Journal of investigative medicine : the official publication of the American Federation for Clinical Research最新文献

{"title":"Vitamin D variability might be linked to sarcopenia, especially with decreased muscle mass in older patients: A retrospective longitudinal study.","authors":"Orhan Cicek, Ilyas Akkar, Zeynep Iclal Turgut, Merve Yilmaz Kars, Mustafa Hakan Dogan, Yagmur Tosun, Muhammet Cemal Kizilarslanoglu","doi":"10.1177/10815589261493463","DOIUrl":"10.1177/10815589261493463","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of the study was to assess the relationship between variations in vitamin D levels, sarcopenia, and the fat-free mass index (FFMI) in individuals 65 years of age and above.</p><p><strong>Materials and methods: </strong>This retrospective study included 215 individuals aged ≥65 years who were followed at a geriatric outpatient clinic between January 2024 and September 2025 and had at least two serial vitamin D measurements. Demographic characteristics, dual X-ray absorptiometry based body composition, comprehensive geriatric assessment findings, comorbidities, and longitudinal vitamin D levels were recorded. Vitamin D variability was assessed using the standard deviation (SD) and coefficient of variation (CV) of repeated measurements, and its association with sarcopenia and low FFMI was evaluated using crude and adjusted logistic regression analyses.</p><p><strong>Results: </strong>The median age was found to be 78 years. In addition, sarcopenia (140/215, 65.1%) and sarcopenic obesity (89/215, 41.4%) were observed in the participants. Patients had a median of three vitamin D measurements (range: 2-4), with a most recent median level of 24.5 ng/mL. In crude analyses, higher vitamin D variability (SD) was associated with sarcopenia (OR: 1.051, 95% confidence interval (CI): 1.002-1.102, <i>p</i> = 0.042) and lower FFMI (OR: 1.061, 95% CI: 1.004-1.121, <i>p</i> = 0.037), and the association with sarcopenia remained significant after adjustment (OR: 1.057, 95% CI: 1.001-1.117, <i>p</i> = 0.048). Among participants with Clinical Frailty Scale <5 and a vitamin D measurement obtained within the past 2 years (<i>n</i> = 27), increases in SD and CV were associated with sarcopenia and low FFMI in both crude and adjusted models (all <i>p</i> < 0.05). However, these subgroup associations did not remain statistically significant after correction for multiple comparisons.</p><p><strong>Conclusion: </strong>In this retrospective cohort, higher vitamin D variability was associated with sarcopenia and low FFMI. As a result, it appears more important to monitor vitamin D measurements in a certain period rather than one time in the evaluation of sarcopenia. For older persons to maintain muscular health, maintaining vitamin D stability may be therapeutically significant.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589261493463"},"PeriodicalIF":2.0,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019110","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":"Immune biomarkers in CTD-ILD: Promise, practicality and the path to validation.","authors":"Nadeem Bandealy, Ajay Wagh, Uzair Ghori","doi":"10.1177/10815589261483682","DOIUrl":"https://doi.org/10.1177/10815589261483682","url":null,"abstract":"","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589261483682"},"PeriodicalIF":2.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876674","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":"Commentary on \"Association between serum lactate/albumin ratio and all-cause mortality in critically ill patients: A meta-analysis\".","authors":"Swati Mehta, Amit Chopra, Elvira O Gosmanova","doi":"10.1177/10815589261483683","DOIUrl":"https://doi.org/10.1177/10815589261483683","url":null,"abstract":"","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589261483683"},"PeriodicalIF":2.0,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148858066","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":"Commentary for \"Inflammatory bowel disease and cardiovascular risk: A meta-analysis\".","authors":"Emanuele Chiara, Maria Letizia Urban","doi":"10.1177/10815589261483671","DOIUrl":"https://doi.org/10.1177/10815589261483671","url":null,"abstract":"","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589261483671"},"PeriodicalIF":2.0,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842735","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":"Commentary on \"The clinical utility and outcomes of hemospray as primary versus salvage therapeutic modality for endoscopic hemostasis: A retrospective cohort study\".","authors":"Sheldon S Smith, Andrew T Mertz, Jerome C Edelson","doi":"10.1177/10815589261483672","DOIUrl":"https://doi.org/10.1177/10815589261483672","url":null,"abstract":"","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589261483672"},"PeriodicalIF":2.0,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842722","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":"Effects of aerobic, resistance, and combined exercise on inflammatory markers in patients with metabolic syndrome: A systematic review and network meta-analysis.","authors":"Shih-Ming Chuang, Kuo-Liong Chien","doi":"10.1177/10815589261483685","DOIUrl":"10.1177/10815589261483685","url":null,"abstract":"<p><strong>Background: </strong>The comparative effectiveness of different exercise modalities on systemic inflammation in patients with metabolic syndrome (MetS) remains poorly defined.</p><p><strong>Objective: </strong>To systematically evaluate and rank the effects of aerobic exercise (AE), resistance training (RT), and combined training (COM) on inflammatory markers (C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) in MetS.</p><p><strong>Methods: </strong>A network meta-analysis of 28 randomized controlled trials (RCTs) was conducted. Data were synthesized using frequentist random-effects models. Treatment efficacy was ranked using the Surface Under the Cumulative Ranking Curve (SUCRA).</p><p><strong>Results: </strong>Compared to the control group, all exercise modalities were associated with reductions in TNF-α levels, though the strength of this evidence is limited by high heterogeneity and potential publication bias. Among the interventions, COM showed the greatest effect (SMD = -1.74; 95% CI: -3.06 to -0.43; SUCRA = 75.7%), followed by RT and AE. For CRP, significant reductions were observed in COM (SMD = -0.79; 95% CI: -1.36 to -0.21; SUCRA = 86.8%) and AE (SMD = -0.64; 95% CI: -0.95 to -0.32), while RT demonstrated a smaller effect. No modalities reached statistical significance for IL-6, although RT ranked highest in SUCRA (75.8%). Notably, CRP findings were robust with moderate certainty and no publication bias (<i>p</i> = 0.86), whereas TNF-α and IL-6 exhibited significant publication bias (<i>p</i> < 0.05) and extreme heterogeneity (<i>I</i>² > 90%).</p><p><strong>Conclusion: </strong>Exercise, particularly COM, appears to be a promising intervention for reducing CRP and TNF-α in MetS. While the findings for CRP are robust, results for TNF-α should be interpreted with caution due to observed heterogeneity and potential publication bias.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589261483685"},"PeriodicalIF":2.0,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805242","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":"Neutrophil-to-lymphocyte ratio as a biomarker for early infection and subsequent mortality in primary membranous nephropathy.","authors":"Yin Zhao, Zhiqin Chen, Jiaoyang Li, Jinhua Liu, Jing Han, Zhongfeng Cheng","doi":"10.1177/10815589261483681","DOIUrl":"10.1177/10815589261483681","url":null,"abstract":"<p><p>ObjectivesMembranous nephropathy (MN) is the leading cause of nephrotic syndrome in adults. For primary membranous nephropathy (PMN), there are few studies analyzing the clinical and pathological characteristics as well as the role of NLR (neutrophil-to-lymphocyte ratio). To explore this, we conducted this single-center, retrospective study.MethodsThis retrospective study enrolled 138 patients with PMN who were diagnosed by renal biopsy and treated at the Affiliated Hospital of Yunnan University, China, from January 2019 to November 2024. Patients were followed up for at least 12 months. Clinical and laboratory data were collected. Intergroup comparisons, survival analyses and receiver operating characteristic (ROC) curve were performed.ResultsThe results revealed that 11 patients (7.97%) in the cohort died. Patients with infection events within the first year of follow-up had higher mortality. Compared with patients without infection events within the first year, older baseline age, higher levels of blood urea nitrogen, serum creatinine, NLR, and a higher incidence of ESRD were observed in both the survival with infection and non-survival with infection groups. The primary infection sites were the respiratory and urinary tracts. Multivariate analyses identified age as an independent predictor of infection, while age and NLR were independent predictors of mortality. The ROC curve analysis demonstrated that the NLR may serve as a predictive marker for all-cause mortality, with an AUC of 0.778 (95% CI: 0.71-0.85). The optimal cutoff value was 2.88, achieving a sensitivity of 0.91 and specificity of 0.61.ConclusionPMN patients who developed infection events within the first year after diagnosis demonstrated higher all-cause mortality. Advanced age, impaired renal function, and elevated NLR were identified as risk factors for mortality. NLR may predict mortality and serve as an accessible biomarker.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589261483681"},"PeriodicalIF":2.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805374","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":"Comparison of SABIHA and 3CPO scores for 30-day mortality in acute heart failure.","authors":"Serdar Özdemir","doi":"10.1177/10815589261483642","DOIUrl":"10.1177/10815589261483642","url":null,"abstract":"<p><strong>Objective: </strong>This study compared the predictive power of Systolic blood pressure, Age, Blood urea nitrogen, Intubation, Heart rate, Anemia (SABIHA) and Three Clinical Criteria for Pulmonary edema (3CPO) scores for 30-day mortality in acute heart failure (AHF).</p><p><strong>Materials and methods: </strong>This retrospective observational study included adult patients presenting to the emergency department with AHF who were subsequently hospitalized. The demographic data, clinical findings, laboratory results, and echocardiographic parameters of the patients were recorded. SABIHA and 3CPO scores were calculated using data obtained at the time of presentation.</p><p><strong>Results: </strong>Data of 342 patients were analyzed, of whom 291 (85%) survived and 51 (15%) died. The median SABIHA score was found to be 2 (2-3) in the survivor group, whereas it was 3 (2-4) in the non-survivor group (<i>p</i> < 0.001). Similarly, the median 3CPO score for the entire cohort was determined to be 2 (1-3). In the survivor group, the median 3CPO score was 2 (1-3), while it was 3 (2-4) in the non-survivor group (<i>p</i> = 0.005). Multivariable analysis demonstrated that both the SABIHA score (OR: 1.84, 95% CI: 1.37-2.48; <i>p</i> < 0.001) and the 3CPO score (OR: 1.29, 95% CI: 1.08-1.54; <i>p</i> = 0.005) remained independent predictors of 30-day mortality.</p><p><strong>Conclusion: </strong>Both the SABIHA and 3CPO scores demonstrated comparable discriminative performance for predicting 30-day mortality in patients with AHF. Although the SABIHA score showed a numerically higher area under the curve and remained an independent predictor in multivariable analysis, the difference in discriminative performance between the two scores was not statistically significant. Therefore, both scores may be useful for early risk stratification, while larger prospective studies are needed to further compare their prognostic performance.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589261483642"},"PeriodicalIF":2.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805283","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":"Harnessing single-cell gene regulatory networks for precision health.","authors":"Julieth López-Castiblanco, Liliana López-Kleine, Yesid Cuesta-Astroz","doi":"10.1177/10815589261483678","DOIUrl":"10.1177/10815589261483678","url":null,"abstract":"<p><p>Cellular diversity in multicellular organisms arises from the functional specialization of individual cells and the influence of both the local tissue microenvironment and external stimuli. Understanding this heterogeneity requires accurate characterization of cell types and the molecular dynamics that define them. In this context, transcriptomic technologies at the single-cell level have become central tools, as they provide a comprehensive view of gene expression and reveal functional molecular patterns. Recent advances have dramatically expanded the number of detectable transcripts and improved data resolution, shifting from bulk measurements that averaged signals across tissues to single-cell approaches capable of quantifying gene expression at the cellular level. This finer resolution enables detailed investigation of cellular functions, interactions, and transitions, and supports the development of multiscale computational models. Within this landscape, biological network-based approaches, particularly gene regulatory networks (GRNs), have emerged as powerful tools for interpreting the functional organization of gene circuits. These methods facilitate the identification of biomarkers, regulatory factors, and key pathways, deepening our understanding of gene regulation and cellular identity through high-resolution transcriptomic data. Transferring this knowledge to clinical practice (diagnosis and treatment) is what we here refer to as precision health. This manuscript examines the current landscape of single-cell RNA sequencing, highlighting key studies that have leveraged this technology to advance biological understanding for clinical purposes by constructing GRNs from single-cell transcriptomic data. Furthermore, it addresses how these insights could contribute to clinical applications and, ultimately, the advancement of precision health. Finally, it discusses the key challenges as a guideline in data analysis and practical applications within this rapidly evolving field.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589261483678"},"PeriodicalIF":2.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805291","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":"Impact of methamphetamine route of administration on cardiac function.","authors":"Ananya Narasimhan, Katlin Wieselthier, Sabrina Yip, Gursavan Khatkar, Emily Lyon, Zachary Hall, Malaika Menon, Joachim Brown, Sebastien Fuchs","doi":"10.1177/10815589261483677","DOIUrl":"10.1177/10815589261483677","url":null,"abstract":"<p><p>BackgroundMethamphetamine use is an increasingly detrimental public health crisis linked to significant cardiovascular harm, particularly methamphetamine-associated cardiomyopathy (MACM), which impairs left ventricular ejection fraction (LVEF). Despite well-documented cardiotoxic effects of methamphetamine, the impact of the route of administration (ROA) on LVEF remains underexplored.ObjectiveThis review examines how various ROAs of methamphetamine affect LVEF. It aims to inform clinical decision-making and support the development of pragmatic, risk-reduction interventions in addiction medicine and emergency settings.MethodsWe conducted a narrative review of peer-reviewed literature, prioritizing studies from the last 15 years while including seminal earlier work as well. Eligible studies examined methamphetamine use with reported LVEF or cardiac outcomes stratified by ROA. We included human and animal studies across diverse settings and excluded editorials, non-cardiac-focused papers, and studies involving exclusively people <18 years or pregnant individuals.Results/FindingsOur review of 57 papers showed that ROA may impact methamphetamine cardiotoxicity. Intravenous use is linked to abrupt hemodynamic stress, including rapid volume shifts, along with embolic risk and severe LVEF decline. Smoking leads to repeated dosing, oxidative stress, production of harmful pyrolytic intermediates and pulmonary vascular injury. Intranasal use causes systemic vasospasm, while oral ingestion results in prolonged exposure and cumulative myocardial stress. However, direct, comparative clinical data on ROA and LVEF remain sparse and confounded by factors such as polysubstance use, homelessness, and underreporting.ConclusionROA may significantly modulate the impact of methamphetamine on LVEF. Future larger-scale, longitudinal studies are critical to clarify this relationship and guide targeted interventions.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589261483677"},"PeriodicalIF":2.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805409","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}