European Journal of Medical Research最新文献

{"title":"Plasma phenylalanine is associated with hospital mortality in acute respiratory distress syndrome: a prospective metabolic profiling cohort study.","authors":"Li-Chung Chiu, Chi-Jen Lo, Chun-Ming Fan, Hsiang-Yu Tang, Tien-Ming Chan, How-Wen Ko, Scott Chih-Hsi Kuo, Ping-Chih Hsu, Chung-Shu Lee, Yu-Jr Lin, Kuo-Chin Kao, Li-Pang Chuang, Han-Chung Hu, Mei-Ling Cheng","doi":"10.1186/s40001-025-03043-y","DOIUrl":"10.1186/s40001-025-03043-y","url":null,"abstract":"<p><strong>Background: </strong>Phenylalanine accumulation is associated with inflammation, immune system activation, and oxidative stress-all of which are involved in the pathophysiology of acute respiratory distress syndrome (ARDS). This study evaluated the correlation between longitudinal changes in plasma phenylalanine levels and clinical outcomes in patients with ARDS.</p><p><strong>Methods: </strong>This prospective observational cohort study conducted in Taiwan focused on plasma amino acid profiling in ARDS patients between February 2017 and June 2018, and again between November 2021 and October 2023. Serial changes in plasma amino acid levels and clinical variables measured at days 1, 3, and 7 after ARDS onset were compared with clinical outcomes.</p><p><strong>Results: </strong>This study included 214 ICU patients, including 180 patients with ARDS and 34 patients without. Among ARDS patients, the in-hospital mortality rate was 45%. Plasma phenylalanine levels were significantly higher among ARDS patients than among ICU controls at all timepoints (days 1, 3, and 7). Plasma phenylalanine levels and phenylalanine/tyrosine ratios were significantly higher among non-survivors than among ARDS survivors throughout the observation period (all p < 0.05). ARDS patients with high plasma phenylalanine levels (> 125.3 µM; 47 patients; 26.1%) presented a significantly elevated risk of organ failure (i.e., higher APACHE II and SOFA scores) as well as 28-, 60-, 90-day, and all-cause hospital mortality, compared to those with low plasma phenylalanine levels (≤ 125.3 µM; 133 patients; 73.9%) (all p < 0.05). Multivariable logistic regression analysis revealed that plasma phenylalanine levels and phenylalanine/tyrosine ratios at day 1 were independently associated with hospital mortality (adjusted OR 1.009, [95% CI 1.001-1.017], p = 0.037 and adjusted OR 2.851, [95% CI 1.045-7.780], p = 0.041, respectively). A plasma phenylalanine level of > 125.3 µM had the highest predictive value for in-hospital mortality (adjusted OR 4.825, [95% CI 1.324-17.583], p = 0.017).</p><p><strong>Conclusions: </strong>Plasma phenylalanine at the onset of ARDS is independently associated with hospital mortality. These findings indicate that phenylalanine metabolism may be disrupted early in the course of ARDS. They also indicate that plasma phenylalanine levels could serve as an early prognostic metabolic biomarker and potential therapeutic target.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"833"},"PeriodicalIF":3.4,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947516","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":"Coronal axis deviations in medial unicompartmental knee arthroplasty failures: an imaging study of patients revised for aseptic loosening.","authors":"Filippo Migliorini, Nicola Maffulli, Daniel Kämmer, Ulf Krister Hofmann, Jörg Eschweiler, Andreas Bell","doi":"10.1186/s40001-025-03112-2","DOIUrl":"10.1186/s40001-025-03112-2","url":null,"abstract":"<p><strong>Purpose: </strong>Aseptic loosening remains a leading cause of revision in medial unicompartmental knee arthroplasty (UKA). This imaging study aimed to identify recurrent patterns of coronal alignment deviation in patients undergoing revision to total knee arthroplasty (TKA) to explore whether subtle malalignment may contribute to biomechanical failure.</p><p><strong>Methods: </strong>Imaging of patients who underwent revision surgery of a medial UKA to TKA for aseptic loosening of the tibial or femoral component was retrieved. Lower limb axes were evaluated using anteroposterior plain radiographs of the leg using the software MediCAD Knie 2D (mediCAD Hectec GmbH, Altdorf, Germany). The radiographic axes of revised patients were compared with established reference values, as defined by the MediCAD Knie 2D software and published literature, to identify common alignment patterns potentially associated with aseptic loosening.</p><p><strong>Results: </strong>Data from 62 patients were analysed. Before the revision surgery, the joint line convergence angle (JLCA, P = 0.002) and the anatomical-mechanical angle (AMA, P < 0.0001) were statistically significantly greater than the corresponding reference values. In contrast, the mechanical lateral distal femoral angle (mLDFA, P < 0.0001), the mechanical and anatomical medial proximal tibial angle (mMPTA and aMPTA, P < 0.0001), and the mechanical and anatomical lateral distal tibial angle (mLDTA and aLDTA, P < 0.0001) were significantly lower than reference. No statistically significant difference was found in the mechanical lateral proximal femoral angle (mLPFA, P = 0.9) or in the mechanical axis deviation (MAD, P = 0.5) when compared to normative data.</p><p><strong>Conclusion: </strong>Our cohort of patients revised from medial UKA to TKA for aseptic loosening frequently exhibited consistent deviations in lower limb alignment, particularly increased AMA and JLCA, and reduced mLDFA, mMPTA, and mLDTA. These subtle but recurrent patterns may alter load distribution across the medial compartment, contributing to implant micromotion and loosening. A detailed preoperative axis assessment may help identify patients at a higher biomechanical risk.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"832"},"PeriodicalIF":3.4,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947593","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":"Enhanced clinical outcomes of uncemented prostheses in revision surgery of distal femoral tumor prostheses: a retrospective study.","authors":"Xiaoyuan Peng, Weiping Ji, Fan Yang, Yizhen Lin, Qingcheng Yang, Zhichang Zhang","doi":"10.1186/s40001-025-03007-2","DOIUrl":"10.1186/s40001-025-03007-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The rising incidence of cancer has highlighted the need for effective treatment strategies, particularly for bone tumors like distal femoral tumors. These tumors are among the most prevalent types of bone malignancies, often necessitating extensive surgical intervention to achieve optimal outcomes. Limb-salvage surgery, which involves resecting the tumor and reconstructing the limb with prosthetic devices, has become the standard approach for managing both malignant and aggressive benign tumors of the distal femur. This technique has largely replaced amputation, allowing patients to retain limb function and improve their quality of life. Despite advancements in surgical methods and prosthetic designs, complications such as aseptic loosening, periprosthetic fractures, and infections remain common, frequently requiring revision surgeries. The choice between cemented and uncemented prostheses in these revision procedures is crucial, as it significantly impacts patient outcomes and long-term functional recovery. This study aims to compare clinical outcomes between cemented and uncemented prostheses in distal femoral tumor revision surgeries, addressing existing gaps in the literature and providing guidance for clinical decision-making.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective study analyzed data from 46 patients who underwent revision surgery for distal femoral tumor prostheses at Shanghai Sixth People's Hospital from 2019 to 2024. Patients were divided into two groups: 22 in the cemented prosthesis group (control) and 24 in the uncemented prosthesis group (experimental). Inclusion criteria required patients to be aged 20-50 years, with confirmed epiphyseal closure and clinical diagnosis of aseptic loosening after distal femoral tumor prosthesis replacement. Patients with severe systemic conditions or infections were excluded to ensure a homogeneous study population. Key parameters evaluated included operation time, intraoperative blood loss, length of hospital stay, and postoperative drainage duration. Functional outcomes were assessed using the Musculoskeletal Tumor Society (MSTS) scoring system and the Karnofsky Performance Status (KPS) scale. Statistical analyses were performed using SPSS software, with significance set at a P value of ≤ 0.05, ensuring robust comparisons of clinical, radiological, and functional outcomes between the two prosthesis types.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The uncemented prosthesis group demonstrated superior clinical outcomes compared to the cemented group. Operation time was significantly shorter (124.75 ± 12.54 min vs. 162.67 ± 19.17 min, P &lt; 0.001), and intraoperative blood loss was markedly lower (412.45 ± 32.12 mL vs. 647.56 ± 37.45 mL, P &lt; 0.001). Postoperative recovery indicators also favored the uncemented group, with shorter hospital stays (16.64 ± 2.67 days vs. 19.78 ± 2.86 days, P = 0.004) and reduced drainage duration (9.85 ± 3.52 days vs. 13.47 ± 3.17 days, P = ","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"834"},"PeriodicalIF":3.4,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947632","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":"Effect of semaglutide on arrhythmic, major cardiovascular, and renal outcomes in patients with overweight or obesity: a systematic review and meta-analysis.","authors":"Rui Wu, Bo Xing, Zijun Zhou, Liming Yu, Huishan Wang","doi":"10.1186/s40001-025-03124-y","DOIUrl":"10.1186/s40001-025-03124-y","url":null,"abstract":"<p><strong>Background: </strong>Semaglutide has demonstrated potential in controlling hyperglycemia and lowering cardiovascular (CV) risk. However, its impact on arrhythmic, major CV, and renal outcomes is not well-defined. This systematic review and meta-analysis aimed to assess these effects in patients with overweight or obesity.</p><p><strong>Methods: </strong>We searched the PubMed, Embase, and Cochrane databases for eligible randomized controlled trials (RCTs) reported up to January 2025. We calculated overall relative risks (RRs) with 95% confidence intervals (CIs) for these outcomes. In addition, subgroup analyses were performed based on age, treatment duration and obesity level.</p><p><strong>Results: </strong>Ten RCTs involving 22,937 patients were included. Compared with the controls, semaglutide significantly reduced the risk of atrial fibrillation (AF) (RR 0.79, 95% CI 0.63-0.99), sinus node dysfunction (RR 0.43, 95% CI 0.19-1.00), acute myocardial infarction (RR 0.72, 95% CI 0.60-0.85), and angina pectoris (RR 0.77, 95% CI 0.61-0.98). Subgroup analyses revealed greater efficacy in patients over 60 years old and those treated for more than 52 weeks, especially for acute myocardial infarction, angina pectoris, and acute kidney injury.</p><p><strong>Conclusion: </strong>Semaglutide reduces the risk of AF, sinus node dysfunction, acute myocardial infarction, and angina pectoris in patients with overweight or obesity. However, its effects on other arrhythmic, CV, and renal outcomes remain uncertain.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"835"},"PeriodicalIF":3.4,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947675","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":"Development and validation of a nomogram for predicting overall and cancer-specific survival in elderly patients (≥ 65 years) with epithelial ovarian cancer.","authors":"Mingzi Tan, Liancheng Zhu, Jian Gao","doi":"10.1186/s40001-025-03114-0","DOIUrl":"10.1186/s40001-025-03114-0","url":null,"abstract":"<p><strong>Background: </strong>Current evidence indicates an uptick in both morbidity and mortality rates of epithelial ovarian cancer (EOC) among the elderly (65 year and older) over the past few years. To date, standardized treatment for elderly patients remains undeveloped. This study utilizes the Surveillance, Epidemiology, and End Results (SEER) database to extract relevant clinicopathological data and construct two nomograms aimed at predicting the prognosis of elderly (65 year and older) patients with EOC. This objective is intended to assist clinicians during clinical decision-making and to assist in individualized prognostication and support clinical decision-making of elderly (65 year and older) EOC patient.</p><p><strong>Methods: </strong>Our analysis screened a total of 22,181 eligible patients, randomly divided into a training cohort (n = 15,529) and validation cohort (n = 6652) at a ratio of 7:3. 64 cases over 65 year old EOC patient were collected for external validation in our hospital. COX and LASSO analyses were used to screen the independent risk factors for overall survival (OS) and cancer-specific survival (CSS) in elderly patients with EOC. The independent risk factors were used to establish a nomogram by using the \"rms\" package. The predictive and clinical utility of nomograms was assessed using concordance index, area under the curve (AUC), calibration curve, decision curve analysis and external validation. Kaplan-Meier analysis was conducted to further stratify OS and CSS in high and low-risk groups, assessing the nomograms' stratification efficacy.</p><p><strong>Results: </strong>The AUCs of the training and validation cohort for OS and CSS prediction at 0.5, 1, 3, 5, and 10 years were significantly higher than the American Joint Committee on Cancer (AJCC) staging system (8th edition). Time-dependent AUC analysis from 1 to 10 years confirmed the nomograms' predictive superiority over the AJCC staging system for both OS and CSS in the training and validation cohorts. Compared with the age, AJCC staging system, the DCA curves of the nomogram showed a greater net gain in the training and external validation cohorts. In the external validation group, C-index of nomogram was 0.938 [95% CI 0.888-0.988], which was significantly better than that of stage (0.762) [95% CI 0.693-0.832] and the results showed that the AUC of Nomogram was significantly higher than that of stage at 1, 3, and 5-year OS and CSS. KM analysis showed that the prognosis of the low-risk group was significantly higher than that of the high-risk group. The developed nomograms outperformed the AJCC staging system in predicting both OS and CSS in elderly (65 year and older) EOC patient.</p><p><strong>Conclusions: </strong>The developed nomograms offer an effective method for predicting the OS and CSS of elderly ovarian cancer patients, aiding clinicians in making personalized survival projections and refining treatment recommendations.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"831"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947603","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":"Progress in brucellosis immune regulation inflammatory mechanisms and diagnostic advances.","authors":"Peipei Lu, Bin Luo, Qian Wang, Lingling Wang, Mengsi Chen, Jintong Jia, Min Yang, Junyao Pan, Jia Liu, Zhiwei Li","doi":"10.1186/s40001-025-03068-3","DOIUrl":"10.1186/s40001-025-03068-3","url":null,"abstract":"<p><p>Brucellosis, a globally prevalent zoonotic disease caused by Brucella species, remains a major public health concern, especially in endemic regions. This study delves into the complex interactions between host immune responses and Brucella infection, focusing on both protective immunity and pathological inflammation. Key topics include pathogen recognition pathways, strategies employed by Brucella to evade immune defenses, and the collaborative roles of innate and adaptive immunity in driving disease progression. Emphasis is placed on how Brucella manipulates host immune regulation to establish chronic infection. From an epidemiological standpoint, this paper discusses transmission routes, risk factors, and the broader implications for global health. Additionally, this study reviews recent advancements in diagnostic techniques, particularly molecular diagnostics and novel biomarker discovery, aimed at enhancing detection accuracy and disease monitoring. Therapeutic strategies, including conventional antimicrobial treatments and emerging immune-based interventions, are also examined, with a focus on their limitations and future potential. This article further addresses challenges such as the heterogeneity of immune responses, obstacles to vaccine development, and the factors contributing to persistent infection. By clarifying the molecular and immunological mechanisms of brucellosis pathogenesis, this work underscores the importance of interdisciplinary approaches to improve understanding, diagnosis, treatment, and clinical management of this enduring infectious disease.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"830"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947542","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":"Knee osteoarthritis rehabilitation: an integrated framework of exercise, nutrition, biomechanics, and physical therapist guidance-a narrative review.","authors":"Hao Liu, Lei Qin, Yanhong Liu, Xiangxiang Meng, Chunjun Li, Ming He","doi":"10.1186/s40001-025-03083-4","DOIUrl":"https://doi.org/10.1186/s40001-025-03083-4","url":null,"abstract":"<p><p>Knee osteoarthritis (KOA) is a prevalent, debilitating chronic joint disease characterized by pain, stiffness, and functional limitations. Non-pharmacological rehabilitation is a fundamental management strategy. This narrative review synthesizes evidence on an integrated KOA rehabilitation framework, including: exercise therapy (aerobic, resistance, neuromuscular training), which reduces pain and improves function through enhanced muscle activation and joint stability; dietary interventions (weight management and anti-inflammatory diets), which lower mechanical load and systemic inflammation; biomechanical optimization (bracing, gait retraining), aimed at reducing joint stress; and physical therapist-guided strategies (individualized exercises, manual therapy, patient education) addressing pain and functional restoration. While these core components demonstrate synergistic potential and highlight the need for personalized approaches, the review notes suboptimal adherence to guideline-recommended therapies in clinical practice. Additionally, supplementary treatments such as manual therapy and acupuncture, although commonly used, lack strong evidence, characterized by low-quality Randomized controlled trials, insufficient sample sizes, and inconsistent findings. This situation warrants further robust research. Future studies should focus on personalized approaches that utilize machine learning, mobile health tools for real-time gait analysis, and novel biotechnologies to address the remaining challenges. This review aims to provide clinicians and researchers with a practical guide to optimize KOA rehabilitation, enhancing patient care and quality of life.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"826"},"PeriodicalIF":3.4,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947493","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":"HIF-1α: a bridge connecting sepsis and acute respiratory distress syndrome.","authors":"Shi-Yan Liu, Hang Ruan, Shu-Sheng Li","doi":"10.1186/s40001-025-03107-z","DOIUrl":"https://doi.org/10.1186/s40001-025-03107-z","url":null,"abstract":"<p><p>Sepsis is a life-threatening condition marked by an abnormal host response to infection that can result in organ dysfunction, making it recognized as one of the primary causes of acute respiratory distress syndrome (ARDS). The pathophysiology of sepsis involves a cascade of events, including heightened pulmonary capillary permeability, dysfunction of alveolar epithelial cells, and the infiltration of inflammatory cells, such as neutrophils, macrophages, monocytes, and lymphocytes. The presence of these inflammatory cells triggers capillary leakages, alveolar epithelial damage, and the accumulation of fluid within the alveolar spaces, leading to compromised gas exchange, acute respiratory failure, and the progression to ARDS. In this complex scenario, Hypoxia-Inducible Factor-1α (HIF-1α) emerges as a pivotal player in maintaining cellular oxygen homeostasis and responding to hypoxia and inflammatory stimuli. This narrative review delves into the intricate molecular and biological characteristics of HIF-1α, elucidating its regulatory role within the context of sepsis and ARDS. By exploring the therapeutic potential of targeting HIF-1α, this review seeks to offer valuable insights into the underlying mechanisms linking sepsis to ARDS. Ultimately, this exploration of HIF-1α seeks to enhance our comprehension of sepsis pathogenesis, identify novel therapeutic avenues, and lay a strong theoretical groundwork for future clinical interventions.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"827"},"PeriodicalIF":3.4,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between triglyceride glucose-body mass index and mortality in intensive care unit patients: a propensity score matching analysis.","authors":"Yongwei Huang, Zongping Li, Xiaoshuang Yin","doi":"10.1186/s40001-025-03128-8","DOIUrl":"https://doi.org/10.1186/s40001-025-03128-8","url":null,"abstract":"<p><strong>Purpose: </strong>Triglyceride glucose-body mass index (TyG-BMI) represents a combined measure to evaluate insulin resistance and predict cerebral and cardiovascular disease risk and the resulting negative consequences. Nevertheless, the prognostic value of TyG-BMI for predicting outcomes, such as mortality, among critically ill patients in the intensive care unit (ICU-CIP) remains understudied. Our study seeks to ascertain the relation between all-cause mortality (ACM) and TyG-BMI among ICU-CIP, regardless of specific diseases, to recognize individuals at high risk and enhance prediction strategies.</p><p><strong>Methods: </strong>The data were acquired from the Medical Information Mart for Intensive Care (MIMIC)-IV database, version 3.2, and estimated the TyG-BMI, incorporating fasting blood glucose, fasting triglycerides, and BMI. The formula used was ln{[fasting triglycerides (mg/dL) × fasting blood glucose (mg/dL)]/2} × BMI. Herein, we included all first-time admitted adult patients, evaluated their TyG-BMI., and conducted a 1:1 propensity score matching (PSM) approach to address possible confounding variables. The critical TyG-BMI level influencing patient survival was determined utilizing maximally selected rank statistics. Kaplan-Meier survival analysis along with multivariate Cox proportional hazards (PH) regression models were utilized to estimate the impact on short- and long-term ACM. Furthermore, restricted cubic spline (RCS) methods explored the linear or non-linear relation between TyG-BMI and ACM, with additional knowledge acquired from interactions and analyses of subgroups.</p><p><strong>Results: </strong>A total of 9,175 ICU-CIP was included; after PSM, the analysis involved 3,642 matched participant pairs. Cox PH fully adjusted regression models demonstrated a significant correlation between higher TyG-BMI (≥ 239.54) and decreased 90 day ACM, both before (hazard ratio [HR] 0.77; 95% confidence interval [CI] 0.69-0.85) and after PSM (HR 0.76; 95% CI 0.68-0.85). Comparable associations were observed for 30 day, 180 day, and 365 day ACM. Post-PSM, RCS analysis revealed a negative L-shaped non-linear relation between both short- and long-term ACM and TyG-BMI. Notably, significant interaction effects were noticed in age, race/ethnicity, and hypertension subgroups, while no interaction effects were found in diabetes and gender subgroups.</p><p><strong>Conclusion: </strong>TyG-BMI is a novel, non-invasive predictor of mortality in ICU-CIP. These findings may inform risk stratification and public health strategies, although validation in diverse populations is warranted.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"829"},"PeriodicalIF":3.4,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947324","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":"Reduced phosphatidylcholine and phosphatidylethanolamine levels correlate with inflammatory activation in sepsis-associated encephalopathy.","authors":"Mubing Qin, Shiyuan Yu, Xin Lu, Chao Gong, Zengrui Song, Huadong Zhu, Yanxia Gao, Yi Li","doi":"10.1186/s40001-025-03115-z","DOIUrl":"https://doi.org/10.1186/s40001-025-03115-z","url":null,"abstract":"<p><strong>Background: </strong>Sepsis-associated encephalopathy (SAE) is a severe complication of sepsis, often leading to poor neurological outcomes. Lipid molecules are increasingly recognized for their potential involvement in both sepsis and cognitive impairment. However, the relationship between lipidomic alterations and SAE remains incompletely understood. This study aims to investigate lipidomic changes in patients with SAE and explore potential associations between lipid metabolism and the development of SAE.</p><p><strong>Methods: </strong>Sepsis patients without pre-existing central nervous system disorders were prospectively enrolled. SAE was defined as a positive result on the Confusion Assessment Method for the ICU (CAM-ICU) or a Glasgow Coma Scale (GCS) score < 15. Blood samples were collected at enrollment and upon any change in cognitive status. Cerebrospinal fluid (CSF) samples were collected based on the physician assessment. Lipid metabolites were analyzed using high-performance liquid chromatography coupled with mass spectrometry.</p><p><strong>Results: </strong>A total of 98 sepsis patients were enrolled, with 39 classified into the SAE group and 59 into the non-SAE group. Plasma levels of phosphatidylethanolamines (PE) and phosphatidylcholines (PC) were significantly decreased in SAE patients. Among these, LPC (18:2), LPC (16:0), LPE (22:6), and LPE (20:4) showed the most notable reductions. Additionally, 3-hydroxy-3-methylglutaryl coenzyme A(HMG-CoA) levels were decreased in SAE patients, while proinflammatory cytokines such as IFN-γ, IL-1ra, MCP-1, and IP-10 were elevated.</p><p><strong>Conclusion: </strong>Reduced levels of PC and PE lipids in SAE patients may reflect underlying inflammatory processes. The observed downregulation of HMG-CoA and upregulation of IP-10 and MCP-1 suggest a potential therapeutic role for statins in the management of SAE. Clinical Trial Registry number and website where it was obtained: Clinical Trial NCT04230447 (Registration Date: 01/02/2021; https://www.</p><p><strong>Clinicaltrials: </strong>gov/study/NCT04230447?cond=Sepsis%20Associated%20Encephalopathy&rank=4 ).</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"828"},"PeriodicalIF":3.4,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947659","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}