Endocrine Practice最新文献

{"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}

{"title":"What Features Predict Poorer Outcomes in Micropapillary Thyroid Carcinoma? A Retrospective Cohort Study","authors":"Shahaboddin Khamooshi MD ,&nbsp;Soghra Rabizadeh MD ,&nbsp;Leila Seddigh MD ,&nbsp;Sahar Karimpour Reyhan MD ,&nbsp;Fatemeh Mohammadi MD, MPH ,&nbsp;Amirhossein Yadegar MD ,&nbsp;Elahe Saffari MD ,&nbsp;Alireza Esteghamati MD ,&nbsp;Manouchehr Nakhjavani MD","doi":"10.1016/j.eprac.2025.03.003","DOIUrl":"10.1016/j.eprac.2025.03.003","url":null,"abstract":"<div><h3>Objective</h3><div>Micropapillary thyroid carcinoma (MPTC), a variant of papillary thyroid carcinoma sized ≤10 mm, is increasingly detected due to advanced ultrasound. This study aimed to describe characteristics and risk assessment of patients with MPTC to predict outcomes and guide initial management.</div></div><div><h3>Methods</h3><div>This retrospective cohort study (June 1980 to September 2023) assessed patients with MPTC using 2015 American Thyroid Association guidelines for risk stratification and determination of response to treatment. Outcomes ranged from excellent to structural incomplete responses.</div></div><div><h3>Results</h3><div>Among 208 patients with papillary thyroid carcinoma with a primary tumor focus ≤10 mm, 68.8% were low risk, 29.3% intermediate risk, and 1.9% high risk. Higher risk was linked to larger tumor size (≥7 mm) (odds ratio [OR], 3.196; <em>P</em> value = .001) and multifocality (OR, 2.431; <em>P</em> value = .004). Age (OR, 0.973; <em>P</em> value = .048) and background Hashimoto thyroiditis (OR, 0.439; <em>P</em> value = .014) were found as protective factors. Excellent response to therapy was observed in 48.4% of patients, whereas structural and biochemical incomplete responses were found to be 11.2% and 7.5%. Recurrence was detected in 14 (8.18%) patients.</div></div><div><h3>Conclusion</h3><div>MPTC generally has a good prognosis and responds well to the treatment. Larger tumors (≥7 mm), younger age (&lt;40 years), multifocality, and absence of Hashimoto thyroiditis correlate with a higher American Thyroid Association risk and poorer outcomes.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 6","pages":"Pages 707-715"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630325","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":"Disparities in Outcomes and Health Care Utilization for Diabetic Ketoacidosis Among Patients With Type 1 and Type 2 Diabetes Mellitus: A 6-Year National Retrospective Cohort Study","authors":"Shellsea Portillo-Canales MD ,&nbsp;John Peters DO, MS ,&nbsp;Garry Francis-Morel MD, MS ,&nbsp;Sandeep Dhindsa MD","doi":"10.1016/j.eprac.2025.04.002","DOIUrl":"10.1016/j.eprac.2025.04.002","url":null,"abstract":"<div><h3>Objective</h3><div>Diabetic ketoacidosis (DKA) represents a significant burden on the health care system. The impact of diabetes type on DKA outcomes remains unclear. This study aims to compare mortality, length of stay (LOS), and hospital costs between patients with type 1 (T1DM) and type 2 diabetes mellitus (T2DM) hospitalized with DKA.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study using data from the 2016-2021 National Inpatient Sample Healthcare Cost and Utilization Project database, focusing on patients admitted for acute care with a diagnosis of DKA. Patients were categorized into 2 cohorts: T1DM versus T2DM. The primary end point was mortality, assessed using multiple logistic regression. Secondary end points included LOS and total hospital charges, analyzed using multiple linear regression, adjusting for potential confounders. Multiple imputations accounted for missing data, and a Bonferroni correction was applied for multiple comparisons.</div></div><div><h3>Results</h3><div>The study included 1 244 184 patients, with 770 109 (62%) T1DM and 474 075 (38%) T2DM. Mortality was significantly higher in patients with T2DM (0.91%) compared to patients with T1DM (0.22%; <em>P</em> &lt; .001). LOS was longer for patients with T2DM (average 3.92 days vs 3.02 days for T1DM; <em>P</em> &lt; .001), as were hospital charges ($10 146.78 for T2DM vs $7811.98 for T1DM; <em>P</em> &lt; .001). Significant disparities were also observed in the demographic and hospital characteristics, including median household income, insurance type, and hospital region.</div></div><div><h3>Conclusion</h3><div>In this national retrospective cohort study, patients with T2DM and DKA had higher mortality rates, longer LOS, and higher health care costs than those with T1DM. These findings highlight critical disparities that may guide future interventions to improve DKA outcomes in patients with T2DM.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 6","pages":"Pages 784-789"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998055","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 Systematic Review on the Impact of Electronic Consultations on Diabetes Care","authors":"Elie Naous MD ,&nbsp;Angela Achkar MD, MSc ,&nbsp;Rebecca A. Morin MLIS, MAS ,&nbsp;Joanna Mitri MD, MS","doi":"10.1016/j.eprac.2025.03.001","DOIUrl":"10.1016/j.eprac.2025.03.001","url":null,"abstract":"<div><h3>Objectives</h3><div>Primary care physicians (PCPs) are increasingly challenged with managing glycemic control in people with diabetes (PWD), especially in the setting of a shortage in endocrinologists. Electronic consultations (e-consults), which enable asynchronous communication between PCPs and specialists through electronic health records, have been introduced to address these issues. This systematic review aims to evaluate the impact of e-consults on glycemic control in PWD, focusing on changes in HbA1c levels.</div></div><div><h3>Methods</h3><div>Two independent reviewers searched PubMed, EMBASE, and the Cochrane Library, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. The review encompasses randomized controlled trials and observational studies. Two reviewers extracted data pertaining to prespecified outcomes of each interest from each included study.</div></div><div><h3>Results</h3><div>Summary tables and narrative synthesis were used (PROSPERO 2024 CRD42024503278). Six studies were included, —two randomized controlled trials and 4 observational studies—assessing the role of e-consults in diabetes care. Most studies did not report significant differences in HbA1c levels between e-consult and control groups. However, benefits such as improved medication usage, reduced costs, enhanced access to specialist care, shorter wait times for in-person visits, and better educational opportunities for PCPs were noted. Implementation barriers included PCP familiarity with e-consults and patient adherence. Limitations include inclusion of only 2 trials and 4 observational studies and heterogeneity between them.</div></div><div><h3>Conclusions</h3><div>E-consults provide valuable benefits in managing diabetes, particularly in resource-limited settings. E-consults offer a promising solution to the endocrinologist shortage, though further research is needed to identify which PWD would benefit most.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 6","pages":"Pages 829-838"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585061","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":"Apolipoprotein Profile in Early Pregnancy and the Link to Gestational Diabetes Mellitus: Insights From Odense Child Cohort","authors":"Kaja K. Faurø MD ,&nbsp;Lasse M. Obel MD ,&nbsp;Henrik T. Christesen DMSc ,&nbsp;Dorte M. Jensen PhD ,&nbsp;Tina K. Jensen PhD ,&nbsp;Dorte Glintborg DMSc ,&nbsp;Marianne S. Andersen DMSc ,&nbsp;Martin Overgaard PhD","doi":"10.1016/j.eprac.2025.02.009","DOIUrl":"10.1016/j.eprac.2025.02.009","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to investigate the potential associations between serum apolipoprotein levels in early pregnancy and the risk of gestational diabetes mellitus (GDM) and adverse pregnancy outcomes.</div></div><div><h3>Methods</h3><div>This was an observational study of the population-based Odense Child Cohort. Pregnant women were followed from inclusion until childbirth. Apolipoprotein levels, including 12 apolipoproteins (ApoA-I, ApoA-II, ApoA-IV, ApoB, ApoC-I, ApoC-II, ApoC-III, ApoD, ApoE, ApoH, ApoJ, and ApoM) were measured by targeted proteomics using liquid chromatography mass spectrometry on late first trimester serum samples stored in a biobank. GDM was defined by WHO 2013 diagnostic criteria.</div></div><div><h3>Results</h3><div>A total of 991 pregnant women were included, of which 415 (41.9%) were diagnosed with GDM. GDM was associated with increasing ApoB (adjusted odds ratio [OR]: 1.26, <em>P</em> = .002) and ApoD levels (adjusted OR: 0.84, <em>P</em> = .021). ApoB levels in early pregnancy correlated significantly and positively with insulin resistance (r = 0.22, <em>P</em> &lt; .001) and beta-cell function in third trimester (r = 0.20, <em>P</em> &lt; .001), whereas early pregnancy ApoD levels were inversely correlated with insulin resistance (r = −0.14, <em>P</em> &lt; .001) and beta-cell function (r = −0.12, <em>P</em> &lt; .001). Finally, high levels of ApoD was significantly associated with lower risk of large-for-gestational-age infants (adjusted OR: 0.78, <em>P</em> = .041).</div></div><div><h3>Conclusions</h3><div>High levels of ApoB and low levels of ApoD in early pregnancy were independently associated with an increased risk of GDM, insulin resistance, and large-for-gestational-age infants (low ApoD only), suggesting potential roles for future management of pregnancy outcomes.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 6","pages":"Pages 805-812"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457309","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 Pragmatic Approach to Monitor for Adrenal Axis Recovery After a Failed Short Synacthen Test","authors":"Anes Harid MSc ,&nbsp;Matthew Rowe PGDip(Endocrinology and Diabetes) ,&nbsp;Nishchil Patel MRCP ,&nbsp;Jinny Jeffery DPhil ,&nbsp;Daniel Flanagan MD ,&nbsp;Andrew McGovern MD","doi":"10.1016/j.eprac.2025.02.019","DOIUrl":"10.1016/j.eprac.2025.02.019","url":null,"abstract":"<div><h3>Objective</h3><div>To identify a morning cortisol threshold value which confirms non-recovery of the adrenal axis and therefore negates the need for a short Synacthen test (SST) in those with known adrenal axis insufficiency.</div></div><div><h3>Methods</h3><div>We collected data from all SSTs (<em>n</em> = 1570 tests; <em>n</em> = 952 individuals) conducted in our hospital over a 10-year period spanning between 1st February, 2013, and 30th January, 2023. We included all tests where baseline cortisol levels were taken before 9:30 <span>am</span> Both 30- and 60-minute cortisol values were measured. Cortisol was measured using the Abbott Architect method. We used the full SST dataset to construct a quantile regression model to predict the 95% centile of peak cortisol response. This model was refitted to the SST follow-up data for those who failed a first SST (<em>n</em> = 115 tests; <em>n</em> = 66 individuals) to identify the baseline cortisol value below which there was a less than 5% chance of passing an SST.</div></div><div><h3>Results</h3><div>Those with an early morning cortisol of ≤126 nmol/L had ≥95% chance of failing an SST. Sixty percent of follow-up SSTs (69/115) exhibited baseline cortisol values below this threshold, and none of these passed an SST.</div></div><div><h3>Conclusion</h3><div>An early morning cortisol ≤126 nmol/L is common in those followed for adrenal axis recovery and is an accurate indicator of non-recovery. Baseline cortisol measurements are therefore a simple way of screening for adrenal axis recovery. Those with a cortisol of &gt;126 nmol/L should go on to have an SST. Using this approach could considerably reduce the need for follow up SSTs in this patient cohort.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 6","pages":"Pages 750-757"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572475","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 of Somapacitan in Treatment-Fatigue Adult Patients With Growth Hormone Deficiency Previously Treated With Once-Daily Growth Hormone Injections: A 24-Week Randomized Active-Controlled Trial","authors":"Mojca Jensterle MD, PhD ,&nbsp;Rok Herman MD ,&nbsp;Ana Klinc MD ,&nbsp;Katja Goričar PhD ,&nbsp;Matej Rakusa MD, PhD ,&nbsp;Andrej Janež MD, PhD","doi":"10.1016/j.eprac.2025.03.005","DOIUrl":"10.1016/j.eprac.2025.03.005","url":null,"abstract":"<div><h3>Objective</h3><div>We evaluated the efficacy of somapacitan in a 24-week, randomized, active-controlled study in patients with growth hormone deficiency (GHD) who experienced fatigue from daily growth hormone (GH) injections.</div></div><div><h3>Methods</h3><div>Twenty-nine adult patients with GHD, pretreated with daily GH for ≥5 years, who had reported treatment-related fatigue, were randomized to somapacitan or daily GH. Outcome measures were changes in treatment satisfaction assessed by Treatment Satisfaction Questionnaire for Medication-9, insulin-like growth factor-1 (IGF-1) standard deviation score, glucose and lipid parameters, body composition, bone mineral density (BMD), carotid intima media thickness, and reactive hyperaemia index, from baseline to week 24.</div></div><div><h3>Results</h3><div>The difference in change in Treatment Satisfaction Questionnaire for Medication-9 score for convenience was significant, in favor of somapacitan (estimated difference, somapacitan-daily GH [95% CI]:23.2 [7.9; 38.4] points, <em>P</em> = .004). No differences between treatment arms in estimated changes from baseline to study-end were observed for IGF-1 levels, glucose and lipid profile, visceral adipose tissue, fat mass (%), lean body mass, and vascular parameters. There was significant difference in BMD of the lumbar spine (estimated difference, somapacitan-daily GH [95% CI] −0.036 (−0.064, −0.009) gr/cm², <em>P</em> = .011).</div></div><div><h3>Conclusion</h3><div>In AGHD patients who were fatigued from the long-term daily GH injections, somapacitan was reported to be more convenient than daily GH. It was effective in maintaining IGF-1 levels and body composition, glucose, lipids, and vascular parameters, comparable to daily GH. Nonsignificant decrease in BMD with somapacitan could reflect a favorable increase in bone metabolic units, as previously observed in naïve patients with GHD during the initial 6-month period of GH therapy.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 6","pages":"Pages 766-775"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662868","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":"Hyperprolactinemia Is Associated With Height Attainment Within or Above Target Height in Adult Patients With Pituitary Stalk Interruption Syndrome","authors":"Yuhan Wang MD ,&nbsp;Jiangfeng Mao MD ,&nbsp;Xi Wang MD ,&nbsp;Min Nie PhD ,&nbsp;Junyi Zhang MD ,&nbsp;Wei Zhang MD ,&nbsp;Hongying Liu MD ,&nbsp;Zhongyue Xu MD ,&nbsp;Xueyan Wu MD","doi":"10.1016/j.eprac.2025.03.010","DOIUrl":"10.1016/j.eprac.2025.03.010","url":null,"abstract":"<div><h3>Objectives</h3><div>Limited data exist on growth-promoting factors beyond growth hormone and insulin-like growth factor 1. This study aimed to identify factors associated with growth in patients with pituitary stalk interruption syndrome (PSIS).</div></div><div><h3>Methods</h3><div>This retrospective cross-sectional study included 62 adult patients with PSIS between January 2021 and September 2024. Demographic data, metabolic parameters, and hormone statuses were compared. Binary logistic regression was used to assess the relationships among hyperinsulinemia, hyperprolactinemia, sex hormone replacement history, thyroxine replacement history and 1) height attainment within or above the target height and 2) height ≥ −2 SD.</div></div><div><h3>Results</h3><div>A total of 62 patients (53 males and 9 females) were included, with a median age of 30.5 years (range: 26.0-32.4). Twelve patients achieved their target height, while the remaining patients did not. Hyperprolactinemia in adult patients with PSIS was positively associated with height attainment within or above the target height (odds ratio [OR] 6.4, 95% CI: 1.6-24.7, <em>P</em> = .007), and this association remained after adjustment for multiple confounders (OR 6.89, 95% CI: 1.19-40.81, <em>P</em> = .032). Additionally, hyperprolactinemia showed a positive association with height ≥ −2 SD (OR 10.5, 95% CI: 2.8-38.5, <em>P</em> &lt; .001), which also remained after adjusting for confounders (OR 13.8, 95% CI: 2.5-77.6, <em>P</em> = .003). These associations were consistently observed in male patients.</div></div><div><h3>Conclusions</h3><div>Hyperprolactinemia was associated with height attainment within or above the target height and in Chinese adult patients with PSIS. Additionally, a significant correlation was observed between hyperprolactinemia and height ≥ −2 SD.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 6","pages":"Pages 724-730"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729472","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":"Sunscreen and 25-Hydroxyvitamin D Levels: Friends or Foes? A Systematic Review and Meta-Analysis","authors":"Elisa Gatta MD ,&nbsp;Carlo Cappelli MD","doi":"10.1016/j.eprac.2025.03.014","DOIUrl":"10.1016/j.eprac.2025.03.014","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the impact of sunscreen use on 25-hydroxyvitamin D (25(OH)D) levels, addressing conflicting findings from observational and interventional studies.</div></div><div><h3>Methods</h3><div>Potentially eligible studies were identified from the PubMed/MEDLINE, Scopus, and Web of Science databases from inception to November 2024, utilizing a search strategy incorporating terms related to “sunscreen” and “vitamin D.” The studies eligible addressed the questions define based on the Population, Intervention, Comparator, Outcome framework: What are 25(OH)D levels in patients exposing to sun applying or not sunscreen? This review followed Preferred Reported Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality assessment and the risk of bias were analyzed using Quality Assessment of Diagnostic Accuracy Studies version 2.</div></div><div><h3>Results</h3><div>We included 22 studies in the qualitative synthesis, and 7 in the quantitative one, encompassing a total of 9470 participants. In vitro studies consistently showed that sunscreen blocks UV-B radiation, crucial for vitamin D₃ production, while population-based studies reported mixed findings. Some studies linked sunscreen use to lower 25(OH)D levels, particularly in individuals with limited sun exposure, while others observed no significant impact. Meta-analysis showed that the adoption of sunscreen is associated to a reduction of 25(OH)D serum concentration (standardized mean difference = −2 ng/mL, 95% confidence interval −3, −1) with a not important heterogeneity across studies (I-square = 37%, <em>P</em> = .15).</div></div><div><h3>Conclusion</h3><div>The existing evidence supports that sunscreen can impair vitamin D₃ synthesis, and as a result decrease serum 25(OH)D levels, but further research is necessary to determine the broader health implications and guide public health recommendations.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 6","pages":"Pages 839-848"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987389","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":"Can Growth Hormone Stimulation Tests in Children Predict the Response to Growth Hormone Treatment?","authors":"Keren Smuel Zilberberg MD ,&nbsp;Michal Yackobovitch–Gavan PhD ,&nbsp;Ariel Tenenbaum MD ,&nbsp;Liron Tirosh Legmann MD ,&nbsp;Liora Lazar MD ,&nbsp;Moshe Phillip MD ,&nbsp;Tal Oron MD","doi":"10.1016/j.eprac.2025.03.007","DOIUrl":"10.1016/j.eprac.2025.03.007","url":null,"abstract":"<div><h3>Objective</h3><div>The efficacy of growth hormone (GH) treatment in short, healthy children diagnosed with growth hormone deficiency (GHD) or idiopathic short stature (ISS) suggests an overlap between these 2 conditions. Although imperfect and inconsistent, GH stimulation testing (GHST) remains the primary diagnostic tool for differentiating GHD and ISS, influencing GH treatment eligibility and dosing. This study aims to assess the clinical significance of GHST by comparing the response to GH treatment in children diagnosed with GHD or ISS based on their GHST results.</div></div><div><h3>Methods</h3><div>A retrospective study in an endocrine clinic at a tertiary pediatric referral center comparing the response to GH treatment over 3 years in children diagnosed with GHD or ISS.</div></div><div><h3>Results</h3><div>Two hundred ninty-one children treated with GH, 97 children diagnosed with GHD, and 194 with ISS are included in the analysis. Height significantly improved, and insulin-like growth factor-1 levels increased independent of the GHST results, gender, or pubertal status (<em>P</em> &lt; .001). When adjusting for dosage, height gain was not associated with the treatment indication, GHD or ISS, or GHST peak levels.</div></div><div><h3>Conclusions</h3><div>Our findings indicate similar responses to GH treatment in children classified as GHD or ISS based on GHST. These results suggest that the pivotal role of GHST in diagnosing and treating short children should be reconsidered.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 6","pages":"Pages 731-738"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729397","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}