Pub Date : 2024-07-23DOI: 10.1016/j.ajg.2024.06.003
Limin Zhang, Shanbing Yang, Kangmei Jia, Shuwen Du, Yan Jia, Xiaojuan Lu, Jiheng Wang
Background and study aims: Mucosal healing (MH) is a crucial indicator of therapeutic effectiveness and prognosis in Crohn's disease (CD). Rapid achievement and long-term maintenance of MH can alleviate the financial and psychological burden on patients. This study aimed to investigate the factors associated with MH in CD patients and enhance clinicians' understanding.
Patients and methods: Patients diagnosed with CD between January 2010 and December 2019 at our hospital were included and divided into two groups based on the attainment of MH during the follow-up period. Demographic data, symptoms, disease classification, laboratory examination results, and treatments were collected and compared between the two groups. Factors with a P-value <0.2 were subjected to multivariate logistic regression analysis to identify the related factors of MH.
Results: Multivariate logistic regression analysis of CD patients revealed that educational level [odds ratio (OR) = 8.167, 95 % confidence interval (CI) 1.440-46.303, P = 0.018] and biological therapy (OR = 15.291, 95 % CI 1.404-166.543, P = 0.025) were associated with MH.
Conclusion: Educational level and biological therapy are factors related to MH in CD patients. These findings suggest that the use of biological therapy and patients' better understanding of the disease contribute to achieving MH.
背景和研究目的：黏膜愈合（MH）是衡量克罗恩病（CD）治疗效果和预后的重要指标。快速实现并长期保持黏膜愈合可减轻患者的经济和心理负担。本研究旨在调查与克罗恩病患者MH相关的因素，并加深临床医生对这些因素的理解：纳入 2010 年 1 月至 2019 年 12 月在我院确诊的 CD 患者，并根据随访期间的 MH 实现情况分为两组。收集两组患者的人口统计学数据、症状、疾病分类、实验室检查结果和治疗方法，并进行比较。P值结果的因素：对 CD 患者进行的多变量逻辑回归分析显示，教育水平[几率比（OR）= 8.167，95% 置信区间（CI）1.440-46.303，P = 0.018]和生物治疗（OR = 15.291，95% CI 1.404-166.543，P = 0.025）与 MH 相关：结论：教育水平和生物疗法是CD患者MH的相关因素。这些研究结果表明，使用生物疗法和患者更好地了解疾病有助于实现MH。
{"title":"Education level and biologic therapy are the related factors of mucosal healing in Patients with Crohn's disease.","authors":"Limin Zhang, Shanbing Yang, Kangmei Jia, Shuwen Du, Yan Jia, Xiaojuan Lu, Jiheng Wang","doi":"10.1016/j.ajg.2024.06.003","DOIUrl":"https://doi.org/10.1016/j.ajg.2024.06.003","url":null,"abstract":"<p><strong>Background and study aims: </strong>Mucosal healing (MH) is a crucial indicator of therapeutic effectiveness and prognosis in Crohn's disease (CD). Rapid achievement and long-term maintenance of MH can alleviate the financial and psychological burden on patients. This study aimed to investigate the factors associated with MH in CD patients and enhance clinicians' understanding.</p><p><strong>Patients and methods: </strong>Patients diagnosed with CD between January 2010 and December 2019 at our hospital were included and divided into two groups based on the attainment of MH during the follow-up period. Demographic data, symptoms, disease classification, laboratory examination results, and treatments were collected and compared between the two groups. Factors with a P-value <0.2 were subjected to multivariate logistic regression analysis to identify the related factors of MH.</p><p><strong>Results: </strong>Multivariate logistic regression analysis of CD patients revealed that educational level [odds ratio (OR) = 8.167, 95 % confidence interval (CI) 1.440-46.303, P = 0.018] and biological therapy (OR = 15.291, 95 % CI 1.404-166.543, P = 0.025) were associated with MH.</p><p><strong>Conclusion: </strong>Educational level and biological therapy are factors related to MH in CD patients. These findings suggest that the use of biological therapy and patients' better understanding of the disease contribute to achieving MH.</p>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761835","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}
Pub Date : 2024-05-06DOI: 10.1016/j.ajg.2024.01.009
Foroogh Alborzi Avanaki, Naser Ebrahimi Daryani, Najmeh Aletaha, Nazanin Hesabgar, Mohammad Saeid Rezaee-Zavareh, Reza Hadi
Background and study aims: Diet is an important underlying factor in ulcerative colitis (UC) disease. The present study aimed to investigate the effect of a gluten-free diet (GFD) on disease severity, quality of life, and inflammatory markers in patients with UC.
Patients and methods: In this triple-blind randomized placebo-controlled clinical trial, we evaluated the effect of a GFD on the erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), fecal calprotectin, disease severity, and quality of life in patients with mild to moderate UC. Patients' quality of life and severity of symptoms were evaluated using the Inflammatory Bowel Disease Questionnaire (IBDQ) and Simple Clinical Colitis Activity Index (SCCAI), respectively. Patients received this regimen for six weeks and were evaluated before and after the intervention.
Results: The mean age of patients (n = 26) was 39.31 years (standard deviation = 9.34). In both study groups, the mean ESR, CRP, IBDQ, and SCCAI showed no statistically significant improvement with the dietary intervention. Fecal calprotectin was increased in both groups without statistical significance.
Conclusions: We could not find any significant effect of GFD on inflammatory markers, quality of life, and disease severity among patients with mild to moderate UC. It is too early to suggest the gluten-free diet as a safe and beneficial regimen for UC patients. There is a need for further investigations with larger sample sizes and longer follow-ups as clinical trials and cohort studies to obtain more reliable results.
{"title":"Short-term effect of gluten-free diet on disease severity, quality of life, and inflammatory markers among patients with mild to moderate ulcerative colitis: A triple-blind randomized placebo-controlled trial.","authors":"Foroogh Alborzi Avanaki, Naser Ebrahimi Daryani, Najmeh Aletaha, Nazanin Hesabgar, Mohammad Saeid Rezaee-Zavareh, Reza Hadi","doi":"10.1016/j.ajg.2024.01.009","DOIUrl":"https://doi.org/10.1016/j.ajg.2024.01.009","url":null,"abstract":"<p><strong>Background and study aims: </strong>Diet is an important underlying factor in ulcerative colitis (UC) disease. The present study aimed to investigate the effect of a gluten-free diet (GFD) on disease severity, quality of life, and inflammatory markers in patients with UC.</p><p><strong>Patients and methods: </strong>In this triple-blind randomized placebo-controlled clinical trial, we evaluated the effect of a GFD on the erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), fecal calprotectin, disease severity, and quality of life in patients with mild to moderate UC. Patients' quality of life and severity of symptoms were evaluated using the Inflammatory Bowel Disease Questionnaire (IBDQ) and Simple Clinical Colitis Activity Index (SCCAI), respectively. Patients received this regimen for six weeks and were evaluated before and after the intervention.</p><p><strong>Results: </strong>The mean age of patients (n = 26) was 39.31 years (standard deviation = 9.34). In both study groups, the mean ESR, CRP, IBDQ, and SCCAI showed no statistically significant improvement with the dietary intervention. Fecal calprotectin was increased in both groups without statistical significance.</p><p><strong>Conclusions: </strong>We could not find any significant effect of GFD on inflammatory markers, quality of life, and disease severity among patients with mild to moderate UC. It is too early to suggest the gluten-free diet as a safe and beneficial regimen for UC patients. There is a need for further investigations with larger sample sizes and longer follow-ups as clinical trials and cohort studies to obtain more reliable results.</p>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877691","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}
Pub Date : 2024-05-01DOI: 10.1016/j.ajg.2024.01.003
Jinxiu Ju , Yating Su , Qingjing Zeng , Jiayi Liang , Xiaodan Zhang , Jie Ren , Lili Wu , Rongqin Zheng
Background and study aims
Periampullary diverticula (PAD), a location-specific type of duodenal diverticula, can cause serious complications. PAD is difficult to differentially diagnose, mainly due to its nonspecific symptoms. This study aimed to identify sonographic features of PAD and to evaluate their value in the differential diagnosis of PAD from stones in the lower common bile duct (CBD).
Patients and Methods
A total of 30 patients with PAD and 60 patients with lower CBD stones were retrospectively enrolled, and sonographic features were analyzed. Measurements of sonographic features included echo shaped, posterior echo changes, location and relation to surrounding organs, and status of intrahepatic and extrahepatic bile duct dilation, and their diagnostic performance was assessed.
Results
Characteristic sonographic features of PAD were identified, including strong echoes (28/30, 93.3 %), strip shape (28/30, 93.3 %), multiple reflections in the posterior echo (27/30, 90.0 %), and location outside the CBD or near the biliary wall in connection with the duodenum (27/30, 90.0 %). Inter-observer agreement was good (Kappa values = 0.69–0.82). Comparative analysis of sonographic features revealed significant differences in echo shape, posterior echo changes (multiple reflections and acoustic shadowing), location and relation to surrounding organs, and intrahepatic and extrahepatic bile duct dilatation status between the dilatation status of the two groups. In particular, these characteristics achieved a sensitivity of 100 % and a specificity of 98 % for the differential diagnosis of PAD and lower CBD stones.
Conclusions
This study identified characteristic sonographic features of PAD, which could be used as potential diagnostic indicators to distinguish PAD from lower CBD stones.
{"title":"Sonographic features of Lemmel’s syndrome: Differential diagnosis from stones in the lower portion of the common bile duct","authors":"Jinxiu Ju , Yating Su , Qingjing Zeng , Jiayi Liang , Xiaodan Zhang , Jie Ren , Lili Wu , Rongqin Zheng","doi":"10.1016/j.ajg.2024.01.003","DOIUrl":"10.1016/j.ajg.2024.01.003","url":null,"abstract":"<div><h3>Background and study aims</h3><p>Periampullary diverticula (PAD), a location-specific type of duodenal diverticula, can cause serious complications. PAD is difficult to differentially diagnose, mainly due to its nonspecific symptoms. This study aimed to identify sonographic features of PAD and to evaluate their value in the differential diagnosis of PAD from stones in the lower common bile duct (CBD).</p></div><div><h3>Patients and Methods</h3><p>A total of 30 patients with PAD and 60 patients with lower CBD stones were retrospectively enrolled, and sonographic features were analyzed. Measurements of sonographic features included echo shaped, posterior echo changes, location and relation to surrounding organs, and status of intrahepatic and extrahepatic bile duct dilation, and their diagnostic performance was assessed.</p></div><div><h3>Results</h3><p>Characteristic sonographic features of PAD were identified, including strong echoes (28/30, 93.3 %), strip shape (28/30, 93.3 %), multiple reflections in the posterior echo (27/30, 90.0 %), and location outside the CBD or near the biliary wall in connection with the duodenum (27/30, 90.0 %). Inter-observer agreement was good (<em>Kappa</em> values = 0.69–0.82). Comparative analysis of sonographic features revealed significant differences in echo shape, posterior echo changes (multiple reflections and acoustic shadowing), location and relation to surrounding organs, and intrahepatic and extrahepatic bile duct dilatation status between the dilatation status of the two groups. In particular, these characteristics achieved a sensitivity of 100 % and a specificity of 98 % for the differential diagnosis of PAD and lower CBD stones.</p></div><div><h3>Conclusions</h3><p>This study identified characteristic sonographic features of PAD, which could be used as potential diagnostic indicators to distinguish PAD from lower CBD stones.</p></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139974130","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}
Pub Date : 2024-05-01DOI: 10.1016/j.ajg.2024.01.014
Abdul Mumit Sarkar , Abdullah Al Mukit , Tanzilul Bari , Rofiqul Islam , Shafiqul Islam , Khalequzzaman Sarker , Manzurul Chowdhury , Mohd. Harun Or Rashid , Abdul Alim
Background and study aims
The mechanism of hepatic encephalopathy is complex and has not been conclusively established. Recent studies support lower serum 25-Hydroxy Vitamin D [25(OH) D] levels in patients with hepatic encephalopathy. This study aimed to evaluate the association between serum 25(OH) D and hepatic encephalopathy in patients with decompensated cirrhosis of liver.
Patients and methods
A total of 70 cirrhosis patients (35 cases of hepatic encephalopathy and 35 patients without encephalopathy as control, mean age 53.07 ± 12.99 years, 67 % male) were recruited for this study. Assessment of the severity of cirrhosis was done by using a model for end-stage liver disease(MELD) and Child Turcotte Pugh (CTP) scores, and assessment of the severity of hepatic encephalopathy was done according to West Haven criteria. Serum 25 (OH) D level was measured by Chemiluminescent Microparticle Immuno Assay(CMIA).
Results
The mean serum 25(OH) D level among hepatic encephalopathy patients was significantly lower in comparison to the control group without encephalopathy (18.76 ± 8.84 nmol/L vs 31.19 ± 13.9 nmol/L, P<0.0001). 91.4 % of hepatic encephalopathy patients had moderate to severe 25(OH)D deficiency as compared to 51.4 % in the control group. There was a significant correlation observed between the severity of the 25 (OH) D deficiency and the severity of liver disease (r = − 0.35, P = 0.002). No statistically significant difference in serum 25(OH) D levels was found among patients with different hepatic encephalopathy grades (P = 0.416).
Conclusion
A significant association was found between a low serum 25(OH) D leveland hepatic encephalopathy. It requires further large-scale multicenter studies to establish it as a risk factor and predictor of hepatic encephalopathy.
{"title":"Association of low serum 25-Hydroxy vitamin D [25(OH) d] with hepatic encephalopathy in patients with decompensated liver cirrhosis","authors":"Abdul Mumit Sarkar , Abdullah Al Mukit , Tanzilul Bari , Rofiqul Islam , Shafiqul Islam , Khalequzzaman Sarker , Manzurul Chowdhury , Mohd. Harun Or Rashid , Abdul Alim","doi":"10.1016/j.ajg.2024.01.014","DOIUrl":"10.1016/j.ajg.2024.01.014","url":null,"abstract":"<div><h3>Background and study aims</h3><p>The mechanism of hepatic encephalopathy is complex and has not been conclusively established. Recent studies support lower serum 25-Hydroxy Vitamin D [25(OH) D] levels in patients with hepatic encephalopathy. This study aimed to evaluate the association between serum 25(OH) D and hepatic encephalopathy in patients with decompensated cirrhosis of liver.</p></div><div><h3>Patients and methods</h3><p>A total of 70 cirrhosis patients (35 cases of hepatic encephalopathy and 35 patients without encephalopathy as control, mean age 53.07 ± 12.99 years, 67 % male) were recruited for this study. Assessment of the severity of cirrhosis was done by using a model for end-stage liver disease(MELD) and Child Turcotte Pugh (CTP) scores, and assessment of the severity of hepatic encephalopathy was done according to West Haven criteria. Serum 25 (OH) D level was measured by Chemiluminescent Microparticle Immuno Assay(CMIA).</p></div><div><h3>Results</h3><p>The mean serum 25(OH) D level among hepatic encephalopathy patients was significantly lower in comparison to the control group without encephalopathy (18.76 ± 8.84 nmol/L vs 31.19 ± 13.9 nmol/L, <em>P</em><0.0001). 91.4 % of hepatic encephalopathy patients had moderate to severe 25(OH)D deficiency as compared to 51.4 % in the control group. There was a significant correlation observed between the severity of the 25 (OH) D deficiency and the severity of liver disease (r = − 0.35, <em>P</em> = 0.002). No statistically significant difference in serum 25(OH) D levels was found among patients with different hepatic encephalopathy grades (<em>P</em> = 0.416).</p></div><div><h3>Conclusion</h3><p>A significant association was found between a low serum 25(OH) D leveland hepatic encephalopathy. It requires further large-scale multicenter studies to establish it as a risk factor and predictor of hepatic encephalopathy.</p></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140066021","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}
Pub Date : 2024-05-01DOI: 10.1016/j.ajg.2024.02.001
Yun Zhou , Shixiong Liu , Ya Zheng , Yuping Wang , Yongning Zhou
Background and study aims
Immunotherapy has emerged as a hot topic in cancer treatment in recent years and has also shown potential in the treatment of Helicobacter pylori-associated gastric cancer. However, there is still a need to identify potential immunotherapy targets.
Material and methods
We used the GSE116312 dataset of Helicobacter pylori-associated gastric cancer to identify differentially expressed genes, which were then overlapped with immune genes from the ImmPort database. The identified immune genes were used to classify gastric cancer samples and evaluate the relationship between classification and tumor mutations, as well as immune infiltration. An immune gene-based prognostic model was constructed, and the expression levels of the genes involved in constructing the model were explored in the tumor immune microenvironment.
Results
We successfully identified 60 immune genes and classified gastric cancer samples into two subtypes, which showed differences in prognosis, tumor mutations, immune checkpoint expression, and immune cell infiltration. Subsequently, we constructed an immune prognostic model consisting of THBS1 and PDGFD, which showed significant associations with macrophages and fibroblasts.
Conclusion
We identified abnormal expression of THBS1 and PDGFD in cancer-associated fibroblasts (CAFs) within the tumor immune microenvironment, suggesting their potential as therapeutic targets.
{"title":"The role of THBS1 and PDGFD in the immune microenvironment of Helicobacter pylori-associated gastric cancer","authors":"Yun Zhou , Shixiong Liu , Ya Zheng , Yuping Wang , Yongning Zhou","doi":"10.1016/j.ajg.2024.02.001","DOIUrl":"10.1016/j.ajg.2024.02.001","url":null,"abstract":"<div><h3>Background and study aims</h3><p>Immunotherapy has emerged as a hot topic in cancer treatment in recent years and has also shown potential in the treatment of Helicobacter pylori-associated gastric cancer. However, there is still a need to identify potential immunotherapy targets.</p></div><div><h3>Material and methods</h3><p>We used the GSE116312 dataset of Helicobacter pylori-associated gastric cancer to identify differentially expressed genes, which were then overlapped with immune genes from the ImmPort database. The identified immune genes were used to classify gastric cancer samples and evaluate the relationship between classification and tumor mutations, as well as immune infiltration. An immune gene-based prognostic model was constructed, and the expression levels of the genes involved in constructing the model were explored in the tumor immune microenvironment.</p></div><div><h3>Results</h3><p>We successfully identified 60 immune genes and classified gastric cancer samples into two subtypes, which showed differences in prognosis, tumor mutations, immune checkpoint expression, and immune cell infiltration. Subsequently, we constructed an immune prognostic model consisting of THBS1 and PDGFD, which showed significant associations with macrophages and fibroblasts.</p></div><div><h3>Conclusion</h3><p>We identified abnormal expression of THBS1 and PDGFD in cancer-associated fibroblasts (CAFs) within the tumor immune microenvironment, suggesting their potential as therapeutic targets.</p></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140870255","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}
Pub Date : 2024-05-01DOI: 10.1016/j.ajg.2024.02.003
Zuohu Niu , Jing Liu , Hongye Peng , Xuan Wu , Xinzhuo Zheng , Shukun Yao , Chunjun Xu
Background and study aims
Metabolic dysfunction-associated fatty liver disease (MAFLD) has become the most common cause of chronic liver disease worldwide. Diet plays a critical role in the prevention and treatment of MAFLD. Our hypothesis was that the intake of some macronutrients, vitamins, or mineral elements is associated with MAFLD.
Patients and methods
Patients with MAFLD can be diagnosed based on the evidence of hepatic steatosis and if they meet any of the three additional criteria of overweight/obesity, diabetes mellitus, or metabolic dysregulation. Diets were recorded using photographs and diaries of meals for seven consecutive days. The consumed dietary composition was compared with the recommended intake according to the China Food Composition Tables (Standard Edition) version 2019 and the Chinese Dietary Reference Intakes version 2013, and its association with MAFLD was assessed by logistical regression analyses.
Results
A total of 229 MAFLD patients and 148 healthy controls were included in this study. MAFLD patients, compared with that by non-MAFLD participants, consumed more polyunsaturated fatty acids (PUFAs) (p < 0.001), vitamin E (p < 0.001), and iron (p = 0.008). The intake of PUFAs (OR = 1.070, 95 % CI: 1.017–1.127, p = 0.009) and vitamin E (OR = 1.100, 95 % CI: 1.018–1.190, p = 0.016) was positively associated with MAFLD. In addition, the percentages of individuals who consumed PUFAs (p = 0.006), vitamin E (p < 0.001), or iron (p = 0.046) above the recommended intake were higher among the individuals with MAFLD. Daily intake of PUFAs > 11 % (OR = 2.328, 95 % CI: 1.290–4.201, p = 0.005) and vitamin E > 14 mg (OR = 2.189, 95 % CI: 1.153–4.158, p = 0.017) was positively correlated with MAFLD.
Conclusions
Patients with MAFLD consumed more PUFAs, vitamin E, and iron in their daily diet. Excessive consumption of PUFAs and vitamin E might be independent risk factors for the incidence of MAFLD.
背景和研究目的：代谢功能障碍相关性脂肪肝（MAFLD）已成为全球最常见的慢性肝病病因。饮食在预防和治疗代谢性脂肪肝中起着至关重要的作用。我们的假设是，某些宏量营养素、维生素或矿物质元素的摄入与 MAFLD 相关：MAFLD患者可根据肝脏脂肪变性的证据以及是否符合超重/肥胖、糖尿病或代谢失调这三项附加标准中的任何一项来诊断。使用照片和连续七天的膳食日记记录饮食。根据《中国食物成分表（标准版）》（2019年版）和《中国居民膳食营养素参考摄入量》（2013年版），将所摄入的膳食成分与推荐摄入量进行比较，并通过统计回归分析评估其与MAFLD的关系：本研究共纳入229名MAFLD患者和148名健康对照者。与非 MAFLD 参与者相比，MAFLD 患者摄入更多的多不饱和脂肪酸（PUFAs）（P 11 %，OR = 2.328，95 % CI：1.290-4.201，p = 0.005），维生素 E > 14 mg（OR = 2.189，95 % CI：1.153-4.158，p = 0.017）与 MAFLD 呈正相关：结论：MAFLD 患者在日常饮食中摄入更多的 PUFA、维生素 E 和铁。结论：MAFLD 患者在日常饮食中摄入较多的 PUFAs、维生素 E 和铁，过量摄入 PUFAs 和维生素 E 可能是 MAFLD 发病的独立风险因素。
{"title":"Dietary composition and its association with metabolic dysfunction-associated fatty liver disease among Chinese adults: A cross-sectional study","authors":"Zuohu Niu , Jing Liu , Hongye Peng , Xuan Wu , Xinzhuo Zheng , Shukun Yao , Chunjun Xu","doi":"10.1016/j.ajg.2024.02.003","DOIUrl":"10.1016/j.ajg.2024.02.003","url":null,"abstract":"<div><h3>Background and study aims</h3><p>Metabolic dysfunction-associated fatty liver disease (MAFLD) has become the most common cause of chronic liver disease worldwide. Diet plays a critical role in the prevention and treatment of MAFLD. Our hypothesis was that the intake of some macronutrients, vitamins, or mineral elements is associated with MAFLD.</p></div><div><h3>Patients and methods</h3><p>Patients with MAFLD can be diagnosed based on the evidence of hepatic steatosis and if they meet any of the three additional criteria of overweight/obesity, diabetes mellitus, or metabolic dysregulation. Diets were recorded using photographs and diaries of meals for seven consecutive days. The consumed dietary composition was compared with the recommended intake according to the China Food Composition Tables (Standard Edition) version 2019 and the Chinese Dietary Reference Intakes version 2013, and its association with MAFLD was assessed by logistical regression analyses.</p></div><div><h3>Results</h3><p>A total of 229 MAFLD patients and 148 healthy controls were included in this study. MAFLD patients, compared with that by non-MAFLD participants, consumed more polyunsaturated fatty acids (PUFAs) (<em>p</em> < 0.001), vitamin E (<em>p</em> < 0.001), and iron (<em>p</em> = 0.008). The intake of PUFAs (OR = 1.070, 95 % CI: 1.017–1.127, <em>p</em> = 0.009) and vitamin E (OR = 1.100, 95 % CI: 1.018–1.190, <em>p</em> = 0.016) was positively associated with MAFLD. In addition, the percentages of individuals who consumed PUFAs (<em>p</em> = 0.006), vitamin E (<em>p</em> < 0.001), or iron (<em>p</em> = 0.046) above the recommended intake were higher among the individuals with MAFLD. Daily intake of PUFAs > 11 % (OR = 2.328, 95 % CI: 1.290–4.201, <em>p</em> = 0.005) and vitamin E > 14 mg (OR = 2.189, 95 % CI: 1.153–4.158, <em>p</em> = 0.017) was positively correlated with MAFLD.</p></div><div><h3>Conclusions</h3><p>Patients with MAFLD consumed more PUFAs, vitamin E, and iron in their daily diet. Excessive consumption of PUFAs and vitamin E might be independent risk factors for the incidence of MAFLD.</p></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1687197924000297/pdfft?md5=c6662739bc0865db19865d88bd86e270&pid=1-s2.0-S1687197924000297-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139913804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1016/j.ajg.2024.01.005
Zheng Chang, Hao Zhang
Background and study aims
The aim of this study is to explore the risk factors for parenteral nutrition-associated liver disease (PNALD) in patients with severe acute pancreatitis by establishing a verification risk model.
Patients and methods
A total of 176 patients with severe acute pancreatitis from January 2019 to August 2021, were assigned into the observation group (n = 88) and control group (n = 88) based on the diagnostic results of PNALD, randomly. Their clinical data were recorded. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL) and alkaline phosphatase (ALP), etc., were detected. The logistic model and desicion tree model were used to analyze the risk factors.
Results
Patients in the observation group had higher levels of ALT, AST, TBIL, and lower level of ALP than those of control group (P < 0.05). Multivariate logistic regression analysis revealed that alcohol intake history, ALT ≥69.65 U/L, AST ≥71.27 U/L, TBIL ≥26.27 μmol/L and ALP ≤45.11 U/L were risk factors for PNALD. The levels of ALT and AST in observation group were two times as high as those in the control group, which conformed to the Danan’s criteria and accorded with the results of univariate analysis.
Conclusion
The regression model showed high consistency with the decision tree model in the prediction of risk factors. Alcohol intake history, ALT ≥69.65 U/L, AST ≥71.27 U/L, TBIL ≥26.27 μmol/L and ALP ≤45.11 U/L are risk factors for PNALD.
背景和研究目的：本研究旨在通过建立验证风险模型，探讨重症急性胰腺炎患者肠外营养相关性肝病（PNALD）的风险因素：根据PNALD的诊断结果，将2019年1月至2021年8月期间的176例重症急性胰腺炎患者随机分为观察组（n=88）和对照组（n=88）。记录他们的临床数据。检测丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、总胆红素（TBIL）和碱性磷酸酶（ALP）等。采用逻辑模型和选择树模型分析风险因素：观察组患者的谷丙转氨酶（ALT）、谷草转氨酶（AST）、谷草转氨酶（TBIL）水平高于对照组，而 ALP 水平低于对照组：回归模型与决策树模型在预测危险因素方面具有高度一致性。酒精摄入史、ALT≥69.65 U/L、AST≥71.27 U/L、TBIL≥26.27 μmol/L和ALP≤45.11 U/L是PNALD的危险因素。
{"title":"A risk model for parenteral nutrition-associated liver disease in patients with severe acute pancreatitis","authors":"Zheng Chang, Hao Zhang","doi":"10.1016/j.ajg.2024.01.005","DOIUrl":"10.1016/j.ajg.2024.01.005","url":null,"abstract":"<div><h3>Background and study aims</h3><p>The aim of this study is to explore the risk factors for parenteral nutrition-associated liver disease (PNALD) in patients with severe acute pancreatitis by establishing a verification risk model.</p></div><div><h3>Patients and methods</h3><p>A total of 176 patients with severe acute pancreatitis from January 2019 to August 2021, were assigned into the observation group (n = 88) and control group (n = 88) based on the diagnostic results of PNALD, randomly. Their clinical data were recorded. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL) and alkaline phosphatase (ALP), etc., were detected. The logistic model and desicion tree model were used to analyze the risk factors.</p></div><div><h3>Results</h3><p>Patients in the observation group had higher levels of ALT, AST, TBIL, and lower level of ALP than those of control group (P < 0.05). Multivariate logistic regression analysis revealed that alcohol intake history, ALT ≥69.65 U/L, AST ≥71.27 U/L, TBIL ≥26.27 μmol/L and ALP ≤45.11 U/L were risk factors for PNALD. The levels of ALT and AST in observation group were two times as high as those in the control group, which conformed to the Danan’s criteria and accorded with the results of univariate analysis.</p></div><div><h3>Conclusion</h3><p>The regression model showed high consistency with the decision tree model in the prediction of risk factors. Alcohol intake history, ALT ≥69.65 U/L, AST ≥71.27 U/L, TBIL ≥26.27 μmol/L and ALP ≤45.11 U/L are risk factors for PNALD.</p></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139913801","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}
Distal esophageal spasm is an uncommon esophageal motility disorder presenting with non-cardiac chest pain and dysphagia. The main goal of therapy is symptom relief with pharmacologic, endoscopic, and surgical therapies. Pharmacologic treatment is less invasive and is the preferred method of choice. The purpose of this study was to compare the effectiveness of diltiazem versus fluoxetine in the treatment of distal esophageal spasm.
Patients and methods
A total of 125 patients with distal esophageal spasm diagnosed using endoscopy, barium esophagogram, and manometry were evaluated. Patients were divided into diltiazem and fluoxetine groups and received a 2-month trial of diltiazem + omeprazole or fluoxetine + omeprazole, respectively. Of 125 patients, 55 were lost to follow up and 70 were eligible for final analysis. Clinical signs and symptoms were assessed before and after therapy using four validated questionnaires: Eckardt score, short form-36, heartburn score, and the hospital anxiety and depression scale.
Results
Both regimens significantly relieved symptoms (a decrease in mean Eckardt score of 2.57 and 3.18 for diltiazem and fluoxetine groups, respectively; and a decrease in mean heartburn score by 0.89 and 1.03 for diltiazem and fluoxetine groups, respectively). Patients’ quality of life improved based on short form-36 (an increase in mean score of 2.37 and 3.95 for fluoxetine and diltiazem groups, respectively). There was no relationship between patients’ improvement and severity of symptoms. Psychological findings based on the hospital anxiety and depression scale were inconsistent (a decrease in mean of 0.143 and 0.57 for fluoxetine and diltiazem groups, respectively; p > 0.05).
Conclusion
Fluoxetine and diltiazem were effective for clinical symptom relief in patients with distal esophageal spasm, but were not promising for improving psychological symptoms. Neither regimen was superior in terms of efficacy. Consequently, it is key to consider side effects and comorbidities when choosing a therapy.
{"title":"Comparison of the efficacy of diltiazem versus fluoxetine in the treatment of distal esophageal spasm: A randomized-controlled-trial","authors":"Mojgan Forootan , Mohsen Rajabnia , Ahmad Ghorbanpoor Rassekh , Saeed Abdi , Mobin Fathi , Mohamad Amin Pourhoseingholi , Pardis Ketabi Moghadam","doi":"10.1016/j.ajg.2023.07.002","DOIUrl":"10.1016/j.ajg.2023.07.002","url":null,"abstract":"<div><h3>Background and study aim</h3><p><span>Distal esophageal spasm<span><span> is an uncommon esophageal motility disorder presenting with non-cardiac chest pain and </span>dysphagia<span><span>. The main goal of therapy is symptom relief with pharmacologic, endoscopic, and surgical therapies. Pharmacologic treatment is less invasive and is the preferred method of choice. The purpose of this study was to compare the effectiveness of </span>diltiazem versus </span></span></span>fluoxetine in the treatment of distal esophageal spasm.</p></div><div><h3>Patients and methods</h3><p>A total of 125 patients with distal esophageal spasm diagnosed using endoscopy<span><span>, barium esophagogram, and manometry<span> were evaluated. Patients were divided into diltiazem and fluoxetine groups and received a 2-month trial of diltiazem + omeprazole or fluoxetine + omeprazole, respectively. Of 125 patients, 55 were lost to follow up and 70 were eligible for final analysis. Clinical signs and </span></span>symptoms<span> were assessed before and after therapy using four validated questionnaires: Eckardt score, short form-36, heartburn<span> score, and the hospital anxiety and depression scale.</span></span></span></p></div><div><h3>Results</h3><p><span>Both regimens significantly relieved symptoms (a decrease in mean Eckardt score of 2.57 and 3.18 for diltiazem and fluoxetine groups, respectively; and a decrease in mean heartburn score by 0.89 and 1.03 for diltiazem and fluoxetine groups, respectively). Patients’ quality of life improved based on short form-36 (an increase in mean score of 2.37 and 3.95 for fluoxetine and diltiazem groups, respectively). There was no relationship between patients’ improvement and severity of symptoms. Psychological findings based on the hospital anxiety and depression scale were inconsistent (a decrease in mean of 0.143 and 0.57 for fluoxetine and diltiazem groups, respectively; </span><em>p</em> > 0.05).</p></div><div><h3>Conclusion</h3><p>Fluoxetine and diltiazem were effective for clinical symptom relief in patients with distal esophageal spasm, but were not promising for improving psychological symptoms. Neither regimen was superior in terms of efficacy. Consequently, it is key to consider side effects and comorbidities when choosing a therapy.</p></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10286914","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}
Pub Date : 2024-05-01DOI: 10.1016/j.ajg.2024.02.004
Jun-Zheng Wu , Chun Zhou , Sheng Liu , Jin-Xing Zhang , Wei Yang , Hai-Bin Shi , Wei-Zhong Zhou
Background and study aims
Esophageal restenosis is a serious complication after esophageal stent placement, which influences the clinical prognosis of stent implantation and the patient's quality of life. TGF-β1/Smads signaling pathway plays an important role in the development of the eosinophilic esophagitis and scar repair after skin trauma. However, the role of TGF-β1/Smads in the development of esophageal restenosis after esophageal stent placement remains unknown. Our study aimed to investigate whether TGF-β1/Smads plays an important role in the development of esophageal restenosis after esophageal stent, and whether the exogenous TGF-β1 inhibitor supplement could ameliorate the esophageal restenosis after esophageal stent.
Material and methods
We established the model of esophageal restenosis after esophageal stenting in rats, and determined the expression levels of TGF-β1/Smads signaling pathway and the relevant markers of fibroblast activation by immunochemistry (IHC), Western Blot and real time qPCR. Those all the indicators were also determined in esophageal fibroblast when exposed to rhTGF-β1 with or without TGF-β1 inhibitor P144.
Results
The serum level of IL-1β and TNFα were significantly increased in stent implantation group compared to blank control group, and obviously ameliorated when treated with P144. The TGF-β1/Smads signaling pathway and the relevant markers of fibroblast activation were significantly increased in stent implantation group compared to blank control group, and obviously ameliorated when treated with P144. Those all the indicators were significantly increased when exposed to rhTGF-β1, and obviously decreased when treated with P144.
Conclusions
TGF-β1 Inhibitor P144 could protect against benign restenosis after esophageal stenting by down-regulating the expression levels of relevant markers of fibroblast activation through TGF-β1/Smads signaling pathway inhibition, and may be used as a novel therapy for benign restenosis after esophageal stenting.
{"title":"TGF-β1 inhibitor P144 protects against benign restenosis after esophageal stenting through TGF-β1/Smads signaling pathway inhibition","authors":"Jun-Zheng Wu , Chun Zhou , Sheng Liu , Jin-Xing Zhang , Wei Yang , Hai-Bin Shi , Wei-Zhong Zhou","doi":"10.1016/j.ajg.2024.02.004","DOIUrl":"10.1016/j.ajg.2024.02.004","url":null,"abstract":"<div><h3>Background and study aims</h3><p>Esophageal restenosis is a serious complication after esophageal stent placement, which influences the clinical prognosis of stent implantation and the patient's quality of life. TGF-β1/Smads signaling pathway plays an important role in the development of the eosinophilic esophagitis and scar repair after skin trauma. However, the role of TGF-β1/Smads in the development of esophageal restenosis after esophageal stent placement remains unknown. Our study aimed to investigate whether TGF-β1/Smads plays an important role in the development of esophageal restenosis after esophageal stent, and whether the exogenous TGF-β1 inhibitor supplement could ameliorate the esophageal restenosis after esophageal stent.</p></div><div><h3>Material and methods</h3><p>We established the model of esophageal restenosis after esophageal stenting in rats, and determined the expression levels of TGF-β1/Smads signaling pathway and the relevant markers of fibroblast activation by immunochemistry (IHC), Western Blot and real time qPCR. Those all the indicators were also determined in esophageal fibroblast when exposed to rhTGF-β1 with or without TGF-β1 inhibitor P144.</p></div><div><h3>Results</h3><p>The serum level of IL-1β and TNFα were significantly increased in stent implantation group compared to blank control group, and obviously ameliorated when treated with P144. The TGF-β1/Smads signaling pathway and the relevant markers of fibroblast activation were significantly increased in stent implantation group compared to blank control group, and obviously ameliorated when treated with P144. Those all the indicators were significantly increased when exposed to rhTGF-β1, and obviously decreased when treated with P144.</p></div><div><h3>Conclusions</h3><p>TGF-β1 Inhibitor P144 could protect against benign restenosis after esophageal stenting by down-regulating the expression levels of relevant markers of fibroblast activation through TGF-β1/Smads signaling pathway inhibition, and may be used as a novel therapy for benign restenosis after esophageal stenting.</p></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139900703","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}
Pub Date : 2024-05-01DOI: 10.1016/j.ajg.2024.01.007
Wen Xu, Guili Xia, Ling Dong, Ying Zhu
Background and study aims
Endoscopic minimally invasive treatment of internal hemorrhoids may cause postoperative pain. The aim of the study is to investigate the analgesic effect of lidocaine plus lauromacrogol on postoperative pain caused by endoscopic rubber band ligation (ERBL) combined with injection sclerotherapy (IS) for internal hemorrhoids treatment.
Patients and methods
Clinical data of grade Ⅲ internal hemorrhoids patients who underwent ERBL combined with IS in department of Digestive Medicine, Shenzhen Hospital of Southern Medical University, were retrospectively analyzed. According to difference in the composition of sclerosing solution, the patients were divided into control group (lauromacrogol group, 46 patients) and study group (lidocaine plus lauromacrogol group, 20 patients). Postoperative pain (quantized by Visual Analogue Scale, VAS), pain relief time and postoperative adverse reactions were compared. The therapeutic effect was followed up 1 month after operation.
Results
VAS of postoperative pain was 0.80 ± 0.42 points and pain relief time was 0.90 ± 0.56 days in the study group, while VAS of postoperative pain was 4.11 ± 1.37 points and pain relief time was 2.57 ± 0.83 days in the control group, there was statistical difference between them (P < 0.05). There was no significant difference in the incidence of postoperative adverse reactions and follow-up therapeutic effect between the control group and the study group.
Conclusion
Lidocaine plus lauromacrogol is useful for pain alleviation on ERBL combined with IS for internal hemorrhoids treatment because of its convenient procedure, low adverse reaction incidence and good therapeutic effect, which is worthy of promotion.
{"title":"Effect of lidocaine on postoperative analgesia of endoscopic rubber band ligation combined with injection sclerotherapy for treatment of internal hemorrhoids: A retrospective study (with video)","authors":"Wen Xu, Guili Xia, Ling Dong, Ying Zhu","doi":"10.1016/j.ajg.2024.01.007","DOIUrl":"10.1016/j.ajg.2024.01.007","url":null,"abstract":"<div><h3>Background and study aims</h3><p>Endoscopic minimally invasive treatment of internal hemorrhoids may cause postoperative pain. The aim of the study is to investigate the analgesic effect of lidocaine plus lauromacrogol on postoperative pain caused by endoscopic rubber band ligation (ERBL) combined with injection sclerotherapy (IS) for internal hemorrhoids treatment.</p></div><div><h3>Patients and methods</h3><p>Clinical data of grade Ⅲ internal hemorrhoids patients who underwent ERBL combined with IS in department of Digestive Medicine, Shenzhen Hospital of Southern Medical University, were retrospectively analyzed. According to difference in the composition of sclerosing solution, the patients were divided into control group (lauromacrogol group, 46 patients) and study group (lidocaine plus lauromacrogol group, 20 patients). Postoperative pain (quantized by Visual Analogue Scale, VAS), pain relief time and postoperative adverse reactions were compared. The therapeutic effect was followed up 1 month after operation.</p></div><div><h3>Results</h3><p>VAS of postoperative pain was 0.80 ± 0.42 points and pain relief time was 0.90 ± 0.56 days in the study group, while VAS of postoperative pain was 4.11 ± 1.37 points and pain relief time was 2.57 ± 0.83 days in the control group, there was statistical difference between them (P < 0.05). There was no significant difference in the incidence of postoperative adverse reactions and follow-up therapeutic effect between the control group and the study group.</p></div><div><h3>Conclusion</h3><p>Lidocaine plus lauromacrogol is useful for pain alleviation on ERBL combined with IS for internal hemorrhoids treatment because of its convenient procedure, low adverse reaction incidence and good therapeutic effect, which is worthy of promotion.</p></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139974097","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}
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