BMC Gastroenterology最新文献

{"title":"Associations of abnormal blood lipid levels with hospitalization cost and disease severity in patients with hyperlipidemic pancreatitis: a retrospective cohort study.","authors":"Wenna Xu, Jichen Wang, Yang Zong, Qiang Fu, Ping Liu, Dao'an Ma, Kun Li, Yee Chao, Zhenxing Zeng, Min Wang, Minxuan Hu, Guozhong Ji","doi":"10.1186/s12876-026-05143-3","DOIUrl":"10.1186/s12876-026-05143-3","url":null,"abstract":"<p><strong>Background: </strong>Hyperlipidemic pancreatitis (HLP) carries a considerable clinical and economic burden. This retrospective study examined how abnormal blood lipid levels relate to hospitalization cost and disease severity in patients with HLP, with the aim of informing risk stratification and lipid management in clinical practice.</p><p><strong>Methods: </strong>We retrospectively reviewed 117 patients with HLP accounting for 171 hospitalizations at Jen Ching Memorial Hospital between January 2018 and June 2025. Total hospitalization cost (THC) was analyzed by gamma regression and length of stay (LOS) by negative binomial regression, with cluster-robust standard errors to account for repeated hospitalizations in the same patient.</p><p><strong>Results: </strong>At the first hospitalization, the median triglyceride (TG) level was 13.56 mmol/L and the median total cholesterol (TC) level was 8.89 mmol/L. The median LOS was 6 days and the median THC was 10,920.44 yuan (US$1,528.85). In multivariable analyses, both lipids were positively associated with THC. Each 1 mmol/L increase in TG corresponded to a 2.2% higher THC (approximately 240 yuan; US$33.60) (rate ratio [RR] = 1.022, 95% confidence interval [CI] = 1.008-1.040, P = 0.013). Each 1 mmol/L increase in TC corresponded to a 5.3% higher THC (approximately 580 yuan; US$81.20) (RR = 1.053, 95% CI = 1.004-1.098, P = 0.046). Higher TG levels were further associated with greater odds of intensive care unit (ICU) transfer and complications.</p><p><strong>Conclusion: </strong>Higher TG and TC levels were associated with greater hospitalization cost, and higher TG levels with severity-related indicators. These associations suggest that lipid levels may be useful for risk stratification in patients with HLP.</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/PMC13670667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547880","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":"Gender differences in the relationship between dynapenic abdominal obesity and non-neoplastic digestive system diseases among middle-aged and older adults.","authors":"Xuetao Dong, Yan Zhang, Yandi Liu, Muran Li","doi":"10.1186/s12876-026-05092-x","DOIUrl":"10.1186/s12876-026-05092-x","url":null,"abstract":"<p><strong>Background: </strong>Non-neoplastic digestive system diseases (NNDSD) are highly prevalent among middle-aged and older adults and represent a substantial global health burden. Dynapenic abdominal obesity (DAO), a clinical phenotype characterized by low muscle strength (dynapenia) combined with abdominal obesity, has been associated with a range of chronic diseases. However, the prospective association between DAO and incident NNDSD has not yet been elucidated. This study aimed to examine the prospective association between DAO and the risk of new-onset NNDSD.</p><p><strong>Methods: </strong>A total of 5,956 participants from five waves of the China Health and Retirement Longitudinal Study were included in the present analysis. Participants were classified into four groups: non-dynapenic/non-abdominally obese (ND/NAO), abdominal obesity only (ND/AO), dynapenia only (D/NAO), and DAO. Multivariable Cox proportional hazards models were employed to evaluate the association between DAO and incident NNDSD.</p><p><strong>Results: </strong>During a median 9-year follow-up, 1,082 incident cases of NNDSD were identified. In the overall population, participants with DAO exhibited a significantly higher risk of NNDSD than those in the ND/NAO group (HR = 1.597, 95% CI: 1.121-2.276). Notably, a pronounced sex-specific difference was observed. A significant association was observed among women (HR = 1.820, 95% CI: 1.235-2.683), whereas no significant association was identified among men.</p><p><strong>Conclusion: </strong>The coexistence of dynapenia and abdominal obesity was associated with an increased risk of incident NNDSD among middle-aged and older women, whereas no such association was observed among men. Early identification of the DAO phenotype may facilitate the implementation of targeted preventive interventions, including combined resistance and aerobic exercise programs, to reduce the risk of NNDSD.</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/PMC13673782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547813","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":"Beyond Gilbert syndrome: exploring the heterozygous UGT1A1 c.41_40dup variant as a potential modifier of bile composition associated with a cholangiopathic phenotype in adults with unexplained chronic cholestasis.","authors":"Alessandro Federico, Mario Romeo, Fiammetta Di Nardo, Carmine Napolitano, Alessia De Gregorio, Claudio Basile, Giusy Senese, Marcello Dallio","doi":"10.1186/s12876-026-05132-6","DOIUrl":"10.1186/s12876-026-05132-6","url":null,"abstract":"<p><strong>Background: </strong>Unexplained chronic cholestasis (UCC) in adults is traditionally interpreted as a hepatocellular or canalicular disorder; however, a subset of patients may instead exhibit a cholangiopathy-driven phenotype. Uridine diphosphate glucuronosyltransferase 1A1 (UGT1A1) plays a key role in bilirubin conjugation and bile composition. The heterozygous UGT1A1 c.41_40dup variant, classically associated with Gilbert Syndrome (GS), is frequently observed in individuals without overt GS. In this setting, reduced UGT1A1 activity has been associated with the production of a bile characterized by an increased proportion of bilirubin monoglucuronide (BMG) and a reduced proportion of bilirubin diglucuronide (BDG). The present study investigates whether this variant contributes to a bile composition-driven cholangiopathic phenotype characterized by chronic biliary epithelial injury.</p><p><strong>Methods: </strong>Seventeen UDCA-naïve, GS-free adults with UCC were enrolled and stratified according to genetic profile: Group A (UGT1A1 c.41_40dup), Group B (UGT1A1 c.41_40dup plus additional variants), and Group C (non-carriers). Biochemical, histological, and clinical features were assessed. UGT1A1 activity and bilirubin conjugate composition (BMG/BDG ratio) were evaluated using high-performance liquid chromatography. At 6 months, biochemical evolution was assessed using ALP levels (> 1.9 × ULN) as a pragmatic benchmark.</p><p><strong>Results: </strong>Patients carrying the UGT1A1 c.41_40dup variant (Group A and B) exhibited significantly reduced enzymatic activity and an increased intrahepatic BMG/BDG ratio compared with non-carriers (both p < 0.0001), along with a higher prevalence of gallstone-related manifestations. Despite normal serum bilirubin, they showed a biochemical profile characterized by persistent ALP and GGT elevation, along with a descriptive pattern of more frequent advanced fibrosis among variant carriers. The overall clinical and biochemical pattern was consistent with a cholangiopathy-associated, ascending cholestasis phenotype. At 6 months, ALP levels > 1.9 × ULN were observed in 70% of variant carriers and 28% of non-carriers; however, this difference did not reach statistical significance after re-analysis using Fisher's exact test and should be interpreted as exploratory.</p><p><strong>Conclusions: </strong>The heterozygous UGT1A1 c.41_40dup variant may contribute to a bile composition-driven cholangiopathic phenotype, promoting secondary biliary injury, consistent with a hypothesis-generating model. These findings support its role as a non-canonical modifier of cholestatic disease and underscore the importance of bile composition in shaping disease expression.</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/PMC13673756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547843","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 role of machine perfusion in preventing recurrence after liver transplant for hepatocellular carcinoma: a systematic review and meta-analysis.","authors":"Ibrahim U Garzali, Ez El Din Abou Zeid, Ali Aloun, Amina I Elyakub, Abdurrahman A Sheshe","doi":"10.1186/s12876-026-05142-4","DOIUrl":"10.1186/s12876-026-05142-4","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) is a leading indication for liver transplantation (LT), but post-transplant recurrence remains a major cause of treatment failure. Ischemia-reperfusion injury (IRI) has been implicated in tumor recurrence through modulation of the hepatic microenvironment. Machine perfusion (MP) techniques reduce IRI and may improve oncologic outcomes. This systematic review and meta-analysis evaluated the impact of MP versus static cold storage (SCS) on HCC recurrence following LT.</p><p><strong>Methods: </strong>A systematic search of PubMed, CENTRAL, Scopus, Google Scholar and ClinicalTrials.gov was conducted from database inception to January 31, 2026. Studies comparing HCC recurrence after LT using MP or SCS graft preservation were included. The primary outcome was post-transplant HCC recurrence. Secondary outcomes included microvascular invasion (MVI), pre-transplant alpha-fetoprotein (AFP), Milan criteria status, and neoadjuvant therapies. Pooled odds ratios (ORs) and standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using RevMan 5.4.1.</p><p><strong>Results: </strong>Ten studies involving 6,652 patients (4,944 SCS and 1,708 MP) were included. Nine studies evaluated hypothermic oxygenated perfusion and one assessed ischemia-free liver transplantation. Meta-analysis demonstrated a significantly higher risk of HCC recurrence in the SCS group compared with the MP group (OR 2.34, 95% CI 1.40-3.91; p = 0.001; I²=53%). Sensitivity analysis confirmed the robustness of the finding (OR 2.26, 95% CI 1.48-3.45; p = 0.0002; I²=22%). Subgroup analysis restricted to hypothermic oxygenated perfusion also favored MP (OR 1.97, 95% CI 1.25-3.10; p = 0.003). No significant differences were observed between groups regarding pre-transplant AFP levels (SMD 0.02, 95% CI - 0.09 to 0.13; p = 0.68), Milan criteria status (OR 0.83, 95% CI 0.59-1.19; p = 0.32), use of neoadjuvant therapies, or MVI.</p><p><strong>Conclusions: </strong>Machine perfusion for liver graft preservation is associated with a lower risk of HCC recurrence after liver transplantation compared with static cold storage. This benefit appears independent of baseline tumor characteristics and pre-transplant treatments. Given the predominance of retrospective studies, further prospective multicenter studies and randomized controlled trials are needed to confirm these findings and define the oncologic role of machine perfusion in liver transplantation for HCC.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535219","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":"Accelerated biological aging and the risk of incident liver cancer: a prospective cohort study of the UK biobank.","authors":"Xiaojuan Liu, Shuangshuang Yang, Conghui Zhang, Ping Chen, Jiangping Li","doi":"10.1186/s12876-026-05103-x","DOIUrl":"10.1186/s12876-026-05103-x","url":null,"abstract":"<p><strong>Background: </strong>While conventional risk factors for liver cancer are well-established, the contribution of biological aging to hepatocarcinogenesis remains poorly understood, representing an important gap in its etiological framework.</p><p><strong>Methods: </strong>We conducted a prospective cohort study using data from the UK Biobank (UKB). Biological age (BA) was assessed using the Klemera-Doubal method (KDM-BA) and PhenoAge algorithms. Multivariable Cox proportional hazards models were used to evaluate associations between BA acceleration and liver cancer incidence, with robustness assessed using restricted cubic splines, subgroup analyses, and sensitivity analyses. Mediation analyses evaluated whether alanine aminotransferase (ALT) and aspartate aminotransferase (AST) mediate the relationship between biological aging and liver cancer.</p><p><strong>Results: </strong>The study included 274,966 participants (mean age 55.75 ± 8.10 years; 53.8% female). Over a median follow-up of 14.67 years, 325 incident liver cancer cases were documented. After multivariable adjustment, each 1-standard deviation (SD) increase in BA acceleration was associated with an elevated liver cancer risk (KDM-BA acceleration: HR = 1.28, 95%CI 1.16-1.41; PhenoAge acceleration: HR = 1.32, 95%CI 1.22-1.43). A nonlinear dose-response relationship was observed between KDM-BA acceleration and liver cancer risk (P < 0.001). Exploratory mediation analyses indicated that the effect of KDM-BA acceleration may be partially mediated by ALT and AST, whereas PhenoAge acceleration appeared to act primarily through direct mechanisms.</p><p><strong>Conclusions: </strong>Accelerated biological aging, as quantified by KDM-BA and PhenoAge, appears to be independently associated with incident liver cancer. The underlying pathways may differ: KDM-BA acceleration is partially mediated by liver enzymes, while PhenoAge acceleration appears to operate largely through direct mechanisms.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535285","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":"Comparative study on the detection efficacy of KU-F50 centrifugal method and routine detection methods for gastrointestinal parasites.","authors":"Rongjiang Liu, Kaili Qin, Shaoheng Huang, Qian Sun, Chu Huang, Lin Liao, Faquan Lin","doi":"10.1186/s12876-026-05120-w","DOIUrl":"10.1186/s12876-026-05120-w","url":null,"abstract":"<p><strong>Objective: </strong>To compare the detection performance of three automated fecal methods for common gastrointestinal parasites and assess the analytical validity of the KU-F50 centrifugal sedimentation method.</p><p><strong>Methods: </strong>A total of 1,290 fecal samples submitted to a hospital from December 10, 2025, to January 15, 2026, were collected. Parallel testing was performed using the KU-F50 centrifugal sedimentation method, the KU-F50 routine detection method, and the KU-F40 routine detection method. Cochran's Q test was used to compare the overall detection rates and the detection rates of various parasite eggs among the three methods.Pairwise comparisons were performed using the McNemar test and Bonferroni correction.</p><p><strong>Results: </strong>The total detection rates for the three methods were 15.81% (204/1290), 14.50% (187/1290), and 13.02% (168/1290), respectively, with a statistically significant difference (Q = 8.763, P = 0.013). Pairwise comparisons were performed using the McNemar test, and the Bonferroni method was adopted to adjust the significance level ([Formula: see text]=0.0167). The results indicated that the overall detection rate of the KU-F50 centrifugal sedimentation method was significantly higher than that of the KU-F40 routine detection method (P = 0.008).Subgroup analysis of individual parasite eggs resealed a statistically significant difference in the detection rate of Clonorchis sinensis eggs among the three methods (Q = 12.365,P = 0.002). Further pairwise comparisons with Bonferroni correction ([Formula: see text]=0.0167) showed that the KU-F50 centrifugal sedimentation method achieved a significantly higher detection rate for Clonorchis sinensis eggs than the KU-F40 routine detection method (P = 0.001). Gradient dilution experiments with Entamoeba samples showed that the KU-F50 centrifugal sedimentation method exhibited a positive deviation at low dilution factors (74.00%~122.00%) and a reduced deviation at high dilution factors (-10.00%~-20.00%). Both the KU-F50 routine detection method and the KU-F40 routine detection method showed negative deviations across the entire gradient. In simulated samples with 5, 10, and 15 pcs/mL, the detection rates of the KU-F50 centrifugal method reached 50%, 80%, and 80%, respectively, which were significantly higher than those of the other two methods (0%~20%). The automatic recognition precision and recall rates of the KU-F50 centrifugal sedimentation method for Clonorchis sinensis eggs were 98.08% and 98.46%, respectively.</p><p><strong>Conclusion: </strong>The KU-F50 Centrifugal sedimentation method yields relatively higher detection rates for digestive tract parasites. Its testing results are in good consistency with manual interpretation, and it shows remarkable advantages in detecting Clonorchis sinensis eggs, possessing certain clinical application potential.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535248","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":"Cholangioscopy-guided laser lithotripsy for difficult pancreatobiliary duct stones: a single-center experience with high single-session duct clearance.","authors":"Şakir Karpuz, Mümin Coşkun","doi":"10.1186/s12876-026-05134-4","DOIUrl":"10.1186/s12876-026-05134-4","url":null,"abstract":"<p><strong>Background and study aims: </strong>The management of difficult pancreatobiliary duct stones remains challenging, particularly in patients with large or impacted stones, unfavorable anatomy, or prior failed endoscopic interventions. Peroral cholangioscopy-guided laser lithotripsy has emerged as a promising therapeutic approach; however, real-world data from consecutive single-center experiences are limited. This study aimed to describe the technical feasibility, procedural outcomes, and safety of cholangioscopy-guided laser lithotripsy in patients with difficult pancreatobiliary duct stones.</p><p><strong>Patients and methods: </strong>This retrospective single-center study included a consecutive series of 16 patients with difficult pancreatobiliary duct stones who underwent peroral cholangioscopy-guided Holmium:YAG laser lithotripsy after unsuccessful conventional endoscopic extraction. Technical success, complete duct clearance, procedural characteristics, and adverse events were analyzed.</p><p><strong>Results: </strong>Technical success was achieved in all patients (100%; exact 95% CI 79.4-100%), with complete duct clearance obtained in a single session in all cases.The median procedure time was 70 min (IQR 59-85; range 50-130). All patients had undergone prior ERCP attempts, with a median of 2 previous procedures. Adverse events occurred in 3 patients (18.7%) and were all mild, including post-procedural pain (12.5%) and mild post-ERCP pancreatitis (6.2%). No severe complications, such as perforation, clinically significant bleeding, or cholangitis, were observed.</p><p><strong>Conclusions: </strong>In this small, heterogeneous single-center series, cholangioscopy-guided laser lithotripsy was technically feasible and was associated with complete duct clearance in a single treatment session in all patients, with only mild adverse events observed. These findings provide descriptive data supporting the potential role of this technique in selected patients with difficult pancreatobiliary duct stones, particularly after unsuccessful conventional endoscopic interventions.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535257","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":"Risk factors and development of a predictive model for chronic kidney disease in patients with metabolic dysfunction-associated steatotic liver disease.","authors":"Jiaojiao Zhu, Yiwen Liu, Siqian Lu, Yiwen Han, Wangpeng Zhao, Lishuai Qu, Jinxia Liu","doi":"10.1186/s12876-026-05076-x","DOIUrl":"10.1186/s12876-026-05076-x","url":null,"abstract":"<p><strong>Aim: </strong>To identify risk factors for chronic kidney disease (CKD) in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) and to develop a risk prediction model for CKD comorbidity within this population, thereby facilitating targeted prevention and early screening.</p><p><strong>Methods: </strong>We retrospectively enrolled 8,975 MASLD patients diagnosed by color Doppler ultrasonography at the Affiliated Hospital of Nantong University between 2021 and 2023. Participants were categorized into CKD and non-CKD groups based on standard diagnostic criteria. Baseline biochemical parameters, including markers of glucose, lipid metabolism, inflammation, and organ function, were compared between two groups. Independent predictors were identified using multivariable logistic regression and incorporated into a nomogram. Model performance was temporally validated in an independent MASLD cohort from 2024 via receiver operating characteristic (ROC) curve analysis, calibration plots, and decision curve analysis (DCA).</p><p><strong>Results: </strong>Compared with the non-CKD group, the CKD group exhibited significantly higher levels of systolic blood pressure, creatinine, triglycerides, and uric acid to high-density lipoprotein cholesterol ratio, but lower hemoglobin compared with the non-CKD group (P < 0.05). Age, systolic blood pressure, hemoglobin, triglycerides, and uric acid to high-density lipoprotein cholesterol ratio were identified as independent predictors of MASLD with CKD. The developed nomogram exhibited strong discriminative power, consistent calibration during temporal validation, and demonstrated favorable net benefit across clinically relevant threshold probabilities in the DCA.</p><p><strong>Conclusion: </strong>The accurate estimation of CKD risk in patients with MASLD is effectively achieved via a nomogram incorporating routinely available clinical indicators, thereby facilitating early screening and individualized interventions for high-risk patients.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535267","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":"Timing of endoscopy and short-term outcomes in cirrhotic patients with acute variceal bleeding: a single-center retrospective study.","authors":"Weixu Chen, Zhiyuan Lu, Hai Wu, Ruihua Shi","doi":"10.1186/s12876-026-05133-5","DOIUrl":"10.1186/s12876-026-05133-5","url":null,"abstract":"<p><strong>Background: </strong>The optimal timing of endoscopy for acute variceal bleeding (AVB) remains uncertain in real-world clinical practice. This study aimed to evaluate the association between endoscopy timing and short-term outcomes in patients with AVB.</p><p><strong>Methods: </strong>We retrospectively included cirrhotic patients with endoscopically confirmed AVB admitted between January 2020 and April 2025 who underwent endoscopic therapy during hospitalization. Patients were categorized according to time from admission to endoscopy: <24 h, 24-72 h, and ≥ 72 h. The primary outcomes were 6-week mortality and rebleeding. Secondary outcomes included length of hospital stay, hospitalization cost, and transfusion requirements. Multivariable logistic regression, Firth penalized logistic regression, subgroup analyses, and sensitivity analyses were performed.</p><p><strong>Results: </strong>A total of 213 patients were included. Compared with endoscopy within 24 h, endoscopy at 24-72 h was associated with higher odds of 6-week mortality (aOR 21.7, 95% CI 2.50-390, p = 0.003) and rebleeding (aOR 3.35, 95% CI 1.12-11.0, p = 0.036). Endoscopy at ≥ 72 h was associated with higher odds of 6-week mortality in the main model (aOR 9.77, 95% CI 1.12-172, p = 0.038), but this association was less consistent across sensitivity analyses. Sensitivity analyses generally supported the association observed for the 24-72 h group. For secondary outcomes, delayed endoscopy was associated with longer hospital stay, whereas endoscopy at 24-72 h was associated with lower transfusion requirements.</p><p><strong>Conclusions: </strong>Endoscopy timing was associated with short-term outcomes in patients with AVB. Endoscopy at 24-72 h was associated with higher odds of 6-week mortality and rebleeding compared with endoscopy within 24 h, whereas findings for endoscopy beyond 72 h were less consistent across sensitivity analyses. These findings support individualized endoscopy timing after adequate resuscitation and stabilization.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148519847","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":"Meta-analysis: safety and efficacy of ustekinumab in pediatric inflammatory bowel disease patients with anti-TNF failure.","authors":"Zhaoyang Heng, Li Zhan, Yuhan Zhang, Keyou Xu, Meng Song, Kelei Zhao, Md Shoykot Jahan, Most Fatema Akter, Ping Lu, Yinghua Ji, Yanting Liu","doi":"10.1186/s12876-026-05078-9","DOIUrl":"10.1186/s12876-026-05078-9","url":null,"abstract":"<p><strong>Background & aims: </strong>Evidence for ustekinumab (UST) in pediatric inflammatory bowel disease (IBD) is limited, particularly in patients who do not respond to anti-tumor necrosis factor (anti-TNF) therapy. We conducted a meta-analysis to evaluate the efficacy and safety of UST in pediatric IBD after anti-TNF failure.</p><p><strong>Methods: </strong>PubMed, Cochrane Library, Embase, and Web of Science were searched from inception through August 2025. We included studies reporting outcomes of UST in pediatric IBD patients with prior anti-TNF failure. Pooled estimates were calculated using fixed- or random-effects models according to heterogeneity (I²).</p><p><strong>Results: </strong>Fifteen studies including 653 pediatric patients were analyzed. Pooled clinical remission rates were 57% (95% CI, 28%-86%) at 8-16 weeks and 68% (95% CI, 58%-79%) at week 52. Steroid-free clinical remission was 44% (95% CI, 38%-49%) at 8-16 weeks and 58% (95% CI, 45%-70%) at week 52. The pooled endoscopic remission rate was 42% (95% CI, 35%-49%) and a biochemical remission rate of 63% (95% CI, 40%-87%). Adverse events occurred in 20% of patients (95% CI, 9%-30%), and serious adverse events occurred in 1% (95% CI, 0%-2%). At week 52, clinical remission rates were 69% in Crohn's disease (CD) and 65% in ulcerative colitis (UC).</p><p><strong>Conclusion: </strong>In pediatric IBD patients with prior anti-TNF failure, UST was associated with favorable pooled remission rates and an acceptable safety profile, although substantial inter-study heterogeneity warrants cautious interpretation. These findings support UST as a feasible therapeutic option in this refractory pediatric setting; while highly generalizable to pediatric CD, the findings for the UC subgroup offer important preliminary evidence that warrants cautious interpretation due to limited precision.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535232","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}