Background: Non-alcoholic fatty liver disease (NAFLD) is a global public health issue. Although liver biopsy remains the gold standard for diagnosing hepatosteatosis, its invasiveness, high cost, and associated risks limit its widespread use. Therefore, there is a need for reliable, non-invasive, and cost-effective biomarkers to aid in the early detection of NAFLD. Our objective was to determine the utility of the triglyceride (TG)-to-high-density-lipoprotein (HDL) ratio in predicting non-alcoholic fatty liver disease. Methods: This retrospective cross-sectional study included 2588 patients who met the inclusion criteria. Demographic data and laboratory results were collected from electronic health records. Experienced radiologists performed abdominal ultrasonography to assess fatty liver according to the EASL 2021 criteria. The TG/HDL ratio and other non-invasive scores (APRI, FIB-4, ALT/AST, TG/glucose) were calculated. Early-stage disease was defined as grade 1 or grade 2 hepatosteatosis. Results: The TG/HDL ratio was significantly higher in NAFLD patients (AUROC: 0.682) and outperformed the other non-invasive indices. At the optimal cut-off value of 1.86, the sensitivity was 80.7%, and the specificity was 45.5%. The TG/HDL ratio correlated positively with markers of glycemic control, inflammation, and liver enzymes. Conclusions: The TG/HDL ratio is an accessible and valuable parameter for predicting non-alcoholic fatty liver disease. It offers a non-invasive alternative to liver biopsy and potentially prevents complications from non-alcoholic fatty liver disease or diagnostic approaches.

Background/Objectives: Cardiovascular complications are the most common cause of mortality and morbidity in diabetic patients. Therefore, the aim of antidiabetic therapy should not only be to provide glucose regulation but also to protect patients from complications and related mortality. Brain natriuretic peptide (BNP) is a peptide secreted as a result of myocardial stress. BNP levels increase under conditions of increased myocardial stress, such as heart failure. It is an important marker not only at the time of diagnosis but also during follow-up. In our study, we aimed to evaluate BNP levels and thus, the factors affecting the risk of developing heart failure during the course of diabetes. Methods: This study was conducted at the diabetes outpatient clinic of the University of Health Sciences, Haseki Training and Research Hospital. A total of 252 patients met the inclusion criteria and were enrolled in the study. All study participants were patients with a confirmed diagnosis of type 2 diabetes. Laboratory parameters, including BNP values, comorbidities, and anamnesis data, were recorded. Results: The mean BNP levels were significantly lower in patients using metformin and pioglitazone. Other antidiabetic medications were not associated with BNP levels. BNP levels were positively correlated with age and diabetes duration and negatively correlated with hemoglobin levels. According to regression analysis, age, metformin use, and hemoglobin levels were found to independently affect BNP levels. Conclusions: Our findings suggest that metformin could potentially play a significant role in preventing the development of heart failure in diabetic patients currently not experiencing this complication owing to its favorable effects on myocardial stress. This suggests metformin’s potential in preventing heart failure in type 2 diabetic patients.

Background/Objectives: Mild autonomous cortisol secretion (MACS) is increasingly recognized in patients with adrenal incidentalomas. While associated with cardiometabolic risk, management strategies remain controversial, particularly regarding functional outcomes. This retrospective comparative cohort study evaluated the impact of adrenalectomy versus conservative management on muscle strength in MACS patients. Materials and Methods: Forty patients with MACS (1-mg dexamethasone suppression test > 1.8 µg/dL) were enrolled: 15 underwent adrenalectomy and 25 received conservative management. Hand grip strength was measured using calibrated dynamometry, and gait speed was assessed with the 1-m walk test at baseline and 6 months. Results: Baseline characteristics are summarized descriptively for the surgical and conservative cohorts. At 6 months, the surgery group showed significant improvements in right hand grip strength (+1.19 ± 0.64 kg, p < 0.001) and left hand grip strength (+1.15 ± 0.49 kg, p < 0.001), representing approximately 5% improvement. In contrast, the conservative group exhibited significant decreases in strength over the same period (right: −0.40 ± 0.25 kg; left: −0.28 ± 0.28 kg, both p < 0.001). The post-surgical 1-mg dexamethasone suppression test decreased from 4.05 ± 1.44 to 1.01 ± 0.34 µg/dL (p < 0.001). Conclusions: Adrenalectomy results in significant improvement in objective muscle strength in MACS patients, with improvement observed in parallel to biochemical resolution of cortisol excess. In contrast, conservative management was associated with progressive decline in grip strength over 6 months. Hand grip dynamometry provides valuable functional outcome data that may guide surgical decision-making in MACS management.

Introduction: Ultrasound-guided microwave ablation is a minimally invasive alternative to surgery for symptomatic benign thyroid nodules, but most outcome data originates from East Asian centres, and evidence from European and Middle Eastern populations is limited. We evaluated the 12-month volumetric response, safety and subgroup outcomes of microwave ablation in a Turkish cohort. Methods: In this single-centre retrospective cohort, 180 consecutive patients with cytologically benign thyroid nodules and complete follow-up underwent ultrasound-guided microwave ablation between January 2019 and May 2025. Thyroid nodule volume was measured by ultrasound at baseline and at 3, 6 and 12 months; volume reduction rate was the primary outcome. Change over time was assessed with repeated-measures analysis of variance (volume) and the Friedman test (volume reduction rate). Results: Mean volume of benign thyroid nodules fell from 10.29 ± 4.15 to 2.86 ± 1.23 cm ³ ( F = 999.7, p < 0.001, η p 2 = 0.848). The median volume reduction rate rose from 40.9% at 3 months to 62.5% at 6 months and 72.6% at 12 months ( p < 0.001). All patients reached ⩾50% volume reduction rate by 6 months, and 65.6% reached ⩾70% by 12 months. Outcomes were independent of sex and baseline volume. No major complications occurred, and 80.6% reported complete symptom resolution. Conclusion: Ultrasound-guided microwave ablation achieved substantial and safe 12-month volume reduction in benign thyroid nodules, supporting it as a viable alternative to thyroidectomy in carefully selected patients.

Background: Non-alcoholic fatty liver disease (NAFLD) is a global public health issue. Although liver biopsy remains the gold standard for diagnosing hepatosteatosis, its invasiveness, high cost, and associated risks limit its widespread use. Therefore, there is a need for reliable, non-invasive, and cost-effective biomarkers to aid in the early detection of NAFLD. Our objective was to determine the utility of the triglyceride (TG) to high-density lipoprotein (HDL) ratio in predicting non-alcoholic fatty liver disease. Methods: This retrospective cross-sectional study included 2588 patients who met the inclusion criteria. Demographic data and laboratory results were collected from electronic health records and recorded. Experienced radiologists performed abdominal ultrasonography to assess fatty liver in line with EASL 2021 criteria. The TG/HDL ratio and other non-invasive scores (APRI, FIB-4, ALT/AST, TG/Glucose) were calculated. Results: TG/HDL ratio was significantly higher in NAFLD patients (AUROC: 0.682), outperforming other non-invasive indices. At the optimal cut-off value of 1.86, sensitivity was 80.7% and specificity 45.5%. The TG/HDL ratio correlated positively with markers of glycemic control, inflammation, and liver enzymes. Conclusions: The TG/HDL ratio is an accessible and valuable parameter in predicting non-alcoholic fatty liver disease. It offers a non-invasive alternative to liver biopsy and potentially prevents complications from non-alcoholic fatty liver disease or diagnostic approaches.