The American Journal of Gastroenterology最新文献

{"title":"High concordance between nonalcoholic fatty liver disease and metabolic dysfunction associated steatotic liver disease in the TARGET-NASH real world cohort.","authors":"A. Barritt, Feng Yu, Andrea R. Mospan, Philip Newsome, M. Roden, Heather L Morris, R. Loomba, B. Neuschwander‐Tetri","doi":"10.14309/ajg.0000000000002796","DOIUrl":"https://doi.org/10.14309/ajg.0000000000002796","url":null,"abstract":"INTRODUCTION\u0000This study investigates the applicability of the new MASLD nomenclature to the real-world TARGET-NASH US adult cohort.\u0000\u0000\u0000METHODS\u0000The new MASLD/MASH nomenclature was applied to patients enrolled with pragmatic diagnoses of NAFL, NASH and NASH cirrhosis and concordance was determined between the definitions.\u0000\u0000\u0000RESULTS\u000099% of TARGET-NASH participants met the new MASLD diagnostic criteria. 1484/1541 (96.3%, kappa 0.974) NAFL patients (MASL), 2195/2201 (99.7%, kappa 0.998) NASH patients (MASH), and 1999/2003 (99.8%, kappa 0.999) NASH cirrhosis patients met the new criteria.\u0000\u0000\u0000CONCLUSION\u0000The new MASLD nomenclature is highly concordant with the prior TARGET-NASH pragmatic definitions.","PeriodicalId":507623,"journal":{"name":"The American Journal of Gastroenterology","volume":"184 S493","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140731133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of the Gastroenterologist in Obesity Management: Now Is the Right Time for Our Involvement.","authors":"S. L. Gold, A. Kornbluth","doi":"10.14309/ajg.0000000000002791","DOIUrl":"https://doi.org/10.14309/ajg.0000000000002791","url":null,"abstract":"","PeriodicalId":507623,"journal":{"name":"The American Journal of Gastroenterology","volume":"36 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140729939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of intra-pancreatic fat deposition with incident diseases of the exocrine and endocrine pancreas: A UK Biobank prospective cohort study.","authors":"Xiaowu Dong, Qingtian Zhu, Chenchen Yuan, Yaodong Wang, Xiaojie Ma, Xiaolei Shi, Weiwei Chen, Zhao Dong, Lin Chen, Qinhao Shen, Hongwei Xu, Yanbing Ding, Weijuan Gong, W. Xiao, Shengfeng Wang, Weiqin Li, Guotao Lu","doi":"10.14309/ajg.0000000000002792","DOIUrl":"https://doi.org/10.14309/ajg.0000000000002792","url":null,"abstract":"OBJECTIVE\u0000Investigate whether increased IPFD heightens the risk of diseases of the exocrine and endocrine pancreas.\u0000\u0000\u0000METHODS\u0000A prospective cohort study was conducted using data from the UK Biobank. IPFD was quantified using MRI and a deep learning-based framework called nnUNet. The prevalence of fatty change of the pancreas (FP) was determined using gender- and age-specific thresholds. Associations between IPFD and pancreatic diseases were assessed with multivariate Cox proportional hazard model adjusted for age, sex, ethnicity, body mass index, smoking and drinking status, central obesity, hypertension, dyslipidemia, liver fat content, and spleen fat content.\u0000\u0000\u0000RESULTS\u0000Of the 42,599 participants included in the analysis, the prevalence of FP was 17.86%. Elevated IPFD levels were associated with an increased risk of acute pancreatitis (AP) (HR per one quintile change [95%CI]: 1.513 [1.179-1.941]), pancreatic cancer (PC) (HR per one quintile change [95%CI]: 1.365 [1.058-1.762]) and diabetes mellitus (DM) (HR per one quintile change [95%CI]: 1.221 [1.132-1.318]). FP was also associated with a higher risk of AP (HR [95%CI]: 3.982 [2.192-7.234]), PC (HR [95%CI]: 1.976 [1.054-3.704]), and DM (HR [95%CI]: 1.337 [1.122-1.593], P=0.001).\u0000\u0000\u0000CONCLUSIONS\u0000FP is a common pancreatic disorder. Fat in the pancreas is an independent risk factor for diseases of both the exocrine pancreas and endocrine pancreas.","PeriodicalId":507623,"journal":{"name":"The American Journal of Gastroenterology","volume":"89 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140728811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asymptomatic Colonic Anisakis Infiltrating a Post-Endoscopic Mucosal Resection Scar.","authors":"K. Sumi, Akira Ishihara, Haruhiro Inoue","doi":"10.14309/ajg.0000000000002797","DOIUrl":"https://doi.org/10.14309/ajg.0000000000002797","url":null,"abstract":"","PeriodicalId":507623,"journal":{"name":"The American Journal of Gastroenterology","volume":"96 S64","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140731773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rates of Recurrent Intestinal Metaplasia and Dysplasia After Successful Endoscopic Therapy of Barrett's Neoplasia by EMR vs ESD and Ablation: A Large North American Multicenter Cohort.","authors":"K. Vantanasiri, Abel Joseph, Karan Sachdeva, Rohit Goyal, Nikita Garg, D. Adoor, A. Kamboj, D. Codipilly, C. Leggett, Kenneth K. Wang, William Harmsen, Umar Hayat, Amitabh Chak, Amit Bhatt, Prasad G. Iyer","doi":"10.14309/ajg.0000000000002798","DOIUrl":"https://doi.org/10.14309/ajg.0000000000002798","url":null,"abstract":"BACKGROUND\u0000Endoscopic eradication therapy (EET) combining endoscopic resection (ER) with endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) followed by ablation is the standard of care for the treatment of dysplastic Barrett's esophagus (BE). We have previously shown comparable rates of complete remission of intestinal metaplasia (CRIM) with both approaches. However, data comparing recurrence after CRIM are lacking. We compared rates of recurrence after CRIM with both techniques in a multicenter cohort.\u0000\u0000\u0000METHODS\u0000Patients undergoing EET achieving CRIM at 3 academic institutions were included. Demographic and clinical data were abstracted. Outcomes included rates and predictors of any BE and dysplastic BE recurrence in the two groups. Cox proportional hazards models and inverse probability treatment weighting (IPTW) analysis were utilized for analysis.\u0000\u0000\u0000RESULTS\u0000621 patients (514 EMR, 107 ESD) achieving CRIM were included in the recurrence analysis. The incidence of any BE (15.7, 5.7 per 100 patient years) and dysplastic BE recurrence (7.3, 5.3 per 100 patient-years) were comparable in the EMR and ESD groups, respectively. On multivariable analyses, the chances of BE recurrence were not influenced by ER technique (HR, 0.87; 95% CI, 0.51-1.49; p= 0.62), which was also confirmed by IPTW analysis (ESD vs EMR: HR, 0.98; 95% CI, 0.56-1.73; p= 0.94). BE length, lesion size, and history of cigarette smoking were independent predictors of BE recurrence.\u0000\u0000\u0000CONCLUSIONS\u0000Patients with BE dysplasia/neoplasia achieving CRIM, initially treated with EMR/ablation had comparable recurrence rates to ESD/ablation. Randomized trials are needed to confirm these outcomes between the two ER techniques.","PeriodicalId":507623,"journal":{"name":"The American Journal of Gastroenterology","volume":"141 S264","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140731211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic Sequelae and All-Cause Mortality in Chronic Pancreatitis With and Without Prior Acute Pancreatitis: A Nationwide Population-Based Cohort Study.","authors":"M. E. Cook, Niels Henrik Bruun, Line Davidsen, P. Vestergaard, A. M. Drewes, S. S. Olesen","doi":"10.14309/ajg.0000000000002799","DOIUrl":"https://doi.org/10.14309/ajg.0000000000002799","url":null,"abstract":"OBJECTIVES\u0000To investigate the risk of metabolic sequelae and all-cause mortality in a population-based cohort of chronic pancreatitis (CP) patients with and without prior acute pancreatitis (AP).\u0000\u0000\u0000METHODS\u0000We used nationwide health registries to identify all Danish residents (>18 years) with incident CP from 2000-2018. Information on AP/CP diagnoses, metabolic sequelae (post-pancreatitis diabetes mellitus (PPDM), exocrine pancreatic dysfunction (EPD), and osteoporosis), and all-cause mortality were obtained from Danish national health registries. CP cases were stratified based on the presence of AP prior to CP diagnosis. The risk of metabolic sequelae and all-cause mortality was expressed as hazard ratios (HRs) with 95% confidence intervals (CIs), calculated using multivariate Cox proportional hazards models.\u0000\u0000\u0000RESULTS\u0000A total of 9655 CP patients were included. Among CP patients, 3913 (40.5%) had a prior AP diagnosis. Compared to patients without a history of AP, patients with prior AP had a decreased risk of death (HR 0.79 (95% CI, 0.74-0.84)), which was largely confined to the initial period after CP diagnosis. Patients with prior AP had an increased risk of PPDM (HR 1.53 (95% CI, 1.38-1.69)), which persisted for up to a decade after CP diagnosis. No overall differences in risk were observed for EPD (HR 0.97 (95% CI, 0.87-1.07)) and osteoporosis (HR 0.87 (95% CI, 0.74-1.02)).\u0000\u0000\u0000CONCLUSIONS\u0000This nationwide study revealed that the majority of CP patients have no prior episode(s) of AP, indicating that an attack of AP sensitizing the pancreas is not essential for CP development. CP patients with and without prior AP have different risk profiles of PPDM and all-cause mortality.","PeriodicalId":507623,"journal":{"name":"The American Journal of Gastroenterology","volume":"211 S662","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140731057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of the Small Bowel Microbiome Reveals Different Profiles in Human Subjects who are Overweight or have Obesity.","authors":"Gabriela Leite, G. Barlow, Mohamad Rashid, Ava Hosseini, D. Cohrs, Gonzalo Parodi, W. Morales, S. Weitsman, A. Rezaie, Mark Pimentel, R. Mathur","doi":"10.14309/ajg.0000000000002790","DOIUrl":"https://doi.org/10.14309/ajg.0000000000002790","url":null,"abstract":"OBJECTIVES\u0000Gut microbiome changes are linked to obesity, but findings are based on stool data. Here, we analyzed the duodenal microbiome and serum biomarkers in subjects with normal weight, overweight, and obesity.\u0000\u0000\u0000METHODS\u0000Duodenal aspirates and serum samples were obtained from subjects undergoing standard-of-care esophagogastroduodenoscopy without colon preparation. Aspirate DNAs were analyzed by 16S rRNA and shotgun sequencing. Predicted microbial metabolic functions and serum levels of metabolic and inflammatory biomarkers were also assessed.\u0000\u0000\u0000RESULTS\u0000Subjects with normal weight (N=105), overweight (N=67) and obesity (N=42) were identified. Overweight-specific duodenal microbial features include lower relative abundance (RA) of Bifidobacterium species and Escherichia coli strain K-12, and higher Lactobacillus intestinalis, L. johnsoni, and Prevotella loeschii RA. Obesity-specific features include higher Lactobacillus gasseri RA and lower L. reuteri (subspecies rodentium), Alloprevotella rava and Leptotrichia spp RA. Escalation features (progressive changes from normal weight through obesity) include decreasing Bacteroides pyogenes, Staphylococcus hominis, and unknown Faecalibacterium species RA, increasing RA of unknown Lactobacillus and Mycobacterium species, and decreasing microbial potential for biogenic amines metabolism. De-escalation features (direction of change altered in normal-to-overweight and overweight-to-obesity) include Lactobacillus acidophilus, L. hominis, L. iners, and Bifidobacterium dentium. An unknown Lactobacillus species is associated with Type IIa dyslipidemia and overweight, whereas Alloprevotella rava is associated with Type IIb and IV dyslipidemias.\u0000\u0000\u0000CONCLUSIONS\u0000Direct analysis of the duodenal microbiome has identified key genera associated with overweight and obesity, including some previously identified in stool, e.g. Bifidobacterium and Lactobacillus. Specific species and strains exhibit differing associations with overweight and obesity, including escalation and de-escalation features that may represent targets for future study and therapeutics.","PeriodicalId":507623,"journal":{"name":"The American Journal of Gastroenterology","volume":"38 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140737668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}