Endocrine Practice最新文献

{"title":"SGLT2 Inhibitors and Nephrolithiasis Risk in Adults With Type 2 Diabetes: A Systematic Review and Meta-analysis.","authors":"Marconi Abreu, Paula C N Santos, Naim Maalouf, Khashayar Sakhaee, Gaspar R Chiappa","doi":"10.1016/j.eprac.2026.09.007","DOIUrl":"https://doi.org/10.1016/j.eprac.2026.09.007","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between sodium-glucose cotransporter 2 inhibitors (SGLT2i) and nephrolithiasis in adults with type 2 diabetes.</p><p><strong>Methods: </strong>We searched PubMed, Embase, and CENTRAL through April 26, 2026, for comparative studies of SGLT2i in adults with type 2 diabetes. We pooled comparison-level effect estimates using restricted maximum likelihood random-effects models and reported summary odds ratios (ORs). We assessed heterogeneity with I² and 95% prediction intervals, performed subgroup analyses and meta-regression, and assessed risk of bias.</p><p><strong>Results: </strong>We included 10 studies, contributing 14 comparisons. SGLT2i were associated with lower odds of nephrolithiasis across all comparators (OR 0.72, 95% CI 0.65-0.80; p < 0.001; I² = 97.5%; 95% prediction interval 0.48-1.08). The association was strongest versus non-user controls (OR 0.55, 95% CI 0.52-0.58), followed by placebo (OR 0.65, 95% CI 0.49-0.85), DPP-4 inhibitors (OR 0.74, 95% CI 0.63-0.86), and glucagon-like peptide-1 receptor agonists (OR 0.79, 95% CI 0.70-0.90) (p for subgroup difference < 0.0001). Associations were consistent across study designs; outcome ascertainment methods did not significantly modify the association. Comparator class accounted for 29.5% of between-comparison variability, although the moderator test was not statistically significant (p = 0.10); follow-up duration was not significantly associated with effect size.</p><p><strong>Conclusion: </strong>SGLT2i were associated with lower odds of nephrolithiasis in adults with type 2 diabetes. Substantial heterogeneity and the largely observational evidence base limit causal interpretation. Future studies should use adjudicated stone outcomes and urinary biochemical data.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080141","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":"Response to: From Glycemic Response to Clinical Trajectories: Extending Phenotyping in GLP-1RA-SGLT2 Inhibitor Combination Therapy.","authors":"Agostino Milluzzo, Lucia Frittitta","doi":"10.1016/j.eprac.2026.09.012","DOIUrl":"10.1016/j.eprac.2026.09.012","url":null,"abstract":"","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073594","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":"Adverse events during the diagnostic work-up for primary aldosteronism.","authors":"Sybille Fuld, Georgiana Constantinescu, Christina Pamporaki, Carmina T Fuss, Stefanie Hahner, Daniel Yagoub, Paula Trosbach, Jacques W M Lenders, Graeme Eisenhofer","doi":"10.1016/j.eprac.2026.09.010","DOIUrl":"https://doi.org/10.1016/j.eprac.2026.09.010","url":null,"abstract":"<p><strong>Objective: </strong>The diagnostic work-up for primary aldosteronism (PA) involves multiple steps with potential for adverse events (AEs). The aim of this study was to identify the frequency and nature of AEs with medication adjustment during screening and associated with subsequent confirmatory and subtyping tests.</p><p><strong>Methods: </strong>Electronic health records of 545 patients with hypertension tested for PA were retrospectively evaluated for AEs under a multicenter cohort study. The study involved multiple procedures, starting with the plasma aldosterone:renin ratio, usually after medication adjustment. Positive screening tests were followed by a saline suppression test (SST) and, if PA was thereby confirmed, by adrenal venous sampling (AVS).</p><p><strong>Results: </strong>Among 545 patients screened for PA, medication adjustment was carried out in 447 (82%). AEs occurred in 36% (163/447) of the patients with medication adjustment and 2% (2/98) of those without. In the group with medication adjustment, there was one fatality, 14 (3%) required emergency care and eight (2%) hospitalization, while 94 (21%) required further medical counseling. Blood pressure dysregulation was the most frequent AE. Higher systolic blood pressure and higher initial antihypertensive medication requirements were associated with increased risk of AEs. AEs associated with the SST occurred in 5 of 267 (2%) patients, including one requiring hospitalization. AEs associated with AVS occurred in 5% (6/119) of patients, including one requiring cardiopulmonary resuscitation for asystole.</p><p><strong>Conclusions: </strong>Mild AEs are commonly associated with medication adjustment during screening for PA. Severe AEs with hospitalization or death are rare. AEs are also relatively rare during confirmatory and subtyping studies.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149037166","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":"From Willingness to Preparedness: Considerations for Italy's Pediatric Type 1 Diabetes Screening Program.","authors":"Eulalia Catamo, Alice Fachin, Antonietta Robino, Gianluca Tamaro, Gianluca Tornese","doi":"10.1016/j.eprac.2026.09.009","DOIUrl":"10.1016/j.eprac.2026.09.009","url":null,"abstract":"","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149037159","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":"Remission or Reprieve? The Three Clocks of Type 2 Diabetes Remission.","authors":"Vivek Jha, Sanjay Kumar Bhadada","doi":"10.1016/j.eprac.2026.09.008","DOIUrl":"10.1016/j.eprac.2026.09.008","url":null,"abstract":"","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029887","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":"Computed Tomography-Based Radiomics Analysis Adds Value to Glycometabolism Assessment in Adrenal Adenoma: An Exploratory Observational Study.","authors":"Baofeng Wu, Xiaojuan Tian, Changxing Fang, Minmin Han, Shuqing Jin, Qinhao Liu, Yi Zhang, Ying Qiao, Yunfeng Liu","doi":"10.1016/j.eprac.2026.09.004","DOIUrl":"10.1016/j.eprac.2026.09.004","url":null,"abstract":"<p><strong>Objective: </strong>This exploratory observational study examined computed tomography (CT) radiomics features associated with glucose metabolism in adrenal adenoma.</p><p><strong>Methods: </strong>A total of 114 patients were initially enrolled, 106 who completed continuous glucose monitoring were analyzed and classified as impaired glucose metabolism (IGM; A1C ≥5.7%, n = 58) or normal glucose metabolism (NGM; n = 48). Radiomics features were extracted from noncontrast, arterial-phase, and venous-phase CT images. After reproducibility assessment, correlation filtering, and least absolute shrinkage and selection operator selection, 7 features were integrated into a Rad-score. Logistic regression evaluated the association between Rad-score and IGM after adjustment for age, body mass index, and midnight cortisol. Discrimination was assessed by receiver operating characteristic analysis, with 1,000 bootstrap resamples for internal validation.</p><p><strong>Results: </strong>Rad-score was higher in IGM than in NGM (0.377 ± 0.510 vs -0.029 ± 0.808; P = .002). It was associated with IGM in univariable analysis (odds ratio [OR] = 2.718, 95% CI 1.360-5.433; P = .005) and remained significant after multivariable adjustment (adjusted OR = 2.681, 95% CI 1.304-5.512; P = .007). Area under the receiver operating characteristic curves were 0.623 for the clinical model, 0.673 for the radiomics model, and 0.704 for the combined model; the combined-versus-clinical difference was not significant by the DeLong test (P = .101). The bootstrap-corrected area under the receiver operating characteristic curve of the combined model was 0.606.</p><p><strong>Conclusion: </strong>A seven-feature CT radiomics signature was independently associated with IGM in patients with adrenal adenoma. These findings are exploratory and require validation in independent cohorts.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015646","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":"Papillary Thyroid Microcarcinoma in the Era of Risk-Adapted Management.","authors":"Hon-Fan Lai, Chen-Hsen Lee","doi":"10.1016/j.eprac.2026.09.002","DOIUrl":"10.1016/j.eprac.2026.09.002","url":null,"abstract":"<p><p>Papillary thyroid microcarcinoma (PTMC) is increasingly diagnosed worldwide, raising concerns about overdiagnosis and overtreatment. Management has evolved from routine surgery toward more individualized, risk-adapted care. A PubMed-based narrative review was conducted using \"papillary thyroid microcarcinoma\" with keywords related to incidence, surgical extent, central lymph node dissection, completion thyroidectomy, active surveillance, thermal ablation, molecular testing, BRAF, and TERT. Clinically relevant studies and contemporary international guidelines were reviewed. Recognition of the indolent nature of PTMC has reshaped management. Lobectomy is sufficient for most low-risk tumors, whereas routine prophylactic central lymph node dissection and completion thyroidectomy for incidental low-volume nodal disease are generally not recommended. Active surveillance has emerged as a safe alternative to immediate surgery, with low progression rates, no demonstrated survival disadvantage, and fewer treatment-related complications. Thermal ablation has gained interest as a minimally invasive option for selected patients who prefer treatment but wish to avoid surgery, although long-term oncologic evidence remains limited. Despite advances in molecular profiling, current biomarkers provide limited additional value beyond conventional clinicopathologic factors for risk stratification and routine clinical utility. The change in management of PTMC is driven by growing recognition of its frequently indolent clinical course. Accumulating evidence supports a personalized approach that matches treatment intensity to disease biology, allowing many patients to avoid unnecessary intervention without compromising oncologic outcomes. Ultimately, the goal of PTMC management is shifting from maximizing treatment to optimizing treatment.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015773","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":"Sex-Based Disparities in In-Hospital Outcomes Among Patients Hospitalized With Hyperthyroidism: A National Inpatient Sample Analysis (2016-2022).","authors":"Sallam Alrosan, Majd Al-Ahmad, Quang Le, Sajana Maharjan, Shourya Tadisina, Emmeline Monique T Ngo, Brandon Barthel","doi":"10.1016/j.eprac.2026.09.003","DOIUrl":"10.1016/j.eprac.2026.09.003","url":null,"abstract":"<p><strong>Objective: </strong>Hyperthyroidism is more common in women, but hospitalized men may have worse outcomes. National U.S. data are limited. We aimed to compare in-hospital mortality, length of stay, and total charges by sex among adults hospitalized with hyperthyroidism.</p><p><strong>Methods: </strong>We analyzed 2016-2022 National Inpatient Sample adult hospitalizations with a principal hyperthyroidism diagnosis (E05.xx), excluding thyroid cancer. Multivariable regression and propensity-score IPTW sensitivity analysis compared outcomes by recorded sex, with females as the reference.</p><p><strong>Results: </strong>Among 58,150 weighted eligible hospitalizations, sex was recorded for 58,130; 74.4% were female and 25.6% male. Men had a higher comorbidity burden (Charlson index ≥5: 16.8% vs 10.4%) and higher prevalences of atrial fibrillation and coronary artery disease (all P < .001). After multivariable adjustment, male sex was independently associated with higher in-hospital mortality (adjusted odds ratio [aOR] 1.82, 95% CI 1.16-2.86), higher total charges (+$5,121), and greater odds of atrial fibrillation (aOR 2.08), acute kidney injury (1.67), respiratory failure (1.25), mechanical ventilation (1.40), cardiac arrest (1.72), and pericardial tamponade (2.87), but lower odds of thyroid storm (0.89). Propensity-score analysis confirmed higher mortality (aOR 1.95, 95% CI 1.23-3.11). Male excess mortality persisted across all years from 2016 to 2022, with progressively widening disparities in total charges and acute kidney injury.</p><p><strong>Conclusion: </strong>In this nationally representative cohort, men with hyperthyroidism had 2-fold higher in-hospital mortality and a greater burden of severe cardiovascular, renal, and respiratory complications despite lower odds of thyroid storm. These findings support sex-specific monitoring and risk stratification at admission.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015831","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":"Changes in Body Composition Assessed by Bioelectrical Impedance Analysis in Patients Treated With Glucagon-Like Peptide-1 Receptor Agonists: A Real-World Experience.","authors":"Jose Atencia Goñi, Mercedes Sánchez Barba, Gilberto Pérez López, Susana Monereo Megías, Olga González Albarrán","doi":"10.1016/j.eprac.2026.09.005","DOIUrl":"10.1016/j.eprac.2026.09.005","url":null,"abstract":"<p><strong>Objective: </strong>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) induce significant weight loss in patients with obesity; however, data on real-world body composition changes are limited.</p><p><strong>Methods: </strong>We conducted a retrospective real-world observational study including 388 adults with obesity treated with GLP-1 RAs and followed them for 6 months in a specialized endocrinology clinic. Body composition was assessed using multifrequency bioelectrical impedance analysis at baseline and at 6 weeks, 3 months, and 6 months. Linear mixed models with a random intercept per patient were used to compare timepoints, with a fully adjusted model to test the independent contribution of adherence and obesity phenotype.</p><p><strong>Results: </strong>A total of 388 patients (40.7% women; mean age 50.3 years) were included in the study. Mean weight loss reached 11.3% at 6 months (P < .001), predominantly driven by fat mass reduction (-22%), with a marked decrease in visceral fat area (-40.6 cm²). Skeletal muscle mass decreased modestly (-1.46 kg) and was modest relative to the concurrent reduction in fat mass. Adherent patients experienced greater fat loss than non-adherent patients. Improvements were observed in anxiety and binge eating behaviors, with a low incidence of adverse events. Phenotype-based characterization revealed baseline differences as well as distinct patterns of fat and muscle loss.</p><p><strong>Conclusion: </strong>In real-world clinical practice, GLP-1 RA therapy combined with lifestyle interventions led to substantial improvements in body composition, characterized by predominant fat and visceral fat loss, with minimal skeletal muscle reduction. These findings support the use of body composition assessments beyond body mass index in obesity management.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149007886","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":"Changes in Abdominal Adiposity and Associations with Metabolic Health Markers Following Tirzepatide in Japanese Participants with Obesity Disease: Results from the SURMOUNT-J Study.","authors":"Hironori Waki, Eiji Kaneyuki, Tomotaka Shingaki, Tomonori Oura, Takashi Nagakubo, Yasushi Ishigaki","doi":"10.1016/j.eprac.2026.09.006","DOIUrl":"10.1016/j.eprac.2026.09.006","url":null,"abstract":"<p><strong>Objectives: </strong>This analysis characterized obesity-related outcomes in SURMOUNT-J and explored relationships among weight loss, abdominal adiposity, and metabolic improvements.</p><p><strong>Methods: </strong>Japanese adults with obesity disease without diabetes were randomized (1:1:1) to tirzepatide (10 or 15 mg) or placebo plus lifestyle modification. Prespecified analyses evaluated changes from baseline to week 72 in obesity and glycemic parameters. Post hoc analyses assessed correlations among changes in weight, anthropometrics, abdominal adiposity (visceral adipose tissue [VAT], subcutaneous adipose tissue [SAT], hepatic fat fraction [HFF]), and glycemic outcomes.</p><p><strong>Results: </strong>Among 225 participants (placebo n = 75; tirzepatide 10 mg n = 73; 15 mg n = 77), tirzepatide significantly increased high molecular weight adiponectin (mean change: 78.9% and 88.4% vs0.9%) and reduced leptin (-57.3% and -63.1% vs-8.4%), high-sensitivity C-reactive protein (-55.1% and -65.3% vs-17.7%), and liver-related markers, including procollagen III (-21.3% and -24.8% vs-3.8%) and cytokeratin-18 (-59.8% and -62.0% vs-32.8%) (all P < .001). Glucose, insulin, and C-peptide AUC during a 75-g oral glucose tolerance test were also significantly reduced. At week 72, weight loss correlated linearly with reductions in adiposity. Weight loss was strongly correlated with VAT reduction (r = 0.722-0.837 across groups), and VAT reductions strongly correlated with waist measures (r = 0.837). Weight and VAT reductions showed moderate correlations with reductions in glucose, insulin, and C-peptide AUC (r = 0.378-0.656).</p><p><strong>Conclusion: </strong>Tirzepatide-induced reductions in body weight and VAT were associated with improvements in metabolic markers and glucose metabolism. Strong associations between anthropometric measures and VAT support their use as surrogate markers of visceral adiposity in Japanese patients with obesity disease.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149007889","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}