Background: While hyperuricemia has been widely studied in cardiovascular and renal diseases, the prognostic impact of low serum uric acid (UA) remains unclear. Emerging evidence suggests hypouricemia may be linked to increased mortality and adverse outcomes. This study aimed to assess the relationship between low UA levels and poor outcomes, including mortality and intensive care unit (ICU) admission, in hospitalized patients. Methods: This retrospective cohort study included 1679 hospitalized patients (744 females, 935 males) from the Internal Medicine Clinic. Patients were categorized into normal and low UA groups based on sex-specific thresholds (male: <3.4 mg/dL, female: <2.4 mg/dL). The primary outcome was in-hospital mortality; secondary outcomes were ICU admission and discharge status. Logistic regression models adjusted for age, chronic kidney disease (CKD), hypertension (HT), and coronary artery disease (CAD). A Prognostic Uric Acid Score (PUAS) was developed using significant predictors and evaluated by Receiver Operating Characteristic (ROC) analysis. Results: Low UA levels were significantly associated with higher ICU admission and mortality (p = 0.012). Multivariate analysis identified age (OR: 1.032), low UA (OR: 2.285), and CKD (OR: 1.571) as predictors of poor prognosis. PUAS showed moderate performance (AUC: 0.664), with a cutoff score of 3.5 optimizing sensitivity and specificity. Conclusions: Low UA levels independently predict mortality and poor prognosis in hospitalized patients. These findings support routine UA monitoring and suggest hypouricemia may be a useful prognostic biomarker. Further studies are needed to understand clinical implications and guide UA-targeted interventions.

The objective is to investigate the potential adverse effects of iron deficiency and iron deficiency anemia on renal functions by utilizing plasma Neutrophil Gelatinase-Associated Lipocalin (NGAL) levels. From September 2021 to February 2022, plasma NGAL levels, hemogram, biochemical parameters were assessed in all participants. They were divided into three groups: Group I (non-anemic iron deficiency), Group II (iron deficiency anemia), and Group III (healthy controls), with comparative analyses conducted. Group I had 38 individuals, Group II had 75 individuals, and Group III included 57 individuals. Plasma NGAL levels were higher in Groups I and II compared to Group III, with no significant difference between Groups I and II. ROC analysis revealed an AUC of 0.63 for NGAL in distinguishing Group II from Group III. No significant disparities were found in serum creatinine and glomerular filtration rate levels among the groups. A significant negative correlation was observed between plasma NGAL levels and ferritin, iron, hemoglobin, and mean corpuscular volume (MCV) levels. Plasma NGAL levels were significantly higher in adult patients with non-anemic iron deficiency and iron deficiency anemia compared to the healthy group. This suggests that elevated plasma NGAL levels in these patients might indicate renal injury due to various mechanisms.

Background and Objectives: The relationship between psychiatric disorders and systemic inflammation remains incompletely understood. Increasing evidence suggests that inflammatory processes may play a role in the biological mechanisms underlying suicidal behavior. This study aimed to investigate the association between classical inflammatory markers and hemogram-derived inflammatory indices in patients who attempted suicide by oral drug overdose. Materials and Methods: This retrospective observational comparative study included 343 patients hospitalized following a suicide attempt by oral medication overdose and 421 age- and sex-matched healthy individuals. Serum C-reactive protein (CRP), albumin levels, complete blood count parameters, and derived inflammatory indices, including the CRP-to-albumin ratio (CAR), neutrophil-to-lymphocyte ratio (NLR), systemic immune–inflammation index (SIII), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR), were analyzed. Results: Patients with suicide attempts had significantly higher CRP, leukocyte, neutrophil, and monocyte levels compared to the comparison group. CAR, NLR, SIII, and MLR values were also significantly elevated, whereas PLR did not differ between groups. ROC analysis demonstrated that CAR showed the highest discriminative ability for suicide attempt, with high sensitivity and specificity. Conclusions: Hemogram-derived inflammatory indices, particularly CAR, were significantly associated with suicide attempts. These easily accessible and low-cost biomarkers may provide additional biological insight into suicide risk assessment. Further prospective studies are needed to confirm these findings.

Background/Objectives: Beyond glycemic control, oral antidiabetic drugs (OADs) may exert class-specific effects on muscle mass and hematologic parameters. However, real-world evidence comparing these effects across OAD classes remains limited. This study aimed to evaluate the differential effects of commonly prescribed OADs on skeletal muscle mass (SMM) and hemoglobin (Hb) levels in adults with type 2 diabetes mellitus (T2DM). Methods: In this prospective observational cohort study, 60 adults with newly initiated OAD therapy were followed for six months at a tertiary care center in Türkiye. Patients were classified according to the OAD class newly added to their regimen (metformin, sulfonylureas, dipeptidyl peptidase-4 inhibitors, pioglitazone, or sodium–glucose cotransporter-2 inhibitors [SGLT2-i]). Multi-frequency bioelectrical impedance analysis was used to evaluate body composition, and hematologic parameters including Hb were obtained at both time points. To account for potential confounders—including age, sex, BMI, baseline Hb, and eGFR—binary logistic regression analyses were performed. Results: Patients initiated on pioglitazone (n = 11) demonstrated a borderline within-group increase in SMM in unadjusted analysis (median delta +0.17 kg, IQR −0.55 to +0.50; p = 0.050); however, this association was attenuated and no longer statistically significant after multivariable adjustment (OR 2.16, 95% CI 0.60–7.83; p = 0.240). In contrast, SGLT2-i users (n = 28) showed a significant increase in Hb (median delta +0.10 g/dL, IQR −0.30 to +0.50; p = 0.022), which remained significant after adjustment (OR 4.22, 95% CI 1.32–13.44; p = 0.015). Other OAD classes were not associated with meaningful changes in SMM or Hb. Conclusions: In this real-world prospective cohort, pioglitazone showed a trend toward increased SMM in unadjusted analysis that did not reach significance after adjustment, suggesting a hypothesis-generating signal warranting further investigation. SGLT2 inhibitors were independently associated with increased Hb levels, though the observed median increment was modest in absolute terms. These findings highlight potentially clinically relevant, non-glycemic effects of OAD classes and may inform individualized treatment selection, particularly in patients at risk of sarcopenia or anemia. Adequately powered, prospective studies are needed to validate and extend these preliminary observations.

Background: Parathyroid hormone (PTH) is closely linked to mineral metabolism, kidney function, inflammation, and cardiovascular disease. However, its clinical significance in unselected hospitalized populations remains insufficiently characterized. We aimed to evaluate the prevalence of elevated PTH and its association with long-term mortality in a real-world cohort of internal medicine inpatients. Methods: In this retrospective cohort study, electronic records of adults hospitalized in an internal medicine department in 2019 were reviewed. Patients with available in-hospital PTH measurements were included. Elevated PTH was defined as >88 pg/mL. Clinical characteristics and laboratory parameters were recorded. The primary outcome was all-cause mortality with a minimum follow-up of 2 years. Cox proportional hazards models adjusted for clinically relevant covariates were used to examine the association between PTH and mortality. Results: A total of 1595 patients were included, of whom 567 (35.5%) had elevated PTH levels. Patients with elevated PTH were older and had a higher burden of chronic kidney disease, cardiovascular disease, and inflammatory and nutritional abnormalities. During a mean follow-up of 22 ± 13 months, mortality occurred more frequently in patients with elevated PTH than in those with normal levels (56.1% vs. 33.7%, p < 0.001). After multivariable adjustment, elevated PTH remained independently associated with increased mortality risk-adjusted HR (1.36, 95% CI 1.15–1.62, p < 0.001). Conclusions: Elevated PTH is common among hospitalized internal medicine patients and is associated with increased long-term mortality. PTH may represent an integrated biomarker reflecting disease burden, inflammation, and renal dysfunction and could contribute to risk stratification in hospitalized populations. Prospective studies are warranted to clarify underlying mechanisms and clinical implications.