European Journal of Endocrinology最新文献

{"title":"Association between premature ovarian insufficiency and biological aging.","authors":"Jinting Zhou, Menglin Fan, Aaron M Lett, Geling Jin, Qiqi You, Jingjing Zeng, Bo Chen, Yucen Wu, Hui Xing, Shaoyong Xu","doi":"10.1093/ejendo/lvaf102","DOIUrl":"https://doi.org/10.1093/ejendo/lvaf102","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to analyze whether premature ovarian insufficiency (POI) is associated with accelerated biological aging, whether the degree of biological aging is exacerbated by an earlier age at menopause, and whether menopausal hormone therapy (MHT) in the POI population is associated with reduced biological aging.</p><p><strong>Design: </strong>This is a cross-sectional study. A total of 229 779 participants aged 40 years and older in the UK Biobank (2006-2010) and NHANES (1999-2018) were included in the study.</p><p><strong>Methods: </strong>Menopause information was collected through questionnaires. Biological age acceleration was defined by the Klemera-Doubal method, which is calculated through biomarkers, in reference to chronological age. Biological age acceleration > 0 was defined as biological aging. Association between POI and biological aging analyzed using multivariate linear regression and logistic regression models.</p><p><strong>Results: </strong>The results showed that participants with POI had an increased risk of biological aging (UK Biobank: OR = 1.50 [95% CI: 1.24-1.82]; NHANES: OR = 1.20 [95% CI: 1.07-1.34]) and decrease in leukocyte telomere length compared with those without POI (UK Biobank: 0.0109 [95% CI: 0.0079-0.0109]). Participants with POI who underwent MHT had reduced risk of aging compared with those who did not (UK Biobank: OR = 0.63 [95% CI: 0.43-0.92]; NHANES: OR = 0.75 [95% CI: 0.61-0.92]).</p><p><strong>Conclusion: </strong>This study showed that participants with POI had a significantly increased risk of biological aging compared with those without POI. Participants with POI who received MHT had a reduced risk of aging compared with those who did not.</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":"192 6","pages":"744-753"},"PeriodicalIF":5.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Delphi panel consensus on recommendations for thromboprophylaxis of venous thromboembolism in endogenous Cushing's syndrome: a position statement.","authors":"","doi":"10.1093/ejendo/lvaf112","DOIUrl":"https://doi.org/10.1093/ejendo/lvaf112","url":null,"abstract":"","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":"192 6","pages":"X1"},"PeriodicalIF":5.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From hyperplasia to carcinoma: a molecular driven adrenal disease.","authors":"Elisa Dybal, Myriam Decaussin-Petrucci, Françoise Descotes, Gérald Raverot, Jean-Christophe Lifante, Christophe Sajous, Jonathan Lopez, Hélène Lasolle","doi":"10.1093/ejendo/lvaf105","DOIUrl":"10.1093/ejendo/lvaf105","url":null,"abstract":"<p><p>Bilateral Macronodular Adrenocortical Disease (BMAD) is characterized by bilateral benign macronodules and, frequently, autonomous cortisol secretion. Germline molecular alterations of tumor suppressor genes are identified in around 30% of cases, the most frequent being ARMC5. Even if adrenocortical nodular disease often occurs with tumor suppressor gene pathogenic variant, the association with adrenal cortical carcinoma (ACC) is rare and no functional studies have proven a link between these two diseases. We reported the case of a woman with an adrenal Cushing's syndrome developed on BMAD. Over 20 years later, ACC was diagnosed, developed inside a benign nodule of macronodular adrenal gland. Germline genotyping showed no alteration in CDKN1B, KDM1A, PRKACA, PRKAR1A, MEN1, APC, ARMC5, or TP53 genes. Next-generation sequencing has been performed in the ACC and the adjacent macronodular tissue, showing a progressive accumulation of somatic protumoral molecular alterations between the benign nodular part of the adrenal gland and the ACC. Therefore, we hypothesize that BMAD could be an early event of ACC development and may beneficiated from more systematic radiological monitoring.</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":" ","pages":"K55-K59"},"PeriodicalIF":5.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revised European Society of Endocrinology Clinical Practice Guideline for the management of aggressive pituitary tumours and pituitary carcinomas.","authors":"Gerald Raverot, Pia Burman, Ana Paula Abreu, Anthony P Heaney, Leonie van Hulsteijn, Andrew L Lin, Hani Marcus, Ann McCormack, Giuseppe Minniti, Stephan Petersenn, Vera Popovic, Marily Theodoropoulou, Jacqueline Trouillas, Olaf M Dekkers","doi":"10.1093/ejendo/lvaf100","DOIUrl":"https://doi.org/10.1093/ejendo/lvaf100","url":null,"abstract":"<p><p>Pituitary tumours, originating from endocrine cells of the anterior pituitary, are quite common, and in most cases well-controlled by surgery or medical treatment. However, a small subset of pituitary tumours presents with multiple local recurrences or tumour progression despite combined surgical, medical or radiotherapeutic treatment. These are known as aggressive pituitary tumours (APT); also called aggressive pituitary neuroendocrine tumours (PitNETs); or, in the rare case of metastases, pituitary carcinomas (PC) or metastatic PitNETs. Early identification of APT is challenging but is of major clinical importance as they are associated with an increased morbidity and mortality even in the absence of metastases. Here, we provide a revision of the first international, interdisciplinary European Society of Endocrinology (ESE) clinical practice guideline on APTs and PC (2018). Since publication of the 2018 guideline, results from the second ESE survey on APT and PC were published, and more data on APT treatment, including temozolomide, immune checkpoint inhibitors and bevacizumab, emerged. These data are reviewed in this guideline and translated into a practical algorithm to guide APT and PC management. Furthermore, standardized reporting of imaging and histopathological investigations of these tumours is proposed, and the role of molecular analysis is discussed. Last, a section is dedicated to special circumstances such as APT in pregnancy.</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":"192 6","pages":"R45-R78"},"PeriodicalIF":5.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic origin of multifocal sporadic medullary thyroid cancer and C-cell hyperplasia.","authors":"Jacqueline Fátima Martins de Almeida, Cristina Romei, Teresa Ramone, Roberta Casalini, Raffaele Ciampi, Beatrice Fuochi, Francesca Signorini, Clara Ugolini, Virginia Cappagli, Laura Sterian Ward, Rossella Elisei","doi":"10.1093/ejendo/lvaf109","DOIUrl":"10.1093/ejendo/lvaf109","url":null,"abstract":"<p><strong>Objective: </strong>Sporadic medullary thyroid cancer (sMTC) mostly presents as a single lesion, but additional tumor foci may be present. The present study aimed to analyze the mutation profile of different tumor foci of multifocal sMTC to verify whether they represent an intra-organ metastatic dissemination or if they are independent tumors. Moreover, the genetics of C-cell hyperplasia (CCH) associated with sMTC was studied to verify whether CCH could be considered preneoplastic or reactive lesions.</p><p><strong>Methods: </strong>Thirty-eight multifocal sMTCs and 15 sMTCs with associated CCH were included: A total of 106 tumor foci and 25 different CCH areas were studied. The mutational status was analyzed by Next-Generation Sequencing and/or droplet-digital PCR.</p><p><strong>Results: </strong>Thirty-one/38 (81.6%) sMTCs had a somatic mutation in the main tumor, while 7/38 (18.4%) cases were negative. Thirty/31 (96.8%) mutated sMTCs had a single mutation, while 3 different mutations were detected in 1 case (3.2%). Twenty-eight/31 (90%) mutated sMTCs showed the same mutation profile in the main tumors and in all secondary foci, while 3 cases were discordant. Eleven/15 (73.4%) sMTC with CCH showed a somatic mutation in the main tumor, while 4 (26.6%) were negative. Only 1/11 (9%) mutated cases showed the same mutation in the main tumor and in the CCH.</p><p><strong>Conclusions: </strong>Our data demonstrate that multiple foci of sMTC share the same driver mutation as the main tumor and support the hypothesis that they are intrathyroidal metastases. Most of the CCH associated with sMTC should not be considered a preneoplastic lesion as they are negative for the mutation of the main sMTC.</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":" ","pages":"737-743"},"PeriodicalIF":5.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ketone supplementation acutely lowers androgen and glucose levels in women with polycystic ovary syndrome: a randomized clinical trial.","authors":"Nikolaj Rittig, Mai Christiansen Arlien-Søborg, Mads V Svart, Henrik Holm Thomsen, Kirstine Kirkegaard, Vinnie H Greve, Mette Mølby Nielsen, Kirstine Stochholm, Marie Juul Ornstrup, Claus Højbjerg Gravholt","doi":"10.1093/ejendo/lvaf106","DOIUrl":"10.1093/ejendo/lvaf106","url":null,"abstract":"<p><strong>Background: </strong>Polycystic ovary syndrome (PCOS) is a common endocrine disorder linked to insulin resistance and elevated androgens. While ketogenic diets reduce androgen and glucose levels in women with PCOS, the direct role of β-hydroxybutyrate (BHB) remains unclear. This study aimed to determine whether BHB supplementation acutely lowers circulating androgen and glucose levels in women with PCOS.</p><p><strong>Methods: </strong>A randomized, placebo-controlled crossover trial was conducted involving 20 women diagnosed with PCOS. Participants underwent fasting blood sampling on 2 occasions. They were randomly assigned to receive either a ketone supplement or a taste-matched placebo. Each intervention was administered over 10 h, with 1 dose administered the evening before and another 2 h prior to blood collection.</p><p><strong>Results: </strong>Following BHB supplementation, blood D-β-hydroxybutyrate levels reached 2.4 ± 1.2 mM, compared with 0.1 ± 0.1 mM in the control group (P < .001). Androgen concentrations were generally lower with BHB supplementation, with mean reductions in testosterone (-13%, 95% CI, -27 to 1, P = .067), free testosterone (-21%, 95% CI, -43% to 1%, P = .057), androstenedione (-14%, 95% CI, -29 to 0, P = .050), and 11-ketotestosterone (-21%, 95% CI, -38 to -4, P = .020) compared with control. Fasting plasma glucose levels were 4.6 ± 0.7 mM after BHB supplementation, versus 5.1 ± 0.4 mM in the placebo group (mean -10%, 95% CI, -5% to -15%, P < .001).</p><p><strong>Conclusion: </strong>Ketone supplementation acutely lowers androgen and glucose levels in women with PCOS. These findings highlight the potential for ketone-based therapies as a novel treatment for PCOS and suggest the need for long-term clinical trials to further explore these effects.</p><p><strong>Clinical trial registration number: </strong>ClinicalTrials.gov (NCT05762822).</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":" ","pages":"717-727"},"PeriodicalIF":5.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe symptomatic hyponatremia in Europe: insights into current clinical practice.","authors":"Julia Beck, Muhammad Fahad Arshad, Ahmed Iqbal, Mirjam Christ-Crain","doi":"10.1093/ejendo/lvaf115","DOIUrl":"10.1093/ejendo/lvaf115","url":null,"abstract":"<p><strong>Introduction: </strong>For the treatment of severe symptomatic hyponatremia, the European Society of Endocrinology (ESE) guidelines (2014) recommend a bolus-wise strategy using hypertonic saline (HTS). However, there are recent controversies regarding the risk of overcorrection and osmotic demyelination syndrome (ODS), leading to significant heterogeneity in practice. The aim of this survey was to evaluate clinical practices and perspectives of endocrinologists across Europe in managing severe symptomatic hyponatremia.</p><p><strong>Methods: </strong>A web-based anonymous cross-sectional survey (REDCap®), endorsed by ESE, was disseminated from 06, 2024 to 02, 2025. Data were analyzed using R-Studio.</p><p><strong>Results: </strong>A total of 662 responses were received. After excluding incomplete and non-European responses, 439 responses from 36 countries were analyzed. Most responses were received from university hospitals (68.6%) and senior clinicians (68.1%). Thirty-one percent of clinicians had experience using both bolus and continuous infusions in managing severe symptomatic hyponatremia, while sole bolus or continuous infusion therapy was preferred by 32% and 23%, respectively. Preferred bolus dosage and strength were 3% 100 mL (28%) and 3% 150 mL (19%), while 5% preferred a weight-based dosage. Most (84%) clinicians preferred one bolus infusion followed by a blood test before repeating a second. Thirty-four percent of respondents had encountered ≥1patient with suspected or confirmed ODS in their practice, with 55% reported ODS being associated with sodium overcorrection.</p><p><strong>Discussion: </strong>This is the first European survey on the management of severe symptomatic hyponatremia, offering valuable insights into real-life clinical practice. Our findings highlight ongoing uncertainties in treatment strategies and underscore the need for future research and evidence-based review of the ESE guidelines.</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":" ","pages":"754-762"},"PeriodicalIF":5.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thyroid volume-new reference values for defining thyroid enlargement.","authors":"Till Ittermann, Aniela Angelow, Jean-François Chenot, Henry Völzke, Margit Heier, Birgit Linkohr, Annette Peters, Christine Meisinger, Simone Kiel","doi":"10.1093/ejendo/lvaf108","DOIUrl":"10.1093/ejendo/lvaf108","url":null,"abstract":"<p><strong>Objective: </strong>Upper reference values for thyroid volume are 25 mL for men and 18 mL for women. Thyroid volume alters with age, body weight, body height, and iodine status, which is not considered in the current limits. The aim was to develop reference equations, considering age, body weight, and height to calculate individual reference values for thyroid volume.</p><p><strong>Design: </strong>This cross-sectional study used data from 3 independent cohorts (SHIP-START, SHIP-TREND, and KORA-F4) in Germany. SHIP-START-0, a population-based health survey, was carried out in Northern Germany, from 1997 to 2001. SHIP-TREND-0, a second independent sample of the same study region, was carried out between 2008 and 2012. KORA-F4, a population-based health survey, was conducted between 2006 and 2008 in Southern Germany.</p><p><strong>Methods: </strong>A total of 11 549 individuals (51% women) were included in the data analysis. Eight thousand six-hundred and six individuals (45% women) were used as the thyroid-healthy reference population when developing equations. Sex-stratified quantile regression models for the 95th percentile using age, body weight, and height as explanatory variables were performed.</p><p><strong>Results: </strong>The overall reference value was 38.7 mL for men and 28.6 mL for women. According to the established cut-offs, 34% of the overall population would have had goitre compared with 7% when using our equations.</p><p><strong>Conclusion: </strong>Upper reference values for thyroid volume are too low for an adult, previously iodine-deficient population and do not consider age, body weight, and height. Using individualised equations reduces the prevalence of thyroid enlargement substantially and can lead to a decrease in overdiagnoses and the use of medical resources.</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":" ","pages":"728-736"},"PeriodicalIF":5.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Locally advanced pheochromocytoma/paraganglioma exhibit high metastatic recurrence and disease specific mortality rates: long-term follow-up of 283 patients.","authors":"Wolfgang Raber, Andreas Scheuba, Rodrig Marculescu, Harald Esterbauer, Johannes Rohrbeck","doi":"10.1093/ejendo/lvaf104","DOIUrl":"10.1093/ejendo/lvaf104","url":null,"abstract":"<p><strong>Importance: </strong>Data on locally advanced (LAP) pheochromocytoma/paraganglioma (PPGL), based on capsular, vascular or periadrenal fat invasion, tumor emboli and extra-adrenal extension, are scarce.</p><p><strong>Objective: </strong>To compare outcomes of patients with LAP and without (nLAP).</p><p><strong>Design: </strong>Retrospective cohort study, 1981-2024, prospectively supplemented 2020-2024.</p><p><strong>Setting: </strong>Referral center.</p><p><strong>Outcomes: </strong>Overall, metastatic and nonmetastatic recurrence, overall (OAS) and disease-specific survival (DSS).</p><p><strong>Results: </strong>Of 283 patients followed for 11.3 ± 8.8 (mean ± SD) years, 79 (27.9%) had LAP. Compared to patients with nLAP (n = 204), patients with LAP had more overall (n = 17 vs. 31, hazard ratio 2.4, 95% CI 1.4-5.0) and metastatic (11 vs. 9, HR 6.8, 2.2-20.6) and similar (6 vs. 22, HR 1.2, 0.5-3.0) nonmetastatic recurrences. OAS was comparable (12 vs. 42 nonsurvivors, HR 1.2, 0.6-2.3), but mortality from metastatic disease was higher with LAP (2 vs. 4 deaths, HR 12.2, 1.8-82.8). Extra-adrenal tumor location was predictive of metastatic and nonmetastatic recurrence but not of OAS or DSS, tumor size of metastatic recurrence and of DSS, cluster 1 and 2 pathogenic variants of overall and nonmetastatic recurrence but not of OAS or DSS. LAP with tumor emboli and extra-adrenal extension predicted overall (HR 4.5, 1.3-14.2 and 5.0, 1.4-13.7) and metastatic recurrence (HR 24.6, 6.4-91.8 and 6.5, 1.6-23.4), OAS (HR 21.2, 2.8-108, tumor emboli only) and DSS (HR 22.6, 3.5-183 and 13.1, 1.7-120), LAP with vessel invasion nonmetastatic recurrence (HR 3.6, 1.2-10.0).</p><p><strong>Conclusion: </strong>Patients with LAP vs. nLAP have higher metastatic recurrences and worse DSS. Tumor emboli and extra-adrenal extension indicated lower DSS, warranting a close follow-up.</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":" ","pages":"705-716"},"PeriodicalIF":5.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to commentary: strengthening endocrinology training: integrating nonclinical competencies, patient, and trainee perspectives for better implementation strategies.","authors":"Anton Luger, Maeve Durkan, Mirjam Christ-Crain, Pedro Marques","doi":"10.1093/ejendo/lvaf111","DOIUrl":"10.1093/ejendo/lvaf111","url":null,"abstract":"","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":" ","pages":"L28-L29"},"PeriodicalIF":5.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}