Nonalcoholic fatty liver disease (NAFLD) is the most common, chronic liver disease worldwide. Within this spectrum, steatosis alone is apparently benign, while nonalcoholic steatohepatitis may progress to cirrhosis and hepatocellular carcinoma. NAFLD is strongly associated with obesity, dyslipidemia, type 2 diabetes mellitus, and cardiovascular disease. The pathogenesis of hepatic steatosis is not clearly known, but its main characteristics are considered insulin resistance, mitochondrial dysfunction, increased free fatty acids reflux from adipose tissue to the liver, hepatocyte lipotoxicity, stimulation of chronic necroinflammation, and fibrogenic response. With recent advances in technology, advanced imaging techniques provide important information for diagnosis. There is a significant research effort in developing noninvasive monitoring of disease progression to fibrosis and response to therapy with potential novel biomarkers, in order to facilitate diagnosis for the detection of advanced cirrhosis and to minimize the need of liver biopsy. The identification of NAFLD should be sought as part of the routine assessment of type 2 diabetics, as sought the microvascular complications and cardiovascular disease, because it is essential for the early diagnosis and proper intervention. Diet, exercise training, and weight loss provide significant clinical benefits and must be considered of first line for treating NAFLD.

Background/Obejctives: Sarcopenic obesity (SO) has gained growing attention in metabolic dysfunction-associated steatotic liver disease (MASLD), yet data in Caucasian populations remain limited. The aim of this study was to assess the prevalence of SO using different definitions and to explore its relationship with steroid androgens, physical performance and frailty in MASLD individuals. Methods: Two hundred Caucasian patients with MASLD and available dual-energy X-ray absorptiometry (DEXA) data were evaluated. Clinical, biochemical, hormonal and elastography data were recorded, while physical performance was assessed using the Short Physical Performance Battery (SPPB) and Liver Frailty Index (LFI). Results: SO prevalence ranged from 34.5% to 76.5% depending on the definition applied (AIMSO score, body mass index, and body fat percentage-based criteria). Across definitions, SO individuals showed greater hepatic steatosis, more metabolic comorbidities and demonstrated poorer physical performance. Lower dehydroepiandrosterone sulfate (DHEAS) levels were independently associated with SO when the definition is based on total body fat percentage, and waist circumference (WC) was consistently linked to SO across all definitions. Separate analysis based on gender, confirmed that DHEAS was independently associated with SO in men, while WC represented an independent factor associated with SO in both genders. Conclusions: In conclusion, SO is common among Caucasian MASLD patients and is accompanied by metabolic, hepatic, hormonal, and functional alterations. These findings may help recognize patients at risk of SO and support more focused assessment and monitoring in clinical practice.

Background/Objectives: Peripheral neuropathy (PN) is a common complication of diabetes mellitus (DM) with prevalence estimates showing considerable variation across studies. This study aimed to assess the prevalence and risk factors of PN in adult Greek subjects with type 2 diabetes mellitus (T2DM). Methods: Τhe PRENEDIG (PREvalence of peripheral NEuropathy in type 2 DIabetes in Greece) study was a nationwide, cross-sectional multicenter study based on data collected from hospital-based diabetes clinics and primary care practices from January 2024 to June 2024 in Greece. Diabetic peripheral neuropathy (DPN) prevalence and severity were evaluated using the Neuropathy Symptom Score (NSS) and the Neuropathy Disability Score (NDS). Additional sensory assessment tools were considered to support clinical evaluation. Multivariate regression analysis examined the association between DPN and potential risk factors. Results: Among the study population (n = 1807), the overall DPN prevalence was 18.87% and increased with longer diabetes duration. DPN prevalence among participants with over 10 years of T2DM reached 26.49%. Logistic regression analysis identified several independent predictors of DPN including diabetes duration > 10 years (p < 0.001), arterial hypertension in participants with diabetes duration < 10 years (OR = 2.69, CI: 1.68–4.30, p < 0.001), HbA1c levels (OR = 1.20, CI: 1.10–1.31, p < 0.001), and age (OR = 1.02, CI: 1.00–1.03, p = 0.024). An interaction-related association was observed, with arterial hypertension not increasing the risk of DPN any further in participants with disease duration > 10 years (OR: 3.73 vs. 3.80 with or without arterial hypertension, respectively). Sensory assessment tools further validated DPN diagnosis. Conclusions: In Greece, DPN is a common complication, affecting nearly one in five T2DM patients. The results of the study reinforce the importance of routine screening, particularly among older patients and those with longer diabetes duration to facilitate early detection and timely management of DPN and its associated complications.

Sarcopenic obesity (SO) has gained growing attention in metabolic dysfunction-associated steatotic liver disease (MASLD), yet data in Caucasian populations remain limited. The aim of the study was to assess the prevalence of SO using different definitions and to explore its relationship with steroid androgens, physical performance and frailty in MASLD individuals. Two hundred Caucasian patients with MASLD and available dual-energy X-ray absorptiometry (DEXA) data were evaluated. Clinical, biochemical, hormonal and elastography data were recorded, while physical performance was assessed using the Short Physical Performance Battery (SPPB) and Liver Frailty Index (LFI). SO prevalence ranged from 34.5% to 76.5% based on different SO definitions. SO individuals showed greater hepatic steatosis, more metabolic comorbidities and demonstrated poorer physical performance. Lower dehydroepiandrosterone sulfate (DHEAS) levels were independently associated with SO when definition is based on total body fat percentage, and waist circumference (WC) was consistently linked to SO across all definitions. Separate analysis based on gender, confirmed DHEAS being independently associated with SO in men, while WC represented an independent SO predictor in both genders. In conclusion, SO is common among Caucasian MASLD patients and is accompanied by metabolic, hepatic, hormonal, and functional alterations, highlighting the need for better identification in clinical practice.