Clinics and research in hepatology and gastroenterology最新文献

英文中文

Associations of advanced therapies in inflammatory bowel diseases 炎性肠病先进治疗的关联。

IF 2.4 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Clinics and research in hepatology and gastroenterology

Pub Date : 2025-10-30 DOI: 10.1016/j.clinre.2025.102726

M. Uzzan , M. Barrau , X. Roblin

引用次数: 0

Update on IBD management: What's new in acute severe UC? - Modern management of perianal disease IBD管理的最新进展：急性重症UC有什么新进展？-肛门周围疾病的现代管理。

IF 2.4 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Clinics and research in hepatology and gastroenterology

Pub Date : 2025-10-30 DOI: 10.1016/j.clinre.2025.102725

David Laharie , Pauline Rivière , Amandine Landemaine , Guillaume Bouguen

引用次数: 0

Do serum biomarkers correlate to the risk of gastric lesions in patients with autoimmune gastritis༟—A systematic review and meta-analysis 血清生物标志物与自身免疫性胃炎患者胃病变风险相关༟-系统评价和荟萃分析

IF 2.4 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Clinics and research in hepatology and gastroenterology

Pub Date : 2025-10-28 DOI: 10.1016/j.clinre.2025.102722

Zijin Liu , Yingqi Wang , Jiayi Hong , Fang He , Lijie Hao , Linmin Liu , Huihong Zhai

Background & Aims

Current surveillance strategies for autoimmune gastritis (AIG) lack consensus, and the prognostic role of serum biomarkers remains unclear. This meta-analysis aimed to evaluate the correlation between serum biomarkers and the risks of gastric lesions in AIG patients.

Methods

Studies comparing serum biomarkers in AIG patients with versus without neuroendocrine tumor (NET), gastric polyp (GP), or gastric cancer (GC) were identified by searching PubMed, EMBASE, and Cochrane databases (up to March 2025). Basic studies, meta-analyses, reviews, case reports, or studies not published in English were excluded. Two investigators independently extracted data and quality-assessed using the Newcastle–Ottawa and AHRQ scales. Statistical analysis used Review Manager 5.4 and Stata MP18. Heterogeneity and publication bias were evaluated. Sensitivity analysis was used to manage heterogeneity and assess the stability of the result.

Results

Thirteen studies (10 for NET, 4 for GP, and 1 for GC) were included. Elevated serum gastrin correlated significantly with NET (MD: 519.05, 95% CI: 227.96∼810.13, P = 0.0005, I²=85%) and GP (MD: 70.54, 95% CI: 43.59∼97.49, P < 0.00001, I²=0%; weighted mean: 240.02 pg/ml). With a high heterogeneity in the NET group, we arranged sensitivity analysis and removed two studies that caused heterogeneity, the result consistently showed a statistical difference (MD: 196.62, 95% CI: 76.61∼316.64, P = 0.001, I²=22%; weighted mean: 811.53 pg/ml). Publication bias was found neither in NET (Begg’s test: P = 0.1078, Egger’s test: P = 0.3553) nor in GP (Begg’s test: P = 1.0000, Egger’s test: P = 0.4771) groups. Chromogranin A (CgA), vitamin B12, and parietal cell antibody (PCA) showed no consistent associations. For GC, limited data suggested milder gastrin elevation and higher Helicobacter pylori co-infection rates.

Discussion

Serum gastrin is correlated with NET and GP in AIG patients. The weighted mean serum gastrin level was 811.53 pg/ml in AIG patients with NET, and 240.02 pg/ml in those with GP. Non-enrollment of randomized controlled trials (RCTs), inconsistency in laboratory methods for biomarker detection and diagnostic criteria, and different units of biomarkers may cause limitations of the present study.

背景与目的：目前自身免疫性胃炎（AIG）的监测策略缺乏共识，血清生物标志物的预后作用仍不清楚。本荟萃分析旨在评估AIG患者血清生物标志物与胃病变风险之间的相关性。方法：通过检索PubMed、EMBASE和Cochrane数据库（截至2025年3月），对伴有神经内分泌肿瘤（NET）、胃息肉（GP）或胃癌（GC）的AIG患者的血清生物标志物进行比较研究（截至2025年3月）。基础研究、荟萃分析、综述、病例报告或非英文发表的研究被排除在外。两名研究者独立提取数据并使用Newcastle-Ottawa和AHRQ量表进行质量评估。统计分析使用Review Manager 5.4和Stata MP18。评估异质性和发表偏倚。敏感性分析用于管理异质性和评估结果的稳定性。结果：纳入13项研究（NET 10项，GP 4项，GC 1项）。血清胃泌素升高与NET （MD: 519.05, 95% CI: 227.96 ~ 810.13， P=0.0005, I2=85%）和GP （MD: 70.54, 95% CI: 43.59 ~ 97.49, P2=0%；加权平均值：240.02 pg/ml）显著相关。由于NET组异质性较高，我们安排了敏感性分析并剔除了两项引起异质性的研究，结果一致显示有统计学差异（MD: 196.62, 95% CI: 76.61 ~ 316.64， P=0.001, I2=22%；加权平均值：811.53 pg/ml）。NET组（Begg检验：P = 0.1078，Egger检验：P = 0.3553）和GP组（Begg检验：P = 1.0000，Egger检验：P = 0.4771）均未发现发表偏倚。嗜铬粒蛋白A （CgA）、维生素B12和壁细胞抗体（PCA）没有一致的相关性。对于GC，有限的数据表明胃泌素轻度升高和幽门螺杆菌合并感染率较高。讨论：血清胃泌素与AIG患者NET和GP相关。AIG合并NET患者加权平均血清胃泌素水平为811.53 pg/ml， GP患者加权平均血清胃泌素水平为240.02 pg/ml。未纳入随机对照试验（RCTs），生物标志物检测和诊断标准的实验室方法不一致，生物标志物单位不同可能导致本研究的局限性。

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引用次数: 0

Cirrhotic cardiomyopathy in children: A comprehensive assessment using ECG, echocardiography, and NT-Pro-BNP 儿童肝硬化心肌病：使用心电图、超声心动图和NT-Pro-BNP进行综合评估。

IF 2.4 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Clinics and research in hepatology and gastroenterology

Pub Date : 2025-10-28 DOI: 10.1016/j.clinre.2025.102721

Ataollahi Maryam , Naghshzan Amir , Haghighat Mahmood , Dehghani Mohsen , Amuzgar Hamid , Kalvandi Gholamreza , Mehdizadegan Nima , Salarian Leila

Objective

To evaluate the prevalence, diagnostic criteria, and predictive factors of cirrhotic cardiomyopathy (CCMP) in pediatric patients with portal hypertension (PHTN), using electrocardiography (ECG), echocardiography, and NT-proBNP levels.

Methods

This cross-sectional study included 54 children with portal hypertension (45 with cirrhosis and 9 without), and 54 age- and sex-matched healthy controls. All participants underwent ECG, echocardiography, and NT-proBNP testing. CCMP was diagnosed based on the Møller-Henriksen criteria. Demographic, clinical, and laboratory variables, including PELD/MELD and Child-Pugh scores, were analyzed. Logistic regression was used to identify predictors of CCMP.

Results

CCMP was identified in 14 cirrhotic patients (31.1 %), with 9 symptomatic and 5 silent cases. No cases were observed among non-cirrhotic patients or controls. The presence of ascites and higher PELD/MELD scores were significantly associated with CCMP. QTc prolongation and reduced ejection fraction were key diagnostic findings. Systolic dysfunction was present in 3 patients, and 4 patients with CCMP died before or shortly after liver transplantation. Multivariate analysis confirmed PELD/MELD score as a significant predictor of CCMP (OR 1.19; 95 % CI 1.038–1.367; p=0.01).

Conclusion

Cirrhotic cardiomyopathy is a prevalent but often silent complication in children with cirrhosis and PHTN. Elevated PELD/MELD scores and the presence of ascites are important predictive factors. Routine cardiac evaluation using ECG, echocardiography, and biomarkers like NT-proBNP is recommended for early detection and risk stratification in this population.

Main Points

Cirrhotic cardiomyopathy (CCMP) is an uncommon yet serious condition in children with liver disease. Current diagnostic criteria require reassessment for pediatric use, particularly considering regional genetic and environmental differences.

目的：通过心电图（ECG）、超声心动图和NT-proBNP水平评估门脉高压（PHTN）患儿肝硬化心肌病（CCMP）的患病率、诊断标准和预测因素。方法：本横断面研究纳入54例门静脉高压症患儿（45例合并肝硬化，9例未合并肝硬化）和54例年龄和性别匹配的健康对照。所有参与者都进行了心电图、超声心动图和NT-proBNP测试。CCMP的诊断基于Møller-Henriksen标准。分析了人口统计学、临床和实验室变量，包括PELD/MELD和Child-Pugh评分。采用Logistic回归确定CCMP的预测因素。结果：14例肝硬化患者（31.1%）发现CCMP，其中9例有症状，5例无症状。在非肝硬化患者或对照组中未观察到病例。腹水的存在和较高的PELD/MELD评分与CCMP显著相关。QTc延长和射血分数降低是主要的诊断结果。3例患者出现收缩功能障碍，4例CCMP患者在肝移植前或移植后不久死亡。多因素分析证实PELD/MELD评分是CCMP的重要预测因子（OR 1.19; 95% CI 1.038 ~ 1.367; p=0.01）。结论：肝硬化心肌病是肝硬化和PHTN患儿的一种常见但通常不明显的并发症。PELD/MELD评分升高和腹水的存在是重要的预测因素。建议使用心电图、超声心动图和NT-proBNP等生物标志物进行常规心脏评估，以便在该人群中进行早期发现和风险分层。要点：肝硬化心肌病（CCMP）是一种罕见但严重的儿童肝脏疾病。目前的诊断标准需要重新评估儿科使用，特别是考虑到区域遗传和环境差异。

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引用次数: 0

Gastrointestinal stromal tumor presenting in the pancreas 出现于胰腺的胃肠道间质瘤。

IF 2.4 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Clinics and research in hepatology and gastroenterology

Pub Date : 2025-10-23 DOI: 10.1016/j.clinre.2025.102715

Jia-Lu Long, Peng Liu

引用次数: 0

Geography, not genetics: Reframing esophageal cancer mortality in rural populations 地理，而非遗传学：重塑农村人口食管癌死亡率。

IF 2.4 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Clinics and research in hepatology and gastroenterology

Pub Date : 2025-10-13 DOI: 10.1016/j.clinre.2025.102714

Saqlain Haider

引用次数: 0

Screening for alcohol consumption in liver transplant recipients: results of a nationwide French survey 肝移植受者饮酒筛查：法国一项全国性调查结果

IF 2.4 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Clinics and research in hepatology and gastroenterology

Pub Date : 2025-10-13 DOI: 10.1016/j.clinre.2025.102712

Jérôme Dumortier , Georges-Philippe Pageaux , Audrey Coilly , Claire Francoz , Filomena Conti , Guillaume Lassailly , Sébastien Dharancy , Pauline Houssel-Debry , José Ursic-Bedoya , Hélène Donnadieu , Groupe de recherche français en greffe de foie (GReF2)

引用次数: 0

Retraction notice for several articles 几篇文章的撤稿通知

IF 2.4 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Clinics and research in hepatology and gastroenterology

Pub Date : 2025-10-10 DOI: 10.1016/j.clinre.2025.102705

引用次数: 0

Loss of Windkessel notch on transcranial doppler, a glancing sign of cerebral hemodynamic alteration 经颅多普勒显示Windkessel缺口缺失，这是脑血流动力学改变的初步迹象。

IF 2.4 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Clinics and research in hepatology and gastroenterology

Pub Date : 2025-10-10 DOI: 10.1016/j.clinre.2025.102713

Vladimir L Cousin, Marine Lys, Ramy Charbel, Jordi Miatello, Pierre Tissières

None.

没有。

引用次数: 0

Evaluation of osteoporosis in adult patients with beta-thalassemia major and its relation to serum sclerostin level 重度β -地中海贫血成年患者骨质疏松及其与血清硬化蛋白水平的关系。

IF 2.4 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Clinics and research in hepatology and gastroenterology

Pub Date : 2025-10-10 DOI: 10.1016/j.clinre.2025.102709

Ahmed Abd El Fattah El Bamby , Tamer Abd El Hamid El bedawi , Mohammed Adel Eltomi , Sara Mamdouh Shoeeb , Enji Abd El Wahab Ibrahim

Background

Beta-thalassemia major (β-TM) is a chronic hemoglobinopathy in which improved survival has shifted focus toward long-term complications, notably osteoporosis. The pathogenesis is multifactorial, involving iron overload, bone marrow expansion, endocrine dysfunction, and impaired osteoblast activity. While histomorphometric data highlight reduced bone formation, clinical evidence demonstrates broader and more severe skeletal abnormalities.

Purpose of study

To evaluate osteoporosis in β-TM patients and examine its relationship with serum sclerostin levels.

Methods

This study employed a cross-sectional case-control design. Enrolled 80 individuals diagnosed with β-TM. Participants were equally assigned to two groups: Group I, consisting of β-TM patients, and Group II, composed of healthy controls matched for age and sex.

Results

Serum sclerostin significantly predict osteoporosis among the tested patients (P < 0.001 and AUC = 0.868) at cut-off>0.61 with 80 %sensitivity, 80 %specificity. T score exhibited significantly lower value in beta TM (group I) when compared to control (group II) (P < 0.001). The poorly chelated group exhibited significantly higher T-scores and serum sclerostin levels. In univariate regression, (hemoglobin, transferrin saturation, serum iron, serum ferritin, total iron binding capacity and serum sclerostin) were independent predictors of osteoporosis β TM patients (P < 0.05). In Multivariate regression, serum sclerostin was independent predictor of osteoporosis in β- TM patients (P = 0.02) while weight, height, BMI, WBCs, Platelets, transferrin saturation, serum iron, ferritin were not.

Conclusions

Patients with β-TM exhibit a greater prevalence of osteoporosis and elevated serum sclerostin levels compared to healthy individuals. The increased serum sclerostin in β-TM patients may reflect impaired bone formation and increased bone loss, thus facilitating osteoporosis development.

背景：β-地中海贫血（β-TM）是一种慢性血红蛋白病，其生存率的提高已转向长期并发症，特别是骨质疏松症。其发病机制是多因素的，包括铁超载、骨髓扩张、内分泌功能障碍和成骨细胞活性受损。虽然组织形态学数据强调骨形成减少，但临床证据显示更广泛和更严重的骨骼异常。研究目的：探讨β-TM患者骨质疏松及其与血清硬化素水平的关系。方法：本研究采用横断面病例-对照设计。招募了80名被诊断为β-TM的个体。参与者被平均分为两组：第一组由β-TM患者组成，第二组由年龄和性别匹配的健康对照组组成。结果：血清硬化蛋白可显著预测骨质疏松症（P0.61，敏感性80%，特异性80%）。与对照组（II组）相比，β-TM患者的T评分明显降低(p结论：β-TM患者骨质疏松症患病率更高，血清硬化蛋白水平升高。β-TM患者血清硬化蛋白升高可能反映了骨形成受损和骨质流失增加，从而促进骨质疏松症的发展。

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Clinics and research in hepatology and gastroenterology

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