Endocrine Practice最新文献

{"title":"Physician Assistants in Clinical Endocrinology: Characteristics and Demographics","authors":"Robert E. McKenna DMSc, MPH, PA-C ,&nbsp;Roderick S. Hooker PhD, MBA, PA ,&nbsp;Mirela Bruza-Augatis PhD, MS, PA-C ,&nbsp;Kasey Puckett MPH ,&nbsp;Andrzej Kozikowski PhD","doi":"10.1016/j.eprac.2024.12.016","DOIUrl":"10.1016/j.eprac.2024.12.016","url":null,"abstract":"<div><h3>Objective</h3><div>Physician assistants (PAs) are employed in endocrinology, but little is known about their roles and activities. The study aimed to assess PAs' employment characteristics in endocrinology compared to those in all other specialties.</div></div><div><h3>Methods</h3><div>This descriptive observational study used the 2022 National Commission on Certification of PAs dataset. The study includes 117 748 board-certified PAs who indicated a clinical specialty in 2022. The characteristics of PAs in endocrinology were examined using descriptive statistics, including counts and percentages for categorical variables; means (with standard deviations), and medians (with interquartile ranges) for continuous variables. Bivariate analyses (ꭙ² and Mann–Whitney U tests) were used to determine statistical differences between PAs practicing in endocrinology versus PAs in all other specialties.</div></div><div><h3>Results</h3><div>This study found that as of 2022, 685 PAs reported practicing in endocrinology. PAs in endocrinology, compared to PAs in all other specialties (all <em>P</em> &lt; .001), were more likely to identify as female (82.0% vs 69.6%), work in an office-based private practice (61.3% vs 37.0%), and participate in telemedicine (70.8% vs 40.1%). Conversely, PAs in endocrinology were less likely to work in a secondary position, saw slightly fewer patients weekly, and earned $10,000 less yearly than their PA colleagues in all other specialties.</div></div><div><h3>Conclusion</h3><div>Examining the PA endocrinology workforce is essential due to the shortage of endocrinologists and the increased prevalence of diabetes as the U.S. population ages. Understanding where PAs in endocrinology are employed and their attributes could assist efforts in specialty modeling to address supply and demand projections.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 4","pages":"Pages 433-438"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902697","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":"Insulin Degludec in Critically Ill Patients With Type 2 Diabetes Mellitus: A Prospective Interventional Study","authors":"Zainab Al Duhailib MBBS, EDIC, MSc ,&nbsp;Hakeam Hakeam MS Pharm, BCPS ,&nbsp;Ammar Almossalem MBBS ,&nbsp;Ahood Alrashidi MBBS ,&nbsp;Abdulrahman Al Zhrani MBBS ,&nbsp;Hassan Al Salman MBBS ,&nbsp;Khalid Alenizy MD, MSc ,&nbsp;Sukaina Alqafashat MBBS ,&nbsp;Munirah Alshalawi BHS ,&nbsp;Gamal Mohamed PhD ,&nbsp;Marat Slessarev MD, PhD ,&nbsp;Bram Rochwerg MD, MSc","doi":"10.1016/j.eprac.2024.12.014","DOIUrl":"10.1016/j.eprac.2024.12.014","url":null,"abstract":"<div><h3>Objective</h3><div>Dysglycemia has deleterious outcomes on critically ill patients with diabetes mellitus (DM). Insulin degludec, an ultralong-acting insulin, is associated with lower rates of hypoglycemia and blood glucose (BG) variability in non-critically ill patients. The experience with insulin degludec in the intensive care units is lacking. This study aimed to assess the effect of insulin degludec on glycemic control in critically ill patients with type 2 DM.</div></div><div><h3>Methods</h3><div>A prospective, interventional study enrolled critically ill patients with type 2 DM. Subjects were started on insulin degludec plus insulin regular correctional doses. BG levels were assessed every 6 hours. The primary outcome was the percentage of BG levels within a target of 140 to 180 mg/dL. The secondary outcomes included the median BG levels, severe hypoglycemia rate, and BG variability.</div></div><div><h3>Results</h3><div>In total, 155 patients were enrolled. The percentage of BG levels within the target was 28.5%. The first day that the median of BG levels within target was on day 2 of insulin degludec therapy, which continued to be within the target for 1 week. Severe hypoglycemia developed in 5 patients (3.2%). The BG variability in the study was 26% using the coefficient of variation.</div></div><div><h3>Conclusion</h3><div>In critically ill patients with type 2 DM, one-fourth of BG levels were within the glycemic target (140-180 mg/dL) with insulin degludec plus insulin regular correctional doses. The median BG levels were in target starting the second day of insulin degludec therapy. The favorable BG variability using insulin degludec merits further investigation for effect on clinical outcomes.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 4","pages":"Pages 503-510"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892957","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":"Prevalence of Second Primary Malignancies in Patients With Well-Differentiated Neuroendocrine Tumors","authors":"Kosma Woliński MD, PhD,&nbsp;Paweł Komarnicki MD,&nbsp;Adam Maciejewski MD, PhD,&nbsp;Jan Musiałkiewicz MD,&nbsp;Paweł Gut MD, PhD,&nbsp;Marek Ruchała MD, PhD","doi":"10.1016/j.eprac.2024.12.020","DOIUrl":"10.1016/j.eprac.2024.12.020","url":null,"abstract":"<div><h3>Objective</h3><div>Neuroendocrine tumors (NETs) constitute a diverse group of tumors. NETs are often diagnosed late, due to nonspecific symptoms. Second Primary Malignancies (SPMs) have been reported in up to 25% of NETs and their incidence has been described as negative predictor of overall survival. We aimed to assess the prevalence of SPMs in patients with NETs treated at a specialized center.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of patients with metastatic well-differentiated gastro-entero-pancreatic neuroendocrine tumors and lung carcinoids treated with Somatostatin Analogs between 2017 and 2019. Control group patients with hormonally inactive pituitary lesions and microprolactinomas hospitalized between 2016 and 2019 were included.</div></div><div><h3>Results</h3><div>One hundred thirty-five patients (85 women, 50 men) with NETs were enrolled. SPMs were more common in NETs compared to control group (<em>P</em> = .029). Twenty-six SPMs were diagnosed in 24 patients (17.8%). The control group comprised 94 patients, among whom 7 patients (7.7%) developed SPMs. Mean (standard deviation) age at the end of follow-up was 64.8 (10.2) years, with duration from NETs diagnosis to the end of follow-up of 5.3 (3.8) years.</div></div><div><h3>Conclusion</h3><div>The risk of SPMs is high in NETs, with multiple neoplasms diagnosed in over one sixth of patients. Active surveillance for SPMs is strongly indicated and should be integral to the follow-up of NETs.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 4","pages":"Pages 426-432"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930911","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":"Estimated Glucose Disposal Rate Predicts the Risk of Incident Metabolic Dysfunction-Associated Steatotic Liver Disease","authors":"Takahiro Ichikawa MD ,&nbsp;Yoshitaka Hashimoto MD, PhD ,&nbsp;Takuro Okamura MD, PhD ,&nbsp;Akihiro Obora MD, PhD ,&nbsp;Takao Kojima MD, PhD ,&nbsp;Hiroshi Okada MD, PhD ,&nbsp;Masahide Hamaguchi MD, PhD ,&nbsp;Michiaki Fukui MD, PhD","doi":"10.1016/j.eprac.2025.01.002","DOIUrl":"10.1016/j.eprac.2025.01.002","url":null,"abstract":"<div><h3>Objectives</h3><div>There is a relationship between insulin resistance and metabolic dysfunction-associated steatotic liver disease (MASLD) and the estimated glucose disposal rate (eGDR), which has been reported as a surrogate marker of insulin resistance. This study aimed to investigate the association between eGDR and the incident MASLD, and compare the ability to predict incident MASLD with other insulin resistance markers.</div></div><div><h3>Methods</h3><div>Retrospective cohort data from a health check-up program were analyzed. Participants were categorized into 4 subgroups according to eGDR quartiles. To assess the association between eGDR quartiles and incident MASLD, logistic regression analyses were used. Additionally, to compare the predictive ability of eGDR, triglyceride/high-density lipoprotein (HDL) cholesterol (TG/HDL) ratio, and triglyceride glucose index with respect to incident MASLD, receiver operating characteristics analysis was used.</div></div><div><h3>Results</h3><div>Of 16 689 participants were included, 3654 developed MASLD. After multivariate adjustment, compared with the lowest eGDR quartile, odds ratios (95% confidence interval [CI]) for incident MASLD in the second, third, and highest GDR quartiles, were 0.775 (0.692-0.868), 0.478 (0.408-0.560), and 0.147 (0.110-0194), respectively. The association between lower eGDR levels and MASLD risk remained consistent across stratification by sex and obesity status. Moreover, the area under the receiver operating characteristics curve (95% CI) for eGDR (0.8 [0.79-0.81]) was higher than for TG/HDL ratio 0.76 [0.79-0.81]) and triglyceride glucose index (0.75 [0.74-0.76]).</div></div><div><h3>Conclusions</h3><div>Lower eGDR levels were associated with an increased risk of incident MASLD. Our findings suggest that eGDR may be a more effective tool for predicting MASLD risk.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 4","pages":"Pages 479-485"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002282","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":"Comparison of Glucagon-Like Peptide-1 Receptor Agonists and Sodium-Glucose Cotransporter Protein-2 Inhibitors on Treating Metabolic Dysfunction-Associated Steatotic Liver Disease or Metabolic Dysfunction-Associated Steatohepatitis: Systematic Review and Network Meta-Analysis of Randomised Controlled Trials","authors":"Ruhan Xu MD,&nbsp;Bo Liu MD,&nbsp;Xianghai Zhou MD","doi":"10.1016/j.eprac.2024.11.017","DOIUrl":"10.1016/j.eprac.2024.11.017","url":null,"abstract":"<div><h3>Objective</h3><div>To assess glucagon-like peptide-1 receptor agonists (GLP-1 receptor agonists) and sodium-glucose cotransporter protein-2 inhibitors (SGLT-2 inhibitors) in patients with metabolic dysfunction-associated steatotic liver disease or metabolic dysfunction-associated steatohepatitis (previously known as nonalcoholic fatty liver disease [NAFLD] and nonalcoholic steatohepatitis [NASH]), we performed a systematic review and network meta-analysis of randomized controlled trials.</div></div><div><h3>Methods</h3><div>The study searched Pubmed, Embase, the Cochrane Library, and Web of Science databases up to November 26, 2023. Two reviewers independently selected the studies, extracted the data, and assessed the risk of bias.</div></div><div><h3>Results</h3><div>Thirty-seven studies were included in the analysis. GLP-1 receptor agonists were found to be more effective than placebo in resolving NASH (relative risk: 2.48, 95% CI:1.86 to 3.30). Both drugs were superior to placebo in reducing liver fat content, as well as decreasing levels of liver enzyme. Network meta-analysis indicated that SGLT-2 inhibitors were more effective than GLP-1 receptor agonists in reducing alanine aminotransferase and aspartate aminotransferase levels. According to the surface under the cumulative probability ranking curve values, GLP-1 receptor agonists and SGLT-2 inhibitors consistently ranked among the top 2 in terms of reducing anthropometric data compared to other included drugs.</div></div><div><h3>Conclusions</h3><div>GLP-1 receptor agonists and SGLT-2 inhibitors have significant effects on reducing liver fat content and liver enzymes in NAFLD or NASH patients compared to placebo. GLP-1 receptor agonists were found to be superior to placebo in resolving NASH. SGLT-2 inhibitors were more effective than GLP-1 receptor agonists in reducing alanine aminotransferase and aspartate aminotransferase levels.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 4","pages":"Pages 521-535"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863079","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":"Optimal Use of Once-Weekly Basal Insulin Efsitora Alfa in Type 1 and Type 2 Diabetes: A Systematic Review and Meta-Analysis","authors":"Deep Dutta MBBS, MD, DM, DNB, FRCP ,&nbsp;Lakshmi Nagendra MBBS, MRCP, MD, DM, DrNB ,&nbsp;Manoj Kumar MBBS, MD, DM ,&nbsp;A.B.M. Kamrul-Hasan MBBS, MD ,&nbsp;Saptarshi Bhattacharya MBBS, MD, DM","doi":"10.1016/j.eprac.2024.12.013","DOIUrl":"10.1016/j.eprac.2024.12.013","url":null,"abstract":"<div><h3>Objective</h3><div>No meta-analysis has holistically analyzed and summarized the efficacy and safety of the novel once-weekly basal insulin efsitora alfa in managing type 1 diabetes (T1D) and type 2 diabetes (T2D).</div></div><div><h3>Methods</h3><div>Clinical trials involving subjects with T1D and T2D receiving once-weekly efsitora alfa in the intervention arm and once-daily basal insulins in the control arm were searched throughout the electronic databases. The primary outcome assessed was the change from baseline in glycated hemoglobin (HbA1c).</div></div><div><h3>Results</h3><div>Data from 6 studies (2465 subjects) were analyzed (follow-up 26-54 weeks). Once-weekly efsitora alfa and once-daily degludec achieved comparable HbA1c reduction in study subjects with T2D (mean difference [MD] 0.02% [−0.11, 0.16]; <em>P</em> = .74) and T1D (MD 0.11% [−0.01, 0.22]; <em>P</em> = .08). Efsitora and degludec were similarly effective in reducing fasting plasma glucose and achieving HbA1c &lt; 7% in subjects with T2D. Individuals with T2D and T1D in the 2 groups had comparable time in range, time above range, and time below range. Subjects with T2D receiving efsitora and once-daily basal insulin had comparable total adverse events, severe adverse events, injection-site reactions, hypersensitivity events, and overall and severe hypoglycemia; however, nocturnal hypoglycemia risk was lower with efsitora (risk ratio 0.85 [0.74, 0.98]; <em>P</em> = .03). However, in individuals with T1D, total adverse events, severe adverse events, and injection-site reactions were higher with efsitora, with comparable risks of hypersensitivity events and overall, severe and nocturnal hypoglycemia.</div></div><div><h3>Conclusion</h3><div>Once-weekly basal insulin efsitora alfa is well tolerated with glycemic efficacy similar to once-daily degludec.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 4","pages":"Pages 471-478"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Low-Dose Tolvaptan (7.5 mg) in the Treatment of Inpatient Hyponatremia: A Retrospective Study","authors":"David C. Llewellyn MBChB, BSc, MRCP ,&nbsp;Eduard Oštarijaš MD ,&nbsp;Sheyaam Sahadevan MBBS ,&nbsp;Thitikorn Nuamek MD ,&nbsp;Corrine Byrne MPharm, PG Dipp PIP, Msc APP ,&nbsp;David R. Taylor BSc (Hons), MSc, PhD, FRCPath ,&nbsp;Royce P. Vincent MBBS, MSc, FRCPath, EuSpLM, MD (Res), SCOPE, FAcadTM ,&nbsp;Georgios K. Dimitriadis MD, MSc, FRCP, FAcadTM, SCOPE/EASO (UK National Fellow), PhD ,&nbsp;Simon JB. Aylwin MA, MBBChir, PhD, FRCP","doi":"10.1016/j.eprac.2024.12.019","DOIUrl":"10.1016/j.eprac.2024.12.019","url":null,"abstract":"<div><h3>Objectives</h3><div>The recommended dose of tolvaptan for hyponatremia secondary to the syndrome of inappropriate antidiuretic hormone is 15 mg. We evaluated the efficacy of an initial 7.5 mg dose and determined the frequency where sodium (Na+) correction exceeded safe limits, defined as an increment of ≥10 mmol/L, within the initial 8 or 24 hours of administration.</div></div><div><h3>Methods</h3><div>A retrospective review of patients with syndrome of inappropriate antidiuretic hormone treated in a single academic hospital in London. The initial dose was 7.5 mg and the second dose was 7.5 or 15 mg.</div></div><div><h3>Results</h3><div>One hundred eighty-one patients were included. With the initial dose, the mean Na + increase was 4.54 ± 3.70 mmol/L (<em>P</em> &lt; .0001) after 4-12 hours, with 8.7% demonstrating an increase exceeding 10 mmol/L. Between 18-30 hours, the mean Na + increase was 6.15 ± 3.51 mmol/L (<em>P</em> &lt; .0001), with 19.4% over-correcting. Over-correction was more likely in patients with a pre-dose Na + concentration of ≤127 mmol/L (OR 13.64, 95% CI 1.80-102.95). No cases of osmotic demyelination syndrome were observed. For patients needing a second dose, the increment in Na + concentration showed no significant difference between 7.5 and 15 mg (<em>P</em> = .532).</div></div><div><h3>Conclusion</h3><div>In our view, tolvaptan can be initiated with a 7.5 mg dose, accompanied by Na + monitoring at 12 and 24 hours. If a second dose is necessary, 7.5 mg is comparably effective to a 15 mg dose, depending on the initial response. Further monitoring should include Na + concentration at around 24 hours after the second dose.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 4","pages":"Pages 419-425"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902684","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":"Highlights from the AACE Consensus Statement on Multiple Endocrine Neoplasia Type 1: A Patient's Perspective","authors":"Jason Keller PhD","doi":"10.1016/j.eprac.2025.02.010","DOIUrl":"10.1016/j.eprac.2025.02.010","url":null,"abstract":"","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 4","pages":"Pages 554-555"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143829440","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 on Management of Multiple Endocrine Neoplasia Type 1","authors":"Jaydira Del Rivero MD ,&nbsp;Alexandra Gangi MD ,&nbsp;Justin P. Annes MD, PhD ,&nbsp;Sina Jasim MD, MPH ,&nbsp;Jason Keller PhD ,&nbsp;Michelle D. Lundholm MD ,&nbsp;Julie M. Silverstein MD ,&nbsp;Tanaz M. Vaghaiwalla MD, MS ,&nbsp;Robert A. Wermers MD","doi":"10.1016/j.eprac.2025.02.001","DOIUrl":"10.1016/j.eprac.2025.02.001","url":null,"abstract":"<div><h3>Objective</h3><div>This document presents the findings of the American Association of Clinical Endocrinology (AACE) on the diagnosis, management, and surveillance of patients with multiple endocrine neoplasia type 1 (MEN1) and associated tumors. The task force included a diverse group of experts in endocrinology, oncology, genetics, surgery, and patient representation. A comprehensive literature review was conducted to address key issues related to the evaluation, surveillance, and treatment of MEN1-related tumors.</div></div><div><h3>Methods</h3><div>The task force, comprised of 9 members with expertise in endocrinology, surgery, medical oncology, genetics, and patient advocacy, collaborated to develop guidance for the evaluation, surveillance, and management of MEN1-associated tumors. Consensus was defined as ≤1 dissenting vote and significant majority as ≥75%. Relevant studies were identified through a literature review process, and consensus statements were based on the available evidence.</div></div><div><h3>Results</h3><div>The task force deliberated on the surveillance, evaluation, and management of MEN1-related tumors including parathyroid, pituitary, and gastroenteropancreatic neuroendocrine tumors and other tumors of relevance. The document also addresses the indications for <em>MEN1</em> genetic testing.</div></div><div><h3>Conclusions</h3><div>This consensus statement aims to offer evidence-informed guidance for health care providers involved in the care of patients with MEN1 and associated tumors. It provides guidance on diagnostic tools, genetic testing criteria, imaging techniques, surgical interventions, and posttreatment monitoring. The practical, patient-centered approach outlined in this document is intended to improve outcomes for individuals with MEN1 and other high-risk endocrine tumors.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 4","pages":"Pages 403-418"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143829347","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":"Prediabetes Phenotypes and All-Cause or Cardiovascular Mortality: Evidence From a Population-Based Study","authors":"Xiufang Kong MD, PhD ,&nbsp;Wei Wang MD, PhD","doi":"10.1016/j.eprac.2025.01.003","DOIUrl":"10.1016/j.eprac.2025.01.003","url":null,"abstract":"<div><h3>Objective</h3><div>Fasting plasma glucose (FPG), glycated hemoglobin A_1C (HbA_1C), and 2-hour postload plasma glucose (2h PG) are all currently used to define prediabetes. We aimed to determine whether a higher number of prediabetes defects correspond to an increased all-cause and cardiovascular disease (CVD) mortality.</div></div><div><h3>Methods</h3><div>Individuals with prediabetes and available information on FPG, HbA_1C, 2h PG, and mortality data were derived from the 2005-2016 National Health and Nutrition Examination Survey. Kaplan-Meier survival curves, Cox proportional hazards regression analysis, and stratified analysis were used to compare all-cause and CVD mortality among participants with one, two, and all three defects.</div></div><div><h3>Results</h3><div>Among the 4511 individuals included, 76.31%, 30.89%, and 41.65% met the FPG-, 2h PG-, and HbA_1C-defined criteria for prediabetes, respectively. There were 2609 (60.78%), 1420 (29.60%), and 482 (9.62%) adults meeting one, two, and all three criteria for prediabetes, respectively. During a median follow-up of 100 months, a total of 534 (180 CVD-related) deaths occurred. The multivariable-adjusted hazard ratios and 95% confidence intervals in those meeting two and three criteria were 1.341 (1.042-1.727) and 1.369 (1.027-1.824), respectively, for all-cause mortality (P for trend = 0.006), and 1.836 (1.228-2.744) and 2.037 (1.092-3.801), respectively, for CVD mortality (P for trend = 0.002), with those meeting only one criterion as the reference. In subgroup analysis, the association between the number of diagnostic criteria for prediabetes and CVD mortality was observed only in men.</div></div><div><h3>Conclusions</h3><div>A higher number of diagnostic criteria for prediabetes was associated with increased all-cause and CVD mortality.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 4","pages":"Pages 486-493"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002287","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}