In our study, we aimed to investigate the relationship between anti-müllerian hormone (AMH) and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) score, which are known to be increased in patients with polycystic ovary syndrome (PCOS), and morning blood pressure surge (MBPS), and whether these measurements are a marker for early cardiovascular disease risk in patients with PCOS. Forty patients aged between 18 and 65 years with hypertension (HT) and PCOS, 40 patients with HT but without PCOS, and 40 people representing the healthy control group were included in our prospective, cross-sectional study. All patients underwent ambulatory blood pressure measurement for 24 hours and MBPS was calculated. The study groups were divided into 3 groups as healthy control group (group 1), patient group with HT without PCOS (group 2), and patient group with HT and PCOS (group 3). MBPS was found to be statistically significantly higher in group 3. In linear regression analysis, AMH and HOMA-IR levels were found to be independently associated with MBPS. In patients with PCOS, AMH, and HOMA-IR levels were significantly higher in the group with MBPS > 25 mm Hg. Early diagnosis and treatment of PCOS and accompanying comorbidities can halt the progression of cardiac disorders and reduce cardiovascular mortality and morbidity. AMH level, HOMA-IR score, and MBPS measurement can be used in early detection and prediction of cardiovascular disease in PCOS patients.

Aim: Contrast-induced acute kidney injury (CI-AKI) is associated with increased risk of morbidity and mortality and specific treatments are needed. In our study, we aimed to investigate the association of sodium-glucose cotransporter-2 inhibitors (SGLT2-I) use with the development of CI-AKI due to coronary angiography (CAG) in patients with DM. Methods: A total of 516 type 2 diabetes mellitus (DM) patients, including 250 SGLT2-I users and 266 non-SGLT2-I users, were included in our retrospective and cross-sectional study. Results: The study groups were divided into CI-AKI (+) and CI-AKI (-). SGLT2-I use was statistically significantly higher in the CI-AKI (-) group. Multivariate logistic regression analysis showed that SGLT2-I use reduced the probability of CI-AKI by 83.8%. Conclusion: Our findings suggest that SGLT2-Is may significantly reduce the risk of CI-AKI in diabetic patients undergoing CAG. In conclusion, the use of SGLT2-I may have a protective and preventive effect against the development of CI-AKI.

Aim: Diabetes mellitus (DM) is associated with the development and progression of metabolic dysfunction-associated steatotic liver disease (MASLD). In our study, we aimed to evaluate the findings of MASLD and fibrosis according to liver ultrasound (USG) imaging, FIB-4 score and fibroscan findings in patients with type 2 DM followed in our internal medicine clinic. Methods: In our retrospective and cross-sectional study, 1282 patients diagnosed with type 2 DM whose anamnesis and previous examinations did not constitute an obstacle for inclusion in the study were included. The abdominal USG imaging of the patients were analysed from the system and the FIB-4 score was calculated. Liver stiffness (LS) measurements were performed with FibroScan® Mini 430 device (Echosens, France). Results: USG imaging was performed in 474 (36.9%) of 1282 patients and MASLD was diagnosed in 341 (71.9%) of these patients. FIB-4 score> was 1.3 in 45 of 341 patients diagnosed with MASLD. Fibroscan imaging was performed in 231 of 341 patients with MASLD. In 52 (22.5%) of 231 patients, LS measurements> were 8 kPa Conclusion: We recommend early screening of MASLD, which is associated with advanced fibrosis and increased cardiovascular mortality and morbidity in patients with DM, with liver USG, measurement of FIB-4 score and evaluation of LS with fibroscan in centres where possible.

Background: Diabetic retinopathy (DR) is the most prevalent microvascular complication of type 2 diabetes mellitus (T2DM) and a recognised marker of systemic vascular injury. Whether DR—graded independently by two experienced ophthalmologists as part of routine institutional care—is independently associated with concurrent nephropathy (urine albumin-to-creatinine ratio [UACR] ≥ 30 mg/g) and subclinical cardiac stress (N-terminal pro-B-type natriuretic peptide [NT-proBNP] ≥ 125 pg/mL) remains insufficiently examined. Methods: Retrospective cross-sectional study of 401 T2DM adults who underwent dilated fundus examination independently graded by two board-certified ophthalmologists (each ≥ 10 years’ experience in diabetic eye disease) using ETDRS-based classification. Inter-physician agreement was quantified by Cohen’s weighted kappa. The primary composite outcome was concurrent nephropathy and subclinical cardiac stress. Multivariable logistic regression adjusted for age, sex, HbA1c, diabetes duration, eGFR, hypertension, and pharmacological treatments. Results: The composite outcome was present in 120 (64.2%) DR-positive vs. 14 (6.5%) DR-negative patients (crude OR: 25.59 (13.78–47.51); p < 0.001; fully adjusted OR: 21.49 (11.02–41.81); p < 0.001). Inter-physician agreement was high (Cohen’s weighted κ = 0.88; 95% CI: 0.83–0.93). Nephropathy alone was found in 164 (87.7%) vs. 76 (35.5%) patients (OR: 12.95 (7.71–21.75); p < 0.001), and elevated NT-proBNP in 137 (73.3%) vs. 39 (18.2%) patients (OR: 12.29 (7.65–19.76); p < 0.001). A significant trend across DR severity grades was observed (p for trend < 0.001), although the gradient was not strictly monotonic. ROC AUC = 0.837 (95% CI: 0.784–0.860). Conclusions: Ophthalmologist-graded DR was independently associated with the concurrent presence of albuminuria and elevated NT-proBNP in T2DM. Because the design is cross-sectional, these findings describe association rather than prediction or causation. They generate the hypothesis that retinal grading may help flag patients in whom cardiorenal biomarker assessment is worth considering, but prospective validation is required before any screening application.

Background and Objective: To compare longitudinal changes in serum C-peptide during dipeptidyl peptidase-4 (DPP-4) inhibitor versus sodium–glucose cotransporter 2 (SGLT2) inhibitor therapy in type 2 diabetes and to evaluate whether baseline C-peptide predicts glycemic response. Materials and Methods: This single-center retrospective new-user cohort study included 196 adults with type 2 diabetes who initiated a DPP-4 inhibitor (n = 99) or an SGLT2 inhibitor (n = 97) following a 12-month washout period. Baseline and follow-up HbA1c, plasma glucose, and fasting C-peptide measurements were assessed over a mean follow-up of 156 days. Glycemic response was defined as an HbA1c reduction of at least 1.0 percentage point. Multivariable linear and logistic regression analyses were performed, and receiver operating characteristic analysis evaluated the predictive performance of baseline C-peptide. Results: HbA1c decreased significantly in both groups, with no between-group difference in HbA1c reduction (1.03 ± 0.87 vs. 0.97 ± 0.83 percentage points; p = 0.650). C-peptide increased significantly in the DPP-4 inhibitor group but not in the SGLT2 inhibitor group (0.18 ± 0.44 vs. 0.03 ± 0.38 ng/mL; between-group p = 0.010). DPP-4 inhibitor therapy remained independently associated with higher follow-up C-peptide (adjusted β = 0.149; p = 0.013). Baseline C-peptide independently predicted glycemic response (adjusted OR = 2.58 per 0.5 ng/mL increase; p < 0.001), whereas treatment class and the treatment-by-C-peptide interaction were not significant. Baseline C-peptide showed good discrimination for response (AUC = 0.805), with a Youden-derived exploratory cut-off of 2.33 ng/mL. Conclusions: DPP-4 inhibitors were associated with a greater increase in fasting C-peptide than SGLT2 inhibitors despite similar glycemic improvement; however, fasting C-peptide change alone should not be interpreted as direct evidence of improved or preserved β-cell function. Higher baseline C-peptide was associated with glycemic response in both treatment groups, although external validation is required before clinical application.