Endocrine Practice最新文献

{"title":"Disparities in osteoporosis care after fragility fracture: a systematic review and meta-analysis.","authors":"Faheem Pottayil, Janice M Bonsu, Brittany E Haws, Ujjawal B Savani, Ryan S Zamanzadeh, Priyathama Vellanki, Thomas M Large","doi":"10.1016/j.eprac.2026.09.001","DOIUrl":"https://doi.org/10.1016/j.eprac.2026.09.001","url":null,"abstract":"<p><strong>Objective: </strong>Fragility fractures are indicative of osteoporosis; evaluation with bone density testing and subsequent pharmacotherapy significantly reduces the risk of subsequent fractures. Sex- and race-based osteoporotic treatment disparities are well described; however, whether disparities persist after fragility fractures remains unclear, especially when all patients after fragility fracture should receive equivalent evaluation.</p><p><strong>Methods: </strong>In this systematic review and meta-analysis, PubMed, CINAHL, Embase, Web of Science, and the Cochrane Library were searched from inception through June 30, 2026, for studies of adults with fragility fractures that reported sex- or race-stratified data on post-fracture osteoporosis pharmacotherapy, DXA testing, or referral. Data were independently extracted by four authors. The primary outcomes were initiation of osteoporosis pharmacotherapy, DXA testing, and referral for osteoporosis evaluation after fragility fracture, stratified by sex and race.</p><p><strong>Results: </strong>Eighty studies were included, of which 47 contributed 69 estimates to at least one meta-analysis. Sex disparities were evaluated in 72 studies and racial disparities in 19 studies. Compared with women, men had lower odds of receiving osteoporosis pharmacotherapy (pooled OR 0·43 [95% CI 0·36-0·50]) or undergoing DXA testing (0·39 [0·31-0·50]). Compared with White patients, Black patients had lower odds of receiving osteoporosis pharmacotherapy (0·63 [0·56-0·70]) or undergoing DXA testing (0·56 [0·50-0·62]).</p><p><strong>Conclusion: </strong>Men and Black patients were significantly less likely to receive osteoporosis pharmacotherapy and bone density testing after fragility fracture. These findings demonstrate persistent inequities in secondary fracture prevention and support the implementation of systematic post-fracture care pathways designed to ensure equitable osteoporosis evaluation and treatment.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001363","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":"Thyroid Function in Children and Adolescents With Idiopathic Growth Hormone (GH) Deficiency After Initiation of Therapy With Recombinant GH.","authors":"Aristeidis Giannakopoulos, Maria Tsanti, Ioannis Amplianitis, Alexandra Efthymiadou, Dionisios Chrysis","doi":"10.1016/j.eprac.2026.08.025","DOIUrl":"10.1016/j.eprac.2026.08.025","url":null,"abstract":"<p><strong>Objective: </strong>Growth hormone (GH)/insulin-like growth factor 1 (IGF-1) and thyroid axes are interconnected. Previous studies reported mixed findings regarding the effect of recombinant GH (rGH) therapy on thyroid function in children with GH deficiency (GHD). This study aimed to investigate longitudinal thyroid function changes over the first year of rGH therapy and assess the secretory capacity of the thyroid gland, using the Structure Parameter Inference Approach (SPINA-GT).</p><p><strong>Methods: </strong>Prospective longitudinal cohort study in a single tertiary center.</p><p><strong>Results: </strong>A total of 111 children with idiopathic GHD were treated with rGH (0.22 mg/kg/wk). Baseline median age was 10.0 years, with 84% being prepubertal. After 12 months of rGH therapy, IGF-1 levels significantly increased (P < .001), whereas free T4 (FT4) levels modestly declined (P = .008). Thyroid-stimulating hormone (TSH) and SPINA-GT index did not show significant changes. Mixed-effects modeling analysis revealed association of FT4 with IGF-1 SD score (P < .001), whereas TSH was not associated with any covariate.</p><p><strong>Conclusion: </strong>The findings of our study are consistent with most previous studies, confirming that rGH therapy in children with GHD induces a modest, statistically significant decline in FT4 while maintaining stable TSH. FT4 was associated with the increase of IGF-1 SD score during rGH therapy while the addition of SPINA-GT evaluation supports the preservation of the thyroid secretory reserve during the first year of rGH treatment.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944535","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":"American Association of Clinical Endocrinology Consensus Statement: Use of Diabetes Technology for Management of Adults with Diabetes.","authors":"Janet B McGill, Amy C Donihi, Halis K Akturk, Matthew Freeby, Abhinav Gupta, William B Horton, M Nauman Jadoon, Sanam Lathief, Sigfrido Miracle-Lopez, Charity Tan, Rodolfo J Galindo","doi":"10.1016/j.eprac.2026.06.011","DOIUrl":"https://doi.org/10.1016/j.eprac.2026.06.011","url":null,"abstract":"<p><strong>Objective: </strong>To provide evidence-informed guidance to assist with shared decision making in the use of advanced technology for the management of adults with diabetes mellitus.</p><p><strong>Methods: </strong>An international task force composed of AACE members with expertise in diabetology and endocrinology reviewed the recent evidence and developed updated guidance for advanced diabetes technology. Relevant studies were identified through a literature review process, and evidence was summarized with key practice points for use of technology in relevant populations. Consensus on the document was obtained through virtual meetings and communications with the task force.</p><p><strong>Results: </strong>The task force deliberated on areas where evidence supports the use of advanced diabetes technology in different populations of individuals with diabetes mellitus. Also discussed were best practices and implementation considerations for the successful adoption of diabetes technology by individuals with all types of diabetes and their health care professionals.</p><p><strong>Conclusions: </strong>This consensus statement aims to provide updated information for health care professionals involved in care for adults with diabetes mellitus. It reviews current evidence that informs best practices in the use of continuous glucose monitoring devices, automated insulin-delivery systems, and other insulin delivery devices, in addition to emerging technologies such as continuous ketone monitoring.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905522","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":"Thermal Ablation for Autonomously Functioning Thyroid Nodules: A Prospective Comparison of Radiofrequency and Microwave Ablation.","authors":"Andrew B Thornton, Eric J Kuo, Catherine McManus, James A Lee, Jennifer H Kuo","doi":"10.1016/j.eprac.2026.08.024","DOIUrl":"10.1016/j.eprac.2026.08.024","url":null,"abstract":"<p><strong>Objective: </strong>Thermal ablation is a minimally invasive treatment for autonomously functioning thyroid nodules with lower risk of hypothyroidism than surgery or radioactive iodine ablation, but data directly comparing thermal ablation modalities are limited. We compared radiofrequency ablation (RFA) and microwave ablation (MWA).</p><p><strong>Methods: </strong>In a prospective single-center cohort, 63 patients with toxic adenoma (TA) or toxic multinodular goiter (TMNG) underwent RFA (n = 47) or MWA (n = 16). The primary outcome was biochemical response, defined as normalization of serum thyroid-stimulating hormone. Secondary outcomes included volume reduction ratio (VRR), ablation time, and complications over 12 months.</p><p><strong>Results: </strong>Median baseline nodule volume was small (4.4 mL), a factor associated with more favorable biochemical response. Biochemical cure was achieved in 89% of patients overall, similar between modalities (P = .63). Contrary to prior reports, TMNG had higher cure rates than TA (100% vs 76%; P = .01). Median VRR exceeded 84% in both groups. MWA required significantly less time per milliliter than RFA (P = .01). Complication rates did not differ between modalities. Nodule rupture exceeded rates in the nonfunctioning nodule literature, possibly reflecting the greater energy required.</p><p><strong>Conclusion: </strong>Thermal ablation is an effective treatment for autonomously functioning nodules, with RFA and MWA as complementary options. TMNG responded more favorably than TA, likely reflecting smaller nodule size. The greater energy required for toxic nodules may increase rupture risk. Trials with longer follow-up are needed to confirm durability and refine energy delivery.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905585","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":"Long-term Elexacaftor/Tezacaftor/Ivacaftor Therapy Improves Glucose Tolerance and Lowers Insulin Concentrations in Cystic Fibrosis.","authors":"Dorothea Appelt, Martha Ruetz, Elisabeth Binder, Katharina Niedermayr, Johannes Eder, Helmut Ellemunter, Teresa Fuchs","doi":"10.1016/j.eprac.2026.08.020","DOIUrl":"10.1016/j.eprac.2026.08.020","url":null,"abstract":"<p><strong>Objective: </strong>Cystic fibrosis-related diabetes (CFRD) is common in cystic fibrosis (CF). While elexacaftor/tezacaftor/ivacaftor (ETI) improves clinical outcomes, effects on glucose metabolism are unclear. We assessed the impact of ETI on glucose tolerance and insulin during oral glucose tolerance tests (OGTTs) in people with CF.</p><p><strong>Methods: </strong>OGTT data from 101 individuals (median age 23 years) were analyzed retrospectively within a 10-year window (5 years pre-to 5 years post-ETI). Tests performed before ETI (n = 378) and during ETI (n = 199) were classified as normal glucose tolerance (NGT), impaired fasting glucose (IFG), indeterminate glycaemia (INDET), impaired glucose tolerance (IGT), or CFRD.</p><p><strong>Results: </strong>Compared with pre-ETI values, mean OGTT glucose decreased (P = .015) and insulin concentrations declined (P < .001) during ETI, with significant glucose changes after 60 and 90 min and insulin after 30, 60, 90 and 120 min. The distribution of glucose metabolism categories during ETI differed by age (P = .004): adolescents (<20 years) more often had INDET than adults (33% vs 22%), whereas adults (≥20 years) more frequently had IGT (20.6% vs 11.0%). Insulin sensitivity improved, with significant changes in Matsuda index (-0.65, P = .017).</p><p><strong>Conclusions: </strong>ETI therapy is associated with improved glucose tolerance and lower insulin concentrations on OGTT, suggesting metabolic benefits of CFTR modulation. Ongoing monitoring of glycaemic status-particularly in adolescents-is warranted to clarify evolving glucose regulation in the ETI era.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905534","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":"Gestational Diabetes Mellitus Is Associated With Adverse Outcomes in Singleton Pregnancies Conceived via Assisted Reproductive Technology: A Nationwide Inpatient Sample Analysis, 2008-2020.","authors":"Meng-Chen Tsai, Pei-Yi Wang, Cheng-Chen Tsai, Hao-Sheng Fu, Li-Wei Chien, Heng-Kien Au","doi":"10.1016/j.eprac.2026.08.023","DOIUrl":"10.1016/j.eprac.2026.08.023","url":null,"abstract":"<p><strong>Objective: </strong>Gestational diabetes mellitus (GDM) is associated with adverse pregnancy outcomes, yet its effects in singleton pregnancies conceived via assisted reproductive technology (ART) remain unclear. This study evaluated the association between GDM and maternal and fetal outcomes in this population.</p><p><strong>Methods: </strong>This retrospective study used the U.S. Nationwide Inpatient Sample 2008 to 2020 to identify singleton pregnancies conceived via ART. Propensity-score matching was performed to balance baseline characteristics between women with and without GDM. Logistic regression assessed associations between GDM and adverse maternal and fetal outcomes.</p><p><strong>Results: </strong>After matching, 9625 women were included (1925 with GDM and 7700 without GDM). GDM was associated with higher odds of preeclampsia (odds ratio [OR] = 1.24, 95% confidence interval [CI]: 1.03-1.50), placenta previa (OR = 1.34, 95% CI: 1.08-1.66), cesarean delivery (OR = 1.30, 95% CI: 1.18-1.44), induction of labor (OR = 1.14, 95% CI: 1.02-1.28), extended hospital stay (OR = 1.48, 95% CI: 1.24-1.76), preterm birth (OR = 1.30, 95% CI: 1.10-1.53), and large for gestational age/fetal macrosomia (OR = 1.54, 95% CI: 1.26-1.90). Stratified analyses showed generally similar associations across subgroups, while formal interaction analyses identified significant interactions for selected outcomes.</p><p><strong>Conclusion: </strong>GDM was significantly associated with adverse maternal and fetal outcomes in singleton pregnancies conceived via ART. These findings highlight the importance of vigilant clinical monitoring for complications such as preeclampsia, excessive fetal growth, preterm birth, and delivery-related complications in this high-risk population.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148896742","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 Glycemic Response to Clinical Trajectories: Extending Phenotyping in GLP-1RA-SGLT2 Inhibitor Combination Therapy.","authors":"Salvatore Corrao","doi":"10.1016/j.eprac.2026.08.022","DOIUrl":"10.1016/j.eprac.2026.08.022","url":null,"abstract":"","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148890958","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":"Impact of Hybrid Continuous Glucose Monitoring on Glycemic Control in a Medical Intensive Care Unit.","authors":"Eileen R Faulds, Melanie Natasha Rayan, Molly McNett, Matthew Exline, Laureen Jones, Abigail Shoben, Chyongchiou J Lin, Brooke Lee, Amanie Rasul, Kathleen M Dungan","doi":"10.1016/j.eprac.2026.08.021","DOIUrl":"10.1016/j.eprac.2026.08.021","url":null,"abstract":"<p><strong>Objective: </strong>Continuous glucose monitoring (CGM) offers real-time glucose data that may improve dysglycemia detection in critically ill patients; however, evidence supporting its clinical effectiveness in the intensive care unit (ICU) remains limited. The objective of this study was to evaluate whether a nurse-driven hybrid continuous glucose monitoring plus point-of-care (POC) validation protocol improves glycemic outcomes compared with standard POC monitoring alone among medical ICU patients receiving continuous intravenous (IV) insulin.</p><p><strong>Methods: </strong>In this single-center prospective intervention cohort study, 100 medical ICU (MICU) patients receiving continuous IV insulin were monitored using a hybrid CGM+POC protocol and compared with 100 matched historical controls. The primary outcome was % time in glucose range (70-180 mg/dL) during continuous IV insulin therapy, calculated using POC values (at least every 4 h) for between-group comparisons. Secondary outcomes included % time in additional glucose ranges, hyperglycemia (>250 and > 400 mg/dL), and hypoglycemia (<70 and < 54 mg/dL).</p><p><strong>Results: </strong>Compared with controls, CGM-managed patients achieved an increased time in range (76% ± 18 vs 64% ± 21; P < .001) with persistent improvement after adjusting for confounders and marked reductions in severe hyperglycemia (>250 mg/dL: 6% ± 11 vs 17% ± 18; >300 mg/dL: 2.7 ± 0.6% vs 11.3 ± 1.4%; P < .001 for both). Hypoglycemic events were infrequent and similar between groups. A total of 3590 temporally matched CGM-POC pairs were available for analysis.</p><p><strong>Conclusion: </strong>In this prospective MICU cohort, real-time hybrid CGM use improved glycemic control and reduced severe hyperglycemia without increasing hypoglycemia, supporting further evaluation of structured CGM integration in critical care practice.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148890959","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":"Patient Redistribution Across Risk Categories in Differentiated Thyroid Cancer Using the 2025 Versus 2015 American Thyroid Association Risk Stratification Systems.","authors":"Lina Pedraza Sanchez, Larry Grullon-Polanco, Kristen J Otto, Caitlin McMullen, Prerna Dogra, Elio Monsour, Sarimar Agosto Salgado, Deepa Danan, Syeda Mahrukh Naqvi, Bruce M Wenig, Christine H Chung, Colleen Veloski, Valentina D Tarasova","doi":"10.1016/j.eprac.2026.08.019","DOIUrl":"https://doi.org/10.1016/j.eprac.2026.08.019","url":null,"abstract":"<p><strong>Objective: </strong>The 2025 American Thyroid Association (ATA) guidelines for differentiated thyroid cancer (DTC) expanded and refined the risk stratification system (RSS). The extent of patient redistribution across risk categories and the clinicopathologic drivers of reclassification remain unclear.</p><p><strong>Methods: </strong>We conducted a retrospective study of adult DTC patients who underwent thyroid surgery at a tertiary cancer center between 1999 and 2025. The 2015 and 2025 ATA RSS criteria were applied to the same cohort using R-based algorithms. Patient migration across risk categories and clinicopathologic factors associated with reclassification were analyzed descriptively.</p><p><strong>Results: </strong>A total of 843 patients with DTC (papillary, follicular, oncocytic, high grade, poorly differentiated) were included in the study. Most patients with DTC (669; 79.4%) remained in the same risk category, while 174 (20.6%) migrated to a different one. Among 2015 ATA low-risk patients, 105 (12.6%) were reclassified to higher-risk categories by the 2025 ATA RSS, including 84 to the low-intermediate group and 21 to the intermediate-high group. Additionally, 69 patients (8.2%) were reclassified from the 2015 intermediate-risk category to the 2025 high-risk category. Consequently, under the 2025 ATA RSS, the proportion of low-risk patients decreased by 29.7%, whereas the 2025 ATA intermediate-risk (low-intermediate and intermediate-high) and high-risk groups increased by 9.6% and 8.2%, respectively. No downward reclassification was observed.</p><p><strong>Conclusion: </strong>Application of the 2025 ATA RSS resulted in upward reclassification. The clinical implications of this redistribution remain to be validated, and further work is needed to correlate the revised risk categories with recurrence rates and disease-specific outcomes.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872752","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 Conversation with Dr. Guillermo Umpierrez: Ketosis-Prone Type 2 Diabetes Mellitus: 3 Decades of Clinical, Pathophysiologic, and Therapeutic Insights","authors":"M. Cecilia Lansang MD, MPH,&nbsp;Guillermo Umpierrez MD","doi":"10.1016/j.eprac.2026.08.002","DOIUrl":"10.1016/j.eprac.2026.08.002","url":null,"abstract":"","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 9","pages":"Pages 1438-1440"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148859429","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}