Endocrine Practice最新文献

{"title":"Avoiding Rebound Vertebral Fractures After Denosumab: Lessons for Practice in Southeast Asia.","authors":"Vivek Jha, Rimesh Pal, Siddharth Madhad, Sanjay Kumar Bhadada","doi":"10.1016/j.eprac.2026.04.018","DOIUrl":"https://doi.org/10.1016/j.eprac.2026.04.018","url":null,"abstract":"","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147863775","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":"A novel method for the evaluation of hypercalciuria in individuals with chronic hypoparathyroidism.","authors":"Elvira O Gosmanova, Carol Zhao, Christopher T Sibley, Michael A Makara, Kenneth R Phelps","doi":"10.1016/j.eprac.2026.04.017","DOIUrl":"https://doi.org/10.1016/j.eprac.2026.04.017","url":null,"abstract":"<p><strong>Objectives: </strong>Guidelines recommend avoiding hypercalciuria during treatment of chronic hypoparathyroidism, but measurements of 24-hour calcium excretion (24uCa) have limitations. We evaluated calcium excretion per volume of filtrate (E_Ca/C_cr), which does not require timed collections, as an alternative to 24uCa to detect hypercalciuria.</p><p><strong>Methods: </strong>This was a post-hoc analysis of the PaTH Forward trial (NCT04009291). Fifty-nine adults with chronic hypoparathyroidism managed with conventional therapy were enrolled in a randomized, double-blind, placebo-controlled 4-week period followed by an open-label extension (OLE), in which all participants received palopegteriparatide (TransConPTH). E_Ca/C_cr was calculated as (Ca_u×cr_s)/cr_u from morning non-fasting samples (Ca_u-urine calcium, cr_u-urine creatinine, and cr_s-serum creatinine). The diagnostic accuracy of E_Ca/C_cr was assessed using receiver operating characteristic analysis.</p><p><strong>Results: </strong>Median(IQR) 24uCa was 381(296-602) mg/day at baseline and declined by 61-72% during OLE. Mean(SD) E_Ca/C_cr was 0.249(0.131) mg/dL at baseline and fell by 47-62% during OLE. Area under the curve for E_Ca/C_cr as a test for hypercalciuria (24uCa >300 mg/day) was 0.837. Hypercalciuria was invariably absent at E_Ca/C_cr <0.083 mg/dL and almost uniformly present at E_Ca/C_cr > 0.212 mg/dL. Positive predictive value of E_Ca/C_cr ≥ 0.149 mg/dL was ≥92% when pretest probability of hypercalciuria was high. Negative predictive value of E_Ca/C_cr was ≥97% at all cutoffs when pretest probability was low.</p><p><strong>Conclusions: </strong>E_Ca/C_cr correlates with 24uCa in patients with chronic hypoparathyroidism. The lowest E_Ca/C_cr cutoff values ensure that hypercalciuria is not missed. Sufficiently high E_Ca/C_cr supports presence of hypercalciuria. In these scenarios, 24uCa collections can be avoided. Intermediate E_Ca/C_cr must be followed by 24uCa.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856205","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":"Erratum to “Altered mRNA Expression of PTEN and PDK1 Genes in Type 2 Diabetes Mellitus Patients of Kashmir Valley: Implications for Insulin Resistance and Metabolic Dysfunction” [Endocr Pract. 2025;31(12):S5]","authors":"Suhail Lone PhD ,&nbsp;Mosin Saleem Khan ,&nbsp;Sabhiya Majid ,&nbsp;Mohammad Hayat Bhat","doi":"10.1016/j.eprac.2026.02.016","DOIUrl":"10.1016/j.eprac.2026.02.016","url":null,"abstract":"","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 5","pages":"Page 859"},"PeriodicalIF":4.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147827839","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":"Thermal Ablation Versus Thyroid Lobectomy for Subcapsular Papillary Thyroid Microcarcinoma: A Multicenter Retrospective Study","authors":"Haoyu Jing MD ,&nbsp;Ruifang Xu MD ,&nbsp;Lin Yan MD ,&nbsp;Mingbo Zhang MD ,&nbsp;Hui Wang MD ,&nbsp;Yujiang Liu MD ,&nbsp;Yukun Luo MD","doi":"10.1016/j.eprac.2026.02.004","DOIUrl":"10.1016/j.eprac.2026.02.004","url":null,"abstract":"<div><h3>Objectives</h3><div>To compare the efficacy of thermal ablation (TA) with thyroid lobectomy (TL) for clinical node-negative subcapsular papillary thyroid microcarcinoma (PTMC) and to assess the impact of occult lymph node metastasis (LNM) or pathologic local invasion on clinical outcomes.</div></div><div><h3>Methods</h3><div>This retrospective study was conducted at 3 referral centers. It included patients with unifocal clinical node-negative subcapsular PTMC who underwent TA (<em>n</em> = 536) or TL (<em>n</em> = 740) from June 2014 to December 2020. The TL group was divided into occult LNM-positive, occult LNM-negative, pathologic local invasion-positive, and pathologic local invasion-negative subgroups based on pathologic findings. Propensity score matching and inverse probability of treatment weighting were used to control for potential confounders. Primary outcomes were disease progression and progression-free survival (PFS). Secondary outcomes included complications and treatment parameters.</div></div><div><h3>Results</h3><div>The median follow-up duration of the primary cohort was 60.1 (42.0) months. After propensity score matching (519 patients per group), no significant differences were observed in disease progression rates (4.0% vs 2.7%) or 5-year PFS rates (95.8% vs 97.2%) between the TA and TL groups (<em>P</em> &gt; .05). After inverse probability of treatment weighting, the TA group exhibited no significant difference in PFS rates compared to the occult LNM-positive (<em>P</em> = .97) or the pathologic local invasion-positive (<em>P</em> = .66) subgroups. Additionally, TA was associated with lower complication rates compared with TL (0.4% vs 2.1%, <em>P</em> = .01)</div></div><div><h3>Conclusions</h3><div>In eligible patients with subcapsular PTMC, TA and TL exhibit comparable 5-year disease progression rates and PFS rates. TA may be an alternative option for eligible patients with subcapsular PTMC who are ineligible for or refuse lobectomy.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 5","pages":"Pages 760-768"},"PeriodicalIF":4.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147321549","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":"Screening for Fear of Hypoglycemia in Type 1 Diabetes: Aligning Clinical Practice With Current Guidelines","authors":"Meryem K. Talbo RD, MSc, PhD ,&nbsp;Tricia M. Peters MD, PhD ,&nbsp;Jean-François Yale MD, PhD ,&nbsp;Alexandra Katz MD, MSc ,&nbsp;Claude Laforest BScEng ,&nbsp;Andréanne Vanasse RN, MSc ,&nbsp;Jessica C. Kichler PhD ,&nbsp;Remi Rabasa-Lhoret MD, PhD ,&nbsp;Anne-Sophie Brazeau RD, PhD","doi":"10.1016/j.eprac.2026.01.004","DOIUrl":"10.1016/j.eprac.2026.01.004","url":null,"abstract":"<div><h3>Objectives</h3><div>Recent clinical guidelines recommend screening for fear of hypoglycemia (FOH) as it is a known barrier in type 1 diabetes (T1D) management. Thus, this study proposes a one-item screening question to identify people living with T1D for whom FOH is a barrier to achieving glycemic targets and well-being.</div></div><div><h3>Methods</h3><div>Cross-sectional analysis using self-reported data from an online registry of people living with T1D. The one-item screening question “[Does] fear of hypoglycemia represent a barrier for you to achieve optimal blood sugar levels?” was validated by evaluating its association with glycemic outcomes (hemoglobin A1c [HbA1c]) and Hypoglycemia Fear Survey-II scores using regression models while adjusting for gender, hypoglycemia history, and hypoglycemia confidence.</div></div><div><h3>Results</h3><div>Among 1437 adults (mean age: 44.3 ± 15.1 years), 43% responded “yes” to the screening question (FOH + group). Participants in the FOH + group were more likely to self-identify as women, use medication to treat depression or anxiety, and report lower hypoglycemia confidence. The FOH + group had on average 0.48% [0.12, 0.83] higher HbA1c levels and were less likely to report reaching the recommended target HbA1c ≤ 7.0% (30% compared to 47%; <em>P</em> &lt; .001). These associations remained significant even after adjusting for gender, hypoglycemia history, and hypoglycemia confidence. Hypoglycemia Fear Survey-II scores were significantly higher in the FOH + group (total score coefficient: 11.0 [9.1, 12.8]).</div></div><div><h3>Conclusions</h3><div>As FOH remains under-assessed clinically, a validated one-item screening question can facilitate targeted and individualized clinical discussions for efficient recommendations and therapeutic adjustments.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 5","pages":"Pages 720-727"},"PeriodicalIF":4.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994332","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":"Aging With Cystic Fibrosis: Endocrine and Metabolic Considerations","authors":"Katie Kaput DO ,&nbsp;Samantha Steinmetz-Wood MD ,&nbsp;Melissa S. Putman MD ,&nbsp;Heidi Guzman MD","doi":"10.1016/j.eprac.2026.01.753","DOIUrl":"10.1016/j.eprac.2026.01.753","url":null,"abstract":"<div><div>Cystic fibrosis (CF) has transitioned from a disease predominantly affecting the pediatric population to a chronic disease of adulthood. As patients with CF continue to prolong their survival with CF transmembrane conductance regulator modulator therapy, there has become increased relevance of age-related endocrine, metabolic, and cardiovascular complications. Endocrinopathies in this population include but are not limited to diabetes, bone disease, menopause, and obesity. In this review, we summarize the current evidence on these endocrine and metabolic complications, emphasizing the importance of early screening, multidisciplinary management, and continued efforts to address the evolving health and quality-of-life needs of an aging CF population including the need for CF-specific population based studies to adapt current clinical practice guidelines that remain targeted towards the general population.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 5","pages":"Pages 795-802"},"PeriodicalIF":4.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146197535","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":"Age-Dependent Muscular Response to Testosterone-Based Gender-Affirming Therapy: Evidence From a 1-Year Observational Study","authors":"Chiara Ceolin MD ,&nbsp;Sandro Savino PhD ,&nbsp;Caterina Gregorio PhD ,&nbsp;Gloria Beraldo PhD ,&nbsp;Martina Dall’Agnol MD ,&nbsp;Giulia Termini MD ,&nbsp;Davide Liborio Vetrano PhD ,&nbsp;Alberto Scala MD ,&nbsp;Alberto Ferlin PhD ,&nbsp;Giuseppe Sergi PhD ,&nbsp;Andrea Garolla PhD ,&nbsp;Marina De Rui PhD","doi":"10.1016/j.eprac.2025.12.012","DOIUrl":"10.1016/j.eprac.2025.12.012","url":null,"abstract":"<div><h3>Objective</h3><div>Age-related variability in the response to testosterone-based gender-affirming hormone therapy (GAHT) among transgender and gender-diverse individuals assigned female at birth remains poorly understood. We investigated 1-year changes in muscle strength and mass after GAHT initiation and examined whether outcomes differ by age at treatment onset.</div></div><div><h3>Methods</h3><div>In this prospective longitudinal observational study, a total of 107 transgender and gender-diverse individuals assigned female at birth adults naïve to GAHT and gender-affirming surgeries were enrolled and stratified into 4 baseline age groups (20-24, 25-29, 30-34, and ≥35 years). Handgrip strength and body composition (dual-energy x-ray absorptiometry) were assessed at baseline and after 12 months of testosterone therapy. Within-group changes and age-related trends were evaluated using linear mixed models and quantile regression.</div></div><div><h3>Results</h3><div>Handgrip strength increased after 1 year across all age groups, with a clear age-related gradient in magnitude. Gains were largest and significant in younger participants: +4.35 kg in the 25-29 group (<em>P</em> = .001) and +2.14 kg in the 20-24 group (<em>P</em> = .025). In the 30-34 and ≥ 35 groups, mean increases were smaller and not significant. Appendicular skeletal muscle mass index showed modest, non-significant increases in younger participants and plateaued or declined from age 30 onward, with the 30-34 groups displaying a decline most evident at the 25th percentile.</div></div><div><h3>Conclusions</h3><div>Age at GAHT initiation markedly influences the anabolic response to testosterone therapy. Strength gains are more pronounced in early adulthood and decline with age, information that may assist clinicians in providing age-appropriate counseling for individuals beginning testosterone therapy.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 5","pages":"Pages 689-695"},"PeriodicalIF":4.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145793636","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":"Metabolic Health Differences Among Women of Age-Based Pre-, Peri-, and Post-Menopausal Stages","authors":"Bong Nguyen PhD ,&nbsp;Melissa Godar MD ,&nbsp;Barbara Lohse PhD, RDN ,&nbsp;Lisa Bailey-Davis DEd, RD ,&nbsp;Elizabeth Ruder PhD, MPH, RDN ,&nbsp;Jacinda M. Nicklas MD, MPH ,&nbsp;Pavani Chilamkuri MD, MPH ,&nbsp;Mariah Pratt BS ,&nbsp;Jannette Berkley-Patton PhD ,&nbsp;Lynda H. Powell PhD ,&nbsp;Betty Drees MD","doi":"10.1016/j.eprac.2025.12.024","DOIUrl":"10.1016/j.eprac.2025.12.024","url":null,"abstract":"<div><h3>Objectives</h3><div>To examine metabolic differences in women with or at risk of metabolic syndrome across 3 age groups used as a proxy for menopausal stages: premenopausal (PreM, &lt;45 years), menopausal transition (PeriM 45-55 years), and postmenopausal (PostM, &gt;55 years).</div></div><div><h3>Methods</h3><div>A total of 718 female subjects across 3 groups, PreM (<em>n</em> = 108, 15%), PeriM (<em>n</em> = 218, 30.4%), and PostM (<em>n</em> = 392, 54.6%), were included. Demographics, intakes of fruits, vegetables, and sugar-sweetened beverages, stress, and substance use were collected using self-reported surveys. Daily steps was assessed using accelerometers. Anthropometric (BMI, and waist circumference) and bioclinical data (blood pressure, fasting glucose, HbA1c, HDL cholesterol, and triglycerides) were measured using a standardized protocol. Analyses included Chi square, ANOVA, and Kruskal-Wallis tests appropriate to normality and variable structure.</div></div><div><h3>Results</h3><div>Lifestyle behaviors and metabolic characteristics differed by group with more negative health behaviors (diet, stress, substance use) and metabolic characteristics (BMI, waist circumference, and HDL) in PreM (<em>P</em> &lt; 0.05). Compared to PreM, PeriM had lower BMI and higher HDL levels (both <em>P</em> &lt; 0.05). Women in PostM group had the lowest stress, physical activity, and BMI but highest systolic BP, HbA1c, and HDL compared to the other 2 groups (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>These results underscore the need for targeted menopausal stage-specific interventions to improve metabolic health and promote healthier lifestyle behaviors across the menopausal transition. Premenopausal women may benefit from early lifestyle and metabolic risk management, while peri- and postmenopausal women should prioritize maintaining physical activity and glycemic control.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 5","pages":"Pages 710-719"},"PeriodicalIF":4.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145942877","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":"Testosterone Replacement Therapy in Prostate Cancer Survivors Treated With Radiation With and Without Androgen Deprivation Therapy: A Retrospective Study and Narrative Review","authors":"Mohan Sonu Chandra MB, BS ,&nbsp;Chengzhi Wang MD ,&nbsp;Thiago Gagliano-Jucá MD, PhD ,&nbsp;Eshaan Gaikwad ,&nbsp;Yili Valentine Shang MPH ,&nbsp;Karol M. Pencina PhD ,&nbsp;Shalender Bhasin MB, BS","doi":"10.1016/j.eprac.2026.01.019","DOIUrl":"10.1016/j.eprac.2026.01.019","url":null,"abstract":"<div><h3>Objective</h3><div>Testosterone replacement therapy (TRT) in prostate cancer survivors with hypogonadism remains controversial due to concerns that restoring testosterone may increase the risk of disease recurrence. We performed a cohort study of men with localized prostate cancer treated with radiotherapy with or without androgen deprivation therapy (ADT), who received TRT, and a narrative review of published studies evaluating TRT after radiotherapy.</div></div><div><h3>Methods</h3><div>Biochemical and clinical recurrence, patient-reported symptoms, prostate-specific antigen, testosterone, and hemoglobin were analyzed in this cohort and published studies.</div></div><div><h3>Results</h3><div>Among 33 men with pathology-confirmed prostate cancer treated with radiation without or with ADT, who received TRT (median age at TRT initiation, 75 [IQR 69.0-77.0] years), median testosterone increased from 66.0 (IQR 16.0-140.0) to 299.3 (IQR 152.5-569.0, <em>P</em> &lt; .001) ng/dL. Prostate-specific antigen rose from 0.04 (IQR 0.02-0.17) to 0.17 ng/mL (IQR 0.04-0.44) (<em>P</em> = .018). TRT was associated with improvements in fatigue, mood, and sexual symptoms; anemia was corrected in 9 of 21 (42.9%) patients with anemia. One patient (3%) developed metastatic disease 3 years after starting TRT. In narrative review of published case-reports, weighted mean biochemical recurrence rate was 3.3% during mean 42.6 months of follow-up.</div></div><div><h3>Conclusions</h3><div>Our cohort study and narrative review found a low incidence of biochemical recurrence in prostate cancer survivors treated with radiation therapy with or without ADT. TRT was associated with correction of anemia and improvements in fatigue, energy, and sexual symptoms. These findings provide the ethical and scientific rationale for a randomized controlled trial to evaluate the safety and efficacy of TRT in this population.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 5","pages":"Pages 679-688"},"PeriodicalIF":4.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100125","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":"Bariatric Surgery in the Management of Metabolic Dysfunction-Associated Steatotic Liver Disease: Long-Term Benefits for Liver Health","authors":"José M. Juárez-Sosa MD ,&nbsp;Misael Uribe MD, PhD ,&nbsp;Eduardo E. Montalvo-Javé MD, PhD ,&nbsp;Natalia Nuño-Lámbarri PhD","doi":"10.1016/j.eprac.2026.01.017","DOIUrl":"10.1016/j.eprac.2026.01.017","url":null,"abstract":"<div><h3>Objective</h3><div>To review the physiological, hormonal, and molecular mechanisms through which bariatric surgery—particularly sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB)—modifies liver disease progression in metabolic dysfunction–associated steatotic liver disease (MASLD).</div></div><div><h3>Methods</h3><div>A narrative review of current literature examining clinical outcomes, mechanistic pathways, and long-term hepatic and cardiometabolic effects of SG and RYGB in patients with MASLD.</div></div><div><h3>Results</h3><div>Both SG and RYGB induce sustained weight loss and durable metabolic improvements. Beyond caloric restriction, these procedures promote significant alterations in gut hormones, bile acid signaling, insulin sensitivity, systemic inflammation, and adipose–liver crosstalk. Clinical evidence demonstrates marked reductions in hepatic steatosis and inflammation, with partial fibrosis regression in selected patients. Bariatric surgery is also associated with decreased incidence of cirrhosis, hepatocellular carcinoma, cardiovascular events, and improved overall survival and quality of life.</div></div><div><h3>Conclusion</h3><div>Bariatric surgery represents a disease-modifying intervention in MASLD, exerting metabolic and hepatic benefits that extend beyond weight reduction. It should be considered an integral component of multidisciplinary management, particularly in patients with obesity and high cardiometabolic risk.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 5","pages":"Pages 838-847"},"PeriodicalIF":4.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100046","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}