BMC Gastroenterology最新文献

{"title":"Sessile serrated lesions of the appendix: a contemporary review of the literature.","authors":"Berkenye Csonka, Tamás Lantos, Anita Sejben","doi":"10.1186/s12876-026-05117-5","DOIUrl":"10.1186/s12876-026-05117-5","url":null,"abstract":"<p><strong>Introduction: </strong>Sessile serrated lesions (SSLs) of the appendix remain a controversial entity due to evolving definitions, diagnostic criteria, and nomenclature. Shifts in diagnostic thresholds - from multiple serrated crypts to a single unequivocally serrated and distorted crypt - have led to discrepancies in lesion classification and retrospective analyses. These controversies, compounded by inconsistent adherence to updated criteria, highlight the need for studies and reviews applying contemporary standards to accurately assess incidence and clinical significance.</p><p><strong>Methods: </strong>The review protocol was registered in PROSPERO (CRD420261299191). Systematic searches of PubMed, Web of Science, Scopus and Ovid were performed for studies published between 2007 and 2025. Eligible studies reporting clinicopathological features of appendiceal SSLs were included.</p><p><strong>Results: </strong>The reported prevalence of appendiceal SSLs is low (approximately 1.11-5.22‰), but increases with age and is markedly higher in patients with serrated polyposis syndrome. Most lesions are incidentally detected histologically, are often macroscopically inconspicuous, and show dysplasia in a minority of cases (~ 28%). Compared with colonic SSLs, appendiceal lesions are less common, show female predominance, and more frequently harbour KRAS rather than BRAF mutations, suggesting partially distinct molecular pathways. Although occasional co-occurrence with mucinous neoplasms and adenocarcinoma may suggest possible biological links, current evidence is insufficient to define a consistent progression pathway or establish their true malignant potential.</p><p><strong>Conclusions: </strong>Overall, the current literature is constrained by small sample sizes, heterogeneous study designs, inconsistent reporting, and substantial publication bias, particularly toward unusual or concurrent neoplastic findings. These limitations preclude definitive conclusions regarding the true prevalence, natural history, and malignant potential of appendiceal SSLs. Further large-scale, systematically characterised, and longitudinally followed cohorts with comprehensive molecular profiling are required to clarify their biological behaviour and clinical significance.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468696","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":"Inflammatory mediators are predictors of clinical outcomes in cirrhotic patients with non-acute decompensation.","authors":"Xixuan Wang, Jiale Shen, Jun Guo, Xiaoying Dong, Feng Yang, Shuling Chen, Hao Ren, Hui Zhou, Xiaoning Feng, Zihao Liang, Dawei Yang, Caiyun Zhang, Qingfang Xiong, Ruiqi Li, Yongfeng Yang","doi":"10.1186/s12876-026-05105-9","DOIUrl":"10.1186/s12876-026-05105-9","url":null,"abstract":"<p><strong>Background: </strong>Non-acute decompensation (NAD) has been proposed as a distinct pathway of decompensation. This study evaluated the prognostic value of inflammatory mediators for subsequent clinical outcomes in patients with NAD.</p><p><strong>Methods: </strong>Outpatients with NAD were included in this ambispective cohort study (Cohort 1 retrospectively; Cohort 2: prospectively). Patients were followed for 24 months. The primary endpoints were the occurrence of acute decompensation (AD), acute-on-chronic liver failure (ACLF), and liver-transplantation-free mortality.</p><p><strong>Results: </strong>Cohort 1 ultimately comprised 373 patients. Cohort 2 included 192 patients. In multivariable analysis of cohort 1, both IL-10 and IL-6 levels independently predicted AD (log-transformed-IL-10, HR: 1.26; 95% confidence interval, CI: 1.16-1.36; P < 0.001; log-transformed-IL-6, HR: 1.13; 95% CI: 1.01-1.27; P = 0.03) and ACLF (log-transformed-IL-10, HR: 2.03; 95% CI: 1.57-2.64; P < 0.001; log-transformed-IL-6, HR: 2.21; 95% CI: 1.57-3.11; P < 0.001). Patients were stratified into three groups: no systemic inflammation (SI), SI without immunodeficiency (ID), and SI with ID (elevated IL-6 + IL-10). While SI alone increased AD risk, the coexistence of ID markedly amplified the risk of severe outcomes. Compared to SI alone, patients with SI + ID had a substantially higher risk of ACLF (Cohort 1 (training) HR: 28.02; 95% CI: 12.54-62.62; Cohort 2 (validating) HR: 39.78; 95% CI: 10.97-144.30). Nearly all deaths occurred in the SI + ID subgroup [Cohort 1: 10/10; Cohort 2: 4/5].</p><p><strong>Conclusions: </strong>A combined biomarker profile of SI (IL-6) and ID (IL-10) identifies a distinct high-risk subgroup among NAD outpatients, characterized by a markedly elevated risk of progression to AD, ACLF and liver-transplantation-free mortality.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469000","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":"Diagnostic performance of fecal eosinophil-derived neurotoxin and lipocalin-2 in pediatric inflammatory bowel disease.","authors":"Ragaey Ahmad Eid, Nada Atteya Fakhry, Doaa Mabrouk Ahmed, Mahmoud Hodeib","doi":"10.1186/s12876-026-05024-9","DOIUrl":"10.1186/s12876-026-05024-9","url":null,"abstract":"<p><strong>Background: </strong>Non-invasive biomarkers for inflammatory bowel disease (IBD) diagnosis in children are needed to reduce dependence on invasive procedures. This study examined fecal eosinophil-derived neurotoxin (fEDN), lipocalin-2 (LCN-2), and calprotectin (FC) as potential non-invasive supportive markers in pediatric IBD.</p><p><strong>Methods: </strong>This case-control study included 90 participants: 30 IBD patients (12 Crohn's disease, 18 ulcerative colitis), 30 acute diarrhea patients, and 30 healthy controls. Fecal samples were analysed for fEDN, LCN-2, and FC levels (ng/mL) using ELISA. Biomarker levels were correlated with clinical and endoscopic activity scores, and diagnostic performance was assessed using receiver operating characteristic (ROC) analysis with pairwise AUC comparisons by DeLong's test.</p><p><strong>Results: </strong>All three biomarkers were significantly elevated in IBD compared to acute diarrhea and healthy controls (p < 0.001). LCN-2 uniquely correlated with disease duration (r = 0.43, p = 0.017) and CRP (r = 0.46, p = 0.011). All markers significantly correlated with the Crohn's Disease Activity Index, with LCN-2 showing the strongest correlation (r = 0.75, p = 0.005). Only FC significantly correlated with the simple endoscopic score (r = 0.63, p = 0.004). For distinguishing IBD from healthy controls, all three markers showed high diagnostic accuracy: calprotectin (AUC = 0.98), fEDN (AUC = 0.95), and LCN-2 (AUC = 0.9), with no statistically significant difference among them (DeLong's test, all p > 0.05). For discriminating IBD from acute diarrhea, FC demonstrated the highest specificity (90%) and overall accuracy (AUC = 0.86), while fEDN performed poorly (AUC = 0.56). All markers showed limited ability to differentiate between IBD subtypes.</p><p><strong>Conclusions: </strong>In this exploratory study, fEDN, LCN-2, and FC were significantly elevated in pediatric IBD and showed variable but complementary discriminative performance across clinical comparisons, with calprotectin demonstrating the strongest overall accuracy for distinguishing IBD from acute diarrhea. LCN-2 was the only marker that correlated with disease duration, suggesting it may reflect chronic inflammatory processes. These findings support the potential utility of these biomarkers as non-invasive supportive tools in the pre-endoscopic assessment of pediatric IBD; however, formal combined-marker analyses were not performed, and the results require validation in larger prospective multicenter studies before clinical application.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13378010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468842","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 retrograde appendicitis therapy versus sub-endoscopic retrograde appendicitis therapy for acute appendicitis: a retrospective observational cohort study.","authors":"Shouli Cao, Song Li, Jinming Yan, Dongyun Xue, Fanlu Meng, Junshan Li, Xiaopei Li","doi":"10.1186/s12876-026-05030-x","DOIUrl":"10.1186/s12876-026-05030-x","url":null,"abstract":"<p><strong>Background: </strong>Acute appendicitis is a common acute abdominal emergency. Laparoscopic appendectomy (LA) carries risks such as bleeding, infection, and negative procedures. Endoscopic retrograde appendicitis therapy (ERAT) is minimally invasive but cannot directly visualize the appendiceal cavity. The novel eyeMax disposable biliary imaging system enables direct observation of the appendix cavity during sub-endoscopic retrograde appendicitis therapy (SERAT), overcoming key limitations of ERAT. The aim of this study is to compare the effectiveness and clinical outcomes of ERAT with SERAT in treating acute appendicitis.</p><p><strong>Method: </strong>This retrospective study analyzed 60 patients undergoing ERAT and 97 undergoing SERAT for acute appendicitis at Shandong Provincial Third Hospital, China, from November 2021 to September 2024. Propensity score matching (PSM, 1:1) was performed to balance baseline characteristics, yielding 55 pairs of patients. Baseline data, procedural indicators, short-term recovery, and long-term recurrence were compared.</p><p><strong>Results: </strong>Baseline characteristics were generally comparable between the two groups before and after PSM. After matching, SERAT was associated with significantly shorter operation time and intubation time than ERAT (24.69 vs. 42.65 min, P < 0.001; 96.38 vs. 241.38 s, P < 0.001). The technical success rate was significantly higher in the SERAT group than in the ERAT group (53/55 vs. 47/55, P = 0.047). No significant differences were found in fecalith removal, 6-hour VAS score, hospital stay, or hospitalization cost. Direct visualization in the SERAT group showed inner-wall congestion and edema in 100% of cases, intracavitary fecaliths in 54.4%, and intraluminal pus in 89%. During follow-up, recurrence-free survival was significantly better in the SERAT group ( P = 0.036). Among patients with follow-up data, recurrence occurred in 3/55 (5.4%) patients in the SERAT group and 11/55(20%) patients in the ERAT group. No long-term adverse events were observed in either group.</p><p><strong>Conclusion: </strong>SERAT is an effective and safe approach for the diagnosis and treatment of acute appendicitis, offering shorter operation and intubation times, a lower recurrence rate, and minimally invasive treatment.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469015","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":"Relationship between sacroiliac joint involvement and intestinal disease activity in newly diagnosed Crohn's disease.","authors":"Gökhan Tonkaz, Hasan Hüseyin Can, Esma Çinar, Özgür Önal, Mehmet Tonkaz, Serdar Aslan, Duygu Erkal, Gökhan Aydın, Aykut Güruf, Ahmet Yasin Yitik","doi":"10.1186/s12876-026-05122-8","DOIUrl":"10.1186/s12876-026-05122-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Axial musculoskeletal involvement represents an important component among the extraintestinal manifestations of Crohn's disease (CD). Sacroiliac joint (SIJ) involvement can be detected at an early stage using imaging modalities. The aim of this study was to evaluate the relationship between SIJ involvement and laboratory parameters, intestinal disease activity, and SIJ anatomical variations in patients with newly diagnosed CD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this single-center retrospective imaging-pathology correlation study, 68 adult patients with a multidisciplinary diagnosis of Crohn's disease established through clinical, endoscopic, radiological, and histopathological evaluation who underwent magnetic resonance enterography (MRE) and pelvic computed tomography (CT) examinations at the time of diagnosis were included. SIJ findings were classified as MRE-detected bone marrow edema-like findings, CT-detected structural SIJ abnormalities, or no involvement. SIJ anatomical forms were evaluated according to the morphological variation classification described by Ziegeler et al. Intestinal disease activity was analyzed using endoscopic (Mayo-based categories), histopathological (Geboes grading system), and clinical phenotype classification (Montreal classification) parameters.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;MRE-detected bone marrow edema-like SIJ findings were detected in 9 patients (13.2%), CT-detected structural SIJ abnormalities in 9 patients (13.2%), and no SIJ involvement in 50 patients (73.5%). Platelet count, ferritin levels, and total iron-binding capacity (TIBC) differed significantly among the groups (p &lt; 0.05). A statistically significant association was observed between endoscopic disease activity categories and SIJ findings (Fisher's exact p &lt; 0.001); however, the distribution pattern did not demonstrate a consistent increase in SIJ abnormalities with increasing endoscopic activity. In histopathological evaluation, a statistically significant association was found between SIJ involvement patterns and histopathological activity (Fisher's exact p &lt; 0.001); however, this association was primarily driven by the complete absence of severe histological activity in the CT-detected structural SIJ abnormalities group. In contrast, no significant relationship was found between disease location or behavior according to the Montreal classification and SIJ involvement patterns (p &gt; 0.05). Similarly, no significant association was identified between SIJ anatomical variations and involvement patterns (p = 0.845).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In patients with newly diagnosed CD, SIJ involvement appears to be most closely associated with histopathological disease activity. The association with endoscopic categories was statistically significant but showed an inverse, non-monotonic pattern, with SIJ findings clustering predominantly among patients with lower Mayo scores. In contrast, SIJ anatomical variations d","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468642","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 lncRNA DARS-AS1 in colorectal cancer and its regulatory effect on tumor progression.","authors":"Qiaoyu Chen, Qijin Xu, Li Zhang","doi":"10.1186/s12876-026-05110-y","DOIUrl":"10.1186/s12876-026-05110-y","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) has high incidence and mortality with limited diagnostic and prognostic methods. This study explored the diagnostic and prognostic significance of the DARS-AS1 in CRC, and its regulatory mechanism via miR-188-5p.</p><p><strong>Methods: </strong>The clinical significance of serum DARS-AS1 was analyzed using receiver operator characteristic (ROC) curves, Cox regression, the Kaplan-Meier method, and chi-square tests. DARS-AS1 silencing effects on CRC cell behavior were analyzed via CCK-8/Transwell assays. This study identified and validated miR-188-5p target genes using online databases and dual-luciferase reporter assays.</p><p><strong>Results: </strong>Serum DARS-AS1 was elevated in CRC patients (P < 0.001), and distinguished them with an area under the curve (AUC) of 0.856. High DARS-AS1 was associated with adverse clinicopathological features (P < 0.05), shorter low disease-free survival (P = 0.008), and worse prognosis [hazard ratio (HR) = 2.400, P = 0.011]. DARS-AS1 was up-regulated in CRC cells (P < 0.001), and silencing it suppressed malignant behavior (P < 0.05). Serum miR-188-5p was down-regulated in CRC patients (P < 0.001), and had a target relationship with DARS-AS1 (r = - 0.733, P < 0.001). miR-188-5p target genes-including PTEN, ESR1, and FBXW7-were enriched in CRC-related pathways; FBXW7 was experimentally validated as a direct target (P < 0.05).</p><p><strong>Conclusions: </strong>This study identifies serum DARS-AS1 as a non-invasive diagnostic and prognostic biomarker for CRC with superior performance to conventional markers, and elucidates the DARS-AS1/miR-188-5p/FBXW7 axis as a novel mechanistic framework for CRC progression, providing both a clinical tool for risk stratification and targets for molecular therapy.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469023","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":"HLA-DQB1*02, HLA-DRB1*03 alleles and HLA-DQB1*02-HLA-DRB1*03 haplotype confer a significant risk of celiac disease in the Mauritanian population.","authors":"Saleck Mahfoudh Ebebecar, Malak Salame, MohamedHameyin, Tijani Hamed, Fatimetou Vetten, Tetou Soumbara, Mohamed Lemine Hmeity, Abdallahi Sidi Mohmed, Houria Abdelghaffar, Ahmed Houmeida","doi":"10.1186/s12876-026-05086-9","DOIUrl":"10.1186/s12876-026-05086-9","url":null,"abstract":"<p><strong>Background and aim: </strong>Celiac disease (CD) is an autoimmune disorder primarily caused by an abnormal immune response to dietary gluten in human leucocytes class II antigens carriers. This preliminary study aimed to assess the specific risk conferred by DQB1 and DRB1 alleles to celiac disease development in the Mauritanian population.</p><p><strong>Materials and methods: </strong>Frequencies of HLA-DQB1and HLA-DRB1alleles and haplotypes were evaluated in 50 celiac disease (CD) patients. The association of HLA-DQB1 and HLA-DRB1with the disease was tested using a control group of 50 non-CD healthy individuals. Genotyping was performed by PCR-SSP and next-generation sequencing (NGS).</p><p><strong>Results: </strong>Genotyping of the studied population revealed that the most frequent alleles of DQB1/DRB1gens among CD patients were DQB1*02(70%) and DQB1*03(9%), DRB1*03 (52%) was the largest group followed by DRB1*07 (12%). The major allelic combination was DRB1*03-DQB1*02, with a frequency of 47%. Analysis of allele frequency in patients and controls revealed a significant association between CD and the two key HLA alleles here respectively DQB1*02(χ² = 44.46; p = 2.59 × 10⁻¹¹) and DRB1*03 (χ² = 8.32; p = 3.9 × 10⁻³). Significant association was also found with DQB1*02-DRB1*03 (χ² = 31.47; p = 2.0 × 10⁻⁸). However, no considerable risk of the disease was conferred by any of the other haplotypes tested here.</p><p><strong>Conclusion: </strong>These preliminary results, consistent with previous literature on CD genetic susceptibility, support the predominant role of DQB1*02 and DRB1*03 alleles and haplotypes in celiac onset in our population. The availability of NGS typing for celiac disease maybe an additive tool to exclude symptoms ambiguity during CD diagnosis in our medical facilities.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148454671","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 online dynamic nomogram for nonobese metabolic dysfunction-associated steatotic liver disease based on body composition analysis.","authors":"Tingting Zheng, Haizhen Yang, Sijia Wang, Xiaoqin Shi, Qingxiu Zhang, Zhongmin Wen","doi":"10.1186/s12876-026-04972-6","DOIUrl":"10.1186/s12876-026-04972-6","url":null,"abstract":"<p><strong>Background: </strong>The factors influencing nonobese Metabolic dysfunction-associated steatotic liver disease are discussed, and an online dynamic nomogram model is constructed.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of 216 non-obese patients with MASLD and 322 non-obese healthy controls from the Second Affiliated Hospital of Soochow University. The data were randomly divided into a training set and a validation set in a 7:3 ratio. Potential variables were initially screened through univariate analysis, correlation analysis, and LASSO regression (including cross-validation). Subsequently, binary logistic regression and SHAP methods were employed to identify independent risk factors, and an online dynamic ROC curve was constructed. Model performance was evaluated using the area under the curve (AUC), sensitivity, specificity, calibration curves, and recalibration methods.</p><p><strong>Results: </strong>LASSO regression initially screened 11 potential variables. Binary logistic regression ultimately identified six independent risk factors which is past history (odds ratio (OR): 2.399, P = 0.0008), triglyceride(TG) (OR: 1.176, P = 0.008), high density lipoprotein cholesterol(HDL-C) (OR: 0.173, P = 0.014), low density lipoprotein cholesterol(LDL-C) (OR: 3.916, P = 0.001), fat mass(Fat) (OR: 4.299, P = 0.0009) and dPhaseAngle(OR: 3.174, P = 0.022). SHAP analysis revealed that TG was the most influential feature, while HDL-C showed a negative contribution. All variance inflation factor (VIF) values were below 1.5, indicating no significant multicollinearity. The AUC values were 0.869 in the training cohort and 0.802 in the validation cohort. The calibration curve demonstrates that the prediction results of the line graph for the outcome closely approximate the ideal curve, aligning with the actual outcomes.</p><p><strong>Conclusion: </strong>An online dynamic nomogram for nonobese MASLD patients with good identified performance was constructed, which can be used as a practical approach for personalized early screening and auxiliary diagnosis of potential risk factors and can assist physicians in making personalized diagnoses and treatments for patients.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148454686","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":"Glucagon-like peptide-1 receptor agonists and pancreatic outcomes in chronic pancreatitis: a real-world cohort study.","authors":"Arkadeep Dhali, Rick Maity, Fayaz Khan, Jyotirmoy Biswas, Abdul Rafae Faisal","doi":"10.1186/s12876-026-05125-5","DOIUrl":"10.1186/s12876-026-05125-5","url":null,"abstract":"<p><strong>Goal: </strong>To evaluate the association between glucagon-like peptide-1 receptor agonists (GLP-1 RA) therapy and pancreatic, gastrointestinal, and mortality outcomes in chronic pancreatitis (CP) using the TriNetX US Collaborative Network.</p><p><strong>Background: </strong>CP patients face heightened risks of pancreatic insufficiency, cancer, and mortality. There are concerns regarding GLP-1 RA use and adverse pancreatic outcomes.</p><p><strong>Methods: </strong>In this retrospective cohort study, adults (age ≥ 18 years) with CP (ICD-10-CM K86.0 or K86.1) were stratified into Cohort 1 (CP + GLP-1 RA, n = 10,978) and Cohort 2 (CP without GLP-1 RA, n = 245,024. After propensity score matching on age, sex, race, and comorbidities, 10,625 patients remained in each cohort. Primary and secondary outcomes were assessed over 3 years via risk analyses and Kaplan-Meier survival analyses.</p><p><strong>Results: </strong>GLP-1 RA users had significantly lower incidence of exocrine insufficiency (3.1% vs. 6.3%; RR 0.491, 95%CI 0.429-0.562, p < 0.001), endocrine insufficiency (6.0% vs. 8.2%; RR 0.742, 95%CI 0.664-0.829, p < 0.001), recurrent acute pancreatitis (5.8% vs. 10.5%; RR 0.554, 95%CI 0.487-0.631, p < 0.001), pancreatic cancer (2.0% vs. 3.9%; RR 0.498, 95%CI 0.421-0.590, p < 0.001), ED visits (17.4% vs. 22.4%; RR 0.778, p < 0.001), hospitalizations (18.0% vs. 26.3%; RR 0.684, p < 0.001), and gastroparesis (2.3% vs. 3.0%; RR 0.771, p = 0.003). Critically, all-cause mortality was 6.9% in GLP-1 RA users versus 16.4% in non-users (RR 0.423, 95%CI 0.390-0.459, p < 0.001), with 3-year survival of 88.6% versus 79.1%.</p><p><strong>Conclusions: </strong>GLP-1 RA use was associated with substantially lower risks of pancreatic and gastrointestinal outcomes, along with improved overall survival, providing observational evidence supporting safety signals.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13393884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148454681","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":"Hepatic and splenic tuberculosis following infliximab therapy for refractory ulcerative colitis: a case report and literature review.","authors":"Shuo Chen, Yanfen Shi, Yang Pang, Xiaodi Wang, Fang Liu, Shiyu Du","doi":"10.1186/s12876-026-05116-6","DOIUrl":"10.1186/s12876-026-05116-6","url":null,"abstract":"<p><strong>Introduction: </strong>Tumor necrosis factor-α (TNF-α) inhibitors are first-line agents for steroid-refractory/resistant ulcerative colitis (UC), but their immunosuppressive effect elevates the risk of opportunistic infections, particularly tuberculosis (TB). Extrapulmonary TB such as hepatic and splenic TB is rare but prone to misdiagnosis. A 55-year-old male was diagnosed with UC in 2003, relieved by sulfasalazine and mesalazine for recurrence in 2021. In 2024, post-perianal abscess surgery, UC relapsed with positive cytomegalovirus (CMV), treated with glucocorticoids and ganciclovir. The patient subsequently developed glucocorticoid-dependent acute severe active UC, presenting with more than 10 bloody stools per day and a Mayo endoscopic score of 3 points. The patient failed to achieve symptom relief after one week of vedolizumab treatment, prompting an immediate adjustment of the therapeutic strategy, and infliximab was therefore initiated. After 6 infliximab doses, he developed fever. T-SPOT/PPD turned positive, with liver and spleen nodules. Biopsy showed epithelioid granulomatous inflammation, Xpert mycobacterium TB/RIF test was positive, leading to hepatic/splenic TB diagnosis. Quadruple anti-TB therapy was initiated. UC relapsed in December 2025, improved by guselkumab. Anti-tuberculosis treatment continues with planned re-evaluation after 1 year.</p><p><strong>Discussion and literature review: </strong>Hepatic/splenic TB lacks specificity, often mimicking drug-induced liver injury. Latest guidelines emphasize baseline TB screening (PPD + TSPOT.TB + chest CT) and 3-6 monthly surveillance during biologic use. Anti-TB drugs may exert synergistic anti-UC effects via cytokine inhibition. Extrapulmonary TB requires ≥ 12 months of anti-TB therapy.</p><p><strong>Conclusion: </strong>Clinicians should remain alert to hepatic/splenic TB in UC patients receiving biologic therapy, particularly those with sequential biologic exposure. Timely pathological and etiological diagnosis and anti-TB therapy improve prognosis, with strict TB surveillance crucial for early detection.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468961","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}