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Rethinking noninvasive steatosis indices:Structural limitations and misclassification across the body mass index spectrum 认领 引用
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作者 Kengo Moriyama 《World Journal of Hepatology》 2026年第5期33-40,共8页
The rebranding of nonalcoholic fatty liver disease(NAFLD)to metabolic dysfunction-associated steatotic liver disease(MASLD)has shifted the clinical focus toward underlying metabolic drivers.This necessitates a re-eval... The rebranding of nonalcoholic fatty liver disease(NAFLD)to metabolic dysfunction-associated steatotic liver disease(MASLD)has shifted the clinical focus toward underlying metabolic drivers.This necessitates a re-evaluation of noninvasive diagnostic tools to better align with metabolic dysfunction as the primary driver of hepatic steatosis.Commonly used indices,including the fatty liver index,hepatic steatosis index,and NAFLD liver fat score,were originally developed to estimate liver fat in general populations but are now applied to diagnose or screen for NAFLD in diverse clinical settings.However,their diagnostic performance is not consistent across different patient populations.In individuals with obesity,these diagnostic indices tend to over-identify hepatic steatosis due to excessively high sensitivity and low specificity.Conversely,in lean populations,these same indices often have low sensitivity,leading to under-diagnosis.These findings indicate that steatosis indices are strongly influenced by body composition and metabolic context.This review proposes a unified conceptual framework in which these indices are interpreted as body composition-dependent tools rather than direct measures of hepatic fat.Their structural reliance on anthropometric variables may result in systematic misclassification across the body mass index spectrum,limiting their utility as universal diagnostic classifiers.Accordingly,a shift toward context-dependent interpretation and integrated diagnostic strategies is required.Effective MASLD management in clinical practice requires combining noninvasive markers with imaging,fibrosis staging,and metabolic assessment to refine risk stratification,particularly in atypical cases such as severe obesity or lean MASLD. 展开更多
关键词 Metabolic dysfunction-associated steatotic liver disease Fatty liver index Hepatic steatosis index Nonalcoholic fatty liver disease liver fat score Body mass index Misclassification Noninvasive indices Hepatic steatosis
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Relationship between preoperative modified frailty index,immune inflammation index,and outcomes of colorectal cancer surgery in older patients 认领 引用 被引量：1
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作者 Xing-Si Qi Nai-Ling Liu +1 位作者 Lin Yang Jing Xie 《World Journal of Gastrointestinal Oncology》 SCIE 2026年第2期151-162,共12页
BACKGROUND With the aging of the population,the proportion of older patients with colorectal cancer(CRC)is increasing annually.Preoperative frailty and chronic inflammatory responses may increase the risk of postopera... BACKGROUND With the aging of the population,the proportion of older patients with colorectal cancer(CRC)is increasing annually.Preoperative frailty and chronic inflammatory responses may increase the risk of postoperative complications and affect long-term survival.AIM To assess modified frailty index(mFI)and systemic immune-inflammation index(SII)for predicting postoperative prognosis in older patients with CRC.METHODS We retrospectively analyzed 247 older patients with CRC who underwent radical resection.The SII was calculated as platelet count×neutrophil count/lymphocyte count.Patients were grouped by complication occurrence.Univariate and multivariate analyses were performed for mFI,SII,and postoperative complications.Using receiver operating characteristic curve analysis,the critical SII value for predicting postoperative recurrence was identified,which was then used to divide patients into high/low mFI and high/low SII groups.Using Kaplan-Meier method between-group survival curves were drawn.RESULTS The 30-day complication rate was 12.55%.Multivariate logistic regression analysis identified smoking history[odds ratio(OR)=4.822],prolonged operation time(OR=1.037),and elevated preoperative mFI(OR=9.342)and SII(OR=1.002)as independent risk factors for postoperative complications(P<0.05).On survival analysis,the average recurrence-free survival(RFS)for patients with a low mFI was 47.04 months[95%confidence interval(CI):45.30-48.79],significantly better than the 33.83 months(95%CI:31.31-36.36)for patients with a high mFI(log-rank,P<0.001).The average RFS for patients with a low SII was 47.00 months(95%CI:45.07-48.94),significantly better than the 40.06 months(95%CI:31.37-43.74)for those with a high SII(log-rank,P<0.001).CONCLUSION In older patients with CRC,the preoperative mFI and SII were significantly correlated with postoperative complications and RFS,warranting closer attention to early recurrence detection and intervention. 展开更多
关键词 Colorectal cancer Laparoscopic radical resection Postoperative complications Recurrence-free survival Modified frailty index Systemic immune-inflammation index
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Fibrosis index nine superiority for cirrhosis in hypopituitarism:Clinical validation of endocrine liver triage tool 认领 引用
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作者 Ting Li Xi Wang +3 位作者 Min Nie Qin Han Xue-Yan Wu Jiang-Feng Mao 《World Journal of Gastroenterology》 SCIE CAS 2026年第28期55-65,共11页
BACKGROUND Hypopituitarism is a high-risk factor for rapidly progressive metabolic dysfunction-associated steatotic liver disease(MASLD)and cirrhosis.Conventional non-invasive tests(NITs)like the fibrosis-4(FIB-4)inde... BACKGROUND Hypopituitarism is a high-risk factor for rapidly progressive metabolic dysfunction-associated steatotic liver disease(MASLD)and cirrhosis.Conventional non-invasive tests(NITs)like the fibrosis-4(FIB-4)index often lack accuracy in endocrine-mediated contexts.The machine-learning-based fibrosis-9(FIB-9)index shows promise in general MASLD but remains unvalidated in hypopituitarism.We hypothesized that FIB-9 would outperform traditional NITs in identifying cirrhosis among these clinical populations.AIM To evaluate FIB-9 performance and compare it with traditional indices and markers for cirrhosis in hypopituitarism.METHODS This retrospective study of 35 patients(19 cirrhosis,16 non-cirrhosis)evaluated the diagnostic accuracy of the FIB-9 index.Comparisons were made with the FIB-4 index,aspartate aminotransferase-to-platelet ratio index(APRI),direct serum fibrosis markers[hyaluronic acid(HA),procollagen III N-terminal peptide,type IV collagen,and laminin],and liver stiffness measurement(LSM).Performance was assessed using the area under the receiver operating characteristic curve(AUROC)method.RESULTS FIB-9 was significantly higher in the cirrhosis group than in controls[3.75(2.04,3.99)vs 0.49(0.04,1.59),P<0.001].FIB-9 demonstrated the highest diagnostic accuracy(AUROC=0.941;95%CI:0.856-1.000),outperforming APRI(AUROC=0.903),FIB-4(AUROC=0.872),and direct markers like HA(AUROC=0.878).At an optimal cutoff of 1.748,FIB-9 yielded 89.5%sensitivity and 100.0%specificity.Notably,individual parameters such as alanine aminotransferase(P=0.417)and albumin(P=0.109)failed to distinguish between groups.LSM was significantly elevated in the cirrhosis group[23.2(15.8,31.9)kPa vs 5.7(3.9,6.8)kPa,P<0.001].CONCLUSION The FIB-9 index is superior to traditional indices and direct markers for identifying cirrhosis in hypopituitarism,serving as a highly reliable rule-in tool for clinical triage. 展开更多
关键词 Hypopituitarism Liver fibrosis Cirrhosis Non-invasive test Craniopharyngioma Fibrosis-9 index Fibrosis-4 index Aspartate aminotransferase-to-platelet ratio index Liver stiffness measurement Metabolic dysfunction-associated steatotic liver disease
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Application of modified Charlson comorbidity index for predicting outcomes following adult living donor liver transplantation 认领 引用
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作者 Gowtham Rajan Amal Francis Sam +2 位作者 Akila Rajakumar Dinesh Jothimani Mohamed Rela 《World Journal of Hepatology》 2026年第1期113-123,共11页
BACKGROUND The model for end-stage liver disease(MELD)score helps assess the severity of liver disease and can predict survival after liver transplant.The Charlson comorbidity index(CCI)is frequently employed to forec... BACKGROUND The model for end-stage liver disease(MELD)score helps assess the severity of liver disease and can predict survival after liver transplant.The Charlson comorbidity index(CCI)is frequently employed to forecast the 10-year survival probability of patients with multiple health conditions.We employed the CCI to evaluate the impact of comorbid health conditions on patients and assess its predictive capability regarding health complications and mortality following living donor liver transplantation(LDLT).AIM To understand the prevalence of extrahepatic comorbidities in our cohort of LDLT patients with modified CCI(mCCI)and to analyze the utility of mCCI as a predictor of morbidity and mortality following LDLT.METHODS After obtaining institutional ethics committee approval,a retrospective analysis was conducted on 497 adult patients who underwent LDLT at our institute between January 2021 and December 2023.RESULTS Our analysis revealed that the area under the curve(AUC)of the original CCI for predicting 90-day mortality decreased when malignancy was assigned a score of 2 in patients with hepatocellular carcinoma undergoing transplantation.Therefore,we used a mCCI.Both MELD and mCCI scores demonstrated predictive value for 90-day mortality,with AUCs of 0.60 and 0.62,respectively.Using regression coefficients,we developed a composite score defined as:Combined score=[mCCI+(MELD/10)].This composite metric improved predictive accuracy,yielding an AUC of 0.70 for 90-day mortality prediction.Patients with a CCI>3 and a MELD>21 had a significantly higher 90-day mortality rate than others(12.5%vs 5.7%;P=0.02).CONCLUSION The mCCI was independent of decompensation and overall disease severity.Combining MELD and CCI scores enhanced the discriminatory power for predicting morbidity and 90-day mortality. 展开更多
关键词 Charlson comorbidity index Post living donor liver transplantation outcomes Composite outcome scores in living donor liver transplantation Charlson comorbidity index vs model for end-stage liver disease Modified Charlson comorbidity index in liver transplantation Outcome prediction in living donor liver transplantation
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Restoration effects of China's Shan-Shui Initiative:Quantitative assessment based on the improved Remote Sensing Ecological Index(kRSEI) 认领 引用
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作者 Yanjun SHEN Shengwei ZHANG +4 位作者 Yanzhao YUAN Bo WANG Tieming LIU Yajun LI Jianbing PENG 《Science China Earth Sciences》 SCIE EI CSCD 2026年第7期2586-2601,共16页
China's Shan-Shui Initiative is deeply integrated into the national ecological security barrier system of the“Three Eco-zones and Four Shelterbelts”.Since 2016,52 major projects have been implemented in batches,... China's Shan-Shui Initiative is deeply integrated into the national ecological security barrier system of the“Three Eco-zones and Four Shelterbelts”.Since 2016,52 major projects have been implemented in batches,and the Shan-Shui Initiative was selected as one of the first 10“World Restoration Flagships”.How effective has the Shan-Shui Initiative been in enhancing regional ecological quality?Currently,systematic quantitative results remain unavailable.Accordingly,this study focuses on the first 25 projects of the Shan-Shui Initiative implemented between 2016 and 2018.Based on longterm multi-source data from 2011 to 2024,an evaluation method using the improved Remote Sensing Ecological Index(kRSEI)was introduced.Combined with the Mann-Kendall trend test,arithmetic mean divisia index(AMDI)decomposition,and wavelet coherence analysis,we assessed the enhancement effects of these projects across the“Three Eco-zones and Four Shelterbelts”.The results indicate that:(1)The kernel normalized difference vegetation index(kNDVI)increased significantly in 14 project areas,but the kRSEI did not show a synchronized improvement,indicating that subsequent projects should prioritize transitioning restoration measures from“greening”to“quality improvement”.(2)The enhancement of kRSEI exhibited land-type differentiation,where forests,grasslands,and croplands were the dominant land types for ecological quality improvement in humid zones,arid/semi-arid zones,and zones with intensive human-land interaction,respectively.(3)AMDI decomposition quantified the contribution effects of different land types to ecological changes,revealing that cropland ecosystems play a significant driving role in ecological quality fluctuations across the“Three Eco-zones and Four Shelterbelts”.(4)Wavelet coherence analysis intuitively reveals the time-frequency associations between climate-environmental factors(temperature,precipitation,standardized precipitation-evapotranspiration index,and soil moisture)and kRSEI.Among these,soil moisture serves as the key carrier for transmitting climateenvironmental influences to the evolution of ecological quality.This study provides a quantitative reference for the assessment methodologies and outcomes regarding the restoration effectiveness of Shan-Shui Initiative.Furthermore,it offers a scientific basis for climate-adaptive optimization and precise land-type configuration in the implementation of these projects. 展开更多
关键词 an-Shui initiative Restoration effectiveness Improved Remote Sensing Ecological Index(kRSEI) Climate response Divisia index decomposition
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Independence verification of peak-strength strain energy storage index from rock specimen shape effects 认领 引用
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作者 Zhichao He Fengqiang Gong +2 位作者 Li Ren Da Huang Weimin Yang 《Journal of Rock Mechanics and Geotechnical Engineering》 SCIE CSCD 2026年第5期3526-3538,共13页
The strain energy storage index(WET)is a crucial index for evaluating rockburst proneness.Interestingly,when conducting tests to obtain WET,variations exist in the shape of coal or rock specimens.However,whether shape... The strain energy storage index(WET)is a crucial index for evaluating rockburst proneness.Interestingly,when conducting tests to obtain WET,variations exist in the shape of coal or rock specimens.However,whether shape factors affect WET has not been theoretically and experimentally verified.In this study,to investigate the independence of WET from specimen shape effects,its rationality was first theoretically derived based on the linear energy storage(LES)laws of rock,indicating that WET is influenced by the energy storage coefficient(ESC)of the rock.Two typical rock materials(granite and red sandstone)with different rockburst proneness were selected to verify the migration effect of cubic and cylindrical specimens on WET via uniaxial compression tests.The experimental results revealed that the mechanical behavior characteristics of rocks were affected by the shape of cylindrical and cubic specimens,whereas the WET and ESC were opposite.Furthermore,the practical WET values closely approximate the theoretical values of energy storage-dissipated ratio predicted by the LES law,converging to the peak-strength strain energy storage index(WPET).Based on the LES law,the influence of specimen shape on WET and WPET was further discussed,concluding that WET and WPET are independent of specimen shape effects.Furthermore,the WPET is more stable than WET and reflects the relative magnitude of energy storage and dissipation during the entire pre-peak of rock.Thus,the peak-strength strain energy storage index can be used as a substitute for WET in evaluating the rockburst proneness of rock. 展开更多
关键词 Rock mechanics Rockburst Strain energy storage index Linear energy storage(LES)law Energy storage coefficient Peak-strength strain energy storage index
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Balaban index of bicyclic chain graphs 认领 引用
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作者 LV Xue-zheng MA Meng-yu WANG Cheng-rui 《Applied Mathematics(A Journal of Chinese Universities)》 SCIE CSCD 2026年第1期194-213,共20页
Chain graphs are{2K2,C3,C5}-free graphs.Balaban index and sum-Balaban index are two important topological indices.In this paper,we concentrate on the subclass of bicyclic connected chain graphs,identifying th... Chain graphs are{2K2,C3,C5}-free graphs.Balaban index and sum-Balaban index are two important topological indices.In this paper,we concentrate on the subclass of bicyclic connected chain graphs,identifying the extremal graphs that exhibit the minimum or maximum Balaban index and sum-Balaban index within this class.Moreover,we provide a systematic ordering of all bicyclic connected chain graphs according to the magnitude of their Balaban index and sum-Balaban index. 展开更多
关键词 Balaban index sum-Balaban index chain graph
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Using the triglyceride-glucose index and derived indexes to forecast progression from pre-diabetes to diabetes:A 3-year follow-up study 认领 引用
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作者 Bing Wang Ming-Chuan Liu +5 位作者 Xu-Han Liu Zhu Zhu Ying-Shu Liu Ting-Ting Zhang Xin-Yu Li Zheng-Nan Gao 《World Journal of Diabetes》 SCIE 2026年第2期116-126,共11页
BACKGROUND Pre-diabetes is a transitional metabolic stage between health and diabetes,serving as a critical warning signal for disease progression.Early intervention targeting risk factors in prediabetic individuals p... BACKGROUND Pre-diabetes is a transitional metabolic stage between health and diabetes,serving as a critical warning signal for disease progression.Early intervention targeting risk factors in prediabetic individuals prevents the progression to type 2 diabetes.AIM To investigate the predictive value of the triglyceride-glucose(TyG)index and its derived indicators for new-onset diabetes in patients with pre-diabetes.METHODS A prospective community-based cohort study was carried out based on subjects aged over 40 years with pre-diabetes in Dalian,Liaoning Province,China.A total of 1352 subjects with complete follow-up data attended the follow-up survey.Multivariable Cox regression models were performed to assess the association of the TyG index and its derived indicators with risk of diabetes in patients with prediabetes.The diagnostic values of the TyG index and derived indicators in predicting new-onset diabetes were analyzed,and suitable cutting points were determined using the receiver operating characteristic(ROC)curve.RESULTS During a 3-year follow-up period,153 cases with incident diabetes were identified,with a cumulative incidence of diabetes of 11.3%;12.6%(43/341)in males and 10.9%(110/1011)in females(χ2=0.760,P=0.375).After adjusting for confounding factors including age,gender,body mass index(BMI)and insulin levels,the risk of diabetes with higher TyG and derived indexes[TyG-BMI and TyG-waist circumference index(TyG-WC)]increased significantly.The TyG index[hazard ratio(HR)=1.389,95%confidence interval(CI):1.011-1.908,P=0.043],TyG-BMI(HR=1.010,95%CI:1.005-1.015,P=0.000)and TyG-WC(HR=1.003,95%CI:1.001-1.005,P=0.001)were all strongly positively correlated with the risk of future diabetes.The ROC curve analysis showed that the area under the curve(AUCs)of the TyG,TyG-BMI and TyG-WC for predicting new diabetes were 0.578(95%CI:0.533-0.624),0.622(95%CI:0.574-0.670)and 0.609(95%CI:0.562-0.657),respectively.The difference in AUC between TyG-BMI and TyG was significant(P=0.047),while the differences between TyG-BMI and TyG-WC(P=0.464)and between TyG-WC and TyG(P=0.175)were not.The TyG-BMI had a larger AUC than the TyG and TyG-WC,and its difference from TyG was significant.The best cut-off points for predicting new diabetes were TyG>8.6,TyG-BMI>247 and TyG-WC>860.Although the AUC values were modest,these indices may serve as preliminary screening tools in resource-limited settings.CONCLUSION The TyG index and its derived indicators were risk factors for the pre-diabetes to diabetes outcome,and may be regarded as predictors of the outcome.The risk of conversion of pre-diabetes to diabetes increased with increases in the TyG index and its derived indicators.The TyG-BMI was better than TyG and TyG-WC in predicting the 3-year outcome for diabetes.Although these indices could aid in the initial risk stratification in primary care,their modest accuracy warrants cautious interpretation. 展开更多
关键词 Triglyceride-glucose index Triglyceride-glucose-body mass index Triglyceride-glucose-waist circumference index Pre-diabetes Diabetes Prospective cohort study
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Interpretation of Appropriate Range of Body Mass Index and Body Weight Management Standards for the Oldest Old:Evidence-based Recommendations from China 认领 引用 被引量：1
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作者 Xiaoyan Ma Peiliang Chen +10 位作者 Chen Chen Xi Meng Jinhui Zhou Shihao Lou Jian Zhang Yao He Li Qi Wenhua Zhao Yuebin Lyu Chen Mao Xiaoming Shi 《Biomedical and Environmental Sciences》 SCIE CAS CSCD 2026年第6期703-710,共8页
With the rapid aging of China's population,the number of adults aged≥80 years is rising,and their nutritional status and weight management have attracted growing attention.Body mass index(BMI)is a commonly used i... With the rapid aging of China's population,the number of adults aged≥80 years is rising,and their nutritional status and weight management have attracted growing attention.Body mass index(BMI)is a commonly used indicator for assessing body weight and nutritional status.However,existing BMI standards were mainly developed for the general adult population,and their applicability to the oldest old population remains uncertain.To provide guidance for BMI evaluation and weight management among the oldest old population in China,the National Health Commission issued the standard“Appropriate body mass index range and weight management standards for the oldest old(WS/T 868-2025)”.Based on evidence from prospective cohort studies including the Chinese Longitudinal Healthy Longevity Survey and the Healthy Aging and Biomarkers Cohort Study,the standard recommends an appropriate BMI range of 22.0–26.9 kg/m2 for adults aged≥80 years and provides recommendations regarding BMI measurement,weight monitoring,and individualized weight management.The implementation of this standard provides scientific evidence for weight evaluation and health management in the oldest old population and contributes to promoting healthy aging. 展开更多
关键词 Oldest old Body mass index Appropriate range Weight management Health professional standard
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Geriatric nutritional risk index associated to long-term prognosis and length of hospitalization in the contemporary transcatheter aortic valve replacement era 认领 引用
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作者 Nick Mattelat Roman Uebelacker +3 位作者 Philipp C Seppelt David Leistner Andreas M Zeiher Silvia Mas-Peiro 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2026年第4期235-245,共11页
BACKGROUND Malnutrition is a common comorbidity in elderly patients with severe aortic valve stenosis undergoing transcatheter aortic valve replacement(TAVR).The geriatric nutritional risk index(GNRI),a validated and ... BACKGROUND Malnutrition is a common comorbidity in elderly patients with severe aortic valve stenosis undergoing transcatheter aortic valve replacement(TAVR).The geriatric nutritional risk index(GNRI),a validated and easy-to-use tool,has been previously associated with short/mid-term outcomes in such patients.This study aimed to confirm this association in the long-term in the contemporary TAVR era using new-generation devices and to evaluate its impact on length of hospitalization.METHODS A total of 1090 consecutive patients aged≥65 years undergoing TAVR between October 2015 and December 2021 at a single tertiary center were included.Patients were stratified into two groups based on baseline GNRI:the GNRI>98(low-risk)group and the GNRI≤98(moderate-to-high risk)group.The primary endpoint was all-cause mortality.Secondary endpoints included total length of hospitalization and length of intensive care unit stay.Kaplan-Meier curves and Cox regression models were used to assess survival differences and potential independent predictors.RESULTS Patients with GNRI≤98 had significantly higher cumulative mortality rates at all evaluated time points compared to patients with GNRI>98(30-day:6.9%vs.2.7%,1-year:39.1%vs.11.4%,5-year:67.3%vs.53.2%,all P<0.05).A multivariable Cox regression analysis showed that GNRI was an independent predictor of long-term mortality(up to five years)after adjusting for clinical,echocardiographic and laboratory parameters(HR=0.94,95%CI:0.92-0.96,P<0.001),with an increasing effect over time.The impact of GNRI on clinical outcomes was observed in patients in all three EuroSCORE II categories(low risk,intermediate risk,and high risk).Total hospitalization and intensive care unit stays were longer in patients with GNRI≤98[8(6-13)days vs.7(5-9)days,P<0.001 and 3(2-5)days vs.2(2-4)days,P<0.001,respectively].CONCLUSIONS In this large European cohort,GNRI was confirmed to be an independent predictor for long-term mortality up to five years in the contemporary era of TAVR use with new-generation devices.Hospital stay was longer in patients with lower GNRI.This easyto-use index could play a valuable role in the preprocedural assessment of patients undergoing TAVR and studies to explore the use of nutritional preprocedural optimization of patients with low GNRI values are warranted. 展开更多
关键词 Transcatheter Aortic Valve Replacement transcatheter aortic valve replacement tavr Long term Prognosis con Length Hospitalization geriatric nutritional risk index gnri Geriatric Nutritional Risk Index Malnutrition
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Modified frailty index and systemic immune-inflammation enable biological risk stratification in geriatric colorectal cancer surgery 认领 引用
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作者 Kai-Zhen Xu Wen-Jian Hu +2 位作者 Yu-Hui Shang Yan-Dong Miao Li-Na Wang 《World Journal of Gastrointestinal Oncology》 SCIE 2026年第7期1-9,共9页
The global demographic shift toward an aging population has significantly increased the incidence of colorectal cancer(CRC)among older adults.However,chronological age alone is an insufficient predictor of surgical ri... The global demographic shift toward an aging population has significantly increased the incidence of colorectal cancer(CRC)among older adults.However,chronological age alone is an insufficient predictor of surgical risk and oncological outcomes.A recent study published by Qi et al in World Journal of Gastrointestinal Oncology identifies the modified frailty index and the systemic immune-inflammation index as critical indices for predicting postoperative complications and recurrence-free survival.This editorial provides an in-depth analysis of how frailty and systemic inflammation intersect to dictate the clinical trajectory of geriatric CRC patients.We discuss the biological mechanisms of immunosenescence,the impact of physiological reserve depletion,and the necessity of incorporating multidimensional indices into routine clinical practice to facilitate personalized prehabilitation and optimized perioperative care. 展开更多
关键词 Colorectal cancer Older adults Modified frailty index Systemic immune-inflammation index Biological risk stratification Postoperative complications Recurrence-free survival
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Predictive value of triglyceride-glucose index and sex hormone-binding globulin in diabetic retinopathy 认领 引用
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作者 Min Zhang Xin-Rui Zhou +3 位作者 Wei-Guo Ma Xiao-Hong Yin Ya Li Rong Li 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2026年第5期921-926,共6页
AIM:To investigate the levels of the triglyceride-glucose(TyG)index and sex hormone-binding globulin(SHBG)in patients with type 2 diabetes mellitus(T2DM)with diabetic retinopathy(DR),and to explore their correlations ... AIM:To investigate the levels of the triglyceride-glucose(TyG)index and sex hormone-binding globulin(SHBG)in patients with type 2 diabetes mellitus(T2DM)with diabetic retinopathy(DR),and to explore their correlations with biochemical parameters and the homeostasis model assessment of insulin resistance(HOMA-IR)in DR patients.METHODS:Patients with T2DM and healthy individuals were enrolled.Age and body mass index(BMI)of the participants were collected,TyG of the subjects was calculated using the formula,SHBG level of the subjects was detected,and blood biochemical indexes were measured at the same time.The changes of each index among the groups were statistically analyzed,and the relationship between TyG,SHBG,DR and each index was analyzed.RESULTS:A total of 150 patients with T2DM and 64 healthy individuals as normal controls(NC,28 males and 36 females,mean age 54.49±10.10y)were enrolled following ophthalmic evaluation.Patients were categorized into non-DR group(42 males and 36 females,mean age 56.68±8.02y)and DR group(35 males and 37 females,mean age,53.83±11.10y).TyG levels were significantly elevated in both non-DR(7.25±0.62)and DR groups(8.02±0.82)compared to controls(6.85±0.48),with the DR group demonstrating higher TyG values than the non-DR group(P<0.05).The level of SHBG(nmol/L)in DR group(25.05±14.06)was lower than that in control group(41.90±22.6)and non-DR group(36.27±20.00;P<0.05).TyG exhibited significant inverse correlations with SHBG(r=-0.455)and high density lipoprotein(HDL;r=-0.430)levels(P<0.05).It was positively correlated with BMI,fasting blood glucose(FBG),2h postprandial blood glucose(PBG),fasting C-peptide(FCP),glycated hemoglobin A1c(HbA1c),HOMA-IR,total cholesterol(TC)and triglycerides(TG)(r=0.406,0.768,0.386,0.393,0.475,0.250,0.242,0.888,respectively,P<0.05).SHBG was negatively correlated with BMI,FBG,FCP,HbA1c and TyG(r=-0.440,-0.304,-0.407,-0.209,-0.455,respectively,P<0.05),and positively correlated with age,TG and HDL(r=0.238,0.034,0.227,respectively,P<0.05).Further multiple regression analysis showed that SHBG was negatively correlated with TyG(P=0.006).CONCLUSION:Elevated TyG index,reduces SHBG levels,and their negative correlation in the DR group suggest potential roles of TyG and SHBG in the pathogenesis and progression of DR.Combined assessment of SHBG and TyG may provide valuable insights for DR prediction and diagnosis. 展开更多
关键词 diabetic retinopathy triglyceride-glucose index sex hormone binding globulin glycated hemoglobin insulin resistance index
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Vulnerability assessment in fractured aquifer using improved vulnerability index:Applied to Gabes aquifer,Southeastern Tunisia 认领 引用
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作者 Mounir Atoui Belgacem Agoubi 《Journal of Groundwater Science and Engineering》 2026年第1期69-82,共14页
The Gabes aquifer system,located in southeastern Tunisia,is a crucial resource for supporting local socio-economic activities.Due to its dual porosity structure,is particularly vulnerable to pollution.This study aims ... The Gabes aquifer system,located in southeastern Tunisia,is a crucial resource for supporting local socio-economic activities.Due to its dual porosity structure,is particularly vulnerable to pollution.This study aims to develop a hybrid model that combines the Fracture Aquifer Index(FAI)with the conventional GOD(Groundwater occurrence,Overall lithology,Depth to water table)method,to assess groundwater vulnerability in fractured aquifer.To develop the hybrid model,the classical GOD method was integrated with FAI to produce a single composite index.Each parameter within both GOD and FAI was scored,and a final index was calculated to delineate vulnerable areas.The results show that the study area can be classified into four vulnerability levels:Very low,low,moderate,and high,indicating that approximately 8%of the area exhibits very low vulnerability,29%has low vulnerability,25%falls into the moderate category,and 38%is considered highly vulnerable.The FAI-GOD model further incorporates fracture network characteristics.This refinement reduces the classification to three vulnerability classes:Low,medium,and high.The outcomes demonstrate that 46%of the area is highly vulnerable due to a dense concentration of fractures,while 17%represents an intermediate zone characterized by either shallow or deeper fractures.In contrast,37%corresponds to areas with lightly fractured rock,where the impact on vulnerability is minimal.Multivariate statistical analysis was employed using Principal Components Analysis(PCA)and Hierarchical Cluster Analysis(HCA)on 24 samples across six variables.The first three components account for over 76%of the total variance,reinforcing the significance of fracture dynamics in classifying vulnerability levels.The FAI-GOD model removes the very-low-vulnerability class and expands the spatial extent of low-and high-vulnerability zones,reflecting the dominant influence of fracture networks on aquifer sensitivity.While both indices use a five-class system,FAI-GOD redistributes vulnerability by eliminating very-low-vulnerability areas and amplifying low/high categories,highlighting the critical role of fractures.A strong correlation(R2=0.94)between the GOD and FAI-GOD indices,demonstrated through second-order polynomial regression,confirms the robustness of the FAI-GOD model in accurately predicting vulnerability to pollution.This model provides a useful framework for assessing the vulnerability of complex aquifers and serves as a decision-making tool for groundwater managers in similar areas. 展开更多
关键词 Groundwater Aquifer vulnerability Fractured media FAI-GOD index GOD index GIS
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Application of a CWFS model-based brittleness index for evaluating anisotropic brittleness in terrestrial shale under triaxial stress 认领 引用
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作者 Jun Zhang Jin-Yuan Zhang +3 位作者 Jia Zeng Zhe-Jun Pan Yu-Wei Li Zi-Yuan Cong 《Petroleum Science》 SCIE EI CAS CSCD 2026年第2期742-761,共20页
For shale reservoir operations,assessing the brittleness of anisotropic shales is vital of optimizing wellbore stability analysis and fracturing design.Current brittleness indices lack effectiveness in characterizing ... For shale reservoir operations,assessing the brittleness of anisotropic shales is vital of optimizing wellbore stability analysis and fracturing design.Current brittleness indices lack effectiveness in characterizing shale brittleness anisotropy.Consequently,the experimental results reported in this paper derived from triaxial tests conducted on shale core samples from the Qingshankou Formation of the Songliao Basin.This study investigates the anisotropy of shale failure patterns and mechanical properties with respect to the bedding plane dip angle(θ),and quantifies the effect of confining pressure.Building on the cohesion weakening and friction strengthening(CWFS)theory,we established a novel triaxial brittleness index(Bt).This index uniquely combines the uniaxial brittleness index(Bu),re flecting inherent brittleness,with the brittleness weakening coefficient(Bw),quantifying the effect of confining pressure.Assessment of the anisotropic brittleness of shale based on Btunder varying confining pressures reveals that Btfirst increases but then decreases with increasingθ.The brittleness peaks atθ=0°and reaches its lowest point atθ=60°,a trend that aligns closely with the observed variations in the failure patterns of shale.Furthermore,the ability of the confining pressure to decrease shale brittleness varies withθ.Atθ=0°,the uniaxial brittleness is the highest,but the confining pressure has the strongest weakening effect on shale brittleness.In contrast,the uniaxial brittleness atθ=90°is second only to that at 0°,but the brittleness in this direction is least affected by the confining pressure.Compared with the five existing brittleness indices,the proposed index accounts for both inherent and apparent brittleness.It is more sensitive to internal lithological characteristics and external stress conditions and has strong potential for integration with geophysical data.This study provides valuable guidance for sweet spot identification,wellbore stability assessment,and fracturing scheme optimization in shale oil and gas exploration. 展开更多
关键词 Shale Brittleness index Anisotropy Friction strengthening Cohesion weakening
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An index for evaluating rock failure using energy release and rock brittleness 认领 引用
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作者 Jian Liu Quan Jiang +4 位作者 Tianbing Xiang Yong Xia Dongqi Hou Guangliang Feng Dingping Xu 《Journal of Rock Mechanics and Geotechnical Engineering》 SCIE CSCD 2026年第7期5259-5272,共14页
Brittle failures such as rockbursts,stress-induced collapses,and spalling pose major risks in deep hard rock engineering,leading to safety incidents,project delays,and increased costs.While conventional brittleness in... Brittle failures such as rockbursts,stress-induced collapses,and spalling pose major risks in deep hard rock engineering,leading to safety incidents,project delays,and increased costs.While conventional brittleness indices are widely used to assess brittle failure susceptibility,they provide only qualitative assessments and cannot quantify the severity or extent of failure.To address these limitations,we conducted compressive tests on multiple rock types and developed a new brittleness index that captures post-peak ductile to brittle transition characteristics.Based on this index,the brittleness-based relative energy release(BRER)parameter was proposed,which integrates rock brittleness and confiningpressure effects into post-peak energy release calculations.Field validation using acoustic testing and microseismic monitoring demonstrates that BRER reliably predicts both the risk and extent of surrounding rock failure,providing a comprehensive and practical tool for assessing and mitigating brittle failure in deep hard rock environments. 展开更多
关键词 Brittle failure Rockburst Energy index Microseismic monitoring Ductile-brittle transition
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Co-exposure of PFASs,PAHs and metals,immune inflammation and triglyceride-glucose index:Exploring associations and mediation effects in children 认领 引用
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作者 Miao Liu Biao Zhang +11 位作者 Yuanyuan Zhang Jie Wang Lei Zhao Wenting Guo Meng Li Huihua Yang Xuefeng Lai Liangle Yang Xiao Meng Cuijuan Wang Zhihu Zhang Xiaomin Zhang 《Journal of Environmental Sciences》 SCIE EI CAS CSCD 2026年第2期384-393,共10页
The associations of co-exposure to per-and polyfluoroalkyl substances(PFAS),polycyclic aromatic hydrocarbons(PAHs),and metals with children’s glycometabolism and the underlying mechanism of immune inflammation are la... The associations of co-exposure to per-and polyfluoroalkyl substances(PFAS),polycyclic aromatic hydrocarbons(PAHs),and metals with children’s glycometabolism and the underlying mechanism of immune inflammation are largely unclear.We conducted a longitudinal panel study to explore the effects of individual and mixture of 27 contaminants on an emerging surrogate indicator of insulin resistance,triglyceride-glucose index(TyG),and the mediation of immunoglobulins and cytokines in children aged 4–6 years and 11–13 years.The results showed robust associations of perfluorooctanoic acid(PFOA),perfluorononanoic acid(PFNA),perfluoroundecanoic acid(PFUnDA),and arsenic(As)with elevated TyG.The interaction of PFNA with PFOA was significant,showing a synergistic effect on TyG.And combined association of each pair of PFOA,PFNA,and As with TyG were enhanced.Meanwhile,the effect of contaminants mixture on TyG was significant for polyfluoroalkyl substances(PFAS)mixture,of which 6:2 Chlorinated polyfluorinated ether sulfonates(Cl-PFESA),PFNA,and PFUnDA weighted more than others.Notably,contaminants were related to immune globulins and cytokines,of which chemokine ligand(CCL)4,interleukin(IL)-1β,IL-9,and tumor necrosis factor(TNF)-α significantly mediated associations of PFOA,PFNA,and PFUnDA with TyG.Accordingly,PFAS and metals were individually and jointly associated with TyG elevation,with 6:2 Cl-PFESA,PFNA,and PFUnDA contributing the most,and CCL4,IL-1β,IL-9,and TNF-α might be the underlying mediators in children. 展开更多
关键词 Priority-controlled contaminants mixture Triglyceride-glucose index Mediation of immune inflammation Panel study
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Effect of loading rate on the brittleness index of granite:An experimental investigation 认领 引用
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作者 YIN Tu-bing LIU Fan +4 位作者 MA Jie-xin DAI Hao LU Jian-fei GUO Wen-xuan LI Xi-bing 《Journal of Central South University》 SCIE EI CAS CSCD 2026年第4期1728-1745,共18页
In deep underground engineering,rock brittleness is closely associated with rockburst and feasibility of hydraulic fracturing.The loading rate plays a crucial role in determining the severity of rockburst and cuttabil... In deep underground engineering,rock brittleness is closely associated with rockburst and feasibility of hydraulic fracturing.The loading rate plays a crucial role in determining the severity of rockburst and cuttability.By conducting uniaxial compression tests and single-cycle loading-unloading experiments,the brittle evolution of four types of granite under different loading rates was investigated.During the uniaxial compression process,acoustic emission parameters were used to characterize the crack evolution patterns.Additionally,the macroscopic failure process of the specimens and the post-failure rock fragments were recorded with a high-speed camera,providing multi-scale validation.This study proposes a quantitative brittleness index based on rock fracture energy,and its validity is verified by analyzing the rock failure process and the macroscopic characteristics of rock fragments.:This work contributes to advancing research on rock brittleness indices considering the coupling between energy evolution and kinematic mechanisms.The research results indicate that as the loading rate increases from 0.1 mm/min to 5 mm/min,the quantitative evaluation index(Bs)for brittleness increases from 0.17 to 0.28,while the qualitative evaluation indices MF(projectile mass ratio)and l(average lumpiness)increase from 0.3261 to 0.4184 and from 32.96 mm to 38.12 mm,respectively.With increasing loading rates,the brittleness of the rock increases significantly.A series of qualitative and quantitative results,including fractal characteristics and acoustic emission parameters,reveal the crack evolution patterns of granite under different loading rates and confirm the rationality of the brittleness index.This study provides theoretical guidance for practical deep underground engineering applications. 展开更多
关键词 linear energy storage law brittleness index fracture mechanism projectile mass ratio average lumpiness
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Joint Impact of Triglyceride-glucose Index and Free Fatty Acid Levels on Cardiovascular Outcomes in Overweight or Obese Patients with Coronary Artery Disease——A Large Multicenter Prospective Study 认领 引用
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作者 Queyun Sun Cheng Cui +20 位作者 Weiting Cai Lin Jiang Jingjing Xu Yi Yao Na Xu Xiaozeng Wang Zhenyu Liu Zheng Zhang Yongzhen Zhang Xiaogang Guo Zhifang Wang Yingqing Feng Qingsheng Wang Jianxin Li Xueyan Zhao Jue Chen Runlin Gao Lei Song Yaling Han Jinqing Yuan Ying Song 《Biomedical and Environmental Sciences》 SCIE CAS CSCD 2026年第6期630-640,共11页
Objective To investigate the joint effect of free fatty acid(FFA)and the triglyceride-glucose(TyG)index on the prognosis of overweight and obese coronary artery disease(CAD)patients.Methods A total of 5,887 patients w... Objective To investigate the joint effect of free fatty acid(FFA)and the triglyceride-glucose(TyG)index on the prognosis of overweight and obese coronary artery disease(CAD)patients.Methods A total of 5,887 patients were enrolled in this study.Restricted cubic spline analyses were used to assess the dose-response relationship of FFA and TyG with major adverse cardiovascular and cerebrovascular events(MACCE).Mediation analysis was used to examine whether TyG mediated the association between FFA and MACCE.Kaplan-Meier survival curves were used to compare the cumulative incidence of events.Multivariable Cox models were used to explore the independent association between Low-/High-FFA and Low-/High-TyG on outcomes.Results FFA and TyG were independent predictors of MACCE.TyG mediated 10.7%of the association between FFA and MACCE.Patients with high FFA and TyG levels exhibited a markedly higher MACCE risk(adjusted hazard ratio:1.951,95%confidence interval:1.533–2.484;P<0.001),with a significant interaction between FFA and TyG.Among patients with elevated FFA levels,MACCE increased progressively across higher TyG tertiles(P for trend=0.001).Conclusions FFA and the TyG index independently predict adverse outcomes in overweight or obese CAD patients,with the TyG index mediating the relationship between FFA and MACCE.Their combined assessment enhances the risk stratification in this population. 展开更多
关键词 TyG index FFA Obesity Coronary artery disease Risk stratification
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Impact of body mass index on the efficacy of acupuncture treatment of postprandial distress syndrome:secondary analysis of a randomized clinical trial 认领 引用
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作者 LI Yuejie YANG Guang +2 位作者 LIU Luping YANG Jingwen LIU Cunzhi 《Journal of Traditional Chinese Medicine》 SCIE CAS CSCD 2026年第2期439-446,共8页
OBJECTIVE:To assess the impact of body mass index(BMI)on the effectiveness of acupuncture in treating postprandial distress syndrome(PDS).METHODS:Data from 278 patients enrolled in a prior multicenter,randomized,sham-... OBJECTIVE:To assess the impact of body mass index(BMI)on the effectiveness of acupuncture in treating postprandial distress syndrome(PDS).METHODS:Data from 278 patients enrolled in a prior multicenter,randomized,sham-controlled trial were analyzed in this secondary study.Patients were classified into three groups according to baseline BMI:low,normal,and high.The primary outcome was the response rate after 4 weeks of treatment.The χ2 test was used to examine the effect of BMI on acupuncture efficacy.After multiple imputation for missing data,logistic regression analysis was performed to evaluate this association.A sensitivity analysis was conducted by combining the low and normal BMI groups.In addition,BMI was analyzed as a continuous variable using logistic regression to explore its relationship with treatment efficacy in the acupuncture group.RESULTS:The χ2 test revealed a statistically significant difference,with the acupuncture group demonstrating a markedly higher response rate than the sham group(82.91%vs 51.79%,χ2=25.34,P<0.001).In both the normal and high BMI categories,the response rate in the acupuncture group(82.91%)was higher than that in the sham acupuncture group(48.21%)(χ2=25.34,P<0.001).Following multiple imputation,logistic regression analysis demonstrated a significant overall association between BMI category and treatment response(P<0.001).Acupuncture showed superior efficacy compared with sham acupuncture[OR=1.97,95%CI(1.34,2.90),P<0.001].At week 4,response rates were 68.4%in the low BMI group,81.7%in the normal BMI group,and 96.3%in the high BMI group(χ2=6.303,P=0.043).A significant difference was observed only between the low and high BMI groups(χ2=6.717,P=0.010).Sensitivity analysis showed that the high BMI group achieved significantly better outcomes than the non-high BMI group in elimination rates at week 8 and week 12(χ2=4.571,P=0.033;χ2=4.589,P=0.032).Logistic regression analysis indicated that BMI was an independent predictor of response rate at week 4[OR=1.186,95%CI(1.010,1.394),P=0.038]and elimination rate at week 12[OR=1.126,95%CI(1.002,1.265),P=0.047],whereas no significant associations were observed at other follow-up points.CONCLUSION:This subgroup analysis indicated that acupuncture improved PDS symptoms across different BMI categories.Acupuncture was suggested as a viable therapeutic option for patients with PDS,particularly those with a higher BMI. 展开更多
关键词 acupuncture body mass index postprandial distress syndrome secondary analysis
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A novel high-precision refractive index measurement scheme based on entangled coherent states and parity detection 认领 引用
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作者 HAO Li-li SONG Fu +2 位作者 LIU Xiao-yan YANG Xiao-hao WANG Qiang 《中国光学（中英文）》 EI CAS CSCD 北大核心 2026年第4期983-991,共9页
Traditional intensity-based refractive index measurement methods are constrained by the classical diffraction limit and the shot noise limit,which severely restricts the improvement of measurement precision.To address... Traditional intensity-based refractive index measurement methods are constrained by the classical diffraction limit and the shot noise limit,which severely restricts the improvement of measurement precision.To address this issue,a novel quantum measurement scheme integrating entangled coherent states(ECS)and parity detection(PD)is proposed.Taking advantage of the non-classical correlation of quantum entanglement,the scheme constructs a dual-mode entangled coherent state light source and realizes high-fidelity signal demodulation through a customized parity detection system.Theoretical derivation and numerical simulation results demonstrate that the measurement resolution of the proposed scheme breaks through the Rayleigh limit,achieving a■-fold improvement compared with the traditional coherent state measurement method in the full loss range.In lossless scenarios and cases with loss rates below 10%,the sensitivity surpasses the shot noise limit.Finally,the experimental challenges are also elaborated in detail.This quantum measurement architecture provides a new technical pathway for precision optical detection,biosensing,and other fields,exhibiting significant practical value and broad application prospects. 展开更多
关键词 refractive index measurements entangled coherent states parity detection super-resolution ultra-sensitivity
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