Identification of the Predictive Factors of Primary Sclerosing Cholangitis in Patients with Inflammatory Bowel Disease
Notice bibliographique
Résumé
Introduction: Primary sclerosing cholangitis (PSC) is associated with inflammatory bowel disease (IBD), ulcerative colitis (UC) in particular. Due to the potential serious complications of this condition, there is a need to identify predictors of disease development. This study attempts to identify the relationship between the levels of several serological markers and the development of PSC in IBD patients. Methods: A case-control study was conducted at the Royal Victoria Hospital between 2013 and 2015. Cases were defined as patients already known for any IBD who were diagnosed with PSC without any other concomitant liver disease. Controls were defined as patients with IBD and no known liver disease. Predating the diagnosis of PSC, serologic levels of alkaline phosphatase (ALP), alanine and aspartate aminotransferases (ALT & AST), gamma glutamyl transpeptidase (GGT), anti-neutrophil cytoplasmic antibody, anti-nuclear antibody, anti-smooth muscle antibody, anti-mitochondrial antibody, immunoglobulins (IgG, IgA and IgM), and anti-liver kidney mitochondrial antibodies were recorded. Patients were excluded if the serological markers were measured after the diagnosis of PSC. Patients were matched based on gender, location, type and subtype of their IBD according to the Montreal Classifi cation. Results: A total of 148 patients, 37 cases and 111 controls were included. The mean age was 46.2 vs 45.8 for cases vs controls. Overall, a diagnosis of UC was more common in cases than controls (57% vs. 39%). Patients in the case group were more likely to have high ALT, AST, ALP, and GGT. Means of liver enzymes were higher in cases than controls (ALT 47.3 vs. 23.0 U/L, AST 42.1 vs. 22.8 U/L, ALP 156.7 vs. 68.5 U/L, and GGT 115.4 vs. 20.1 U/L). IgG was found to be predictive of developing PSC with an odd's ratio (OR) = 5.83, 95% confidence interval (CI) (2.27-14.99) on multivariate analysis. Furthermore patients who smoked were less likely to have PSC OR = 0.19, 95% CI (0.06-0.58). Similar results were found when stratifying based on IBD type. Patients with UC who were asymptomatic were more likely to have PSC, OR = 3.45, 95% CI (1.33-8.93), while those with rectal bleeding were less likely, OR = 0.13, 95% CI (0.03-0.62). Conclusion: Our study demonstrated that high IgG level is predictive of developing PSC in patients with IBD while smoking is protective. In addition, PSC was shown to develop in patients with quiescent disease. Further prospective studies are required to further investigate our findings.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».