Endocrine Practice最新文献

{"title":"Cystic Fibrosis–Related Diabetes: Pathophysiology, Spectrum of Glycemic Abnormalities, and Evolving Approaches to Screening","authors":"Jennifer Apsan MD,&nbsp;Kajal Gandhi DO, MPH,&nbsp;Juan Pablo Perdomo Rodriguez MD,&nbsp;Mónica E. Bianco MD,&nbsp;Sara K. Bartz MD,&nbsp;Christine L. Chan MD","doi":"10.1016/j.eprac.2026.04.016","DOIUrl":"10.1016/j.eprac.2026.04.016","url":null,"abstract":"<div><div>Cystic fibrosis–related diabetes (CFRD) is a well-recognized and increasingly prevalent complication of cystic fibrosis (CF), most frequently developing in adolescence and adulthood. CFRD is associated with pulmonary function decline, poor nutritional status, and increased infection risk, and contributes to increased morbidity and mortality. The objective of this review is (1) to provide a summary of CFRD pathophysiology, highlighting the spectrum of glycemic abnormalities preceding development of CFRD, and (2) to review CFRD screening guidelines, including a narrative review of the current evidence for different CFRD screening approaches. We also review challenges to screening and important considerations in the setting of novel CF therapeutics and increasing longevity in this population.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 9","pages":"Pages 1401-1408"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812514","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":"Association Between Clinical Factors and Postoperative Hypoglycemia in Pheochromocytoma and Paraganglioma: A Retrospective Cohort Study","authors":"Yuke Li MM,&nbsp;Wencong Han MD,&nbsp;Yujian Cui MM,&nbsp;Jinwei Wang PhD,&nbsp;Zheng Zhang MD,&nbsp;Nan Li MD","doi":"10.1016/j.eprac.2026.04.009","DOIUrl":"10.1016/j.eprac.2026.04.009","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to investigate the correlation between clinical factors and postoperative hypoglycemia in pheochromocytoma and paraganglioma (PPGL).</div></div><div><h3>Methods</h3><div>This retrospective cohort study included adult patients who underwent PPGL surgery with pathologic confirmation. The primary endpoint was the occurrence of postoperative hypoglycemia. Pre- and intraoperative clinical variables were collected. Independent risk factors for postoperative hypoglycemia were identified using multivariate logistic regression analysis, and a predictive model along with a nomogram was constructed and validated.</div></div><div><h3>Results</h3><div>A total of 346 PPGL patients were enrolled. Postoperative hypoglycemia occurred in 45 patients (13.0%), with 35 cases (83.3%) occurring within 24 h after surgery. Multivariate analysis identified age &lt; 30 years (odds ratio [OR] 3.091, 95% confidence interval [CI] 1.145-8.344, <em>P</em>= .026), history of chronic kidney disease (OR 3.253, 95% CI 1.213-8.725, <em>P</em>= .019), preoperative typical symptoms (defined as the presence of at least one of the classic triad: headaches, palpitations, or sweating) (OR 2.207, 95% CI 1.119-4.355, <em>P</em>= .022), preoperative positive semi-quantitative urine glucose (OR 2.986, 95% CI 1.063-8.390, <em>P</em>= .038), and adrenal tumor (OR 3.224, 95% CI 1.208-8.604, <em>P</em>= .019) as independent risk factors for postoperative hypoglycemia. The area under the receiver operating characteristic curve for the predictive model was 0.734 (95% CI 0.659-0.809). Calibration plots suggested good consistency between the predicted and actual risk. The final model was visualized via a nomogram.</div></div><div><h3>Conclusions</h3><div>Clinical factors were independently associated with the occurrence of postoperative hypoglycemia in PPGL. The visual nomogram developed in this study aided in predicting the risk of postoperative hypoglycemia in PPGL patients.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 9","pages":"Pages 1387-1394"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728757","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":"Denosumab and Risk of Type 2 Diabetes Risk Among Patients With Osteoporosis: A Retrospective Cohort Study","authors":"Cheng-Han Han MD,&nbsp;Yu-Chen Tsai MS,&nbsp;Shiow-Ing Wang PhD,&nbsp;Renin Chang MD, PhD,&nbsp;James Cheng-Chung Wei MD, PhD","doi":"10.1016/j.eprac.2026.05.031","DOIUrl":"10.1016/j.eprac.2026.05.031","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the risk of new-onset type 2 diabetes mellitus (T2D) between intravenous (IV) bisphosphonates and denosumab among patients with osteoporosis.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study using the TriNetX database from 2016 to 2024. Patients with osteoporosis initiating IV bisphosphonates (zoledronic acid or ibandronate) or denosumab were identified and assigned to respective cohorts. Propensity score matching (1:1) was applied to balance demographics, lifestyle factors, health care utilization, comorbidities, medications, and laboratory parameters. The primary outcome was incident T2D, defined by International Statistical Classification of Diseases, 10th Revision code E11 or the initiation of antidiabetic medications. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated.</div></div><div><h3>Results</h3><div>After matching, 20 735 patients remained in each cohort. Compared with denosumab, IV bisphosphonates were associated with a significantly lower risk of T2D at 1, 3, 5, and 7 years (HRs: 0.745 [95% CI 0.649-0.856], 0.806 [95% CI 0.731-0.890], 0.818 [95% CI 0.747-0.895], and 0.821 [95% CI 0.753-0.896], respectively; all <em>P</em> &lt; .001). Subgroup analyses demonstrated consistent risk reduction among females (HR 0.739), individuals aged ≥65 years (HR 0.688), Whites (HR 0.799), and Black or African Americans (HR 0.608).</div></div><div><h3>Conclusions</h3><div>Among patients with osteoporosis, IV bisphosphonates were associated with a lower risk of incident T2D compared with denosumab. These findings suggest potential metabolic benefits of IV bisphosphonates and support the need for prospective studies to validate these observations.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 9","pages":"Pages 1378-1386"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148175618","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":"Perioperative Implications of Belzutifan Therapy in HIF2A-Related Pheochromocytoma and Paraganglioma","authors":"Shinichiro M. Koga MPH, MD, PhD","doi":"10.1016/j.eprac.2026.07.006","DOIUrl":"10.1016/j.eprac.2026.07.006","url":null,"abstract":"","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 9","pages":"Page 1444"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148445135","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":"Ketosis-Prone Type 2 Diabetes Mellitus: 3 Decades of Clinical, Pathophysiologic, and Therapeutic Insights","authors":"Guillermo Umpierrez MD,&nbsp;Priyathama Vellanki MD,&nbsp;Omolade Oladejo MD","doi":"10.1016/j.eprac.2026.03.007","DOIUrl":"10.1016/j.eprac.2026.03.007","url":null,"abstract":"<div><h3>Background</h3><div>Over 3 decades ago, our group reported that newly diagnosed Black patients with diabetic ketoacidosis (DKA) are obese and that many of them can discontinue insulin after the acute episode, revealing a clinical course consistent with type 2 diabetes. This presentation is now recognized as ketosis-prone type 2 diabetes mellitus (KPDM).</div></div><div><h3>Methods</h3><div>We review observational, prospective, and interventional studies that characterize the epidemiology, clinical features, pathophysiology, and management of KPDM. Patients typically present with severe hyperglycemia, metabolic acidosis, obesity, male predominance, and a strong family history of type 2 diabetes.</div></div><div><h3>Results</h3><div>KPDM accounts for 20% to 50% of new-onset DKA in Black and Hispanic adults and has been reported globally. Acute management follows standard DKA protocols, but insulin requirements decline rapidly after the crisis, with ∼70% achieving near-normoglycemic remission. Pathophysiologic studies show reversible β-cell dysfunction and transient insulin resistance, resembling type 2 diabetes. Low prevalence of autoantibody positivity distinguishes KPDM from latent autoimmune diabetes. Pharmacologic therapy with metformin, dipeptidyl peptidase-4 inhibitors, or glucagon-like peptide-1 receptor agonists prolongs remission, preserves β-cell function, and reduces hyperglycemic relapse.</div></div><div><h3>Conclusions</h3><div>KPDM exemplifies diabetes heterogeneity and is a common presentation of DKA, particularly among obese Black and Hispanic adults. Early recognition and individualized therapy optimize β-cell recovery, prolong near-normoglycemic remission, and improve outcomes. Further research is needed to define optimal long-term management and prevention strategies to sustain remission and reduce diabetic complications.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 9","pages":"Pages 1430-1437"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722284","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":"PREVENT Equations Versus Polled Cohort Equations Versus Multi-Ethnic Study of Atherosclerosis Equations—How Should the Physician Choose?","authors":"David S. Schade MD,&nbsp;Allen Adolphe MD, PhD,&nbsp;Samuel Wann MD,&nbsp;Robert Philip Eaton MD","doi":"10.1016/j.eprac.2026.03.104","DOIUrl":"10.1016/j.eprac.2026.03.104","url":null,"abstract":"","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 9","pages":"Pages 1419-1421"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766062","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 Genetic Testing in Endocrinology Practice: A Single-Center Experience Focused on Lipid and Monogenic Diabetes Disorders","authors":"Rebecca B.K. Wong MD,&nbsp;Adam D. McIntyre BSc,&nbsp;Jian Wang MD,&nbsp;Robert A. Hegele MD,&nbsp;Amanda J. Berberich MD, PhD","doi":"10.1016/j.eprac.2026.04.005","DOIUrl":"10.1016/j.eprac.2026.04.005","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to describe the use and clinical impact of genetic testing in an academic endocrinology practice, including its effects on diagnosis, treatment selection, medication access, and downstream management.</div></div><div><h3>Methods</h3><div>This single-center, retrospective descriptive study evaluated probands in an adult academic endocrinology practice who underwent clinically indicated genetic testing. Genetic testing included next-generation sequencing panels and targeted Sanger sequencing. Polygenic risk scores for lipid traits were calculated using previously validated methods. Clinical utility and downstream management actions attributable to genetic results were also assessed.</div></div><div><h3>Results</h3><div>Of 216 individuals tested, 187 met inclusion criteria. Most were evaluated for familial hypercholesterolemia (48.1%), hypertriglyceridemia (35.3%), or monogenic diabetes (21.9%). Overall, 123 individuals (65.8%) had a pathogenic or likely pathogenic variant (24.6%) and/or a high polygenic risk scores (≥75th percentile) (46.5%). Genetic test results were considered clinically helpful in 92.5% (95% CI 87.8-95.5) of cases, most commonly by clarifying diagnosis, prognosis, or eligibility for targeted therapies or coverage. A specific new clinical action beyond baseline management occurred in 17.6% (95% CI 12.9-23.7) of individuals, including treatment intensification or de-escalation, medication coverage approval, referral for surgery, or initiation of appropriate screening.</div></div><div><h3>Conclusions</h3><div>In a real-world academic endocrine practice, genetic testing frequently provided clinically meaningful information and led to direct changes in management. Utility varied by condition and available therapies. These findings support selective expansion of access to genetic testing and further development of standardized approaches for its integration into endocrine care.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 9","pages":"Pages 1362-1368"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662343","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":"Silent Bilateral Adrenal Incidental Pheochromocytomas: Time to Reconsider Routine Surgery?","authors":"Abdurehman Abdurehman MBBS,&nbsp;Muhammad Uzair Gull MBBS,&nbsp;Syed Athar Mehmood MBBS","doi":"10.1016/j.eprac.2026.05.017","DOIUrl":"10.1016/j.eprac.2026.05.017","url":null,"abstract":"","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 9","pages":"Page 1443"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147971326","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":"Comment on “Qualitative Analysis of Caregiver and Patient Experiences with and Barriers to Medical Nutrition Therapy Utilization in Pediatric Type 1 Diabetes”","authors":"Bhumesh Tyagi MD,&nbsp;Leelabati Toppo MD,&nbsp;Aishwarya Biradar MD","doi":"10.1016/j.eprac.2026.05.014","DOIUrl":"10.1016/j.eprac.2026.05.014","url":null,"abstract":"","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 9","pages":"Pages 1441-1442"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147971198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Info for Readers/Subscription page","authors":"","doi":"10.1016/S1530-891X(26)01100-6","DOIUrl":"10.1016/S1530-891X(26)01100-6","url":null,"abstract":"","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"32 9","pages":"Pages A1-A2"},"PeriodicalIF":4.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148861702","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}