Alessandro Rizzi, Teresa Polimeno, Maria Laura Leo, Ambra Moriconi, Martina Policriti, Linda Tartaglione, Annamaria Merola, Anna Tropea, Rosanna Apa, Dario Pitocco
{"title":"DIFFERENT GLYCEMIC VARIABILITY IN WOMEN WITH POLYCYSTIC OVARY SYNDROME WITH AND WITHOUT INSULIN RESISTANCE: A PILOT STUDY.","authors":"Alessandro Rizzi, Teresa Polimeno, Maria Laura Leo, Ambra Moriconi, Martina Policriti, Linda Tartaglione, Annamaria Merola, Anna Tropea, Rosanna Apa, Dario Pitocco","doi":"10.1016/j.eprac.2025.06.020","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.06.020","url":null,"abstract":"<p><strong>Introduction: </strong>Polycystic ovary syndrome (PCOS) is a complex endocrine and metabolic disorder that affects 10-13% of women in reproductive age and it is often associated with insulin resistance (IR). There is lack of evidence about glucose profiles evaluated throughout continuous glucose monitoring (CGM) in women with PCOS, especially according to the presence of IR.</p><p><strong>Methods: </strong>Women with PCOS ≥18 years old underwent CGM (Freestyle Libre 2, Abbott®) for 14 days. Insulin resistance was defined by homeostatic model assessment for insulin resistance (HOMA-IR) >2 or quantitative insulin sensitivity check index (QUICKI) <0.357. CGM metrics were compared between the two groups. Associations between hormonal assays and CGM metrics were also evaluated.</p><p><strong>Results: </strong>In 36 women with PCOS, median age 22 [18-26] years, BMI 27.5 (6.6) Kg/m<sup>2</sup>, time in range (TIR, 70-180 mg/dl) and time in tight range (TiTR, 70-140 mg/dl) were comparable between women with and without IR (p>0.05). Independently to the score used to evaluate IR, women with IR presented lower coefficient of variation compared to those without IR (using HOMA-IR, CV non-IR 17.1 [12.0-19.8] vs IR 13.5 [11.2-15.5], p=0.04; using QUICKI non-IR 17.3 [11.2-19.9] vs IR 13.8 [10.9-15.7], p=0.04). Follicle stimulating hormone was also correlated with mean sensor glucose, time spent above 140 mg/dl and glucose management indicator.</p><p><strong>Conclusion: </strong>Women with PCOS presented overall good glucose control. No differences in TIR and TiTR were detected but women with IR presented lower coefficient of variation.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564698","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}
Meghana Koleti, Claramence Dokyi, Jean Kim, L Maria Belalcazar
{"title":"A Scoping Review of Self-Medication in Exogenous Cushing's Syndrome: The Role of Social Determinants of Health in the Case Report Literature.","authors":"Meghana Koleti, Claramence Dokyi, Jean Kim, L Maria Belalcazar","doi":"10.1016/j.eprac.2025.06.024","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.06.024","url":null,"abstract":"<p><p>The occurrence of exogenous Cushing's syndrome (E-CS) after self-medication with over-the-counter products containing steroids is well documented. However, the potential role of underlying social determinants of health (SDoH) on the practice of self-medication resulting in CS has not been systematically investigated. Using primary sources published in the form of case reports or case series from 1998- 2024, and adhering to PRISMA-ScR guidelines, we performed a scoping review to investigate the contribution of SDoH on the occurrence of CS due to self-medication. Information on SDoH, patient demographics, product and reason for use, and clinical complications was extracted. Only reports in English and on adults were included. Thirty-six reports met inclusion criteria. Seven of eight reports from the United States involved an over-the-counter product with undisclosed steroid content marketed for joint disease; 19 of the 28 international case reports/series involved self-medication with labeled pharmaceutical products. Although complications were consistently identified, only five of 36 reports on E-CS due to self-medication discussed and three provided information on SDoH. Social factors identified included lack of access to healthcare, low health literacy, language barriers, and traditional and cultural practices. All reports, except two, were found in journals with pre-publication peer review processes. Our findings point to the weak presence of SDoH in the case report literature on E-CS due to self-medication. It is necessary to move away from solely disease-focused approaches to those that incorporate SDoH. Peer reviewers and journal editors may help advance change by requesting that case reports/series on self-medication inform on SDoH.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564697","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":"Simplification of the oral sodium loading test: 2-day method replacing 3-day method.","authors":"Zewen Li, Jian Zhong, Yunying Cui, Songlin Yu, Ling Qiu, Anli Tong","doi":"10.1016/j.eprac.2025.06.021","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.06.021","url":null,"abstract":"<p><strong>Objectives: </strong>As one of the diagnostic tests for primary aldosteronism (PA), the oral sodium loading test (OSLT) usually takes 3 days, which is time-consuming.This study aims to investigate the possibility of the 2-day method replacing the 3-day method in the OSLT.</p><p><strong>Methods: </strong>In this prospective study, both PA patients and healthy participants were recruited and underwent an oral high-sodium diet for 3 consecutive days from December 2023 to December 2024. Daily fasting blood and 24h urine samples were collected before, on the second day, and on the third day of the OSLT.</p><p><strong>Results: </strong>12 PA patients [median age of 51.5 (42.0∼57.0) years, 75% men] and 12 healthy participants [median age of 30.5(24.0-39.8)years, 25% men] were recruited in this study. After oral sodium loading, all participants had a 24h urinary sodium> 200 mmol/24h. 24h urinary aldosterone (UALD) was not significantly different between the second day and the third day in PA patients [18.24 (15.58∼33.83) vs. 17.25 (12.74∼27.06) μg/24h, P=0.583], as well as in healthy participants [2.65 (1.67∼3.82) vs. 2.63 (1.63∼4.34) μg/24h, P=0.747]. There was a strong correlation of 24h UALD on the second day and the third day in both PA patients and healthy participants (r=0.8322 and 0.9333, respectively). Aldosterone-related steroid hormone profile showed no statistically significant difference between the two days, either for PA patients or for healthy participants.</p><p><strong>Conclusions: </strong>This study confirms that the 2-day method can replace the 3-day method in OSLT for a more convenient diagnosis of PA.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559531","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}
Muhammad Daoud Butt, Siew Chin Ong, Tooba Malik, Azra Rafiq, Aniekan Joshua Ibanga, Muhammad Nasir Kalam
{"title":"Empowering Diabetes Care Through Pharmacist-Led Education: A Randomized Controlled Trial in a Low-Resource Setting.","authors":"Muhammad Daoud Butt, Siew Chin Ong, Tooba Malik, Azra Rafiq, Aniekan Joshua Ibanga, Muhammad Nasir Kalam","doi":"10.1016/j.eprac.2025.06.022","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.06.022","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the effectiveness of a pharmacist-led diabetes self-management education (DSME) intervention on clinical outcomes, health-related quality of life (HRQoL), and diabetes knowledge among patients with type 2 diabetes mellitus (T2DM).</p><p><strong>Methods: </strong>A parallel-group, randomized controlled trial was conducted involving 400 patients with T2DM were assigned to either an intervention group (IG) receiving structured DSME over 12 months or a control group (CG) receiving standard care. Primary outcomes included changes in glycated haemoglobin (HbA1c) levels and diabetes knowledge, assessed using the Michigan Diabetes Knowledge Test (MDKT). Secondary outcomes included lipid profiles, blood pressure, diabetes self-management behaviors (DSMQ), and HRQoL (EQ-5D-5L). Data analysis involved ANCOVA and repeated measures ANOVA, with subgroup stratification based on baseline clinical risk profiles.</p><p><strong>Results: </strong>Participants in the IG exhibited significant reductions in HbA1c levels (from 9.12% to 8.02%) compared to those in the CG (from 9.27% to 9.01%; p < 0.001, η<sup>2</sup> = 0.13) and increased diabetes knowledge scores (from 11.10 to 14.88; p < 0.001). Significant group × time interaction effects were observed for HbA1c and random blood glucose. Subgroup analysis revealed notable improvements in total cholesterol (p = 0.03), triglycerides (p = 0.04), low-density lipoprotein (LDL) (p = 0.03), and systolic blood pressure (p = 0.05) among participants with elevated baseline levels. The IG also showed significant gains in self-management behaviors (p < 0.001) and HRQoL scores (p < 0.001).</p><p><strong>Conclusion: </strong>The pharmacist-led DSME program was effective in enhancing glycemic control glycemic control, diabetes knowledge, self-management behaviours, and HRQoL in patients with T2DM. Findings from subgroup analyses underscore the potential of tailored pharmacist-led interventions to optimize outcomes in high-risk populations.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144552668","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":"Postoperative considerations following pituitary surgery: A guide for clinicians.","authors":"Erica A Giraldi, Adriana G Ioachimescu","doi":"10.1016/j.eprac.2025.06.018","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.06.018","url":null,"abstract":"<p><p>Transsphenoidal surgery represents primary treatment for pituitary adenomas (other than prolactin-secreting) and other sellar/suprasellar masses including craniopharyngiomas. Endocrine evaluation for anterior hypopituitarism and water metabolism disorders is indicated in all patients. Transient fluid restriction postoperatively in patients without vasopressin deficiency reduces the risk of hyponatremia and hospital readmission. In Cushing disease, postoperative serum cortisol levels in the first postoperative days guide further management. In acromegaly, remission is established primarily by IGF-1 measurement three months postoperatively. Patients with functioning adenomas require proactive management of comorbidities related to hormone excess and lifelong monitoring for recurrence. Surgical outcomes are superior at high-volume institutions with neurosurgical and endocrinological expertise.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526929","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":"Effects of Plasma Aldosterone and Renin Concentrations with Blood Pressure Variation and Hypertension Risk in Chinese Adults: A Population-Based Hakka Biobank Study.","authors":"Fuxiang Fang, Jingwei Lin, Mingli Li, Zheng Wen, Diman Mai, Jingwen Liu, Lingyu Ye, Yezhou Wu, Xuefang Liang, Fuhua Hu, Yibi Lan, Junwu Ran, Renzhi Tan, Yongchen Li, Libing Lai, Jinlian Li, Yongxian Wu, Zheng Lu, Shengzhu Huang, Chao Wang, Zengnan Mo","doi":"10.1016/j.eprac.2025.06.015","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.06.015","url":null,"abstract":"<p><strong>Objectives: </strong>The renin-angiotensin-aldosterone system (RAAS) has been implicated in regulating blood pressure (BP), yet its effects on BP-related phenotypes are not well characterized in the Chinese population.</p><p><strong>Methods: </strong>Based on 8914 participants from the Hakka Biobank (HKB) cohort of China, regression models, restricted cubic spline (RCS), and subgroup analyses were used to analyze associations of plasma aldosterone concentration (PAC), plasma renin concentration (PRC), and the aldosterone-to-renin ratio (ARR) with multiple BP-related phenotypes.</p><p><strong>Results: </strong>Multivariable regression models indicated that higher log-PAC and log-ARR, and lower log-PRC, were associated with higher systolic blood pressure, diastolic blood pressure, pulse pressure, and mean arterial pressure (all P < 0.001). A 1-unit higher log-PAC or lower log-PRC was linked to higher risks of systolic, diastolic, clinic, and systolic-diastolic hypertension, with the odds ratios (ORs) ranging from 1.67 (95% confidence interval [CI], 1.47-1.85) to 6.29 (95% CI, 4.48-8.83); and the OR of a higher log-ARR ranged from 1.66 (95% CI, 1.47-1.86) for systolic-diastolic hypertension to 2.42 (95% CI, 2.14-2.73) for clinic hypertension. Consistent associations were observed in subgroup and sensitivity analyses, as well as the participants with renin-independent aldosteronism compared to those with normal aldosterone concentration or renin-dependent aldosteronism (all P < 0.05). Moreover, RCS model revealed significant non-linear associations between log-PAC, log-PRC and log-ARR with hypertension (all P nonlinearity < 0.05).</p><p><strong>Conclusions: </strong>Higher PAC and ARR, lower PRC were associated with adverse BP variation and elevated risk of hypertension, especially among participants in the context of renin suppression or autonomous aldosterone secretion.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511701","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}
Irene Mamali, Georgios K Markantes, Dionysios V Chartoumpekis, Kostas B Markou, Ioannis Kioutsioukis, Marina A Michalaki
{"title":"Establishing Serum Thyroglobulin Reference Values and Predictors of its Variability in an Iodine-Sufficient Population.","authors":"Irene Mamali, Georgios K Markantes, Dionysios V Chartoumpekis, Kostas B Markou, Ioannis Kioutsioukis, Marina A Michalaki","doi":"10.1016/j.eprac.2025.06.017","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.06.017","url":null,"abstract":"<p><strong>Objectives: </strong>Serum thyroglobulin (Tg) is a key biomarker for various thyroid conditions. However, population-specific reference values (RVs) are missing, and clinical practice relies on manufacturer-provided RVs. This study aimed to establish Tg RVs in an iodine-sufficient population using the strict National Academy of Clinical Biochemistry (NACB) criteria and to identify determinants of serum Tg levels.</p><p><strong>Methods: </strong>We screened 420 volunteers through history, physical examination, thyroid function tests (TFTs), urine iodine excretion, and thyroid ultrasonography. Thyroid volume (TTV) was estimated in a subset of the study population. We selected 140 subjects for NACB criteria-based Tg RVs determination (Cohort 1) and 154 for Tg determinant analysis (Cohort 2). Redundancy Analysis and Variation Partition were performed to quantify the explained variance of Tg from five variables -smoking, age, gender, TSH, and TTV.</p><p><strong>Results: </strong>The RVs for Tg, calculated as mean ± 2 standard deviations on log-transformed data (as per the NACB criteria), were 2.95-56.23 ng/mL, whereas those suggested by our Tg assay manufacturer are 3.5-77 ng/mL. A model including all five predictors explained only 7.5% of Tg variability, with smoking (4.8%) and TTV (2.7%) as the only significant contributors. Subgroup analysis showed that TSH had a minor impact only in men, while age and gender were not significant contributors.</p><p><strong>Conclusions: </strong>Population-specific RVs for Tg are essential in clinical decision-making. Known clinical/biochemical variables explained only a small proportion of Tg variability. Our findings underscore the need to identify additional determinants of Tg levels.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511702","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}
Rashi Sandooja, Oksana Hamidi, Catherine D Zhang, Prerna Dogra, Shobana Athimulam, Leili Rahimi, Camila Villavicencio Torres, Shireen R Chacko, William Young, Irina Bancos
{"title":"Bilateral Adrenal Nodules Presenting With Mild Autonomous Cortisol Secretion.","authors":"Rashi Sandooja, Oksana Hamidi, Catherine D Zhang, Prerna Dogra, Shobana Athimulam, Leili Rahimi, Camila Villavicencio Torres, Shireen R Chacko, William Young, Irina Bancos","doi":"10.1016/j.eprac.2025.06.019","DOIUrl":"10.1016/j.eprac.2025.06.019","url":null,"abstract":"<p><strong>Objective: </strong>Benign adrenocortical adenomas are frequently diagnosed on cross-sectional imaging performed for unrelated reasons. Up to 15% to 20% of adrenal nodules are bilateral, representing bilateral adenomas or primary bilateral macronodular adrenal hyperplasia.</p><p><strong>Methods: </strong>Mild autonomous cortisol secretion (MACS), diagnosed based on an abnormal dexamethasone suppression test, is seen in 19% to 44% of patients with adrenal adenomas. Distinguishing unilateral from bilateral MACS in patients with bilateral nodules is important to guide appropriate therapy and relies on imaging phenotype, and, in some cases, on adrenal vein sampling.</p><p><strong>Results: </strong>MACS is associated with cardiovascular morbidity, poor quality of life, frailty, and increased mortality. Reversal of MACS improves these outcomes; however, management of patients with bilateral MACS is challenging. Unilateral adrenalectomy in patients with bilateral nodules and MACS may lead to permanent remission (if MACS is unilateral), temporary remission, or improvement of the degree of MACS (if MACS is bilateral). No medical therapy is currently approved for MACS.</p><p><strong>Conclusion: </strong>Here, we review the presentation, diagnosis, and management of patients with bilateral adrenal nodules and MACS.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505137","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":"Risk stratification and long-term outcome of benign thyroid nodules - a 11-year cohort study.","authors":"Sapir Pinhas, Jonathan Cohen, Raviv Allon, Nadav Ben-David, Noam Koch, David Kiderman, Elchanan Zloczower, Taiba Zornitzki, Moshe Yehuda, Yonatan Lahav, Oded Cohen","doi":"10.1016/j.eprac.2025.06.016","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.06.016","url":null,"abstract":"<p><strong>Objectives: </strong>The recommended follow-up interval and length, as well as the indication for repat fine needle aspiration in benign nodules remains unclear up to date. The purpose of the study was to evaluate the long-term follow-up and management outcomes of benign thyroid nodules.</p><p><strong>Methods: </strong>A retrospective study included 1,224 nodules from 1,071 patients with initial benign thyroid nodules, between 2010 and 2014. Phone calls were made to obtain updated information from patients when information was missing. The main outcome of the study was a change in the nodule's ROM - defined either as a malignant pathology (when obtained) or by cytology (repeated BSRTC III, IV, V, or VI). Secondary outcomes included the yield of repeated FNA. Data included demographics, sonographic data, follow-up adherence, repeat FNA results, surgery types, and pathologic results.</p><p><strong>Results: </strong>The average follow-up period was 9.48 ± 1.72 years. 0.65% (7/1071) of patients remained without follow-up. The ROM was 3.43% (42/1224). Benign nodules >2 cm had a higher ROM compared to smaller nodules (5.3% vs. 1.3% respectively, p-value<0.001). Repeat FNA and a change in nodule size did not significantly change ROM. Among the 41 malignant nodules with documented size, 33 (80.49%) were nodules larger than 2 cm. A total of 35 cases (85.37%) were diagnosed within the first 3 years of follow-up.</p><p><strong>Conclusion: </strong>ROM for benign nodules remains considerably low, especially for nodule smaller than 2 cm. Long-term follow-up and repeated FNA and follow-up for BTSC II thyroid nodules without suspicious features should be reconsidered.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511703","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}
Caiyan Mo, Tao Tong, Yao Wang, Hongyu Liu, Dan Liang, Ying Guo, Jian Xu, Liyong Zhong
{"title":"The Effect of Growth Hormone-Secreting Pituitary Adenoma Disease Activity on Thyroid Nodules.","authors":"Caiyan Mo, Tao Tong, Yao Wang, Hongyu Liu, Dan Liang, Ying Guo, Jian Xu, Liyong Zhong","doi":"10.1016/j.eprac.2025.06.013","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.06.013","url":null,"abstract":"<p><strong>Objective: </strong>Previous studies on thyroid nodules in patients with growth hormone-secreting pituitary adenoma (GHPA) had small sample sizes and inconsistent findings. This study aims to summarize the clinical characteristics of thyroid nodules in patients with GHPA, investigate the relationship between thyroid nodule volume and disease activity, and analyze risk factors associated with thyroid nodule development.</p><p><strong>Methods: </strong>There were 150 patients with GHPA included from a retrospective review of medical records from January 2009 to December 2024. At baseline, correlations were investigated between growth hormone (GH), insulin-like growth factor-1 (IGF-1), thyroid-stimulating hormone (TSH) with maximum thyroid nodule diameter (TND) and total thyroid nodule volume (TTNV). A binary logistic regression analysis was used to explore the risk factors for the development of thyroid nodules in patients with GHPA. Data from 54 patients were available for longitudinal follow-up measures of thyroid nodule characteristics between baseline and last follow-up.</p><p><strong>Results: </strong>The prevalence of thyroid nodules in patients with GHPA was 74%. Baseline TND and TTNV were positively correlated with age and IGF-1 levels and negatively correlated with TSH levels. Patients with thyroid nodules exhibited higher GH levels. During prospective follow-up, TND significantly decreased following a marked reduction in GH/IGF-1 levels. Logistic regression analysis identified baseline GH level as an independent risk factor for thyroid nodule occurrence.</p><p><strong>Conclusion: </strong>Chronic elevation of GH/IGF-1 levels in patients with GHPA is associated with the development and progression of thyroid nodules. Following treatment of GHPA, a reduction in GH/IGF-1 levels correlates with a decrease in thyroid nodule volume. Close monitoring of nodule growth and regular thyroid ultrasonography are recommended, particularly for nodules with malignant features.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144495232","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}