Scandinavian Journal of Gastroenterology最新文献

{"title":"Predicting colorectal adenoma recurrence: the role of systemic inflammatory markers and insulin resistance.","authors":"Zhiqiang Li, Danyun Zhao, Chunyan Zhu","doi":"10.1080/00365521.2025.2469801","DOIUrl":"10.1080/00365521.2025.2469801","url":null,"abstract":"<p><strong>Background: </strong>Colorectal adenomas (CRA) exhibit high recurrence rates following endoscopic resection. Insulin resistance (IR) and chronic inflammation, increasingly prevalent due to unhealthy lifestyles, are key factors in CRA development. This study aimed to evaluate the predictive power of combining the inflammation score with the triglyceride-glucose (TyG) index for CRA recurrence.</p><p><strong>Methods: </strong>We conducted a comprehensive analysis of the clinical characteristics of 847 CRA patients who underwent endoscopic resection. Postoperative recurrence of CRA was assessed using logistic regression analyses to determine odds ratios (ORs) and 95% confidence intervals (CIs). The receiver operating characteristic (ROC) curve analysis was utilized to predict the risk of CRA recurrence based on the inflammation score and TyG index.</p><p><strong>Results: </strong>Among the 847 CRA included in the study, 126 experienced recurrences. Logistic regression analysis identified NLR (OR 2.641, 95% CI 1.982-3.549), TyG (OR 1.494, 95% CI 1.146-1.956), three or more adenomas (OR 2.182, 95% CI 1.431-3.322) and CRA larger than 10 mm (OR 1.917, 95% CI 1.267-2.921) as independent risk factors for CRA recurrence. ROC curves demonstrated the efficacy of NLR (AUC 0.701, 95% CI 0.652-0.750) and TyG (AUC 0.607, 95% CI 0.553-0.660) in predicting CRA recurrence. The combination of NLR, TyG and adenoma characteristics showed improved performance in predicting CRA recurrence (AUC 0.762, 95% CI 0.718-0.805).</p><p><strong>Conclusions: </strong>Elevated NLR and TyG were associated with an increased risk of CRA recurrence. The integration of NLR and TyG with CRA characteristics significantly enhanced the predictive power for CRA recurrence.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"300-306"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516628","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":"Evaluation of the validity of pancreatoduodenectomy for octogenarian patients with biliary tract carcinoma from the perspective of recurrence.","authors":"Wataru Izumo, Hiromichi Kawaida, Ryo Saito, Yuuki Nakata, Hidetake Amemiya, Yudai Higuchi, Takashi Nakayama, Suguru Maruyama, Koichi Takiguchi, Katsutoshi Shoda, Kensuke Shiraishi, Shinji Furuya, Yoshihiko Kawaguchi, Daisuke Ichikawa","doi":"10.1080/00365521.2025.2469123","DOIUrl":"10.1080/00365521.2025.2469123","url":null,"abstract":"<p><strong>Objective: </strong>To clarify the short- and long-term validity of pancreatoduodenectomy in octogenarian patients with biliary tract carcinoma.</p><p><strong>Methods: </strong>We compared 23 and 141 patients aged ≥80 and <80 years, who underwent pancreatoduodenectomy for biliary tract carcinoma (distal cholangiocarcinomas and ampullary carcinomas) and evaluated the relationship between age, clinicopathological factors, and surgical and oncological outcomes, especially in terms of recurrence.</p><p><strong>Results: </strong>Median overall survival time of distal cholangiocarcinoma and ampullary carcinoma was 92 and 109 months (<i>p</i> = 0.13). Postoperative complications, mortality, and adjuvant chemotherapy rates did not differ between the groups. Although the 5-year recurrence-free survival rate was similar, the 5-year disease-specific survival and overall survival rate were significantly shorter in octogenarians (≥80 years: 43.5, 47.1, and 35.3%; <80 years: 54.1, 69.2, and 63.0%; <i>p</i> = 0.41, 0.016, and 0.034, respectively). The median time from recurrence to death for octogenarian patients was significantly shorter than that of younger patients (3.3 <i>vs.</i> 16.1 months, <i>p</i> < 0.001). At recurrence, the serum albumin level, prognostic nutritional index, controlling nutritional status score, and treatment rate for recurrence were lower in octogenarians. The multivariate analysis identified age ≥80 years (hazard ratio: 3.8), low prognostic nutritional index (hazard ratio: 2.9), high serum carbohydrate antigen 19-9 (hazard ratio: 2.6), and failure to implement treatment after recurrence (hazard ratio: 3.0) as independent risk factors for a short time from recurrence to death. Furthermore, age ≥80 years (odds ratio 0.09) was an independent risk factor for treatment implementation after recurrence.</p><p><strong>Conclusions: </strong>Octogenarians had a shorter survival time after recurrence, resulting from low nutritional indices and a reduced rate of treatment implementation at the time of recurrence.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"312-321"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483522","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":"Effect of periampullary diverticulum morphology on ERCP cannulation and clinical results.","authors":"Yavuz Cagir, Muhammed Bahaddin Durak, Cem Simsek, Ilhami Yuksel","doi":"10.1080/00365521.2025.2469121","DOIUrl":"10.1080/00365521.2025.2469121","url":null,"abstract":"<p><strong>Aim: </strong>Periampullary diverticulum (PAD) is a common anatomical variant that can potentially impact the technical difficulty and outcomes of endoscopic retrograde cholangiopancreatography (ERCP), necessitating a comprehensive understanding of its effects on the procedure. To evaluate the effect of PAD subtypes and diameter on ERCP cannulation success and clinical outcomes.</p><p><strong>Materials and methods: </strong>The study included patients with PAD and papilla-naïve patients undergoing ERCP for suspected common bile duct stones or distal benign strictures (due to PAD compression). PAD subtyping was based on Lobo and Li-Tanaka classifications. Diverticulum size was categorized as small (<1 cm), medium (1-2 cm), and giant (≥2 cm).</p><p><strong>Results: </strong>Of the 907 patients analyzed, 164 (18%) had PAD with a median age of 63 years. PAD patients were significantly older than non-PAD patients and had more comorbidities. The most frequent PAD type was 2B (34.1%) based on the Li-Tanaka classification. Subgroup analysis of PAD types 1, 2, 3, and 4 showed no statistically significant differences in cannulation time, success, total procedure time, or adverse events (AEs). Overall cannulation success rates were similar between PAD and non-PAD groups (99.4% vs 99.6%). Analysis based on diverticulum size revealed higher probabilities of giant stones and procedure-related AEs in giant diverticula. The risk of post-ERCP pancreatitis was notably low at 1.8% in the PAD group.</p><p><strong>Conclusion: </strong>Diverticulum size, rather than PAD subtype, may be more closely associated with cannulation success and procedure-related AEs in ERCP. Individualized management considering diverticulum size may improve outcomes in PAD patients undergoing ERCP.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"292-299"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482656","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":"Selected comorbidities increases the likelihood of an incomplete colonoscopy during colorectal cancer screening.","authors":"Camilla Thorndal, Birgitte Skau, Issam Al-Najami, Lasse Kaalby, Gunnar Baatrup, Anastasios Koulaouzidis, Ulrik Deding","doi":"10.1080/00365521.2025.2465623","DOIUrl":"10.1080/00365521.2025.2465623","url":null,"abstract":"<p><strong>Objective: </strong>The risk of incomplete colonoscopy is associated with demographic factors and general comorbidity. However, focus on specific comorbidities is limited. This study aimed to investigate the association between selected comorbidities and incomplete colonoscopy in colorectal cancer (CRC) screening.</p><p><strong>Methods: </strong>This register-based study included 71,973 Danish screening participants, undergoing colonoscopy after positive fecal immunochemical test. The selected comorbidities were divided into hematological disease, endocrine disease (nondiabetes), endocrine disease (diabetes related), upper gastrointestinal (GI) disease, lower GI disease, other diseases of digestive system, hepatobiliary and pancreatic (HBP) disease, CRC, intraabdominal cancer (except CRC), and mental disease. Outcomes were incomplete colonoscopy due to poor bowel preparation and other reasons. Multivariate logistic regression models were applied.</p><p><strong>Results: </strong>Of 5,428 (7.5%) incomplete colonoscopies, 2,625 (3.6%) were due to poor bowel preparation and 2,803 (3.9%) due to other reasons. Individuals with specific comorbidities were compared to those without, exhibiting varying odds ratios (OR) for incomplete colonoscopy. For poor bowel preparation, ORs were 1.20 (95%CI: 1.04;1.39), 1.43 (95%CI: 1.30;1.56), 1.86 (95%CI: 1.66;2.09), 1.27 (95%CI: 1.12;1.43), and 1.64 (95%CI: 1.47;1.83) for hematological, endocrine (nondiabetes), endocrine (diabetes related), HBP, and mental disease, respectively, and 1.29 (95%CI: 1.09;1.52) for intraabdominal cancer (except CRC). Incomplete colonoscopies due to other reasons showed ORs of 1.24 (95%CI: 1.08;1.43), 1.18 (95%CI: 1.03;1.36), 1.19 (95%CI: 1.05;1.35), and 1.30 (95%CI: 1.15;1.47) for hematological, endocrine (diabetes related), HBP, and mental disease, respectively, and 1.35 (95%CI: 1.15;1.60) for intra-abdominal cancer (except CRC).</p><p><strong>Conclusion: </strong>Participants with specific comorbidities had significantly higher probability of having an incomplete colonoscopy, suggesting that certain comorbidities could be used prospectively as a predictive factor.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"283-291"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586610","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":"Identification of novel biomarkers for gastric adenocarcinoma through two-sample Mendelian randomization analysis of the human plasma proteome.","authors":"Jingjing Tian, Qingrui Cai, Shiying Li, Zhanfei Guo, Yanbao Liu, Zhiwei Zhang, Zhongchao Huo","doi":"10.1080/00365521.2025.2472198","DOIUrl":"10.1080/00365521.2025.2472198","url":null,"abstract":"<p><strong>Background: </strong>Papillary gastric adenocarcinoma (PGC), a histological subtype of gastric cancer (GC), is characterized by malignant potential and poor prognosis. Therefore, identifying novel biomarkers is urgently needed to enhance PGC diagnosis and treatment outcomes.</p><p><strong>Methods: </strong>This study utilized two-sample Mendelian randomization (MR) to explore potential causal relationships between human blood plasma proteins and GC. Heterogeneity testing, pleiotropy assessment, and directionality analyses were performed to evaluate identified plasma proteins. Additionally, pathway enrichment analysis was conducted to elucidate the molecular mechanisms underlying the causal associations between plasma proteins and GC development.</p><p><strong>Results: </strong>MR analysis of 4,907 plasma proteins related to GC risk identified 90 proteins with potential causal relationships. The findings revealed that DNAJB9, CHCHD10, and suppressor of cytokine signaling 3 exhibited protective effects against GC, while Syntaxin-8, alcohol dehydrogenase 7, and UDP-glucose 4-epimerase were associated with increased GC risk at the genetic level.</p><p><strong>Conclusion: </strong>In the present study, the six plasma proteins identified through comprehensive MR analysis may serve as potential biomarkers for GC, offering new insights for future molecular diagnosis and therapeutic strategies.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"394-404"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573937","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":"AS score: a novel score for predicting clinical outcomes in upper gastrointestinal bleeding.","authors":"Akif Yarkaç, Seyran Bozkurt, Ataman Köse, Çağrı Safa Buyurgan, Halil Oktay Usluer, Gülhan Temel","doi":"10.1080/00365521.2025.2459237","DOIUrl":"10.1080/00365521.2025.2459237","url":null,"abstract":"<p><strong>Background: </strong>Upper gastrointestinal tract bleeding (UGIB) is an significant cause of admission to emergency departments and hospitalizations.</p><p><strong>Aims: </strong>The aim of our study was to compare the pre-endoscopic risk scores used in the literature with our new score (AS score) in patients admitted to the emergency department due to upper gastrointestinal bleeding (UGIB).</p><p><strong>Methods: </strong>A total of 541 patients admitted to the emergency department of a tertiary care hospital due to UGIB were included in the study. Pre-endoscopic risk scores and AS score were compared in terms of the need for hospitalization, need for intensive care, need for endoscopic treatment, and mortality.</p><p><strong>Results: </strong>All of the scores analysed in the study were found to be effective in predicting the need for hospitalization, the need for intensive care, the need for endoscopic treatment, and mortality. The most effective score in predicting mortality was the AS score. In addition, the sensitivity of the AS score was higher than the other scores in predicting the need for intensive care.</p><p><strong>Conclusions: </strong>The AS score is a new tool that may be useful in the management of patients admitted to the emergency department due to UGIB because of its advantages, such as not including laboratory parameters, being calculated in a very short time in the triage area at the time of patient presentation, and being integrated with the Charlson comorbidity index.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"213-218"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067566","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":"Health-related quality of life at diagnosis and follow-up in Faroese and Danish patients with inflammatory bowel disease - a Faroese IBD cohort study.","authors":"Turid Hammer, Frederikke Agerbo Modin, Kári Rubek Nielsen, Jóngerð Midjord, Ebbe Langholz, Vibeke Andersen, Jens Frederik Dahlerup, Jens Kjeldsen, Natalia Pedersen, Pia Munkholm, Johan Burisch","doi":"10.1080/00365521.2025.2453429","DOIUrl":"10.1080/00365521.2025.2453429","url":null,"abstract":"<p><strong>Background and aims: </strong>Patients with inflammatory bowel disease (IBD) have lower health-related quality of life (HRQoL) than the general population. The highest incidence and prevalence rates of IBD in the world are found in the Faroe Islands, however, the HRQoL of Faroese patients is unknown. This study aimed to determine their HRQoL at diagnosis and two years of follow-up in comparison with Danish patients.</p><p><strong>Methods: </strong>All patients (15 years or older) were invited to answer the Short Form 12 questionnaire (SF-12) and Short Inflammatory Bowel Disease Questionnaire (SIBDQ) at diagnosis and follow-up. Faroese patients were included from 2010 to 2022, and Danish patients in 2010.</p><p><strong>Results: </strong>160 Faroese patients and 160 Danish patients completed questionnaires twice. For Faroese patients with IBD, the physical and mental component summary scores (SF-12) significantly improved from 46.6 and 44.0 to 49.4 and 47.7, respectively. Total SIBDQ scores also improved from 46.6 to 53.9. However, Faroese patients had significantly lower scores at diagnosis of social functioning, mental health, and mental component summary (SF-12) as well as lower emotional scores (SIBDQ) compared with Danish patients.</p><p><strong>Conclusions: </strong>Faroese patients with IBD improved their HRQoL from diagnosis to follow-up, although greater improvements were observed for Danish patients. Increased awareness of the HRQoL of this patient group is warranted as Faroese patients had lower mental and emotional scores than Danish patients at diagnosis.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"225-234"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010421","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":"Insulin sensitivity in moderately severe to acute severe ulcerative colitis.","authors":"Daniel Bergemalm, Bayar Baban, Olle Ljungqvist, Jonas Halfvarson","doi":"10.1080/00365521.2025.2459870","DOIUrl":"10.1080/00365521.2025.2459870","url":null,"abstract":"<p><strong>Background: </strong>Patients hospitalized with moderately severe or acute severe ulcerative colitis (UC) may experience metabolic disturbances, including alterations in insulin resistance due to inflammation and the administration of glucocorticoids (GCs). This pilot study aimed to evaluate insulin sensitivity in patients hospitalized for moderately severe to severe UC.</p><p><strong>Method: </strong>Patients hospitalized for moderately-severely active UC at Örebro University Hospital, Sweden, were eligible for inclusion. Quantification of insulin sensitivity was performed using the hyperinsulinemic euglycemic clamp (HEC) methodology. Assessment of insulin sensitivity was performed during both the index flare and while patients were in steroid-free clinical, biochemical and endoscopic remission during follow-up. Additionally, healthy controls were evaluated using HEC for comparison.</p><p><strong>Results: </strong>Five patients with moderately-severely active UC, treated with intravenous GCs for ≥2 days, were included and underwent HEC assessment. During the index flare, four patients received second-line treatment with infliximab due to non-response to GC, and one patient was subsequently referred for acute subtotal colectomy. At inclusion, all five patients exhibited significantly reduced insulin sensitivity, and levels appeared similar regardless of the outcome of the index flare. At remission during follow-up, the insulin sensitivity was restored to levels comparable to healthy controls (<i>n</i> = 5).</p><p><strong>Conclusion: </strong>The study demonstrates that patients with moderately severe to severe UC experience significant insulin resistance, irrespective of the outcome of the flare. The reduced insulin sensitivity is likely driven by a combination of active inflammation and GC treatment, as insulin sensitivity returned to normal levels when patients achieved remission during follow-up.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"243-247"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067584","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":"Specialty laboratory testing for chronic abdominal pain in irritable bowel syndrome.","authors":"Michael Cymbal, Arjun Chatterjee, Patricia Ajayi-Fox, Ruishen Lyu, Moises Auron, Brian B Baggott","doi":"10.1080/00365521.2025.2456491","DOIUrl":"10.1080/00365521.2025.2456491","url":null,"abstract":"<p><strong>Background: </strong>Irritable bowel syndrome (IBS) is a common gastrointestinal disorder seen by both primary care providers (PCPs) and gastroenterologists, and further diagnostic testing is generally discouraged unless red-flag symptoms are present.</p><p><strong>Aims: </strong>Examine if advanced serologic testing for chronic abdominal pain in IBS patients followed society-specific guidelines and evaluate the diagnostic accuracy of these tests.</p><p><strong>Methods: </strong>The study involved a retrospective cross-sectional analysis of adults aged 18 and older who were seen at our institution between 2013 and 2018. Tests included: C1 esterase inhibitor, MEFV gene, urine porphobilinogen, anti-dsDNA, and heavy metal screening. Patients with preexisting rheumatological conditions or diagnoses such as hereditary angioedema, porphyria, familial Mediterranean fever, or lead poisoning were excluded. An appropriateness scale based on disease-specific guidelines was used to evaluate test suitability.</p><p><strong>Results: </strong>Among 26,732 IBS patients, 143 underwent advanced laboratory testing, with 85.3% ordered by gastroenterologists. Only 12.5% of tests adhered to society-specific guidelines, and the positive test rate was 2.1%. The total cost of testing was $46,542, with $39,007 spent on tests deemed inappropriate.</p><p><strong>Conclusions: </strong>The findings emphasize the effectiveness and importance of adhering to Rome IV criteria, as advanced testing often fails to improve diagnostic accuracy and increases unnecessary healthcare costs.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"248-252"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034160","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 use of ELF in predicting liver fibrosis prevalence and fibrosis progression in the general population.","authors":"Kustaa Saarinen, Martti Färkkilä, Antti Jula, Iris Erlund, Terhi Vihervaara, Annamari Lundqvist, Fredrik Åberg","doi":"10.1080/00365521.2025.2454247","DOIUrl":"10.1080/00365521.2025.2454247","url":null,"abstract":"<p><strong>Background and aims: </strong>The enhanced liver fibrosis (ELF) test has good discrimination performance in detecting advanced liver fibrosis. The chronic liver disease (CLivD) risk score based on clinical data accurately predicts risk for future severe liver disease. Considering the ELF test as a surrogate marker for liver fibrosis, we analyzed predictors of elevated ELF (eELF) and its change.</p><p><strong>Methods: </strong>The study cohort consisted of Finnish general population-based health surveys Health2000 and a follow-up study 10 years later Health2011 with 6084 and 2937 individuals, respectively with phenotype and ELF data. eELF was defined as ELF ≥ 9.8, and clinically relevant fibrosis progression as an ELF change ≥0.6. CLivD risk score was calculated at baseline. Analyses were age-adjusted.</p><p><strong>Results: </strong>Obesity measures and diabetes predicted eELF at baseline. Only waist-hip ratio (WHR) could predict clinically relevant fibrosis progression over the follow-up consistently among men and women (OR 1.35 and 1.41, respectively). High-risk alcohol use was a significant risk factor for eELF only among men (OR 1.72, <i>p</i> = 0.049), and it did not predict fibrosis progression in either sex. Although elevated transaminases were associated with eELF, in most individuals with eELF they were within reference limits. Increased CLivD scores correlated with baseline and the change of ELF values over the 10-year follow-up independent of baseline ELF (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Liver fibrosis progression is difficult to predict based on single risk factors or liver enzymes. ELF had limited value to predict fibrosis progression. The CLivD score, based on multiple risk factors, predicted both occurrence of baseline eELF and its progression over a 10-year follow-up.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"262-272"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391678","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}