Purpose: The aim of this study was to investigate the relationship between non-alcoholic fatty liver disease (NAFLD), non-alcoholic fatty pancreas (or pancreatic) disease (NAFPD) and HOMA indices in obese patients without a diagnosis of diabetes mellitus, using ultrasound (US) as a common non-invasive diagnostic tool during routine examinations. Methods: In this single-centre, retrospective study, the records of patients who applied to the obesity outpatient clinic in 2023 were reviewed. Digital records were scanned and patients with abdominal ultrasound reports indicating age, gender, body mass index(BMI), fasting plasma glucose, fasting plasma glucose, C-peptide level and degree of pancreatic and hepatic steatosis were included in the study. Patients with known chronic disease or diabetes mellitus and patients with specific drug use were excluded from the study. Homa indices were calculated using fasting plasma glucose and C-peptide levels. Results: A total of 62 patients were included. Body mass index was 39.1, 91% had NAFLD and 82% had NAFPD. There was a significant positive correlation between BMI and NAFLD and NAFPD. HOMA scores revealed a statistically significant impact of NAFLD on insulin resistance (HOMA-IR) and insulin sensitivity (HOMA-S) but not on beta-cell function (HOMA-B). No significant effect of NAFPD on HOMA scores was observed. Conclusion: The findings underline the association between NAFLD and insulin resistance and highlight the metabolic burden of ectopic fat deposition in obese patients. In contrast, there was no significant correlation between NAFPD and either insulin resistance or beta-cell function, suggesting that the metabolic impact of pancreatic steatosis may be different. These findings may help to guide clinical strategies for detecting and treating metabolic disorders in obesity.

Objective Atherosclerosis is a leading cause of cardiovascular diseases such as myocardial infarction and stroke. Obesity, particularly regional fat distribution, is known to play a significant role in the pathogenesis of atherosclerosis. The aim of our study is to investigate the relationship between the anterior mediastinal fat tissue area, posterior cervical subcutaneous fat tissue thickness, and the presence of carotid plaque. Methods This retrospective study included 273 patients who underwent carotid CT angiography between 2021 and 2023. Patients under 18 years, with malignancy, or with inadequate image quality were excluded. Anterior mediastinal fat tissue area was measured manually on axial CT images, and posterior cervical subcutaneous fat thickness was measured on sagittal images. Statistical analyses included the Mann-Whitney U test, Spearman's correlation, and logistic regression. Results There was a significant positive correlation between mediastinal fat area and carotid plaque presence (rs = 0.3417, p < 0.05). The optimal cut-off value for mediastinal fat area to detect carotid plaque was 575 mm², with 78.79% sensitivity and 62.67% specificity. No significant correlation was found between cervical fat thickness and carotid plaque presence. Conclusion The anterior mediastinal fat tissue area is a moderate predictor of carotid plaque presence and can be easily measured during routine CT scans. This measurement may help identify patients at risk of atherosclerosis and guide further diagnostic evaluations.

Objectives: This study aims to evaluate the presence of osteoporosis by measuring the distal femur cortex thickness on routine knee MRI performed for any reason. We aim to determine if these measurements can serve as a reliable indicator of bone mineral density (BMD) and thus facilitate early diagnosis of osteoporosis. Methods: A retrospective study was conducted with approval from the hospital’s Ethics Committee. Patients who underwent dual-energy X-ray absorptiometry (DXA) and knee MRI within 6 months were included. Exclusion criteria were patients under 18, those with a gap of more than 6 months between scans, prior knee surgeries, trauma, bone tumours, or non-diagnostic MRI results. MRI examinations were performed on a 1.5 Tesla scanner. Measurements included average cortical bone thickness (CBTavg), distal femoral cortical index-1 (DFCI-1), and distal femoral cortical index-2 (DFCI-2). A radiologist blinded to DXA scores conducted the measurements. Statistical analyses were performed using the Mann-Whitney U test and receiver operating characteristic (ROC) analysis. Results: A total of 74 patients were included. Significant differences were found between the normal BMD group and the osteopenia/osteoporosis group for CBTavg, DFCI-1, and DFCI-2 (P < 0.01). ROC analysis showed high diagnostic accuracy with an area under the curve (AUC) of 0.92 for CBTavg, 0.90 for DFCI-1, and 0.91 for DFCI-2. Optimal cut-off values were determined as 4.52 mm for CBTavg, 2.58 mm for DFCI-1, and 1.12 mm for DFCI-2. Conclusion: The study demonstrates that osteopenia/osteoporosis can be effectively diagnosed using distal femur cortex thickness measurements on routine knee MRI. These measurements provide a simple, fast, and practical method for opportunistically detecting osteoporosis, facilitating early intervention and management. Advances in knowledge: This study is the first to demonstrate that distal femur cortex thickness measurements on routine knee MRI can effectively predict osteoporosis, offering a novel, opportunistic screening method that enhances early detection and intervention strategies.