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Response to cabergoline treatment, gonadal axis recovery, and outcomes of drug withdrawal, in men with microprolactinoma: a retrospective cohort study. 微催乳素瘤男性患者对卡麦角林治疗的反应、性腺轴恢复和停药的结果:一项回顾性队列研究
IF 3.7 3区 医学
Endocrine Pub Date : 2025-04-09 DOI: 10.1007/s12020-025-04215-w
Yaron Rudman, Neta Simon, Rona Shimon, Genady Drozdinsky, Efrat Markus, Hadar Duskin-Bitan, Hiba Masri-Iraqi, Gloria Tsvetov, Amit Akirov, Ilan Shimon
{"title":"Response to cabergoline treatment, gonadal axis recovery, and outcomes of drug withdrawal, in men with microprolactinoma: a retrospective cohort study.","authors":"Yaron Rudman, Neta Simon, Rona Shimon, Genady Drozdinsky, Efrat Markus, Hadar Duskin-Bitan, Hiba Masri-Iraqi, Gloria Tsvetov, Amit Akirov, Ilan Shimon","doi":"10.1007/s12020-025-04215-w","DOIUrl":"https://doi.org/10.1007/s12020-025-04215-w","url":null,"abstract":"<p><strong>Purpose: </strong>Due to the low incidence of male microprolactinoma, there is a paucity of data in the literature regarding its management. Our aim was to investigate the long-term outcomes of cabergoline treatment in men with microprolactinoma.</p><p><strong>Methods: </strong>In this single-center retrospective cohort study, we reviewed patient's records at prolactinoma diagnosis, following cabergoline discontinuation (if occurred), and at the last clinic visit. We collected all available clinical data, laboratory tests, and pituitary magnetic resonance imaging. We report response rates, gonadal axis recovery, and outcomes following cabergoline discontinuation.</p><p><strong>Results: </strong>The study cohort included 47 men with microprolactinoma [age at diagnosis 45.6 ± 17.6 years; median prolactin 70.0 ng/ml (IQR 51.0-103.4); low testosterone, 34 men (72.3%); adenoma diameter 5.6 ± 2.0 mm; median follow-up 7.1 years (IQR 3.5-10.4)]. Forty-two patients (89.4%) achieved normal prolactin levels within a median treatment time of 4.0 months (IQR 3.0-5.5) and had normal testosterone at last clinic visit. Five men (10.6%) did not achieve prolactin normalization, of whom 3 men remained hypogonadal. Mild side effects occurred in 4.3% of patients and disappeared with dose reduction. Thirteen men that achieved normal prolactin attempted drug discontinuation, but only 5 remained with normoprolactinemia. Men who maintained normal prolactin levels were treated longer with cabergoline [median treatment of 10 years (IQR 4.6-10.3) vs 2.0 years (IQR 1.5-3.2); p < 0.01].</p><p><strong>Conclusions: </strong>Ninety percent of men harboring microprolactinoma achieved normoprolactinemia and subsequent testosterone normalization with cabergoline treatment. Men that discontinued cabergoline after prolonged prolactin suppression (>5 years) achieved sustained remission. These findings assist informed decision-making, between medical and surgical treatment.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810849","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
Tailoring TSH suppression in differentiated thyroid carcinoma: evidence, controversies, and future directions. 分化型甲状腺癌中定制TSH抑制:证据、争议和未来方向。
IF 3.7 3区 医学
Endocrine Pub Date : 2025-04-09 DOI: 10.1007/s12020-025-04223-w
Xinxin Song, Xin Zhi, Linxue Qian
{"title":"Tailoring TSH suppression in differentiated thyroid carcinoma: evidence, controversies, and future directions.","authors":"Xinxin Song, Xin Zhi, Linxue Qian","doi":"10.1007/s12020-025-04223-w","DOIUrl":"https://doi.org/10.1007/s12020-025-04223-w","url":null,"abstract":"<p><strong>Purpose: </strong>This review focus on the controversial benefits of thyroid hormone suppression therapy (THST) in differentiated thyroid carcinoma (DTC) and its associated risks, highlighting the need for individualized strategies to optimize therapeutic outcomes and guide future research.</p><p><strong>Methods: </strong>A systematic literature search on TSH suppression in DTC over the past 10 years was conducted, prioritizing RCTs, large cohort studies, and non-inferiority trials, with additional references identified from retrieved articles.</p><p><strong>Results: </strong>Tailored postoperative TSH strategies should consider factors such as risk stratification, treatment modality, histologic subtype, and adverse effect risks. In this context, mechanistic studies offer potential insights that could inform personalized TSH management, though further validation is required. Clinical evidence on THST in DTC remains controversial, particularly for high-risk patients, where support for stringent TSH suppression (<0.1 mU/L) is limited. Data for intermediate-risk DTC are insufficient due to cohort heterogeneity, while TSH suppression in low-risk DTC is largely discouraged. The well-documented adverse effects of excessive THST, including cardiovascular complications and osteoporosis, further provide a strong rationale against its routine use. Additionally, achieving and maintaining target TSH levels in real-world practice remains challenging, underscoring the need for refined approaches.</p><p><strong>Conclusion: </strong>Current evidence provides limited support for the TSH targets recommended by the 2015 ATA guidelines. Optimizing postoperative TSH management should account for individualized factors, including risk stratification, treatment modalities, histologic subtypes, and susceptibility to adverse effects. Future research should prioritize well-designed studies with clearly defined suppression levels and appropriate confounder adjustments, emphasizing personalized approaches to balance therapeutic benefits and adverse effects.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810038","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
Association of changes in metabolic syndrome with new-onset and progression of chronic kidney disease. 代谢综合征变化与慢性肾脏疾病新发和进展的关系
IF 3.7 3区 医学
Endocrine Pub Date : 2025-04-01 Epub Date: 2024-11-30 DOI: 10.1007/s12020-024-04119-1
Naihui Zhao, Yinggen Zhang, Peipei Liu, Xiaofu Zhang, Zihao Zhang, Wenli Ou, Ao Dong, Yanhe Chang, Shuohua Chen, Guodong Wang, Shouling Wu, Xiuhong Yang
{"title":"Association of changes in metabolic syndrome with new-onset and progression of chronic kidney disease.","authors":"Naihui Zhao, Yinggen Zhang, Peipei Liu, Xiaofu Zhang, Zihao Zhang, Wenli Ou, Ao Dong, Yanhe Chang, Shuohua Chen, Guodong Wang, Shouling Wu, Xiuhong Yang","doi":"10.1007/s12020-024-04119-1","DOIUrl":"10.1007/s12020-024-04119-1","url":null,"abstract":"<p><strong>Background: </strong>Metabolic syndrome (MetS) is an independent risk factor for new-onset and progression of chronic kidney disease (CKD). However, whether changes in MetS are associated with the new-onset CKD and its progression remains unknown.</p><p><strong>Methods: </strong>A total of 36,571 participants from the Kailuan Study were enrolled in this study, including 27,072 without CKD and 9499 with CKD at baseline. According to the changes of MetS, 4 groups were divided as follows: MetS-free group, MetS-recovered group, MetS-developed group, and MetS-persistent group. Cox regression models were used to explore the association of changes in MetS with new-onset and progression of CKD.</p><p><strong>Results: </strong>During a median follow-up of 8.38 years, 3313 cases of new-onset CKD were identified in participants without CKD. Compared with the MetS-free group, the hazard ratio (HR) and 95% confidence interval (95% CI) for new-onset CKD in the MetS-recovered, MetS-developed and MetS-persistent groups was 1.34 (1.18-1.53), 1.46 (1.30-1.63) and 1.85 (1.69-2.02), respectively. Among 9499 participants with CKD, during a median follow-up of 8.18 years, a total of 2305 experienced CKD progression. Compared with the MetS-free group, the HR (95% CI) for CKD progression in each group were 1.05 (0.91-1.22), 1.34 (1.17-1.55) and 1.65 (1.49-1.83), respectively. Furthermore, the association between changes in MetS and new-onset CKD was stronger in younger and middle-aged participants (≤60 years old) compared with older participants.</p><p><strong>Conclusions: </strong>Developed MetS and persistent MetS were both risk factors for the new-onset and progression of CKD. Even with recovery from MetS, an association of MetS with kidney damage remained.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":"99-109"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767062","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
Elevated thyroid-stimulating hormone levels, independent of Hashimoto's thyroiditis, increase thyroid cancer risk: Insights from genetic and clinical evidence. 促甲状腺激素水平升高,独立于桥本甲状腺炎,增加甲状腺癌的风险:从遗传和临床证据的见解。
IF 3.7 3区 医学
Endocrine Pub Date : 2025-04-01 Epub Date: 2024-12-07 DOI: 10.1007/s12020-024-04126-2
Yingying Feng, Aoyi Xiao, Chengwei Xing, Qichen Dai, Xudong Liu, Jie Liu, Lin Feng
{"title":"Elevated thyroid-stimulating hormone levels, independent of Hashimoto's thyroiditis, increase thyroid cancer risk: Insights from genetic and clinical evidence.","authors":"Yingying Feng, Aoyi Xiao, Chengwei Xing, Qichen Dai, Xudong Liu, Jie Liu, Lin Feng","doi":"10.1007/s12020-024-04126-2","DOIUrl":"10.1007/s12020-024-04126-2","url":null,"abstract":"<p><strong>Purpose: </strong>Hashimoto's thyroiditis (HT) is a prevalent autoimmune disorder and thyroid cancer (TC) is the most prevalent endocrine malignancy. Recent debates have focused on whether HT increases the risk of developing TC. This study combined Mendelian randomization (MR) and observational methods to investigate the potential causal relationship between HT and TC risk.</p><p><strong>Methods: </strong>First, we performed two-sample MR and multivariable MR (MVMR) analysis using the genome-wide association studies (GWAS) data from multiple databases, including European and East Asian populations, to estimate the effect of HT and thyroid-stimulating hormone (TSH) levels on TC risk. Second, we conducted an observational study using data from the National Health and Nutrition Examination Survey (NHANES) database and evaluated the association between HT, TSH, and TC prevalence through logistic regression model and restricted cubic spline model.</p><p><strong>Results: </strong>Our MR findings revealed no significant association between HT and TC risk in both populations. However, elevated TSH levels significantly increased TC and papillary thyroid carcinoma (PTC) risk, while lower TSH levels were associated with reduced TC risk. Further MVMR analysis and an observational study confirmed this. Additionally, our observational study also indicated no significant relationship between HT and TC prevalence and abnormal TSH levels correlated with higher TC risk.</p><p><strong>Conclusion: </strong>HT was not a TC risk factor, but high TSH levels increased TC risk. Controlling TSH within normal ranges through thyroid hormone replacement was recommended to reduce TC risk in HT patients with elevated TSH levels, even those without symptoms.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":"175-184"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791201","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
Nongenetic risk factors for thyroid cancer: an umbrella review of evidence. 甲状腺癌的非遗传危险因素:证据综述。
IF 3.7 3区 医学
Endocrine Pub Date : 2025-04-01 Epub Date: 2025-01-02 DOI: 10.1007/s12020-024-04155-x
Ge Peng, Xiaohui Pan, Ziwei Ye, Xianyanling Yi, Qingxing Xie, Xinyi Zhang, Nanwei Tong
{"title":"Nongenetic risk factors for thyroid cancer: an umbrella review of evidence.","authors":"Ge Peng, Xiaohui Pan, Ziwei Ye, Xianyanling Yi, Qingxing Xie, Xinyi Zhang, Nanwei Tong","doi":"10.1007/s12020-024-04155-x","DOIUrl":"10.1007/s12020-024-04155-x","url":null,"abstract":"<p><strong>Background: </strong>The incidence of thyroid cancer has increased annually, but the risk factors for thyroid cancer are still unclear. In this umbrella review, we aimed to identify associations between nongenetic risk factors and thyroid cancer incidence, and assess the quality and validity of the evidence.</p><p><strong>Methods: </strong>PubMed, Embase and the Cochrane Database of Systematic Reviews were searched to identify related meta-analyses or systematic reviews of epidemiological studies. We extracted the estimated summary effect and 95% confidence interval (CI) through fixed or random effects models of each meta-analysis. AMSTAR2 and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) were used to evaluate the methodological quality of the included meta-analyses and the quality of evidence respectively. Further subgroup analyses by sex and sensitivity analyses were conducted.</p><p><strong>Results: </strong>We identified 53 articles with 112 associations, of which 69 had significant relationships with thyroid cancer risk, including factors related to iodine, nitrates, fish, vitamin D, tea, alcohol, smoke, body mass index (BMI), pesticides, X-ray, I<sup>131</sup>, oral contraceptives, flavonoids, reproductive factors and some medical conditions. However, most studies (65%) were categorized as \"critically low\" on the basis of AMSTAR2, and most evidence (86%) was of weak quality since the classification by GRADE was very low. Moreover, subgroup and sensitivity analyses revealed more risk factors in women than in men.</p><p><strong>Conclusion: </strong>We found that several modifiable factors have essential effects in the primary prevention of thyroid cancer, but few high-quality studies exist. In the future, more well-conducted, especially prospective, studies are needed to confirm the results.</p><p><strong>Trial registration: </strong>The protocol for this review was registered in PROSPERO (CRD42022352841).</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":"60-74"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914035","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
Characteristics of lipid metabolism and fat distribution in patients with primary hyperparathyroidism and their Mendelian randomization study. 原发性甲状旁腺功能亢进患者脂质代谢和脂肪分布特征及其孟德尔随机化研究。
IF 3.7 3区 医学
Endocrine Pub Date : 2025-04-01 Epub Date: 2024-12-19 DOI: 10.1007/s12020-024-04141-3
Ying Zhang, Min Yang, Yinqiong Wu, Qin Wang
{"title":"Characteristics of lipid metabolism and fat distribution in patients with primary hyperparathyroidism and their Mendelian randomization study.","authors":"Ying Zhang, Min Yang, Yinqiong Wu, Qin Wang","doi":"10.1007/s12020-024-04141-3","DOIUrl":"10.1007/s12020-024-04141-3","url":null,"abstract":"<p><strong>Objective: </strong>Primary hyperparathyroidism (PHPT) is characterized by elevated parathyroid hormone (PTH) levels and hypercalcemia. Although research suggests a potential link between PTH and lipid metabolism, the evidence remains inconclusive. This study investigated lipid metabolism and fat distribution in PHPT patients.</p><p><strong>Methods: </strong>We studied 157 PHPT patients and strictly matched 1:1 controls based on sex, age, and BMI from our hospital (2020-2023). We recorded clinical data and used quantitative computed tomography (QCT) to measure lumbar spine bone mineral density and assess visceral and subcutaneous fat areas. Mendelian randomization analysis, utilizing genome-wide association study (GWAS) data, investigated the causal relationships between PHPT and various anthropometric measures, including body mass index (BMI), waist-to-hip ratio (WHR), and waist circumference (WC). Additionally, the analysis examined the associations between PTH levels and these same anthropometric traits: BMI, WHR, and WC.</p><p><strong>Results: </strong>The study included 47 males and 110 females in each group. There were no statistically significant differences between the two groups regarding BMI, triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total fat area (TFA), abdominal visceral fat area (VFA), subcutaneous fat area (SFA), or the VFA/SFA ratio (P > 0.05). After adjusting for albumin-corrected calcium, estimated glomerular filtration rate (eGFR), and 25-hydroxyvitamin D (25OHD), correlations between PTH and BMI, TG, TC, HDL-C, LDL-C, and the VFA/SFA ratio were not significant in either group (P > 0.05). Furthermore, when all the study subjects were divided into three groups based on PTH tertiles, correlations between PTH and the aforementioned indices remained nonsignificant after adjusting for albumin-corrected calcium, eGFR, and 25OHD (P > 0.05). In a two-sample Mendelian randomization study, no significant associations were observed between PHPT and BMI, WHR, or WC. Similarly, no significant associations were identified between PTH levels and BMI, WHR, or WC.</p><p><strong>Conclusions: </strong>No statistically significant disparities were discerned in lipid metabolism markers or fat distribution between PHPT patients and controls. No significant correlation exists between PTH levels and lipid metabolism or fat distribution. Furthermore, no causal relationship was established between PHPT and BMI, WHR, or WC, nor between PTH levels and these anthropometric measures.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":"295-303"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863786","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
The relationship between excessive iodine during pregnancy and adverse pregnancy complications. 妊娠期过量碘与不良妊娠并发症的关系。
IF 3.7 3区 医学
Endocrine Pub Date : 2025-04-01 Epub Date: 2024-12-20 DOI: 10.1007/s12020-024-04134-2
Shasha Li, Hongying Zha, Yumeng Cui, Lu Sun, Lin Yu, Qingxin Yuan
{"title":"The relationship between excessive iodine during pregnancy and adverse pregnancy complications.","authors":"Shasha Li, Hongying Zha, Yumeng Cui, Lu Sun, Lin Yu, Qingxin Yuan","doi":"10.1007/s12020-024-04134-2","DOIUrl":"10.1007/s12020-024-04134-2","url":null,"abstract":"<p><strong>Purpose: </strong>Iodine nutrition during pregnancy plays an important role in fetal development and maternal outcomes. Iodine deficiency has been proved to be associated with maternal thyroid dysfunction, adverse fetal outcomes and neurodevelopmental disorders in offspring. At present, there are few studies concentrate on the effects of iodine excess during pregnancy on thyroid function, maternal and neonatal outcomes, and the results are still controversial. The aim of this study was to evaluate the effects of excessive iodine status on thyroid function, glycolipid metabolism, and maternal and neonatal outcomes.</p><p><strong>Methods: </strong>A total of 595 pregnant women who gave birth at the First Affiliated Hospital of Nanjing Medical University from January 2023 to December 2023 were included in this study. Blood and urine samples were collected during the second trimester of pregnancy. Thyroid function include thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3) and urinary iodine concentrations (UIC) were measured. Maternal and neonatal outcomes were collected.</p><p><strong>Results: </strong>Participants were divided into four groups based on UIC, with median UIC values of 100.5, 200, 314.2, and 655 μg/L, respectively. UIC was found to be positively associated with TSH, and negatively associated with FT3 and FT4. Fasting blood glucose (FBG) levels were elevated both in iodine deficiency and excess group. A U-shaped relationship between UIC and thyroid dysfunction were found. Iodine deficiency, excess iodine and even more than adequate iodine can lead to increased incidence of thyroid diseases such as isolated hypothyroxinaemia and overt hyperthyroidism. Importantly, iodine excess was found to be related with higher prevalence of umbilical cord around neck and eclampsia as well as higher blood glucose and low-density lipoprotein(LDL) level.</p><p><strong>Conclusion: </strong>Abnormal iodine status especially iodine excess during pregnancy was found to be related with higher prevalence of adverse mother and fetus outcomes, abnormal blood glucose and lipid level.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":"203-210"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871661","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
Data-driven cluster analysis of lipids, inflammation, and aging in relation to new-onset type 2 diabetes mellitus. 数据驱动的脂质、炎症和衰老与新发2型糖尿病相关的聚类分析
IF 3.7 3区 医学
Endocrine Pub Date : 2025-04-01 Epub Date: 2025-01-02 DOI: 10.1007/s12020-024-04154-y
Ha-Eun Ryu, Seok-Jae Heo, Jong Hee Lee, Byoungjin Park, Taehwa Han, Yu-Jin Kwon
{"title":"Data-driven cluster analysis of lipids, inflammation, and aging in relation to new-onset type 2 diabetes mellitus.","authors":"Ha-Eun Ryu, Seok-Jae Heo, Jong Hee Lee, Byoungjin Park, Taehwa Han, Yu-Jin Kwon","doi":"10.1007/s12020-024-04154-y","DOIUrl":"10.1007/s12020-024-04154-y","url":null,"abstract":"<p><strong>Purpose: </strong>Early detection and intervention are vital for managing type 2 diabetes mellitus (T2DM) effectively. However, it's still unclear which risk factors for T2DM onset are most significant. This study aimed to use cluster analysis to categorize individuals based on six known risk factors, helping to identify high-risk groups requiring early intervention to prevent T2DM onset.</p><p><strong>Methods: </strong>This study comprised 7402 Korean Genome and Epidemiology Study individuals aged 40 to 69 years. The hybrid hierarchical k-means clustering algorithm was employed on six variables normalized by Z-score-age, triglycerides, total cholesterol, non-high-density lipoprotein cholesterol, high-density lipoprotein cholesterol and C-reactive protein. Multivariable Cox proportional hazard regression analyses were conducted to assess T2DM incidence.</p><p><strong>Results: </strong>Four distinct clusters with significantly different characteristics and varying risks of new-onset T2DM were identified. Cluster 4 (insulin resistance) had the highest T2DM incidence, followed by Cluster 3 (inflammation and aging). Clusters 3 and 4 exhibited significantly higher T2DM incidence rates compared to Clusters 1 (healthy metabolism) and 2 (young age), even after adjusting for covariates. However, no significant difference was found between Clusters 3 and 4 after covariate adjustment.</p><p><strong>Conclusion: </strong>Clusters 3 and 4 showed notably higher T2DM incidence rates, emphasizing the distinct risks associated with insulin resistance and inflammation-aging clusters.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":"151-161"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914032","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
Predictors of growth hormone level on postoperative day one in patients with acromegaly. 肢端肥大症患者术后第一天生长激素水平的预测因素。
IF 3.7 3区 医学
Endocrine Pub Date : 2025-04-01 Epub Date: 2024-12-20 DOI: 10.1007/s12020-024-04130-6
Haixiang Li, Ziqi Li, Tianshun Feng, Yuyang Chen, Jiansheng Zhong, Liangfeng Wei, Shousen Wang
{"title":"Predictors of growth hormone level on postoperative day one in patients with acromegaly.","authors":"Haixiang Li, Ziqi Li, Tianshun Feng, Yuyang Chen, Jiansheng Zhong, Liangfeng Wei, Shousen Wang","doi":"10.1007/s12020-024-04130-6","DOIUrl":"10.1007/s12020-024-04130-6","url":null,"abstract":"<p><strong>Purpose: </strong>The growth hormone (GH) level on postoperative day one (POD1), i.e., POD1GH, holds significant value in assessing surgical efficacy and predicting long-term remission in patients with acromegaly. This study aims to explore the factors that influence the GH level of POD1 after microscopic transsphenoidal surgery (mTSS) in patients with acromegaly, providing insights for preoperative clinical decisions.</p><p><strong>Methods: </strong>A total of 85 acromegaly patients undergoing mTSS were included in this study. Sex; age; body mass index (BMI); preoperative serum hormone levels and tumor characteristics were assessed for their correlation with POD1GH levels. POD1GH level non-remission, defined as POD1GH > 2.5 ng/mL, was considered an outcome.</p><p><strong>Results: </strong>The patients with acromegaly were divided into two groups: adult males (43 cases) and adult females (42 cases), with mean ages of 43.33 ± 11.92 years and 47.02 ± 14.18 years, respectively. Correlation and multivariate linear regression analyses revealed positive correlations of preoperative GH and prolactin (PRL) levels in females with POD1GH levels, while preoperative FT3 and TT levels in males were negatively correlated with POD1GH levels. Binary logistic regression and receiver operating characteristic (ROC) analyses identified preoperative GH levels ≥30.25 ng/mL (OR = 2.236, 95%CI = 1.402-3.567, p < 0.001), FT3 levels ≤4.415 pmol/L (OR = 0.329, 95%CI = 0.167-0.648, p < 0.001), and age ≤51 years (OR = 0.566, 95%CI = 0.352-0.911, p = 0.019) as independent risk factors for POD1GH level non-remission.</p><p><strong>Conclusions: </strong>Preoperative GH, FT3, TT, and PRL levels are correlated with POD1GH levels, with variations observed between sex. Age, preoperative GH, and FT3 levels can predict POD1GH level non-remission. Therefore, the comprehensive consideration of multiple hormone axes is necessary for predicting postoperative efficacy.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":"249-261"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871660","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}
引用次数: 0
Comparative evaluation of ChatGPT-4, ChatGPT-3.5 and Google Gemini on PCOS assessment and management based on recommendations from the 2023 guideline. 基于2023指南建议的ChatGPT-4、ChatGPT-3.5和谷歌Gemini对PCOS评估和管理的比较评价
IF 3.7 3区 医学
Endocrine Pub Date : 2025-04-01 Epub Date: 2024-12-02 DOI: 10.1007/s12020-024-04121-7
Irmak Gunesli, Seren Aksun, Jana Fathelbab, Bulent Okan Yildiz
{"title":"Comparative evaluation of ChatGPT-4, ChatGPT-3.5 and Google Gemini on PCOS assessment and management based on recommendations from the 2023 guideline.","authors":"Irmak Gunesli, Seren Aksun, Jana Fathelbab, Bulent Okan Yildiz","doi":"10.1007/s12020-024-04121-7","DOIUrl":"10.1007/s12020-024-04121-7","url":null,"abstract":"<p><strong>Context: </strong>Artificial intelligence (AI) is increasingly utilized in healthcare, with models like ChatGPT and Google Gemini gaining global popularity. Polycystic ovary syndrome (PCOS) is a prevalent condition that requires both lifestyle modifications and medical treatment, highlighting the critical need for effective patient education. This study compares the responses of ChatGPT-4, ChatGPT-3.5 and Gemini to PCOS-related questions using the latest guideline. Evaluating AI's integration into patient education necessitates assessing response quality, reliability, readability and effectiveness in managing PCOS.</p><p><strong>Purpose: </strong>To evaluate the accuracy, quality, readability and tendency to hallucinate of ChatGPT-4, ChatGPT-3.5 and Gemini's responses to questions about PCOS, its assessment and management based on recommendations from the current international PCOS guideline.</p><p><strong>Methods: </strong>This cross-sectional study assessed ChatGPT-4, ChatGPT-3.5, and Gemini's responses to PCOS-related questions created by endocrinologists using the latest guidelines and common patient queries. Experts evaluated the responses for accuracy, quality and tendency to hallucinate using Likert scales, while readability was analyzed using standard formulas.</p><p><strong>Results: </strong>ChatGPT-4 and ChatGPT-3.5 attained higher scores in accuracy and quality compared to Gemini (p = 0.001, p < 0.001 and p = 0.007, p < 0.001 respectively). However, Gemini obtained a higher readability score compared to the other chatbots (p < 0.001). There was a significant difference between the tendency to hallucinate scores, which were due to the lower scores in Gemini (p = 0.003).</p><p><strong>Conclusion: </strong>The high accuracy and quality of responses provided by ChatGPT-4 and 3.5 to questions about PCOS suggest that they could be supportive in clinical practice. Future technological advancements may facilitate the use of artificial intelligence in both educating patients with PCOS and supporting the management of the disorder.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":"315-322"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767140","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
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