Digestive and Liver Disease最新文献

英文中文

Helicobacter pylori multiplex serology in patients with autoimmune atrophic gastritis negative for Helicobacter pylori at histology: A case-control study 组织学上幽门螺杆菌阴性的自身免疫性萎缩性胃炎患者的多重幽门螺杆菌血清学：一项病例对照研究。

IF 3.8 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Digestive and Liver Disease

Pub Date : 2026-01-02 DOI: 10.1016/j.dld.2025.12.002

Marica Vavallo , Julia Butt , Sophia Cingolani , Giulio Cozza , Francesco Paolo Schiavone , Emanuele Dilaghi , Laura Belloni , Matteo Franchitto , Bruno Annibale , Tim Waterboer , Edith Lahner

Background

Autoimmune atrophic gastritis (AAG) is an immune-mediated disorder affecting the gastric oxyntic mucosa. Two pathogenetic models are proposed: a pure autoimmune disorder or gastric autoimmunity triggered by Helicobacter pylori (Hp)-infection. In AAG, histological diagnosis of Hp may be challenging and serology can help assess exposure to Hp-infection. This study aimed to determine seroreactivity to Hp-antigens in AAG patients by using Hp-multiplex serology assay.

Methods

A single-centre case-control study on 178 adults: 75 patients with serological and histological AAG diagnosis, 25 controls with histologically Hp-positive-non-atrophic gastritis (Ctr-NAG-Hp+) and 78 subjects with a healthy stomach (Ctr-HS). Sera were analysed using Hp-multiplex serology assay allowing simultaneous detection of antibodies to 13 Hp-proteins. Overall positivity cutoff: seroreactivity to more than 3 Hp-antigens.

Results

The number of seroreactive Hp-antigens was higher in AAG than in Ctr-HS(mean±SEM 2.2±0.3 vs 1.4±0.22,p=0.02) and lower than in Ctr-NAG-Hp+ patients (mean±SEM 5.4±0.5,p<0.001).Overall Hp-seropositivity in AAG was two-fold higher than in Ctr-HS but not statistically significant (21.1% vs 10.3%,p=0.06) and lower than in Ctr-NAG-Hp+(80%,p<0.0001). Complete absence of seroreactivity was similar in AAG and Ctr-HS (29.3% vs 38.5%, p=0.23) and significantly higher than in Ctr-NAG-Hp+ (4%, p=0.009). Main immunogenic Hp-proteins were HP0010(GroEL),HP1098(HcpC),HP0695(HyuA),HP0875(Catalase),HP1564,HP0547(CagA) and HP0243(NapA) with seroreactivity in >50% of AAG patients.

Conclusions

By Hp-multiplex serology, 30% of histologically Hp-negative AAG pts had no seroreactivity, likely belonging to the pure AAG type. Conversely, 20% of AAG pts showed Hp exposure, indicating that infection might have triggered gastric autoimmunity. The remaining AAG patients showed seroreactivity below cut-off for seropositivity and thus not definitively categorisable by this approach.

背景：自身免疫性萎缩性胃炎（AAG）是一种影响胃氧合粘膜的免疫介导性疾病。提出了两种发病模式：单纯的自身免疫性疾病或幽门螺杆菌感染引发的胃自身免疫。在AAG中，Hp的组织学诊断可能具有挑战性，血清学可以帮助评估Hp感染暴露。本研究旨在采用hp -复合血清学方法测定AAG患者对hp抗原的血清反应性。方法：对178名成人进行单中心病例对照研究：75例血清学和组织学诊断为AAG的患者，25例组织学上hp阳性-非萎缩性胃炎（cr - nag - hp +）对照，78例健康胃（cr - hs）对照。采用hp多重血清学方法分析血清，同时检测13种hp蛋白的抗体。总体阳性切断：对3种以上hp抗原有血清反应。结果：AAG患者血清反应性hp抗原数量高于cr - hs患者（平均±SEM 2.2±0.3 vs 1.4±0.22,p=0.02），低于cr - nag - hp +患者（平均±SEM 5.4±0.5,p = 50%）。结论：hp -多重血清学结果显示，30%组织学hp阴性的AAG患者无血清反应，可能属于纯AAG型。相反，20%的AAG患者显示Hp暴露，表明感染可能引发了胃自身免疫。其余AAG患者的血清反应低于血清阳性的临界值，因此不能通过该方法明确分类。

{"title":"Helicobacter pylori multiplex serology in patients with autoimmune atrophic gastritis negative for Helicobacter pylori at histology: A case-control study","authors":"Marica Vavallo , Julia Butt , Sophia Cingolani , Giulio Cozza , Francesco Paolo Schiavone , Emanuele Dilaghi , Laura Belloni , Matteo Franchitto , Bruno Annibale , Tim Waterboer , Edith Lahner","doi":"10.1016/j.dld.2025.12.002","DOIUrl":"10.1016/j.dld.2025.12.002","url":null,"abstract":"<div><h3>Background</h3><div>Autoimmune atrophic gastritis (AAG) is an immune-mediated disorder affecting the gastric oxyntic mucosa. Two pathogenetic models are proposed: a pure autoimmune disorder or gastric autoimmunity triggered by <em>Helicobacter pylori</em> (Hp)-infection. In AAG, histological diagnosis of Hp may be challenging and serology can help assess exposure to Hp-infection. This study aimed to determine seroreactivity to Hp-antigens in AAG patients by using Hp-multiplex serology assay.</div></div><div><h3>Methods</h3><div>A single-centre case-control study on 178 adults: 75 patients with serological and histological AAG diagnosis, 25 controls with histologically Hp-positive-non-atrophic gastritis (Ctr-NAG-Hp+) and 78 subjects with a healthy stomach (Ctr-HS). Sera were analysed using Hp-multiplex serology assay allowing simultaneous detection of antibodies to 13 Hp-proteins. Overall positivity cutoff: seroreactivity to more than 3 Hp-antigens.</div></div><div><h3>Results</h3><div>The number of seroreactive Hp-antigens was higher in AAG than in Ctr-HS(mean±SEM 2.2±0.3 vs 1.4±0.22,p=0.02) and lower than in Ctr-NAG-Hp+ patients (mean±SEM 5.4±0.5,p<0.001).Overall Hp-seropositivity in AAG was two-fold higher than in Ctr-HS but not statistically significant (21.1% vs 10.3%,p=0.06) and lower than in Ctr-NAG-Hp+(80%,p<0.0001). Complete absence of seroreactivity was similar in AAG and Ctr-HS (29.3% vs 38.5%, p=0.23) and significantly higher than in Ctr-NAG-Hp+ (4%, p=0.009). Main immunogenic Hp-proteins were HP0010(GroEL),HP1098(HcpC),HP0695(HyuA),HP0875(Catalase),HP1564,HP0547(CagA) and HP0243(NapA) with seroreactivity in >50% of AAG patients.</div></div><div><h3>Conclusions</h3><div>By Hp-multiplex serology, 30% of histologically Hp-negative AAG pts had no seroreactivity, likely belonging to the pure AAG type. Conversely, 20% of AAG pts showed Hp exposure, indicating that infection might have triggered gastric autoimmunity. The remaining AAG patients showed seroreactivity below cut-off for seropositivity and thus not definitively categorisable by this approach.</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"58 2","pages":"Pages 212-219"},"PeriodicalIF":3.8,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145896389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

The unbearable cost of being gluten-free: rethinking celiac disease screening. 无谷蛋白食品难以承受的成本：重新思考乳糜泻筛查。

IF 3.8 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Digestive and Liver Disease

Pub Date : 2026-01-02 DOI: 10.1016/j.dld.2025.12.009

Ruggiero Francavilla, Vanessa Nadia Dargenio, Stefania Paola Castellaneta, Fernanda Cristofori

引用次数: 0

Construction and validation of a screening model for minimal hepatic encephalopathy in patients with cirrhosis: A multi-center study 肝硬化患者最小肝性脑病筛查模型的构建和验证：一项多中心研究。

IF 3.8 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Digestive and Liver Disease

Pub Date : 2026-01-02 DOI: 10.1016/j.dld.2025.12.006

Cong Xie , Jingyu Wang , Yushan Meng , Yining Huang , Hang Zhang , Bin Cao

Background

Clinical practice currently lacks objective and accurate screening tools for minimal hepatic encephalopathy (MHE). Therefore, we aimed to develop an MHE prediction model based on common risk factors.

Methods

A total of 514 and 191 cirrhotic patients were included in the training and external validation cohorts, respectively. Best subset selection was applied to screen for predictors. Logistic regression was selected for model development because it outperformed four machine learning algorithms (Random Forest, Adaptive Boosting, Support Vector Machines, and Naive Bayes) in this study. Discrimination, calibration, and clinical decision-making utility of the model were evaluated. Furthermore, the model was compared with the Stroop test for MHE assessment.

Results

From 44 potential predictors, 6 variables were identified as significant and included in the prediction model: upper gastrointestinal bleeding (odds ratio, 4.17; 95% confidence interval, 2.53–6.88), ascites (2.86; 1.59–5.16), albumin (0.76; 0.70–0.82), ammonia-ULN-ratio (5.89; 3.43–10.13), model for end-stage liver disease (1.16; 1.08–1.26), and long-term oral lactulose (0.04; 0.01–0.11). The model exhibited robustness and outperformed the Stroop test for MHE identification, with areas under the receiver operating characteristic curves of 0.882 and 0.867 for the training and validation datasets, respectively. An interactive web-based nomogram is accessible at https://xc-web.shinyapps.io/dynnomapp/.

Conclusions

This model enables rapid MHE screening.

背景：临床实践目前缺乏客观和准确的筛选工具对最小肝性脑病（MHE）。因此，我们旨在建立一个基于常见危险因素的MHE预测模型。方法：共有514例和191例肝硬化患者分别被纳入训练和外部验证队列。最佳子集选择应用于筛选预测因子。选择逻辑回归进行模型开发是因为它在本研究中优于四种机器学习算法（随机森林，自适应增强，支持向量机和朴素贝叶斯）。评估该模型的鉴别、校准和临床决策效用。并将该模型与Stroop检验进行比较。结果：从44个潜在预测因素中，有6个变量被确定为显著并纳入预测模型：上消化道出血（优势比4.17；95%可信区间2.53-6.88）、腹水（2.86;1.59-5.16）、白蛋白（0.76;0.70-0.82）、氨- uln比（5.89;3.43-10.13）、终末期肝病模型（1.16;1.08-1.26）和长期口服乳果糖（0.04;0.01-0.11）。该模型具有较好的稳健性，在MHE识别上优于Stroop检验，训练集和验证集的受试者工作特征曲线下面积分别为0.882和0.867。可在https://xc-web.shinyapps.io/dynnomapp/.Conclusions访问交互式基于web的nomogram：此模型可实现MHE的快速筛选。

{"title":"Construction and validation of a screening model for minimal hepatic encephalopathy in patients with cirrhosis: A multi-center study","authors":"Cong Xie , Jingyu Wang , Yushan Meng , Yining Huang , Hang Zhang , Bin Cao","doi":"10.1016/j.dld.2025.12.006","DOIUrl":"10.1016/j.dld.2025.12.006","url":null,"abstract":"<div><h3>Background</h3><div>Clinical practice currently lacks objective and accurate screening tools for minimal hepatic encephalopathy (MHE). Therefore, we aimed to develop an MHE prediction model based on common risk factors.</div></div><div><h3>Methods</h3><div>A total of 514 and 191 cirrhotic patients were included in the training and external validation cohorts, respectively. Best subset selection was applied to screen for predictors. Logistic regression was selected for model development because it outperformed four machine learning algorithms (Random Forest, Adaptive Boosting, Support Vector Machines, and Naive Bayes) in this study. Discrimination, calibration, and clinical decision-making utility of the model were evaluated. Furthermore, the model was compared with the Stroop test for MHE assessment.</div></div><div><h3>Results</h3><div>From 44 potential predictors, 6 variables were identified as significant and included in the prediction model: upper gastrointestinal bleeding (odds ratio, 4.17; 95% confidence interval, 2.53–6.88), ascites (2.86; 1.59–5.16), albumin (0.76; 0.70–0.82), ammonia-ULN-ratio (5.89; 3.43–10.13), model for end-stage liver disease (1.16; 1.08–1.26), and long-term oral lactulose (0.04; 0.01–0.11). The model exhibited robustness and outperformed the Stroop test for MHE identification, with areas under the receiver operating characteristic curves of 0.882 and 0.867 for the training and validation datasets, respectively. An interactive web-based nomogram is accessible at <span><span>https://xc-web.shinyapps.io/dynnomapp/</span><svg><path></path></svg></span>.</div></div><div><h3>Conclusions</h3><div>This model enables rapid MHE screening.</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"58 2","pages":"Pages 232-240"},"PeriodicalIF":3.8,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145896376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Giant gastric inflammatory fibroid polyp conditioning outlet obstruction successfully resected by endoscopy 胃镜下成功切除巨胃炎性肌瘤息肉调节出口梗阻。

IF 3.8 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Digestive and Liver Disease

Pub Date : 2026-01-01 DOI: 10.1016/j.dld.2025.11.020

Junzhen Hou, Liping Yi, Li Zheng, Li Zhang

引用次数: 0

A case of colorectal malakoplakia in a patient with cytomegalovirus-associated refractory ulcerative colitis 巨细胞病毒相关难治性溃疡性结肠炎伴结直肠斑疹1例。

IF 3.8 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Digestive and Liver Disease

Pub Date : 2026-01-01 DOI: 10.1016/j.dld.2025.08.086

Shinichiro Kawatoko , Hidetaka Yamamoto , Yuta Fuyuno , Junji Umeno

引用次数: 0

Anal neoplasm: Streamline follow-up of low-grade dysplasia 肛门肿瘤：低级别不典型增生的流线随访。

IF 3.8 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Digestive and Liver Disease

Pub Date : 2026-01-01 DOI: 10.1016/j.dld.2025.09.013

Aurore Carlo , Laurent Siproudhis , Amandine Landemaine , Claire Gouriou , Claire Grolhier , Astrid Lièvre , Sébastien Henno , Charlène Brochard

Background

Screening strategies for anal cancer are based on repeated assessments in targeted populations. Low-grade lesions are frequently diagnosed, but the progression to invasive cancer is not the rule. The aim of the present study was to identify risk levels in these patients to refine screening strategies.

Methods

The data of consecutive patients referred for screening of anal intraepithelial lesions were collected prospectively. Patients with low-grade intraepithelial lesions (LSILs) at referral and at least two clinical evaluations, including cytology and virology, were included. HPV DNA screening, high-grade lesion (HSIL) and invasive cancer incidence data were extracted.

Results

From April 2010 to December 2020, 194 patients with LSILs were included, with a median follow-up of 48 months. The cumulative probabilities of HSILs were 13.7% [9.5–19.4] at 1 year and 44.4% [35.9–53.3] at 5 years. Past history of HIV, HPV lesions, HPV subtypes (except HPV16), tobacco consumption and body mass index were not significantly related to HSILs. HPV16 status and age older than 44 years at baseline were associated with a greater risk of HSIL.

Conclusions

Patients with LSIL have a low risk of HSILs, except those with HPV16 subtype at baseline. After a first-year a reasonable recommendation may be a 4-year interval between two screening visits.

背景：肛门癌的筛查策略是基于对目标人群的反复评估。低级别病变经常被诊断出来，但进展为浸润性癌症并不是规律。本研究的目的是确定这些患者的风险水平，以完善筛查策略。方法：前瞻性收集连续进行肛门上皮内病变筛查的患者资料。在转诊时有低级别上皮内病变（LSILs）的患者和至少两项临床评估，包括细胞学和病毒学，被纳入。提取HPV DNA筛查、高级别病变（HSIL）和浸润性癌发生率数据。结果：2010年4月至2020年12月，纳入194例LSILs患者，中位随访时间为48个月。1年HSILs的累积概率为13.7%[9.5-19.4]，5年HSILs的累积概率为44.4%[35.9-53.3]。HIV病史、HPV病变、HPV亚型（HPV16除外）、烟草消费和体重指数与HSILs无显著相关性。HPV16状态和基线年龄大于44岁与HSIL的风险增加相关。结论：LSIL患者发生HSILs的风险较低，但基线时HPV16亚型患者除外。一年后，合理的建议是每隔4年进行两次筛查。

{"title":"Anal neoplasm: Streamline follow-up of low-grade dysplasia","authors":"Aurore Carlo , Laurent Siproudhis , Amandine Landemaine , Claire Gouriou , Claire Grolhier , Astrid Lièvre , Sébastien Henno , Charlène Brochard","doi":"10.1016/j.dld.2025.09.013","DOIUrl":"10.1016/j.dld.2025.09.013","url":null,"abstract":"<div><h3>Background</h3><div>Screening strategies for anal cancer are based on repeated assessments in targeted populations. Low-grade lesions are frequently diagnosed, but the progression to invasive cancer is not the rule. The aim of the present study was to identify risk levels in these patients to refine screening strategies.</div></div><div><h3>Methods</h3><div>The data of consecutive patients referred for screening of anal intraepithelial lesions were collected prospectively. Patients with low-grade intraepithelial lesions (LSILs) at referral and at least two clinical evaluations, including cytology and virology, were included. HPV DNA screening, high-grade lesion (HSIL) and invasive cancer incidence data were extracted.</div></div><div><h3>Results</h3><div>From April 2010 to December 2020, 194 patients with LSILs were included, with a median follow-up of 48 months. The cumulative probabilities of HSILs were 13.7% [9.5–19.4] at 1 year and 44.4% [35.9–53.3] at 5 years. Past history of HIV, HPV lesions, HPV subtypes (except HPV16), tobacco consumption and body mass index were not significantly related to HSILs. HPV16 status and age older than 44 years at baseline were associated with a greater risk of HSIL.</div></div><div><h3>Conclusions</h3><div>Patients with LSIL have a low risk of HSILs, except those with HPV16 subtype at baseline. After a first-year a reasonable recommendation may be a 4-year interval between two screening visits.</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"58 1","pages":"Pages 125-130"},"PeriodicalIF":3.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Recompensation after acute decompensation in alcohol-related cirrhosis is rare and likely unrelated to platelet-poor plasma thrombin generation and fibrinolysis 酒精相关性肝硬化急性失代偿后的再代偿很少见，可能与血小板不足的血浆凝血酶生成和纤维蛋白溶解无关。

IF 3.8 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Digestive and Liver Disease

Pub Date : 2026-01-01 DOI: 10.1016/j.dld.2025.09.018

Alberto Zanetto , Dario Saltini , Elena Campello , Cristiana Bulato , Sabrina Gavasso , Patrizia Burra , Paolo Simioni , Marco Senzolo

Background

Hemostasis may be involved in cirrhosis progression. However, its potential involvement in hepatic recompensation is unknown.

Objective

We investigated predictors of recompensation, including coagulation and fibrinolysis, in acutely decompensated, alcohol-related cirrhosis.

Methods

Clinical and laboratory data were collected at hospitalization. Coagulation was assessed via factor VIII, natural anticoagulants, and thrombin generation assay. Fibrinolysis was assessed via pro and anti-fibrinolytic factors and plasmin-antiplasmin complexes. Patients were prospectively followed up for recompensation according to Baveno VII criteria.

Results

We included 224 patients (Child-Pugh B/C 46/54 %). Cumulative rate of recompensation was 5.4 % (median follow-up: 450 days). Patients who achieved recompensation had lower MELD (12 vs. 17, p = 0.02), Child-Pugh C (25 % vs 56 %, p = 0.04), and higher platelet count (106 × 10⁹/L vs. 83 × 10⁹/L) than those who did not, without differences in coagulation and fibrinolysis. In Cox-regression analysis, Child-Pugh was the only predictor of recompensation (HR: 0.26; p = 0.02). Same results were observed with the “expanded” Baveno VII criteria for recompensation. A competing risk analysis considering ACLF/liver-related death, transplantation, and TIPS as competing risks showed comparable results.

Conclusion

In acutely decompensated, alcohol-related cirrhosis, recompensation is rare and linked to the baseline severity of liver disease. Coagulation and fibrinolysis seem not to be involved in cirrhosis recompensation.

背景：止血可能与肝硬化进展有关。然而，其在肝脏代偿中的潜在作用尚不清楚。目的：研究急性失代偿酒精相关性肝硬化患者再代偿的预测因素，包括凝血和纤溶。方法：收集患者住院时的临床及实验室资料。通过凝血因子VIII、天然抗凝剂和凝血酶生成试验评估凝血情况。通过原纤溶因子和抗纤溶因子以及纤溶蛋白-抗纤溶蛋白复合物来评估纤溶。根据Baveno VII标准对患者进行前瞻性的再补偿随访。结果：纳入224例患者（Child-Pugh B/C 46/ 54%）。累计再补偿率为5.4%（中位随访：450天）。获得再补偿的患者MELD较低（12比17，p = 0.02）， Child-Pugh C较低（25%比56%，p = 0.04），血小板计数较高（106 × 109/L比83 × 109/L），凝血和纤溶无差异。cox回归分析中，Child-Pugh是再补偿的唯一预测因子（HR: 0.26; p = 0.02）。“扩展”的巴韦诺VII补偿标准也观察到同样的结果。一项考虑ACLF/肝脏相关死亡、移植和TIPS为竞争风险的竞争风险分析显示了类似的结果。结论：在急性失代偿、酒精相关性肝硬化中，再代偿是罕见的，并且与肝脏疾病的基线严重程度有关。凝血和纤溶似乎与肝硬化再代偿无关。

{"title":"Recompensation after acute decompensation in alcohol-related cirrhosis is rare and likely unrelated to platelet-poor plasma thrombin generation and fibrinolysis","authors":"Alberto Zanetto , Dario Saltini , Elena Campello , Cristiana Bulato , Sabrina Gavasso , Patrizia Burra , Paolo Simioni , Marco Senzolo","doi":"10.1016/j.dld.2025.09.018","DOIUrl":"10.1016/j.dld.2025.09.018","url":null,"abstract":"<div><h3>Background</h3><div>Hemostasis may be involved in cirrhosis progression. However, its potential involvement in hepatic recompensation is unknown.</div></div><div><h3>Objective</h3><div>We investigated predictors of recompensation, including coagulation and fibrinolysis, in acutely decompensated, alcohol-related cirrhosis.</div></div><div><h3>Methods</h3><div>Clinical and laboratory data were collected at hospitalization. Coagulation was assessed via factor VIII, natural anticoagulants, and thrombin generation assay. Fibrinolysis was assessed via pro and anti-fibrinolytic factors and plasmin-antiplasmin complexes. Patients were prospectively followed up for recompensation according to Baveno VII criteria.</div></div><div><h3>Results</h3><div>We included 224 patients (Child-Pugh B/C 46/54 %). Cumulative rate of recompensation was 5.4 % (median follow-up: 450 days). Patients who achieved recompensation had lower MELD (12 vs. 17, <em>p</em> = 0.02), Child-Pugh C (25 % vs 56 %, <em>p</em> = 0.04), and higher platelet count (106 × 10<sup>9</sup>/L vs. 83 × 10<sup>9</sup>/L) than those who did not, without differences in coagulation and fibrinolysis. In Cox-regression analysis, Child-Pugh was the only predictor of recompensation (HR: 0.26; <em>p</em> = 0.02). Same results were observed with the “expanded” Baveno VII criteria for recompensation. A competing risk analysis considering ACLF/liver-related death, transplantation, and TIPS as competing risks showed comparable results.</div></div><div><h3>Conclusion</h3><div>In acutely decompensated, alcohol-related cirrhosis, recompensation is rare and linked to the baseline severity of liver disease. Coagulation and fibrinolysis seem not to be involved in cirrhosis recompensation.</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"58 1","pages":"Pages 88-95"},"PeriodicalIF":3.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Author's reply: Comment on “Effects of exercise on body composition, fitness, and blood pressure in overweight or obese patients with MASLD” 作者回复：关于“运动对超重或肥胖MASLD患者身体成分、健康和血压的影响”的评论。

IF 3.8 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Digestive and Liver Disease

Pub Date : 2026-01-01 DOI: 10.1016/j.dld.2025.10.033

Jiu Chen , Peng Gong , Jun Xie

引用次数: 0

Impact of oral butyrate on clinical and biochemical parameters in IBD: A randomized placebo-controlled study targeting gut microbiota 口服丁酸盐对IBD临床和生化参数的影响：一项针对肠道微生物群的随机安慰剂对照研究。

IF 3.8 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Digestive and Liver Disease

Pub Date : 2026-01-01 DOI: 10.1016/j.dld.2025.11.014

Sonia Facchin , Matteo Calgaro , Mattia Pandolfo , Andrea Buda , Brigida Barberio , Fabiana Zingone , Nicola Vitulo , Edoardo Vincenzo Savarino

Background and Aims

We performed a randomized, double-blind, placebo-controlled, trial to investigate the changes in microbiome composition induced by Butyrate-Lsc-Microincapsulated (BLM) supplementation in IBD patients and its impact on disease activity.

Methods

140 IBD patients (n=60 Crohn's disease, CD and n=80 Ulcerative Colitis, UC) were randomized to oral administration of BLM, plus conventional therapy. Stool samples were assessed by 16S sequencing and fecal calprotectin (fCal) analysis. For the microbiota analysis, the Firmicutes/Bacteroidota (F/B) ratio was used. Clinical disease activity was assessed by using the Harvey-Bradshaw-Index (HBI) for CD and partial-Mayo-Score for UC, Quality-of-life (QoL) by using Inflammatory-Bowel-Disease-Questionnaire-32 (IBDQ) and adherence-dietary-recommendation was evaluated before and after supplementation

Results

microbiota analysis revealed two principal enterotypes, defined by the F/B ratio, in both CD and UC patients. BLM exerted a more pronounced effect on Enterotype 1 (low F/B ratio), resulting in greater clinical and biochemical improvements and potentially identifying a target population. After supplementation, clinical disease activity (p=0.013) and fCal (p=0.047) improved significantly in CD, while fCal showed a marginal reduction in UC (p=0.09). QoL increased significantly in both CD (p<0.001) and UC (p=0.003).

Conclusions

Supplementation with BLM, by modulating the gut microbiota, significantly improved disease outcomes and QoL in patients with IBD.

ClinicalTrial.gov registration

NCT04879914

背景和目的：我们进行了一项随机、双盲、安慰剂对照的试验，以研究补充丁酸盐- lsc微胶囊（BLM）对IBD患者微生物组组成的变化及其对疾病活动性的影响。方法：140例IBD患者（n=60克罗恩病，CD和n=80溃疡性结肠炎，UC）随机分为口服BLM加常规治疗组。粪便样本采用16S测序和粪钙保护蛋白（fCal）分析进行评估。微生物群分析采用厚壁菌门/拟杆菌门（F/B）比值。使用Harvey-Bradshaw-Index （HBI）评估CD的临床疾病活动性，使用部分mayo - score评估UC的临床疾病活动性，使用Inflammatory-Bowel-Disease-Questionnaire-32 （IBDQ）评估生活质量（QoL），并在补充剂前后评估饮食推荐。结果：微生物群分析揭示了CD和UC患者的两种主要肠道类型，由F/B比率定义。BLM对1型肠型（低F/B比）的影响更明显，导致更大的临床和生化改善，并有可能确定目标人群。补充后，CD患者的临床疾病活动性（p=0.013）和fCal （p=0.047）显著改善，而UC患者的fCal略有降低（p=0.09）。结论：补充BLM，通过调节肠道微生物群，显著改善IBD患者的疾病结局和生活质量。临床试验：政府注册：NCT04879914。

{"title":"Impact of oral butyrate on clinical and biochemical parameters in IBD: A randomized placebo-controlled study targeting gut microbiota","authors":"Sonia Facchin , Matteo Calgaro , Mattia Pandolfo , Andrea Buda , Brigida Barberio , Fabiana Zingone , Nicola Vitulo , Edoardo Vincenzo Savarino","doi":"10.1016/j.dld.2025.11.014","DOIUrl":"10.1016/j.dld.2025.11.014","url":null,"abstract":"<div><h3>Background and Aims</h3><div>We performed a randomized, double-blind, placebo-controlled, trial to investigate the changes in microbiome composition induced by Butyrate-Lsc-Microincapsulated (BLM) supplementation in IBD patients and its impact on disease activity.</div></div><div><h3>Methods</h3><div>140 IBD patients (n=60 Crohn's disease, CD and n=80 Ulcerative Colitis, UC) were randomized to oral administration of BLM, plus conventional therapy. Stool samples were assessed by 16S sequencing and fecal calprotectin (fCal) analysis. For the microbiota analysis, the Firmicutes/Bacteroidota (F/B) ratio was used. Clinical disease activity was assessed by using the Harvey-Bradshaw-Index (HBI) for CD and partial-Mayo-Score for UC, Quality-of-life (QoL) by using Inflammatory-Bowel-Disease-Questionnaire-32 (IBDQ) and adherence-dietary-recommendation was evaluated before and after supplementation</div></div><div><h3>Results</h3><div>microbiota analysis revealed two principal enterotypes, defined by the F/B ratio, in both CD and UC patients. BLM exerted a more pronounced effect on Enterotype 1 (low F/B ratio), resulting in greater clinical and biochemical improvements and potentially identifying a target population. After supplementation, clinical disease activity (p=0.013) and fCal (p=0.047) improved significantly in CD, while fCal showed a marginal reduction in UC (p=0.09). QoL increased significantly in both CD (p<0.001) and UC (p=0.003).</div></div><div><h3>Conclusions</h3><div>Supplementation with BLM, by modulating the gut microbiota, significantly improved disease outcomes and QoL in patients with IBD.</div></div><div><h3>ClinicalTrial.gov registration</h3><div>NCT04879914</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"58 1","pages":"Pages 64-73"},"PeriodicalIF":3.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145699718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Sarcopenia is associated with an unfavorable outcome in patients with acute pancreatitis: A propensity score analysis 骨骼肌减少症与急性胰腺炎患者的不良预后相关：倾向评分分析。

IF 3.8 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Digestive and Liver Disease

Pub Date : 2026-01-01 DOI: 10.1016/j.dld.2025.10.013

Fabienne Bender , Leon Marzeion , Juliane Liese , Matthias Hecker , Matthias Wolff , Theresa König , Franziska Willis , Ivan de la Peña Thevenet , Christopher Tuffs , Alexander Brose , Joern Pons-Kühnemann , Winfried Padberg , Andreas Hecker , Moritz J. Strowitzki

Background

Sarcopenia and age are risk factors for poor outcomes in acute pancreatitis (aP). However, the role of sarcopenia independent of patients’ age remains unclear, and assessment methods vary.

Aims

This study assessed sarcopenia, using the Hounsfield unit average calculation (HUAC) for the psoas muscle, and its impact on aP outcomes, independent of other risk factors.

Methods

208 aP patients who received early computed tomography (CT) were classified as sarcopenic or non-sarcopenic based on HUAC. Propensity score matching (PSM) reduced heterogeneity. Clinical outcomes and independent predictors of intensive care unit (ICU) admission were determined by multivariable logistic regression.

Results

After PSM, sarcopenic patients (n = 53) had longer hospital (24.9 ± 20.6d vs. 18.2 ± 27.3d; p = 0.0006) and ICU stays (9.5 ± 16.5d vs. 6.2 ± 25.8d; p = 0.0077) than non-sarcopenic patients (n = 53). ICU admission was more frequent (58.5 % vs. 37.7 %; p = 0.0325), and aP-associated morbidity such as pleural effusion occurred more often (p = 0.0019). Independent predictors of ICU admission included pleural effusion or ascites (p = 0.0116) and impaired coagulation (p = 0.0365).

Conclusion

Sarcopenia identified via HUAC in early aP is associated with a worse clinical outcome. Pleural effusion or ascites and changes in blood coagulation independently predict ICU admission in sarcopenic aP patients. Early nutritional and physical therapy should be considered to prevent and treat sarcopenia in aP patients.

背景：骨骼肌减少症和年龄是急性胰腺炎（aP）预后不良的危险因素。然而，肌少症独立于患者年龄的作用仍不清楚，评估方法也各不相同。目的：本研究评估肌肉减少症，使用腰大肌的Hounsfield单位平均计算（HUAC），及其对aP结果的影响，独立于其他危险因素。方法：208例早期行计算机断层扫描（CT）的aP患者，根据HUAC分为肌少症和非肌少症。倾向评分匹配（PSM）降低了异质性。采用多变量logistic回归确定重症监护病房（ICU）入院的临床结局和独立预测因素。结果：经PSM治疗后，肌少症患者（n = 53）的住院时间（24.9±20.6d比18.2±27.3d, p = 0.0006）和ICU住院时间（9.5±16.5d比6.2±25.8d, p = 0.0077）均高于非肌少症患者（n = 53）。ICU住院率更高（58.5%比37.7%,p = 0.0325）， ap相关并发症如胸腔积液发生率更高（p = 0.0019）。ICU入院的独立预测因素包括胸腔积液或腹水（p = 0.0116）和凝血功能受损（p = 0.0365）。结论：早期aP患者通过HUAC检测出的骨骼肌减少症与较差的临床预后相关。胸腔积液或腹水及凝血变化可独立预测肌减少性aP患者是否入住ICU。早期应考虑营养和物理治疗，以预防和治疗肌少症的aP患者。

{"title":"Sarcopenia is associated with an unfavorable outcome in patients with acute pancreatitis: A propensity score analysis","authors":"Fabienne Bender , Leon Marzeion , Juliane Liese , Matthias Hecker , Matthias Wolff , Theresa König , Franziska Willis , Ivan de la Peña Thevenet , Christopher Tuffs , Alexander Brose , Joern Pons-Kühnemann , Winfried Padberg , Andreas Hecker , Moritz J. Strowitzki","doi":"10.1016/j.dld.2025.10.013","DOIUrl":"10.1016/j.dld.2025.10.013","url":null,"abstract":"<div><h3>Background</h3><div>Sarcopenia and age are risk factors for poor outcomes in acute pancreatitis (aP). However, the role of sarcopenia independent of patients’ age remains unclear, and assessment methods vary.</div></div><div><h3>Aims</h3><div>This study assessed sarcopenia, using the Hounsfield unit average calculation (HUAC) for the psoas muscle, and its impact on aP outcomes, independent of other risk factors.</div></div><div><h3>Methods</h3><div>208 aP patients who received early computed tomography (CT) were classified as sarcopenic or non-sarcopenic based on HUAC. Propensity score matching (PSM) reduced heterogeneity. Clinical outcomes and independent predictors of intensive care unit (ICU) admission were determined by multivariable logistic regression.</div></div><div><h3>Results</h3><div>After PSM, sarcopenic patients (<em>n</em> = 53) had longer hospital (24.9 ± 20.6d vs. 18.2 ± 27.3d; <em>p</em> = 0.0006) and ICU stays (9.5 ± 16.5d vs. 6.2 ± 25.8d; <em>p</em> = 0.0077) than non-sarcopenic patients (<em>n</em> = 53). ICU admission was more frequent (58.5 % vs. 37.7 %; <em>p</em> = 0.0325), and aP-associated morbidity such as pleural effusion occurred more often (<em>p</em> = 0.0019). Independent predictors of ICU admission included pleural effusion or ascites (<em>p</em> = 0.0116) and impaired coagulation (<em>p</em> = 0.0365).</div></div><div><h3>Conclusion</h3><div>Sarcopenia identified via HUAC in early aP is associated with a worse clinical outcome. Pleural effusion or ascites and changes in blood coagulation independently predict ICU admission in sarcopenic aP patients. Early nutritional and physical therapy should be considered to prevent and treat sarcopenia in aP patients.</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"58 1","pages":"Pages 96-103"},"PeriodicalIF":3.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145451343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Digestive and Liver Disease

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀