European Journal of Endocrinology最新文献

{"title":"Mild autonomous cortisol secretion in patients with aldosterone-producing adenoma and risk for cardiac remodeling and diastolic dysfunction.","authors":"Cheng-Hsuan Tsai, Che-Wei Liao, Xue-Ming Wu, Zheng-Wei Chen, Chien-Ting Pan, Yi-Yao Chang, Bo-Ching Lee, Chia-Hung Chou, Chin-Chen Chang, Vin-Cent Wu, Chi-Sheng Hung, Anand Vaidya, Yen-Hung Lin","doi":"10.1093/ejendo/lvaf007","DOIUrl":"10.1093/ejendo/lvaf007","url":null,"abstract":"<p><strong>Background: </strong>Mild autonomous cortisol secretion (MACS) is common in adrenal adenomas, including patients with primary aldosteronism (PA) with aldosterone-producing adenomas (APA). This study investigated the impact of MACS on cardiac remodeling and diastolic dysfunction in patients with APA.</p><p><strong>Methods: </strong>We prospectively enrolled 483 patients with APA. MACS was defined as a cortisol level >1.8 μg/dL after an overnight dexamethasone-suppression test (DST). Clinical, biochemical, and echocardiographic data were collected at baseline and one-year following targeted treatments.</p><p><strong>Results: </strong>In this prospective cohort, 21% of patients with APA had concurrent MACS. Patients with MACS were older, had a higher prevalence of diabetes, larger adrenal tumor size, higher left ventricular mass index (LVMI), and worse diastolic function (E/e'). Multivariable linear regression analysis showed that concurrent MACS with APA was an independent risk factor for higher LVMI and worse E/e'. Among patients who underwent adrenalectomy, both those with and without MACS showed significant improvements in LVMI and E/e'. In contrast, among patients who received mineralocorticoid receptor antagonist (MRA) treatment, significant LVMI improvement was only observed in patients without MACS. MRA therapy did not improve E/e' regardless of the presence or absence of MACS.</p><p><strong>Conclusions: </strong>The presence of MACS in patients with PA was associated with worse cardiac hypertrophy and diastolic dysfunction. Surgical adrenalectomy was able to effectively reverse cardiac remodeling in patients with PA and concurrent MACS; however, MRA therapy was not associated with significant improvements in cardiac function. These findings highlight the independent deleterious effects of cortisol on cardiovascular disease in PA.</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":" ","pages":"81-90"},"PeriodicalIF":5.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002204","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":"Hormonal regulation of human adipose tissue lipolysis: impact of adipose GIP system in overweight and obesity.","authors":"Sebastian Brachs, Dominik Soll, Finja Beer, Nadine Huckauf, Anish Konkar, Joachim Spranger, Hartmut Rütten, Knut Mai","doi":"10.1093/ejendo/lvae151","DOIUrl":"https://doi.org/10.1093/ejendo/lvae151","url":null,"abstract":"<p><strong>Objective: </strong>Given the promising effects of GLP-1/GIP/glucagon receptor triagonists on weight loss in animals and humans, improved understanding of underlying mechanism is required. We investigated a direct lipolytic effect of a specific GLP-1/GIP/glucagon receptor triagonist on human adipose tissue to disentangle central and peripheral effects as potential drivers of weight loss.</p><p><strong>Design and methods: </strong>Isolated primary adipocytes from subcutaneous adipose tissue biopsies of 22 non-diabetic subjects [63.0 (57.0-69.5) years] were incubated with increasing concentrations of isoprenaline, GLP-1, GIP, glucagon, or a GLP-1/GIP/glucagon receptor triagonist. Glycerol concentration was measured following stimulation to assess lipolysis. mRNA expression of adipose tissue receptors was analyzed in parallel.</p><p><strong>Results: </strong>Glycerol concentration only increased by isoprenaline, GIP (+13%), and GLP-1/GIP/glucagon receptor triagonist (+28%) but not by GLP-1 or glucagon. This effect was not related to age or body mass index (BMI). Higher adipose tissue GIP receptor mRNA expression was related to elevated glycerol release after GIP and GLP-1/GIP/glucagon receptor triagonist stimulation.</p><p><strong>Conclusions: </strong>Direct lipolytic effects of GIP seem to exist in human subcutaneous adipose tissue. This might be targetable by multiple receptor agonists, especially with a high GIP receptor affinity. Such a mechanism can potentiate the beneficial effect on weight loss and will therefore represent a promising target of future research.</p><p><strong>Clinical trial registration number: </strong>The trial was registered at German Clinical Trials Register (drks.de) as DRKS00010049.</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":"192 2","pages":"91-99"},"PeriodicalIF":5.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398813","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":"Descriptive analysis and outcomes of PitNETs treated surgically during pregnancy and postpartum.","authors":"Cindy Odot, Mathilde Brière, Chiara Villa, Théophraste Henry, Stephan Gaillard, Philippe Caron, Lionel Groussin, Yves Reznik, Anne Rod, Camille Ghorra, Marie-Laure Raffin-Sanson, Bertrand Baussart, Mirella Hage","doi":"10.1093/ejendo/lvaf018","DOIUrl":"10.1093/ejendo/lvaf018","url":null,"abstract":"<p><strong>Objective: </strong>Data on pituitary neuroendocrine tumours (PitNETs) surgically treated during pregnancy are limited, and no studies have compared these cases to those treated in non-pregnant women. This study aimed to describe the clinical, radiological, and histological profiles of patients treated surgically for PitNETs during pregnancy and evaluate long-term prognosis.</p><p><strong>Design: </strong>This study was multicentric, observational, and retrospective.</p><p><strong>Methods: </strong>We included 10 patients from 5 university hospitals who underwent surgical treatment for PitNETs during pregnancy or within 12 months postpartum, along with 30 matched non-pregnant controls treated surgically for PitNETs. Clinical and histological data, as well as progression-free survival without additional treatment, were compared between pregnant and non-pregnant patients.</p><p><strong>Results and conclusions: </strong>Among the 10 PitNETs, 4 were corticotropic, 2 gonadotropic, 2 lactotropic, and 2 somatotropic. The primary surgical indication (tumour syndrome with or without failure of medical treatment) was similar between the two groups: 7/10 vs 19/30 (P = 1.00). There was no statistically significant difference in volume (P = .072) or radiological invasion markers (optic chiasm compression, P = .059, and cavernous sinus invasion, P = .274). However, PitNETs in pregnant women showed higher mitotic activity (P = .038) and were more frequently classified as grade 2b (Trouillas clinicopathological classification; P = .049). The need for second-line treatment was also more frequent (P = .005). PitNETs requiring surgical treatment during pregnancy are characterized by increased proliferative activity and progression after surgery. Despite this, the long-term prognosis remains favourable. These results need confirmation in a larger study.</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":" ","pages":"150-158"},"PeriodicalIF":5.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373801","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":"Phenotype and genotype of 23 patients with hypopituitarism and pathogenic GLI2 variants.","authors":"Karine Aouchiche, Camille Charmensat, Pertuit Morgane, Cécile Teinturier, Patricia Bretones, Aude Brac de la Perriere, Valérie Layet, Natacha Bouhours-Nouet, Marie-Christine Vantyghem, Elsa Haine, Marie-Laure Nunes-Sanchez, Odile Camard, Sabine Baron, Frederic Castinetti, Anne Barlier, Thierry Brue, Rachel Reynaud, Alexandru Saveanu","doi":"10.1093/ejendo/lvaf015","DOIUrl":"10.1093/ejendo/lvaf015","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the phenotype and genotype of patients with congenital hypopituitarism (CH) and pathogenic (P) GLI2 variants.</p><p><strong>Methods: </strong>A large cohort of patients with hypopituitarism was screened for GLI2 variants using a next-generation sequencing panel. Genotype-phenotype correlations were then assessed using GENHYPOPIT phenotypic data.</p><p><strong>Results: </strong>Of the 39 GLI2 variants identified in 717 index cases, 17 were classified as pathogenic and likely pathogenic. All these GLI2 variants were identified in 23 patients (17 index cases and 6 relatives) with associated pituitary stalk interruption syndrome or extrapituitary manifestations. GLI2 variants were the most frequently identified genetic cause in patients with syndromic hypopituitarism (68%): 88% (15/17) of mutations were truncating variants, and 45% were de novo. Most patients with a GLI2 variant (21/23, 91%) had hypopituitarism, including 21.7% (5/23) presenting isolated growth hormone deficiency. Two patients had Kallmann syndrome. Pituitary morphological abnormalities were present in 84% of the patients with P GLI2 variants (index cases and affected relatives). The remaining signs included neurocognitive disorders (38%), hexadactyly (27%), cardiac septal defects, and renal/vesical abnormalities. A possible digenic origin (GLI2/HESX1) is proposed in one family.</p><p><strong>Conclusion: </strong>In this large multicentric international cohort, GLI2 was the most frequently identified genetic cause of syndromic CH with constant association of pituitary stalk interruption syndrome or extrapituitary clinical features. In addition to polydactyly and neurocognitive disorders, cardiac and renal abnormalities were also frequently observed and should be investigated further. The variable expression of GLI2-associated phenotypes justifies further research in this area.</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":" ","pages":"110-118"},"PeriodicalIF":5.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406465","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":"A new broom sweeps clean: CLDN16 surpasses the BRAF-V600E mutation as an unrivaled biomarker in papillary thyroid cancer.","authors":"Yefeng Cai, Yawen Guo, Wenli Ma, Pu Cheng, Liehao Jiang, Shuyan Shen, Fahuan Song, Lei Zhu, Yiqun Hu, Yao Chen, Yanting Duan, Xiujun Cai, Quan Li, Guowan Zheng, Minghua Ge","doi":"10.1093/ejendo/lvaf003","DOIUrl":"https://doi.org/10.1093/ejendo/lvaf003","url":null,"abstract":"<p><strong>Objective: </strong>This study assessed CLDN16 as a potential replacement or improvement biomarker for papillary thyroid cancer (PTC), addressing the limitations associated with the prevalently used BRAF-V600E mutation.</p><p><strong>Design: </strong>Database analyses, tissue validation, RNA sequencing, and functional assays were conducted to evaluate CLDN16 as a PTC biomarker and its clinical application.</p><p><strong>Methods: </strong>CLDN16 expression was examined in PTC and normal thyroid/para-tumor tissues and compared across various cancer types. We evaluated diagnostic accuracy, stability in primary and metastatic sites, and associations with aggressive features. Knockdown experiments were performed to investigate the impact on PTC cell behavior. Additionally, we developed a support vector machine model for diagnosing malignant and high-risk PTCs.</p><p><strong>Results: </strong>CLDN16 demonstrated high specificity for PTC, with positive detection rates (88.0% in The Cancer Genome Atlas [TCGA] and 88.3% in our center) significantly surpassing BRAF-V600E (47.5% in TCGA and 74.3% in our center). This resulted in superior diagnostic accuracy (ROC-CLDN16 = 0.922 vs ROC-BRAF-V600E = 0.742 in TCGA). CLDN16 exhibited stable expression across primary and metastatic sites and was associated with aggressive features, including extrathyroidal extension and lymph node metastasis. CLDN16 knockdown inhibited migration, invasion, and iodine uptake in PTC cells. Clinically, CLDN16 effectively identified malignancy in BRAF wild patients (94.2%), and combined with BRAF-V600E, achieved 96.9% accuracy. The incorporation of CLDN16 into PTC molecular typing facilitated precise high-risk identification (92.0% accuracy in the training set and 100% in the validation set).</p><p><strong>Conclusions: </strong>CLDN16 presents a promising biomarker that could surpass BRAF-V600E, offering effective clinical utility and revolutionizing PTC molecular typing for precise high-risk identification.</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":"192 2","pages":"128-140"},"PeriodicalIF":5.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491292","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":"Optimizing diagnostic strategies for central adrenal insufficiency in pituitary disease.","authors":"Linus Haberbosch, Nina M T Meyer, Lara Lechner, Marie Jensen, Dominik Soll, Leonard Kozarzewski, Linus Hesse, Oliver Blankenstein, Vanessa Hubertus, Peter Vajkoczy, Christian J Strasburger, Joachim Spranger, Lukas Maurer, Knut Mai","doi":"10.1093/ejendo/lvaf002","DOIUrl":"https://doi.org/10.1093/ejendo/lvaf002","url":null,"abstract":"<p><strong>Objective: </strong>Central adrenal insufficiency (CAI) affects a significant number of patients with pituitary disease, and a missed diagnosis can be fatal. The optimal diagnostic algorithm, however, is still controversial. Here, we present a single-centre study with the systematic use of the overnight metyrapone test (OMT) and the short synacthen test (SST) in a large cohort of patients with pituitary disease.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 161 patients with pituitary disease or after pituitary surgery and suspected CAI. Data from OMT (n = 134), SST (n = 156), and long-term clinical outcomes (n = 97) were evaluated.</p><p><strong>Results: </strong>Validated in the sub-cohort with available clinical outcome evaluation after a mean of 2.7 years, 11-desoxycortisol (11-DOF, cut-off >200 nmol/L) in the OMT achieved a sensitivity of 100% and a specificity of 94%. Adrenocorticotropic hormone measurement offered no additional diagnostic benefit. Cortisol in the SST (cut-off >450 nmol/L after 30 min) showed an inferior sensitivity of 75.0% and a specificity of 80.2%. To assess the usefulness of the tests in pre-classified risk groups according to the recently proposed CAI-Score, we calculated CAI subgroup prevalence as well as positive/negative predictive value (NPV) for the SST in each risk group. In the low-risk group (CAI-Score = 0), the SST achieved a high NPV (0.99), while showing no clear benefit in the other groups.</p><p><strong>Conclusions: </strong>This study reaffirms the value of 11-DOF in the OMT as a reliable diagnostic tool for CAI, while confirming the limitations of the SST. These data indicate to consider SST as a single test procedure for low-risk patients.</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":"192 2","pages":"100-109"},"PeriodicalIF":5.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406468","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":"When selection becomes selection bias.","authors":"Kristina Laugesen, Olaf M Dekkers, Rolf H H Groenwold, Nils Skajaa","doi":"10.1093/ejendo/lvaf014","DOIUrl":"10.1093/ejendo/lvaf014","url":null,"abstract":"<p><p>Selection in clinical research does not necessarily result in selection bias. To understand when selection leads to bias, we discuss collider-conditioning bias, which is a common and often self-inflicted type of selection bias. Collider-conditioning bias may be difficult to recognize, and paying more attention to the bias could therefore increase the quality of research. In this paper, we aim to increase awareness and understanding of the topic.</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":" ","pages":"E1-E3"},"PeriodicalIF":5.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074175","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":"Real-life experience on efficacy and safety of setmelanotide treatment in prepubertal children.","authors":"Ahmet Kahveci, Ilknur Kurt, Serap Turan, Tulay Guran, Abdullah Bereket, Belma Haliloglu","doi":"10.1093/ejendo/lvaf008","DOIUrl":"https://doi.org/10.1093/ejendo/lvaf008","url":null,"abstract":"<p><p>Monogenic obesity, characterized by severe, early-onset obesity due to single-gene defects, often resists traditional weight management strategies. This report presents real-life experiences on the efficacy and safety of setmelanotide, an MC4R agonist, in 4 prepubertal children (ages 3-9) with LEPR and POMC deficiencies. Findings indicate that setmelanotide is effective at lower doses in our patients with POMC deficiency (0.3-0.5 mg/day) than the patients with LEPR deficiency (2.5 mg/day). Treatment was generally well-tolerated, with injection site reactions and hyperpigmentation as common side effects. As novel findings, gonadotropin-related effects such as hypothalamo-pituitary-gonadal axis activation and testicular descent were observed in 2 patients. Growth deceleration was noted in 2 children, and recovery from central hypothyroidism in 1 patient with POMC deficiency. Overall, setmelanotide appears to be effective and well-tolerated in young children with monogenic obesity. However, further studies are necessary to evaluate the long-term effects of early intervention on growth and pubertal development.</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":"192 2","pages":"K15-K18"},"PeriodicalIF":5.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074178","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":"Body composition and cardiometabolic risks of patients with adrenal tumours in relation to hormonal activity: a large cross-sectional single-centre study.","authors":"Jung Hee Kim, Han Na Jang, Seung Shin Park, Jeong Hee Yoon, Young Min Cho, Sang Joon Park, Jeong Min Lee, Ji Won Yoon","doi":"10.1093/ejendo/lvae167","DOIUrl":"https://doi.org/10.1093/ejendo/lvae167","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to examine how different types of adrenal hormone excess influence body composition.</p><p><strong>Design: </strong>A retrospective, cross-sectional, single-centre study.</p><p><strong>Methods: </strong>We retrospectively enrolled 2971 consecutive adults with adrenal tumours and age-, sex-, and body mass index-matched controls at a 1:3 ratio. The area and attenuation of skeletal muscle and fat at the L3 vertebrae were measured using computed tomography-based analysis software. Prevalence ratios of cardiometabolic outcomes were calculated using the Poisson regression.</p><p><strong>Results: </strong>Patients with non-functioning adenoma (n = 1354) and mild autonomous cortisol secretion (MACS; n = 786) showed similar body compositions. Patients with overt Cushing's syndrome (CS) had the highest visceral fat (VF) area to skeletal muscle area ratio (1.14), while pheochromocytoma (PHEO) patients had the lowest (0.52). Muscle attenuation was lowest in CS and highest in PHEO (32.6 vs 41.5 Hounsfield units, P < .001). Mild autonomous cortisol secretion patients had higher risks of hypertension and dyslipidaemia than non-functioning adenoma patients. Non-functioning adenoma and MACS patients had higher VF area and lower muscle/fat attenuation compared with controls, while primary aldosteronism patients had body compositions similar to controls, except for higher fat attenuation.</p><p><strong>Conclusions: </strong>Adrenal tumours are associated with altered body composition. Even patients with non-functioning adenoma and MACS had increased VF area and lower muscle and fat attenuation compared with controls, indicating potential cardiometabolic risks.</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":"192 2","pages":"141-149"},"PeriodicalIF":5.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556169","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":"Levothyroxine supplementation trials in preconception and pregnant women.","authors":"Rebecca Man, Rima Dhillon-Smith, Tim I M Korevaar","doi":"10.1093/ejendo/lvaf012","DOIUrl":"10.1093/ejendo/lvaf012","url":null,"abstract":"<p><p>Thyroid disorders are common in women of childbearing age, representing the second most prevalent endocrine disorder in this population. Low thyroid function preconception and during pregnancy has been associated with a range of adverse outcomes including subfertility, miscarriage, preterm birth, and ongoing health problems in the neonate. Levothyroxine (LT4) treatment is routinely used in women with overt hypothyroidism (OH) to achieve a euthyroid status and consequently reduce the risk of these adverse outcomes. However, in other groups, such as those with subclinical hypothyroidism (SCH) or thyroid autoimmunity, the evidence is less clear and subsequently guidelines differ in their recommendations. Here we explore key trials exploring the use of LT4 in different types of thyroid disorder, including OH, SCH, isolated hypothyroxinemia, and thyroid autoimmunity. We examine how these disorders are defined in different trials, the specifics of the populations included, and the varying timing and dosage of LT4. By exploring the limitations of these trials and the interactions between results, we highlight issues for future research and practical considerations for policy-makers and clinicians caring for women with low thyroid function during preconception and pregnancy.</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":" ","pages":"R7-R15"},"PeriodicalIF":5.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406462","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}