Clinical Endocrinology最新文献

{"title":"British Thyroid Association Survey of Graves' Disease Management in the UK","authors":"Michael Atkinson,&nbsp;Medha Agrawal,&nbsp;Koteshwara Muralidhara,&nbsp;Prakash Abraham,&nbsp;Bijay Vaidya,&nbsp;Onyebuchi E. Okosieme","doi":"10.1111/cen.15266","DOIUrl":"10.1111/cen.15266","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Recent years have seen changes and uncertainties in evidence and guideline recommendations in Graves' disease treatment. To understand the impact of these developments on current practice, we undertook a survey of Graves' disease management in the United Kingdom and compared this to other national and international surveys.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Members of the British Thyroid Association, the UK Society for Endocrinology and regional endocrinology networks, were invited by e-mail to complete a 15-min online survey (October 2022 to March 2023).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of 158 eligible respondents, 99% were endocrinologists. For a 40-year-old female with a first presentation of Graves' hyperthyroidism, TSH-receptor antibodies (TRAb) were requested at diagnosis and at follow-up by 95% and 76%, respectively. Isotope scans and ultrasound were rarely requested (&lt; 5%). Majority (95%) would treat with antithyroid drugs (ATD), predominantly Carbimazole (CMZ), while radioactive iodine (RAI) was preferred for recurrent disease (81%). Common reasons for avoiding RAI were thyroid eye disease, pregnancy intention, or contact with young children whereas biochemical severity, goitre, or male sex did not influence decision to use RAI. Propylthiouracil (PTU) was preferred in preconception and early pregnancy, but after the first-trimester, 50% would continue PTU while 50% switch back to CMZ.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The survey confirms a growing application of TRAbs, both for diagnostic and prognostic purposes. ATDs remain the preferred first-line therapy for Graves' disease, which is consistent with global trends but contrary to National Institute of Health and Care Excellence (NICE) guidance. Further studies are required to explore the clinical and pragmatic determinants of current treatment approaches.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"103 3","pages":"376-384"},"PeriodicalIF":2.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cen.15266","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of AMH and AMHR2 Variants in Polycystic Ovary Syndrome: ‘A Comprehensive Analysis’","authors":"Sameh Sarray,&nbsp;Intissar Ezzidi,&nbsp;Assila Ben Salem,&nbsp;Hassen Ben Abdennebi,&nbsp;Nabil Mtiraoui","doi":"10.1111/cen.15269","DOIUrl":"10.1111/cen.15269","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Variants in the genes encoding anti-mullerian hormone (<i>AMH</i>) and its receptor 2 (<i>AMHR2</i>) have been identified as potential contributors to the development of polycystic ovary syndrome (PCOS). However, results from association studies examining their role in PCOS have been inconsistent.</p>\u0000 \u0000 <p>This study aims to investigate the potential association between <i>AMH</i> and <i>AMHR2</i> gene variants and the risk of PCOS as well as their influence on serum AMH levels in a Tunisian cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The case-control study recruited 327 PCOS women and 396 healthy controls. DNA was extracted and genotyped for three variants in the <i>AMH</i> gene namely, rs4807216, rs10407022 and rs8112524 as well as three variants in the <i>AMHR2</i> gene, including rs2002555, rs11170553 and rs2272002, using the TaqMan SNP genotyping assay. Fasting serum AMH levels were quantified using ELISA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Significant metabolic differences were observed in the PCOS cohort, including higher BMI, and elevated levels of AMH, glucose, triglycerides, and cholesterol, along with lower FSH levels. The investigation of genetic associations between <i>AMH</i> and <i>AMHR2</i> gene variants and PCOS susceptibility revealed notable genotype-specific correlations with lipid profiles. Specifically, the <i>AMH</i> rs8112524 A/A and G/A genotypes were correlated to increased triglyceride levels, while the <i>AMHR2</i> rs2002555 G/G genotype, as well as the rs11170553 T/T and C/T genotypes, were correlated with decreased HDL levels. However, no significant allelic, genotypic or haplotypic associations were identified, nor was any substantial impact on serum AMH levels observed. Additionally, interaction and epistasis analyses indicated that the <i>AMH</i> and <i>AMHR2</i> variants had no significant predictive capabilities regarding PCOS susceptibility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although <i>AMH</i> and <i>AMHR2</i> variants may not directly influence PCOS susceptibility, they could play a role in modulating lipid metabolism associated with the syndrome.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"103 2","pages":"242-250"},"PeriodicalIF":3.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985761","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":"Nonlinear Relationship Between Monocyte-to-Lymphocyte Ratio and Bone Mineral Density in Type 2 Diabetes Mellitus: Mediating Role of Fat Distribution","authors":"Ying Yang,&nbsp;Shuyun Li,&nbsp;Gang Tian,&nbsp;Lingling Li,&nbsp;Jia Bai,&nbsp;Jinyang An,&nbsp;Xinsai Li,&nbsp;Yangyang Zhang,&nbsp;Zijuan Guo,&nbsp;Haihong Lv","doi":"10.1111/cen.15267","DOIUrl":"10.1111/cen.15267","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of study is to clarify the relationship between monocyte-to-lymphocyte ratio (MLR) and lumbar spine bone mineral density (BMD) in type 2 diabetes mellitus (T2DM), and analyse the mediating role of fat distribution, providing a new indicator for the early diagnosis of osteoporosis in T2DM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 430 T2DM patients over 50 years were included. Subjects were divided into T1, T2 and T3 three groups based on MLR. The adjusted regression models, subgroup analysis, generalised additive model (GAM), smoothed curve fitting, and mediated effects analysis methods were used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results indicated a significant negative correlation between MLR and lumbar spine BMD in T2DM (<i>β</i> = −0.701; 95%CI: −0.112, −0.290). Subgroup analysis, smoothed curve fitting and threshold effect analysis showed a nonlinear relationship between MLR and BMD, with an optimal inflection point at an MLR value of 0.1266. Additionally, the ratio of visceral to subcutaneous fat area (VSR) was negatively correlated with lumbar spine BMD (<i>β</i> = −0.775; 95%CI: −1.007, −0.504). Mediation effect analysis of VSR between MLR and lumbar spine BMD showed that the total effect estimate was −0.0717, the direct effect estimate was −0.0524, the mediation effect estimate was −0.0193, with the mediated proportion accounting for 26.88% of the total effect.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>MLR is significantly associated with lumbar spine BMD in T2DM. Higher MLR levels correlated with reduced BMD. VSR plays a significant mediating role in this relationship, highlighting MLR's potential utility in osteoporosis diagnosis and importance of fat management for bone health.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"103 4","pages":"471-479"},"PeriodicalIF":2.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985746","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":"Innovative Approaches to Improve the Success of Pituitary Surgery in Cushing's Disease: A Cost-Effectiveness Perspective","authors":"Femke J. C. Jacobs,&nbsp;Tim M. Govers,&nbsp;Jurgen J. Fütterer,&nbsp;Annenienke van de Ven,&nbsp;Maroeska M. Rovers","doi":"10.1111/cen.15263","DOIUrl":"10.1111/cen.15263","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Patients require additional treatment when pituitary surgery for Cushing's disease is unsuccessful. Exciting innovations in pituitary surgery bring hope for achieving better outcomes. Quantifying the potential value of these innovations using early health economic modelling can provide guidance throughout their development. The aim of this study was to explore the conditions for success of these innovations using cost-effectiveness analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>The model consists of a decision tree and state-transition model with a 10-year time horizon.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients</h3>\u0000 \u0000 <p>The model simulates the clinical management of patients with Cushing's disease and pituitary surgery as primary treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements</h3>\u0000 \u0000 <p>Model input was derived from literature and expert opinion. Model outcomes were incremental healthcare costs and incremental quality-adjusted life-years (QALY). We performed scenario analyses, including a headroom and threshold analysis, to determine the maximum innovation price for cost-effectiveness. Probabilistic sensitivity analysis and one-way sensitivity analyses were performed to address the impact of uncertainty on outcome parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The headroom analysis showed that per patient 0.028 QALYs could be gained and 2082 euros could be saved over 10 years. With a willingness to pay of 80,000 euros, the maximum price of an innovation is 4288 euros (95% CI: 3377–5181) to reach cost-effectiveness. Sensitivity analyses showed that utility values mainly determined cost-effectiveness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our early health economic model exploring the conditions for success of innovations in pituitary surgery shows room for improvement, but also the importance of accurate health-related quality of life data to assess the economic value of innovations in individuals with CD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"103 2","pages":"216-224"},"PeriodicalIF":3.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cen.15263","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative Unstimulated Thyroglobulin Accurately Predicts Outcomes in High-Risk Differentiated Thyroid Cancer: A Retrospective Cohort Study","authors":"Julia Isabel Richter Cicogna,&nbsp;Sophia Yada Noguchi,&nbsp;Adriano Namo Cury,&nbsp;Giovanna Marcela Vieira Della Negra,&nbsp;Laís de Oliveira Teles Fraga,&nbsp;Marcelo Soares Schalch,&nbsp;Rafael de Cicco,&nbsp;Carolina Ferraz da Silva,&nbsp;Rosália Do Prado Padovani","doi":"10.1111/cen.15260","DOIUrl":"10.1111/cen.15260","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>High-risk differentiated thyroid cancer (DTC) patients show variable outcomes. While postoperative stimulated thyroglobulin (STg) is a recognized predictive marker, the prognostic significance of unstimulated thyroglobulin (UTg) is still unexplored. This study aims to assess the prognostic value of postoperative UTg in high-risk DTC patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Retrospective cohort study (2015–2024) at two Brazilian tertiary hospitals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients</h3>\u0000 \u0000 <p>One thousand DTC patients were identified, of which 144 were high-risk. Fifty seven patients met the inclusion criteria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Clinical, pathological, and laboratory data were collected. Outcomes were categorized as favorable (excellent/indeterminate responses) or unfavorable (biochemical/structural incomplete responses). Receiver Operating Characteristic (ROC) curves determined cutoff values for predicting outcomes and metastases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Significant predictors of unfavorable outcomes included advanced age (<i>p</i> = 0.048), larger tumor size (<i>p</i> = 0.002), higher UTg (<i>p</i> &lt; 0.001), and STg (<i>p</i> &lt; 0.001). UTg was an independent risk factor for 1-year outcomes (OR = 0.008; 95% CI: 0.001–0.088; <i>p</i> &lt; 0.001). UTg cutoff of 2.1 ng/mL distinguished outcomes with high sensitivity (83.3%), specificity (96.0%), and accuracy (90.7%). A higher cutoff of 3.8 ng/mL identified metastases (sensitivity 86.4%, specificity 90.5%). UTg showed non-inferiority to stimulated thyroglobulin (STg) in predicting outcomes (<i>p</i> = 0.964) and metastasis (<i>p</i> = 0.980).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Postoperative UTg is a strong prognostic marker in high-risk DTC patients, providing a non-inferior alternative to STg with greater accessibility and fewer side effects. We propose a clinical algorithm to optimize the management of these cases. When UTg levels exceed 2.1 ng/mL, particularly higher than 3.8 ng/mL, investigation of potentially resectable metastatic foci should be considered before radioiodine therapy. Prospective studies are needed to validate this algorithm.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"103 2","pages":"260-268"},"PeriodicalIF":3.0,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cen.15260","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Maternal Hypothyroidism in Pregnancy: A Danish Regional Study","authors":"Karoline Schack,&nbsp;Line Meyer Laustsen,&nbsp;Randi Ziska Sørensen,&nbsp;Maja Hjelm Lundgaard,&nbsp;Nanna Maria Uldall Torp,&nbsp;Jesper Karmisholt,&nbsp;Stine Linding Andersen","doi":"10.1111/cen.15259","DOIUrl":"10.1111/cen.15259","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Hypothyroidism in pregnant women must be carefully managed to prevent complications. The aim of this study was to evaluate compliance with clinical recommendations for the monitoring and treatment of hypothyroidism in pregnant women and to assess the clinical action upon each biochemical monitoring at different time points in pregnancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Retrospective cohort study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Pregnant women with known hypothyroidism in the North Denmark Region, 2022–2024, who were managed in the Departments of Endocrinology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements</h3>\u0000 \u0000 <p>Medical records were reviewed for information on biochemical monitoring of thyroid-stimulating hormone (TSH) and Levothyroxine (L-T4) treatment in the pregnancy. The primary study endpoint was the frequency of biochemical monitoring and dose adjustments of L-T4.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Altogether 175 pregnant women with hypothyroidism treated with L-T4 before the pregnancy were studied. Biochemical monitoring of TSH in the pregnancy was performed one to 12 times (median 7 times). When considered until and including the 12th week of pregnancy, the number of women with dose adjustment following biochemical control was 84 of 166 (50.6% (95% CI: 42.7%–58.4%)), whereas from the 13th to 24th week it was 35 of 164 (21.3% (95% CI: 15.3%–28.4%)), and from the 25th week of pregnancy and onwards it was 17 of 165 (10.3% (95% CI: 6.1%–16.0%)).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In a Danish regional cohort of pregnant women with hypothyroidism, biochemical monitoring of thyroid function was often performed and was mostly followed by a change in the dose of L-T4 in early pregnancy ( ~ 50% of the women) and rarely in late pregnancy ( ~ 10% of the women).</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"103 2","pages":"269-276"},"PeriodicalIF":3.0,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cen.15259","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Mortality in Patients With Multiple Endocrine Neoplasia Type 1","authors":"Jasmine J. Zhu,&nbsp;John R Burgess","doi":"10.1111/cen.15257","DOIUrl":"10.1111/cen.15257","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Multiple Endocrine Neoplasia Type 1 (MEN 1) is an autosomal dominant disease predisposing to hyperplasia and neoplasia in diverse endocrine tissues. Patients typically present with endocrine abnormalities before the age of 30 years and have reduced life expectancy. Our objective was to determine predictors of premature mortality in MEN 1.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Tertiary hospital based retrospective cohort study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients</h3>\u0000 \u0000 <p>One hundred and thirty patients with a common <i>MEN1</i> genotype.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements</h3>\u0000 \u0000 <p>Kaplan-Meier survival analysis of median life expectancy (MLE).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The overall cohort MLE was 70.8 years. Sex and year of birth were not predictive of survival. A diagnosis before age 45 years of adrenal nodularity (MLE 51.8 years), hypergastrinaemia (MLE 66.2 years), or liver lesions (MLE 38.6) were associated with a significant reduction in survival (26.2 years, <i>p</i> &lt; 0.01, 6.4 years, <i>p</i> = 0.03, and 30.3 years, <i>p</i> &lt; 0.01 respectively) compared to being diagnosed with these conditions later in life. In contrast, diagnosis before age 45 years of pancreatic nodularity (MLE 68.9 years) and primary hyperparathyroidism (MLE 68.9 years) were not predictive of survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients with MEN 1 diagnosed before age 45 with adrenal nodularity, hypergastrinaemia or liver lesions had significantly reduced survival. The explanation for non-secretory and benign adrenal macronodular hyperplasia being associated with diminished life expectancy is unclear.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"103 1","pages":"50-56"},"PeriodicalIF":3.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cen.15257","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated Triglyceride-Glucose Index Is Associated With Insulin Resistance, Metabolic Syndrome Components, Nonalcoholic Fatty Liver Disease, and Adverse Pregnancy Outcomes in Chinese Women With Polycystic Ovary Syndrome","authors":"Jiaxing Feng,&nbsp;Rong Luo,&nbsp;Jingshu Gao,&nbsp;Yu Wang,&nbsp;Jing Cong,&nbsp;Hongli Ma,&nbsp;Xiaoke Wu","doi":"10.1111/cen.15252","DOIUrl":"10.1111/cen.15252","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Aim&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To investigate the associations of triglyceride-glucose index (TyG) with anthropometric characteristics, metabolic/endocrine profiles, and pregnancy outcomes in Chinese women with polycystic ovary syndrome (PCOS).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This secondary analysis of the Acupuncture and Clomiphene for Chinese Women with Polycystic Ovary Syndrome trial (PCOSAct) included 956 participants with prospectively collected data. TyG was calculated using fasting triglyceride and glucose levels (Ln [TG (mg/dL) × FPG (mg/dL)/2]). Linear regression and trend analyses evaluated relationships between TyG and clinical parameters. Receiver operating characteristic (ROC) curves assessed TyG's predictive capacity for insulin resistance (IR), metabolic syndrome (MS), and nonalcoholic fatty liver disease (NAFLD). Multivariable logistic regression estimated risks for metabolic outcomes and pregnancy outcomes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Linear trends revealed that the TyG was positively associated with age, body mass index (BMI), waist circumference, hip circumference, waist-to-hip ratio, systolic blood pressure, diastolic blood pressure, FPG, fasting insulin, the homeostatic model assessment for insulin resistance (HOMA-IR), total cholesterol, triglycerides, low-density lipoprotein (LDL), apolipoprotein B, free androgen index, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and the prevalence of IR, MS, and NAFLD across various standards. Conversely, TyG was negatively correlated with the quantitative insulin sensitivity check index (QUICKI), high-density lipoprotein (HDL), apolipoprotein A1, sex hormone-binding globulin (SHBG), and the prevalence of ovulation per cycle, conception, pregnancy, and live birth. After adjusting for age and BMI, a significant linear relationship was observed between TyG and components of MS, IR markers, and ALT. The ROC curve analysis indicated that the AUC&lt;sub&gt;MS-IDF&lt;/sub&gt; was 0.871 (95% CI: 0.846–0.896), with a sensitivity of 81.4% and specificity of 81.2% at a cut-off value of 8.745, and the AUC&lt;sub&gt;IR-HOMA-IR&lt;/sub&gt; was 0.782 (95% CI: 0.753–0.811), with 71.9% sensitivity and 70.3% specificity at a cut-off of 8.585, and the AUC&lt;sub&gt;NAFLD&lt;/sub&gt; was 0.705 (95% CI: 0.644–0.766), with 76.8% sensitivity and 59.3% specificity at a cut-off value of 8.665. Logistic regression analysis demonstrated that participants in the highest quartile (Q4) of TyG had significantly higher odds ratios (OR) for MS (OR: 38.36, 95% CI: 20.03–73.46, &lt;i&gt;P&lt;/i&gt;-trend &lt; 0.001) and IR (OR: 12.49, 95% CI: 7.3–21.35, &lt;i&gt;P&lt;/i&gt;-trend &lt; 0.001) compared to those in the lowest quart","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"103 3","pages":"317-326"},"PeriodicalIF":2.4,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cen.15252","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multicenter Study on the Clinical Characteristics, Diagnosis, and Treatment Outcomes of Insulinoma: Insights From 15 Medical Centres","authors":"Şenay Topsakal,&nbsp;Güzin Fidan Yaylalı,&nbsp;Zeliha Yarar,&nbsp;Fatma Avcı Merdin,&nbsp;Seda Karslı,&nbsp;Sema Çiftçi,&nbsp;Mehmet Sercan Ertürk,&nbsp;Barış Önder Pamuk,&nbsp;Ayşe Özdemir Yavuz,&nbsp;Kader Uğur,&nbsp;Ogün Bilen,&nbsp;Sayid Shafi Zuhur,&nbsp;İsmail Engin,&nbsp;Mehmet Güven,&nbsp;Fazıl Mustafa Cesur,&nbsp;Sevgül Fakı,&nbsp;Şefika Burçak Polat,&nbsp;Bekir Çakır,&nbsp;Hatice Özışık,&nbsp;Gökçen Ünal Kocabaş,&nbsp;Mehmet Erdoğan,&nbsp;Şevki Çetinkalp,&nbsp;İlkcan Çerçi Koçar,&nbsp;Esen Akbay,&nbsp;Sema Yarman","doi":"10.1111/cen.15255","DOIUrl":"10.1111/cen.15255","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to evaluate the clinical characteristics, diagnostic approaches, and treatment outcomes of insulinoma patients from diverse regions across the country. We conducted a retrospective analysis of medical records from 76 adult patients diagnosed with insulinoma between 2018 and 2023 at 15 medical centres. Data collected included demographics, presenting symptoms, laboratory and imaging results, surgical reports, pathology findings, and clinical follow-up information.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Multi-centre retrospective study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study revealed that key factors such as age, BMI, symptom duration, tumour size, and follow-up period were similar across genders. The majority of patients experienced neuroglycopenic symptoms, particularly during fasting. Insulinoma was typically diagnosed either during fasting or spontaneously, with no significant gender differences in glucose and insulin levels during hypoglycemia. However, men exhibited higher C-peptide levels (<i>p</i> &lt; 0.05). Common comorbidities included hypertension, hypothyroidism, and cardiovascular conditions, and some patients had been using antiepileptics or antidepressants before their diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Preoperative tumour diagnoses were largely accurate, with endoscopic ultrasound (EUS) being the most effective method. Most tumours were small ( &lt; 2 cm) and located in the pancreas body, with the majority being solitary. Surgical treatments primarily involved enucleation or distal pancreatectomy. Follow-up data indicated high remission rates, with low rates of nonremission and mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study emphasises that early diagnosis and intervention, particularly in patients with a history of neurological or psychiatric issues, postprandial symptoms, or rapid symptom improvement after treatment, can lead to significantly better outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"103 1","pages":"57-65"},"PeriodicalIF":3.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cen.15255","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cytological Assessment of Adrenal Tumours: Insights From 22-Years Single Centre Experience","authors":"Ana Carasel,&nbsp;Jan Calissendorff,&nbsp;C. Christofer Juhlin,&nbsp;Henrik Falhammar","doi":"10.1111/cen.15254","DOIUrl":"10.1111/cen.15254","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The incidence of adrenal tumours has increased in the last decades, mainly due to increased use of imaging. The diagnostic evaluation of adrenal masses can be complex and, in some cases, necessitates cytological evaluation. However, concerns remain regarding the potential complications associated with adrenal gland biopsy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>We conducted a retrospective cohort study to evaluate the safety and diagnostic effectiveness of cytology in patients who underwent fine-needle aspiration (FNA) of adrenal glands at Karolinska University Hospital in Stockholm, Sweden, between 2000 and 2022. The aim was to evaluate the accuracy of the sample and the complication rate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Measurements</h3>\u0000 \u0000 <p>A total of 241 patients and 251 FNAs were included, with 10 patients undergoing two FNAs each. Data on clinical, radiological and laboratory presentation was collected and corelated with cytological findings and outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Diagnostic FNA was obtained in 90% of patients (<i>n</i> = 217) with endoscopic ultrasound technique being most successful (95.8%), followed by CT (88.7%) and transabdominal ultrasound technique (86.7%). The sensitivity and the specificity were 93.8% respectively 96.7%. More than half of the FNA samples (52.7%) indicated a diagnosis consistent with metastases to the adrenal gland. The complication rate was 7.9% (<i>n</i> = 20). Based on the FNA results, adrenalectomy was performed on 13.6%, while 52.8% of the patients with benign findings were managed conservatively. Chemotherapy was started for 78.7% of patients with malignant findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>FNA of the adrenal glands is a safe, minimally invasive diagnostic procedure that can be useful in the assessment of adrenal lesions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"103 2","pages":"157-166"},"PeriodicalIF":3.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cen.15254","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}