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.

Gallstone disease is one of the most common gastrointestinal disorders. Despite extensive research exploring the risk factors associated with gallstones, the association between depressive symptoms and gallstones remains inadequately understood. This study aimed to assess the association between depressive symptoms and the prevalence of gallstones among adults in the United States. In this study, a cross-sectional design utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning the years 2017 to 2020. The assessment of depressive symptoms was conducted through the utilization of the Patient Health Questionnaire-9 (PHQ-9), which assigns total scores ranging from 0 to 27. Participants with PHQ-9 scores equal to or exceeding 10 were categorized as having clinically relevant depressive symptoms. Multivariable adjusted logistic regression and subgroup analysis were used to assess the association between depressive symptoms and gallstone prevalence. A total of 7,797 participants aged 20 years or older were enrolled in this study, of whom 835 had a self-reported history of gallstones. After multiple adjustments, each one-point increase in PHQ-9 scores was associated with a 5 % increase in the risk of gallstones (odds ratio [OR], 1.05; 95 % confidence interval [CI], 1.03, 1.07, P < 0.001). Compared to individuals with PHQ-9 scores < 10, participants with PHQ-9 total scores ≥ 10 exhibited a 79 % higher risk of gallstones (OR = 1.79, 95 % CI: 1.43, 2.23, P < 0.001). Depressive symptoms were associated with an elevated prevalence of gallstones. However, it is important to note that further validation through prospective cohort studies is warranted to confirm this finding.

Background: Heart failure (HF) is a global health challenge with high morbidity and mortality. The serum creatinine/albumin ratio (CAR), a marker of renal dysfunction and malnutrition, has shown prognostic value in other critical illnesses but remains underexplored in HF patients.Methods: This retrospective cohort study included 1,893 HF patients hospitalized at the Fourth People's Hospital of Zigong, China, between December 2016 and June 2019. Cox proportional hazards models assessed the association between CAR and 28-day mortality. Dose-response relationship was assessed using restricted cubic spline analysis, Kaplan–Meier curves illustrated survival differences, and Receiver Operating Characteristic (ROC) analysis evaluated CAR's predictive performance.Results: Patients with CAR ≥ 3.5 were older, had worse cardiac function, and had more comorbidities than those with CAR < 3.5.A linear relationship was observed between CAR and 28-day mortality. Each 1-unit increase in CAR was associated with a 14% higher mortality risk (HR: 1.14, 95% CI: 1.07–1.21, p < 0.001). ROC analysis showed that CAR had an AUC of 77.1%, which was slightly higher than creatinine alone (76.2%) and markedly better than BNP (68.0%) and albumin alone (64.9%).Conclusion: In patients with HF, CAR may serve as an independent predictor of 28-day mortality. Its ability to simultaneously reflect renal dysfunction, malnutrition, and inflammation highlights its potential as a valuable biomarker for risk stratification. Further multicenter, prospective studies are needed to confirm its clinical utility and investigate its role alongside other biomarkers in guiding personalized treatment strategies and improving patient outcomes.

Background: Acute pancreatitis (AP) is a prevalent gastrointestinal emergency with a wide spectrum of clinical outcomes, varying from mild cases to severe forms. The early identification of high-risk patients is essential for improving prognosis. However, the predictive and prognostic potential of the C-reactive protein to serum calcium ratio (CCR) in AP has not been investigated. This study aims to explore the association between CCR and disease severity in patients with AP.Methods: This retrospective cross-sectional study included 476 AP patients. The CCR was calculated from C-reactive protein and serum calcium levels within the first 24 h of admission. Multivariable logistic regression models were used to evaluate the relationship between CCR and AP severity, with restricted cubic spline analysis and receiver operating characteristic (ROC) analysis to assess dose–response and predictive performance, respectively.Results: Of the 476 patients, 176 (37%) had mild acute pancreatitis (MAP) and 300 (63%) had moderate to severe AP. The CCR distribution had a median value of 17.5, with an interquartile range (IQR) of 3.0 to 60.2. Each unit increase in CCR was associated with a 7% increase in the risk of developing moderate to severe AP (OR: 1.07; 95% CI: 1.06–1.09). In fully adjusted models, this association remained statistically significant. The area under the curve (AUC) for CCR in predicting moderate to severe AP was 86.9%, with a sensitivity of 73.7% and specificity of 89.2%.Conclusion: The CCR measured within the first 24 h of admission shows promise as a valuable biomarker for predicting the severity of AP. However, further multicenter prospective cohort studies are needed to confirm its clinical utility and investigate its role in improving treatment strategies and patient management.

This study aims to evaluate the associations of Klemera-Doubal Method Biological Age Acceleration (KDM-BAA) and Phenotypic Age Acceleration (PAA) with all-cause and cause-specific mortality in U.S. adults with Cardio-Kidney-Metabolic (CKM) syndrome stages 0–3 and to establish risk prediction models. Data were obtained from 16,837 participants in NHANES 1999–2010 and 2015–2018, linked to mortality through 2019. Biological age was estimated using KDM-BA and Phenotypic Age algorithms, with residuals defining Biological Age Acceleration (BAA). Cox proportional hazards models were applied, and LASSO-Cox nomograms were developed for mortality prediction. Over a median follow-up of 11.33 years, 10.8% of the weighted population (9.75 million adults) died. After full adjustment for confounders, KDM-BAA positivity increased the risk of all-cause, CVD, and non-CVD mortality by 41%, 74%, and 31%, respectively; PAA positivity showed even larger increases – 103%, 79%, and 112%. Both metrics consistently exhibited a positive association in multiple subgroups and sensitivity analyses. The LASSO-Cox-based nomogram showed favorable discrimination (training AUCs 0.776 and 0.775 at 10 and 20 years; validation AUCs 0.765 and 0.757, respectively) and good calibration, suggesting potential clinical applicability. BAA independently predicts long-term mortality among individuals with CKM stages 0–3. PAA provides superior prognostic value, supporting the importance of monitoring biological aging to guide early intervention and improve long-term outcomes.

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.