Objectives: Adropin is a novel marker of metabolic syndrome and insulin resistance. The aim of this study was to explore the association of serum adropin levels with hepatosteatosis among adult patients. Materials and Methods: Serum biochemical parameters including liver and renal function tests, insulin levels, and serum adropin levels were compared between adult patients with nonalcoholic fatty liver disease (NAFLD) and healthy control cases. Results: A total of 51 patients with a mean age of 37.9 ± 9.96 years diagnosed with grade 2–3 hepatosteatosis and 30 healthy control cases with a mean age of 34.8 ± 9.5 years were included in the study. Serum adropin levels in the NAFLD group were statistically significantly lower than in the control cases (588.4 ± 261.0 vs. 894.2 ± 301.2, respectively; p < 0.001). The study participants were further subdivided into 2 groups as patients with (n = 35) or without (n = 46) insulin resistance using the serum homeostatic model of assessment-insulin resistance (HOMA-IR). Serum adropin levels were statistically significantly lower in patients with insulin resistance (p < 0.01). There was a negative correlation between adropin levels and serum insulin, HOMA-IR, urea, gamma-glutamyl transferase, total cholesterol, and triglyceride levels. Conclusion: We observed a decrease in serum adropin levels among adult patients with NAFLD. We also found lower levels of serum adropin in patients with insulin resistance, supporting previous data in the literature. Studies investigating the association of adropin levels with other inflammatory parameters are warranted to define its exact role in the pathogenesis of hepatosteatosis.

Background/Aims: Primary biliary cholangitis (PBC) is a chronic liver disease influenced by environmental, genetic, and epigenetic fac tors, with varying incidence across populations. This study compared demographic, biochemical, and treatment responses in Danish and Turkish PBC patients. Materials and Methods: Four cohorts were analyzed: (1) 101 incident Turkish patients, (2) 77 incident Danish patients, (3) 103 prevalent Turkish patients, and (4) 155 prevalent Danish patients. Demographics, biochemical data, disease severity, and response to ursodeoxy cholic acid (UDCA) were assessed. Regression analysis was applied to the entire cohort to identify factors associated with the UDCA response. Results: Female dominance was noted in all cohorts (>90%) except the Danish incident group (75%). Turkish patients in the preva lent cohort were younger than Danish patients. Antimitochondrial antibody (AMA) positivity was higher in Turkish cohorts (92%-97%) compared to Danish cohorts (75%-88%). Biochemical data were similar across groups, with 15% of both populations having cirrhosis. Turkish patients showed a higher complete response to UDCA. Elevated alanine aminotransferase (ALT) levels reduced UDCA response, while Turkish ethnicity and older age improved it. Conclusion: Despite similar disease severity and age at diagnosis between Danish and Turkish PBC patients, Turkish patients had higher AMA positivity and better responses to UDCA treatment. These findings suggest potential genetic or environmental influences on treat ment efficacy. Cite this article as: Eruzun H, Bossen L, Turan Gökçe D, et al. Clinical and biochemical characteristics of a Danish and Turkish cohort of incident and prevalent patients with primary biliary cholangitis. Turk J Gastroenterol. 2025;36(4):241-246.

The gamma-glutamyl transferase to platelet ratio (GPR) has been reported to be as effective as the aspartate transaminase to platelet ratio index (APRI) and fibrosis index based on the 4 factors (FIB-4) in showing the fibrosis stage in patients with chronic hepatitis B. It has been demonstrated that APRI and FIB-4 are successful in the assessment of fibrosis in primary biliary cholangitis (PBC). We investigated the effectiveness of GPR in predicting advanced fibrosis and cirrhosis in patients with biopsy-proven untreated PBC. A total of 35 patients with biopsy-proven PBC were included in this study. The biopsy fibrosis stages of all patients at diagnosis were compared using the APRI, FIB-4, and GPR values. The diagnostic accuracy of GPR for detecting advanced fibrosis and cirrhosis was also investigated. The area under the receiver operating characteristic curve (AUROC) of GPR was 0.84, the cutoff point was 4.81, the sensitivity was 0.41, and the specificity was 0.96 for detecting advanced fibrosis. Our study showed that GPR was more sensitive than APRI and FIB-4 in detecting advanced fibrosis in patients with PBC. GPR could be used as an effective noninvasive marker in PBC to show advanced fibrosis at the time of diagnosis.

Objective: Acute pancreatitis can cause local or systemic complications and has high morbidity and mortality rates. In the early stages of pancreatitis, a decrease in the barrier function of the intestines and an increase in bacterial translocation are observed. Zonulin is a marker used to evaluate the integrity of the intestinal mucosal barrier. We aimed to investigate whether measuring serum zonulin levels would contribute to the early prediction of complications and severity in acute pancreatitis. Materials and Methods: Our study was an observational, prospective study and included 58 patients with acute pancreatitis and 21 healthy controls. Causes of pancreatitis and serum zonulin levels of the patients at the time they were diagnosed with pancreatitis were recorded. The patients were evaluated in terms of pancreatitis severity, organ dysfunction, complications, sepsis, morbidity, length of hospital stay, and mortality Results: Zonulin levels were higher in the control group and lowest in the severe pancreatitis group. No significant difference was observed in zonulin levels according to disease severity. There was no significant difference between zonulin levels in patients who developed organ dysfunction or sepsis. In patients with acute pancreatitis complications, zonulin levels were found to be significantly lower with a mean of 8.6 ng/mL (P < .02). Conclusion: Zonulin levels are not a guide in the diagnosis of acute pancreatitis, in determining its severity, and in the development of sepsis and organ dysfunction. The zonulin level at the time of diagnosis may be helpful in predicting complicated acute pancreatitis. Zonulin levels are not effective in demonstrating necrosis or infected necrosis. Cite this article as: Avcıoğlu U, Eruzun H. Serum zonulin levels as an early biomarker in predicting the severity and complications of acute pancreatitis. Eurasian J Med 2023;55(1):78-82.