Endocrine Connections最新文献

{"title":"Transcriptomic analysis of palmitoylation-related genes reveals a preferential association with BCAA catabolism in adipose tissue from pediatric obesity.","authors":"ShiRui Cao, Jing Chen, Chao Liu, PeiHong Zhao, Le Zhang, YuTong Hou, MinKai Cao, Jia Xia","doi":"10.1530/EC-26-0395","DOIUrl":"10.1530/EC-26-0395","url":null,"abstract":"<p><strong>Background: </strong>Pediatric obesity is a major public health challenge with adverse effects on health and long-term metabolic outcomes. Although diet and genetic susceptibility contribute to obesity across the life course, pediatric obesity may be particularly influenced by early-life developmental and maternal factors. Protein palmitoylation is linked to lipid metabolism, but whether palmitoylation-related programs differ between pediatric and adult obesity remains unclear.</p><p><strong>Methods: </strong>We analyzed transcriptomic datasets from pediatric and adult obesity using differential expression analysis and weighted gene co-expression network analysis (WGCNA). Candidate genes were further evaluated in a juvenile high-fat diet-induced obesity mouse model and online obesity databases.</p><p><strong>Results: </strong>In both age groups, palmitoylation-related candidate common hub genes were significantly enriched in lipid metabolic pathways. However, pediatric-specific palmitoylation-related candidate common hub genes were prominently enriched in branched-chain amino acid (BCAA) metabolic and catabolic processes. Least absolute shrinkage and selection operator regression prioritized seven candidate genes. In the juvenile obesity model, four genes (Cldn2, Mccc2, Pcca, and Vdac2) were consistently downregulated in adipose tissue from obese offspring, correlating significantly with fat mass. Downregulation was less pronounced in obese adult mice, whereas total protein palmitoylation was markedly elevated in both age groups, with a greater increase in juveniles. Of the four genes, Mccc2 and Pcca were directly involved in BCAA catabolism, suggesting an association between BCAA metabolism and pediatric obesity.</p><p><strong>Conclusion: </strong>These findings provide a basis for future mechanistic studies of age-related differences in adipose tissue metabolism in obesity.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":"15 9","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918773","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":"Systematic review of benign thyroid enlargement as a rare cause of arterial compression: clinical presentations and outcomes.","authors":"Ammar Matthew Hudefi, Noah Bogart, Kenny Nguyen, Lindsay Blake, Alexa Robbins, Anvesh Kompelli","doi":"10.1530/EC-26-0521","DOIUrl":"10.1530/EC-26-0521","url":null,"abstract":"<p><p>The objective of this study is to systematically characterize the presentation, management, and outcomes of arterial complications secondary to benign thyroid enlargement, thereby improving clinical recognition and management of this rare entity. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines across PubMed, Web of Science, Embase, and Scopus for studies published from January 1990 to February 2026. This review was registered with PROSPERO CRD420251156228. Studies describing arterial compression, displacement, stenosis, or occlusion attributable to benign thyroid pathology were included. Ten studies met the inclusion criteria, comprising 10 patients with a median age of 66 years, of whom 80% were female. Six patients presented with acute neurologic symptoms, including limb-shaking episodes and lateralized weakness, while the remainder exhibited subacute or chronic compressive complaints. Computed tomography with or without angiography was the primary diagnostic modality. The common carotid artery was involved in nine patients, including bilateral compression in two patients. Multinodular goiter was the most common pathology, with goiter sizes reaching up to 15 cm. Surgical management via thyroidectomy was performed in five patients, while the others were managed conservatively. Follow-up was documented in only five of the ten patients; in each of these, symptoms resolved without reported recurrence, while the remaining five reports contained no post-treatment follow-up data. In conclusion, benign thyroid enlargement is a rare but clinically significant cause of cervical arterial compression that can precipitate neurologic symptoms mimicking cerebrovascular disease. Cross-sectional imaging is essential for diagnosis, and both surgical decompression and conservative strategies were followed by symptom resolution in the cases with documented follow-up. Because the evidence base comprises ten single-patient reports with incomplete follow-up, no objective outcome measures, and no comparative data, certainty of evidence is very low, and these findings should be regarded as hypothesis-generating rather than as guidance for management.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891407","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":"Post-bariatric hypoglycaemia: an under-recognized complication of weight loss surgery - a case series.","authors":"Sreevatsa Tatachar, Khushboo Agarwal, Sandhiya Paravathareddy, Stephen Jiwanmall, Dheeraj Kattula, Nitin Kapoor","doi":"10.1530/EC-26-0480","DOIUrl":"10.1530/EC-26-0480","url":null,"abstract":"<p><p>Post-bariatric hypoglycaemia (PBH) has emerged as a significant, under-recognized complication following Roux-en-Y gastric bypass (RYGB) and other weight loss surgeries. The purpose of this study was to characterize the timing, clinical presentation, diagnosis and management outcomes of PBH in a diverse case series from a multi-speciality centre in Southern India owing to a predominantly high-carbohydrate diet and distinct bariatric phenotype. This was a retrospective observational case series analysis from a multidisciplinary bariatric clinic at a tertiary teaching hospital in Southern India from May 2017 to April 2024. Time to onset of PBH, nadir plasma glucose levels, management approach (diet, medication and surgery), complication rates and patient follow-up duration were evaluated. Nine adults (mean age: 41.5 years; both sexes) were diagnosed and managed for PBH following RYGB. PBH onset ranged from 1 month to 5 years following RYGB (mean: 17 months). Nadir glucose levels ranged from 16 to 67 mg/dL. Hyperinsulinaemia and nesidioblastosis were diagnosed in select cases. Patients received individualized medical nutrition therapy, medication (voglibose, octreotide and diazoxide) and, in severe/refractory cases, surgical procedures such as reversal of RYGB or subtotal pancreatectomy, as was required in two patients. Frequent and severe PBH episodes were more common in patients with higher initial BMI and persistent carbohydrate-heavy diet intake. PBH after bariatric surgery presents with variable onset, severity and duration, emphasizing the need for long-term multidisciplinary follow-up and individualized management, especially for high-risk populations. Early recognition and tailored intervention can improve clinical outcomes and patients' quality of life.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900325","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":"Context-dependent effects of triiodothyronine on progesterone secretion and cAMP responses in rat ovarian tissues.","authors":"Chien-Chen Lu, Jou-Chun Chou, Hsi-Chang Shih, Shyi-Wu Wang, Paulus S Wang","doi":"10.1530/EC-26-0464","DOIUrl":"10.1530/EC-26-0464","url":null,"abstract":"<p><p>Thyroid hormones are essential regulators of metabolism and reproduction; however, their direct influence on ovarian steroidogenesis remains incompletely understood. This study examined the context-dependent effects of triiodothyronine (T3) on progesterone secretion and cyclic adenosine monophosphate (cAMP) signaling in rat ovarian tissues. Using in vitro static culture and in vivo thyroid status models, we assessed the impact of T3, thyroxine (T4), porcine follicle-stimulating hormone (pFSH), and human chorionic gonadotropin (hCG) across estrous phases. Progesterone and cAMP levels were quantified by radioimmunoassay (RIA). T3 significantly enhanced basal cAMP synthesis and progesterone secretion in non-luteal ovarian cells, particularly when administered prior to hCG stimulation. This priming effect was consistent across proestrus, estrus, and diestrus phases. Conversely, both T3 and T4 dose-dependently suppressed basal and hCG-induced progesterone secretion in luteal tissues and isolated luteal cells. In vivo experiments confirmed that hyperthyroid conditions elevated ovarian cAMP content, whereas hypothyroidism induced by propylthiouracil (PTU) sensitized gonadotropin responsiveness. Collectively, these findings demonstrate that T3 exerts dual and context-dependent effects on ovarian progesterone production, which are closely associated with modulation of cAMP signaling pathways. These results suggest that thyroid hormone status may influence ovarian function through cAMP-mediated mechanisms and highlight a potential link between thyroid dysfunction and altered reproductive endocrine regulation. Further studies are warranted to elucidate the underlying molecular pathways.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918848","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":"Post-cycle therapy after androgen abuse: a narrative review of mechanisms, evidence, and clinical perspectives.","authors":"Diederik L Smit, Tijs Verdegaal, Peter Bond, Willem de Ronde","doi":"10.1530/EC-26-0319","DOIUrl":"10.1530/EC-26-0319","url":null,"abstract":"<p><p>Post-cycle therapy (PCT) refers to the use of pharmacological agents - most commonly selective estrogen receptor modulators (SERMs), human chorionic gonadotropin (hCG), and aromatase inhibitors (AIs) - after cessation of androgen abuse to accelerate recovery of the hypothalamic-pituitary-gonadal (HPG) axis. Exogenous androgens suppress endogenous testosterone production through negative feedback, often resulting in a transient hypogonadal state that may persist for weeks to months, and occasionally longer, depending on cycle characteristics and individual factors. The rationale of PCT is to mitigate this suppression and reduce symptoms of androgen deficiency. However, evidence supporting its use is limited, with most data derived from observational studies or extrapolated from other forms of secondary hypogonadism. While some studies suggest that PCT may accelerate short-term hormonal and seminal recovery, spontaneous recovery occurs in the majority of individuals within months after cessation. Three perspectives can be distinguished. In real-world practice, PCT is widely used, often without medical supervision, driven by cultural norms and concerns about symptom persistence. From an academic standpoint, PCT is generally not recommended because of uncertain benefits and potential risks. A third perspective describes a pragmatic rationale for considering a short course of PCT in carefully selected individuals with significant symptom burden or risk of relapse into androgen abuse, while acknowledging that this approach is not supported by robust clinical evidence. This review aims to clarify the rationale, evidence gaps, and clinical implications of these perspectives to support informed clinical decision-making.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817857","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":"Management of non-medical androgen use: a position statement by the Society for Endocrinology.","authors":"Bonnie Grant, Channa N Jayasena, Satyajit Nag, Richard Quinton","doi":"10.1530/EC-26-0361","DOIUrl":"10.1530/EC-26-0361","url":null,"abstract":"<p><p>Non-medical androgen use, commonly involving anabolic-androgenic steroids, represents an increasing public health concern. Non-medical androgen use is associated with significant morbidity and mortality, including cardiovascular disease, erythrocytosis, dyslipidaemia, infertility, sexual dysfunction, psychiatric manifestations and suppression of the hypothalamic-pituitary-gonadal axis. Men with current or previous non-medical androgen use are increasingly presenting to endocrine and reproductive medicine services, often with hypogonadal symptoms, infertility or concerns regarding recovery following cessation. However, both patients and clinicians frequently report mistrust, uncertainty and limited confidence in management approaches. This Society for Endocrinology position statement summarises the currently available evidence relating to non-medical androgen use, associated health consequences, biochemical recovery following cessation and potential management strategies. Current evidence suggests that most men will experience biochemical recovery of the HPG axis within approximately 12 months of androgen cessation, although recovery timelines vary substantially and some individuals may develop persistent hypogonadism. Symptoms such as low mood, fatigue, anxiety and sexual dysfunction may persist despite biochemical recovery and are likely influenced by psychological factors in addition to serum testosterone concentrations. Existing evidence supporting pharmacological interventions, including human chorionic gonadotrophin, selective oestrogen receptor modulators, aromatase inhibitors or testosterone therapy, remains limited and of low quality, with no robust evidence demonstrating improved long-term recovery or symptom outcomes. Clinicians should approach individuals who misuse androgens with compassion, professionalism and a non-judgemental attitude while remaining alert to undisclosed androgen use. Further longitudinal and interventional studies are required to better characterise recovery trajectories, identify predictors of persistent morbidity and inform evidence-based management strategies.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891411","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":"CYP19A1 variation in healthy children: associations with breast development and pubertal gynecomastia.","authors":"Veronica L R Groendahl, Stine A Holmboe, Alexander S Busch, Casper P Hagen, Jørgen H Petersen, Trine H Johannsen, Kristian Almstrup, Hanne Frederiksen, Anders Juul, Lise Aksglaede","doi":"10.1530/EC-26-0182","DOIUrl":"10.1530/EC-26-0182","url":null,"abstract":"<p><strong>Background: </strong>CYP19A1 encodes aromatase, the enzyme converting androgens to estrogens, thereby influencing breast tissue development in healthy children.</p><p><strong>Objective: </strong>To examine associations between CYP19A1 single nucleotide polymorphisms (SNPs) and circulating estradiol (E2) and testosterone (T), the E2/T ratio and age at thelarche in girls, and the presence of gynecomastia in boys.</p><p><strong>Methods: </strong>A total of 1,023 healthy participants (aged 5.9-20.0 years) from the Copenhagen Puberty Study were assessed for pubertal status, and serum sex steroid concentrations were measured by LC-MS/MS. Genotyping of CYP19A1 SNPs (rs727479 A>C, rs2899472 A>C and rs10046 C>T) was performed.</p><p><strong>Results: </strong>Girls with the AA genotype in rs727479 and rs2899472 showed tendencies toward earlier pubertal onset. In a combined efficacy allele model, each additional allele was associated with 1.6 months earlier puberty (P = 0.06), and girls with 5-6 vs 0-2 efficacy alleles presented with significantly lower pubertal age (P = 0.02). The CYP19A1 genotype was not associated with E2, T or E2/T levels. Boys with the CC genotype in rs727479 had the highest prevalence of pubertal gynecomastia (73%, P < 0.01). Boys with gynecomastia showed higher E2 and T (SDS) than unaffected boys (both P < 0.01), with no difference in E2/T. In age-matched analyses, E2 (SDS) remained elevated in boys with gynecomastia (0.81 vs 0.19, P = 0.04).</p><p><strong>Conclusion: </strong>CYP19A1 variants may influence pubertal timing in girls. In boys, pubertal gynecomastia appeared to be linked with the CYP19A1 genotype and was associated with elevated E2 concentrations.</p><p><strong>Significance statement: </strong>Aromatase, encoded by CYP19A1, catalyzes the conversion of androgens to estrogens. The contribution of common CYP19A1 genetic variants to variation in pubertal development in healthy children is not fully understood. In this cohort from the Copenhagen Puberty Study, we examined associations between CYP19A1 polymorphisms and circulating sex steroid concentrations, age at puberty and pubertal gynecomastia in boys. By integrating genetic, hormonal and clinical pubertal data, this study provides additional insights into potential links between aromatase-related genetic variation and normal pubertal development.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13545751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757828","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":"Differential somatostatin sensitivity of corticotropic and somatotropic responses following amino acid infusion.","authors":"Elvar Már Sturlaugsson Jóhönnuson, Josephine Reiche, Michael M Richter, Nicolai J Wewer Albrechtsen","doi":"10.1530/EC-26-0537","DOIUrl":"10.1530/EC-26-0537","url":null,"abstract":"<p><strong>Objective: </strong>Amino acids stimulate pituitary hormone secretion, but whether somatostatin-sensitive pathways differentially regulate activation of the corticotropic and somatotropic axes during amino acid infusion remains unclear. We investigated whether somatostatin signalling constrains growth hormone secretion following amino acid infusion differently from ACTH and cortisol responses in humans.</p><p><strong>Methods: </strong>We conducted a randomized, within-subject crossover study in 15 healthy adults with three morning visits: amino acid infusion plus saline, somatostatin analogue infusion plus saline, and combined amino acid plus somatostatin analogue infusion. Vamin, an amino acid mixture, was infused at 331 mg·kg-1·h-1 from 0 to 45 min, and octreotide, a somatostatin analogue, was infused at 200 ng·kg-1·min-1 from -75 to 165 min; blood was sampled from -75 to 300 min. Post hoc exploratory outcomes included baseline-subtracted area-under-the-curve measures for cortisol, ACTH, and growth hormone, analysed using repeated-measures mixed-effects models.</p><p><strong>Results: </strong>Following amino acid infusion, ACTH and cortisol showed rapid responses, peaking around 45 min, whereas growth hormone increased gradually and peaked around 120 min. Compared with somatostatin analogue alone, amino acid infusion increased peak concentrations and baseline-subtracted exposures for cortisol, ACTH, and growth hormone. Co-infusion with somatostatin analogue substantially reduced ACTH and cortisol responses but almost completely abolished growth hormone secretion.</p><p><strong>Conclusion: </strong>Corticotropic and somatotropic responses were observed following intravenous amino acid infusion in humans, with markedly different somatostatin sensitivity. Growth hormone secretion was almost completely suppressed by somatostatin analogue administration, whereas ACTH and cortisol responses remained partly preserved, suggesting that HPA axis activation can partly escape somatostatin inhibition.</p><p><strong>Significance statement: </strong>Amino acids are commonly viewed as nutritional substrates, but they can also act as endocrine stimuli. In this study, intravenous amino acid infusion was followed by activation of both the corticotropic and somatotropic axes in healthy adults, producing rapid ACTH-cortisol responses and a delayed growth hormone response. The findings show that these responses differ markedly in their sensitivity to somatostatin signalling: growth hormone secretion was almost completely suppressed by somatostatin analogue administration, whereas ACTH and cortisol responses remained partly preserved. These findings provide physiological insights into how corticotropic and somatotropic responses following amino acid infusion differ in their sensitivity to octreotide.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891379","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":"Impact of GAD-65 antibody detection on antihyperglycemic therapy in T2D.","authors":"Sharon Halliburton, Eric Herber, Kevin M Pantalone, Marcie Parker, Amanda Soric","doi":"10.1530/EC-25-0785","DOIUrl":"10.1530/EC-25-0785","url":null,"abstract":"<p><p>Guidelines recommend that latent autoimmune diabetes in adults be managed similarly to type 1 diabetes, emphasizing early insulin initiation, while other guidance suggests incorporating non-insulin antihyperglycemic therapies based on comorbidities and C-peptide levels. The objective of this study was to explore whether glutamic acid decarboxylase-65 autoantibody detection in individuals diagnosed with type 2 diabetes impacts antihyperglycemic treatment. This retrospective, observational cohort study at an academic integrated delivery network in Northeast Ohio utilized electronic medical records. Individuals previously diagnosed with type 2 diabetes who tested positive for glutamic acid decarboxylase-65 autoantibodies between September 1, 2021, and September 1, 2023, were included. The primary outcome compared the median number of non-insulin antihyperglycemic medication classes at the time of autoantibody detection and after 12 months. Participants had a mean age of 57.2 ± 13.7 years, 73.3% were white, with a median body mass index of 26.2 kg/m2, and 82.1% had an estimated glomerular filtration rate greater than 60 mL/min/1.73 m2. A median of 1 (0-2) non-insulin antihyperglycemic medication class was present at detection and 1 (0-1.5) post-detection (P < 0.0001). Significantly fewer individuals were prescribed metformin, dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists, sodium-glucose cotransporter 2 inhibitors, sulfonylureas, and thiazolidinediones, whereas significantly more individuals were prescribed bolus insulin after detection. Although most individuals had a baseline C-peptide value within 12 months prior to detection, significantly fewer C-peptide assessments occurred during the subsequent 12-month follow-up period. In individuals with type 2 diabetes, glutamic acid decarboxylase-65 autoantibody detection was associated with significantly fewer prescribed non-insulin antihyperglycemics and significantly more insulin agents 12 months after detection.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13545754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759128","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":"Vitamin D levels and skeletal quality of life in adult Langerhans cell histiocytosis.","authors":"Christos Gravvanis, Marina Kouveletsou, Maria Yavropoulou, Eleftherios Chatzellis, Athanasios Papatheodorou, Dimitrios Christoulas, Ioannis Athanasopoulos, Athanasios D Anastasilakis, Polyzois Makras","doi":"10.1530/EC-26-0382","DOIUrl":"10.1530/EC-26-0382","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to prospectively evaluate the association between vitamin D optimization and quality of life (QoL) and bone metabolism in adult patients with Langerhans cell histiocytosis (LCH).</p><p><strong>Design and methods: </strong>In this prospective, uncontrolled, observational study, 45 adult LCH patients received individualized cholecalciferol supplementation for 3 months to achieve serum 25-hydroxyvitamin D (25(OH)D) levels ≥30 ng/mL. Skeletal-related and general QoL were assessed using the QUALEFFO-41 and SF-36 questionnaires, respectively. Biochemical markers of calcium metabolism and bone turnover were measured at baseline and follow-up. Correlation and exploratory linear regression analyses evaluated associations between changes in parameters.</p><p><strong>Results: </strong>Levels of 25(OH)D increased significantly (22.8 ± 10.3 to 34.3 ± 8.2 ng/mL, P < 0.0005), followed by a reduction in parathyroid hormone (PTH) (55.7 ± 21.1 to 49.0 ± 15.8 pg/mL, P = 0.024). Improvements were observed in QUALEFFO-41 subdomains (household activities and mental condition) and SF-36 domains (bodily pain and emotional role limitations). C-terminal telopeptide (CTX) levels decreased (P = 0.006), consistent with reduced bone resorption. Changes in 25(OH)D were inversely correlated with changes in PTH (r = -0.35, P = 0.024), and changes in PTH were correlated with changes in CTX (r = -0.41, P = 0.007). No correlation was found between changes in 25(OH)D and CTX.</p><p><strong>Conclusion: </strong>In this uncontrolled cohort, vitamin D optimization was associated with improvements in selected QoL domains and favourable changes in calcium metabolism and bone resorption markers, supporting routine assessment and correction of vitamin D deficiency in this population.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891363","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}