Background: The C-reactive protein/lymphocyte ratio (CLR) is a prognostic biomarker of various diseases. However, its significance in acute pancreatitis (AP) remains unknown. The main aim of this study was to investigate the association between the CLR and disease severity in patients with AP. Methods: This cross-sectional study included 476 AP patients [mild acute pancreatitis (MAP), n=176; moderately severe acute pancreatitis (MSAP) and severe acute pancreatitis (SAP), n=300]. The primary exposure of interest was the baseline CLR. The primary outcome was the incidence of moderate to severe AP. Multivariate logistic regression and restricted cubic spline analyses were performed to evaluate the association between the CLR and the incidence of moderate to severe AP. Receiver operating characteristic (ROC) analysis was conducted to assess the predictive efficacy, sensitivity, and specificity of CLR in predicting the incidence of moderate to severe AP. Results: The mean age of the patients was 44±13.2 years, and 76.5% were male. The distribution of CLR was 31.6 (interquartile range, 4.5, 101.7). Moderate to severe AP occurred in 300 cases (63.0%). After multiple adjustments, CLR was independently associated with the incidence of moderate to severe AP (odds ratio, 1.04; 95% CI: 1.03–1.05; P< 0.001). A nonlinear relationship was found between CLR and the incidence of moderate to severe AP, with a threshold of approximately 45. The effect size and CI below and above the threshold value were 1.061 (1.033–1.089) and 1.014 (0.997–1.031), respectively. The area under the curve (AUC) for CLR was 87.577% (95% CI: 84.443– 90.710%) with an optimal cut-off value of 30.835, resulting in a sensitivity of 73.7% and a specificity of 88.6%. Conclusions: There was a nonlinear relationship with a saturation effect between the CLR and the incidence of moderate to severe AP. The CLR measured within 24 h of admission may serve as a promising biomarker for predicting the emergence of moderate to severe AP, thereby providing a more scientifically grounded basis for preventing such cases. Nonetheless, further research is warranted to validate and strengthen these findings.

Gut microbes are important for the development of atherosclerotic cardiovascular disease (ASCVD), and the dietary index for gut microbiota (DI-GM), a new measure of gut flora-friendly diets, has not been systematically investigated in relation to ASCVD. This study aimed to evaluate the correlation between DI-GM and the risk of ASCVD in American older adults, also to analyze the mediating role of body mass index (BMI). Researchers selected 2234 elderly participants ≥ 65 years of age from the National Health and Nutrition Examination Survey (NHANES) from 2015 to 2018 for a cross-sectional cohort study. Stratified analyses were taken based on DI-GM quartile. To achieve our research objectives, we employed logistic regression analysis, smooth curve fitting, interaction effects analysis, and mediation analysis. After adjusting for confounders, individuals with higher DI-GM had a significantly lower risk of ASCVD (highest quartile vs. lowest quartile OR = 0.73, 95% CI: 0.52–1.01, P < 0.001). DI-GM was linearly negatively associated with ASCVD (P = 0.13) and the association was stable in the diabetes subgroup (interaction P > 0.05), but age, gender and BMI may modify the association between DI-GM and ASCVD (interaction P < 0.05). BMI mediated 11.51% of the association between DI-GM and ASCVD (95% CI: 2.54%-54.1%, P = 0.016). DI-GM is likely to be a promising indicator for the assessment of the risk of ASCVD, with BMI exhibiting a partial mediating effect in this association. Future studies should prioritize a comprehensive investigation of the underlying mechanisms by which DI-GM contributes to atherogenesis, with the aim of enhancing the efficacy of early prevention strategies for ASCVD.

Background: Portal vein diameter (PVD) is an important and objective marker of portal pressure and may be associated with the risk of recurrent esophagogastric variceal bleeding (EGVB) in patients with cirrhosis. However, the specific relationship between the two has not been clearly established. This study aims to investigate the association between PVD and the risk of recurrent EGVB in patients with cirrhosis. Methods: This study used a retrospective cohort design, including 1223 patients with cirrhosis discharged from Quanzhou First Hospital between January 2014 and December 2018. After applying inclusion and exclusion criteria, a total of 247 patients (179 males and 68 females) were included in the analysis. Portal vein diameter (PVD, in mm) was measured using standardized abdominal ultrasound or CT scans. EGVB events were confirmed by endoscopic diagnosis. The association between PVD and recurrent EGVB was assessed using a multivariate logistic regression model, adjusting for age, gender, etiology of cirrhosis, comorbidities, Child-Pugh classification, portal vein thrombosis (PVT), and laboratory indicators (such as platelet count, albumin, and coagulation function parameters). Stratified analyses and interaction tests were further conducted to verify the robustness of the results. Results: The incidence of recurrent EGVB increased significantly with an increase in PVD (trend test P =0.023). The multivariate-adjusted model showed that for every 1 mm increase in PVD, the risk of recurrent EGVB increased by 19% (HR=1.19, 95% CI: 1.01-1.40, P =0.039). Stratified analysis indicated that the risk was particularly significant when PVD>14 mm (adjusted HR=3.61, P =0.022). Subgroup analysis showed that, apart from an interaction between age and PVD (interaction P 0.05). Conclusions: An increased portal vein diameter is an independent risk factor for recurrent EGVB in patients with cirrhosis, with a particularly significant increase in risk when PVD>14 mm. Monitoring changes in PVD can provide an important basis for clinical identification of high-risk patients and optimization of portal hypertension management, thereby reducing the incidence of recurrent bleeding events.

Glycemic control plays a crucial role in the outcomes of acute pancreatitis (AP), yet traditional glucose metrics have shown limited prognostic value. This study investigates the association between mean glucose area under the curve (AUC) and mortality outcomes in AP patients. We conducted a retrospective cohort study of 1085 intensive care unit patients with AP using data from the Medical Information Mart for Intensive Care IV database. Patients were stratified into tertiles based on mean glucose AUC. Multivariable Cox regression and restricted cubic spline analyses were employed to assess the relationship between mean glucose AUC and mortality outcomes. Predictive performance was quantified using receiver operating characteristic curve analysis, and robustness was further tested through comprehensive subgroup and sensitivity analyses. A higher mean glucose AUC was significantly associated with increased mortality risk. In the fully adjusted model, the hazard ratio for in-hospital mortality was 1.10 (95% confidence interval: 1.08–1.12; P < .001). Compared with the lowest tertile, patients in the highest tertile demonstrated an 11.12-fold increased mortality risk (95% confidence interval: 5.78–21.41; P < .001). Mean glucose AUC showed superior discriminative capacity for predicting in-hospital mortality (AUC = 0.783) compared with other glucose metrics. The association remained robust across various subgroups and sensitivity analyses. Mean glucose AUC serves as a powerful, independent predictor of in-hospital mortality in AP patients. This novel metric outperforms conventional glucose parameters in prognostic accuracy, suggesting its potential utility in clinical risk stratification and treatment optimization.