Background/Aims: Pancreatic steatosis (PS) is a pathology associated with metabolic syndrome (MS), endocrin and exocrine disfunctions of the pancreas, and fatty liver. The data on the frequency of PS are very limited. We aimed to evaluate the frequency of PS detected by transabdominal ultrasonography (TAU) in gastroenterology clinics located in different geographical regions of Turkey and the factors associated with it. Materials and Methods: Volunteers were evaluated by TAU for PS and hepatosteatosis (HS), and its degree. Pancreatic stiffness was evaluated by ultrasonographic shear wave elastography (SWE). All demographic, physical, and biochemical parametres were measured. Results: A total of 1700 volunteers from 14 centers throughout Turkey were included in the study. Mean age was 48.03 +- 20.86 years (56.9% female). Prevalance of PS was detected in 68.9%. In the PS group, age, body mass index (BMI), waist circumference, systolic blood pressure, fasting blood glucose (FBG), lipid levels, insulin resistance, diabetes mellitus, hypertension, MS frequency, and pancreatic SWE score were increasing, and fecal elastase level was decreasing in correlation with the degree of PS. The frequency of HS was 55.5%. Hepatosteatosis [odds ratio (OR): 9.472], increased age (OR: 1.02), and BMI (OR: 1.089) were independent risk factors for the occurrence of PS. Lean-PS rate was 11.8%. The lean-PS group was predominantly female and younger than non-lean PS. Also it has lower blood pressure, FBG, liver enzymes, lipid levels, and HS rates. Conclusion: The frequency of PS was found 68.9% in Turkey. Its relationship was determined with age, BMI, HS, MS (and its components), pancreatic stiffness, and fecal elastase level. Keywords: Elastography, exocrine pancreatic insufficiency, lean steatosis, pancreas stiffness, pancreatic steatosis, ultrasonography Cite this article as: Sezgin O, Yaraş S, Cindoruk M, et al. Prevalence of pancreatic steatosis and its associated factors in Turkey: A nation-wide multicenter study. Turk J Gastroenterol. 2024;35(3):239-254.

Background: Hepatitis B Virus (HBV) screening rates before starting immunosuppressive treatments are suboptimal. The aim of the study was to evaluate the efficacy of a new electronic alert system in increasing HBV screening rates. Methods: The electronic alert system, HBVision2, identifies patients at risk of HBV reactivation when a pre-determined International Classification of Diseases (ICD)-10 code is entered into the hospital’s database or immunosuppressive treatment is prescribed. The system evaluates the prior Hepatitis B Surfage Antigen (HBsAg) and anti-Hepatitis B Core Immunglobulin G (HBc IgG) results and sends an alert code to the clinician for screening if serology is not completely available or consult a specialist in case of positive serology. The HBV screening and consultation rates of patients before (control group) and after HBVision2 were retrospectively compared. The clinical course of unscreened and/or unconsulted patients was determined, and the clinical efficacy of HBVision2 in preventing HBVr was predicted. Results: Control group included 815 patients (52.6% male, mean age: 60 ± 12, 82.5% with oncologic malignancy) and study group included 504 patients (56% male, mean age: 60 ± 13, 91.4% with oncologic malignancy). Groups were similar with respect to gender, mean age, and HBVr risk profile of the immunosuppressive treatment protocols. Overall, both HBsAg (from 55.1% to 93.1%) and anti- HBc IgG screening rates significantly increased (from 4.3% to 79.4%) after the electronic alert system (P < .001, for both). Consultation rates of anti-HBc IgG-positive patients significantly increased from 40% to 72.7% (P = .012). HBVr developed in 2 patients (2.6%) who were not screened and/or consulted after the alert system. Alert program prevented the development of HBVr in 10 patients (1.9%) of the study group and decreased the development of HBVr by 80%. Conclusion: Electronic alert system significantly improved HBsAg and anti-HBc IgG screening rates before starting immunosuppressive treatment and prevented the development of HBVr to a great extent. However, screening rates are still below optimal and need to be improved.

Background/Aims: Sleep disorders (SDs) are frequently seen in cirrhotics. Polysomnography (PSG), actigraphy and electroencephalogram (EEG) are common objective methods to diagnose SDs. The most commonly used subjective methods are the Pittsburgh Sleep Quality Index (PSQI) and Epworth sleepiness scale (ESS). In this study, we aimed to evaluate the effect of liver transplantation on SDs by using a combination of objective (PSG and EEG) and subjective methods (PSQI and ESS). Material and Methods: Eighteen cirrhotic patients on a liver transplantation (LTx) waiting list were included in the study. Patient clinical status, biochemical parameters were evaluated. All patients completed validated Turkish forms of the PSQI and ESS before and nine-months after LTx. All patients underwent EEG and PSG before and nine-months after LTx. Results: Eighteen patients with liver cirrhosis (male: 12; 66.7%, mean age: 53.22±10.43 years) were included in the study. Pre-transplant and nine-month post-transplant mean PSQI and ESS scores were 8.4±3.11 and 7.28±3.89; 4.5±2.8 and 4.72±2.91 (p<0.01), respectively. Pre-transplantation, metabolic encephalopathy was detected in 6 of 18 patients by EEG, while metabolic encephalopathy was detected in only one patient post-transplant. Post-transplantation PSG sleep duration (all stages) increased relative to pre-transplant PSG values. Sleep latency (SL) and REM (Rapid eye movement) latency were found to be reduced relative to pre-transplant values. Conclusion: This was a pilot study comparing SDs in pre- and post-liver transplant patients by combining subjective and objective methods. Significant SD improvements were found at the ninth month.

Cite this article as: Acar Ş, Akyıldız M. A new prognostic model for primary sclerosing cholangitis. Turk J Gastroenterol 2019; 30(11): 1004-6.