BMC Gastroenterology最新文献

{"title":"Neoadjuvant chemotherapy with or without PD-1/PD-L1 inhibitors in resectable esophageal squamous cell carcinoma: a meta-analysis based on randomized controlled trials.","authors":"Ye Zhang, Jie Chen, Fenglian Yu, Wenxiong Zhang, Yingmei Zhong","doi":"10.1186/s12876-025-04030-7","DOIUrl":"https://doi.org/10.1186/s12876-025-04030-7","url":null,"abstract":"<p><strong>Background: </strong>Neoadjuvant chemotherapy (NC) is a cornerstone in the management of resectable esophageal squamous cell carcinoma (ESCC). The integration of PD-1/PD-L1 inhibitors into NC (NIC) regimens has shown promise; however, its efficacy and safety remain uncertain. This meta-analysis aims to compare the potential risks and clinical benefits of NIC versus NC in patients with resectable ESCC based on randomized controlled trials (RCTs).</p><p><strong>Methods: </strong>A thorough search of six databases was performed to identify RCTs evaluating NIC and NC in resectable ESCC. Key outcomes analyzed included the pathological complete response (pCR) rate and the major pathological response (MPR) rate. Other outcomes analyzed included overall survival (OS), event-free survival (EFS), surgery rate, R0 resection rate, and adverse events (AEs).</p><p><strong>Results: </strong>Four RCTs encompassing 605 patients were included. NIC significantly improved pCR rate (risk ratio [RR]: 2.66 [1.63, 4.34], P < 0.0001) and MPR rate (RR: 1.74 [1.02, 2.95], P = 0.04) compared to the NC group. Only one phase III RCT reported survival outcomes, showing that the NIC group demonstrated improved OS (HR: 0.48 [0.24, 0.96], P = 0.04) and EFS (HR: 0.62 [0.39, 0.99], P = 0.05). Additionally, surgery rate (RR: 1.11 [1.03, 1.20], P = 0.008) and the number of resected lymph nodes (mean difference [MD]: 3.91 [0.60, 7.21], P = 0.02) were also higher in the NIC group. The R0 resection rate, duration of surgery, and intraoperative blood loss were comparable between the groups. However, the rate of immune-related AEs (irAEs) (RR: 40.80 [5.67, 293.37], P = 0.0002) was significantly higher in the NIC group. Similar surgical complications were observed between the two groups.</p><p><strong>Conclusions: </strong>NIC demonstrates superior efficacy in improving pCR and MPR in resectable ESCC compared to NC alone, and may potentially provide survival benefits, although it is associated with a higher risk of irAEs.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"416"},"PeriodicalIF":2.5,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between C-reactive protein to lymphocyte ratio and gallstones: a cross-sectional study.","authors":"Xiaoyang Sun, Jie Lin, Zhenao Wang, Chenfang Zhang, Kai Zhao, Xuewen Zhang, Jiyao Sheng","doi":"10.1186/s12876-025-04000-z","DOIUrl":"https://doi.org/10.1186/s12876-025-04000-z","url":null,"abstract":"<p><strong>Background: </strong>Inflammation plays a key role in the development of gallstones, and the C-reactive protein to lymphocyte ratio (CLR) has been introduced as a promising biomarker for evaluating inflammatory processes. Nonetheless, its correlation with gallstone prevalence remains ambiguous. This study aims to evaluate the potential link between CLR levels and gallstone prevalence.</p><p><strong>Methods: </strong>This study utilized data from the National Health and Nutrition Examination Survey, covering the periods from March 2017 to 2020 and 2021 to 2023. Multivariate logistic regression was employed to examine the association between CLR and gallstone prevalence. Furthermore, smoothed curve fitting, subgroup analysis, and interaction testing were performed to provide a comprehensive evaluation. We also employed receiver operating characteristic (ROC) curves to determine the predictive ability of the index for gallstones.</p><p><strong>Results: </strong>Among the 13,386 participants included in this study, 1,444 were diagnosed with gallstones. In a fully adjusted model, a small but statistically significant positive association between CLR and the prevalence of gallstones was observed (odds ratio [OR] = 1.07, 95% CI: 1.01-1.12). Compared to individuals in the lowest tertile of CLR (T1), those in the middle tertile (T2) showed a non-significant increase in gallstone prevalence (OR = 1.10, 95% CI: 0.94-1.29), while the highest tertile (T3) exhibited a statistically significant elevation (OR = 1.20, 95% CI: 1.03-1.41). Smoothed curve fitting further confirmed this positive relationship. Bonferroni-corrected subgroup analysis demonstrated a statistically significant association between CLR and gallstones in the \"Married/Living with Partner\" subgroup (P < 0.0015), while no significant associations were observed in the other subgroups. Additionally, Bonferroni-corrected interaction tests indicated no significant interactions between CLR and gallstones across all subgroups (P for interaction > 0.0038).</p><p><strong>Conclusion: </strong>Higher CLR was associated with higher gallstone prevalence. However, additional large-scale prospective studies are required to further investigate the role of CLR in the prevalence of gallstones.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"415"},"PeriodicalIF":2.5,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between the immune-inflammation index and the severity and clinical outcomes of patients with inflammatory bowel disease: a systematic review and meta-analysis.","authors":"Peiji Li, Yilin Wu, Wei Xiong, Jiahui Cao, Mengyun Chen, Zhaowei Yuan, Wenxin Guo, Bing Yang","doi":"10.1186/s12876-025-04033-4","DOIUrl":"https://doi.org/10.1186/s12876-025-04033-4","url":null,"abstract":"<p><strong>Background: </strong>Existing studies have explored the association between immune-inflammatory indices and inflammatory bowel disease (IBD), but there is a lack of comprehensive evidence. This meta-analysis and systematic review seeks to synthesize the data of available clinical research and offer the latest and comprehensive evidence-based conclusions regarding whether these immune-inflammatory indices can effectively predict the severity, activity, and prognosis of IBD.</p><p><strong>Methods: </strong>Seven databases were comprehensively retrieved from their establishment to March 23, 2025. The combined results were described through standardized mean differences (SMD) or odds ratios (OR) with 95% confidence intervals (CI). Review Manager 5.4 and STATA 15.0 were leveraged for data analysis.</p><p><strong>Results: </strong>Our analysis included 35 studies involving 5,870 patients. The aggregated data revealed that the neutrophil-to-lymphocyte ratio (NLR) (OR = 1.18, 95% CI:1.04 to 1.34; P = 0.001) (SMD = 1.01, 95%CI = 0.73 to 1.29, P < 0.001), platelet-to-lymphocyte ratio (PLR) (SMD = 0.60, 95%CI = 0.46 to 0.74, P < 0.001), neutrophil-to-platelet ratio (NPR) (OR = 1.20, 95% CI:1.08 to 1.32, P < 0.001), and C-reactive protein to albumin ratio (CRP/ALB) (OR = 1.50, 95% CI:1.38 to 1.65, P < 0.001) were potentially linked to disease activity in IBD patients. PLR (SMD = 1.08, 95%CI = 0.60 to 1.55, P < 0.001) showed potential associations with disease severity in IBD patients. Additionally, NLR (SMD = 0.43, 95%CI = 0.15 to 0.70, P = 0.002) and eosinophil-to-lymphocyte ratio (ELR) (SMD = 0.63, 95%CI = 0.26 to 1.00, P < 0.001) had potential associations with endoscopic response in IBD patients. Moreover, NLR was potentially associated with disease relapse(OR = 1.35, 95% CI:1.09 to 1.68; P = 0.006) and steroid responsiveness (SMD = 0.50, 95%CI = 0.15 to 0.85, P = 0.005).</p><p><strong>Conclusion: </strong>NLR, PLR, NPR, and CRP/ALB are potential predictors of disease activity in IBD patients. PLR shows the potential to predict disease severity, while NLR and ELR are potential indicators of endoscopic response. Furthermore, NLR is also a potential predictor of relapse and steroid responsiveness. Currently, there is insufficient evidence to support an association between NLR and the severity of IBD, whereas lymphocyte-to-monocyte ratio (LMR) appears to be associated with both the severity and activity of IBD and PLR and eosinophil*neutrophil-to-lymphocytes ratio (ENLR) are associated with endoscopic response in IBD.</p><p><strong>Prospero registration: </strong>CRD 42024609659.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"414"},"PeriodicalIF":2.5,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A preliminary exploration of a predictive model and nomogram for the efficacy of compound digestive enzyme therapy based on serum (PGI, PGII, VIP, and PRDX1) in patients with functional dyspepsia.","authors":"Jiachao Pan, Bo Zhang, Wenqiang Ren","doi":"10.1186/s12876-025-04024-5","DOIUrl":"https://doi.org/10.1186/s12876-025-04024-5","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore the feasibility of constructing compound digestive enzyme therapeutic effect prediction model based on serum pepsinogen I (PGI), pepsinogen II (PGII), vasoactive intestinal peptide (VIP), and peroxidase 1 (PRDX1) in patients with functional dyspepsia (FD), and draw nomograms, to provide reference for the selection of clinical treatment.</p><p><strong>Methods: </strong>A total of 249 FD patients who visited the Department of Gastroenterology in our hospital from January 2021 to December 2024 were selected, and the preoperative clinical and laboratory indicators were collected. the patient cohort was split in a 7:3 ratio into a training set (n = 174) and a validation set (n = 75). The risk factors were screened by univariate and multivariate logistic regression in the training set, and the nomogram model was constructed. The receiver operating characteristic curve (ROC) was drawn and the calibration curve was used to evaluate the effectiveness of the model. The model was verified in the verification set, and the clinical value was evaluated by decision curve analysis (DCA).</p><p><strong>Results: </strong>The results of multivariate logistic regression showed that PGI, PGII, VIP, PRDX1, white blood cell count, aspartate aminotransferase and high density lipoprotein cholesterol were the independent risk factors for poor efficacy of compound digestive enzymes in the treatment of FD. The C-index was 0.830 and 0.827, respectively, the area under the ROC curve (AUC) was 0.835 (95% CI: 0.792-0.941) and 0.835 (95% CI: 0.687-0.983), and the sensitivity and specificity were 0.768, 0.857, and 0.778, 0.780, respectively.</p><p><strong>Conclusion: </strong>The therapeutic effect prediction model of compound digestive enzyme base on serum PGI, PGII, VIP, PRDX1 in patients with FD has some clinical value, but it still need to be further verified by large sample size and multi-center study.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"413"},"PeriodicalIF":2.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative efficacy of gelatin sponge, microcoils, and nbca in arterial gastrointestinal bleeding: a retrospective study.","authors":"Longxiang Lai, Xian Liu, Juan Su","doi":"10.1186/s12876-025-04010-x","DOIUrl":"10.1186/s12876-025-04010-x","url":null,"abstract":"<p><strong>Background: </strong>Arterial gastrointestinal bleeding poses a serious threat to life that requires timely and effective intervention. This study evaluated the effectiveness of three different embolization strategies: the use of gelatin sponge alone, in combination with microcoils, and in combination with n-butyl cyanoacrylate (NBCA).</p><p><strong>Methods: </strong>This retrospective study included 68 patients with acute arterial gastrointestinal bleeding (Forrest F1), categorized into three embolization groups: gelatin sponge alone (n = 23), gelatin sponge + microcoils (*n* = 23), and gelatin sponge + NBCA (n = 22). Clinical success was defined as complete hemostasis without rebleeding within 30 days. Multivariate analysis adjusted for age, NSAID use, and bleeding site.</p><p><strong>Results: </strong>The gelatin sponge + NBCA group achieved 100% clinical success, significantly higher than gelatin sponge + microcoils (91.30%) and gelatin sponge alone (65.22%) (P < 0.001). Rebleeding rates were lowest with NBCA (0% vs. 34.78% for gelatin sponge alone; P < 0.001), and complication rates favored NBCA (13.6% vs. 47.8%; P = 0.013). Multivariate analysis confirmed the superiority of combination strategies, with gelatin sponge + NBCA showing the highest odds of success (adjusted OR = 24.12, 95% CI: 2.98-195.21, P = 0.003). Subgroup analyses revealed no significant interaction between embolic strategy and bleeding site (P > 0.05), though upper GI cases trended toward higher success rates (92.3-100%) compared to lower GI (80-100%).</p><p><strong>Conclusion: </strong>The study underscores the superiority of combination embolic strategies over the application of gelatin sponge alone for managing arterial gastrointestinal bleeding. The addition of microcoils and NBCA to gelatin sponge enhances both the efficacy and durability of embolic interventions, suggesting their preferential use in clinical practice to optimize patient outcomes.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"412"},"PeriodicalIF":2.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144156903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive analysis of risk factors and nomogram development for predicting hepatic metastasis following radical resection of adenocarcinoma of the esophagogastric junction.","authors":"Lili Deng, Jie Sun, Jing Wang, Xiaokai Duan, Baozhong Li","doi":"10.1186/s12876-025-04014-7","DOIUrl":"10.1186/s12876-025-04014-7","url":null,"abstract":"<p><strong>Background: </strong>Adenocarcinoma of the esophagogastric junction (AEG) often presents with subtle early symptoms and delayed diagnosis, frequently resulting in liver metastasis and a poor prognosis. This study aimed to investigate the primary risk factors influencing postoperative liver metastasis in AEG and to develop a simple predictive model to facilitate clinical risk stratification and individualized follow-up strategies.</p><p><strong>Methods: </strong>This retrospective study analyzed data from 524 patients with AEG who underwent radical resection, with patients randomly divided into a training group (368 cases) and a validation group (156 cases). Clinical and pathological information was collected, and independent factors significantly associated with postoperative liver metastasis were identified using univariate and multivariate Cox regression analyses. Based on these findings, a nomogram model was constructed to predict the 1-year and 3-year liver metastasis-free survival rates, and the model's predictive performance and clinical utility were evaluated using the C-index, ROC curves, and calibration curves.</p><p><strong>Results: </strong>Multivariate analysis revealed that thoracoabdominal surgery, higher N stage (N1 and N2/N3), moderate-to-poor differentiation, the presence of vascular tumor thrombus, intestinal type according to Lauren classification, and P53 status were independent risk factors for postoperative liver metastasis. The nomogram model based on these six indicators demonstrated high predictive accuracy in both the training group (C-index = 0.966) and the validation group (C-index = 0.976), with ROC AUCs for both the 1-year and 3-year predictions exceeding 0.96 and favorable calibration curves, confirming the model's strong predictive efficacy.</p><p><strong>Conclusions: </strong>The predictive model developed in this study can effectively assess the risk of postoperative liver metastasis in patients with AEG, thereby providing a scientific basis for postoperative monitoring and individualized treatment, with the potential to improve patient outcomes in clinical practice.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"409"},"PeriodicalIF":2.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144156931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a new predictive model for the immune tolerance stage of chronic HBV infection based on the liver histopathological changes.","authors":"Wentao Li, Rui Huang, Jian Wang, Binhao Zhang, Qiupeng Wang, Jiang Feng, Tongjing Xing","doi":"10.1186/s12876-025-03999-5","DOIUrl":"https://doi.org/10.1186/s12876-025-03999-5","url":null,"abstract":"<p><strong>Objective: </strong>To identify clinical and viral indicators for the development of a new model to accurately differentiate the stages of chronic hepatitis B virus (HBV) infection based on histopathological changes in the liver.</p><p><strong>Methods: </strong>Clinical and liver pathology data from chronic hepatitis B (CHB) patients who underwent liver biopsy were retrospectively collected. The patients were allocated into test and validation groups. The area under the receiver operating characteristic (ROC) curve (AUC) was calculated to idneitfy the optimal diagnostic value for differentiating the stages of chronic HBV infection.</p><p><strong>Results: </strong>A total of 118 patients and 73 patients who met the diagnostic and inclusion criteria were selected as the test group and validation group, respectively. Multivariate analysis revealed that HBeAg was independently correlated with the IT and IC stages. The cutoff value of HBeAg used to quantitatively differentiate between IT and IC was 1335 S/CO. The AUC values were 0.921 (95% confidence interval (CI): 0.836-0.971) and 0.846 (95% CI: 0.726-0.967) in the test and validation groups, respectively. A new prediction model of the IT stage was established by using three indicators, namely, HBeAg, HBsAg and HBV DNA. The AUC values were 0.923 (95% CI: 0.864-0.982, p < 0.001) and 0.89 (95% CI: 0.787-0.994, p < 0.01) in the test and validation groups, respectively, when this prediction model was used. For the new model, CMA guidelines (2019 version), EASL guidelines (2017 version) and AASLD guidelines (2018 version), the error rates in the test group were 4.65%, 11.62%, 23.26%, and 46.51%, respectively, while the errors rates in the validation group were 20.0%, 25.0%, 40.0%, and 45.0%, respectively.</p><p><strong>Conclusions: </strong>High levels of HBeAg, rather than HBeAg positivity, may serve as a predictor of the IT stage. A predictive model for the immune tolerance stage was established by combining three indicators. Compared with the recommended standards from multiple current guidelines, the new prediction model has a significantly lower error rate.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"408"},"PeriodicalIF":2.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A cooling off period: decline in the use of hot biopsy forceps technique in colonoscopy in the U.S. Medicare population 2000-2019.","authors":"Andrew J Read, Jacob E Kurlander, Akbar K Waljee, Sameer D Saini","doi":"10.1186/s12876-025-04020-9","DOIUrl":"10.1186/s12876-025-04020-9","url":null,"abstract":"<p><strong>Background: </strong>The use of hot biopsy forceps (with electrocautery) is no longer routinely recommended given increased complications compared to cold biopsy forceps (without electrocautery). It is unknown how often the technique is currently used in the United States (U.S.) or how its usage has changed over time.</p><p><strong>Aim: </strong>To characterize the use of hot biopsy forceps by U.S. Medicare providers over time, identify provider characteristics of those who more commonly perform this technique, and determine if there are regional differences in use of this technique within the U.S.</p><p><strong>Methods: </strong>We performed a retrospective cross-sectional study using U.S. Medicare summary data from 2000 to 2019 to analyze the frequency of cold and hot biopsies. We used detailed provider and state summary files to characterize providers' demographics, including geographic region, to identify regional variation in use of these techniques, and identify factors associated with use of hot biopsy forceps from 2012 to 2019.</p><p><strong>Results: </strong>The hot biopsy forceps technique peaked in 2003 (412,165/year) and declined to 108,232/year in 2019, while the cold biopsy forceps technique increased from 482,862/year in 2000 to 1,533,558/year in 2019. Use of hot biopsy forceps was more common by non-gastroenterologists and in rural practice settings. In addition, there was up to 50-fold difference in utilization in these techniques between states (on a population normalized basis), with the highest rate of use in the southeastern U.S.</p><p><strong>Conclusion: </strong>Variation in the use of hot biopsy forceps by region and provider suggests a potential area for quality improvement given the comparative advantages of the cold biopsy forceps technique. De-implementation of an existing endoscopic practice may require different approaches than implementation of a new practice.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"411"},"PeriodicalIF":2.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144156862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relative fat mass and risk of metabolic dysfunction associated steatotic liver disease and severe hepatic steatosis in U.S. adults: analysis of NHANES 2017-2020 data.","authors":"Jianjun Wang, Wei He, Xianfu Cai, Zhaohui Hu, Yonghai Peng, Xi Chen, Pei Yang, Xintao Zeng, Sirui Chen, Decai Wang","doi":"10.1186/s12876-025-04006-7","DOIUrl":"10.1186/s12876-025-04006-7","url":null,"abstract":"<p><strong>Background: </strong>Relative fat mass (RFM) is a novel, easily calculated, and cost-effective index of fat content and distribution in the body, associated with the odds of developing various obesity-related diseases. However, its association with metabolic dysfunction associated steatotic liver disease (MASLD) and severe hepatic steatosis (SHS) is underexplored. This study aims to examine the relationship between RFM and the odds of having MASLD or SHS in the general adult population.</p><p><strong>Methods: </strong>This was a population-based cross-sectional study using data from the National Health and Nutrition Examination Survey (2017.01-2020.03). The aim of the statistical analysis was to examine the association between RFM and the prevalence of MASLD and SHS. Logistic regression was applied to explore this relationship. Nonlinear associations between RFM levels and MASLD or SHS prevalence were assessed using smoothed curve fitting and threshold effect models. Subgroup analyses were conducted to evaluate the consistency of this association across different population groups.</p><p><strong>Results: </strong>A total of 6699 participants were included in this study, of whom 2825 had MASLD and 1834 had SHS. After adjusting for confounders, significant positive associations were observed between RFM and the prevalence of MASLD and SHS (odds ratio [OR]: 1.22, 95% confidence interval [CI: ] 1.18-1.26 and OR: 1.26, 95% CI: 1.21-1.30). Smoothed curve fitting and threshold effect analysis showed a nonlinear relationship between RFM and the prevalence of MASLD and SHS, with thresholds of 41.96 for MASLD prevalence and 40.42 for SHS prevalence. When the subgroups were analyzed according to sex, age, race, education level, smoking status, household income, body mass index, hypertension, and diabetes, no significant interactions were found between RFM and most subgroups.</p><p><strong>Conclusions: </strong>Our results demonstrated a positive nonlinear relationship between RFM and the prevalence of MASLD and SHS, with a threshold effect. Lower RFM levels are associated with lower odds of MASLD and SHS. These findings suggest that RFM may serve as a simple, cost-effective tool for identifying individuals at increased odds of NAFLD and SHS in the general population.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"410"},"PeriodicalIF":2.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of the diagnosis of gastroesophageal reflux disease by a trial of potassium-competitive acid blocker treatment.","authors":"Peiwen Dong, Lin Lin, Kaidi Sun, Feng Tang, Qian Li, Xinxu Zhou, Fuli Liu, Zhilin Yang, Jiao Li, Lin Jiang, Ping Zhao, Xiaobin Sun, Qiong Wang","doi":"10.1186/s12876-025-03981-1","DOIUrl":"https://doi.org/10.1186/s12876-025-03981-1","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study was to explore the accuracy of the diagnosis of gastro-esophageal reflux disease (GERD) through tegoprazan treatment trials, and to analyze factors that may influence test accuracy.</p><p><strong>Methods: </strong>This was a single-blind, single-arm 2 weeks tegoprazan treatment trials from March 2023 to April 2024. Patients with 'typical' reflux or heartburn as their most troublesome symptom who were considered likely to have GERD were recruited.: Patients were submitted to endoscopy and/or esophageal pH monitoring. After the recording patient used tegoprazan for 2 weeks. This was defined as positive for tegoprazan therapy if the scores for symptoms have decreased to 50%, 75% and 100% of the baseline after 1 and 2 weeks. Calculate different sensitivity, specificity and Youden index for each criterion.</p><p><strong>Results: </strong>This represents a mid-term report from the study, with 98 and 91 fully evaluable at one and two weeks. The Youden index indicated that a symptom relief of > 75% after one week offers greater diagnostic value with sensitivity and specificity of 77.5% and 51.9%. Multivariate regression analysis indicated that lower BMI, preference for coffee, endoscopic mucosal erosion, ineffective esophageal peristalsis and positive SAP are independent risk factors predicting the efficacy of P-CAB treatment.</p><p><strong>Conclusions: </strong>The P-CAB test (tegoprazan) presents a promising tool for the diagnosis of GERD. A one-week treatment with a criterion of 75% reduction in symptom scores from baseline may be the most cost-effective approach.</p><p><strong>Trial registration: </strong>chictr.org.cn registration number ChiCTR2200065994.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"406"},"PeriodicalIF":2.5,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}