Endocrine Practice最新文献

{"title":"Bone Mineral Density Improvement After Resolution of Endogenous Cushing Syndrome: A Systematic Review and Meta-Analysis","authors":"Nipith Charoenngam MD ,&nbsp;Thanitsara Rittiphairoj MD, MPH ,&nbsp;Charalampos Plessias MD ,&nbsp;Thanathip Suenghataiphorn MD ,&nbsp;Thitiphan Srikulmontri MD ,&nbsp;Phuuwadith Wattanachayakul MD ,&nbsp;Merve Kurt MD","doi":"10.1016/j.eprac.2024.12.009","DOIUrl":"10.1016/j.eprac.2024.12.009","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to identify all evidence to evaluate bone mineral density (BMD) improvement after resolution of endogenous Cushing syndrome (eCS).</div></div><div><h3>Methods</h3><div>Potentially eligible studies were identified from the EMBASE and PubMed databases from inception to February 2024, utilizing a search strategy incorporating terms related to \"Bone mineral density\" and \"Cushing syndrome\". Eligible studies must include patients diagnosed with eCS. These studies must present lumbar spine (LS) or femoral neck (FN) BMD measurements before and after resolution of eCS. Point estimates with standard errors were extracted from each study and combined using the generic inverse variance method. Meta-regression analysis was utilized to explore factors influencing BMD improvement.</div></div><div><h3>Results</h3><div>After systematic review, 5085 records were identified. After systematic review, 12 studies (302 patients, mean age of 13-44 years, % female patients 57%-92%, follow-up time 16-60 months) were eligible. The meta-analysis demonstrated that resolution of eCS resulted in improvements in LS BMD (pooled mean difference T-score: +0.86, I² 80.4%; 95%CI 0.51-1.21; Z-score: +0.86, 95%CI 0.57-1.16, I² 75.9%) and FN BMD (pooled mean difference: T-score: +0.38, 95%CI 0.26-0.51, I² 0.0%; Z-score: +0.44, 95%CI 0.31-0.57, I² 20.3%). The meta-regression analysis identified factors potentially influencing LS BMD increases, including longer follow-up time, higher %female patients and lower mean baseline 24-hour UFC, while none of these factors were significantly associated with FN BMD changes.</div></div><div><h3>Conclusion</h3><div>Our study presents the degree and influencing factors of BMD improvement following eCS resolution. These findings offer guidance for management of eCS-associated osteoporosis.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 3","pages":"Pages 345-351"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In the Shadow of Enthusiasm: Hype, Hope, and Evidence Guiding the Vitamin D Debate","authors":"Anastassios G. Pittas MD MS","doi":"10.1016/j.eprac.2024.11.019","DOIUrl":"10.1016/j.eprac.2024.11.019","url":null,"abstract":"","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 3","pages":"Pages 396-398"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive Analysis of Mitotane-Related Adverse Events Using the Food and Drug Administration Adverse Event Reporting System","authors":"Xing Wang MD,&nbsp;Jun Li MD,&nbsp;Yunfeng Zhang PhD,&nbsp;Ruizhen Huang MD,&nbsp;Penglin Zhang MM,&nbsp;Honglin Hu MD","doi":"10.1016/j.eprac.2024.11.007","DOIUrl":"10.1016/j.eprac.2024.11.007","url":null,"abstract":"<div><h3>Objective</h3><div>Mitotane is currently the only product approved by the Food and Drug Administration for the treatment of adrenocortical cancer. However, there is a lack of comprehensive studies on the adverse events of mitotane.</div></div><div><h3>Methods</h3><div>Adverse event reports for mitotane in the Food and Drug Administration Adverse Event Reporting System database since 2004 were collected and analyzed to identify mitotane as the primary suspect drug. Reporting ratios, multi-item γ Poisson constrictors, proportional reporting ratios, and Bayesian confidence propagation neural networks were used to analyze the disproportionality of mitotane-related adverse events.</div></div><div><h3>Results</h3><div>A total of 21 433 114 adverse event reports were retrieved from the Food and Drug Administration Adverse Event Reporting System database, with 772 cases identified where mitotane was the primary suspected drug. Positive signals were observed for adverse reactions listed on the drug label, such as nausea, diarrhea, vomiting, dizziness, loss of appetite, and adrenal insufficiency. Additionally, potential adverse reactions not specified on the label were detected, including fatigue, malignant tumor progression, ovarian cysts, chills, amnesia, and Q-T interval prolongation on the electrocardiogram. These findings highlight the critical need for vigilant monitoring of adverse events, particularly during the first few months of treatment.</div></div><div><h3>Conclusion</h3><div>This study provides preliminary safety data on the practical application of mitotane, confirming some known adverse reactions and revealing other potential risks. These findings provide critical safety information for clinicians prescribing mitotane for the treatment of adrenocortical cancer.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 3","pages":"Pages 278-285"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686430","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":"Once-Weekly Tirzepatide Versus Once-Daily Basal Insulin in Managing Type 2 Diabetes Inadequately Controlled With Oral anti-Hyperglycemic Drugs: A Systematic Review and Meta-Analysis","authors":"A.B.M. Kamrul-Hasan MBBS, MD ,&nbsp;Shahjada Selim MBBS, MD, FACE ,&nbsp;Faria Afsana MBBS, MD, FACE ,&nbsp;Lakshmi Nagendra MBBS, MRCP, MD, DM, DrNB, FRCP ,&nbsp;Rezwana Ahmed MS, PhD ,&nbsp;Deep Dutta MBBS, MD, DM, DNB, FRCP, FACE","doi":"10.1016/j.eprac.2024.12.005","DOIUrl":"10.1016/j.eprac.2024.12.005","url":null,"abstract":"<div><h3>Objective</h3><div>No meta-analysis has been published comparing the efficacy and safety of tirzepatide vs once-daily basal insulins in subjects with type 2 diabetes (T2D) inadequately controlled with oral anti-hyperglycemic drugs. This meta-analysis was conducted to address this knowledge gap.</div></div><div><h3>Methods</h3><div>Randomized controlled trials involving subjects with T2D inadequately controlled with oral anti-hyperglycemic drugs and receiving tirzepatide in intervention arm and basal insulins in control arm as add-on therapy were searched throughout the electronic databases. The primary outcome assessed was the change from baseline in hemoglobin A1c (HbA1c).</div></div><div><h3>Results</h3><div>Three randomized controlled trials involving 4339 subjects met the inclusion criteria. Compared to basal insulins, tirzepatide arms achieved greater reductions from the baseline in HbA1c (tirzepatide 5 mg: mean difference (MD) −0.89% [95% CI: −1.23, −0.54]; tirzepatide 10 mg: MD −1.11% [95% CI: −1.42, −0.79]; and tirzepatide 15 mg: MD −1.23% [95% CI: −1.48, −0.97]; <em>P</em> &lt; .00001 for all). Additionally, the proportions of patients achieving HbA1c levels below 7.0%, 6.5%, and 5.7% were significantly greater in the tirzepatide groups than in the basal insulin group. Greater body weight and blood pressure reductions were observed with tirzepatide than with basal insulins. Moreover, tirzepatide had a more favorable impact on lipid profile. Hypoglycemia was less frequent with tirzepatide. Gastrointestinal adverse events (AEs) were more frequent with tirzepatide (all doses) than basal insulin, although serious AEs were comparable between the 2 groups.</div></div><div><h3>Conclusion</h3><div>Tirzepatide outperformed basal insulins in controlling blood glucose, body weight, blood pressure, and lipids in subjects with T2D and is generally well-tolerated except for its higher gastrointestinal AEs.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 3","pages":"Pages 315-325"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822005","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)00052-7","DOIUrl":"10.1016/S1530-891X(25)00052-7","url":null,"abstract":"","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 3","pages":"Pages A1-A2"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143552064","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":"Assessing Changes in Nonspecific Symptoms After Parathyroidectomy for Primary Hyperparathyroidism Using a Smartwatch","authors":"Gustavo Romero-Velez MD ,&nbsp;Huijun Xiao MSc ,&nbsp;James F. Bena MSc ,&nbsp;Dara Z. Ikejiani MS ,&nbsp;Eren Berber MD ,&nbsp;Katherine Heiden MD ,&nbsp;Vikram Krishnamurthy MD ,&nbsp;Joyce Shin MD ,&nbsp;Allan Siperstein MD ,&nbsp;Judy Jin MD","doi":"10.1016/j.eprac.2024.12.002","DOIUrl":"10.1016/j.eprac.2024.12.002","url":null,"abstract":"<div><h3>Objective</h3><div>Parathyroidectomy (PTX) is indicated in primary hyperparathyroidism (PHPT) with osteoporosis or nephrolithiasis. There is not a uniform consensus on the benefit of PTX for nonspecific symptoms, but patient-reported questionnaires have demonstrated improved quality of life (QOL) afterward. This study aimed to evaluate physical activity and sleep after PTX using smartwatch technology.</div></div><div><h3>Methods</h3><div>A prospective study of consecutive patients undergoing PTX for PHPT from August 2022 to July 2023 was conducted. Each patient received a smartwatch to continuously track physical activity and sleep, starting 1 month before to 6 months postoperatively. Euthyroid patients undergoing thyroidectomy served as controls. A disease-specific QOL questionnaire was completed at baseline and 6 months. Data were compared within and between groups using linear mixed effect models.</div></div><div><h3>Results</h3><div>Forty-five patients were enrolled (PTX = 36, thyroidectomy = 9). The PTX group showed higher proportion of light sleep (68% vs 60%, <em>P</em> = .006), and a lower proportion of deep sleep (14% vs 18%, <em>P</em> &lt; .001) when compared with the thyroidectomy group before surgery. After patients with PTX showed improvement in the QOL questionnaire (–16.0, <em>P</em> &lt; .001) but there were no significant changes seen in the overall smartwatch physical activity or sleep patterns. However, improvements in the mood and sleep subcategory of the QOL questionnaire were associated with more deep sleep and lower number of nighttime awakenings.</div></div><div><h3>Conclusion</h3><div>Patients with PHPT seem to have worse sleeping patterns at baseline. Significant improvement after PTX can be seen using QOL questionnaires that are associated with sleep smartwatch data.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 3","pages":"Pages 333-338"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiofrequency Ablation of Toxic Thyroid Nodules: An Early Experience of a Single Institution in the United States","authors":"Alexis R. Schiazza BS ,&nbsp;Catherine McManus MD ,&nbsp;Shawn Hsu MD ,&nbsp;Eric Kuo MD ,&nbsp;James Lee MD ,&nbsp;Jennifer H. Kuo MD","doi":"10.1016/j.eprac.2024.12.006","DOIUrl":"10.1016/j.eprac.2024.12.006","url":null,"abstract":"<div><h3>Objective</h3><div>The field of endocrine surgery has been expanding its minimally invasive techniques to treat a wide range of thyroid pathologies. Radiofrequency ablation (RFA) is one targeted thermal therapy that has been identified as safe and effective for the treatment of benign pathologies as an alternative to surgery. We have employed RFA at our institution and are reporting our experience with this techniques safety, efficacy, and considerations in the treatment of toxic adenomas and multinodular goiters.</div></div><div><h3>Methods</h3><div>Forty-one patients with symptomatic hyperthyroidism from toxic nodules who elected to receive ultrasound-guided RFA in the office were followed with imaging, laboratory studies, and clinical questionnaires. Volume of thyroid nodules was recorded by ultrasound at intervals approximately 1, 3, 6, and 12 months after the procedure.</div></div><div><h3>Results</h3><div>Solitary and multinodular lesions responded with a mean volume reduction of 80.57% by 12 months following RFA. Patients achieved significant improvement in cosmetic and clinical symptoms with 35 of 41 patients sustaining remission from hyperthyroid state. Pain was the most frequently reported complication of this procedure, although it did not result in early termination of procedure of affect treatment outcomes.</div></div><div><h3>Conclusion</h3><div>In our early experience, RFA is a safe and effective method for treating hyperfunctioning thyroid nodules of benign etiologies. To further validate and support these findings, expansion of this cohort and more extensive follow-up will allow us to better characterize the outcomes of RFA and compare this approach to both surgical and other minimally invasive thermal ablative approaches.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 3","pages":"Pages 352-358"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822006","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":"Histopathologic and Clinical Features of Bethesda III-VI Nodules Harboring Isolated RAS Mutations","authors":"Young-Ji Seo MD ,&nbsp;Hattie H. Huston-Paterson MD, MSHPM ,&nbsp;Max A. Schumm MD ,&nbsp;Xochitl R. Longstaff BA ,&nbsp;Elena G. Hughes MS ,&nbsp;Chi-Hong Tseng PhD ,&nbsp;Dianne S. Cheung MD ,&nbsp;Michael W. Yeh MD ,&nbsp;James X. Wu MD ,&nbsp;Masha J. Livhits MD","doi":"10.1016/j.eprac.2024.12.001","DOIUrl":"10.1016/j.eprac.2024.12.001","url":null,"abstract":"<div><h3>Objective</h3><div>Although thyroid tumors possessing isolated <em>RAS</em> mutations are generally considered to be indolent, the oncologic outcomes of tumors evaluated with comprehensive molecular testing have not been well characterized.</div></div><div><h3>Methods</h3><div>We performed a retrospective cohort study of 368 consecutive patients with Bethesda III-VI thyroid nodules at a single institution (2016-2021) who underwent molecular testing with ThyroSeq v3. Patients with isolated <em>RAS</em> mutations were identified, and those with isolated <em>BRAF V600E</em>-mutated cancers were used as comparators. Outcomes of interest included rate of malignancy, high-risk histopathologic features, and structural disease recurrence.</div></div><div><h3>Results</h3><div>A total of 50 patients (14%) had an isolated <em>RAS-</em>mutated nodule, of whom 41 underwent surgery (median age, 43 years; female, 83%). The malignancy rate on final pathology was 46%, whereas 32% of patients had noninvasive follicular thyroid neoplasm with papillary-like nuclear features and 22% had benign histopathology. In comparison, the isolated <em>BRAF</em>-mutated cohort (86 [24%] patients; median age, 45 years; female, 68%) had a 100% rate of malignancy. Only 2 (11%) of the isolated <em>RAS</em> patients with malignant histopathology had lymph node metastasis, compared with 34 (39%) of the <em>BRAF</em> cohort (<em>P</em> = .016). Over a median follow-up of 5 years, no patients with isolated <em>RAS</em> mutations had a structural recurrence compared with 5 patients (6%) in the isolated <em>BRAF</em> cohort.</div></div><div><h3>Conclusion</h3><div>Bethesda III-VI thyroid nodules with isolated RAS mutations have a low rate of aggressive histopathologic features and are unlikely to recur. Thyroid lobectomy may be sufficient treatment for these tumors.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 3","pages":"Pages 366-372"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Postprandial Glycemic Control Using Fiasp vs Insulin Aspart in Hospitalized Patients With Type 2 Diabetes","authors":"Sara M. Alexanian MD,&nbsp;Michael C. Cheney MS,&nbsp;Nicole L. Spartano PhD,&nbsp;Jenny C. Bello-Ramos MD,&nbsp;Niyoti Reddy MD,&nbsp;Aamir Malik MD,&nbsp;Jonila Murati MD,&nbsp;Howard A. Wolpert MD,&nbsp;Devin W. Steenkamp MD","doi":"10.1016/j.eprac.2024.11.015","DOIUrl":"10.1016/j.eprac.2024.11.015","url":null,"abstract":"<div><h3>Objective</h3><div>Hyperglycemia in hospitalized patients is associated with increased morbidity and mortality. Basal-bolus insulin therapy is the treatment of choice for most patients. The efficacy of an ultrarapid vs rapid-acting insulin in hospitalized patients with diabetes has not been evaluated. We assessed noninferiority in efficacy and safety of Fiasp vs aspart (Novolog) as part of a basal-bolus insulin regimen in noncritically ill patients with type 2 diabetes in a safety-net hospital.</div></div><div><h3>Methods</h3><div>This prospective, open-label, randomized trial included 137 patients with diabetes admitted to a non-intensive care unit setting. Subjects were treated with glargine at bedtime and either Fiasp or Novolog for prandial and correction insulin. Subjects were enrolled for a minimum of 4 or maximum of 6 meal boluses. Capillary blood glucose was used for insulin adjustment and a blinded Dexcom G6 Pro captured data for study analysis. The primary endpoint was time spent in sensor glucose range 100-180 mg/dL in the 4-hour postprandial period (assessed among 106 participants with ≥ 4 meals with a 4-hour postprandial period). Time spent in hypoglycemic ranges (&lt;70, &lt;54, &lt;40 mg/dL) was assessed for safety.</div></div><div><h3>Results</h3><div>Four-hour postprandial time in range 100-180 mg/dL was 45% in the Fiasp group vs 36% in the Novolog group (<em>P</em> = .012; meeting prespecified noninferiority criteria). Other glycemic metrics were similar between groups with no difference in time spent in hypoglycemic ranges.</div></div><div><h3>Conclusion</h3><div>Fiasp provides noninferior postprandial glucose control in hospitalized patients with type 2 diabetes when compared to Novolog with no increase in rates of hypoglycemia.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 3","pages":"Pages 306-314"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791220","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":"Treatment of Hypothyroidism by Age and Sex in the United States: A NHANES and Optum Claims Data Analysis","authors":"Alexander H. Tessnow MD ,&nbsp;Benjamin J. Gigliotti MD ,&nbsp;Jennifer M. Perkins MD ,&nbsp;Chris P. Schneiderman MPh ,&nbsp;Brett Pinsky PhD ,&nbsp;Dianlin Guo MD, PhD ,&nbsp;Bruce Barger DO ,&nbsp;Varinder Singh PhD ,&nbsp;Oscar Antunez Flores MD ,&nbsp;Kathleen L. Wyne MD","doi":"10.1016/j.eprac.2024.12.004","DOIUrl":"10.1016/j.eprac.2024.12.004","url":null,"abstract":"<div><h3>Objective</h3><div>Recent data using NHANES and Optum Claims data (OCD) showed an increase in primary hypothyroidism (HT) prevalence in the United States following the 2002 NHANES III report. Using these data, we characterized treatment patterns of overt HT (OHT) in the United States.</div></div><div><h3>Methods</h3><div>Data on adults with OHT were collected from NHANES (2009-2012) and OCD (2012-2019). Disease status was determined from laboratory results or evidence of HT treatment (levothyroxine or liothyronine). OHT was defined as thyroid-stimulating hormone &gt; 4.0 mIU/L and free thyroxine &lt; 0.8 ng/dL or evidence of OHT treatment. Results were stratified by age group and sex. NHANES data were further stratified by insurance status (private/Medicare vs neither).</div></div><div><h3>Results</h3><div>Overall, &gt; 72% received treatment, with &gt; 80% of the OCD cohorts receiving treatment. Among the NHANES cohort, treatment rates increased with advancing age and were consistently higher in females than in males (age 18–44: 47.3% vs 39.9%; 45–59: 76.8% vs 51.1%; ≥ 60: 91.9% vs 65.6%, respectively). Among the OCD cohorts, treatment patterns were similar across age group and sex (&gt; 78% treated). Among the NHANES cohort that were not privately/Medicare insured, overall treatment rates were 50%, with those ≥ 60 having highest treatment rates (&gt; 75%). Moreover, &lt; 50% of reproductive-aged women in the NHANES dataset received treatment, which was reduced to 22% among uninsured patients.</div></div><div><h3>Conclusions</h3><div>This study provides important updates regarding treatment of OHT and highlights treatment disparities, especially among men and women of reproductive age, using both total and insured population estimates.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 3","pages":"Pages 359-365"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}