Endocrine Connections最新文献

{"title":"Biomarkers of metastatic disease in pheochromocytoma and paraganglioma.","authors":"Sara Donato, Aura D Herrera-Martínez, Verónica Alejandra Jacome-Gaibor, Ignacio Ruz-Caracuel, Rodrigo Toledo, Marta Araujo-Castro","doi":"10.1530/EC-26-0501","DOIUrl":"10.1530/EC-26-0501","url":null,"abstract":"<p><p>Pheochromocytomas and paragangliomas (PPGLs) are rare neuroendocrine tumors with variable metastatic potential. While metastatic disease occurs in approximately 10-20% of cases, its prediction remains a major clinical challenge, as no histological system has been universally validated to reliably identify aggressive tumors at diagnosis. This review aims to provide a comprehensive and updated overview of current and emerging biomarkers of metastatic risk in PPGL, encompassing histopathological scoring systems, genetic and molecular markers, biochemical phenotyping, liquid biopsy approaches, and imaging-based biomarkers. Among established markers, germline SDHB mutation status, loss of SDHB expression by immunohistochemistry, elevated plasma 3-methoxytyramine, and histopathological scoring systems, such as GAPP and COPPS, represent the most clinically validated tools for risk stratification. Emerging biomarkers - including somatic alterations in ATRX and TERT, genomic instability indices, tumor immune microenvironment characterization, circulating tumor DNA, and oncometabolite quantification - show promise in refining prognostic assessment but require prospective validation before routine clinical implementation. Accurate risk stratification in PPGL demands a multiparametric and dynamic approach, integrating clinical, genetic, biochemical, and molecular parameters. Future progress will depend on large prospective international cohorts, standardized biomarker platforms, and biomarker-driven clinical trial designs to translate emerging molecular knowledge into improved patient outcomes.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13545749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677555","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":"Association of testosterone-to-estradiol ratio with inflammation and clinical outcomes among postmenopausal HFpEF.","authors":"Miaomiao Qi, Qiongying Wang, Runmin Sun, Mingze Li, Lulu Zhu, Wenting Wang, Xin Fan, Jing Yu","doi":"10.1530/EC-26-0231","DOIUrl":"10.1530/EC-26-0231","url":null,"abstract":"<p><strong>Graphical abstract: </strong></p><p><strong>Abstract: </strong></p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577408","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":"PCOS-like phenotype in rats after intrauterine EV exposure: puberty and adulthood.","authors":"Gabriela Rosas, Evelin M Hernández-García, Leonardo Gómez-Emeterio, Rosa Linares, Elizabeth Vieyra, Deyra A Ramírez, Julieta A Espinoza, Andrea Chaparro, Leticia Morales-Ledesma","doi":"10.1530/EC-26-0315","DOIUrl":"10.1530/EC-26-0315","url":null,"abstract":"<p><p>Polycystic ovary syndrome (PCOS) is the most common endocrinopathy affecting female fertility. It has been hypothesized that PCOS has its origins during intrauterine life, where prenatal exposure to endocrine-disrupting environments during critical developmental windows induces developmental disruptions, leading to long-term reproductive dysfunction. While prenatal androgen exposure is a well-established factor, the role of estrogenic imbalance remains critical, yet less analyzed. Estradiol valerate (EV) is widely used to induce PCOS-like phenotypes; however, its potential role in disrupting early development and altering postnatal reproductive function remains unknown. This study evaluated whether prenatal exposure to EV results in PCOS-like reproductive alterations that manifest at puberty or adulthood in rats. For this purpose, gravid rats were subcutaneously injected with EV or sesame oil (Vh) on gestational day 18. Offspring were euthanized at puberty or adult stage, in estrus. Compared with the Vh group, EV-exposed offspring exhibited early-onset reproductive disruptions during puberty, including precocious vaginal opening, estrous acyclicity, low testosterone levels, and a decreased ovulatory response accompanied by precyst formation. In adult life, these alterations had progressed into a PCOS-like phenotype, characterized by body weight gain, increased testosterone levels, acyclicity, anovulation, and the presence of follicular cysts. These findings indicate that prenatal exposure to EV is sufficient to induce a progressive reproductive phenotype that resembles PCOS in adulthood.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13506521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683755","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":"Circulating Apelin-13, β-catenin and bone mineral density in postmenopausal women.","authors":"Qi Yao, Shuang Ma, Xiaoxue Bao, Yukun Li","doi":"10.1530/EC-25-0886","DOIUrl":"10.1530/EC-25-0886","url":null,"abstract":"<p><strong>Abstract: </strong>The aim of this study was to investigate associations of circulating Apelin-13, β-catenin, Exendin-4, and Nesfatin-1 with site-specific bone mineral density (BMD) in postmenopausal women, representing adipose-endocrine, Wnt/β-catenin, incretin-related, and energy homeostasis pathways. A total of 315 postmenopausal women were classified into normal bone mass, osteopenia, or osteoporosis group according to World Health Organization criteria using dual-energy X-ray absorptiometry. Serum biomarkers were measured by enzyme-linked immunosorbent assay. Lumbar spine BMD and hip BMD were analyzed separately using group comparisons, Spearman correlation, fully adjusted multivariable linear regression, and exploratory receiver operating characteristic (ROC) analyses. Lumbar spine BMD was 0.936 ± 0.084, 0.935 ± 0.121, and 0.741 ± 0.105 g/cm2 in the normal bone mass, osteopenia, and osteoporosis groups, respectively; hip BMD was 0.942 ± 0.045, 0.878 ± 0.073, and 0.702 ± 0.084 g/cm2. Apelin-13 decreased across groups from 702.09 ± 56.42 to 624.98 ± 43.99 and 334.37 ± 91.49 pg/mL, and β-catenin from 100.23 ± 11.34 to 76.21 ± 14.65 and 54.33 ± 8.25 ng/mL. In fully adjusted models, Apelin-13 was independently associated with lumbar spine BMD (β = 0.547, P < 0.001) and hip BMD (β = 0.524, P < 0.001), while β-catenin was associated with hip BMD (β = 0.272, P < 0.001). Exploratory ROC analyses suggested apparent discriminatory performance for Apelin-13, β-catenin, Nesfatin-1, Exendin-4, and the combined model, with AUCs of 1.000, 0.944, 0.680, 0.613, and 1.000, respectively; these findings should be interpreted cautiously and require external validation. Apelin-13 and β-catenin may serve as circulating biomarkers related to site-specific bone mass status, requiring external validation.</p><p><strong>Endocrine connections: </strong>Bone loss is common in women after menopause, yet blood-based markers that reflect bone health remain limited. In this study, we measured four circulating biomarkers related to metabolic and bone regulatory pathways and compared them with BMD. Women with higher BMD generally had higher levels of Apelin-13 and β-catenin, and these two biomarkers showed the strongest associations with bone mass. These findings suggest that circulating biomarkers may provide additional information about bone mass status, but further validation in independent populations is needed before clinical use.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13545753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148445052","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":"Fibroblast growth factor 21 and its relationship with central precocious puberty in girls.","authors":"Xiaojing Hao, Jiangya Wang, Ran Zhou, Meng Sun, Yaying Cheng","doi":"10.1530/EC-26-0320","DOIUrl":"10.1530/EC-26-0320","url":null,"abstract":"<p><strong>Background: </strong>Studies have shown that obesity and insulin resistance are associated with central precocious puberty (CPP) in girls. Serum fibroblast growth factor 21 (FGF21) levels are associated with obesity and insulin resistance and are also related to ovarian development, reproductive function, and gonadotropin-releasing hormone (GnRH) neuron development. The aim of this study was to investigate the levels of serum FGF21 in girls with CPP.</p><p><strong>Methods: </strong>This study enrolled 106 girls aged 6-10 years who were evaluated at the hospital's Growth and Development Clinic. The cohort comprised 55 girls diagnosed with CPP as the case group and 51 age-matched girls with normal growth and development as the control group. Data including age, age at onset of puberty or menarche, anthropometric measurements, IGF1 levels, bone age (BA), ovarian and uterine development, hormone profiles, β-Klotho levels, and FGF21 levels were collected and statistically analyzed.</p><p><strong>Results: </strong>Bone age advancement, IGF1, β-Klotho, and FGF21 levels showed statistically significant differences between the CPP and control groups. FGF21 and β-Klotho levels were negatively associated with CPP, with areas under the ROC curve of 0.833 and 0.770, respectively. The optimal cut-off values were 156.28 pg/mL and 7,057.18 pg/mL for β-Klotho. In girls with CPP, the FGF21 levels were weakly positively correlated with the β-Klotho levels (r = 0.273).</p><p><strong>Conclusion: </strong>Compared with age-matched girls without pubertal initiation, girls diagnosed with CPP had significantly lower serum levels of FGF21 and β-Klotho, suggesting that FGF21 may be involved in the regulation of pubertal onset. However, the underlying molecular mechanisms require further investigation.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13545746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758025","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":"A multi-model study of the association between BMI and AMH in Chinese women.","authors":"Zhen Wang, Yanfei Liu, Yonghai Shen, Lin Ma, Xinyan Shi","doi":"10.1530/EC-26-0223","DOIUrl":"10.1530/EC-26-0223","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether body mass index (BMI) is associated with anti-Müllerian hormone (AMH) in Chinese women and whether PCOS, age, or testosterone modifies this association.</p><p><strong>Methods: </strong>We analyzed 670 women (20-39 years) from Hangzhou Women's Hospital. Primary analyses included linear regression and generalized additive models (GAMs) with thin-plate splines, and multi-group structural equation modeling to test PCOS effect modification. Secondary analyses included interaction tests and Chinese BMI category comparisons. All models were adjusted for age, follicle-stimulating hormone, luteinizing hormone, and testosterone.</p><p><strong>Results: </strong>BMI showed no significant linear association with log-AMH (β = 0.008; adjusted R2 = 0.398). GAMs confirmed a near-linear relationship without threshold effects. However, underweight women (BMI < 18.5 kg/m2) had significantly lower log-AMH than normal-weight women (β = -0.14, P = 0.036), with no significant differences for overweight or obese categories. PCOS did not modify the BMI-AMH association.</p><p><strong>Conclusion: </strong>BMI is not a clinically meaningful predictor of ovarian reserve as a continuous variable. Lower AMH in underweight women highlights a subgroup warranting attention in reproductive assessments, while PCOS status does not influence this relationship.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13452033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535606","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":"Arrhythmia and cardiomyopathy risk in Taiwan with complementary biobank evidence on thyroid genetic susceptibility: an integrative population-based framework.","authors":"Yi-Chang Lin, Yao-Ching Huang, Ya-Ting Yang, Su-Wen Chuang, Tsu-Hsuan Weng, Chun-Teng Tsai, Chi-Hsiang Chung, Chang-Huei Tsao, Wu-Chien Chien, Chien-Sung Tsai","doi":"10.1530/EC-26-0366","DOIUrl":"10.1530/EC-26-0366","url":null,"abstract":"<p><strong>Background: </strong>Arrhythmia-induced cardiomyopathy (AiCM) is a potentially reversible cause of ventricular dysfunction; however, only a subset of patients with arrhythmia develop cardiomyopathy. Emerging evidence suggests that endocrine factors, particularly thyroid dysfunction with genetic susceptibility, may contribute to inter-individual variability in arrhythmia-related myocardial outcomes.</p><p><strong>Methods: </strong>We performed a dual-cohort population-based study using the National Health Insurance Research Database (NHIRD, 2000-2015) and the Taiwan Biobank (TWB). In NHIRD, we examined the association between newly diagnosed arrhythmia and incident cardiomyopathy using Cox proportional hazards models. In TWB, genome-wide data, thyroid-stimulating hormone (TSH), polygenic risk scores (PRSs), lifestyle factors, and metabolic comorbidities were analyzed using multivariable regression and interaction models to assess determinants of thyroid dysfunction.</p><p><strong>Results: </strong>In the NHIRD cohort, arrhythmia was associated with a significantly increased risk of incident cardiomyopathy (adjusted hazard ratio (aHR): 2.49, 95% CI: 1.94-2.96), with atrial fibrillation showing the strongest association among arrhythmia subtypes. In the TWB cohort, a higher thyroid polygenic risk score was strongly associated with thyroid dysfunction (adjusted odds ratio (aOR): 6.64, 95% CI: 5.86-7.52). The association between genetic susceptibility and thyroid dysfunction was further modified by metabolic and lifestyle factors, including diabetes, hyperlipidemia, and dietary patterns. Genome-wide analysis identified multiple loci associated with thyroid-stimulating hormone regulation, consistent with a polygenic architecture of thyroid endocrine traits.</p><p><strong>Conclusion: </strong>Arrhythmia was associated with an increased risk of cardiomyopathy in a nationwide cohort, while thyroid genetic susceptibility was strongly associated with thyroid dysfunction in a biobank cohort and modified by metabolic and lifestyle factors. These findings provide complementary population-level evidence of parallel cardiovascular and endocrine-genetic associations. Because the two cohorts were not individually linked, causal inference cannot be established. The results support a systems-level framework of endocrine-cardiac interaction and suggest that integrated clinical and genetic risk assessment may help identify individuals who warrant closer monitoring.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469695","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":"A quantum approach to the endocrinology of obesity.","authors":"Sanjay Kalra, Nitin Kapoor","doi":"10.1530/EC-26-0450","DOIUrl":"10.1530/EC-26-0450","url":null,"abstract":"","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148445081","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":"Thyroid function, nutritional status, inflammation, and sarcopenia in hemodialysis patients: an integrated cross-sectional analysis.","authors":"Karina Schiavoni Scandelai, Hércules Rezende Freitas, Maria das Graças Coelho de Souza, Rachel Bregman, Ana Beatriz Winter Tavares","doi":"10.1530/EC-26-0217","DOIUrl":"10.1530/EC-26-0217","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to investigate the interrelationships among thyroid function, nutritional status, inflammation, and sarcopenia in patients undergoing hemodialysis (HD) and to identify variables associated with sarcopenia using a penalized regression approach.</p><p><strong>Design: </strong>This is a cross-sectional study.</p><p><strong>Methods: </strong>A total of 101 HD patients and 33 euthyroid controls were evaluated. Thyroid hormones, inflammatory biomarkers, leptin, and albumin were measured. Nutritional status was assessed using the Geriatric Nutritional Risk Index (GNRI), and body composition by bioelectrical impedance analysis. Sarcopenia was defined by reduced handgrip strength and confirmed by skeletal muscle mass or skeletal muscle index. Penalized regression (LASSO) with internal validation was applied to identify variables associated with sarcopenia.</p><p><strong>Results: </strong>Compared with controls, HD patients were older and had higher TSH, C-reactive protein, IL-6, TNF-α, and leptin levels and lower FT3, FT4, albumin, and GNRI values (all P < 0.05), with no difference in BMI. Probable and confirmed sarcopenia were more prevalent in HD patients (48.5 and 26.7%) than in controls (18.1 and 6.0%, P = 0.004). In the penalized regression model, FT3, TSH, GNRI, and dialysis status were selected as variables associated with sarcopenia (bootstrap-corrected AUC = 0.72; recalibrated AUC = 0.79).</p><p><strong>Conclusion: </strong>HD patients exhibited concurrent thyroid, inflammatory, and nutritional alterations associated with sarcopenia. FT3, TSH, GNRI, and dialysis status formed an integrated biological signature associated with sarcopenia. These findings support an integrative modelling approach and require validation in larger independent cohorts.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148270708","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":"Increased mortality in chronic hypoparathyroidism: a nationwide cohort study in Sweden.","authors":"Wafa Kamal, Ylva Trolle Lagerros, Michael Mannstadt, Tim Spelman, Olle Kämpe, Sigridur Björnsdottir","doi":"10.1530/EC-25-0450","DOIUrl":"10.1530/EC-25-0450","url":null,"abstract":"<p><strong>Context: </strong>Previous studies on mortality outcomes in patients with chronic hypoparathyroidism have reported inconsistent results.</p><p><strong>Objective: </strong>To assess all-cause and cause-specific mortality and estimate the prevalence of chronic hypoparathyroidism in Sweden.</p><p><strong>Methods: </strong>Chronic hypoparathyroidism was defined as the combination of ICD-10 diagnoses and long-term dispensations of active vitamin D. Nationwide diagnostic codes, drug dispensation, and mortality data were obtained from the National Patient Register, Prescribed Drugs Register, Cause of Death Register, and the Total Population Register. Mortality was compared between groups using Cox proportional hazards models, adjusting for age and baseline comorbidities.</p><p><strong>Results: </strong>We identified 1,982 individuals with chronic hypoparathyroidism between 1997 and 2018, yielding a minimum prevalence of 19.4 per 100,000 inhabitants. We randomly selected 19,820 controls matched by age, sex, and county of residence.After excluding individuals with baseline thyroid cancer and their controls, 1,825 patients and 17,922 controls remained. Patients had higher all-cause mortality than controls (HR: 1.55; 95% CI: 1.40-1.72). Mortality was higher in patients with nonsurgical (HR: 2.16, 95% CI: 1.76-2.65) than postsurgical hypoparathyroidism (HR: 1.39, 95% CI: 1.23-1.58). The strongest associations were observed for endocrine, nutritional, and metabolic disorders (HR: 6.46, 95% CI: 2.43-17.21), followed by infectious diseases (HR: 3.53, 95% CI: 2.07-6.04), genitourinary diseases (HR: 2.40, 95% CI: 1.33-4.33), respiratory diseases (HR: 1.67, 95% CI: 1.23-2.28), and circulatory diseases (HR: 1.47, 95% CI: 1.23-1.77).</p><p><strong>Conclusion: </strong>Patients with chronic hypoparathyroidism have an elevated risk of all-cause mortality, particularly those with nonsurgical disease. These findings highlight the clinical burden of the disease.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13383239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148263911","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}