Medicine最新文献

{"title":"Investigating the causal links among gut microbiome features, inflammation-related proteins, and diverticular disease: Insights from a mediation Mendelian randomization study.","authors":"Jie Zhou, Yixin Xu, Haitao Wang, Kun Wang, Chao Chen","doi":"10.1097/MD.0000000000042676","DOIUrl":"https://doi.org/10.1097/MD.0000000000042676","url":null,"abstract":"<p><p>The pathophysiological mechanisms underlying diverticular disease (DD) remain incompletely understood, and there is considerable debate regarding the roles of gut microbiome features and inflammation-related proteins in the development of the disease. In this study, we employed mediation Mendelian randomization (MR) analysis to investigate the causal relationships among these 3 factors. In this study, we conducted a MR analysis on the genome-wide association studies data of 412 gut microbiome features (207 microbial taxa and 205 pathways), 91 inflammation-related proteins, and DD. We employed the inverse-variance weighted (IVW) method as our primary screening approach, followed by a mediation MR analysis to explore potential causal relationships among these 3 aspects. Our findings were further reinforced by comprehensive heterogeneity analyses, horizontal pleiotropy testing, outlier detection, and \"leave-one-out\" sensitivity analysis. Through our screening process, we identified potential causal relationships between DD and 18 gut microbiome features, as well as 6 inflammation-related proteins. These include s_Oscillibacter_unclassified (IVW odds ratio (OR): 1.139; 95% confidence interval (CI): 1.044-1.241, P  = .003), g_Bilophila (IVW OR: 1.107, 95% CI: 1.016-1.206, P  = .020), T-cell surface glycoprotein CD5 levels (IVW OR: 1.065, 95% CI: 1.011-1.123, P  = .019), and inosine 5'-phosphate biosynthesis I (IVW OR: 0.882, 95% CI: 0.800-0.973, P  = .012), etc. In the mediation MR analysis, we found that the genetic predictors of g_Bilophila and inosine 5'-phosphate biosynthesis I could explain 23.956% and 24.630% of the variation in T-cell surface glycoprotein CD5 levels, respectively. This study detailed analysis of the links between gut microbiome features, inflammation-related proteins, and DD offers key insights into DD pathogenesis and prevention.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 22","pages":"e42676"},"PeriodicalIF":1.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180703","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":"Prevalence and influencing factors of liver injury in naïve patients with HIV/AIDS in Nanjing from 2005 to 2022: Cross-sectional study.","authors":"Nawei Yu, Xiaoyun Di, Zihao Xia, Jingli Peng, Mingli Zhong, Mengqing Li, Hongjing Guan, Chen Chen, Rentian Cai, Hongxia Wei","doi":"10.1097/MD.0000000000041261","DOIUrl":"https://doi.org/10.1097/MD.0000000000041261","url":null,"abstract":"<p><p>To investigate the prevalence of liver injury and the factors influencing severe liver injury in antiretroviral therapy (ART)-naïve patients with human immunodeficiency virus (HIV) infection. ART-naïve HIV-1 infected patients who visited the outpatient department of the Infection Department of the Second Hospital of Nanjing between January 1, 2005, and May 31, 2022, were included in the study. The clinical data of patients with baseline liver injury were retrospectively collected. Liver injury was classified as grade 1, 2, 3, or 4 according to the severity scale of adverse events in adults and children with acquired immunodeficiency syndrome (AIDS), based on the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin (TBIL). A total of 982 patients were included in the analysis. The overall prevalence of liver injury (grades 1-4) was 19.3% (982/5099), with grade 1 liver injury (75.9%, 745/982) be the most common. Multivariate logistic regression analysis revealed that high-density lipoprotein cholesterol (HDL-C) was a protective factor against severe liver injury (odds ratio [OR] = 0.28, 95% CI = 0.08-0.99, P = .048). Conversely, hepatitis B virus (HBV) infection (OR = 4.02, 95% CI = 1.82-8.88, P = .001) elevated gamma-glutamyl transpeptidase (GGT, OR = 1.04, 95% CI = 1.01-1.06, P = .004), and elevated levels of lactic dehydrogenase (LDH, OR = 1.03, 95% CI = 1.01-1.04, P = .002) were identified as independent risk factors for severe liver injury in newly treated HIV/AIDS patients. Liver injury is prevalent among HIV/AIDS patients who have not initiated ART. HDL-C, HBV infection, GGT, and LDH are significant factors influencing the severity of liver injury.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 22","pages":"e41261"},"PeriodicalIF":1.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180764","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":"Genetic association between STAT1 and systemic lupus erythematosus: A two-sample Mendelian randomization observational study.","authors":"Tingting Yang, Tongtong Xiong, Lu Wang, Liying Luo, Huimin Mei, Jinglong Yang, Xueming Yao, Yijun Xiong, Xudong Zhang, Huang Cong","doi":"10.1097/MD.0000000000042593","DOIUrl":"https://doi.org/10.1097/MD.0000000000042593","url":null,"abstract":"<p><p>Systemic lupus erythematosus (SLE) is commonly observed in women of reproductive age and is often accompanied by other autoimmune conditions, such as Sjögren syndrome, rheumatoid arthritis, and thyroid diseases. The presence of comorbidities has the potential to negatively impact the overall health, quality of life, and happiness of affected individuals. While biologics and CAR-T cell therapies are effective, they come with substantial financial burdens, and traditional treatments remain non-curative with significant side effects. Recent studies indicate that necroptosis is a pivotal factor in the pathogenesis of SLE, underscoring the urgent need for a comprehensive and in-depth analysis of the causal relationship between necroptosis and SLE. Using summary-level data from genome-wide association studies, we conducted Mendelian randomization (MR) analysis on 53,301 participants to explore the interaction between signal transducer and activator of transcription 1 (STAT1) and SLE. This investigation included 122 individuals with SLE and 456,226 controls. In the primary analysis, the inverse variance weighted method was employed to obtain preliminary results. Subsequently, sensitivity analyses were conducted to evaluate the reliability of the findings and to identify and address any potential confounding factors. These analyses included a leave-one-out method and an in-depth inspection of funnel plots, which is an effective method for ensuring the reliability of the MR results, thereby elucidating the plausible genetic relationship between STAT1 and SLE. In this study, we utilized 241 single nucleotide polymorphisms related to the interferon/ receptor-interacting serine/threonine-protein kinase 3/phosphorylase glycogen axis within the necroptosis pathway as instrumental variables. Through inverse variance weighted analysis, we observed a significant causal relationship between STAT1 and SLE (odds ratio: 0.556, 95% CI: 0.335-0.92, P = .023). Sensitivity analyses, including MR-Egger regression and MR pleiotropy residual sum and outlier tests, confirmed the robustness and consistency of the results. The MR analysis results confirmed a causal relationship between STAT1 and SLE. This study offers novel insights into the pathogenesis of SLE and presents new perspectives for therapeutic interventions. Consequently, this research provides a foundation for the development of novel treatment and prevention strategies for SLE.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 22","pages":"e42593"},"PeriodicalIF":1.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182370","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":"Mammogram mastery: Breast cancer image classification using an ensemble of deep learning with explainable artificial intelligence.","authors":"Proloy Kumar Mondal, Md Khurshid Jahan, Haewon Byeon","doi":"10.1097/MD.0000000000042242","DOIUrl":"https://doi.org/10.1097/MD.0000000000042242","url":null,"abstract":"<p><p>Breast cancer is a serious public health problem and is one of the leading causes of cancer-related deaths in women worldwide. Early detection of the disease can significantly increase the chances of survival. However, manual analysis of mammogram mastery images is complex and time-consuming, which can lead to disagreements among experts. For this reason, automated diagnostic systems can play a significant role in increasing the accuracy and efficiency of diagnosis. In this study, we present an effective deep learning (DL) method, which classifies mammogram mastery images into cancer and noncancer categories using a collected dataset. Our model is pretrained based on the Inception V3 architecture. First, we run 5-fold cross-validation tests on the fully trained and fine-tuned Inception V3 model. Next, we apply a combined method based on likelihood and mean, where the fine-tuned Inception V3 model demonstrated superior performance in classification. Our DL model achieved 99% accuracy and 99% F1 score. In addition, interpretable AI techniques were used to enhance the transparency of the classification process. The finely tuned Inception V3 model demonstrated the highest performance in classification, confirming its effectiveness in automatic breast cancer detection. The experimental results clearly indicate that our proposed DL-based method for breast cancer image classification is highly effective, especially its application in image-based diagnostic methods. This study brings to the fore the huge potential of AI-based solutions, which can play a significant role in increasing the accuracy and reliability of breast cancer diagnosis.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 22","pages":"e42242"},"PeriodicalIF":1.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182777","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":"Predicting thyroid cancer recurrence using supervised CatBoost: A SHAP-based explainable AI approach.","authors":"Ahmad A Hanani, Turker Berk Donmez, Mustafa Kutlu, Mohammed Mansour","doi":"10.1097/MD.0000000000042667","DOIUrl":"https://doi.org/10.1097/MD.0000000000042667","url":null,"abstract":"<p><p>Recurrence prediction in well-differentiated thyroid cancer remains a clinical challenge, necessitating more accurate and interpretable predictive models. This study investigates the use of a supervised CatBoost classifier to predict recurrence in well-differentiated thyroid cancer patients, comparing its performance against other ensemble models and employing Shapley Additive Explanations (SHAP) to enhance interpretability. A dataset comprising 383 patients with diverse demographic, clinical, and pathological variables was utilized. Data preprocessing steps included handling values and encoding categorical features. The dataset was split into training and testing sets using a 70:30 ratio. Model performance was evaluated using accuracy and area under the receiver operating characteristic curve. A comparative analysis was conducted with other ensemble methods, such as Extra Trees, LightGBM, and XGBoost. SHAP analysis was employed to determine feature importance and assess model interpretability at both the global and local levels. The supervised CatBoost classifier demonstrated superior performance, achieving an accuracy of 97% and an area under the receiver operating characteristic curve of 0.99, outperforming competing models. SHAP analysis revealed that treatment response (SHAP value: 2.077), risk stratification (SHAP value: 0.859), and lymph node involvement (N) (SHAP value: 0.596) were the most influential predictors of recurrence. Local SHAP analyses provided insight into individual predictions, highlighting that misclassification often resulted from overemphasizing a single factor while overlooking other clinically relevant indicators. The supervised CatBoost classifier demonstrated high predictive performance and enhanced interpretability through SHAP analysis. These findings underscore the importance of incorporating multiple predictive factors to improve recurrence risk assessment. While the model shows promise in personalizing thyroid cancer management, further validation on larger, more diverse datasets is warranted to ensure robustness.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 22","pages":"e42667"},"PeriodicalIF":1.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182778","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":"Prognostic impact of incomplete revascularization in coronary artery bypass grafting: Association between residual SYNTAX score, magnetic resonance imaging, myocardial injury, and cardiovascular events.","authors":"Diogo Freitas Cardoso de Azevedo, Whady Hueb, Eduardo Gomes Lima, Paulo Cury Rezende, Cesar Higa Nomura, José Antonio Franchini Ramires, Roberto Kalil Filho","doi":"10.1097/MD.0000000000042478","DOIUrl":"https://doi.org/10.1097/MD.0000000000042478","url":null,"abstract":"<p><p>Cardiac biomarkers are frequently released after revascularization. Incomplete revascularization may be a potential mechanism of action. This study aimed to investigate the relationship between the completeness of revascularization, quantified by the residual SYNTAX score (rSS), and myocardial injury, infarction, and cardiac events after coronary artery bypass grafting. This study included patients with stable coronary artery disease who underwent surgery. Troponin levels, cardiac magnetic resonance, and late gadolinium enhancement were assessed before and after the procedure. The baseline SYNTAX score was determined from the angiograms, and the rSS was measured based on the operative report for each patient after the procedure. Of the 136 surgical patients studied, no significant correlations were found between the rSS and median peak troponin level (R = 0.06, P = .47). The rSS was not a predictor of myocardial infarction, as assessed by late gadolinium enhancement (odds ratio [OR] 0.96, 95% confidence interval [CI] 0.86-1.03; P = .51) and release of troponin higher than the median (OR 1.00, 95% CI 0.92-1.08; P = .93). After multivariate analysis in a model including variables, only cardiopulmonary bypass time was a significant predictor of troponin peak release, which was higher than the median (OR 1.01, 95% CI 1.002-1.019; P = .01). During the 5-year follow-up, the incomplete revascularization group had more major cardiovascular events than the complete revascularization group (rSS = 0) (P log-rank = .006, adjusted hazard ratio = 11.32; P = .001). Myocardial injury and infarction were not significantly associated with the completeness of revascularization. However, the rSS had a prognostic impact during follow-up for cardiovascular events.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 22","pages":"e42478"},"PeriodicalIF":1.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181455","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":"Psoriasis complicated with polymyositis successfully treated with Ixekizumab: A case report.","authors":"Shengli Chen, Jifeng Liu","doi":"10.1097/MD.0000000000042550","DOIUrl":"https://doi.org/10.1097/MD.0000000000042550","url":null,"abstract":"<p><strong>Rationale: </strong>Psoriasis is an immune-mediated chronic inflammatory skin disease that is rarely complicated by polymyositis in clinical practice. Here, we report a patient with psoriasis, following treatment with Etanercept, who exhibited an increase in creatine kinase (CK) levels and a decline in muscle strength. After combined treatment with methylprednisolone, methotrexate, and Ixekizumab, the psoriasis rash completely subsided and CK levels returned to normal.</p><p><strong>Patient concerns: </strong>The patient was a 22-year-old female with systemic erythema and scale itching for 3 months, and her serum CK level was 1711 U/L without muscle pain and muscle weakness. She was diagnosed with psoriasis and myositis awaiting investigation and was then treated with Etanercept at 50 mg weekly. At the 6-month follow-up with ongoing Etanercept treatment, her serum CK level was elevated to 3465 U/L. Electromyography and thigh magnetic resonance imaging revealed myositis. After methylprednisolone and methotrexate tablet treatment for polymyositis, she developed pulmonary pneumonia, and methotrexate and methylprednisolone tablets were withdrawn. Although the pneumonia was controlled, the facial erythema, plaques, scales, and rash gradually increased and spread all over the body. Moreover, gastrocnemius pain and fatigue persisted. The patient was treated with subcutaneous injection of 160 mg of Ixekizumab combined with methylprednisolone tablet (8 mg/d), after 2 weeks, the dosage was reduced to 80 mg once every 2 weeks, and the patient's psoriastic rash had completely disappeared after 4 weeks. The patient continued to receive subcutaneous injections of Ixekizumab 80 mg once a month and methylprednisolone tablet 6 mg every day. Six months later, no rash recurrence was noted and her CK level was within the normal range.</p><p><strong>Diagnoses: </strong>The patient was diagnosed with psoriasis with polymyositis.</p><p><strong>Interventions: </strong>After combined treatment with methylprednisolone, methotrexate, and Ixekizumab, the psoriasis rash completely subsided and CK levels returned to normal.</p><p><strong>Outcomes: </strong>Our case shows that Ixekizumab is an effective treatment for psoriasis complicated with polymyositis, which is worth clinical application.</p><p><strong>Lessons: </strong>Although Etanercept can be used to treat psoriasis and dermatomyositis, it can also aggravate the myositis. Ixekizumab is an effective treatment for psoriasis complicated by polymyositis.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 22","pages":"e42550"},"PeriodicalIF":1.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181897","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 emergency department carbon footprint calculator: Design and validation.","authors":"Lucas Rodriguez-Jimenez, Macarena Romero-Martín, Juan Gómez-Salgado","doi":"10.1097/MD.0000000000041652","DOIUrl":"https://doi.org/10.1097/MD.0000000000041652","url":null,"abstract":"<p><p>Carbon footprint calculators could lead to positive environmental actions, raise awareness, and justify sustainable actions. Emergency departments worldwide receive a large number of patients every year, representing a high carbon footprint. Our tool aims to provide a comprehensive tool created by emergency nurses to measure the carbon footprint of emergency departments. A literature review was conducted to establish the boundaries of the calculator. The pertinence of the resulting boundary inventory was evaluated by a panel of experts. A version 1 of the calculator was designed including the experts' suggestions. The scope, accuracy of calculation and pertinence of conversion factors were assessed by the same panel of experts. Tool was also tested by a group of health professionals as potential users, in terms of clarity, ease of use, viability, and usefulness. Results: The agreement among experts was measured with the content validity index and Aiken V. The results showed good content validity (CVI = 0.74 and V = 0.87 in the first panel; CVI = 0.81 and V = 0.90 in the second panel). Three main themes emerged from the focus group: calculator overview, data collection and benefits. A validated, and comprehensive tool was obtained for carbon footprint calculation, offering a thorough analysis of scope 1, 2 and 3 emissions in the emergency department.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 22","pages":"e41652"},"PeriodicalIF":1.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181976","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":"Effectiveness of continuous intravenous insulin infusion in hypertriglyceridemia-induced acute pancreatitis of varying severity: A longitudinal study.","authors":"Tuan Quoc Le, Hien Thi Thu Le, Nhung Thi Tuyet Tran, Nam Nhat Nguyen, Tu Tuan Tran","doi":"10.1097/MD.0000000000042674","DOIUrl":"https://doi.org/10.1097/MD.0000000000042674","url":null,"abstract":"<p><p>Among causes of acute pancreatitis, hypertriglyceridemia has gained increasing recognition, with a higher prevalence in Asian populations. Intravenous insulin infusion is the primary treatment for hypertriglyceridemia-induced acute pancreatitis (HTGP). However, the effectiveness and safety of insulin therapy may vary depending on baseline triglyceride levels and individual insulin resistance. Additionally, the necessity of rapid triglyceride reduction to prevent disease progression remains unclear. This study aims to assess the efficacy and safety of insulin infusion in HTGP patients with varying triglyceride levels and evaluate its impact on disease progression. This prospective study enrolled 54 patients aged 18 years or older diagnosed with HTGP and treated with insulin infusion between October 2022 and June 2023. Diagnosis and severity classification followed the 2012 revised Atlanta criteria. Patients received continuous intravenous insulin following a standardized protocol. Patients were stratified into 2 groups based on median baseline triglyceride levels: high (<25.455 mmol/L) and extremely high (≥25.455 mmol/L). Triglyceride levels were measured at baseline and at 12, 24, 48, and 72 hours posttreatment, along with other biochemical and clinical parameters. Differences in mean change from baseline and other indices between the 2 groups were compared and the association between triglyceride reduction and disease progression was assessed. Statistical significance was set at P < .05. A total of 54 patients (mean age: 48 ± 10 years, 88.9% male) were included in the study. Baseline characteristics, including age, body mass index, and history of diabetes, pancreatitis, gallstones, and alcohol consumption, were similar between the high and extremely high triglyceride groups (all P > .05). Triglyceride levels decreased significantly in both groups, with a greater reduction observed in the extremely high group at all time points. A greater triglyceride reduction within the first 12 hours was significantly associated with a lower risk of worsening pancreatitis (odds ratio 0.642, 95% confidence interval 0.347-0.892, P = .049). Continuous intravenous insulin infusion is a safe and effective treatment for reducing triglyceride levels in HTGP. Early triglyceride reduction, particularly within the first 24 hours, plays a crucial role in preventing disease deterioration.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 22","pages":"e42674"},"PeriodicalIF":1.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182154","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 effect of traditional Chinese medicine on renal function: A longitudinal cohort study with findings from 2011 to 2015 CHARLS.","authors":"Wei Li, Ning Sun, Michelle Gamber, Maxwell J Chen, Wenjie Sun","doi":"10.1097/MD.0000000000042567","DOIUrl":"https://doi.org/10.1097/MD.0000000000042567","url":null,"abstract":"<p><p>Current treatment methods for kidney disease are limited. Traditional Chinese Medicine (TCM) is proposed as an alternative therapy to treat those patients with kidney disease in China though the toxicities of TCM remain unclear. The estimated glomerular filtration rate (eGFR) is used to reflect kidney function and determine kidney disease stages. This study aims to examine the effect of TCM on eGFR among middle-aged Chinese. Data were drawn from 3 waves (2011-2015) of the China Health and Retirement Longitudinal Study for a secondary analysis involving Chinese adults aged 45 and older. TCM was categorized into 3 levels: never, moderate, and heavy use. Generalized linear mixed models were used to estimate the effect of TCM use on eGFR, adjusting for covariates and stratifying by baseline self-reported kidney disease. Among 5944 individuals, the proportions of never, moderate, and heavy TCM users were 63.1%, 26.0%, and 10.9%, respectively. Overall, TCM use was significantly associated with impaired renal function at baseline, and the association was consistent among those without kidney disease. Lower eGFR was associated with increased TCM usage (moderate: Beta: -0.77 [95% CI: -1.45, -0.10], and heavy: -0.84 [-1.79, 0.11]). eGFR decreased slower among heavy users compared to the never group (1.40 [0.36, 2.44]). TCM use is associated with impaired renal function among Chinese elderly. Further research is needed to better understand the mechanisms behind the complicated relationship between TCM use and renal function.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 22","pages":"e42567"},"PeriodicalIF":1.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182371","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}