Background/Objectives: Herpes zoster (HZ) poses a substantial risk to adults aged ≥ 50, particularly those with chronic disease, and may lead to postherpetic neuralgia. Following Saudi Arabia’s introduction of the recombinant zoster vaccine (RZV), we assessed the RZV’s uptake among adults ≥ 50 and their willingness to receive it and examined how knowledge and attitudes influenced these outcomes. Methods: In 2024, we conducted a cross-sectional, interview-based study in the outpatient clinics of a Riyadh tertiary hospital using a structured questionnaire adapted from the literature to assess knowledge, attitudes, and practices regarding HZ and RZV. Results: Among 333 participants, HZ vaccine uptake was low (12%). Among the unvaccinated, 45.7% (134/293) were willing to be vaccinated, and knowledge of HZ and RZV was low (mean: 3.84/14). Uptake was most strongly associated with physician recommendation (OR: 7.5; 95% CI: 2.79–20.11), followed by greater knowledge (OR: 1.42; 95% CI: 1.19–1.67). Willingness was best predicted by higher attitude scores (OR: 1.28; 95% CI: 1.12–1.48). The most reported barrier was low perceived risk (27%; n = 79). Conclusions: Uptake among adults aged ≥50 with chronic disease was low due to poor knowledge and low perceived risk, yet many were willing to be vaccinated. Enhancing physician–patient counseling and targeted campaigns addressing HZ risk and RZV misconceptions could increase uptake.

Background: Diabetes mellitus is prevalent in Saudi Arabia. Our study aims to estimate the rate and time of developing macrovascular and microvascular complications in diabetic patients in a primary care setting. Methodology: This is a retrospective cohort study. All collected data were retrieved using medical files and the electronic patient records of all diabetics having regular follow-ups in Family Medicine clinics, King Faisal Specialist Hospital & Research Centre in Riyadh, Saudi Arabia, from the beginning of January 2002 to the end of December 2018. The data included the demographics of patients diagnosed with diabetes mellitus, their HbA1c, and the follow-up duration of the development of complications, which included cardiovascular complications and diabetic nephropathy. Results: We included 365 patients, of whom 47.1% males and 52.9% were females. The mean age of diabetes mellitus diagnosis in our population was 50 years (SD± 11.3). The mean duration of follow-up was 7.14 years (SD± 3.9). The rate of developing cardiovascular complications and diabetic nephropathy was 11.2% and 10.4%, respectively. The mean time to develop cardiovascular complications and diabetic nephropathy was 6 (SD± 3.9) and 5.24 (SD± 3.2) years, respectively. The mean time to develop the first diabetes complication was 5.5 years (SD± 3.6). There was no statistical significance in the mean of HbA1c between patients who developed diabetic complications and those who did not. Conclusion: Diabetes complications are common in the Saudi community. The duration of the development of cardiovascular complications and diabetic nephropathy was shorter than that indicated in international and national reports. Robust screening programs to diagnose and improve the control of diabetes mellitus should be established in the Kingdom.

Introduction: Hyperuricemia is increasingly recognized as a metabolic disorder linked to dyslipidemia, insulin resistance, and vascular complications. In Saudi Arabia, the prevalence of hyperuricemia is rising with obesity and diabetes, yet its relationship with lipid-derived cardiometabolic indices remained understudied. This study aimed to examine the associations between uricemia status and lipid-derived cardiometabolic indices in a large adult cohort. Methods: This retrospective cross-sectional study analyzed data from 7652 adults, including 5385 normouricemic (NU) and 2267 hyperuricemic (HU). Key cardiometabolic indices, including the triglyceride-glucose index (TyG), non-high-density lipoprotein cholesterol (non-HDL-C), remnant cholesterol (RC), atherogenic index of plasma (AIP), and Castelli risk indices I and II (CRI-I, CRI-II), were calculated. Associations were evaluated treating HU as the exposure and the lipid-derived cardiometabolic indices as the outcomes. Multivariable regression analyses, receiver operating characteristic (ROC) curves, and prevalence-based association estimates were used to assess these relationships. Results: HU individuals exhibited significantly higher TG along with lowered HDL-C. Median TyG (4.61), AIP (0.38), non-HDL-C (147 mg/dL), RC (18 mg/dL), CRI-I (4.30), and CRI-II (2.85) were higher in the HU group compared to NU group, with non-HDL-C and CRI-I falling within the abnormal range, AIP in the high-risk range, and TyG and CRI-II at borderline levels. Across the separately adjusted models, hyperuricemia showed consistent positive associations with RC, AIP, CRI-I, and CRI-II, whereas associations with TyG and non-HDL-C diminished after adjustment for renal or liver markers. ROC analysis demonstrated modest discriminatory ability of uric acid for elevated indices, with AIP (AUC = 0.641) and CRI-I (AUC = 0.640) exhibiting the highest performance. The prevalence of elevated indices was substantially higher in HU, particularly for CRI-II (44.0% vs. 25.9%) and CRI-I (28.2% vs. 13.7%). Conclusions: These findings highlight associations between HU and lipid-derived cardiometabolic indices, but further longitudinal research is required to determine whether HU has a clinical predictive value in cardiovascular risk assessment.

Background: Lipid disturbance is a hallmark of cardiometabolic abnormalities and a primary contributor to cardiovascular disease risk. Immunometabolic markers show promise for better risk classification. This study evaluated the uric acid to Platelet ratio (UAPR) as lipid abnormality marker in a broad cohort of Saudi adults. Methods: Data from 7781 adults in the Elta Medical Laboratory database were analysed. Subjects were stratified by lipid status, and UAPR levels were analyzed. Additionally, lipid abnormality distribution across UAPR tertiles and risk profiles, including ROC analysis, were evaluated. Results: UAPR were markedly increased in patients with abnormal lipid profiles while high UAPR (H-UAPR) subjects showed multiple dyslipidemic patterns including elevated levels of triglycerides (TG), low-density lipoprotein (LDL-C), non-high-density lipoprotein (non-HDL-C), and remnant cholesterol (RC), alongside reduced HDL-C levels. Notably, UAPR correlated with all lipid parameters, most strongly and inversely with HDL-C (r = −0.314) and remained independently associated with TG and HDL-C in multivariable regression. Consistently, H-UAPR was common across all dyslipidemic forms, especially low HDL-C, nearly twice as frequent as in N-UAPR (52.4% vs. 35.0%). The odds were specifically increased for low HDL-C (OR = 2.02, p < 0.0001) and a high TC/HDL-C ratio (OR = 2.94, p < 0.0001) in H-UAPR patients. ROC analysis demonstrated that UAPR had moderate yet significant diagnostic performance, particularly for identifying high TC/HDL-C (AUC = 0.671, p < 0.001) and HDL-C (AUC = 0.618, p < 0.001). Conclusions: UAPR shows considerable promise as an immunometabolic marker linked to various dyslipidemic forms with potential for hyperlipidemia screening and stratification, warranting further validation.

Early identification of ICU patients with sepsis who are at risk of early death remains clinically important. The aspartate aminotransferase-to-platelet ratio index (APRI) is a simple laboratory-derived index, but its clinical value for very early mortality in adult ICU patients with sepsis remains insufficiently characterized. This study evaluated the association between admission APRI and short-term mortality in ICU patients with sepsis. This retrospective cohort study included 266 adults admitted to the ICU with sepsis. APRI was calculated from AST and platelet measurements obtained within 24 h of admission. Patients were categorized according to mortality timing. Associations with 7-day mortality were evaluated using logistic regression adjusted for age, sex, and comorbidity status. ROC and survival analyses were also performed. Of 266 patients, 32 died within 7 days, 88 between 8 and 28 days, and 72 after 28 days, and 74 survived. APRI was highest among patients who died within 7 days (median 1.919, IQR 0.631–5.009) compared with survivors (0.472, IQR 0.192–1.531; p = 0.0056). Higher log-transformed APRI remained associated with 7-day mortality after adjustment for age, sex, and comorbidity status (OR = 2.77, 95% CI 1.57–5.01; p = 0.0004). APRI showed modest discrimination for 7-day mortality (AUC = 0.687, 95% CI 0.580–0.793) and lower discrimination for 28-day mortality (AUC = 0.623, 95% CI 0.555–0.690). Elevated APRI was also associated with reduced short-term survival. Elevated admission APRI is independently associated with early mortality and reduced short-term survival in ICU patients with sepsis. However, its modest discrimination supports its use as an adjunct to established clinical risk assessment tools.

Background and Objectives: Advances in antiretroviral therapy have improved survival among people living with HIV, drawing greater attention to hepatic and metabolic comorbidities. However, associations between HIV viral burden and routine liver and lipid biochemical markers remain poorly characterized in Saudi Arabia. This study investigated these associations among people living with HIV in Saudi Arabia. Materials and Methods: We retrospectively reviewed the medical records of 84 patients with HIV attending King Khalid University Hospital, Riyadh, between 2017 and 2025. Patients were classified into high-viral-load (H-VL; HIV RNA ≥100,000 copies/mL) and low-viral-load (L-VL; <100,000 copies/mL) groups. Liver and lipid markers were compared using the Mann–Whitney U test. Associations with HIV RNA were assessed using Spearman correlations and regression models adjusted for age and sex. Receiver operating characteristic analysis evaluated discrimination between the two groups. Results: The study included 84 patients (median age, 34 years; 81.0% male), of whom 50 (59.5%) had higher HIV viral load (H-VL; ≥100,000 copies/mL). Compared with the lower-viral-load group, H-VL patients had higher AST/ALT ratios, gamma-glutamyl transferase (GGT), and triglycerides (TG), and lower albumin and high-density lipoprotein cholesterol (HDL-C). HIV viral load correlated positively with GGT (r = 0.313, p = 0.0042) and TG (r = 0.453, p = 0.0018), and inversely with albumin (r = −0.405, p = 0.0001) and HDL-C (r = −0.448, p = 0.0023). Following adjustment for age and sex, significant associations persisted for GGT (β = 0.082, q = 0.046), AST/ALT ratio (β = 0.047, q = 0.041), albumin (β = −2.346, q < 0.011), TG (β = 0.092, q = 0.022), and HDL-C (β = −0.074, q = 0.041) after false discovery rate correction. In sensitivity analyses, only albumin remained significant after additional adjustment for anemia (q = 0.011), whereas associations with AST, GGT, AST/ALT ratio, albumin, TG, and HDL-C persisted after adjustment for estimated glomerular filtration rate (all q < 0.05). HDL-C showed the highest, although moderate, discriminatory performance for H-VL (area under the curve (AUC) = 0.755), followed by TG (AUC = 0.735). Conclusions: Higher HIV viral burden was associated with elevated GGT and triglycerides and reduced albumin and HDL-C. Although several associations persisted after adjustment, residual confounding remains possible. Prospective studies incorporating comprehensive treatment and clinical data are needed to clarify these relationships.