European Journal of Endocrinology最新文献

{"title":"The natural course of bone mineral density in transgender youth before medical treatment; a cross sectional study.","authors":"Maria Anna Theodora Catharina van der Loos, Lidewij Sophia Boogers, Daniel Tatting Klink, Martin den Heijer, Chantal Maria Wiepjes, Sabine Elisabeth Hannema","doi":"10.1093/ejendo/lvae126","DOIUrl":"10.1093/ejendo/lvae126","url":null,"abstract":"<p><strong>Objective: </strong>Bone mineral density (BMD) Z-scores decrease during puberty suppression in transgender youth. Assessment of treatment impact has been based on the assumption that without intervention, BMD Z-scores remain stable. However, the natural course of BMD in this population is unknown.</p><p><strong>Design: </strong>Retrospective cross-sectional study.</p><p><strong>Methods: </strong>Dual-energy X-ray absorptiometry scans prior to medical intervention were included from 333 individuals assigned male at birth (AMAB) and 556 individuals assigned female at birth (AFAB) aged 12-25 years. The relationship between age and BMD Z-scores of sex assigned at birth was analysed for the lumbar spine (LS), total hip (TH), femoral neck (FN), and total-body-less-head (TBLH), adjusted for height SDS, height-adjusted lean mass Z-score, and whole body percentage fat Z-score.</p><p><strong>Results: </strong>In individuals AMAB, the BMD Z-score was negatively associated with age between 12 and 22 years: LS -0.13/year (95% confidence interval, CI -0.17; -0.10); TH -0.05/year (95% CI -0.08; -0.02); FN -0.06/year (95% CI -0.10; -0.03); and TBLH -0.12/year (95% CI -0.15; -0.09). Adjusting for height-adjusted lean mass Z-score attenuated the association at the LS and TBLH and eliminated the association at the TH and FN. BMD Z-scores and age were not associated between 22 and 25 years. In individuals AFAB, BMD Z-scores were only associated with age at the TBLH (-0.08/year, 95% CI -0.12; -0.04) between age 12 and 20 years.</p><p><strong>Conclusion: </strong>In individuals AMAB aged 12-22 years prior to any treatment, BMD Z-scores were inversely correlated with age. This could imply that BMD increases less in individuals AMAB than in the general population, and that changes in Z-score during puberty suppression and subsequent hormone supplementation are not necessarily due to treatment, but possibly related to lifestyle factors.</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":" ","pages":"426-432"},"PeriodicalIF":5.3,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364918","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":"Diagnosis and management of pituitary adenomas in children and adolescents.","authors":"Dominique Maiter, Philippe Chanson, Stefan Matei Constantinescu, Agnès Linglart","doi":"10.1093/ejendo/lvae120","DOIUrl":"10.1093/ejendo/lvae120","url":null,"abstract":"<p><strong>Background: </strong>Pituitary adenomas (PAs)-also now called pituitary neuroendocrine tumours or Pit-NETS-are rare in children and adolescents and exceptional below the age of 10. Most evidence-based high-quality data are derived from larger studies in adult patients.</p><p><strong>Aims: </strong>We will review recent knowledge on the epidemiology, clinical features, diagnosis, and treatment modalities of the different types of pituitary adenomas diagnosed in children and adolescents, emphasizing the many reasons why these cases should be discussed within pituitary-specific multidisciplinary teams with experts from both paediatric and adult practice.</p><p><strong>Conclusions: </strong>Paediatric PA presents multiple peculiarities that may challenge their adequate management. They are overall proportionally larger and more aggressive than in adults, with potential mass effects including hypopituitarism. Hormonal hypersecretion is frequent, resulting in clinical syndromes affecting normal growth and pubertal development. Prolactinomas represent the most frequent subtype of PA found during childhood, followed by adrenocorticotropin (ACTH) and growth hormone (GH)-secreting adenomas, while clinically non-functioning adenomas are exceptionally diagnosed before the age of 16. The occurrence of a pituitary tumour in a young individual should also prompt genetic testing in each case, searching for either germline mutations in one of the known genes that may drive inherited/familial PA (such as the multiple endocrine neoplasia type 1 or MEN1 gene, or the aryl hydrocarbon receptor interacting protein or AIP gene), or for a mosaic activating mutation of GNAS as found in the McCune-Albright syndrome.</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":" ","pages":"R55-R69"},"PeriodicalIF":5.3,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142389031","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":"Dissociation between liver fat content and fasting metabolic markers of selective hepatic insulin resistance in humans.","authors":"Felix A Westcott, Shilpa R Nagarajan, Sion A Parry, Dragana Savic, Charlotte J Green, Thomas Marjot, Elspeth Johnson, Thomas Cornfield, Ferenc E Mózes, Paige O'Rourke, Jessica Mendall, David Dearlove, Barbara Fielding, Kieran Smith, Jeremy W Tomlinson, Leanne Hodson","doi":"10.1093/ejendo/lvae123","DOIUrl":"10.1093/ejendo/lvae123","url":null,"abstract":"<p><strong>Objective: </strong>Fasting hyperglycemia and hypertriglyceridemia are characteristic of insulin resistance (IR) and rodent work has suggested this may be due to selective hepatic IR, defined by increased hepatic gluconeogenesis and de novo lipogenesis (DNL), but this has not been shown in humans.</p><p><strong>Design: </strong>Cross-sectional study in men and women across a range of adiposity.</p><p><strong>Methods: </strong>Medication-free participants (n = 177) were classified as normoinsulinemic (NI) or hyperinsulinemic (HI) and as having low (LF) or high (HF) liver fat content measured by magnetic resonance spectroscopy. Fractional gluconeogenesis (frGNG) and hepatic DNL were measured using stable isotope tracer methodology following an overnight fast.</p><p><strong>Results: </strong>Although HI and HF groups had higher fasting plasma glucose and triglyceride concentrations when compared to NI and LF groups respectively, there was no difference in frGNG. However, HF participants tended to have lower frGNG than LF participants. HI participants had higher DNL compared to NI participants but there was no difference observed between liver fat groups.</p><p><strong>Conclusions: </strong>Taken together, we found no metabolic signature of selective hepatic IR in fasting humans. DNL may contribute to hypertriglyceridemia in individuals with HI but not those with HF. Glycogenolysis and systemic glucose clearance may have a larger contribution to fasting hyperglycemia than gluconeogenesis, especially in those with HF, and these pathways should be considered for therapeutic targeting.</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":" ","pages":"463-472"},"PeriodicalIF":5.3,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11497584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NT-proBNP levels in patients with primary hyperaldosteronism and autonomous cortisol cosecretion.","authors":"Anna Hirsch, Christian Adolf, Isabel Stüfchen, Felix Beuschlein, Denise Brüdgam, Martin Bidlingmaier, Martin Reincke, Marcus Quinkler","doi":"10.1093/ejendo/lvae119","DOIUrl":"10.1093/ejendo/lvae119","url":null,"abstract":"<p><strong>Context: </strong>Patients with primary aldosteronism (PA) have higher cardiac comorbidities including more pronounced left ventricular hypertrophy than patients with essential hypertension.</p><p><strong>Objective: </strong>Autonomous cortisol cosecretion (ACS) is a common subtype in PA associated with a worse metabolic profile.</p><p><strong>Hypothesis: </strong>Autonomous cortisol cosecretion may affect myocardial parameters and result in a worse cardiac outcome compared to patients with PA and without ACS.</p><p><strong>Methods: </strong>Three hundred and sixty-seven patients with PA undergoing 1 mg dexamethasone suppression test (DST) and echocardiography at baseline from 2 centers of the German Conn's Registry were included. Follow-up for up to 3.8 years was available in 192 patients.</p><p><strong>Results: </strong>Patients with PA and ACS had higher NT-proBNP levels at baseline compared to patients with PA without ACS (114 vs 75.6 pg/mL, P = .02), but showed no difference in echocardiography values. NT-proBNP levels showed a significant positive correlation (r = 0.141, P = .011) with cortisol levels after DST at baseline. In response to therapy of PA, NT-proBNP levels decreased, but remained significantly higher in patients with ACS compared to patients without ACS. At follow-up, left ventricle end-diastolic dimension (LVEDD) decreased significantly only in patients without ACS. Left atrial diameter (LAD) decreased significantly in patients without ACS and in female patients with ACS but not in male patients. Left ventricular mass index (LVMI) significantly improved in female patients without ACS but remained unchanged in female patients with ACS as well as in male patients at follow-up.</p><p><strong>Conclusions: </strong>In patients with PA, concomitant ACS is associated with a worse cardiac profile and only partial recovery even years after initiation of targeted PA therapy.</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":" ","pages":"444-456"},"PeriodicalIF":5.3,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344042","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":"Association of hyperandrogenaemia with hypertension and cardiovascular events in pre-menopausal women: a prospective population-based cohort study.","authors":"Katri Tuorila, Meri-Maija Ollila, Elisa Hurskainen, Juha Tapanainen, Stephen Franks, Terhi Piltonen, Kari Kaikkonen, Laure Morin-Papunen","doi":"10.1093/ejendo/lvae124","DOIUrl":"10.1093/ejendo/lvae124","url":null,"abstract":"<p><strong>Objective: </strong>The present study aimed to clarify the conflicting association of premenopausal hyperandrogenaemia (HA) with the development of hypertension and cardiovascular disease (CVDs) in women.</p><p><strong>Design: </strong>A population-based cohort study including 5889 women.</p><p><strong>Methods: </strong>The association of serum testosterone (T), sex hormone-binding globulin (SHBG), and free androgen index (FAI) at age 31 with blood pressure (BP) and hypertension (BP ≥ 140/90 mmHg and/or use of antihypertensive medication) at ages 31 and 46 and with CVDs (angina pectoris [AP] and/or acute myocardial infarction [AMI] n = 74, transitory cerebral ischaemia and/or stroke n = 150) and combined CVD events (AP, AMI, stroke, heart failure, or CVD mortality n = 160) by age 53 was investigated.</p><p><strong>Results: </strong>T and FAI were positively associated with systolic and diastolic BP at ages 31 and 46 in the multivariable model. Compared to their lowest quartile, the highest quartiles of T and FAI were positively associated with hypertension at age 31 in the multivariable model. During the 22-year follow-up, FAI was positively associated with increased risk of AP/AMI (hazard ratio [HR]: 2.02, 95% CI: 1.06-3.85) and overall CVD events or mortality (HR: 1.54, 95% CI: 1.02-2.33) in the unadjusted models. However, the significance disappeared after adjusting for body mass index (BMI).</p><p><strong>Conclusions: </strong>Women with HA at premenopausal age had an elevated risk of hypertension, and together with BMI, increased risk of CVD events and CVD mortality during the 22-year follow-up. However, because of several study limitations regarding ethnicity and BMI characteristics, a longer follow-up of this cohort and future studies in ethnically diverse populations are needed to verify the results.</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":" ","pages":"433-443"},"PeriodicalIF":5.3,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371256","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":"Higher Peak Height Velocity in Early Maturing Girls Depends on Insulin rather than Fat Mass or IGF-I.","authors":"Kaspar Sørensen,Casper P Hagen,Anders Juul","doi":"10.1093/ejendo/lvae115","DOIUrl":"https://doi.org/10.1093/ejendo/lvae115","url":null,"abstract":"OBJECTIVEAge at pubertal onset has decreased over the recent decades. Early maturing girls have longer puberty duration, and higher peak height velocity (PHV) than late maturing girls. To what extent this is generated by increased insulin-like growth factor-I (IGF-I), fat mass or fasting insulin levels is currently unknown.DESIGN, SETTING, PARTICIPANTSA population-based study - part of the COPENHAGEN puberty study - longitudinal part. Eighty-one girls evaluated biannually for a median of 10 (2-15) visits for a total of 815 evaluations.METHODSPubertal staging, anthropometric measures, PHV, skin fold thickness (SFT) and IGF-I and fasting Insulin levels were measured.RESULTSEarly maturing girls achieved similar final height compared to late maturing girls (166.1 vs 167.1 cm, p = 0.36). Early pubertal onset was associated with significantly greater PHV (8.7 vs. 7.4 cm/year, p < 0.001) and a longer puberty duration (age at onset of breast development to age at PHV [1.8 vs. 1.1 years, p < 0.001]) compared with late maturation. After correcting for age at pubertal onset, neither BMI, SFT nor IGF-I levels differed between early versus late maturing girls. By contrast, fasting insulin levels were significantly higher in early compared with late maturing girls 1.5, 2.0 and 3.0 years after pubertal onset (all p = 0.039).CONCLUSIONGrowth velocity was higher and more prolonged in early compared with late maturing girls and associated with higher insulin levels. Thus, the higher insulin levels may compensate for the shorter total growth period by intensifying the pubertal growth period.","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":"16 1","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142255206","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":"The phenotype of the pediatric patient with Cushing syndrome but without obesity.","authors":"Cameron Padilla,Constantine A Stratakis,Christina Tatsi","doi":"10.1093/ejendo/lvae114","DOIUrl":"https://doi.org/10.1093/ejendo/lvae114","url":null,"abstract":"OBJECTIVECushing syndrome (CS) often presents with obesity that is not as severe in children as it is in adults. The role of obesity in the severity of metabolic syndrome in children with CS has not been studied. This study evaluates whether pediatric patients with CS have obesity-specific differences in their demographic, biochemical and presenting findings.DESIGNCohort study.METHODSWe analyzed 273 patients with young onset of CS at ≤ 18 years old and classified as patients with or without obesity based on their BMI z-scores.RESULTSPatients without obesity (n=84, 31%) were more frequently females with an older age of onset compared to patients with obesity (n=189, 69%). Consistent with their older age, patients without obesity were also more likely to have advanced Tanner stages. Patients with and without obesity had similar duration of disease, but patients with obesity showed higher markers of hypercortisolemia (urinary free cortisol). A higher prevalence of hypertension and insulin resistance was seen in patients with obesity than those without obesity, adjusting for urinary free cortisol (UFC) (p < .05 for all comparisons). While fatty liver disease was not statistically different among the entire cohort, elevated alanine transaminase (ALT) and metabolic dysfunction-associated steatotic liver disease (MASLD) scores were more common in ACTH-dependent CS patients with obesity (p < .05).CONCLUSIONSWeight gain appears to mediate some but not all the cortisol-associated complications in pediatric CS. Therefore, obesity may be a modifiable risk factor among these patients.","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":"8 1","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142269092","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":"No effect of surgery on kidney and cardiovascular risk factors in mild primary hyperparathyroidism: secondary analyses from a 10-year randomized controlled trial.","authors":"Ansgar Heck, Mikkel Pretorius, Karolina Lundstam, Kristin Godang, Mikael Hellström, Thor Ueland, Jens Bollerslev","doi":"10.1093/ejendo/lvae109","DOIUrl":"10.1093/ejendo/lvae109","url":null,"abstract":"<p><strong>Objective: </strong>Renal function and the skeleton are classic target organs in primary hyperparathyroidism (PHPT), affected by the chronic course of the disease. Most patients diagnosed today exhibit mild PHPT, characterized by slight hypercalcemia and no or unspecific symptoms. Concerns have been raised that PHPT could promote deteriorating kidney function and increase cardiovascular risk directly. To examine the effect of parathyroidectomy (PTX) on mild PHPT on renal function and markers for bone turnover, cardiovascular disease (CVD), and vascular inflammation.</p><p><strong>Design: </strong>Prospective randomized controlled trial. ClinicalTrials.gov: NCT00522028.</p><p><strong>Setting: </strong>Eight Scandinavian referral centers.</p><p><strong>Participants: </strong>From 1998 to 2005, 191 patients with mild PHPT were included in Sweden, Norway, and Denmark. Of these 150 were included in the present analyses.</p><p><strong>Intervention: </strong>Seventy patients were randomized to PTX and 80 to observation without intervention (OBS).</p><p><strong>Measures: </strong>e-GFR was calculated based on creatinine and cystatin C. Markers of CVD and systemic inflammation: osteoprotegerin, vascular cell adhesion molecule 1, soluble CD40 ligand, interleukin-1 receptor antagonist, von Willebrand factor. Bone turnover markers: C-terminal telopeptide of type 1 collagen (CTX-1) and serum Procollagen type 1 N-terminal propeptide.</p><p><strong>Results: </strong>No differences in the development of renal function or vascular and systemic inflammation were detected. CTX-1 was lower in PTX after 10 years.</p><p><strong>Limitations: </strong>Secondary analyses of a randomized controlled trial.</p><p><strong>Conclusion: </strong>PTX does not appear to affect renal function or markers of CVD and vascular inflammation in mild PHPT in a ten-year perspective.</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":" ","pages":"354-360"},"PeriodicalIF":5.3,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142072369","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":"Decoding 11-oxygenated androgen synthesis: insights from enzyme gene expression and LC-MS/MS quantification.","authors":"Jie Zheng, Yifu Wang, Jinghang Jiang, Tingwei Jin, Yixuan Liu, Yi Guo, Zhongyuan Chen, Cheng Su, Honghong Wang, Juanjuan Xie, Bingqian Guo, Yufang Lv, Yajie Guo, Yuanliang Xie, Mingli Li, Shengzhu Huang, Jingling Liao, Yu Ye, Linjian Mo, Zhenyuan Yu, Lin Huang, Yonghua Jiang, Zengnan Mo","doi":"10.1093/ejendo/lvae104","DOIUrl":"10.1093/ejendo/lvae104","url":null,"abstract":"<p><strong>Background: </strong>Adrenal-origin and peripheral tissue-transformed 11-oxygenated androgens are recognized as significant androgens. However, our current understanding of the synthesis of 11-oxygenated androgens, including the organs and cell types involved, remains limited.</p><p><strong>Methods: </strong>We performed comprehensive analyses on an extensive dataset of normal human tissues, which included bulk RNA data from 30 tissues, single-cell RNA sequencing (scRNA) data from 16 tissues and proteomics data from 29 tissues, to characterize the expression profiles of enzyme-encoding genes. To validate the findings, immunohistochemical and liquid chromatography-tandem mass spectrometry (LC-MS/MS) techniques were employed.</p><p><strong>Results: </strong>Our investigation revealed that the gene expression levels of the enzymes HSD11B2 and AKR1C3 were notably elevated in the kidney and intestines. Intriguingly, within these organs, we observed an increasing trend in enzyme expression with age in women, while a decreasing trend was apparent in men. scRNA analysis revealed that HSD11B2 was predominantly expressed in collecting duct principal cells in the kidney, while AKR1C3 was primarily expressed in the proximal tubules. Intriguingly, nearly all epithelial cells in the intestine expressed these key enzymes. Further analysis using LC-MS/MS revealed that the kidney exhibited the highest levels of 11-ketoandrostenedione (11KA4) and 11-ketotestosterone (11KT) among the seven tissues examined, and substantial synthesis of 11KA4 and 11KT was also observed in the intestine. Finally, we developed the TransMap website (http://gxmujyzmolab.cn:16245/TransMap/) to provide comprehensive visualization of all currently available transcriptome data.</p><p><strong>Conclusion: </strong>This study offers an overarching perspective on tracing the synthesis of 11-oxygenated androgens in peripheral tissues, thereby providing valuable insights into the potential role of these androgens in humans.</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":" ","pages":"288-299"},"PeriodicalIF":5.3,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105630","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":"Impact of antiresorptive agents on mortality risk in postmenopausal women with osteoporosis: insights from a nationwide cohort study.","authors":"Kyoung Jin Kim,Seong Hee Ahn,So Young Park,Jimi Choi,Gi Hwan Bae,Ha-Young Kim,Kyoung Min Kim,","doi":"10.1093/ejendo/lvae111","DOIUrl":"https://doi.org/10.1093/ejendo/lvae111","url":null,"abstract":"IMPORTANCEOsteoporosis-related fractures are associated with increased mortality risk among postmenopausal women, yet the impact of antiosteoporotic medications on mortality is not fully understood.OBJECTIVEThis study evaluates the effect of antiresorptive agents (ARs) on mortality risk in postmenopausal women with osteoporosis.DESIGNThis is a nationwide cohort study using data from the National Screening Program for Transitional Ages (2008-2017).SETTINGData were derived from a national cohort of postmenopausal women in South Korea.PARTICIPANTSThis study included 117 871 postmenopausal women diagnosed with osteoporosis. Of them, 15 895 patients who used ARs, such as bisphosphonates or selective estrogen receptor modulators, for at least 1 year were matched 1:1 with nonusers using propensity scores.EXPOSURESExposure to ARs for at least 1 year was compared with no AR use.MAIN OUTCOMES AND MEASUREMortality outcomes were assessed using multivariable Cox proportional hazard regression models, focusing on all-cause mortality and cause-specific mortality, particularly cardiovascular disease (CVD) and injury-/fracture-related deaths.RESULTSIn AR users, there were 102 deaths (mortality rate 1.41 per 1000 person-years), compared with 221 deaths in non-users (mortality rate 3.14 per 1000 person-years), yielding a hazard ratio (HR) of 0.43 (95% CI, 0.34-0.54). Antiresorptive agent users showed a 52% reduction in CVD mortality risk (HR, 0.48; 95% CI, 0.34-0.69) and a 54% reduction in injury-/fracture-related mortality risk (HR, 0.46; 95% CI, 0.27-0.76). The analysis indicated a consistent decrease in all-cause and CVD mortality risks with longer durations of AR use.CONCLUSIONS AND RELEVANCEThe use of ARs in postmenopausal women with osteoporosis is associated with significantly lower risks of all-cause mortality, especially from cardiovascular events and fractures. The mortality reduction benefits appear to be enhanced with prolonged AR therapy, highlighting the potential importance of sustained treatment in this population.","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":"62 1","pages":"361-369"},"PeriodicalIF":5.8,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142255231","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}