Clinical Endocrinology最新文献

{"title":"Puberty-Promoting Treatment and Psychosocial Well-Being in Boys With Constitutional Delay of Puberty: A Randomized Controlled Trial.","authors":"Laura Kariola, Tero Varimo, Mitja Lääperi, Hanna Huopio, Sirpa Tenhola, Raimo Voutilainen, Jorma Toppari, Silja Kosola, Päivi J Miettinen, Olli Raitakari, Marko Elovainio, Taneli Raivio, Matti Hero","doi":"10.1111/cen.70039","DOIUrl":"https://doi.org/10.1111/cen.70039","url":null,"abstract":"<p><strong>Objective: </strong>In boys, constitutional delay of growth and puberty (CDGP) has been associated with diverse negative psychosocial effects. Albeit alleviating distress is one of the main reasons for inducing pubertal development, the impact of puberty-promoting treatment on psychosocial wellbeing is under-researched. Our objective was to investigate the impact of puberty-promoting therapies on the behavioural patterns as defined by the temperament characteristics emotionality, activity, and sociability (EAS) in boys with CDGP.</p><p><strong>Design: </strong>The study is a randomized, controlled, open-label trial.</p><p><strong>Patients: </strong>Thirty boys were randomized to receive either aromatase inhibitor letrozole (2.5 mg/day) (n = 15) or intramuscular testosterone (1 mg/kg/every 4 weeks) (n = 15) for 6 months and followed up to 12 months. To compare our results with healthy peers, an age- and postal-code matched, and a national reference population were collected.</p><p><strong>Measurements: </strong>Temperament characteristics were evaluated with a standardized and validated questionnaire at 0-, 6-, and 12-month visits.</p><p><strong>Results: </strong>In comparison to local peers, boys with CDGP were more withdrawn (p = 0.02) and experienced less anger (p = 0.02) and fear (p = 0.02). Compared to both local and national controls, there was a significant difference in emotionality, CDGP boys being less negatively emotional than peers (p = 0.04). Sociability was higher in the Lz-group in comparison to the T-group both after the 6-month treatment period (-0.48, 95% CI: 0.89; -0.08, p = 0.019) and at 12-month follow-up (-0.72, CI: 95%, -1.12; -0.32, p = 0.001).</p><p><strong>Conclusion: </strong>Overall, boys with CDGP exhibited a generally docile temperament. The administration of puberty-promoting treatments did not result in any adverse psychosocial effects on the temperament characteristics assessed.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Influence of Health Literacy on the Control of Hypothyroidism in Patients Under Levothyroxine Treatment.","authors":"Jessyka Krause Meneses, Daniella Araujo Muniz, Débora Moroto, João Roberto Maciel Martins, Carolina Castro Porto Silva Janovsky","doi":"10.1111/cen.70047","DOIUrl":"https://doi.org/10.1111/cen.70047","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between health literacy levels and biochemical control of hypothyroidism, measured by serum TSH and free thyroxine (FT4) levels, in patients receiving levothyroxine (L-T4) therapy.</p><p><strong>Methods: </strong>We conducted a cross-sectional study at the Thyroid Disorders Outpatient Clinic, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM/UNIFESP), between April and December 2024. The protocol was approved by the institutional ethics committee (CAAE: 76540423.5.0000.5505), and all participants provided written informed consent. Adult patients aged 18-65 years with primary hypothyroidism on levothyroxine (L-T4) therapy were screened; 274 met eligibility criteria after exclusions. Health literacy was assessed using the Brazilian-Portuguese Newest Vital Sign (NVS), administered face-to-face by trained staff. Demographic and clinical data, including comorbidities, L-T4 dose, TSH, and FT4 levels, were extracted from electronic records. Biochemical analyses were performed using electrochemiluminescence immunoassays. Statistical analyses included ANOVA, χ² tests, and generalised linear regression, with significance set at p < 0.05.</p><p><strong>Results: </strong>Among 274 patients included in the final analysis, health literacy was inversely associated with serum TSH levels, and this association remained significant in fully adjusted models. A marginal trend was observed for FT4, but it did not reach statistical significance after adjustment. Patients with lower literacy scores required higher levothyroxine doses per kilogram, suggesting less efficient treatment control. No significant differences in comorbidities were observed across literacy strata.</p><p><strong>Conclusions: </strong>Limited health literacy was independently associated with poorer biochemical control of hypothyroidism, reflected by higher TSH concentrations and greater levothyroxine dose requirements. These findings reinforce health literacy as a modifiable determinant of treatment success. Incorporating literacy-sensitive strategies-such as plain-language counselling, teach-back techniques, and visual aids-into routine care may help stabilise TSH, optimise levothyroxine therapy, and improve long-term outcomes in this population.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary Gonadotropins as Markers of Puberty in Girls and Boys During Late Childhood and Adolescence: Evidence From the SCAMP Cohort.","authors":"Alexander Spiers, Supitcha Patjamontri, Rachel B Smith, Chen Shen, Mireille B Toledano, S Faisal Ahmed","doi":"10.1111/cen.70045","DOIUrl":"https://doi.org/10.1111/cen.70045","url":null,"abstract":"<p><strong>Introduction: </strong>Urinary gonadotropins measurement is a noninvasive method for evaluation of pubertal development and may have utility in population studies.</p><p><strong>Objectives: </strong>To investigate the utility of urinary gonadotropins as a noninvasive biomarker of puberty in boys and girls.</p><p><strong>Methods: </strong>School-based adolescent cohort study with two time points for collecting school time urine samples and self-reported assessment of puberty through the Pubertal Development Scale (PDS) approximately 2 years apart. FSH and LH were measured by two-site sandwich immunoassay and corrected for creatinine excretion.</p><p><strong>Results: </strong>A total of 941 samples from 741 girls and 1198 samples from 899 boys aged between 11 and 16 years were analysed. Samples were collected at a median age of 12.3 years (range 11.1, 13.2) and 14.2 years (13.4, 15.7). The annual change for uLH:FSH ratio was +0.028 (95% [0.021, 0.035]) and +0.035 (95% [0.027, 0.043]) in girls and boys, respectively. In a subgroup analysis of 59 samples from girls and 233 samples from boys, collected within 90 days of a PDS, were analysed for correlations with self-reported pubertal development. In girls, uLH:FSH ratio showed positive correlations with self-report breast development (r = 0.29), self-report menarchal status(r = 0.35), composite PDS score (r = 0.39) and PDS-derived pubertal categories (r = 0.45). In boys, uLH:FSH revealed negligible correlations with self-reported pubertal development, PDS composite score and PDS-derived pubertal categories.</p><p><strong>Conclusions: </strong>An increase in urinary LH:FSH ratio is associated with an increase in self-reported pubertal development in adolescent girls and represents a valid noninvasive biomarker of puberty in population studies.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Question: How to Approach a Patient Presenting With Sweating and Flushing.","authors":"J Sellicks, A Morrison, M J Levy","doi":"10.1111/cen.70041","DOIUrl":"https://doi.org/10.1111/cen.70041","url":null,"abstract":"<p><p>Sweating and flushing are normal physiological processes, but may be the presenting feature of endocrine disease and are a frequent reason for referral from primary care. The most common endocrinopathies causing sweating include excursions of blood glucose, hypogonadism and thyroid dysfunction. Rarer pathologies include phaeochromocytoma or paraganglioma (PPGL), neuroendocrine tumours (NETs), and medullary thyroid carcinoma, which present with a constellation of symptoms that require a clinical index of suspicion. The pre-test probability of sweating being caused by rare endocrinopathies is significantly increased in the context of a family history of known tumour-predisposing germline mutations. Primary hyperhidrosis may have a hypothalamic basis and should be referred for consideration of neurological disease. Where no endocrine pathology is found, managing patient expectations, considering potential causes such as medication and non-endocrine diseases, and involving other clinicians with a pragmatic approach to symptom improvement are important aspects of the consultation in patients with sweating and flushing.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Physical Exercise on Cardiovascular Autonomic Modulation in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis.","authors":"João Vitor Martins Bernal, Juan Carlos Sánchez-Delgado, Noemi Marchini de Souza Couto, Adriana Marcela Jácome-Hortúa, Victor Barbosa Ribeiro, Kelly Yoshida de Melo, Lucas Dalvit Ferreira, Annick Beatriz Oliveira Dias de Macedo, Hugo Celso Dutra de Souza","doi":"10.1111/cen.70042","DOIUrl":"https://doi.org/10.1111/cen.70042","url":null,"abstract":"<p><strong>Objective: </strong>Women with polycystic ovary syndrome (PCOS) exhibit cardiovascular autonomic imbalance, an important predictor of mortality. Physical exercise is an intervention known to enhance cardiovascular autonomic modulation in various populations. However, it remains unclear whether these benefits extend to women with PCOS, given that specific pathophysiological characteristics may influence autonomic adaptations. Therefore, this review aimed to synthesize the available evidence to improve understanding of this topic.</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Methods: </strong>A systematic search of CENTRAL, Embase, PubMed, Scopus, and Web of Science was conducted, followed by a snowball search to ensure comprehensive coverage of relevant randomized and non-randomized clinical trials. Random-effects meta-analyses were performed to quantitatively summarize the effects of exercise interventions on autonomic cardiovascular regulation in this population. The certainty of evidence was assessed using the GRADEpro tool.</p><p><strong>Results: </strong>Five studies were selected, including 316 women with PCOS (214 in the exercise group and 102 in the control group). The meta-analysis indicated that aerobic exercise reduces the percentage of sequences with three consecutive cardiac cycles without significant variations (mean difference [MD = -6.13; 95% CI = -8.56 to -3.71, p < 0.001; I² = 0%; moderate-certainty evidence) and increase the percentage of sequences with three consecutive cardiac cycles with two different variations (MD = 7.16; 95% CI = 4.61 to 9.72; p < 0.001; I² = 8%; moderate-certainty evidence) and the root mean square of successive differences (MD = 12.84; 95% CI = 2.66 to 23.03; p = 0.01; I² = 52%; low-certainty evidence).</p><p><strong>Conclusion: </strong>The benefits of aerobic exercise on cardiovascular autonomic modulation appear to extend to women with PCOS, increasing vagal modulation and reducing sympathetic modulation. However, further studies are needed to strengthen the evidence and clarify the effects of other exercise modalities.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urea for Treatment of SIAD Induced Hyponatremia: Experience of an Oncology Center.","authors":"Sara Gil Dos Santos, Raquel Calheiros, Joana Oliveira, Isabel Inácio, Ana Paula Santos, Pedro Souteiro","doi":"10.1111/cen.70044","DOIUrl":"https://doi.org/10.1111/cen.70044","url":null,"abstract":"<p><strong>Introduction: </strong>Inappropriate antidiuresis syndrome (SIAD) induced hyponatremia is the most common electrolyte disturbance found in cancer patients. Available treatment options are limited by their poor efficacy, tolerability, or cost. Urea is a promising alternative, but its use in the oncology setting remains insufficiently characterized. We aimed to evaluate the efficacy and safety of urea in the management of chronic SIAD-induced hyponatremia in patients with cancer.</p><p><strong>Methods: </strong>We conducted a retrospective observational study of patients diagnosed with SIAD and treated with oral urea at our Oncology Center between August 2021 and June 2023. Sodium levels were recorded before urea initiation, at the first reevaluation and at the last available follow-up.</p><p><strong>Results: </strong>The cohort included 28 patients, mostly men (71%), with a mean age of 63.9 ± 10.0 years; 86% had metastatic disease. Lung cancer was the most frequent diagnosis, mostly small cell lung carcinoma. Urea treatment resulted in a statistically significant increase in serum sodium both in inpatients (mean increase of 2.4 ± 3.5 mmol/L after 12 (23) hours, p = 0.016) and outpatients (mean increase of 8.6 ± 6.6 mmol/L after 8 (11) days, p = 0.003). No cases of sodium overcorrection or clinically significant adverse events were reported. One patient complained of urea taste, with no impact on treatment adherence. Sodium normalization following cancer treatment allowed for urea discontinuation in 21% of cases. Median follow-up was 84 days (range 3 days-20.9 months).</p><p><strong>Conclusion: </strong>Our study suggests that urea may be a safe, effective, and well-tolerated option for the long-term management of SIAD-related hyponatremia in oncology patients, but further studies are necessary to confirm these observations.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Responses to Comment on 'Second Primary Papillary Thyroid Carcinoma: Insights From Competing Risk Analysis and Post-RAIT'.","authors":"Mingjun Wang, Wenjie Chen, Peiheng Li, Yanping Gong","doi":"10.1111/cen.70043","DOIUrl":"https://doi.org/10.1111/cen.70043","url":null,"abstract":"","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on 'Second Primary Papillary Thyroid Carcinoma: Insights From Competing Risk Analysis and Post-RAIT'.","authors":"Ahmet Necati Sanli, Deniz Esin Tekcan Sanli","doi":"10.1111/cen.70040","DOIUrl":"https://doi.org/10.1111/cen.70040","url":null,"abstract":"","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Catch-Up Growth in Children With Congenital Hypothyroidism on Thyroxine Therapy: A Retrospective Study.","authors":"Preeti Singh, Smriti Rohtagi, Rajeev Kumar Malhotra, Anju Seth","doi":"10.1111/cen.70038","DOIUrl":"https://doi.org/10.1111/cen.70038","url":null,"abstract":"<p><strong>Background and objective: </strong>Despite advances in neonatal care, delayed diagnosis and treatment of congenital hypothyroidism (CH) remain prevalent in regions lacking universal screening. This retrospective study evaluated catch-up growth patterns in 65 children with a delayed diagnosis of CH. Study children were stratified into four groups based on age at thyroxine initiation: Groups A (< 1 year), B (1-<3 years), C (3-<5 years), and D (5-10 years).</p><p><strong>Measurements: </strong>Growth outcomes, in terms of serial height z scores, skeletal maturation, proportion achieving catch-up growth, and time to catch-up, were assessed at baseline and after 3 years of thyroxine.</p><p><strong>Results: </strong>Within 3 years of treatment initiation, 64.6% (42/65) of children achieved complete catch-up in linear growth, and 56.9% (37/65) attained optimum catch-up. Among those treated before 1 year of age (Group A), 76% (19/25) achieved complete and optimum catch-up over a median (IQR) duration of 22 [12-33] months. In children diagnosed after 1 year of age (Groups B-D combined), 57.5% (23/40) attained complete catch-up, of whom 78.3% (18/23) achieved optimum growth, with time to catch-up increasing progressively with later age at diagnosis (median range-25-34 months). The greatest change in height z-scores was observed in the first-year post-treatment across all groups, with a decline thereafter. Catch-up in skeletal maturation was observed in 72.3% (47/65) of children and occurred earlier than catch-up in linear growth.</p><p><strong>Conclusion: </strong>Early thyroxine initiation in CH is critical for optimal linear and skeletal growth. Delayed diagnosis is associated with slower, suboptimal recovery and an increased risk of compromised final adult height.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guiding Management of Bethesda V Thyroid Nodules: The Role of Molecular Testing.","authors":"Idit Tessler, Grégoire B Morand, Nir A Gecel, Arad Dotan, Tzahi Yamin, Eran E Alon, Richard J Payne, Galit Avior","doi":"10.1111/cen.70032","DOIUrl":"https://doi.org/10.1111/cen.70032","url":null,"abstract":"<p><strong>Objective: </strong>The 2023 Bethesda System update introduced molecular testing as a management option for Bethesda V cytology nodules, aiming to guide surgical decision-making. This study investigates the correlation between molecular profiling and malignancy aggressiveness.</p><p><strong>Design: </strong>We conducted a retrospective multicenter study involving patients with Bethesda V cytology and confirmed malignant pathology who underwent molecular profiling between 2018 and 2021.</p><p><strong>Patients: </strong>A total of 156 patients with Bethesda V cytology and final malignant histology were included.</p><p><strong>Measurements: </strong>Malignancy aggressiveness was assessed based on histopathological features following 2015 ATA guidelines. Demographic data, pathology results, and genetic variants were analyzed. Molecular profiling results were stratified according to variant risk levels.</p><p><strong>Results: </strong>We identified 161 Bethesda V nodules, of which 153 (95.0%) were malignant on final pathology. Genetic stratification revealed no detected mutations in 39.7% (n = 56), low-risk (n = 49, 31.4%), and intermediate-risk variants (n = 45, 28.8%). Only one patient had a high-risk variant. Patients with intermediate-risk variants had a sixfold risk of aggressive disease compared to those with low-risk variants (49% vs. 8.2%, p < 0.001). RAS mutations were the most common among the low-risk group (68.8%) and BRAF V600E predominated in the intermediate-risk group (93.3%).</p><p><strong>Conclusions: </strong>Our findings suggest that molecular profiling offers insights into risk stratification for Bethesda V thyroid lesions, demonstrating a very low incidence of aggressive pathology in the low-risk molecular group.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}