Emre Sarandöl

This study aimed to compare the acute effects of two 4v4 small‐sided game (SSG) formats, touch‐restricted SSG (SSGt) and free‐play SSG (SSGf), on serum brain‐derived neurotrophic factor (BDNF) levels, cognitive performance, and technical actions in young male soccer players. Thirty‐two young male soccer players completed two 4v4 SSG conditions in a randomized crossover design: SSGt (a maximum of two ball touches per possession) and an SSGf. Serum BDNF was measured before and after each session. Executive function was assessed with the Stroop task, cognitive load was evaluated with the Rating Scale of Mental Effort (RSME), and technical actions were analyzed through match performance metrics. Internal load was monitored using heart rate, rating of perceived exertion, and blood lactate levels. Serum BDNF increased significantly only in the SSGt condition, with higher post‐exercise values than in the SSGf condition. Mental effort was also significantly greater in SSGt. Executive function performance improved only in SSGt, as reflected by faster completion time in the incongruent color‐word interference condition, whereas errors and corrections did not differ between conditions. Moreover, SSGt showed higher numbers of successful passes and shots, fewer unsuccessful passes, and lost balls, whereas interceptions were higher in SSGf. In conclusion, 4v4 SSG with a touch restriction may be a useful strategy for shaping acute neurotrophic, executive‐function, and technical‐action responses in soccer players. These findings suggest that touch restrictions may help coaches broaden the training stimulus of SSG by increasing cognitive demands without reducing technical effectiveness. Trial Registration: This study was retrospectively registered at ClinicalTrials.gov (Identifier: NCT07395765)

Background: This study aimed to compare the immediate effects of small-sided games (SSGs) and running-based high-intensity interval training (HIITrb) on serum brain-derived neurotrophic factor (BDNF) levels, cognitive performance, and enjoyment in young, male soccer players. Methods: Twenty-four soccer players [age: 19.2 ± 0.8 years] completed one session each of four-a-side SSG or HIITrb in a randomized, counterbalanced, and crossover design, with a one-week washout period. Blood samples and Trail Making Tests (TMTs) A and B were measured before and after exercise. Heart rate (HR) was monitored throughout the games, and ratings of perceived exertion (RPE) and enjoyment were collected at the end of the measurements. Results: The results show no significant effects of time (p > 0.775), group (p > 0.276) or time × group interaction (p > 0.199) on BDNF levels. For TMT-A, the time effect (p = 0.866) and group effect (p = 0.057) were not significant; however, the time × group interaction was significant (p < 0.019), indicating a superior performance in the SSG compared to HIITrb. In the TMT-B, significant effects were observed for both time (p < 0.001) and group (p < 0.001), while the time × group interaction effect was not statistically significant (p > 0.061). Furthermore, enjoyment levels did not differ significantly between conditions (p = 0.976). Conclusions: These findings suggest that four-a-side SSG may enhance processing speed compared to HIITrb without changes in serum BDNF levels. Coaches may consider using 4v4 SSG formats in early training sessions or warm-ups to stimulate processing speed and mental readiness in young soccer players.

Background/Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) in adolescents, including non-obese phenotypes, is an increasingly important public health issue. The current study investigated the use of controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) as non-invasive tools, along with fibroblast growth factor-21 (FGF-21) and cytokeratin-18 (CK-18), in non-obese MASLD, obese MASLD, and healthy control groups, exploring metabolic and hepatic profiles in these groups. Materials and Methods: This cross-sectional study recruited 195 adolescents aged 9-18 years, stratified into controls (n = 92), non-obese MASLD (n = 32), and obese MASLD (n = 39) groups according to FibroScan and MASLD diagnostic criteria. FibroScan measured LSM and CAP, while enzyme-linked immunosorbent assay kit (ELISA) was used to analyze serum FGF-21 and CK-18 levels. Anthropometric, metabolic, and liver enzyme parameters were assessed. Results: Metabolic dysfunction-associated steatotic liver disease groups had higher LSM than controls. Fibroblast growth factor-21 levels were significantly higher in MASLD groups, especially in obese MASLD, while CK-18 levels showed variability without significant group differences. Obese MASLD adolescents had marked metabolic dysfunction with higher insulin, homeostasis model assessment for insulin resistance, triglycerides, and liver enzymes compared to non-obese MASLD and controls. Conclusion: Fibroblast growth factor-21 has emerged as a potential biomarker for assessing metabolic dysfunction in MASLD, while LSMs from FibroScan provide valuable insights into fibrosis risk. Elevated FGF-21 levels and FibroScan parameters reflect their potential usefulness in non-invasive assessment of MASLD severity, particularly in obese adolescents. However, further longitudinal studies are needed to establish their roles in predicting disease progression and guiding clinical management. Cite this article as: Keskin M, Aysegul Arsoy H, Kara O, et al. Metabolic and hepatic profiles of non-obese and obese metabolic dysfunction-associated steatotic liver disease in adolescents: the role of FibroScan parameters, fibroblast growth factor-21, and cytokeratin-18. Turk J Gastroenterol. 2025;36(3):152-161.

A relationship between endothelial dysfunction and oxidative stress has been shown in the pathogenesis of diabetes and/or hypertension. Antihypertensive drugs (angiotensin-converting enzyme inhibitors [ACEi], angiotensin II type 1 receptor blockers [ARB], and third-generation beta-blockers) can improve oxidative stress. This study evaluated the effects of losartan (ARB) treatment alone and combined with cilazapril (ACEi) or carvedilol on oxidative stress and antioxidants in hypertensive type 2 diabetic patients. Thirty of 56 patients completed the study. All patients received 50 mg losartan daily for 6 weeks, then were randomised into three groups for 6 weeks. In the first group, losartan was increased to 100 mg/day, and in the second and third groups, carvedilol or cilazapril was added to losartan 50 mg/day treatment, respectively. Apolipoprotein B malondialdehyde (basal and Δ-MDA), serum paraoxonase (PON) and arylesterase (AE), erythrocyte superoxide dismutase (SOD) and glutathione peroxidase (Gpx) parameters were studied. The characteristics of the three groups were comparable (p>0.05). Blood pressure (BP) decreased significantly in all three groups before and after randomisation in the six-week periods. The largest BP decrease was seen in the ARB+ACEi group (systolic BP: 16.5±7.4 mmHg, diastolic BP: 10.5±2.8 mmHg), and the smallest decrease was seen in the high-dose ARB group (systolic BP: 9±6.1 mmHg, diastolic BP: 3±4.8 mmHg). Throughout the study, no significant changes were detected in basal and Δ-MDA levels and SOD, Gpx, PON and AE activities in inter- and intra-group comparisons. Our observations showed that different antihypertensive therapy approaches effectively lowered BP in hypertensive type 2 diabetics but did not affect oxidant and antioxidant systems in the short term.

Objective: To define the impact of obesity on inflammatory and oxidative disturbances in antipsychotic‐treated schizophrenia patients.Methods: Several cytokines, inflammatory, metabolic, and oxidative status markers were evaluated in obese (n = 40) and non‐obese (n = 40) antipsychotic‐treated patients and compared with age‐and BMI‐matched controls (n = 80).Results: Schizophrenia patients had higher leptin, TNF‐α, adiponectin, visfatin, resistin, P‐selectin, NPY, BDNF, CD40‐L, MCP‐1, and malondialdehyde, and lower IL‐6, ghrelin, neopterin, and vitamin E levels compared to their respective controls (p < 0.001). Total oxidant status was higher in non‐obese patients compared to controls (p < 0.001), total antioxidant capacity was higher in obese compared to non‐obese patients (p < 0.01), but vitamin A and paraoxonase levels were not different. High sensitive‐CRP levels were higher in obsese controls relative to non‐obese controls (p < 0.05) and in obese patients relative to non‐obese patients (p < 0.001). Fasting glucose, insulin, HbA1c, HOMA‐IR, uric acid, total cholesterol, and triglyceride concentrations were higher in obese patients compared to non‐obese patients. Insulin concentrations and HOMA‐IR were also higher in obese controls than in non‐obese controls.Conclusions: Our results suggest that inflammatory responses and oxidative stress develop independently from obesity in antipsychotic‐treated schizophrenia patients. However, schizophrenia‐induced obesity causes metabolic disturbances; thereby, obese schizophrenia patients are more liable to cardiovascular events and progress of metabolic syndrome than non‐obese patients.

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) and polycystic ovary syndrome (PCOS) share several pathophysiological mechanisms. While the prevalence of MASLD has been extensively studied in PCOS populations, the occurrence of PCOS among female adolescents with transient elastography (TE)-confirmed MASLD in pediatric hepatology settings remains poorly characterized. This cross-sectional study aims to address this knowledge gap and elucidate potential clinical and biochemical differences between female adolescents with MASLD and comorbid PCOS compared to those without PCOS. Methods: The study cohort included 45 female adolescents with TE-diagnosed MASLD. Comparative analyses of clinical and laboratory parameters were performed between those with (n = 19) and those without (n = 26) comorbid PCOS, diagnosed according to the Rotterdam criteria. Results: Adolescents with MASLD and comorbid PCOS exhibited significantly higher weight, lower height, and increased waist circumference compared to those without PCOS. Additionally, the prevalence of acanthosis nigricans was significantly higher in the PCOS group (68.4% versus 34.6%, p = 0.025). Regarding laboratory parameters, serum phosphorus levels and liver enzymes—including aspartate aminotransferase, alanine aminotransferase, and gamma-glutamyl transferase—were significantly lower in adolescents with comorbid PCOS. However, no significant differences were observed in lipid profiles, glucose metabolism, or novel non-invasive biomarkers of MASLD. Conclusions: This study reveals distinct clinical and biochemical profiles in female adolescents with MASLD and comorbid PCOS compared to those without PCOS. These findings have the potential to inform and refine future screening protocols and diagnostic algorithms for these interrelated conditions, specifically tailored to pediatric hepatology settings.

Strong association between homocysteine (Hcy) and metabolic syndrome (MetS) is documented in individuals with schizophrenia and it is suggested that alterations in Hcy levels might be secondary to metabolic changes induced by atypical antipsychotics (AA). Serum paraoxonase (PON-1) activity, which is negatively affected by increased Hcy concentrations are lower in schizophrenia, and this may impact the development of metabolic side effects. Forty-five subjects with schizophrenia and 43 healthy volunteers, matched according to age, gender, smoking habits, and MetS predictors, were enrolled in this study to examine how Hcy level, PON-1 activity, and MetS indicators influence each other in schizophrenic individuals on AA treatment. Serum Hcy concentrations were significantly higher (15 ± 8 μmol/L vs 12 ± 3 μmol/L), and PON activity tended to be impaired (182±82 U/L vs 216 ± 110 U/L) in schizophrenia. Serum Hcy concentrations were not different between subjects with and without metabolic syndrome in study (14±4 μmol/L and 16±9 μmol/L) and control groups (12±3 μmol/L and 13±7 μmol/L), respectively. Similarly, PON and aryl esterase (AE) activities were not different between subjects with and without metabolic syndrome in study (PON: 185±100 U/L and 181±76 U/L; AE: 84±34 kU/L and 89±20 kU/L) and control (PON: 215±111 U/L and 216±113 U/L; AE: 83±27 kU/L and 88±33 kU/L) groups, respectively. . Hcy levels and MetS predictors were not statistically correlated. Results indicate that schizophrenic subjects on AA treatment have increased levels of Hcy compared to healthy controls and this is not influenced by the presence of MetS.

Background Among one of the common hereditary causes of chronic kidney disease is autosomal-dominant polycystic kidney disease (ADPKD), and its incidence rate is reported as one between 500 and 1.000 individuals. The most common complications of ADPKD are hypertension (HT) and end-stage renal disease (ESRD). HT occurring in the early stage of ADPKD leads to deteriorations in renal function. Aims It was aimed to investigate the ischemia-modified albumin (IMA) levels and the effect of renin–angiotensin–aldosterone system (RAAS) blockers on serum IMA levels in patients with ADPKD. Methods One hundred and fifteen patients were included as ADPKD (n = 50), HT (n = 35), and healthy control (HC) groups (n = 30). Patients with ADPKD and HT were divided into two subgroups as RAAS blocker-users and non-users. Results Serum IMA levels were detected as 0.42 (0.17–0.80) in ADPKD and 0.28 (0.04–0.51) in HT and 0.36 (0.22–0.56) in HC groups as absorbance units (ABSU), and the highest serum IMA level was seen in Group ADPKD. Serum IMA levels were 0.33 ± 0.14 in RAAS blocker-users and 0.41 ± 0.11 ABSU in non-users with ADPKD. Serum IMA levels were witnessed to be significantly lower in RAAS blocker-users in Groups ADPKD (p = 0.038) and HT (p = 0.004), compared to non-users. Given basal and 6-month values of those with ADPKD, the levels of serum IMA within 6 months were significantly lower (p = 0.002). Conclusions We consider that serum IM levels should be assessed in oxidative stress (OS)-related conditions, such as ADPKD, and RAAS blockers may be effective in reducing serum IMA levels in ADPKD and HT patients.

Purpose Shock wave lithotripsy (SWL) is the first option in the treatment of pediatric kidney stones; however, optimal frequency is still uncertain. The aim of this study was to compare low frequency [60 shocks per minute (SWs/min)] and intermediate frequency [90 SWs/min] in terms of lithotripsy success, complications, cardiac arrhythmia, anesthesia time, secondary procedures, and efficiency quotient (EQ) in children. Methods Seventy-eight consecutive children who received SWL for radiopaque renal stones between July 2016 and January 2020 were randomly divided into two groups: Group 60 (SWL frequency: 60 SWs/min) and Group 90 (SWL frequency: 90 SWs/min). After exclusion (remaining 71 children), Group 60 (n = 38) and Group 90 (n = 33) were compared using univariate analysis. Results The median age of children (37 girls, 34 boys) was 5 (1–16) years. Patient demographics and stone features were similar between the groups. Success rate after the last SWL session was 81.6% (n = 31) for Group 60 and 87.9% (n = 29) for Group 90 (p = 0.527). Stone-free rate after the first, second, and third sessions was 42.1%, 18.4%, and 21.1% for Group 60 and 48.5%, 27.3%, and 12.1% for Group 90, respectively. Additional treatment rate was similar between the groups. In Group 60, the EQ was 57.83, and it was 64.07 in Group 90. Median total anesthesia time was significantly longer in Group 60 (74.5 min) than in Group 90 (32 min; p < 0.001). Conclusion Intermediate frequency and low-frequency pediatric SWL have similar success rates; however, intermediate-frequency SWL has a shorter anesthesia time.