BMC Gastroenterology最新文献

{"title":"Real world clinical practice patterns in nocturnal GERD management: insights from nationwide RELIEF survey.","authors":"Sandip Pal, G Manoharan, Prashant Bhandarkar, P Manohar Reddy, Atul Shende, R S Arun, Balaji Laxminarayana Shetty B, Saptarshi Bishnu, Sanjeeb Roy, Sucheta Mehta, Namita Ghag, Apurva Jawdekar, Aniket Vaidya","doi":"10.1186/s12876-026-05084-x","DOIUrl":"10.1186/s12876-026-05084-x","url":null,"abstract":"<p><strong>Background and objectives: </strong>Nocturnal symptoms of GERD interfere with daytime functioning, work, and social activities, thereby negatively affecting health-related quality of life. Therefore, the present survey aimed to evaluate the clinical practice patterns regarding the management of nocturnal GERD in India.</p><p><strong>Methods: </strong>A digital questionnaire-based nationwide RELIEF survey was conducted among health care practitioners (HCPs) with gastroenterology practice across India. Physicians voluntarily responded to the survey questionnaire consisting of 24 questions based on their clinical experience. Following the collection of completed questionnaires, data were reviewed and analyzed.</p><p><strong>Results: </strong>Of the 500 HCPs who were approached, 498 completed the study. GERD contributed to > 30% of patient burden every month. According to 25.30% of HCPs, 21-30% of patients with GERD complain of nocturnal symptoms. The most common risk factors in patients with nocturnal GERD were late-night meals (67.67%), followed by smoking (51%), BMI > 25 kg/m² (50.20%), and a high-fat diet (50.40%). Most HCPs (83%) relied on symptoms and medical history to diagnose nocturnal GERD. A single-dose proton pump inhibitor (PPI) regimen was the most preferred treatment, reported by 31.53% of HCPs, with esomeprazole preferred by 54% of physicians. Efficacy (58.03%), minimum or no drug-drug interactions (29.92%), and cost (22.49%) are the important aspects for choosing a PPI. HCPs (63.18%) opted for 4-8 weeks of PPI therapy to achieve resolution of nocturnal GERD symptoms, followed by 3-6 months of maintenance therapy (57.95%). Common causes of non-adherence to PPIs, as reported by 80.72% of HCPs, were stopping treatment once symptoms improved (53.01%), cost (39.56%), and incomplete disease awareness (29.92%). Most of the HCPs (42.77%) reported no side effects with the use of PPIs.</p><p><strong>Conclusion: </strong>The survey highlighted key insights into managing nocturnal GERD in India, with nearly one-fourth of GERD patients reporting nocturnal symptoms like heartburn and regurgitation, emphasizing the need for lifestyle modifications and suitable pharmacological interventions. The management strategy primarily includes PPI therapy, with esomeprazole being the preferred choice for nocturnal GERD.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13681958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and biopsychosocial associations of functional constipation: a cross-sectional study among adults in Türkiye.","authors":"Cansu Memiç-İnan, Emre Duman, Eren Canbolat, Ayşe Nur Songür-Bozdağ, Mustafa Çapraz","doi":"10.1186/s12876-026-05062-3","DOIUrl":"10.1186/s12876-026-05062-3","url":null,"abstract":"<p><strong>Background: </strong>Functional constipation is a prevalent functional gastrointestinal disorder with substantial public health implications. Evidence on its biopsychosocial determinants in middle-income settings is limited. This study aimed to determine the prevalence of functional constipation and its associations with sociodemographic characteristics, dietary habits, eating behaviors, physical activity, and anthropometric factors among adults in Türkiye.</p><p><strong>Methods: </strong>This study was conducted with 429 individuals aged 19-64 years who presented for examination and follow-up at the Department of Internal Medicine outpatient clinic of a public hospital in Türkiye. Functional constipation was defined by Rome IV criteria. Constipation severity was assessed with the Constipation Severity Instrument. Eating disorder risk was screened using the five-item The Sick, Control, One Stone, Fat, Food (SCOFF) Questionnaire; picky eating was measured with the Adult Picky Eating Questionnaire. Anthropometrics were measured to compute body mass index (BMI). Physical activity and selected dietary frequencies were self-reported. Predictors of functional constipation were examined via binary logistic regression with covariates informed by prior literature. Statistical significance was set at α = 0.05.</p><p><strong>Results: </strong>Participants' mean age was 38.2 ± 15.0 years; 53.1% were female; 50.6% had BMI ≥ 25 kg/m². The prevalence of functional constipation was 21.0% (90/429). In multivariable analyses, higher age (OR = 1.029, 95% CI: 1.005-1.055) and female sex (OR = 1.899, 95% CI: 1.007-3.578) were associated with greater odds of functional constipation. Eating disorder risk was also associated with greater odds of functional constipation (per point on SCOFF: OR = 1.280, 95% CI: 1.024-1.600). In contrast, higher BMI was associated with lower odds (OR = 0.932, 95% CI: 0.879-0.989), and engaging in physical activity was associated with substantially lower odds of functional constipation (OR = 0.168, 95% CI: 0.095-0.300). Family history, smoking, alcohol use, water intake, and frequencies of meat, vegetable, and fruit consumption were not significant in the adjusted model; meal skipping showed borderline significance (OR = 2.001, 95% CI: 0.996-4.020; p = 0.051).</p><p><strong>Conclusions: </strong>The findings of the study indicate that functional constipation has a considerable prevalence in this clinical adult sample. Functional constipation was associated with older age, female sex, and eating disorder risk, and was inversely associated with higher BMI and physical activity. The results support the routine assessment of eating disorder risk and the promotion of physical activity as part of comprehensive management strategies. Prospective studies are needed to clarify the causal pathways underlying these observed associations.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of functional constipation and its associated factors among adults in Dar es Salaam, Tanzania: a population-based cross-sectional study.","authors":"David G Paulo, Sharon K Ismail, Ewaldo Vitus Komba","doi":"10.1186/s12876-026-05152-2","DOIUrl":"10.1186/s12876-026-05152-2","url":null,"abstract":"<p><strong>Background: </strong>Constipation is a common bowel complaint in the general population that can negatively impact quality of life. Epidemiological data on constipation in Africa particularly in Tanzania is limited. We aimed to determine the prevalence of functional constipation (FC) and its associated factors among community-dwelling adults in Dar es Salaam, Tanzania.</p><p><strong>Methods: </strong>This was a population-based cross-sectional study, conducted among 784 adults aged ≥ 18 years, from September to November 2019 in Temeke, Dar es salaam, Tanzania. A multistage, cluster random sampling technique was used to select participants. Data were collected at a household level using a structured questionnaire and a face-to-face interview. Rome IV diagnostic criteria were used to diagnose functional constipation. Data entry was done using EpiInfo version 7.2 (CDC, Georgia, USA) and analysed using Stata software 15.1 (StataCorp, Texas, USA). Logistic regression models were used to study the association between functional constipation and sociodemographic characteristics, diet, alcohol consumption, cigarette smoking and fluid intake. A P value of < 0.05 was considered significant.</p><p><strong>Results: </strong>Out of 784 participants, 98 (12.5%) met the Rome IV criteria for functional constipation. The prevalence of functional constipation was higher among females 76 (13.9%) than males 22 (9.2%) but the difference was not statistically significant (p = 0.650). In multivariable logistic regression analysis, age 50-59 years (aOR, 2.73; 95%CI, 1.22-6.12; p = 0.015), 60 + years (aOR 3.30; 95%CI, 1.43-7.61; p < 0.01) and past cigarette smoking (aOR, 3.38; 95%CI, 1.14-10.04; p < 0.028) were independently associated with an increased risk of FC. Fluid intake 1-1.5L per day (aOR, 0.33; 95%CI, 0.13-0.85; p < 0.022) and more than 1.5L per day (aOR, 0.31; 95%CI, 0.13-0.76; p < 0.010) was significantly associated with decreased odds of having FC.</p><p><strong>Conclusion: </strong>The prevalence of constipation was relatively high in the general adult population in Temeke. Participants with old age and past cigarette smoking history were more likely to suffer from constipation while higher fluid intake was associated with lower odds of functional constipation.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between serum uric acid and gallbladder stones in Korean women: a cross-sectional study of 19,329 cases.","authors":"Hoonsub So, Young-Jee Jeon, Doo-Ho Lim","doi":"10.1186/s12876-026-05138-0","DOIUrl":"https://doi.org/10.1186/s12876-026-05138-0","url":null,"abstract":"<p><strong>Background: </strong>Gallbladder stones represent a common gastrointestinal disorder influenced by various metabolic and lifestyle-related risk factors. Serum uric acid (UA), a byproduct of purine metabolism, has been suggested as a potential contributor to gallstone formation, but the association remains unclear. This study aimed to investigate the relationship between serum UA levels and gallbladder stone prevalence in Korean women.</p><p><strong>Methods: </strong>We conducted a retrospective, cross-sectional study of 19,329 Korean women who underwent abdominal ultrasonography as part of general health examinations. Participants were categorized into quartiles based on their serum UA levels. Multivariable logistic regression models were employed to evaluate the association between serum UA levels and gallbladder stone prevalence. Adjustments were made for potential confounders, including age, body mass index, lifestyle factors, and metabolic parameters.</p><p><strong>Results: </strong>The mean age of the participants was 48.4 ± 10.3 years, with a mean serum UA level of 4.23 ± 0.91 mg/dL. The prevalence of gallbladder stones increased significantly across serum UA quartiles, from 4.0% in the lowest quartile to 6.0% in the highest quartile (p < 0.001). In the fully adjusted model, participants in the highest quartile had a significantly higher risk of gallbladder stones compared to those in the lowest quartile (OR: 1.430, 95% CI: 1.174-1.740, p < 0.001).</p><p><strong>Conclusions: </strong>Elevated serum UA levels were significantly associated with an increased prevalence of gallbladder stones in Korean women. This association remained significant after adjustment for multiple potential confounders. Further prospective studies are needed to clarify the temporal relationship between serum UA and gallstone development and to determine the clinical significance of this association.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-, endoscopist-, and procedure-related factors associated with adenoma detection in first screening colonoscopies at a Lebanese tertiary hospital: a retrospective cohort study.","authors":"Mariane Ibrahim Ghantous, Nadeen Zayour, Nadia Al Sabagh, Nada Mchawrab, Ogarite Kattan, Omar Eljammal, Sally El Hajj Ahmad, Maha Hoteit, Zahra Sadek, Bilal Hoteit, Nikolaos Tzenios, Mahmoud Hallal","doi":"10.1186/s12876-026-05158-w","DOIUrl":"10.1186/s12876-026-05158-w","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) is a leading cause of cancer-related deaths worldwide, and is largely preventable through colonoscopy, during which adenomatous polyps can be detected and removed. The adenoma detection rate (ADR) and polyp detection rate (PDR) are key quality indicators of colonoscopy quality and are inversely associated with post-colonoscopy CRC. These indicators may be influenced by patient-, physician-, and procedure-related factors. This study aimed to evaluate the ADR and PDR, identify factors influencing these indicators, and compare them among gastroenterologists at a Lebanese medical center.</p><p><strong>Methods: </strong>This observational, single-center, retrospective cohort study included 257 patients aged 50-75 years who underwent first-time screening colonoscopy over 3 years. Data on patient characteristics and colonoscopy findings were collected. ADR and PDR were calculated according to established guidelines, with ADR additionally estimated using the adenoma-to-polyp detection rate quotient (APDRQ). Descriptive statistics were applied, and chi-square or Fisher's exact tests were used to assess associations between patient-, physician-, and procedural related factors and adenoma detection.</p><p><strong>Results: </strong>Out of 257 patients, 159 had polyps detected during colonoscopy. The overall ADR was 44.4%, and the PDR was 61.8% over the three-year study period. The ADR was 52.1% in men and 38.0% in women, whereas the PDR was 68.6% in men and 56.3% in women. Although the overall ADR and PDR met or exceeded the recommended benchmarks, disparities were noted in detection rates between males and females. Bowel preparation quality and guarantor type significantly influenced adenoma detection, whereas other factors related to patients and endoscopists had no significant effect. The estimated ADRs derived from the PDRs for five endoscopists were also high, surpassing the 25% benchmark; however, their annual estimated ADRs were relatively below this threshold.</p><p><strong>Conclusion: </strong>This study provides valuable regional data and underscores the need for standardized quality monitoring and further multicentric prospective research to optimize CRC prevention in Lebanon.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13679282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-adjusted eosinophilia in preterm infants with feeding intolerance: a retrospective cohort study.","authors":"Ozge Serce Pehlevan, Merve Cekildas, Ayla Gunlemez","doi":"10.1186/s12876-026-05093-w","DOIUrl":"10.1186/s12876-026-05093-w","url":null,"abstract":"<p><strong>Purpose: </strong>Feeding intolerance (FI) remains diagnostically challenging because of nonspecific symptoms and overlap with multiple gastrointestinal conditions. This study investigated the association between peripheral eosinophilia and FI in preterm infants with exploratory evaluation of necrotizing enterocolitis (NEC) and cow's milk protein-related gastrointestinal disease in relation to eosinophilia.</p><p><strong>Methods: </strong>In this retrospective cohort study, 122 preterm infants (< 34 weeks' gestation, < 2000 g) with eosinophil counts ≥ 700/mm³ were included. Infants were subsequently reclassified according to gestational- and postnatal-age-adjusted eosinophil reference values. Clinical features of FI, NEC, and cow's milk protein-related gastrointestinal disease were compared between infants with and without age-adjusted eosinophilia. Multivariable logistic regression was used to explore clinical variables independently associated with feeding intolerance.</p><p><strong>Results: </strong>Age-adjusted eosinophilia was present in 100 infants. FI was more frequent in eosinophilic infants (86% vs. 63.6%, p = 0.027), with longer feeding interruption (median 2 vs. 0.5 days, p = 0.028), more abdominal distension (60% vs. 31.8%, p = 0.019), and prolonged hospitalization (60 vs. 41 days, p = 0.034). In the primary multivariable model, age-adjusted eosinophilia was independently associated with feeding intolerance (OR 6.00; 95% CI 1.32-27.26; p = 0.020), although the association was attenuated in sensitivity analysis (OR 2.87; 95% CI 0.86-9.58; p = 0.087). All 13 NEC cases occurred in eosinophilic infants, although the temporal relationship between eosinophilia and NEC varied. Suspected cow's milk protein-related gastrointestinal disease was identified in 11 infants, all of whom showed clinical improvement following dietary elimination.</p><p><strong>Conclusions: </strong>Age-adjusted eosinophilia was frequently observed in preterm infants with FI and more severe gastrointestinal manifestations. While unlikely to be causally related to FI, it may reflect an accompanying immune or inflammatory response during gastrointestinal disease. Eosinophil counts may provide supportive information in selected infants with persistent FI or NEC-like presentations, particularly when alternative inflammatory gastrointestinal processes are being considered.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An ensemble machine learning approach for predicting colorectal polyps using novel inflammatory markers.","authors":"Linxiao Zhang, Yingfei Wu, Qi Jin, Ying Wen, Yuxi Wang, Han Qi, Xiaoning Zhang, Weihua Yu","doi":"10.1186/s12876-026-05106-8","DOIUrl":"10.1186/s12876-026-05106-8","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the associations of two novel inflammatory-nutritional markers, the C-reactive Protein-Albumin-Lymphocyte (CALLY) index and C-reactive protein-to-lymphocyte ratio (CLR), with colorectal polyps, and to develop machine learning models for improved risk prediction.</p><p><strong>Methods: </strong>The study conducted a retrospective analysis of 946 patients who underwent colonoscopy at the Second Qilu Hospital of Shandong University from 2023 to 2024. Clinical, laboratory, and endoscopic data were retrieved. Four machine learning models were developed: Random Forest (RF), Support Vector Machine (SVM), eXtreme Gradient Boosting (XGBoost), and Light Gradient Boosting Machine (LightGBM). Additionally, a Stacking ensemble model was constructed, integrating RF, XGBoost, and SVM with logistic regression as the meta-learner. Model performance was evaluated using metrics including the Area Under the Curve (AUC), accuracy, precision, recall, F1-score, and Kappa coefficient.</p><p><strong>Results: </strong>Both the CALLY index and CLR were significantly associated with the presence of colorectal polyps. The Stacking ensemble model achieved the highest predictive performance (AUC: 0.96), outperforming all individual base models. The RF, SVM, and XGBoost models also attained robust predictive capability (AUC: 0.75-0.76). By comparison, LightGBM exhibited suboptimal performance (AUC = 0.72). Feature importance analysis revealed CA19-9 as the top predictive factor.</p><p><strong>Conclusion: </strong>Elevated CLR and reduced CALLY index, together with traditional risk factors, synergistically contribute to colorectal polyp formation. The Stacking ensemble model serves as a highly accurate tool for identifying individuals at high risk of colorectal polyps, thereby facilitating targeted screening and timely early intervention. These findings support the incorporation of multi-dimensional inflammatory-nutritional biomarkers and machine learning strategies into clinical practice to optimize Colorectal Cancer (CRC) prevention.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13679232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge levels of physiotherapy students on celiac disease: an exploratory cross-sectional study.","authors":"Hayriye Kul Karaali̇, Nazlı Demi̇r, Özlem Özcan, Berra Si̇rek, Elif Başbelen","doi":"10.1186/s12876-026-05144-2","DOIUrl":"10.1186/s12876-026-05144-2","url":null,"abstract":"<p><strong>Introduction: </strong>Future physiotherapists may contribute to multidisciplinary care for individuals with celiac disease; however, evidence regarding their knowledge levels remains limited. This exploratory study aimed to address this gap.</p><p><strong>Materials and methods: </strong>This cross-sectional study included 297 physiotherapy students. Data were collected online using a researcher-developed 30-item questionnaire assessing knowledge of celiac disease symptoms, diagnosis-treatment, and disease-related considerations. Knowledge scores were calculated based on correct responses, with a maximum score of 59, and statistical analyses were performed to examine associated factors.</p><p><strong>Results: </strong>Among the 297 participants, 91.6% reported having previously heard of celiac disease. The median total knowledge score was 15.0 out of 59. While 62.5% of participants selected \"I don't know\" for extraintestinal manifestations, 39.0% reported no knowledge regarding diagnostic methods. Although exercise was considered beneficial by 64.0% of participants, only 8.7% identified high-intensity interval training. Female students had higher total knowledge scores than male students [16.0 (11.25-23.0) vs. 12.0 (5.0-18.0); p = 0.001]. In multivariable analysis, female gender (B = 4.763; p = 0.001) and being a third- or fourth-year student were associated with higher total knowledge scores.</p><p><strong>Discussion: </strong>This exploratory study suggests preliminary knowledge gaps among physiotherapy students regarding celiac disease, particularly extraintestinal involvement, diagnostic approaches, and disease-specific rehabilitation-related considerations.</p><p><strong>Conclusion: </strong>The findings should be interpreted cautiously but may support considering disease-specific educational content within multidisciplinary physiotherapy training.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between the PNPLA3 I148M (rs738409) polymorphism and risk of metabolic dysfunction-associated steatotic liver disease: a meta-analysis (2015-2025).","authors":"Muteia'a Hamood, Mohammed Ahmed Al-Salehi, Ali F Hussein, Khalid Mohammed Naji, Rakesh Rawal","doi":"10.1186/s12876-026-05160-2","DOIUrl":"10.1186/s12876-026-05160-2","url":null,"abstract":"<p><strong>Background: </strong>Metabolically-dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease worldwide and is strongly influenced by genetic susceptibility. Among the identified genetic variants, the patatin-like phospholipase domain-containing protein 3 (PNPLA3) rs738409 (I148M) polymorphism has been consistently associated with hepatic steatosis and disease progression. However, previous meta-analyses included fewer studies, limited ethnic diversity, and insufficient investigation of between-study heterogeneity. This study aimed to comprehensively evaluate the association between the PNPLA3 rs738409 polymorphism and MASLD susceptibility.</p><p><strong>Methods: </strong>A systematic literature search was conducted in PubMed, Embase, Scopus, Web of Science, and Google Scholar to identify eligible case-control studies published between 2015 and 2025. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated under allelic, dominant, homozygous, heterozygous, and combined genotype models using random-effects meta-analysis. Between-study heterogeneity was assessed using the I² statistic, and ethnicity-based subgroup analyses were performed to investigate potential sources of heterogeneity.</p><p><strong>Results: </strong>Forty-one studies comprising 9,064 patients with MASLD and 10,894 controls were included. The G allele was significantly associated with increased susceptibility to MASLD (OR = 1.70, 95% CI: 1.49-1.93). Individuals carrying the GG genotype had approximately a twofold higher risk of MASLD (OR = 2.00, 95% CI: 1.65-2.42), whereas the CC genotype showed a protective association (OR = 0.51, 95% CI: 0.44-0.59). Significant associations were also observed for the CG genotype (OR = 1.22, 95% CI: 1.08-1.38) and the dominant model (CG + GG vs. CC) (OR = 2.64, 95% CI: 1.86-3.75). Although substantial between-study heterogeneity was observed (I² = 66%-96%), ethnicity-based subgroup analyses explained part of the variability while demonstrating consistent associations across major ethnic populations.</p><p><strong>Conclusions: </strong>This updated meta-analysis confirms that the PNPLA3 rs738409 (I148M) polymorphism is a major genetic susceptibility factor for MASLD across diverse populations. Although ethnicity contributes to between-study heterogeneity, the association remains robust across populations. These findings support the incorporation of PNPLA3 into multifactorial risk assessment models and provide an updated evidence base for future precision medicine approaches in MASLD.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of neutrophil-to-high-density lipoprotein ratio with all-cause mortality among individuals with non-alcoholic fatty liver disease: the NHANES database prospective cohort study.","authors":"Yawei Xing, Jie Wang, Hebo Cheng, Mengwei Xiao, Fan Du, Mengjun Qiu","doi":"10.1186/s12876-026-05136-2","DOIUrl":"10.1186/s12876-026-05136-2","url":null,"abstract":"<p><strong>Background: </strong>Non-alcoholic fatty liver disease (NAFLD) is a global public health crisis linked to elevated all-cause and cardiovascular mortality. The neutrophil-to-high-density lipoprotein ratio (NHR) is an emerging inflammatory-lipid biomarker that integrates systemic inflammation and lipid dysregulation. However, its prognostic value for long-term mortality in NAFLD remains undetermined.</p><p><strong>Methods: </strong>We conducted a population-based prospective cohort study using data from the National Health and Nutrition Examination Survey (NHANES) 1999-2018. A total of 5,320 participants diagnosed with NAFLD were enrolled and divided into four groups according to quartiles of NHR (Q1-Q4). Multivariate Cox regression, restricted cubic spline, threshold effect, and subgroup analyses were used to evaluate the association between NHR and all-cause mortality.</p><p><strong>Results: </strong>During a mean follow-up of 9.2 years, 1,172 all-cause deaths and 392 cardiovascular disease (CVD) deaths were documented. In the fully adjusted Cox models, higher NHR was significantly associated with elevated risks of all-cause mortality (HR = 1.27, 95% CI: 1.02-1.57) and CVD mortality (HR = 2.15, 95% CI: 1.44-3.22) in a dose-response manner, but not with cancer mortality. Further adjustment for blood lipids and hepatic function markers did not materially alter the results, supporting the robustness of the observed associations. Threshold and spline analyses further revealed a significant nonlinear relationship between NHR and all-cause mortality, with an inflection point of 2.072, when NHR was equal to or above 2.072, each 1-unit increase was associated with an 8% elevation in all-cause mortality risk (HR = 1.08, 95% CI: 1.04-1.12, P < 0.001). Subgroup stratified analyses were performed as exploratory analyses. Although the association between elevated NHR and all-cause mortality reached statistical significance within several individual subgroups, no significant multiplicative interaction was detected for any stratifying factor, indicating no meaningful effect modification across these population strata.</p><p><strong>Conclusion: </strong>Elevated NHR is independently associated with an increased risk of all-cause and cardiovascular mortality in NAFLD patients. NHR may serve as a simple, inexpensive, and readily available prognostic biomarker for risk stratification and clinical management in this population.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}