Endocrine最新文献

{"title":"Bone marrow adipose tissue in cardiometabolic disease: marrow niche remodeling, inflammatory hematopoiesis, and vascular pathology.","authors":"Zhuoqun Ma, Wei Luo, Yuanbo Li, Hong Li, Chaomin Li","doi":"10.1007/s12020-026-04824-z","DOIUrl":"https://doi.org/10.1007/s12020-026-04824-z","url":null,"abstract":"<p><p>Bone marrow adipose tissue (BMAT) is increasingly recognized as a metabolically active, endocrine, and immunomodulatory component of the marrow niche rather than a passive fat depot. This narrative review synthesizes biological, imaging, epidemiological, and therapeutic evidence linking BMAT and marrow metabolic activation with cardiometabolic disease. BMAT arises from marrow stromal progenitors and exhibits depot-specific heterogeneity, endocrine activity, insulin responsiveness, and context-dependent expansion during aging, diabetes, obesity, menopause, osteoporosis, and chronic kidney disease. Mechanistically, experimental studies indicate that marrow adipocytes and adipocyte-lineage niche cells can influence hematopoiesis through metabolic and local signaling, whereas trained immunity is established primarily in HSPCs, myeloid progenitors, and monocyte/macrophage populations. Human MRI/MRS studies characterize BMAT quantity and composition, whereas ¹⁸F-FDG PET reflects non-BMAT-specific marrow activation associated with vascular inflammation and early atherosclerosis; direct BMAT-cardiovascular evidence remains limited. Emerging population imaging and genetic analyses support BMAT as a disease-associated phenotype, particularly for osteoporosis and fractures. Interventions affecting metabolic, inflammatory, skeletal, or marrow pathways have differing degrees of BMAT-related evidence, and none has established that modifying BMAT improves cardiovascular outcomes. This review identifies BMAT as an emerging research phenotype while emphasizing that its causal, prognostic, and therapeutic relevance to cardiovascular disease remains unresolved.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165279","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":"Synergistic antitumor effects of 5-fluorouracil and vorinostat in preclinical models of pheochromocytomas and paragangliomas.","authors":"Wenqian Zhang, Yue Zhou, Yunying Cui, Tianyi Li, Zewen Li, Weidong Ren, Anli Tong","doi":"10.1007/s12020-026-04811-4","DOIUrl":"https://doi.org/10.1007/s12020-026-04811-4","url":null,"abstract":"<p><strong>Purpose: </strong>Therapeutic options for metastatic pheochromocytomas and paragangliomas (PPGLs) are largely limited, highlighting the need for novel strategies. This study aimed to investigate the efficacy and safety of 5-fluorouracil (5-FU) and vorinostat (SAHA), alone or in combination in preclinical PPGL models.</p><p><strong>Methods: </strong>The growth inhibitory effects of 5-FU and SAHA were investigated in PC-12 cells and human PPGL primary cultures (n = 4) using CCK-8 assays. Drug interactions were evaluated utilizing the Chou-Talalay method. Specific mechanisms were explored via flow cytometry, wound healing, and transwell assays. In vivo efficacy and safety were assessed using mouse subcutaneous xenograft models.</p><p><strong>Results: </strong>Both monotherapies inhibited PC-12 growth in a dose- and time-dependent manner (5-FU: 0-160 μM and SAHA: 0-80 μM). The combination therapy (20 μM 5-FU + 10 μM SAHA) exhibited a robust synergistic effect with the combination index < 1, achieving 43% growth inhibition in PC-12 cells and nearly 70% in primary cultures, significantly outperforming monotherapies. This combination significantly exacerbated G0/G1 cell cycle arrest and suppressed PC-12 cell migration and invasion. In vivo, the combined treatment reduced final tumor volumes by approximately 50% and significantly decreased the Ki-67 index. Despite mild body weight loss on days 15 and 21, no evident histopathological organ damage was observed.</p><p><strong>Conclusions: </strong>This study provides the first preclinical evidence that combining SAHA with 5-FU exerts a robust synergistic antitumor effect in PPGLs with no evident histopathological organ damage, laying a strong foundation for developing novel combination therapy for metastatic PPGLs.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166969","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":"Association of miRNA-500 and AGE-RAGE axis in the development of thyroid cancer.","authors":"Nazia Shoaib, Rizwana Sanaullah Waraich, Hurtamina Khan, Syeda Zauraiz Sohail, Syeda Sumayya Tariq, Fadieleh Adnan Sohail","doi":"10.1007/s12020-026-04822-1","DOIUrl":"https://doi.org/10.1007/s12020-026-04822-1","url":null,"abstract":"<p><p>Worldwide, thyroid cancer is 7th most prevalent cancer, with projections indicating further increases by 2035. Few studies indicate role of micro RNA and RAGE receptor in cancer development. We hypothesize that micro RNA 500 may be associated with thyroid cancer development by effecting the AGE-RAGE axis. For the first time this study reported that miRNA-500 expression was higher in serum of subjects with papillary thyroid carcinoma (PTC) as compared to healthy controls. Similarly, higher levels of Advanced glycation end Products (AGEs) were seen and positively associated with mi-RNA500, in serum of PTC patients. While comparing the cancer and normal tissue of PTC patients we found enhanced expression of miRNA-500, RAGE receptor gene and protein in cancer tissue. RAGE ligands including HMGB-1 and S-100 were also found elevated in PTC cancer tissue as compared to normal tissue. In human thyroid cancer cells overexpressing miRNA-500 showed enhanced NFkB expression and oxidative stress however, this effect was diminished after blocking RAGE, linking miRNA-500 and RAGE together in development of thyroid cancer. Protein-protein interaction (PPI) pathway analysis further suggested that miR-500 target genes are embedded within a broader inflammatory signaling framework relevant to thyroid cancer biology. Our results demonstrate the association of miRNA-500 with RAGE axis along with preliminary evidence of pharmacological modulation, in thyroid cancer.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165688","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":"Stage and age as distinct determinants of competing mortality in parathyroid carcinoma: a population-based analysis.","authors":"Mehmet Zafer Sabuncuoğlu, Ismail Zihni, Bilal Turan, Serdar Acar, Isa Karaca","doi":"10.1007/s12020-026-04782-6","DOIUrl":"https://doi.org/10.1007/s12020-026-04782-6","url":null,"abstract":"<p><strong>Purpose: </strong>Parathyroid carcinoma is a rare endocrine malignancy in which much of the long-term morbidity relates to chronic hypercalcemia. Conventional survival analyses treat deaths from causes other than the cancer as censoring events, which can distort estimates of cause-specific risk. We applied competing-risk methodology to characterize cause-specific mortality and to determine whether distinct clinical factors differentially influence cancer-specific and cardiovascular/renal mortality.</p><p><strong>Methods: </strong>Patients with malignant parathyroid carcinoma (primary site C75.0) were identified from the SEER Research Data, 17 Registries, November 2023 submission (2000-2021). Cause-specific, cardiovascular/renal, and other-cause deaths were defined a priori as competing events. Cumulative incidence functions were estimated using the Aalen-Johansen estimator, compared with Gray's test, and modeled with Fine-Gray subdistribution hazard regression, adjusting for age, sex, race, and stage.</p><p><strong>Results: </strong>Among 656 patients (median follow-up, 86 months), 213 died: 61 (9.3%) from cancer-specific causes, 68 (10.4%) from cardiovascular/renal causes, and 84 (12.8%) from other causes. Cancer-specific mortality plateaued after roughly a decade (15-year cumulative incidence, 11.0%), whereas cardiovascular/renal mortality continued to rise (12.3%) and ultimately exceeded it. In multivariable Fine-Gray models, advanced (regional/distant) stage was independently associated with cancer-specific death (subdistribution hazard ratio [sHR], 3.37; 95% CI, 1.72-6.60) but not cardiovascular/renal death, whereas age ≥ 60 years was independently associated with cardiovascular/renal death (sHR, 2.43; 95% CI, 1.49-3.96) but not cancer-specific death.</p><p><strong>Conclusions: </strong>Cancer-specific and cardiovascular/renal mortality follow distinct competing-risk trajectories in parathyroid carcinoma, with stage primarily determining cancer-specific mortality and age primarily determining cardiovascular/renal mortality. These findings support consideration of competing-risk profiles when planning long-term surveillance, including cardiovascular and renal follow-up.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164151","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":"Dynamic transitions from prediabetes to diabetes and incident cardiovascular events in middle-aged and older chinese adults: a nationwide longitudinal study.","authors":"Shanshan Liang, Fei Ding, Xinyu Wang, Chuanmin Tao, Wei Gan","doi":"10.1007/s12020-026-04799-x","DOIUrl":"https://doi.org/10.1007/s12020-026-04799-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Prediabetes is a heterogeneous metabolic state that may revert to normoglycemia, persist, or progress to type 2 diabetes mellitus (T2DM). However, the cardiovascular implications of different prediabetes transition patterns and the ability to predict diabetes progression among middle-aged and older Chinese adults remain unclear. We aimed to characterize glycemic transitions, examine their associations with incident cardiovascular events, and develop prediction models for progression from prediabetes to T2DM.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This longitudinal cohort study used data from the China Health and Retirement Longitudinal Study. Glycemic status was defined according to American Diabetes Association criteria using fasting plasma glucose, HbA1c, self-reported diabetes, and medication use. Four-year glycemic transitions from Wave 1 to Wave 3 were assessed among 7,927 participants. Among participants with baseline prediabetes, multinomial logistic regression was used to identify factors associated with reversion to normal glucose tolerance or progression to T2DM. A Wave 3 landmark design was applied to examine subsequent incident heart disease and stroke in separate outcome-specific cohorts. Prediction models for 4-year T2DM progression were developed and internally validated using a stratified 70:30 training-test split; no external validation was performed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 3,313 participants with baseline prediabetes, 696 (21.01%) reverted to normal glucose tolerance, 2,007 (60.58%) remained in prediabetes, and 610 (18.41%) progressed to T2DM over 4 years. Higher BMI, fasting glucose, HbA1c, dyslipidemia, smoking, and C-reactive protein, together with lower grip strength, were associated with higher odds of progression. Older age, male sex, higher fasting glucose, and higher HbA1c were associated with lower odds of reversion. Compared with stable normal glucose tolerance, prediabetes progression was associated with higher odds of incident heart disease (adjusted odds ratio [aOR], 1.53; 95% CI, 1.13-2.09), whereas the association with incident stroke was not statistically significant (aOR, 1.29; 95% CI, 0.90-1.87). Stable T2DM was associated with higher odds of both incident heart disease (aOR, 1.36; 95% CI, 1.04-1.79) and stroke (aOR, 1.44; 95% CI, 1.05-1.97). The full-variable logistic regression model achieved the highest discrimination for T2DM progression (AUC, 0.715; 95% CI, 0.674-0.754), modestly outperforming the clinical baseline model (AUC, 0.699; 95% CI, 0.656-0.739) and the evaluated tree-based models.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Prediabetes showed dynamic 4-year transitions within the analytic cohort. Progression from prediabetes to T2DM was associated with higher subsequent odds of incident heart disease, whereas its adjusted association with incident stroke was not statistically significant. The full-variable logistic regression model showed moderate discrimination an","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166832","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":"Radiofrequency versus microwave ablation for non-functioning benign thyroid nodules: a single-institution comparative cohort study.","authors":"A Thornton, I Comens, E J Kuo, J A Lee, C McManus, J H Kuo","doi":"10.1007/s12020-026-04829-8","DOIUrl":"https://doi.org/10.1007/s12020-026-04829-8","url":null,"abstract":"<p><strong>Purpose: </strong>Thermal ablation (TA) has emerged as an alternative to surgery in selected patients with benign thyroid nodules, achieving substantial nodule volume reduction with improved cosmesis and lower risk of post-procedural hypothyroidism than thyroidectomy. However, comparative data from North American practice remain limited. We compared the efficacy and safety of radiofrequency ablation (RFA) and microwave ablation (MWA) for non-functioning benign thyroid nodules.</p><p><strong>Methods: </strong>In this single-institution comparative cohort, 224 patients with 291 nodules underwent RFA and 47 patients with 60 nodules underwent MWA for non-functioning benign thyroid nodules (2019-2025). Nodule volume, volume reduction ratio (VRR), symptoms, cosmesis, and complications were compared between the modalities over a 12-month follow-up period.</p><p><strong>Results: </strong>Baseline volumes were larger in the MWA cohort (median 29.0 vs. 16.6 mL, p = 0.004). Median VRR reached 77.8% (RFA) and 70.8% (MWA) by 12 months, with no significant between-group difference at any timepoint. After adjustment for baseline volume, estimated mean volume did not differ significantly between modalities. Final nodule volume tracked closely with baseline volume across volume groups. Median symptom and cosmesis scores improved for each group post-ablation. Complication rates were low and similar between groups, the most common being periprocedural pain (15.6% RFA, 12.8% MWA).</p><p><strong>Conclusion: </strong>RFA and MWA achieved comparable volume reduction, symptom improvement, and complication rates for non-functioning benign thyroid nodules.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165315","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":"Post-dexamethasone cortisol levels in non-functioning adrenal incidentalomas: a pooled individual participant data analysis.","authors":"Iacopo Chiodini, Vittoria Favero, Cristina Eller-Vainicher, Valentina Morelli, Serena Palmieri, Irina Bancos, Alfredo Scillitani","doi":"10.1007/s12020-026-04832-z","DOIUrl":"https://doi.org/10.1007/s12020-026-04832-z","url":null,"abstract":"<p><strong>Introduction: </strong>Non-functioning adrenal incidentalomas (NFAI) are defined by 1 mg-dexamethasone suppression test (F-1mgDST) cortisol levels < 1.8 µg/dL. However, many individuals with NFAI may exhibit subtle hypercortisolism associated with increased cardiometabolic and skeletal risk. The aims of the present study are to compare F-1mgDST distributions between individuals with NFAI and population-based controls and to explore whether alternative F-1mgDST thresholds would meaningfully modify patient classification.</p><p><strong>Methods: </strong>This is a pooled individual participant data analysis of 7 studies evaluating cortisol secretion in patients with type 2 diabetes, osteoporosis and/or fragility fractures, hypertension, or adrenal incidentalomas. The study included 1681 participants (915 NFAI, 766 controls) with F-1mgDST < 1.8 µg/dL. Data included age, sex, body mass index (BMI), F-1mgDST, and adrenocorticotroph hormone (ACTH). We assessed the between-group differences in F-1mgDST and ACTH and the accuracy of different F-1mgDST thresholds for identifying NFAI.</p><p><strong>Results: </strong>Compared to controls, patients with NFAI had lower age and ACTH levels (62.1 ± 9.8 and 59.8 ± 12.0 years, 25.1 ± 14.1 pg/mL and 16.3 ± 10.4, respectively, p < 0.001 for all comparisons), but higher BMI and F-1mgDST values (28.1 ± 4.9 and 29.0 ± 5.0 kg/m², 1.04 ± 0.37 µg/dL and 1.13 ± 0.39 µg/dL, respectively, p < 0.001 for all comparisons) and were more less frequently females (48.0% and 38.6%, respectively, p < 0.001). A propensity score analysis performed on 730 patients and 730 age-, BMI- and gender-matched controls confirmed these findings. We did not identify any F-1mgDST threshold with an accuracy exceeding 60% for distinguishing controls from patients with NFAI. The F-1mgDST threshold the best balance between sensitivity (54.8%) and specificity (57.2%) was set at 1.1 µg/dL (30 nmol/L), although with a low accuracy of 55.8%.</p><p><strong>Conclusions: </strong>Individuals with NFAI have higher F-1mgDST levels than controls. More than 40% overlap exists in F-1mgDST values between NFAI and controls.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166639","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":"Activator of Sirt6 exerts antitumor activity in pituitary neuroendocrine tumors.","authors":"Hong Yao, Beibei Fan, Chuanbao Li, Desheng Chen, Zhuoyi Tang, Jingwei Ye, Weiting Gu, Yijun Cheng, Hao Tang, Shaojian Lin, Li Xue, Yanting Liu, Zhe Bao Wu","doi":"10.1007/s12020-026-04780-8","DOIUrl":"10.1007/s12020-026-04780-8","url":null,"abstract":"<p><strong>Context: </strong>Pituitary neuroendocrine tumor (PitNET) is one of the most common intracranial neuroendocrine tumors. Surgical resection is the first choice for most subtypes of PitNETs. However, radical removal of invasive tumors remains challenging. A novel pharmacological therapy is objectively needed. Sirtuin 6 (Sirt6) is a member of the NAD⁺-dependent class III deacetylase sirtuin family, which plays a key role in tumorigenesis in many tumors. However, the role of Sirt6 and its activator in PitNETs is still unclear.</p><p><strong>Objective: </strong>In the study, we investigated the expression of Sirt6 and the antitumor effect of the Sirt6 activator MDL-800 in PitNETs.</p><p><strong>Methods: </strong>The expression of Sirt6 was detected in PitNET and cell lines by RNA-seq, immunohistochemistry, and western blotting. To test Sirt6 and its activator MDL-800, the cell viability, clone formation, and xenograft experiment were conducted. Autophagy was evaluated by microscopy and western blotting analysis. The efficacy of MDL-800 in the human primary PitNET cells was also investigated by the cell viability assay.</p><p><strong>Results: </strong>Low expression of Sirt6 was found in PitNET tissues and two pituitary cell lines. Sirt6 inhibited cell proliferation and clone formation. Treatment with MDL-800 suppressed cell growth in vitro and in vivo. Further mechanistic studies showed that MDL-800 could lead to lethal autophagy and exert an antitumor effect in human primary PitNET cells.</p><p><strong>Conclusion: </strong>Our results suggest that activation of Sirt6 by its selective activator MDL-800 is a promising therapy for PitNETs.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126907","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 impact of psammoma bodies on long-term prognosis in papillary thyroid carcinoma.","authors":"Ayser Seda Hasdemir, Fatma Avcı Merdin, Asya Tuğçe Bol, Serpil Dizbay Sak, Sevim Güllü","doi":"10.1007/s12020-026-04819-w","DOIUrl":"10.1007/s12020-026-04819-w","url":null,"abstract":"<p><strong>Introduction: </strong>Psammoma bodies are characteristic calcified structures of papillary thyroid carcinoma (PTC), but their pathogenesis and prognostic significance remain unclear. This study evaluated their association with clinicopathological features at diagnosis and long-term recurrence in classic PTC.</p><p><strong>Methods: </strong>This retrospective study analyzed 102 patients with classic-type PTC followed for a minimum five-year period. Patients were stratified according to psammoma body presence or absence in histopathological specimens.</p><p><strong>Results: </strong>The cohort included 102 patients (77 female, 25 male) with a mean diagnostic age of 40.4 (± 13.9) years. Psammoma bodies were identified in 66 cases (64.7%). Patients with psammoma bodies were diagnosed at a younger age (p = 0.015). Although psammoma body presence did not differ by gender, the rate of stromal coarse calcification was significantly higher in male patients (36.0%) than in female patients (13.0%) (p = 0.030). On univariable analysis, the prevalence of lymph node metastasis at diagnosis was significantly higher in the psammoma body-positive group (p = 0.001). In multivariable logistic regression analysis, the number of metastatic lymph nodes showed a positive trend toward an association with psammoma body presence, although this did not reach statistical significance (p = 0.078, OR = 1.745, 95% CI: 0.939-3.241). The presence of lymphocytic thyroiditis in non-tumorous thyroid tissue was associated with a reduced incidence of lymph node metastasis (37.1% versus 62.9%). Concerning long-term outcomes, recurrence rates were numerically higher in the psammoma body-positive group without achieving statistical significance (p = 0.532).</p><p><strong>Conclusion: </strong>Psammoma body presence was significantly associated with lymph node metastasis at diagnosis in classic PTC; however, this association was not independently confirmed in multivariable analysis. Psammoma bodies may be associated with nodal disease, but their independent clinical significance remains unclear.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127026","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":"Autoimmune polyendocrine syndrome in type 1 diabetes: why formal diagnosis matters for clinical utility.","authors":"Stella Bernardi, Riccardo Candido","doi":"10.1007/s12020-026-04827-w","DOIUrl":"10.1007/s12020-026-04827-w","url":null,"abstract":"<p><p>In response to Huang et al., we clarify the take-home message of our study on autoimmune polyendocrine syndrome (APS) in type 1 diabetes mellitus (T1DM). Existing guidelines recommend screening T1DM patients for thyroid and celiac diseases. When positive, there is a lack of guidance on how to proceed. Nevertheless, if T1DM patients do have AITD or celiac disease, they qualify for an APS diagnosis, which signals a high pretest probability for additional autoimmunity. Our data show that among 198 patients meeting APS criteria at baseline, only 17/198 (8.6%) had a formal APS diagnosis documented in their medical records. Extended screening uncovered new autoantibody positivity in 39% and new autoimmune diseases in 11.5% of patients. In the end, this led us to signal an under-recognition of APS in T1DM. Based on this evidence, we do not advocate for universal, broad screening panels in routine practice. Instead, we argue that formal diagnostic recognition and medical record documentation of APS are essential first steps to prevent fading clinical awareness and trigger lifelong vigilance.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126876","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}