Clinics (Sao Paulo, Brazil)最新文献

{"title":"Navigating multimodal machine learning in papillary thyroid carcinoma: perspectives on pathomics and radiomics integration in thyroidology.","authors":"Ilker Sengul, Demet Sengul","doi":"10.1016/j.clinsp.2026.101120","DOIUrl":"10.1016/j.clinsp.2026.101120","url":null,"abstract":"","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"81 ","pages":"101120"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A genetic variant of long non-coding RNA TINCR is associated with psoriasis in the Turkish population.","authors":"Egemen Akgun, Fadime Mutlu Icduygu, Burak Aksan, Isil Deniz Oguz, Sevgi Kulakli, Ebru Alp","doi":"10.1016/j.clinsp.2026.101189","DOIUrl":"10.1016/j.clinsp.2026.101189","url":null,"abstract":"<p><strong>Background: </strong>TINCR and H19 are long non-coding RNAs known to be involved in keratinocyte proliferation and differentiation. The objective of this study was to investigate the contribution of TINCR rs2288947 and H19 rs217727 polymorphisms to the pathogenesis of psoriasis.</p><p><strong>Methods: </strong>The study group comprised 284 patients with psoriasis and 253 healthy controls. Real-time PCR method was used for genotyping of rs2288947 and rs217727 polymorphisms.</p><p><strong>Results: </strong>In rs2288947 polymorphism, AA genotype (BH-adjusted p = 0.014, adjusted OR = 1.92, 95% CI 1.20‒3.09), combined genotypes GA+AA (BH-adjusted p = 0.021, adjusted OR = 1.64, 95% CI 1.10‒2.45) and A allele (BH-adjusted p = 0.014, adjusted OR = 1.39, 95% CI 1.10‒1.76) showed a significant association with psoriasis. For H19 rs217727, results were inconclusive, reflecting limited precision of the effect estimates in our study cohort (overall genotype distribution, p = 0.425), and despite high genotyping quality, control genotype distributions deviated from Hardy-Weinberg equilibrium.</p><p><strong>Conclusion: </strong>Our findings indicate that the TINCR rs2288947 polymorphism may be associated with an elevated risk of psoriasis in this Turkish cohort. H19 rs217727 showed no significant association; given the breadth of the confidence intervals, this result is best viewed as inconclusive. Independent replication and functional assays will help clarify biological relevance.</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"81 ","pages":"101189"},"PeriodicalIF":2.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of female breast cancer burden in China along the global sociodemographic gradient: risk attribution, decomposition, and age-period-cohort evidence from GBD 2021.","authors":"Yixin Si, Jialin Liu, Liuqiyu Xu, Wenya Ye, Jiating Li, Yun Peng, Zhen Hu","doi":"10.1016/j.clinsp.2026.101166","DOIUrl":"10.1016/j.clinsp.2026.101166","url":null,"abstract":"<p><strong>Objective: </strong>To assess temporal changes in female breast cancer burden in China from 1990 to 2021, its global and Socio-Demographic Index (SDI) status, attributable risks, death drivers and age-period-cohort (APC) features based on GBD 2021 data.</p><p><strong>Methods: </strong>We extracted data on incidence, deaths, DALYs and seven attributable risks for China, the world and five SDI regions. Estimated Annual Percentage Change (EAPC) analyzed age-standardized rate trends. Shapley decomposition divided attributable death changes into population growth, aging, age-specific mortality and Population Attributable Fraction (PAF). APC models estimated temporal drifts.</p><p><strong>Results: </strong>From 1990 to 2021, the Age-Standardized Incidence Rate (ASIR) increased from 24.54 to 29.36 per 100,000 (EAPC = 0.30%, 95% CI: 0.20 to 0.41%) in China, whereas the Age-Standardized Mortality Rate (ASMR) decreased from 10.65 to 6.46 per 100,000 (EAPC = -2.02%, 95% CI -2.20 to -1.85%). By 2021, both rates were lower in China than in the global population and all five SDI regions. The leading PAFs for Disability-Adjusted Life-Years (DALYs) burden were high red meat intake, secondhand smoke, high fasting plasma glucose, high body mass index, and low physical activity. Decomposition showed that increasing risk-specific attributable deaths were mainly driven by population growth and ageing, while declining age-specific mortality contributed negatively. Incidence net drift was 0.232%/year; mortality net drift was -2.115%/year.</p><p><strong>Conclusion: </strong>China showed a transitional breast cancer burden pattern, characterized by slowly rising incidence, declining age-standardized mortality, and a shift toward metabolic risk contribution. Population ageing and metabolic risk accumulation may continue to increase the absolute burden despite improvements in mortality risk.</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"81 ","pages":"101166"},"PeriodicalIF":2.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of potential solid organ donors in São Paulo, Brazil: Reasons for non-donation and the impact of infectious causes.","authors":"Luiza Arcas Gonçalves, Edvaldo Leal de Moraes, Maristela Pinheiro Freire, Leonardo Borges de Barros E Silva, Wellington Andraus, Luiz Augusto Carneiro D' Albuquerque, Edson Abdala, Alice Tung Wan Song","doi":"10.1016/j.clinsp.2026.101171","DOIUrl":"10.1016/j.clinsp.2026.101171","url":null,"abstract":"<p><strong>Background: </strong>Solid organ transplantation is a life-saving therapy for patients with end-stage organ disease; however, the persistent imbalance between organ demand and supply substantially increases waiting-list mortality. Expanding the donor pool is essential but must be balanced with safety and minimization of infectious risk. This study aimed to describe the main reasons for organ non-donation, with a particular focus on infectious causes, and to identify factors associated with procurement failure.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using secondary data from the Organ Procurement Organization at Hospital das Clinicas, University of São Paulo, from 2019 to 2023. Monthly rates of donor exclusion due to infectious causes were evaluated, with comparisons between pandemic and non-pandemic periods. Factors associated with non-donation due to infection were assessed using Poisson regression with robust variance. The COVID-19 pandemic period was defined as March 2020 to March 2022.</p><p><strong>Results: </strong>A total of 2591 potential solid organ donors were evaluated. Medical contraindications were the leading cause of non-donation, predominantly driven by infectious causes. The proportion of infection-related non-donation increased significantly during the pandemic compared with the non-pandemic period (45.3% vs. 28.2%; p < 0.001). White ethnicity, intensive care unit admission, and trauma or vascular causes of death were identified as protective factors against non-donation due to infection. The most frequent infectious causes were COVID-19, uncontrolled bacterial infections, HIV and tuberculosis.</p><p><strong>Conclusions: </strong>Infectious diseases represent a potentially modifiable cause of non-donation. These findings highlight the need for continuous reassessment of donation-related infectious risks and evidence-based donor infection management to prevent unnecessary organ loss.</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"81 ","pages":"101171"},"PeriodicalIF":2.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the efficacy of the ESC 2025 guidelines for the management of cardiovascular disease and pregnancy.","authors":"Akos Koller, Johanna Takács","doi":"10.1016/j.clinsp.2026.101177","DOIUrl":"10.1016/j.clinsp.2026.101177","url":null,"abstract":"<p><strong>Objectives: </strong>Human Pregnancy-related Cardiovascular Diseases (CVDs) are unique and difficult to study because of many unknown, potentially harmful effects of medical interventions on the fetus. Because of that, there are only sparse data and mechanisms available, which could provide recommendations with strong evidence for physicians.</p><p><strong>Study design: </strong>To assess the efficacy of the European Society of Cardiology (ESC) 2025 Guidelines for the management of cardiovascular disease and Pregnancy (Pregnancy-GL-2025), we used a previously developed mathematical analytic method.</p><p><strong>Main outcome measures: </strong>A total of 208 Recommendations and Evidence were analyzed, of which 161 Recommendations concern certain CVD. To assess the efficacy, the Certainty/Uncertainty ratio and the Certainty Index (CI, ranging from -1 to +1) were calculated.</p><p><strong>Results: </strong>In total, the Pregnancy-GL-2025 showed 64.4% of the Class I and III Recommendations (CVDs, 62.7%). The ESC Pregnancy-GL-2025 includes mostly Evidence C (89.4%) and showed 78.8% Certainty (CI = 0.58). Although it includes only a few higher-quality Evidence, these are related to the Class I Recommendations, resulting in a high level of Certainty.</p><p><strong>Conclusions: </strong>The mathematical analysis of the ESC Pregnancy-GL-2025 showed that it has several helpful Recommendations, yet they are supported primarily by Evidence C. However, because of a few higher-quality evidence related to Class I Recommendations, the overall efficacy of the guideline was relatively high. In addition, the mathematical analysis used instead of frequency analyses does not imply a lower efficacy of a guideline. Thus, we propose that this type of evaluation of guidelines, as a complementary quantitative approach to describing guidelines' recommendations, can facilitate the development of new guidelines.</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"81 ","pages":"101177"},"PeriodicalIF":2.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative hepatic encephalopathy predicts early postoperative complications after orthotopic liver transplantation: a retrospective cohort study.","authors":"Imran Muhammad, Faisal Ul Rehman, Jinzhen Cai","doi":"10.1016/j.clinsp.2026.101176","DOIUrl":"10.1016/j.clinsp.2026.101176","url":null,"abstract":"<p><strong>Background: </strong>Early postoperative complications remain an important source of morbidity after Orthotopic Liver Transplantation (OLT). Identifying preoperative factors associated with these complications may help improve perioperative risk assessment and postoperative management. This study evaluated clinical predictors of early postoperative complications following OLT, with particular emphasis on preoperative hepatic encephalopathy.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of adult patients who underwent OLT at the Organ Transplantation Center of The Affiliated Hospital of Qingdao University between January 2014 and December 2024. The primary endpoint was the occurrence of at least one clinically significant postoperative complication within 30 days after transplantation. Potential predictors were evaluated using univariate analyses followed by multivariable logistic regression. Model discrimination was assessed using receiver operating characteristic curve analysis.</p><p><strong>Results: </strong>Among 1,478 liver transplant recipients, 130 (8.8%) developed at least one early postoperative complication. On univariate analysis, body height, body weight, serum albumin, total bilirubin, international normalized ratio, intraoperative blood loss, hepatic encephalopathy, and ascites were associated with postoperative complications. In the multivariable model, preoperative hepatic encephalopathy remained independently associated with an increased risk of early postoperative complications (Odds Ratio [OR = 1.999]; 95% Confidence Interval [95% CI 1.23‒3.25]; p = 0.005). Greater intraoperative blood loss showed a borderline association with postoperative complications (OR = 1.00007; p = 0.052). The model demonstrated moderate discriminatory performance, with an area under the receiver operating characteristic curve of 0.699.</p><p><strong>Conclusions: </strong>Preoperative hepatic encephalopathy was independently associated with early postoperative complications after OLT. These findings suggest that hepatic encephalopathy may be useful as a readily available marker for identifying recipients at increased postoperative risk. Further prospective and multicenter studies incorporating comprehensive donor, recipient, and perioperative variables are warranted to validate these findings and improve postoperative risk prediction.</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"81 ","pages":"101176"},"PeriodicalIF":2.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of platelet-rich fibrin concentrates in alveolar ridge preservation after tooth extraction: A systematic review of randomized clinical trials with tomographic evaluation.","authors":"Daniela Meneses-Santos, Anderson Carlos Marçal, Caio Melo Mesquita, Walbert de Andrade Vieira, Marcelo Dias Moreira de Assis Costa, João Botelho, Sigmar de Mello Rode, Luiz Renato Paranhos","doi":"10.1016/j.clinsp.2026.101172","DOIUrl":"10.1016/j.clinsp.2026.101172","url":null,"abstract":"<p><strong>Purpose: </strong>To systematically review the scientific evidence on the effect of Platelet-Rich Fibrin (PRF) concentrates' application on tomographically evaluated alveolar ridge preservation in post-extraction sockets.</p><p><strong>Methods: </strong>A systematic search was conducted in seven electronic databases, and two additional bases as sources of gray literature, with no language or date restrictions. Randomized clinical trials comparing the use of PRF concentrates with placebo or no intervention were included. Tooth extractions were performed atraumatically, and alveolar ridge preservation was assessed by cone-beam computed tomography, measuring ridge width (horizontal) and height (vertical) changes. Two reviewers assessed the risk of bias with RoB 2.0 tool. Meta-analysis and GRADE assessment were also performed.</p><p><strong>Results: </strong>A total of 2843 studies were initially identified. After duplicate removal and screening, 13 studies were included in the qualitative analysis, totaling 599 evaluated sockets. The included studies, published between 2016 and 2024, presented several methodological differences and reported controversial effects of PRF and L-PRF, compared to control groups. Individual risk of bias varied from high to some concerns mainly related to poor blinding and lack of reporting details. In meta-analysis, pooled estimates did not show statistical significance for either alveolar ridge width or height. Certainty of evidence was rated very low due to small sample size and wide confidence intervals crossing the null effect line.</p><p><strong>Conclusion: </strong>Based on very low evidence, the application of PRF concentrates did not demonstrate appreciable benefits or harms for alveolar ridge preservation. However, these findings should be interpreted with caution due to data heterogeneity and bias concerns in primary studies. Thus, the evidence is insufficient to recommend its sole use as a predictable ridge preservation technique, and there is a current need on well-designed and standardized randomized clinical trials in this research field.</p><p><strong>Registration: </strong>Protocol registered in the PROSPERO database (CRD42025638069).</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"81 ","pages":"101172"},"PeriodicalIF":2.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Wechat-based prehospital data transmission on reperfusion times in ST-elevation myocardial infarction: a prospective observational study.","authors":"Shangchen Li, Haibo Wu, Ying Wang, Yanqing Wang, Yuyang Xiao, Dan Yang, Dongxia Liu","doi":"10.1016/j.clinsp.2026.101188","DOIUrl":"10.1016/j.clinsp.2026.101188","url":null,"abstract":"<p><strong>Objectives: </strong>Early diagnosis of acute ST-segment Elevation Myocardial Infarction (STEMI) is important for the treatment of patients. A Class I evidence demonstrates that every 30-minute delay in PCI is linked to a 7.5% relative increase in 1-year mortality¹ \"WeChat\" is a convenient communication tool that enables the transmission of patient information ‒ including basic details, condition assessments, and relevant laboratory results ‒ to the receiving hospital via WeChat-based transmission. Simultaneously, patients are rapidly transported to the hospital by ambulance for treatment. Thus, the hospital can receive patient information before their arrival, thereby significantly reducing diagnosis and treatment time. This integrated model is collectively referred to as WeChat-based transmission. Therefore, the early activation of WeChat-based emergency medical services transmission plays a critical role in improving patient prognosis. The present study sought to investigate the use of WeChat-based transmission in patients with acute STEMI.</p><p><strong>Methods: </strong>409 eligible STEMI patients (May 2022-November 2024) were grouped by WeChat-based transmission use: 96 in the observation group and 313 in the control group. Baseline data, medical history, and key times (S-to-FMC, d-to-B, TIT) were compared. Factors influencing WeChat-based transmission use were analyzed via SPSS 22.0 (p < 0.05 significant).</p><p><strong>Results: </strong>96 (23.4%) patients in the WeChat-based transmission group and 313 (76.6%) patients in the N-WeChat group were enrolled. S‑to‑FMC time was associated with lower median values in the WeChat‑based transmission group (median 75 vs. 120 minutes, p < 0.05); similar patterns were seen for D‑to‑B time (50 vs. 67 minutes, p < 0.05) and total ischemia time (121.5 vs. 150.0 minutes, p < 0.05). Shorter time to Acute Myocardial Infarction (AMI) diagnosis, as well as shorter D‑to‑B and TIT times, were observed among patients in the WeChat‑based transmission group relative to patients in the non‑WeChat‑based transmission group.</p><p><strong>Conclusion: </strong>WeChat-based transmission was associated with shorter S-to-FMC, d-to-B, and TIT times during patient transfer for PCI. However, it is not fully used for transporting chest pain patients in and around Shijiazhuang City. Therefore, strengthening WeChat-based transmission function in public education of pre-hospital rescue remains the focus of our future work.</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"81 ","pages":"101188"},"PeriodicalIF":2.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between urinary polycyclic aromatic hydrocarbon metabolites and diabetes-related mortality: a longitudinal study in U.S. adults.","authors":"Ao Li, Yuxin Pan, Mingcong Chen, Yang Meng, Yang Zhang, Mingyi Zhao, Lin Liu","doi":"10.1016/j.clinsp.2026.101169","DOIUrl":"10.1016/j.clinsp.2026.101169","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to explore the association between urinary Polycyclic Aromatic Hydrocarbons (PAHs) and diabetes prevalence and all-cause mortality in U.S. adults using data from 8,124 participants in the 2003-2014 NHANES cycles METHODS: Weighted logistic regression and Cox proportional hazards models were employed to analyze the effects of individual and combined PAH metabolites. Confounders were adjusted, and nonlinear relationships were explored through restricted cubic splines.</p><p><strong>Results: </strong>Weighted quantile sum regression revealed that co-exposure to six urinary PAHs was significantly associated with higher diabetes prevalence (OR = 1.131, 95% CI 1.008-1.269) and all-cause mortality (OR = 1.330, 95% CI 1.051-1.684), with 2-hydroxynaphthalene contributing most to diabetes risk and 1-hydroxynaphthalene to mortality risk within the mixture. In exploratory analyses of individual metabolites, nominal (unadjusted for multiple comparisons) positive associations were observed for ΣPAHs and 1-hydroxynaphthalene with diabetes prevalence. ΣPAHs also showed a modest association with all-cause mortality.</p><p><strong>Conclusions: </strong>These findings suggest that PAH exposure is associated with a higher prevalence of diabetes and, among individuals with diabetes, higher all-cause mortality.</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"81 ","pages":"101169"},"PeriodicalIF":2.4,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between lipid accumulation product and the prevalence of peripheral artery disease: A cross-sectional study based on NHANES 1999‒2004.","authors":"Ling-Bin Mi, A-Bing Li","doi":"10.1016/j.clinsp.2026.101175","DOIUrl":"10.1016/j.clinsp.2026.101175","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the association between Lipid Accumulation Product (LAP) and the prevalence of Peripheral Artery Disease (PAD) among US adults using nationally representative data from the National Health and Nutrition Examination Survey (NHANES).</p><p><strong>Methods: </strong>Data from NHANES conducted between 1999 and 2004 were utilized for this analysis. Survey-weighted logistic regression models were used to examine the association between Log-transformed LAP (Ln-LAP) and PAD prevalence, with Ln-LAP analyzed both as a continuous variable and according to tertiles. Restricted cubic spline analysis was performed to assess the dose-response relationship. Prespecified subgroup analyses and exploratory machine-learning analyses using random forest and Light Gradient Boosting Machine models were also conducted.</p><p><strong>Results: </strong>Among 5,202 participants, 287 had PAD. The findings indicate a significant positive association between the natural logarithm of LAP (Ln-LAP) and the prevalence of PAD. After adjustment for potential confounders, each one-unit increase in Ln-LAP was associated with 36% higher odds of prevalent PAD (OR = 1.36, 95% CI 1.18-1.58). Notably, this association is particularly pronounced in specific subgroups, including women, individuals with estimated Glomerular Filtration Rate (eGFR) less than 60 mL/min/1.73 m², and those who were high school graduates or above. In exploratory machine-learning analyses, Ln-LAP showed relatively high feature importance for PAD classification.</p><p><strong>Conclusion: </strong>Our study suggests a notable positive association between LAP levels and the prevalence of PAD. The association appeared to be approximately linear and may be more pronounced in specific subgroups. Given the cross-sectional design, causal inference cannot be made.</p>","PeriodicalId":520594,"journal":{"name":"Clinics (Sao Paulo, Brazil)","volume":"81 ","pages":"101175"},"PeriodicalIF":2.4,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149077040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}