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

{"title":"Associations between lifestyle behaviours and vascular parameters in women: An umbrella review (the MUJER-EVA Project).","authors":"Iris Otero-Luis, Alicia Saz-Lara, Carla Geovanna Lever-Megina, Iván Cavero-Redondo, Francisco de Los Cobos-Arteaga, Natalia Sánchez-Aguadero","doi":"10.1177/10815589261473287","DOIUrl":"10.1177/10815589261473287","url":null,"abstract":"<p><p>Cardiovascular disease is the leading cause of death in women, who also experience worse outcomes after a cardiovascular event. Lifestyle factors such as diet, physical activity, and smoking influence the process of vascular ageing. Therefore, the aim of this study was to examine the associations between lifestyle behaviours and various vascular parameters in women. A systematic search was conducted in different databases (PubMed, Scopus, Cochrane, and Web of Science) from their inception to April 2025. Standardised mean differences and their corresponding 95% confidence intervals for each outcome are presented in forest plots to assess the relationships between lifestyle behaviours and vascular parameters in women. All the statistical analyses were conducted via STATA 15 software. Twenty studies were included in the umbrella review. Flow-mediated dilation significantly improved following dietary and physical exercise interventions, particularly aerobic exercise and high-intensity interval training, whereas tobacco use was associated with a marked reduction. No significant effects were observed in terms of the relationship between physical exercise and the intima-media thickness. In contrast, various types of physical activity resulted in significant reductions in pulse wave velocity. This umbrella review demonstrates that lifestyle behaviours influence vascular parameters such as flow-mediated dilation and pulse wave velocity in women. However, further research is needed to provide more specific findings.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589261473287"},"PeriodicalIF":2.0,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581998","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":"Retinochoroidal structural and microvascular changes assessed by optical coherence tomography angiography in obese children: Association with insulin resistance indices-a pilot study.","authors":"Rasha Abd El Samad Fawaz, Heba Mohamed Abd El Glil, Dina Fathy Rashad, Rasha Muhammad Ibrahim Rashed, Marwa Elhady","doi":"10.1177/10815589261473281","DOIUrl":"10.1177/10815589261473281","url":null,"abstract":"<p><strong>Background: </strong>Childhood obesity is associated with metabolic dysfunction and may be accompanied by early microvascular alterations. The retinal and choroidal circulation can be assessed non-invasively using optical coherence tomography angiography (OCTA).</p><p><strong>Objective: </strong>To explore retinochoroidal structural and microvascular changes in children with obesity and assess their association with insulin resistance indices, including Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and triglyceride glucose (TyG) index.</p><p><strong>Methods: </strong>This exploratory pilot cross-sectional comparative study included 20 obese children (BMI >95th percentile) and 20 healthy normal-weight children (BMI >5th and <85th percentile for age and sex) as controls. OCTA 6 × 6 mm scans were used to assess central macular thickness, choroidal thickness, foveal avascular zone, choriocapillaris flow area, and superficial/deep retinal vessel densities (SVD/DVD) in parafoveal and perifoveal sectors. Anthropometric measurements, lipid profile, HOMA-IR, and TyG index were assessed and correlated with OCTA parameters.</p><p><strong>Results: </strong>Obese children had significantly lower visual acuity and thinner choroidal thickness compared with normal-weight controls. OCTA showed significant reductions in SVD and DVD across multiple parafoveal and perifoveal sectors, with more consistent involvement of DVD. Waist-to-height ratio, HOMA-IR, and TyG index showed significant negative correlations with several OCTA parameters, particularly DVD. Effect size analysis showed large differences in TyG index, whole DVD, and parafoveal DVD between obese and normal-weight children.</p><p><strong>Conclusion: </strong>Childhood obesity was associated with subclinical retinochoroidal structural and microvascular differences, particularly involving the deep capillary plexus. These exploratory findings suggest that OCTA may provide useful non-invasive information about obesity-related ocular changes in children, especially in relation to central adiposity and insulin resistance. Larger longitudinal studies are needed to confirm these findings and clarify their clinical relevance.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589261473281"},"PeriodicalIF":2.0,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148582004","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":"Investigating body image disturbance among Syrian refugees in northern Jordan.","authors":"Sara Barham, Hani Omar, Ahmad Al Athamneh, Anas Khaleel, Hakam Alaqabani, Ali Alkaf, Ahmed S A Ali Agha","doi":"10.1177/10815589261473288","DOIUrl":"10.1177/10815589261473288","url":null,"abstract":"<p><strong>Background: </strong>Body image disturbance (BID) affects physical and mental health, particularly in vulnerable populations like refugees. Syrian refugees in Jordan face unique challenges, including displacement and limited healthcare access, which may exacerbate BID. This study investigates BID, weight perception, and health behaviors among Syrian refugees in the Zaatari camp.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 487 Syrian refugees (61.4% males, 38.6% females) in the Zaatari camp between September and December 2022. Data collection involved Stunkard's silhouettes and a health and lifestyle questionnaire. Statistical analysis was performed using IBM SPSS Statistics for Windows, version 27.0 (IBM Corp., Armonk, NY, USA).</p><p><strong>Results: </strong>Males had higher rates of overweight (23.8%) and obesity (8.6%) than females (15.4% and 3.1%, respectively). Among overweight participants, 71 females (14.5% of the total sample) and 109 males (22.3% of the total sample) perceived themselves as having an average weight, indicating underestimation of their weight status. Physical inactivity (26.1% females, 44.15% males) and poor dietary adherence (37.4% females, 59.3% males) were prevalent. Smoking was reported by 22.1% of participants, primarily cigarette use among smokers (71.3%). Regarding perceived social influence, 109 overweight males (22.3%) and 69 overweight females (14.17%) reported that they believed their parents perceived them as being of average weight.</p><p><strong>Conclusion: </strong>Targeted health education and culturally sensitive interventions are needed to address BID and promote healthier behaviors among Syrian refugees. Expanding education and integrating psychiatric and nutritional counseling could mitigate BID's effects. Future research should explore sustainable, community-driven health solutions.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589261473288"},"PeriodicalIF":2.0,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581988","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":"Circular RNAs as next-generation biomarkers for minimal residual disease: Mechanistic insights and clinical translation.","authors":"Tareq Nayef AlRamadneh, Hussein Salim Abed, Sarah Qutayba Badraldin, Jasur Rizaev, Sirojiddin Sultanov, Rasim M Salih, Mohamed Adil Jaber","doi":"10.1177/10815589261473276","DOIUrl":"10.1177/10815589261473276","url":null,"abstract":"<p><p>Minimal residual disease (MRD) denotes the persistence of malignant cells below the detection limits of conventional diagnostics and is a principal determinant of relapse and therapeutic failure. Enhancing MRD detection is therefore essential for precision oncology. Tumor-derived circular RNAs (circRNAs)-covalently closed transcripts defined by back-splice junctions-have emerged as compelling biomarkers for MRD owing to their exceptional stability, resistance to exonucleases, and enrichment in extracellular vesicles, which together enable reliable detection in biofluids. Beyond these analytical advantages, circRNAs actively participate in tumor biology through miRNA sponging, protein scaffolding, and transcriptional regulation, processes that contribute to epithelial-mesenchymal transition, therapy resistance, and metastatic competence. This review integrates current knowledge of circRNA biogenesis and molecular function, surveys cancer-type-specific circRNA expression signatures, and evaluates evidence for their utility in MRD monitoring across hematologic and solid malignancies. We propose multilayered diagnostic frameworks combining circRNA profiling with circulating tumor DNA, exosomal cargo analysis, and AI-driven bioinformatics to improve sensitivity, specificity, and longitudinal risk stratification. Finally, we critically examine translational hurdles-preanalytical standardization, assay harmonization, cross-platform reproducibility, clinical thresholding, and prospective validation-and outline strategic priorities to accelerate clinical implementation of circRNA-based MRD surveillance for personalized patient management.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589261473276"},"PeriodicalIF":2.0,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581969","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":"Comparative optimization of alkaline phosphatase reference intervals using Hoffmann and refineR methods in age- and sex-stratified LIS data.","authors":"Si Wang, Qian Li, Shen Wang, Yuxia Li, Chaomei Yang","doi":"10.1177/10815589261473292","DOIUrl":"10.1177/10815589261473292","url":null,"abstract":"<p><strong>Background: </strong>Alkaline phosphatase (ALP) is a routinely used biochemical marker whose concentrations are substantially influenced by age, growth, developmental stage, and sex. The use of an overly broad or unified reference interval (RI) may introduce bias into result interpretation.</p><p><strong>Methods: </strong>A total of 345,469 ALP test results were included after data cleaning from a large-scale Laboratory Information System dataset. After stratification by age and sex, ALP RIs were estimated using the Hoffmann and refineR methods. Their stability, concordance with external RIs, and effects on abnormal result classification were compared. A small independent set of 50 healthy individuals was used for preliminary verification.</p><p><strong>Results: </strong>ALP exhibited an overall right-skewed distribution, with higher levels in children and adolescents than in adults. Supplementary pediatric subgroup analysis showed substantial heterogeneity within the original 0-18-year stratum, especially across childhood and pubertal age ranges. Males generally had higher ALP levels than females before 50 years of age, whereas this sex-related difference became less pronounced thereafter. ALP varied nonlinearly with age, reaching a peak during puberty, followed by gradual decline and stabilization in adulthood. Although the Hoffmann and refineR methods yielded similar lower-limit estimates, refineR provided a better fit to the right tail of the distribution, generated higher upper limits, showed closer agreement with external RIs, and produced a more balanced pattern of abnormal classification. No out-of-range results were observed in the preliminary verification set.</p><p><strong>Conclusions: </strong>ALP interpretation should consider age and sex stratification. The refineR-derived intervals may provide a practical option for local RI optimization, pending further validation in larger independent cohorts.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589261473292"},"PeriodicalIF":2.0,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148582032","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":"Circulating and urinary microRNAs in diabetic kidney disease: Stage and sample-specific signatures with biomarker potential - A systematic review and exploratory meta-analysis.","authors":"Gangireddy Venkatratna Bharat, MohanRam Murugan, Ria Murugesan, Lavanya Ayyasamy, Madhumitha Haridoss, Janardanan Subramonia Kumar","doi":"10.1177/10815589261473283","DOIUrl":"10.1177/10815589261473283","url":null,"abstract":"<p><p>Diabetic kidney disease (DKD) is a leading cause of end-stage renal disease, and early detection remains challenging because conventional biomarkers lack sensitivity. MicroRNAs (miRNAs) have emerged as promising non-invasive biomarkers, but evidence remains inconsistent. This study systematically evaluated dysregulated miRNAs in DKD and their associations with clinical parameters across albuminuria stages. PubMed, Scopus, and Embase were searched for studies assessing miRNA expression in DKD. Standardised mean differences (SMDs) were pooled using random-effects models, and risk of bias was assessed using the Newcastle-Ottawa Scale. The SMD of urinary miRNA124 in normoalbuminuria was 2.04 (95% CI: 1.16-2.92, <i>I</i>² = 77.2%, <i>p</i> ≤ 0.00001), microalbuminuria 7.76 (95% CI: 5.67-9.84, <i>I</i>² = 78.1%, <i>p</i> ≤ 0.00001), and macroalbuminuria 13.04 (95% CI: 10.94-15.13, <i>I</i>² = 40.8%, <i>p</i> < 0.00001). Urinary and circulating miRNA21 showed progressive upregulation across normoalbuminuria, microalbuminuria, and macroalbuminuria with SMDs of 3.34 (95% CI: -0.56 to 7.24, <i>I</i>² = 95.9%, <i>p</i> = 0.0933) and 0.50 (95% CI: -0.36 to 1.36, <i>I</i>² = 89.7%, <i>p</i> = 0.2520); 4.02 (95% CI: 2.69-5.36, <i>I</i>² = 80.0%, <i>p</i> < 0.0001) and 1.78 (95% CI: 0.00-3.56, <i>I</i>² = 96.7%, <i>p</i> = 0.0499); and 4.61 (95% CI: 0.18-9.03, <i>I</i>² = 97.8%, <i>p</i> = 0.0413) and 4.77 (95% CI: -1.29 to 10.82, <i>I</i>² = 98.4%, <i>p</i> = 0.1230), respectively. Circulating miRNA126 was consistently downregulated in normoalbuminuria, microalbuminuria, and macroalbuminuria with SMDs -0.85 (95% CI: -1.87 to 0.18, <i>I</i>² = 95.0%, <i>p</i> = 0.1044), -1.59 (95% CI: -2.67 to -0.52, <i>I</i>² = 93.0%, <i>p</i> = 0.0035), and -1.87 (95% CI: -4.67 to 0.93, <i>I</i>² = 98.1%, <i>p</i> = 0.1901). Urinary miRNA192 was downregulated, whereas circulating miRNA192 showed inconsistent expression. Correlation analyses demonstrated positive associations between urinary miRNA34a and UACR (<i>r</i> = 0.39) and HbA1c (<i>r</i> = 0.20), while circulating miRNA21 (<i>r</i> = -0.37) and miRNA192 (<i>r</i> = -0.26) were inversely associated with albuminuria. Overall, urinary miRNA124, miRNA21, and miRNA34a, together with circulating miRNA126 and miRNA192, show promise as biomarkers of DKD progression, although prospective validation studies are required.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589261473283"},"PeriodicalIF":2.0,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581967","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":"EXPRESS: Value of T-lymphocyte subsets, immunoglobulin, and complements in assessing efficacy and prognosis of connective tissue disease-associated interstitial lung disease.","authors":"Junliang Yang, Lei Liu, Yilin Wang, Shanshan Li, Yaqin Teng, Juan Wang, Xinmiao Xu, Jiliang Wang","doi":"10.1177/10815589261473285","DOIUrl":"https://doi.org/10.1177/10815589261473285","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated the clinical value of combined T‑lymphocyte subset, immunoglobulin, and complement testing in assessing treatment efficacy and prognosis in connective tissue disease‑associated interstitial lung disease (CTD‑ILD).</p><p><strong>Methods: </strong>A total of 110 CTD‑ILD patients, 90 CTD patients without ILD, and 110 healthy controls were enrolled. High‑resolution chest CT and lung function tests were performed in CTD‑ILD and CTD patients. Serum CD4+, CD8+, IgA, IgG, IgM, C3, and C4 levels were measured. CTD‑ILD patients received prednisone plus cyclophosphamide and were categorized into good/poor efficacy groups and good/poor prognosis groups after 6‑month follow‑up. Independent risk factors for poor prognosis were identified by logistic regression, and ROC analysis assessed the predictive value of combined indicators.</p><p><strong>Results: </strong>Compared with CTD and control groups, CTD‑ILD patients had reduced lung function, lower T‑lymphocyte subsets, elevated immunoglobulin, and reduced complements (P < 0.05). Poor efficacy and poor prognosis groups showed lower CD4+/CD8+ levels, higher immunoglobulins, and lower complements than their counterparts (P < 0.05). CD8+, IgA, C3, and C4 were independent predictors of treatment efficacy, while CD4+, CD8+, IgA, C3, and C4 independently predicted prognosis. ROC analysis confirmed the combined assay's predictive value.</p><p><strong>Conclusion: </strong>Combined measurement of T‑lymphocyte subsets, immunoglobulins, and complements provides significant predictive information for treatment response and prognosis in CTD‑ILD patients.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589261473285"},"PeriodicalIF":2.0,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581983","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 accuracy of serum lactate in mortality prediction in sepsis patients: A systematic review and meta-analysis.","authors":"Keyi Li, Hangqi Zhu, Houying Liu, Wei Du, Jing Wu, Chenjin Li, Guolin Song","doi":"10.1177/10815589261473284","DOIUrl":"10.1177/10815589261473284","url":null,"abstract":"<p><strong>Objective: </strong>Our study aims to assess the accuracy of serum lactate (SL) in mortality prediction among sepsis patients.</p><p><strong>Methods: </strong>PubMed, Embase, Cochrane Library, and Web of Science were searched until March 27, 2025. The quality of cohort and case-control studies was rated via the Newcastle-Ottawa Scale (NOS), and that of cross-sectional ones was assessed per the Agency for Healthcare Research and Quality (AHRQ) criteria. Our meta-analysis was completed using Stata 15.</p><p><strong>Results: </strong>34 studies involving 46,300 sepsis patients were included. Pooled analyses demonstrated that elevated SL was significantly associated with rising mortality in sepsis patients (when effect size (ES) was reported as hazard ratio (HR): HR = 1.85, 95% CI: 1.29-2.66, <i>p</i> < 0.05; when ES was reported as odds ratio (OR): OR = 1.52, 95% CI: 1.39-1.67, <i>p</i> < 0.001). 17 studies evaluated the performance of SL for mortality prediction in sepsis patients, revealing the pooled sensitivity, specificity, and an area under the curve (AUC) of 0.80 (95% CI: 0.75-0.85), 0.37 (95% CI: 0.25-0.51), and 0.73 (95% CI: 0.68-0.76).</p><p><strong>Conclusions: </strong>Elevated SL is closely associated with mortality in sepsis patients, particularly when the threshold is ≥4 mmol/L. Nevertheless, its diagnostic value remains limited. Future research should address the standardization of lactate measurement procedures and the development of multimodal prediction models for a transformation and breakthrough from risk stratification to precise intervention.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589261473284"},"PeriodicalIF":2.0,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564488","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":"Association of frailty with rapid kidney function decline in adults with normal kidney function.","authors":"Xiaowei Zheng, Qian Zhao, Kaixin Zhang","doi":"10.1177/10815589261473275","DOIUrl":"10.1177/10815589261473275","url":null,"abstract":"<p><strong>Background and objectives: </strong>The association between frailty and kidney function remains poorly investigated. We aimed to evaluate the associations between frailty status and kidney function (rapid kidney function) decline and progressed to CKD in middle-aged and older Chinese population.</p><p><strong>Methods: </strong>A total of 3,112 participants with eGFRcr-cys ≥60 ml/min per 1.73 m² and aged more than 60 years from the China Health and Retirement Longitudinal Study were included in analyses. Frailty was assessed using the Frailty Phenotype, which included assessments of unintentional weakness, slowness, exhaustion, low activity, and shrinking.</p><p><strong>Results: </strong>During the 4 years of follow-up, 499 (16.03%) participants experienced kidney function decline and 118 (3.79%) participants progressed to CKD. After multivariable adjustment of baseline eGFRcr-cys level and other risk factors, each 1-unit higher in frailty score was associated with 17% increased risk for the rapid decline in kidney function (annualized decline in eGFRcr-cys ≥3 ml/min per 1.73 m²). In addition, frailty was associated with an increased risk of rapid decline in kidney function (odds ratio = 1.17, 95% confidence interval:1.04-1.30). Individuals with slowness or exhaustion alone also had increased risk of rapid decline in kidney function.</p><p><strong>Conclusion: </strong>Frailty was associated with increased risk of rapid decline in kidney function among Chinese adults with normal kidney function.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589261473275"},"PeriodicalIF":2.0,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148475714","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":"Meta-analysis of the clinical efficacy of microcatheter-assisted trabeculotomy in the treatment of glaucoma.","authors":"Yuqiu Zhang, Juan Wang, Xingjian Chen","doi":"10.1177/10815589261462552","DOIUrl":"10.1177/10815589261462552","url":null,"abstract":"<p><p>This meta-analysis systematically evaluates the clinical efficacy and safety of microcatheter-assisted trabeculotomy in glaucoma treatment. We searched databases including PubMed, Embase, Web of Science, Wiley Library, China National Knowledge Infrastructure, Wanfang, and VIP. Four randomized controlled trials and 3 case-control studies, totaling 460 patients, were included. Data were analyzed using Stata/MP18 (StataCorp LLC, College Station, TX, USA) to calculate risk ratio, standardized mean difference (SMD), and 95% confidence interval (CI). It showed a significant short-term (3-6 months) reduction in intraocular pressure (IOP) with microcatheter-assisted trabeculotomy compared to control procedures (SMD = -0.39, 95% CI: -0.72 to -0.05, <i>p</i> = 0.01). Subgroup analysis suggested a significant short-term benefit in adults (SMD = -0.71, 95% CI: -1.37 to -0.05, <i>p</i> = 0.04), but not in pediatric patients. For long-term IOP (>1 year), the overall reduction was statistically significant (SMD = -0.46, 95% CI: -0.89 to -0.04, <i>p</i> = 0.03), with a significant benefit observed in adults (SMD = -1.03, 95% CI: -1.41 to -0.64, <i>p</i> < 0.01) but not in pediatric patients. No significant differences were found in postoperative success rates, number of antiglaucoma medications, or the incidence of ciliary detachment. Current evidence suggests that microcatheter-assisted trabeculotomy provides significant IOP-lowering effects in both the short and long-term overall, with a significant benefit in adults, whereas the benefit in children remains unclear. Its effects on surgical success rates and medication burden remain inconclusive. These findings support its potential as an effective surgical option, but highlight the need for further high-quality, long-term studies.</p>","PeriodicalId":520677,"journal":{"name":"Journal of investigative medicine : the official publication of the American Federation for Clinical Research","volume":" ","pages":"10815589261462552"},"PeriodicalIF":2.0,"publicationDate":"2026-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148255458","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}