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Age and sex differences in intrapancreatic fat deposition: A cross-sectional CT study 胰腺内脂肪沉积的年龄和性别差异:横断面CT研究。
IF 2.4 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-01-24 DOI: 10.1016/j.clinre.2026.102770
Yiping Zhang, Dingzhe Zhang, Rongzhou Wang, Rui Yu, Yu Wang, Jianhua Wang, Xiao Chen

Background/aims

Intra-pancreatic fat deposition (IPFD) is associated with health issues, yet its distribution patterns across age and gender remain unclear. This study analyzed differences in computed tomography (CT)-based IPFD content among different age and gender groups.

Methods

A retrospective cohort of 1305 adults undergoing chest CT examinations was established. Pancreatic and splenic CT attenuation values were measured, pancreas-to-spleen CT ratio (P/S) and pancreas-to-spleen CT difference (P-S) were also calculated which served as indicators of IPFD. Pearson correlation analysis was employed to assess the relationship between each parameter and age stratified by sex. Multiple linear regression was applied to evaluate the independent effects of age and sex.

Results

Pancreatic fat-related CT parameters were negatively correlated with age (r = -0.527 to -0.467, p < 0.001). Compared to young adults aged 21–29 years, pancreatic CT attenuation and both the P/S ratio and P-S difference fallen markedly by the 51–59-year group. An even greater difference was observed in individuals over 70 years of age. The P/S ratio and P-S of males were significantly lower than female in each age group. Multiple linear regression showed that age were independent negative predictors of all parameters (p < 0.001), while gender was an independent influencing factor of the P/S ratio (β = 0.073, p = 0.004) and P-S (β = 0.072, P = 0.004), but had no independent predictive effect on the unadjusted pancreatic CT value.

Conclusion

IPFD shows a gradual increase with advancing age and is higher in males compared to females.
背景/目的:胰腺内脂肪沉积(IPFD)与健康问题相关,但其在年龄和性别中的分布模式尚不清楚。本研究分析了不同年龄和性别人群中基于计算机断层扫描(CT)的IPFD含量的差异。方法:对1305名接受胸部CT检查的成年人进行回顾性队列研究。测量胰腺和脾脏CT衰减值,计算胰脾CT比值(P/S)和胰脾CT差值(P-S),作为IPFD的指标。采用Pearson相关分析评估各参数与按性别分层的年龄之间的关系。采用多元线性回归评价年龄和性别的独立影响。结果:胰腺脂肪相关CT参数与年龄呈负相关(r = -0.527 ~ -0.467,p < 0.001)。与21-29岁的青壮年相比,51-59岁组胰腺CT衰减、P/S比和P-S差均明显下降。在70岁以上的人身上观察到的差异甚至更大。各年龄组男性P/S比和P-S均显著低于女性。多元线性回归结果显示,年龄是各参数的独立负向预测因素(p < 0.001),性别是p /S比(β = 0.073,p = 0.004)和p -S (β = 0.072,p = 0.004)的独立影响因素,但对未调整胰腺CT值无独立预测作用。结论:IPFD随年龄增长逐渐增高,男性高于女性。
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引用次数: 0
Sensitivity and specificity of magnetic resonance elastography in liver diseases in the pediatric age group 磁共振弹性成像在儿童年龄组肝脏疾病中的敏感性和特异性。
IF 2.4 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-01-19 DOI: 10.1016/j.clinre.2026.102768
Paulina Chodnicka, Elżbieta Jurkiewicz, Kamil Janowski, Maria Janowska, Agnieszka Pytlewska, Małgorzata Gołuch, Małgorzata Markiewicz-Kijewska, Maciej Pronicki, Wiesława Grajkowska, Piotr Socha

Objectives

Liver fibrosis staging in pediatric patients traditionally relies on invasive methods, such as liver biopsy, which pose risks and limitations. Magnetic Resonance Elastography (MRE) has emerged as a promising noninvasive alternative. This study aimed to validate the use of MRE in pediatric liver diseases and assess its diagnostic accuracy.

Methods

A total of 110 participants (61 with autoimmune hepatitis (AIH), 33 post-liver transplantation (LTx), and 16 healthy controls) underwent MRE examinations. Liver biopsies were performed based on ESPGHAN indications in patients with AIH and according to institutional post-transplant protocols in LTx patients. Biochemical data were collected including ALT (alanine aminotransferase), AST (aspartate transaminase), INR (international normalized ratio), bilirubin, and platelet counts. The APRI (aspartate aminotransferase to platelet ratio index) and FIB 4 (Fibrosis Index Based on 4 Factors) were calculated.

Results

In AIH patients MRE showed a sensitivity of 76.2% and specificity of 84.6% for moderete to severe fibrosis, incomplete cirrhosis and cirrhosis (Ishak 4–6, AUC 0.828, cutoff 3.28 kPa) and a sensitivity of 80% and specificity of 88.9% for incomplete cirrhosis and cirrhosis (Ishak 5–6, AUC 0.896, cutoff 3.68 kPa). In LTx patients, MRE demonstrated a sensitivity of 80% and specificity of 91.3% for moderete to severe fibrosis and cirrhosis (Ishak 4–6, AUC 0.865, cutoff 3.1 kPa). Inter-observer agreement for MRE was excellent (ICC(3,1) of 0.988)

Conclusions

MRE is a valuable noninvasive tool offering an accurate assessment of fibrosis. Further research is warranted to expand MRE's utility across diverse pediatric liver conditions. This validation of the MRE highlights its potential to enhance clinical decision-making and patient care in pediatric hepatology.
目的:儿童肝纤维化分期传统上依赖于侵入性方法,如肝活检,这存在风险和局限性。磁共振弹性成像(MRE)已成为一种很有前途的非侵入性替代技术。本研究旨在验证MRE在儿童肝脏疾病中的应用,并评估其诊断准确性。方法:共有110名参与者(自身免疫性肝炎(AIH) 61名,肝移植后(LTx) 33名,健康对照16名)进行了MRE检查。根据AIH患者的ESPGHAN适应症和LTx患者的机构移植后方案进行肝活检。收集生化数据,包括谷丙转氨酶(ALT)、谷草转氨酶(AST)、国际标准化比值(INR)、胆红素、血小板计数。计算APRI(天冬氨酸转氨酶与血小板比值指数)和FIB 4(基于4因素的纤维化指数)。结果:在AIH患者中,MRE对中重度纤维化、不完全肝硬化和肝硬化(Ishak 4-6, AUC 0.828,截止值3.28 kPa)的敏感性为76.2%,特异性为84.6%;对不完全肝硬化和肝硬化(Ishak 5-6, AUC 0.896,截止值3.68 kPa)的敏感性为80%,特异性为88.9%。在LTx患者中,MRE对中重度纤维化和肝硬化的敏感性为80%,特异性为91.3% (Ishak 4-6, AUC 0.865,截止值3.1 kPa)。MRE的观察者间一致性非常好(ICC(3,1) = 0.988)。结论:MRE是一种有价值的无创工具,可以准确评估纤维化。进一步的研究是必要的,以扩大MRE的效用在不同的儿童肝脏疾病。MRE的验证强调了其在儿科肝病学中加强临床决策和患者护理的潜力。
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引用次数: 0
Muricholic acids and autotaxin in intrahepatic cholestasis of pregnancy: A case-control study 妊娠期肝内胆汁淤积的胆酸和自taxin:一项病例对照研究。
IF 2.4 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-01-19 DOI: 10.1016/j.clinre.2026.102769
Katharina Köstenbauer , Theresa Bauer , Patrick Greimel , Tanja Strini , Axel Schlagenhauf , Jörg Jahnel
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引用次数: 0
FXR dysregulation as the metabolic nexus driving cholesterol gallstone disease FXR失调作为代谢联系驱动胆固醇胆结石病。
IF 2.4 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-01-13 DOI: 10.1016/j.clinre.2026.102767
Sarvesh Sabarathinam , Nila Ganamurali , K K S Kartheekeyan , Manoj Kumar Narasimhan , Evelyn Sharon Sukumaran
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引用次数: 0
Fecal calprotectin in patients with concomitant primary sclerosing cholangitis and inflammatory bowel disease: a systematic review and meta-analysis 伴有原发性硬化性胆管炎和炎症性肠病患者的粪便钙保护蛋白:一项系统回顾和荟萃分析
IF 2.4 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-01-13 DOI: 10.1016/j.clinre.2026.102764
Giorgia Burrelli Scotti , Fabrizio Zullo , Marco Mattana , Francesco Covotta , Emanuela Ribichini , Domenico Alvaro , Vincenzo Cardinale

Background

Primary sclerosing cholangitis (PSC) is strongly associated with inflammatory bowel disease (IBD), with up to 70% of PSC patients having concomitant IBD (PSC-IBD). Fecal Calprotectin (FC) is a validated surrogate biomarker of intestinal inflammation in IBD. Emerging evidence suggests that FC may also reflect biliary inflammation in PSC.

Aim

This study aimed to compare FC concentrations in patients with PSC-IBD versus IBD only.

Methods

A systematic literature search was performed (PROSPERO registration no. CRD42024600985). Studies reporting FC levels in both PSC-IBD and IBD-only patients were included. The outcome of interest was the difference in mean FC concentration between the two groups.

Results

Seven studies met the inclusion criteria. There was no significant difference in the mean FC levels between PSC-IBD and IBD patients (-5.10, 95% confidence interval [CI] -45.40 to -35.2; p= 0.8). The findings remained non-significant when endoscopic remission was considered (12.82, 95% CI -19.33 to 44.97; p= 0.43).

Conclusions

FC levels did not significantly differ between PSC-IBD and IBD groups. The available evidence is limited and heterogeneous. Larger, well-designed studies are needed to determine whether FC can serve as a surrogate biomarker of PSC progression, particularly in patients with endoscopic remission of colitis or without concomitant IBD.
背景:原发性硬化性胆管炎(PSC)与炎症性肠病(IBD)密切相关,高达70%的PSC患者伴有IBD (PSC-IBD)。粪钙保护蛋白(FC)是一种有效的IBD肠道炎症替代生物标志物。新出现的证据表明FC也可能反映PSC的胆道炎症。目的:本研究旨在比较PSC-IBD患者与单纯IBD患者的FC浓度。方法:进行系统的文献检索(PROSPERO注册号:;CRD42024600985)。研究报告了PSC-IBD和仅ibd患者的FC水平。我们感兴趣的结果是两组间FC平均浓度的差异。结果:7项研究符合纳入标准。PSC-IBD和IBD患者的平均FC水平无显著差异(-5.10,95%可信区间[CI] -45.40至-35.2;p= 0.8)。当考虑内镜缓解时,结果仍然不显著(12.82,95% CI -19.33至44.97;p= 0.43)。结论:FC水平在PSC-IBD组和IBD组之间无显著差异。可获得的证据是有限的和不同的。需要更大规模、设计良好的研究来确定FC是否可以作为PSC进展的替代生物标志物,特别是在内镜下结肠炎缓解或无合并IBD的患者中。
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引用次数: 0
Comment on “Comparison of repeat hepatectomy with radiofrequency ablation for the survival of hepatocellular carcinoma with solitary intrahepatic recurrence after hepatectomy” 对“重复肝切除术与射频消融术对肝切除术后单发肝内复发肝细胞癌生存率的比较”的评论。
IF 2.4 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-01-13 DOI: 10.1016/j.clinre.2026.102762
Kanishka Harariya , Thakur Rohit Singh , Ankita Kalra , Swarupanjali Padhi , Fayaz Ahamed
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引用次数: 0
Clinical characteristics and risk factors of drug-induced hepatotoxicity in cancer patients following repeated chemotherapy cycles 反复化疗周期后肿瘤患者药物性肝毒性的临床特点及危险因素分析。
IF 2.4 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-01-13 DOI: 10.1016/j.clinre.2026.102763
Qunxiang Cao , Siyang Chen , Yutian Zhang , Juping Yang , Zhaohui Wang
<div><h3>Objective</h3><div>This study investigates the incidence, clinical characteristics, and risk factors of drug-induced liver injury (DILI) in cancer patients undergoing multiple courses of common chemotherapy drugs, providing evidence for developing DILI prevention and control strategies in clinical practice.</div></div><div><h3>Methods</h3><div>A retrospective cohort study included 165 cancer patients who received multiple courses of common chemotherapy drugs between January 2023 and January 2025. Participants were divided into a study group (<em>n</em> = 45, DILI occurrence) and a control group (<em>n</em> = 120, no DILI occurrence) based on DILI development. Baseline patient data, chemotherapy regimens, and liver function indicators were collected. Univariate analysis screened potential risk factors, while multivariate logistic regression validated independent risk factors. Spearman's rank correlation analyzed associations between risk factors and DILI severity.</div></div><div><h3>Results</h3><div>The overall DILI incidence among 165 patients was 27.27% (45/165), predominantly moderate in severity. Distribution by grade was: Grade 1 (mild) 14 cases (31.11%), Grade 2 (moderate) 24 cases (53.33%), Grade 3 (severe) 7 cases (15.56%), with no Grade 4 injury. Comparison of baseline characteristics between groups revealed higher DILI incidence among patients aged ≥60 years, with alcohol consumption history, viral hepatitis history, underlying liver disease, ≥3 chemotherapy drugs, and without prophylactic hepatoprotective/cholagogue use (all <em>p</em> < 0.05). Post-chemotherapy, the study group exhibited significantly higher levels of ALT, AST, ALP, GGT, and TBIL compared to the control group (all <em>p</em> < 0.001). Multivariate analysis confirmed that age ≥60 years (OR=2.964, 95% CI: 1.247–7.043, <em>p</em> = 0.014), history of alcohol consumption (OR=3.684, 95% CI: 1.523–8.912, <em>p</em> = 0.004), history of viral hepatitis (OR=3.116, 95% CI: 1.116–8.696, <em>p</em> = 0.030), underlying liver disease (OR=3.293, 95% CI: 1.312–8.266, <em>p</em> = 0.011), use of ≥3 chemotherapy drugs (OR=1.666, 95% CI: 1.031–2.690, <em>p</em> = 0.037), and lack of prophylactic hepatoprotective and cholagogue medication use (OR=0.326, 95% CI: 0.137–0.772, <em>p</em> = 0.011) were identified as independent risk factors for DILI occurrence. Spearman analysis revealed positive correlations between age, alcohol consumption history, viral hepatitis history, underlying liver disease, and number of chemotherapy drugs with DILI severity, while a negative correlation was observed between hepatoprotective and cholagogue drug use and DILI severity.</div></div><div><h3>Conclusion</h3><div>Tumor patients undergoing multiple courses of common chemotherapy drugs exhibit a high incidence of DILI, predominantly moderate in severity. Age ≥60 years, history of alcohol consumption, history of viral hepatitis, underlying liver disease, use of ≥3 chemotherapy drugs, and lac
目的:探讨多疗程常用化疗药物对肿瘤患者药物性肝损伤(DILI)的发生率、临床特点及危险因素,为临床制定药物性肝损伤防治策略提供依据。方法:一项回顾性队列研究纳入了165名在2023年1月至2025年1月期间接受了多个疗程常用化疗药物的癌症患者。根据DILI的发展情况将参与者分为研究组(n=45, DILI发生)和对照组(n=120,无DILI发生)。收集基线患者资料、化疗方案和肝功能指标。单因素分析筛选潜在危险因素,多因素logistic回归验证独立危险因素。Spearman秩相关分析危险因素与DILI严重程度之间的关系。结果:165例患者DILI总发生率为27.27%(45/165),以中度严重程度为主。分级分布:1级(轻度)14例(31.11%),2级(中度)24例(53.33%),3级(重度)7例(15.56%),无4级损伤。各组间基线特征比较显示,年龄≥60岁、有饮酒史、病毒性肝炎史、有基础肝病、化疗药物≥3种、未预防性使用保肝/凝胆剂的患者DILI发生率较高(均为p)。结论:多疗程常用化疗药物的肿瘤患者DILI发生率较高,严重程度以中度为主。年龄≥60岁、饮酒史、病毒性肝炎史、潜在肝病、使用≥3种化疗药物、缺乏预防性保肝和催胆药物是DILI的独立危险因素。前5个因素与损伤严重程度呈正相关,而保肝和催胆药物使用呈负相关。临床医生应加强对高危人群的监测和实施预防性干预措施。
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引用次数: 0
Modeling the importance of coenzyme Q9, glutathione and mitochondrial complex activity in a high fat diet model by a multivariate approach 用多变量方法模拟高脂肪饮食模型中辅酶Q9、谷胱甘肽和线粒体复合物活性的重要性。
IF 2.4 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-01-13 DOI: 10.1016/j.clinre.2026.102766
Francisco Baez , Damian Soria , Mario Contin , Carolina Caniffi , Valeria Tripodi
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引用次数: 0
Associations of episodic and tonic appetite-related signals with malnutrition and appetite dysregulation in end-stage liver disease 终末期肝病患者营养不良和食欲失调与间歇性和强直性食欲相关信号的关联
IF 2.4 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-01-12 DOI: 10.1016/j.clinre.2026.102765
François Le Calvez , James King , Alexis Couret , Armand Abergel , David Thivel , Gaël Ennequin
Malnutrition is highly prevalent in end-stage liver disease (ESLD), while being strongly associated with sarcopenia and poor prognosis in this population. The physiological regulation of energy intake is influenced by tonic signals, reflecting body composition and metabolic demands, and episodic signals, arising from gastrointestinal peptides, that remain to be better explored in the context of ESLD. The present narrative review analyzed 94 studies that characterises circulating concentrations of ghrelin, CCK, PYY, GLP-1 and leptin in cirrhosis and hepatocellular carcinoma. Overall, in patients with ESLD, orexigenic signaling, particularly from ghrelin and Fat-Free Mass (FFM) appears blunted, while anorexigenic peptides (CCK, PYY, GLP-1) are frequently elevated, prolonging satiety. Leptin regulation is inconsistent, reflecting both inflammation-driven increases and fat mass-related decreases. These disturbances converge toward a mismatch between elevated metabolic requirements and insufficient energy intake. Understanding how ESLD disrupts appetite-regulating pathways may help design new strategies to restore nutritional balance and improve clinical outcomes.
营养不良在终末期肝病(ESLD)中非常普遍,同时与该人群中的肌肉减少症和预后不良密切相关。能量摄入的生理调节受到反映身体成分和代谢需求的强直信号和胃肠道肽产生的情景信号的影响,这些信号在ESLD的背景下仍有待更好地探索。本综述分析了94项研究,这些研究描述了肝硬化和肝细胞癌中胃饥饿素、CCK、PYY、GLP-1和瘦素的循环浓度。总的来说,在ESLD患者中,厌氧信号,特别是来自胃饥饿素和无脂质(FFM)的信号似乎变迟钝,而厌氧肽(CCK, PYY, GLP-1)经常升高,延长了饱腹感。瘦素的调节是不一致的,反映了炎症驱动的增加和脂肪量相关的减少。这些干扰汇聚成代谢需求升高和能量摄入不足之间的不匹配。了解ESLD如何破坏食欲调节途径可能有助于设计新的策略来恢复营养平衡和改善临床结果。
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引用次数: 0
BEND3 is associated with poor prognosis and treatment response in Hepatocellular Carcinoma BEND3与肝细胞癌的不良预后和治疗反应相关
IF 2.4 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-01-05 DOI: 10.1016/j.clinre.2026.102759
Valbert Oliveira Costa Filho , Pedro Robson Costa Passos , Márcia Valéria Pitombeira Ferreira , Silvia Helena Barem Rabenhorst
{"title":"BEND3 is associated with poor prognosis and treatment response in Hepatocellular Carcinoma","authors":"Valbert Oliveira Costa Filho ,&nbsp;Pedro Robson Costa Passos ,&nbsp;Márcia Valéria Pitombeira Ferreira ,&nbsp;Silvia Helena Barem Rabenhorst","doi":"10.1016/j.clinre.2026.102759","DOIUrl":"10.1016/j.clinre.2026.102759","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"50 2","pages":"Article 102759"},"PeriodicalIF":2.4,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Clinics and research in hepatology and gastroenterology
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