significant complication. Rectal non-steroidal anti-inflammatory drugs (NSAIDs), particularly diclofenac and indomethacin, have been shown to reduce the incidence of PEP. However, real-world data comparing their efficacy remains limited. This study aimed to compare the efficacy of rectal diclofenac and indomethacin in preventing PEP among patients undergoing ERCP and to identify patient subgroups that may benefit more from one drug over the other.</div></div><div><h3>Methods</h3><div>A single-center, retrospective observational study was conducted, analyzing ERCP procedures. A total of 2344 procedures were evaluated, whereas 767 patients were included after exclusion of whom 322 received rectal indomethacin and 445 received rectal diclofenac. The primary outcome was the incidence of PEP, while secondary outcomes included post-ERCP bleeding, cardiorespiratory complications, and other adverse events. Subgroup analyses were performed to evaluate the effectiveness of each drug based on clinical risk factors.</div></div><div><h3>Results</h3><div>The overall incidence of PEP was 6.6%, with approaching but not reaching significant difference between the indomethacin (8.7%) and diclofenac (5.2%) groups (p = 0.057). Subgroup analyses revealed that diclofenac was more effective in preventing PEP in patients with a naive papilla undergoing sphincterotomy (p = 0.048).</div></div><div><h3>Conclusions</h3><div>This study suggests that rectal diclofenac may offer a slight advantage over indomethacin in preventing PEP, particularly in high-risk groups, such as patients undergoing sphincterotomy; which was not previously published in the existing literature.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"50 1","pages":"Article 102742"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145699466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and risk factors of portopulmonary hypertension in chronic liver disease: systematic review and meta-analysis","authors":"Tareq Alsaleh ,&nbsp;Amir Harb ,&nbsp;Parikshit Chapagain ,&nbsp;Bassel Dakkak ,&nbsp;Prachi Mann ,&nbsp;Nouman Shafique ,&nbsp;Nihal Khan ,&nbsp;Mohamad Khaled Almujarkesh ,&nbsp;Ayman Koteish","doi":"10.1016/j.clinre.2025.102748","DOIUrl":"10.1016/j.clinre.2025.102748","url":null,"abstract":"<div><h3>Background</h3><div>Portopulmonary hypertension (PoPH) increases perioperative mortality in liver transplantation, underscoring the need for early detection. To better quantify its burden and improve detection, we performed a systematic review and meta-analysis of studies reporting PoPH prevalence and risk factors among adults with chronic liver disease (CLD).</div></div><div><h3>Methods</h3><div>We searched multiple databases through March 2025 for studies reporting the prevalence and risk factors of PoPH in CLD. The primary outcome of interest was the pooled prevalence, while the secondary outcome was risk factors. Standard meta-analysis methods were followed using the random-effects model, generating pooled effect estimates with 95% confidence intervals (CI). Heterogeneity was assessed using the I²% statistic.</div></div><div><h3>Results</h3><div>A total of 48 studies were included, comprising 16,351 CLD patients (mean age 55.5; 60% males). The pooled prevalence of PoPH on RHC was 2.4 % (95% CI: 1.4, 4.1; I² = 93.3%), whereas the pooled prevalence on TTE was 8.7% (95% CI: 5.9, 12.7). Significant risk factors for PoPH on TTE were female sex (OR 1.83), autoimmune hepatitis (AIH) (OR 1.92), older age (MD 2.19), and higher INR (MD 0.11). AIH was a significant risk factor for PoPH on RHC (OR 2.28). Meta-regression revealed significant decrease of RHC-based prevalence with time (-0.07% per year; p=0.007). Egger’s tests showed no publication bias.</div></div><div><h3>Conclusion</h3><div>PoPH confirmed by RHC is uncommon but appears overestimated by TTE. Females, patients with AIH, older age, and coagulopathy may benefit from earlier screening. Standardized echocardiographic thresholds and prospective multicenter studies are needed to refine prevalence and risk prediction.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"50 1","pages":"Article 102748"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145780592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}