Siyuan Peng, Bo Zhao, Xiaolei Yi, Xuhui Li, Jun Zhang, Jie Wang, Ruineng Li
{"title":"Advances in Islet Function Replacing Strategies After Total Pancreatectomy.","authors":"Siyuan Peng, Bo Zhao, Xiaolei Yi, Xuhui Li, Jun Zhang, Jie Wang, Ruineng Li","doi":"10.1016/j.eprac.2025.07.012","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.07.012","url":null,"abstract":"<p><p>Total pancreatectomy is one of the radical treatments for various severe pancreatic conditions, including pancreatic cancer, chronic pancreatitis, and pancreatic trauma. However, the postoperative complication rate is higher compared to other surgical methods, and all patients inevitably develop insulin-dependent diabetes due to the loss of islet function. Previously, studies focused on pancreas/islet transplantation or stem cell therapy conducted in diabetic patients have achieved significant success, suggesting that adopting similar strategies to preserve or restore islet function after total pancreatectomy is feasible. To date, numerous preclinical and clinical studies have been conducted in this field, providing some basis for selecting islet function replacing strategies (IFRSs) after total pancreatectomy. This article will provide a review of the existing IFRSs after total pancreatectomy, as well as those in various stages of research. It will analyze the clinical evidence, advantages, and disadvantages of different strategies, thereby offering a reference for physicians in the relevant field.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706754","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":"Implications of GLP-1 Receptor Agonists on Thyroid Function and Thyroid Nodules: A Drug Target Mendelian Randomization and Cohort Study.","authors":"Zhijun Zhang, Jingyun Yang, Ling Gao","doi":"10.1016/j.eprac.2025.07.013","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.07.013","url":null,"abstract":"<p><strong>Objectives: </strong>GLP-1 receptor agonists are antidiabetic medications, with conflicting reports about their relationship with thyroid diseases. This study investigates their effects on thyroid function and nodules in patients with diabetes.</p><p><strong>Methods: </strong>Mendelian randomization (MR) was conducted to examine the association between genetically proxied GLP-1 receptor agonist activity and thyroid diseases. This was followed by a cohort study involving 169 patients with diabetes, who were divided into a control group (Control group, W/O GLP-1 treatment) and a GLP-1 receptor agonist treatment group (GLP-1RAs group) based on their medication usage. Patients' thyroid function tests, thyroid nodule diameters and TI-RADS classifications were compared at baseline and after 12 months of treatment.</p><p><strong>Results: </strong>Through MR, GLP-1 receptor agonists decrease fT4 levels within the normal range [OR (95% CI) = 0.9948 (0.9936-0.9961), P<0.001]. Cohort study showed that after treatment, the nodule diameter increased in both the Control group (0.69 vs. 0.77, p=0.004) and the GLP-1 group (0.68 vs. 0.71, p=0.019). In the GLP-1 group, the TI-RADS (2.60 vs. 2.69, p=0.007) levels increased, while the fT4 (1.26 vs. 1.17, p=0.005) levels decreased. However, linear regression did not show significant association between GLP-1 and post-treatment differences in thyroid function or thyroid nodule.</p><p><strong>Conclusions: </strong>GLP-1 receptor agonists treatment of 12 months in patients with diabetes is considered relatively safe regarding thyroid disease although there is a potential risk for decreasing of fT4 levels and nodule growth/progression, with no clear evidence of superiority over other antidiabetic treatments.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706755","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}
Rohit Parab, Jenna M Feeley, Maria Valero, Laya Chadalawada, Gian-Gabriel P Garcia, Sudeshna Sil Kar, Anant Madabhushi, Marc D Breton, Jing Li, Hui Shao, Francisco J Pasquel
{"title":"Artificial Intelligence in Diabetes Care: Applications, Challenges, and Opportunities Ahead.","authors":"Rohit Parab, Jenna M Feeley, Maria Valero, Laya Chadalawada, Gian-Gabriel P Garcia, Sudeshna Sil Kar, Anant Madabhushi, Marc D Breton, Jing Li, Hui Shao, Francisco J Pasquel","doi":"10.1016/j.eprac.2025.07.008","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.07.008","url":null,"abstract":"<p><p>Artificial intelligence (AI) is rapidly transforming clinical medicine, and its potential impact on diabetes care is particularly noteworthy. In recent years, both traditional machine learning approaches and deep learning algorithms have been applied to improve screening for complications of diabetes such as retinopathy, macular edema, and neuropathy, predict disease progression risk, and enhance clinical decision support systems for diagnosis, prognosis, and treatment optimization. AI-driven solutions are also emerging to identify noninvasive biomarkers for detecting diabetes and prediabetes, analyze the macronutrient content of meals using image-based deep learning methods, integrate novel risk prediction tools within electronic health records, and optimize automated insulin delivery (AID) systems. These advancements hold promise for streamlining patient care, personalizing treatment plans, and ultimately improving clinical outcomes. In this narrative review, we examine the latest AI applications in diabetes care, exploring their capabilities, limitations, and the future directions necessary to realize their full potential to improve the care of people living with diabetes.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667418","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":"Management of Primary Hyperparathyroidism: Historical and Contemporary Perspectives.","authors":"Sheryl T Y Htoo, Natalie E Cusano","doi":"10.1016/j.eprac.2025.07.009","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.07.009","url":null,"abstract":"<p><p>Primary hyperparathyroidism (PHPT) is a frequently diagnosed endocrine condition most commonly caused by a single parathyroid adenoma. Our understanding of the epidemiology and management of PHPT have evolved in the past few decades. Asymptomatic PHPT has been the most common presentation in developed countries since the advent of routine biochemical screening. Symptomatic disease is now also decreasing in developing nations. Normocalcemic PHPT is a newer phenotype that can be diagnosed in the setting of elevated PTH concentrations with persistently normal serum calcium, however, evaluation for secondary causes of hyperparathyroidism is critical as it is a diagnosis of exclusion. Genetic testing can be helpful in patients younger than 30 years of age and/or patients with intermediate or equivocal ranges of the urinary calcium to creatinine ratio (between 0.01 and 0.02) to differentiate PHPT from FHH and to evaluate for other genetic etiologies that may affect management. Surgery is the recommended treatment modality for symptomatic PHPT, and patients with asymptomatic PHPT meeting recommended criteria should also be considered for parathyroidectomy. \"Asymptomatic\" patients should be screened for the presence of nephrolithiasis and/or vertebral fracture, since many will be reclassified as having symptomatic disease with further investigation. For poor surgical candidates or patients not meeting criteria for surgery, medical therapy includes cinacalcet for hypercalcemia and antiresorptive therapies for osteoporosis.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667420","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}
Hang Zhao, Xiaozhun Tang, Duoping Wang, Peng-Cheng Yu, Cong He, Xu-Feng Chen, Wei-Dong Ye, Jia-Hao Wu, Jia-Qian Hu, Yu-Long Wang
{"title":"Prognostic Factors and Survival Outcomes in Thyroid Cancer Patients with Bone Metastasis: Insights from a Population-Based Cohort Study.","authors":"Hang Zhao, Xiaozhun Tang, Duoping Wang, Peng-Cheng Yu, Cong He, Xu-Feng Chen, Wei-Dong Ye, Jia-Hao Wu, Jia-Qian Hu, Yu-Long Wang","doi":"10.1016/j.eprac.2025.07.010","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.07.010","url":null,"abstract":"<p><strong>Objectives: </strong>Thyroid cancer (TC) is the most common endocrine malignancy, and bone metastasis (BM) is the second most common type of metastasis after lung metastasis. BM is associated with a poor prognosis; however, relevant research remains limited. This study aims to evaluate the prognostic factors and survival outcomes in patients with thyroid cancer with bone metastasis (TCBM).</p><p><strong>Methods: </strong>Data from patients with thyroid cancer with bone metastasis were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Univariable and multivariable Cox proportional hazards regression models were used to identify survival predictors. Survival outcomes were calculated using the Kaplan-Meier method and compared using the log-rank tests.</p><p><strong>Results: </strong>A total of 696 TCBM patients from 2010 to 2021 were included in this study. For the TCBM patients, those age ≥55 years (P < 0.001); those with anaplastic thyroid cancer (P < 0.001); those with brain, liver and lung metastases (all P < 0.05); and those with T4 stage disease (P = 0.011) exhibited significantly worse overall survival (OS), with radioisotope therapy (P < 0.001) significantly improved OS. Additionally, significant factors for cancer-specific survival (CSS) included ATC (P < 0.001); liver and lung metastases (all P < 0.001); and radioisotope treatment (P < 0.001).</p><p><strong>Conclusion: </strong>Our study revealed the critical role of age, pathological subtype, metastatic lesions, and radioisotope therapy in determining the prognosis of TCBM. These findings contribute to providing more rational treatment decisions and risk stratification for TCBM patients.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667421","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":"Chronic Hypoparathyroidism - Current and Emerging Therapies.","authors":"Sarah Khan, Aliya A Khan","doi":"10.1016/j.eprac.2025.07.011","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.07.011","url":null,"abstract":"<p><p>Hypoparathyroidism (HypoPT) is a rare endocrine disorder characterized by low serum calcium due to insufficient parathyroid hormone (PTH) and results in significant complications. Conventional treatment for hypoparathyroidism with calcium salts and activated vitamin D has limitations such as inadequate control of symptomatic hypocalcemia and large pill burden. PTH replacement therapy offers a more physiologic alternative to conventional therapy. PTH (1-34) has a short half-life of 1 hour and is used off-label for the treatment of hypoparathyroidism. rhPTH (1-84) has a half life of 3 hours and improves symptom control but its production is being halted due to manufacturing issues. Palopegteriparatide has a 60-hour half life and results in an infusion like PTH release profile. This molecule is effective in lowering urinary calcium, maintaining serum eucalcemia, lowering serum phosphate and reducing pill burden and is now approved by the FDA and EMA. Emerging therapies include Eneboparatide which is currently being evaluated in phase 3 clinical trials. Encalaret is a calcilytic molecule which is in phase 3 clinical trials and is a promising molecule for autosomal dominant hypocalcemia type 1. New molecules include an oral PTH1receptor agonist which is in phase 1 clinical trials. A weekly PTH molecule is also being evaluated in phase 2 clinical trials.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667419","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":"Impact of vitamin D and calcium on falls and fractures in older adults.","authors":"Bess Dawson-Hughes","doi":"10.1016/j.eprac.2025.07.007","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.07.007","url":null,"abstract":"<p><p>The objective of this review is to explore the evidence linking both low and high circulating levels of 25-hydroxyvitamin D to risk of falls and/or fractures in older adults. The important role of calcium intake in this context is also described. The quality of evidence, related to participant characteristics, methods of fall and fracture assessments, biomarker assays employed, and other factors are considered. There is growing evidence that both low intakes of vitamin D and calcium and excess intake of vitamin D have untoward effects of risk of falls and fractures. Verification of the 25(OH)D range that currently appears to minimize risk of falls and fractures, 20 to 40 ng/ml, is important, because it will have obvious implications for devising optimal supplementation strategies in large parts of the global population that is dually deficient in calcium and vitamin D.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Factors of Composite Target of Time in Range and Time below Range among Children and Adolescents with Type 1 Diabetes Mellitus Using Open-Source Automated Insulin Delivery.","authors":"Mengyun Lei, Yongwen Zhou, Chaofan Wang, Ping Ling, Ying Ni, Daizhi Yang, Xubin Yang, Wen Xu, Hongrong Deng, Jinhua Yan","doi":"10.1016/j.eprac.2025.07.006","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.07.006","url":null,"abstract":"<p><strong>Objectives: </strong>To explore glycemic outcomes after open-source Android artificial pancreas system (AAPS) use and factors of achieving composite target (time in range of 70-180mg/dL [TIR]>70% and time below range of 70mg/dL [TBR70] <4%) among children and adolescents with type 1 diabetes mellitus (T1DM).</p><p><strong>Methods: </strong>T1DM people aged under 18 years and who used AAPS for ≥6 months were included. Continuous glucose monitoring (CGM) metrics were calculated after 3 and 6 months of AAPS use. Logistic regression model was used to explore factors of achieving composite target at 6 months.</p><p><strong>Results: </strong>Seventy-seven participants (44.16% male) were included. Median age was 10.64(6.90,12.72) years, T1DM duration was 2.03(0.59,4.43) years and baseline HbA1c was 7.78±2.12%. After 3 and 6 months, 67.53% and 66.23% achieved TIR>70%, while 57.14% and 54.55% achieved TBR70<4%, respectively. After 3 months, the achievement rate composite target was 41.56 % and slightly declined to 35.06 % at 6 months(P>0.05). The age at AAPS initiation (OR=1.32), T1DM duration (OR=0.72), and frequency of daily meal announcements (OR=1.40) were associated factors of achieving composite target at 6 months (all P<0.05).</p><p><strong>Conclusions: </strong>T1DM children and adolescents with older age, shorter T1DM duration at AAPS initiation, and higher meal announcement frequency during AAPS use had the potential to successfully achieve composite target.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648865","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":"Growth hormone and bone: pre-clinical and clinical perspectives.","authors":"Kevin Cj Yuen","doi":"10.1016/j.eprac.2025.07.005","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.07.005","url":null,"abstract":"<p><strong>Objective: </strong>Growth hormone (GH) is essential for growth and bone metabolism. This article reviews pre-clinical data that has shaped our understanding of the mechanisms underpinning the effects of GH on bone beyond the downstream activation of IGF-I generation and summarizes the clinical data of GH deficiency (GHD) and acromegaly on bone health parameters and fracture risk.</p><p><strong>Methods: </strong>A literature search was conducted on PubMed using the following key words: growth hormone, IGF-I, bone, growth hormone deficiency and acromegaly. The discussion of therapy in GHD and acromegaly patients, and their fracture risk assessment was based on evidence derived from previously published pre-clinical and clinical studies.</p><p><strong>Results: </strong>Pre-clinical and clinical data have demonstrated important pleiotropic effects of GH and IGF-I on bone formation and resorption. Growth hormone exerts direct and IGF-dependent and independent effects on bone, while IGF-I acts in an endocrine and autocrine/paracrine manner. In GHD, decreased bone turnover, delayed statural growth, low bone mass, and increased fracture risk are observed, whereas acromegaly is associated with increased bone turnover but decreased lumbar bone mineral density and increased vertebral fracture and osteoarthritis risk. Treatment aimed at normalizing the GH/IGF-I axis decreases the fracture risk in GHD, but not acromegaly.</p><p><strong>Conclusion: </strong>Pre-clinical and clinical studies have improved our understanding of the role of GH in bone in healthy individuals and in disease states. More research is needed to identify the effects of GH on bone and to determine how best to treat GHD and acromegaly patients, so that their bone health is optimized.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648876","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}