Journal of clinical gastroenterology最新文献

{"title":"Comparative Outcomes After Index Myocardial Infarction in Patients With Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis.","authors":"Bachviet Nguyen, Stephanie Quon, Christopher Ma, Sunny Singh","doi":"10.1097/MCG.0000000000002372","DOIUrl":"10.1097/MCG.0000000000002372","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel disease (IBD) is a chronic systemic inflammatory disorder associated with elevated cardiovascular risk. While prior studies have linked IBD to increased risk of myocardial infarction (MI), post-MI outcomes in this population remain poorly characterized. We aimed to evaluate post-MI outcomes in patients with IBD compared with non-IBD controls.</p><p><strong>Methods: </strong>A systematic review and meta-analysis was conducted following PRISMA guidelines. Five databases were searched from inception to July 2025. We included observational studies comparing post-MI outcomes in adults with and without IBD. Random-effects meta-analyses were performed using hazard ratios (HRs) and odds ratios (ORs) with 95% CIs. Heterogeneity was assessed using the I2 statistic.</p><p><strong>Results: </strong>Nine retrospective cohort studies encompassing 9.45 million patients were included. IBD was associated with significantly increased risk of MACE (HR: 1.31, 95% CI: 1.07-1.59), all-cause mortality (HR: 1.25, 95% CI: 1.12-1.39), and recurrent MI (HR: 1.22, 95% CI: 1.08-1.39) following index myocardial infarction compared with non-IBD patients. Pooled ORs showed increased odds of major bleeding (OR: 1.38, 95% CI: 1.13-1.70) and transfusion (OR: 1.41, 95% CI: 1.35-1.47), but lower odds of heart failure (OR: 0.81, 95% CI: 0.74-0.89) and no significantly increased odds of stroke.</p><p><strong>Conclusions: </strong>Patients with IBD have statistically significantly higher risks of MACE, all-cause mortality, recurrent MI, blood transfusions, and major bleeding compared with the non-IBD population. These findings emphasize the potential role for tailored cardiovascular risk stratification, bleeding risk mitigation, and longitudinal management strategies in patients with IBD.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":"603-612"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772810","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":"Suicide Attempts, Schizophrenia, and Depression Among Inflammatory Bowel Disease Patients: Data From a Large Database.","authors":"Vered Richter, Nechama Markovitz, Yoav Krupik, Noa Menkes-Caspi, Yarden Itzhaky, Daniel L Cohen, Haim Shirin, Roba Ganayem, Naim Abu-Freha","doi":"10.1097/MCG.0000000000002308","DOIUrl":"10.1097/MCG.0000000000002308","url":null,"abstract":"<p><strong>Background and aims: </strong>Psychiatric disorders are more common in inflammatory bowel disease (IBD) patients compared with the general population. We aimed to investigate the prevalence and risk factors of depression, schizophrenia, and suicide attempts among IBD patients in Israel.</p><p><strong>Methods: </strong>Data on IBD patients over 25 years (1999 to 2024) was extracted from the Clalit Health Maintenance Organization. Possible risk factors were investigated via multivariate analyses. A matched case-control analysis was performed of attempted suicide cases.</p><p><strong>Results: </strong>A total of 3,262,623 adults were analyzed. The frequency rate of suicide attempts was 1.5%, schizophrenia 1.3%, and depression 25.7% among 19,100 Crohn's disease (CD) patients compared with 1.1%, 1.4%, and 23.0% among 17,731 ulcerative colitis (UC) patients. In a multivariate analysis, female gender (OR 1.284, P <0.001), smoking (OR 1.479, P <0.001), CD (OR 1.274, P <0.010), schizophrenia (OR 7.69, P <0.001), and depression (OR 6.284, P <0.001) were found to be predictors of suicide attempts. Case-control analysis of 490 patients with a prior suicide attempt revealed significantly higher rates of schizophrenia (13.1% vs. 1.2%, P <0.001) and depression (70.0% vs. 19.6%, P <0.001) among the suicide group. In a multivariate analysis, schizophrenia (OR 9.873, P <0.001) and depression (OR 8.964, P <0.001) were significant risk factors for suicide attempts. The mortality rate among those with a suicide attempt (98/490, 20%) was significantly higher compared with those without a suicide attempt (5301/36,341, 14.6%, P <0.001).</p><p><strong>Conclusion: </strong>The main risk factor for suicide attempts among IBD patients is comorbid psychiatric disease. Proactive mental health care by gastroenterologists and integrated psychology services is highly recommended.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":"648-653"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145768211","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":"Noninvasive Screening for High-Risk Esophageal Varices in Cirrhosis: Current and Emerging Methods.","authors":"Eric Markarian, Tien Dong, Arpan Patel, James H Tabibian","doi":"10.1097/MCG.0000000000002378","DOIUrl":"10.1097/MCG.0000000000002378","url":null,"abstract":"<p><p>The primary goal of variceal screening in patients with cirrhosis is to identify high-risk esophageal varices (HREV) and implement preventative measures. Historically, endoscopic screening was recommended for all patients with cirrhosis; however, this approach is increasingly recognized as neither cost-effective nor clinically necessary for all patients. As the prevalence of compensated advanced chronic liver disease (cACLD) continues to rise, there is increasing interest in noninvasive risk stratification methods to effectively tailor patient selection for endoscopic screening. Current clinical guidelines encourage the use of noninvasive predictive scores and algorithms to accurately identify patients at increased risk of having HREV and thereby reduce unnecessary screening endoscopies. In this review, we provide an evaluation of the various available noninvasive methods to predict HREV, including the Baveno criteria, platelet count:spleen diameter ratio, and the EVendo score. We review the performance, strengths, and limitations of these noninvasive methods-especially the machine learning-based EVendo score-and discuss future directions for optimizing risk stratification in patients with cirrhosis.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":"582-587"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815655","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":"Fiber Intake in Inflammatory Bowel Disease: Impact of Disease Activity and Predictors of High Fiber Intake.","authors":"Jaya Vasudevan, Dagny Larson, John Damianos, Chandershekhar Shori, Clara DiVincenzo, Yetunde Ishola, Zhouwen D Tang, Jill K J Gaidos, Marissa Burgermaster, Linda A Feagins","doi":"10.1097/MCG.0000000000002258","DOIUrl":"10.1097/MCG.0000000000002258","url":null,"abstract":"<p><strong>Goals: </strong>To assess if patients were meeting dietary fiber recommendations and compare intake between those with active versus inactive IBD, and between Crohn's (CD) and ulcerative colitis (UC).</p><p><strong>Background: </strong>Fiber is an important component of the diet to maintain a healthy gut, including in patients with inflammatory bowel disease (IBD).</p><p><strong>Study: </strong>A prospective, multicenter, cross-sectional study of eating habits was performed in 2 academic gastroenterology practices. Patients completed a food frequency questionnaire to assess fiber intake. Objective evidence of disease activity was assessed through fecal calprotectin, endoscopy or cross-sectional imaging. High fiber diets were those with ≥30 g/day for men or ≥25 g/day for women. Multivariate logistic regression analysis was performed to assess predictors of high fiber intake.</p><p><strong>Results: </strong>Of 117 patients (71 CD, 43 UC, 3 IBDU), only 26% of patients were consuming high fiber diets. Average dietary fiber intake was lower for patients with active disease versus inactive disease (19 g vs. 24 g, P =0.0048) but on subgroup analysis this remained significant in UC (13 g vs. 22 g, P =0.0044) but not CD (21 g vs. 24 g, P =0.38). Increased education on nutrition was the most important predictor of eating a high fiber diet.</p><p><strong>Conclusions: </strong>While most IBD patients are not eating high fiber diets, dietary fiber intake is likely similar to the average American diet. Fiber consumption is lower for IBD patients with active disease, particularly for patients with UC. Given education is the best predictor for consuming a high fiber diet, increased education efforts on the benefits of fiber should improve dietary fiber intake.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":"641-647"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280203","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":"Optimal Management of Conventional Adenomas in 2026: Current and Evolving Recommendations and Ongoing Controversies.","authors":"Bianca Thakkar, Rachael Hagen, Joseph C Anderson","doi":"10.1097/MCG.0000000000002356","DOIUrl":"10.1097/MCG.0000000000002356","url":null,"abstract":"<p><p>Adenomas are the most common precancerous colorectal lesions detected during colonoscopy. The techniques, endoscopic tools, and recommendations for detection, resection, and surveillance continue to change. This review summarizes current practice regarding detection and resection as well as national and international guidelines for screening, surveillance intervals, and recommended resection techniques, while highlighting areas where recommendations diverge or remain uncertain. We discuss key controversies shaping clinical decision-making, including topics such as the use of all-examination versus screening-specific adenoma detection rate (ADR) thresholds, the impact of computer-aided polyp detection (CADe) on quality benchmarks, and the debated significance of villous features or high-grade dysplasia in guiding follow-up intensity. We use the calendar year 2026 as the reference starting point for optimal adenoma management. In our review, we integrate current guideline recommendations with emerging evidence and ongoing shifts in endoscopic practice, rather than relying on anticipated formal guideline updates. By synthesizing established standards with new data and advancing technologies, this review provides a practical overview to support gastroenterologists in optimizing adenoma management and applying guideline-based care.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":"588-602"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147283958","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":"Trends in Substance Use Disorder Among Hospitalized Patients With Inflammatory Bowel Disease: An 11-Year Nationwide Study.","authors":"Melanie Zheng, Lauren DeDecker, Po-Hung Chen, Berkeley N Limketkai","doi":"10.1097/MCG.0000000000002205","DOIUrl":"10.1097/MCG.0000000000002205","url":null,"abstract":"<p><strong>Goals: </strong>We described the temporal trend of substance use disorder (SUD) and SUD subtypes among patients hospitalized with inflammatory bowel disease (IBD), accounting for readmissions within the calendar year.</p><p><strong>Background: </strong>One in six patients with IBD is estimated to have a concomitant SUD. SUD has had mounting morbidity and mortality rates since 2010 and has been shown to adversely affect IBD activity.</p><p><strong>Study: </strong>We performed a retrospective analysis of patients hospitalized at least once with IBD from 2010 through 2020 using the Nationwide Readmissions Database. Multivariable logistic regression analysis evaluated associations between SUD and age, sex, insurance type, income for the ZIP Code, and geographic region.</p><p><strong>Results: </strong>Of 2,532,450 patients hospitalized with IBD, 26.5% and 17.0% involved SUD in Crohn's disease (CD) and ulcerative colitis (UC), respectively. Between 2010 and 2020, the prevalence of patients with SUD increased from 23.8% to 27.9% in CD (P trend <0.001) and 14.2% to 19.4% in UC (P trend <0.001). Rates of alcohol, opioid, and cannabis use disorders increased (P trend <0.001 for all). Patients with SUD were more likely to be male [CD: OR: 1.26; 95% CI: 1.24-1.27; UC: 1.34, (1.31-1.36)], have Medicaid insurance compared with Medicare [CD: 1.59, (1.55-1.63); UC: 1.84, (1.78-1.90)], and be in a lower income quartile [lowest to highest quartile, CD: 1.54, (1.51-1.58); UC: 1.56, (1.52-1.61)].</p><p><strong>Conclusions: </strong>SUD among IBD patients continued to increase over time, with the predominant substances used shifting from alcohol to opioids and cannabis. Rates of SUD among patients hospitalized with CD were consistently higher than those with UC or with non-IBD-related hospitalizations.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":"634-640"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carvedilol Versus Endoscopic Variceal Ligation for Prophylaxis of Esophageal Variceal Bleeding in Patients With Liver Cirrhosis: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Luiz G S Almeida, Ocílio R Gonçalves, Thiago H F de Oliveira, João V Andrade Fernandes, Hildel F L Filho, Maria J G Siqueira, Paweł Łajczak, Wagner Rios-Garcia, Jefferson H Marques Fontes, Lucas L Mendes, Marcos de Vasconcelos Carneiro","doi":"10.1097/MCG.0000000000002380","DOIUrl":"10.1097/MCG.0000000000002380","url":null,"abstract":"<p><strong>Background: </strong>Esophageal variceal bleeding (EVB) is a life-threatening complication of liver cirrhosis. Carvedilol, a nonselective β-blocker with α1-blocking properties, and endoscopic variceal ligation (EVL) are both recommended for prophylaxis, but their comparative performance remains uncertain.</p><p><strong>Methods: </strong>A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted, searching PubMed, Web of Science, and Embase to July 2025. Trials comparing carvedilol with EVL in adults with cirrhosis were included. Outcomes included all-cause and bleeding-related mortality, variceal bleeding, hepatic complications, and adverse events.</p><p><strong>Results: </strong>Nine RCTs enrolling 1385 patients were included. Carvedilol and EVL showed no significant differences in all-cause mortality (RR: 1.00, 95% CI: 0.64-1.54), variceal bleeding (RR: 1.04, 95% CI: 0.75-1.45), or bleeding-related mortality (RR: 1.71, 95% CI: 0.83-3.50). Rates of ascites (new or worsening), hepatocellular carcinoma, spontaneous bacterial peritonitis, hepatorenal syndrome/acute kidney injury, and TIPS requirement were also comparable. Treatment-related adverse event rates did not differ significantly (RR: 1.43, 95% CI: 0.65-3.11).</p><p><strong>Conclusion: </strong>Carvedilol and EVL provide similar prophylactic efficacy and safety profiles for EVB prevention in cirrhosis. Carvedilol represents a viable, noninvasive alternative, particularly in settings where endoscopy is impractical.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":"569-581"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838494","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":"Impact of Sleep Positioning Device on Acid Exposure and Outcomes in Lung Transplant Recipients With Gastroesophageal Reflux Disease.","authors":"Manik Aggarwal, Lucy Thuita, Tyler Greathouse, Jesse Rappaport, Adam Kichler, Zubin Arora, Yi Qin, Olufemi Akindipe, Andrew Tang, Sudish Murthy, Charles Lane, Marie Budev, Usman Ahmad, Scott Gabbard","doi":"10.1097/MCG.0000000000002300","DOIUrl":"10.1097/MCG.0000000000002300","url":null,"abstract":"<p><strong>Introduction: </strong>Gastroesophageal reflux disease (GERD) plays an important role in lung transplant (LT) outcomes. This study aims to evaluate the impact of a novel sleep positioning device (SPD) on lung function in LT recipients with GERD.</p><p><strong>Methods: </strong>In this single-center cohort study, LT recipients (2014 to 2019) with GERD who were prescribed an SPD within 2 years of LT were included. A historical control group of LT recipients with GERD on PPI only (2011 to 2013) was selected to compare forced expiratory volume in 1 second (FEV1) as a marker of lung function.</p><p><strong>Results: </strong>Twenty LT recipients using SPD (cases) and 54 patients in the historical control group with proven GERD were included. Mean (SD) interval between LT and SPD prescription was 8.6 (5.7) months. Mean % predicted FEV1 was higher in SPD users than controls post-LT at 6 months (80% vs. 69%) and 1 year (80% vs. 71%), respectively. Among SPD users, post-SPD FEV1 was higher than pre-SPD FEV1 (82% vs. 70%).</p><p><strong>Conclusion: </strong>Use of a novel SPD can stabilize or improve pulmonary function in patients with GERD after LT. SPD may be a safe and cost-effective adjunctive therapy for the management of GERD after LT.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":"619-625"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146018743","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":"Urban Residency is Independently Associated With Allergic Phenotype and Inflammatory Changes in Eosinophilic Esophagitis.","authors":"Mayssan Muftah, Davis A Hartnett, Brent Hiramoto, Ryan Leung, Rama Nassri, Ryan Flanagan, Jennifer X Cai, Wai-Kit Lo, Walter W Chan","doi":"10.1097/MCG.0000000000002383","DOIUrl":"10.1097/MCG.0000000000002383","url":null,"abstract":"<p><strong>Goals: </strong>To identify clinical features associated with geographic residency in patients with eosinophilic esophagitis (EoE).</p><p><strong>Background: </strong>Prior studies on the geographic distribution of eosinophilic esophagitis (EoE) have focused on disease prevalence. Geographic and environmental factors may impact the clinical characteristics and phenotypes of EoE, although data remain limited.</p><p><strong>Study: </strong>This was a cross-sectional study of consecutive patients residing in Massachusetts with newly diagnosed EoE (≥15 eosinophils/hpf). Patients' residency settings were classified as urban or nonurban based on the 2020 US Census and residential zip codes. Clinical, endoscopic, and histologic variables were recorded. EoE patients in urban versus nonurban settings were compared using the student t test or the Fisher exact test for univariate analyses. Multivariable logistic regression was performed to identify the independent association between urban residency and comorbid atopic conditions, the inflammatory endotype, and the fibrostenotic endotype.</p><p><strong>Results: </strong>Six hundred eighty-three EoE patients were included, with 136 (20.0%) urban and 547 (80%) nonurban residents. Urban patients had higher rates of atopy (63.2% vs. 51.8%, P =0.02), severe food/environmental allergies (17.7% vs. 8.3%, P =0.002), and inflammatory findings endoscopic (43.4% vs. 27.8%, P =0.0006). On multivariable analysis, atopy (OR=1.57, CI: 1.02-2.40, P =0.04), severe food/environmental allergies (OR=1.99, CI: 1.09-3.63, P =0.02), and inflammatory findings (OR=1.90, CI: 1.22-2.94, P =0.004) remained independently associated with urban residency.</p><p><strong>Conclusions: </strong>Urban residency is independently associated with severe food/environmental allergies and inflammatory endoscopic findings at EoE diagnosis, suggesting increased allergic phenotype and active inflammation at presentation. Allergen exposure, particularly indoors, and social determinants may be contributory factors. Environmental considerations, such as geographic residency, may impact EoE disease presentation, activity, and outcome.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":"613-618"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729157","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":"The Association of Free Testosterone Levels With Frailty Metrics in Advanced Chronic Liver Disease.","authors":"Miguel Sogbe, Brittany Bromfield, Roberto Tellez, Pamela M Bloomer, Jaime Herrera-Caceres, Christopher B Hughes, Michael A Dunn, Andres Duarte-Rojo","doi":"10.1097/MCG.0000000000002192","DOIUrl":"10.1097/MCG.0000000000002192","url":null,"abstract":"<p><strong>Background: </strong>Frailty is common in advanced chronic liver disease (AdvCLD). Key assessment tools for frailty in this population include the liver frailty index (LFI), the 6-minute walk test (6MWT), and the gait speed test (GST). This study investigates the relationship between free testosterone (FT) levels and these frailty measures in men with AdvCLD.</p><p><strong>Methods: </strong>In this prospective cohort study of 197 male AdvCLD patients awaiting liver transplantation, frailty was assessed using the LFI, 6MWT, and GST. Participants were classified as having low or normal FT levels, and associations with frailty measures were analyzed using multivariable linear and logistic regression models.</p><p><strong>Results: </strong>Of the 197 patients, 41 (20.8%) had low FT levels. This group was more likely to have a higher Child-Turcotte-Pugh class, higher MELD-Na scores, and a history of hepatic encephalopathy compared with patients with normal FT levels ( P <0.05). Those with low FT also demonstrated greater frailty, with significantly poorer performance on the LFI and shorter distances on the 6MWT ( P <0.05); the GST difference did not reach statistical significance ( P =0.106). In multivariable regression analysis, including age, MELD-Na score, and Child-Turcotte-Pugh score, only low FT levels (OR: 2.4, P =0.043) were independently associated with frailty. Similarly, in multivariable linear regression, FT levels were independently associated with LFI scores and 6MWT ( P <0.05).</p><p><strong>Conclusion: </strong>Low FT is associated with increased frailty in male patients with AdvCLD. Additional research may help identify therapeutic approaches to improve frailty in this patient group.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":"661-666"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784377","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}