Gut and Liver最新文献

{"title":"Effect of <i>Helicobacter pylori</i> Eradication on Metabolic Parameters and Body Composition including Skeletal Muscle Mass: A Matched Case-Control Study.","authors":"Suh Eun Bae, Kee Don Choi, Jaewon Choe, Min Jung Lee, Seonok Kim, Ji Young Choi, Hana Park, Jaeil Kim, Hye Won Park, Hye-Sook Chang, Hee Kyong Na, Ji Yong Ahn, Kee Wook Jung, Jeong Hoon Lee, Do Hoon Kim, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung","doi":"10.5009/gnl240494","DOIUrl":"10.5009/gnl240494","url":null,"abstract":"<p><strong>Background/aims: </strong>Findings on the impact of <i>Helicobacter pylori</i> eradication on metabolic parameters are inconsistent. This study aimed to evaluate the effects of <i>H. pylori</i> eradication on metabolic parameters and body composition, including body fat mass and skeletal muscle mass.</p><p><strong>Methods: </strong>We retrospectively reviewed the data of asymptomatic patients who underwent health screenings, including bioelectrical impedance analysis, before and after <i>H. pylori</i> eradication between 2005 and 2021. After matching individuals based on key factors, we compared lipid profiles, metabolic parameters, and body composition between 823 patients from the eradicated group and 823 patients from the non-eradicated groups.</p><p><strong>Results: </strong>Blood pressure, erythrocyte sedimentation rate, and glycated hemoglobin values were significantly lower in the eradicated group than in the non-eradicated group. However, changes in body mass index (BMI), body fat mass, appendicular skeletal muscle mass (ASM), waist circumference, and lipid profiles were not significantly different between the two groups. In a subgroup analysis of individuals aged >45 years, blood pressure, erythrocyte sedimentation rate, and glycated hemoglobin changes were significantly lower in the eradicated group than in the non-eradicated group. BMI values were significantly higher in the eradicated group than in the non-eradicated group; however, no significant differences were observed between the two groups regarding changes in body weight, body fat mass, ASM, or waist circumference. Total cholesterol and low-density lipoprotein cholesterol levels were significantly lower in the eradicated group than in non-eradicated group.</p><p><strong>Conclusions: </strong><i>H. pylori</i> eradication significantly reduced blood pressure, glucose levels, and systemic inflammation and improved lipid profiles in patients aged >45 years. BMI, body fat mass, ASM, and waist circumference did not significantly differ between patients in the eradicated group and those in the non-eradicated group.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":"19 3","pages":"346-354"},"PeriodicalIF":3.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983956","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":"Metabolic Disorders and Inflammatory Bowel Diseases.","authors":"Hye Kyung Hyun, Jae Hee Cheon","doi":"10.5009/gnl240316","DOIUrl":"10.5009/gnl240316","url":null,"abstract":"<p><p>Inflammatory bowel disease (IBD) is characterized by chronic immune-mediated intestinal inflammation, presenting with a spectrum of metabolic disorders as well as intestinal and extraintestinal manifestations. Lifestyle factors, genetic predisposition, immune dysfunction, and gut bacteria composition contribute to the development of IBD. Several comorbidities, including cardiovascular diseases, thrombosis, and metabolic disorders, have been associated with IBD. Therefore, metabolic disorders, including nonalcoholic fatty liver disease, type 2 diabetes mellitus, and obesity have become the focus of attention in patients with IBD. Identifying and managing these conditions can significantly influence patient outcomes and enhance overall management. Therefore, this review aimed to elucidate the current understanding of relevant and emerging metabolic comorbidities and extraintestinal manifestations associated with IBD and their clinical significance.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"307-317"},"PeriodicalIF":3.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142947731","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":"Population Pharmacokinetic Model for the Use of Intravenous or Subcutaneous Infliximab in Patients with Inflammatory Bowel Disease: Real-World Data from a Prospective Cohort Study.","authors":"Joo Hye Song, Sung Noh Hong, Myeong Gyu Kim, Minjung Kim, Seong Kyung Kim, Eun Ran Kim, Dong Kyung Chang, Young-Ho Kim","doi":"10.5009/gnl240503","DOIUrl":"10.5009/gnl240503","url":null,"abstract":"<p><strong>Background/aims: </strong>Infliximab treatment failure in patients with inflammatory bowel disease may result from sub-optimal infliximab trough level. An understanding of pharmacokinetics (PKs) is important to maintain an optimal trough level. PK studies of the switch to subcutaneous (SC) infliximab from intravenous (IV) infliximab using real-world data are lacking. We aimed to develop a population PK model of IV and SC infliximab to predict individual infliximab exposure during maintenance therapy.</p><p><strong>Methods: </strong>We used data from prospectively collected data on IV and SC infliximab concentrations in patients with inflammatory bowel disease receiving maintenance treatment from February 2020 to December 2022 at Samsung Medical Center. Population PK analysis was conducted by using a two-compartment model with first-order absorption and first-order elimination. Goodness-of-fit plots and visual predictive check were used to evaluate the PK model.</p><p><strong>Results: </strong>A total of 2,132 samples from 181 patients (149 Crohn's disease and 32 ulcerative colitis) were analyzed. We developed an infliximab population PK model using body mass index, albumin, C-reactive protein level, and the anti-drug antibody level and validated its predictive performance.</p><p><strong>Conclusions: </strong>It may be possible to predict the infliximab trough level of both IV and SC infliximab in patients with inflammatory bowel disease during maintenance treatment by using our model in real-world practice.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":"19 3","pages":"376-387"},"PeriodicalIF":3.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999149","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":"Predicting Mortality and Cirrhosis-Related Complications with MELD3.0: A Multicenter Cohort Analysis.","authors":"Jihye Lim, Ji Hoon Kim, Ahlim Lee, Ji Won Han, Soon Kyu Lee, Hyun Yang, Heechul Nam, Hae Lim Lee, Do Seon Song, Sung Won Lee, Hee Yeon Kim, Jung Hyun Kwon, Chang Wook Kim, U Im Chang, Soon Woo Nam, Seok-Hwan Kim, Pil Soo Sung, Jeong Won Jang, Si Hyun Bae, Jong Young Choi, Seung Kew Yoon, Myeong Jun Song","doi":"10.5009/gnl240584","DOIUrl":"10.5009/gnl240584","url":null,"abstract":"<p><strong>Background: </strong>/Aims: This study aimed to evaluate the performance of the Model for End-Stage Liver Disease (MELD) 3.0 for predicting mortality and liver-related complications compared with the Child-Pugh classification, albumin-bilirubin (ALBI) grade, the MELD, and the MELD sodium (MELDNa) score.</p><p><strong>Methods: </strong>We evaluated a multicenter retrospective cohort of incorporated patients with cirrhosis between 2013 and 2019. We conducted comparisons of the area under the receiver operating characteristic curve (AUROC) of the MELD3.0 and other models for predicting 3-month mortality. Additionally, we assessed the risk of cirrhosis-related complications according to the MELD3.0 score.</p><p><strong>Results: </strong>A total of 3,314 patients were included. The mean age was 55.9±11.3 years, and 70.2% of the patients were male. Within the initial 3 months, 220 patients (6.6%) died, and the MELD3.0 had the best predictive performance among the tested models, with an AUROC of 0.851, outperforming the Child-Pugh classification, ALBI grade, MELD, and MELDNa. A high MELD3.0 score was associated with an increased risk of mortality. Compared with that of the group with a MELD3.0 score <10 points, the adjusted hazard ratio of the group with a score of 10-20 points was 2.176, and that for the group with a score of ≥20 points was 4.892. Each 1-point increase in the MELD3.0 score increased the risk of cirrhosis-related complications by 1.033-fold. The risk of hepatorenal syndrome showed the highest increase, with an adjusted hazard ratio of 1.149, followed by hepatic encephalopathy and ascites.</p><p><strong>Conclusions: </strong>The MELD3.0 demonstrated robust prognostic performance in predicting mortality in patients with cirrhosis. Moreover, the MELD3.0 score was linked to cirrhosis-related complications, particularly those involving kidney function, such as hepatorenal syndrome and ascites.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":"19 3","pages":"427-437"},"PeriodicalIF":3.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017243","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":"Korean Registry on the Current Management of <i>Helicobacter pylori</i> (K-Hp-Reg): Interim Analysis of Adherence to the Revised Evidence-Based Guidelines for First-Line Treatment.","authors":"Hyo-Joon Yang, Joon Sung Kim, Ji Yong Ahn, Ok-Jae Lee, Gwang Ha Kim, Chang Seok Bang, Moo In Park, Jae Yong Park, Sun Moon Kim, Su Jin Hong, Joon Hyun Cho, Shin Hee Kim, Hyun Joo Song, Jin Woong Cho, Sam Ryong Jee, Hyun Lim, Yong Hwan Kwon, Ju Yup Lee, Seong Woo Jeon, Seon-Young Park, Younghee Choe, Moon Kyung Joo, Dae-Hyun Kim, Jae Myung Park, Beom Jin Kim, Jong Yeul Lee, Tae Hoon Oh, Jae Gyu Kim","doi":"10.5009/gnl240489","DOIUrl":"10.5009/gnl240489","url":null,"abstract":"<p><strong>Background/aims: </strong>The Korean guidelines for <i>Helicobacter pylori</i> treatment were revised in 2020, however, the extent of adherence to these guidelines in clinical practice remains unclear. Herein, we initiated a prospective, nationwide, multicenter registry study in 2021 to evaluate the current management of <i>H. pylori</i> infection in Korea.</p><p><strong>Methods: </strong>This interim report describes the adherence to the revised guidelines and their impact on first-line eradication rates. Data on patient demographics, diagnoses, treatments, and eradication outcomes were collected using a web-based electronic case report form.</p><p><strong>Results: </strong>A total of 7,261 patients from 66 hospitals who received first-line treatment were analyzed. The modified intention-to-treat eradication rate for first-line treatment was 81.0%, with 80.4% of the prescriptions adhering to the revised guidelines. The most commonly prescribed regimen was the 14-day clarithromycin-based triple therapy (CTT; 42.0%), followed by tailored therapy (TT; 21.2%), 7-day CTT (14.1%), and 10-day concomitant therapy (CT; 10.1%). Time-trend analysis demonstrated significant increases in guideline adherence and the use of 10-day CT and TT, along with a decrease in the use of 7-day CTT (all p<0.001). Multivariate logistic regression analysis revealed that guideline adherence was significantly associated with first-line eradication success (odds ratio, 2.03; 95% confidence interval, 1.61 to 2.56; p<0.001).</p><p><strong>Conclusions: </strong>The revised guidelines for the treatment of <i>H. pylori</i> infection have been increasingly adopted in routine clinical practice in Korea, which may have contributed to improved first-line eradication rates. Notably, the 14-day CTT, 10-day CT, and TT regimens are emerging as the preferred first-line treatment options among Korean physicians.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":"19 3","pages":"364-375"},"PeriodicalIF":3.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992826","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":"Short-term and Long-term Clinical Outcomes of Combined Caudate Lobectomy for Intrahepatic Cholangiocarcinoma Involving the Hepatic Hilus: A Propensity Score Analysis.","authors":"Di Zeng, Yaoqun Wang, Ningyuan Wen, Bei Li, Nansheng Cheng, Jiong Lu","doi":"10.5009/gnl240158","DOIUrl":"10.5009/gnl240158","url":null,"abstract":"<p><strong>Background/aims: </strong>Extended hepatectomy combined with caudate lobe resection has been approved for the radical resection of hilar cholangiocarcinoma. There was a lack of credible research on the clinical value of caudate lobectomy (CL) for intrahepatic cholangiocarcinoma involving the hepatic hilus when combined with hepatectomy. We aimed to compare the short-term and long-term outcomes of the combined procedure with those of only CL for curative resection of intrahepatic cholangiocarcinoma involving the hepatic hilus.</p><p><strong>Methods: </strong>This single-center retrospective cohort study of patients with hilar cholangiocarcinoma was conducted from January 2007 to December 2021. Patients who underwent radical resection were enrolled in this study. The short-term and long-term clinical outcomes of the groups were compared before and after propensity score matching (PSM).</p><p><strong>Results: </strong>A total of 282 patients were included. There were no statistically significant differences in perioperative clinical outcomes between the CL group and the non-CL group before and after PSM. Compared to patients in the non-CL group, patients in the CL group had significantly longer overall survival before and after PSM (p=0.007 before PSM, p=0.033 after PSM). Moreover, compared to the non-CL group, the CL group had longer disease-free survival before and after PSM (p<0.001 before PSM, p=0.019 after PSM).</p><p><strong>Conclusions: </strong>The postoperative complications of the CL group were comparable to those of the non-CL group. CL improved the long-term survival of patients with intrahepatic cholangiocarcinoma involving the hepatic hilus when combined with hepatectomy. Therefore, hepatectomy combined with caudate lobe resection should be performed for patients with hilar cholangiocarcinoma.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"438-453"},"PeriodicalIF":3.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345203","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 Efficacy and Safety of Endoscopic Ultrasound-Guided Retroperitoneal Fluid Collection Drainage with Novel Electrocautery-Enhanced Lumen-Apposing Metal Stents (with Video).","authors":"Sung Hyun Cho, Yoonchan Lee, Tae Jun Song, Dongwook Oh, Dong-Wan Seo","doi":"10.5009/gnl240452","DOIUrl":"10.5009/gnl240452","url":null,"abstract":"<p><strong>Background/aims: </strong>Various lumen-apposing metal stents (LAMS) have been used for the endoscopic ultrasound-guided transmural drainage (EUS-TD) of postoperative pancreatic fluid collections (POPFC) and peripancreatic fluid collections (PFC). In this study, we aimed to assess the efficacy and safety of novel electrocautery-enhanced LAMSs (Hot-Plumber with Z-EUS IT) with different inter-flange lengths (13 to 33 mm) for managing POPFC and PFC.</p><p><strong>Methods: </strong>We reviewed the interventional EUS database of Asan Medical Center to identify consecutive patients with POPFC or PFC who underwent EUS-TD with the novel LAMSs between April 2023 and December 2023. Technical success, clinical success, and adverse events were evaluated.</p><p><strong>Results: </strong>Ten patients (5 with POPFCs and 5 with PFCs) were included in the analysis. The technical and clinical success rates were 100% and 90%, respectively. The LAMS was placed using either the freehand technique (n=5) or the over-the-guide wire technique (n=5). One patient successfully underwent endoscopic necrosectomy for walled-off necrosis through a novel LAMS. Two patients experienced adverse events (one stent migration and one infection). The LAMS was removed in 7 out of 10 patients after resolution of the fluid collection at a median of 61 days (interquartile range, 31 to 69 days) post-LAMS placement.</p><p><strong>Conclusions: </strong>EUS-TD using the novel LAMS for POPFC and PFC demonstrated high efficacy and an acceptable safety profile. This novel LAMS represents a viable option when selecting stents for EUS-guided drainage of the POPFC and PFC.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"454-461"},"PeriodicalIF":3.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763447","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":"Expanding the Potential of Endoscopic Ultrasound-Guided Drainage: Clinical Insights into a Novel Multi-Length Lumen-Apposing Metal Stents.","authors":"Eunae Cho","doi":"10.5009/gnl250195","DOIUrl":"10.5009/gnl250195","url":null,"abstract":"","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":"19 3","pages":"303-304"},"PeriodicalIF":3.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015396","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":"Influence of <i>Helicobacter pylori</i> Infection and Eradication Therapy on Nutrition and Metabolic Parameters.","authors":"Mitsushige Sugimoto, Masaki Murata","doi":"10.5009/gnl250159","DOIUrl":"10.5009/gnl250159","url":null,"abstract":"","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":"19 3","pages":"297-298"},"PeriodicalIF":3.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997740","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":"Repurposing of Antiplatelet Agent: Cilostazol for the Treatment of Alcohol-Related Liver Disease.","authors":"Jong Ryeol Eun, Seung Up Kim","doi":"10.5009/gnl240295","DOIUrl":"10.5009/gnl240295","url":null,"abstract":"<p><p>Alcohol-related liver disease (ALD) is a serious global health concern, characterized by liver inflammation and progressive fibrosis. There are no Food and Drug Administration-approved drugs, thus effective treatments are needed. Severe alcoholic hepatitis (AH) is the most severe manifestation of ALD, with a 28-day mortality rate ranging from 20% to 50%. For decades, pentoxifylline, an antiplatelet agent, has been used off-label for the treatment of severe AH owing to its tumor necrosis factor-α inhibition properties. However, the STOPAH trial did not reveal the survival benefit of pentoxifylline. Consequently, pentoxifylline is no longer recommended as the first-line therapy for severe AH. In contrast, cilostazol is widely used as an antiplatelet agent in cardiovascular medicine and demonstrates promising results. Cilostazol is a selective phosphodiesterase type 3 inhibitor, whereas pentoxifylline is non-selective. Recent studies using experimental models of alcohol-induced liver injury and other liver diseases have yielded promising results. Although cilostazol shows promise for hepatoprotective effects, it has not yet been evaluated in human clinical trials. In this review, we will explore the mechanism underlying the hepatoprotective effects of cilostazol, along with the pathophysiology of alcohol-induced liver injury, addressing the pressing need for effective therapeutic options for patients with ALD.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"318-326"},"PeriodicalIF":3.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142947787","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}