Endocrine Connections最新文献

{"title":"EXPRESSION OF CONCERN: Intracellular FGF1 promotes invasion and migration in thyroid carcinoma via HMGA1 independent of FGF receptors.","authors":"Zuyao Chen, Xiaolin Zhong, Weiqiang Tang, Min Xia, Chang Liu, Yinping Guo, Yan Yi, Qingshan Jiang, Xuyu Zu, Jing Zhong","doi":"10.1530/EC-23-0014e2","DOIUrl":"10.1530/EC-23-0014e2","url":null,"abstract":"","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":"15 6","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13326652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204350","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":"Accumulated safety data of recombinant human growth hormone therapy in Korean children over a 10-year period: interim results from the LG Growth Study.","authors":"Yoo-Mi Kim, Young-Jun Rhie, Hyun-Wook Chae, Jaehyun Kim, Young Ah Lee, Hae Sang Lee, Yong Hee Hong, Ja Hye Kim, Moon Bae Ahn, Yejin Jeon, Choong Ho Shin","doi":"10.1530/EC-26-0073","DOIUrl":"10.1530/EC-26-0073","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to evaluate the long-term safety outcomes of recombinant human growth hormone (rhGH) administered to Korean pediatric patients with growth disorders, including growth hormone deficiency, Turner syndrome, idiopathic short stature, small for gestational age, chronic kidney disease, and Prader-Willi syndrome, using the 10-year interim data from the nationwide LG Growth Study registry in the Republic of Korea.</p><p><strong>Design: </strong>This is a prospective, multicenter, observational study.</p><p><strong>Methods: </strong>This interim analysis included 5,040 patients from 96 centers, representing 19,878 patient-years of treatment between November 2011 and December 2022. Although the registry spans 10 years, follow-up was limited to periods of active GH treatment and, therefore, varied across patients. Patients received daily or weekly rhGH. Adverse events (AEs), adverse drug reactions (ADRs), serious AEs (SAEs), and serious ADRs (SADRs) were recorded and compared with international registry data.</p><p><strong>Results: </strong>Overall, AEs occurred in 34.2% of patients, ADRs in 7.0%, SAEs in 3.2%, and SADRs in 0.3%. The most frequent AE was scoliosis (1.6%), followed by headache (0.8%) and injection site pain (0.5%). Three malignant neoplasms were reported, yielding a standardized incidence ratio of 1.1 (95% confidence interval: 0.21-2.69), comparable to expected national rates. Craniopharyngioma recurrence occurred in 14.3% of affected patients, consistent with international data.</p><p><strong>Conclusion: </strong>Over the 10 years, rhGH therapy in Korean pediatric patients demonstrated a low incidence of ADRs and SADRs, with malignancy and tumor recurrence rates similar to those in global registries. These findings support the long-term safety of rhGH for pediatric growth disorders, with continued surveillance warranted.</p><p><strong>Significance: </strong>Using 10 years of real-world data from a pediatric registry, conducted in the Republic of Korea, this study provides one of the largest single-nation safety evaluations of rhGH therapy across multiple etiologies of short stature. The low incidence rates of ADRs and SADRs, in alignment with rates reported for other large-scale international registries, provide reassuring evidence of the safety of rhGH for clinicians and caregivers.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13250655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147962647","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":"Pattern of height and weight development in a large cohort of underage Chinese pseudohypoparathyroidism patients from a single center.","authors":"Yi Yang, An Song, Hanze Du, Yan Jiang, Mei Li, Weibo Xia, Xiaoping Xing, Ou Wang, Hui Pan","doi":"10.1530/EC-25-0865","DOIUrl":"10.1530/EC-25-0865","url":null,"abstract":"<p><strong>Objective: </strong>Pseudohypoparathyroidism (PHP) is a rare disorder characterized by hypocalcemia and elevated PTH. Although short stature is a key feature, especially in PHP type 1 (PHP1), growth data in Chinese patients remained limited.</p><p><strong>Methods: </strong>Clinical data, including height, age, and biochemical indices, were retrospectively collected from PHP1 patients at Peking Union Medical College Hospital. Molecular diagnosis was performed using MS-MLPA, Sanger sequencing, and WES. Growth charts for height, weight, and BMI in underage patients were constructed.</p><p><strong>Results: </strong>A total of 92 PHP1 patients (58 males, 34 females), including 32 pseudohypoparathyroidism type 1A (PHP-1A), 49 sporadic pseudohypoparathyroidism type 1B (PHP-S1B), and 11 autosomal dominant pseudohypoparathyroidism type 1B (PHP-AD1B), were recruited. Growth velocity peaked at 12 years in males and 5 years in females, with height plateau at 14 and 13 years, respectively. Adult height was 160.0 cm (SDS -1.04) in males and 155.0 cm (SDS -0.52) in females. PHP-1A patients had significantly shorter adult height than PHP-1B (male: 157.0 ± 6.9 vs 171.9 ± 8.9, P = 0.004; female: 146.8 ± 10.2 vs 156.2 ± 4.9, P = 0.007). PHP-1A showed early-onset weight gain from age 1, persisting into adulthood. Adult Wt-SDS was 1.67 vs 1.55 in males and 2.00 vs 3.10 in females (PHP-1A vs PHP-1B). Weight curves exceeded population P50 in most groups, with no significant differences in adult weight, Wt-SDS, BMI, or obesity prevalence between subtypes.</p><p><strong>Conclusion: </strong>Chinese PHP1 patients show early growth plateau and short stature, more severe in PHP-1A. Obesity varies by subtype and sex, with earlier and more persistent weight gain in PHP-1A. These growth charts may aid clinical management.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13250648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835137","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":"Recognition and accreditation of postgraduate training centres in endocrinology in Europe.","authors":"Hans Perrild, Anton Luger, Mirjam Christ-Crain, Jerome Bertherat, Graham Roberts, Richard Quinton, Teri Brouwer, Maeve Durkan, Josanne Vassallo","doi":"10.1530/EC-26-0056","DOIUrl":"10.1530/EC-26-0056","url":null,"abstract":"<p><strong>Background: </strong>The quality of care of patients with endocrine diseases depends on the training of trainees. To ensure this, the European Society of Endocrinology (ESE) and the UEMS (European Union of Medical Specialists) Section and Board of Endocrinology (SBE) have recently published the updated curriculum and formulated recommendations on postgraduate training.</p><p><strong>Aim: </strong>To complement this, information on the number of training centres and trainees in endocrinology in European countries, on the process of accreditation and re-accreditation of training centres and on the organisation of training is presented here.</p><p><strong>Methods: </strong>Delegates to the General Assembly of the UEMS SBE were asked to complete a questionnaire.</p><p><strong>Results: </strong>Delegates from 35 countries provided data. In three countries, endocrine training occurs in other countries, and in one country, endocrinology is not a recognised independent speciality. Thirty-one delegates reported 767 training centres, 18 reported having rotation centres, and 26 reported a total of 4,248 trainees. An accreditation process, which varies across countries, is in place in 27 countries. Re-accreditation is mandatory in 22 countries at intervals ranging from 1 to 7 years. Thirteen countries have a train-the-trainer programme, and the trainee-to-trainer ratio varies from 3:1 to 1:1.</p><p><strong>Conclusion: </strong>The accreditation and re-accreditation process of training centres varies across European countries. Information on the number of trainees might provide a basis to estimate whether a sufficient number of endocrinologists are produced in Europe to ensure optimal care of the growing number of patients with endocrine and metabolic diseases.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13240279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147962662","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":"Androgenetic alopecia in polycystic ovary syndrome: a cutaneous marker of systemic metabo-inflammatory and endocrine dysfunction.","authors":"Farzaneh Motafeghi, Marzieh Saei Ghare Naz, Fahimeh Ramezani Tehrani, Samira Behboudi-Gandevani","doi":"10.1530/EC-25-0728","DOIUrl":"10.1530/EC-25-0728","url":null,"abstract":"<p><p>Polycystic ovary syndrome (PCOS) is a multifaceted endocrine-metabolic disorder in which androgenetic alopecia (AGA) serves as a prominent clinical marker of profound systemic dysregulation, extending beyond simple hyperandrogenism. This condition imposes a significant psychosocial burden on affected women, yet its complete pathophysiology remains incompletely understood, leading to therapeutic plateaus. This review advances the central hypothesis that alopecia in PCOS results from a synergistic failure of local follicular metabolic signaling and genetic predisposition. This framework posits that the hair follicle in susceptible individuals is a site of intrinsic vulnerability where systemic insults, principally insulin resistance and chronic low-grade inflammation, converge with specific gene polymorphisms. This local pathology both amplifies and is amplified by systemic hyperandrogenism, rendering androgen action a necessary but insufficient component of the complete pathophysiological cascade. This integrated perspective recontextualizes the roles of insulin, inflammatory mediators, and genetic variants as direct effectors of follicular distress, not merely as upstream triggers of androgen excess. We critically synthesize the evidence supporting this model, examining the intricate intersections of systemic hormone bioavailability, local androgen conversion, follicular bioenergetics, and genetic susceptibility. Furthermore, we provide an evidence-based, mechanistically organized framework for the management of PCOS-associated alopecia, evaluating therapeutic modalities based on their targeted action within this complex network. A deeper, systems-level understanding of this interplay is essential for moving beyond current therapeutic limitations and developing personalized management strategies that address the complete pathophysiological axis, ultimately improving both cutaneous and long-term systemic health outcomes for women with PCOS.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13232606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835048","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 between serum meteorin-like protein and metabolic dysfunction-associated steatotic liver disease in patients with type 2 diabetes mellitus: a cross-sectional study.","authors":"Yanqian Zhuang, Jinbo Chen, Rongkun Xu, Chunmei Li, Pin Chen, Wen Guo","doi":"10.1530/EC-25-0885","DOIUrl":"10.1530/EC-25-0885","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study is to investigate the association between serum meteorin-like protein (Metrnl) and metabolic dysfunction-associated steatotic liver disease (MASLD) in type 2 diabetes mellitus (T2DM) and evaluate its incremental discriminatory value beyond the Hepatic Steatosis Index (HSI).</p><p><strong>Methods: </strong>This cross-sectional study enrolled 198 T2DM patients (110 T2DM-only; 88 T2DM + MASLD). Metrnl levels were measured via ELISA. Multivariable and ordinal logistic regressions assessed the independent association between the Metrnl and MASLD presence and ultrasonographic severity, adjusting for clinical confounders. Discriminatory performance was evaluated using ROC analyses and likelihood-ratio tests.</p><p><strong>Results: </strong>Serum Metrnl was significantly lower in the T2DM + MASLD group versus T2DM-only (0.65 (0.46, 0.82) vs 0.75 (0.62, 0.88) ng/mL, P = 0.007). After full adjustment for adiposity, lipids, liver enzymes, and insulin resistance, lower Metrnl remained independently associated with higher MASLD risk (OR = 0.238, 95% CI: 0.061-0.931, P = 0.039) and greater steatosis severity (P < 0.001). Adding Metrnl to HSI significantly improved the diagnostic model fit (AUC increased from 0.727 to 0.747, P = 0.011).</p><p><strong>Conclusion: </strong>Decreased serum Metrnl is independently associated with the MASLD presence and severity in T2DM, irrespective of obesity and insulin resistance. Metrnl serves as a distinct metabolic correlate, offering modest incremental value in multiparameter risk assessment models.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13216852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147947980","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":"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":3.4,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13216854/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nrf2 mRNA in the first trimester as a predictive biomarker for gestational diabetes mellitus.","authors":"Xinli Zhong, Si Li, Xingya Liu, Qian Li, Ping Shen","doi":"10.1530/EC-26-0077","DOIUrl":"10.1530/EC-26-0077","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore the role of the nuclear factor E2-related factor 2 (Nrf2)-Kelch-like ECH-associated protein 1 (Keap1)-antioxidant response element (ARE)/heme oxygenase-1 (HO-1) signaling pathway in the development of gestational diabetes mellitus (GDM) during the first trimester and to evaluate its potential as an early predictor biomarker.</p><p><strong>Methods: </strong>A prospective nested case-control study including 97 matched pairs of GDM patients and healthy controls was conducted. Peripheral blood collected between gestational weeks 8 and 12 was analyzed for mRNA levels of Nrf2, Keap1, and HO-1 using quantitative real-time PCR (qRT-PCR) analysis.</p><p><strong>Results: </strong>During the first trimester, the GDM group showed significantly higher levels of Nrf2 and HO-1 mRNA, while Keap1 expression was comparable to controls. Elevated Nrf2 mRNA levels were associated with a higher GDM risk (odds ratio (OR) = 2.369, 95% confidence interval (CI): 1.700-3.302, P < 0.001), with increased Nrf2 mRNA levels being positively linked to GDM development. Receiver operating characteristic (ROC) curve analysis indicated that first-trimester Nrf2 mRNA expression could predict mid-gestation GDM diagnosis with an area under the curve (AUC) of 0.770 (95% CI: 0.704-0.827).</p><p><strong>Conclusion: </strong>In the early trimester of pregnancy, individuals with GDM show a significant increase in the mRNA expression of Nrf2 and HO-1. Nrf2 mRNA serves as an independent predictor of GDM development, supporting its possible role in pathogenesis and potential utility for early screening.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13193075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835060","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 Effraimidis, Eleni Sazakli, Olga Karapanou, Katerina Saltiki, Marina A Michalaki","doi":"10.1530/EC-25-0796","DOIUrl":"10.1530/EC-25-0796","url":null,"abstract":"<p><strong>Background: </strong>Over the past decade, the management of papillary thyroid carcinoma (PTC) has become increasingly individualized, with less aggressive approaches recommended for low-risk diseases. However, the real-world implementation of these recommendations remains limited.</p><p><strong>Objective: </strong>This study aims 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 nonadherence 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, a shortage of experienced surgeons outside major centers, and skepticism regarding guideline safety.</p><p><strong>Conclusion: </strong>Our findings underscore persistent 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":3.4,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13187569/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting time to glycemic stability in hospitalized type 2 diabetes patients using insulin resistance indices: a nomogram development and validation study.","authors":"Ying Ke, Shasha Shi, Nan Zhou, Hongyuan Shi, Ming Zhang, Yi He, Haixia Liu, Xiaoyun Liu, Jing Jiang, Cuicui Lv, Nan Zhao","doi":"10.1530/EC-26-0111","DOIUrl":"10.1530/EC-26-0111","url":null,"abstract":"<p><strong>Background: </strong>Achieving rapid glycemic stability with intensive insulin therapy in hospitalized type 2 diabetes patients remains unpredictable. We hypothesized that the underlying insulin resistance is a key determinant of this response. This exploratory study aimed to test this hypothesis and develop a predictive nomogram.</p><p><strong>Methods: </strong>We retrospectively analyzed 393 hospitalized patients initiating insulin pump therapy with continuous glucose monitoring. Stability was defined as time in range >70% for 24 consecutive hours. Collected data included body mass index, hemoglobin A1c (HbA1c), fasting glucose, fasting insulin, lipids, and calculated insulin resistance indices. Cox regression identified predictors of time to stability.</p><p><strong>Results: </strong>Analysis confirmed insulin resistance's significant role. Multivariate Cox regression identified older age, higher fasting insulin, elevated HbA1c, and a higher triglyceride-glucose (TyG) index as independent risk factors for prolonged time to stability (all P < 0.05), with the TyG index interpreted as a marker of lipotoxic metabolic inflexibility rather than merely a surrogate of insulin resistance. A nomogram integrating these factors demonstrated good predictive accuracy, with a C-index of 0.801 (95% CI: 0.77-0.83). Calibration and decision curve analysis supported its clinical utility.</p><p><strong>Conclusion: </strong>Insulin resistance significantly influences time to glycemic stabilization. The developed nomogram, incorporating the TyG index, fasting insulin, age, and HbA1c, provides a practical tool for early risk stratification, potentially guiding more personalized inpatient diabetes management.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13193067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766141","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}