Endocrine Practice最新文献

{"title":"Apolipoprotein Profile in Early Pregnancy and the Link to Gestational Diabetes Mellitus: Insights From Odense Child Cohort","authors":"Kaja K. Faurø MD ,&nbsp;Lasse M. Obel MD ,&nbsp;Henrik T. Christesen DMSc ,&nbsp;Dorte M. Jensen PhD ,&nbsp;Tina K. Jensen PhD ,&nbsp;Dorte Glintborg DMSc ,&nbsp;Marianne S. Andersen DMSc ,&nbsp;Martin Overgaard PhD","doi":"10.1016/j.eprac.2025.02.009","DOIUrl":"10.1016/j.eprac.2025.02.009","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to investigate the potential associations between serum apolipoprotein levels in early pregnancy and the risk of gestational diabetes mellitus (GDM) and adverse pregnancy outcomes.</div></div><div><h3>Methods</h3><div>This was an observational study of the population-based Odense Child Cohort. Pregnant women were followed from inclusion until childbirth. Apolipoprotein levels, including 12 apolipoproteins (ApoA-I, ApoA-II, ApoA-IV, ApoB, ApoC-I, ApoC-II, ApoC-III, ApoD, ApoE, ApoH, ApoJ, and ApoM) were measured by targeted proteomics using liquid chromatography mass spectrometry on late first trimester serum samples stored in a biobank. GDM was defined by WHO 2013 diagnostic criteria.</div></div><div><h3>Results</h3><div>A total of 991 pregnant women were included, of which 415 (41.9%) were diagnosed with GDM. GDM was associated with increasing ApoB (adjusted odds ratio [OR]: 1.26, <em>P</em> = .002) and ApoD levels (adjusted OR: 0.84, <em>P</em> = .021). ApoB levels in early pregnancy correlated significantly and positively with insulin resistance (r = 0.22, <em>P</em> &lt; .001) and beta-cell function in third trimester (r = 0.20, <em>P</em> &lt; .001), whereas early pregnancy ApoD levels were inversely correlated with insulin resistance (r = −0.14, <em>P</em> &lt; .001) and beta-cell function (r = −0.12, <em>P</em> &lt; .001). Finally, high levels of ApoD was significantly associated with lower risk of large-for-gestational-age infants (adjusted OR: 0.78, <em>P</em> = .041).</div></div><div><h3>Conclusions</h3><div>High levels of ApoB and low levels of ApoD in early pregnancy were independently associated with an increased risk of GDM, insulin resistance, and large-for-gestational-age infants (low ApoD only), suggesting potential roles for future management of pregnancy outcomes.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 6","pages":"Pages 805-812"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457309","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 Pragmatic Approach to Monitor for Adrenal Axis Recovery After a Failed Short Synacthen Test","authors":"Anes Harid MSc ,&nbsp;Matthew Rowe PGDip(Endocrinology and Diabetes) ,&nbsp;Nishchil Patel MRCP ,&nbsp;Jinny Jeffery DPhil ,&nbsp;Daniel Flanagan MD ,&nbsp;Andrew McGovern MD","doi":"10.1016/j.eprac.2025.02.019","DOIUrl":"10.1016/j.eprac.2025.02.019","url":null,"abstract":"<div><h3>Objective</h3><div>To identify a morning cortisol threshold value which confirms non-recovery of the adrenal axis and therefore negates the need for a short Synacthen test (SST) in those with known adrenal axis insufficiency.</div></div><div><h3>Methods</h3><div>We collected data from all SSTs (<em>n</em> = 1570 tests; <em>n</em> = 952 individuals) conducted in our hospital over a 10-year period spanning between 1st February, 2013, and 30th January, 2023. We included all tests where baseline cortisol levels were taken before 9:30 <span>am</span> Both 30- and 60-minute cortisol values were measured. Cortisol was measured using the Abbott Architect method. We used the full SST dataset to construct a quantile regression model to predict the 95% centile of peak cortisol response. This model was refitted to the SST follow-up data for those who failed a first SST (<em>n</em> = 115 tests; <em>n</em> = 66 individuals) to identify the baseline cortisol value below which there was a less than 5% chance of passing an SST.</div></div><div><h3>Results</h3><div>Those with an early morning cortisol of ≤126 nmol/L had ≥95% chance of failing an SST. Sixty percent of follow-up SSTs (69/115) exhibited baseline cortisol values below this threshold, and none of these passed an SST.</div></div><div><h3>Conclusion</h3><div>An early morning cortisol ≤126 nmol/L is common in those followed for adrenal axis recovery and is an accurate indicator of non-recovery. Baseline cortisol measurements are therefore a simple way of screening for adrenal axis recovery. Those with a cortisol of &gt;126 nmol/L should go on to have an SST. Using this approach could considerably reduce the need for follow up SSTs in this patient cohort.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 6","pages":"Pages 750-757"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572475","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 of Somapacitan in Treatment-Fatigue Adult Patients With Growth Hormone Deficiency Previously Treated With Once-Daily Growth Hormone Injections: A 24-Week Randomized Active-Controlled Trial","authors":"Mojca Jensterle MD, PhD ,&nbsp;Rok Herman MD ,&nbsp;Ana Klinc MD ,&nbsp;Katja Goričar PhD ,&nbsp;Matej Rakusa MD, PhD ,&nbsp;Andrej Janež MD, PhD","doi":"10.1016/j.eprac.2025.03.005","DOIUrl":"10.1016/j.eprac.2025.03.005","url":null,"abstract":"<div><h3>Objective</h3><div>We evaluated the efficacy of somapacitan in a 24-week, randomized, active-controlled study in patients with growth hormone deficiency (GHD) who experienced fatigue from daily growth hormone (GH) injections.</div></div><div><h3>Methods</h3><div>Twenty-nine adult patients with GHD, pretreated with daily GH for ≥5 years, who had reported treatment-related fatigue, were randomized to somapacitan or daily GH. Outcome measures were changes in treatment satisfaction assessed by Treatment Satisfaction Questionnaire for Medication-9, insulin-like growth factor-1 (IGF-1) standard deviation score, glucose and lipid parameters, body composition, bone mineral density (BMD), carotid intima media thickness, and reactive hyperaemia index, from baseline to week 24.</div></div><div><h3>Results</h3><div>The difference in change in Treatment Satisfaction Questionnaire for Medication-9 score for convenience was significant, in favor of somapacitan (estimated difference, somapacitan-daily GH [95% CI]:23.2 [7.9; 38.4] points, <em>P</em> = .004). No differences between treatment arms in estimated changes from baseline to study-end were observed for IGF-1 levels, glucose and lipid profile, visceral adipose tissue, fat mass (%), lean body mass, and vascular parameters. There was significant difference in BMD of the lumbar spine (estimated difference, somapacitan-daily GH [95% CI] −0.036 (−0.064, −0.009) gr/cm², <em>P</em> = .011).</div></div><div><h3>Conclusion</h3><div>In AGHD patients who were fatigued from the long-term daily GH injections, somapacitan was reported to be more convenient than daily GH. It was effective in maintaining IGF-1 levels and body composition, glucose, lipids, and vascular parameters, comparable to daily GH. Nonsignificant decrease in BMD with somapacitan could reflect a favorable increase in bone metabolic units, as previously observed in naïve patients with GHD during the initial 6-month period of GH therapy.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 6","pages":"Pages 766-775"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662868","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":"Hyperprolactinemia Is Associated With Height Attainment Within or Above Target Height in Adult Patients With Pituitary Stalk Interruption Syndrome","authors":"Yuhan Wang MD ,&nbsp;Jiangfeng Mao MD ,&nbsp;Xi Wang MD ,&nbsp;Min Nie PhD ,&nbsp;Junyi Zhang MD ,&nbsp;Wei Zhang MD ,&nbsp;Hongying Liu MD ,&nbsp;Zhongyue Xu MD ,&nbsp;Xueyan Wu MD","doi":"10.1016/j.eprac.2025.03.010","DOIUrl":"10.1016/j.eprac.2025.03.010","url":null,"abstract":"<div><h3>Objectives</h3><div>Limited data exist on growth-promoting factors beyond growth hormone and insulin-like growth factor 1. This study aimed to identify factors associated with growth in patients with pituitary stalk interruption syndrome (PSIS).</div></div><div><h3>Methods</h3><div>This retrospective cross-sectional study included 62 adult patients with PSIS between January 2021 and September 2024. Demographic data, metabolic parameters, and hormone statuses were compared. Binary logistic regression was used to assess the relationships among hyperinsulinemia, hyperprolactinemia, sex hormone replacement history, thyroxine replacement history and 1) height attainment within or above the target height and 2) height ≥ −2 SD.</div></div><div><h3>Results</h3><div>A total of 62 patients (53 males and 9 females) were included, with a median age of 30.5 years (range: 26.0-32.4). Twelve patients achieved their target height, while the remaining patients did not. Hyperprolactinemia in adult patients with PSIS was positively associated with height attainment within or above the target height (odds ratio [OR] 6.4, 95% CI: 1.6-24.7, <em>P</em> = .007), and this association remained after adjustment for multiple confounders (OR 6.89, 95% CI: 1.19-40.81, <em>P</em> = .032). Additionally, hyperprolactinemia showed a positive association with height ≥ −2 SD (OR 10.5, 95% CI: 2.8-38.5, <em>P</em> &lt; .001), which also remained after adjusting for confounders (OR 13.8, 95% CI: 2.5-77.6, <em>P</em> = .003). These associations were consistently observed in male patients.</div></div><div><h3>Conclusions</h3><div>Hyperprolactinemia was associated with height attainment within or above the target height and in Chinese adult patients with PSIS. Additionally, a significant correlation was observed between hyperprolactinemia and height ≥ −2 SD.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 6","pages":"Pages 724-730"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729472","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":"Sunscreen and 25-Hydroxyvitamin D Levels: Friends or Foes? A Systematic Review and Meta-Analysis","authors":"Elisa Gatta MD ,&nbsp;Carlo Cappelli MD","doi":"10.1016/j.eprac.2025.03.014","DOIUrl":"10.1016/j.eprac.2025.03.014","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the impact of sunscreen use on 25-hydroxyvitamin D (25(OH)D) levels, addressing conflicting findings from observational and interventional studies.</div></div><div><h3>Methods</h3><div>Potentially eligible studies were identified from the PubMed/MEDLINE, Scopus, and Web of Science databases from inception to November 2024, utilizing a search strategy incorporating terms related to “sunscreen” and “vitamin D.” The studies eligible addressed the questions define based on the Population, Intervention, Comparator, Outcome framework: What are 25(OH)D levels in patients exposing to sun applying or not sunscreen? This review followed Preferred Reported Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality assessment and the risk of bias were analyzed using Quality Assessment of Diagnostic Accuracy Studies version 2.</div></div><div><h3>Results</h3><div>We included 22 studies in the qualitative synthesis, and 7 in the quantitative one, encompassing a total of 9470 participants. In vitro studies consistently showed that sunscreen blocks UV-B radiation, crucial for vitamin D₃ production, while population-based studies reported mixed findings. Some studies linked sunscreen use to lower 25(OH)D levels, particularly in individuals with limited sun exposure, while others observed no significant impact. Meta-analysis showed that the adoption of sunscreen is associated to a reduction of 25(OH)D serum concentration (standardized mean difference = −2 ng/mL, 95% confidence interval −3, −1) with a not important heterogeneity across studies (I-square = 37%, <em>P</em> = .15).</div></div><div><h3>Conclusion</h3><div>The existing evidence supports that sunscreen can impair vitamin D₃ synthesis, and as a result decrease serum 25(OH)D levels, but further research is necessary to determine the broader health implications and guide public health recommendations.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 6","pages":"Pages 839-848"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987389","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":"Can Growth Hormone Stimulation Tests in Children Predict the Response to Growth Hormone Treatment?","authors":"Keren Smuel Zilberberg MD ,&nbsp;Michal Yackobovitch–Gavan PhD ,&nbsp;Ariel Tenenbaum MD ,&nbsp;Liron Tirosh Legmann MD ,&nbsp;Liora Lazar MD ,&nbsp;Moshe Phillip MD ,&nbsp;Tal Oron MD","doi":"10.1016/j.eprac.2025.03.007","DOIUrl":"10.1016/j.eprac.2025.03.007","url":null,"abstract":"<div><h3>Objective</h3><div>The efficacy of growth hormone (GH) treatment in short, healthy children diagnosed with growth hormone deficiency (GHD) or idiopathic short stature (ISS) suggests an overlap between these 2 conditions. Although imperfect and inconsistent, GH stimulation testing (GHST) remains the primary diagnostic tool for differentiating GHD and ISS, influencing GH treatment eligibility and dosing. This study aims to assess the clinical significance of GHST by comparing the response to GH treatment in children diagnosed with GHD or ISS based on their GHST results.</div></div><div><h3>Methods</h3><div>A retrospective study in an endocrine clinic at a tertiary pediatric referral center comparing the response to GH treatment over 3 years in children diagnosed with GHD or ISS.</div></div><div><h3>Results</h3><div>Two hundred ninty-one children treated with GH, 97 children diagnosed with GHD, and 194 with ISS are included in the analysis. Height significantly improved, and insulin-like growth factor-1 levels increased independent of the GHST results, gender, or pubertal status (<em>P</em> &lt; .001). When adjusting for dosage, height gain was not associated with the treatment indication, GHD or ISS, or GHST peak levels.</div></div><div><h3>Conclusions</h3><div>Our findings indicate similar responses to GH treatment in children classified as GHD or ISS based on GHST. These results suggest that the pivotal role of GHST in diagnosing and treating short children should be reconsidered.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 6","pages":"Pages 731-738"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729397","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":"Autoimmune Primary Adrenal Insufficiency: Understanding the Past, Present, and Future","authors":"Asif Surani MD,&nbsp;Ty B. Carroll MD","doi":"10.1016/j.eprac.2025.04.008","DOIUrl":"10.1016/j.eprac.2025.04.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Primary adrenal insufficiency (PAI), or Addison's disease, results from adrenal gland dysgenesis or destruction, leading to impaired production of glucocorticoids, mineralocorticoids, and adrenal androgens. Our understanding of the etiology, pathophysiology, and clinical manifestations of PAI has significantly evolved since this condition was originally described.</div></div><div><h3>Results</h3><div>Over the past 3 decades, the epidemiology and demographics of PAI has shifted, with autoimmune PAI now recognized as the most common cause. This shift has been influenced by increasing awareness of autoimmunity and the widespread use of immune modulating medications, such as immune checkpoint inhibitors. The diagnosis of PAI is often delayed, likely due to its nonspecific clinical presentation. This delay may result in increased morbidity and mortality from adrenal crisis. While treatment involves lifelong hormone replacement therapy, optimizing glucocorticoid dosing remains a challenge. Emerging therapeutic approaches focus on preserving residual adrenal function and preventing disease progression, offering hope for improved long-term outcomes.</div></div><div><h3>Conclusion</h3><div>This review provides an updated overview of the epidemiology, pathophysiology, and future directions in the care of autoimmune PAI. It examines key pathophysiologic and autoimmune features of PAI and explores future directions aimed at identifying genetic and molecular markers that may change the diagnosis, treatment, and outcome of this important endocrinopathy.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 6","pages":"Pages 813-820"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964532","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(25)00886-9","DOIUrl":"10.1016/S1530-891X(25)00886-9","url":null,"abstract":"","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 6","pages":"Pages A1-A2"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144254310","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 MD ,&nbsp;Dick C. Chan PhD ,&nbsp;Jing Pang PhD ,&nbsp;Biyanka Jaltotage MD ,&nbsp;Gerald F. Watts PhD ,&nbsp;Nick S.R. Lan MBBS ,&nbsp;Damon A. Bell PhD ,&nbsp;Abdul R. Ihdayhid PhD ,&nbsp;Oyekoya T. Ayonrinde PhD ,&nbsp;Girish Dwivedi PhD","doi":"10.1016/j.eprac.2025.02.013","DOIUrl":"10.1016/j.eprac.2025.02.013","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>TG/HDL-C ratio was significantly associated with HRP (odds ratio, 1.27; 95% CI, 1.04-1.56; <em>P</em> = .020) and HS (odds ratio, 1.71; 95% CI, 1.17-2.51; <em>P</em> = .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 (<em>P</em> = .042) and inclusion in a predictive model outperformed the FH-Risk-Score (area under receiver operating characteristic 0.74 vs 0.63; <em>P</em> = .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 (<em>P</em> = .043). TG/HDL-C ratio was strongly positively correlated (<em>P</em> &lt; .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).</div></div><div><h3>Conclusion</h3><div>TG/HDL-C ratio was strongly associated with HRP, HS, and cardiac events in patients with FH treated with long-term cholesterol-lowering therapy.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 6","pages":"Pages 776-783"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","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":"Benefits of Glucagon-like Peptide-1 Receptor Agonists After Kidney Transplantation","authors":"Sukhdeep S. Sahi MBBS ,&nbsp;Oscar Garcia Valencia MD ,&nbsp;Jie Na MS ,&nbsp;Adley Lemke PharmD ,&nbsp;Dustin Duffy MS ,&nbsp;Byron Smith MS ,&nbsp;Pavel Navratil MD ,&nbsp;Pooja Budhiraja MBBS ,&nbsp;Tayyab S. Diwan MD ,&nbsp;Naim Issa MD ,&nbsp;Mark D. Stegall MD ,&nbsp;Aleksandar Denic MD, PhD ,&nbsp;Ahmed A. Abdelrheem MB, ChB ,&nbsp;Hani M. Wadei MD ,&nbsp;Walter D. Park ,&nbsp;Pankaj Shah MD ,&nbsp;Yogish C. Kudva MD ,&nbsp;Aleksandra Kukla MD","doi":"10.1016/j.eprac.2025.02.020","DOIUrl":"10.1016/j.eprac.2025.02.020","url":null,"abstract":"<div><h3>Objective</h3><div>Benefits of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in kidney transplant (KT) recipients have not been adequately studied.</div></div><div><h3>Methods</h3><div>We retrospectively examined the effects of GLP-1 RA on mortality, kidney outcomes and metabolic parameters in KT recipients with type 2 diabetes mellitus (T2DM) treated versus not treated with GLP-1 RA. A reference group of KT recipients not treated with GLP-1 RA was used for comparison. Data were analyzed using analysis of variance, χ2 tests, and generalized estimating equation models. GLP-1 RA was used as a time-dependent model in Cox regression modeling. For survival analysis, the final model fitting was stratified by race-ethnicity.</div></div><div><h3>Results</h3><div>Seventy-seven KT recipients with T2DM were treated with GLP-1 RA for at least 12 months. Reference group included 2094 patients not on GLP-1 RA. The mean (SD) age at transplant was 57.9 (9.5) and 60.8 (9.5) years for the treatment and reference groups, respectively. Median follow-up time from the index date for mortality was 1.5 (IQR 0.99, 2.4) in the treatment and 5.8 (IQR 3.4, 9.1) years in the reference group. GLP-1 RA use was associated with improved survival (<em>P</em> = .049), decreased urine albumin to creatinine ratio (net reduction of 10.62 mg/g per year, <em>P</em> = .003), slower estimated glomerular filtration rate decline (1.04 vs 1.56 mL/min/1.73 m² per year, <em>P</em> = .04), and lower troponin levels.</div></div><div><h3>Conclusions</h3><div>GLP-1 RA in KT recipients with T2DM was associated with reduced mortality, and improved kidney function compared to the reference group. Larger, prospective studies are needed to fully evaluate the risks and benefits of GLP-1 RA therapy in KT recipients.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 6","pages":"Pages 798-804"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585064","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}