Expert Review of Endocrinology & Metabolism最新文献_第8页

The vascular complications of diabetes: a review of their management, pathogenesis, and prevention. 糖尿病的血管并发症：管理、发病机制和预防综述。

IF 3.2

Expert Review of Endocrinology & Metabolism Pub Date : 2024-01-01 DOI: 10.1080/17446651.2023.2279533

Juliet Meir, Lillian Huang, Sumaita Mahmood, Harris Whiteson, Scott Cohen, Wilbert S Aronow

{"title":"The vascular complications of diabetes: a review of their management, pathogenesis, and prevention.","authors":"Juliet Meir, Lillian Huang, Sumaita Mahmood, Harris Whiteson, Scott Cohen, Wilbert S Aronow","doi":"10.1080/17446651.2023.2279533","DOIUrl":"10.1080/17446651.2023.2279533","url":null,"abstract":"Introduction: This review highlights the pathogenesis of both microvascular and macrovascular complications of diabetes and how these mechanisms influence both the management and preventative strategies of these complications. The cumulative data shown in this review suggest hyperglycemic and blood pressure control remain central to this intricate process.Areas covered: We reviewed the literature including retrospective, prospective trials as well as meta-analysis, and post hoc analysis of randomized trials on microvascular andmacrovascular complications.Expert opinion: Further research is needed to explore the ideal intervention targets and preventative strategies needed to prevent macrovascular complications. Furthermore, as the data for trials looking at microvascular complications lengthen more long-term data will further elucidate the role that the duration of diabetes has on these complications. Additionally, trials looking to maximize hyperglycemic control with multiple agents in diabetes, such as metformin, SGL2isand GLP-1 receptor agonists are currently in process, which will have implications for rates of microvascular as well as macrovascular complications.","PeriodicalId":12107,"journal":{"name":"Expert Review of Endocrinology & Metabolism","volume":" ","pages":"11-20"},"PeriodicalIF":3.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72014036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Is inverse association between lipoprotein(a) and diabetes mellitus another paradox in cardiometabolic medicine? 脂蛋白（a）与糖尿病之间的反向关联是心血管代谢医学中的另一个悖论吗？

IF 3.2

Expert Review of Endocrinology & Metabolism Pub Date : 2024-01-01 DOI: 10.1080/17446651.2023.2293108

Donatos Tsamoulis, Constantine E Kosmas, Loukianos S Rallidis

{"title":"Is inverse association between lipoprotein(a) and diabetes mellitus another paradox in cardiometabolic medicine?","authors":"Donatos Tsamoulis, Constantine E Kosmas, Loukianos S Rallidis","doi":"10.1080/17446651.2023.2293108","DOIUrl":"10.1080/17446651.2023.2293108","url":null,"abstract":"Introduction: The impact of Type II Diabetes mellitus (T2DM) on cardiovascular disease (CVD) is well-established, while lipoprotein(a) [Lp(a)] has recently emerged as a recognized CVD risk factor. The rising prevalence of T2DM resulting from modern lifestyles and the development of specific Lp(a)-lowering agents brought the association between T2DM and Lp(a) in the forefront.Areas covered: Despite advancements in T2DM treatment, diabetic patients remain at very-high risk of CVD. Lp(a) may, to some extent, contribute to the persistent CVD risk seen in diabetic patients, and the coexistence of T2DM and elevated Lp(a) levels appears to synergistically amplify overall CVD risk. The relationship between T2DM and Lp(a) is paradoxical. On one hand, high Lp(a) plasma concentrations elevate the risk of diabetic microvascular and macrovascular complications. On the other hand, low Lp(a) plasma concentrations have been linked to an increased risk of developing T2DM.Expert opinion: Comprehending the association between T2DM and Lp(a) is critical due to the pivotal roles both entities play in overall CVD risk, as well as the unique aspects of their relationship. The mechanisms underlying the inverse association between T2DM and Lp(a) remain incompletely understood, necessitating further meticulous research.","PeriodicalId":12107,"journal":{"name":"Expert Review of Endocrinology & Metabolism","volume":" ","pages":"63-70"},"PeriodicalIF":3.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138801059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Different doses of imeglimin for management of type 2 diabetes mellitus: a systematic review, meta-analysis, and meta-regression of randomized clinical trials. 不同剂量的依米明治疗2型糖尿病:随机临床试验的系统回顾、荟萃分析和荟萃回归

IF 3.2

Expert Review of Endocrinology & Metabolism Pub Date : 2024-01-01 DOI: 10.1080/17446651.2023.2290488

Hikmat Permana, Nanny Natalia Mulyani Soetedjo, Theo Audi Yanto, Marshell Tendean, Timotius Ivan Hariyanto, Ketut Suastika

{"title":"Different doses of imeglimin for management of type 2 diabetes mellitus: a systematic review, meta-analysis, and meta-regression of randomized clinical trials.","authors":"Hikmat Permana, Nanny Natalia Mulyani Soetedjo, Theo Audi Yanto, Marshell Tendean, Timotius Ivan Hariyanto, Ketut Suastika","doi":"10.1080/17446651.2023.2290488","DOIUrl":"10.1080/17446651.2023.2290488","url":null,"abstract":"Background: A new medication for type 2 diabetes mellitus (T2DM) called imeglimin can target all three organs involved in the pathogenesis of DM, namely the liver, skeletal muscles, and pancreas. This research seeks to examine the most efficacious and safe dose of imeglimin for the management of T2DM.Research design and methods: Using particular keywords, we searched the CENTRAL, Medline, Scopus, and ClinicalTrials.gov databases for pertinent literature. The results of continuous variables were pooled into the mean difference (MD) and dichotomous variables into odds ratio (OR) along with their 95% confidence intervals (95% CI) using fixed-effect models.Results: Our pooled analysis revealed that imeglimin 1000 mg twice daily [MD -0.90% p < 0.00001] and 1500 mg twice daily [MD -0.84% p = 0.0003] as monotherapy was associated with a higher reduction in the HbA1c compared to placebo. This superiority was still maintained when given as combination therapy. Regrettably, there was an observed escalation in gastrointestinal AEs as the dosage of imeglimin was raised, despite the absence of a corresponding improvement in its efficacy in decreasing HbA1c levels.Conclusions: Our study suggests that imeglimin 1000 mg twice daily may offer the most optimum therapeutic effects for glycemic control without compromising its safety profiles.","PeriodicalId":12107,"journal":{"name":"Expert Review of Endocrinology & Metabolism","volume":" ","pages":"89-98"},"PeriodicalIF":3.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138477048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diagnosis and management of post-bariatric surgery hypoglycemia. 减肥手术后低血糖症的诊断和治疗。

IF 3.2

Expert Review of Endocrinology & Metabolism Pub Date : 2023-09-01 Epub Date: 2023-11-28 DOI: 10.1080/17446651.2023.2267136

Lina Alkhaled, Abbas Al-Kurd, W Scott Butsch, Sangeeta R Kashyap, Ali Aminian

{"title":"Diagnosis and management of post-bariatric surgery hypoglycemia.","authors":"Lina Alkhaled, Abbas Al-Kurd, W Scott Butsch, Sangeeta R Kashyap, Ali Aminian","doi":"10.1080/17446651.2023.2267136","DOIUrl":"10.1080/17446651.2023.2267136","url":null,"abstract":"Introduction: While bariatric surgery remains the most effective treatment for obesity that allows substantial weight loss with improvement and possibly remission of obesity-associated comorbidities, some postoperative complications may occur. Managing physicians need to be familiar with the common problems to ensure timely and effective management. Of these complications, postoperative hypoglycemia is an increasingly recognized complication of bariatric surgery that remains underreported and underdiagnosed.Area covered: This article highlights the importance of identifying hypoglycemia in patients with a history of bariatric surgery, reviews pathophysiology and addresses available nutritional, pharmacological and surgical management options. Systemic evaluation including careful history taking, confirmation of hypoglycemia and biochemical assessment is essential to establish accurate diagnosis. Understanding the weight-dependent and weight-independent mechanisms of improved postoperative glycemic control can provide better insight into the causes of the exaggerated responses that lead to postoperative hypoglycemia.Expert opinion: Management of post-operative hypoglycemia can be challenging and requires a multidisciplinary approach. While dietary modification is the mainstay of treatment for most patients, some patients may benefit from pharmacotherapy (e.g. GLP-1 receptor antagonist); Surgery (e.g. reversal of gastric bypass) is reserved for unresponsive severe cases. Additional research is needed to understand the underlying pathophysiology with a primary aim in optimizing diagnostics and treatment options.","PeriodicalId":12107,"journal":{"name":"Expert Review of Endocrinology & Metabolism","volume":" ","pages":"459-468"},"PeriodicalIF":3.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41233602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The impact of neuropsychological functions on self-care/self-management of type 2 diabetes in middle-aged people: a scoping review and meta-analysis. 神经心理功能对中年人2型糖尿病自我护理/自我管理的影响：范围界定综述和荟萃分析。

IF 2.7

Expert Review of Endocrinology & Metabolism Pub Date : 2023-09-01 Epub Date: 2023-11-28 DOI: 10.1080/17446651.2023.2268171

Hsiao-Mei Chen, Chien-Ning Huang, Ro-Ting Lin, Bei-Yi Su

{"title":"The impact of neuropsychological functions on self-care/self-management of type 2 diabetes in middle-aged people: a scoping review and meta-analysis.","authors":"Hsiao-Mei Chen, Chien-Ning Huang, Ro-Ting Lin, Bei-Yi Su","doi":"10.1080/17446651.2023.2268171","DOIUrl":"10.1080/17446651.2023.2268171","url":null,"abstract":"Introduction: This study aimed to investigate the impact of neuropsychological functions on self-care/self-management in middle-aged individuals with type 2 diabetes (T2DM).Areas covered: A comprehensive literature search was conducted from January 2012 to April 2023 across multiple databases. Ten articles were included in the scoping review, and 3 articles were included in the meta-analysis. The findings consistently indicated an association between reduced neuropsychological functions and poor self-care/self-management in this population. Memory functions, executive functions, and other domains were found to be significantly related to self-care/self-management, including diet management, exercise, blood glucose monitoring, and foot care.Expert opinion: This study highlights the importance of considering neuropsychological factors in understanding and improving diabetes management outcomes. The findings underscore the need for comprehensive neuropsychological assessments and the development of targeted interventions to address specific vulnerable domains. Future research should focus on elucidating underlying mechanisms, addressing methodological inconsistencies, and exploring the effectiveness of interventions targeting neuropsychological impairments. Incorporating technology and personalized approaches into diabetes management can enhance self-care/self-management and clinical outcomes in individuals with T2DM.","PeriodicalId":12107,"journal":{"name":"Expert Review of Endocrinology & Metabolism","volume":" ","pages":"525-540"},"PeriodicalIF":2.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41195892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The current role of SGLT2 inhibitors in type 2 diabetes and beyond: a narrative review. SGLT2抑制剂在2型糖尿病及其后疾病中的作用：叙述性综述。

IF 3.2

Expert Review of Endocrinology & Metabolism Pub Date : 2023-09-01 Epub Date: 2023-05-08 DOI: 10.1080/17446651.2023.2210673

André J Scheen

{"title":"The current role of SGLT2 inhibitors in type 2 diabetes and beyond: a narrative review.","authors":"André J Scheen","doi":"10.1080/17446651.2023.2210673","DOIUrl":"10.1080/17446651.2023.2210673","url":null,"abstract":"Introduction: Sodium-glucose cotransporter 2 inhibitors (SGLT2is, gliflozins), the most recent oral antihyperglycaemic agents, provide a cardiorenal protection, an effect independent of their glucose-lowering potency.Areas covered: The antihyperglycaemic potency of SGLT2is was compared with that of dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 receptor agonists, especially when added to metformin monotherapy. Main results of cardiovascular/renal outcome trials with SGLT2is were summarized in different populations: patients with type 2 diabetes mellitus (T2DM) with or without established cardiovascular disease, patients (with or without T2DM) with heart failure (with reduced or preserved left ventricular ejection fraction) and in patients (with or without T2DM) with chronic kidney disease (CKD, including stage 4). Original papers and meta-analyses of these different trials have consistently reported a reduction in hospitalization for heart failure (alone or combined with cardiovascular mortality) and a reduced progression of CKD, with an overall good safety profile.Expert opinion: Global use of SGLT2is has increased over time but remains suboptimal despite clinically relevant cardiovascular and renal protection, particularly in patients most likely to benefit. SGLT2is has proven both positive benefit-risk balance and cost-effectiveness in at risk patients. New prospects are expected in other complications, i.e. metabolic-associated fatty liver disease and neurodegenerative disorders.","PeriodicalId":12107,"journal":{"name":"Expert Review of Endocrinology & Metabolism","volume":"18 4","pages":"271-282"},"PeriodicalIF":3.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9852532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Endocrine factors associated with infertility in women: an updated review. 与女性不孕相关的内分泌因素：最新综述。

IF 3.2

Expert Review of Endocrinology & Metabolism Pub Date : 2023-09-01 Epub Date: 2023-09-13 DOI: 10.1080/17446651.2023.2256405

Marcio José Concepción-Zavaleta, Julia Cristina Coronado-Arroyo, Juan Eduardo Quiroz-Aldave, María Del Carmen Durand-Vásquez, Sofía Pilar Ildefonso-Najarro, Luciana Del Pilar Rafael-Robles, Luis Alberto Concepción-Urteaga, Elman Rolando Gamarra-Osorio, Jacsel Suárez-Rojas, José Paz-Ibarra

{"title":"Endocrine factors associated with infertility in women: an updated review.","authors":"Marcio José Concepción-Zavaleta, Julia Cristina Coronado-Arroyo, Juan Eduardo Quiroz-Aldave, María Del Carmen Durand-Vásquez, Sofía Pilar Ildefonso-Najarro, Luciana Del Pilar Rafael-Robles, Luis Alberto Concepción-Urteaga, Elman Rolando Gamarra-Osorio, Jacsel Suárez-Rojas, José Paz-Ibarra","doi":"10.1080/17446651.2023.2256405","DOIUrl":"10.1080/17446651.2023.2256405","url":null,"abstract":"Introduction: Infertility is defined as the inability to conceive after unprotected sexual intercourse for at least 12 consecutive months. Our objective is to present an updated narrative review on the endocrine causes of infertility in women.Areas covered: A comprehensive review was conducted using Scielo, Scopus, and EMBASE databases, comprising 245 articles. The pathophysiology of infertility in women was described, including endocrinopathies such as hypothalamic amenorrhea, hyperprolactinemia, polycystic ovary syndrome, primary ovarian insufficiency, obesity, thyroid dysfunction, and adrenal disorders. The diagnostic approach was outlined, emphasizing the necessity of hormonal studies and ovarian response assessments. Additionally, the treatment plan was presented, commencing with non-pharmacological interventions, encompassing the adoption of a Mediterranean diet, vitamin supplementation, moderate exercise, and maintaining a healthy weight. Subsequently, pharmacological treatment was discussed, focusing on the management of associated endocrine disorders and ovulatory dysfunction.Expert opinion: This comprehensive review highlights the impact of endocrine disorders on fertility in women, providing diagnostic and therapeutic algorithms. Despite remaining knowledge gaps that hinder more effective treatments, ongoing research and advancements show promise for improved fertility success rates within the next five years. Enhanced comprehension of the pathophysiology behind endocrine causes and the progress in genetic research will facilitate the delivery of personalized treatments, thus enhancing fertility rates.","PeriodicalId":12107,"journal":{"name":"Expert Review of Endocrinology & Metabolism","volume":" ","pages":"399-417"},"PeriodicalIF":3.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10215357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of group medical visits on patient engagement and quality of life. 团体就诊对患者参与度和生活质量的影响。

IF 3.2

Expert Review of Endocrinology & Metabolism Pub Date : 2023-09-01 Epub Date: 2023-11-28 DOI: 10.1080/17446651.2023.2268716

Charlotte T Boyd, John G Spangler, Carmen G Strickland, Jennifer E Roper, Julienne K Kirk

{"title":"Impact of group medical visits on patient engagement and quality of life.","authors":"Charlotte T Boyd, John G Spangler, Carmen G Strickland, Jennifer E Roper, Julienne K Kirk","doi":"10.1080/17446651.2023.2268716","DOIUrl":"10.1080/17446651.2023.2268716","url":null,"abstract":"Background: Group medical visits (GMV) effectively improve patient care and outcomes through interactive education, increased patient contact, and facilitated social support. This quality improvement research examined if patient activation and quality of life correlate with weight, blood pressure (BP), and hemoglobin A1c (A1C) through GMV interventions.Methods: Participants were enrolled in GMV Lighten Up for weight management or GMV Diabetes. At pre- and post-intervention, patients completed the Patient Activation Measure (PAM) and the health-related quality of life measure, the SF-12; and were assessed for weight, blood pressure (BP), and hemoglobin A1c (A1C).Results: Weight and PAM scores significantly improved regardless of group. For patients in GMV Diabetes, A1C significantly decreased. GMV Lighten Up participants had statistically significant declines in diastolic BP. Both groups improved patient activation, but statistically significantly so only in GMV Diabetes participants. SF-12 scores did not statistically significantly improve. There were no predictors of A1C and PAM score change for the Diabetes GMV. However, age, SBP and SF-12 scores predicted PAM score changes in GMV Lighten up participants.Conclusions: Participants in this study showed overall improvement in biomarkers and patient activation. Thus, GMV continue to be a viable method for healthcare delivery.","PeriodicalId":12107,"journal":{"name":"Expert Review of Endocrinology & Metabolism","volume":" ","pages":"549-554"},"PeriodicalIF":3.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41195891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Treatment of vitamin D deficiency in children. 儿童维生素D缺乏症的治疗。

IF 3.2

Expert Review of Endocrinology & Metabolism Pub Date : 2023-09-01 Epub Date: 2023-11-28 DOI: 10.1080/17446651.2023.2270053

Philip R Fischer, Casey R Johnson, Kaitlin N Leopold, Thomas D Thacher

{"title":"Treatment of vitamin D deficiency in children.","authors":"Philip R Fischer, Casey R Johnson, Kaitlin N Leopold, Thomas D Thacher","doi":"10.1080/17446651.2023.2270053","DOIUrl":"10.1080/17446651.2023.2270053","url":null,"abstract":"Introduction: Vitamin D deficiency affects from 10% to 50% in various pediatric population groups and causes life-threatening hypocalcemia in infants, crippling rickets in infants and children, and increased risk of subsequent adult metabolic and neurologic problems.Areas covered: An English language literature search of PubMed was performed since 1940 as were the authors' personal literature collections. References identified in the reviewed literature are considered.Diagnosis: The diagnosis of vitamin D deficiency is based on serum 25-hydroxyvitamin D levels. Clinical features of rickets include bone deformities and elevated alkaline phosphatase. Most children and adolescents who are biochemically vitamin D deficient do not have specific symptoms or signs of deficiency.Prevention: Prevention of vitamin D deficiency is via exposure to sunshine, food and beverage fortification, and dietary supplementation.Treatment: Effective treatment of vitamin D deficiency is via oral or injectable administration of vitamin D. Dosing and duration of vitamin D therapy have been described for healthy children and for children with underlying medical conditions, but recommendations vary.Expert opinion: Further investigation is needed to determine long-term non-skeletal effects of childhood vitamin D deficiency, benefits of supplementation in asymptomatic individuals with biochemical vitamin D deficiency, and appropriate screening for vitamin D deficiency in asymptomatic children and adolescents.","PeriodicalId":12107,"journal":{"name":"Expert Review of Endocrinology & Metabolism","volume":" ","pages":"489-502"},"PeriodicalIF":3.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49675965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bone health and prevalent fractures in women with polycystic ovary syndrome: a meta-analysis and endocrine-context pathophysiology review. 多囊卵巢综合征妇女的骨健康和常见骨折：一项荟萃分析和内分泌相关病理生理学综述。

IF 3.2

Expert Review of Endocrinology & Metabolism Pub Date : 2023-09-01 Epub Date: 2023-05-30 DOI: 10.1080/17446651.2023.2216294

Jerilynn C Prior, Sonia Shirin, Azita Goshtasebi

{"title":"Bone health and prevalent fractures in women with polycystic ovary syndrome: a meta-analysis and endocrine-context pathophysiology review.","authors":"Jerilynn C Prior, Sonia Shirin, Azita Goshtasebi","doi":"10.1080/17446651.2023.2216294","DOIUrl":"10.1080/17446651.2023.2216294","url":null,"abstract":"Introduction: Bone health in those with Polycystic Ovary Syndrome (PCOS) is complex, but the general consensus is that cortical areal bone mineral density (aBMD) sites will be higher in PCOS than in age- and BMI-similar controls. However, spine aBMD sites may be lower, especially in non-obese PCOS. Whether or not incident fracture risk is increased in PCOS is currently controversial; no meta-analysis has yet assessed prevalent fractures.Areas covered: We assessed the bone effects of PCOS-related ovarian hormone alterations, e.g. androgen excess, tonically normal/higher estradiol, and lower-than-normal progesterone levels. We also highlighted evidence that common PCOS medications (e.g. combined hormonal contraceptives [CHC], metformin, and spironolactone) have important bone effects. In adolescents, meta-analysis of CHC showed significant negative aBMD changes. Inflammation has negative PCOS bone effects and is linked with CHC use.Expert opinion: Is fracture risk altered by PCOS? Our meta-analysis showed a 25% increased risk of prevalent fracture in PCOS versus controls; this did not reach statistical significance. Future prospective research needs to collect and evaluate ovulation characteristics, progesterone exposure, and adolescent CHC use, in addition to the complex variables that may influence risks for prevalent or incident fragility fractures and/or for cortical and cancellous aBMD values in PCOS.","PeriodicalId":12107,"journal":{"name":"Expert Review of Endocrinology & Metabolism","volume":"18 4","pages":"283-293"},"PeriodicalIF":3.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9909060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0