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Peer-reviewedCC BY 4.0Frontiers in Immunology

Age-stratified analysis reveals heterogeneity in factors associated with gastrointestinal bleeding in IgA vasculitis: a retrospective study in a large volume center

  • Jinxi Zhao1
  • Lulu Rao1
  • Ruiheng Xie1
  • Quxin Juhou1
  • Dongqing Wang1
  • Xiaomin Shi1
  • Wei Zhang1
  • Lei Shi1
  • Yan Peng1
  • Xiaohong Wang2
  • Xiaowei Tang1,3
  1. 1Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University
  2. 2Department of Gastroenterology, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University
  3. 3Department of Endoscopic Medicine, the Affiliated Hospital of Southwest Medical University
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Abstract

Background: Gastrointestinal (GI) bleeding represents a severe complication of IgA vasculitis (IgAV). Most current analyses of risk factors aggregate patients across all ages, potentially obscuring critical age-specific differences. This study aimed to delineate factors independently associated with GI bleeding in IgAV across distinct age groups.

Methods: We conducted a retrospective study involving 964 IgAV patients stratified into four age cohorts: preschool (3–6 years, n=192), school-age (7–12 years, n=313), adolescent (13–17 years, n=202), and adult (>18 years, n=257). Univariable analyses were followed by Firth’s penalized logistic regression within each age cohort to evaluate factors associated with GI bleeding. Model discrimination was evaluated using the area under the receiver operating characteristic curve (AUC), with optimism correction performed via 1,000 bootstrap resamples.

Results: The pattern of factors associated with GI bleeding differed across age strata. In preschool children, NAR was significantly associated with GI bleeding (OR = 5.88). In school-age children, NAR (OR = 2.02), summer onset (OR = 2.47), and medium and high SII (OR = 2.72/3.70) were associated with GI bleeding. In adolescents, high SII (OR = 6.22) and log(FIB/GLO) (OR = 4.57) remained significant, while in adults, high SII was the predominant associated factor (OR = 9.53). These principal associations remained significant after FDR correction for multiple comparisons. The optimism-corrected AUC values of the age-specific models ranged from 0.686 in preschool children to 0.784 in adults.

Conclusion: The factors associated with GI bleeding in IgAV showed heterogeneous patterns across age strata, with neutrophil-related inflammatory markers more prominent in younger children and systemic inflammatory and coagulation-related markers more prominent in older groups. These exploratory findings support further investigation of age-specific risk assessment in IgAV.

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Cite

BibTeXRIS
BibTeX
@article{zhao2026agestratified,
  title = {{Age-stratified analysis reveals heterogeneity in factors associated with gastrointestinal bleeding in IgA vasculitis: a retrospective study in a large volume center}},
  author = {Jinxi Zhao and Lulu Rao and Ruiheng Xie and Quxin Juhou and Dongqing Wang and Xiaomin Shi and Wei Zhang and Lei Shi and Yan Peng and Xiaohong Wang and Xiaowei Tang},
  journal = {Frontiers in Immunology},
  year = {2026},
  month = oct,
  doi = {10.3389/fimmu.2026.1883230},
  url = {https://www.frontiersin.org/articles/10.3389/fimmu.2026.1883230/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Age-stratified analysis reveals heterogeneity in factors associated with gastrointestinal bleeding in IgA vasculitis: a retrospective study in a large volume center
AU  - Jinxi Zhao
AU  - Lulu Rao
AU  - Ruiheng Xie
AU  - Quxin Juhou
AU  - Dongqing Wang
AU  - Xiaomin Shi
AU  - Wei Zhang
AU  - Lei Shi
AU  - Yan Peng
AU  - Xiaohong Wang
AU  - Xiaowei Tang
PY  - 2026
DA  - 2026/10/21
JO  - Frontiers in Immunology
DO  - 10.3389/fimmu.2026.1883230
UR  - https://www.frontiersin.org/articles/10.3389/fimmu.2026.1883230/full
AB  - Background: Gastrointestinal (GI) bleeding represents a severe complication of IgA vasculitis (IgAV). Most current analyses of risk factors aggregate patients across all ages, potentially obscuring critical age-specific differences. This study aimed to delineate factors independently associated with GI bleeding in IgAV across distinct age groups.  Methods: We conducted a retrospective study involving 964 IgAV patients stratified into four age cohorts: preschool (3–6 years, n=192), school-age (7–12 years, n=313), adolescent (13–17 years, n=202), and adult (>18 years, n=257). Univariable analyses were followed by Firth’s penalized logistic regression within each age cohort to evaluate factors associated with GI bleeding. Model discrimination was evaluated using the area under the receiver operating characteristic curve (AUC), with optimism correction performed via 1,000 bootstrap resamples.  Results: The pattern of factors associated with GI bleeding differed across age strata. In preschool children, NAR was significantly associated with GI bleeding (OR = 5.88). In school-age children, NAR (OR = 2.02), summer onset (OR = 2.47), and medium and high SII (OR = 2.72/3.70) were associated with GI bleeding. In adolescents, high SII (OR = 6.22) and log(FIB/GLO) (OR = 4.57) remained significant, while in adults, high SII was the predominant associated factor (OR = 9.53). These principal associations remained significant after FDR correction for multiple comparisons. The optimism-corrected AUC values of the age-specific models ranged from 0.686 in preschool children to 0.784 in adults.  Conclusion: The factors associated with GI bleeding in IgAV showed heterogeneous patterns across age strata, with neutrophil-related inflammatory markers more prominent in younger children and systemic inflammatory and coagulation-related markers more prominent in older groups. These exploratory findings support further investigation of age-specific risk assessment in IgAV.
SN  - 1664-3224
ER  -