European Journal of Gastroenterology & Hepatology最新文献

{"title":"Co-occurrence of autoimmune liver disease and gallstones: a clinically overlooked phenomenon.","authors":"Yujie Hu, Man Liu, Shuqian Li, Yinglan Ji, Yingxi Su, Jie Yang, Xue Zhang, Simin Zhou, Liping Guo, Yanni Li, Ying Ran, Xingliang Zhao, Hongyu Chu, Shijing Dong, Hui Yang, Qing Zhang, Zhongqing Zheng, Lu Zhou","doi":"10.1097/MEG.0000000000002978","DOIUrl":"10.1097/MEG.0000000000002978","url":null,"abstract":"<p><strong>Background: </strong>Gallstone disease is a relatively common complicating condition in patients with autoimmune liver disease (AILD) in clinical practice, yet this phenomenon has not been reported previously. Thus, we investigated the prevalence and the clinical characteristics of gallstones in patients with AILD.</p><p><strong>Methods: </strong>We retrospectively analyzed 560 patients with AILD, comprising 207 with primary biliary cholangitis (PBC), 289 with autoimmune hepatitis (AIH), and 64 with PBC-AIH overlap syndrome (PBC-AIH), who attended the General Hospital of Tianjin Medical University from November 2012 to October 2022. In addition, 937 control (CTRL) individuals matched for age and sex were included.</p><p><strong>Results: </strong>The proportion of patients with AILD, PBC, AIH, and PBC-AIH complicated by gallstones was 32.5, 35.7, 28.4, and 40.6%, significantly higher than in the CTRL (14.3%). Types of gallstones are predominantly multiple stones (43.4%), followed by single stones (32.4%) and sludge stones (6%). Patients with AILD with gallstones exhibited significantly higher age at the first visit ( P  = 0.007) and serum biochemical markers associated with bile duct injury, such as gamma-glutamyl transpeptidase ( P  = 0.003) and alkaline phosphatase ( P  = 0.001). Patients with AILD aged 61.5 and older were significantly more prone to gallstones ( P  = 0.003).</p><p><strong>Conclusion: </strong>Gallstones are a common comorbidity in patients with AILD, predominantly multiple stones. Patients with gallstones should be aware of the early diagnosis of AILD to prevent delayed treatment. Older patients with AILD should be alerted and prevented from developing stones. Our findings provide new ideas for clinical diagnosis and etiologic investigation.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1049-1054"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004309","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":"Bevacizumab for refractory gastrointestinal angiodysplasia: a case report and literature review.","authors":"Alicia Furumaya, Lia C M J Goltstein, Maarten E Tushuizen, Michael Klemt-Kropp","doi":"10.1097/MEG.0000000000003059","DOIUrl":"https://doi.org/10.1097/MEG.0000000000003059","url":null,"abstract":"<p><p>Currently, symptomatic gastrointestinal (GI) angiodysplasia is treated with argon plasma coagulation (APC) via endoscopic procedures, supplemented with octreotide or thalidomide treatment. However, suboptimal response and side effects are often seen. Bevacizumab, an angiogenesis inhibitor, may provide an alternative systemic therapy for patients with refractory GI angiodysplasia. A 75-year-old male patient with cirrhosis and portal hypertension due to metabolic dysfunction-associated steatotic liver disease presented with recurrent anemia and overt GI bleeding. Initial endoscopic findings showed a combination of portal hypertensive gastropathy and GI angiodysplasia. Anemia persisted despite repeated APC and octreotide. After transjugular intrahepatic portosystemic shunt, portal hypertensive gastropathy resolved; however, GI angiodysplasia remained and caused refractory symptomatic anemia and overt bleeding. Finally, we resorted to off-label bevacizumab in the absence of other viable treatment options. The patient initially responded to treatment but has needed top-up dosing, the effect of which remains to be evaluated. In conclusion, we describe our initial experience with off-label bevacizumab in the treatment of refractory GI angiodysplasia. Based on our experience and literature, bevacizumab may be a viable option for patients with refractory GI angiodysplasia, which should be further evaluated in future studies before it can be implemented in clinical practice.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033087","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":"Comparative effectiveness and safety of probiotics with psychotropic potential in mental health benefits in irritable bowel syndrome: a systematic review and network meta-analysis.","authors":"Theodore Rokkas, Konstantinos Ekmektzoglou, Evangelia Tsanou, Ludovica Bricca, Alexandra-Eleftheria Menni, Paraskevas Golfakis, Katerina Kotzampassi","doi":"10.1097/MEG.0000000000003062","DOIUrl":"https://doi.org/10.1097/MEG.0000000000003062","url":null,"abstract":"<p><strong>Background: </strong>The use of probiotics as a treatment for irritable bowel syndrome (IBS) is gaining attention, with recent studies indicating that certain probiotics or combinations may have mental health benefits for patients with IBS.</p><p><strong>Aims: </strong>To systematically review and meta-analyze, using network meta-analysis (NWM), the comparative effectiveness and safety of probiotics with psychotropic potential on quality of life, depression, and anxiety in patients with IBS.</p><p><strong>Methods: </strong>Relevant randomized controlled trials (RCTs) were analyzed, using a Bayesian NWM, to compare the performance of probiotics with mental health benefits in IBS treatment. Treatment effectiveness was assessed using surfaces under cumulative ranking (SUCRA) values.</p><p><strong>Results: </strong>The analysis included 3154 participants assigned to nine different treatments: Bifidobacterium longum, Saccharomyces, Clostridium butyricum, Bifidobacterium lactis, Lactobacillus acidophilus, Lactobacillus casei strain Shirota, Lactobacillus plantarum, probiotic combinations, and placebo. B. longum and probiotic combinations were found to be significantly more effective than placebo. In terms of improving quality of life (QoL), B. longum was the most effective (SUCRA = 89.7%), while L. plantarum was the least effective (SUCRA = 14.9%). For alleviating depression and anxiety, the combination of probiotics (SUCRA = 95.6%) and L. acidophilus (SUCRA = 74.2%) showed the best results, respectively.</p><p><strong>Conclusion: </strong>Some probiotics or combinations may offer benefits for patients with IBS in improving QoL, depression, and anxiety; however, as this is a developing field, additional research is necessary to fully understand the effectiveness, underlying mechanisms, and specific strains that may be advantageous. More high-quality RCTs are needed to substantiate these therapeutic possibilities.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033099","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":"Evaluating the completeness of postoperative endoscopic recurrence assessment in Crohn's disease patients with Kono-S anastomoses.","authors":"Nikita Parkash, Charlotte Keung, Sally J Bell, Gregory T Moore","doi":"10.1097/MEG.0000000000003063","DOIUrl":"https://doi.org/10.1097/MEG.0000000000003063","url":null,"abstract":"<p><strong>Background and aims: </strong>Despite therapeutic advances, resection rates in Crohn's disease remain high. Kono-S is a novel anastomosis for ileocolonic resections; however, its altered configuration may challenge standard endoscopic assessment, particularly in the absence of validated scoring tools. This study evaluated the endoscopic assessment of Kono-S anastomosis anatomy and recurrence stratification using Rutgeert's score.</p><p><strong>Methods: </strong>This retrospective study included colonoscopies performed on Crohn's disease patients with Kono-S anastomosis between March 2021 and 2025. Data included procedure dates, endoscopist subspecialty [inflammatory bowel disease (IBD) vs. non-IBD], and colonoscopy findings. Colonoscopies were rescored via Rutgeert's score and evaluated for completeness of assessment, defined as correct identification and photodocumentation of the anastomosis substructures. Factors associated with completeness were determined using Mann-Whitney U or Fisher's exact tests. Inter-rater reliability between endoscopists was calculated using Fleiss' kappa.</p><p><strong>Results: </strong>Forty-nine colonoscopies performed a median of 31 weeks postsurgery were included. Endoscopic recurrence (≥i2b) was 16.2% (median follow-up 153 weeks). Most procedures (89.5%) were performed by IBD subspecialists. Thorough assessments were achieved in 73.5% of colonoscopies, with IBD endoscopists significantly more likely to provide complete assessments (79.5%) compared with non-IBD endoscopists (20%, P = 0.014). Agreement with the rescored Rutgeerts occurred in 41 (93.2%) cases. Concordance with the central reading was high for IBD endoscopists (Fleiss' kappa: 0.897, P < 0.001) but tended towards moderate for non-IBD endoscopists (Fleiss' kappa: 0.467, P = 0.351).</p><p><strong>Conclusion: </strong>With increasing adoption of the Kono-S technique, this study suggests that IBD-specific endoscopy training is essential for accurate assessment of postoperative recurrence in patients with Crohn's disease.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033049","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":"Dietary vitamin E intake in metabolic dysfunction-associated steatotic liver disease and all-cause/cause-specific mortality.","authors":"Donghee Kim, Pojsakorn Danpanichkul, Karn Wijarnpreecha, Aijaz Ahmed","doi":"10.1097/MEG.0000000000003065","DOIUrl":"https://doi.org/10.1097/MEG.0000000000003065","url":null,"abstract":"<p><strong>Aims: </strong>We investigated the independent association between dietary vitamin E intake among individuals with metabolic dysfunction-associated steatotic liver disease (MASLD) and all-cause and cause-specific mortality in a representative sample of the USA.</p><p><strong>Methods: </strong>We used the 2007-2014 US National Health and Nutrition Examination Survey with mortality follow-up through 2019 (median: 8.6 years). Cox regression models were used to assess the association between dietary vitamin E intake in MASLD and all-cause and cause-specific mortality.</p><p><strong>Results: </strong>Among the 10 193 individuals with MASLD (mean age: 46.8 years and male: 48.0%), greater dietary vitamin E intake was correlated with a gradual reduction in the risk of all-cause mortality, which remained significant after adjustment for clinical and metabolic risk factors (hazard ratio: 0.68, 95% confidence interval: 0.50-0.94 for the fourth quartile compared with the first quartile; P for trend = 0.018). This association remained more pronounced in older populations, males, and non-Hispanic Whites than in their counterparts. Increased dietary vitamin E intake demonstrated trends associated with reduced cancer-related mortality.</p><p><strong>Conclusion: </strong>Higher dietary vitamin E intake in MASLD was associated with a lower risk of all-cause mortality.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033025","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":"Feasibility and Preliminary Efficacy of combined home-based fecal calprotectin self-testing and therapeutic drug monitoring-guided intervention in Patients with moderate-to-severe inflammatory bowel disease.","authors":"Guomin Lu, Jing Sun, Hu Du","doi":"10.1097/MEG.0000000000003061","DOIUrl":"https://doi.org/10.1097/MEG.0000000000003061","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel diseases (IBD), including Crohn's disease and ulcerative colitis, significantly impact patients' lives. Effective management often involves invasive and costly monitoring.</p><p><strong>Objective: </strong>To evaluate the feasibility of integrating home-based fecal calprotectin testing with therapeutic drug monitoring (TDM) in managing moderate-to-severe IBD.</p><p><strong>Methods: </strong>A prospective, single-arm pilot study involved patients performing weekly home-based fecal calprotectin tests and attending regular clinic visits for TDM. Data on adherence, clinical disease activity, fecal calprotectin levels, therapeutic adjustments, and healthcare utilization were collected and analyzed.</p><p><strong>Results: </strong>High adherence to home-based fecal calprotectin testing (88%) and strong concordance with laboratory-based fecal calprotectin measures were observed. Clinical disease activity scores significantly decreased from a baseline of 7.2-2.7 by week 24. The proportion of patients achieving clinical remission increased from 0% at baseline to 50% at week 24. TDM facilitated 28 therapeutic adjustments, including 20 dose escalations, five de-escalations, and three therapy switches.</p><p><strong>Conclusion: </strong>Integrating home-based fecal calprotectin testing with TDM is feasible for personalized management of IBD. The observed clinical trends warrant confirmation in controlled trials.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033083","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":"Global liver cancer burden attributed to high body mass index: trends, projections, and its relationship with socioeconomic development status (1990-2021).","authors":"Xiaohua Ma, Ting Pan, Na Gao, Shujie Yu, Xiao Ma, Dongfeng Pan, Peifeng Liang","doi":"10.1097/MEG.0000000000003057","DOIUrl":"https://doi.org/10.1097/MEG.0000000000003057","url":null,"abstract":"<p><strong>Background: </strong>As the third leading cause of cancer-related mortality globally, liver cancer exhibits a rising metabolic risk profile, with high BMI emerging as a critical etiological driver.</p><p><strong>Objective: </strong>To systematically quantify the global burden of liver cancer disease attributable to high BMI from 1990 to 2021 and project its epidemiological trajectory through 2036.</p><p><strong>Methods: </strong>Using the Global Burden of Disease data for 2021, we analyzed mortality rates, disability-adjusted life years (DALYs), and age-standardized rates categorized by sex, age, time cohort, and sociodemographic index (SDI) strata. We employed spatiotemporal clustering to identify regional patterns of burden, and utilized autoregressive integrated moving average models to predict future trends.</p><p><strong>Results: </strong>In 2021, high BMI accounted for 46 200 (95% uncertainty interval: 42 800-49 700) liver cancer deaths and 1.24 million (95% uncertainty interval: 1.15-1.33) DALYs globally, representing 3.5 and 3.2% increases from 1990, respectively. The burden of deaths and DALYs demonstrated significant sex differences (male to female ratio of 1.6 : 1 and 1.9 : 1, respectively), age-dependent progression (peak mortality at 90-94 years for men: 6.54 per 100 000; peak mortality at 95+ for women: 6.53 per 100 000), and SDI-associated increases (R2 = 0.039, P < 0.0001). Projections indicate that the age-standardized death rate will rise to 17.63 per 100 000 (95% uncertainty interval: 16.83-18.44) by 2036, representing a 120% increase from 2021 levels.</p><p><strong>Conclusion: </strong>High BMI-associated liver cancer burden has intensified globally since 1990, disproportionately affecting males, aging populations, and high-SDI regions. Accelerated epidemiological transitions and persistent obesity trends suggest continued burden escalation without targeted metabolic intervention strategies.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854985","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":"Role swapping between nurses and physicians in simulated endoscopy training enhances collaboration and teamwork: a prospective observational pilot study.","authors":"Federica Borrelli de Andreis, Salvatore F Vadalà di Prampero, Ilaria Simonelli, Francesca Motta, Silvana Fusha, Francesco Esposito, Alessia Mancini, Anna Di Gemma, Guido Costamagna, Milutin Bulajic","doi":"10.1097/MEG.0000000000003051","DOIUrl":"https://doi.org/10.1097/MEG.0000000000003051","url":null,"abstract":"<p><strong>Background and aims: </strong>Gastrointestinal endoscopy is a collaborative process requiring technical and nontechnical skills from both physicians and nurses. Role swapping during simulated procedures has the potential to enhance skill development and team dynamics. The study aimed to evaluate the impact of role swapping on technical and nontechnical skills, as well as on team collaboration and satisfaction, among endoscopists and nurses during simulated endoscopic procedures.</p><p><strong>Methods: </strong>A pilot study was conducted with 22 participants (10 endoscopists and 12 nurses). Participants completed pre- and postsimulation assessments using validated self-rating scales: Non-Technical Skills for Surgeons (NOTSS), Scrub Practitioners' List of Intraoperative Non-Technical Skills (SPLINTS), and customised technical skills questionnaires. Role swapping training sessions included onsite classes, randomised role-swapping simulations, and a 2-week postsimulation assessment. Wilcoxon nonparametric tests assessed differences between pre- and postsimulation scores.</p><p><strong>Results: </strong>Role swapping significantly improved NOTSS and SPLINTS scores across key domains: communication, decision-making, situational awareness, and teamwork (P < 0.05). Endoscopists reported significant confidence gains in instrument preparation, medication dilution, and patient discharge (P < 0.05). Nurses demonstrated improvement in motor skills, mucosal inspection, and loop reduction handling during colonoscopy (P < 0.05). Both groups expressed high satisfaction with role swapping training.</p><p><strong>Conclusion: </strong>Role swapping in simulated settings significantly enhances technical and nontechnical skills, fostering teamwork and mutual respect between physicians and nurses. This innovative approach could improve clinical practice and patient safety in real-world settings.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854986","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":"Attitudes of physicians managing inflammatory bowel disease toward alterations of liver function tests: an Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD) survey.","authors":"Nicola Pugliese, Cristina Bezzio, Stefano Festa, Flavio Andrea Caprioli, Sara Renna, Edoardo Vincenzo Savarino, Angela Variola, Massimo Claudio Fantini, Simone Saibeni, Ambrogio Orlando, Daniela Pugliese, Fabio Salvatore Macaluso, Davide Polverini, Arianna Dal Buono, Roberto Gabbiadini, Laura Loy, Alessio Aghemo, Alessandro Armuzzi","doi":"10.1097/MEG.0000000000003016","DOIUrl":"10.1097/MEG.0000000000003016","url":null,"abstract":"<p><strong>Background: </strong>Liver diseases are common in patients with inflammatory bowel disease (IBD). Little is known about how specialists perceive and manage liver enzyme abnormalities. This study investigates the current practice and educational needs of IBD specialists in the management of liver enzyme abnormalities.</p><p><strong>Methods: </strong>A 22-question web-based survey was distributed to members of the Italian Group for the study of IBD, covering their demographics, workplace features, and approaches to managing liver enzyme abnormalities in IBD patients.</p><p><strong>Results: </strong>The survey was completed by 205/439 (46.7%) respondents. The majority of respondents were over 45 years old (38.5%) and worked in Northern Italy (61%). Most were gastroenterologists (86%) practicing in public hospitals (45%), with 21.5% having a defined referral pathway to a dedicated liver unit for IBD patients. Ninety-seven percent of physicians reported regular monitoring of transaminases, while 88% also monitored gamma-glutamyl transpeptidase and 76% alkaline phosphatase (ALP). In cases of abnormal enzyme levels, over 70% reported ordering additional diagnostic tests independently, with notable heterogeneity in the thresholds used to trigger further investigation. The conditions most frequently suspected in cases of mild transaminase elevations were metabolic dysfunction-associated steatotic liver disease (71%) and drug-induced liver injury (17%). A significant proportion of physicians (57%) considered their training in managing liver enzyme abnormalities adequate but acknowledged the need for further educational opportunities. The main barrier identified was the lack of specific guidelines and actionable flowcharts (62%).</p><p><strong>Conclusion: </strong>This survey reveals heterogeneity in monitoring and management of liver enzyme abnormalities among IBD specialists. Most physicians recognize the need for improved training and specific guidelines.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"930-934"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324866","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":"Heterogeneity of cardiometabolic and hepatic fibrosis risks in nonalcoholic fatty liver disease among lean, overweight, and obese populations: a multicenter cross-sectional study.","authors":"Lili Gao, Wujun Xiong, Yong Wang, Wei Wang, Xiaoliang Wang, Hao Zhang","doi":"10.1097/MEG.0000000000002977","DOIUrl":"10.1097/MEG.0000000000002977","url":null,"abstract":"<p><strong>Objective: </strong>Given that cardiovascular events induced by metabolic disorders are the leading cause of death in nonalcoholic fatty liver disease (NAFLD), this study aimed to explore the heterogeneity of cardiometabolic and liver fibrosis risks among lean, overweight, and obese NAFLD individuals.</p><p><strong>Methods: </strong>A multicenter cross-sectional study was conducted across three hospitals in Pudong from July 2022 to June 2023. Health checkup data were obtained and stratified by BMI categories. Multivariable logistic regression was performed to analyze the association between NAFLD and risk factors for cardiometabolic diseases and liver fibrosis across different BMI categories.</p><p><strong>Results: </strong>The study included 37,122 patients, with 25.25% diagnosed with NAFLD. Over 97% of these patients met the criteria for metabolic dysfunction-associated fatty liver disease. NAFLD detection rates were 7.72% in lean, 33.99% in overweight, and 63.56% in obese individuals. Non-obese patients had significantly lower cardiometabolic disease prevalence than obese patients ( P < 0.001). All NAFLD subtypes, except lean NAFLD (negatively associated with total cholesterol) and obese NAFLD (no significant association with total triglycerides), were linked to other cardiometabolic or liver fibrosis risk factors ( P < 0.05). Additioinally, only obese NAFLD demonstrated a negative correlation with age.</p><p><strong>Conclusion: </strong>Non-obese NAFLD, despite a relatively better metabolic profile than obese NAFLD, still poses significant cardiometabolic and fibrosis risks. Interventions targeting cardiovascular events and liver disease progression are essential for all NAFLD subtypes, customized to their metabolic characteristics. The detection rates in this study provide a valuable reference for estimating local NAFLD prevalence.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"975-981"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989866","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}