Current Opinion in Endocrinology & Diabetes and Obesity最新文献_第10页

Biomarkers in gastroenteropancreatic neuroendocrine neoplasms. 胃肠胰神经内分泌肿瘤的生物标志物研究。

IF 3.2 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2023-06-01 DOI: 10.1097/MED.0000000000000805

Isa Mulingbayan Jacoba, H Christian Weber

{"title":"Biomarkers in gastroenteropancreatic neuroendocrine neoplasms.","authors":"Isa Mulingbayan Jacoba, H Christian Weber","doi":"10.1097/MED.0000000000000805","DOIUrl":"https://doi.org/10.1097/MED.0000000000000805","url":null,"abstract":"Purpose of review: Gastroenteropancreatic neuroendocrine neoplasms (GEP-NEN) represent a heterogenous group of rare tumors emanating from neuroendocrine cells that are clinically silent for prolonged periods of time without detection. Traditional biomarkers lack sufficiently high enough specificity and sensitivity for these tumors and their secreted products. New molecules are sought to improve accuracy of detection and monitoring of GEP-NENs. The purpose of this review is to highlight recent advances in the discovery of novel biomarkers and their potential characteristics and utility as markers of GEP-NENs.Recent findings: Several recent GEP-NEN investigations regarding NETest demonstrate superior sensitivity and specificity in diagnosis and disease monitoring as compared with chromogranin A. Among several tissue-based emergent candidate molecules as biomarkers for GEP-NEN INSM1 has demonstrated consistently excellent characteristics when compared with traditional markers including chromogranin A, synaptophysin, and CD56.Summary: For the diagnosis and clinical monitoring of NEN, there still exists a considerable need for better biomarkers. Novel technology has resulted in a promising liquid biopsy for the detection and monitoring of GEP-NENs. The search for improved tissue biomarkers has resulted in identification of one potential candidate whereas several others remain in the investigatory phase.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":"30 3","pages":"175-180"},"PeriodicalIF":3.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10311659","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}

引用次数: 0

Molecular tools for diagnosing diseases of the adrenal cortex. 诊断肾上腺皮质疾病的分子工具。

IF 3.2 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2023-06-01 DOI: 10.1097/MED.0000000000000809

Fabio R Faucz, Andrea G Maria, Constantine A Stratakis

{"title":"Molecular tools for diagnosing diseases of the adrenal cortex.","authors":"Fabio R Faucz, Andrea G Maria, Constantine A Stratakis","doi":"10.1097/MED.0000000000000809","DOIUrl":"https://doi.org/10.1097/MED.0000000000000809","url":null,"abstract":"Purpose of review: The adrenal glands produce some of the most essential for life hormones, including cortisol and other steroids, and catecholamines. The former is produced from the adrenal cortex, whereas the latter is from the medulla. The two parts are anatomically and functionally distinct and it would be impossible in the context of one short article to cover all molecular updates on both the cortex and the medulla. Thus, in this review, we focus on the molecular tools available for diagnosing adrenocortical diseases, such as adrenal insufficiency, Cushing and Conn syndromes, and their potential for advancing medical care and clinical outcome.Recent findings: The advent of next generation sequencing opened doors for finding genetic diseases and signaling pathways involved in adrenocortical diseases. In addition, the combination of molecular data and clinicopathologic assessment might be the best approach for an early and precise diagnosis contributing to therapeutic decisions and improvement of patient outcomes.Summary: Diagnosing adrenocortical diseases can be challenging; however, the progress of molecular tools for adrenocortical disease diagnosis has greatly contributed to early detection and to meliorate patient outcomes.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":"30 3","pages":"154-160"},"PeriodicalIF":3.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10256823","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}

引用次数: 0

Editorial introductions. 编辑介绍。

IF 3.2 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2023-06-01 DOI: 10.1097/MED.0000000000000808

引用次数: 0

Glucocorticoid withdrawal syndrome: what to expect and how to manage. 糖皮质激素戒断综合征:预期和如何管理。

IF 3.2 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2023-06-01 DOI: 10.1097/MED.0000000000000804

Verena Theiler-Schwetz, Alessandro Prete

{"title":"Glucocorticoid withdrawal syndrome: what to expect and how to manage.","authors":"Verena Theiler-Schwetz, Alessandro Prete","doi":"10.1097/MED.0000000000000804","DOIUrl":"https://doi.org/10.1097/MED.0000000000000804","url":null,"abstract":"Purpose of review: Glucocorticoid withdrawal syndrome (GWS) can develop after withdrawing exposure to supraphysiological levels of endogenous or exogenous glucocorticoids due to an established physical dependence. It is characterised by symptoms similar to adrenal insufficiency but needs to be regarded as a separate entity. GWS is often under-recognised in clinical practice and affected patients can experience significant impairment in their quality of life.Recent findings: A cornerstone in GWS management is adequate patient education and reassurance that symptoms are expected and typically temporary. Patients with endogenous Cushing's syndrome need to be aware that psychopathology may persist into the postoperative period. GWS is more likely to develop in severe Cushing's syndrome and in patients with very low levels of cortisol after surgery. Postoperatively, glucocorticoid replacement should be initiated and tapered in an individualised approach but there is currently no consensus on the best tapering strategy. If symptoms of GWS develop, glucocorticoid replacement ought to be temporarily increased to the previous, well tolerated dose. No randomised studies have thus far compared regimens for withdrawing glucocorticoids after treatment for anti-inflammatory or immunosuppressive causes to determine the best and safest tapering strategy. One open-label, single-arm trial in patients with asthma has recently proposed a personalised glucocorticoid tapering regimen which included the systematic assessment of adrenal function.Summary: Awareness of GWS by treating physicians and patient education are essential. Evidence on optimal GWS management after Cushing's syndrome treatment is scarce, but new data are emerging for tapering after long-term glucocorticoid treatment.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":"30 3","pages":"167-174"},"PeriodicalIF":3.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10604738","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}

引用次数: 2

Surgical approaches to the adrenal gland. 肾上腺的外科手术。

IF 3.2 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2023-06-01 DOI: 10.1097/MED.0000000000000810

Alaa Sada, Travis J McKenzie

{"title":"Surgical approaches to the adrenal gland.","authors":"Alaa Sada, Travis J McKenzie","doi":"10.1097/MED.0000000000000810","DOIUrl":"https://doi.org/10.1097/MED.0000000000000810","url":null,"abstract":"Purpose of review: Review the literature on the surgical management of adrenal diseases, highlighting the various surgical approaches and their respective pros and cons.Recent findings: Minimally invasive adrenalectomy is commonly used for small and benign adrenal tumors, whereas open adrenalectomy is preferred for larger tumors and primary adrenal malignancy. Although minimally invasive adrenalectomy results in shorter recovery and fewer complications compared with open, the latter offers better oncologic outcomes in the setting of primary adrenal malignancy. Adrenalectomy is performed transabdominally or retroperitoneoscopically, both yielding equivalent results and recovery. Traditional laparoscopic or robotic equipment can be utilized for either minimally invasive approach. Subtotal adrenalectomy may be appropriate for patients with genetically associated pheochromocytoma to preserve cortical function and reduce the risk of adrenal insufficiency. However, the potential benefits of sparing adrenal function must be weighed against the risk of recurrence.Summary: Adrenalectomy is becoming increasingly common worldwide. For benign and small adrenal tumors, minimally invasive adrenalectomy is generally considered the standard approach, while open adrenalectomy is preferred for primary adrenal malignancy and larger tumors. Subtotal adrenalectomy may be appropriate for patients with bilateral adrenal pheochromocytoma, as it can reduce the need for lifelong glucocorticoid dependency.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":"30 3","pages":"161-166"},"PeriodicalIF":3.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10255878","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}

引用次数: 1

Can remnant cholesterol (triglyceride-rich lipoproteins) reclassify estimated risk of atherosclerotic cardiovascular disease? 残余胆固醇(富含甘油三酯的脂蛋白)能否重新分类动脉粥样硬化性心血管疾病的估计风险?

IF 3.2 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2023-04-01 DOI: 10.1097/MED.0000000000000799

Takahito Doi, Børge G Nordestgaard, Anne Langsted

{"title":"Can remnant cholesterol (triglyceride-rich lipoproteins) reclassify estimated risk of atherosclerotic cardiovascular disease?","authors":"Takahito Doi, Børge G Nordestgaard, Anne Langsted","doi":"10.1097/MED.0000000000000799","DOIUrl":"https://doi.org/10.1097/MED.0000000000000799","url":null,"abstract":"Purpose of review: To summarize recent studies analyzing reclassification of estimated risk of myocardial infarction (MI) and ischemic heart disease (IHD) by inclusion of remnant cholesterol (= cholesterol content in triglyceride-rich lipoproteins) in primary and secondary prevention settings.Recent findings: For individuals in a primary prevention setting with remnant cholesterol levels at least 95th percentile (≥1.6 mmol/l, 61 mg/dl), 23% of MI and 21% of IHD events developed later were reclassified correctly from below to above 5% for 10-year occurrence when remnant cholesterol levels were added to models based on conventional risk factors, whereas no events were reclassified incorrectly. Overall improved reclassification of MI was also observed for remnant cholesterol levels as low as at least 50th percentile (≥0.6 mmol/l, 25 mg/dl); however, the addition of remnant cholesterol over the entire concentration range yielded insignificant improvements of NRI for MI but slightly improved reclassification of NRI for IHD. In a secondary prevention setting, addition of remnant cholesterol over the entire concentration range to a conventional risk model improved reclassification.Summary: Elevated remnant cholesterol levels considerably improves reclassification of individuals who later develop MI and IHD, in primary as well as in secondary prevention settings.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":"30 2","pages":"128-135"},"PeriodicalIF":3.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10622454","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}

引用次数: 3

Cardiovascular disease in metabolic-associated fatty liver disease. 代谢相关脂肪性肝病中的心血管疾病。

IF 3.2 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2023-04-01 DOI: 10.1097/MED.0000000000000803

Leon A Adams

引用次数: 0

Editorial introductions. 编辑介绍。

IF 3.2 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2023-04-01 DOI: 10.1097/MED.0000000000000800

引用次数: 0

Low-carbohydrate diets in type 1 diabetes: balancing benefits and risks. 1型糖尿病的低碳水化合物饮食:平衡益处和风险。

IF 3.2 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2023-04-01 DOI: 10.1097/MED.0000000000000797

Michael Hancock, Kharis Burns, Seng Khee Gan, Gerard T Chew

{"title":"Low-carbohydrate diets in type 1 diabetes: balancing benefits and risks.","authors":"Michael Hancock, Kharis Burns, Seng Khee Gan, Gerard T Chew","doi":"10.1097/MED.0000000000000797","DOIUrl":"https://doi.org/10.1097/MED.0000000000000797","url":null,"abstract":"Purpose of review: Interest in the use of calorie restriction with low-carbohydrate diets for patients with type 1 diabetes appears to be increasing despite physicians' discomfort about its longer term outcomes. A divergence in opinion regarding the balance of benefits and safety may lead to patient disengagement from conventional medical supervision. This review describes the current evidence regarding the benefits and risks of these diets and suggests a way forward to addressing this potential misalignment between the aims of patients and their physicians.Recent findings: Benefits on glycaemia are observed in many studies, with improved HbA1c, time within target range and reduced glycaemic variability. A characteristic lipid profile with high LDL cholesterol is observed in many patients, but association with future cardiovascular events is undefined. A negative impact on growth has been identified in the paediatric population, and impact on mental health and disordered eating is of theoretical concern, without measurement in clinical studies.Summary: Patients will continue to trial and, with immediate glycaemic benefits, potentially remain on lower carbohydrate diets irrespective of concern by treating physicians about potential longer term risks. A supportive multidisciplinary approach with greater nutritional supervision and more research is required, to allow these patients to achieve their desired glycaemic outcomes without compromising longer term safety.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":"30 2","pages":"113-122"},"PeriodicalIF":3.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10260252","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}

引用次数: 2

Eicosapentaenoic acid vs. docosahexaenoic acid for the prevention of cardiovascular disease. 二十碳五烯酸与二十二碳六烯酸预防心血管疾病。

IF 3.2 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2023-04-01 DOI: 10.1097/MED.0000000000000796

Ty E Sweeney, Sean P Gaine, Erin D Michos

{"title":"Eicosapentaenoic acid vs. docosahexaenoic acid for the prevention of cardiovascular disease.","authors":"Ty E Sweeney, Sean P Gaine, Erin D Michos","doi":"10.1097/MED.0000000000000796","DOIUrl":"https://doi.org/10.1097/MED.0000000000000796","url":null,"abstract":"Purpose of review: Populations with greater fatty fish intake have lower risk of coronary heart disease. However, trials testing omega-3 fatty acids (FA) on cardiovascular outcomes have yielded inconsistent results. In this review, we summarize the major cardiovascular trials examining omega-3 FA supplementation, and compare differences with eicosapentaenoic acid (EPA) alone vs. docosahexaenoic acid (DHA) combined with EPA.Recent findings: The JELIS and REDUCE-IT trials both demonstrated significant reduction in cardiovascular events with high dose EPA in the form of icosapent ethyl (IPE), with a similar trend seen in the RESPECT-EPA trial. In contrast, the ASCEND, VITAL, STRENGTH, and OMEMI trials examining EPA+DPA combinations failed to demonstrate benefit. Beyond the difference in omega-3 FA formulations (IPE vs. omega-3 carboxylic acid), other differences between REDUCE-IT and STRENGTH include the achieved EPA levels, differing properties that EPA and DHA have on membrane stabilization, and the comparator oils tested in the trials.Summary: The totality of evidence suggests EPA alone, administered in a highly-purified, high-dose form, improves cardiovascular outcomes among patients with elevated triglycerides at high cardiovascular risk, but EPA and DHA together does not. Current guidelines endorse the use of IPE in statin-treated patients at high cardiovascular risk who have triglycerides >135 mg/dl.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":"30 2","pages":"87-93"},"PeriodicalIF":3.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10258645","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}

引用次数: 1