Background: Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) represents a growing concern in the context of metabolic disorders, particularly among individuals diagnosed with type 2 diabetes mellitus (T2DM). This study aimed to investigate the prevalence of MASLD among newly diagnosed T2DM patients and identify the risk factors for MASLD in this population. Methods: This prospective study included 128 patients with newly diagnosed T2DM between January 2022 and June 2023. Demographic, clinical, anthropometric (BMI, waist circumference), and laboratory data (glucose, HbA1c, lipid profile, ALT, AST, creatinine, platelet count) were collected. MASLD was diagnosed based on ultrasonographic evidence of hepatic steatosis with at least one cardiometabolic risk factor after excluding other causes. Linear regression models were used to determine independent predictors. Results: MASLD was detected in 80.4% of patients. Compared with the MASLD (−) group, the MASLD (+) group had significantly higher ALT (47.1 ± 23 U/L vs. 24.9 ± 8 U/L, p < 0.001) and non-HDL cholesterol (189 ± 57 mg/dL vs. 167 ± 28 mg/dL, p = 0.047). Spearman correlation showed positive associations of MASLD severity with waist circumference, LDL cholesterol, and platelet count. ALT and BMI were independently associated with MASLD in linear regression analysis. Conclusions: This study underscores the significant prevalence of MASLD in newly diagnosed T2DM patients, emphasizing the relevance of early detection in addressing this common comorbidity in the diabetic population.

Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) prevalence data in Türkiye is limited. We aimed to determine the nationwide prevalence of MASLD and advanced hepatic fibrosis risk in subjects with cardiometabolic risk factors (CMRF). Despite recent international consensus redefining fatty liver disease terminology, no nationwide MASLD study has been reported in Türkiye. Methods: This cross-sectional study included 14,371 adults with ≥1 CMRF from 44 centers across 31 cities. MASLD was diagnosed using liver ultrasonography plus cardiometabolic criteria. Advanced fibrosis risk was assessed by fibrosis-4 (FIB-4) score (≥1.3 for ≤65 years; ≥2.0 for >65 years). Logistic regression was used to identify independent predictors of high FIB-4. Results: A total of 61.4% of participants were women, the mean age was 51.3 ± 14.4 years, and the mean BMI was 31.4 ± 6.0 kg/m². MASLD prevalence was 75.7% (n = 10,873), rising with the number of CMRFs (56.5% with one factor vs. 83.4% with all). The prevalence of high FIB-4 scores was 12.0% overall, being lower in MASLD patients than non-MASLD patients (11.2% vs. 14.4%, p < 0.001). FIB-4 scores decreased with increasing BMI (28.1% underweight vs. 8.7% class III obesity). Male sex, T2DM, and hypertension independently predicted high FIB-4 scores, while smoking, higher BMI, and MASLD were inversely associated. Conclusions: Three-quarters of Turkish adults with CMRF have MASLD. Standard FIB-4 thresholds may underestimate fibrosis risk in obese and smoking populations, underscoring the need for adjusted cut-offs or alternative tools. This study is the first to provide nationwide MASLD prevalence data in Türkiye.

Objectives: Obesity is a significant public health concern, as it is associated with the development of numerous chronic diseases. The prevalence of obesity and attendant diseases has been increasing over recent years. This study attempted to ascertain the frequency of chronic diseases in obese patients in Türkiye for the first time on this scale. Methods: A retrospective study was conducted, with patients admitted to the internal medicine outpatient clinics or obesity centers between December 2023 and December 2024 included in this study. Participants were recruited from seven regions, 20 provinces, and 28 centers, and the inclusion criteria were met by those aged 18 years and over with a body mass index (BMI) of 30 kg per square meter (kg/m²) or above. Their status, with respect to chronic diseases, and their anthropometric parameters were documented. Results: The total number of patients was 10,121, with a mean age of 45.2 ± 13.92. Of these, 7222 (71.35%) were female. The prevalence of type 2 diabetes mellitus (T2DM), hypertension (HT), dyslipidemia (DL), coronary artery disease (CAD), obstructive pulmonary disease (OPD), obstructive sleep apnea syndrome (OSAS), and fatty liver disease (FLD) was found to be 35.01%, 78.19%, 12.37%, 10.32%, 5.88%, and 75.12%, respectively. A subsequent analysis of the prevalence of these diseases by region revealed a statistically significant variation between regions (p < 0.001 for all regions). Conclusions: This study represents a substantial contribution to the existing body of knowledge in this field, particularly with regard to the identification of the current chronic disease rate of obese patients in Türkiye.

Background: Obstructive sleep apnea syndrome (OSAS) is associated with altered body composition, including increased fat accumulation and potential reductions in muscle quality. Sarcopenic obesity—a condition marked by simultaneous muscle degradation and adiposity—is of growing concern in OSAS populations. Methods: We conducted a retrospective study evaluating thoracoabdominal CT scans of 71 OSAS patients and 34 age- and sex-matched controls. Erector spinae muscle thickness and subcutaneous fat were measured at the L1 vertebral level. Associations with clinical markers such as BMI, CRP, and oxygen saturation were examined. Results: OSAS patients had significantly greater muscle thickness and subcutaneous fat compared to controls (p < 0.01). Muscle thickness was positively correlated with BMI and waist circumference but inversely associated with CRP and oxygen saturation. Despite structural hypertrophy, these findings suggest impaired muscle quality and support the presence of sarcopenic obesity in OSAS. Conclusions: CT-based imaging provides valuable structural insights but may overestimate muscle function, particularly in obese OSAS patients. These results highlight the need to integrate imaging with functional assessments to accurately diagnose sarcopenia and guide individualized management strategies.

Introduction: Type 2 diabetes mellitus is a chronic metabolic disorder often accompanied by alterations in serum magnesium levels. This study aimed to investigate the relationship between serum magnesium concentration and glycemic control, comorbidities, and medication use in patients with type 2 diabetes mellitus. Methods: A retrospective cross-sectional analysis was conducted using data from 502 patients. Glycemic control was assessed based on HbA1c levels, and serum magnesium concentrations were evaluated concerning clinical and demographic variables. Statistical analyses included ttests, Mann-Whitney U tests, logistic regression, and ROC curve analysis. Results: Patients with poor glycemic control had significantly lower serum magnesium levels. Magnesium levels were lower in females, particularly postmenopausal women. Magnesium levels were significantly associated with hypertension, gender, and the use of specific medications such as metformin and indapamide. Logistic regression revealed a significant inverse association between serum Magnesium levels and congestive heart failure (OR = 0.055), but not with other comorbidities. ROC analysis revealed limited predictive value of magnesium for glycemic control (AUC = 0.41). Discussion: Although group-level differences in magnesium were evident, magnesium levels alone were not reliable predictors of glycemic control. However, the associations with CHF, HT, gender, and specific medications suggest that magnesium plays a multifaceted role in type 2 diabetes mellitus management. Conclusion: Regular monitoring of serum magnesium may aid in identifying at-risk patients, especially those with hypertension, CHF, or on magnesium-depleting medications. Further prospective studies are needed to clarify the clinical utility of magnesium in diabetes care.

Background/Objectives: Identifying reliable predictors of all-cause mortality in intensive care unit (ICU) patients undergoing percutaneous endoscopic gastrostomy (PEG) remains clinically important to decide the route of nutrition. This study aimed to assess the prognostic significance of hepatic biomarkers, particularly the Fibrosis-4 (FIB-4) score. Methods: We conducted a retrospective cohort study in the ICUs of a tertiary care university hospital. Adult patients who underwent PEG between 1 January 2022 and 31 December 2024 were included. Pre-procedural demographic, clinical, and laboratory data were retrieved from electronic medical records. The primary outcome was all-cause mortality within three years of PEG placement. Survival analyses were performed using Kaplan–Meier curves and Cox proportional hazards regression to identify independent predictors. Results: Older age, elevated FIB-4, total and direct bilirubin, gamma glutamyl transferase (GGT), lactate dehydrogenase (LDH), ferritin, c-reactive protein (CRP), procalcitonin, INR, and prothrombin (PT) levels, and reduced calcium, platelet count, and albumin were significantly associated with all-cause mortality (p < 0.05). ROC analysis identified FIB-4, GGT, LDH, and albumin as significant predictors of mortality. Kaplan–Meier analysis confirmed that patients with higher FIB-4, GGT, and LDH, and lower albumin levels, had significantly shorter survival. Cox proportional hazards regression analysis revealed that while the FIB-4 score was a significant predictor of mortality in the univariate model, it lost its independent prognostic value when adjusted for confounders. Instead, lower albumin, elevated CRP, and increased GGT emerged as the independent risk factors for mortality. Conclusions: Pre-procedural albumin, CRP, and GGT levels are strong independent prognostic indicators of all-cause mortality in ICU patients undergoing PEG. While FIB-4 serves as a practical initial screening tool, adverse outcomes might be primarily driven by systemic inflammation and nutritional depletion rather than isolated hepatic fibrosis.