Endocrine Connections最新文献

{"title":"Neurophysin-I dynamics upon different pituitary provocation tests in healthy participants.","authors":"Andi Nikaj, Cihan Atila, Deborah Rudin, Dino Luethi, Clara O Sailer, Bettina Winzeler, Sandrine A Urwyler, Julie Refardt, Prof Matthias E Liechti, Prof Mirjam Christ-Crain","doi":"10.1530/EC-25-0929","DOIUrl":"https://doi.org/10.1530/EC-25-0929","url":null,"abstract":"<p><strong>Background: </strong>Oxytocin (OXT) is known for its role in regulating social behaviour, such as emotion recognition and bonding. The evidence for clinically relevant OXT deficiency is constantly increasing, but measurement of OXT is challenging. In contrast, neurophysin-I (NP-I), the carrier protein of OXT, co-released equimolarly, is a stable surrogate biomarker for OXT. This study evaluated OXT and NP-I levels upon four different pituitary provocation tests.</p><p><strong>Design: </strong>Secondary analysis of four interventional diagnostic trials at the University Hospital Basel, Switzerland.</p><p><strong>Methods: </strong>Sixty-six participants underwent a pituitary provocation test, 11 the hypertonic saline test, 20 the arginine infusion test, 25 the oral macimorelin test, and 10 the glucagon injection test. Plasma NP-I and OXT were measured at baseline and once plasma sodium level reached ≥ 150 mmol/L for the hypertonic saline, after 60min for the arginine infusion, after 60min, 120min, and 180min for the glucagon injection, and after 45min for the oral macimorelin test. Primary outcome was change from baseline to maximally stimulated NP-I levels.</p><p><strong>Results: </strong>Median [IQR] NP-I levels increased minimally in response to hypertonic saline (baseline: 55 pM, stimulated: 59 pM, relative median change of -8% [-16, +9]) and significantly to glucagon injection (baseline: 82 pM, stimulated: 94 pM, relative median change of +18% [+7, +28]). Median OXT levels showed similar trends in response to hypertonic saline (baseline: 0.36, stimulated: 0.48, relative median change of +22% [-15, +96]) and to glucagon injection (baseline: 82.7 pg/ml [62.3, 94.3], stimulated: 93.4 pg/ml [87.2, 121], relative median change of +25% [+6, +59). There were no increases in NP-I plasma levels nor OXT levels upon arginine infusion and oral macimorelin.</p><p><strong>Conclusion: </strong>NP-I showed minimal responses to pituitary provocation tests, paralleling OXT dynamics. These findings highlight NP-I's potential as a reliable and technically robust surrogate biomarker for OXT activity, warranting further evaluation in clinical and experimental settings.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766091","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":"Adiponectin modulates the diurnal hepatic transcriptome and energy metabolism in male mice.","authors":"Misa Hirose, Enrique Calvo, Violetta Pilorz, Meike Kaehler, Ingolf Cascorbi, Inga Nagel, Leonardo Vinicius Monteiro de Assis, Henrik Oster","doi":"10.1530/EC-26-0016","DOIUrl":"10.1530/EC-26-0016","url":null,"abstract":"<p><p>Adiponectin is an adipocyte-derived hormone with insulin-sensitizing and lipid-lowering effects. Its expression and circulating levels show pronounced variation across the day, which opens the possibility that adiponectin influences metabolic programs in target tissues, such as the liver in a time-of-day dependent manner. To test this, we compared liver circadian transcriptome profiles (with sampling at 4-h intervals) between adiponectin-deficient (ADQ-KO) and wild-type (ADQ-WT) mice. Adiponectin loss led to tonic (i.e. time-independent) transcriptional changes in the liver with 1,393 differentially expressed genes (518 up- and 875 downregulated). These included upregulation of chromatin and RNA processing pathways and downregulation of immune and mitochondrial metabolic genes. At the same time, circadian analysis identified a marked reprogramming of transcriptome rhythms in ADQ-KO livers with changes in MESOR (n = 3,369 transcripts), amplitude (n = 386), and phase of gene expression (n = 603). Genes associated with mitochondrial respiration and fatty acid metabolism showed reduced rhythm amplitude and MESOR, whereas glycolytic genes exhibited increased MESOR. One of the identified adiponectin candidate targets and a regulator of hepatic metabolism, Hif1a, was further studied by functional assays in murine hepatocytes. Pharmacological adiponectin receptor activation promoted glycolysis and mitochondrial respiration under normoxia, but these effects were attenuated under hypoxia mimicry, consistent with HIF1a-dependent interference. These findings suggest adiponectin as a regulator of liver circadian metabolism, modulating both the timing and magnitude of energy-related gene expression programs, potentially in part through a HIF1a-mediated mechanism.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688826","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":"Clinical characteristics and management of PD-1/PD-L1 inhibitor-induced secondary adrenal insufficiency.","authors":"Na Li, Tianfu Liang, Hanbing Xie, Ye Niu","doi":"10.1530/EC-26-0079","DOIUrl":"10.1530/EC-26-0079","url":null,"abstract":"<p><strong>Graphical abstract: </strong></p><p><strong>Abstract: </strong>Programmed cell death-1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitors significantly improve outcomes in multiple malignancies; however, they can induce immune-related endocrine adverse events, such as secondary adrenal insufficiency (SAI), a rare but potentially severe complication. We aimed to systematically analyze the clinical characteristics, changes in endocrine function, and treatment outcomes of SAI induced by PD-1/PD-L1 immune checkpoint inhibitors. This single-center retrospective study included 75 patients with tumors diagnosed with SAI following PD-1/PD-L1 inhibitor therapy. Clinical data were collected via electronic medical records, and clinical characteristics and prognosis data were analyzed using descriptive statistical methods. SAI occurred at any cycle during immunotherapy, with a median onset of 5.70 months. Clinically, fatigue was the most common symptom (80.0%), followed by loss of appetite (26.7%) and nausea (9.3%). Endocrine function assessments revealed that severe hypothalamic-pituitary-adrenal (HPA) axis impairment occurred in all patients; thyroid function abnormalities occurred in 34.7% of patients, with PD-1/PD-L1 inhibitor-related hypothyroidism accounting for 88.5%, of which 65.2% of hypothyroidism cases preceded SAI diagnosis. Central hypothyroidism (4.0%) and gonadal involvement (1.3%) were relatively rare; treatment outcome analysis showed that only 8.3% (1/12) of patients receiving high-dose glucocorticoid therapy recovered HPA axis function; 98.7% (74/75) of patients on long-term glucocorticoid replacement therapy tolerated subsequent anti-tumor treatment, and 59.5% maintained the regimen, including ICIs. These findings reveal the need to enhance endocrine monitoring during immunotherapy, prioritize HPA axis evaluation in patients with thyroid dysfunction, and promptly initiate standardized glucocorticoid replacement therapy upon SAI diagnosis to ensure continuity of anti-tumor treatment.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147671533","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":"De-Escalation Implementation in Low-Risk Papillary Thyroid Cancer: A Nationwide Survey.","authors":"Grigoris Efraimidis, Eleni Sazakli, Olga Karapanou, Katerina Saltiki, Marina A Michalaki","doi":"10.1530/EC-25-0796","DOIUrl":"https://doi.org/10.1530/EC-25-0796","url":null,"abstract":"<p><strong>Background: </strong>Over the past decade, management of papillary thyroid carcinoma (PTC) has become increasingly individualized, with less aggressive approaches recommended for low-risk disease. However, real-world implementation of these recommendations remains limited.</p><p><strong>Objective: </strong>To assess real-world management patterns and therapeutic preferences regarding surgical extent, radioactive iodine (RAI) use, and thyrotropin (TSH) levels in low- and low-to-intermediate-risk PTC through a nationwide survey.</p><p><strong>Methods: </strong>A nationwide web-based survey was conducted among members of the Greek Endocrine Society (25% response rate) between November 2023 and April 2024. The questionnaire comprised demographic items, 12 clinical scenarios, and a final section exploring general reasons for non-adherence to clinical guidelines; this report focuses on eight scenarios related to low- and low-to-intermediate-risk papillary thyroid carcinoma.</p><p><strong>Results: </strong>For an 18 mm intrathyroidal low-risk PTC, 67.7% of respondents recommended total thyroidectomy, while 51.8% favored adjuvant RAI. When reclassified as low-to-intermediate risk 92.5% endorsed RAI, often at higher doses (70 mCi), particularly among more experienced and those practicing in large cities. TSH suppression targets in case of excellent response varied: nearly half selected 0.5-2.0 μU/mL for low-risk PTC, but most favored tighter suppression (0.1-0.5 μU/mL) in low-to-intermediate-risk scenarios. Senior endocrinologists prefer traditional approaches. Barriers to guideline adherence included limited access to molecular and ultrasonography testing, shortage of experienced surgeons outside major centers, and skepticism regarding guideline safety.</p><p><strong>Conclusion: </strong>Our findings underscore persistence practice variation driven by professional experience and local healthcare infrastructure, underscoring the need for targeted local implementation strategies, particularly outside major urban centers.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765966","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":"Factors affecting the quality of life of adults living with Congenital Adrenal Hyperplasia: A qualitative study of lived experience.","authors":"K Lynette James, Nicola Parkin, Sue Elford, Christine McKnight, Rhiannon Phillips, Timothy Pickles, S Faisal Ahmed, Nils Krone, Sofia Llahana, Michael O'Reilly, Jeremy W Tomlinson, D Aled Rees","doi":"10.1530/EC-26-0033","DOIUrl":"https://doi.org/10.1530/EC-26-0033","url":null,"abstract":"<p><strong>Objective: </strong>Congenital adrenal hyperplasia (CAH) is a genetic condition caused by enzymatic defects of adrenal steroidogenesis. The physical manifestations of CAH are well recognised but the effects on health-related quality of life (HRQoL) are unclear. We sought to explore the factors impacting the HRQoL of individuals with CAH.</p><p><strong>Design: </strong>Phenomenological qualitative study of lived experience.</p><p><strong>Methods: </strong>In-depth, timeline-assisted, semi-structured interviews were undertaken virtually with participants recruited via the Living with CAH patient support group. Participants, purposively selected until data saturation, were adults (≥18 years) with CAH and parents/partners of adults with CAH. Interviews were audio-recorded, transcribed verbatim and analysed using Framework Analysis.</p><p><strong>Results: </strong>Twenty-three participants were interviewed (20 classic, 1 non-classic, 2 mothers). Most participants (n=19) were female. CAH has a profound physical, psychological and psychosocial impact on individuals. The psychological wellbeing of women was compromised by trauma from childhood medical examinations and lack of agency in treatment decision. Poor self-esteem, shame and negative body image impaired female social functioning. Female sexual dysfunction from genital malformation/surgery and psychosexual issues negatively impacted intimate relationships. Fertility and reproductive choices were a concern to both sexes. Complex family dynamics with dependent relationships was evident.</p><p><strong>Conclusion: </strong>This study identified a breadth of factors impacting HRQoL in CAH - domains overlooked by an existing measure which predominantly focus on physical symptoms. Further work is needed to develop a sensitive, comprehensive disease-specific HRQoL measure which reflects the lived experience of individuals with CAH to facilitate delivery of patient-centred care and improved patient outcomes.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766069","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 IGF Signaling Axis in Thyroid Cancer: Biological Complexity and Therapeutic Challenges.","authors":"Youyun Peng, Shaojie Xu, Hanning Li, Xingrui Li, Yaying Du","doi":"10.1530/EC-26-0144","DOIUrl":"https://doi.org/10.1530/EC-26-0144","url":null,"abstract":"<p><p>Dysregulation of the insulin-like growth factor (IGF) axis plays an important role in thyroid cancer progression, dedifferentiation, and therapeutic resistance. While most differentiated thyroid cancers have favorable outcomes, a clinically significant subset develops aggressive behavior or becomes radioiodine (RAI)-refractory, for which effective treatments remain limited. Aberrant activation of IGF ligands, IGF-1 receptor (IGF-1R), insulin receptor isoforms (especially IR-A), and IGF-binding proteins (IGFBPs) enhances oncogenic signaling through the PI3K/AKT and MAPK pathways and disrupts differentiation programs essential for iodine handling. Emerging evidence supports an IGF-2/IR-A-dominant autocrine circuit as a feature of aggressive and RAI-refractory disease, highlighting its potential relevance for biomarker-driven patient stratification. However, clinical translation of IGF-axis targeting in thyroid cancer remains limited, and IGF-1R-directed monotherapies have shown only modest efficacy owing to signaling redundancy, adaptive resistance, metabolic toxicities, and the lack of validated predictive biomarkers for patient selection. Consequently, current translational efforts increasingly emphasize rational combination strategies, targeted delivery platforms, and molecular imaging approaches. This review summarizes key mechanistic and translational insights into IGF signaling in thyroid cancer and discusses how IGF-axis modulation may be integrated into precision oncology strategies for advanced disease.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766097","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":"Phosphate handling as a determinant of osteoporosis in primary hyperparathyroidism.","authors":"Sebastian Szewczyk, Michał Popow, Urszula Ambroziak","doi":"10.1530/EC-26-0118","DOIUrl":"10.1530/EC-26-0118","url":null,"abstract":"<p><strong>Introduction: </strong>Primary hyperparathyroidism is characterized by chronic parathyroid hormone excess, leading to hypercalcemia, increased bone turnover, and skeletal complications. Although osteoporosis is a common manifestation of these, the biochemical determinants of bone loss remain insufficiently defined. The roles of active vitamin D and renal phosphate handling require further clarification. This study aimed to identify biochemical determinants of osteoporosis in patients with primary hyperparathyroidism, with a particular focus on the contribution of calcitriol levels and renal phosphate handling. We further sought to evaluate their predictive performance in discriminating osteoporotic from non-osteoporotic individuals.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 74 adults with primary hyperparathyroidism ineligible for surgery, assessing serum calcium, phosphate, vitamin D metabolites, parathormone, and 24 h urinary calcium. Renal phosphate handling was estimated by TMP/GFR. Logistic regression and ROC analyses identified independent predictors and optimal cutoff values for osteoporosis.</p><p><strong>Results: </strong>Osteoporosis was present in 33.8% of patients. Individuals with osteoporosis demonstrated significantly higher calcitriol levels and lower renal phosphate reabsorption, also in multivariate analysis, while serum calcium, phosphate, and 25-hydroxyvitamin D did not differ between groups. Receiver operating characteristic curve analysis identified clinically meaningful cutoff values for both parameters.</p><p><strong>Conclusion: </strong>Increased levels of the active form of vitamin D and impaired renal conservation of phosphate are independently associated with osteoporosis in primary hyperparathyroidism, outperforming traditional biochemical markers. Incorporating these measures into routine clinical assessment may improve identification of patients at high skeletal risk and enhance decision-making in the management of bone disease in primary hyperparathyroidism.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13130875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147644458","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":"Clinical features of Italian adult individuals with X-linked hypophosphatemia: a multicenter retrospective study.","authors":"Silvia Carrara, Giampiero I Baroncelli, Gaetano Paride Arcidiacono, Marco Barale, Maria Luisa Brandi, Valentina Camozzi, Elena Castellano, Filomena Cetani, Pasquale Comberiati, Simone Della Valentina, Cristina Eller-Vainicher, Nadia Edvige Foligno, Sandro Giannini, Laura Gianotti, Giorgia Grassi, Martina Laganà, Silvia Lai, Gemma Marcucci, Laura Masi, Francesca Paglia, Andrea Palermo, Adolfo Marco Perrotta, Francesca Pigliaru, Massimo Procopio, Vincenzo Rochira, Silverio Rotondi, Rosaria Maddalena Ruggeri, Marco Onofrio Torres, Silvia Vai, Giuseppe Vezzoli, Marta Zampogna, Sabrina Corbetta","doi":"10.1530/EC-25-0756","DOIUrl":"10.1530/EC-25-0756","url":null,"abstract":"<p><strong>Objective: </strong>X-linked hypophosphatemia (XLH) is the most common congenital phosphate disorder affecting individuals throughout the lifespan. We investigated the skeletal burden, the cardiovascular involvement, the diagnostic performance and the therapeutic management in a cohort of Italian adults with XLH.</p><p><strong>Design: </strong>Cross-sectional study involving 15 Italian tertiary centers.</p><p><strong>Methods: </strong>Retrospective study.</p><p><strong>Results: </strong>In total, 170 adults (110 females and 60 males), aged 44.6 ± 14.6 (19-83) years, were identified. i) Skeletal deformities were detected in 87.1% of individuals, fractures/pseudofractures in 44.7%, osteophytosis in 65.4% and enthesopathies in 57.6%. Dental disease affected 72.4% of individuals. The skeletal burden was heavier in males than in females. ii) Hypertension occurred in 14.7% of individuals and was associated with elevated plasma intact FGF23 levels; dyslipidemia, diabetes and cerebrovascular events occurred in very few individuals. iii) FGF23 levels were measured in 30.0% of individuals; they were >30 pg/mL (nv 23-95) in nearly all individuals but overtly elevated in 58.8%. Genetic analysis has been performed in 86.5% of the cohort, and PHEX mutations were identified in 95.2% of the individuals without evidence of genotype/phenotype correlation. iv) 44.2% of individuals were on conventional therapy, 32.5% were on burosumab, and 23.3% were untreated. Individuals having received diagnosis in the adulthood (n = 14) were neither medically nor surgically treated during their childhood.</p><p><strong>Conclusion: </strong>The burden of XLH disease in adulthood is determined by skeletal manifestations and dental disease and may be more severe in males. Additionally, cardiometabolic impairment may not be common. The disease burden impacts most of the individuals, beyond those presenting the criteria for burosumab reimbursement.</p><p><strong>Significance statement: </strong>Data from a consistent cohort of adults with XLH highlighted that skeletal and dental disease-related complications significantly affect XLH individuals during adulthood and aging. Skeletal features associated with aging occur earlier in adults with XLH, being more evident when untreated or poorly treated with conventional therapy. The disease burden impacts most of individuals, beyond those presenting the criteria for burosumab reimbursement. The study contributes in increasing awareness toward adult XLH individuals and provides data for implementing the disease management and the health policy planning.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13130878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590874","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":"Metformin improves endotoxemia and alters folliculogenesis in women with polycystic ovary syndrome.","authors":"Mateusz Trzcinski, Izabela Chudzicka-Strugala, Katherine Kim, Piotr Piekarski, Robert Spaczynski, Barbara Zwoździak, Beata Banaszewska, Leszek Pawelczyk, R Jeffrey Chang, Antoni J Duleba","doi":"10.1530/EC-26-0120","DOIUrl":"https://doi.org/10.1530/EC-26-0120","url":null,"abstract":"<p><p>Polycystic ovary syndrome (PCOS) is associated with excessive ovarian androgen production, increased number of ovarian follicles and a wide range of other endocrine and metabolic derangements including endotoxemia. Metformin is often used in treatment of PCOS, especially to improve glucose metabolism. This study evaluated effects of metformin on endotoxemia, folliculogenesis and endocrine profiles. In a prospective trial, women with PCOS received metformin (500 mg t.i.d.) for three months and underwent baseline and post-treatment evaluations of their endocrine and metabolic profiles as well as detailed ultrasonographic evaluations of ovaries. Metformin treatment was associated with reduced lipopolysaccharides (LPS) by 19% (P<0.0001) and LPS binding protein (LPB) by 26% (P<0.0001). In parallel, the number of small antral follicles (<6mm) declined by 8% (P=0.005), total testosterone decreased by 13% (P=0.0003), ovarian testosterone production in response to hCG declined by 73% (P=0.03) and fasting insulin decreased by 19% (P=0.02). Reduction of testosterone following treatment with metformin may be due to a combination of multiple effects of metformin including improvement of endotoxemia, reduction of folliculogenesis and decreased insulin.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716022","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":"Characterization of the patient profile and efficacy of empirical radioiodine therapy in differentiated thyroid cancer with biochemical evidence without identified iodine-avid structural metastatic disease.","authors":"Fernanda Fabrini Gomes, Lígia Vera Montali da Assumpção, Elba Cristina de Sá Camargo Etchebehere, Denise Engelbrecht Zantut-Wittmann","doi":"10.1530/EC-25-0712","DOIUrl":"10.1530/EC-25-0712","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the profile of patients and tumor features of differentiated thyroid carcinoma (DTC) with biochemical evidence without structurally demonstrable metastatic disease in the postoperative follow-up, regarding the response to empirical radioiodine therapy (RIT).</p><p><strong>Methods: </strong>A retrospective study of 196 patients with DTC followed up at a tertiary service from 1990 to 2018 was performed. All of them presented negative diagnostic whole-body scan (WBS) and high TG levels. Based on criteria indicating greater severity, as higher TG levels, 72 of them received empirical RIT. All remained in follow-up with their outcomes assessed.</p><p><strong>Results: </strong>Carcinoma histopathological characteristics were similar between the groups of patients. In all the assessed moments, TG levels were higher in patients who received RIT than in patients who did not receive it. Regarding WBS after RIT, 57.74% of cases showed uptake, with one-third showing evidence of distant metastasis and 23.94% with cervical uptake in remnant/recurrence of thyroid or lymph node tissue. Patients who received RIT showed a partial reduction in suppressed serum TG, while patients who did not receive RIT exhibited stability of TG during follow-up.</p><p><strong>Conclusion: </strong>After radioiodine therapy administered with biochemical evidence of metastases but without identification of iodine-avid structural disease, metastatic foci avid for iodine were identified in 57% of cases, with a subsequent reduction in serum TG, indicating a potential therapeutic benefit. Despite similar tumor histopathological characteristics, the outcomes differed between patients who received RIT and those who did not, highlighting the importance of individualizing this indication.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590790","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}