Endocrine Practice最新文献

{"title":"Prediabetes Phenotypes and All-Cause or Cardiovascular Mortality: Evidence From a Population-Based Study","authors":"Xiufang Kong MD, PhD ,&nbsp;Wei Wang MD, PhD","doi":"10.1016/j.eprac.2025.01.003","DOIUrl":"10.1016/j.eprac.2025.01.003","url":null,"abstract":"<div><h3>Objective</h3><div>Fasting plasma glucose (FPG), glycated hemoglobin A_1C (HbA_1C), and 2-hour postload plasma glucose (2h PG) are all currently used to define prediabetes. We aimed to determine whether a higher number of prediabetes defects correspond to an increased all-cause and cardiovascular disease (CVD) mortality.</div></div><div><h3>Methods</h3><div>Individuals with prediabetes and available information on FPG, HbA_1C, 2h PG, and mortality data were derived from the 2005-2016 National Health and Nutrition Examination Survey. Kaplan-Meier survival curves, Cox proportional hazards regression analysis, and stratified analysis were used to compare all-cause and CVD mortality among participants with one, two, and all three defects.</div></div><div><h3>Results</h3><div>Among the 4511 individuals included, 76.31%, 30.89%, and 41.65% met the FPG-, 2h PG-, and HbA_1C-defined criteria for prediabetes, respectively. There were 2609 (60.78%), 1420 (29.60%), and 482 (9.62%) adults meeting one, two, and all three criteria for prediabetes, respectively. During a median follow-up of 100 months, a total of 534 (180 CVD-related) deaths occurred. The multivariable-adjusted hazard ratios and 95% confidence intervals in those meeting two and three criteria were 1.341 (1.042-1.727) and 1.369 (1.027-1.824), respectively, for all-cause mortality (P for trend = 0.006), and 1.836 (1.228-2.744) and 2.037 (1.092-3.801), respectively, for CVD mortality (P for trend = 0.002), with those meeting only one criterion as the reference. In subgroup analysis, the association between the number of diagnostic criteria for prediabetes and CVD mortality was observed only in men.</div></div><div><h3>Conclusions</h3><div>A higher number of diagnostic criteria for prediabetes was associated with increased all-cause and CVD mortality.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 4","pages":"Pages 486-493"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002287","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 Aspects of Medical Therapy in Graves Disease","authors":"Rutu Shah MD,&nbsp;Samantha E. Adamson MD, PhD,&nbsp;Sina Jasim MD, MPH","doi":"10.1016/j.eprac.2024.12.012","DOIUrl":"10.1016/j.eprac.2024.12.012","url":null,"abstract":"<div><h3>Objective</h3><div>Graves disease (GD) is the most common cause of hyperthyroidism. Treatment options include antithyroid drugs (ATDs), radioactive iodine, and surgery. In this review, we focus on the medical aspects of managing GD.</div></div><div><h3>Methods</h3><div>The authors conducted a literature review of PubMed to include studies and review articles on GD management, ATDs, long-term safety of antithyroid drugs, hyperthyroidism in pregnancy, Graves ophthalmopathy, and special circumstances related to hyperthyroidism.</div></div><div><h3>Results</h3><div>In adjunction to ATDs, medical management for GD also includes beta-blockers, glucocorticoids, and iodine containing agents. ATDs are currently the preferred option for initial management of GD, reflecting a shift in practice observed in the United States over the past 2 decades. ATDs in appropriate doses are well-tolerated and safe when used for longer duration, during pregnancy, and other circumstances discussed in this article. Routine thyroid function tests are important for monitoring. Thyrotropin receptor antibody plays an essential role in determining duration of treatment and assessing the likelihood of recurrence.</div></div><div><h3>Conclusion</h3><div>Medical management of GD with antithyroid drug is safe and effective. Long-term use beyond 24 months in patients with elevated thyrotropin receptor antibody is a reasonable alternative option to surgery and radioactive iodine due to higher rates of remission.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 4","pages":"Pages 536-546"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863043","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 Predictive Model for Graves’ Disease Recurrence After Antithyroid Drug Therapy: A Retrospective Multicenter Cohort Study","authors":"Omar El Kawkgi MD ,&nbsp;David Toro-Tobon MD ,&nbsp;Freddy J.K. Toloza MD ,&nbsp;Sebastian Vallejo MD ,&nbsp;Cristian Soto Jacome MD ,&nbsp;Ivan N. Ayala MD ,&nbsp;Bryan A. Vallejo MD ,&nbsp;Camila Wenczenovicz MD ,&nbsp;Olivia Tzeng MD ,&nbsp;Horace J. Spencer MS ,&nbsp;Jeff D. Thostenson MS ,&nbsp;Dingfeng Li MD ,&nbsp;Jacob Kohlenberg MD ,&nbsp;Eddy Lincango MD ,&nbsp;Sneha Mohan MD ,&nbsp;Jessica Castellanos-Diaz MD ,&nbsp;Spyridoula Maraka MD ,&nbsp;Naykky Singh Ospina MD ,&nbsp;Juan P. Brito MD","doi":"10.1016/j.eprac.2024.12.011","DOIUrl":"10.1016/j.eprac.2024.12.011","url":null,"abstract":"<div><h3>Objectives</h3><div>Predicting recurrence after antithyroid drug (ATD) cessation is crucial for optimal treatment decision-making in patients with Graves' disease (GD). We aimed to identify factors associated with GD recurrence and to develop a model using routine pretherapeutic clinical parameters to predict GD recurrence risk during the first year following ATD discontinuation.</div></div><div><h3>Methods</h3><div>This electronic health records-based observational cohort study analyzed patients with GD treated with ATDs at 3 U.S. academic centers. Demographic, clinical characteristics, and GD recurrence within 1 year following ATD discontinuation were assessed. Univariable and multivariable analyses were performed. A predictive model for GD recurrence was developed and visualized as a nomogram.</div></div><div><h3>Results</h3><div>Among the 523 patients included in the study, 211 (40.34%) discontinued treatment. Of these, the 142 (67.29%) that had a follow-up period exceeding 12 months after stopping ATD were used for the development of the predictive model. Among the patients included in the model, the majority were women (<em>n</em> = 111, 78.16%), with a mean age of 49.29 years (standard deviation 16.31) and baseline free thyroxine (FT4) levels averaging 3.39 ng/dl (standard deviation 2.25). Additionally, 79 of 211 patients (37.44%) experienced recurrence within 1 year. Multivariable analysis indicated a 31% increased risk of GD recurrence per additional decade of age (odds ratio 1.31, 95% confidence interval 1.03-1.66, <em>P</em> = .0258), and a 65% increased risk of GD recurrence for every 2.0 ng/dL rise in baseline FT4 (odds ratio 1.65, 95% confidence interval 1.08-2.50, <em>P</em> = .0192). The recurrence predictive model's area under the curve was 0.69 in the derivation dataset and 0.65 in cross-validation.</div></div><div><h3>Conclusions</h3><div>This study introduced a practical model that can be used during the initial therapeutic decision-making process. It utilizes easily accessible baseline clinical data to predict the likelihood of GD recurrence after 1 year of ATD therapy. Further research is needed to identify other factors affecting risk of recurrence and develop more precise predictive models.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 4","pages":"Pages 455-464"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853542","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":"The Challenge of Fractures in Patients With Chronic Kidney Disease","authors":"Andrea G. Kattah MD, MSc ,&nbsp;Silvia M. Titan MD ,&nbsp;Robert A. Wermers MD","doi":"10.1016/j.eprac.2024.12.018","DOIUrl":"10.1016/j.eprac.2024.12.018","url":null,"abstract":"<div><h3>Objective</h3><div>People with chronic kidney disease (CKD) are at increased risk of fractures in comparison to the non-CKD population, and fractures are associated with high mortality and worsening quality of life. However, the approach for evaluation of bone disease and fracture risk in CKD is different from the approach in the general population.</div></div><div><h3>Methods</h3><div>The authors conducted a literature review of PubMed to include studies on pathophysiology of CKD mineral bone disorder, fracture risk assessment, and therapeutic options in the setting of CKD.</div></div><div><h3>Results</h3><div>The higher risk observed in the CKD population is related to the complex interplay of changes in bone turnover (T), mineralization (M), and volume (V), along with other risk factors accumulated as glomerular filtration rate declines. The diagnosis of the type of renal osteodystrophy is not based only on assessment of bone density and traditional risk factors for osteoporosis. There are limitations of currently available fracture risk tools in the CKD population. Treatment choice should take into consideration the 3 components of the TMV classification along with the stage of kidney disease and comorbidities, but the assessment of these components has not been well established.</div></div><div><h3>Conclusions</h3><div>Current data are limited on efficacy and safety of treatments for fracture prevention in CKD. As new medications for the treatment of osteoporosis become available, there is an urgency to establish more clear guidelines for the diagnosis, fracture risk stratification, and treatment of bone disease in CKD.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 4","pages":"Pages 511-520"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902708","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":"Corrigendum to “Sodium-Glucose Cotransporter 2 Inhibitors Reduce the Risk of Hospitalization for Heart Failure and Amputation Rate Compared With Incretin-Based Therapy in Patients With Diabetic Foot Disease: A Nationwide Population-Based Study” [Endocrine Practice 30 (2024) 424-430]","authors":"Yi-Hsuan Lin ,&nbsp;Chia-Hung Lin ,&nbsp;Yu-Chih Lin ,&nbsp;Yu-Yao Huang ,&nbsp;An-Shun Tai ,&nbsp;Shih-Chen Fu ,&nbsp;Sheng-Hsuan Lin","doi":"10.1016/j.eprac.2025.01.006","DOIUrl":"10.1016/j.eprac.2025.01.006","url":null,"abstract":"","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 4","pages":"Page 556"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406271","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":"Info for Readers/Subscription page","authors":"","doi":"10.1016/S1530-891X(25)00086-2","DOIUrl":"10.1016/S1530-891X(25)00086-2","url":null,"abstract":"","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 4","pages":"Pages A3-A4"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143829418","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":"Association of Baseline Thyroid Stimulating Hormone With In-Hospital Outcomes in Patients With Atrial Fibrillation and Coronary Artery Diseases","authors":"Lisha Zhang MD,&nbsp;Yan Zhang PhD,&nbsp;Fuxue Deng MD,&nbsp;Wei Jiang PhD","doi":"10.1016/j.eprac.2024.12.015","DOIUrl":"10.1016/j.eprac.2024.12.015","url":null,"abstract":"<div><h3>Objective</h3><div>Thyroid stimulating hormone (TSH) is related to increased atrial fibrillation (AF) inducibility and plays an important role in a variety of cardiovascular diseases. However, the association of baseline TSH with in-hospital outcomes in patients with AF and coronary artery disease (CAD) is unknown. This study aimed to investigate the distribution of baseline TSH and its association with in-hospital outcomes (major adverse cardiovascular events, all-cause death, or heart failure [HF]) in AF patients combined with CAD.</div></div><div><h3>Methods</h3><div>A total of 19 725 patients with AF were included. The status of blood TSH was investigated. Patients with AF and CAD were divided into low, median, and high-TSH subgroups based on tertiles of baseline TSH levels. Clinical characteristics and in-hospital outcomes were compared. Logistic regression analysis was performed to determine the association of TSH with in-hospital outcomes. Subgroup analysis was also performed.</div></div><div><h3>Results</h3><div>In patients with AF and CAD, compared with the low-TSH group, the median-TSH (OR 0.277, 95% CI 0.078-0.991, <em>P</em> = .048) and high-TSH (OR 0.163, 95% CI 0.036-0.750, <em>P</em> = .020) groups were associated with decreased all-cause death. Besides, high TSH showed a protective role for HF events, and the same results were seen in females, age ≥75, and non–non-hypertension subgroups.</div></div><div><h3>Conclusion</h3><div>Higher baseline TSH presented a protective effect on in-hospital all-cause death and HF in patients with AF combined with CAD.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 4","pages":"Pages 465-470"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892955","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":"Influence of Radioiodine Therapy on Oral Health and Salivary Production in Patients With Differentiated Thyroid Carcinoma","authors":"Jorge Ramires Terrazas MD ,&nbsp;Clarissa Robalinho Penna Marins ,&nbsp;Maria Elvira Pizzigatti Correa PhD ,&nbsp;Lígia Vera Montali da Assumpção MD, PhD ,&nbsp;Denise Engelbrecht Zantut-Wittmann MD, PhD","doi":"10.1016/j.eprac.2025.01.001","DOIUrl":"10.1016/j.eprac.2025.01.001","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the characteristics related to oral health and salivary production in patients with differentiated thyroid carcinoma (DTC) after radioiodine therapy (RIT).</div></div><div><h3>Methods</h3><div>Cross-sectional study, which included patients with DTC after ablative and/or adjuvant RIT. Patients underwent assessment of oral health conditions, subjective assessment of xerostomia, and measurement of salivary flow. Salivary glands were assessed by cervical ultrasound at the time of clinical evaluation.</div></div><div><h3>Results</h3><div>Sixty-seven DTC patients were included. Oral health was found very good or good in 60% of patients, 84% had no dental plaque or a slight amount, and 53% had normal-looking gums. There was a negative correlation between the salivary flow with activity of RIT ablative, number of RITs received, and total activity of radioiodine administered until oral assessment. Reduction in parotid gland volume on ultrasound was associated with greater number of times receiving RIT, longer time between RIT and patient assessment, greater 131I activity administered.</div></div><div><h3>Conclusion</h3><div>Good or very good oral health was observed in 60% of patients with DTC after RIT, 15% reported hyposalivation, and 13%, frequent xerostomia. Higher number and higher total activity of radioiodine administered, as well as reduction in the volume and heterogeneous texture of parotid gland on ultrasound were predictive factors of lower salivary flow.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 4","pages":"Pages 439-446"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970028","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":"Mixed Methods Randomized Controlled Trial Comparing Quality of Life for Pregnant Women With Type 1 Diabetes Using Hybrid Closed-Loop to Sensor-Augmented Pump Therapy","authors":"Elizabeth O. Buschur MD, FACE ,&nbsp;Julia Reedy MA ,&nbsp;Cari Berget RN, MPH, CDCES ,&nbsp;Juliana G. Barnard MA ,&nbsp;Rachel Garcetti PA-C, MS ,&nbsp;Emily Nease MS, CDCES, RDN ,&nbsp;Anna Bartholomew MPH, BSN, RN, CCRP ,&nbsp;Carly Johnson BS ,&nbsp;Kimberly A. Driscoll PhD ,&nbsp;Kathleen M. Dungan MD, MPH ,&nbsp;Janet K. Snell-Bergeon PhD ,&nbsp;Laura L. Pyle PhD ,&nbsp;Sarit Polsky MD, MPH","doi":"10.1016/j.eprac.2025.01.005","DOIUrl":"10.1016/j.eprac.2025.01.005","url":null,"abstract":"<div><h3>Objective</h3><div>Type 1 diabetes in pregnancy is challenging. This study explores how assisted hybrid closed-loop therapy (HCL) versus sensor-augmented pump therapy (SAPT) impacts quality of life in pregnancy.</div></div><div><h3>Methods</h3><div>We interviewed 22 of 24 participants randomized to HCL or SAPT in the Pregnancy Intervention with a Closed-Loop System study. Participants completed questionnaires about hypoglycemia fear and device satisfaction and trust.</div></div><div><h3>Results</h3><div>Quality of life was similar among women with type 1 diabetes using HCL (<em>n</em> = 12) and SAPT (<em>n</em> = 12) throughout pregnancy and early postpartum. Hypoglycemia fear was not statistically different between groups but improved in the HCL group in the second trimester versus baseline. Glucose monitoring satisfaction and trust increased during pregnancy in the HCL group but decreased in the SAPT group. Women trusted their mode of insulin delivery despite stress and frustration with fluctuating glucose and risks of hyperglycemia to their fetuses. Women who preferred less involvement with their management preferred HCL, whereas those desiring more involvement preferred SAPT.</div></div><div><h3>Conclusion</h3><div>These similarities demonstrate that open communication is needed between provider and patient to determine perceived benefits versus burdens of HCL use in pregnancy, especially in the United States where available HCL systems lack pregnancy-specific algorithms and Food and Drug Administration approval for pregnancy use.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 4","pages":"Pages 494-502"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036765","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":"Stroke in the Patient With Type 2 Diabetes","authors":"Terri W. Jerkins MD ,&nbsp;David S.H. Bell MB","doi":"10.1016/j.eprac.2025.01.010","DOIUrl":"10.1016/j.eprac.2025.01.010","url":null,"abstract":"<div><h3>Objective</h3><div>Persons living with type 2 diabetes mellitus (T2DM) have a significantly greater risk of stroke (1.5 to 3 times higher than normoglycemic individuals). The traditional approach to primary and secondary stroke prevention has been control of risk factors. While this has resulted in prolongation of life in patients with diabetes, the risk for recurrent stroke in these patients still remains higher than in the normoglycemic population, and patients with T2DM post stroke have a poorer quality of life (increases in handicap and death).</div></div><div><h3>Methods</h3><div>Multiple publications on the pathophysiology which increases stroke in T2DM were reviewed as well as new publications looking at the effect of traditional and new risk factor modification on stroke are summarized.</div></div><div><h3>Results</h3><div>Traditional risk factor modification is refined with recommended levels of lipids and blood pressure and methods of anticoagulation. More recently, studies with antidiabetic drugs (glucagon-like peptide 1 RA and pioglitazone) have been shown to prevent both primary and secondary stroke in patients with diabetes.</div></div><div><h3>Conclusions</h3><div>Worldwide, stroke is the second leading cause of death and the third leading cause of disability. Both risk and the outcomes are greatly worsened by the presence of T2DM. Newer recommendations can improve these outcomes.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 4","pages":"Pages 547-553"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364115","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}