Background: The aim of this study was to evaluate the prevalence of osteopenia and osteoporosis in adult patients with celiac disease (CD) at diagnosis and/or in the follow-up after a gluten-free diet (GFD). Methods: Adult patients diagnosed with CD were retrospectively screened through follow-up records and computer databases. Patients assessed by dual-energy X-ray absorptiometry (DEXA) at diagnosis and/or in the follow-up after a GFD were included in the study. Results: One hundred patients who underwent a DEXA scan at least once after diagnosis or after being on a GFD were included in the study. The mean age of the patients at diagnosis was 34.61 ± 10.3 years, and 84% of the patients (n = 84) were female. At the time of diagnosis (n = 46), the prevalence of osteopenia and osteoporosis was 67.3% and 15.2%, respectively, at the lumbar spine, and 43.4% and 10.8%, respectively, at the femur. After a GFD (n = 78), the prevalence of osteopenia and osteoporosis was 61.5% and 8.9%, respectively, at the lumbar spine, and 37.1% and 2.5%, respectively, at the femur. Conclusion: The prevalence of CD patients with low bone mineral density (BMD) is high after diagnosis and in the follow-up after a GFD. It is important for all patients with CD to undergo a DEXA scan to determine the follow-up and/or treatment characteristics. Cite this article as: Sayar S, Aykut H, Kaya Ö, et al. Bone mineral density screening and the frequency of osteopenia/osteoporosis in Turkish adult patients with Celiac disease. Turk J Gastroenterol. 2021; 32(7): 600-607.

Background and Objectives: Percutaneous endoscopic gastrostomy (PEG) is a widely accepted method for long-term enteral nutrition, but procedure-related complications and early mortality remain major concerns. Nutritional and inflammatory indices such as serum albumin, C-reactive protein (CRP), Prognostic Nutritional Index (PNI), and Nutrition Risk Screening (NRS-2002) may provide prognostic value, yet comparative data in PEG cohorts are limited. This study aimed to identify predictors of complications and 90-day mortality after PEG and to compare the prognostic performance of nutritional indices. Materials and Methods: A retrospective cohort of 122 consecutive adult patients undergoing PEG between January and December 2024 was analyzed. Demographic, clinical, and laboratory parameters were collected, including albumin, CRP, PNI, and NRS-2002. Complications were categorized as early (≤30 days) or late (>30 days), and all-cause mortality was assessed at 30 and 90 days. Univariate and multivariate logistic regression models were used to evaluate predictors of complications and 90-day mortality. To address multicollinearity, albumin, PNI, and NRS-2002 were separately tested in adjusted models, with model performance assessed by AIC, BIC, Nagelkerke R², and C-index. Results: Early complications occurred in 4.9% and late complications in 8.2% of patients, for a total complication rate of 13.1%. Thirty-day mortality was 4.1%, 90-day mortality 17.2%, and total in-hospital mortality during the study year 30.3%. Neuromuscular indication was independently associated with increased risk of complications (aOR 5.0, 95% CI 1.2–20.0, p = 0.028) but reduced 90-day mortality (aOR 0.15, 95% CI 0.03–0.80, p = 0.025). Lower baseline albumin independently predicted higher 90-day mortality (aOR 0.92, 95% CI 0.86–0.99, p = 0.034). Elevated CRP demonstrated a borderline association with mortality (p = 0.051), while NRS-2002 ≥5 and Δ-PNI showed borderline trends toward increased mortality risk. In model comparison, none of the nutritional indices achieved independent statistical significance, but all demonstrated similar performance (AIC = 114, C-index 0.72–0.74). Conclusions: PEG outcomes are strongly influenced by baseline indication and nutritional–inflammatory status. Neuromuscular patients and patients with dysphagia face higher complication risk but lower short-term mortality, while hypoalbuminemia, elevated CRP, and high NRS-2002 or declining PNI identify patients at greater risk of death. Systematic integration of albumin, CRP, PNI, and NRS-2002 may improve risk stratification and management in PEG candidates.

Background/Objectives: Acute severe ulcerative colitis (ASUC) is a high-risk condition associated with intense inflammation and a substantial risk of early colectomy. Intravenous steroids (IVS) remain the first-line therapy; however, steroid nonresponse is common. While the C-reactive protein-to-albumin ratio (CAR) has been proposed as a prognostic marker, data on its dynamic changes and late-phase performance remain limited. This study aimed to evaluate the serial performance of albumin and CAR at days 3 and 7 and to assess their association with early and delayed steroid response in a real-world cohort of biologic-naive ASUC patients. Methods: Biologic-naive patients hospitalized with ASUC between 2010 and 2023 were retrospectively analyzed. Disease severity and treatment response were defined using Truelove–Witts and Oxford criteria. Clinical and biochemical parameters, including albumin, CAR, and neutrophil-to-lymphocyte ratio (NLR), were assessed at baseline and on days 3 and 7. Associations with steroid response were evaluated using ROC analysis and multivariable logistic regression. Results: Ninety-eight patients were included. The IVS response rate was 11.2% on day 3 and 56.1% by day 7. Among nonresponders, 25% required infliximab rescue therapy, and colectomy occurred in 12.2%. Although day 3 CAR showed a trend toward discrimination, this did not reach statistical significance (p = 0.098) and should be considered exploratory. By day 7, responders had significantly higher albumin levels and lower CAR values (p < 0.05). Albumin (AUC = 0.702) and CAR (AUC = 0.713) demonstrated comparable performance. In multivariable analyses, day 7 albumin and CAR were significantly associated with steroid response, whereas NLR was not associated. Conclusions: Albumin and CAR are clinically relevant biomarkers associated with steroid response in ASUC. Early changes, particularly in CAR, may provide preliminary signals of nonresponse but require cautious interpretation. In contrast, day 7 measurements appear to reflect ongoing inflammatory dynamics and treatment evolution rather than true baseline predictors. Serial assessment of these biomarkers may support treatment monitoring and help optimize the timing of rescue therapy.

Background/Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) highlights the central role of metabolic dysregulation in hepatic steatosis. Patients with inflammatory bowel disease (IBD) are increasingly recognized to have an adverse cardiometabolic risk profile; however, data regarding MASLD prevalence and associated factors in this population remain limited, particularly in regions with a high metabolic burden such as Türkiye. This study aimed to determine the prevalence of MASLD in patients with IBD and to identify the metabolic and disease-related factors associated with its development. Methods: In this retrospective cross-sectional study, adult patients with IBD followed at a tertiary referral center in Türkiye were included. Hepatic steatosis was assessed using routine abdominal imaging, and MASLD was defined according to the 2023 Delphi Consensus criteria. Clinical, demographic, and metabolic variables were analyzed. Multivariable logistic regression analysis was performed to identify factors independently associated with MASLD. Results: A total of 194 IBD patients who had abdominal imaging available within the previous 6 months were included, of whom 61.3% had MASLD. MASLD was more prevalent in patients with UC than in those with CD (70.7% vs. 55.5%, p = 0.036). However, UC diagnosis was not independently associated with MASLD after multivariable adjustment. Patients with MASLD were older and had higher body mass index and less favorable metabolic profiles. In multivariable analysis, age (OR 1.055, 95% CI 1.022–1.089; p < 0.001), body mass index (OR 1.199, 95% CI 1.092–1.316; p < 0.001), and triglyceride levels (OR 1.012, 95% CI 1.004–1.020; p = 0.005) were independently associated with MASLD. In contrast, disease-related factors, including disease activity, biologic therapy, and prior surgery, were not independently associated with MASLD. Conclusions: MASLD prevalence was high among selected IBD patients with available abdominal imaging and appears to be more strongly associated with metabolic risk factors than with disease-specific characteristics. In populations with a high background cardiometabolic burden, MASLD in IBD may largely reflect the underlying regional metabolic milieu. These findings support the integration of metabolic risk assessment and proactive MASLD screening into routine IBD care. Prospective longitudinal studies are needed to clarify the causal relationship between metabolic dysfunction, IBD-related factors, and MASLD progression.