Clinical Endocrinology最新文献

{"title":"Malignancy Risk of Paediatric Thyroid Nodules Classified According to the Bethesda System.","authors":"Katia Averbukh-Oren, Sabri El-Saied, Roy Hod, Amit Ritter, Ben-Zion Joshua, Liran Stiler-Timor, Hagit Shoffel-Havakuk, Liora Lazar, Gideon Bachar","doi":"10.1111/cen.15280","DOIUrl":"https://doi.org/10.1111/cen.15280","url":null,"abstract":"<p><strong>Introduction: </strong>Thyroid nodules are less common in children than in adults; however, when diagnosed, they carry a greater risk of malignancy. The Bethesda System for Reporting Thyroid Cytopathology uses six cytological categories to predict thyroid nodule malignancy using fine-needle aspiration. This study aimed to estimate the malignant potential of thyroid nodules in children using the Bethesda system.</p><p><strong>Methods: </strong>We conducted a retrospective study of 121 patients aged ≤ 19 years who underwent thyroid surgery following fine-needle aspiration (FNA) of a suspicious nodule between 2001 and 2019 at two tertiary medical centres. All FNA specimens were evaluated and categorised according to the Bethesda classification system. The prevalence of malignancy for each cytological category was calculated and subsequently compared with the findings of the final pathology.</p><p><strong>Results: </strong>The mean age at the time of operation was 14.8 years, and 79.5% of the patients were female. The mean nodule size was 24.8 mm. The distribution of nodules across Bethesda cytological categories, from B1 to B6, was as follows: 2, 50, 19, 17, 10, 23 nodules. An analysis of the final pathology reports revealed 66 malignant nodules (54.5%). The malignancy risk was 24% for nodules categorised as B2, 52.6% for nodules categorised as B3, 58.8% for nodules categorised as B4, and 100% each for nodules categorised as B5-B6.</p><p><strong>Conclusions: </strong>Our findings indicate that the malignancy rates for all categories of the Bethesda system were higher in paediatric patients than in adults, including a substantial proportion of cytologically benign nodules. Moreover, our observed rates exceeded those previously reported in comparable studies of the paediatric population, as indicated by the American Thyroid Association guidelines. We propose a more intensive approach for paediatric patients with suspected clinical or sonographic features.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157229","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 Impact of Metformin on Plasma Prolactin Levels in Antipsychotics-Treated Men With Hyperprolactinemia and Early-Onset Androgenic Alopecia.","authors":"Robert Krysiak, Karolina Kowalcze, Marek Krzystanek, Witold Szkróbka, Bogusław Okopień","doi":"10.1111/cen.15281","DOIUrl":"https://doi.org/10.1111/cen.15281","url":null,"abstract":"<p><strong>Objective: </strong>Metformin decreases elevated levels of pituitary hormones. Little is known about the association between the reproductive axis and hormonal effects of this drug. The purpose of our study was to investigate whether activity of the hypothalamic-pituitary-gonadal axis determines metformin action on prolactin levels in men with prolactin excess.</p><p><strong>Design/subjects/measurements: </strong>This prospective cohort study included two groups of men with drug-induced hyperprolactinemia and type 2 diabetes or prediabetes: men with normal hair growth (group A, n = 23) and men with late-onset androgenic alopecia (group B; n = 22). Both groups, matched for age, HOMA-IR, and prolactin concentration, were treated for 6 months with metformin. The outcomes of interest included glucose homeostasis markers (fasting glucose, glycated hemoglobin and HOMA-IR), plasma prolactin (both total and monomeric), other pituitary hormones (gonadotropins, TSH and ACTH), and peripheral hormones (testosterone, DHEAS and IGF-1).</p><p><strong>Results: </strong>Before metformin treatment, group B was characterized by higher values of LH, LH/FSH ratio, testosterone (total, free and bioavailable) and DHEAS compared to group A. Six-month metformin treatment reduced fasting glucose, glycated hemoglobin and HOMA-IR in both groups, though this effect was more pronounced in group A. The decrease in total and monomeric prolactin was observed only in group A. Their degree correlated inversely with total, free and bioavailable testosterone, positively with baseline prolactin levels, and positively with the impact on HOMA-IR. Compared to baseline values, follow-up LH was higher in group A and lower in group B.</p><p><strong>Conclusions: </strong>These findings suggest that androgen excess may attenuate metformin action on overactive lactotrophs in men with early-onset androgenic alopecia.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144156002","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":"Correction to \"Limited Utility of Routine Surveillance Ultrasound in Differentiated Thyroid Cancer Patients With Undetectable Postoperative Thyroglobulin Levels\".","authors":"","doi":"10.1111/cen.15284","DOIUrl":"https://doi.org/10.1111/cen.15284","url":null,"abstract":"","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149547","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":"Waking Salivary Cortisone vs Serum Cortisol in the Short Synacthen Test in Screening for Adrenocortical Insufficiency: Results of a Service Evaluation.","authors":"Adrian Heald, Mathilde Mordaunt, Natalie Gallant, Hannah Baker, Waseem Majeed, Rupinder Kochhar, Akheel A Syed, Rajshekhar Mudaliar, Ramadan Abushufa, Fahmy Hanna, David Marshall, Ian Laing, Brian Keevil, Anthony A Fryer","doi":"10.1111/cen.15279","DOIUrl":"https://doi.org/10.1111/cen.15279","url":null,"abstract":"","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144156689","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":"Not All Patients With Idiopathic Hypogonadotropic Hypogonadism Exhibit a Eunuch-Like Stature.","authors":"Wang Jinwen, Dai Ying, Wang Chunliang, Gong Weikun","doi":"10.1111/cen.15285","DOIUrl":"https://doi.org/10.1111/cen.15285","url":null,"abstract":"","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149599","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 Efficacy of Semaglutide on Hypothalamic Obesity Caused by Craniopharyngioma Surgery.","authors":"Xi Wang, Hailu Ma, Fang Wang, Hongmei Long, Chenyang Li, Min Nie, Qin Han, Jiangfeng Mao, Xueyan Wu","doi":"10.1111/cen.15262","DOIUrl":"https://doi.org/10.1111/cen.15262","url":null,"abstract":"<p><strong>Background: </strong>Hypothalamic obesity, weight gain dominantly due to hypothalamic dysfunction, is a challenge for patients with craniopharyngioma surgery. Semaglutide, a long-acting GLP-1 receptor agonist, has shown promise in obesity management. However, the efficacy in this specific patient population remains underexplored.</p><p><strong>Objective: </strong>This study aimed to evaluate the efficacy of semaglutide on weight reduction in patients with craniopharyngioma surgery.</p><p><strong>Methods: </strong>A prospective clinical study was conducted involving 23 patients with obesity after craniopharyngioma surgery who attended the outpatient endocrinology department at Peking Union Medical College Hospital from March 2023 to October 2024. Patients were divided into a treatment group receiving semaglutide (n = 14) and a control group undergoing lifestyle intervention alone (n = 9). Parameters including weight, BMI, waist circumference, blood glucose and lipid profiles, were collected at baseline, 3 and 6 months of treatment.</p><p><strong>Results: </strong>The treatment group showed a significant reduction in weight after 3 months (108.9 ± 20.9 kg vs. 100.8 ± 20.2 kg, p < 0.001) and after 6 months (108.9 ± 20.9 kg vs. 96.1 ± 23.1 kg, p < 0.001). Conversely, the control group experienced weight gain over the same periods. After 3 months, 64.3% of patients in the treatment group achieved weight loss greater than 5%. And after 6 months this rate increased to 90%.</p><p><strong>Conclusion: </strong>Semaglutide demonstrated significant effects on weight loss in patients with hypothalamic obesity with craniopharyngioma surgery, providing a viable option for managing obesity in this population.</p><p><strong>Trial registration: </strong>ChiCTR2400094933.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155884","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":"Efficacy and Safety of Three-Years Growth Hormone Treatment in Girls With Turner Syndrome and Growth Hormone Deficiency: A Case-Control Study.","authors":"Rosario Ferrigno, Daniela Cioffi, Valeria Pellino, Maria Cristina Savanelli, Deborah Veneruso, Carmelo Piscopo, Antonella Klain","doi":"10.1111/cen.15276","DOIUrl":"https://doi.org/10.1111/cen.15276","url":null,"abstract":"<p><strong>Background: </strong>Turner syndrome (TS) is a chromosomal disorder characterized by specific clinical features, including cardiac and renal malformations and short stature. In these patients, recombinant growth hormone (GH) treatment is currently recommended, showing positive effects on growth rate, with good tolerability. However, height improvement and growth outcome in TS girls is reportedly impaired compared with other girls treated with GH due to other reason, including GH deficiency (GHD).</p><p><strong>Aim: </strong>The aim of the current study was to compare the growth outcome and the safety of 3-years GH treatment in TS and GHD girls.</p><p><strong>Patients & methods: </strong>The study included 20 girls, 10 with TS diagnosis (4 full complete monosomy of X chromosome, 40%; 6 partial monosomy (mosaic) of X chromosome, 60%) and 10 with isolated idiopathic GHD diagnosis, matched for age (range: 4.17-10.42 years; median: 6.8 ± 2.37) treated with GH (starting dosage: 33.08 ± 4.31 μg/kg/day in TS girls and 32.17 ± 2.51 μg/kg/day in GHD girls) for at least 36 months. Growth parameters, glycemic profile, and IGF-1 levels were collected every 6 months.</p><p><strong>Results: </strong>Compared to baseline, both TS and GHD children showed a significant improvement in height, weight, and growth rate after 3 years of treatment with GH (p ≤ 0.01), already evident after 6 months of treatment (p ≤ 0.016). Noteworthy, patients in both groups showed a constant, significant improvement in height until 24 months of treatment, as a significantly increase was observed both after 12 months compared to 6 months of treatment (p ≤ 0.008) and after 24 months compared to 12 months of treatment (p ≤ 0.031), whereas only GHD girls showed a significant increase after 36 months compared to 30 months of treatment (p = 0.035). Comparing the two study groups, TS girls showed a lower height and a lower height increase throughout the study, but these differences reached statistical significance only after six and 12 months of treatment (T6: +0.42 ± 0.23 SDS in TS vs +0.74 ± 0.38 SDS in GHD, p = 0.045; T12: +0.59 ± 0.34 vs +0.93 ± 0.39 SDS in GHD, p = 0.034). Considering safety profile, treatment was well tolerated, as the most frequently reported adverse event was autoimmune thyroiditis (two TS girls, 10%); no hyperglycemia occurred throughout the treatment, whereas one TS girl (5%) and one GHD girl (5%) experience transient hypertransaminasemia and hypercholesterolemia, respectively.</p><p><strong>Conclusions: </strong>In conclusion, GH treatment in both TS and GHD girls is an effective, safe treatment for short stature, improving both height and growth rate, especially during the first year of treatment. Moreover, although growth outcomes were significantly better in GHD girls in the first year of treatment, over time no significant differences were observed between TS and GHD girls.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119017","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":"Radiological Activity Score (RAS)-MRI Characteristics in Dysthyroid Optic Neuropathy in a Multi-Ethnic Thyroid Eye Disease Population.","authors":"Malik Moledina, Vickie Lee, Kunwar Bhatia, Gitta Madani, Claire Feeney, Nicole George, Nour Houbby, Daisy Metcalf, Natalie Man, Rajni Jain, Ahmad Aziz, Ravi Kumar Lingam","doi":"10.1111/cen.15272","DOIUrl":"https://doi.org/10.1111/cen.15272","url":null,"abstract":"<p><strong>Purpose: </strong>Dysthyroid Optic Neuropathy (DON) is a sight threatening and diagnostically challenging complication of Thyroid Eye Disease (TED). We provide a comparative analysis of the MRI features associated between patietnts with and without DON.</p><p><strong>Methods: </strong>Anonymised retrospective cohort study of patients with TED over eleven years. All patients had Axial T1-weighted and coronal 3 mm MRI STIR images. In a subset, a 3-mm-thick non-echoplanar HASTE DWI sequence was acquired in the coronal plane, and an ADC map was calculated using the diffusion scan raw data. Assessment of apical crowding (AC), extraocular muscle (EOM) enlargement (E), peri-muscular fat (PMF)/muscle signal intensity (SI) and Apparent Diffusion Coefficient (ADC) were analysed on coronal images.</p><p><strong>Results: </strong>Twenty-six consecutive DON and 516 non-DON cases. In the DON group, elevated EOMSI, PMFSI, EOME and AC were present in 54.6%, 25.9%, 72.7% and 64.6%, respectively, compared to 24.1%, 6.2%, 42.1% and 5.9% in the non-DON (p = 0.001, p = 0.000, p = 0.001 and p = 0.000). The average ADC value in the DON cohort was 1373 ± 319 versus 973 ± 237 in the non-DON (p = 0.000). Likelihood of DON on Univariable Regression Analysis (Odds Ratios): Apical Crowding (29.1 x p = 0.000) and ADC Value ≥ 1200 (7.3 x p = 0.000). On Multivariable Regression Analysis (Odds Ratios): Apical Crowding 22.1 x (p = 0.000) and ADC Value ≥ 1200 3.7 x (p = 0.027).</p><p><strong>Conclusion: </strong>MRI features associated with a higher diagnostic likelihood of DON include significant AC and elevated ADC values. ADC may show reasonable promise in diagnosing and predicting DON.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109945","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 Use of miRNA Panel as a Growth Plate Marker of Short-Term Response to GH.","authors":"Caroline Rosa Pellicciari, Thayna Rosa Bispo, Itatiana Ferreira Rodart, Leandra Steinmetz, Adriana Aparecida Siviero Miachon, Angela Maria Spinola E Castro, Durval Damiani, Cristiane Kochi, Carlos Alberto Longui","doi":"10.1111/cen.15278","DOIUrl":"https://doi.org/10.1111/cen.15278","url":null,"abstract":"<p><strong>Introduction: </strong>Recombinant human growth hormone (GH) therapy shows variable growth responses in patients with growth hormone deficiency (GHD), highlighting the need for reliable biomarkers to predict individual sensitivity.</p><p><strong>Objective: </strong>This study investigated circulating microRNAs (miRNAs) involved in growth plate regulation during GH therapy in prepubertal children with GHD, aiming to establish a miRNA panel correlating with GH responsiveness.</p><p><strong>Patients and methods: </strong>Sixteen patients were treated with daily recombinant GH (0.033 mg/kg) for 6 months. Two participants were excluded for protocol noncompliance, and one withdrew due to the spontaneous onset of puberty. Circulating levels of six miRNAs (miR-22-3p, miR-30c-5p, miR-140-5p, miR-340-5p, miR-494-3p, and miR-16-5p) were measured via digital PCR at baseline and at 1, 3, and 6 months of therapy. Clinical data (height, weight, growth velocity) and hormone levels were collected simultaneously.</p><p><strong>Results: </strong>All miRNAs displayed a characteristic response pattern: significant increases at 1 and 6 months, with a transient decline at 3 months. Despite these changes, no significant correlations were identified between miRNA levels and growth velocity, height SDS, or IGF-1 levels. The study included treatment-naïve patients and those with prior GH therapy following a 30-day wash-out period. While the treatment-naïve group exhibited greater height-SDS gains (p = 0.008), no differences in miRNA expression were observed between groups, nor was there a correlation between miRNA levels and height-SDS increments.</p><p><strong>Conclusion: </strong>While this miRNA panel identified treatment-responsive miRNAs, it did not correlate with growth outcomes. Increasing the sample size and incorporating additional miRNAs could enhance its clinical utility for predicting GH treatment sensitivity in GHD patients.</p><p><strong>Trial registration: </strong>NCT05946915.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109949","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":"Salivary Testosterone, Androstenedione and 11-Oxygenated 19-Carbon Concentrations Differ by Age and Sex in Children.","authors":"Julie Park, Andrew Titman, Orla Bright, Silothabo Dliso, Alena Shantsila, Gregory Y H Lip, Jo Adaway, Brian Keevil, Daniel B Hawcutt, Joanne Blair","doi":"10.1111/cen.15258","DOIUrl":"https://doi.org/10.1111/cen.15258","url":null,"abstract":"<p><strong>Background: </strong>The diagnosis and management of childhood adrenal disorders is challenging. Clinical markers of hormone excess or deficiency may take months to manifest, and traditional biomarkers correlate only partially with clinical outcomes. Recent work has indicated that 11 oxygenated 19-carbon (11oxC19) steroids may be useful in the assessment of adrenal function. 11oxC19 steroids, testosterone (T) and androstenedione (A4), can be measured in saliva, but very little is known about these hormones in healthy children.</p><p><strong>Methods: </strong>Participants collected saliva samples 30 min after waking and every 2 h until bedtime. Samples were analysed for T, A4, 11 ketotestosterone (11KT) and 11βhydroxyandrostenedione (11OHA4) by liquid chromatography tandem mass spectrometry.</p><p><strong>Results: </strong>Fifty-two (30 male) healthy children aged 10.4 ± 3.9 (5.0-17.5) participated. Median height SDS was 0.4 (IQR -0.3 to 1.01) and median BMI SDS was 0.3 (IQR -0.2 to 1.3). All steroids showed a diurnal rhythm, with all hormones decreasing in measured concentration at time points that are 30 min after waking. Salivary T was higher in postpubertal children, particularly boys (p < 0.001). Salivary A4 was lower in boys compared to girls (p = 0.009) and did not differ with pubertal development. 11KT increased with age (p < 0.001) and concentrations were similar between boys and girls. 11OHA4 reduced in concentration with age (p = 0.03) and was below detectable limits after the early morning peak in both sexes.</p><p><strong>Conclusion: </strong>For the first time we describe the physiological profile of 11KT and 11OHA4 in children. Further data are required to establish reference ranges, which should consider age, sex, pubertal status and time of sampling.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101392","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}