Endocrine Practice最新文献

{"title":"Transient vs Permanent Congenital Hypothyroidism: Does Thyroid Volume Tell the Tale?","authors":"Sarah A Ackah, Erica A Eugster, Todd D Nebesio, Rebeca Santos, S Gregory Jennings, George J Eckert, Boaz Karmazyn","doi":"10.1016/j.eprac.2025.05.745","DOIUrl":"10.1016/j.eprac.2025.05.745","url":null,"abstract":"<p><strong>Objectives: </strong>Congenital hypothyroidism (CH) can be transient or permanent. We evaluated if thyroid volume measured by ultrasound can be distinguish between the 2 forms.</p><p><strong>Methods: </strong>Retrospective study (1/2005-12/2019) on patients with CH with eutopic thyroids. Permanent CH was defined as the inability to discontinue levothyroxine therapy after age 3, while transient CH included a successful trial off levothyroxine. Demographic and clinical characteristics were retrieved from the electronic medical records. Fisher's Exact tests and t-tests were used to compare categorial and continuous variables between children with transient and permanent CH. Receiver-operating characteristic curve analysis evaluated thyroid volume and thyroid-stimulating hormone (TSH) as individual predictors of transient/permanent CH. A classification tree analysis was used to combine thyroid volume and TSH for prediction.</p><p><strong>Results: </strong>Significant differences were found between the 2 groups in terms of TSH levels and thyroid volume. Thyroid volume in patients with transient CH was significantly smaller (1.0 ± 0.5 mL) compared to those with permanent CH (2.3 ± 2.6 mL). No transient CH patient had thyroid volume below 0.3 mL or above 2.5 mL. Combining TSH level at diagnosis of ≥200 mIU/L and thyroid volume ≤0.6 mL or ≥2.5 mL provided sensitivity of 78.4% and specificity of 85.7% in differentiating between transient and permanent CH.</p><p><strong>Conclusion: </strong>Thyroid volume ≥2.5 mL or ≤0.36 mL was seen only in permanent CH, potentially avoiding the need for a trial off levothyroxine. Using both TSH level and thyroid volume provides increased sensitivity and specificity for differentiating between permanent and transient CH.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233524","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":"Perineural Invasion Is Not an Independent Risk Factor for Recurrence and Lateral Neck Metastasis in Thyroid Cancer: A Propensity Score Matching Analysis.","authors":"Joonseon Park, Sue Youn Kim, Chan Kwon Jung, Solji An, Ja Seong Bae, Kwangsoon Kim","doi":"10.1016/j.eprac.2025.05.747","DOIUrl":"10.1016/j.eprac.2025.05.747","url":null,"abstract":"<p><strong>Objectives: </strong>Perineural invasion (PNI) in thyroid cancer is a relatively rare but significant pathologic feature with crucial implications for prognosis and management. This study investigates the impact of PNI on recurrence and lateral neck lymph node metastasis (N1b) in patients with thyroid cancer.</p><p><strong>Methods: </strong>This retrospective analysis included 8572 patients with thyroid cancer who underwent surgery from January 2000 to December 2020 at Seoul St. Mary's Hospital. Clinicopathologic characteristics and outcomes were compared between the patients with and without PNI before and after propensity score matching (PSM). The logistic regression analysis identified the risk factors for N1b, whereas the Cox regression analysis determined the risk factors for recurrence.</p><p><strong>Results: </strong>Of the 8572 patients, 144 (1.7%) presented with PNI. The PNI group had higher rates of gross extrathyroidal extension, vascular and lymphatic invasion, and advanced TNM stage. The recurrence rates were higher in the PNI group both before (11.1% vs 5.6%) and after PSM (11.3% vs 5.6%). PNI was a significant risk factor for N1b in the univariate logistic regression analysis but not in the multivariate analysis before and after PSM. The Cox regression analysis revealed that PNI is a significant risk factor for recurrence before PSM but not after PSM.</p><p><strong>Conclusions: </strong>The PNI in thyroid cancer was associated with higher recurrence rates and increased N1b. However, it was not considered a significant independent risk factor for recurrence or N1b. Further research is needed to refine the management strategies for patients with PNI to improve prognosis.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233522","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":"Pituitary Stalk Lesions: Causes and Diagnostic Challenges.","authors":"Roberto Salvatori","doi":"10.1016/j.eprac.2025.05.750","DOIUrl":"10.1016/j.eprac.2025.05.750","url":null,"abstract":"<p><p>The pituitary stalk (PS) is a funnel-shaped structure that connects the hypothalamus to the pituitary gland. It contains some anterior pituitary cells, the hypophyseal vessels, and the axons of neurons whose bodies are located in the hypothalamus and terminate in the posterior pituitary gland, where they store and release arginine vasopressin and oxytocin. The PS is best visualized by magnetic resonance imaging. PS thickening (PST) is often associated with arginine vasopressin deficiency, but it can also present with anterior pituitary hormones deficits or normal pituitary function. PST can be an isolated finding, or be expression of a multisystem infectious, inflammatory, or neoplastic process. Accordingly, these cases are best managed with the input of pituitary specialists from different disciplines. Although PS biopsy can provide a pathologic diagnosis, this is an invasive procedure that requires an experienced neurosurgeon and carries significant risks. This review discusses the causes and symptoms of PST, and addresses the demographic, history, physical examination, biochemical and radiological features that can help the endocrinologist in identifying the most likely cause of PST in any given patient, and to decide when biopsy is needed.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233523","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 Continuous Glucose Monitoring Versus Blood Glucose Monitoring During a Carbohydrate-Restricted Nutrition Intervention in People With Type 2 Diabetes: 6-Month Follow-up Outcomes From a Randomized Clinical Trial.","authors":"Holly J Willis, Stephen E Asche, Rebecca N Adams, Caroline G P Roberts, Amy L McKenzie, Shannon Krizka, Shaminie J Athinarayanan, Alison R Zoller, Brittanie M Volk, Richard M Bergenstal","doi":"10.1016/j.eprac.2025.05.746","DOIUrl":"10.1016/j.eprac.2025.05.746","url":null,"abstract":"<p><strong>Objectives: </strong>Low and very-low carbohydrate eating patterns can improve glycemia in people with type 2 diabetes (T2D). Continuous glucose monitoring (CGM) may also help improve glycemic outcomes, like time in range (TIR). This research evaluated differences in diabetes-related outcomes when people with T2D used CGM or blood glucose monitoring (BGM) to support dietary choices and medication management for 6 months during a virtual, medically supervised ketogenic diet program (MSKDP). Three-month primary outcomes are published, and here we report 6-month follow-up outcomes.</p><p><strong>Methods: </strong>The IGNITE study (Impact of Glucose moNitoring and nutrItion on Time in rangE) randomized participants to use CGM (N = 81) or BGM (N = 82) to support care during 6 months in a MSKDP. Glycemia, diabetes medications, dietary intake, ketones, and weight were assessed at baseline (Base) and month 6 (M6); differences between and within arms were evaluated.</p><p><strong>Results: </strong>Adults (N = 163) with mean (SD) T2D duration of 9.7 (7.7) years and HbA1c of 8.1% (1.2%) participated. From Base to M6, TIR improved from 61% to 87% for CGM and from 63% to 88% for BGM (P < .001), with no difference in changes between arms (P = .99). HbA1c decreased at least 1.3% from Base to M6 in both arms (P < .001). Diabetes medications were deintensified in both arms based on medication effect scores (P < .01). Energy and carbohydrate intake decreased (P < .001) and participants in both arms had clinically meaningful weight loss (P < .001).</p><p><strong>Conclusions: </strong>The CGM and BGM arms achieved similar and significant improvements in glycemia and other diabetes-related outcomes after 6 months in this MSKDP.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224771","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":"Reducing Inpatient Hypoglycemia: A Diversified Approach to a Complex Problem.","authors":"Audrey Lane, Melissa McKnight, Kaeli Samson, Mitchell Nohner, Andjela Drincic","doi":"10.1016/j.eprac.2025.05.744","DOIUrl":"10.1016/j.eprac.2025.05.744","url":null,"abstract":"<p><strong>Objective: </strong>Hypoglycemia in hospitalized patients is a persistent adverse event. Three quality improvement interventions were implemented with the aim of reducing hypoglycemia. Each intervention was targeted at one component of typical inpatient insulin management (basal, prandial, and correction) to attempt to achieve this singular quality improvement aim.</p><p><strong>Methods: </strong>Incidence of hypoglycemia in nonobstetrics patients ≥ 19 years of age at a tertiary hospital receiving scheduled insulin before and after the implementation of quality improvement initiatives was compared. Incidence was defined as the number of unique patients with a hypoglycemic event in each month, divided by all admissions for that month. The interventions included integrating weight-based insulin guidance into the electronic medical record, the addition of a carbohydrate-limited diet, and increasing the threshold for correction insulin administration from 150 mg/dL to 180 mg/dL.</p><p><strong>Results: </strong>After implementation of the interventions, there was a significantly lower incidence of hypoglycemia associated with prandial insulin (P = .02) and correction insulin (P < .001). There was not a significant decrease in hypoglycemia associated with basal insulin in the overall sample (P = .25). There was a significant decrease in a subgroup analysis focused on hospital-associated hyperglycemia and type 2 diabetes (via exclusion of patients with type 1 diabetes or cystic fibrosis-related diabetes) (P = .005). Notably, following the interventions, there was a reduction in institutional blood glucose readings within goal range (71-179 mg/dL), which presumably translates to an increase in hyperglycemia, given the known decrease in hypoglycemia (P value < .0001).</p><p><strong>Conclusion: </strong>Through a multipronged approach consisting of three unique QI interventions - each targeting one aspect of inpatient insulin management - our academic institution was able to significantly reduce the number of inpatient hypoglycemic events.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224772","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 Nondipping Blood Pattern in Type 1 Diabetes Mellitus: Pathophysiology, Complications, and Management Strategies","authors":"Michał Kulecki MD ,&nbsp;Dariusz Naskręt MD, PhD ,&nbsp;Aleksandra Uruska MD, PhD ,&nbsp;Dorota Zozulińska-Ziółkiewicz MD, PhD","doi":"10.1016/j.eprac.2025.02.015","DOIUrl":"10.1016/j.eprac.2025.02.015","url":null,"abstract":"<div><h3>Background</h3><div>The nondipping blood pressure (BP) pattern, characterized by a less than 10% decline in sleep-time BP compared to awake-time values, is prevalent in individuals with type 1 diabetes mellitus (T1DM) and is associated with increased cardiovascular (CV) risk.</div></div><div><h3>Case Report</h3><div>This review discusses the prevalence, pathophysiological mechanisms, complications, and management strategies of the nondipping pattern in T1DM. The nondipping pattern is linked to poor cardiac autonomic function, higher rates of albuminuria, early markers of diabetic kidney disease, and increased arterial stiffness. It is also associated with a two-fold increase in all-cause mortality.</div></div><div><h3>Discussion</h3><div>Despite its clinical significance, there is no consensus on specific treatment recommendations for nondippers with T1DM. While some studies suggest that bedtime administration of antihypertensive medications, such as ACE inhibitors and angiotensin II receptor blockers, can improve the dipping pattern and reduce CV events, these findings are primarily based on studies in the general hypertensive population. Emerging evidence also indicates a potential role for vitamin D supplementation and lifestyle interventions in improving BP variability.</div></div><div><h3>Conclusion</h3><div>Further research is needed to develop evidence-based management strategies tailored to nondippers with T1DM, aiming to reduce CV risk and improve long-term outcomes.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 6","pages":"Pages 821-828"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536907","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":"ChatGPT-4's Accuracy in Estimating Thyroid Nodule Features and Cancer Risk From Ultrasound Images","authors":"Esteban Cabezas MD ,&nbsp;David Toro-Tobon MD ,&nbsp;Thomas Johnson MD ,&nbsp;Marco Álvarez MD ,&nbsp;Javad R. Azadi MD ,&nbsp;Camilo Gonzalez-Velasquez MD ,&nbsp;Naykky Singh Ospina MD ,&nbsp;Oscar J. Ponce MD, MSc ,&nbsp;Megan E. Branda MS ,&nbsp;Juan P. Brito MD, MS","doi":"10.1016/j.eprac.2025.03.008","DOIUrl":"10.1016/j.eprac.2025.03.008","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the performance of GPT-4 and GPT-4o in accurately identifying features and categories from thyroid nodule ultrasound images following the American College of Radiology Thyroid Imaging Reporting and Data System (TI-RADS).</div></div><div><h3>Methods</h3><div>This comparative validation study, conducted between October 2023 and May 2024, utilized 202 thyroid ultrasound images sourced from 3 open-access databases. Both complete and cropped versions of each image were independently evaluated by expert radiologists to establish a reference standard for TI-RADS features and categories. GPT-4 and GPT-4o were prompted to analyze each image, and their generated TI-RADS outputs were compared to the reference standard.</div></div><div><h3>Results</h3><div>GPT-4 demonstrated high specificity but low sensitivity when assessing complete thyroid ultrasound images across most TI-RADS categories, resulting in mixed overall accuracy. For low-risk nodules (benign), GPT-4 achieved 25.0% sensitivity, 99.5% specificity, and 93.6% accuracy. In contrast, in the higher risk moderately suspicious category GPT-4 showed 75% sensitivity, 22.2% specificity, and 42.1% accuracy. While GPT-4 effectively identified features like smooth margins (73% vs 65% the reference standard), it struggled to identify other features like isoechoic echogenicity (5% vs 46%), and echogenic foci (3% vs 27%). The assessment of cropped images using both GPT-4 and GPT-4o followed similar patterns, though with slight deviations indicating a decrease in performance compared to GPT-4's assessment of complete images.</div></div><div><h3>Conclusion</h3><div>While GPT-4 and GPT-4o models show potential for improving the efficiency of thyroid nodule triage, their performance remains suboptimal, particularly in higher-risk categories. Further refinement and validation of these models are necessary before clinical implementation.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 6","pages":"Pages 716-723"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729471","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":"Virta Intervention in CommuniTies in ColORado (VICTOR) Pilot Study to Improve Diabetes and Cardiovascular Risk in Rural Communities - Primary Results","authors":"Cecilia C. Low Wang MD ,&nbsp;Ray Estacio MD ,&nbsp;Stephanie Coronel-Mockler MPH ,&nbsp;Nick Flattery MPH ,&nbsp;Pete D. Hanson MS ,&nbsp;Rebecca N. Adams PhD ,&nbsp;Amy L. McKenzie PhD ,&nbsp;David Harrison MD ,&nbsp;Marc P. Bonaca MD, MPH","doi":"10.1016/j.eprac.2025.03.013","DOIUrl":"10.1016/j.eprac.2025.03.013","url":null,"abstract":"<div><h3>Objective</h3><div>Innovative strategies combining local community health workers (CHWs) and digital health may improve type 2 diabetes (T2D) care and cardiovascular risk in rural communities. To conduct a cluster-randomized, open-label, multisite study to evaluate the hypothesis that in rural communities served by CHW in the Colorado Heart Healthy Solutions (CHHS) program, referral to a digital continuous care intervention (CCI) would improve hemoglobin A1c (A1c) in patients with T2D as compared with CHHS alone.</div></div><div><h3>Methods</h3><div>Adults in the CHHS program with T2D taking at least 1 antihyperglycemic medication, A1c ≥ 7.5%, body mass index ≥25 kg/m² and who provided electronic informed consent were cluster-randomized to CHHS vs CCI+CHHS. The primary outcome was change in A1c from baseline to end of phase 1 (3 months).</div></div><div><h3>Results</h3><div>Fifty-one individuals had evaluable data. Mean ± SD age was 59.6 ± 10 years, body mass index 34.4 ± 7 kg/m², and A1c 8.9 ± 1.3% at baseline. The change in A1c from baseline was not significant between groups. However, A1c decreased from baseline to end of phase 1 by −1.2% in CHHS and −1.5% in CCI+CHHS, <em>P</em> &lt; .001 in each group. A higher proportion of individuals in CCI+CHHS achieved 5% or greater weight loss (<em>P</em> &lt; .05), and significant net decrease in number and/or dose of antihyperglycemic medications (<em>P</em> &lt; .05).</div></div><div><h3>Conclusions</h3><div>Combining a CHW program with referral to CCI did not result in greater A1c reduction, but led to improvements in A1c, weight, and medication burden in individuals with T2D in a rural setting.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 6","pages":"Pages 790-797"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969861","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":"Global Incidence, Risk Factors, and Temporal Trends of Adrenal Cancer: A Systematic Analysis of Cancer Registries","authors":"Junjie Huang PhD ,&nbsp;Yat Ching Fung BSocSc ,&nbsp;Sze Chai Chan MSc ,&nbsp;Wing Sze Pang BSocSc ,&nbsp;Veeleah Lok MPH ,&nbsp;Lin Zhang PhD ,&nbsp;Xu Lin MD ,&nbsp;Don Eliseo Lucero-Prisno III PhD ,&nbsp;Wanghong Xu PhD ,&nbsp;Zhi-Jie Zheng PhD ,&nbsp;Edmar Elcarte MA ,&nbsp;Claire Chenwen Zhong PhD ,&nbsp;Mellissa Withers PhD ,&nbsp;Martin C.S. Wong MD ,&nbsp;NCD Global Health Research Group, Association of Pacific Rim Universities (APRU)","doi":"10.1016/j.eprac.2025.03.002","DOIUrl":"10.1016/j.eprac.2025.03.002","url":null,"abstract":"<div><h3>Objective</h3><div>Adrenal gland cancer (AGC) is a rare cancer with a poor prognosis. Studies on this cancer have been limited. This study, for the first time, aims to analyze the global disease burden and trends of AGC in country level and examine lifestyle and socioeconomic risk factors to generate hypotheses.</div></div><div><h3>Methods</h3><div>The Global Cancer Observatory database was used to extract the incidence rate of AGC in 2020. Age-standardized rates (ASRs) of AGC incidence and lifestyle/metabolic risk factor prevalence were obtained from databases. Linear regression and Joinpoint regression were used to assess associations with risk factors and Average Annual Percentage Change of AGC incidence.</div></div><div><h3>Results</h3><div>Globally, there were an estimated 16 961 new AGC cases in 2020 (ASR: 0.14 per 100 000 persons). Higher disease burden was observed mainly in European regions. ASRs were comparable between sexes (males: 0.16; females: 0.14). The higher ASR was observed among the older population aged 50 to 74 years with an ASR of 0.31 compared with the younger population aged 15 to 49 years with an ASR of 0.07. Higher AGC incidence was associated with higher Human Development Index, gross domestic product, and lifestyle-related factors such as physical inactivity, obesity, hypertension, and lipid disorder (β = 0.005-0.052).</div></div><div><h3>Conclusion</h3><div>The overall incidence trend showed a decrease, with 3 countries reporting significant decreases and 1 country reporting a significant increase. Similar patterns were observed by sex and age group, except for an overall increase among the younger population.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 6","pages":"Pages 739-749"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613989","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":"Early-Life Risks of Central Precocious Puberty","authors":"Wei-Jou Yin ,&nbsp;Jhih-Wei Hsu PhD ,&nbsp;Chun-Chang Chen PhD ,&nbsp;Emily Chia-Yu Su PhD ,&nbsp;San-Yuan Wang PhD ,&nbsp;Yan-Jen Chen BSc ,&nbsp;Yang-Ching Chen MD, PhD","doi":"10.1016/j.eprac.2025.03.004","DOIUrl":"10.1016/j.eprac.2025.03.004","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the factors in early life that may contribute to central precocious puberty (CPP).</div></div><div><h3>Methods</h3><div>The study utilized data from the Taiwan Puberty Longitudinal Study, including 2241 children under pubertal assessment and a questionnaire of risk factors. We analyzed associations using the Fitting Generalized Linear Models in R (R Core Team, 2023), with R studio (Posit, 2023) version 4.3.1.</div></div><div><h3>Results</h3><div>Among the 2241 children examined, 745 had CPP. Overall, higher gestational weight gain (GWG) increased the risk of CPP (odds ratio [OR]: 1.03, 95% CI: 1.01-1.05); while higher GWG served as a protective factor in females (OR: 0.97, 95% CI: 0.95-0.99). Maternal gestational diabetes mellitus (GDM) also increased the CPP risk, particularly in males (OR: 2.66, 95% CI: 1.00-7.25). Longer exclusive breastfeeding was linked to lower CPP risk overall (OR: 0.96, 95% CI: 0.93-1.00) but was not significant when analyzed by gender.</div></div><div><h3>Conclusions</h3><div>Higher maternal GWG was associated with an increased risk of CPP overall, while GWG became negatively associated with CPP, only in females. Maternal GDM was linked to a higher risk of CPP, particularly in males. The duration of exclusive breastfeeding was inversely correlated with CPP risk, but this effect was not significant when analyzed by gender.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 6","pages":"Pages 758-765"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639670","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}