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: The objective of this study was to examine the efficacy of a synbiotic in addressing recurrent abdominal pain in children, including functional abdominal pain, and to assess its impact on serum levels of pro-inflammatory and anti-inflammatory cytokines. Methods: We included 80 patients diagnosed with Functional Abdominal Pain Not Otherwise Specified according to the Rome IV criteria and divided the sample into two groups: the synbiotic group (Lactobacillus helveticus, Lactobacillus casei, Bifidobacterium lactis, chicory inulin) (Group 1) and the placebo group (Group 2). We inquired about pre-intervention and post-intervention symptoms in both groups and measured their blood cytokine levels. All statistical analyses were performed using SPSS 23 for Windows. Results: The 80 patients with functional abdominal pain had a mean age of 11.48 ± 3.86 years. The groups were compared for the severity of symptoms before and after the intervention, and no statistical difference was found (p>0.05). There was no significant difference between the synbiotic group and the placebo group in terms of pre-intervention serum pro-inflammatory or anti-inflammatory cytokine levels (TNF α, IFN γ, IL-10, TGF β, IL-13), and no statistically significant difference was determined after 8 weeks of synbiotic or placebo administration (p>0.05). A comparison was made of pre-treatment and post-treatment cytokine levels in each group. The most significant finding was the substantial increase in IL-13 levels post-treatment in the synbiotic group (p < 0.001). Conclusion: In the present study, no differences were found between the symbiotic and placebo groups with regard to functional abdominal pain symptoms or serum cytokine levels. However, a significant increase in IL-13 levels was detected after treatment in the symbiotic group. There is a need for further research on the optimal dosage and duration of synbiotic application, the type of probiotic that should be administered, and its effect on cytokine levels in functional gastrointestinal diseases.

It has been demonstrated that elevated serum uric acid (sUA) levels elicit both pro-inflammatory and pro-oxidative effects. A growing body of evidence suggests that this may play a contributory role in the development of Non-alcoholic fatty liver disease (NAFLD) in children with obesity. The objective of the present study is to evaluate the association between sUA levels, the sUA/creatinine (Cr) ratio and paediatric NAFLD. This single-center, cross-sectional, comparative study was conducted at a tertiary care center. The study cohort comprised 228 patients with obesity (body mass index (BMI) ≥ 95th percentile) and 167 healthy controls without obesity or overweight. Both groups were 9–18 years of ages, matched for sex and pubertal stage. A diagnosis of NAFLD was made following an ultrasound examination of the liver, with other possible causes of hepatic disease being excluded. A significantly elevated level of sUA, and sUA/Cr values weres observed in the group of patients with obesity in comparison to the control group ( p < 0.001). In the group with obesity, NAFLD was detected by abdominal ultrasonography in 169 (74.2%) patients, whereas NAFLD was not detected in 59 (25.8%) patients. The levels of sUA and sUA/Cr were significantly elevated in the obese NAFLD group in comparison to the obese non-NAFLD and control groups ( p < 0.001). An elevated WC, ALT, and the ratio of sUA/Cr were associated with an increased risk of NAFLD. A one-unit increase in sUA/Cr was found to be associated with an increased risk of NAFLD (OR = 1.323, 95% CI: 1.001–1.748). The findings of our study indicate that an elevated WC, ALT, and the ratio of sUA/Cr were associated with an increased risk of NAFLD. Nevertheless, no such correlation was identified between sUA and NAFLD.

Giriş ve Amaç: Helicobacter pylori(H.pylori) enfeksiyonu tüm dünyada en yaygın kronik enfeksiyonlardan biridir. Gelişmekte olan ülkelerde bulaş genellikle çocukluk döneminde olmaktadır. Düşük sosyoekonomik seviyede yaşayanlarda daha sık görülmektedir. Tamamen asemptomatik olabileceği gibi, gastrointestinal ve ekstraintestinal semptomlarla karşımıza çıkabileceği de bilinmektedir. Bu çalışmada çocuklarda H.pylori seroprevalansının saptanması, risk faktörleri ve semptomların değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya Bursa ilinde beş farklı ilköğretim okulundan randomizasyonla 6-16 yaş arası 489 öğrenci alındı. Kabul eden ailelerden sosyoekonomik bilgileri ve çocuklarındaki semptomları sorgulayan anketleri doldurmaları istendi. Okullara gidilerek çocukların antropometrik ölçümleri yapıldı. H.pylori İmmunglobulin G (IgG) çalışılmak üzere çocuklardan 5 ml kan örneği alındı. Çocuklar H.pylori IgG pozitifliğine göre 2 gruba ayrılarak sosyoekonomik özellikler ve semptomlar karşılaştırıldı. Bulgular: Çalışmaya 489 öğrenci alındı, %48,7 kız ve %51,3 erkekti. Yaş ortalaması 9,9±2,3 yıldı. H. pylori seropozitifliği %44 çocukta saptandı. Kızların %52,1’i, erkeklerin %36,3’ü seropozitif bulundu (p=0,0001). Sosyoekonomik faktörlerden babanın eğitim düzeyi azaldıkça çocukta H. pylori sıklığının arttığı saptandı (p=0,005). H. pylori seropozitif olanlarda boy ve vücut ağırlığı Z skorları negatif olanlara göre anlamlı olarak düşüktü (p=0,012 ve p=0,03;sırasıyla). Yaş gruplarına göre bakıldığında H.pylori seropozitiflerde 6-10 yaşta vücut ağırlığının ( p=0,03), 10 yaşından büyüklerde ise boy uzunluğunun (p=0,04) daha geri olduğu saptandı. Sonuç: Bursa ilinde ilköğretim çağında saptanan H.pylori seropozitivite sıklığı Türkiye verileri ile uyumludur. Vücut ağırlığı ve boy uzunluğunun seropozitiflerde daha geri olduğu görülmüştür. Seropozitivitenin 10 yaştan küçük çocuklarda vücut ağırlığını, 10 yaştan büyük olanlarda ise boy uzunluğunu ön planda etkilediği görülmüştür. Sonuç olarak çocuklarda H.pylori, bulaş sonrası asemptomatik kalabilen ancak çocuklarda büyümeyi olumsuz etkilediği unutulmaması gereken önemli bir faktördür.