Prevalence, determinants, and fibrosis risk stratification of metabolic-associated fatty liver disease in a Turkish primary care setting: A retrospective study.

Background and Aim: Metabolic-associated fatty liver disease (MAFLD) is a condition that frequently goes unnoticed as it typically remains asymptomatic until progressing to an advanced stage. As a result, it is essential to implement opportunistic screening initiatives within family medicine practices to accurately identify and refer selected at-risk patients to specialized care. This study aims to investigate the prevalence of MAFLD and advanced hepatic fibrosis among primary care patients in Turkiye by utilizing non-invasive tests. Materials and Methods: We performed a retrospective analysis of prospectively collected data from February 1, 2022, to April 14, 2023, at a Family Medicine Outpatient Clinic. The Hepatic Steatosis Index (HSI) was used to identify fatty liver cases, followed by established MAFLD criteria for diagnosis. Patients were then categorized based on advanced fibrosis risk using the fibrosis-4 (FIB-4) index. Results: Among the 450 patients who sought primary care during the study period (286 women and 164 men; mean age: 48.2±13.7 years), 295 (65.6%) were diagnosed with MAFLD using HSI values and established criteria. Diabetes mellitus emerged as the sole independent predictor of MAFLD. FIB-4 values classified 242 (82%) and 53 (18%) patients with MAFLD at low and intermediate risk of advanced fibrosis, respectively, with none at high risk. Conclusion: MAFLD exhibits a notable prevalence among Turkish patients who presented at a Family Medicine Outpatient Clinic. Given the growing impact of metabolic diseases, primary care providers and non-liver specialists should actively participate in MAFLD screening programs.

COVID-19 Vaccine hesitancy and influencing factors: An example from Turkey.

Objective: To find out the opinions concerning vaccine hesitancy of people and influencing factors who had not received COVID-19 vaccination. Methods: This is a descriptive cross-sectional study. It was carried out between February and April 2022 with individuals who were not vaccinated against COVID-19. It included 634 participants registered at a family health center in Rize, Turkey. Data were collected by telephone using a questionnaire. For statistical analysis, the R programming language was used. The Boruta algorithm was used to rank the variables associated to the reasons for not trusting the vaccine. Results: "I do not trust vaccines (67%)" is the most frequently cited reason for not being vaccinated. The most often cited reasons for not trusting vaccinations are that vaccines are produced for the benefit of foreign companies (56.2%), vaccines are ineffective (55.5%), and vaccines have not undergone sufficient scrutiny (53.2%). According to Boruta analyses, the top three variables most closely associated with not trusting COVID-19 vaccines were belief that vaccines are produced for the benefit of foreign countries/vaccines companies, imported vaccines have not undergone sufficient scrutiny, and vaccines being ineffective. Conclusions: People do not get vaccinated because they do not trust vaccinations due to concerns about their safety, effectiveness, political influences, and potential adverse effects.

Changes in body mass index-z scores in 3-year-old children during the COVID-19 pandemic: a 2-year retrospective cohort study.

OBJECTIVE: Given how dramatically the pandemic has affected food systems, the economy, and the daily lives of children over the past 2 years, the potential impact of the pandemic on childhood obesity requires careful investigation. The aim of this study was to investigate the change in body mass index z-score in 3-year-old children and the inducing factors during the pandemic period. METHODS: The body mass index z-scores of all children participating in the study were calculated at the beginning of the pandemic (3-year-old body mass index z-score) and in its second year (5-year-old body mass index z-score). RESULTS: This study, conducted during the 2-year pandemic period, found a strong association between the body mass index z-scores of children aged 3 and 5 years. The mean body mass index z-score increased between these time points for both boys and girls (p=0.013; p=0.034). In two different linear regression models created for the change in body mass index z score, gestational weight gain was found to be related. The regression coefficients (95% confidence intervals) and corresponding p-values were 0.580 (0.217-0.944) and p=0.002 for model 1, whereas they were 0.585 (0.217-0.961) and p=0.002 for model 2. CONCLUSION: This study showed an increase in body mass index z-scores in early childhood period during the COVID-19 pandemic. To prevent this increase, new strategies should be developed by considering the changes brought by the pandemic period.

Evaluation of malnutrition frequency and related factors of geriatric patients in need of home healthcare.

OBJECTIVE: The nutritional status of frail elderly people receiving home health services should be evaluated. This study aimed to determine the nutritional status of patients aged ≥65 years registered in the Home Healthcare Services unit and investigate the factors that may be associated with malnutrition. METHODS: This cross-sectional descriptive study was conducted during routine visits to patients and their caregivers. A total of 161 patients were asked to fill in surveys asking about sociodemographic characteristics, patient history, and clinical status. Anthropometric measurements were taken from all patients. The Mini Nutritional Assessment Short Form was applied to the patients for screening purposes. Patients who scored ≤11 on the Mini Nutritional Assessment Short Form were then asked to complete the full Mini Nutritional Assessment form. RESULTS: According to the Mini Nutritional Assessment Short Form and Mini Nutritional Assessment tests, almost half of the elderly patients included in the study (49.7%, n=161) were malnourished or at risk of malnutrition. Analyses showed that those who had COVID-19 [odds ratio (OR): 9.423, 95%CI 2.448-36.273) and those diagnosed with dementia/depression (OR: 8.688, 95%CI 3.246-23.255) were more likely to be malnourished, whereas those with diabetes (OR: 0.235, 95%CI 0.084-0.657) were less likely to have malnutrition. Strikingly, those who were fed by caregivers (OR: 15.061, 95%CI 3.617-62.710) were also more likely to be malnourished than those with self-feeding ability. CONCLUSION: Malnutrition or the risk of malnutrition is common in elderly patients receiving home care services. Many factors can have an impact on malnutrition.

Changes in body mass index-z scores in 3-year-old children during the COVID-19 pandemic: a 2-year retrospective cohort study

SUMMARY OBJECTIVE: Given how dramatically the pandemic has affected food systems, the economy, and the daily lives of children over the past 2 years, the potential impact of the pandemic on childhood obesity requires careful investigation. The aim of this study was to investigate the change in body mass index z-score in 3-year-old children and the inducing factors during the pandemic period. METHODS: The body mass index z-scores of all children participating in the study were calculated at the beginning of the pandemic (3-year-old body mass index z-score) and in its second year (5-year-old body mass index z-score). RESULTS: This study, conducted during the 2-year pandemic period, found a strong association between the body mass index z-scores of children aged 3 and 5 years. The mean body mass index z-score increased between these time points for both boys and girls (p=0.013; p=0.034). In two different linear regression models created for the change in body mass index z score, gestational weight gain was found to be related. The regression coefficients (95% confidence intervals) and corresponding p-values were 0.580 (0.217-0.944) and p=0.002 for model 1, whereas they were 0.585 (0.217-0.961) and p=0.002 for model 2. CONCLUSION: This study showed an increase in body mass index z-scores in early childhood period during the COVID-19 pandemic. To prevent this increase, new strategies should be developed by considering the changes brought by the pandemic period.

The Role of Hematological Inflammatory Biomarkers in the Diagnosis of Lung Cancer and in Predicting TNM Stage.

OBJECTIVE: The aim of study is to investigate whether hematological inflammatory biomarkers could be useful to detect patients with lung cancer. METHODS: The contribution of hematological biomarkers to the diagnosis of lung cancer and prediction of TNM was examined. RESULTS: NLR, PLR, MPV values were found to be higher in patients with lung cancer (all p < .001). NLR and PLR were found to be high, MPV was found to be lower in disease of advanced stage (p < .001). CONCLUSIONS: This study found that NLR, PLR and MPV values were significantly higher in patients with lung cancer.

Caesarean delivery increases the risk of overweight or obesity in 2-year-old children.

The aim of this prospective cohort study was to reveal the effect of mode of delivery, independently of other confounders, on the risk of overweight or obesity in infants (age-sex-specific body mass index ≥ 85th percentile). In total, 294 infants born in the Rize Province between November 1 2013, and September 30 2014, and their mothers were included; all infants attended well-child visits with the same family physician for up to two years. Multivariate logistic regression analysis was performed to determine significant associations. The odds ratio (OR) of overweight and obese children aged 2 years in association with the mode of delivery was estimated by logistic regression analysis. In crude analysis, compared with vaginal delivery, the use of Caesarean Section delivery was associated with the risk of childhood overweight or obesity [OR: 2.06; 95% confidence interval (CI): 1.08-4.30]. Even after multivariate adjustment, this increased risk persisted (adjusted OR: 1.93; 95% CI: 1.13-4.18). In conclusion, significantly increased risk of overweight or obesity was found in 2-year-old children born via Caesarean delivery.Impact statementWhat is already known on this subject? Although there are studies on the relationship between childhood obesity and Caesarean Section delivery, results are inconsistent.What do the results of this study add? This is the first prospective cohort study showing the effect of Caesarean delivery on childhood obesity in Turkish children.What are the implications of these findings from clinical practice and/or further research? Future studies should further investigate the exact reasons underlying the association between Caesarean delivery and childhood metabolic syndrome.

Maternal Gestational Diabetes and Early Childhood Obesity: A Retrospective Cohort Study.

Background: Recently, childhood obesity has become one of the most serious public health problems in the world. Gestational diabetes mellitus (GDM) is considered a risk factor for childhood overweight and obesity. The study aimed at investigating the relationship between maternal GDM and childhood obesity in children aged from 1 to 3 years. Methods: In this retrospective cohort study, 237 GDM and 296 non-GDM mothers and their offspring who were followed up by Family Medicine Clinics in Rize province of Turkey were assessed. World Health Organization (WHO) criteria were used for the diagnosis of maternal GDM. Crude and adjusted logistic regression models were calculated for the association of gestational diabetes and childhood overweight/obesity. Gender and age-specific percentile tables were used for the categorization of BMI. Results: Statistical analysis carried out with adjustment for potential confounders (mother's age, educational status, smoking status, BMI, gestational weight gain, children's gender, and gestational birth weight) provided results with an odds ratio of 2.99; 95% CI 1.14-7.94 and 7.77; 95% CI 1.92-31.37 for the impact of gestational diabetes on childhood overweight and obesity at 2 and 3 years of age, respectively. Conclusions: This study found evidence for maternal GDM to cause the risk of early childhood obesity. Therefore, proper intervention strategies are required for this high-risk population.

Relationship between anaemia during pregnancy and preterm delivery.

The purpose of this study was to analyse the relationship between preterm delivery and maternal anaemia. This retrospective cohort study was completed with 483 women; 294 of them had a normal delivery and 189 had a preterm delivery. The haemoglobin (Hb) values of all the women participating in the study were measured in the first and second trimesters, and the average Hb values were calculated. The pregnant women participating in the study were divided into three groups, according to their Hb level: those with Hb level <10 g/dl, those with Hb level between 10 and 11 g/dl and those with Hb level >11 g/dl. In crude analysis, women with low Hb levels had an increased rate of preterm delivery (odds ratio, 2.42; 95% CI, 1.07-5.49). Our study provides data that low Hb level is effective in preterm delivery. Impact statement What is already known on this subject? Serum Hb levels have inconsistent associations with a risk of preterm delivery. What the results of this study add? Compared with term delivery Hb levels are lower in preterm delivery. It is necessary to take into account the Hb levels of both the first and second trimester of the pregnancy when describing the pregnancy anaemia. What the implications are of these findings for clinical practice and/or further research? Given these results, physicians should take into account anaemia in pregnancy when considering the risk of a preterm delivery.

Effects of infant feeding practices and maternal characteristics on early childhood obesity. / Efectos de las prácticas alimentarias durante la lactancia y de las características maternas en la obesidad infantil.

INTRODUCTION: Early childhood obesity is a serious health problem not only because it causes serious health problems in children, but also because it poses a risk of obesity in the later stages of life. OBJECTIVE: The aim of our study was to determine the effect of feeding (breastfeeding times, exclusive breastfeeding times, instances of night-time bottle feeding) and maternal characteristics (weight gain during pregnancy, BMI, socioeconomic status) on childhood overweight and obesity in children up to 36 months old. POPULATION AND METHODS: Babies born in the province of Rize (Turkey) between the dates of November 1, 2013 and September 30, 2014 whom birth weights between 2500gr and 4500gr participated in our prospective cohort study. The present study lasted for 3 years and 11 interviews were conducted with each mother of the infants during this period. Relationship between obesity or overweight and feeding practices evaluated into two groups according to their feeding practices. RESULTS: 294 healthy children were included. Mean weight of the babies at 36 months were 14.6 kilograms, 6 babies (2 %) were overweight, 20 babies (7 %) were obese, and 268 babies (91 %) were at an normal weight. 82 babies (21 %) exclusive breastfed less than six months and 212 babies (55 %) exclusive breastfed six months or more. Overweight and obesity is less frequent among children who were exclusively breastfed for at least six months (p<0.05). CONCLUSION: We concluded.that exclusive breastfeeding time and maternal obesity have a significant effect on childhood overweight and obesity.

Introducción. La obesidad infantil es un problema de salud grave en los niños e implica un riesgo posterior de obesidad. Objetivo. El objetivo fue determinar el efecto de la alimentación (tiempo de lactancia materna, de lactancia materna exclusiva, lactancia artificial nocturna) y de las características maternas (aumento de peso durante el embarazo, IMC, situación socioeconómica) en el sobrepeso y la obesidad en niños hasta 36 meses. Población y métodos. Se incorporaron al estudio bebés nacidos en Rize (Turquía) entre el 1 de noviembre de 2013 y el 30 de septiembre de 2014, con pesos al nacer entre 2500 g y 4500 g. En tres años, se hicieron 11 entrevistas con las madres. Los niños se asignaron a dos grupos para evaluar la relación entre la obesidad o el sobrepeso y las prácticas alimentarias. Resultados. Se incluyeron 294 niños sanos. El peso medio de los bebés a los 36 meses fue 14,6 kg; 6 (2 %) tenían sobrepeso; 20 (7 %) eran obesos y 268 (91 %) tenían peso normal. De ellos, 82 (21 %) habían recibido exclusivamente leche materna durante menos de seis meses y 212 (55 %) solo leche materna durante seis meses o más. El sobrepeso y la obesidad fueron menos frecuentes entre los niños que recibieron exclusivamente leche materna durante al menos seis meses (p< 0,05). Conclusión. El tiempo de lactancia materna exclusiva y la obesidad materna tienen un efecto importante en el sobrepeso y la obesidad infantiles.

Efecto de la lactancia en las infecciones pediátricas frecuentes: estudio de cohorte prospectivo de cinco años / Effect of breastfeeding on common pediatric infections: a 5-year prospective cohort study

Introducción. En los estudios realizados se encontró que la duración de la lactancia tiene un efecto reductor sobre las infecciones frecuentes en los niños durante el período de lactancia. Objetivo. El objetivo de este estudio fue abordar la asociación entre la duración de la lactancia y las enfermedades infecciosas frecuentes en los niños hasta los 5 años de edad para demostrar los efectos protectores de la leche materna. Población y métodos. Se incluyeron 411 lactantes nacidos en Rize, Turquía, entre enero de 2011 y diciembre de 2011. Este estudio de cohorte, prospectivo duró cinco años; en este período, se realizaron 11 entrevistas con cada madre de los lactantes. Se dividió a los lactantes en dos grupos: amamantados durante más y menos de 12 meses, y se estudió la asociación entre la lactancia y las infecciones, como otitis media aguda, gastroenteritis aguda, infección respiratoria aguda e infección urinaria. Resultados. De los 411 nacimientos, se incluyeron 270 lactantes, 193 (71,5%) recibieron lactancia durante más de 12 meses y 77 (28,5%), durante menos de 12 meses. Los lactantes del primer grupo tuvieron menos casos de otitis media aguda y gastroenteritis aguda (n = 77; 28,52%) en comparación con los lactantes amamantados durante menos de 12 meses en el período de cinco años (p < 0,05). Conclusiones. Con este estudio se detectó que la lactancia durante más de 12 meses reduce significativamente las infecciones frecuentes durante la niñez, como la otitis media y la gastroenteritis durante los primeros cinco años de vida.

Introduction.The studies conducted revealed that breastfeeding duration has a reducing effect on common infectious diseases in the children during breastfeeding period. Objective. The aim of the present study was to address the association between breastfeeding duration and common infectious diseases in the children until 5 years of age to show long-term protective effects of the breast milk. Material and methods. The study included 411 infants who were born in Rize (Turkey) between January 2011 and December 2011. The present prospective-cohort study lasted for 5 years and 11 interviews were conducted with each mother of the infants during this period. The infants were divided into two groups as those who were breastfed more and less than 12 months and the association between breastfeeding and infections such as acute otitis media, acute gastroenteritis, acute respiratory tract infections and acute urinary system infections was investigated. Results. Of 270 infants 193 (71.5%) were breastfed longer than 12 months and 77 (28.5%) were breastfed less than 12 months. Infants in the first group had less acute otitis media and acute gastroenteritis (n= 77, 28.52%) when compared with the infants breastfed less than 12 months during 5-year period (p <0.05). Conclusion. The present study detected that breastfeeding duration longer than 12 months significantly reduces the common childhood infections such as otitis media and gastroenteritis during the first 5 years of life.

Effect of breastfeeding on common pediatric infections: a 5-year prospective cohort study. / Efecto de la lactancia en las infecciones pediátricas frecuentes: estudio de cohorte prospectivo de cinco años.

INTRODUCTION: The studies conducted revealed that breastfeeding duration has a reducing effect on common infectious diseases in the children during breastfeeding period. OBJECTIVE: The aim of the present study was to address the association between breastfeeding duration and common infectious diseases in the children until 5 years of age to show long-term protective effects of the breast milk. MATERIAL AND METHODS: The study included 411 infants who were born in Rize (Turkey) between January 2011 and December 2011. The present prospective-cohort study lasted for 5 years and 11 interviews were conducted with each mother of the infants during this period. The infants were divided into two groups as those who were breastfed more and less than 12 months and the association between breastfeeding and infections such as acute otitis media, acute gastroenteritis, acute respiratory tract infections and acute urinary system infections was investigated. RESULTS: Of 270 infants 193 (71.5%) were breastfed longer than 12 months and 77 (28.5%) were breastfed less than 12 months. Infants in the first group had less acute otitis media and acute gastroenteritis (n= 77, 28.52%) when compared with the infants breastfed less than 12 months during 5-year period (p <0.05). CONCLUSION: The present study detected that breastfeeding duration longer than 12 months significantly reduces the common childhood infections such as otitis media and gastroenteritis during the first 5 years of life.

INTRODUCCIÓN: En los estudios realizados se encontró que la duración de la lactancia tiene un efecto reductor sobre las infecciones frecuentes en los niños durante el período de lactancia. OBJETIVO: El objetivo de este estudio fue abordar la asociación entre la duración de la lactancia y las enfermedades infecciosas frecuentes en los niños hasta los 5 años de edad para demostrar los efectos protectores de la leche materna. POBLACIÓN Y MÉTODOS: Se incluyeron 411 lactantes nacidos en Rize, Turquía, entre enero de 2011 y diciembre de 2011. Este estudio de cohorte, prospectivo duró cinco años; en este período, se realizaron 11 entrevistas con cada madre de los lactantes. Se dividió a los lactantes en dos grupos: amamantados durante más y menos de 12 meses, y se estudió la asociación entre la lactancia y las infecciones, como otitis media aguda, gastroenteritis aguda, infección respiratoria aguda e infección urinaria. RESULTADOS: De los 411 nacimientos, se incluyeron 270 lactantes, 193 (71,5%) recibieron lactancia durante más de 12 meses y 77 (28,5%), durante menos de 12 meses. Los lactantes del primer grupo tuvieron menos casos de otitis media aguda y gastroenteritis aguda (n = 77; 28,52%) en comparación con los lactantes amamantados durante menos de 12 meses en el período de cinco años (p < 0,05). CONCLUSIONES: Con este estudio se detectó que la lactancia durante más de 12 meses reduce significativamente las infecciones frecuentes durante la niñez, como la otitis media y la gastroenteritis durante los primeros cinco años de vida.

Evaluation of the relationship between serum apelin levels and vitamin D and mean platelet volume in diabetic patients.

OBJECTIVES: It was reported that Vitamin D deficiency was associated with a greater risk of cardiometabolic diseases, obesity, impaired glucose tolerance and diabetes mellitus type 2, arterial hypertension, and dyslipidemia. Apelin is an adipocytokine suspected to have a role in skeletal muscle glucose utilization and glycemic regulation which may be a promising treatment modality for diabetes. It was recently reported that increased mean platelet volume (MPV) was emerging as an independent risk factor for thromboembolism, stroke, and myocardial infarction. In patients with diabetes, MPV was higher compared with the normal glycemic controls; in addition, it has been proposed that an increase in MPV may play a role in the micro- and macro-vascular complications related to diabetes. We postulated that deficiency in Vitamin D levels might be associated with higher MPV and lower serum apelin levels leading a further increase in insulin resistance in diabetic patients. So, we aimed to investigate Vitamin D levels, MPV and serum apelin levels in diabetic patients and their correlations between each other. MATERIALS AND METHOD: This is a cross-sectional study design. Seventy-eight patients with Diabetes Mellitus type 2, admitted to our outpatient clinic of internal medicine department at Bezmialem Vakif University, were included in our study. Forty-one patients were female; 37 patients were male. Serum apelin levels, fasting glucose levels, urea, creatinine, triglycerides, total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), fasting serum insulin level, HbA1c, free T3, free T4, TSH, vitamin D (25-OH Vitamin D) and complete blood counts were analyzed in all subjects. RESULTS: Each sex was analyzed separately. We found that a positive correlation existed between serum apelin levels and BMI in female patients. (r: 0.380, P: 0.014) There was also a significant positive correlation between MPV and HbA1c and fasting glucose levels and a negative correlation between MPV and PLT. (r: 0.377, P: 0.021; r: 0.395, P: 0.014; r: -0.401, P: 0.011; respectively) We failed to show a significant relationship between serum vitamin D levels, serum apelin levels and MPV in patients with diabetes mellitus type 2. CONCLUSION: We failed to show an association between vitamin D, apelin and MPV higher volumes of which may have a role in cardiovascular complications related to diabetes by increasing platelet activation.

Vaspin and lipocalin-2 levels in severe obsructive sleep apnea.

BACKGROUND: Vaspin and lipocalin-2 are less-known recent members of adipocytokine family. There are ongoing studies investigating the role of vaspin ve lipocalin-2 in metabolic syndrome (MS). Obstructive sleep apnea syndrome (OSAS) is independently associated with an increased prevalence of MS. We aimed to measure the levels of vaspin and lipocalin-2 which are secreted from adipocytes in patients with severe OSAS and examine the relationship between these two adipocytokines and OSAS. METHODS: THE STUDY CONSISTED OF TWO GROUPS: severe OSAS patients with an apnea-hypopnea index (AHI) of >30/h (OSAS group, 34 subjects) and age-matched healthy volunteers with a AHI <5/h (control group, 25 subjects) Serum levels of vaspin and lipocalin-2 in these two groups were compared. RESULTS: Serum levels of vaspin were significantly lower in OSAS group; patients with severe OSAS compared with control group; healthy volunteers (OSAS group: 0.69±0.5 vs. control group: 1.24±1.13; P=0.034). The difference between the two groups in terms of serum levels of lipocalin-2 has not reached statistical significance (OSAS group: 61.6±18.2 vs. control group: 68.5±20.1; P=0.17). CONCLUSIONS: We found that serum vaspin levels were significantly lower in patients with severe OSAS compared with healthy controls. Lipocalin-2 levels were similar. The decrease in serum vaspin levels in severe OSAS patients may be important in diagnosis and follow-up of these patients.

Assessment of serum apelin and lipocalin-2 levels in patients with subclinical hypothyroidism.

OBJECTIVES: Subclinical hypothyroidism is the precursor to hypothyroidism because it has a tendency to transform into hypothyroidism. Subclinical hypothyroidism is considered one of the risk factors causing metabolic syndrome. Metabolic syndrome can be characterized by plasma levels of apelin and lipocalin-2, both released from adipocytes. In the present study, we aimed to measure serum apelin and lipocalin-2 levels of patients with subclinical hypothyroidism and compare them with serum apelin and lipocalin-2 levels from healthy individuals. METHODS: This was a cross-sectional study. A total of 80 subjects were enrolled in the study and divided into two groups: Group A included 39 patients (females, n=34) diagnosed with subclinical hypothyroidism, and Group B (the control group) comprised 41 healthy volunteers (females, n=38). Serum samples were obtained from each participant for the measurement of apelin and lipocalin-2. These were then stored at minus 80°C until the time of analysis, when serum apelin and lipocalin-2 levels of the two groups were compared. RESULTS: Patients with subclinical hypothyroidism (Group A and Group B subjects [healthy controls]) were comparable with respect to gender, age, and body mass index (BMI) (P=0.412, P=0.863, and P=0.269, respectively), nor was there a statistically significant difference between groups in terms of apelin and lipocalin-2 levels (P=0.87, and P=0.67, respectively). Apelin levels showed a positive and significant correlation with BMI (P=0.034). Serum lipocalin-2 levels showed significant positive correlations with BMI and creatinine levels (P=0.002, and P=0.025, respectively). CONCLUSION: In the present study, no significant difference of serum apelin and lipocalin-2 levels was observed between patients with subclinical hypothyroidism and healthy control subjects. Positive correlations were found, however, between serum apelin level and BMI as well as between serum lipocalin-2 and BMI and creatinine levels.