Endocrine Practice最新文献

{"title":"Predawn Versus Preiftar Timing of Levothyroxine Administration During Ramadan Intermittent Fasting: A Multicenter Randomized Controlled Trial","authors":"Reem M. Alamoudi MBBS, MD, MHSc ,&nbsp;Samah Nawar MBBS, MD ,&nbsp;Abdulrhman Al Mulla MBBS, MD ,&nbsp;Hiba Alharbi MBBS, MD ,&nbsp;Ali Alqarni MBBS, MD ,&nbsp;Abdullah M. Alzahrani MBBS, MD ,&nbsp;Walaa Busaad MBBS, MD ,&nbsp;Nasser Alahmari MBBS, MD ,&nbsp;Nouf Alshamrani MBBS, MD ,&nbsp;Lujain Alkhalifa MBBS, MD ,&nbsp;Yousef Saleh MBBS, MD ,&nbsp;Majed Ramadan PhD ,&nbsp;Anwar Borai PhD","doi":"10.1016/j.eprac.2026.01.008","DOIUrl":"10.1016/j.eprac.2026.01.008","url":null,"abstract":"<div><h3>Objectives</h3><div>To compare 2 levothyroxine (LT4) dosing regimens during Ramadan: preiftar and predawn, with respect to thyroid biochemical control and patient satisfaction.</div></div><div><h3>Methods</h3><div>This multicenter, open-label randomized controlled trial recruited adults with primary hypothyroidism from 3 Saudi cities (Jeddah, Riyadh, and Al-Ahsa). Patients with thyroid cancer were excluded. Thyroid-stimulating hormone (TSH) and free thyroxine (FT4) levels were measured 2 weeks before and 4 to 6 weeks after Ramadan. Participants were randomized to take LT4 either before breaking the fast (preiftar) or just before fasting began (predawn).</div></div><div><h3>Results</h3><div>A total of 303 (156 preiftar and 147 predawn) participants completed the study. Groups were comparable in demographic characteristics and comorbidities. Mean age was 49 ± 12 years; 87% were female; mean disease duration was 9.7 ± 8.3 years. Weekly LT4 dose was 753 ± 349 μg (preiftar) versus 733 ± 266 μg (predawn; <em>P</em> = .001). Pre-Ramadan TSH level was 2.56 ± 2.16 mIU/L versus 2.46 ± 1.72 mIU/L (<em>P</em> = .3), and FT4 level was 13.45 ± 2.1 versus 13.08 ± 2.4 pmol/L (<em>P</em> = .16). Post-Ramadan TSH level was 3.64 ± 4.1 versus 4.07 ± 4.2 mIU/L (<em>P</em> = .78), and FT4 level was 12.96 ± 0.1 versus 12.64 ± 0.2 pmol/L (<em>P</em> = .003). Within-group post-Ramadan changes were nonsignificant. Repeated measures analysis of variance showed no significant differences in TSH or FT4 levels over time or between groups (<em>P</em> = .47 and <em>P</em> = .81). Compliance and satisfaction were comparable.</div></div><div><h3>Conclusion</h3><div>Both preiftar and predawn LT4 regimens maintained thyroid stability during Ramadan. Either can be safely adopted according to patient preference.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 5","pages":"Pages 745-751"},"PeriodicalIF":4.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100010","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":"Radiofrequency Ablation for Primary Thyroid Cancer","authors":"Iram Hussain MD, ECNU","doi":"10.1016/j.eprac.2026.01.023","DOIUrl":"10.1016/j.eprac.2026.01.023","url":null,"abstract":"<div><div>Radiofrequency ablation (RFA) has emerged as a promising minimally invasive treatment for low-risk papillary thyroid carcinoma (PTC), particularly for low-risk papillary thyroid microcarcinomas. This review summarizes the current evidence on the indications, efficacy, and safety of RFA in the management of PTC. Recent studies demonstrate a significant volume reduction with most tumors having a complete or near-complete response, low progression and recurrence rates and a favorable safety profile. RFA has the advantage of preserving thyroid function, avoiding visible scarring, and reduced recovery time. Emerging guidelines and international consensus statements now acknowledge RFA as a viable option in carefully selected cases, particularly for tumors less than 1 cm in maximum diameter without extrathyroidal extension or nodal involvement. Existing data support RFA as an effective, safe, and well-tolerated alternative to surgery and active surveillance for managing low-risk PTC, though more long-term data are needed to confirm durability. Since outcomes are operator-dependent, the growing demand for this procedure necessitates the development of centers of excellence with experienced operators.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 5","pages":"Pages 803-811"},"PeriodicalIF":4.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100063","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":"Implementing the 2025 AACE Obesity Algorithm: Bridging Guidelines With Real-World Clinical Practice","authors":"Lance Sloan MD, MSE, FASN, FASPC, FEAA,&nbsp;Julia Blanchette PhD, RN, BC-ADM, CDCES, FADCES,&nbsp;Bhargavi Patham MD, PhD, DABOM, DABCL, FACE","doi":"10.1016/j.eprac.2026.02.017","DOIUrl":"10.1016/j.eprac.2026.02.017","url":null,"abstract":"","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 5","pages":"Pages 857-858"},"PeriodicalIF":4.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147364575","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":"Superior Efficacy of Denosumab Over Zoledronic Acid in Increasing Femoral Neck Bone Mineral Density in Osteoporosis Patients With Type 2 Diabetes Mellitus","authors":"Dongxu Han MSc ,&nbsp;Bingxin Li MSc ,&nbsp;Jingnan Liu BSc ,&nbsp;Liqin Chen BSc ,&nbsp;Hongxia Wang BSc ,&nbsp;Lingdan Yuan BSc ,&nbsp;Miao Xuan PhD ,&nbsp;Lige Song PhD","doi":"10.1016/j.eprac.2026.01.022","DOIUrl":"10.1016/j.eprac.2026.01.022","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to compare the antiosteoporotic efficacy of zoledronic acid (ZOL) with denosumab (DEN) in osteoporosis patients with type 2 diabetes mellitus (T2DM).</div></div><div><h3>Methods</h3><div>This was a prospective, open-label, nonrandomized clinical study. Osteoporotic women with T2DM aged 50 to 80 years were enrolled and assigned to either the ZOL group (<em>n</em> = 45) or the DEN group (<em>n</em> = 75) based on patient preference. The efficacy endpoint included the percent change from baseline in bone mineral density (BMD), bone turnover markers, and the fracture risk evaluated by the fracture risk assessment tool after 1 year. The propensity score-matched analysis was performed to confirm the robustness.</div></div><div><h3>Results</h3><div>After 1-year of treatment, DEN was more effective than ZOL at increasing femoral neck BMD (least-squares mean [LS mean] difference 4.59% [95% confidence interval [CI]: 0.93% to 8.25%]; <em>P</em> = .017), but not at BMD in the lumbar spine or total hip. Besides, compared with the ZOL group, the DEN group demonstrated greater suppression of osteocalcin (LS mean difference −20.58% [95% CI: −39.93 to −1.24]; <em>P</em> = .041) and a greater reduction in major osteoporotic fracture risk (LS mean difference −11.20% [95% CI: −20.76 to −1.64]; <em>P</em> = .025).</div></div><div><h3>Conclusions</h3><div>The results suggest that DEN should be considered as a potentially better option for T2DM patients who have low femoral neck BMD.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 5","pages":"Pages 737-744"},"PeriodicalIF":4.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100188","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 Impact of the Ketogenic Diet on the Lipid Profile in Adults: A Comprehensive Review and Meta-Regression Analysis of Randomized Controlled Trials","authors":"Chaoyue Chang MD ,&nbsp;Yuxia Liu MD ,&nbsp;Pejman Rohani MD ,&nbsp;Navideh Khodadadi MSc ,&nbsp;Kousalya Prabahar PhD ,&nbsp;Mohammad Hassan Sohouli PhD","doi":"10.1016/j.eprac.2026.01.009","DOIUrl":"10.1016/j.eprac.2026.01.009","url":null,"abstract":"<div><h3>Objectives</h3><div>The impact of the ketogenic diet (KD) on lipid metabolism remains inconclusive. To address this gap, we conducted a meta-regression analysis of randomized controlled trials to evaluate the overall influence of KD on lipid profile parameters in adults.</div></div><div><h3>Methods</h3><div>A comprehensive search of 5 major electronic databases was carried out using predefined keywords to identify randomized controlled trials assessing the effects of KD on lipid outcomes. Pooled weighted mean differences with 95% confidence intervals were calculated employing a random-effects model.</div></div><div><h3>Results</h3><div>Sixty-two studies were analyzed. The meta-analysis results from the included randomized controlled trials indicated a significant decrease in triglyceride levels (weighted mean difference [WMD]: −19.96 mg/dl, 95% CI: −26.10 to −13.81) and the triglyceride/high-density lipoprotein-cholesterol (HDL-C) ratio (WMD: −0.31, 95% CI: −0.49 to −0.12), despite a notable increase in HDL-C (WMD: 3.61 mg/dl, 95% CI: 1.44 to 5.57), low-density lipoprotein-cholesterol (LDL-C) (WMD: 8.49 mg/dl, 95% CI: 5.45 to 11.52), and total cholesterol (WMD: 8.14 mg/dl, 95% CI: 3.41 to 12.88) concentrations following KD compared to the control group. However, LDL-C levels increased by 8.49 mg/dL, which may carry potential adverse implications. Furthermore, the findings indicated a linear correlation between alterations in HDL-C and the duration of KD intervention.</div></div><div><h3>Conclusions</h3><div>The ketogenic diet significantly improves triglycerides and HDL-C but also leads to modest increases in LDL-C. Given the lack of long-term cardiovascular outcome data, these findings should be interpreted with caution.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 5","pages":"Pages 819-828"},"PeriodicalIF":4.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100141","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":"Persistence of Residual Insulin Secretion in Long-Standing Cystic Fibrosis-Related Diabetes","authors":"Irene Aguilera García MD ,&nbsp;Francois Mifsud MD, PhD ,&nbsp;Jennifer Da Silva BS ,&nbsp;Fideline Bonnet-Serrano MD, PhD ,&nbsp;Florence Camus-Bablon MD ,&nbsp;Pierre-Régis Burgel MD, PhD ,&nbsp;Etienne Larger MD, PhD","doi":"10.1016/j.eprac.2026.02.008","DOIUrl":"10.1016/j.eprac.2026.02.008","url":null,"abstract":"<div><h3>Objective</h3><div>The pathophysiology of cystic fibrosis-related diabetes (CFRD) remains poorly understood, with uncertainty whether the insulin secretion defect progresses over time, characterized by a decline in C-peptide and an increase in proinsulin-to-C-peptide ratio. CFRD is often compared to type 1 diabetes (T1D), which is associated with complete beta-cell exhaustion. Similarly, insulin is the sole therapy recommended for CFRD. We aimed to examine beta-cell function over time in adults with CFRD and compare it with T1D.</div></div><div><h3>Methods</h3><div>This retrospective cross-sectional study compared fasting C-peptide measurements between 59 adults (≥18 years) with CFRD (PwCFRD) and 1185 people with T1D (PwT1D). The fasting and stimulated proinsulin-to-C-peptide ratio after a mixed meal tolerance test was quantified in a subset of 18 PwCFRD and 75 PwT1D.</div></div><div><h3>Results</h3><div>Fasting C-peptide was higher in PwCFRD (0.27 [0.34]) than in PwT1D (0.00 [0.04], P &lt; .001). The duration of CFRD did not correlate with C-peptide secretion (P = .736), even after adjustment for glycated hemoglobin and insulin therapy (P = .714). Proinsulin-to-C-peptide ratio was lower in PwCFRD than in PwT1D at baseline (<em>P</em> &lt; .001) and 2 h (<em>P</em> = .001) after a mixed meal tolerance test. PwCFRD who required intravenous antibiotics the previous year showed a significantly lower C-peptide secretion (<em>P</em> = .042), but there was no difference between patients receiving or not receiving cystic fibrosis transmembrane conductance regulator modulator therapy.</div></div><div><h3>Conclusion</h3><div>C-peptide levels in our cohort of PwCFRD were independent of diabetes duration, in contrast to PwT1D. A lower proinsulin-to-C-peptide ratio in PwCFRD compared to PwT1D suggested lower beta-cell dysfunction at fasting and stimulated evaluation. This supports the use of non-insulin therapies for adults with CFRD.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 5","pages":"Pages 788-794"},"PeriodicalIF":4.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225840","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":"National Trends in the Supply and Demand for Endocrinology, Diabetes, and Metabolism Training in the United States","authors":"Jason Silvestre MD ,&nbsp;Aundrea E. Loftley MD ,&nbsp;Robert J. Ferdon MS ,&nbsp;Robert A. Ravinsky MD, MPH ,&nbsp;Harsha Karanchi MD","doi":"10.1016/j.eprac.2026.01.020","DOIUrl":"10.1016/j.eprac.2026.01.020","url":null,"abstract":"<div><h3>Objective</h3><div>Previous studies have highlighted emerging deficiencies in the U.S. endocrinologist workforce. Yet, few studies have analyzed the training pathway for endocrinologists. The purpose of this study was to define the annual number of applicants and training positions for U.S. endocrinology training.</div></div><div><h3>Methods</h3><div>This was a cross-sectional study of applicants for endocrinology, diabetes, and metabolism fellowship training in the United States (2009 to 2025). Annual match outcomes were calculated, and trends were assessed with linear regression.</div></div><div><h3>Results</h3><div>From 2009 to 2025, there was growth in the annual number of endocrinology training positions (223 to 386, 73.1% increase, <em>P</em> &lt; .001) and number of applicants (325 to 488, 50.2% increase, <em>P</em> &lt; .001). The annual applicant-to-training position ratio decreased (1.46 to 1.26, <em>P</em> &lt; .001), while the annual match rate increased (60.0% to 77.9%, <em>P</em> &lt; .001). The annual rate of unfilled training positions decreased over the study period (12.6% to 1.6%, <em>P</em> &lt; .001). The annual representation of U.S. allopathic medical school graduates decreased (50.8% to 30.0%, <em>P</em> &lt; .001), while the annual representation of non-U.S. allopathic medical school graduates increased (49.2% to 70.0%, <em>P</em> &lt; .001) among matched endocrinology fellows. Annual match rates for U.S. allopathic medical school graduates exceeded those for non-U.S. allopathic medical school graduates (90.7% vs 67.7%, <em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Growth in endocrinology training positions has exceeded growth in the number of applicants. Surveillance of match outcomes is warranted as anticipated shortages of endocrinologists may trigger potential deleterious consequences for population health needs.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 5","pages":"Pages 848-854"},"PeriodicalIF":4.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100062","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":"Comment on Frey et al A Real-World Pharmacovigilance Analysis of Lorlatinib-Associated Metabolic Effects Using the FDA Adverse Events Reporting System (FAERS) Database From 2013 to 2024","authors":"Parth Aphale PhD,&nbsp;Himanshu Shekhar BHMS,&nbsp;Shashank Dokania BHMS","doi":"10.1016/j.eprac.2025.08.011","DOIUrl":"10.1016/j.eprac.2025.08.011","url":null,"abstract":"","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 5","pages":"Pages 855-856"},"PeriodicalIF":4.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100030","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":"Endocrine Care During Transition in Emerging Adults With Cystic Fibrosis: A Single Center Retrospective Study","authors":"Crystal Cobb DO ,&nbsp;Jenna Feeley BS ,&nbsp;José Nilo G Binongo PhD, MS, MEd ,&nbsp;William R. Hunt MD ,&nbsp;Tanicia Daley MD, MPH ,&nbsp;Rachel W. Linnemann MD ,&nbsp;Arlene Stecenko MD ,&nbsp;Vin Tangpricha MD, PhD","doi":"10.1016/j.eprac.2026.02.007","DOIUrl":"10.1016/j.eprac.2026.02.007","url":null,"abstract":"<div><h3>Objectives</h3><div>Two common endocrine manifestations of cystic fibrosis (CF) are cystic fibrosis-related diabetes (CFRD) and cystic fibrosis-related bone disease (CFBD). Trends in CF endocrinopathies in emerging adults during health care transition have not been well studied. Our primary aim was to examine changes in glycemic control in participants with CFRD and bone density in all participants up to 10 years after transition to adult CF care. Secondary aims included analyzing rates of endocrine screening exams.</div></div><div><h3>Methods</h3><div>This was a retrospective chart review study that included participants ages 18-30 with CF who transitioned to a single center adult CF clinic between January 2013 and June 2023. The final cohort included 94 participants. Bone mineral density based on vitamin D status, CFRD diagnosis and highly effective modulator use was compared using two-sample <em>t</em>-tests, and linear mixed effects analysis was used to analyze hemoglobin A1c over time.</div></div><div><h3>Results</h3><div>Participants with CFRD on insulin demonstrated a mean increase of hemoglobin A1c by a geometric mean of 7.8% (62 mmol/mol) to 9.4% (79 mmol/mol) after 5 years of adult follow up (<em>P</em> = .003). Forty-seven percent of all emerging adults exhibited at least one bone mineral density Z-score &lt; -1. Completion rates of oral glucose tolerance tests and dual-energy x-ray absorptiometry screenings were low.</div></div><div><h3>Conclusions</h3><div>Health outcome measures of CFRD and CFBD worsen during transition from pediatric to adult CF care at a single CF Care Center. Physicians should recognize this vulnerable period of transition and institute programs to increase screening of CFRD and CFBD during this period.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 5","pages":"Pages 779-787"},"PeriodicalIF":4.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146197498","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":"Success Rate and Safety of Adrenal Venous Sampling via the Antecubital Approach: A Systematic Review and Meta-Analysis","authors":"Zhitian Huang MD,&nbsp;Hongwu Li MD,&nbsp;Kaiwen Jiang MD,&nbsp;Wentao Ma MD,&nbsp;Yubao Zou MD,&nbsp;Hui Dong MD,&nbsp;Xiongjing Jiang MD","doi":"10.1016/j.eprac.2026.01.021","DOIUrl":"10.1016/j.eprac.2026.01.021","url":null,"abstract":"<div><h3>Objective</h3><div>This meta-analysis aimed to evaluate the success rate and safety of adrenal venous sampling (AVS) via the antecubital approach and to compare these outcomes with the femoral approach.</div></div><div><h3>Methods</h3><div>A systematic search was performed in PubMed, Embase, Cochrane Library, Web of Science, and Wanfang Data from inception to May 1, 2025. The primary outcome was the success rate of right and left adrenal vein cannulation. Secondary outcomes included procedure-related complications, fluoroscopy time, and contrast agent volume. Comparative outcomes were reported as odds ratios (ORs) and weighted mean differences (WMDs).</div></div><div><h3>Results</h3><div>A total of 11 studies involving 2332 patients with primary aldosteronism undergoing AVS were included. The antecubital approach for AVS showed no statistically significant differences compared with the femoral approach in right adrenal vein cannulation success rate (antecubital single-arm pooled estimate: 91.9%, 95% CI: 85.26% to 95.70%; comparative analysis: OR 1.43, 95% CI: 0.23-9.04), left adrenal vein cannulation success rate (95.35%, 95% CI: 94.34% to 96.19%; OR 1.44, 95% CI: 0.63-3.28), procedure-related complications (0.36%, 95% CI: 0.07% to 0.79%; OR 0.51, 95% CI: 0.17-1.60), fluoroscopy time (7.64 minutes, 95% CI: 6.12-9.16; WMD 0.62 minutes, 95% CI: −0.75 to 1.99), or contrast agent volume (19.37 mL, 95% CI: 15.9-22.83; WMD 0.19 mL, 95% CI: −0.57 to 0.96).</div></div><div><h3>Conclusion</h3><div>Antecubital AVS demonstrated acceptable success rates and safety, particularly in moderate- to high-volume centers, without clear inferiority to the femoral approach.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 5","pages":"Pages 812-818"},"PeriodicalIF":4.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100153","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}