Clinics最新文献

{"title":"Planetary health: Real challenges for elderly population","authors":"Fulvio A. Scorza , Josef Finsterer , Antonio-Carlos G. de Almeida , Marcelo F. de Mello","doi":"10.1016/j.clinsp.2026.100911","DOIUrl":"10.1016/j.clinsp.2026.100911","url":null,"abstract":"","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100911"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147518189","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":"Skin layer thickness, muscle elasticity and their effects on pain level in fibromyalgia patients","authors":"Selçuk Akan ,&nbsp;Mehtap Balaban ,&nbsp;Ahmet Kor ,&nbsp;Bahadir Erturk","doi":"10.1016/j.clinsp.2025.100858","DOIUrl":"10.1016/j.clinsp.2025.100858","url":null,"abstract":"<div><h3>Background</h3><div>Fibromyalgia (FM) is a chronic, non-inflammatory syndrome characterized by widespread body pain, fatigue, sleep disturbances, impaired cognitive function and anxiety. Peripheral and central sensitization are thought to cause chronic pain in this disorder, which impairs quality of life. No specific laboratory test, radiographic method, or biomarker has been identified for diagnosis. As its physiopathology is not fully understood, no specific treatment has been identified. At this stage, studies are needed to facilitate diagnosis and guide treatment.</div></div><div><h3>Methods</h3><div>Eighty-nine women with FM and 36 healthy controls were enrolled in this cross-sectional, case-controlled, single-centre study. FM-related measurements (number of tender points, myalgic score, pain Visual Analogue Scale [VAS]) were recorded. All participants underwent an analysis of trapezius muscle thickness and elasticity. Skin and subcutaneous tissue thickness, and hypodermis thickness were measured by using B-mode Ultrasonography (USG) and tension (compression) Sonoelastography (SEL).</div></div><div><h3>Results</h3><div>Skin thickness was lower in FM patients than in healthy controls (<em>p</em> &lt; 0.01). Both trapezius muscle thickness and elastography scores were higher in the FM group compared to controls (<em>p</em> &lt; 0.05 and <em>p</em> &lt; 0.001, respectively). A significant correlation was found between VAS score and elastography scores (<em>r</em> = 0.661, <em>p</em> &lt; 0.001); however, there was no significant correlation between VAS score and trapezius or skin thickness.</div></div><div><h3>Conclusion</h3><div>Patients with FM have lower skin thickness and higher trapezius muscle thickness and elastography scores than healthy controls. The thinner skin thickness in FM compared to controls may represent a potentially important factor in the pathophysiological mechanism of peripheral sensitization.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100858"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879786","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":"External validation of a nomogram for predicting tubulointerstitial lesions in IgA nephropathy: a cross-regional study in China","authors":"Xinyu Wang ,&nbsp;Litian Pu ,&nbsp;Lu Song ,&nbsp;Jian Xu ,&nbsp;Hu Meng ,&nbsp;Meng Yang ,&nbsp;Yan Xu ,&nbsp;Qiao Wang ,&nbsp;Lijuan Sun ,&nbsp;Feifei Liu ,&nbsp;Yaling Yu ,&nbsp;Yaxi Zhao ,&nbsp;Ying Shen ,&nbsp;Qinyuan Deng","doi":"10.1016/j.clinsp.2026.100860","DOIUrl":"10.1016/j.clinsp.2026.100860","url":null,"abstract":"<div><h3>Background</h3><div>A diagnostic nomogram for predicting tubulointerstitial lesions (T1/2) in IgA Nephropathy (IgAN), developed in Guangzhou (GZ) using estimated Glomerular Filtration Rate (eGFR) and Urinary Protein Excretion (UPE), demonstrated high accuracy (AUC = 0.92) but lacked external validation.</div></div><div><h3>Methods</h3><div>The authors externally validated the nomogram in an independent cohort from Kunming (KM, n = 387; median altitude: 1,891 m), including a high-altitude subgroup (&gt; 2,000 m, n = 155). Model performance was evaluated using Receiver Operating Characteristic (ROC) curves, calibration plots, and Decision Curve Analysis (DCA). Both creatinine-based eGFR (eGFRcr) and Creatinine-Cystatin C-based eGFR (eGFRcr-cys), each combined with UPE, were assessed.</div></div><div><h3>Results</h3><div>The nomogram achieved nearly identical AUCs of 0.80 in the overall KM cohort for both eGFRcr-UPE (95% CI: 0.75–0.85) and eGFRcr-cys-UPE (95% CI: 0.74–0.85), demonstrating strong generalizability across eGFR formulas. In the high-altitude subgroup, performance significantly improved (AUC = 0.89; 95% CI: 0.83–0.95) for both models.</div></div><div><h3>Conclusion</h3><div>External validation demonstrates that the nomogram combining eGFR and UPE is feasible for non-invasive prediction of T1/2 lesions, with comparable performance between eGFRcr and eGFRcr-cys. The improved accuracy observed at high altitude suggests altitude-related influences that merit further study. Prospective studies are needed to determine its prognostic value for clinical outcomes such as CKD progression and treatment response.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100860"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260556","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":"A cross-sectional analysis of all vena cava filter placement over 9-years in Brazil: trends and mortality rates in a population of over 200 million","authors":"Clara Sanches Bueno ,&nbsp;Hedra Marques Santos ,&nbsp;Júlia Freire Castanheira ,&nbsp;Bruno Jeronimo Ponte ,&nbsp;Felipe Soares Oliveira Portela ,&nbsp;Marcelo Fiorelli Alexandrino da Silva ,&nbsp;Marcelo Passos Teivelis ,&nbsp;Alexandre Fioranelli ,&nbsp;Nelson Wolosker","doi":"10.1016/j.clinsp.2026.100874","DOIUrl":"10.1016/j.clinsp.2026.100874","url":null,"abstract":"<div><h3>Background</h3><div>Venous Thromboembolism (VTE) is a major global health concern, with Vena Cava Filters (VCFs) serving as an alternative to anticoagulation in high-risk patients. Brazil’s VCF trends remain understudied, particularly in its dual public-private healthcare system. This database study allows a broad overview of the Brazilian healthcare landscape.</div></div><div><h3>Methods</h3><div>This cross-sectional nationwide analysis used Brazilian public (SUS/TabNet) and private (ANS/D-TISS) healthcare databases (2015–2023) to assess VCF placement rates, regional disparities, and in-hospital mortality. Data included 21,630 procedures, analyzed via generalized linear models (Gamma/Poisson distributions).</div></div><div><h3>Results</h3><div>The private system performed 57% of VCFs (12,323) despite covering only 25% of the population, with a 4.25-fold higher procedure rate per capita than the public system (29.45 vs. 6.42 per-million). Women accounted for 57.8% of recipients. The Southeast region dominated (70% private, 40.5% public), while the North and Midwest had the lowest rates. Mortality rates were comparable (public 6.7% vs. private 7.4%, <em>p</em> = 0.066), peaking during COVID-19. Procedure volumes rose 140% over 9-years, contrasting with declining U.S. trends post-FDA restrictions.</div></div><div><h3>Conclusions</h3><div>Brazil’s VCF use reflects systemic disparities, with private-system overrepresentation and regional gaps. This study enables unprecedented insights into large-scale VCF implementation across diverse healthcare subsystems.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100874"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146777060","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":"Generative listening leading to generative action to enhance interdisciplinary connections in a specialized referral hospital setting","authors":"Alfredo Jose Mansur ,&nbsp;Orival de Freitas Filho ,&nbsp;Cicero Piva de Albuquerque ,&nbsp;Brigitte Feiner de Mello ,&nbsp;Leila Suemi Harima Letaif ,&nbsp;Edivaldo Massazo Utiyama","doi":"10.1016/j.clinsp.2026.100886","DOIUrl":"10.1016/j.clinsp.2026.100886","url":null,"abstract":"<div><h3>Objectives</h3><div>To contribute to the organizational culture and interdisciplinary connections to surpass frontiers created by evolving specialization that put professionals as well as processes apart. In addition, we preserved and stimulated local established professional skills.</div></div><div><h3>Methods</h3><div>The authors worked by listening to organizational demands as well as demands of colleagues at work in a network organizational non-mandatory working weekly forums through videoconferences. Forums were devoted to specific scenarios, such as surgical center facilities, outpatient clinics, hybrid rooms, clinical directors, multidisciplinary leadership, intensive care units’ leadership, and institutional life. Mandatory (by local regulation) subcommittee forums occurred every two weeks. Participants of the meetings were in their working place. Every leadership would be present at most in two forums each week; participation might rotate between local leaderships.</div></div><div><h3>Results</h3><div>200 interdisciplinary nonmandatory working forums were carried out in 2024; number of invites ranged between 52 (hybrid room) and 131 (clinical units’ leadership), participations ranged between 718 (hybrid room) and 791 (clinical units leadership) and mean participation ranged between 17.4 (range 11‒25; standard deviation 3.21) and 20.1 (range 11‒27; standard deviation 3.40). Hundred six mandatory forums were carried out in 2024; the number of invites ranged between 10 (subcommittee of pharmacology) and 19 (review of mortality); mean participation ranged between 9 (range 5‒12; standard deviation 2.16) and 11.7 (range 6‒15; standard deviation 2.24). Specific practical initiatives were born from these forums.</div></div><div><h3>Conclusions</h3><div>The authors consider that interdisciplinary connectivity was participative to a shared understanding of processes and associated requirements.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100886"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367824","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":"Predictive value of serum chitinase 3-like 1 for dysfunctional autogenous arteriovenous fistulas in patients with chronic kidney disease stage G5","authors":"You Wen Lin ,&nbsp;Qing Zhang ,&nbsp;Ying Sheng Xu ,&nbsp;Ting Qu","doi":"10.1016/j.clinsp.2025.100852","DOIUrl":"10.1016/j.clinsp.2025.100852","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;Arteriovenous Fistula (AVF) is the preferred vascular access for patients with Chronic Kidney Disease Stage G5 (CKDG5). Normal AVF function is an important prerequisite for hemodialysis, and there are few reports of studies predicting the factors affecting dysfunctional AVF. The aim of this study was to investigate the expression of Chitosanase-3-Like protein-1 (CHI3L1) in AVFs from patients with end-stage renal disease and to analyze the potential mechanism of its role in AVF dysfunction.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;CKDG5 patients who underwent AVF surgery at our institution from January 2020 to September 2023 were prospectively collected. The general clinical data and laboratory data were collected in detail, and the occurrence of postoperative dysfunctional AVF was recorded. Then, the optimal diagnostic threshold of serum CHI3L1 was observed by the Receiver Operating Characteristic (ROC) curve. Kaplan-Meier survival curve and Log-rank test were used for survival analysis. Multi-factor backward logic analysis was used to screen baseline clinical factors and construct prediction Model 1. Subsequently, serum CHI3L1 was combined with baseline clinical factors to construct Prediction Model 2. The predictive value of the two models was evaluated by the ROC curve and the Area Under the Curve (AUC).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 152 CKDG5 patients who underwent AVF surgery were continuously included. They were divided into a normal AVF group (&lt;em&gt;n&lt;/em&gt; = 64) and a dysfunctional AVF group (&lt;em&gt;n&lt;/em&gt; = 88). Gender, age, body mass index, primary disease, diameter of cephalic vein, diameter of radial artery, follow-up time, and levels of Ca, K, total cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein, white blood cell count, platelets, fasting blood glucose, and hemoglobin in both groups were not statistically significant between the two groups (&lt;em&gt;p&lt;/em&gt; &gt; 0.05). Systolic blood pressure, diastolic blood pressure, parathyroid hormone, serum albumin, and CHI3L1 were increased, whereas serum phosphorus level was decreased in CKDG5 patients with dysfunctional AVF (&lt;em&gt;p&lt;/em&gt; &lt; 0.05). The AUC of serum CHI3L1 was 0.797 (95% CI 0.728‒0.866, &lt;em&gt;p&lt;/em&gt; &lt; 0.001), the optimal cut-off value was 148.0 ng/mL, the sensitivity was 62.5%, and the specificity was 84.38%. The primary fluency rate in the high serum CHI3L1 level group was significantly lower than that in the low serum CHI3L1 level group (&lt;em&gt;p&lt;/em&gt; &lt; 0.001). Multifactorial logistic regression analysis showed that elevated serum CHI3L1 was an independent risk factor for postoperative dysfunctional AVF. The predictive value of the CHI3L1-containing predictive Model 2 was higher, with a net benefit at threshold probabilities of 0.2‒0.9 for its clinical decision curve.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;This study proposes a risk prediction model of serum CHI3L1 combined with clinical risk factors, which can be","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100852"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879848","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":"Anesthetic challenges of the first successful living-donor uterus transplantation in Latin America: a case report","authors":"Rui Carlos Detsch Junior ,&nbsp;Joel Avancini Rocha Filho ,&nbsp;Daniel Negrini Medeiros ,&nbsp;Luiz Marcelo Sá Malbouisson ,&nbsp;Rafael Soares Nunes Pinheiro ,&nbsp;Rubens Macedo Arantes Junior ,&nbsp;Daniel Reis Weisberg ,&nbsp;Wellington Andraus ,&nbsp;Mats Brännström ,&nbsp;Dani Ejzenberg ,&nbsp;José Maria Soares Junior ,&nbsp;Edmund Chada Baracat ,&nbsp;Maria José Carvalho Carmona ,&nbsp;Marcelo Luis Abramides Torres","doi":"10.1016/j.clinsp.2026.100920","DOIUrl":"10.1016/j.clinsp.2026.100920","url":null,"abstract":"<div><h3>Background</h3><div>Uterus transplantation is an emerging treatment for absolute uterine factor infertility. While surgically complex, the procedure also presents unique challenges for anesthetic management, particularly in living-donor scenarios, where two major operations proceed in close succession with partial temporal overlap. The authors report the anesthetic management and challenges of the first successful living-donor uterus transplantation in Latin America.</div></div><div><h3>Case presentation</h3><div>A 34-year-old female recipient with Mayer-Rokitansky-Küster-Hauser syndrome and her 31-year-old sister, with two previous vaginal births, as the living-donor. The donor's anesthesia was challenging due to the prolonged surgical time, requiring extended general anesthesia with extended mechanical ventilation and continuous invasive monitoring. Another key challenge was managing the donor's significant postoperative pain, necessitating a robust multimodal approach. The recipient's anesthetic course focused on maintaining hemodynamic stability, normothermia, and appropriate fluid balance during major fluid shifts, vascular clamping, and graft reperfusion. Both patients remained hemodynamically stable without vasopressor support throughout their respective procedures.</div></div><div><h3>Conclusion</h3><div>This landmark case demonstrates that successful living-donor uterus transplantation is feasible in a new clinical setting but underscores the critical importance of a specialized, proactive anesthetic strategy. Anesthesiologists must be prepared for prolonged surgical times, control postoperative pain in the donor, and complex hemodynamic management in the recipient. A multidisciplinary approach, psychological support, and comprehensive strategies to minimize perioperative discomfort for the donor, are crucial for optimizing outcomes for both donor and recipient.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100920"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147523805","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":"Comparing traditional and AI-enhanced mentorship for leadership development in medicine","authors":"Ayla Mohtat ,&nbsp;Fabio Ynoe Moraes ,&nbsp;Alireza Mansouri ,&nbsp;Ruth Gotian","doi":"10.1016/j.clinsp.2026.100956","DOIUrl":"10.1016/j.clinsp.2026.100956","url":null,"abstract":"","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100956"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679867","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":"Risk predictive value of white blood cell count in patients with diabetes‑associated lower urinary tract symptoms: A population-based study","authors":"Ning Liu ,&nbsp;Dingjie Zhou ,&nbsp;Nihao Cao","doi":"10.1016/j.clinsp.2026.100928","DOIUrl":"10.1016/j.clinsp.2026.100928","url":null,"abstract":"<div><h3>Background</h3><div>The prevalence of diabetes‑associated Lower Urinary Tract Symptoms (LUTS) is relatively low, and there are limited clinical studies on its associated factors. The present study proposed to investigate the predictive value of various inflammatory indices in patients with diabetes‑associated LUTS.</div></div><div><h3>Methods</h3><div>Utilizing data from the National Health and Nutrition Examination Survey 2005‒2008, patients were categorized into four groups: normal group, Diabetes Mellitus (DM) group, LUTS group, and diabetes‑associated LUTS group. Inflammatory indices included C-Reactive Protein (CRP), White Blood Cell (WBC) count, Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), Systemic Inflammation Response Index (SIRI), and Systemic Inflammation Index (SII). Multivariate logistic regression and Restricted Cubic Splines (RCS) were employed to evaluate the relationship between inflammatory indices and diabetes‑associated LUTS.</div></div><div><h3>Results</h3><div>A total of 5680 participants were included in the final analysis, comprising 3779 females and 1901 males. The prevalence of diabetes‑associated LUTS was 6.9% in females and 2.2% in males. Diabetes-associated LUTS was associated with older age, lower educational level, hypertension, congestive heart failure, coronary heart disease, emphysema, and higher body mass index and inflammatory indices. Furthermore, multivariate logistic regression analysis revealed that WBC count was a significant factor for both female and male diabetes‑associated LUTS patients, with higher WBC levels correlating with increased diabetes‑associated LUTS risk (females: adjusted Odds Ratio [OR] = 1.115 [1.032‒1.205], <em>p</em> = 0.006; males: OR = 1.207 [1.083‒1.345], <em>p</em> = 0.001). RCS revealed a positive association between WBC count and diabetes‑associated LUTS in female and male participants.</div></div><div><h3>Conclusion</h3><div>Inflammatory markers such as CRP and WBC count were higher in the diabetes‑associated LUTS group compared to the other three groups. WBC count is an associated factor for diabetes‑associated LUTS, and incorporating WBC count into clinical assessments can aid in identifying diabetes‑associated LUTS patients, thereby facilitating targeted interventions.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100928"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147709433","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":"Systemic immune-inflammatory index predicts all-cause and cardiovascular mortality in metabolic syndrome: A prospective cohort study using NHANES data","authors":"Yao Sun ,&nbsp;Shuguang Yang ,&nbsp;Zengli Xiao ,&nbsp;Youzhong An ,&nbsp;Huiying Zhao","doi":"10.1016/j.clinsp.2026.100919","DOIUrl":"10.1016/j.clinsp.2026.100919","url":null,"abstract":"<div><h3>Background</h3><div>This study aims to evaluate the association between SII and the prevalence of MetS in the female population of the United States, utilizing data from the National Health and Nutrition Examination Survey (NHANES) 2013–2018.</div></div><div><h3>Methods</h3><div>The study analyzed data from 6140 participants. The association between SII and MetS was investigated using both univariate and multivariable analyses. Additionally, the relationship between SII and all-cause as well as cardiovascular mortality was assessed through Cox proportional hazards regression models.</div></div><div><h3>Results</h3><div>MetS was prevalent in 37.52% of the study population. Participants diagnosed with MetS showed higher SII scores compared to those without MetS. There was a nonlinear “J”-shaped dose-response relationship between increased SII levels and increased all-cause mortality in the MetS population. The same trend of relationship between SII levels and cardiovascular mortality was observed in people aged 60-years and older in the MetS population.</div></div><div><h3>Conclusion</h3><div>The results of this study suggest that there is a significant association between elevated SII and the presence of MetS, and that systemic inflammation indicated by SII may contribute to the development and progression of MetS and its associated complications. Further studies are warranted to elucidate the underlying mechanisms between SII and MetS and to evaluate the clinical utility of SII in risk stratification and management strategies.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100919"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147709434","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}