Gastroenterology Insights

Background: Vitamin D (VD) insufficiency is present in chronic pancreatitis (CP), leading to increased cardiovascular risk, bone complications, impaired quality of life, and increased mortality. This study aimed to determine the prevalence of VD deficiency in patients with CP and to assess its relationship to CP progression and associated cardiovascular complications. Methods: Seventy patients were enrolled and evaluated for pancreatic exocrine insufficiency by fecal elastase-1, CP severity by M-ANNHEIM classification, cardiovascular risk by 10-year risk mortality scores (SCORE and FRS), and for arterial stiffness using pulse wave velocity (PWV) at a. carotis and a. femoralis. Determination of 25-hydroxyvitamin D was performed by an LC-MS/MS method. Resting energy expenditure was calculated using the Harris–Benedict formula. Results: Mean VD levels were 37.86 ± 24.36 nmol/L (range 3.854–99.874 nmol/L); only five patients were in sufficiency status. VD levels correlated significantly with body mass index (BMI) and resting energy expenditure. In patients with severe structural changes, we observed lower VD levels regardless of etiology (p < 0.01). VD levels were lower in patients with pancreatic exocrine insufficiency (PEI), p < 0.05. Patients with mild CP by M-ANNHEIM had lower levels of VD compared to moderate and advanced CP, p < 0.05. At a cut-off of VD 11.95 nmol/L, we verified pancreatic lithiasis with 89.4% sensitivity, 83.3% specificity, and AUC of 0.826 ± 0.113 (95% CI, 0.61–1). VD status worsened with the increase in the 10-year risk mortality by both SCORE and FRS and PWV, p < 0.05. Conclusions: Most of our patients with CP were VD insufficient. Monitoring of nutritional status in patients with CP is mandatory to prevent the development of malnutrition complications and the associated morbidity and mortality.

Background/Objectives: Helicobacter pylori infection is a key etiological factor in upper gastrointestinal bleeding (UGIB) due to its role in mucosal injury and ulcer formation. Despite its clinical relevance, data from the Colombian Caribbean are limited. This study aimed to describe the incidence and clinical–endoscopic features of H. pylori-associated UGIB in a high-complexity hospital in Barranquilla, Colombia. Methods: A retrospective cohort study was conducted including adults (≥18 years) admitted for UGIB between 2021 and 2023. Demographic, clinical, and endoscopic variables were obtained from institutional records. Non-parametric tests (Fisher’s exact, Wilcoxon rank-sum) were applied to compare sex and admission diagnosis. Multiple-correspondence analysis explored associations among clinical and pathological parameters. Significance was set at p < 0.05. Results: Among 329 patients with UGIB, 44 (13%) tested positive for H. pylori. The median age was 60 years, and 57% were male. Melena (48%) and hematemesis (45%) were the main presenting symptoms. Hypertension was significantly more frequent in men (45% vs. 15%, p = 0.04), while chronic gastritis was the most common histopathological finding (75%), followed by gastrointestinal ulcer (23%) and intestinal adenocarcinoma (16%). The majority of ulcers were Forrest IIA (50%), followed by III (40%) and IB (10%), with no sex differences (p > 0.92). Multiple correspondence analysis revealed that male patients tended to present melena and chronic gastritis, whereas females and older adults were more likely to exhibit hematemesis. Conclusions: H. pylori-associated UGIB in this cohort primarily affected older adults with chronic gastritis and hypertension. Recognition of these clinical–pathological profiles may guide early detection, targeted therapy, and prevention strategies in similar regional contexts.

Objectives: Liver steatosis is one of the main causes of liver disease with several clinical implications, such as steatohepatitis, liver cirrhosis, and hepatocellular carcinoma. It is associated with increased cardiovascular risk. Reliable, non-invasive methods to classify and evaluate improvement or worsening of liver steatosis at the diagnosis and during follow-up are therefore essential. This study aims to evaluate the accuracy of ultrasound fat fraction (USFF) in a population of patients with moderate to morbid obesity. Method: A total of 95 obese patients were evaluated for liver steatosis with ultrasound visual assessment and USFF measurement using the Samsung RS85 Prestige system. 84 patients were included (exclusion criteria were morphological features of advanced liver disease or cirrhosis, active viral hepatitis, alcohol use disorder, liver enzymes alteration and heart failure) Based on the visual assessment, patients were classified into four categories: absent, mild, moderate, and severe steatosis. The distribution of USFF values across groups was analyzed using one-way ANOVA with post-hoc comparisons. Receiver Operating Characteristic (ROC) curves were generated, and the Youden index was applied to determine optimal USFF cut-off points for each steatosis grade. Results: Mean USFF values increased progressively across the severity spectrum and significant differences in mean USFF values were observed across all four steatosis grades groups (p < 0.001). Based on the Youden index, the following cut-offs have been proposed: no steatosis USFF < 7.33, mild steatosis USFF < 11.66, moderate steatosis USFF < 16.30. Conclusions: Our findings suggest that USFF may offer a valuable tool for objectively quantifying liver fat content with a more easily comparable parameter, improving the accuracy of steatosis grading and follow-up.