Gut and Liver最新文献

{"title":"Influence of Cytokine Genetic Polymorphisms in <i>Helicobacter pylori</i>-Associated Gastric Inflammation According to Sex in South Korea.","authors":"Hee Jin Kim, Nayoung Kim, Jae Young Jang, Sihyun Kim, Jongchan Lee, Hyeon Jeong Oh","doi":"10.5009/gnl230359","DOIUrl":"10.5009/gnl230359","url":null,"abstract":"<p><strong>Background/aims: </strong>: The relationship between genetic polymorphisms and gastric inflammation remains unclear. This study aimed to evaluate the impact of genetic polymorphisms on <i>Helicobacter pylori</i> (HP)-associated gastritis according to sex.</p><p><strong>Methods: </strong>: Two hundred thirty-two male and 404 female subjects with current HP infection were prospectively enrolled. The genotyping of <i>IL-1B-511</i> C/T, <i>IL-1RN</i> variable number of tandem repeats, <i>IL-6-572</i> G/C, <i>IL-8-251</i> A/T, <i>IL-8-781</i> C/T, <i>IL-10-1082</i> G/A, <i>IL-10-592</i> C/A, <i>TNF-A-308</i> G/A, and transforming growth factor (<i>TGF</i>)-<i>B-509</i> C/T, was determined by polymerase chain reaction-restriction fragment length polymorphism. The degree of monocyte or neutrophil infiltration, atrophic gastritis, and intestinal metaplasia was evaluated using the updated Sydney system.</p><p><strong>Results: </strong>: Among the male subjects, moderate/severe atrophic gastritis of the corpus was higher in <i>IL-1B-511</i> CC carriers than in CT and TT carriers independent of age, alcohol consumption, and HP virulence factors (26.9% vs 10.4%; adjusted hazard ratio [HR], 4.377; 95% confidence interval, 1.387 to 13.814). In females, <i>IL-8-251</i> AA carriers were independently and significantly associated with moderate/severe atrophic gastritis of the corpus compared with that in AT and TT carriers (21.4% vs 6.0%, adjusted HR=3.799). In males, the <i>IL-8-251</i> TT genotype was associated with moderate/severe intestinal metaplasia of the corpus compared with the AT and AA genotypes (13.4% vs 5.6%, adjusted HR=3.128), while the <i>IL-10-592</i> CA and CC genotypes were associated with moderate/severe monocyte infiltration of the antrum compared with AA genotype (83.6% vs 71.8%, adjusted HR=2.227).</p><p><strong>Conclusions: </strong>: Genetic polymorphisms in cytokines play different roles in HP-associated gastritis according to sex.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"1002-1013"},"PeriodicalIF":3.4,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139930863","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":"Cellular Plasticity in Gut and Liver Regeneration.","authors":"Minwook Kim, Yoojeong Park, You Sun Kim, Sungjin Ko","doi":"10.5009/gnl240005","DOIUrl":"10.5009/gnl240005","url":null,"abstract":"<p><p>The intestine and liver share a unique regenerative property that sets them apart from other mammalian visceral organs. The intestinal epithelium exhibits rapid renewal, making it one of the fastest renewing tissues in humans. Under physiological conditions, intestinal stem cells within each intestinal crypt continuously differentiate into the different types of intestinal epithelial cells to maintain intestinal homeostasis. However, when exposed to tissue damage or stressful conditions such as inflammation, intestinal epithelial cells in the gastrointestinal tract exhibit plasticity, allowing fully differentiated cells to regain their stem cell properties. Likewise, hepatic epithelial cells possess a remarkable regenerative capacity to restore lost liver mass through proliferation-mediated liver regeneration. When the proliferation-mediated regenerative capacity is impaired, hepatocytes and biliary epithelial cells (BECs) can undergo plasticity-mediated regeneration and replenish each other. The transition of mammalian liver progenitor cells to hepatocytes/BECs can be observed under tightly controlled experimental conditions such as severe hepatocyte injury accompanied by the loss of regenerative capacity. In this review, we will discuss the mechanism by which cellular plasticity contributes to the regeneration process and the potential therapeutic implications of understanding and harnessing cellular plasticity in the gut and liver.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"949-960"},"PeriodicalIF":3.4,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855366","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":"Combi-Elastography versus Transient Elastography for Assessing the Histological Severity of Metabolic Dysfunction-Associated Steatotic Liver Disease.","authors":"Yun Kyu Lee, Dong Hyeon Lee, Sae Kyung Joo, Heejoon Jang, Young Ho So, Siwon Jang, Dong Ho Lee, Jeong Hwan Park, Mee Soo Chang, Won Kim","doi":"10.5009/gnl240198","DOIUrl":"10.5009/gnl240198","url":null,"abstract":"<p><strong>Background/aims: </strong>Combi-elastography is a B-mode ultrasound-based method in which two elastography modalities are utilized simultaneously to assess metabolic dysfunction-associated steatotic liver disease (MASLD). However, the performance of combi-elastography for diagnosing metabolic dysfunction-associated steatohepatitis (MASH) and determining fibrosis severity is unclear. This study compared the diagnostic performances of combi-elastography and vibration-controlled transient elastography (VCTE) for identifying hepatic steatosis, fibrosis, and high-risk MASH.</p><p><strong>Methods: </strong>Participants who underwent combi-elastography, VCTE, and liver biopsy were selected from a prospective cohort of patients with clinically suspected MASLD. Combi-elastography-related parameters were acquired, and their performances were evaluated using area under the receiver-operating characteristic curve (AUROC) analysis.</p><p><strong>Results: </strong>A total of 212 participants were included. The diagnostic performance for hepatic steatosis of the attenuation coefficient adjusted by covariates from combi-elastography was comparable to that of the controlled attenuation parameter measured by VCTE (AUROC, 0.85 vs 0.85; p=0.925). The performance of the combi-elastography-derived fibrosis index adjusted by covariates for diagnosing significant fibrosis was comparable to that of liver stiffness measured by VCTE (AUROC, 0.77 vs 0.80; p=0.573). The activity index from combi-elastography adjusted by covariates was equivalent to the FibroScan-aspartate aminotransferase score in diagnosing high-risk MASH among participants with MASLD (AUROC, 0.72 vs 0.74; p=0.792).</p><p><strong>Conclusions: </strong>The performance of combi-elastography is similar to that of VCTE when evaluating histology of MASLD.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"1048-1059"},"PeriodicalIF":3.4,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521745","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":"Predictors of Choledocholithiasis in Cholecystectomy Patients and Their Cutoff Values and Prediction Model in Korea in Comparison with the 2019 ASGE Guidelines.","authors":"Jung Hun Woo, Hwanhyi Cho, Kihyun Ryu, Young Woo Choi, Sanghyuk Lee, Tae Hee Lee, Dae Sung Kim, In Seok Choi, Ju Ik Moon, Seung Jae Lee","doi":"10.5009/gnl230534","DOIUrl":"10.5009/gnl230534","url":null,"abstract":"<p><strong>Background/aims: </strong>: In 2019, the American Society for Gastrointestinal Endoscopy (ASGE) established clinical predictors for choledocholithiasis. Our study was designed to evaluate these predictors within the Korean clinical context, establish cutoff values, and develop a predictive model.</p><p><strong>Methods: </strong>: This retrospective study analyzed patients who underwent laparoscopic cholecystectomy. The relationships between choledocholithiasis and predictors including age, blood tests, and imaging findings were assessed through univariate and multivariate logistic regression analyses. We established Korean cutoff values for these predictors and developed a scoring system for choledocholithiasis using a multivariate logistic regression. The performance of this scoring system was then compared with that of the 2019 ASGE guidelines through a receiver operating characteristic curve.</p><p><strong>Results: </strong>: We established Korean cutoff values for age (>70 years), alanine aminotransferase (>26.5 U/L), aspartate aminotransferase (>28.5 U/L), gamma-glutamyl transferase (GGT; >82.5 U/L), alkaline phosphatase (ALP; >77.5 U/L), and total bilirubin (>0.95 mg/dL). In the multivariate analysis, only age >70 years, GGT >77.5 U/L, ALP >77.5 U/L, and common bile duct dilatation remained significant. We then developed a new Korean risk stratification model from the multivariate analysis, with an area under the curve of 0.777 (95% confidence interval, 0.75 to 0.81). Our model was stratified into the low-risk, intermediate-risk, and high-risk groups with the scores being <1.0, 1.0-5.5, and >5.5, respectively.</p><p><strong>Conclusions: </strong>: Predictors of choledocholithiasis in cholecystectomy patients and their cutoff values in Korean should be adjusted and further studies are needed to develop appropriate guidelines.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"1060-1068"},"PeriodicalIF":3.4,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140848664","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":"Pharmacological Interventions for Cirrhotic Ascites: From Challenges to Emerging Therapeutic Horizons.","authors":"Yuan Gao, Xin Liu, Yunyi Gao, Meili Duan, Bing Hou, Yu Chen","doi":"10.5009/gnl240038","DOIUrl":"10.5009/gnl240038","url":null,"abstract":"<p><p>Ascites is the most common complication in patients with decompensated cirrhosis. This condition results in a severely impaired quality of life, excessive healthcare use, recurrent hospitalizations and significant morbidity and mortality. While loop diuretics and mineralocorticoid receptor antagonists are commonly employed for symptom relief, our understanding of their impact on survival remains limited. A comprehensive understanding of the underlying pathophysiological mechanism of ascites is crucial for its optimal management. The renin-angiotensin-aldosterone system (RAAS) is increasingly believed to play a pivotal role in the formation of cirrhotic ascites, as RAAS overactivation leads to a reduction in urine sodium excretion then a decrease in the ability of the kidneys to excrete water. In this review, the authors provide an overview of the pathogenesis of cirrhotic ascites, the challenges associated with current pharmacologic treatments, and the previous attempts to modulate the RAAS, followed by a description of some emerging targeted RAAS agents with the potential to be used to treat ascites.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"934-948"},"PeriodicalIF":3.4,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142106750","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":"Can Patients with Clarithromycin-Resistant <i>Helicobacter pylori</i> Infection Be Treated with a 7-Day Bismuth-Based Quadruple Therapy?","authors":"Jung-Wook Kim, Albert C Kim","doi":"10.5009/gnl240511","DOIUrl":"10.5009/gnl240511","url":null,"abstract":"","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":"18 6","pages":"931-933"},"PeriodicalIF":3.4,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618775","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":"Gallstone Dissolution Effects of Combination Therapy with n-3 Polyunsaturated Fatty Acids and Ursodeoxycholic Acid: A Randomized, Prospective, Preliminary Clinical Trial.","authors":"See Young Lee, Sung Ill Jang, Jae Hee Cho, Min Young Do, Su Yeon Lee, Arong Choi, Hye Sun Lee, Juyeon Yang, Dong Ki Lee","doi":"10.5009/gnl230494","DOIUrl":"10.5009/gnl230494","url":null,"abstract":"<p><strong>Background/aims: </strong>: Ursodeoxycholic acid (UDCA) is the only well-established and widely used agent for dissolving gallstones. Epidemiological and animal studies have suggested potential therapeutic benefits of n-3 polyunsaturated fatty acids (PUFA) for dissolving cholesterol gallstones. We evaluated whether adding PUFA to UDCA improves gallstone dissolution in patients with cholesterol gallstones.</p><p><strong>Methods: </strong>: This randomized, prospective, preliminary clinical trial compared the efficacy and safety of UDCA plus PUFA combination therapy (combination group) with those of UDCA monotherapy (monotherapy group). The inclusion criteria were a gallstone diameter ≤15 mm on ultrasonography, radiolucent stones on plain X-ray, and no to mild symptoms. Gallstone dissolution rates, response rates, and adverse events were evaluated.</p><p><strong>Results: </strong>: Of the 59 screened patients, 45 patients completed treatment (24 and 21 in the monotherapy and combination groups, respectively). The gallstone dissolution rate tended to be higher in the combination group than in the monotherapy group (45.7% vs 9.9%, p=0.070). The radiological response rate was also significantly higher in the combination group (90.5% vs 41.7%, p=0.007). In both groups, dissolution and response rates were higher in patients with gallbladder sludge than in those with distinct stones. Four adverse events (two in each group) were observed, none of which were study drug-related or led to drug discontinuation. The incidence of these adverse events was similar in both groups (combination vs monotherapy: 9.5% vs 8.3%, p=0.890).</p><p><strong>Conclusions: </strong>: UDCA plus PUFA therapy dissolves cholesterol gallstones more effectively than UDCA monotherapy, without significant complications. Further prospective, large-scale studies of this combination therapy are warranted.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"1069-1079"},"PeriodicalIF":3.4,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140847479","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":"Impact of Korean Military Service on the Prevalence of Steatotic Liver Disease: A Longitudinal Study of Pre-enlistment and In-Service Health Check-Ups.","authors":"Jaejun Lee, Jae Hyeop Jung, Sung Jun Choi, Beomman Ha, Hyun Yang, Pil Soo Sung, Si Hyun Bae, Jeong-A Yu","doi":"10.5009/gnl240077","DOIUrl":"10.5009/gnl240077","url":null,"abstract":"<p><strong>Background/aims: </strong>Young Korean men are obligated to serve in the military for 18 to 21 months. We investigated the effects of military service on steatotic liver disease (SLD) and other metabolic parameters.</p><p><strong>Methods: </strong>Pre-enlistment health check-up performed from 2019 to 2022 and in-service health check-up performed from 2020 to 2022 were merged as paired data. SLD was defined as a hepatic steatosis index of 36 or higher. Hypertension (HTN) and hypertriglyceridemia were also included in the analysis.</p><p><strong>Results: </strong>A total of 503,136 paired cases were included in the analysis. Comparing pre-enlistment and in-service health check-ups, the prevalence of SLD (22.2% vs 17.6%, p<0.001), HTN (7.6% vs 4.3%, p<0.001), and hypertriglyceridemia (8.1% vs 2.9%, p<0.001) decreased during military service. In terms of body mass index, the proportion of underweight (8.2% vs 1.4%, p<0.001) and severely obese (6.1% vs 4.9%, p<0.001) individuals decreased over time. Regarding factors associated with SLD development and resolution, age was positively associated with SLD development (odds ratio, 1.146; p<0.001) and a health check-up interval of <450 days was a protective factor for SLD development (odds ratio, 0.746; p<0.001). Those serving in the marines were less likely to develop SLD, whereas those serving in the navy were more likely to develop SLD. Serving in the army or the navy was negatively associated with SLD resolution, whereas serving in the air force was positively associated with SLD resolution.</p><p><strong>Conclusions: </strong>The prevalence of SLD, HTN, and hypertriglyceridemia decreased substantially during Korean military service.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"888-896"},"PeriodicalIF":3.4,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11391135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141476478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Biliary Drainage on the Prognosis of Patients with Hepatocellular Carcinoma and Bile Duct Invasion.","authors":"Keungmo Yang, Hyun Yang, Chang Wook Kim, Hee Chul Nam, Ji Hoon Kim, Ahlim Lee, U Im Chang, Jin Mo Yang, Hae Lim Lee, Jung Hyun Kwon, Soon Woo Nam, Soon Kyu Lee, Pil Soo Sung, Ji Won Han, Jeong Won Jang, Si Hyun Bae, Jong Young Choi, Seung Kew Yoon, Hee Yeon Kim","doi":"10.5009/gnl240032","DOIUrl":"10.5009/gnl240032","url":null,"abstract":"<p><strong>Background/aims: </strong>Bile duct invasion (BDI) is rarely observed in patients with advanced hepatocellular carcinoma (HCC), leading to hyperbilirubinemia. However, the efficacy of pretreatment biliary drainage for HCC patients with BDI and obstructive jaundice is currently unclear. Thus, the aim of this study was to assess the effect of biliary drainage on the prognosis of these patients.</p><p><strong>Methods: </strong>We retrospectively enrolled a total of 200 HCC patients with BDI from multicenter cohorts. Patients without obstructive jaundice (n=99) and those who did not undergo HCC treatment (n=37) were excluded from further analysis. Finally, 64 patients with obstructive jaundice (43 subjected to drainage and 21 not subjected to drainage) were included. Propensity score matching was then conducted.</p><p><strong>Results: </strong>The biliary drainage group showed longer overall survival (median 10.13 months vs 4.43 months, p=0.004) and progression-free survival durations (median 7.00 months vs 1.97 months, p<0.001) than the non-drainage group. Multivariate analysis showed that biliary drainage was a significantly favorable prognostic factor for overall survival (hazard ratio, 0.42; p=0.006) and progression-free survival (hazard ratio, 0.30; p<0.001). Furthermore, in the evaluation of first response after HCC treatment, biliary drainage was beneficial (p=0.005). Remarkably, the durations of overall survival (p=0.032) and progression-free survival (p=0.004) were similar after propensity score matching.</p><p><strong>Conclusions: </strong>Biliary drainage is an independent favorable prognostic factor for HCC patients with BDI and obstructive jaundice. Therefore, biliary drainage should be contemplated in the treatment of advanced HCC with BDI to improve survival outcomes.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"877-887"},"PeriodicalIF":3.4,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11391144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633175","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":"Real-World Bleeding Risk of Anticoagulant and Nonsteroidal Anti-inflammatory Drugs Combotherapy versus Anticoagulant Monotherapy.","authors":"Moonhyung Lee, Jae Myung Cha","doi":"10.5009/gnl230541","DOIUrl":"10.5009/gnl230541","url":null,"abstract":"<p><strong>Background/aims: </strong>The incidence of acute gastrointestinal bleeding (GIB) increases with the utilization of anticoagulant and nonsteroidal anti-inflammatory drugs (NSAIDs). This study aimed to compare the risk of GIB between anticoagulant and NSAIDs combotherapy and anticoagulant monotherapy in real-world practice.</p><p><strong>Methods: </strong>We investigated the relative risk of GIB in individuals newly prescribed anticoagulant and NSAIDs combination therapy and that in individuals newly prescribed anticoagulant monotherapy at three hospitals using \"common data model.\" Cox proportional hazard models and Kaplan-Meier estimation were employed for risk comparison after propensity score matching.</p><p><strong>Results: </strong>A comprehensive analysis of 2,951 matched pairs showed that patients who received anticoagulant and NSAIDs combousers exhibited a significantly higher risk of GIB than those who received anticoagulant monousers (hazard ratio [HR], 1.66; 95% confidence interval [CI], 1.30 to 2.12; p<0.001). The risk of GIB associated with anticoagulant and NSAIDs combination therapy was also significantly higher than that associated with anticoagulant monotherapy in patients aged >65 years (HR, 1.53; 95% CI, 1.15 to 2.03; p=0.003) and >75 years (HR, 1.89; 95% CI, 1.23 to 2.90; p=0.003). We also found that the risk of GIB was significantly higher in the patients who received anticoagulant and NSAIDs combousers than that in patients who received anticoagulant monousers in both male (p=0.016) and female cohorts (p=0.010).</p><p><strong>Conclusions: </strong>The risk of GIB is significantly higher in patients who receive anticoagulant and NSAIDs combotherapy than that in patients who receive anticoagulant monotherapy. In addition, the risk of GIB associated with anticoagulant and NSAIDs combotherapy was much higher in individuals aged >75 years. Therefore, physicians should be more aware of pay more attention to the risk of GIB when they prescribe anticoagulant and NSAIDs.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"824-833"},"PeriodicalIF":3.4,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11391146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140897886","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}