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    Evaluation of hepatic steatosis in obese children and adolescents using immune-inflammatory markers and shear wave elastography
    (Sciendo, 2025) Akcicek, Mehmet; Dag, Nurullah
    Aim To investigate the changes in liver stiffness and immune-inflammatory markers associated with obesity and the degree of hepatic steatosis in obese children and adolescents. Methods A total of 76 obese children and adolescents aged 6-18 years, with body mass index percentiles >95th, were included in the study. Patients with metabolic syndrome, diabetes mellitus, and chronic liver disease were excluded. A control group of 44 patients of healthy and normal-weight children was included. Laboratory values from the past month were analyzed using patient records. Shear wave elastography and ultrasound examinations were performed on a single device by the same experienced radiologist. Results The systemic immune-inflammation index and pan-immune inflammation values were significantly higher in obese patients with hepatic steatosis compared to obese patients without hepatic steatosis (p <0.001). Liver stiffness values were significantly higher in steatotic patients compared to nonsteatotic patients (p <0.001). A significant difference was observed between hepatic steatosis grades in terms of immune-inflammation index and pan-immune inflammation value values (p <0.001). There was a strong, positive, statistically significant correlation between liver stiffness and immune-inflammation index and pan-immune inflammation value (p <0.05). Conclusions Immune-inflammatory biomarkers and shear wave elastography may provide valuable insights into the diagnosis and follow-up of inflammation and fibrosis in the evaluation of hepatic steatosis in obese children and adolescents.
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    Evaluation of meniscal elasticity using shear wave elastography in obese children and adolescents: a preliminary cross-sectional study
    (Springer, 2024) Dag, Nurullah; Sinanoglu, Muhammed S.
    Background Musculoskeletal problems such as pain, joint pathology, increased risk of fracture, and the development of structural deformities are common in childhood obesity. Increased mechanical stress on the knee joint leads to degenerative changes in the cartilage and meniscus. Meniscal elasticity values increase in meniscal degeneration. Shear wave elastography (SWE) is an ultrasound-based imaging technique based on the principle of measuring tissue elasticity.Objective We aimed to investigate the changes in meniscal stiffness and thickness that can be caused by obesity in children and adolescents using SWE.Materials and methods In this prospective cross-sectional study, the menisci of obese (n=44) and age- and sex-matched healthy weight (n=44) children and adolescents were assessed by SWE. Meniscal elasticity was measured in kPa on the coronal plane. Independent samples t-test was used to compare meniscal elasticity values between groups. Additionally, Pearson's correlation test was used to examine the relationships between elasticity values and age, height, weight, and body mass index (BMI).Results Meniscal elasticity values were significantly higher in the obese group than in the control group (P<0.001). In both groups, there was no significant difference in meniscal stiffness between the boys and girls or between the right and left sides. In the obese group, there were weak and moderate positive correlations between meniscal elasticity values and age, weight, and BMI (P<0.05). There was no significant difference in meniscal thickness between the obese and control groups.Conclusion Meniscal stiffness is increased in obese children and adolescents.
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    Evaluation of the core muscles of children and adolescents with nocturnal enuresis using shear wave elastography: a preliminary study
    (Nature Portfolio, 2025) Sinanoglu, Muhammed Selcuk; Dag, Nurullah; Sinanoglu, Bercem; Ozdemir, Filiz
    The purpose of this study was to determine any changes in the rectus abdominis and diaphragm muscles, which are core muscles, in children and adolescents with nocturnal enuresis (NE) using the shear wave elastography (SWE). In this case-control study, the rectus abdominis and diaphragm muscles of 40 children and adolescents with NE and 40 healthy controls were evaluated. The rectus abdominis muscle was examined at the right supra- and subumbilical levels, and the diaphragm at the right 9th-10th intercostal space. The thickness of both muscles was measured by gray scale ultrasound and muscle stiffness was measured by SWE. The demographic characteristics of the patients such as sex and age and their anthropometric measurements including height, weight, and BMI were recorded. Compared to the control group, the NE group had significantly lower mean rectus abdominis muscle stiffness values on both the supraumbilical and subumbilical levels (p < 0.05). There was no significant difference in mean rectus abdominis thickness and diaphragm thickness-stiffness values between the groups (p > 0.05). According to the results of the study, it is thought that NE children have problems with core stabilization and that children with NE should be directed to appropriate treatment. However, future studies are needed with larger sample sizes and other factors that are thought to affect muscle architecture.
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    Ultrasound and shear wave elastography assessment of diaphragm thickness and stiffness in malnourished pediatric patients
    (Springer, 2024) Sinanoglu, M. Selcuk; Gungor, Sukru; Dag, Nurullah; Varol, Fatma Ilknur; Kenc, Senay; Gok, Emre
    Our objective was to obtain information about diaphragm muscle mass, strength, and quality using conventional US and US-based imaging method shear wave elastography (SWE) in pediatric patients with primary malnutrition. We also sought to evaluate the usability of SWE in the diagnosis and follow-up of sarcopenia. We evaluated the diaphragm thickness and stiffness of patients diagnosed with primary malnutrition in the pediatrics and pediatric gastroenterology outpatient clinic using US and US-based SWE. The data were compared with those of an age- and gender-matched healthy control group. The study included 115 volunteers. Of the cases included, 53 were healthy controls and 62 (54%) were patients with primary malnutrition. There was no significant difference between the groups in terms of age and gender (p = 0.891 and p = 0.923, respectively). The malnourished patient group had significantly lower diaphragm thickness and stiffness. There is a significant positive correlation between anthropometric measurement Z scores and diaphragm thickness and stiffness.Conclusion: Our study indicated that there was a reduction in the thickness of the diaphragm and a decline in its stiffness, which could be an indirect indicator of the quality and strength of the diaphragm muscle. These findings suggest that US and SWE evaluation of the diaphragm muscle may have the potential for use in the diagnosis and follow-up of sarcopenia. However, further comprehensive randomized controlled studies are needed to confirm this. What is Known: center dot Magnetic resonance imaging, computed tomography, and dual-energy x-ray absorptiometry are commonly used in the evaluation of sarcopenia. center dot The psoas and paraspinal muscles are commonly used in the evaluation of sarcopenia. What is New: center dot Ultrasound and shear wave elastography can be used in the evaluation of pediatric sarcopenia. center dot Diaphragm muscle can be used in the evaluation of pediatric sarcopenia.