European Journal of Gastroenterology & Hepatology最新文献

{"title":"Comment on 'The prognostic value of protein induced by vitamin K absence or antagonist-II in hepatocellular carcinoma patients undergoing surgical resection'.","authors":"Kishankumar Mahida, Snehal Rajendra Jagtap","doi":"10.1097/MEG.0000000000003173","DOIUrl":"https://doi.org/10.1097/MEG.0000000000003173","url":null,"abstract":"","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":"38 6","pages":"776"},"PeriodicalIF":1.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812804","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":"Efficacy and tolerability of plecanatide for irritable bowel syndrome with constipation and chronic idiopathic constipation: a systematic review and meta-analysis.","authors":"Umar Akram, Hoor Ul Ain, Shahzaib Ahmed, Eeshal Fatima, Muhammad Ahmed Raza, Eeman Ahmad, Hamza Ashraf, Hareesha Rishab Bharadwaj, Uzma Asif, Ahmed Jamal Chaudhary, Daniel Buckles","doi":"10.1097/MEG.0000000000003115","DOIUrl":"https://doi.org/10.1097/MEG.0000000000003115","url":null,"abstract":"<p><p>Constipation is a common gastrointestinal disorder with limited effective treatments and a significant impact on quality of life. Plecanatide, a guanylate cyclase-C agonist, has shown promise in improving symptoms with a favorable safety profile. This meta-analysis aimed to evaluate the effectiveness and tolerability of plecanatide in patients with irritable bowel syndrome with constipation (IBS-C) and chronic idiopathic constipation (CIC). A comprehensive search was performed across Medline, Embase, Cochrane CENTRAL, and ClinicalTrials.gov up till March 2025. Only randomized controlled trials (RCTs) comparing plecanatide with placebo in IBS-C and CIC were included. A random-effects model was used to calculate risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals. Study quality was assessed using the Cochrane risk of bias tool (RoB 2.0) and evidence certainty with the Grading of Recommendations, Assessment, Development, and Evaluation approach. Data from seven RCTs involving 6319 patients (CIC: 3707 and IBS-C: 2612) were pooled. Among these, 4350 patients received plecanatide and 1969 received a placebo. In patients with CIC, plecanatide significantly improved spontaneous bowel movements (SBMs) per week (MD = 1.39), stool consistency (MD = 0.70), SBMs within 24 h (RR = 1.35), complete SBMs within 24 h (RR = 1.88), and overall responders (RR = 1.73). In patients with IBSC, it improved stool consistency (MD = 0.79), SBMs within 24 h (RR = 1.42), and overall responders (RR = 1.64). Diarrhea risk was higher with plecanatide (RR = 4.11), while other adverse events were comparable to placebo. In conclusion, plecanatide significantly improves bowel symptoms in CIC and IBS-C patients. None of the adverse events showed significant treatment differences except diarrhea, which showed a fourfold higher risk in the plecanatide group.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":"38 6","pages":"661-669"},"PeriodicalIF":1.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812727","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":"Retrospective review of organ transplant sources in five studies published in the journal.","authors":"Christine Silvain","doi":"10.1097/MEG.0000000000003198","DOIUrl":"https://doi.org/10.1097/MEG.0000000000003198","url":null,"abstract":"","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":"38 6","pages":"659-660"},"PeriodicalIF":1.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812741","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":"SAFE vs. FIB-4: diagnostic accuracy for clinically significant fibrosis in U.S. adults with cardiometabolic risk factors - a NHANES 2017-2020 analysis.","authors":"Adem Aydin, Yucel Aydin, Carolina I Borz-Baba","doi":"10.1097/MEG.0000000000003161","DOIUrl":"10.1097/MEG.0000000000003161","url":null,"abstract":"<p><strong>Background: </strong>Steatotic liver disease (SLD), largely driven by cardiometabolic dysfunction, affects nearly one-third of the global population and may progress to advanced fibrosis. Although liver biopsy remains the gold standard for fibrosis assessment, noninvasive tools such as the Fibrosis-4 (FIB-4) and the recently developed steatosis-associated fibrosis estimator (SAFE) score are used risk stratification. We compared the diagnostic accuracy of FIB-4 and SAFE for detecting clinically significant fibrosis in adults with cardiometabolic risk factors.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of 2196 adults aged 18-80 years from the National Health and Nutrition Examination Survey (2017-2020) with valid liver stiffness measurements (LSM) by FibroScan. Individuals with known chronic liver disease, excessive alcohol use, or missing data were excluded. Clinically significant fibrosis was defined as LSM ≥ 8.0 kPa. Diagnostic performance was evaluated using sensitivity, specificity, predictive values, and area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>SAFE demonstrated superior discrimination compared with FIB-4 (AUC 0.719 vs. 0.578; P < 0.001). As a rule-out test, SAFE showed higher sensitivity (78% vs. 41%) and negative predictive value (95% vs. 91%). FIB-4 missed 58.6% of patients with significant fibrosis, whereas SAFE missed 22%. SAFE consistently outperformed FIB-4 across age, sex, MASLD status, and glycemic control subgroups.</p><p><strong>Conclusion: </strong>These findings support the use of SAFE over FIB-4 as a noninvasive screening tool for significant fibrosis in patients with cardiometabolic risk factors.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"738-746"},"PeriodicalIF":1.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147354229","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 between 12 insulin resistance surrogates with metabolic dysfunction-associated steatotic liver disease risk and all-cause mortality: data from the NHANES III (1988-1994).","authors":"Zhengyuan Yue, Yang Zhang, Jiahao Zhang, Kadirye Alimjan, Zhongguang Wu, Liang Shi","doi":"10.1097/MEG.0000000000003157","DOIUrl":"10.1097/MEG.0000000000003157","url":null,"abstract":"<p><strong>Background: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) has been shown to be intimately linked to the presence of insulin resistance. This study aimed to comprehensively evaluate 12 insulin resistance surrogates in relation to MASLD risk and all-cause mortality, utilizing nationwide data from the National Health and Nutrition Examination Survey (NHANES) III (1988-1994).</p><p><strong>Methods: </strong>This study analyzed 10 303 adults aged greater than or equal to 20 years from the NHANES III (1988-1994) cohort, identifying 2199 individuals with MASLD. The mortality data for this cohort were collected from the National Death Index. Twelve surrogate markers of insulin resistance were evaluated, including triglyceride-glucose (TyG) index, TyG-BMI, TyG-waist circumference, TyG-waist-to-height ratio, C-reactive protein-triglyceride-glucose index, atherogenic index of plasma (AIP), AIP-BMI, AIP-waist circumference, AIP-waist-to-height ratio, estimated glucose disposal rate (eGDR), metabolic score for insulin resistance, and homeostatic model assessment of insulin resistance (HOMA-IR). Statistical analyses employed logistic regression and Cox proportional hazards models to assess associations. Additionally, restricted cubic splines (RCSs) and Kaplan-Meier curves were utilized alongside subgroup and sensitivity analyses. Predictive performance was examined using receiver operating characteristic analysis and machine learning (XGBoost).</p><p><strong>Results: </strong>Among 10 303 participants, MASLD prevalence was 21.3%. In models that have undergone full adjustment, eGDR was negatively correlated with the risk of MASLD [odds ratio = 0.827, 95% confidence interval (CI): 0.780-0.878], while all other indices showed positive associations. In 2199 MASLD patients with 1015 deaths during follow-up, TyG-related indices, C-reactive protein-triglyceride-glucose index, and HOMA-IR were significant correlates with higher all-cause mortality, whereas eGDR was inversely correlated (hazard ratio = 0.887, 95% CI: 0.844-0.933). Two sensitive analyses further supported the overall results in the overall models. The RCS curve exhibited nonlinear dose-response relationships for several indices. XGBoost analyses identified eGDR as the strongest predictor of mortality among insulin resistance surrogates, second only to age.</p><p><strong>Conclusion: </strong>Most insulin resistance surrogates were significantly associated with both MASLD risk and mortality, while eGDR emerged as a robust protective factor with superior predictive performance. These results emphasize the pivotal role of insulin resistance in MASLD and highlight eGDR as a promising noninvasive tool for stratifying risk and predicting adverse outcomes in clinical and public health settings.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"724-737"},"PeriodicalIF":1.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive management of modifiable factors and all-cause mortality in patients with metabolic dysfunction-associated steatotic liver disease.","authors":"Jingdan Zhang, Bingbing Wang, Zeran Wang, Fan Feng, Naren, Hongyan Ge","doi":"10.1097/MEG.0000000000003176","DOIUrl":"10.1097/MEG.0000000000003176","url":null,"abstract":"<p><strong>Background and aims: </strong>To assess the association between comprehensive control of modifiable factors and all-cause mortality in metabolic dysfunction-associated steatotic liver disease (MASLD) patients, explore effect modification by liver fibrosis, sex, and age, and compare mortality risk between MASLD patients with different control levels and the non-MASLD population.</p><p><strong>Methods: </strong>This retrospective cohort study included 15 802 MASLD patients from US National Health and Nutrition Examination Survey 2003-2018. A comprehensive management score was constructed based on seven modifiable factors (blood pressure, glucose, lipids, inflammation, smoking, alcohol, physical activity). Patients were categorized into low, intermediate, and high control groups. Multivariable Cox models, likelihood ratio tests, and stratified analyses were used to assess associations and effect modifications.</p><p><strong>Results: </strong>Over 7.8 years median follow-up, 1524 deaths occurred. Compared with low control, high control was associated with 34% lower mortality [hazard ratio = 0.66, 95% confidence interval (CI): 0.54-0.81], with a 21% risk reduction per control level increment (hazard ratio = 0.79, 95% CI: 0.72-0.86). The effect was not modified by liver fibrosis ( P -interaction = 0.75) but was significantly modified by sex ( P < 0.001): risk reduction was 46% in females (hazard ratio = 0.54, 95% CI: 0.37-0.79) and 21% in males (hazard ratio = 0.79, 95% CI: 0.62-0.99). No age interaction was found ( P = 0.14). Compared with non-MASLD population, high-control MASLD patients had 32% lower mortality (hazard ratio = 0.68, 95% CI: 0.61-0.76). Sensitivity analyses confirmed robustness.</p><p><strong>Conclusion: </strong>Comprehensive management of modifiable factors was significantly associated with lower mortality in MASLD patients, independent of liver fibrosis and more pronounced in females. High-level control may enable survival outcomes superior to the general population.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"765-773"},"PeriodicalIF":1.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503559","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":"Appendicectomy in active ulcerative colitis: is the evidence strong enough to support clinical recommendation? A critical appraisal.","authors":"Bernardo de Faria Moraes, Leonardo Corrêa Süffert, Guilherme Grossi Lopes Cançado","doi":"10.1097/MEG.0000000000003181","DOIUrl":"https://doi.org/10.1097/MEG.0000000000003181","url":null,"abstract":"","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":"38 6","pages":"777-778"},"PeriodicalIF":1.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812749","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":"Letter to the editor regarding 'Correlation between infliximab trough levels and postoperative endoscopic recurrence in patients with Crohn's disease'.","authors":"İbrahim Ethem Güven","doi":"10.1097/MEG.0000000000003182","DOIUrl":"https://doi.org/10.1097/MEG.0000000000003182","url":null,"abstract":"","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":"38 6","pages":"779"},"PeriodicalIF":1.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812769","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":"Second-line infliximab therapy for ulcerative colitis (SLIT-UC): a retrospective cohort study.","authors":"Ciarán P C Galts, Sama Anvari, Mawiyah Haq, Kevin Grossman, Dorota Borovsky, Aaron Wen, Emily C L Wong, Hiu-Ki Rachel Tran, Abdulrahman Albassam, Smita Halder, John K Marshall, Neeraj Narula","doi":"10.1097/MEG.0000000000003132","DOIUrl":"https://doi.org/10.1097/MEG.0000000000003132","url":null,"abstract":"<p><strong>Background: </strong>Infliximab's efficacy as a second-line agent in moderate or severe ulcerative colitis after prior advanced therapy failure is unclear. Registration trials for infliximab did not assess its efficacy after exposure to other advanced therapies, a sequence in which it is increasingly used. We evaluate infliximab's second-line effectiveness, identify predictors of response, and compare outcomes to its first-line use.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of adults with ulcerative colitis treated with infliximab at a tertiary care center. Patients were categorized by line of therapy. Clinical and endoscopic outcomes at 1 year were compared between first-line and second-line users. Multivariable logistic regression was used to assess predictors of 1-year clinical remission.</p><p><strong>Results: </strong>Among 225 included patients, 143 received infliximab first-line and 82 as second-line or subsequent therapy. Clinical response at 1 year was significantly lower in second-line users (odds ratio 0.53, 95% confidence interval: 0.28-0.99, P  = 0.049) and remained significantly lower after adjustment for biosimilar and concurrent steroid use. Dose escalation was more common with second-line use (57.3% vs. 42.0%, P  = 0.026). Endoscopic and histologic remission was numerically lower in second-line users (47.7% vs. 33.3% and 27.0% vs. 41.7%, respectively), though these were not statistically significant ( P  = 0.180 and 0.099, respectively).</p><p><strong>Conclusion: </strong>Infliximab remains effective as a second-line agent in ulcerative colitis, though with reduced response and higher rates of dose escalation as compared to use first-line. These findings support its continued use while highlighting the need for optimized patient selection and treatment strategies in therapy-exposed populations.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":"38 6","pages":"691-698"},"PeriodicalIF":1.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812777","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":"Comment on 'Home-based transcutaneous electrical acupuncture-point stimulation for depressive symptoms in inflammatory bowel disease: a randomized feasibility study'.","authors":"Zilong Chen, Xiangrui Lin, Mingxian Chen","doi":"10.1097/MEG.0000000000003168","DOIUrl":"https://doi.org/10.1097/MEG.0000000000003168","url":null,"abstract":"","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":"38 6","pages":"774-775"},"PeriodicalIF":1.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812800","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}