AIM:To clarify the clinical correlations and causal relationships between lipid metabolism and the progression of thyroid-associated ophthalmopathy(TAO).METHODS:This case-control study retrieved clinical data from 201...AIM:To clarify the clinical correlations and causal relationships between lipid metabolism and the progression of thyroid-associated ophthalmopathy(TAO).METHODS:This case-control study retrieved clinical data from 2018 to 2023.A total of 2591 patients were enrolled,including 197 patients with TAO(case group)and 2394 patients with hyperthyroidism without TAO(control group).Serum lipid parameters,including triglycerides,total cholesterol,high-density lipoprotein(HDL),low-density lipoprotein(LDL),and the HDL/total cholesterol ratio,as well as thyroid function markers,were compared between the two groups.Correlation analyses were performed to evaluate the associations between serum lipid levels and key ocular manifestations of TAO,including exophthalmos degree,clinical activity score,and disease severity.Furthermore,Mendelian randomization(MR)analysis was conducted using genome-wide association study(GWAS)datasets,with hyperthyroidism as the exposure variable and serum lipid parameters as the outcome variables,to infer the causal relationship between hyperthyroidism,lipid metabolism,and TAO progression.RESULTS:The TAO group consisted of 101 males and 96 females,while the hyperthyroidism group included 706 males and 1688 females.Compared with the control group,patients with TAO had significantly higher levels of triglycerides(1.83±1.21 vs 1.40±1.08 mmol/L,P<0.01),total cholesterol,LDL,and HDL.Correlation analysis showed that triglyceride levels were positively correlated with exophthalmos degree,whereas HDL levels were inversely correlated with exophthalmos degree.No significant associations were found between serum lipid levels and clinical activity score(P>0.1).MR analysis confirmed that hyperthyroidism exerted a causal effect in reducing serum triglycerides[inverse-variance weighting odds ratio(OR)=0.035,95%confidence interval(CI):0.01-0.12]and total cholesterol(OR=0.085,95%CI:0.02-0.34),with no evidence of horizontal pleiotropy(MR-PRESSO P>0.05).CONCLUSION:Elevated serum triglyceride levels are an independent risk factor for TAO severity,especially exophthalmos,and triglyceride metabolism is inversely regulated by thyroid function.展开更多
BACKGROUND Gastric cancer(GC)is the fifth most common malignancy and the third leading cause of death worldwide.Despite advancements in immunotherapies,patient prognosis remains poor,necessitating the identification o...BACKGROUND Gastric cancer(GC)is the fifth most common malignancy and the third leading cause of death worldwide.Despite advancements in immunotherapies,patient prognosis remains poor,necessitating the identification of key prognostic factors to optimize the treatment approaches.Insulin resistance,as indicated by the triglyceride glucose(TyG)index,is increasingly recognized for its impact on cancer progression and immune modulation,and its potential role in GC prognosis is of particular interest.AIM To investigate whether the TyG index,a surrogate marker of insulin resistance,can predict the prognosis of patients with advanced GC receiving immunotherapy combined with chemotherapy.METHODS This retrospective study included 300 patients with advanced GC who received sintilimab combined with chemotherapy.The patients were categorized into two groups according to high or low TyG index,and independent prognostic factors for overall survival(OS)were determined using Cox proportional hazards regression analysis,which led to the development of a nomogram model.RESULTS Of the included patients,136 had a high TyG index and 164 had a low TyG index.The median progression-free survival of the high TyG index group was significantly longer than that of the low TyG index group.Similarly,the median OS of the high TyG index group was significantly longer than that of the low TyG index group.The ob-jective response and disease control rates in the two groups were 18.38%vs 9.15%and 58.82%vs 46.95%,res-pectively.No significant difference was noted in the incidence of adverse reactions at any level between the two groups(P>0.05).In multivariate analysis,the Eastern Cooperative Oncology Group score,programmed cell death ligand 1 expression,and TyG index acted as independent prognostic factors for OS.Of these factors,the hazard ratio of the TyG index was 0.36(95%confidence interval:0.36-0.55,P<0.001),and the nomogram model re-emphasized its importance as the main predictor of patient prognosis,followed by programmed cell death ligand 1 expression and the Eastern Cooperative Oncology Group score.CONCLUSION The TyG index is a long-term predictor of the efficacy of immunotherapy combined with chemotherapy,and patients with a high index have a better prognosis.展开更多
Background Cardiovascular disease(CVD)remains a major health challenge globally,particularly in aging populations.Using data from the China Health and Retirement Longitudinal Study(CHARLS),this study examines the Trig...Background Cardiovascular disease(CVD)remains a major health challenge globally,particularly in aging populations.Using data from the China Health and Retirement Longitudinal Study(CHARLS),this study examines the Triglyceride-glucose(TyG)index dynamics,a marker for insulin resistance,and its relationship with CVD in Chinese adults aged 45 and older.Methods This reanalysis utilized five waves of CHARLS data with multistage sampling.From 17,705 participants,5,625 with TyG index and subsequent CVD data were included,excluding those lacking 2011 and 2015 TyG data.TyG derived from glucose and triglyceride levels,CVD outcomes via self-reports and records.Participants divided into four groups based on TyG changes(2011–2015):low-low,low-high,high-low,high-high TyG groups.Results Adjusting for covariates,stable high group showed a significantly higher risk of incident CVD compared to stable low group,with an HR of 1.18(95%CI:1.03–1.36).Similarly,for stroke risk,stable high group had a HR of 1.45(95%CI:1.11–1.89).Survival curves indicated that individuals with stable high TyG levels had a significantly increased CVD risk compared to controls.The dynamic TyG change showed a greater risk for CVD than abnormal glucose metabolism,notably for stroke.However,there was no statistical difference in single incidence risk of heart disease between stable low and stable high group.Subgroup analyses underscored demographic disparities,with stable high group consistently showing elevated risks,particularly among<65 years individuals,females,and those with higher education,lower BMI,or higher depression scores.Machine learning models,including random forest,XGBoost,CoxBoost,Deepsurv and GBM,underscored the predictive superiority of dynamic TyG over abnormal glucose metabolism for CVD.Conclusions Dynamic TyG change correlate with CVD risks.Monitoring these changes could predict and manage cardiovascular health in middle-aged and older adults.Targeted interventions based on TyG index trends are crucial for reducing CVD risks in this population.展开更多
BACKGROUND Although recent studies have reported the reliability of triglyceride-glucose index(TyG)as a biomarker for evaluation of insulin resistance,the research exploring the association of TyG-body mass index(BMI)...BACKGROUND Although recent studies have reported the reliability of triglyceride-glucose index(TyG)as a biomarker for evaluation of insulin resistance,the research exploring the association of TyG-body mass index(BMI)with major cardiovascular outcomes and all-cause mortality among the type 2 diabetes mellitus(T2DM)population remains scarce.AIM To ascertain whether TyG-BMI correlates with cardiovascular outcomes and mortality risk in individuals diagnosed with T2DM.METHODS Data were drawn from the ACCORD trial and its subsequent follow-up(ACCORDION),which together included 10190 participants.To evaluate the associations of TyG-BMI with future cardiovascular outcomes and overall mortality risk among T2DM patients,Cox’s proportional-hazards model was employed.Non-linear associations and thresholds were investigated by performing restricted cubic spline regression,fitting smooth curves,and conducting piecewise regression.Additionally,we examined whether the above findings were robust through interaction and subgroup analyses.The robustness of results was further verified by a series of sensitivity assessments.Through the area under the receiver operating characteristic curve estimation,the incremental predictive power of TyG-BMI beyond conventional risk factors was also evaluated.RESULTS Applying multivariable Cox regression analysis,we identified a significant correlation of TyG-BMI with both cardiovascular outcomes and overall mortality.Specifically,after adjusting for multiple confounders,the cardiovascular mortality,congestive heart failure(CHF)and overall mortality risks in the highest TyG-BMI quartile were 1.74,2.65 and 1.42 times greater,respectively,when compared to the lowest quartile.The analysis revealed that TyG-BMI was linked nonlinearly to both types of mortality,while a two-stage linear regression discerned inflection points at 252.77 for cardiovascular mortality and 245.90 for overall mortality.TyG-BMI was found to correlate positively with future CHF.Additionally,introducing TyG-BMI into conventional prediction models resulted in a substantial improvement of their predictability for cardiovascular outcomes and overall mortality when compared to incorporating TyG or BMI alone.CONCLUSION Among T2DM individuals,a higher TyG-BMI is linked strongly to elevated risks of cardiovascular outcomes and overall mortality,highlighting its utility as a predictive marker for these risks.展开更多
BACKGROUND The triglyceride glucose-body mass index(TyG-BMI)is a novel indicator of insulin resistance(IR).Obstructive sleep apnea(OSA)is a prevalent disorder characterized by recurrent complete or partial collapse of...BACKGROUND The triglyceride glucose-body mass index(TyG-BMI)is a novel indicator of insulin resistance(IR).Obstructive sleep apnea(OSA)is a prevalent disorder characterized by recurrent complete or partial collapse of the pharyngeal airway during sleep;however,the relationship between these two conditions remains unexplored.We hypothesized that a higher TyG-BMI is associated with the occurrence of OSA.AIM To assess the association between TyG-BMI and OSA in adults in the United States.METHODS A cross-sectional study was conducted utilizing data from the National Health and Nutrition Examination Surveys spanning from 2005-2008 to 2015-2018.TyGBMI was calculated as Ln[triglyceride(mg/dL)×fasting blood glucose(mg/dL)/2]×BMI.Restricted cubic splines were used to analyze the risk of TyG-BMI and OSA occurrence.To identify potential nonlinear relationships,we combined Cox proportional hazard regression with smooth curve fitting.We also conducted sensitivity and subgroup analyses to verify the robustness of our findings.RESULTS We included 16794 participants in the final analysis.Multivariate regression analysis showed that participants with a higher TyG-BMI had a higher OSA incidence.After adjusting for all covariates,TyG-BMI was positively correlated with the prevalence of OSA(odds ratio:1.28;95%confidence interval:1.17,1.40;P<0.001);no significant nonlinear relationship was observed.Subgroup analysis showed no strong correlation between TyG-BMI and OSA in patients with diabetes.The correlation between TyG-BMI and OSA was influenced by age,sex,smoking status,marital status,hypertensive stratification,and obesity;these subgroups played a moderating role between TyGBMI and OSA.Even after adjusting for all covariates,there was a positive association between TYG-BMI and OSA prevalence.CONCLUSION A higher TyG-BMI index is linked to higher chances of developing OSA.As TyG-BMI is an indicator of IR,managing IR may help reduce the risk of OSA.展开更多
BACKGROUND Gastric cancer,a globally prevalent malignant tumor,continues to exhibit high incidence and mortality rates.Although radical gastrectomy remains the primary treatment for this disease,postoperative complica...BACKGROUND Gastric cancer,a globally prevalent malignant tumor,continues to exhibit high incidence and mortality rates.Although radical gastrectomy remains the primary treatment for this disease,postoperative complications frequently arise,negatively impacting short-term recovery and significantly reducing patients’quality of life.In this context,accurately predicting the risk of postoperative recurrence and metastasis,coupled with targeted interventions,could substantially improve patient outcomes.The C-reactive protein-triglyceride-glucose index(CTI),a composite biomarker that integrates metabolic disturbances and systemic inflammation,has garnered increasing attention in oncology.The prognostic nutritional index(PNI),a composite measure based on serum albumin and peripheral blood lymphocyte count,is used to evaluate both the nutritional status and systemic immune function of patients.In recent years,both the CTI and PNI have demonstrated significant prognostic value in predicting tumor outcomes,assessing treatment responses,and formulating personalized treatment strategies.AIM To investigate whether the combined inflammation and insulin resistance marker,the CTI,can serve as a prognostic indicator for patients undergoing radical gastrectomy for gastric cancer.Additionally,it seeks to develop a predictive model by incorporating the PNI alongside CTI.METHODS This retrospective study included a total of 300 patients who underwent radical gastrectomy.The patients were classified into high and low CTI groups based on their CTI index.Cox proportional hazards regression analysis was performed to identify independent prognostic factors influencing overall survival(OS)and disease-free survival(DFS),and two nomogram models were developed.RESULTS Of the included patients,131 had a high CTI and 169 had a low CTI.The DFS period of the low CTI group was significantly longer than that of the high CTI group.The number of postoperative adjuvant treatments,T stage,N stage,CTI,and PNI were identified as independent prognostic factors for DFS.The hazard ratio for CTI was 2.07(95%confidence interval:1.36-3.17,P<0.001).In terms of OS,the OS period of the low CTI group was significantly longer than that of the high CTI group.Whether adjuvant treatment was administered,T stage,CTI,and PNI were independent prognostic factors for OS.The hazard ratio for CTI was 2.47(95%confidence interval:1.44-4.23,P=0.001).The nomogram models for OS and DFS further emphasized the importance of CTI as a key predictor of patient prognosis.CONCLUSION CTI is a long-term prognostic indicator for the outcome of radical gastrectomy for gastric cancer.Patients with lower CTI values have a better prognosis.The prediction models constructed by combining CTI with PNI has good predictive ability for DFS and OS after radical gastrectomy.展开更多
Metabolic dysfunction-associated steatotic liver disease,characterized by pathological intracellular triglyceride(TG)accumulation,is mechanistically associated with the disrupted spatiotemporal regulation of hepatocyt...Metabolic dysfunction-associated steatotic liver disease,characterized by pathological intracellular triglyceride(TG)accumulation,is mechanistically associated with the disrupted spatiotemporal regulation of hepatocyte nuclear factor(HNF)-dependent transcriptional programs.HNFs,including key members such as HNF-1α,HNF-4α,and HNF-6,constitute a liver-enriched family of transcription factors that govern hepatic lipid metabolism through hierarchical transcriptional regulatory networks.These networks critically regulate the dynamic equilibrium of TG metabolism,encompassing TG synthesis,storage,lipolysis,and lipoprotein-mediated export.This review comprehensively deciphers the molecular cascades through which HNF dysfunction exacerbates TG metabolic disorder in metabolic dysfunction-associated steatotic liver disease.Additionally,we evaluate emerging translational strategies targeting key HNF regulatory nodes and discuss current clinical challenges as well as potential solutions.展开更多
基金Supported by the National Natural Science Foundation of China(No.82371104)the Natural Science Foundation of Hunan Province(No.2023JJ30851).
文摘AIM:To clarify the clinical correlations and causal relationships between lipid metabolism and the progression of thyroid-associated ophthalmopathy(TAO).METHODS:This case-control study retrieved clinical data from 2018 to 2023.A total of 2591 patients were enrolled,including 197 patients with TAO(case group)and 2394 patients with hyperthyroidism without TAO(control group).Serum lipid parameters,including triglycerides,total cholesterol,high-density lipoprotein(HDL),low-density lipoprotein(LDL),and the HDL/total cholesterol ratio,as well as thyroid function markers,were compared between the two groups.Correlation analyses were performed to evaluate the associations between serum lipid levels and key ocular manifestations of TAO,including exophthalmos degree,clinical activity score,and disease severity.Furthermore,Mendelian randomization(MR)analysis was conducted using genome-wide association study(GWAS)datasets,with hyperthyroidism as the exposure variable and serum lipid parameters as the outcome variables,to infer the causal relationship between hyperthyroidism,lipid metabolism,and TAO progression.RESULTS:The TAO group consisted of 101 males and 96 females,while the hyperthyroidism group included 706 males and 1688 females.Compared with the control group,patients with TAO had significantly higher levels of triglycerides(1.83±1.21 vs 1.40±1.08 mmol/L,P<0.01),total cholesterol,LDL,and HDL.Correlation analysis showed that triglyceride levels were positively correlated with exophthalmos degree,whereas HDL levels were inversely correlated with exophthalmos degree.No significant associations were found between serum lipid levels and clinical activity score(P>0.1).MR analysis confirmed that hyperthyroidism exerted a causal effect in reducing serum triglycerides[inverse-variance weighting odds ratio(OR)=0.035,95%confidence interval(CI):0.01-0.12]and total cholesterol(OR=0.085,95%CI:0.02-0.34),with no evidence of horizontal pleiotropy(MR-PRESSO P>0.05).CONCLUSION:Elevated serum triglyceride levels are an independent risk factor for TAO severity,especially exophthalmos,and triglyceride metabolism is inversely regulated by thyroid function.
文摘BACKGROUND Gastric cancer(GC)is the fifth most common malignancy and the third leading cause of death worldwide.Despite advancements in immunotherapies,patient prognosis remains poor,necessitating the identification of key prognostic factors to optimize the treatment approaches.Insulin resistance,as indicated by the triglyceride glucose(TyG)index,is increasingly recognized for its impact on cancer progression and immune modulation,and its potential role in GC prognosis is of particular interest.AIM To investigate whether the TyG index,a surrogate marker of insulin resistance,can predict the prognosis of patients with advanced GC receiving immunotherapy combined with chemotherapy.METHODS This retrospective study included 300 patients with advanced GC who received sintilimab combined with chemotherapy.The patients were categorized into two groups according to high or low TyG index,and independent prognostic factors for overall survival(OS)were determined using Cox proportional hazards regression analysis,which led to the development of a nomogram model.RESULTS Of the included patients,136 had a high TyG index and 164 had a low TyG index.The median progression-free survival of the high TyG index group was significantly longer than that of the low TyG index group.Similarly,the median OS of the high TyG index group was significantly longer than that of the low TyG index group.The ob-jective response and disease control rates in the two groups were 18.38%vs 9.15%and 58.82%vs 46.95%,res-pectively.No significant difference was noted in the incidence of adverse reactions at any level between the two groups(P>0.05).In multivariate analysis,the Eastern Cooperative Oncology Group score,programmed cell death ligand 1 expression,and TyG index acted as independent prognostic factors for OS.Of these factors,the hazard ratio of the TyG index was 0.36(95%confidence interval:0.36-0.55,P<0.001),and the nomogram model re-emphasized its importance as the main predictor of patient prognosis,followed by programmed cell death ligand 1 expression and the Eastern Cooperative Oncology Group score.CONCLUSION The TyG index is a long-term predictor of the efficacy of immunotherapy combined with chemotherapy,and patients with a high index have a better prognosis.
基金the National Natural Science Foundation of China(grant numbers 82070434,LYQ)。
文摘Background Cardiovascular disease(CVD)remains a major health challenge globally,particularly in aging populations.Using data from the China Health and Retirement Longitudinal Study(CHARLS),this study examines the Triglyceride-glucose(TyG)index dynamics,a marker for insulin resistance,and its relationship with CVD in Chinese adults aged 45 and older.Methods This reanalysis utilized five waves of CHARLS data with multistage sampling.From 17,705 participants,5,625 with TyG index and subsequent CVD data were included,excluding those lacking 2011 and 2015 TyG data.TyG derived from glucose and triglyceride levels,CVD outcomes via self-reports and records.Participants divided into four groups based on TyG changes(2011–2015):low-low,low-high,high-low,high-high TyG groups.Results Adjusting for covariates,stable high group showed a significantly higher risk of incident CVD compared to stable low group,with an HR of 1.18(95%CI:1.03–1.36).Similarly,for stroke risk,stable high group had a HR of 1.45(95%CI:1.11–1.89).Survival curves indicated that individuals with stable high TyG levels had a significantly increased CVD risk compared to controls.The dynamic TyG change showed a greater risk for CVD than abnormal glucose metabolism,notably for stroke.However,there was no statistical difference in single incidence risk of heart disease between stable low and stable high group.Subgroup analyses underscored demographic disparities,with stable high group consistently showing elevated risks,particularly among<65 years individuals,females,and those with higher education,lower BMI,or higher depression scores.Machine learning models,including random forest,XGBoost,CoxBoost,Deepsurv and GBM,underscored the predictive superiority of dynamic TyG over abnormal glucose metabolism for CVD.Conclusions Dynamic TyG change correlate with CVD risks.Monitoring these changes could predict and manage cardiovascular health in middle-aged and older adults.Targeted interventions based on TyG index trends are crucial for reducing CVD risks in this population.
文摘BACKGROUND Although recent studies have reported the reliability of triglyceride-glucose index(TyG)as a biomarker for evaluation of insulin resistance,the research exploring the association of TyG-body mass index(BMI)with major cardiovascular outcomes and all-cause mortality among the type 2 diabetes mellitus(T2DM)population remains scarce.AIM To ascertain whether TyG-BMI correlates with cardiovascular outcomes and mortality risk in individuals diagnosed with T2DM.METHODS Data were drawn from the ACCORD trial and its subsequent follow-up(ACCORDION),which together included 10190 participants.To evaluate the associations of TyG-BMI with future cardiovascular outcomes and overall mortality risk among T2DM patients,Cox’s proportional-hazards model was employed.Non-linear associations and thresholds were investigated by performing restricted cubic spline regression,fitting smooth curves,and conducting piecewise regression.Additionally,we examined whether the above findings were robust through interaction and subgroup analyses.The robustness of results was further verified by a series of sensitivity assessments.Through the area under the receiver operating characteristic curve estimation,the incremental predictive power of TyG-BMI beyond conventional risk factors was also evaluated.RESULTS Applying multivariable Cox regression analysis,we identified a significant correlation of TyG-BMI with both cardiovascular outcomes and overall mortality.Specifically,after adjusting for multiple confounders,the cardiovascular mortality,congestive heart failure(CHF)and overall mortality risks in the highest TyG-BMI quartile were 1.74,2.65 and 1.42 times greater,respectively,when compared to the lowest quartile.The analysis revealed that TyG-BMI was linked nonlinearly to both types of mortality,while a two-stage linear regression discerned inflection points at 252.77 for cardiovascular mortality and 245.90 for overall mortality.TyG-BMI was found to correlate positively with future CHF.Additionally,introducing TyG-BMI into conventional prediction models resulted in a substantial improvement of their predictability for cardiovascular outcomes and overall mortality when compared to incorporating TyG or BMI alone.CONCLUSION Among T2DM individuals,a higher TyG-BMI is linked strongly to elevated risks of cardiovascular outcomes and overall mortality,highlighting its utility as a predictive marker for these risks.
基金Supported by Sanming Project of Medicine in Shenzhen,No.SZZYSM202202010。
文摘BACKGROUND The triglyceride glucose-body mass index(TyG-BMI)is a novel indicator of insulin resistance(IR).Obstructive sleep apnea(OSA)is a prevalent disorder characterized by recurrent complete or partial collapse of the pharyngeal airway during sleep;however,the relationship between these two conditions remains unexplored.We hypothesized that a higher TyG-BMI is associated with the occurrence of OSA.AIM To assess the association between TyG-BMI and OSA in adults in the United States.METHODS A cross-sectional study was conducted utilizing data from the National Health and Nutrition Examination Surveys spanning from 2005-2008 to 2015-2018.TyGBMI was calculated as Ln[triglyceride(mg/dL)×fasting blood glucose(mg/dL)/2]×BMI.Restricted cubic splines were used to analyze the risk of TyG-BMI and OSA occurrence.To identify potential nonlinear relationships,we combined Cox proportional hazard regression with smooth curve fitting.We also conducted sensitivity and subgroup analyses to verify the robustness of our findings.RESULTS We included 16794 participants in the final analysis.Multivariate regression analysis showed that participants with a higher TyG-BMI had a higher OSA incidence.After adjusting for all covariates,TyG-BMI was positively correlated with the prevalence of OSA(odds ratio:1.28;95%confidence interval:1.17,1.40;P<0.001);no significant nonlinear relationship was observed.Subgroup analysis showed no strong correlation between TyG-BMI and OSA in patients with diabetes.The correlation between TyG-BMI and OSA was influenced by age,sex,smoking status,marital status,hypertensive stratification,and obesity;these subgroups played a moderating role between TyGBMI and OSA.Even after adjusting for all covariates,there was a positive association between TYG-BMI and OSA prevalence.CONCLUSION A higher TyG-BMI index is linked to higher chances of developing OSA.As TyG-BMI is an indicator of IR,managing IR may help reduce the risk of OSA.
文摘BACKGROUND Gastric cancer,a globally prevalent malignant tumor,continues to exhibit high incidence and mortality rates.Although radical gastrectomy remains the primary treatment for this disease,postoperative complications frequently arise,negatively impacting short-term recovery and significantly reducing patients’quality of life.In this context,accurately predicting the risk of postoperative recurrence and metastasis,coupled with targeted interventions,could substantially improve patient outcomes.The C-reactive protein-triglyceride-glucose index(CTI),a composite biomarker that integrates metabolic disturbances and systemic inflammation,has garnered increasing attention in oncology.The prognostic nutritional index(PNI),a composite measure based on serum albumin and peripheral blood lymphocyte count,is used to evaluate both the nutritional status and systemic immune function of patients.In recent years,both the CTI and PNI have demonstrated significant prognostic value in predicting tumor outcomes,assessing treatment responses,and formulating personalized treatment strategies.AIM To investigate whether the combined inflammation and insulin resistance marker,the CTI,can serve as a prognostic indicator for patients undergoing radical gastrectomy for gastric cancer.Additionally,it seeks to develop a predictive model by incorporating the PNI alongside CTI.METHODS This retrospective study included a total of 300 patients who underwent radical gastrectomy.The patients were classified into high and low CTI groups based on their CTI index.Cox proportional hazards regression analysis was performed to identify independent prognostic factors influencing overall survival(OS)and disease-free survival(DFS),and two nomogram models were developed.RESULTS Of the included patients,131 had a high CTI and 169 had a low CTI.The DFS period of the low CTI group was significantly longer than that of the high CTI group.The number of postoperative adjuvant treatments,T stage,N stage,CTI,and PNI were identified as independent prognostic factors for DFS.The hazard ratio for CTI was 2.07(95%confidence interval:1.36-3.17,P<0.001).In terms of OS,the OS period of the low CTI group was significantly longer than that of the high CTI group.Whether adjuvant treatment was administered,T stage,CTI,and PNI were independent prognostic factors for OS.The hazard ratio for CTI was 2.47(95%confidence interval:1.44-4.23,P=0.001).The nomogram models for OS and DFS further emphasized the importance of CTI as a key predictor of patient prognosis.CONCLUSION CTI is a long-term prognostic indicator for the outcome of radical gastrectomy for gastric cancer.Patients with lower CTI values have a better prognosis.The prediction models constructed by combining CTI with PNI has good predictive ability for DFS and OS after radical gastrectomy.
基金Supported by the Science and Technology Planning Projects of Guizhou Province,No.QKHJC-MS[2025]384the Science and Technology Planning Projects of Zunyi City,No.ZSKHHZ(2023)470+3 种基金the WBE Liver Fibrosis Foundation,No.CFHPC2025028Chinese Foundation for Hepatitis Prevention and Control Muxin Research Fund of Chronic Hepatitis B,No.MX202404Beijing Liver and Gallbladder Mutual Aid Public Welfare Foundation Artificial Liver Special Fund,No.iGandanF-1082024-RGG018the Student Innovation and Entrepreneurship Training Program of Zunyi Medical University,No.2024106610923.
文摘Metabolic dysfunction-associated steatotic liver disease,characterized by pathological intracellular triglyceride(TG)accumulation,is mechanistically associated with the disrupted spatiotemporal regulation of hepatocyte nuclear factor(HNF)-dependent transcriptional programs.HNFs,including key members such as HNF-1α,HNF-4α,and HNF-6,constitute a liver-enriched family of transcription factors that govern hepatic lipid metabolism through hierarchical transcriptional regulatory networks.These networks critically regulate the dynamic equilibrium of TG metabolism,encompassing TG synthesis,storage,lipolysis,and lipoprotein-mediated export.This review comprehensively deciphers the molecular cascades through which HNF dysfunction exacerbates TG metabolic disorder in metabolic dysfunction-associated steatotic liver disease.Additionally,we evaluate emerging translational strategies targeting key HNF regulatory nodes and discuss current clinical challenges as well as potential solutions.
