The Kaohsiung journal of medical sciences最新文献

{"title":"A^1vB Genotype With Weak A Antigen Expression: Resolution of an ABO Discrepancy Using Serological and Molecular Approaches.","authors":"Wan-Hua Yang, Fen-Cing Liou","doi":"10.1002/kjm2.70192","DOIUrl":"10.1002/kjm2.70192","url":null,"abstract":"","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70192"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147346211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glycemic Control, Animal Protein Intake, and the Risk of Diabetic Retinopathy Progression Among Patients With Type 2 Diabetes.","authors":"Yu-Ju Wu, Chih-Cheng Hsu, Chih-Yiu Tsai, Shang-Jyh Hwang, Kun-Der Lin, Pi-Chen Lin, Ya-Fang Huang, Chiao-I Chang, Meng-Chuan Huang","doi":"10.1002/kjm2.70200","DOIUrl":"10.1002/kjm2.70200","url":null,"abstract":"<p><p>Effective glycemic control and food consumption play crucial roles in modulating diabetic retinopathy (DR) progression. This observational longitudinal study explored the hemoglobin A1c (HbA1c) and dietary patterns and their associations with the risk and progression of DR among 369 individuals with type 2 diabetes. Participants were grouped by DR development as DM (no DR, n = 280), DR-M (stable DR, n = 40), and DR-W (worsening DR, n = 49) over 3 years using the American Academy of Ophthalmology DR Severity Scale. Dietary intake was evaluated using a validated food frequency questionnaire and principal component analysis. High intake was defined as a component score ≥ 2/3 and low as < 2/3. Over 3 years, HbA1c ≥ 7% and a diabetes duration > 20 years linked to a higher risk of DR-M, with stronger effects seen with high animal protein intake. High animal protein intake was independently correlated with DR-W (OR = 2.58, 95% CI: 1.17-5.70). A one-unit increase in HbA1c and HbA1c ≥ 7% resulted in 2.33-fold (95% CI: 1.08-5.06) and 8.25-fold (95% CI: 1.64-41.43) higher risks of DR-W, respectively, in those with high, but not low intake. Poor glycemic control and diabetes duration exceeding 20 years served as key contributors to DR-M development and persistence over 3 years, with higher risks in strata of high animal protein intake. High animal protein intake also intensified the adverse impact of poor glycemic control on DR-W. In summary, moderating animal protein consumption, alongside optimal glycemic management, may be relevant to DR progression. Given small DR subgroup sizes, these exploratory findings require confirmation in larger, independent cohorts.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70200"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LncRNA NORAD Enhances Inflammatory Injury in Sepsis-Associated Acute Lung Damage Through miR-150-5p/STAT1-Dependent NF-κB Activation.","authors":"Han Liu, Xi-Xi Chen, Gui-Hua Wei, Feng Li, Hai-Yan Zong","doi":"10.1002/kjm2.70191","DOIUrl":"10.1002/kjm2.70191","url":null,"abstract":"<p><p>Acute lung injury (ALI) is a severe complication of sepsis, yet the role of lncRNA NORAD in its pathogenesis remains unclear. Using LPS-stimulated BEAS-2B and HBEC3-KT cells as well as cecal ligation and puncture (CLP)-induced ALI models in C57BL/6 mice, we found that NORAD expression was markedly upregulated and promoted cell injury characterized by reduced viability, enhanced apoptosis, increased cytokine secretion, and aggravated lung damage. Mechanistic studies combining dual-luciferase and RIP assays revealed that NORAD directly bound miR-150-5p to derepress STAT1, leading to elevated STAT1, p-STAT1, and p-p65 levels and activation of JAK/STAT and NF-κB signaling. Silencing NORAD alleviated lung injury in vitro and in vivo, as evidenced by improved cell survival, decreased concentration of total protein in bronchoalveolar lavage fluid (BALF), reduced inflammatory response, lower wet/dry (W/D) ratio, diminished caspase-3 levels, and decreased histological injury scores in CLP mice. Furthermore, knockdown of miR-150-5p or overexpression of STAT1 abolished the protective effects of NORAD inhibition, whereas overexpression of miR-150-5p or knockdown of STAT1 mitigated the injury-promoting effects of NORAD overexpression. These findings demonstrate that NORAD exacerbates sepsis-induced ALI via the miR-150-5p/STAT1 axis, providing new insights into potential therapeutic targets for sepsis-related lung injury.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70191"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147350160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Triglyceride-Related Indices and Risk of Acute Pancreatitis: A Prospective Study in UK Biobank.","authors":"Jing-Bo Li, Yu-Jiao Zhu, Yang-Jie Liao, Jia-Yi Wang","doi":"10.1002/kjm2.70189","DOIUrl":"10.1002/kjm2.70189","url":null,"abstract":"<p><p>Triglyceride-related indices, including triglyceride-glucose (TyG), TyG related to body mass index (TyG-BMI), TyG related to waist circumference (TyG-WC), TyG related to waist-to-height ratio (TyG-WHtR), atherogenic index of plasma (AIP), cardiometabolic index (CMI), visceral adiposity index (VAI), and lipid accumulation product (LAP), are simple surrogate indicators of insulin resistance. Nevertheless, few studies have explored the association between triglyceride-related indices and acute pancreatitis (AP). A total of 387,275 participants from the UK Biobank were included. Cox regression models provided hazard ratios (HRs) with 95% confidence intervals (CIs) for the association between triglyceride-related indices and the risk of AP. Restricted cubic splines (RCS) and receiver operating characteristic (ROC) were employed to evaluate and visualize the relationship. These triglyceride-related indices were significantly associated with an increased risk of AP. Compared with the lowest quartile, the HRs (95% CIs) of AP in the highest quartile were 1.52 (1.33, 1.74), 1.54 (1.34, 1.77), 2.32 (2.02, 2.65), 2.83 (2.43, 3.30), 2.86 (2.46, 3.32), 2.16 (1.88, 2.49), 1.95 (1.71, 2.22), and 2.49 (2.15, 2.87), respectively, for the TyG, AIP, TyG-BMI, TyG-WC, TyG-WHtR, CMI, VAI, and LAP index. RCS analyses showed that the above relationships except for AIP were nonlinear (P for nonlinear < 0.05). ROC curves showed that TyG-WHtR was the best predictor for AP. Elevated triglyceride-related indices were positively related to AP onset. Among them, the TyG-WHtR index displayed the strongest predictive power for the onset of AP, which was expected to become a more effective metric for identifying populations at early risk of AP.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70189"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147392157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"METTL14 Regulates Myocardial Infarction Progression via m⁶A-Dependent Modulation of OTUD1-Mediated Deubiquitination of DUSP6.","authors":"Cheng-Cheng Wei, Ya-Fang Shen, Jin-Yu Zhang","doi":"10.1002/kjm2.70193","DOIUrl":"10.1002/kjm2.70193","url":null,"abstract":"<p><p>Myocardial infarction (MI) is the most severe clinical manifestation of coronary artery diseases (CVD) and serves as a critical driver of sudden cardiac death and heart failure (HF). Its pathophysiology begins with the abrupt cessation of coronary blood flow, leading to severe ischemia and subsequent cardiomyocyte necrosis. This study aimed to investigate the molecular mechanisms by which METTL14 regulates the progression of MI in mice via the OTUD1/DUSP6 signaling axis. An MI mouse model was established by ligating the left anterior descending (LAD) coronary artery. The progression of MI was evaluated through echocardiography, HE staining, Masson's trichrome staining, TUNEL assay, and assessment of inflammatory cytokines. Mechanistically, Me-RIP, PAR-CLIP Co-IP, and protein stability assays were performed to dissect the interactions within the METTL14/OTUD1/DUSP6 axis. Our results demonstrated that METTL14 was highly expressed in the MI mouse model. Silencing METTL14 significantly reduced the left Ventricular Internal Diameter at end-diastole (LVIDd) and left Ventricular Internal Diameter at end-systole (LVIDs), increased ejection fraction (EF) and fractional shortening (FS), and attenuated histopathological damage, apoptosis, and the levels of inflammatory cytokines (TNF-α and IL-β). Further analysis revealed that METTL14 promotes OTUD1 mRNA stability and expression by modulating its m⁶A modification. In turn, METTL14 influences DUSP6 expression by regulating OTUD1-mediated ubiquitination. Collectively, silencing METTL14 modulates the MI disease process through the OTUD1/DUSP6 signaling axis, suggesting that METTL14 plays a pivotal role in MI progression. These findings indicate that targeting METTL14 may represent a potential therapeutic strategy to alleviate pathological injury, apoptosis, and inflammation during MI.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70193"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147577258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-Linear Threshold Effect of Dynamic Estimated Plasma Volume Status on Revealing In-Hospital Mortality Risk in Sepsis.","authors":"Zhi-An Si, Sheng-Bing Xia, Yang Zou, Xiao-Yan Wang","doi":"10.1002/kjm2.70278","DOIUrl":"10.1002/kjm2.70278","url":null,"abstract":"<p><p>This retrospective cohort study evaluated the association between estimated plasma volume status (ePVS) and in-hospital mortality in adult patients with sepsis from the MIMIC-IV (v2.2) database. After excluding patients with early death, readmission, red blood cell transfusion, malignancy, or missing ePVS data, 17,403 patients meeting Sepsis-3 criteria were included. ePVS was calculated using hemoglobin and hematocrit. Early ePVS (ePVS1), late-ICU ePVS (ePVS2), and ePVS change were analyzed using multivariable logistic regression, restricted cubic splines, threshold analysis, prediction metrics, Kaplan-Meier analysis, subgroup analysis, and sensitivity analyses. In-hospital mortality was 13.2%. ePVS2 and ePVS change were significantly higher in non-survivors, whereas the difference in ePVS1 was small. After adjustment, ePVS2 (adjusted odds ratio [OR] = 1.14, 95% confidence interval [CI]: 1.11-1.18, p < 0.001) and ePVS change (adjusted OR = 1.04, 95% CI: 1.02-1.05, p < 0.001) remained independently associated with in-hospital mortality, while ePVS1 was not significant. Non-linear and threshold analyses suggested lower risk at ePVS2 of approximately 6-8 dL/g and ePVS change of -4.5 to 2, with increased risk at ePVS2 ≥ 8 dL/g or ePVS change ≥ 2. Late-ICU ePVS2 and ePVS change may supplement volume-status assessment and short-term prognostic stratification in sepsis, but prospective validation is needed.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70278"},"PeriodicalIF":3.1,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13519500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Triptolide Suppresses Tongue Squamous Cell Carcinoma Progression via PI3K-AKT Pathway Inhibition: An Integrative Network Pharmacology and Experimental Validation Study.","authors":"Shan-Shan Wang, Hong-Cheng Wei, Lin Jiang, Yi-Sen Shao","doi":"10.1002/kjm2.70283","DOIUrl":"10.1002/kjm2.70283","url":null,"abstract":"<p><p>Tongue squamous cell carcinoma, the most aggressive subtype of oral squamous cell carcinoma, which is associated with high mortality, frequent recurrence, and early lymph-node metastasis. Triptolide, a bioactive diterpenoid from Tripterygium wilfordii, exhibits broad anticancer activity. Although its inhibitory action on OSCC has been established, its specific molecular regulatory mechanisms in TSCC, a distinct and aggressive subtype, remain largely underexplored. The present study investigates the regulatory role of triptolide in the PI3K-AKT signaling pathway, which is a critical axis intimately linked to tumor survival and metastasis. A network-pharmacology workflow was used to intersect triptolide putative targets with TSCC-related genes. Core hubs were identified with Cytoscape; KEGG and GO analyses highlighted the PI3K-AKT axis as the top enriched pathway. Binding kinetics were quantified by molecular docking and surface plasmon resonance (SPR). Cellular assays (CCK-8, Transwell, wound-healing, Western blot and immunofluorescence) validated the predictions. We retrieved 389 common targets and shortlisted eight key nodes (JUN, MAPK1, MAPK3, AKT1, TP53, BCL2, STAT3, MYC). SPR revealed high-affinity binding of triptolide to AKT1 and PI3K. Functionally, triptolide dose-dependently suppressed TSCC cell proliferation, invasion, and migration, downregulated PI3K-AKT signaling proteins, and reduced the colocalization and phosphorylation levels of p-PI3K and p-AKT. This study is the first to demonstrate the pivotal role of the PI3K-AKT signaling pathway in mediating the antitumor effects of triptolide in tongue squamous cell carcinoma. Our findings thereby provide a novel theoretical foundation for the development of traditional Chinese medicine-based therapeutic strategies targeting this malignancy.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70283"},"PeriodicalIF":3.1,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13519503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pretreatment Prediction of Tumor Recurrence in Breast Cancer After Neoadjuvant Systemic Therapy Using Machine Learning With Clinical and CT Radiomics Features.","authors":"Huei-Yi Tsai, Jo-Ching Wang, Wei-Shiuan Chung, Jui-Sheng Hsu, Shu-Yen Lin, Ming-Feng Hou, Ming-Chung Chou","doi":"10.1002/kjm2.70288","DOIUrl":"10.1002/kjm2.70288","url":null,"abstract":"<p><p>This study aimed to develop machine learning models for predicting tumor recurrence in breast cancer before neoadjuvant systemic therapy (NST) by integrating clinical and radiomic features derived from pretreatment computed tomography (CT). We retrospectively enrolled 235 patients with 237 breast tumors who underwent contrast-enhanced CT before NST. Datasets were randomly divided into five-fold training and testing sets using semi-random partitioning to ensure similar clinical characteristics between the two subsets. Subsequently, a nested five-fold cross-validation was performed to develop a recurrence prediction model using three machine learning algorithms across clinical, radiomics, and integrated models. The performance of prediction models was compared using the area under the receiver-operating characteristic curve (AUC), and the best clinical and radiomics models were further integrated to develop the final model. Kaplan-Meier analysis with a log-rank test was conducted to compare survival curves between high- and low-risk groups stratified by the prediction models. The comparisons demonstrated that the random survival forest (RSF) clinical model (mean AUC = 0.755) and the Cox-least absolute shrinkage and selection operator (Cox-LASSO) radiomics model (mean AUC = 0.636) outperformed other machine learning algorithms. The integration of the clinical (RSF) and radiomics (Cox-LASSO) models achieved a mean AUC of 0.777 in predicting tumor recurrence. The log-rank analysis revealed significant differences in the survival curves between the high- and low-risk groups stratified by the integration model on the testing sets. In conclusion, the integration of clinical and CT-based radiomics models was helpful for the pretreatment prediction of tumor recurrence in patients with breast cancer after NST.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70288"},"PeriodicalIF":3.1,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13519504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stage-Dependent Prognostic Value of the Joint MASLD-NAFLD Fibrosis Score Phenotype Across the Cardiovascular-Kidney-Metabolic Syndrome Continuum: A Retrospective NHANES Cohort Analysis, 1999-2018.","authors":"Yi-Fei Wang, Jian-Li Zhang, Yun-Fei Wang, Jun-Peng Xiong, Rong-Hui Yu, Ze-Ping Hu","doi":"10.1002/kjm2.70285","DOIUrl":"10.1002/kjm2.70285","url":null,"abstract":"<p><p>The cardiovascular-kidney-metabolic (CKM) framework and metabolic dysfunction-associated steatotic liver disease (MASLD) describe a shared clinical continuum, but the prognostic value of joint fatty liver index (FLI)-NAFLD fibrosis score (NFS) phenotypes across CKM stages is uncertain. We analyzed 10 National Health and Nutrition Examination Survey cycles (1999-2018) linked to mortality through 2019. Among 31,317 adults, participants were classified as A (no MASLD/NFS-low), B (MASLD/NFS-low), C (no MASLD/NFS-high), or D (MASLD/NFS-high) and stratified by operational CKM Stages 0-4. Survey-weighted survival analyses and Cox models incorporated 20-imputation covariate analysis; exposure, outcome, follow-up, and survey-design fields were not imputed. During 291,392.5 person-years, 4284 all-cause and 1417 cardiovascular deaths occurred. All-cause survival differed across phenotypes in Stages 2-4 (p < 0.001 for each), but not between A and B in Stage 1 (p = 0.695). At Stage 2, adjusted D-versus-A hazard ratios were 1.57 (95% CI 1.30-1.91) for all-cause mortality and 2.09 (1.57-2.79) for cardiovascular mortality; corresponding Stage 4 estimates were 1.44 (1.21-1.70) and 1.25 (0.96-1.64). The full stage interaction was non-estimable, and supported-stage interaction p values were 0.113 and 0.122. Joint-phenotype associations varied across supported CKM stages, but sparse early-stage phenotypes, a small apparent discrimination gain, and nominal subgroup findings support external validation rather than immediate clinical deployment.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70285"},"PeriodicalIF":3.1,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13519501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Proof-of-Concept Study of Language-Stratified Assessment for Minimal Hepatic Encephalopathy: Integrating the Animal Naming Test and Serum IL-6.","authors":"Hsin-Che Lin, Cheng Jen Chen, Tsung-Han Wu, Po-Wen Gu, Chun-Yi Tsai, Wey-Ran Lin, Chao-Wei Hsu, Chun-Yen Lin, Rong-Nan Chien, Chien-Hao Huang, Piero Amodio","doi":"10.1002/kjm2.70271","DOIUrl":"https://doi.org/10.1002/kjm2.70271","url":null,"abstract":"<p><p>Minimal hepatic encephalopathy (MHE) involves subtle cognitive dysfunction and systemic inflammation and is associated with an increased risk of overt hepatic encephalopathy. The Animal Naming Test (ANT₁) is a rapid semantic fluency tool for MHE assessment, but its performance across different primary spoken languages remains unclear. We conducted a prospective proof-of-concept study to evaluate the diagnostic performance of ANT₁ and serum interleukin-6 (IL-6) in Mandarin- and Taiwanese Hokkien-speaking cirrhotic patients. A total of 65 cirrhotic patients and 34 healthy controls were enrolled. Patients completed ANT₁, simplified ANT₁ (S-ANT₁), and standard psychometric assessments. MHE was defined by abnormal PHES and/or visually assessed EEG slowing. Diagnostic discrimination was evaluated using AUROC analyses stratified by primary spoken language. A post hoc exploratory Taiwanese-calibrated S-ANT₁ was also assessed in Taiwanese Hokkien-speaking patients. Sixteen cirrhotic patients (24.6%) were diagnosed with MHE. Patients with MHE had lower ANT1 scores and higher serum IL-6 levels than those without MHE. In Mandarin-speaking patients (n = 44), ANT₁ demonstrated an AUROC of 0.760, while serum IL-6 showed an AUROC of 0.841. The composite model combining ANT₁ and serum IL-6 showed a numerically higher AUROC of 0.895, but this improvement was not statistically significant in pairwise DeLong comparisons. In Taiwanese Hokkien-speaking patients (n = 21), standard ANT₁ showed a lower AUROC of 0.679. The exploratory Taiwanese-calibrated S-ANT₁ showed a numerically higher AUROC of 0.776; however, this post hoc finding was based on a small subgroup with 7 MHE events and requires external validation. This study suggests that primary spoken language may be associated with ANT₁ performance in MHE assessments. Integrating ANT₁ with serum IL-6 showed numerically improved discrimination in Mandarin speakers, whereas exploratory demographic calibration of S-ANT₁ showed a numerically higher AUROC in Taiwanese Hokkien speakers. These findings are exploratory and hypothesis-generating, necessitating validation in larger independent cohorts before clinical implementation.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70271"},"PeriodicalIF":3.1,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}