Category: Nevin Manimala

Fa Yi Xue Za Zhi. 2025 Dec 25;41(6):552-558. doi: 10.12116/j.issn.1004-5619.2023.431205.

ABSTRACT

OBJECTIVES: To explore the method of postmortem submersion interval (PMSI) estimation for bodies from the Jingzhou reach of the Yangtze River, utilizing an aquatic decomposition score.

METHODS: A total of 105 cases of known PMSI bodies recovered from the Jingzhou reach of the Yangtze River were collected from the cases handled by the Jingzhou Branch of Yangtze River Shipping Public Security Bureau from 2018 to 2022. Considering the average monthly temperature, these cases were categorized into summer and winter groups, with the threshold set at 20 ℃. For each case, the total aquatic decomposition score (TADS) was assessed using the aquatic decomposition score table. The relationship between TADS and PMSI was explored using statistical approach, and two regression equations were established respectively through the natural logarithmic transformation of PMSI. Six bodies recovered in 2023 from the Jingzhou reach of the Yangtze River were selected to verify the equations.

RESULTS: In both summer and winter groups, PMSI was positively correlated with TADS (R²>0.70). The regression equation of summer group was TADS=5.117+4.825×ln(PMSI), and for the winter group, it was TADS=3.191+3.967×ln(PMSI).

CONCLUSIONS: The decomposition degree of the bodies can be used to estimate PMSI combined with the feature of water temperature of the Jingzhou reach of the Yangtze River.

PMID:41796028 | DOI:10.12116/j.issn.1004-5619.2023.431205

Zhonghua Yi Xue Za Zhi. 2026 Mar 10;106(9):848-856. doi: 10.3760/cma.j.cn112137-20250708-01661.

ABSTRACT

Objective: To explore the mechanism of vitamin K2 (VitK2) regulating matrix Gla protein (MGP) in inhibiting tumor growth in inflammation-associated colorectal cancer (CAC) model mice. Methods: Twenty-six C57BL/6 male mice, 6-8 weeks old and weighing 20-25 g, were divided into 4 groups according to the random number table method (each group received different treatments): normal group (treated with olive oil gavage and physiological saline intraperitoneal injection) (n=5), model group [treated with olive oil gavage, azoxymethane (AOM) intraperitoneal injection, and dextran sulfate sodium (DSS) solution drinking treatment)] (n=5), 30 mg group (treated with 30 mg·kg^-1·d^-1 of vitamin K2 gavage, AOM intraperitoneal injection, and DSS solution drinking treatment) (n=8), and 60 mg group (treated with 60 mg·kg^-1·d^-1 of vitamin K2 gavage, AOM intraperitoneal injection, and DSS solution drinking treatment) (n=8). The mice were sacrificed at the end of the 12th week, and the number and length diameter of colon tumors in each group were compared. The expression level of nuclear proliferation antigen (Ki-67) in colon tissues was assessed by immunohistochemistry (IHC), while the levels of MGP protein and Smad1/5 pathway-associated proteins were determined by Western blotting (WB). Additionally, the expression of MGP mRNA was quantified using real-time quantitative PCR (RT-qPCR). According to different treatment methods, colon cancer epithelial cell line SW480 cells were divided into control group [treated with dimethyl sulfoxide (DMSO)], 100 μmol/L group (treated with 100 μ mol/L VitK2), 200 μmol/L group (treated with 200 μ mol/L VitK2), 400 μmol/L group (treated with 400 μ mol/L VitK2), empty vector group (SW480 cells were transfected with empty plasmid) and MGP overexpressing group (SW480 cells were transfected with MGP overexpressing plasmid). After 48 hours of treatment, the expression of MGP protein, changes in the Smad1/5 pathway, and cell proliferation at different time points (24, 48, 72, and 96 hours) after treatment were detected. Results: All mice in the model group, 30 mg group, and 60 mg group developed colorectal tumors, with a tumorigenesis rate of 100% (17/17). There was no significant difference in the number of colon tumors between the 30 mg and 60 mg groups and the model group (both P>0.05), but the long diameter of tumors in the 30 mg or 60 mg groups was smaller than those in the model group (both P<0.05). There was no significant difference in tumor number or long diameter between the 30 mg and 60 mg groups (both P>0.05). The Ki-67 protein expression levels in the 30 mg and 60 mg groups were both lower than those in the model group (both P<0.05). Meanwhile, the MGP protein expression levels and pSmad1/5 protein expression levels in the 30 mg and 60 mg groups were both higher than those in the model group (all P<0.05). There was no statistically significant difference in MGP mRNA levels between the 30 mg and 60 mg groups and the model group (both P>0.05). Furthermore, there was no statistically significant difference in the expression levels of Ki-67 protein, MGP protein, pSmad1/5 protein, or MGP mRNA between the 30 mg and 60 mg groups (all P>0.05). In the cell experiments, the MGP and pSmad1/5 protein expression levels in the 100 μmol/L group showed no statistically significant difference compared to the control group (both P>0.05). The MGP and pSmad1/5 expression levels in the 200 μmol/L and 400 μmol/L groups were both higher than those in the control group (both P<0.001). After 72 and 96 hours, the cell proliferation capacity in the 200 μmol/L and 400 μmol/L groups was both lower than that in the control group (both P<0.001). The pSmad1/5 protein expression level in the MGP overexpression group was higher than that in the empty vector group (P<0.001). After 24, 48, 72, and 96 hours, the cell proliferation capacity in the MGP overexpression group was lower than that in the empty vector group (all P<0.001). Conclusion: VitK2 can inhibit the growth of CAC model mice by promoting MGP expression and activating Smad1/5 pathway.

PMID:41796008 | DOI:10.3760/cma.j.cn112137-20250708-01661

Zhonghua Yi Xue Za Zhi. 2026 Mar 10;106(9):834-840. doi: 10.3760/cma.j.cn112137-20250722-01813.

ABSTRACT

Objective: To investigate the distribution patterns of vertebral bone density in degenerative lumbar scoliosis (DLS) patients with different coronal imbalance classifications. Methods: A retrospective study was conducted on 154 patients with DLS who underwent long-segment spinal fusion surgery at Nanjing Drum Tower Hospital between January 2017 and December 2022. The patients were classified according to the Nanjing Drum Tower coronal imbalance classification of DLS: Type A, coronal balance distance (CBD) <3 cm; Type B, CBD ≥3 cm and C₇ plumb line (C₇PL) located on the concave side; Type C, CBD ≥3 cm and C₇PL located on the convex side. The major curve Cobb angle and CBD were measured on preoperative standing full-spine radiographs. Preoperative assessments also included L_1-4 T-scores and femoral neck T-scores obtained from dual-energy X-ray absorptiometry (DXA). Additionally, overall vertebral body bone density and Hounsfield unit (HU) values on the concave and convex sides were measured using preoperative CT scans. The patients with L_{1 HU} value <110 were diagnosed with osteoporosis (OP). Comparative analyses included OP prevalence and coronal plane bone mass distribution patterns among the different coronal classifications. Results: A total of 154 patients were included in this study, comprising 21 males and 133 females, with an average age of (62.9±6.6) years. Among them, 99 patients were classified as Type A, 30 as Type B, and 25 as Type C. The prevalence of OP was 48.7% (75/154), with the prevalence in Type C (72.0%, 18/25) patients being higher than that in Types A (44.4%, 44/99) and B (43.3%, 13/30) (both P<0.05). The mean HU value of the S₁ vertebra for all patients was 140.8±63.1, it was the lowest in Type C patients (108.2±53.4), which was statistically significantly lower than that in Types A and B patients (150.2±66.0 and 137.1±52.0, respectively, both P<0.05). For all the patients, the HU values on the concave side of the main curve were all greater than those on the convex side (all P<0.005), with the greatest asymmetry observed at the apex vertebra. The asymmetry ratios of the concave to convex sides of the S₁ vertebra in Type B and Type C patients were higher than those in Type A patients (1.25±0.24, 1.23±0.24, and 1.11±0.22, respectively; P<0.01). Conclusions: Patients with DLS exhibit a high prevalence of OP, with Type C patients showing the highest OP prevalence and the lowest bone density at the S₁ vertebral body. Based on these findings, it is recommended that, for type C patients, distal internal fixation be performed using iliac screws or S₂ sacroiliac screws to reduce the risk of internal fixation failure.

PMID:41796006 | DOI:10.3760/cma.j.cn112137-20250722-01813

Zhonghua Yi Xue Za Zhi. 2026 Mar 10;106(9):828-833. doi: 10.3760/cma.j.cn112137-20250810-02022.

ABSTRACT

Objective: To explore the relationship between preoperative thyroglobulin (Tg) levels and recurrence risk as well as treatment response in patients with differentiated thyroid cancer (DTC). Methods: A retrospective analysis was conducted on the clinical data of 604 patients with DTC who underwent total thyroidectomy at Shanghai Renji Hospital from January 1, 2020, to December 31, 2024. The postoperative recurrence status of patients was recorded, with follow-up ending on June 30, 2025. Determine the cut-off value of preoperative Tg for predicting patient prognosis using the maximum selected rank statistic method. Multivariate Cox proportional hazards regression model was used to analyze the risk factors for postoperative recurrence in DTC patients. Survival curves were plotted using the Kaplan-Meier method, and the log-rank test was used to evaluate the differences in postoperative disease-free survival rates and treatment response among DTC patients with different preoperative Tg levels. Results: Among the 604 patients, 417 were female and 187 were male, with the age of 45.0(36.0, 57.0) years. The preoperative Tg was 20.2 (10.4, 44.3) μg/L, and the follow-up period was 1.40 (0.85, 2.84) years. Multivariate Cox proportional hazards regression model analysis revealed that preoperative Tg levels≥36.2 μg/L (HR=14.180, 95%CI:1.745-115.200) was a risk factor for postoperative recurrence in DTC. Patients with the preoperative Tg level of<36.2 μg/L had a higher 3-year disease-free survival rate compared to those with the preoperative Tg level of≥36.2 μg/L (99.8% vs 92.3%, P<0.001). The proportion of patients with the favorable treatment response was lower among those with the preoperative Tg level of≥36.2 μg/L compared to those with the preoperative Tg level of<36.2 μg/L, whereas the proportions of patients with biochemical incomplete, structural incomplete, and indeterminate responses were higher among those with the preoperative Tg level of≥36.2 μg/L (all P<0.05). Conclusions: Preoperative Tg levels are significantly associated with the recurrence risk and treatment response in DTC patients. The Tg level of≥36.2 μg/mL indicates a high recurrence risk and poor treatment response.

PMID:41796005 | DOI:10.3760/cma.j.cn112137-20250810-02022

Zhonghua Yi Xue Za Zhi. 2026 Mar 10;106(9):813-818. doi: 10.3760/cma.j.cn112137-20250807-02000.

ABSTRACT

Objective: To compare the therapeutic effects of hemithyroidectomy (HT) versus total thyroidectomy (TT) on sporadic medullary thyroid carcinoma (sMTC). Methods: Clinical data of sMTC patients firstly treated in Tianjin Medical University Cancer Institute and Hospital from January 2011 to December 2019 were reviewed retrospectively. The patients were categorized into the HT group and the TT group based on the extents of primary tumor resection. The differences in clinical characteristics between the two groups were compared. A 1∶1 matching of variables including tumor stage and mulifocality was performed using propensity score matching (PSM) to balance the baseline differences between the two groups. Subsequently, the differences in biochemical cure rate, biochemical recurrence rate, and structural recurrence rate between the two groups were compared. Survival curves were plotted using the Kaplan-Meier method, and the log-rank test was utilized to compare the differences in progression-free survival and overall survival between the two groups. Results: A total of 199 patients with sMTC were included in the study, comprising 80 males and 119 females, with the age [M(Q₁,Q₃)] of 51.0 (42.0,59.0) years. Before PSM, 117 patients were in HT group and 82 patients were in TT group. There were statistically significant differences in preoperative calcitonin, N stage, TNM stage, and the number of lesions between the two groups (all P<0.05). After PSM, 63 patients were in HT group and 63 patients were in TT group. There was no statistically significant difference in all clinicopathological characteristics between the two groups (all P>0.05). Before PSM, the biochemical cure rate in the HT group was higher than that in the TT group [76.4% (81/106) vs 60.5% (46/76), P=0.021]. There were no statistically significant differences in the biochemical recurrence rate and structural recurrence rate between the HT group and the TT group [4.7% (5/106) vs 7.9% (6/76), 8.5% (10/117) vs 15.9% (13/82), both P>0.05]. The progression-free survival of the HT group was longer than that of the TT group [(137.26±3.53) vs (114.12±5.98) months, P=0.025]. There was no statistically significant difference in overall survival between the HT group and the TT group [(142.12±2.91) vs (126.92±5.15) months, P=0.140]. After PSM, there were no statistically significant differences between the HT group and the TT group in terms of biochemical cure rate [66.7% (40/60) vs 77.2% (44/57)], biochemical recurrence rate [5.0% (3/60) vs 7.0% (4/57)], structural recurrence rate [12.7% (8/63) vs 17.5% (11/63)], progression-free survival [(130.69±5.07) vs (112.19±6.91) months], and overall survival [(136.05±4.04) vs (124.71±6.83) months] (all P>0.05). Conclusions: The therapeutic effects of HT and TT on sMTC are comparable. With careful preoperative evaluation, selective performance of HT is safe and feasible.

PMID:41796003 | DOI:10.3760/cma.j.cn112137-20250807-02000

Zhonghua Gan Zang Bing Za Zhi. 2026 Feb 20;34(2):161-169. doi: 10.3760/cma.j.cn501113-20251017-00440.

ABSTRACT

Objective: To investigate the effect of antinuclear antibodies on the clinicopathological characteristics, short-term treatment response, and long-term prognosis of primary biliary cholangitis. Methods: A retrospective analysis was performed on 690 cases with primary biliary cholangitis who were treated in eight medical centers, including Nanjing Second Hospital, from January 2017 to October 2023, and were divided into a negative group (96 cases) and a positive group (594 cases) according to antinuclear antibody status. Propensity score matching (1∶1) was used to balance age and gender factors. The laboratory indicators, liver histological characteristics, short-term biochemical responses, and the occurrence of decompensated event conditions were compared between the two groups. An independent sample t-test was used for comparison between groups of continuous variables that conformed to normal distribution. The Mann-Whitney U test was used for comparison between groups of continuous variables with non-normal distribution. The χ² test or Fisher’s exact test was used for comparison of categorical variables between the two groups. The Mann-Whitney U test was used for rank data.The log-rank test was employed to compare the differences between groups in the Kaplan-Meier survival analysis.The Cox proportional hazards model was used to analyze the risk factors affecting prognosis. The cut-off value of the numerical variable was determined by the receiver operating characteristic curve. Results: There were 96 cases following matching in each group. The levels of aspartate aminotransferase (88.10 U/L vs. 71.55 U/L), γ-glutamyl transferase (278.61 U/L vs. 144.00 U/L), alkaline phosphatase (229.98 U/L vs. 159.68 U/L), and immunoglobulin G (19.90 U/L vs. 17.73 U/L) were significantly increased (P <0.05). The proportion of patients with positive anti-gp210 antibodies and/or anti-SP100 antibodies was significantly higher than that of the anti-nuclear antibody-negative group (21.43% vs. 5.26%, P=0.005). Liver histology showed that the detection rate of epithelioid granuloma was higher in the anti-nuclear antibody positive group (37.50% vs. 22.92%, P=0.028), while the degree of interface inflammation (none/mild/moderate/severe:2.08%/8.33%/63.54%/26.04% vs. 18.75%/23.96%/36.46%/20.83%, P<0.001) and Nakanuma-hepatitis activity score (HA0/HA1/HA2/HA3: 2.08%/4.17%/58.33%/35.42% vs. 23.96%/18.75%/35.42%/21.88%, P<0.001) were significantly higher in the anti-nuclear antibody-negative group. There was no statistically significant difference in the 1-year biochemical response rate and the incidence rate of decompensation between the two groups (P>0.05). Multivariate Cox regression analysis showed that platelet count ≤0.3× upper limit of normal value, albumin count ≤0.6×upper limit of normal value, and fibrosis stage S≥S3 were independent risk factors for decompensation of cirrhosis in patients with primary biliary cholangitis. Conclusions: Patients with antinuclear antibody-positive primary biliary cholangitis exhibit a phenotype of “high inflammatory burden,” suggesting that antinuclear antibody status may serve as a potential serological marker of disease activity, and its value in long-term prognosis and treatment decision-making needs to be further verified by prospective studies.

PMID:41795975 | DOI:10.3760/cma.j.cn501113-20251017-00440

Zhonghua Gan Zang Bing Za Zhi. 2026 Feb 20;34(2):154-160. doi: 10.3760/cma.j.cn501113-20251029-00463.

ABSTRACT

Objective: To investigate the efficacy and safety profile of transjugular intrahepatic portosystemic shunt received by elderly patients with cirrhosis (age >75 years). Methods: A retrospective analysis was conducted on the data of patients who underwent TIPS for cirrhosis at Nanjing Drum Tower Hospital, affiliated with Nanjing University School of Medicine, from January 2019 to December 2021. Patients were divided into an elderly group (> 75 years) and a younger group (≤ 75 years) according to age. Propensity score matching was performed in a 1∶1 ratio. Statistical analysis was performed using the independent samples t-test, the Mann-Whitney U test, and the χ² test. Postoperative survival rate, rebleeding rate, and incidence rate of hepatic encephalopathy were analyzed using the Kaplan-Meier method between the two patient groups. Results: A total of 37 elderly and 478 younger cases were screened. Propensity score matching was performed in line with a 1∶1 ratio. Finally, 32 cases were included in each group. The elderly and younger patient groups had no statistically significant differences in the 1-year postoperative rebleeding rate [9.4% (3/32) vs. 6.3% (2/32), P=0.562], the incidence rate of hepatic encephalopathy [37.5% (12/32) vs. 18.8% (6/32), P=0.060], and the survival rate [25% (8/32) vs. 15.6% (5/32), P=0.371]. The incidence rate of hepatic encephalopathy according to the Child-Pugh class A stratification at 1 year following surgery had no statistically significant difference between the two patient groups’ liver function [12.5% (1/8) vs. 11.1% (1/9), P=0.896]. However, the incidence rate of hepatic encephalopathy at 1 year following surgery with Child-Pugh class B and C had a statistically significant difference between the two patient groups’ liver function [45.8% (11/24) vs. 21.7% (5/23), P=0.037]. Conclusion: Transjugular intrahepatic portosystemic shunt (TIPS) is equally safe and effective in elderly compared to younger patients. However, the incidence rate of postoperative hepatic encephalopathy is significantly higher in patients with Child-Pugh class B and C.

PMID:41795974 | DOI:10.3760/cma.j.cn501113-20251029-00463

Zhonghua Gan Zang Bing Za Zhi. 2026 Feb 20;34(2):147-153. doi: 10.3760/cma.j.cn501113-20250120-00031.

ABSTRACT

Objective: To analyze the incidence rate, compare the differences, and assess the risk factors for portal vein thrombosis (PVT) formation after different endoscopic treatment methods in patients with esophagogastric varices in cirrhosis. Methods: The laboratory, imaging, and endoscopic treatment methods data for 289 patients with esophagogastric varices in liver cirrhosis who initially received endoscopic treatment at the Endoscopy Center of You’an Hospital, affiliated with Capital Medical University, from January 2020 to December 2022, were retrospectively included. The incidence rate of PVT within 1 year after systematic standardized endoscopic treatment was statistically analyzed. Univariate and multivariate logistic regression analyses were used to screen the risk factors for PVT formation after endoscopic treatment. The t-test or rank-sum test was used to compare continuous data between the two groups. The χ² test was used for categorical data. Results: The incidence rate of portal vein thrombosis (PVT) within 1 year was 20.76% (60/289) among 289 patients with esophagogastric varices in cirrhosis who underwent standard endoscopic treatment. The PVT incidence rate was 22.81% (13/57) in patients who used sclerotherapy alone and 15.22% (7/46) in patients who used ligation rings alone, with no statistically significant difference in the PVT incidence among different endoscopic treatment methods (χ²=2.354, P>0.05). Univariate analysis showed statistically significant differences in preoperative platelet count, spleen thickness, spleen long diameter, model for end-stage liver disease score, ascites, and smoking between the PVT group and the non-PVT group (P<0.05). Multivariate logistic regression analysis showed that preoperative platelet count [odds ratio (OR) = 0.988, 95% (confidence interval, CI): 0.979-0.998, P = 0.018], splenic ultrasound thickness (OR = 1.051, 95%CI: 1.003-1.101, P = 0.038), massive ascites (OR = 14.153, 95%CI: 2.517-79.577, P = 0.003), and smoking (OR = 2.537, 95%CI: 1.267-5.076, P = 0.009) were independent risk factors for PVT formation. Conclusion: The incidence rate of PVT is similar to the current known annual incidence rate of PVT following endoscopic treatment in patients with esophagogastric varices in liver cirrhosis, and different endoscopic treatment methods have no significant effect on PVT formation. Preoperative platelet count, spleen thickness, massive ascites, and smoking are risk factors for PVT formation.

PMID:41795973 | DOI:10.3760/cma.j.cn501113-20250120-00031

Zhonghua Gan Zang Bing Za Zhi. 2026 Feb 20;34(2):134-146. doi: 10.3760/cma.j.cn501113-20241024-00556.

ABSTRACT

Objective: To reveal the role of dietary composition in the onset and prognosis of patients with liver cirrhosis by analyzing, exploring, and observing the correlational features between dietary composition and clinical indicators and mortality. Methods: A cirrhosis population was obtained from the National Health and Nutrition Examination survey from 2001 to 2018. Patients with cirrhosis (155 cases) were matched with healthy controls (615 cases) in accordance with a 1:4 ratio. Data on 37 food patterns, clinical indicators such as personal medical history and laboratory tests, and the status and cause of death of patients were obtained from the database. Univariate and logistic regression analyses were used to identify influencing factors. Kaplan-Meier survival curves were used to examine the impact of specific dietary intake on patient mortality. Results: Multivariate analysis revealed that patients with cirrhosis had higher daily alcohol consumption than healthy controls (OR=1.11, 95%CI: 1.03-1.19, P<0.01), while there was no statistically significant difference in food intake (P>0.05). Total starchy vegetable intake was lower in patients with cirrhosis than in controls (OR=0.38, 95%CI: 0.17-0.88, P=0.02) among the subgroup of patients with cirrhosis who drank alcohol. Total starchy vegetable intake was higher in patients with cirrhosis than in controls (OR=1.55, 95%CI: 1.01-2.38, P=0.04) among the subgroup of patients with cirrhosis who did not drink alcohol. Subgroup analysis by gender revealed that male patients with cirrhosis consumed less dark green vegetables (OR=0.24, 95%CI: 0.06-0.96, P=0.04), while female patients consumed more meat (OR=1.28, 95%CI: 1.05-1.54, P=0.01). Spearman analysis revealed no statistically significant correlation between any dietary composition and the aspartate aminotransferase-to-platelet ratio index and mortality. Conclusion: Excessive intake of starchy vegetables and meat and insufficient intake of dark green vegetables may be associated with the onset of cirrhosis in non-drinking female and male populations, respectively, suggesting the potential significance of dietary factors in the course of cirrhotic diseases.

PMID:41795972 | DOI:10.3760/cma.j.cn501113-20241024-00556

Zhonghua Gan Zang Bing Za Zhi. 2026 Feb 20;34(2):115-123. doi: 10.3760/cma.j.cn501113-20241219-00627.

ABSTRACT

Objective: To explore the occurrence of risk factors, construct a nomogram, and evaluate its predictive value for progressive liver fibrosis (PLF) in patients with metabolic-associated fatty liver disease (MAFLD). Methods: The clinical data of 259 MAFLD cases who visited the Obesity Department of Hubei Provincial Hospital of Traditional Chinese Medicine from May 2022 to October 2023 was retrospectively analyzed. Patients were divided into the PLF and non-progressive liver fibrosis (NPLF) group based on whether their liver stiffness measurement (LSM) value detected by FibroTouch >12 kPa. Univariate analysis was used to screen influencing factors. The original dataset of influencing factors was reconstructed using the Synthetic Minority Over-sampling Technique (SMOTE) algorithm. LASSO-logistic regression was used to determine independent risk factors for progressive liver fibrosis in MAFLD patients based on the SMOTE algorithm. A nomogram was constructed. Receiver operating characteristic (ROC) curves, Hosmer-Lemeshow calibration curves, and decision curves were plotted to evaluate the nomogram performance. Results: Univariate analysis showed statistically significant differences in terms of gender, smoking history, body mass index, visceral fat area, skeletal muscle content, basal metabolic rate, waist circumference, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase, high-density lipoprotein cholesterol (HDL-C), apolipoprotein A1, high-sensitivity C-reactive protein (hs-CRP), glycated hemoglobin, homeostatic model assessment for insulin resistance index (HOMA-IR), ultrasound attenuation parameter (UAP), and stages of liver fatty degeneration (P<0.05) between the PLF group and the NPLF group. LASSO-logistic regression showed that HDL-C, hs-CRP, HOMA-IR, and UAP were independent occurrence risk factors for progressive liver fibrosis in MAFLD (P<0.05). The nomogram model constructed based on logistic regression results showed areas under the ROC curves of 0.893 (95% CI: 0.848-0.938), 0.802 (95% CI: 0.711-0.892), and 0.863 (95% CI: 0.815-0.911) in the SMOTE training, validation, and original datasets, respectively. The Hosmer-Lemeshow tests showed all P>0.05. The calibration curves indicated substantial consistency between the model’s predictions and actual results. Decision curve analysis showed that the model had high clinical benefit when the threshold probabilities were 0.02-0.87, 0.03-0.96, and 0.02-0.79, respectively. Conclusion: HDL-C, hs-CRP, HOMA-IR, and UAP levels are independent risk factors for progressive liver fibrosis. The nomogram model established on these grounds has high accuracy and can be used for early-stage identification and risk prediction of progressive liver fibrosis in patients with MAFLD.

PMID:41795970 | DOI:10.3760/cma.j.cn501113-20241219-00627