BMC Gastroenterology最新文献

{"title":"Clinicopathological features of early-onset colorectal cancer in Japanese patients: a single-center retrospective study.","authors":"Yutaka Okagawa, Keita Seto, Koki Yoshida, Kota Hanada, Sota Hirokawa, Yusuke Tomita, Kaho Tokuchi, Takeyoshi Minagawa, Kohtaro Morita, Kei Yane, Michiaki Hirayama, Hitoshi Kondo, Tetsuya Sumiyoshi","doi":"10.1186/s12876-025-03725-1","DOIUrl":"10.1186/s12876-025-03725-1","url":null,"abstract":"<p><strong>Background: </strong>The incidence of early-onset colorectal cancer (EoCRC), defined as CRC diagnosed at < 50 years of age, is increasing globally. However, only a few studies are reported from Japan, and the clinicopathological features of EoCRC in Japanese patients remain unknown.</p><p><strong>Methods: </strong>We retrospectively investigated consecutive Japanese patients who were pathologically diagnosed with invasive CRC at our hospital from January 2015 to December 2021. Patients were categorized into those who were diagnosed with CRC at < 50 years (early-onset group) and ≥ 50 years (late-onset group) of age. We compared the clinicopathological findings between the two groups.</p><p><strong>Results: </strong>The analysis included 731 patients. EoCRC was diagnosed in 46 patients　(6.3% of all patients). Of them, 41.3% demonstrated a positive fecal immunochemical test (FIT) for CRC screening as a diagnostic opportunity, which was significantly higher than that in the late-onset group (p = 0.032). Rectal cancer was significantly more prevalent in the early-onset group compared to the late-onset group (45.7% vs. 26.4%, p < 001). No significant difference in the rate of clinical stage at presentation was found between the two groups. Furthermore, patients with positive FIT were more likely diagnosed at an earlier stage.</p><p><strong>Conclusions: </strong>EoCRC among Japanese patients tends to occur on the rectum and is more frequently diagnosed with FIT screening compared to late-onset CRC. Patients with advanced stage were diagnosed by symptoms, indicating the usefulness of FIT screening in diagnosing EoCRC at an early stage.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"156"},"PeriodicalIF":2.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11899674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603120","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":"Prognostic value of tumor deposits and positive lymph nodes in colorectal cancer surgery: improved staging for long-term prognosis.","authors":"Yixin Heng, Mudan Huang, Jiaxin Xu, Xiaoyu Wu, Ning Huang, Yinghao Cao, Le Qin","doi":"10.1186/s12876-025-03713-5","DOIUrl":"10.1186/s12876-025-03713-5","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the prognostic value of the presence and number of tumor deposits (TDs) and the combination of TDs and number of positive lymph nodes (PLNs) in patients undergoing colorectal cancer (CRC) surgery, and to modify N staging.</p><p><strong>Method: </strong>The clinical data of 1470 patients with stage I-IV CRC who underwent surgery in Wuhan Union Hospital from February 2014 to May 2018 were collected. The optimal cutoff value for TD + PLNs was obtained using X-tile software, and patients were regrouped accordingly. Cox univariate and multivariate analysis were used to screen the factors affecting the prognosis of patients. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to evaluate the predictive ability of independent prognostic factors for overall survival (OS) and disease-free survival (DFS) of patients.</p><p><strong>Result: </strong>The presence of TD was associated with poor OS (HR = 2.478, 95%CI: 1.794-3.422, P<0.001) and DFS (HR = 2.516, 95%Cl: 1.874-3.377, P<0.001). Combined with TD and PLNs, a total of 128 of 395 N1 patients were reclassified re-staged as N2(TD + PLNs ≥ 3), which had a worse prognosis than those diagnosed with N1. Compared with Tumor Node Metastasis stage and TD number, the multivariate model constructed using independent prognostic factors showed better predictive power for OS (AUC:0.769 vs. 0.681 vs. 0.650) and DFS (AUC:0.757 vs. 0.702 vs. 0.650).</p><p><strong>Conclusion: </strong>TD significantly affects the long-term prognosis of CRC patients. Combining TD and PLNs to redefine the tumor staging of CRC patients can improve the accuracy of long-term prognosis of surgical patients.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"154"},"PeriodicalIF":2.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11899793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603638","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":"Feasibility of cholecystectomy in patients with silent common bile duct stones cohort prospective single arm multicentre study.","authors":"Ahmad A Maklad, Mahmoud Eltantawy, Mohammed Siam, Mohamed Abdelshafy","doi":"10.1186/s12876-024-03459-6","DOIUrl":"10.1186/s12876-024-03459-6","url":null,"abstract":"<p><strong>Background: </strong>The management of patients with concomitant gallbladder stones with silent CBDS still involves a wide range of debates, and there is little evidence regarding the recommendation of CBD clearance either before cholecystectomy or in the same session. In this study, we aimed to discuss the feasibility of performing LC with a wait-and-see strategy for patients with silent CBS.</p><p><strong>Method: </strong>Patients with silent CBDS identified during preoperative examinations for gallbladder stones were studied for the feasibility of performing LC with a wait-and-see strategy for silent CBS.</p><p><strong>Results: </strong>Sixty patients who presented with gallbladder stones with silent CBDS underwent LC between February 2023 and July 2023. Seventeen patients (28.3%) underwent laparoscopic acute cholecystectomy, and 43 (71.7%) patients underwent laparoscopic elective cholecystectomy; all of these procedures were completed laparoscopically. Two patients (3.3%) developed symptomatic CBDS, both of whom were treated medically without intervention. Sixteen patients (26.7%) experienced spontaneous CBDS during the follow-up period.</p><p><strong>Conclusion: </strong>Patients who present with symptomatic gall bladder stones either acutely or electively with asymptomatic CBDS can undergo laparoscopic cholecystectomy without suffering from CBDS with acceptable short-term outcomes.</p><p><strong>Trial registration: </strong>This study was registered at Suez med - IRB office under trial registration no. 6 and registered at clinicaltrials.gov (NCT06349876) in 31/3/2024.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"158"},"PeriodicalIF":2.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11899859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603690","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":"Impact of blood lead and manganese levels on metabolic dysfunction-associated steatotic liver disease prevalence: insights from NHANES (2017-2020).","authors":"Wenying Guo, Ting Weng, Yufei Song","doi":"10.1186/s12876-025-03731-3","DOIUrl":"10.1186/s12876-025-03731-3","url":null,"abstract":"<p><strong>Background: </strong>The metabolic dysfunction-associated steatotic liver disease (MASLD) paradigm represents a significant departure from the previous nonalcoholic fatty liver disease (NAFLD) framework, offering a non-stigmatizing approach that enhances awareness and accelerates patient understanding. Our primary aim was to investigate the potential relationship between blood lead and manganese exposure and the onset of MASLD.</p><p><strong>Methods: </strong>Using data from the National Health and Nutrition Examination Survey (NHANES) database spanning from 2017 to 2020, a cross-sectional study included 4,475 participants was performed to assess the relationship. The statistical analysis used throughout the study included multivariable linear regression and multiple logistic regression models, adjusted for potential confounders to ensure robust and reliable results. We applied a thorough multivariable analysis, examining various factors including age, sex, and ethnicity to enhance the robustness of our findings.</p><p><strong>Results: </strong>Employing linear regression models in our study, we observed a clear positive correlation between elevated levels of blood lead and manganese and Controlled attenuation parameter (CAP). Additionally, employing multiple logistic regression models for detailed analysis, we noted a significant increase in the likelihood of MASLD with higher levels of blood lead and manganese.</p><p><strong>Conclusion: </strong>The findings of this study strongly suggest a notable correlation between increased levels of blood lead and manganese with both CAP and the presence of MASLD. This study represents a population-based approach, enhancing the generalizability of the findings to the broader U.S.</p><p><strong>Population: </strong></p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"160"},"PeriodicalIF":2.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11899840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603712","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":"Development and validation of an interpretable machine learning model for predicting the risk of hepatocellular carcinoma in patients with chronic hepatitis B: a case-control study.","authors":"Linghong Wu, Zengjing Liu, Hongyuan Huang, Dongmei Pan, Cuiping Fu, Yao Lu, Min Zhou, Kaiyong Huang, TianRen Huang, Li Yang","doi":"10.1186/s12876-025-03697-2","DOIUrl":"10.1186/s12876-025-03697-2","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to develop and internally validate an interpretable machine learning (ML) model for predicting the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB) infection.</p><p><strong>Methods: </strong>We retrospectively collected clinical data from patients with HCC and CHB treated at the Fourth Affiliated Hospital of Guangxi Medical University from January 2022 to December 2022, including demographics, comorbidities, and laboratory parameters. The datasets were randomly divided into a training set (361 cases) and a validation set (155 cases) in a 7:3 ratio. Variables were screened using Least Absolute Shrinkage and Selection Operator (LASSO) and multifactor logistic regression. The prediction model of HCC risk in CHB patients was constructed based on five machine learning models, including logistic regression (LR), K-nearest neighbour (KNN), support vector machine (SVM), random forest (RF) and artificial neural network (ANN). Receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis (DCA) were used to evaluate the predictive performance of the model in terms of identification, calibration and clinical application. The SHapley Additive exPlanation (SHAP) method was used to rank the importance of the features and explain the final model.</p><p><strong>Results: </strong>Among the five ML models constructed, the RF model has the best performance, and the RF model predicts the risk of HCC in patients with CHB in the training set [AUC: 0.996, 95% confidence interval (CI) (0.991-0.999)] and internal validation set [AUC: 0.993, 95% CI (0.986-1.000)]. It has high AUC, specificity, sensitivity, F1 score and low Brier score. Calibration showed good agreement between observed and predicted risks. The model yielded higher positive net benefits in DCA than when all participants were considered to be at high or low risk, indicating good clinical utility. In addition, the SHAP plot of the RF showed that age, basophil/lymphocyte ratio (BLR), D-Dimer, aspartate aminotransferase/alanine aminotransferase (AST/ALT), γ-glutamyltransferase (GGT) and alpha-fetoprotein (AFP) can help identify patients with CHB who are at high or low risk of developing HCC.</p><p><strong>Conclusion: </strong>ML models can be used as a tool to predict the risk of HCC in patients with CHB. The RF model has the best predictive performance and helps clinicians to identify high-risk patients and intervene early to reduce or delay the occurrence of HCC. However, the model needs to be further improved through large sample studies.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"157"},"PeriodicalIF":2.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11899164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603437","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":"Whether preoperative biliary drainage leads to better patient outcomes of pancreaticoduodenectomy: a meta-analysis and systematic review.","authors":"Bo Zhang, Zekun Lang, Kexiang Zhu, Wei Luo, Zhenjie Zhao, Zeliang Zhang, Zhengfeng Wang","doi":"10.1186/s12876-025-03761-x","DOIUrl":"10.1186/s12876-025-03761-x","url":null,"abstract":"<p><strong>Objective: </strong>To investigate whether preoperative biliary drainage is beneficial for patients undergoing pancreaticoduodenectomy.</p><p><strong>Methods: </strong>The PubMed, Cochrane Library and the Web of Science were systematically searched for relevant trials that included outcome of pancreaticoduodenectomy with and without preoperative biliary drainage from January 2010 to May 2024. The primary outcomes are postoperative pancreatic fistula and intra-abdominal infection. Data is pooled using the risk ratio or standardized mean difference with 95% confidence interval. The study protocol was registered prospectively with PROSPERO (CRD42022372584).</p><p><strong>Results: </strong>A total of 39 retrospective cohort studies with 33,516 patients were included in this trial. Compared with no preoperative biliary drainage, the preoperative biliary drainage group had a longer hospital stay (SMD, 0.14). Performing preoperative biliary drainage significantly increases the risk of postoperative pancreatic fistula (RR, 1.09), intra-abdominal infection (RR, 1.09), surgical site infection (RR, 1.84), and sepsis (RR, 1.37). But preoperative biliary drainage lowers risk of bile leak (RR, 0.74).</p><p><strong>Conclusion: </strong>Preoperative biliary drainage before pancreaticoduodenectomy increases the risk of postoperative complications without clear overall benefits. Routine PBD is not recommended for younger patients with mild to moderate jaundice but may be considered for high-risk patients, such as those with severe infections or progressive jaundice. Optimizing preoperative biliary drainage duration and timing may help reduce complications. Further research is needed to refine patient selection and perioperative strategies.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"161"},"PeriodicalIF":2.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11900024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603724","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":"Endoscopic resection of rectal neuroendocrine tumors: zero disease-related deaths during a 10-year follow-up period.","authors":"Yasuyo Hayashi, Haruei Ogino, Yosuke Minoda, Yoshimasa Tanaka, Yoshitaka Hata, Masaru Kubokawa, Seiichiro Sakisaka, Kazuhiro Haraguchi, Shin-Ichiro Fukuda, Soichi Itaba, Daisuke Yoshimura, Shunsuke Takahashi, Munehiro Tanaka, Hiroaki Kubo, Shinichi Somada, Eikichi Ihara, Yoshihiro Ogawa","doi":"10.1186/s12876-025-03736-y","DOIUrl":"10.1186/s12876-025-03736-y","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal neuroendocrine tumors (GI-NETs) are slow-growing tumors with the potential for malignancy that originate from neuroendocrine cells. Therefore, early diagnosis and treatment of GI-NETs are necessary to prevent metastasis. The widespread use of colonoscopy, which allows early detection of rectal neuroendocrine tumors (rNETs) that are small enough to be treated endoscopically, has resulted in an increasing rate of endoscopic resection of rNETs. However, whether the long-term prognosis of endoscopically resected rNETs is favorable has not yet been determined. This study aimed to assess whether endoscopically resected rNETs affect the long-term prognosis of patients.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical records of 163 consecutive patients with rNETs who underwent endoscopic resection at 11 hospitals in Japan between 1999 and 2012. The primary analysis focused on 47 patients with 51 rNETs who underwent ≥ 10 years of follow-up. The secondary analysis focused on patients who underwent less than 10 years of follow-up.</p><p><strong>Results: </strong>The median follow-up period of patients included in the primary analysis was 12.3 years (range, 10-19.1 years). The median lesion size was 5 mm (range, 2-12). Three lesions were treated using conventional endoscopic mucosal resection (EMR). Twenty-nine lesions were treated using modified EMR. Nineteen lesions were treated using endoscopic submucosal dissection. The R1 resection rate and lymphovascular invasion rate were 15.7% and 25.5%, respectively. The curative resection (CR) rate and non-CR rate were 66.7% and 33.3%, respectively. Two patients with lesions treated with non-CR underwent radical surgery. None of the 47 patients experienced lesion recurrence during the 10-year follow-up period. Two patients whose lesions were treated with CR died of other diseases.</p><p><strong>Conclusions: </strong>Death attributable to rNETs did not occur among patients who underwent at least 10 years of follow-up after endoscopic resection.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"155"},"PeriodicalIF":2.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11900432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603615","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":"Descriptive analysis of common causes of upper gastrointestinal bleeding in pediatric patients in Kerman: a study from 2022 to 2023.","authors":"Maryam Gholami Shahrebabak, Nazanin Zeinali Nezhad, Mohammad Aref Azadmanesh, Amirhossein Shahpar, Azam Gholami Shahrebabak","doi":"10.1186/s12876-025-03750-0","DOIUrl":"10.1186/s12876-025-03750-0","url":null,"abstract":"<p><strong>Background: </strong>Upper gastrointestinal bleeding (UGIB) in pediatric patients is a significant clinical concern requiring prompt diagnosis and management. This study aims to provide a descriptive analysis of the common causes of UGIB in pediatric patients in Kerman, Iran.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at Afzalipour Hospital, Kerman, from January 2022 to December 2023. All pediatric patients under 18 years with UGIB were included. Data on demographics, clinical presentation, and endoscopic findings were collected and analyzed.</p><p><strong>Results: </strong>A total of 120 patients were included, with a mean age of 8.8 ± 4.7 years. Hematemesis was the predominant presenting feature (57.5%). All patients underwent endoscopy, with a diagnostic yield of 88.4%. Gastric erosion was the most common cause of UGIB (33.3%), followed by esophageal varices (13.3%). The etiology varied across age groups, with Mallory-Weiss syndrome being the second most common cause in infants. Blood transfusion was required in 31.67% of patients.</p><p><strong>Conclusion: </strong>This study highlights the common causes and clinical features of pediatric UGIB in Kerman, Iran. Gastric erosion (33.3%) was the most frequent cause, and endoscopy achieved a high diagnostic yield (88.4%). Blood transfusion was necessary in 31.67% of patients. These findings emphasize the need for age-specific diagnostic strategies and reflect regional differences in UGIB etiology.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"152"},"PeriodicalIF":2.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596272","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 single nucleotide polymorphisms in PNPLA3, TM6SF2 and MBOAT7 genes and markers of cancer aggressiveness in a Sri Lankan NASH-related HCC cohort.","authors":"Saumya Madushani Samarasinghe, Asanka Sudeshini Hewage, Rohan Chaminda Siriwardana, Kamani Hemamala Tennekoon, Madunil Anuk Niriella, Sumadee De Silva, Visula Abeysuriya","doi":"10.1186/s12876-025-03738-w","DOIUrl":"10.1186/s12876-025-03738-w","url":null,"abstract":"<p><strong>Background: </strong>Single nucleotide polymorphisms (SNPs) in patatin-like phospholipase domain-containing protein 3 (PNPLA3), transmembrane 6 superfamily member 2 (TM6SF2) and membrane bound O-acyltransferase domain containing 7 (MBOAT7) genes were reported to be strongly associated with non-alcoholic fatty liver disease (NAFLD) pathogenicity among different populations. We investigated whether these SNPs are associated with prognostic factors and genetic biomarkers of non-alcoholic steatohepatitis (NASH)-related hepatocellular carcinoma (HCC) in the Sri Lankan context.</p><p><strong>Methods: </strong>We conducted an exploratory study to evaluate the prevalence of five SNPs (PNPLA3 rs738409, PNPLA3 rs2281135, PNPLA3 rs2294918, TM6SF2 rs58542926 and MBOAT7 rs641738) as genetic risk factors for NASH-HCC pathogenicity. We genotyped 48 NASH-HCC patient samples collected at a clinical setting using a minisequencing method. Impact of each SNP with tumor prognostic factors such as nodularity, tumor size and AFP (alpha-feto protein) level was analyzed using chi square test. We also analyzed the expression of micro RNA-122 (miR-122) in serum and leukocyte telomere length via quantitative real-time PCR. Associations between each SNP with micro RNA-122 (miR-122) expression level and leukocyte telomere length of NASH-HCC patients were analyzed using one-way analysis of variance (ANOVA) test and independent t test. Relationships among tested SNPs and some well-established HCC risk factors such as age, BMI, gender, diabetes status and the cirrhotic stage were also analyzed using chi square test, independent t-test and One-way ANOVA test.</p><p><strong>Results: </strong>Our analyses demonstrated significant associations between PNPLA3 rs2281135 variant and tumor nodularity. Also, PNPLA3 rs2281135 and PNPLA3 rs2294918 variants were significantly associated with miR-122 expression levels of NASH-HCC patients. Further, age and body mass index (BMI) were significantly associated with PNPLA3 rs2281135 variant in our study cohort.</p><p><strong>Conclusion: </strong>We found that in the Sri Lankan NASH-related HCC cohort, some PNPLA3 variants (rs2281135 and rs2294918) correlate with tumor nodularity, higher miR-122 expression, and distinct demographic features such as age and BMI. Our work highlights the role of specific SNPs in tumor aggressiveness, contributing to the precision screening for HCC in NASH patients.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"151"},"PeriodicalIF":2.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596270","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":"Effect of L-carnitine supplementation on muscle cramps in liver cirrhosis: results from a retrospective cohort study.","authors":"Gholam Reza Sivandzadeh, Ali Shahsavari, Elahe Meftah, Ramin Niknam, Ali Reza Safarpour","doi":"10.1186/s12876-025-03730-4","DOIUrl":"10.1186/s12876-025-03730-4","url":null,"abstract":"<p><strong>Background: </strong>Muscle cramps are among the common debilitating complications of liver cirrhosis. Since this complication lacks effective treatments, we aimed to evaluate the effectiveness of L-carnitine supplementation in reducing the frequency, duration, and severity of muscle cramps in patients with liver cirrhosis.</p><p><strong>Methods: </strong>The present retrospective cohort was conducted on adult patients referred between November 2022 and December 2023 to a tertiary referral hospital in Shiraz, Iran. Patients with confirmed liver cirrhosis who had muscle cramps ≥ 4 times per month without other secondary etiologies for muscle cramps were evaluated for inclusion. They were included if they had taken an oral L-carnitine supplement of 1000 mg/day for one month and had available medical records of the assessment of their cramps before and one month after starting the supplement.</p><p><strong>Results: </strong>From the 702 patients screened, 195 (27.8%) had muscle cramps, and 91 (13.0%) met the inclusion criteria. The respective median age and cirrhosis duration (interquartile range (IQR)) of the included patients were 61.0 (16.0) and 2.0 (3.0) years, and 48 (53%) were male. Median daily, weekly, and monthly cramp frequency and severity were higher in females (P-values < 0.05). We noted reduced daily, weekly, and monthly frequency of the cramps, their severity, and their mean duration following L-carnitine supplementation (respective median (IQR) of absolute percentage change: 100 (100.0), 60 (88.33), 50 (75.0), 50 (77.5), and 40.0 (44.58); P-values < 0.001). Additionally, daily, weekly, and monthly cramps completely resolved in 29 (31.9%), 21 (23.1%), and 13 (14.3%) after supplementation. BMI correlated with the percentage change of all the mentioned cramp indices (P-values < 0.05), and age correlated with the percentage change in the monthly frequency of cramps (P-value = 0.042). Changes in cramp indices did not differ significantly between males and females.</p><p><strong>Conclusions: </strong>L-carnitine supplementation seems to be a promising therapeutic option for cramps in liver cirrhosis. Further studies with control groups and larger samples are required to confirm this finding.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"150"},"PeriodicalIF":2.5,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584592","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}