Endocrine Practice最新文献

{"title":"Clinical Accuracy of Continuous Glucose Monitoring Immediately After Kidney Transplant in Patients With Type 2 Diabetes.","authors":"Qurrat-Ul-Ain Aziz, Kavita Batra, Sanna Fatima, Jared Splinter, Amber Laurel Champion, Ajay M Kumar, Kenneth E Izuora","doi":"10.1016/j.eprac.2025.04.022","DOIUrl":"10.1016/j.eprac.2025.04.022","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the accuracy of a blinded continuous glucose monitoring (CGM) device compared with point-of-care testing (POCT) and serum glucose measurements in the immediate postoperative period among kidney transplant recipients with type 2 diabetes mellitus (DM).</p><p><strong>Methods: </strong>In this prospective study, we enrolled 22 participants aged ≥18 years, with type 2 DM, immediately after kidney transplant. We applied a blinded CGM device that sampled interstitial glucose every 15 minutes and collected POCT and serum glucose values. Using matched pairs of glucose readings between CGM and POCT and between CGM and serum glucose, we calculated bias and absolute relative difference and conducted a Clarke Error Grid Analysis.</p><p><strong>Results: </strong>Eighty-two percent of the participants were male, with a mean age of 58 ± 9.69 years, mean body mass index of 30 ± 6.41 kg/m², and baseline mean A1C level of 6.7 ± 1.07%. The mean durations of type 2 DM and end-stage kidney disease were 19 ± 10.6 and 3 ± 2.27 years, respectively. There were 327 and 72 matched pairs of CGM/POCT and CGM/serum glucose data, respectively. Clarke Error Grid Analysis comparing CGM/POCT showed 83.79% of values in zone A and 15.29% in zone B (combined 99.08%), with a mean absolute relative difference of 13.24%. For CGM/serum glucose, values of 83.1% were in zone A, and values of 16.9% were in zone B (combined 100%), with a mean absolute relative difference of 13.10%.</p><p><strong>Conclusion: </strong>CGM provided accurate blood glucose measurements compared with POCT and serum glucose values in patients with type 2 DM after kidney transplant. When used in this patient population, CGM devices have the potential to improve clinical outcomes through earlier detection and intervention for glycemic excursions.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992727","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":"Diagnostic Performance of Noninvasive Tests for Identifying Advanced Fibrosis in Metabolic Dysfunction-Associated Fatty Liver Disease With Mixed Etiologies.","authors":"He Yi, Yan Zhang, Ziwei Zhou, Weixia Sun, Yifan Wang, Wenxuan Tao, Hekai Yu, Liqin Yao, Jia Li, Ling Li","doi":"10.1016/j.eprac.2025.04.021","DOIUrl":"10.1016/j.eprac.2025.04.021","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the performance of fibrosis-4 index (FIB-4), nonalcoholic fatty liver disease fibrosis score (NFS) and aspartate aminotransferase to platelet ratio index (APRI) for advanced fibrosis in metabolic dysfunction-associated fatty liver disease (MAFLD) subgroups categorized by concomitant liver conditions.</p><p><strong>Methods: </strong>We conducted a multicentered study comprising inpatients with type 2 diabetes mellitus and MAFLD. Participants were categorized into 2 groups: MAFLD with pure metabolic etiologies (MAFLD-P) and MAFLD with mixed etiologies (MAFLD-M). Diagnostic performance of FIB-4, NFS, and APRI was assessed by area under the curve (AUC), sensitivity, and specificity.</p><p><strong>Results: </strong>This study comprised a total of 1475 participants, with a mean (SD) age of 58.4 (13) years and 835 (56.6%) males. FIB-4 and APRI had higher AUCs for advanced fibrosis in the MAFLD-M group than in the MAFLD-P group (MAFLD-M vs MAFLD-P: FIB-4 0.680 vs 0.591, P = .0442; APRI 0.723 vs 0.631, P = .0363). No significant difference was observed in the AUC of NFS between the 2 subgroups (MAFLD-M 0.572 vs MAFLD-P 0.617; P = .3237). Besides, the sensitivity of FIB-4 (69.6% vs 54.0%; P = .019) and APRI (43.5% vs 26.1%; P = .005) was higher in the MAFLD-M group. However, no significant difference in sensitivity of NFS and specificity of FIB-4, NFS, and APRI was observed between subgroups.</p><p><strong>Conclusions: </strong>In this diagnostic study of the type 2 diabetes mellitus population, FIB-4 and APRI showed better performance for identifying advanced fibrosis in MAFLD with mixed etiologies.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990688","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":"Efficacy and Safety of Teprotumumab in Thyroid Eye Disease: A Systematic Review and Meta-Analysis","authors":"Wenxin Huang MM ,&nbsp;Xiaodan Ou MD ,&nbsp;Shuzhen Lin MM ,&nbsp;Wei Lin MD ,&nbsp;Gang Chen MD, PhD ,&nbsp;Huibin Huang MD ,&nbsp;Junping Wen MD, PhD","doi":"10.1016/j.eprac.2025.01.012","DOIUrl":"10.1016/j.eprac.2025.01.012","url":null,"abstract":"<div><h3>Objective</h3><div>Teprotumumab was approved by the US Food and Drug Administration (FDA) for treating Graves' orbitopathy in adults on January 21, 2020. This study evaluates its efficacy and safety in treating thyroid eye disease (TED).</div></div><div><h3>Methods</h3><div>We reviewed studies on teprotumumab for TED treatment from PubMed, Web of Science, EMBASE, Cochrane library, and Clinical trials. gov up to January 1, 2024. Outcomes included proptosis response, diplopia, Clinical Activity Score (CAS) score, and adverse events (AEs).</div></div><div><h3>Results</h3><div>Our analysis included 10 studies, 4 randomized controlled trials, and 6 observational studies. The randomized controlled trials involved 210 teprotumumab patients and 193 controls. Teprotumumab significantly improved proptosis response (relative risk [RR] 4.18, 2.72-6.43), diplopia regression (RR 2.29, 1.54-3.41), and CAS score (RR 3.09, 1.98-4.80) compared to placebo. A significant reduction in proptosis was observed (standardized mean difference −8.38, −9.25 - −7.52). The risk of AEs and serious AEs was higher with teprotumumab. The 6 observational studies included 211 patients, showing an 82% proptosis response rate, a −3.31 mm change in proptosis, a 0.58 diplopia improvement rate, and a 0.66 pooled effect size for CAS score. AE incidence was 0.78, and serious AEs were 0.31.</div></div><div><h3>Conclusion</h3><div>Teprotumumab effectively reduces proptosis, improves diplopia, and lowers disease activity in TED, regardless of previous treatments, severity, or dosage, albeit with increased AEs. It has the potential to become a vital first-line treatment for TED, enhancing patient quality of life.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 5","pages":"Pages 640-649"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424595","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":"Exploring the Link Between Thyroid Disorders and Obesity: Mechanisms, Impacts, and Clinical Implications","authors":"Ashni Dharia MD ,&nbsp;Dimpi Desai MD ,&nbsp;Kaniksha Desai MD","doi":"10.1016/j.eprac.2025.02.005","DOIUrl":"10.1016/j.eprac.2025.02.005","url":null,"abstract":"<div><h3>Objective</h3><div>Obesity and thyroid dysfunction are among the most significant challenges in endocrinology, frequently overlapping to create complexities in weight management. Even after achieving euthyroidism, weight variations persist, significantly affecting patients' quality of life. This review explores the mechanisms linking hypothyroidism and hyperthyroidism to weight fluctuations, emphasizing their impact on basal metabolic rate, appetite regulation, glucose and lipid metabolism, and thermogenesis.</div></div><div><h3>Methods</h3><div>We conducted a comprehensive review using PubMed and Google Scholar, applying the search criteria: (obesity OR overweight) AND (Hashimoto's thyroiditis OR hyperthyroidism OR hypothyroidism OR Thyroid Cancer). From this search, we reviewed 500 publications and finally included 71 publications, focusing on broad clinical questions regarding the role of thyroid hormones in weight regulation and metabolism, the impact of thyroid disorders and their treatments on obesity, and approaches for managing obesity in the context of thyroid dysfunction.</div></div><div><h3>Results</h3><div>In hypothyroidism, the impact of levothyroxine therapy on weight changes is discussed, along with the potential role of T3 supplementation. For hyperthyroid patients, the effects of antithyroid medications, radioactive iodine therapy, and thyroidectomy on weight regulation are explored. Pharmacological and nonpharmacological strategies for managing obesity in thyroid disorders are reviewed. Lifestyle interventions and pharmacotherapies are evaluated for their efficacy and potential effects on thyroid function. Lastly, the implications of bariatric surgery are explored, including its effects on thyroid function, medication absorption, and postsurgical management of thyroid disorders.</div></div><div><h3>Conclusion</h3><div>This review underscores the importance of an integrated, multidisciplinary approach to managing obesity in the context of thyroid dysfunction to optimize patient outcomes.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 5","pages":"Pages 660-667"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424789","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":"Antiresorptive Therapy to Reduce Fracture Risk and Effects on Dental Implant Outcomes in Patients With Osteoporosis: A Systematic Review and Osteonecrosis of the Jaw Taskforce Consensus Statement","authors":"Dalal S. Ali MD, MSc, FRCPI ,&nbsp;Aliya A. Khan MD, FRCPC, FACP, FACE, FASBMR ,&nbsp;Archibald Morrison DDS, PhD ,&nbsp;Sotirios Tetradis DDS, PhD ,&nbsp;Reza D. Mirza MD, MSc, FRCPC ,&nbsp;Mohamed El Rabbany DDS, MSc, PhD, FRCDC ,&nbsp;Bo Abrahamsen MD, PhD ,&nbsp;Tara L. Aghaloo DDS, MD, PhD ,&nbsp;Hatim Al-Alwani MD ,&nbsp;Rana Al-Dabagh DDS ,&nbsp;Athanasios D. Anastasilakis MD ,&nbsp;Mohit Bhandari O.Ont, MD, PhD, FRCSC ,&nbsp;Jean-Jacques Body MD ,&nbsp;Maria Luisa Brandi MD, PhD ,&nbsp;Romina Brignardello-Petersen PhD ,&nbsp;Jacques P. Brown MD ,&nbsp;Angela M. Cheung MD ,&nbsp;Juliet Compston MD ,&nbsp;Cyrus Cooper MD ,&nbsp;Adolfo Diez-Perez MD, PhD ,&nbsp;Salvatore L. Ruggiero DMD, MD, FACS","doi":"10.1016/j.eprac.2025.02.016","DOIUrl":"10.1016/j.eprac.2025.02.016","url":null,"abstract":"<div><h3>Objective</h3><div>Placement of a dental implant in a patient on antiresorptive therapy has been hypothesized to increase the risk of medication-related osteonecrosis of the jaw (MRONJ) and/or impact implant survival. In patients with osteoporosis, the risk of MRONJ with antiresorptive therapy is only marginally higher than observed in the general population.</div></div><div><h3>Methods</h3><div>The International ONJ Taskforce conducted a systematic review of the literature and evaluated the outcomes of implant placement in individuals with osteoporosis receiving antiresorptive therapy.</div></div><div><h3>Results</h3><div>The data were reviewed by the International Taskforce, and consensus was achieved on the following GRADEd recommendation. In patients with osteoporosis on antiresorptive therapy, the Taskforce suggests that antiresorptive therapy does not need to be stopped prior to proceeding with dental implant (weak recommendation, very low-quality evidence). Long-term bisphosphonate use maybe associated with a small increase in the risk of MRONJ (3 cases per 1000 patients; adjusted hazard ratio: 4.09, 95% CI: 2.75-6.09, <em>P</em> &lt; .001, moderate certainty).</div></div><div><h3>Conclusion</h3><div>Current evidence does not suggest an association between antiresorptive therapy in patients with osteoporosis and dental implant failure. Implants may be safely placed in the presence of concomitant use of bisphosphonates or denosumab in patients with osteoporosis with no evidence of an increased risk of implant failure/compromise.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 5","pages":"Pages 686-698"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906535","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":"Delivery Mode and Neonatal Thyrotropin Levels: Insights From a Systematic Review and Meta-Analysis","authors":"Mohadese Dashtkoohi MD ,&nbsp;Mohammadamin Parsaei MD ,&nbsp;Mohammad Sadeq Najafi MD ,&nbsp;Elahe Amirkhalili PhD ,&nbsp;Mohammadreza Chashmyazdan PhD ,&nbsp;Pantea Nazeri PhD","doi":"10.1016/j.eprac.2025.02.006","DOIUrl":"10.1016/j.eprac.2025.02.006","url":null,"abstract":"<div><h3>Background</h3><div>Optimal thyroid function is particularly crucial during infancy. This systematic review and meta-analysis aimed to investigate the relationship between the mode of delivery and neonatal thyrotropin levels at birth.</div></div><div><h3>Methods</h3><div>We conducted a systematic search of MEDLINE/PubMed, Web of Science, Embase, Scopus, and the Cochrane Library for studies published up to 2023. Hedges’ g with 95% confidence intervals was calculated to compare mean thyroid-stimulating hormone (TSH) levels based on the mode of delivery. Additionally, TSH levels were compared based on blood sampling methods, heel blood vs cord blood, using the same meta-analytic approach. A random effects model was employed due to the presence of heterogeneity. This study is registered with PROSPERO under the number CRD42024533649.</div></div><div><h3>Results</h3><div>A total of 1438 studies were identified, of which 18 met the criteria for the systematic review. The meta-analysis of ten studies revealed significantly higher pooled TSH levels in neonates born via vaginal delivery compared to those delivered by cesarean section (Hedges’ g = 0.390; <em>P</em> = .002). In the heel blood subgroup, no significant difference in TSH levels was found between vaginal and cesarean deliveries (Hedges’ g = 0.167; <em>P</em> = .111). However, in the cord blood subgroup, neonates delivered vaginally exhibited significantly higher TSH levels than those delivered by cesarean section (Hedges’ g = 0.493; <em>P</em> = .002).</div></div><div><h3>Conclusion</h3><div>The study found that the method of delivery has a significant impact on neonatal TSH levels, especially in umbilical cord blood samples, highlighting the need to consider delivery mode in evaluating neonatal health.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 5","pages":"Pages 631-639"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424427","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":"Diabetes Status and Cardiovascular Complications Risk in Noncardiac Surgery: A Population-Based Cohort Study","authors":"Yunxi Ji MD ,&nbsp;Zhihan Lyu MD ,&nbsp;Bin Cui PhD ,&nbsp;Weiqing Wang MD, PhD","doi":"10.1016/j.eprac.2025.02.011","DOIUrl":"10.1016/j.eprac.2025.02.011","url":null,"abstract":"<div><h3>Objective</h3><div>Patients with diabetes are considered to be at high surgical risk due to the potential occurrence of cardiovascular and diabetes-related complications. Limited research exists on the cardiovascular risk profiles of patients with prediabetes and undiagnosed diabetes in noncardiac surgery. In this population-based cohort study, we investigated different glycated hemoglobin levels and their associated postoperative cardiovascular risks.</div></div><div><h3>Methods</h3><div>In this perioperative cohort study, participants were categorized into four groups: nondiabetes, prediabetes, undiagnosed diabetes, and diagnosed diabetes. The primary endpoint was the occurrence of major adverse cardiovascular events (MACE) at 30 days postoperatively, with secondary outcomes assessed at 90 days. The association between various groups and postoperative MACE was evaluated using Cox proportional hazards models and Kaplan-Meier curves. Subgroup analyses and sensitivity analyses were also performed.</div></div><div><h3>Results</h3><div>We enrolled 13 207 eligible patients undergoing noncardiac surgeries, among whom 3841 (29.08%) had prediabetes and 1521 (11.52%) had undiagnosed diabetes. In the 30-day postoperative period, the prediabetes group (hazard ratio [HR] [95% CI]: 1.70 [1.15, 2.52]), undiagnosed diabetes group (HR [95% CI]: 2.36 [1.15, 3.68]), and diagnosed diabetes group (HR [95% CI]: 2.33 [1.54, 3.53]) exhibited increased risks of MACE compared to the nondiabetes group. Similar findings were observed for the 90-day postoperative MACE. Further subgroup analysis revealed a significant interaction between sex and states of glycemic regulation (P for interaction &lt; 0.005).</div></div><div><h3>Conclusion</h3><div>In this cohort, a notable proportion of patients with prediabetes or undiagnosed diabetes were found to be undergoing noncardiac surgeries. They were associated with an increased risk of developing postoperative MACE.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 5","pages":"Pages 585-591"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523060","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)00113-2","DOIUrl":"10.1016/S1530-891X(25)00113-2","url":null,"abstract":"","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 5","pages":"Pages A1-A2"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906095","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":"Central Hypothyroidism: Advances in Etiology, Diagnostic Challenges, Therapeutic Targets, and Associated Risks","authors":"Pedro Iglesias MD","doi":"10.1016/j.eprac.2025.02.004","DOIUrl":"10.1016/j.eprac.2025.02.004","url":null,"abstract":"<div><h3>Objective</h3><div>Central hypothyroidism is a rare disorder resulting from impaired thyroid hormone production due to deficiencies in TSH secretion from the pituitary or TRH secretion from the hypothalamus. This review aims to summarize recent advances in the etiology, diagnosis, and treatment of central hypothyroidism, with an emphasis on diagnostic and therapeutic challenges.</div></div><div><h3>Methods</h3><div>A comprehensive review of the literature was conducted, focusing on genetic and acquired causes, particularly those related to hypothalamic–pituitary tumors and the effects of surgical and radiotherapeutic interventions. Diagnostic approaches and treatment strategies, including levothyroxine therapy and monitoring, are analyzed.</div></div><div><h3>Results</h3><div>Early diagnosis requires simultaneous measurement of free T4 and TSH to prevent neurological sequelae, especially in congenital cases. Central hypothyroidism is associated with risks such as growth and developmental impairment, as well as metabolic and cardiovascular disturbances. Levothyroxine therapy is crucial for correcting hormonal deficits and improving patient outcomes; however, careful dosing is necessary to avoid potential complications, particularly in vulnerable populations.</div></div><div><h3>Conclusions</h3><div>Personalized treatment and continuous monitoring are essential to optimize clinical outcomes and enhance the quality of life in affected individuals. A thorough understanding of central hypothyroidism's etiology and management is necessary to improve early detection and therapeutic strategies.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 5","pages":"Pages 650-659"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413776","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":"Long-Term Impact of Thyroid Eye Disease on Quality of Life: Insights From a Retrospective Cohort Study","authors":"Jan Schovanek MD, PhD ,&nbsp;Martin Radvansky PhD ,&nbsp;Marta Karhanova MD, PhD, FEBO ,&nbsp;Marie Bolacka MD ,&nbsp;Klara Pekarova MD ,&nbsp;Roman Dohnal MD ,&nbsp;Martin Radvansky Jr. MSc ,&nbsp;Milos Kudelka PhD ,&nbsp;Eva Kriegova PhD ,&nbsp;David Karasek MD, PhD","doi":"10.1016/j.eprac.2025.02.003","DOIUrl":"10.1016/j.eprac.2025.02.003","url":null,"abstract":"<div><h3>Objectives</h3><div>Thyroid eye disease (TED) seriously affects patients’ quality of life (QoL), even if the disease is stable and nonactive. Data on clinical factors negatively influencing the QoL of patients with TED and long-term outcomes are limited. This study aims to evaluate the lasting impact of TED on QoL, focusing on the effects of previous TED treatments and identifying factors influencing long-term outcomes.</div></div><div><h3>Methods</h3><div>A retrospective cohort study included 151 patients treated for active, moderate-to-severe and severe TED, with a mean follow-up of 8 years.</div></div><div><h3>Results</h3><div>Higher clinical activity scores at diagnosis correlated with lower QoL scores. Thyroidectomy before immunosuppressive treatment was associated with lower QoL and an increased likelihood of orbital decompression. Any disease progression necessitating second-line treatments also negatively affected QoL. A decrease in thyrotropin receptor antibodies during active treatment and early treatment initiation positively affected visual functioning. Time-dependent regression analysis demonstrated no significant trend in QoL changes over time.</div></div><div><h3>Conclusion</h3><div>Our data reveal that disease severity, the timing of interventions and disease progression contribute to less favorable long-term QoL outcomes, extending years beyond active treatment. Early and accurate diagnosis and appropriate treatment can minimize poor long-term QoL in patients with TED.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 5","pages":"Pages 607-613"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413778","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}