Endocrine journal最新文献

{"title":"Physiological and pathophysiological actions of insulin in the liver.","authors":"Naoto Kubota, Tetsuya Kubota, Takashi Kadowaki","doi":"10.1507/endocrj.EJ24-0192","DOIUrl":"10.1507/endocrj.EJ24-0192","url":null,"abstract":"<p><p>The liver plays an important role in the control of glucose homeostasis. When insulin levels are low, such as in the fasting state, gluconeogenesis and glycogenolysis are stimulated to maintain the blood glucose levels. Conversely, in the presence of increased insulin levels, such as after a meal, synthesis of glycogen and lipid occurs to maintain the blood glucose levels within normal range. Insulin receptor signaling regulates glycogenesis, gluconeogenesis and lipogenesis through downstream pathways such as the insulin receptor substrate (IRS)-phosphoinositide 3 (PI3) kinase-Akt pathway. IRS-1 and IRS-2 are abundantly expressed in the liver and are thought to be responsible for transmitting the insulin signal from the insulin receptor to the intracellular effectors involved in the regulation of glucose and lipid homeostasis. Impaired insulin receptor signaling can cause hepatic insulin resistance and lead to type 2 diabetes. In the present study, we focus on a concept called \"selective insulin resistance,\" which has received increasing attention recently: the frequent coexistence of hyperglycemia and hepatic steatosis in people with type 2 diabetes and obesity suggests that it is possible for the insulin signaling regulating gluconeogenesis to be impaired even while that regulating lipogenesis is preserved, suggestive of selective insulin resistance. In this review, we review the progress in research on the insulin actions and insulin signaling in the liver.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":"149-159"},"PeriodicalIF":1.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical comparison and genetic analysis in pheochromocytoma with primary aldosteronism.","authors":"Xurong Mai, Mitsuhiro Kometani, Toshiaki Kato, Ko Aiga, Shigehiro Karashima, Daisuke Aono, Seigo Konishi, Koshiro Nishimoto, Kazuyoshi Hosomichi, Atsushi Watanabe, Yuko Noda, Yoshiyu Takeda, Takashi Yoneda","doi":"10.1507/endocrj.EJ24-0150","DOIUrl":"10.1507/endocrj.EJ24-0150","url":null,"abstract":"<p><p>Pheochromocytoma is a rare form of adrenal hypertension. This study aimed to investigate the clinical characteristics and associated genetic mutations in patients with pheochromocytoma and primary aldosteronism. We retrospectively analyzed data from 23 patients with pheochromocytoma diagnosed and treated between 2011 and 2022. Three cases were complicated by primary aldosteronism. Compared to 15 other patients without primary aldosteronism complications, these three patients had a greater suppression of plasma renin activity (0.2 vs. 2.3 ng/mL/h, p < 0.01) and a higher aldosterone-to-renin ratio (p < 0.01). No significant differences were found in blood pressure, serum potassium levels, or plasma aldosterone concentrations between the two groups. In genetic analysis, among the three patients with pheochromocytoma and primary aldosteronism, two had a KCNJ5 (G151R) mutation in the pheochromocytoma tumor tissues. However, no CYP11B2- or CYP11B1-positive cells were detected via immunostaining in the pheochromocytoma tissues of these three patients. To our knowledge, this is the first study to reveal the presence of the KCNJ5 mutation, commonly considered specific to primary aldosteronism, in pheochromocytoma cases clinically complicated by primary aldosteronism. The findings suggest that patients with pheochromocytoma and suppressed plasma renin activity should be assessed for primary aldosteronism.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":"193-203"},"PeriodicalIF":1.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knockdown of Gfi1 increases BMSCs exosomal miR-150-3p to inhibit osteoblast ferroptosis in steroid-induced osteonecrosis of the femoral head through BTRC/Nrf2 axis.","authors":"Liwen Zheng, Changjie Zhang, Lele Liao, Zhijie Hai, Xin Luo, Haoliang Xiao","doi":"10.1507/endocrj.EJ24-0306","DOIUrl":"10.1507/endocrj.EJ24-0306","url":null,"abstract":"<p><p>The ferroptosis of osteoblasts has been demonstrated to play a significant role in the development of steroid-induced osteonecrosis of the femoral head (SONFH). Additionally, microRNAs (miRNAs) have been identified as regulators of SONFH progression. However, the precise role of miRNAs in the regulation of osteoblast ferroptosis remains unclear. This study explored the role of exosomal miR-150-3p, derived from bone marrow mesenchymal stem cells (BMSCs), in osteoblast ferroptosis in SONFH. Dexamethasone (DEX) was used to treat osteoblasts to induce ferroptosis. BMSCs exosomes with different levels of miR-150-3p were introduced into a co-culture with the cells. To verify the targeting relationship between growth factor independence 1 (Gfi1) and the miR-150-3p promoter, as well as between miR-150-3p and beta-transducin repeat containing E3 ubiquitin protein ligase (BTRC), respectively, chromatin immunoprecipitation (ChIP), RNA immunoprecipitation (RIP), and dual luciferase assays were employed. It was found that BMSCs-Exos-miR-150-3p mitigated DEX-triggered ferroptosis in osteoblasts. MiR-150-3p directly targeted BTRC, leading to its downregulation in osteoblasts. The BTRC/Nuclear factor erythroid 2-related factor 2 (Nrf2) pathway was involved in the inhibition of DEX-induced osteoblast ferroptosis by BMSCs-Exos-miR-150-3p. Overexpression of BTRC reversed the inhibitory effect of BMSCs-Exos-miR-150-3p. In a SONFH rat model, BMSCs-Exos-miR-150-3p alleviated ferroptosis in osteoblasts through BTRC/Nrf2. In addition, Gfi1 bonded to the miR-150-3p promoter and inhibited its transcription. Gfi1 silencing elevated miR-150-3p levels and improves cell viability of BMSCs. In conclusion, our results suggest that BMSCs-Exos-miR-150-3p alleviates SONFH by suppressing ferroptosis through the regulation of BTRC/Nrf2 and miR-150-3p may be a potential target for SONFH treatment.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":"205-219"},"PeriodicalIF":1.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathological and molecular characteristics of papillary thyroid carcinoma in adolescent and young adult patients.","authors":"Van Phu Thang Nguyen, Hirokazu Kurohama, Yuko Akazawa, Thi Ngoc Anh Nguyen, Katsuya Matsuda, Yuki Matsuoka, Zhanna Mussazhanova, Kenichi Yokota, Shinya Satoh, Hiroyuki Yamashita, Thi Nhung Nguyen, Yerkerzhan Sailaubekova, Masahiro Nakashima","doi":"10.1507/endocrj.EJ24-0504","DOIUrl":"10.1507/endocrj.EJ24-0504","url":null,"abstract":"<p><p>Adolescent and young adult (AYA, 15-39 years old) patients with papillary thyroid carcinoma (PTC) experience significant psychological distress and place great importance on obtaining information regarding the disease; however, their demands remain unmet. We aimed to investigate clinicopathological and molecular features of PTC in AYA patients and compare them to those of PTC in older patients (≥40 years). This retrospective study enrolled 1,677 patients diagnosed with PTC from January 2018 to December 2022, with 400 AYA patients and 1,277 older adults. At the time of diagnosis, AYA patients with PTC had higher rates of presentation in females, larger tumor size (>2.0 cm), lymphatic vessel invasion, chronic thyroiditis, clinical lymph node metastasis, and pathologic lymph node metastasis, but lower rates of multifocality and extrathyroidal extension compared with PTC in older adults. The two groups had no significant differences regarding surgical method and distant metastasis. The prevalences of BRAF p.V600E and TERT promoter mutations of PTC were significantly lower in AYA patients (69.1% vs. 82.6% and 1.3% vs. 18.8%, respectively; both p < 0.001). In conclusion, PTC in AYA patients differed from PTC in older patients. Particularly, BRAF p.V600E and TERT promoter mutations in AYA with PTC were less frequently observed than in older adults.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":"221-227"},"PeriodicalIF":1.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of radiologists in the diagnosis and management of adrenal disorders.","authors":"Sota Oguro, Hiromitsu Tannai, Hideki Ota, Kazumasa Seiji, Hiroki Kamada, Yoshitaka Toyama, Kei Omata, Yuta Tezuka, Yoshikiyo Ono, Fumitoshi Satoh, Sadayoshi Ito, Tetsuhiro Tanaka, Hideki Katagiri, Kei Takase","doi":"10.1507/endocrj.EJ24-0156","DOIUrl":"10.1507/endocrj.EJ24-0156","url":null,"abstract":"<p><p>This study aimed to focus on the role of radiologists in the diagnosis and management of adrenal lesions, particularly primary aldosteronism (PA) and secondary hypertension. As hypertension affects more than one-third of the population in Japan, identifying secondary causes such as PA and adrenal lesions is crucial. Establishing a radiological differential diagnosis of adrenal lesions using advanced imaging techniques, such as computed tomography and magnetic resonance imaging, is crucial. Knowledge of the imaging findings of various benign and malignant adrenal lesions, such as adrenocortical adenomas, cortisol-producing lesions, pheochromocytomas, adrenocortical carcinoma, malignant lymphoma, and metastatic tumors, is necessary. Adrenal venous sampling (AVS) plays a crucial role in accurately localizing aldosterone hypersecretion in PA, especially when imaging fails to provide a clear diagnosis. This paper details the technical aspects of AVS, emphasizing catheterization techniques, anatomical considerations, and the importance of preprocedural imaging for successful sampling. Furthermore, we explore segmental adrenal venous sampling (SAVS), a more refined technique that samples specific adrenal tributary veins, offering enhanced diagnostic accuracy, particularly for microadenomas or challenging cases that may be missed with conventional AVS. The methodology for performing SAVS, along with the interpretation criteria for successful sampling and lateralization, is also outlined. Furthermore, radiologists have initiated treatments for unilateral PA, such as radiofrequency ablation, and play an integral role in the management of adrenal lesions. Collaborative approaches across clinical departments are required to enhance patient management in medical care involving the adrenal gland.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":"131-148"},"PeriodicalIF":1.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between muscle quality and whole-body vibration exercise-induced changes in plasma hypoxanthine following an oral glucose load in healthy male subjects.","authors":"Tomoyuki Hara, Yuya Fujishima, Hitoshi Nishizawa, Yusuke Kawachi, Takashi Nakamura, Seigo Akari, Yoshiyuki Ono, Hirotaka Watanabe, Taka-Aki Sakaue, Yoshinari Obata, Hirofumi Nagao, Shiro Fukuda, Takashi Kanamoto, Mitsuyoshi Takahara, Naoto Katakami, Ken Nakata, Iichiro Shimomura","doi":"10.1507/endocrj.EJ24-0358","DOIUrl":"10.1507/endocrj.EJ24-0358","url":null,"abstract":"<p><p>Blood levels of hypoxanthine (HX) have been suggested as potential biomarkers associated with intramuscular metabolic dynamics in response to exercise. This pilot randomized crossover trial (UMIN000036520) aimed to investigate the changes in plasma HX after whole-body vibration exercise (WBVE) and their relationships with body composition and muscle-related parameters, enrolling eighteen healthy male volunteers. In the WBVE-alone intervention, the study subjects performed 20-min of WBVE. In the OGTT → WBVE intervention, a 75-g oral glucose load (OGL) was administered 30 min prior to the start of the WBVE intervention. Blood samples were collected before the start and 10 min after the end of WBVE in both interventions. WBVE resulted in a significant increase in plasma HX levels, which was accompanied by increased blood ammonia, pyruvic acid, and lactic acid levels. The HX increase following WBVE was suppressed by prior OGL. In the WBVE-alone intervention, there were no significant correlations between the post-WBVE changes in plasma HX (ΔHX) levels and any of the clinical parameters. On the other hand, in the OGTT → WBVE intervention, ΔHX showed significant negative correlations with muscle mass (ρ = -0.62, p = 0.01), strength (ρ = -0.71, p = 0.005), and muscle quality (ρ = -0.81, p = 0.0007) in the legs. In conclusion, these findings suggest possible associations between post-WBVE increases in plasma HX levels and muscle status, particularly under the glucose-supplemented condition. The measurement of plasma HX concentrations following WBVE may have clinical applications in the identification of high-risk populations for sarcopenia.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":"171-181"},"PeriodicalIF":1.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142617088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A narrative review of long-term inorganic iodine monotherapy for Graves' disease with a historical relationship between iodine and thyroid.","authors":"Natsuko Watanabe","doi":"10.1507/endocrj.EJ24-0186","DOIUrl":"10.1507/endocrj.EJ24-0186","url":null,"abstract":"<p><p>Almost a century has passed since Plummer reported the efficacy of short-term preoperative inorganic iodine therapy for Graves' disease in the 1920s. Since there were concerns about the escape phenomenon and exacerbation with inorganic iodine, antithyroid drugs became the mainstay of pharmacotherapy for Graves' disease following their development in the 1940s. With regard to long-term inorganic iodine monotherapy, Trousseau reported a case in the 1860s, and several subsequent reports suggested its efficacy. Around 1930, Thompson et al. published a number of papers and concluded that long-term inorganic iodine monotherapy was useful if limited to mild cases under careful follow-up. From Japan, in 1970, Nagataki et al. reported that, of 12 patients treated with inorganic iodine, three remained eumetabolic for more than two years. Since 2014, some reports have also been published from Japan. A summary of these recent reports is given below. The starting dose of potassium iodide is around 50 mg/day, and candidate responders have mild disease, with FT4 <2.76 ng/dL (35.5 pmol/L), a small goiter, and are female and elderly. Response rates are relatively high, at 60-80%, and the remission rate is about 40%. In cases of insufficient response, changing therapy should be considered. Inorganic iodine can be used as a possible alternative if the patient experiences adverse events with antithyroid drugs and/or prefers conservative treatments, with an understanding of their efficacy and limitations. These recent reports have been published from Japan, where iodine is sufficient, and the dose of inorganic iodine is empirical and requires further study.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":"23-36"},"PeriodicalIF":1.3,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11778387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transition from hypothyroidism to Graves' disease, development of thyroid eye disease, progression to optic neuropathy after inpatient pulse therapy, and long-term administration of outpatient pulse therapy: a case report with review of literature.","authors":"Koichiro Mizuochi, Yuji Hiromatsu, Yui Nakamura, Aya Sonezaki, Ayaka Adachi, Tamotsu Kato, Nobuhiko Wada, Tomohiro Kurose, Shiho Watanabe","doi":"10.1507/endocrj.EJ24-0347","DOIUrl":"10.1507/endocrj.EJ24-0347","url":null,"abstract":"<p><p>A 55-year-old woman transitioned from hypothyroidism to Graves' disease (GD) and then developed thyroid eye disease (TED) with proptosis and diplopia. After three cycles of daily methylprednisolone pulse therapy, her condition progressed to dysthyroid optic neuropathy with decreased visual acuity in both eyes. Her clinical activity score (CAS) was 7 points. Orbital magnetic resonance imaging (MRI) showed that the enlarged extraocular muscles were compressing the optic nerve in the area of the cones. Although her visual acuity recovered during two further cycles of daily pulse therapy, disease activity persisted for 4 years. TED exacerbated five times. Each time, the patient received weekly pulse therapy with no adverse reactions until her ophthalmopathy was relieved. The total cumulative dose of methylprednisolone was 59.5 g. Thyroid-stimulating antibody (TSAb) was positive from the time of hypothyroidism onset and became strongly positive with the onset of GD and the progress of TED. In addition, MRI was useful for the evaluation of the pathophysiology of ophthalmopathy. This case report suggests that careful monitoring by both endocrinologists and ophthalmologists using CAS, ophthalmological assessments, TSAb measurement, and orbital MRI are useful for making treatment decisions for TED.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":"115-122"},"PeriodicalIF":1.3,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11778384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mutual associations among responsiveness to differential diagnostic tests for Cushing's disease, tumor size, and somatostatin receptor 5 expression in corticotroph tumors.","authors":"Karolina Budzen, Kosuke Mukai, Yuto Mitsui, Michio Otsuki, Atsunori Fukuhara, Satoru Oshino, Youichi Saitoh, Masaharu Kohara, Eiichi Morii, Iichiro Shimomura","doi":"10.1507/endocrj.EJ24-0344","DOIUrl":"10.1507/endocrj.EJ24-0344","url":null,"abstract":"<p><p>There are differences in the responsiveness to differential diagnostic tests for Cushing's disease (CD), corticotroph tumor size, and the somatostatin receptor (SSTR) 5 expression in corticotroph tumors between CD patients. The differences in SSTR5 expression are particularly significant for identifying therapeutic targets for CD. However, prospective predictors of SSTR5 expression remain unclear. Thus, our objective was to elucidate the relationships among these clinical characteristics of CD, including SSTR5 expression. In 27 hospitalized patients with CD at Osaka University Hospital, Osaka, Japan, associations between corticotroph tumor diameter, the response of ACTH and cortisol to differential diagnostic tests for CD (CRH, desmopressin [DDAVP], and high-dose dexamethasone suppression test [HDDST]), the ACTH/cortisol index, and the SSTR5 immunoreactive score were retrospectively investigated. The response to differential diagnostic tests, ACTH/cortisol index, tumor diameter, and SSTR5 expression were significantly related (vs. tumor diameter [CRH: r = -0.54; DDAVP: r = -0.54; HDDST r = -0.67; ACTH/cortisol index: r = 0.76; SSTR5: r = -0.61], vs. CRH [DDAVP: r = 0.63, HDDST: r = 0.72, ACTH/cortisol index: r = -0.45; SSTR5: r = 0.56], vs. DDAVP [HDDST: r = 0.66; ACTH/cortisol index: r = -0.46; SSTR5: r = 0.76], vs. HDDST [ACTH/cortisol index: r = -0.62; SSTR5: r = 0.77], ACTH/cortisol index vs. SSTR5: r = -0.67). The areas under the receiver operating characteristic curve for the prediction of high SSTR5 expression via the CRH test, DDAVP test, HDDST, ACTH/cortisol index, and tumor diameter were 0.79, 0.87, 0.80, 0.71, and 0.71, respectively. Tests for differential diagnosis of CD, the ACTH/cortisol index, and the corticotroph tumor diameter have the potential for identifying SSTR5 expression in corticotroph tumors. These parameters may reflect the biological characteristics of corticotroph tumors.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":"93-102"},"PeriodicalIF":1.3,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11778363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current status of the thyroid hormone measurement items in patients receiving levothyroxine monotherapy by the management based on the thyroid tissue volume.","authors":"Mitsuru Ito, Hanna Deguchi-Horiuchi, Sawako Takahashi, Mako Hisakado, Kazuyoshi Kohsaka, Eijun Nishihara, Shuji Fukata, Mitsushige Nishikawa, Akira Miyauchi, Takashi Akamizu","doi":"10.1507/endocrj.EJ24-0259","DOIUrl":"10.1507/endocrj.EJ24-0259","url":null,"abstract":"<p><p>We and other investigators reported that mild TSH suppression with levothyroxine (LT₄) was needed to achieve normal free triiodothyronine (FT₃) levels and metabolic euthyroid state in athyreotic patients. Consequently, management methods based on thyroid tissue volume have been implemented for patients receiving LT₄ at the Kuma Hospital. This retrospective study examined the composition of the thyroid hormone measurement items (serum-free thyroxine [FT₄], FT₃, and FT₄ + FT₃) in patients receiving LT₄ monotherapy. According to the etiology of hypothyroidism, 36% of the 25,523 patients included in this study underwent total thyroidectomy (TT). Thirteen percent and 14% had undergone ¹³¹I treatment for hyperthyroidism (RIT) and partial thyroidectomy (PT), respectively. Moreover, 37% of patients had received non-invasive treatment (NIT). The proportion of patients who underwent only FT₃ measurements was higher (TT, 93%; RIT, 61%) in the first two groups, whereas the proportion of patients who underwent only FT₄ measurements was higher (PT, 50%; NIT, 65%) in the remaining two groups. Only FT₃ measurements were performed in 58% of patients. Only FT₄ measurements were performed in 34% of patients. The serum TSH levels were suppressed in nearly half of the patients (46%). Thus, FT₃ was the major thyroid hormone measured in patients receiving LT₄ treatment, and the serum TSH levels were suppressed in nearly half of the patients. This may be attributed to the management guidelines at our hospital, a specialized facility for thyroid disease, wherein half of the patients present are athyreotic or have atrophic thyroid glands after TT or RIT.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":"69-77"},"PeriodicalIF":1.3,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11778342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}