Clinical Endocrinology最新文献

{"title":"The Use of Prednisolone 2.5 mg Daily During Ramadan Fasting in Patients With Adrenal Insufficiency","authors":"Meng-Loong Mok,&nbsp;Nusrath Salma Farook,&nbsp;Nicholas Ken Yoong Hee,&nbsp;Tharsini Sarvanandan,&nbsp;Quan- Hziung Lim,&nbsp;Lee-Ling Lim,&nbsp;Shireene Vethakkan,&nbsp;Jeyakantha Ratnasingam","doi":"10.1111/cen.15176","DOIUrl":"10.1111/cen.15176","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>A previous study had established the safety and preserved of quality of life in patients with adrenal insufficiency (AI) who received prednisolone 5 mg once daily at sahur (predawn) during Ramadan fasting. It has been postulated that a lower dose of prednisolone between 2 and 3 mg may be sufficient for glucocorticoid replacement in this group of patients. This study aimed to assess the safety and effect on quality of life in patients with AI given prednisolone 2.5 mg during Ramadan fasting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with AI on twice-daily hydrocortisone, who had low or moderate risk of adrenal crisis and intended to fast, were recruited. Patients were given prednisolone 2.5 mg once daily taken at sahur(predawn) and Ramadan education was given. Weight, sleep duration, physical activity, biochemical parameters and quality of life measurements (SF-36 questionnaire) were analysed at the end of Ramadan and compared against the patient's own baseline readings before the start of Ramadan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 16 patients (10 men, median age 60 [50.3, 68] years) were recruited. All patients were on 15–20 mg of hydrocortisone (in divided doses) before Ramadan, and intended to fast. Five of the participants had type 2 diabetes with low IDF-DAR risk category. 18.7% of the participants were unable to complete all 29 days of fasting. Up to 62.5% of the participants reported at least one adverse event. There was a statistically significant reduction in weight (median: −1.6 [−2.5, −0.3] kg, <i>p</i> &lt; .01), systolic blood pressure (median: −17.0 (−28.8, −4.3) mmHg, <i>p</i> &lt; .01) and diastolic blood pressure (median: −13.0 (−17.8, −3.8) mmHg, <i>p</i> &lt; .01). Quality of life measures were preserved in all domains.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>With prednisolone 2.5 mg daily in Ramadan fasting, more than half of the participants experienced symptoms of AI, with significant reduction in weight and blood pressure. We conclude that prednisolone 2.5 mg daily is insufficient during the somewhat stressful state of Ramadan fasting. Further studies with prednisolone 3–4 mg daily in settings with readily available prednisolone 1 mg tablets may further elucidate the safety of using lower dose prednisolone in Muslim patients who fast with AI during Ramadan.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"102 2","pages":"103-110"},"PeriodicalIF":3.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142805804","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":"Redefining Diagnostic Cut-Offs for the Indirect Water Deprivation Test","authors":"Yash Akkara,&nbsp;Kavita Narula,&nbsp;Katharine Lazarus,&nbsp;Deborah Papadopoulou,&nbsp;Sirazum Choudhury,&nbsp;Niamh Martin,&nbsp;Karim Meeran","doi":"10.1111/cen.15172","DOIUrl":"10.1111/cen.15172","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>An incorrect diagnosis of arginine vasopressin deficiency and resistance (AVP-D and AVP-R) results in the potentially dangerous use of desmopressin in healthy individuals. The water deprivation test is a central diagnostic test in patients with polydipsia polyuria syndrome (PPS). This study aims to determine the effectiveness of the current interpretation of reference ranges.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a retrospective analysis of 135 patients who underwent a water deprivation test between August 2014 and August 2023. All patient diagnoses were reviewed, and variability and receiver operating characteristic (ROC) curves were determined for serum osmolality, serum sodium and urine osmolality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Serum sodium demonstrated reduced variability compared with serum osmolality (0.72% vs. 1.16%, respectively, 37.5% reduction; <i>p</i> &lt; 0.001). The standard serum osmolality cut-off value of ≥ 300 mOsm/kg in diagnosing AVP-D, AVP-R, and primary polydipsia (PP) achieved a sensitivity of 76.19% and specificity of 76.92%. A serum sodium cut-off value of ≥ 148 mmol/L demonstrated 100% specificity in excluding PP. This cut-off was used alongside urine osmolality cut-off values of &gt; 630 mOsm/kg (for PP) and &lt; 383 mOsm/kg (for AVP-D/AVP-R). Review of post-desmopressin urine osmolality and clinical monitoring was performed in equivocal diagnostic cases (<i>n</i> = 6), achieving 100% sensitivity and 100% specificity within the study sample.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study demonstrates that a serum sodium cut-off of ≥ 148 mmol/L in tandem with urine osmolality yields the best diagnostic accuracy to differentiate between AVP-D, AVP-R, and PP. Serum sodium may be more reliable than serum osmolality in the investigation of patients with PPS, demonstrating lower biological and analytical variability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"102 2","pages":"149-155"},"PeriodicalIF":3.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784335","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":"Correction to \"Magnetic Resonance Imaging as a Predictor of Therapeutic Response to Pasireotide in Acromegaly\".","authors":"","doi":"10.1111/cen.15177","DOIUrl":"https://doi.org/10.1111/cen.15177","url":null,"abstract":"","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766825","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":"Diet Quality Scores and Central Precocious Puberty Risk in Chinese Girls: A Case-Control Study.","authors":"Yujie Qin, Hongyang Deng, Mengnan Lu, Lujie Liu, Meng Li, Jing Zhou, Yanfeng Xiao","doi":"10.1111/cen.15173","DOIUrl":"https://doi.org/10.1111/cen.15173","url":null,"abstract":"<p><strong>Objective: </strong>Diet is an important factor influencing central precocious puberty (CPP). This study aimed to investigate the relationship among diet quality, pro-inflammatory diets, and CPP in Chinese girls.</p><p><strong>Design, patients and measurements: </strong>This case-control study enroled 112 Chinese girls with CPP and 131 healthy controls. Children's dietary intake was assessed using a validated food frequency questionnaire, anthropometric and sociodemographic data were collected and serum interleukin-6 levels were measured. We calculated the Children's Dietary Inflammatory Index (C-DII), Chinese Children's Dietary Index (CCDI), Dietary Approaches to Stop Hypertension (DASH) score, and the adjusted Dietary Approaches to Stop Hypertension (aDASH) score. The association between diet and the risk of CPP was analysed using logistic regression models.</p><p><strong>Results: </strong>After adjustment, higher C-DII scores were associated with an increased risk of CPP (P for trend = 0.034), and aDASH scores were significantly negatively associated with the risk of CPP (P for trend = 0.048). Serum IL-6 levels were significantly higher in the case group than in the control group and were positively correlated with the risk of CPP (P for trend = 0.006).</p><p><strong>Conclusions: </strong>High-quality dietary patterns and an anti-inflammatory diet may contribute to the prevention of CPP in Chinese girls.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766828","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":"WITHDRAWN: New thyroid fine needle aspiration biopsy needle. Prospective, randomized, clinical study.","authors":"","doi":"10.1111/cen.12554","DOIUrl":"10.1111/cen.12554","url":null,"abstract":"<p><strong>Withdrawal: </strong>Erhan Aysan, Yeliz Ersoy, Zuhal Gucin, Merve Cengiz, Huseyin Akbulut, Sema Arici, Mahmut Muslumanoglu. New thyroid fine needle aspiration biopsy needle. Prospective, randomized, clinical study, Clinical Endocrinology, 15th July 2014. https://doi.org/10.1111/cen.12554 WITHDRAWAL: The above article, first published online on Wiley Online Library (wileyonlinelibrary.com) on 15th July 2014, has been withdrawn by agreement between the Editors in Chief, Prof Aled Rees and Prof Maralyn Druce and John Wiley and Sons Ltd. The withdrawal has been made because the authors did not respond to requests to finalise the article for publication.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"101 6","pages":"690"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557308","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":"Relationship Between Body Composition and Insulin Resistance Evaluated by the TyG Index: A Retrospective Study Among Chinese Population","authors":"Yufang Luo,&nbsp;Lei Liu,&nbsp;Min Liu,&nbsp;Chenyi Tang,&nbsp;Hong Liu,&nbsp;Meng Wang,&nbsp;Guo Feng,&nbsp;Jinru Wu,&nbsp;Wei Wu","doi":"10.1111/cen.15171","DOIUrl":"10.1111/cen.15171","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The triglyceride glucose (TyG) index, a novel and easily obtained marker of insulin resistance (IR), has been shown to predict metabolic diseases. Monitoring body composition is crucial in assessing disease states. This study aimed to investigate the relationship between body composition and IR as assessed by the TyG index.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Between January 2018 and December 2021, 12,186 individuals were initially enroled, with 4061 adults were ultimately included. Body composition, including fat mass (FM), fat mass index (FMI), fat-free mass (FFM), fat-free mass index (FFMI), and percent body fat (PBF), was measured using bioelectrical impedance analysis. Spearman analysis assessed correlations between body composition indices and the TyG index. Binary logistic regression identified independent predictors of IR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Older women (≥ 50 years old) showed significantly higher BMI, PBF, FM, FMI, FFMI, HOMA-IR, and the TyG index, but lower FFM compared to younger women; Older men exhibited significantly lower BMI, FM, FFM, FFMI, HOMA-IR, and the TyG index than the younger men. FM, FMI, FFM, FFMI, and PBF were positively correlated with the TyG index. FFMI and PBF significantly predicted IR in both genders. Combined FFMI and PBF yielded an area under the ROC curves of 0.718 in women and 0.661 in men for IR diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The TyG index correlates with body composition parameters of FFMI and PBF as well as HOMA-IR potentially making it a convenient marker of metabolic risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"102 3","pages":"264-272"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766834","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":"New Pituitary Adenoma Classification System to Individualise Management and Improve Long-Term Prognosis","authors":"Gudmundur Johannsson,&nbsp;Oskar Ragnarsson,&nbsp;Thomas Skoglund","doi":"10.1111/cen.15170","DOIUrl":"10.1111/cen.15170","url":null,"abstract":"&lt;p&gt;There is a need for a classification that helps to risk-stratify patients with pituitary adenomas and to identify their best treatment options. The proposed clinical classification for pituitary neoplasms, published earlier this year in &lt;i&gt;The Lancet Diabetes &amp; Endocrinology&lt;/i&gt; [&lt;span&gt;1&lt;/span&gt;], is an attempt to stratify patients according to their long-term prognosis and to enable individualised management and therapy decisions. The proposal was initiated by the Pituitary Society, and endorsed by the Endocrine Society, European Society of Endocrinology, International Society of Pituitary Surgeons, American Association of Clinical Endocrinology and US and Canadian Academy of Pathology. This proposal is partly a response to the 2022 WHO reclassification of pituitary adenomas as pituitary neuroendocrine tumours (PitNET) that is limited to patients who have received surgical treatment [&lt;span&gt;2&lt;/span&gt;], and has been criticised for not adding any new support for clinical decision making of patients with pituitary adenoma [&lt;span&gt;3&lt;/span&gt;]. Thus, the aim of the new clinical classification was to provide an evidence-based system that predicts prognosis, guides treatment and allows comparison of different types of interventions that can be used locally and in a global setting.&lt;/p&gt;&lt;p&gt;The proposed classification model enables the assessment of all types of pituitary adenomas, regardless of whether surgical resection has provided tissue for histological examination or not. A panel of experts included nine factors associated with prognosis for patients with pituitary adenoma: phenotype, secretory status, hypopituitarism, size, mass effect, invasion, residual tumour, histopathology and genetic syndromes. A semiquantitative system was adopted for these nine risk factors where scores of 0 or 1 reflect the absence or presence of the risk factor, and a score of 2 was assigned to specific factors that are strongly associated with poor prognosis. The scores were then summed up to reflect the cumulative effect of all risk factors. The authors acknowledge that the classification system requires validation in independent studies, preferably prospective ones.&lt;/p&gt;&lt;p&gt;The outcome among patients with pituitary adenoma is influenced by many factors as implicated in the proposed clinical classification system. It is influenced by the pituitary tumour phenotype and its behaviour, the presence of hypopituitarism, but also other related comorbidities such as cardiovascular disorders, hypertension and diabetes mellitus [&lt;span&gt;4-7&lt;/span&gt;]. Since histopathology alone cannot adequately predict which tumours will progress after surgery, combined scoring systems incorporating adenoma invasiveness from imaging have been developed to support individualised tumour surveillance and management [&lt;span&gt;8, 9&lt;/span&gt;]. This combination of imaging and histopathology has improved the prediction of tumour behaviour after surgery, however, the search for new biomarkers that better reflects ","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"102 2","pages":"147-148"},"PeriodicalIF":3.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142726566","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":"Defining Clinical Characteristics of Individuals With and Without Post-Bariatric Hypoglycemia After Gastric Bypass","authors":"Ashna Grover,&nbsp;Maryam Farahmandsadr,&nbsp;Hamayle Saeed,&nbsp;Cameron Cummings,&nbsp;Amanda Sheehan,&nbsp;Lei Pei,&nbsp;Donald C. Simonson,&nbsp;Mary Elizabeth Patti","doi":"10.1111/cen.15169","DOIUrl":"10.1111/cen.15169","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Context</h3>\u0000 \u0000 <p>Post-bariatric hypoglycemia (PBH) is a complication of bariatric surgery including Roux-en-Y gastric bypass (RYGB). It remains unclear why only some individuals develop PBH.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To identify clinical characteristics distinguishing post-RYGB individuals with PBH, versus without symptomatic hypoglycemia (RYGB non-hypo).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design and Setting</h3>\u0000 \u0000 <p>Cross-sectional observational study in academic referral centre. Adults 18–70, without current diabetes, were recruited into three groups: (1) PBH (<i>n</i> = 39); (2) RYGB non-hypo (<i>n</i> = 25); and (3) individuals without history of upper gastrointestinal surgery (<i>n</i> = 17). Outcome measures included between-group differences in medical history and medication use, and survey-based scores for hypoglycemia, dumping syndrome, and autonomic symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>PBH participants were 92% female, age 53.4 ± 11.9 y, BMI 31.2 ± 5.6 kg/m², versus RYGB non-hypo (100% female, age 53.2 ± 10.5 y, BMI 32.2 ± 8.0 kg/m²) and controls (65% female, age 44.5 ± 14.6 y, BMI 30.8 ± 6.3 kg/m²). 87% of PBH reported level 3 hypoglycemia, with emergency visits in 28% and vehicle accidents in 8%. Reduced hypoglycemia awareness was reported by 82%; 13%–17% were classified as unaware (modified Clarke/Gold scores). Preoperative hypoglycemia symptoms and family history were reported by 26% and 18% of PBH. PBH had significantly higher survey scores for hypoglycemia, dumping syndrome, and autonomic symptoms, and higher self-reported neuropathy, autonomic neuropathy, orthostatic hypotension, reflux esophagitis, intestinal dysmotility, and IBS (all <i>p</i> &lt; 0.05 vs. RYGB non-hypo). Gabapentin and PPI use was more frequent in PBH.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>High rates of IBS, dumping symptoms, and orthostatic hypotension suggest disordered autonomic regulation as a potential contributor to PBH. Self-reported preoperative symptoms and family history of hypoglycemia suggest possible preoperative differences in glucose metabolism in PBH.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"102 2","pages":"111-120"},"PeriodicalIF":3.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738659","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":"Tumor Size as a Predictive Indicator for Lymph Node Metastasis in Papillary Thyroid Carcinoma: An Inverted L-Shaped Curve Analysis Based on the SEER Database","authors":"Jia-Hua Chen,&nbsp;Mi Zhang,&nbsp;Yang-Yang He,&nbsp;Yong Hong","doi":"10.1111/cen.15168","DOIUrl":"10.1111/cen.15168","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Papillary thyroid carcinoma (PTC) frequently metastasises to lymph nodes, with lymph node metastasis (LNM) occurring with high frequency in small, early-stage tumors. The present study examines the inverse <span>l</span>-shaped relationship between tumor size and the likelihood of LNM in patients diagnosed with PTC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a detailed retrospective cohort analysis of 48,021 cases of papillary thyroid cancer using data from the Epidemiology, and End Results (SEER) database from 1992 to 2019. Our study used various analytical methods, including logistic regression, spline curve fitting, and variable interaction assessment, to clarify the association between tumor size and LNM rates. We rigorously controlled for potential confounders such as patient age, sex, ethnicity, tumor size, extrathyroidal extension (ETE), histopathological characteristics and distant metastases. In addition, we thoroughly investigated and quantitatively assessed the relationship between adjusted tumor size measurements and the likelihood of LNM development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median tumor size among the 48,021 patients diagnosed with PTC was 1.3 cm. Among these patients, 12,365 (25.75%) had LNM, with a median tumor size of 1.9 cm in this group. A comparative analysis shows a significant difference in tumor sizes between PTC patients who were LNM-positive and those who were LNM-negative. The relationship between tumor size and the likelihood of LNM exhibits a distinct nonlinear pattern. Specifically, below a diameter threshold of 1.978 cm, the probability of LNM significantly increases with larger tumor sizes (odds ratio [OR] = 2.363, 95% confidence Interval [CI]: 2.214–2.523). Once this threshold is surpassed, the effect of tumor size on LNM incidence levels off (OR = 1.031, 95% CI: 1.003–1.061).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The results of this study confirm that tumor size significantly determines the likelihood of LNM in patients with PTC. We found an inverse <span>l</span>-shaped relationship between tumor size and the probability of LNM. As the tumor size increased below 1.978 cm, the likelihood of LNM increased, but not with tumor size above that threshold. These findings provide new insights into the complex relationship between tumor size and LNM in PTC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"102 2","pages":"214-222"},"PeriodicalIF":3.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715572","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":"Ovarian Stimulation Effects on Ghrelin Secretion and Reproductive Potential","authors":"Fernando Beltramone,&nbsp;Patricia Estofán,&nbsp;Noelia Piccinali,&nbsp;Pedro Javier Torres,&nbsp;Nicolás David Ramírez,&nbsp;Verónica Inés Cantarelli,&nbsp;Marina Flavia Ponzio,&nbsp;Rubén Darío Motrich,&nbsp;Mariano Severgnini,&nbsp;Ana Carolina Martini","doi":"10.1111/cen.15167","DOIUrl":"10.1111/cen.15167","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Finely regulated Ghrelin (Ghrl) secretion is essential during early pregnancy, as infra or supraphysiologic levels can be detrimental. Since oestrogens stimulate Ghrl synthesis, ovarian stimulation (OS) might increase ghrelinemia, thus being detrimental for fertility. The aim of this work was to evaluate whether OS increases ghrelinemia and associates with maternal endocrine and immune biomarkers and reproductive success.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>The 97 women undergoing assisted reproduction were grouped as follows: OS: undergoing OS and fresh embryo transfer (<i>n</i> = 35); FET: undergoing frozen embryo transfer in a cycle different from that of OS (<i>n</i> = 25) and, OD: undergoing embryo transfer in oocyte donation cycles (<i>n</i> = 37). At embryo transfer day, several endocrine and immune biomarkers were assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>OS patients showed significantly higher serum estradiol, progesterone and Ghrl, than those not stimulated. Patients that suffered miscarriage showed significantly lower concentrations of sex-hormones, with a similar trend for Ghrl, that deserves further investigation. Moreover, OS patients showed decreased frequencies of circulating T cells and reduced ratios of uNK/NK cells, which significantly associated with serum levels of sex-hormones. Besides, ROC curves identified cut-off values predictive of clinical pregnancy and/or miscarriage for peripheral counts of uNK cells, T cells, and uNK/NK cells ratio.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>As hypothesised, OS significantly increased serum Ghrl in correlation with sex-hormone levels. These last, significantly associated with maternal immune response and reproductive outcome. Although Ghrl exhibited a similar profile, it did not reach statistical significance, indicating the need for further investigation. Additionally, the identification of maternal immunological cut-off values holds significant clinical relevance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"102 2","pages":"156-166"},"PeriodicalIF":3.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647085","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}