Background: Nonalcoholic fatty liver disease (NAFLD) is common in adults with polycystic ovary syndrome (PCOS), and several studies on adults have investigated its influencing factors. However, factors associated with NAFLD in adolescents with PCOS remain unknown.Purpose: This study aimed to investigate the presence of NAFLD in adolescents with PCOS using the noninvasive methods of vibration-controlled transient elastography (VCTE) and ultrasonography (USG), along with assessing NAFLD-related metabolic and hormonal risk factors.Methods: This study included patients aged 12–18 years who were diagnosed with PCOS according to the Rotterdam criteria. The control group included young women with similar age and body mass index (BMI) z scores, who had menstruated regularly for more than 2 years. Patients with PCOS were divided into hyperandrogenemia and nonhyperandrogenemia groups based on serum androgen level. USG was performed on all patients to evaluate the presence of hepatic steatosis. Liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) were assessed using VCTE (Fibroscan). Clinical, laboratory, and radiological data were compared between groups.Results: This study included 124 adolescent girls aged 12–18 years (61 with PCOS, 63 controls). BMI z scores were similar between groups. Waist circumference and total cholesterol, triglyceride, and alanine aminotransferase levels were higher in the PCOS versus the control group. The presence of hepatic steatosis on USG was similar between groups. However, the rate of hepatic steatosis on USG was higher in patients with hyperandrogenic PCOS (P=0.01). LSM and CAP measurements were similar between groups.Conclusion: No increase in prevalence of NAFLD was observed among adolescents with PCOS. However, hyperandrogenemia is a risk factor for NAFLD. Therefore, adolescents with PCOS and elevated androgen level should be screened for NAFLD.

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.

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.

Sindirim Sistemi Hastalıklarında Oral Bulgular Eyyüp TAŞDEMİR Gastroözofageal Reflü Hastalığı Feridun GÜRLEK Gardner Sendromu Arda YAVUZ Peutz-Jeghers Sendromu Kübra AKAN Hemorajik Hastalıklar Sibel AKPINAR TEKGÜNDÜZ AIDS Muammer ÇELİK Kollajen Doku Hastalıkları Suade Özlem BADAK Vitamin Eksiklikleri ve Malabsorbsiyonlar Murat KEMAHLI İnflamatuvar Barsak Hastalıkları Erhan ERGİN Kurşun Zehirlenmesi Uğur GÜLÖKSÜZ Plummer Vinson Sendromu Çınar YILDIRIM Halitozis Çınar YILDIRIM Disfaji Fatih KIVRAKOĞLU Odinofaji Nuran AY Globus Sensation-Boğazda Kitle Duygusu Hüseyin Samet KOCA Arzu OR KOCA Retrosternal Yanma (Heartburn) Işıl KİBAR AKILLI Kalp Dışı Göğüs Ağrısı Müge BİLGE Bulantı ve Kusmaya Yaklaşım Elif Tuğba TUNCEL İshal – Diyare Pınar ERGEN Konstipasyon Tedavi Sibel GÜRAY MUNGAN Dispepsi Sevil ÖZER SARI Meteorizm ve Aşırı Gaz Ülkü BULUT BATUR Aerofaji-Hava Yutma, Geğirme Mehmet Önder EKMEN Flatulans Mehmet KÖSTEK Akut ve Kronik GİS Kanamalar Bahar BEKTAN KANAT Hematokezya Halit Eyyüp MUNGAN Okült Kanamalar Saygın ALTINER Gaitada Gizli Kanama Nazif YALÇIN Özofajit ve Hiatus Hernisi/Mallory Weiss Sendromu Berrin YALINBAŞ KAYA Ersin AKGÖLLÜ Portal Hipertansiyona Bağlı Kanamalar Yavuz ÇAĞIR Hemorajik ve Erozif Gastrit Yonca YILMAZ ÜRÜN Malignitelere Bağlı GİS Kanamalar Rabia KÖKSAL Hemobilia ve Aortoenterik Fistüller Yusuf Murat BAĞ Vasküler Anomali ve Ektaziler Hatice KÖSTEK Alt GIS Kanama Yapan Nedenler Dursun Burak ÖZDEMİR Kilo Kaybına Neden Olan Psikiyatrik Bozukluklar Neslihan CANSEL Visseral Ağrılar ve Somatoparietal Ağrı Barış TÜRKER Akut Abdominal Ağrılı Hastaya Yaklaşım ve Fizik Muayene Kutay SAĞLAM Akut Apandisit Ahmet KARAYİĞİT Akut Kolesistit Hüsnü Çağrı GENÇ Akut Pankreatit Sanem KAYHAN Duodenum Ülseri Perforasyonu Ahmet Cem ESMER İnce Barsak Obstrüksiyonu Kutay SAĞLAM Akut Divertikülit Jale AYALOĞLU Akut Mezenter İskemisi ve Abdominal Aort Anevrizması Hilal KURTOĞLU GÜMÜŞEL Kadınlarda Genital Nedenli Karın Ağrıları Sümeyye ÇİÇEK Spontan Bakteriyel Peritonit Harun KÜÇÜK Toraks ve Pulmoner Kökenli Karın Ağrıları (Kardiyak Harici) Işıl KİBAR AKILLI Nörolojik Kökenli Karın Ağrıları Osman Bilge KAYA Metabolik Nedenlere Bağlı Karın Ağrıları Mustafa Gürkan HAYTAOĞLU Hematolojik Nedenlere Bağlı Karın Ağrıları Lale AYDIN KAYNAR Toksinlere Bağlı Karın Ağrısı Burçin UYGUN Enfeksiyonlara Bağlı Karın Ağrıları Özlem AYDIN Ailesel Akdeniz Ateşi Recep EVCEN Kronik Yineleyici Karın Ağrıları ve Kronik Devamlı Karın Ağrıları Salih CIRIK Kronik Epigastrik Ağrı Timur ORHANOĞLU Peptik Ülser Ağrısı ve Mide Kanseri Evren PEKER Akut ve Kronik Gastritler Gözde TÜRKEL Akut ve Kronik Mezenterik İskemiler Murat DEVECİ Sağ Üst Kadran Ağrıları Murat KESKİN Karın Sağ Alt Kadran Ağrıları Banu TAŞKIRAN TATAR Sol Üst Kadran Karın Ağrıları Rahmi ASLAN Sol Alt Kadran Ağrısı Ayşe KEFELİ Hipogastrium Ağrıları Ayşe Nilgün KUL GİS Endoskopik İnceleme ve GİS Endoskopi Endikasyonları Fatih COŞKUN Endoskopi Kontrendikasyonlar ve Komplikasyonları Bünyamin SARITAŞ ERCP (Endoskopik Retrograd Kolanjio-Pankreatografi) Fatma ERSEVEN Karın İnspeksiyonu Sabri Engin ALTINTOP Karın Palpasyonu Seval AKPINAR Karın Perküyonu (Perküsyon) Başak ÇAKIR GÜNEY Karın Oskültasyonu Mehmet ALPUA

This comprehensive study delves into the potential link between Neuromedin U (NmU) serum levels and the development of non-alcoholic fatty liver disease (NAFLD), a condition of increasing global prevalence and significant public health concern. The research provides a nuanced understanding of the disease's etiology by examining a cohort of 112 participants, including individuals with and without NAFLD. The study meticulously considers a spectrum of variables such as demographic factors, body composition metrics, and blood parameters. Advanced diagnostic tools like Fibroscan® are employed to ascertain NAFLD presence, ensuring accurate and reliable results.