Pub Date : 2026-01-13DOI: 10.14309/ajg.0000000000003919
Shyna Zhuoying Gunalan,Michelle Shi Ni Law,Yi Xin Kua,Zhenning Yu,Ryan Yan Zhe Lim,Asvin Selvakumar,Nicholas Syn,Karn Wijarnpreecha,Benjamin Nah,Zi Xuan Zhang,Ming-Hua Zheng,Toru Nakamura,Asahiro Morishita,Won Mook Choi,Vincent L Chen,Cheng Han Ng,Mei Chin Lim,Hirokazu Takahashi,Mark Muthiah
INTRODUCTIONMetabolic dysfunction-associated steatohepatitis (MASH) is an advanced form of metabolic dysfunction-associated steatotic liver disease (MASLD), characterised by hepatocellular injury, inflammation and varying degrees of fibrosis. Non-invasive, accurate diagnostic tools are critical for identifying patients "at risk" (MAS ≥4, F ≥2). This meta-analysis evaluates the diagnostic performance of imaging-based technologies for ruling in (TRI) and ruling out (TRO) "at risk" MASH.METHODSA systematic search of Medline and Embase (inception to December 20, 2024) identified studies reporting on MRI-based diagnostic techniques for "at risk" MASH. Eligible studies were independently screened, with 20 studies meeting inclusion criteria. Sensitivity, specificity, and diagnostic odds ratios (DORs) were calculated using bivariate meta-analysis, applying pre-specified TRO and TRI thresholds to each technique.RESULTSTwenty studies involving 9,480 participants were included. FAST demonstrated highest TRO sensitivity (0.871) with moderate specificity (0.567) and TRI specificity (0.900) with reduced sensitivity (0.441). MEFIB achieved high TRO sensitivity (0.812) but lower specificity (0.606); TRI specificity was 0.872, sensitivity was 0.500. MAST exhibited intermediate performance, while cT1 thresholds showed variable diagnostic accuracy. A sensitivity analysis of head-to-head studies shows superior performance in FAST compared to other diagnostic methods.CONCLUSIONFAST with its accessibility and robust diagnostic performance may be well-suited for large-scale application. MRI-based techniques are effective non-invasive options for diagnosing "at risk" MASH in MASLD and may provide strong alternatives. Rather than challenging existing perspectives, this study provides a reflective overview of current evidence on imaging-based modalities for "at risk" MASH.
{"title":"Imaging Based Modalities for Identifying \"At Risk\" MASH. A Diagnostic Test Meta-analysis.","authors":"Shyna Zhuoying Gunalan,Michelle Shi Ni Law,Yi Xin Kua,Zhenning Yu,Ryan Yan Zhe Lim,Asvin Selvakumar,Nicholas Syn,Karn Wijarnpreecha,Benjamin Nah,Zi Xuan Zhang,Ming-Hua Zheng,Toru Nakamura,Asahiro Morishita,Won Mook Choi,Vincent L Chen,Cheng Han Ng,Mei Chin Lim,Hirokazu Takahashi,Mark Muthiah","doi":"10.14309/ajg.0000000000003919","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003919","url":null,"abstract":"INTRODUCTIONMetabolic dysfunction-associated steatohepatitis (MASH) is an advanced form of metabolic dysfunction-associated steatotic liver disease (MASLD), characterised by hepatocellular injury, inflammation and varying degrees of fibrosis. Non-invasive, accurate diagnostic tools are critical for identifying patients \"at risk\" (MAS ≥4, F ≥2). This meta-analysis evaluates the diagnostic performance of imaging-based technologies for ruling in (TRI) and ruling out (TRO) \"at risk\" MASH.METHODSA systematic search of Medline and Embase (inception to December 20, 2024) identified studies reporting on MRI-based diagnostic techniques for \"at risk\" MASH. Eligible studies were independently screened, with 20 studies meeting inclusion criteria. Sensitivity, specificity, and diagnostic odds ratios (DORs) were calculated using bivariate meta-analysis, applying pre-specified TRO and TRI thresholds to each technique.RESULTSTwenty studies involving 9,480 participants were included. FAST demonstrated highest TRO sensitivity (0.871) with moderate specificity (0.567) and TRI specificity (0.900) with reduced sensitivity (0.441). MEFIB achieved high TRO sensitivity (0.812) but lower specificity (0.606); TRI specificity was 0.872, sensitivity was 0.500. MAST exhibited intermediate performance, while cT1 thresholds showed variable diagnostic accuracy. A sensitivity analysis of head-to-head studies shows superior performance in FAST compared to other diagnostic methods.CONCLUSIONFAST with its accessibility and robust diagnostic performance may be well-suited for large-scale application. MRI-based techniques are effective non-invasive options for diagnosing \"at risk\" MASH in MASLD and may provide strong alternatives. Rather than challenging existing perspectives, this study provides a reflective overview of current evidence on imaging-based modalities for \"at risk\" MASH.","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145961501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-06DOI: 10.14309/ajg.0000000000003865
Fatemeh Sadeghi,Nicholas J Talley,Weimin Ye
{"title":"Response to Shah et al and Li et al.","authors":"Fatemeh Sadeghi,Nicholas J Talley,Weimin Ye","doi":"10.14309/ajg.0000000000003865","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003865","url":null,"abstract":"","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145907568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-05DOI: 10.14309/ajg.0000000000003900
Jeffrey Schwartz,Aanchal Kapoor,Christina C Lindenmeyer
{"title":"Navigating Complexities in the Liver ICU: A Fireside Chat with a Liver Intensivist.","authors":"Jeffrey Schwartz,Aanchal Kapoor,Christina C Lindenmeyer","doi":"10.14309/ajg.0000000000003900","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003900","url":null,"abstract":"","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145897456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-23DOI: 10.14309/ajg.0000000000003897
Megan A Adams,Andrew Feld
AI is emerging as a transformative force reshaping healthcare delivery, including in clinical gastroenterology. However, its many benefits cannot be fully realized without also reconciling associated ethical, legal, and regulatory concerns to ensure its responsible use. Here, we present an overview of the core principles of responsible use of healthcare AI, including equity and fairness, patient autonomy, data privacy and security, accountability for AI-related patient harm, human agency, and regulation, using GI-relevant examples to highlight the benefits and risks of this powerful technology. We conclude with our predictions regarding the future legal and ethical impact of AI in our field.
{"title":"Ethical and Legal Considerations for Responsible Use of AI in Clinical Gastroenterology.","authors":"Megan A Adams,Andrew Feld","doi":"10.14309/ajg.0000000000003897","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003897","url":null,"abstract":"AI is emerging as a transformative force reshaping healthcare delivery, including in clinical gastroenterology. However, its many benefits cannot be fully realized without also reconciling associated ethical, legal, and regulatory concerns to ensure its responsible use. Here, we present an overview of the core principles of responsible use of healthcare AI, including equity and fairness, patient autonomy, data privacy and security, accountability for AI-related patient harm, human agency, and regulation, using GI-relevant examples to highlight the benefits and risks of this powerful technology. We conclude with our predictions regarding the future legal and ethical impact of AI in our field.","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145807591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-22DOI: 10.14309/ajg.0000000000003896
Koen J H Wijsman,Derk C F Klatte,Hani M Babiker,Aleksander M Bogdanski,Brandon R Grossardt,Jeanin E van Hooft,Monique E van Leerdam,J Sven D Mieog,Alexander D Weston,Michael B Wallace,Yan Bi
INTRODUCTIONA deeper understanding of the factors influencing survival in patients with pancreatic ductal adenocarcinoma (PDAC) is essential for optimizing treatment strategies. This study investigates the independent association of body composition parameters with overall survival in patients with PDAC.METHODSThis retrospective multi-site cohort study included patients diagnosed with PDAC. Diagnostic computed tomography (CT) scans were retrieved and body composition was evaluated using a validated deep learning-based segmentation algorithm that measured tissue volume and density in a 20 cm vertical abdominal section.RESULTSA total of 1666 patients with PDAC were included, 938 male (56.3%), median age 69 years old (IQR 61 - 76). In the subgroup of patients who underwent surgical resection (n=509), myosteatosis (intramuscular infiltration of adipose tissue; HR 1.56, 95% CI 1.16 - 2.11, P=0.004), sarcopenic obesity (HR 1.75, 95% CI 1.06 - 2.91, P=0.03), and less subcutaneous adipose tissue (HR 1.09, 95% CI 1.03 -1.16, P=0.002) were associated with higher mortality. In patients receiving palliative systemic therapy (n=439), lower skeletal muscle density (HR 1.43, 95% CI 1.03 -1.99, P=0.03) was associated with higher mortality. In patients who did not undergo tumor-targeted treatment (n=718), less visceral adipose tissue (HR 1.04, 95% CI 1.01 - 1.08, P=0.02) was associated with higher mortality.DISCUSSIONBody composition parameters, derived from CT scans at the time of PDAC diagnosis, particularly low skeletal muscle density, sarcopenic obesity, and low adipose tissue, are independently associated with OS in patients with PDAC. Evaluating body composition at diagnosis could enhance clinical decision-making and enable more personalized treatment strategies.
深入了解影响胰腺导管腺癌（PDAC）患者生存的因素对于优化治疗策略至关重要。本研究调查了PDAC患者体成分参数与总生存率的独立关联。方法本研究为回顾性多中心队列研究，纳入诊断为PDAC的患者。检索诊断性计算机断层扫描（CT），并使用经过验证的基于深度学习的分割算法评估身体成分，该算法测量了20厘米垂直腹部切片的组织体积和密度。结果共纳入PDAC患者1666例，其中男性938例（56.3%），中位年龄69岁（IQR 61 ~ 76）。在接受手术切除的患者亚组（n=509）中，肌骨化症（肌肉内脂肪组织浸润；风险比1.56,95% CI 1.16 - 2.11， P=0.004）、肌肉减少型肥胖（风险比1.75,95% CI 1.06 - 2.91， P=0.03）和皮下脂肪组织较少（风险比1.09,95% CI 1.03 -1.16， P=0.002）与较高的死亡率相关。在接受姑息性全身治疗的患者中（n=439），较低的骨骼肌密度（HR 1.43, 95% CI 1.03 -1.99， P=0.03）与较高的死亡率相关。在未接受肿瘤靶向治疗的患者中（n=718），较少的内脏脂肪组织（HR 1.04, 95% CI 1.01 - 1.08， P=0.02）与较高的死亡率相关。PDAC诊断时CT扫描得出的身体组成参数，特别是低骨骼肌密度、肌肉减少性肥胖和低脂肪组织，与PDAC患者的OS独立相关。在诊断时评估身体成分可以增强临床决策，并实现更个性化的治疗策略。
{"title":"Association Between CT-Based AI-Derived Body Composition and Survival in Patients With Pancreatic Ductal Adenocarcinoma.","authors":"Koen J H Wijsman,Derk C F Klatte,Hani M Babiker,Aleksander M Bogdanski,Brandon R Grossardt,Jeanin E van Hooft,Monique E van Leerdam,J Sven D Mieog,Alexander D Weston,Michael B Wallace,Yan Bi","doi":"10.14309/ajg.0000000000003896","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003896","url":null,"abstract":"INTRODUCTIONA deeper understanding of the factors influencing survival in patients with pancreatic ductal adenocarcinoma (PDAC) is essential for optimizing treatment strategies. This study investigates the independent association of body composition parameters with overall survival in patients with PDAC.METHODSThis retrospective multi-site cohort study included patients diagnosed with PDAC. Diagnostic computed tomography (CT) scans were retrieved and body composition was evaluated using a validated deep learning-based segmentation algorithm that measured tissue volume and density in a 20 cm vertical abdominal section.RESULTSA total of 1666 patients with PDAC were included, 938 male (56.3%), median age 69 years old (IQR 61 - 76). In the subgroup of patients who underwent surgical resection (n=509), myosteatosis (intramuscular infiltration of adipose tissue; HR 1.56, 95% CI 1.16 - 2.11, P=0.004), sarcopenic obesity (HR 1.75, 95% CI 1.06 - 2.91, P=0.03), and less subcutaneous adipose tissue (HR 1.09, 95% CI 1.03 -1.16, P=0.002) were associated with higher mortality. In patients receiving palliative systemic therapy (n=439), lower skeletal muscle density (HR 1.43, 95% CI 1.03 -1.99, P=0.03) was associated with higher mortality. In patients who did not undergo tumor-targeted treatment (n=718), less visceral adipose tissue (HR 1.04, 95% CI 1.01 - 1.08, P=0.02) was associated with higher mortality.DISCUSSIONBody composition parameters, derived from CT scans at the time of PDAC diagnosis, particularly low skeletal muscle density, sarcopenic obesity, and low adipose tissue, are independently associated with OS in patients with PDAC. Evaluating body composition at diagnosis could enhance clinical decision-making and enable more personalized treatment strategies.","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145807590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-16DOI: 10.14309/ajg.0000000000003887
Hersh Shroff,Oren K Fix
{"title":"Practical Applications of Artificial Intelligence to Improve Efficiency and Reduce Burnout in Gastroenterology and Hepatology Practices.","authors":"Hersh Shroff,Oren K Fix","doi":"10.14309/ajg.0000000000003887","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003887","url":null,"abstract":"","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145759965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-16DOI: 10.14309/ajg.0000000000003889
Jonggi Choi,Vy H Nguyen,Eric Przybyszewski,Jiunn Song,Allison Carroll,Megan Michta,Erik Almazan,Tracey G Simon,Raymond T Chung
BACKGROUND AND AIMSSodium-glucose cotransporter-2 inhibitors (SGLT2is) are widely prescribed for type 2 diabetes mellitus (T2DM) and may confer hepatoprotective effects. This study investigated their association with hepatocellular carcinoma (HCC) risk compared with other antidiabetic medications.METHODSWe conducted a retrospective cohort study using the electronic health records from Mass General Brigham (Boston, USA) and Asan Medical Center (Seoul, Korea) from 2013 to 2024. Adults with T2DM newly initiating SGLT2i, dipeptidyl peptidase-4 inhibitor (DPP4i), glucagon-like peptide-1 receptor agonist (GLP-1RA), or sulfonylureas were included. A 6-month landmark analysis was employed to minimize early event bias. Inverse probability weighting combined with Fine-Gray competing risk models estimated subdistribution hazard ratios (SHRs) for incident HCC, accounting for transplant and death as competing events.RESULTSAfter weighting, data from 6,733 SGLT2i, 4,495 GLP-1RA, 23,229 DPP4i, and 17,034 sulfonylurea initiators were analyzed. Over a median follow-up of 3.9 years (277,155 person-years), 623 HCC cases occurred. SGLT2i use was associated with significantly lower HCC risk versus sulfonylureas (SHR 0.44, 95% CI: 0.25-0.79) and DPP4i (SHR 0.53, 95% CI: 0.30-0.93). The comparison with GLP-1RA showed comparable risk (SHR 0.87, 95% CI: 0.40-1.91). Subgroup analyses demonstrated consistent protective associations of SGLT2i in patients ≤65 years, males, and those with chronic liver disease. Sensitivity analyses, including 12-month landmark analysis and adjustments for additional confounders, confirmed robustness of findings.CONCLUSIONSSGLT2 inhibitor therapy was associated with reduced risk of HCC compared with DPP4 inhibitors and sulfonylureas, supporting their potential chemopreventive role in patients with T2DM.
背景和目的钠-葡萄糖共转运蛋白-2抑制剂（SGLT2is）广泛用于2型糖尿病（T2DM），并可能具有肝脏保护作用。本研究调查了它们与肝细胞癌（HCC）风险的关系，并与其他降糖药物进行了比较。方法采用2013年至2024年美国布里格姆总院（Boston， USA）和韩国首尔牙山医疗中心（Asan Medical Center, Seoul, Korea）的电子健康记录进行回顾性队列研究。新启动的T2DM成人患者包括SGLT2i、二肽基肽酶-4抑制剂（DPP4i）、胰高血糖素样肽-1受体激动剂（GLP-1RA）或磺脲类药物。采用6个月的里程碑分析来减少早期事件偏差。逆概率加权结合Fine-Gray竞争风险模型估计了HCC事件的亚分布风险比（SHRs），将移植和死亡作为竞争事件。结果加权后，分析了6733个SGLT2i、4495个GLP-1RA、23229个DPP4i和17034个磺脲类引发剂的数据。在中位随访3.9年（277,155人年）期间，发生了623例HCC病例。与磺脲类药物（SHR 0.44, 95% CI: 0.25-0.79）和DPP4i （SHR 0.53, 95% CI: 0.30-0.93）相比，SGLT2i的使用显著降低了HCC风险。与GLP-1RA的比较显示相当的风险（SHR 0.87, 95% CI: 0.40-1.91）。亚组分析显示，SGLT2i在≤65岁、男性和慢性肝病患者中具有一致的保护作用。敏感性分析，包括12个月的里程碑分析和其他混杂因素的调整，证实了研究结果的稳健性。结论：与DPP4抑制剂和磺脲类药物相比，ssglt2抑制剂治疗与HCC风险降低相关，支持其在T2DM患者中的潜在化学预防作用。
{"title":"Association of SGLT2 Inhibitors with Reduced Hepatocellular Carcinoma Risk in Patients with Type 2 Diabetes.","authors":"Jonggi Choi,Vy H Nguyen,Eric Przybyszewski,Jiunn Song,Allison Carroll,Megan Michta,Erik Almazan,Tracey G Simon,Raymond T Chung","doi":"10.14309/ajg.0000000000003889","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003889","url":null,"abstract":"BACKGROUND AND AIMSSodium-glucose cotransporter-2 inhibitors (SGLT2is) are widely prescribed for type 2 diabetes mellitus (T2DM) and may confer hepatoprotective effects. This study investigated their association with hepatocellular carcinoma (HCC) risk compared with other antidiabetic medications.METHODSWe conducted a retrospective cohort study using the electronic health records from Mass General Brigham (Boston, USA) and Asan Medical Center (Seoul, Korea) from 2013 to 2024. Adults with T2DM newly initiating SGLT2i, dipeptidyl peptidase-4 inhibitor (DPP4i), glucagon-like peptide-1 receptor agonist (GLP-1RA), or sulfonylureas were included. A 6-month landmark analysis was employed to minimize early event bias. Inverse probability weighting combined with Fine-Gray competing risk models estimated subdistribution hazard ratios (SHRs) for incident HCC, accounting for transplant and death as competing events.RESULTSAfter weighting, data from 6,733 SGLT2i, 4,495 GLP-1RA, 23,229 DPP4i, and 17,034 sulfonylurea initiators were analyzed. Over a median follow-up of 3.9 years (277,155 person-years), 623 HCC cases occurred. SGLT2i use was associated with significantly lower HCC risk versus sulfonylureas (SHR 0.44, 95% CI: 0.25-0.79) and DPP4i (SHR 0.53, 95% CI: 0.30-0.93). The comparison with GLP-1RA showed comparable risk (SHR 0.87, 95% CI: 0.40-1.91). Subgroup analyses demonstrated consistent protective associations of SGLT2i in patients ≤65 years, males, and those with chronic liver disease. Sensitivity analyses, including 12-month landmark analysis and adjustments for additional confounders, confirmed robustness of findings.CONCLUSIONSSGLT2 inhibitor therapy was associated with reduced risk of HCC compared with DPP4 inhibitors and sulfonylureas, supporting their potential chemopreventive role in patients with T2DM.","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145759967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-16DOI: 10.14309/ajg.0000000000003890
Zhi Liu,Jiayong Wang,Jinbo Jiang
{"title":"Appendicovesical Fistula Presenting With Intermittent Passage of Food Residues in Urine.","authors":"Zhi Liu,Jiayong Wang,Jinbo Jiang","doi":"10.14309/ajg.0000000000003890","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003890","url":null,"abstract":"","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145759966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-15DOI: 10.14309/ajg.0000000000003828
David T Rubin,Ashwin N Ananthakrishnan,Corey A Siegel,Edward L Barnes,Millie D Long
{"title":"Correction: ACG Clinical Guideline Ulcerative Colitis in Adults.","authors":"David T Rubin,Ashwin N Ananthakrishnan,Corey A Siegel,Edward L Barnes,Millie D Long","doi":"10.14309/ajg.0000000000003828","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003828","url":null,"abstract":"","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145732720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-12DOI: 10.14309/ajg.0000000000003885
Johan Hardvik Åkerström,Giola Santoni,My von Euler-Chelpin,Helgi Birgisson,Eivind Ness-Jensen,Joonas H Kauppila,Dag Holmberg,Jesper Lagergren
OBJECTIVESGlucagon-like peptide-1 receptor agonists (GLP-1RAs) induce weight loss, and have been associated with an overall decreased risk of esophageal cancer. Obesity is strongly associated with esophageal adenocarcinoma and substantial weight loss may decrease the risk of this malignancy, whereas weight loss does not decrease the risk of esophageal squamous cell carcinoma. We examined the hypothesis that GLP-1RA treatment decreases the risk of esophageal adenocarcinoma.METHODSThis multinational population-based case-control study included all cases of esophageal adenocarcinoma and esophageal squamous cell carcinoma in adults who had dispensed medication for type 2 diabetes in Denmark (2007-2020), Finland (2011-2018), Iceland (2009-2019), Norway (2007-2019), or Sweden (2007-2020). For each case participant, >10 control participants who had dispensed medication for type 2 diabetes were randomly sampled from the general populations. Data came from nationwide health-data registries. Multivariable logistic regression provided odds ratios (OR) with 95% confidence intervals (CI), adjusted for sex, age, calendar year, country, comorbidity, gastroesophageal reflux disease, obesity, alcohol overconsumption, and tobacco smoking.RESULTSThis study included 2,909 case participants with esophageal adenocarcinoma, 670 case participants with esophageal squamous cell carcinoma, and 55,408 control participants. The risk of esophageal adenocarcinoma was not decreased in GLP-1RA users compared with non-users (adjusted OR 1.3, 95% CI 1.1-1.5). Instead, the risk of esophageal squamous cell carcinoma was decreased (adjusted OR 0.5, 95% CI 0.3-0.8).CONCLUSIONSStandard GLP-1RA treatment in patients with type 2 diabetes might not decrease the risk of esophageal adenocarcinoma. The validity of the observed decreased risk of esophageal squamous cell carcinoma is uncertain.
{"title":"Glucagon-like peptide-1 receptor agonist treatment and risk of esophageal cancer.","authors":"Johan Hardvik Åkerström,Giola Santoni,My von Euler-Chelpin,Helgi Birgisson,Eivind Ness-Jensen,Joonas H Kauppila,Dag Holmberg,Jesper Lagergren","doi":"10.14309/ajg.0000000000003885","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003885","url":null,"abstract":"OBJECTIVESGlucagon-like peptide-1 receptor agonists (GLP-1RAs) induce weight loss, and have been associated with an overall decreased risk of esophageal cancer. Obesity is strongly associated with esophageal adenocarcinoma and substantial weight loss may decrease the risk of this malignancy, whereas weight loss does not decrease the risk of esophageal squamous cell carcinoma. We examined the hypothesis that GLP-1RA treatment decreases the risk of esophageal adenocarcinoma.METHODSThis multinational population-based case-control study included all cases of esophageal adenocarcinoma and esophageal squamous cell carcinoma in adults who had dispensed medication for type 2 diabetes in Denmark (2007-2020), Finland (2011-2018), Iceland (2009-2019), Norway (2007-2019), or Sweden (2007-2020). For each case participant, >10 control participants who had dispensed medication for type 2 diabetes were randomly sampled from the general populations. Data came from nationwide health-data registries. Multivariable logistic regression provided odds ratios (OR) with 95% confidence intervals (CI), adjusted for sex, age, calendar year, country, comorbidity, gastroesophageal reflux disease, obesity, alcohol overconsumption, and tobacco smoking.RESULTSThis study included 2,909 case participants with esophageal adenocarcinoma, 670 case participants with esophageal squamous cell carcinoma, and 55,408 control participants. The risk of esophageal adenocarcinoma was not decreased in GLP-1RA users compared with non-users (adjusted OR 1.3, 95% CI 1.1-1.5). Instead, the risk of esophageal squamous cell carcinoma was decreased (adjusted OR 0.5, 95% CI 0.3-0.8).CONCLUSIONSStandard GLP-1RA treatment in patients with type 2 diabetes might not decrease the risk of esophageal adenocarcinoma. The validity of the observed decreased risk of esophageal squamous cell carcinoma is uncertain.","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"427 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145732590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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