Metabolic syndrome (MetS) represents a huge burden on the health system. This study aimed to investigate the association between MetS and certain indirect insulin resistance (IR) indicators according to gender. The triglyceride–glucose index (TyG), TyG–body mass index (TyG–BMI), the TyG–waist-to-height ratio (TyG–WHtR), TyG–waist circumference (TyG–WC), the triglyceride to high-density-lipoprotein cholesterol index (TG/HDL-c) and recently proposed indicators such as the metabolic score for IR (MetS-IR), TyG–neck circumference (TyG–NC) and the TyG–neck-circumference-to-height ratio (TyG–NHtR) were evaluated in 2594 subjects enrolled in the PREDATORR study. Univariate and multivariate logistic regression was performed to identify the association between MetS and the indirect IR indicators, as well as the risk factors. The participants were divided into two groups, according to gender. Data were analyzed using SPSS version 26.0. TyG, TyG–WC, TyG–NC, TyG–NHtR and TG/HDL-c had higher values in the male group, while TyG–BMI, TyG–WHtR and MetS-IR had approximately equal values in the two studied groups, but also statistically significantly higher values in MetS (+) vs. MetS (−) subjects (p < 0.001). For both studied groups, the multivariate logistic regression analysis demonstrated that TyG and MetS-IR were independent predictors for MetS. Both in the female and in the male group, TyG had the largest area under the receiver operating characteristic (AUROC) curve. Thus, in females, the TyG AUROC curve was 0.890; 95% CI 0.873–0.907; p < 0.001; cut-off value 8.51, with 81.4% sensitivity and 80.0% specificity. In males, the TyG AUROC curve was 0.880; 95% CI 0.861–0.899; p < 0.001; cut-off value 8.69, with 78.5% sensitivity and 84.6% specificity. All of the analyzed indirect IR indicators had statistically significantly higher values in MetS (+) vs. MetS (−) subjects. TyG and MetS-IR are independent predictive factors for MetS, regardless of the subject’s gender.

Background: The coronavirus disease 2019 pandemic (COVID-19) is the most important global health crisis to date. In this study, we performed an analysis to find the association between liver damage, FIB-4 score and the severity of COVID-19 disease. Methods: We included a total of 580 patients that tested positive for SARS-CoV-2 infection and were hospitalized. No patient included had any known history of liver disease. Liver function tests were performed, and FIB-4 score was calculated in order to assess their involvement in the disease progression. Results: More than half of the patients had elevated liver function tests. Age, high body mass index, associated heart disease and diabetes were associated with poor outcome. Corticosteroids, antibiotics, and anticoagulants strongly correlated with liver injuries. Liver impairment and injury, as well as a FIB-4 score higher than 3.5, also correlated with higher degrees of disease severity. Conclusion: Liver injury and elevated FIB-4 score were associated with poor clinical outcome and disease severity, as well as being a valuable tool to predict COVID-19-related mortality.

We compared oxidative markers and their links to inflammation in diabetic nephropathy and hemodialysis to identify independent determinants. We studied 180 adults, 90 patients with type 2 diabetes and diabetic nephropathy and 90 patients on hemodialysis. We measured serum advanced oxidation protein products (AOPP) and thiobarbituric acid reactive substances (TBARS) by enzyme-linked immunosorbent assay (ELISA). Partial correlations were adjusted for age, sex, and albumin with false discovery rate (FDR) control. Principal component analysis (PCA) summarized inflammatory indices and linear models tested predictors of AOPP and TBARS. Oxidative damage was higher in hemodialysis, with AOPP median 25.80 versus 5.06 and TBARS 8.49 versus 1.89, p less than 0.0001. C reactive protein (CRP) and mean corpuscular volume-to-lymphocyte ratio (MCVL) were higher in patients ongoing hemodialysis; systemic immune-inflammation index (SII) was higher in diabetic nephropathy. PCA yielded a dominant inflammation axis in both cohorts, 74.73 percent in hemodialysis and 85.20 percent in diabetic nephropathy. In regression, creatinine (β = 2.47, p = 0.026) predicted AOPP in hemodialysis. Dialysis vintage inversely predicted TBARS, β = −0.2305, p = 0.0209. In diabetic nephropathy, the PCA inflammation score predicted AOPP, β = 1.134, p = 0.0003. Protein oxidation tracked systemic inflammation in diabetic nephropathy, but not in hemodialysis. AOPP outperformed TBARS as an inflammatory partner and a practical monitoring candidate in diabetic kidney disease. Prospective studies should test for prognostic value and therapy sensitivity.

Background and Objectives: Chronic kidney disease (CKD) and maintenance hemodialysis (HD) are frequently associated with psychological distress and impaired health-related quality of life (HRQoL). However, the relationships between depressive, anxiety, and stress symptoms, clinical factors, and HRQoL remain insufficiently understood in routine care. This study aimed to assess the prevalence of psychological distress and to explore cross-sectional correlates of kidney disease-specific and generic HRQoL in Romanian patients receiving long-term HD, providing one of the first detailed characterizations of these relationships in an Eastern European maintenance HD cohort. Materials and Methods: This single-center cross-sectional study included 125 adult patients undergoing maintenance HD for at least one year. Baseline assessment comprised socioeconomic, demographic and clinical and paraclinical data, including Charlson Comorbidity Index (CCI), dialysis adequacy (spKt/V), cognitive function, psychological distress assessed with the Depression, Anxiety and Stress Scale (DASS-21R), and HRQoL evaluated using the Kidney Disease Quality of Life Short Form (KDQOL-SF™ 1.3). HRQoL domains and physical and mental component summary scores (PCS, MCS) were analyzed using descriptive statistics, correlation analyses, and multivariable linear regression. Follow-up assessments at approximately one year were summarized descriptively. Results: Disease-specific HRQoL revealed marked impairment in perceived disease burden and work status, while physical HRQoL was substantially reduced (PCS 36.5 ± 9.6). Mental HRQoL was relatively preserved (MCS 48.8 ± 8.8). At baseline, 48.0% of patients reported at least mild depressive symptoms, 34.4% anxiety symptoms, and 44.0% stress symptoms. spKt/V showed a modest association with PCS. Psychological distress demonstrated weak associations with HRQoL; stress was independently associated with lower MCS, with limited explained variance (R² ≤ 0.15). Conclusions: Psychological distress is common among Romanian HD patients and is cross-sectionally associated with markedly impaired physical HRQoL. While the present design does not allow causal inferences, these findings support the implementation of routine psychological screening and the consideration of targeted psychosocial interventions in HD care.

In patients diagnosed with multiple myeloma (MM), the primary complaints at the time of diagnosis are often related to bone involvement, significantly impacting quality of life and increasing both morbidity and mortality. Obesity is associated with a chronic inflammatory state that results in the production of various cytokines and adipokines, which may promote bone destruction. Adiponectin, an adipokine predominantly secreted by adipocytes, is notably diminished in circulation among individuals with obesity, a phenomenon that has also been observed in MM. This reduction may contribute to the disruption of an already compromised bone architecture. The increase in adipose tissue is associated with heightened leptin production, a key adipokine, which can play a significant role in the pathophysiology of MM and its related bone complications. Obesity is associated with hyperinsulinemia and increased levels of free IGF-1. In MM, IGF-1 plays a critical role as a growth factor, produced by both myeloma cells and osteoclasts within the bone marrow microenvironment. Our gathered data indicates a significant relationship between the adipokines produced by adipose tissue and the bone matrix, particularly in the context of obesity and MM. However, it is important to note that the existing body of research on this topic is relatively sparse, with the majority of studies conducted on murine models rather than human subjects. This limitation highlights a critical need for further investigation to elucidate the precise mechanisms that contribute to bone destruction under these conditions.

Case Presentation: A 67-year-old man presented with transient loss of consciousness and dizziness after weeks of vomiting, weakness, and recurrent syncopal episodes. Initial laboratory findings showed hyponatremia (Na 125 mEq/L), severe hypokalemia (K 2.3 mEq/L), hypochloremia (Cl 77 mEq/L), metabolic alkalemia (pH 7.5; HCO₃⁻ 34 mEq/L), low serum osmolality (263 mOsm/L) with inappropriately concentrated urine (332 mOsm/kg), and prerenal azotemia (creatinine 3.4 mg/dL; eGFR 19 mL/min/1.73 m²; blood urea 209 mg/dL). Contrast-enhanced CT, along with colonoscopy, identified a large mucus-secreting villous adenoma in the upper rectum. After fluid and electrolyte replacement, the patient underwent surgical resection with complete remission of symptoms and correction of electrolyte abnormalities on follow-up. Conclusion: Rectal villous adenomas should be considered in older adults with unexplained hypovolemia, hypokalemic hyponatremia, and metabolic alkalemia. Early recognition and definitive resection are curative and prevent kidney injury.