Nilsu Kalaycı

Background: Non-alcoholic fatty liver disease (NAFLD) is a global public health issue. Although liver biopsy remains the gold standard for diagnosing hepatosteatosis, its invasiveness, high cost, and associated risks limit its widespread use. Therefore, there is a need for reliable, non-invasive, and cost-effective biomarkers to aid in the early detection of NAFLD. Our objective was to determine the utility of the triglyceride (TG)-to-high-density-lipoprotein (HDL) ratio in predicting non-alcoholic fatty liver disease. Methods: This retrospective cross-sectional study included 2588 patients who met the inclusion criteria. Demographic data and laboratory results were collected from electronic health records. Experienced radiologists performed abdominal ultrasonography to assess fatty liver according to the EASL 2021 criteria. The TG/HDL ratio and other non-invasive scores (APRI, FIB-4, ALT/AST, TG/glucose) were calculated. Early-stage disease was defined as grade 1 or grade 2 hepatosteatosis. Results: The TG/HDL ratio was significantly higher in NAFLD patients (AUROC: 0.682) and outperformed the other non-invasive indices. At the optimal cut-off value of 1.86, the sensitivity was 80.7%, and the specificity was 45.5%. The TG/HDL ratio correlated positively with markers of glycemic control, inflammation, and liver enzymes. Conclusions: The TG/HDL ratio is an accessible and valuable parameter for predicting non-alcoholic fatty liver disease. It offers a non-invasive alternative to liver biopsy and potentially prevents complications from non-alcoholic fatty liver disease or diagnostic approaches.

Background: Non-alcoholic fatty liver disease (NAFLD) is a global public health issue. Although liver biopsy remains the gold standard for diagnosing hepatosteatosis, its invasiveness, high cost, and associated risks limit its widespread use. Therefore, there is a need for reliable, non-invasive, and cost-effective biomarkers to aid in the early detection of NAFLD. Our objective was to determine the utility of the triglyceride (TG) to high-density lipoprotein (HDL) ratio in predicting non-alcoholic fatty liver disease. Methods: This retrospective cross-sectional study included 2588 patients who met the inclusion criteria. Demographic data and laboratory results were collected from electronic health records and recorded. Experienced radiologists performed abdominal ultrasonography to assess fatty liver in line with EASL 2021 criteria. The TG/HDL ratio and other non-invasive scores (APRI, FIB-4, ALT/AST, TG/Glucose) were calculated. Results: TG/HDL ratio was significantly higher in NAFLD patients (AUROC: 0.682), outperforming other non-invasive indices. At the optimal cut-off value of 1.86, sensitivity was 80.7% and specificity 45.5%. The TG/HDL ratio correlated positively with markers of glycemic control, inflammation, and liver enzymes. Conclusions: The TG/HDL ratio is an accessible and valuable parameter in predicting non-alcoholic fatty liver disease. It offers a non-invasive alternative to liver biopsy and potentially prevents complications from non-alcoholic fatty liver disease or diagnostic approaches.

Background/Objectives: Cardiovascular complications are the most common cause of mortality and morbidity in diabetic patients. Therefore, the aim of antidiabetic therapy should not only be to provide glucose regulation but also to protect patients from complications and related mortality. Brain natriuretic peptide (BNP) is a peptide secreted as a result of myocardial stress. BNP levels increase under conditions of increased myocardial stress, such as heart failure. It is an important marker not only at the time of diagnosis but also during follow-up. In our study, we aimed to evaluate BNP levels and thus, the factors affecting the risk of developing heart failure during the course of diabetes. Methods: This study was conducted at the diabetes outpatient clinic of the University of Health Sciences, Haseki Training and Research Hospital. A total of 252 patients met the inclusion criteria and were enrolled in the study. All study participants were patients with a confirmed diagnosis of type 2 diabetes. Laboratory parameters, including BNP values, comorbidities, and anamnesis data, were recorded. Results: The mean BNP levels were significantly lower in patients using metformin and pioglitazone. Other antidiabetic medications were not associated with BNP levels. BNP levels were positively correlated with age and diabetes duration and negatively correlated with hemoglobin levels. According to regression analysis, age, metformin use, and hemoglobin levels were found to independently affect BNP levels. Conclusions: Our findings suggest that metformin could potentially play a significant role in preventing the development of heart failure in diabetic patients currently not experiencing this complication owing to its favorable effects on myocardial stress. This suggests metformin’s potential in preventing heart failure in type 2 diabetic patients.

Background/Objectives: Cardiovascular complications are the most common cause of mortality and morbidity in diabetic patients. Therefore, the aim of antidiabetic therapy should not only be to provide glucose regulation but also to protect patients from com-plications and related mortality. Brain natriuretic peptide (BNP) is a peptide secreted as a result of myocardial stress. BNP levels increase in conditions of increased myocar-dial stress, such as heart failure. It is important not only in diagnosis but also in fol-low-up. In our study, we aimed to evaluate BNP level and, thus, the factors affecting the risk of developing heart failure in the course of diabetes mellitus. Methods: This study was conducted at the University of Health Sciences, Haseki Training and Re-search Hospital diabetes outpatient clinic. Two hundred fifty-two patients met the in-clusion criteria and were enrolled in the study. Laboratory parameters, including BNP values, comorbidities, and anamnesis data, were recorded. Results: The mean BNP levels were significantly lower in patients using metformin and pioglitazone. Other antidiabetic medications were not associated with BNP levels. BNP levels were posi-tively correlated with age and diabetes duration and negatively correlated with hemo-globin. According to regression analysis, age, metformin use, and hemoglobin were found to independently affect BNP levels. Conclusions: Our findings suggest that metformin could potentially play a significant role in preventing the development of heart failure in diabetic patients without heart failure, owing to its favorable effects on myocardial stress. This suggests metformins potential in preventing heart failure in type 2 diabetic patients.

Background/Objectives: Acute pancreatitis (AP) is characterized by pancreatic gland inflammation, and its clinical course ranges from mild to severe. Predicting the severity of AP early and reliably is important. In this study, we investigate the potential use of the Controlling Nutritional Status (CONUT) score as a prognostic marker in acute pancreatitis. Methods: We examined 336 patients who had been hospitalized with an AP diagnosis in the internal medicine clinic. The patients included in the study were followed up for 5 years. The study analyzed the specific variables of age, gender, and AP etiology as recorded biochemical parameters for all study participants and calculated the effects of age, sex, Bedside Index of Severity in AP (BISAP), the revised Atlanta classification, and the CONUT score on mortality. Results: When compared with surviving patients, non-surviving patients had higher scores for BISAP, CONUT, and the Atlanta Classification (p ˂ 0.001). In the non-surviving group, hemoglobin, lymphocyte, and albumin levels were significantly lower and creatinine, uric acid, and procalcitonin levels were significantly higher compared to the surviving group (p ˂ 0.001, 0.003, ˂0.001, ˂0.001, 0.005, ˂0.001, respectively). The multivariate analysis showed a significant association of mortality with age, CONUT, and BISAP scores (p ˂ 0.003, 0.001, 0.012 respectively). The CONUT score was separated into two groups based on the median value. The predicted survival time in the group with a CONUT score > 2 (53.8 months) was significantly lower than in the group with a CONUT score ≤ 2 (63.8 months). The cumulative incidence of all-cause mortality was significantly higher in the patients with higher CONUT scores. Conclusions: This study has assigned the CONUT score as an independent risk factor for mortality in AP.