Clinical Endocrinology最新文献

{"title":"In Reply to Gad Et Al \"Clinical Impact of New Reference Intervals for the Roche Prolactin II Immunoassay\".","authors":"Robert D Nerenz, Bradley R Javorsky, Jenna Sarvaideo, Joely A Straseski, Erin Earll","doi":"10.1111/cen.15191","DOIUrl":"https://doi.org/10.1111/cen.15191","url":null,"abstract":"","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945777","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":"Body Composition, Adipocytokine, and Metabolic Parameters in Men With Congenital Hypogonadotropic Hypogonadism.","authors":"Rui Zhang, Jiangfeng Mao, Min Nie, Xi Wang, Tengda Xu, Fengling Chen, Ailing Song, Yingying Hu, Bingqing Yu, Qibin Huang, Bang Sun, Wei Zhang, Junyi Zhang, Songbai Lin, Xueyan Wu","doi":"10.1111/cen.15189","DOIUrl":"https://doi.org/10.1111/cen.15189","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the long-term effects of hormone therapies on the body composition, adipokines and metabolic parameters of adult men with congenital hypogonadotropic hypogonadism (CHH).</p><p><strong>Methods: </strong>Sixty-six patients with CHH and 21 healthy controls were recruited. Patients were divided into untreated (n = 33) and treated (n = 33) groups based on hormone therapy history. Body composition was assessed using dual-energy X-ray absorptiometry (DXA), and adipokines and metabolic parameters were measured in all participants.</p><p><strong>Results: </strong>Compared to the healthy control group, patients in the treated group had lower serum testosterone levels (p < 0.001), increased body fat percentage (BFP) and visceral adipose tissue (VAT) volume, decreased lean soft tissue (LST) and bone mineral content (BMC) (p < 0.05), increased serum leptin levels accompanied by decreased adiponectin (ADP) (p < 0.05), higher HOMA-IR with lower QUICKI (p < 0.05). Compared to the untreated group, patients in the treated group (therapy duration 4.8 ± 2.3 years) had higher serum testosterone levels (p < 0.001), decreased BFP and VAT volume, increased LST and BMC (p < 0.05), decreased serum leptin levels (p < 0.001), and decreased HOMA-IR accompanied by increased QUICKI (p < 0.05). Among them, VAT volume, LST, BMC, HOMA-IR and QUICKI reached healthy control levels (p > 0.05). Multiple stepwise linear regression analysis showed serum testosterone levels were negatively correlated with BFP (β = -0.564, p < 0.001) and VAT volume (β = -0.260, p = 0.045), positively correlated with LST (β = 0.305, p = 0.018) and BMC (β = 0.423, p = 0.001). Serum testosterone levels were independently negatively correlated with leptin levels (β = -0.277, p = 0.004).</p><p><strong>Conclusions: </strong>Patients with untreated CHH had impaired body composition, adipokines and metabolic parameters. While hormone therapies can improve body composition and glucolipid metabolism in patients with CHH, this imperfect treatment does not fully rescue body composition abnormalities when compared to healthy individuals. Abnormal metabolic parameters in patients with CHH are associated with increased fat mass and abnormal serum leptin level. Serum testosterone levels were independently negatively correlated with leptin levels.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930739","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":"Ghrelin: An Emerging Therapy for Heart Failure.","authors":"Nikolaos Theodorakis, Georgios Feretzakis, Magdalini Kreouzi, Dimitrios Anagnostou, Christos Hitas, Vassilios S Verykios, Maria Nikolaou","doi":"10.1111/cen.15196","DOIUrl":"https://doi.org/10.1111/cen.15196","url":null,"abstract":"<p><strong>Objective: </strong>Ghrelin is emerging as a promising therapeutic option for heart failure (HF) due to its potent inotropic, anabolic, and cardioprotective properties. This review aims to critically examine the available clinical evidence on ghrelin therapy in HF, while also incorporating key findings from preclinical studies that support its therapeutic potential.</p><p><strong>Methods: </strong>A comprehensive search was conducted in PubMed and the Cochrane Library up to September 15, 2024, using the keywords \"heart failure\" and \"ghrelin.\" From 247 identified records, four randomized controlled trials, one open-label trial, one observational study, and key preclinical studies were included. Two independent authors performed the screening and quality assessment, with any discrepancies resolved through consensus.</p><p><strong>Results: </strong>Clinical trials investigating ghrelin's acute effects in HF patients have demonstrated significant improvements in cardiac output, ranging from 15% to 30%. Moreover, one study showed that a 3-week course of ghrelin therapy significantly increased maximal oxygen consumption, lean body mass, and grip strength in HF patients. Preclinical studies further support these clinical findings, highlighting additional benefits of ghrelin, including modulation of the autonomic nervous system, promotion of vasodilation, enhancement of endothelial function, prevention of myocardial remodeling, reduction of arrhythmogenic risk, and increased muscle mass in HF models.</p><p><strong>Conclusions: </strong>Ghrelin is a promising therapeutic option for HF, particularly as an inotropic agent with multifaceted benefits, including autonomic nervous system modulation, anabolic effects, and metabolic regulation. However, further trials are required to confirm its long-term efficacy and safety and assess whether its benefits can translate into reductions in hard clinical endpoints.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930740","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 Comparison of the Predictive Value of International Medullary Thyroid Carcinoma Grading System (IMTCGS) With That of Other Risk Factors in a Chinese Medullary Thyroid Carcinoma Cohort.","authors":"Jiajia Ni, Xinyi Zhang, Yalan Liu, Yan Ling","doi":"10.1111/cen.15195","DOIUrl":"https://doi.org/10.1111/cen.15195","url":null,"abstract":"<p><strong>Background: </strong>The International Medullary Thyroid Carcinoma Grading System (IMTCGS) was recently introduced in medullary thyroid carcinoma (MTC). This study aimed to assess the predictive value of the IMTCGS for disease response and survival, and compare its predictive ability with that of other traditional risk factors in a Chinese MTC cohort.</p><p><strong>Methods: </strong>The data of 137 MTC patients undergoing initial surgery between January 2004 and June 2023 were included for analysis. Histologic features were reviewed by two pathologists. Kaplan-Meier survival analysis and Cox proportional hazard model were performed to analyse the association between risk factors (including IMTCGS high vs low grade) and progression-free survival (PFS) and disease-specific survival (DSS). ROC analysis and Delong's test were used to compare the predictive ability of IMTCGS with that of other risk factors.</p><p><strong>Results: </strong>Local recurrence, distant metastasis, and disease-specific death were observed in 14/134 (10.45%), 3/134 (2.24%), and 6/137 (4.38%) MTC patients, respectively. IMTCGS, TNM stage, postoperative calcitonin, postoperative CEA, and vascular invasion were associated with PFS in Kaplan-Meier survival analysis (all p < 0.05). Postoperative calcitonin was the only independent predictor for PFS in multivariate analysis (HR = 1.002, p = 0.002). ROC analysis and Delong's test showed that postoperative calcitonin had superior predictive value for structural recurrence than IMTCGS (AUC 0.90 vs. 0.64, p = 0.002). IMTCGS, TNM stage, and vascular invasion were associated with DSS in Kaplan-Meier survival analysis (both p < 0.05). In multivariate analysis, IMTCGS was the only independent predictor for DSS (HR = 11.23, p = 0.05). The AUC of IMTCGS was 0.81 (p = 0.01) for disease-specific death.</p><p><strong>Conclusion: </strong>In this Chinese MTC cohort, IMTCGS was a powerful predictor of disease-specific death, while postoperative calcitonin was a powerful predictor of structural recurrence.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920916","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":"Prevalence and Predictive Features of CT-Derived Nonalcoholic Fatty Liver Disease in Metabolically Healthy MACS.","authors":"Burcu Candemir, Kadir Kisip, Şafak Akın, Hatice Tuba Sanal, Mustafa Taşar, Mustafa Candemir, Neşe Ersöz Gülçelik","doi":"10.1111/cen.15194","DOIUrl":"https://doi.org/10.1111/cen.15194","url":null,"abstract":"<p><strong>Objective: </strong>Patients with mild autonomous cortisol secretion (MACS) are at increased risk of cardiometabolic outcomes, such as hyperglycemia, metabolic syndrome, and cardiovascular diseases. Nonalcoholic fatty liver disease (NAFLD) is also associated with increased cardiometabolic risk. We aimed to investigate the prevalence and predictors of NAFLD in metabolically healthy subjects with MACS.</p><p><strong>Methods: </strong>Forty patients with MACS and 60 patients with nonfunctioning adrenal incidentaloma (NFAI) matched for age, gender, and body mass index were included. We excluded various diseases that may lead to NAFLD, such as diabetes, cardiovascular diseases, and liver disorders. Non-alcoholic fatty liver disease was evaluated with unenhanced abdominal computed tomography and noninvasive fatty liver indices.</p><p><strong>Results: </strong>Patients with MACS had lower mean liver attenuation values (Hounsfield units, HU) than those with NFAI (p = 0.001). Visceral adiposity index, hepatic steatosis index, and fatty liver index were higher in the MACS group than in the NFAI group (p = 0.009, p = 0.002, p = 0.023, respectively). However, there was no significant association between the mean liver HU value and these indices. There was a significant association between serum cortisol level after the 1 mg dexamethasone suppression test (DST) and mean liver HU value independent of other traditional risk factors in various models performed in multivariable linear regression analysis.</p><p><strong>Conclusions: </strong>Our findings suggest that MACS is associated with an increased risk of NAFLD, and serum cortisol level after 1 mg DST is an independent predictor of NAFLD in patients with MACS.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920919","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":"Managing Hypoglycaemia in Patients With Insulinoma—A Tertiary Centre Experience and Review of the Literature","authors":"Sophie Howarth,&nbsp;Tak-Wai Ho,&nbsp;James Wimbury,&nbsp;Ruth Casey","doi":"10.1111/cen.15188","DOIUrl":"10.1111/cen.15188","url":null,"abstract":"<p>The management of hypoglycaemia is pivotal in the care of patients with insulinoma. Blood glucose monitoring and regulation needs careful attention pre- and peri-operatively for patients undergoing surgical resection and as part of the long-term management for patients with inoperable or metastatic disease. Hypoglycaemia symptoms are frequently pervasive and disabling, with many patients showing impaired hypoglycaemia awareness that can lead to life-threatening severe hypoglycaemia. Herein, we review the literature and describe our tertiary centre experience in the mutli-disciplinary management of hypoglycaemia for patients with proven insulinomas. We propose a stepwise algorithm for the management of hypoglycaemia, stratified by localised versus metastatic disease. We discuss our strategy for the nutritional management of hypoglycaemia, reviewing the evidence for the use of cornstarch products and artificial nutrition. We discuss pharmacological management including diazoxide, somatostatin receptor antagonists (SSAs), everolimus and glucocorticoids, in addition to other therapeutic interventions such as peptide receptor radionuclide therapy (PRRT) and endoscopic ablation.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"102 3","pages":"344-354"},"PeriodicalIF":3.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cen.15188","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909287","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":"Prognostic Significance of Preoperative NLR or PLR and PASS Score Combinations in Pheochromocytoma and Paraganglioma","authors":"Ümit Çavdar,&nbsp;Derya Sema Yaman Kalender,&nbsp;Berna Demir Yüksel,&nbsp;Barış Önder Pamuk,&nbsp;Abdurrahman Çömlekçi,&nbsp;Mehmet Sercan Ertürk,&nbsp;Emine Özlem Gür,&nbsp;Aslı Kahraman,&nbsp;Kutsal Yörükoglu,&nbsp;Serkan Yener","doi":"10.1111/cen.15192","DOIUrl":"10.1111/cen.15192","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Context</h3>\u0000 \u0000 <p>Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have recently emerged in assessing pheochromocytomas and paragangliomas (PPGLs). However, their combined use with PASS scale has not yet been explored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Our goal was to investigate the prognostic values of NLR and PLR and incorporate the PASS score into our analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from 74 histologically confirmed pheochromocytomas/paragangliomas across two centres were assessed. Poor prognosis was characterised by the presence of metastasis or disease-specific mortality. Clinical characteristics such as age, gender, primary tumour size and location, and urinary metanephrine and normetanephrine levels, alongside NLR, PLR, and the PASS score as prognostic markers, were analysed. The prognostic value of the PASS score combined with NLR or PLR was evaluated using Receiver Operating Characteristic Curve (ROC), univariate, and multivariate regression analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty-four patients with better prognosis and 10 patients with poor prognosis were included in the analysis, with mean PASS scores of 4 and 9, respectively. Poor prognosis was significantly higher in patients with NLR Á 3.43 (Area Under Curve(AUC) = 0.761; 70% sensitivity, 82.8% specificity, 38.9% PPV and 94.7% NPV) and with PLR &gt; 193.12 (AUC = 0.738; 70% sensitivity, 76.2% specificity, 30% PPV and 94% NPV). The PASS and preoperative NLR or PLR combination predicted poor prognosis significantly in the multivariate models (OR: 125; 95% CI: 6.25–∞; <i>p</i> = 0.001 for PASS ≥ 6 and NLR &gt; 3.43 and OR: 28.57; 95% CI: 3–250; <i>p</i> = 0.003 for PASS ≥ 6 and PLR &gt; 193.12).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>As the roles of NLR and PLR in prediction of prognosis is gaining recognition, combining these with PASS score may improve preoperative stratification of prognosis and management of patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"102 3","pages":"362-368"},"PeriodicalIF":3.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909380","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":"Are Oral Somatostatin Receptor Ligands Moving Closer to Becoming a Reality?","authors":"David S. McLaren,&nbsp;Nikolaos Kyriakakis,&nbsp;Khyatisha Seejore,&nbsp;Julie Lynch,&nbsp;Robert D. Murray","doi":"10.1111/cen.15193","DOIUrl":"10.1111/cen.15193","url":null,"abstract":"<div>\u0000 \u0000 <p>With the current therapeutic modalities available to endocrinologists, control of GH and IGF-I is now possible in almost all patients with acromegaly with multi-modality therapy. Despite biochemical control of GH and IGF-I, patients with acromegaly continue to experience impaired quality of life. Although there are likely multiple factors contributing to this dissatisfaction with current medical therapies, in particular the widely utilised injectable long-acting somatostatin receptor ligands (iSRL), is a contributor. The iSRLs require intramuscular or deep subcutaneous injection with a wide bore needle that can be complicated by injection site pain, erythema, subcutaneous nodule formation, and for most individuals require attendance with a healthcare professional every 28 days to safely administered the medication. Two oral SRL (oSRL) formulations, Oral Octreotide Capsules and Paltusotine have been developed with clinical studies showing them to have promise as a therapeutic alternative to iSRL.</p>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"102 3","pages":"288-290"},"PeriodicalIF":3.0,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142906792","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":"Osteocalcin in Infancy and Early Childhood and Its Correlation With Later Growth and Body Composition: A Longitudinal Birth Cohort Study.","authors":"Sara Berggren, Jovanna Dahlgren, Ola Andersson, Stefan Bergman, Josefine Roswall","doi":"10.1111/cen.15187","DOIUrl":"https://doi.org/10.1111/cen.15187","url":null,"abstract":"<p><strong>Background: </strong>Osteocalcin is a metabolic active hormone, which correlates positively with bone formation and inversely with body mass index and waist circumference in adults.</p><p><strong>Objectives: </strong>To investigate whether osteocalcin in infancy and early childhood were related to childhood growth or body composition.</p><p><strong>Methods: </strong>A Swedish longitudinal birth cohort with blood samples from 551 children from birth until 5 years of age. Regular anthropometric measurements were carried out up to 8 years of age and dual-energy X-ray absorptiometry (DXA) scans were also performed at 8 years. The results included p-values and Spearman's rho (ρ).</p><p><strong>Results: </strong>Osteocalcin at 4 months of age correlated inversely and consecutively with weight from 4 to 24 months and to waist circumference from 6 to 24 months in boys. The correlations for girls were limited to weight at 4 months and waist circumference at 6 and 18 months (ρ < 0.3, p = 0.001 to 0.048). The boys' osteocalcin levels at 5 years correlated positively with their height and weight at 5 and 6.5 years (ρ < 0.3, p < 0.01). Meanwhile, the girls' osteocalcin at 3 years showed positive correlations to all weight and height measurements until 8 years of age (ρ < 0.3, p = 0.003 to 0.023). DXA data showed that the boys' osteocalcin at 5 years correlated with the fat-free mass index (FFMI) (ρ 0.212, p = 0.026) but not the fat mass index (FMI) at 8 years. The opposite was seen for the girls' osteocalcin at 3 years, which correlated with FMI (ρ 0.222, p = 0.020) but not FFMI.</p><p><strong>Conclusion: </strong>Early levels of osteocalcin showed inverse correlations with later weight, height and body composition in infancy and positive correlations during childhood. The weak but consistent correlations suggest that osteocalcin carries information about future growth. Girls with high osteocalcin at 3 and 5 years had a larger fat mass at 8 years, while boys, in contrast, had a larger lean mass. These sex differences need to be further explored.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892705","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":"Prevalence of Vitamin D Deficiency With Biochemical Abnormalities in Children Undergoing Vitamin D Testing","authors":"Mark J. Bolland,&nbsp;Paul Hofman,&nbsp;Andrew Grey","doi":"10.1111/cen.15184","DOIUrl":"10.1111/cen.15184","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Vitamin D deficiency (VDD) in children can cause hypocalcaemia and rickets, but the prevalence of these complications and the 25-hydroxyvitamin D (25OHD) concentrations below which they arise is uncertain. We investigated this in children (&lt; 18 years) with 25OHD measurements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design, Measurement and Patients</h3>\u0000 \u0000 <p>We obtained 25OHD results from the regional laboratory database, alongside albumin-adjusted serum calcium (aCa), parathyroid hormone (PTH) and alkaline phosphatase (ALP) within 6 months of the index 25OHD. We defined confirmed VDD with biochemical abnormalities (VDDba) as all of low aCa, elevated PTH and elevated ALP. Possible/potential VDDba were defined as 2/3 VDDba criteria with the third test missing (possible), or in the normal range (potential). Clinical records of identified cases were reviewed, and a consensus diagnosis was reached.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 30,663 25OHD measurements were identified over 11.5 years (1 January 2009 to 15 June 2020); mean age 8 y, 47% female. After excluding ineligible results, 12,858 25OHD measurements from 9516 individuals with ≥ 2 aCa, PTH and ALP were analysed. Median 25OHD was 61 nmol/L; 36% &lt; 50 nmol/L, 10% &lt; 25 nmol/L. In total, 152 index 25OHD measurements were categorised as VDDba (30 confirmed, 23 possible and 99 potential). Following record review, 118 individuals (111 &lt; 3 years) had 120 clinically confirmed VDDba episodes (62 clinical rickets, 15 biochemical rickets, 16 hypocalcaemia, 23 secondary hyperparathyroidism and 4 partially treated rickets). Fifty-six had undetectable 25OHD, and 104 &lt; 25 nmol/L. The proportion of clinically confirmed VDDba was 0.9% for all eligible 25OHD measurements, and 8% for 25OHD &lt; 25 nmol/L.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>VDDba is uncommon in children undergoing 25OHD testing, and occurs almost entirely in children &lt; 3 years.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"102 3","pages":"255-263"},"PeriodicalIF":3.0,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892317","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}