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

Effect of incretins on skeletal health. 胰蛋白酶对骨骼健康的影响

IF 3.2 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2023-08-01 Epub Date: 2023-06-12 DOI: 10.1097/MED.0000000000000813

Jakob Starup-Linde, Katrine Hygum, Bente Langdahl

{"title":"Effect of incretins on skeletal health.","authors":"Jakob Starup-Linde, Katrine Hygum, Bente Langdahl","doi":"10.1097/MED.0000000000000813","DOIUrl":"10.1097/MED.0000000000000813","url":null,"abstract":"Purpose of review: The incretin hormones, glucagon like peptide-1 (GLP-1) and gastric inhibitory peptide (GIP), have been shown to decrease bone resorption in humans. The aim of this review is to collate evidence and current advances in the research within the last year on the effect of incretins on skeletal health.Recent findings: Preclinical studies show potential direct beneficial effects on bone by GLP-1 and GIP, however real world epidemiological data show no effects of GLP-1 receptor analogues on fracture risk. This may be due to the weight loss accompanied by GLP-1 treatment which may have detrimental effects on bone. GIP is shown to reduce bone resorption and increase bone formation. Further evidence suggests an additive effect of GIP and glucagon like peptide-2, which could affect bone by different mechanisms.Summary: GIP and GLP-1 based therapies are more widespread used and may have potential beneficial effects on bone, possibly counterbalanced by weight loss. Long-term effects and side-effects of GIP or GIP/ GLP-2 co-administration remain to be elucidated, and longer term treatment trials are needed.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":"30 4","pages":"206-212"},"PeriodicalIF":3.2,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9873107","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

Diagnostic strategies in adrenal insufficiency. 肾上腺功能不全的诊断策略。

IF 3.2 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2023-06-01 DOI: 10.1097/MED.0000000000000806

Vasiliki Siampanopoulou, Elisavet Tasouli, Anna Angelousi

{"title":"Diagnostic strategies in adrenal insufficiency.","authors":"Vasiliki Siampanopoulou, Elisavet Tasouli, Anna Angelousi","doi":"10.1097/MED.0000000000000806","DOIUrl":"https://doi.org/10.1097/MED.0000000000000806","url":null,"abstract":"Purpose of review: Adrenal insufficiency (AI) is the clinical manifestation of deficient production of glucocorticoids with occasionally deficiency also in mineralocorticoids and adrenal androgens and constitutes a fatal disorder if left untreated. The aim of this review is to summarize the new trends in diagnostic methods used for determining the presence of AI.Recent findings: Novel aetiologies of AI have emerged; severe acute respiratory syndrome coronavirus 2 infection was linked to increased frequency of primary AI (PAI). A new class of drugs, the immune checkpoint inhibitors (ICIs) widely used for the treatment of several malignancies, has been implicated mostly with secondary AI, but also with PAI. Salivary cortisol is considered a noninvasive and patient-friendly tool and has shown promising results in diagnosing AI, although the normal cut-off values remain an issue of debate depending on the technique used. Liquid chromatography-mass spectrometry (LC-MS/MS) is the most reliable technique although not widely available.Summary: Our research has shown that little progress has been made regarding our knowledge on AI. Coronavirus disease 2019 and ICIs use constitute new evidence on the pathogenesis of AI. The short synacthen test (SST) remains the 'gold-standard' method for confirmation of AI diagnosis, although salivary cortisol is a promising tool.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":"30 3","pages":"141-153"},"PeriodicalIF":3.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10312617","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

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