Frontiers in Medicine最新文献

{"title":"Research hotspots and trends on illicit drugs: a bibliometric and visualized analysis.","authors":"Yinyu Chen, Gaolin Zheng, Xinyan Yang, Guangmei Wu, Qianyun Nie, Peng Zhang","doi":"10.3389/fmed.2025.1583173","DOIUrl":"10.3389/fmed.2025.1583173","url":null,"abstract":"<p><strong>Objective: </strong>To explore the current status and developmental trend of drug research in the international arena through bibliometric methods and visualization analysis.</p><p><strong>Methods: </strong>In this study, drug-related articles published from 2015 to 2024 in the core collection of Web of Science databases were analyzed, and bibliometric and visualization analyses of annual publication volume, countries (regions), institutions, journals, and keywords were achieved using CiteSpace v.6.2.R7 software.</p><p><strong>Results: </strong>A total of 5,797 publications on drug research were included between 2015 and 2024, with the annual publication volume progressively increasing on an annual basis. Among the 117 publishing countries (regions), the United States published the most articles, with 1,534 publications, followed by the United Kingdom with 611 articles. Additionally, the literature was sourced from 1,441 journals, with a total of 1,398 publications in the top 10 journals. DRUG TESTING AND ANALYSIS ranked first with 259 articles. Finally, keyword clustering and emergence analysis revealed that current research hotspots were concentrated in the areas of drug abuse, new psychoactive substances, synthetic drugs, and wastewater treatment.</p><p><strong>Conclusion: </strong>The volume of drug-related research publications is steadily increasing globally. However, there is a pressing need to further strengthen global collaboration and interdisciplinary research, as well as to promote the development of a broader international scientific research network. In particular, advanced technological approaches and policy strategies must be explored to address the global challenges posed by drug-related issues, particularly in the detection, management, and prevention of synthetic drugs. The enhancement of data sharing, technological exchange, and collaborative actions among nations plays an instrumental role in the establishment of a more efficient and coordinated global drug governance system, better equipping the international community to address the threats posed by drugs to public health and social security.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1583173"},"PeriodicalIF":3.1,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301653","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":"Successful management of severe pulmonary form of leptospirosis with VV-ECMO, prone ventilation, and bronchoalveolar lavage: two case reports.","authors":"Meisong Chen, Haohao Wu, Lutao Xie, Min Wu, Pin Lan","doi":"10.3389/fmed.2025.1598589","DOIUrl":"10.3389/fmed.2025.1598589","url":null,"abstract":"<p><strong>Background: </strong>Leptospirosis is a globally prevalent zoonotic acute infectious disease that can rapidly progress to severe pulmonary form of leptospirosis (SPFL), leading to multiple organ failure with a high mortality rate. It is estimated that approximately 58,900 deaths occur annually due to leptospirosis, with critically ill patients admitted to intensive care units facing extremely high fatality rates. Therefore, timely and effective treatment strategies are crucial.</p><p><strong>Case presentation: </strong>Two patients developed fever after farm work exposure, followed by progressive dyspnea and hemoptysis, leading to hospitalization. They rapidly developed acute respiratory distress syndrome (ARDS) and diffuse alveolar hemorrhage (DAH) with severe thrombocytopenia, accompanied by a continuous decline in the ratio of the partial pressure of arterial oxygen to the fraction of inspired oxygen (PaO₂/FiO₂ [P/F]). Despite endotracheal intubation and mechanical ventilation, hypoxemia persisted. Venovenous extracorporeal membrane oxygenation (VV-ECMO) was initiated to provide oxygenation support, heparin anticoagulation was not used in the early stage. Meanwhile, prone ventilation and bronchoscopy alveolar lavage were performed to promote the clearance of pulmonary hemorrhage, along with anti-infection treatment. The diagnosis of leptospirosis was confirmed through Metagenomic Next-Generation Sequencing (mNGS). Both patients ultimately recovered, were successfully weaned from life support, discharged in stable condition, and returned to normal life.</p><p><strong>Conclusion: </strong>Early VV-ECMO support, combined with prone ventilation and bronchoalveolar lavage, can improve the prognosis of patients with SPFL. mNGS testing aids in the definitive diagnosis of leptospirosis and provides a reliable basis for antibiotic selection.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1598589"},"PeriodicalIF":3.1,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12162303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301663","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":"Prediction of tumor deposits in stage I-III gastric cancer: a clinically applicable nomogram integrating clinicopathology outcomes.","authors":"Kunjie Wang, Yue Huo, Yuanfang Zhang, Song Guo, Weiguang Yu, Na Xiao, Shenyong Su, Lin An","doi":"10.3389/fmed.2025.1577569","DOIUrl":"10.3389/fmed.2025.1577569","url":null,"abstract":"<p><strong>Objective: </strong>This study seeks to identify clinicopathological risk factors associated with tumor deposits (TD) development in stage I-III gastric cancer patients and to construct a visualized predictive model for clinical application.</p><p><strong>Methods: </strong>A retrospective cohort of 1,284 gastric cancer patients treated at the Affiliated Hospital of Hebei University (September 2010-September 2022) was analyzed. Patients were stratified into training (<i>n</i> = 963) and validation (<i>n</i> = 321) cohorts via simple randomization at a 3:1 ratio. Lasso regression analysis was employed to screen variables, followed by multivariate logistic regression to establish an individualized nomogram. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC), calibration plots, and decision curve analysis (DCA).</p><p><strong>Results: </strong>TD-positive patients (<i>n</i> = 224) exhibited significantly reduced overall survival and disease-free survival compared to TD-negative counterparts (<i>n</i> = 1,060, <i>p</i> < 0.05). Multivariate logistic regression analysis confirmed tumor size (OR = 1.26; 95% CI 1.01-2.21), elevated CEA (OR = 2.04; 95% CI 1.02-3.16), elevated CA199 (OR = 1.007, 95% CI:1.003-1.011), and pN stage (OR = 3.22; 95% CI 2.12-4.34) as independent predictors of TD occurrence (all <i>p</i> < 0.05). The nomogram demonstrated robust discriminative capacity, with AUC values of 0.803 (95% CI 0.751-0.894) and 0.864 (95% CI 0.725-0.917) in the training and validation cohorts, respectively. Calibration plots revealed excellent agreement between predicted and observed probabilities. DCA further validated the model's clinical utility, showing superior net benefits across threshold probabilities of 1-99%.</p><p><strong>Conclusion: </strong>This TD-specific nomogram, incorporating tumor size, serum biomarkers (CEA/CA199), and pathological staging (pN), provides a clinically applicable tool for preoperative risk stratification and personalized therapeutic decision-making in stage I-III gastric cancer.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1577569"},"PeriodicalIF":3.1,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12162724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301651","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":"Linear association between serum potassium levels and 28-day mortality among ICU patients with diabetes and sepsis: a multicenter study.","authors":"Anxiang Cai, Tianyi Zhang, Kaiwen Gao, Xinglin Chen, Shu Li, Qisheng Lin, Shan Mou, Zhaohui Ni, Haijiao Jin","doi":"10.3389/fmed.2025.1582894","DOIUrl":"10.3389/fmed.2025.1582894","url":null,"abstract":"<p><strong>Background: </strong>Dysregulation of serum potassium is a common electrolyte disturbance in critically ill patients, and both hypokalemia and hyperkalemia have been linked to adverse outcomes in sepsis. However, the relationship between serum potassium levels and mortality in ICU patients with diabetes and sepsis remains poorly understood.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using data from the eICU Collaborative Research Database (2014-2015). The study included 5,104 adult ICU patients with diabetes and sepsis from 208 hospitals in the U.S. Serum potassium levels measured within 24 h of ICU admission were categorized into hypokalemia (<3.5 mmol/L), normokalemia (3.5-5.0 mmol/L), and hyperkalemia (>5.0 mmol/L). Multivariable logistic regression models were used to assess the association between serum potassium levels and 28-day ICU mortality.</p><p><strong>Results: </strong>Of the 5,104 patients (mean age, 66.8 years; 49.1% male), 1,046 (20.5%) had hypokalemia, 3,377 (66.2%) had normokalemia, and 681 (13.3%) had hyperkalemia. After adjusting for demographic factors, comorbidities, and treatment measures, each 1 mmol/L increase in serum potassium was associated with a 25% higher risk of 28-day mortality (adjusted OR, 1.25; 95% CI, 1.07-1.47). Compared to hypokalemia, hyperkalemia was associated with significantly higher mortality risk (adjusted OR, 1.86; 95% CI, 1.17-2.96). A linear relationship was observed between serum potassium levels and mortality (<i>P</i> = 0.006), differing from the previously reported U-shaped relationship in general ICU populations.</p><p><strong>Conclusions and relevance: </strong>Elevated serum potassium levels were independently associated with increased 28-day mortality in ICU patients with diabetes and sepsis. These findings suggest that potassium management strategies should be specifically tailored for this high-risk patient population.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1582894"},"PeriodicalIF":3.1,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12162910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301647","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":"Cell death-related signature genes: risk-predictive biomarkers and potential therapeutic targets in severe sepsis.","authors":"Yanan Li, Yuqiu Tan, Zengwen Ma, Weiwei Qian","doi":"10.3389/fmed.2025.1577203","DOIUrl":"10.3389/fmed.2025.1577203","url":null,"abstract":"<p><p>Sepsis is a systemic inflammatory response syndrome that predisposes to severe lung infections (SeALAR) such as sepsis-associated acute lung injury (Se/ALI) or sepsis-associated acute respiratory distress syndrome (Se/ARDS). Through a systematic bioinformatics approach, this study aimed to unravel the pathogenesis of SeALAR and explore potential biomarkers and individualized therapeutic targets. We analyzed differential genes in the peripheral blood of SeALAR patients based on the GSE10474 and GSE32707 datasets, and identified 352 significantly differentially expressed genes. Various signaling pathways related to immune regulation were found to be significantly altered via GO and KEGG enrichment analysis. Further combining cell death-related gene screening and four machine learning algorithms (including LASSO-logistic, Gradient Boosting Machine, Random Forest and xGBoost), nine SeALAR-characterized cell death genes (SeDGs) were screened and a risk prediction model based on SeDGs was constructed that demonstrated good prediction performance. In immunoassays, ssGSEA showed that Activated.CD8.T.cell, CD56bright.natural.killer.cell, MDSC, Natural.killer.T.cell, T.follicular.helper. cell and TType.1.T.helper.cell had significantly lower infiltration abundance than lower infiltration levels compared to the Se group. GSEA analysis revealed key immune pathways in which SeDGs may be involved. In addition, unsupervised clustering analysis revealed that SeALAR patients could be classified into two molecular subtypes, providing a new direction for the development of individualized immunotherapy strategies. In conclusion, this study systematically analyzed the molecular features and immune disorder mechanism of SeALAR from a multidimensional perspective, and thus provides a theoretical basis and potential targets for precision medicine intervention and targeted drug development.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1577203"},"PeriodicalIF":3.1,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301627","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":"Efficacy and safety of traditional Chinese medicine in the treatment of chronic pulmonary diseases: a systematic review and meta-analysis.","authors":"Shan An, Hong-Yan Cai","doi":"10.3389/fmed.2025.1512729","DOIUrl":"10.3389/fmed.2025.1512729","url":null,"abstract":"<p><strong>Background: </strong>To assess the efficacy and safety of various TCMIs treatments for COPD using network meta-analysis, providing evidence and guidance for clinical practice.</p><p><strong>Methods: </strong>We will search 7 databases for randomized controlled trials of TCMI for the COPD, including PubMed, the Cochrane Library, EMbase, China National Knowledge Infrastructure, China Biological Medicine, Chinese Scientific Journals Database, and Wan-fang databases, from the date of the establishment of each database to October 31, 2021. The network meta-analysis will be implemented through Aggregate Data Drug Information System 1.16.8 and Stata13.0 software. Pulmonary function included forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and FEV1/FVC will be the primary outcomes, FEV1 as a percentage of the estimated value, maximal voluntary ventilation (MVV), MVV as a percentage of the estimated value, 6 min walking distance, The St.</p><p><strong>Results: </strong>A total of seven appropriate studies were identified, encompassing 490 patients. The quality of the literature was satisfactory, with no significant publication bias detected. The effectiveness rate for patients receiving a combination of TCM and Western Medicine (WM) compared to those on WM alone was evaluated as an odds ratio (OR), with statistical testing yielding <i>Z</i> = 6.09. For PO2 levels post-treatment, the mean difference (MD) was reported as 5.92.</p><p><strong>Conclusion: </strong>The results of this study will evaluate the efficacy and safety of TCMI in the treatment of COPD, and provide decision-making references for future clinical and scientific research.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD420251047046, identifier CRD420251047046.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1512729"},"PeriodicalIF":3.1,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12162991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301637","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":"Case Report: <i>Streptococcus dysgalactiae</i> ssp. <i>dysgalactiae</i> bloodstream infections in patients with breast cancer after radiotherapy and chemotherapy.","authors":"Chongmei Tian, Su Dong, Zhixin You, Yaping Zhao, Hongfeng Xu, Jingbai Chen, Yuejuan Fang","doi":"10.3389/fmed.2025.1572998","DOIUrl":"10.3389/fmed.2025.1572998","url":null,"abstract":"<p><p>Bloodstream infections are life-threatening conditions in patients with breast cancer, especially among older individuals. Although the most common risk factor in these patients with tumors is the use of severe neutropenia secondary to myelosuppressive chemotherapy and radiotherapy, other factors are possibly associated with the invasive pathogenicity of microorganisms, including <i>Streptococcus dysgalactiae</i>. <i>Streptococcus dysgalactiae</i> ssp. <i>dysgalactiae (SDSD)</i> has been considered both an environmental pathogen and a contagious pathogen. However, there have been few reports of bloodstream infections with SDSD in patients with breast cancer after radiotherapy and chemotherapy. In this study, we report an interesting case of bloodstream infection caused by SDSD in an older patient with breast cancer after radiotherapy and chemotherapy. A 60-year-old Chinese woman had a history of breast cancer for 2 years. She developed chills and fever after puncturing blood blisters in the mouth, accompanied by fatigue and poor appetite. After 6 days of antimicrobial therapy, the patient showed gradual recovery. Bloodstream infections with SDSD in patients with breast cancer are rare. Therefore, accurate diagnosis and timely treatment can be lifesaving.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1572998"},"PeriodicalIF":3.1,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12162340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301617","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 predictive value <i>of TyG</i> index for ischemic stroke in patients undergoing maintenance hemodialysis.","authors":"Yaqing Wang, Xiaojie He, Yuqing Wang, Xiaodong Li","doi":"10.3389/fmed.2025.1584674","DOIUrl":"10.3389/fmed.2025.1584674","url":null,"abstract":"<p><strong>Objectives: </strong>Triglyceride-glucose (TyG) index is strongly correlated with insulin resistance (IR). A plethora of studies has established the role of TyG index in cerebrovascular diseases. However, the predictive value of TyG index for new-onset ischemic stroke (IS) in maintenance hemodialysis (MHD) patients remains unclear. This study aims to explore the correlation between TyG index and the occurrence of IS in MHD patients.</p><p><strong>Methods: </strong>This study analyzed clinical data and cranial Computed Tomography results of patients undergoing MHD at Baoding First Central Hospital from January 2019 to January 2024. TyG index was calculated using fasting blood glucose and triglyceride levels. Univariate Logistic regression analysis was employed to identify factors associated with IS, incorporating variables with <i>P</i> < 0.05 into multivariate Logistic regression analysis, with results expressed as odds ratio (OR) and 95% confidence interval (95% CI). Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of TyG index for the occurrence of IS.</p><p><strong>Results: </strong>Triglyceride-glucose index in the IS group was significantly higher than that in the non-IS group, with a statistically significant difference [9.32 (8.87, 9.92) vs 8.59 (8.06, 9.12), <i>P</i> < 0.001]. Variables with <i>P</i> < 0.05 from the univariate Logistic regression analysis, along with clinically relevant variables, were included in the multivariate Logistic regression analysis, indicating that an elevated TyG index is a factor associated with IS in hemodialysis patients (OR = 2.09, 95% CI 1.073-3.781, <i>P</i> < 0.001). ROC curve analysis revealed that the optimal cutoff value of TyG index for diagnosing new-onset IS in MHD patients was 9.2, with an area under the curve of 0.75 (95% CI 0.70-0.79, <i>P</i> < 0.001). Restricted cubic spline analysis demonstrated a non-linear relationship between TyG index and risk (non-linear <i>p</i> = 0.010).</p><p><strong>Conclusion: </strong>Triglyceride-glucose index is significantly elevated in MHD patients with new-onset IS, serving as a potential risk factor for such events and offering valuable clinical diagnostic reference.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1584674"},"PeriodicalIF":3.1,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12162943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301665","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":"Construction and validation of nomogram model for endoscopic submucosal dissection in patients with early colorectal cancer based on intestinal microflora and clinical pathological parameters.","authors":"Wenpeng Han, Yanyan Liu, Bo Zhang, Jing Liu, Mingxia Sun, Hongqing Zhuo","doi":"10.3389/fmed.2025.1604257","DOIUrl":"10.3389/fmed.2025.1604257","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the prognostic factors of endoscopic submucosal dissection (ESD) in early colorectal cancer patients and to develop a predictive model for assessing prognostic risk.</p><p><strong>Methods: </strong>We retrospectively analyzed the data of 126 patients with early colorectal cancer who underwent ESD treatment at our hospital from February 2022 to February 2024. All cases were randomly divided into the training set (88 cases) and the verification set (38 cases) in a ratio of 7:3. According to the prognosis of patients, they were divided into good prognosis group and bad prognosis group. Within the training set, multivariate Logistic regression analysis was used to identify the independent risk factors affecting the prognosis of ESD treatment and a nomogram prediction model was constructed. The validity of the model prediction was assessed by plotting the receiver operating characteristic (ROC) curve and the calibration curve, and the results were verified in the validation set. The clinical application value of Decision Curve Analysis (DCA) was explored.</p><p><strong>Results: </strong>Among the 126 patients, 33 cases (26.19%) had poor prognosis after ESD treatment. Logistic analysis showed that tumor size, lymph node metastasis, preoperative serum CEA level, Bacteroides abundance and Enterococcus abundance were the independent risk factors for poor prognosis of ESD treatment (<i>p</i> < 0.05). The nomogram model achieved C-index values of 0.898 (training set) and 0.926 (validation set), with mean absolute errors of 0.101 and 0.066, respectively. In the Hosmer-Lemeshow test, the <i>χ</i> values for the training and validation sets were 8.143(<i>p</i> = 0.419) and 10.591(<i>p</i> = 0.226), respectively. The ROC curves show AUC values of 0.897(95% CI 0.795-0.998) and 0.917(95% CI 0.752-1.000) for the training and validation sets, respectively, and a combination of sensitivity and specificity of 0.870 and 0.938, respectively, and 0.895 and 0.857, respectively.</p><p><strong>Conclusion: </strong>The nomogram prediction model based on the intestinal flora and clinical pathological parameters of patients with early colorectal cancer has high accuracy and calibration degree, which can provide a key reference for formulating individualized treatment plan in clinical and evaluating the prognosis of patients.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1604257"},"PeriodicalIF":3.1,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12162587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301630","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":"Association between eGDR and MASLD and liver fibrosis: a cross-sectional study based on NHANES 2017-2023.","authors":"Wenjing Peng, Zeyu Li, Nian Fu","doi":"10.3389/fmed.2025.1579879","DOIUrl":"10.3389/fmed.2025.1579879","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the association between estimated glucose disposal rate (eGDR) and metabolic dysfunction-associated steatotic liver disease (MASLD), as well as liver fibrosis, using data from the National Health and Nutrition Examination Survey (NHANES) 2017-2023 dataset.</p><p><strong>Methods: </strong>Data from 7,855 participants in the NHANES 2017-2023 dataset were analyzed. Multivariable logistic regression models were constructed to assess the association between eGDR (both continuous and quartiles) and MASLD, as well as liver fibrosis, adjusting for potential confounders. Generalized additive models (GAM) were used to explore non-linear relationships, stratified by age, hypertension, diabetes, cardiovascular disease (CVD), and body mass index (BMI). A two-piecewise linear regression model was used to examine threshold effects. Subgroup analyses were conducted to assess effect modification. Mediation analysis was performed to determine the role of the atherogenic index of plasma (AIP). Sensitivity analysis was performed to test the robustness of the results.</p><p><strong>Results: </strong>In the fully adjusted model, higher eGDR was inversely associated with both MASLD and liver fibrosis (MASLD: OR = 0.62, 95% CI: 0.53-0.72, <i>p</i> < 0.0001; liver fibrosis: OR = 0.50, 95% CI: 0.42-0.58, <i>p</i> < 0.0001). Participants in higher eGDR quartiles (Q2, Q3, and Q4) had progressively lower odds of both MASLD and liver fibrosis compared to those in Q1 (MASLD: Q2: OR = 0.56, 95% CI: 0.37-0.84, <i>p</i> = 0.0047; Q3: OR = 0.25, 95% CI: 0.12-0.50, <i>p</i> = 0.0001; Q4: OR = 0.13, 95% CI: 0.05-0.31, <i>p</i> < 0.0001; liver fibrosis: Q2: OR = 0.24, 95% CI: 0.13-0.44, <i>p</i> < 0.0001; Q3: OR = 0.06, 95% CI: 0.02-0.16, <i>p</i> < 0.0001; Q4: OR = 0.05, 95% CI: 0.01-0.19, <i>p</i> < 0.0001). A non-linear relationship with threshold effects at an eGDR value of 3.25 was observed for MASLD. Subgroup analyses revealed that the inverse association between eGDR and MASLD was more pronounced in individuals without diabetes. Additionally, smoothing curve fitting showed that the dose-response relationship between eGDR and both MASLD and liver fibrosis differed by metabolic and clinical status. Mediation analysis suggested that AIP partially mediated the association between eGDR and MASLD, accounting for approximately 10.6% of the total effect. Sensitivity analyses excluding extreme eGDR values confirmed the robust inverse associations with MASLD and liver fibrosis.</p><p><strong>Conclusion: </strong>This study found a significant non-linear inverse association between eGDR and both MASLD and liver fibrosis, with a threshold effect observed for MASLD. The association was stronger in non-diabetic individuals and partially mediated by AIP. Moreover, the dose-response relationships varied across metabolic and clinical subgroups.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1579879"},"PeriodicalIF":3.1,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12162473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301615","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}