Endocrine journal最新文献

{"title":"Indicators for predicting continuous insulin infusion therapy-related hypokalemia: multicenter retrospective cohort study.","authors":"Yuichiro Iwamoto, Tomohiko Kimura, Masato Kubo, Yui Okamoto, Ryo Inaba, Takashi Itoh, Toshitomo Sugisaki, Kazunori Dan, Hideyuki Iwamoto, Yoshiro Fushimi, Junpei Sanada, Hayato Isobe, Fuminori Tatsumi, Yukiko Kimura, Fumiko Kawasaki, Masashi Shimoda, Shuhei Nakanishi, Kohei Kaku, Hideaki Kaneto","doi":"10.1507/endocrj.EJ26-0061","DOIUrl":"10.1507/endocrj.EJ26-0061","url":null,"abstract":"<p><p>Hypokalemia is a common and potentially life-threatening complication of continuous intravenous insulin infusion (CII) in patients with hyperglycemic crises. However, no simple quantitative indicator can estimate the risk of hypokalemia at treatment initiation. This multicenter retrospective cohort study enrolled patients hospitalized for hyperglycemic crises who received CII. Clinical data available at CII initiation were collected. Machine-learning techniques were primarily employed for feature selection and model comparison to develop a simple, clinically interpretable prediction model. A logistic regression-based indicator was constructed using the most contributory variables and validated internally and externally. Hypokalemia was defined as a serum potassium level <3.5 mmol/L. The model-building and external validation cohorts included 99 and 55 patients, respectively. Among multiple candidate models, a lightweight logistic regression model using only two variables, serum potassium level and insulin infusion rate per body weight, was selected for clinical applicability. In internal validation, the model demonstrated good discriminative performance (receiver operating characteristic-area under the curve [ROC-AUC] 0.821). When applied to the external validation cohort, the ROC-AUC was 0.655, and accuracy decreased slightly. A lower threshold may increase sensitivity in screening, whereas a higher threshold may improve specificity. In conclusion, this study presents a simple and clinically applicable indicator for predicting CII-related hypokalemia using only two routinely available variables at treatment initiation. This model supports individualized electrolyte monitoring during the acute management of hyperglycemic crises. Additionally, it may facilitate safer and more efficient clinical decision-making without reliance on complex algorithms.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":"1037-1044"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13572949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147962581","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":"Transient pancreatic enlargement with peripancreatic inflammatory changes two days before clinical presentation and diagnosis of atezolizumab-related fulminant type 1 diabetes mellitus followed by pancreatic atrophy: a case report with review of literature.","authors":"Takahiko Inukai, Takahiro Tsutsumi, Miku Yamazaki, Saki Komai, Sonomi Noda, Hiroyuki Uchinuma, Kyoichiro Tsuchiya","doi":"10.1507/endocrj.EJ26-0303","DOIUrl":"https://doi.org/10.1507/endocrj.EJ26-0303","url":null,"abstract":"<p><p>Immune checkpoint inhibitor (ICI)-related type 1 diabetes is a rare but potentially life-threatening immune-related adverse event, and imaging findings immediately before clinical presentation and diagnosis have rarely been documented. We report a 71-year-old woman with large cell neuroendocrine carcinoma who developed fulminant type 1 diabetes mellitus during carboplatin, nab-paclitaxel, and atezolizumab therapy. The day of clinical presentation and diagnosis was defined as Day 0. On Day -1, she developed nausea and appetite loss without abdominal pain. On Day 0, she presented with impaired consciousness and fever; laboratory evaluation showed plasma glucose 1,435 mg/dL, glycated hemoglobin (HbA1c) 6.9%, marked ketonemia, severe hyperosmolality, negative anti-glutamic acid decarboxylase (GAD) antibody, and near-complete insulin deficiency. The metabolic presentation was interpreted as diabetic ketoacidosis/hyperosmolar hyperglycemic state (DKA/HHS) overlap. Computed tomography (CT) performed on Day -2 showed radiologic enlargement of the pancreatic tail with increased peripancreatic fat attenuation, both of which had resolved on Day 0. Pancreatic volume increased from 46.0 mL at baseline to 82.5 mL on Day -2, decreased to 47.9 mL on Day 0, and further declined to 39.0 mL at 6-month follow-up. This hypothesis-generating case documents incidental transient pancreatic enlargement with peripancreatic inflammatory changes shortly before diagnosis, followed by pancreatic atrophy. This case suggests that incidental pancreatic enlargement during ICI therapy may serve as an early radiologic clue to immune-related diabetes, supporting prompt metabolic evaluation even in the absence of abdominal pain or pancreatic enzyme elevation.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of dabrafenib plus trametinib in BRAFV600E-mutated advanced thyroid carcinoma: Real world experience in 37 patients.","authors":"Haruhiko Yamazaki, Nobuyasu Suganuma, Mei Kadoya, Katsuhiko Masudo, Ai Matsui, Aya Saito","doi":"10.1507/endocrj.EJ25-0629","DOIUrl":"10.1507/endocrj.EJ25-0629","url":null,"abstract":"<p><p>This study aimed to investigate the clinical efficacy and safety of dabrafenib plus trametinib for BRAFV600E-mutated advanced thyroid carcinoma in a Japanese real-world setting. We analyzed 37 BRAFV600E-mutated advanced thyroid carcinoma patients treated with dabrafenib plus trametinib between November 2023 and July 2025. Thirty-one patients (84%) had papillary thyroid carcinoma (PTC) histology, one (3%) had poorly differentiated thyroid carcinoma (PDTC) histology, and 5 (13%) had anaplastic thyroid carcinoma (ATC) histology. Among 31 PTC patients, dabrafenib plus trametinib was initiated as first-line treatment in 16 patients. The most common previous systemic therapy was lenvatinib (n = 16, 43%). The most common sites of target lesion were the lung (n = 23, 62%) and lymph node (n = 23, 62%). The median sum of the diameters of the target lesion was 40 mm (range, 8-166 mm). The objective response and disease control rates were 29% and 74% in patients with PTC, and 50% and 83% in patients with non-PTC (PDTC and ATC), respectively. The 12-month progression-free survival rates in patients with PTC and non-PTC (PDTC and ATC) were 73.2% (95% confidence interval [CI], 48.7-87.4%) and 60.0% (95% CI, 12.6-88.2%) (hazard ratio, 2.769; 95% CI, 0.691-11.1; p = 0.134), respectively. Dabrafenib plus trametinib treatment showed a response rate similar to that observed in clinical trials for BRAFV600E-mutated advanced thyroid carcinoma in this real-world study. However, long-term follow-up is required to determine the efficacy of dabrafenib plus trametinib treatment.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":"1045-1054"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13572947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147927676","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":"Multimodal management of giant prolactinoma with extensive amyloid spherule deposition: a case report with review of the literature.","authors":"Aysel Unver Ozkahraman, Merve Korkmaz Yilmaz, Huseyin Karatay, Sidar Bagbudar, Ebubekir Akpinar, Buruc Erkan, Mehmet Karagulle, Mesut Yilmaz, Mutlu Niyazoglu, Esra Hatipoglu","doi":"10.1507/endocrj.EJ26-0079","DOIUrl":"10.1507/endocrj.EJ26-0079","url":null,"abstract":"<p><p>Amyloid spherule-containing prolactinomas are rare entities associated with dopamine agonist (DA) resistance and aggressive behaviour. We report a giant amyloid spherule-containing prolactinoma with a substantial tumour burden and markedly elevated prolactin levels, highlighting novel multimodal therapeutic strategies. A 49-year-old man presented with headache and visual disturbance. Imaging revealed a giant pituitary macroadenoma (63 × 84 × 46 mm) with Knosp grade 4 cavernous sinus invasion and clivus erosion. Laboratory investigations revealed marked hyperprolactinemia (prolactin (PRL): 30,969 ng/mL) and autonomous growth hormone (GH) hypersecretion. Histopathology confirmed a sparsely granulated lactotroph tumour with extensive amyloid spherules and dystrophic calcifications (Ki-67: 8%). Notably, immunohistochemistry demonstrated PRL positivity without GH immunoreactivity, suggesting tumour heterogeneity with sampling limitations. Comprehensive systemic amyloidosis screening, the first systematic evaluation reported for this entity, excluded systemic disease. Following surgical debulking with extensive residual disease, postoperative cabergoline treatment resulted in a reduction in the PRL (4,700→927 ng/mL). Given the presence of amyloid-associated dopamine resistance, cabergoline was discontinued, and radiotherapy (RT) (45 Gy) was initiated to control the amyloid burden, followed by temozolomide. Based on evidence from other malignancies suggesting RT-mediated amyloid reduction, cabergoline was reintroduced postradiotherapy without paradoxical tumour growth. Concurrent cabergoline-temozolomide therapy, a novel approach that differs from conventional sequential protocols, achieved a dramatic response: 93.4% prolactin reduction (10,320→677 ng/mL) and 52.4% tumour volume reduction. This superior outcome far exceeded that of initial postsurgical cabergoline monotherapy (80% reduction), suggesting that RT successfully modulated the amyloid burden and restored dopamine sensitivity. This case suggests that RT may restore dopamine agonist sensitivity in patients with amyloid-containing prolactinomas, potentially enabling concurrent dopamine agonist-temozolomide therapy in refractory cases, warranting further validation.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":"1081-1090"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13572945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148041717","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":"Primary aldosteronism with intellectual disability associated with CACNA1H and PPP2R5D mutations: a case report with review of literature.","authors":"Wennan Zhang, Yiwen Zhang, Yangyang Wang, Yu Xue, Lili Xu, Hui Yan","doi":"10.1507/endocrj.EJ26-0175","DOIUrl":"https://doi.org/10.1507/endocrj.EJ26-0175","url":null,"abstract":"<p><p>Mutations in the CACNA1H and PPP2R5D genes have been associated with functional abnormalities affecting both the endocrine and nervous systems. The CACNA1H gene encodes the T-type calcium channel CaV3.2, and pathogenic variants may alter channel activation and inactivation, resulting in increased intracellular calcium influx. Elevated intracellular calcium in adrenal zona glomerulosa cells acts as a key signal for aldosterone biosynthesis, thereby promoting excessive aldosterone secretion and contributing to the development of hypertension. The PPP2R5D gene encodes a regulatory subunit of protein phosphatase 2A (PP2A). Mutations in this gene may disrupt the regulatory function of PP2A, impairing the dephosphorylation of key neuroproteins and consequently affecting neural signal transduction and brain function. Cases of early-onset hypertension accompanied by intellectual disability associated with concurrent CACNA1H and PPP2R5D mutations remain rare. We report the case of an 18-year-old female presenting with early-onset hypertension and intellectual disability. Hypertension was first diagnosed at the age of 10 years and was accompanied by recurrent dizziness and headache. Physical examination revealed central obesity and signs of hyperandrogenism. Laboratory evaluation demonstrated elevated aldosterone levels with suppressed plasma renin activity, suggesting primary aldosteronism. Genetic analysis identified heterozygous variants in CACNA1H (c.6866C>T) and PPP2R5D (c.985A>G). Based on the clinical features and genetic findings, the patient was diagnosed with familial hyperaldosteronism type IV complicated by intellectual disability. This case highlights the importance of considering genetic forms of primary aldosteronism in young patients with early-onset hypertension and atypical clinical manifestations. Genetic testing may facilitate accurate diagnosis and guide individualized management.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148826313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of phase angle versus skeletal muscle mass profiling with body fat mass in relation to glycemic control in type 2 diabetes: a cross-sectional study.","authors":"Shuhei Nakanishi, Masashi Shimoda, Tomohiko Kimura, Junpei Sanada, Yoshiro Fushimi, Yuichiro Iwamoto, Masato Kubo, Ryo Inaba, Yui Okamoto, Hideyuki Iwamoto, Kohei Kaku, Hideaki Kaneto","doi":"10.1507/endocrj.EJ26-0238","DOIUrl":"https://doi.org/10.1507/endocrj.EJ26-0238","url":null,"abstract":"<p><p>While preserving skeletal muscle mass (SMM) is advocated in type 2 diabetes mellitus (T2DM), mass-based assessments often overlook muscle quality. This study aimed to investigate whether the balance between cellular integrity (phase angle [PhA]) and metabolic load (body fat mass [BFM]) is more clinically relevant to glycemic control than SMM-based profiling in patients with T2DM. In this cross-sectional study of 622 patients, participants were stratified into four groups based on sex-specific medians of PhA and BFM, and similarly for SMM and BFM. Multivariate logistic regression evaluated associations with glycemic targets (HbA1c <8.0% and <7.0%), adjusting for confounders. Sensitivity analyses utilized continuous Z-scores and interaction terms. High-PhA/High-BFM and High-PhA/Low-BFM groups showed significantly higher odds of HbA1c <8.0% compared with the Low-PhA/High-BFM reference group (adjusted odds ratio [OR] 2.05, 95% confidence interval [CI] 1.22-3.44; OR 2.10, 95% CI 1.21-3.64, respectively). Conversely, SMM/BFM combinations showed no significant associations. Neither profile was significantly associated with the stricter HbA1c <7.0% target. In continuous models, the PhA × BFM interaction was significantly associated with achievement of HbA1c <8.0% (p = 0.025), whereas SMM × BFM interaction was not. In conclusion, the PhA/BFM interplay shows a clearer association with glycemic control than SMM/BFM profiling in T2DM. Higher PhA may reflect a more favorable metabolic phenotype against adiposity and is associated with a lower likelihood of severe hyperglycemia (HbA1c ≥8.0%). PhA/BFM profiling offers a novel approach to identify high-risk patients overlooked by conventional mass-based assessments.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148826325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interleukin-1β decreases hepatic ATP-binding cassette subfamily A member 1 expression through p38 mitogen-activated protein kinase signaling and an H-89-sensitive pathway.","authors":"Jingya Lyu, Kensaku Fukunaga, Zhangchi He, Hitomi Imachi, Toshihiro Kobayashi, Takanobu Saheki, Takafumi Yoshimura, Eri Harada, Kosuke Izumi, Wenyi Jiang, Haotian Zhang, Ly Rathana, Hisakazu Iwama, Jinghui Guo, Koji Murao","doi":"10.1507/endocrj.EJ26-0223","DOIUrl":"https://doi.org/10.1507/endocrj.EJ26-0223","url":null,"abstract":"<p><p>Steatotic liver disease is a common metabolic disorder, and interleukin-1β (IL-1β) contributes to hepatic inflammation and lipid accumulation. ATP-binding cassette subfamily A member 1 (ABCA1) regulates cholesterol efflux and lipid homeostasis. This study examined whether IL-1β suppresses hepatic ABCA1 expression and explored the underlying signaling and transcriptional mechanisms. Primary mouse hepatocytes and HepG2 cells were treated with IL-1β. ABCA1 expression was assessed by Western blotting and RT-qPCR, and ABCA1 promoter activity was examined using luciferase reporter assays with inhibitors targeting phosphoinositide 3-kinase (PI3K), p38 mitogen-activated protein kinase (p38 MAPK), or an H-89-sensitive pathway. Prolactin regulatory element-binding protein (PREB) involvement was evaluated by nuclear protein analysis, PREB-binding-site mutation, and siRNA-mediated knockdown. Lipid accumulation was assessed by intracellular cholesterol measurement and Oil Red O staining. IL-1β decreased ABCA1 protein and mRNA expression in a dose- and time-dependent manner and suppressed ABCA1 promoter activity. Inhibition of p38 MAPK or treatment with H-89 attenuated IL-1β-induced suppression of promoter activity and endogenous ABCA1 expression. Representative immunoblotting showed that IL-1β enhanced p38 MAPK phosphorylation, whereas SB203580 attenuated this response. IL-1β reduced nuclear PREB expression, and p38 MAPK inhibition restored nuclear PREB expression. Mutation of the PREB-binding site or PREB knockdown abolished IL-1β-mediated suppression of ABCA1 expression. IL-1β also increased intracellular cholesterol content and Oil Red O-positive lipid accumulation. These findings suggest that IL-1β suppresses hepatic ABCA1 expression through p38 MAPK signaling and an H-89-sensitive pathway, at least partly involving PREB-associated transcriptional regulation, and that this suppression is associated with hepatocellular lipid accumulation.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148826283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship of serum 25-hydroxyvitamin D with the metabolic score for insulin resistance in Korean adults.","authors":"Young Hoon Cho, Eun Sun Lee, Joonho Ahn","doi":"10.1507/endocrj.EJ26-0266","DOIUrl":"https://doi.org/10.1507/endocrj.EJ26-0266","url":null,"abstract":"<p><p>Vitamin D has been linked to insulin sensitivity and glucose metabolism. However, few studies have separately examined the association between serum 25-hydroxyvitamin D₂ (25(OH)D₂) and 25-hydroxyvitamin D₃ (25(OH)D₃) levels and insulin resistance. Therefore, we investigated the associations of serum 25(OH)D₂, 25(OH)D₃, and total 25-hydroxyvitamin D (25(OH)D) levels with the metabolic score for insulin resistance (METS-IR) in a nationally representative sample of Korean adults. This cross-sectional study analyzed data from 9,297 adults aged ≥19 years who participated in the 2022-2023 Korea National Health and Nutrition Examination Survey. Linear regression was used to examine the associations of serum 25(OH)D₂, 25(OH)D₃, and total 25(OH)D levels with the METS-IR. Total 25(OH)D (β = -0.0843, 95% confidence interval [CI]: -0.0995 to -0.0691) and 25(OH)D₃ levels (β = -0.0831, 95% CI: -0.0983 to -0.0680) showed significant, linear inverse associations with the METS-IR. However, serum 25(OH)D₂ levels were not significantly associated with the METS-IR. Stratified analyses revealed that the inverse association between the 25(OH)D₃ level and METS-IR was significantly stronger in participants with obesity, diabetes mellitus, or hypercholesterolemia than in their counterparts. These findings were consistent across all the sensitivity analyses. In this nationally representative study of Korean adults, total 25(OH)D and its principal component 25(OH)D₃ were inversely associated with the METS-IR. In contrast, 25(OH)D₂ was not associated, a finding most likely attributable to its very low circulating concentrations. Because total 25(OH)D performed comparably to 25(OH)D₃, it remains a practical measure of vitamin D status in metabolic care.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Observational study of the relationship between the use of real-time continuous glucose monitoring and glycemic control in patients with diabetes in Japan: the REALJ study.","authors":"Masao Toyoda, Naoki Sakane, Akiko Suganuma, Masahito Ogura, Junnosuke Miura, Daisuke Tsuriya, Akinori Hayashi, Hideaki Sawaki, Shota Suzuki, Tatsuhiko Urakami, Yushi Hirota, Arata Itoh, Shu Meguro, Kenji Kamiuchi, Tomokazu Matsuda, Hitomi Nakayama, Yoshihiko Yuyama, Tomoyuki Kawamura, Atsuhito Tone, Ken Kato, Akira Kuroe, Akio Kuroda, Munehide Matsuhisa, Akira Shimada, Takashi Murata","doi":"10.1507/endocrj.EJ26-0183","DOIUrl":"https://doi.org/10.1507/endocrj.EJ26-0183","url":null,"abstract":"<p><p>Although randomized controlled trials have demonstrated the efficacy of real-time continuous glucose monitoring (rtCGM), evidence from routine clinical practice remains limited, particularly in Asian populations. This study aimed to evaluate the effectiveness and safety of rtCGM initiation in individuals with diabetes. This multicenter, single-arm, retrospective, observational study was conducted at 34 sites across Japan (Clinical trial registration: UMIN000054275). Adults ≥18 years of age with diabetes who began using the Dexcom G6 rtCGM system, had a baseline glycated hemoglobin (HbA1c) level ≥7.5%, and continued rtCGM for at least 26 weeks were included. Factors associated with changes in HbA1c levels were examined using multivariate linear regression models. Among 192 participants, the mean HbA1c levels at 26 weeks were significantly lower (8.62 ± 1.14% vs. 7.88 ± 1.16%, p < 0.001) than those at baseline, with a difference of -0.73 ± 1.03%. In the multivariate analysis, greater HbA1c reduction was independently associated with higher baseline HbA1c (β = -0.40; p < 0.001), longer CGM active time (β = -0.008; p = 0.043), and older age (β = -0.010; p = 0.012), whereas prior isCGM use was associated with smaller reductions (β = +0.28; p = 0.045). Sex was also independently associated with changes in HbA1c levels (p = 0.028). During the 26-week follow-up period, one patient (0.5%) experienced diabetic ketoacidosis and four individuals (2.1%) experienced severe hypoglycemia. rtCGM initiation was associated with significantly lower HbA1c levels after 26 weeks of rtCGM use. These findings support the efficacy and safety of the Dexcom G6 in routine clinical practice.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical features of hereditary adrenocortical unresponsiveness to adrenocorticotropin (HAUA) in Japan: from a nationwide questionnaire based survey.","authors":"Eri Tanimoto, Kenichi Kashimada, Bunzo Matsuura, Hideki Yamaguchi, Masafumi Kurajoh, Toshie Segawa, Kenji Ohba, Yuki Abe, Yasunori Wada, Junko Kanno, Yoichiro Oda, Toshihiro Tajima, Hirotaka Shibata, Tomonobu Hasegawa","doi":"10.1507/endocrj.EJ26-0099","DOIUrl":"10.1507/endocrj.EJ26-0099","url":null,"abstract":"<p><p>Hereditary adrenocortical unresponsiveness to adrenocorticotropin (HAUA) is a rare congenital disorder characterized by isolated glucocorticoid deficiency with preserved mineralocorticoid production. HAUA encompasses familial glucocorticoid deficiency (FGD) and triple A syndrome (AAAS) and is caused by autosomal recessive defects in ACTH-signaling-related genes, including MC2R, MRAP, AAAS, NNT, TXNRD2, and MCM4. To clarify the current clinical characteristics of HAUA (including FGD and AAAS) in Japan, we conducted a nationwide questionnaire-based survey. The primary survey identified the number of affected patients, and the secondary survey collected detailed clinical information. Fifteen patients were identified from 12 institutions. Detailed clinical data were obtained from nine patients (mean age, 40.6 years). Most patients developed symptoms during childhood [3.75 (0-8) years]. Seven presented with chronic adrenal insufficiency, and two experienced life-threatening events, hypoglycemia or encephalopathy. Genetic confirmation was obtained in four cases. All patients received glucocorticoid replacement therapy (mean hydrocortisone-equivalent dose, 13.0 mg/m²/day). Notably, 50% of adult patients were obese (BMI ≥25 kg/m²), although no clear association between glucocorticoid dose and BMI was observed. Despite the limited cohort size, this study provides detailed clinical information on HAUA (including FGD and AAAS) in Japan and suggests a potential risk of obesity in long-term management.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148721284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}