Journal of gastrointestinal and liver diseases : JGLD最新文献

Background and aims: Late-evening snacks bring multiple benefits to liver cirrhosis patients. However, a consensus on the nutrient composition of the snack is still not clear. This study showed a direct comparison between a protein snack and a a branched-chained amino acid (BCAA) snack.

Methods: A randomized clinical trial with 32 Vietnamese liver cirrhosis outpatients (61.0, 57-63 years), allocated into two groups: Protein group (n=16) and BCAA group (n=16) took place. Both groups received a snack providing 270-300 kcal, 50g carbohydrates, <5g lipid, and 13g of protein with 8g being protein powder in Protein group and 4g protein powder and 4g BCAA powder in BCAA group. Serum biochemical parameters, anthropometric data, and Chronic Liver Disease Questionnaire scores were examined in both groups before and after the 3-week intervention.

Results: After receiving the snacks for 3 weeks, albumin was significantly increased in the Protein group (p<0.01) while it was not in the BCAA group. Only the ALT liver enzyme was statistically decreased in the Protein group (p<0.01). After the intervention, the handgrip strength of the Protein group increased from 24.3kg (±9.1 SD) to 25.7kg (±9.2 SD) (p=0.012); while, in BCAA group, the mean also changed from 24.7kg (±6.6 SD) to 25.6kg (±7.4 SD) (p=0.237). The overall Chronic Liver Disease Questionnaire score was significantly increased from 6.0 to 6.7 and 6.6 in the Protein group and the BCAA group, respectively.

Conclusions: A protein snack is an effective dietary intervention in improving albumin, biochemical parameters, and nutritional status for compensated liver cirrhosis outpatients. Considering cost, availability, and taste, a BCAA snack might be unnecessary for liver cirrhosis outpatients.

Aims: The purpose of this study was to evaluate proton pump inhibitor (PPI) response rates for gastroesophageal reflux disease (GERD) phenotypes and functional heartburn (FH) according to the different diagnostic techniques.

Methods: This was a retrospective, noninterventional, single-center study, presenting real-life data. Among 1,233 patients, 510 patients agreed to respond and were evaluated via a validated questionnaire consisting of 28 questions. Patients were classified into: Group I (n=54) if the diagnosis was based only on history, Group II (n=151) if diagnosis was documented on history and upper gastrointestinal endoscopy (UGE), and Group III (n=305) if diagnosis was based on history, UGE, high-resolution manometry and intraesophageal 24-h ambulatory pH-impedance monitoring. Patients were classified into 5 phenotypes (according to the final diagnosis): erosive esophagitis (EE) (n=117), non-erosive reflux disease (NERD) (n=94), FH (n=58), reflux hypersensitivity (RH) (n=16) and Barrett esophagus (BE) (n=20). A response rate under 50% was accepted as being nonresponsive with double doses after 8 weeks of treatment. A very good response was defined as being over 80% improvement of typical symptoms.

Results: The response rates for heartburn and regurgitation of all the patients were 85.3% and 82.2%, respectively. The heartburn and regurgitation response rates of Group I patients were 79.6% and 70.4%; 91.4% and 85.4% for Group II; whereas 83.3% and 82.6% for Group III. The heartburn and regurgitation response rates of BE were 90% and 90%, for EE 88% and 87.2%, for NERD 85.2% and 85.1%, for RH 68.8% and 62.5% and for FH 72.4% and 74.1%. Response rates for both heartburn and regurgination were 40% in BE, 41.4% in EE, 18.8% in NERD, 24.1% in RH and 15.5% in FH.

Conclusions: We demonstrated higher PPI response rates than Western populations in all the GERD patients. More than 1/3 of the patients exhibited very good response rates for both heartburn and regurgitation. The response rates of patients who were diagnosed via all the diagnostic modalities are lower than those who were diagnosed via only history and UGE.

Background and aims: Religious fasting observed in diverse populations may influence the reporting of digestive symptoms. Greek-Orthodox (Byzantine style) religious fasting is prolonged and similar to a vegan diet. We aimed to evaluate the association between functional gastrointestinal symptoms and disorders of gut-brain interaction (DGBI) with this religious fasting.

Methods: We investigated Romanian participants in the Rome Foundation Global Epidemiology Study who observe Greek-Orthodox religious fasting, by adding specific questions on religious fasting to the study questionnaire. Data were analyzed in connection with the reported gastrointestinal symptoms.

Results: 2015 Romanians were included in the analyses. Overall, 716 (35.5%) of the respondents practiced some fasting, of which 446 (62.3%) fasted on Easter and Christmas, 90 (12.6%) observed all fasts, and 625 (87.3%) practiced weekly fasting. Of the latter, 167 (23.3%) fasted every week and 90 (12.6%) reported symptoms during fasting. There were no statistically significant associations between Greek-Orthodox fasting, to any degree, with upper or lower DGBI or gastrointestinal symptoms.

Conclusions: The results from this representative sample show that a substantial proportion of the Romanian population adheres to Greek-Orthodox fasting. However, in contrast to the a priori hypothesis, we did not have sufficient evidence that religious fasting is associated with the prevalence of DGBI, or with functional gastrointestinal symptoms.

Background and aims: Both metabolic dysfunction-associated steatotic liver disease (MASLD) and fibrosis have been associated with type 2 diabetes mellitus (T2DM), but the roles of T2DM and related biomarkers in the association between MASLD and fibrosis are yet to be fully elucidated. This study aimed at assessing whether the association between MASLD and fibrosis is mediated by T2DM.

Methods: A total of 6,060 participants from NHANES 2017-2020 were enrolled in the cross-sectional analyses. Pairwise associations among MASLD, fibrosis, T2DM, and T2DM-related biomarkers [plasma fasting glucose, hemoglobin A1c (HbA1c), serum insulin, and homeostatic model assessment for insulin resistance (HOMA-IR)] were examined, and then the extent to which MASLD progresses to fibrosis through T2DM and the biomarkers was assessed.

Results: We found a higher risk of T2DM and higher levels of T2DM-related biomarkers were associated with MASLD. Moreover, T2DM and higher levels of T2DM-related biomarkers were positively associated with fibrosis risk. T2DM, plasma fasting glucose, HbA1c, serum insulin, and HOMA-IR mediated 10.1%, 9.99%, 10.5%, 5.98%, and 7.28% of the association between MASLD and fibrosis, respectively. In addition, the mediation effect of T2DM varied in different groups of age, body mass index, and antidiabetic medication.

Conclusions: T2DM and T2DM-related biomarkers partly mediated the association between MASLD and fibrosis.

Background and aims: The occurrence of anti-tuberculosis drug-induced hepatotoxicity (ATDH) deserves our attention. To explore the role of ATP-binding cassette B6 (ABCB6) polymorphisms and serum levels in the risk of antituberculosis drug-induced hepatotoxicity (ATDH).

Methods: A 1:4 matched case‒control study was conducted. Four single nucleotide polymorphisms (SNPs) and serum ABCB6 levels were analyzed, and false discovery rate (FDR) was performed to correct for multiple comparison.

Results: 224 ATDH cases and 896 controls were included. SNP rs1109867 in ABCB6 gene had a decreased risk of ATDH under dominant models (FDR corrected p-value = 0.027). Furthermore, serum ABCB6 levels at three different times in the ATDH cases were higher than those in the controls.

Conclusions: SNP rs1109867 in ABCB6 gene may contribute to the susceptibility to ATDH among patients receiving anti-TB treatment.

Background and aims: Lymphomas of the gastrointestinal tract represent a rare pathology, frequently associated with a poor outcome. This study aimed to determine the prognostic factors of digestive tract lymphomas and to evaluate the role of endoscopy in the diagnosis and outcome.

Methods: Our prospective study evaluated a number of 63 patients diagnosed with digestive tract lymphomas.

Results: The mean age of the patients was 62 years ± 13.1 years. Most of the patients had B-cell lymphoma (88.8%). Localization was represented by the stomach (44.4%), followed by the small bowel (25.4%) and the oropharynx (14.2%). Diffuse large B-cell lymphoma was the most common subtype (52.3%), followed by Mantle cell lymphoma (15.8%) and MALT (14.2%). T-cell lymphoma was present in a small number of patients. Anaplastic large cell lymphoma was the most common subtype of T-cell lymphoma (6.35%) and was localized in the small bowel. One-quarter of the patients had complications such as bleeding, obstruction, or perforation. Chemotherapy alone (38.1%) was the most common treatment option, followed by surgery (28.5%). Endoscopic examination and sampling biopsy were performed on 74.6% of the patients included in the study, with a positive diagnosis for lymphoma in 58.7% of the cases. Age (p=0.208), higher ECOG values (p=0.0487), and level of albumin (p=0.0355) were independent prognostic factors for overall survival. Endoscopic monitoring impacted overall survival (p<0.0001), due to the early detection of relapse.

Conclusions: Age, high ECOG value, and low albumin levels are independent prognostic factors for overall survival. Early diagnosis of recurrent gastrointestinal tract lymphomas by endoscopy increases overall survival.

Background and aims: To explore the prognostic role of programmed cell death-ligand 1 (PD-L1) in patients with gastrointestinal stromal tumours (GISTs).

Methods: PD-L1 expression was detected using immunohistochemistry in tissue microarrays from 96 GISTs samples. Survival of patients was assessed using Kaplan - Meier analysis. Possible risk factors for GISTs were explored using Cox proportional hazards regression models. The role of PD-L1 in GISTs proliferation, invasion, and metastasis was assessed using colony formation assay, scratch, transwell invasion, and migration assays.

Results: Survival in GISTs patients was significantly associated with PD-L1 expression (p < 0.05). High PD-L1 expression in GISTs resulted in relatively short overall survival (p=0.016). Univariate regression analysis showed that PD-L1 was a risk factor for poor prognosis (p<0.05). Compared with the control group, knockdown of PD-L1 significantly decreased the colony formation rate, and cell migration and invasion were inhibited compared with the control group. The wound healing ability of PD-L1 knockdown group was significantly weaker than that of the control group.

Conclusions: The results suggest that overexpression of PD-L1 is a risk factor for a poor prognosis in patients with GISTs. Knockdown of PD-L1 significantly inhibited the development of GISTs. PD-L1 may serve as a biomarker for the poor prognosis of GISTs and a potential therapeutic target.

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