Endocrine Practice最新文献

{"title":"The Cardiovascular Outcomes Between Liraglutide and Dulaglutide Among Different Chronic Kidney Disease Stages in Patients With Type 2 Diabetes","authors":"Yu-Xuan Cai MD ,&nbsp;Feng-Hsuan Liu MD ,&nbsp;Jui-Hung Sun MD ,&nbsp;Chia-Hung Lin MD, PhD","doi":"10.1016/j.eprac.2024.11.016","DOIUrl":"10.1016/j.eprac.2024.11.016","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate the effectiveness and safety of 2 glucagon-like peptide-1 receptor agonists (GLP-1 RAs) liraglutide and dulaglutide, in patients with type 2 diabetes mellitus (T2DM) at various stages of chronic kidney disease (CKD). In addition to analyzing Major Adverse Cardiovascular Events (MACE) as the primary outcome, kidney function deterioration, renal disease, and other drug-related safety events, such as urinary tract infections, pancreatitis, amputations, and cancers were measured.</div></div><div><h3>Research Design and Methods</h3><div>This retrospective analysis included 362 842 T2DM patients from the Chang Gung Research Database between 2011 and 2019, identifying 2830 GLP-1 RAs users. After applying exclusion criteria, 1572 patients (945 on liraglutide, 627 on dulaglutide) were included. The primary outcome was MACE incidence across CKD stages.</div></div><div><h3>Results</h3><div>Of the included patients, 945 used liraglutide, and 627 used dulaglutide. This study found no significant difference in the incidence of MACE between the 2 drugs across varying kidney function levels. However, in patients using liraglutide, a significant increase in MACE incidence was observed with deteriorating kidney function, from an HR of 1.401 (95% CI 0.663-2.958) at an eGFR of 60-89 ml/min/1.73 m² to an HR of 4.078 (95% CI 1.111-14.971, <em>P</em> = .0079) at an eGFR of &lt;15 ml/min/1.73 m², a trend not observed in dulaglutide users (<em>P</em> = .1906).</div></div><div><h3>Conclusion</h3><div>Both liraglutide and dulaglutide are effective GLP-1 RAs in T2DM patients, but their impact on cardiovascular outcomes varies with CKD stage in liraglutide users. In contrast, this trend was not observed with dulaglutide, suggesting a potentially greater cardiovascular benefit of dulaglutide at more advanced CKD stages.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 3","pages":"Pages 292-297"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846182","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":"Association Between Life's Essential 8 and Diabetic Kidney Disease in Patients With Diabetes Mellitus: Evidence From National Health and Nutrition Examination Survey 2005-2018","authors":"Yi Wei MD ,&nbsp;Jiangyi Yu MD","doi":"10.1016/j.eprac.2024.12.010","DOIUrl":"10.1016/j.eprac.2024.12.010","url":null,"abstract":"<div><h3>Background</h3><div>Diabetic kidney disease (DKD) is often connected with an elevated cardiovascular disease risk. A novel index, the Life's Essential 8 (LE8), was developed with the American Heart Association to ascertain cardiovascular health. In people with diabetes mellitus, we aimed to estimate if LE8 possessed a connection with DKD risk.</div></div><div><h3>Methods</h3><div>We implemented data from the National Health and Nutrition Examination Survey from 2005 to 2018. The correlation between LE8 and DKD was evaluated with weighted multivariate logistic regression models and restricted cubic spline models with covariate adjustments. In addition, we performed subgroup analyses and interaction tests.</div></div><div><h3>Results</h3><div>After taking into account relevant confounding factors, the findings indicated that higher levels of LE8 was linked to a decreased probability of developing DKD (per 10-point increase in LE8, OR = 0.75, 95%CI = 0.68-0.84, <em>P</em> &lt; .001). The subscales of the LE8 similarly demonstrated negative associations with DKD risk. After grouping the LE8 scores, it was found that individuals with high LE8 were significantly less likely to develop DKD compared to those with low LE8 (OR = 0.32, 95%CI = 0.15-0.70, <em>P</em> = .005). The association between LE8 and DKD was consistent across different subgroups.</div></div><div><h3>Conclusion</h3><div>LE8 scores were shown to have a significantly negative association with the risk of DKD in people with diabetes mellitus. By concentrating on the state of cardiovascular health, it may be possible to lessen the impact of DKD.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 3","pages":"Pages 326-332"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863856","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 Debatable Clinical Utility of the 2024 Vitamin D Guideline: Bridging the Gap Between Current Guidelines, Practical Clinical Recommendations, and Utilization of Emerging Evidence in Vitamin D Disease Prevention","authors":"Michael F. Holick Ph.D., M.D.","doi":"10.1016/j.eprac.2025.02.002","DOIUrl":"10.1016/j.eprac.2025.02.002","url":null,"abstract":"","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 3","pages":"Pages 399-402"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406195","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":"Factors Influencing the Care and Management of Diabetic Foot Ulcers: A Scoping Review","authors":"Omorogieva Ojo BSc, MSc, PhD ,&nbsp;Joshua Boateng BPharm, MSc, PhD ,&nbsp;Rosana Pacella BSc, PhD ,&nbsp;Ann Hanrahan BSocSci, MSocSci, PhD ,&nbsp;Ryan Essex BSocSc, MPH, PhD ,&nbsp;Lesley Dibley BSc, MPhil, PhD","doi":"10.1016/j.eprac.2024.11.010","DOIUrl":"10.1016/j.eprac.2024.11.010","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this scoping review is to explore the experiences of patients’ and healthcare practitioners on the factors that influence the care and management of diabetes-related foot ulcers (DFUs).</div></div><div><h3>Methods</h3><div>Levac et al’s 6-stage framework and the Preferred Reporting Items for Systematic Review and Meta-analysis extension for scoping reviews, guided the review. The SPIDER tool was used to define key elements of the review question. Searches for relevant articles were conducted in electronic databases (PUBMED, CINAHL, AMED, Embase, Cochrane Database of Systematic Reviews, and PsycINFO), Google Scholar, and hand searches of reference lists.</div></div><div><h3>Results</h3><div>Eight articles met the inclusion criteria and were included in the review. Three themes were identified: Communication and Education about DFUs; Challenges of managing DFUs; and Barriers to treatment and management. The themes are presented as a narrative synthesis.</div></div><div><h3>Conclusion</h3><div>Inadequate knowledge of diabetic foot care by patients and inconsistent communication by healthcare professionals were primary factors affecting the effective management of diabetes-related foot ulcers. Consistent, patient-focused education that is supported by knowledgeable health care professionals should form the foundation of effective diabetic foot ulcer care.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 3","pages":"Pages 380-389"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767085","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":"Association Between Food Insecurity and Inability to Obtain Provider-Recommended Medications, Multidisciplinary Services, and Technology in Youth and Young Adults With Diabetes: A Cross-Sectional Study","authors":"Nadine El Kalach MS ,&nbsp;Emmanuel F. Julceus MD ,&nbsp;A. Caroline Rudisill PhD ,&nbsp;Faisal S. Malik MD ,&nbsp;Kate Flory PhD ,&nbsp;Edward A. Frongillo PhD ,&nbsp;Katherine A. Sauder PhD ,&nbsp;Jason A. Mendoza MD ,&nbsp;Angela D. Liese PhD","doi":"10.1016/j.eprac.2024.11.014","DOIUrl":"10.1016/j.eprac.2024.11.014","url":null,"abstract":"<div><h3>Objective</h3><div>We assessed if food insecurity (FI) is associated with not obtaining recommended diabetes medications, technology, and multidisciplinary services, and explored the most common reasons for not obtaining recommended treatments in youth and young adults (YYA) with diabetes.</div></div><div><h3>Methods</h3><div>In this cross-sectional study, among 911 YYA with type 1 diabetes (T1D) and 144 with type 2 diabetes (T2D) from the SEARCH Food Security Cohort Study Follow-up 1 (2018-2021), FI (≥ 3 items affirmed from the 18-item Household Food Security Survey module), and inability to obtain recommended treatments were self-reported.</div></div><div><h3>Results</h3><div>Almost 30% of YYA with T1D and FI and 20% of YYA with T2D and FI did not obtain 1 or more recommended treatments. Participants with T1D who reported FI had higher odds of not obtaining insulin (OR 3.2, 95% CI 1.2-8.4), mental health counseling (OR 3.3, 95% CI 1.3-8.2), diabetes education (OR 3.6, 95% CI 1.4-9.3), an insulin pump (OR 2.2, 95% CI 1.2-4.4), and a continuous glucose monitor (OR 2.5, 95% CI 1.5-4.4) compared to those who reported food security. Among participants with T2D, FI was related to not obtaining dietician services (OR 8.1, 95% CI 1.2-53.8). Participants with T1D and FI reported more financial reasons for not obtaining a continuous glucose monitor compared to food secure participants.</div></div><div><h3>Conclusion</h3><div>YYA with diabetes and FI face constraints in obtaining medications, diabetes technology, and multidisciplinary services, largely due to financial and structural reasons. New strategies are needed to bridge the gap between medical care required vs obtained by YYA with diabetes.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 3","pages":"Pages 298-305"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791290","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":"Clinical Characteristics, and Prevalence of Hepatic and Bone Mineral Density Abnormalities in Patients With Sheehan Syndrome: Data From a Tertiary Care Center","authors":"Shoiab Mohd Patto DnB ,&nbsp;Mohammad Hayat Bhat DM ,&nbsp;Mohammad Salem Baba DM ,&nbsp;Shabir Ahmad Bhat MD ,&nbsp;Shahnawaz Mir DM ,&nbsp;Suhail Shafi Lone MD ,&nbsp;Pinaki Dutta DM","doi":"10.1016/j.eprac.2024.12.008","DOIUrl":"10.1016/j.eprac.2024.12.008","url":null,"abstract":"<div><h3>Objective</h3><div>Sheehan syndrome (SS), or postpartum pituitary necrosis, occurs due to reduced vascular supply to pituitary gland after postpartum hemorrhage, often linked to coagulation abnormalities, and pituitary antibodies. A smaller sella turcica volume is a risk factor for SS, consequent to compressive effects on the pituitary stalk. Hypopituitarism in SS increases the risk of metabolic liver and bone diseases. This study aimed to assess the clinical profile of SS, estimate sella turcica volume, and quantify liver fat and bone mineral density.</div></div><div><h3>Methods</h3><div>This case-control study recruited 50 patients with SS and an equal number of healthy controls.</div></div><div><h3>Results</h3><div>The mean age (52.14 ± 8.47 vs 51.20 ± 7.46 years, <em>P</em> = .55) and body mass index (23.33 ± 3.61 vs 23.46 ± 3.10 kg/m², <em>P</em> = .86) were similar between patients with SS and controls. Lactational failure occurred in 88%, and 96% had secondary amenorrhea. Overall, 94% of patients had growth hormone deficiency, 96% had hypogonadism, 96% had thyrotroph failure, and 92% had corticotroph failure. Sella turcica volume was lower in patients with SS than in controls (350.90 ± 109.05 mm³ vs 565.47 ± 85.15 mm³, <em>P</em> ≤ .01) but there was no correlation with age, body mass index, childbirth duration, insulin-like growth factor 1, or number of pituitary hormone deficiencies. The distribution of hepatic steatosis was mild in 4%, moderate in 8% and severe in 12%. The results indicate that 10% of patients had mild fibrosis, 4% had moderate fibrosis, and none had severe fibrosis. Osteopenia was present in 30% of patients and osteoporosis in 60% of patients.</div></div><div><h3>Conclusion</h3><div>Patients with SS had a lower sella turcica volume than controls. Additionally, 90% of patients had osteoporosis or osteopenia, and many also had hepatic steatosis or fibrosis.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 3","pages":"Pages 339-344"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863870","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, Dariusz Naskręt, Aleksandra Uruska, Dorota Zozulińska-Ziółkiewicz","doi":"10.1016/j.eprac.2025.02.015","DOIUrl":"10.1016/j.eprac.2025.02.015","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Case report: </strong>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.</p><p><strong>Discussion: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-28","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":"Triglyceride to High-Density Lipoprotein Cholesterol Ratio as a Marker of Subclinical Coronary Atherosclerosis and Hepatic Steatosis in Familial Hypercholesterolemia.","authors":"Gavin Huangfu, Dick C Chan, Jing Pang, Biyanka Jaltotage, Gerald F Watts, Nick S R Lan, Damon A Bell, Abdul R Ihdayhid, Oyekoya T Ayonrinde, Girish Dwivedi","doi":"10.1016/j.eprac.2025.02.013","DOIUrl":"10.1016/j.eprac.2025.02.013","url":null,"abstract":"<p><strong>Objective: </strong>Features of the cardiometabolic syndrome are prevalent in patients with familial hypercholesterolemia (FH). Triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio, a surrogate marker of insulin resistance, may be a robust predictor of cardiac events in the general population. We explored the association between TG/HDL-C ratio and high-risk coronary artery plaque (HRP) and hepatic steatosis (HS) in asymptomatic patients with FH.</p><p><strong>Methods: </strong>We conducted a cross-sectional study of 290 patients (mean age = 49 years, 44% male) who underwent computed tomography coronary angiography for cardiovascular risk assessment. HRP and HS were assessed from computed tomography coronary angiography, and TG/HDL-C ratio was derived from the fasting lipid panel collected around time of scanning. Associations were assessed using binary logistic and Kaplan-Meier analysis.</p><p><strong>Results: </strong>TG/HDL-C ratio was significantly associated with HRP (odds ratio, 1.27; 95% CI, 1.04-1.56; P = .020) and HS (odds ratio, 1.71; 95% CI, 1.17-2.51; P = .005) after adjusting for age, body mass index, smoking, and coronary calcium score. TG/HDL-C ratio was associated with HRP in patients treated with lipid-lowering medications (P = .042) and inclusion in a predictive model outperformed the FH-Risk-Score (area under receiver operating characteristic 0.74 vs 0.63; P = .004). An elevated TG/HDL-C ratio predicted myocardial infarction or coronary revascularization over a median follow-up of 91 months with 10 cardiac events recorded (P = .043). TG/HDL-C ratio was strongly positively correlated (P < .001 for all) with markers of cardiometabolic dysfunction: lipid accumulation product (r = 0.81), visceral adiposity index (r = 0.96), and triglyceride-glucose index (r = 0.91).</p><p><strong>Conclusion: </strong>TG/HDL-C ratio was strongly associated with HRP, HS, and cardiac events in patients with FH treated with long-term cholesterol-lowering therapy.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531271","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":"Diabetes Status and Cardiovascular Complications Risk in Noncardiac Surgery: A Population-Based Cohort Study.","authors":"Yunxi Ji, Zhihan Lyu, Bin Cui, Weiqing Wang","doi":"10.1016/j.eprac.2025.02.011","DOIUrl":"10.1016/j.eprac.2025.02.011","url":null,"abstract":"<p><strong>Objective: </strong>Patients with diabetes are considered to be at high surgical risk due to the potential occurrence of cardiovascular and diabetes-related complications. Limited research exists on the cardiovascular risk profiles of patients with prediabetes and undiagnosed diabetes in noncardiac surgery. In this population-based cohort study, we investigated different glycated hemoglobin levels and their associated postoperative cardiovascular risks.</p><p><strong>Methods: </strong>In this perioperative cohort study, participants were categorized into four groups: nondiabetes, prediabetes, undiagnosed diabetes, and diagnosed diabetes. The primary endpoint was the occurrence of major adverse cardiovascular events (MACE) at 30 days postoperatively, with secondary outcomes assessed at 90 days. The association between various groups and postoperative MACE was evaluated using Cox proportional hazards models and Kaplan-Meier curves. Subgroup analyses and sensitivity analyses were also performed.</p><p><strong>Results: </strong>We enrolled 13 207 eligible patients undergoing noncardiac surgeries, among whom 3841 (29.08%) had prediabetes and 1521 (11.52%) had undiagnosed diabetes. In the 30-day postoperative period, the prediabetes group (hazard ratio [HR] [95% CI]: 1.70 [1.15, 2.52]), undiagnosed diabetes group (HR [95% CI]: 2.36 [1.15, 3.68]), and diagnosed diabetes group (HR [95% CI]: 2.33 [1.54, 3.53]) exhibited increased risks of MACE compared to the nondiabetes group. Similar findings were observed for the 90-day postoperative MACE. Further subgroup analysis revealed a significant interaction between sex and states of glycemic regulation (P for interaction < 0.005).</p><p><strong>Conclusion: </strong>In this cohort, a notable proportion of patients with prediabetes or undiagnosed diabetes were found to be undergoing noncardiac surgeries. They were associated with an increased risk of developing postoperative MACE.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523060","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":"Primary Aldosteronism Classification With 18-Oxocortisol and Gallium-68-Pentixafor Positron Emission Tomography/Computed Tomography.","authors":"Yinjie Gao, Jie Ding, Yu Wang, Yue Zhou, Yushi Zhang, Ling Qiu, Li Huo, Anli Tong","doi":"10.1016/j.eprac.2025.02.012","DOIUrl":"10.1016/j.eprac.2025.02.012","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore the noninvasive and accurate evaluation methods of primary aldosteronism (PA) classification.</p><p><strong>Methods: </strong>There were 99 patients with aldosterone-producing adenoma (APA) and 61 with idiopathic hyperaldosteronism recruited in this study. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) and gallium-68 (⁶⁸Ga)-pentixafor positron emission tomography (PET)/computed tomography (CT) were performed in this cohort. Statistical analysis was used to calculate the diagnostic efficiency of single or double methods.</p><p><strong>Results: </strong>In steroid profiling detected by LC-MS/MS, the average levels of 6 steroids apart from aldosterone in the APA group were higher than those in the idiopathic hyperaldosteronism group. The differential diagnostic efficiency of 18-oxocortisol (cutoff value at 0.132 ng/mL) was greater than other steroids, with a sensitivity of 75.3% and specificity of 91.2%. As for ⁶⁸Ga-pentixafor PET/CT, visual analysis showed a sensitivity of 93.7% and specificity of 56.3%. At the optimum maximum standardized uptake value of 8.00, the sensitivity was 69.8%, and the specificity was 93.7%. Taking into account the 18-oxocortisol level and ⁶⁸Ga-pentixafor PET/CT maximum standardized uptake value, 100% of patients with double positive results were placed in the right APA subtype. If the 18-oxocortisol level with ⁶⁸Ga-pentixafor PET/CT visual analysis was combined for PA subtyping, the sensitivity of at least 1 positive was 95.2%, and a total of 87.2% of patients could be classified correctly.</p><p><strong>Conclusion: </strong>The LC-MS/MS and ⁶⁸Ga-pentixafor PET/CT have great advantages on the subtyping of PA. There was a high accuracy of the combination of the 2 methods, which will contribute to avoid an unnecessary adrenal venous sampling operation before surgery for most patients with PA.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523061","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}