Clinical Endocrinology最新文献

{"title":"Intermediate-Risk Papillary Thyroid Cancer: Not Everyone Needs Radioactive Iodine","authors":"Ignacio Fuentes,&nbsp;Marlín Solórzano,&nbsp;Annette Madison,&nbsp;Joel Falcón,&nbsp;Catalina Ruiz,&nbsp;Joaquín Viñambres,&nbsp;Rodolfo Cabello,&nbsp;Nicole Lustig,&nbsp;Lorena Mosso,&nbsp;Rodrigo Jaimovich,&nbsp;Juan Carlos Quintana,&nbsp;Francisco Domínguez,&nbsp;Hernán E. González,&nbsp;Pablo H. Montero,&nbsp;Francisco Cruz,&nbsp;Antonieta Solar,&nbsp;José M. Domínguez","doi":"10.1111/cen.70180","DOIUrl":"10.1111/cen.70180","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Intermediate-risk papillary thyroid carcinoma (PTC) accounts for 40%–60% of newly diagnosed PTC and comprises a heterogeneous group with variable recurrence risk. The benefit of postoperative radioactive iodine (RAI) remains uncertain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To describe features, response-to-therapy outcomes, and ATA 2025 recurrence-risk redistribution in patients with ATA 2015 intermediate-risk PTC managed without adjuvant RAI.</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> Methods</h3>\u0000 \u0000 <p>Adults (≥ 18 years) with ATA 2015 intermediate-risk PTC treated with total thyroidectomy (TT) or thyroid lobectomy (TL), with/without lymph node dissection, and followed for ≥ 1 year were included. Omission of postoperative RAI was based on histopathology, cervical ultrasound (US), serum thyroglobulin (Tg), and anti-thyroglobulin antibodies (TgAb) measured within 6 months postoperatively. TL patients required negative US. TT patients required negative US plus Tg &lt; 1 ng/mL if TgAb-negative, or stable/declining TgAb if positive. Response to therapy was assessed using ATA 2015 dynamic risk stratification and reassessed with ATA 2025 criteria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ninety-nine patients were included; 84 (84.8%) were women, the mean age was 40.2 ± 13.3 years, and the median follow-up was 4.8 years. Microscopic extrathyroidal extension was present in 51 (51.5%), lymph node metastases in 37 (37.4%), and extranodal extension in 4 (4.0%). By ATA 2015, 67 (67.7%) had an excellent response and 32 (32.3%) an indeterminate response; no incomplete responses or structural recurrences occurred. ATA 2025 reclassified 3 (3.0%) as low risk, 39 (39.4%) as low-intermediate, 52 (52.5%) as high-intermediate, and 5 (5.1%) as high risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Selected intermediate-risk PTC patients managed without adjuvant RAI had excellent mid-term outcomes, supporting a risk-adapted de-escalation strategy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"105 5","pages":"582-589"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520041","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":"A Ten Year Overview of Adrenal Vein Sampling in Croatia: Insights and Outcomes","authors":"Karin Zibar Tomsic,&nbsp;Ana Marija Alduk,&nbsp;Elvira Kresic,&nbsp;Ivana Kraljevic,&nbsp;Darko Kastelan","doi":"10.1111/cen.70182","DOIUrl":"10.1111/cen.70182","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Adrenal vein sampling (AVS) is the gold standard for subtype differentiation in primary aldosteronism (PA), yet it remains technically demanding and resource intensive. However, data on long-term performance, learning curves, and concordance with imaging in real-world clinical practice are limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective single-centre study including patients with PA who underwent AVS between January 2016 and June 2025. AVS was performed under continuous adrenocorticotropic hormone stimulation using a sequential sampling protocol. Procedural success, learning curve, and diagnostic concordance with computed tomography (CT) were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 251 patients underwent 268 AVS procedures. Overall procedural success was achieved in 79% of cases. When stratified by radiologist experience, success rates increased significantly from 70% during the first 3 years to 87.5% in the subsequent 7 years (<i>p</i> = 0.003), demonstrating a clear learning curve. Repeat procedures were required in 7% of patients and were successful in 82% of cases. Among 240 patients with conclusive AVS results, concordance between CT and AVS was 61%. CT demonstrated a sensitivity of 69% and specificity of 55% for correct PA subtype classification, with substantial false-positive and false-negative rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CT alone is an unreliable surrogate for subtype classification in PA and may lead to inappropriate management decisions. In contrast, AVS achieves high and progressively improving success rates, largely driven by radiologist experience, while also providing reliable diagnostic information for subtype classification. These findings support centralising AVS procedures in institutions with extensive experience, emphasising its crucial role in the optimal management of PA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"105 5","pages":"533-539"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cen.70182","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148599770","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":"What Endocrinologists Should Know About Iodine: Population Deficiency, Individual Excess and Misinformation in the United Kingdom","authors":"Peter N. Taylor,&nbsp;Malcolm Prentice,&nbsp;Sarah Bath,&nbsp;Emilie Combet,&nbsp;Nadia Schoenmakers,&nbsp;Vicki E. Smith,&nbsp;Fraser W. Gibb,&nbsp;Nicola Zammitt,&nbsp;Onyebuchi Okosieme,&nbsp;Kristien Boelaert,&nbsp;John Lazarus,&nbsp;Mark Vanderpump","doi":"10.1111/cen.70162","DOIUrl":"10.1111/cen.70162","url":null,"abstract":"<p>Iodine deficiency, once considered eliminated in the United Kingdom, has re-emerged, particularly among women of reproductive age, in whom requirements are increased during pregnancy and lactation. The declining consumption of dairy and white fish, the emerging use of unfortified plant-based milk alternatives, and the absence of a national iodisation policy have contributed to a return of mild to moderate iodine deficiency. Vegans and individuals avoiding dairy are at particular risk. Simultaneously, social-media-driven wellness trends promote ‘thyroid detoxes’ or ‘iodine resets’ and kelp-based supplements that deliver supraphysiological iodine doses far exceeding recommended intake. Endocrinologists now face a dual challenge: widespread under-recognition of population iodine insufficiency and a growing minority of patients presenting with iodine-induced thyroid dysfunction. This review summarises current UK iodine status, the physiological and clinical relevance of iodine to thyroid and neurodevelopmental health, modern dietary risk factors and the clinical approach to those influenced by online misinformation. Routine dietary counselling and public health fortification represent cost-effective interventions to prevent both extremes. Population-based solutions would correct iodine status efficiently and align the UK with other high-income countries.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"105 5","pages":"523-530"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cen.70162","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147962437","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":"Subacute Thyroiditis in Denmark: A Nationwide Study of 1763 Cases","authors":"Marco Juul Thomsen,&nbsp;Niels Henrik Bruun,&nbsp;Nanna Maria Uldall Torp,&nbsp;Jesper Karmisholt,&nbsp;Stig Andersen,&nbsp;Stine Linding Andersen","doi":"10.1111/cen.70173","DOIUrl":"10.1111/cen.70173","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Subacute thyroiditis (SAT) is a differential diagnosis in the clinical care of hypo- and hyperthyroid patients, but large-scale population data on the incidence, patient characteristics, and outcome are limited. Thus, the aim was to determine the incidence of SAT in the Danish population and to characterise patient demographics and the risk of permanent hypothyroidism.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Retrospective cohort study based on Danish nationwide health registers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients</h3>\u0000 \u0000 <p>Individuals diagnosed with SAT at Danish hospitals from 1995 to 2016, covering the years before and after the implementation of mandatory iodine fortification in Denmark as of July 2000.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements</h3>\u0000 \u0000 <p>Annual incidence rates of SAT were calculated overall and by geographical region (East and West Denmark). The development of permanent hypothyroidism following SAT was evaluated based on redeemed prescriptions of levothyroxine (L-T4) within a 4-year follow-up period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1763 individuals were identified with a diagnosis of SAT among 1,747,168 individuals at risk. The overall nationwide incidence increased from 3.3/100,000 individuals (95% confidence interval (CI): 2.5–4.4) in 1995 to 6.2/100,000 individuals (95% CI: 5.1–7.6) in 2016, with no regional difference (<i>p</i> = 0.18). Follow-up showed that 459 of 1763 patients with SAT (26.0%) started treatment with L-T4, and in 224 of these patients (48.7%), the duration of L-T4 treatment exceeded 36 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In a Danish nationwide cohort, the incidence of SAT increased during a 22-year period without geographical difference. Notably, the frequency of long-term L-T4 treatment was high, emphasising a focus on the post-diagnosis management of patients with SAT.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"105 5","pages":"573-581"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cen.70173","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148270570","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":"Converging Growth Trajectories During Recombinant Human Growth Hormone Therapy in Children With Isolated and Combined Pituitary Hormone Deficiency.","authors":"Chi Dung Vu, Quang Duy Pham, Phuong Thao Bui, Ngoc Khanh Nguyen, Thi Bich Ngoc Can, Thi Hang Nguyen, Hoang Lan Nguyen, Thi Chi Mai Tran, Van Duc Bui, Thu Ha Nguyen","doi":"10.1111/cen.70215","DOIUrl":"https://doi.org/10.1111/cen.70215","url":null,"abstract":"<p><strong>Objective: </strong>Growth hormone deficiency (GHD) is an important cause of growth failure in children. Although recombinant human growth hormone (rhGH) promotes catch-up growth, longitudinal differences in treatment response between isolated growth hormone deficiency (IGHD) and combined pituitary hormone deficiency (CPHD) remain unclear. This study compared longitudinal growth trajectories during rhGH therapy between IGHD and CPHD patients.</p><p><strong>Design and patients: </strong>A retrospective cohort study included 72 IGHD and 48 CPHD patients.</p><p><strong>Measurements: </strong>Height standard deviation score (SDS) was assessed at baseline and after 12, 24, 36 and 48 months of rhGH therapy. Longitudinal trajectories were analysed using linear mixed-effects models adjusted for age at treatment initiation, bone age, BMI SDS and pituitary MRI findings.</p><p><strong>Results: </strong>CPHD patients had more severe growth impairment at baseline than those with IGHD (height SDS: -5.00 ± 1.57 vs. -3.20 ± 1.12; p < 0.001). However, CPHD demonstrated greater catch-up growth, achieving larger cumulative height SDS gains after 48 months (3.10 ± 1.36 vs. 1.92 ± 0.87 SDS; p < 0.001). Mixed-effects modelling confirmed significantly different longitudinal growth trajectories (time-by-diagnosis interaction: χ²= 66.62, p < 0.001). Adjusted height SDS improved from -3.40 to -1.49 in IGHD and from -4.56 to -1.55 in CPHD. At 48 months, the adjusted CPHD-IGHD difference was -0.06 SDS (95% CI, -0.63 to 0.51), consistent with substantial convergence of the two growth trajectories. Older age at treatment initiation and abnormal pituitary MRI findings were independently associated with lower height SDS across follow-up.</p><p><strong>Conclusions: </strong>Despite more severe baseline growth impairment, children with CPHD experienced greater catch-up growth during rhGH therapy, resulting in substantial convergence of longitudinal height SDS trajectories toward those of children with IGHD over 4 years.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104945","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":"Preoperative CALLY Index for Identifying Atypical Parathyroid Tumors","authors":"Rıza Deryol,&nbsp;Hilal Yıldırım Deryol,&nbsp;Hakan Kırıt,&nbsp;Görkem Yıldız,&nbsp;Soykan Arıkan","doi":"10.1111/cen.70169","DOIUrl":"10.1111/cen.70169","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Atypical parathyroid tumors (APTs) are diagnostically challenging neoplasms that display worrisome histopathological features but do not meet the criteria for carcinoma. Conventional biochemical and imaging parameters have limited discriminatory accuracy, and no validated preoperative biomarker exists to identify APT reliably. This study evaluated the diagnostic performance of the C-reactive protein–albumin–lymphocyte (CALLY) index as a composite immunonutritional marker for distinguishing APT from typical parathyroid adenomas (TPA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective observational study with a matched analytical case–control design included adult patients who underwent parathyroidectomy for primary hyperparathyroidism between June 2020 and December 2025. All histopathologically confirmed APT cases were included, and age- and sex-matched TPA controls were selected from a larger institutional database. The primary diagnostic outcome was histopathologically confirmed APT. Diagnostic accuracy was assessed using receiver operating characteristic (ROC) analysis, and independent predictors of atypical pathology were identified using multivariable logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 50 APT cases and 156 matched TPA controls formed the analytical cohort (<i>n</i> = 206). The CALLY index was significantly lower in APT than in TPA (median 3.11 vs. 10.55; <i>p</i> &lt; 0.001). ROC analysis demonstrated excellent discriminatory performance for APT–TPA differentiation (AUC = 0.941), with an optimal cutoff of ≤ 5.73 yielding 88.0% sensitivity, 86.5% specificity, and 95.7% negative predictive value. Low CALLY remained the strongest independent predictor of APT (OR: 37.29; <i>p</i> &lt; 0.001), outperforming serum calcium, PTH, and tumor diameter.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The preoperative CALLY index may serve as a simple and accessible adjunctive marker for identifying patients with an increased likelihood of atypical parathyroid pathology before surgery. Its clinical value appears to lie primarily in preoperative APT–TPA discrimination and risk stratification rather than prediction of postoperative recurrence. Prospective multicenter validation is warranted before routine clinical implementation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"105 5","pages":"540-548"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210310","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":"Long-Term Outcomes of Gonadotropin-Releasing Hormone Analogue Therapy in Central Precocious Puberty: A Comparative Analysis of Obese and Normal-Weight Girls","authors":"Natee Sakornyutthadej,&nbsp;Jirawat Pruksasri,&nbsp;Pat Mahachoklertwattana,&nbsp;Sarunyu Pongratanakul,&nbsp;Orapan Upakankul,&nbsp;Preamrudee Poomthavorn","doi":"10.1111/cen.70195","DOIUrl":"10.1111/cen.70195","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine final height (FH), body mass index (BMI) changes, and age at menarche in obese girls with idiopathic central precocious puberty (CPP) treated with gonadotropin-releasing hormone analogue (GnRHa), compared with their normal-weight counterparts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design, Patients and Measurements</h3>\u0000 \u0000 <p>Height outcomes, FH, BMI changes and age at menarche of girls with idiopathic CPP treated with GnRHa who had reached FH were reviewed. Comparisons were performed between the overweight/obese and normal-weight groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 726 patients were enroled (269 overweight/obese and 457 normal-weight). At diagnosis, overweight/obese girls were taller (median (interquartile range) height standard deviation score (SDS): 1.53 (0.69, 2.12) versus 0.80 (0.28, 1.40), <i>p</i> &lt; 0.001), and had greater degree of bone age advancement (2.5 (1.8, 3.2) vs. 2.0 (1.1, 2.7) years, <i>p</i> &lt; 0.001). The overweight/obese group had greater height gain (FH—initial predicted adult height) following GnRHa treatment (8.0 (4.4, 11.5) vs. 6.8 (3.6, 10.7) cm, <i>p</i> = 0.010). BMI SDSs at FH were less than those at diagnosis in both groups (overweight/obese: 1.26 (0.52, 2.07) vs. 1.70 (1.23, 2.51), and normal-weight: −0.23 (−0.79, 0.47) versus 0.26 (−0.35, 0.67), <i>p</i> &lt; 0.001). Notably, 109 overweight/obese girls had normalised BMI SDS at FH. The interval from GnRHa discontinuation to menarche was comparable between the two groups (14.4 (8.4, 19.2) vs. 14.4 (9.6, 19.2) months, <i>p</i> = 0.961).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>GnRHa therapy had a beneficial effect on height gain in both CPP girls with overweight/obesity and normal weight. BMI SDSs at FH were less than those at diagnosis in both groups.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"105 5","pages":"549-555"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618728","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 Clinical Utility of Individual Iodine Status Measures in Infants With Abnormal Thyroid Function: A Systematic Review.","authors":"Sabrina Bilston-John, Ellen Fawcett, Yoon Hi Cho, Michelle Marion Jack","doi":"10.1111/cen.70214","DOIUrl":"https://doi.org/10.1111/cen.70214","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate methods used to assess individual iodine status in infants under 2 years of age and to examine their clinical utility in relation to thyroid dysfunction across different clinical contexts.</p><p><strong>Design: </strong>The protocol was registered on PROSPERO and followed PRISMA guidelines. Five databases and grey literature were searched, with backward and forward citation searching. Studies were independently screened, extracted, and appraised by two reviewers, with disagreements resolved by a third reviewer.</p><p><strong>Results: </strong>Thirty-one studies met inclusion criteria. Urinary iodine concentration (UIC) was the most used method (n = 26), with significant heterogeneity. UIC and breast milk iodine concentration (BMIC) reflected iodine excess, including in cases of congenital hypothyroidism (CH) and were associated with abnormal thyroid function tests in known exposure scenarios in some studies. Prematurity was a key modifier of iodine handling and thyroid response. In CH due to iodine deficiency, maternal UIC was a better indicator than infant UIC. Measurement timing, infant age and health status were significant confounders. Thyroglobulin (Tg) showed associations with iodine exposure, serum iodine, and thyroid dysfunction, but its relationship with infant UIC remains unclear.</p><p><strong>Conclusions: </strong>No single method reliably assesses iodine status in individual infants. Interpretation of iodine biomarkers should consider clinical context, gestational age, timing of measurement, and exposure history. A multi-modal, context-specific approach integrating iodine measures and thyroid function testing is recommended. Longitudinal studies are needed to establish age- and gestation-specific reference ranges and to refine clinical interpretation of assessment methods, including novel markers of iodine status.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079753","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 \"Metformin vs Myoinositol: Which Is Better in Obese Polycystic Ovary Syndrome Patients? A Randomized Controlled Crossover Study\".","authors":"","doi":"10.1111/cen.70207","DOIUrl":"10.1111/cen.70207","url":null,"abstract":"","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976108","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":"Diagnostic Yield of Brain MRI in Pediatric Short Stature: Hypothalamic-Pituitary Lesions and Incidental Findings in Real-World Practice.","authors":"Mustafa Zubeidat, Tamer Sobeh, Shai Shrot","doi":"10.1111/cen.70206","DOIUrl":"https://doi.org/10.1111/cen.70206","url":null,"abstract":"<p><strong>Background: </strong>Brain MRI is widely performed in children with short stature or suspected growth hormone deficiency(GHD) to exclude hypothalamic-pituitary (HP) pathology, yet its diagnostic yield in routine practice is uncertain. We aimed to evaluate the prevalence, clinical significance, and distribution of HP and extrahypothalamic abnormalities in a large real-world pediatric referral cohort, and to assess the incremental diagnostic value of gadolinium contrast and pituitary morphometry.</p><p><strong>Methods: </strong>We retrospectively reviewed 330 children (mean age: 9.2 ± 3.7 years; 60.3% boys) who underwent pituitary-protocol brain MRI between 2011 and 2024. Clinical presentation was classified as isolated short stature/suspected GHD or complex endocrine/neurologic features. Imaging findings were categorized as HP or non-HP, and classified as clinically significant (major/minor) or non-significant. Pituitary height was measured relative to age- and sex-adjusted norms.</p><p><strong>Results: </strong>Clinically significant abnormalities were identified in 22 children (6.7%), including four major lesions (1.2%). HP abnormalities were present in 30 patients (9.1%), with 11 (3.3%) clinically significant: eight microadenomas and three large sellar masses. Non-HP abnormalities occurred in 41 children (12.4%); 11 (3.3%) were clinically significant, including white matter changes, Chiari I malformation, and subependymal heterotopia. A suspected thalamic tumor represented the only major non-HP lesion. Notably, most major abnormalities occurred in children without complex endocrine presentations.</p><p><strong>Conclusion: </strong>Among children evaluated for short stature or suspected GHD, clinically significant MRI abnormalities were uncommon and major HP pathology was rare. Nonetheless, the few high-impact lesions identified carried critical management implications, including contraindication to GH therapy and neurosurgical referral, often in children with otherwise uncomplicated presentations. In a pediatric population where delayed diagnosis may adversely affect growth, pubertal development, and treatment safety, these findings support a risk-adapted imaging strategy that preserves diagnostic vigilance while promoting responsible resource utilization.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918747","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}