Frontiers in Endocrinology最新文献

{"title":"Multicenter cohort study reveals: composite inflammatory indexs are associated with increased risk of diabetes in patients with hypertension.","authors":"Fengyou Yao, Junqi Gou, Xiao Zhu, Kai Tang, Chaohui Liu","doi":"10.3389/fendo.2026.1819071","DOIUrl":"https://doi.org/10.3389/fendo.2026.1819071","url":null,"abstract":"<p><strong>Background: </strong>Patients with hypertension commonly exhibit a persistent chronic inflammatory state. Accumulating evidence suggests that inflammation can induce insulin resistance, which is a key pathological mechanism in the development of diabetes. However, whether composite inflammatory indices are independently associated with the risk of incident diabetes in hypertensive patients remains insufficiently supported by current evidence.</p><p><strong>Methods: </strong>Multivariable-adjusted Cox proportional hazards regression models were used to assess the associations between composite inflammatory indices and the risk of incident diabetes in patients with hypertension. Kaplan-Meier (KM) curves were generated to visually depict the cumulative incidence of diabetes across different levels of these inflammatory indices. Furthermore, comparative analyses were conducted to identify the most predictive composite inflammatory marker.</p><p><strong>Results: </strong>Cox regression analysis revealed that elevated composite inflammatory indices were significantly associated with an increased risk of incident diabetes in patients with hypertension. KM curves further demonstrated that individuals with higher inflammatory levels exhibited a significantly higher cumulative incidence of diabetes during follow-up compared to those with lower levels. Moreover, comparative analyses among the inflammatory markers identified the inflammatory burden index (IBI) as the most effective predictor of diabetes risk.</p><p><strong>Conclusion: </strong>This study demonstrates that elevated composite inflammatory indices are closely associated with an increased risk of future diabetes in patients with hypertension, with a notable threshold effect. These findings suggest that actively controlling inflammatory levels may help reduce the risk of diabetes in this population. Furthermore, the IBI holds promise as a simple and accessible risk assessment tool for screening and early identification of individuals at high risk for diabetes.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"17 ","pages":"1819071"},"PeriodicalIF":4.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning screening of risk factors for diabetic microvascular complications and construction of a gradient boosting decision tree predictive model.","authors":"Min Xiao, Yuhao Fu, Yan Li, Qian Liu, Xianyi Qiao, Hongjin Zhang, Xingxing Zhu, Jiajia Wang","doi":"10.3389/fendo.2026.1784699","DOIUrl":"https://doi.org/10.3389/fendo.2026.1784699","url":null,"abstract":"<p><strong>Objective: </strong>To develop a machine learning-based classification model to aid in the early diagnosis of diabetic microvascular complications.</p><p><strong>Methods: </strong>This study analyzed clinical and laboratory data from 1,498 patients, categorized into two groups: diabetes alone and diabetes with microvascular complications. Independent risk factors for complications were identified through intergroup comparison, collinearity analysis, and logistic regression. Nine machine learning models were subsequently developed and compared. A comprehensive evaluation of the binary classification performance of the Gradient Boosting Decision Tree (GBDT) model was performed.</p><p><strong>Results: </strong>Urea, fibrinogen (FIB), prothrombin time (PT), D-dimer (DD), creatine kinase MB isoenzyme (CKMB), lipoprotein(a) (Lpa), activated partial thromboplastin time (APTT), triglycerides (TG), and cholinesterase (CHE) were identified as independent risk factors for diabetic microvascular complications. Among the nine predictive models constructed, the GBDT model demonstrated superior performance across multiple metrics, including the area under the receiver operating characteristic curve (AUC) and sensitivity, indicating strong generalization ability on the validation set. Further evaluation confirmed its consistent and robust predictive performance across training, validation, and test datasets. Calibration curve analysis showed good agreement between predicted probabilities and actual outcomes. Decision curve analysis demonstrated the model's clinical utility, and the Kolmogorov-Smirnov (KS) curve indicated excellent discriminatory power.</p><p><strong>Conclusion: </strong>The GBDT model, constructed based on the identified risk factors, exhibits outstanding predictive performance and promising application potential. It provides important theoretical support and a practical tool for the early identification and targeted intervention of diabetic microvascular complications.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"17 ","pages":"1784699"},"PeriodicalIF":4.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Steroid hormones in early pregnancy and adverse birth outcomes: a Chinese birth cohort.","authors":"Weixiang Wu, Cunwei Ji, Hongyu Li, Fuqiang Diao, Lihong Wu, Xiaolin Ruan, Youwen Luo, Mingyong Luo","doi":"10.3389/fendo.2026.1667039","DOIUrl":"https://doi.org/10.3389/fendo.2026.1667039","url":null,"abstract":"<p><strong>Background: </strong>Adverse birth outcomes (ABOs) are major public health concerns. While maternal steroid hormones are essential for fetal development, their individual and combined effects on ABO remain unclear.</p><p><strong>Methods: </strong>This prospective cohort study included 364 pregnant women (30.7 ± 4.0 years) in Guangzhou, China. Nineteen steroid hormones were measured by LC-MS/MS. Regression and Qgcomp models were used to assess individual and combined associations with ABO, including low birth weight, macrosomia, small for gestational age (SGA), large for gestational age, and preterm birth.</p><p><strong>Results: </strong>Pregnant women with ABO had higher levels of androstenedione (A4) and testosterone (T) and lower levels of 11-deoxycortisol (11-DOF) and estriol (E3). In linear regression models, each 1-SD increase in cortisol (F) was associated with increases of 0.18 cm (95% CI: 0.02, 0.34) in birth length and 0.24 cm (95% CI: 0.04, 0.44) in head circumference, whereas estrone (E1) was inversely associated with gestational age (-0.20 weeks, 95% CI: -0.36, -0.05). In logistic regression analyses, each 1-SD increase in A4 (OR = 1.36, 95% CI: 1.07, 1.72), T (OR = 1.37, 95% CI: 1.08, 1.73), and dihydrotestosterone (DHT) (OR = 1.32, 95% CI: 1.03, 1.69) was associated with higher odds of ABO, whereas 11-DOF was inversely associated with ABO (OR = 0.70, 95% CI: 0.50, 0.98). For SGA, each 1-SD increase in A4 (OR = 1.40, 95% CI: 1.01, 1.94) and T (OR = 1.47, 95% CI: 1.08, 1.99) was associated with increased risk, whereas F (OR = 0.84, 95% CI: 0.72, 0.97) and 11-DOF (OR = 0.58, 95% CI: 0.35, 0.95) were inversely associated. In Qgcomp analyses, the androgen mixture was associated with ABO (OR = 1.40, 95% CI: 1.00, 1.97) and SGA (OR = 1.77, 95% CI: 1.04, 3.01), with A4 and T contributing the largest weights. Consistent directional patterns were observed for androgen-related hormones across outcomes and analytical approaches.</p><p><strong>Conclusions: </strong>Maternal hormonal milieu in early pregnancy may be associated with fetal growth and ABO risk, with consistent patterns for androgen-related hormones. These findings are exploratory and require validation in larger cohorts.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"17 ","pages":"1667039"},"PeriodicalIF":4.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"24-hour diastolic blood pressure average real variability predicts renal progression in diabetic kidney disease: a comprehensive cohort study.","authors":"Yanqing Hu, Shan Ma, Ting Yu, Dan Wu, Yang Wu","doi":"10.3389/fendo.2026.1834470","DOIUrl":"https://doi.org/10.3389/fendo.2026.1834470","url":null,"abstract":"<p><strong>Objective: </strong>Diabetic kidney disease (DKD) is the leading cause of end-stage renal disease (ESRD) worldwide. Blood pressure variability (BPV), especially diastolic BPV (DBPV), is closely linked to renal microcirculation but remains understudied in DKD. This study aimed to evaluate the association of DBPV with renal progression, identify an optimal risk threshold, and explore antihypertensive drug implications.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 2,143 DKD patients who underwent 24-hour ambulatory BP monitoring (ABPM) between 2018 and 2022, with a median follow-up of 4.8 years. Multiple DBPV parameters including standard deviation (SD), coefficient of variation (CV), average real variability (ARV), and nocturnal dipping were analyzed. Dynamic changes in DBPV were assessed in 1,328 patients with serial ABPM data.</p><p><strong>Results: </strong>After full adjustment, 24-hour DBP ARV was the strongest predictor of renal outcomes. Each 1 mmHg increase was associated with 18% higher odds of rapid estimated glomerular filtration rate (eGFR) decline (OR = 1.18, 95%CI:1.13-1.23), 22% higher ESRD risk (HR = 1.22, 95%CI:1.15-1.29), and 20% higher composite renal event risk (HR = 1.20, 95%CI:1.14-1.26). ROC analysis determined the optimal threshold of 24-hour DBP ARV for ESRD prediction as 10.2 mmHg (sensitivity=76.2%, specificity=61.8%), above which ESRD risk increased 3.1-fold. Patients with increased DBPV over time had a 2.4-fold higher ESRD risk than those with decreased DBPV. Calcium channel blockers (CCBs) were associated with lower DBP ARV than RAAS inhibitors or beta-blockers. Adding 24-hour DBP ARV to traditional risk models significantly improved ESRD prediction (C-statistic: 0.73 to 0.80). The association was stronger in patients with advanced DKD or severely increased albuminuria, and combined high DBP ARV and SBP ARV conferred a 4.5-fold higher ESRD risk.</p><p><strong>Conclusion: </strong>24-hour DBP ARV (threshold 10.2 mmHg) is an independent predictor of renal progression in DKD. Rising DBPV amplifies renal risk, and CCBs may better reduce DBPV. Incorporating ABPM-derived DBPV into DKD management improves risk stratification and supports personalized interventions.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"17 ","pages":"1834470"},"PeriodicalIF":4.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of preadmission metformin use and prognosis in patients with sepsis with diabetes: a systematic review and meta-analysis.","authors":"Mingying Zhang, Zhibin Lin, Chao Chen, Xiaoze Zhong, Weijun Liu, Zhanmao Chen, Tietao Chen, Chengqing Song, Guanyuan Tian, Kefei Wu","doi":"10.3389/fendo.2026.1815219","DOIUrl":"https://doi.org/10.3389/fendo.2026.1815219","url":null,"abstract":"<p><strong>Background: </strong>Preadmission metformin may lower mortality in diabetic sepsis patients, but evidence is conflicting, necessitating a systematic review and meta-analysis for confirmation.</p><p><strong>Methods: </strong>We systematically searched MEDLINE (via PubMed), EMBASE, and Cochrane CENTRAL from inception to September 1, 2025, for cohort studies evaluating metformin use in septic patients with diabetes. Study quality was assessed using the Newcastle-Ottawa Scale. Two reviewers independently screened studies, extracted data, and evaluated methodological quality. Meta-analysis was conducted using STATA statistical software and Review Manager software, calculating pooled odds ratios with 95% confidence intervals via the inverse variance random-effects model. The MET group included diabetic sepsis patients with preadmission metformin exposure, and the NM group included those without.</p><p><strong>Results: </strong>This meta-analysis of 14 studies (12,687 patients), all with low bias risk, demonstrated that preadmission metformin use in sepsis-diabetes patients was associated with reduced overall mortality (OR 0.58, 95% CI 0.44-0.75, P < 0.00001). Significant reductions were observed in 28-day (OR 0.61, P = 0.002), 90-day (OR 0.48, P = 0.001), 365-day (OR 0.33, P = 0.0005), and in-hospital mortality (OR 0.43, P < 0.02). However, 30-day (OR 0.71, P = 0.06), 60-day (OR 0.72, P = 0.22), and ICU mortality (OR 0.76, P = 0.25) showed no significant differences. Notably, metformin also significantly improved serum creatinine (MD -0.32, P = 0.04) and metformin usage was associated with elevated serum lactate levels.</p><p><strong>Conclusions: </strong>This meta-analysis links preadmission metformin use in diabetic sepsis patients to reduced mortality-particularly 28-day, 90-day, 365-day, and in-hospital-along with decreased serum creatinine. Clinically and from a public health standpoint, these data support the integration of metformin history as a favorable prognostic indicator into updated clinical guidelines, thereby informing future antimicrobial stewardship and sepsis bundle strategies. These findings support further evaluation of metformin's benefits in large-scale, multicenter randomized controlled trials.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"17 ","pages":"1815219"},"PeriodicalIF":4.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"J-shaped relationship between creatinine levels and the risk of three major adverse events in patients after percutaneous coronary intervention.","authors":"Xiang Zhu, Xiaqin Zha, Jiali Su, Yuanan Lu, Chao Yu, Lei Wu","doi":"10.3389/fendo.2026.1832279","DOIUrl":"https://doi.org/10.3389/fendo.2026.1832279","url":null,"abstract":"<p><strong>Background and aims: </strong>To evaluate the correlation between creatinine (Cre) level and the risk of three kinds of adverse events in patients after percutaneous coronary intervention (PCI), and to clarify its potential correlation threshold and independent predictive value.</p><p><strong>Methods and results: </strong>This investigation was designed as a retrospective cohort analysis, encompassing 3, 878 individuals diagnosed with acute myocardial infarction who received PCI between January 2018 and December 2020. The primary outcomes were three types of adverse events that occurred post-procedure. To explore the relationship between Cre levels and the outcome measures, a restricted cubic spline model was employed, while the Cox proportional hazards regression model assessed the independent predictive significance. There were 996 instances (25.7%) of adverse events reported. The evaluation using a restricted cubic spline model revealed a notable J-shaped relationship between creatinine levels and the likelihood of three types of adverse events following PCI (nonlinear <i>P</i> < 0.05), with the inflection point identified at 110 μmol/L. When considering Cre=110 μmol/L as the baseline, patients with Cre levels below this threshold (low value group) exhibited a 15.5% increase in MACE risk (95% CI: 1.006-1.327, <i>P</i> = 0.0416), a 15.6% increase in NACE risk (95% CI: 1.004-1.330, <i>P</i> = 0.0436) and a 16.1% increase in MACCE risk (95% CI: 1.015-1.329, <i>P</i> = 0.0301).</p><p><strong>Conclusion: </strong>There is a J-shaped correlation between Cre level and the risk of three kinds of adverse events in patients after PCI, and the inflection point of 110 μmol/L can be used as the key threshold for clinical risk stratification and individualized intervention.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"17 ","pages":"1832279"},"PeriodicalIF":4.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case report and literature review: isolated ACTH deficiency induced by combined nivolumab and trastuzumab therapy in gastric adenocarcinoma.","authors":"Liwei Shi, Jinrong Wang, Xiaohong Xie, Wei Gu","doi":"10.3389/fendo.2026.1742701","DOIUrl":"https://doi.org/10.3389/fendo.2026.1742701","url":null,"abstract":"<p><strong>Background: </strong>Isolated adrenocorticotropic hormone (ACTH) deficiency (IAD) is an uncommon endocrine disorder characterised by the selective reduction or absence of pituitary ACTH secretion, resulting in secondary adrenal insufficiency while other pituitary hormone axes remain functional. The clinical manifestations of this condition are frequently non-specific, and may include symptoms such as fatigue, decreased appetite, weight loss, hypotension, and hyponatremia. These symptoms can be easily confused with those of other diseases, resulting in either missed diagnoses or misdiagnoses. Glucocorticoid replacement therapy is generally considered to provide effective symptom relief and a favourable prognosis. In recent years, the widespread use of immune checkpoint inhibitors (ICIs) in cancer treatment has resulted in a significant increase in immune-related adverse events (irAEs). Isolated ACTH deficiency has been reported as a rare yet severe endocrine-type irAE, potentially arising from immune-mediated pituitary injury. In view of the nonspecific nature of its clinical presentation, early recognition and timely intervention are of critical importance.</p><p><strong>Case presentation: </strong>The present study reports the case of a patient diagnosed with gastric adenocarcinoma who underwent laparoscopic total gastrectomy, followed by combination therapy with oxaliplatin (OXA), nivolumab, and trastuzumab. Approximately eight months into the treatment regimen, the patient exhibited symptoms of isolated ACTH deficiency and hypothyroidism, indicative of a multi-endocrine system adverse reaction. Such multi-system endocrine dysfunction following this combination therapy is relatively uncommon. The present study analyses the patient's clinical presentation, laboratory findings, and imaging data, and discusses the differential diagnosis from post-gastrectomy dumping syndrome.</p><p><strong>Conclusion: </strong>This case demonstrates that in patients with malignant tumours receiving nivolumab and trastuzumab therapy, the presence of unexplained hypoglycaemia, persistent fatigue, anorexia, nausea, or vomiting - non-specific symptoms - should raise high suspicion for immune-related endocrine adverse reactions. It is imperative to emphasise the significance of preliminary testing for serum cortisol, ACTH, and thyroid function levels. Early recognition and prompt initiation of hormone replacement therapy can effectively prevent misdiagnosis, missed diagnosis, and delayed treatment.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"17 ","pages":"1742701"},"PeriodicalIF":4.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral artery disease in diabetes.","authors":"Sheena Amin, Eri Fukaya, Anand Athavale","doi":"10.3389/fendo.2026.1811582","DOIUrl":"https://doi.org/10.3389/fendo.2026.1811582","url":null,"abstract":"<p><p>Peripheral artery disease in diabetes mellitus represents a distinct clinical entity characterized by diffuse distal arterial disease, medial calcification, microvascular dysfunction, neuropathy, and a pro-thromboinflammatory milieu. These features contribute to atypical presentations, diagnostic challenges, accelerated progression, and elevated risks of limb loss and cardiovascular events. Management requires integrated strategies encompassing metabolic optimization, lifestyle modification, pharmacotherapy, antithrombotic therapy, supervised exercise, and timely revascularization. Emerging approaches, including GLP-1 receptor agonists, SGLT2 inhibitors, and regenerative therapies, show promise in improving vascular, functional, and limb outcomes. Advancing outcomes in diabetic peripheral artery disease will depend on mechanism-driven screening, individualized therapies, and novel interventions to prevent complications.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"17 ","pages":"1811582"},"PeriodicalIF":4.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endocrinologist-led glucose management in the emergency ICU: a retrospective before-after study.","authors":"Long Zhang, Zhang-Sheng Zhao, Chun-Xia Gu, You-Li Ma, Xiao-Fang Yu","doi":"10.3389/fendo.2026.1790977","DOIUrl":"https://doi.org/10.3389/fendo.2026.1790977","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness and safety of an endocrinologist-led glucose management (ELGM) model integrating real-time continuous glucose monitoring (RT-CGM) and continuous insulin infusion therapy, compared with conventional glucose management in critically ill patients admitted to the emergency intensive care unit (EICU).</p><p><strong>Methods: </strong>In this single-center, retrospective before-after study, adult EICU patients with stays ≥24 hours were included. Patients admitted in 2023 received conventional glucose management (control), whereas those admitted in 2024 were managed using the ELGM model. Endocrinologists served as primary decision-makers, supported by RT-CGM, point-of-care testing, and continuous insulin infusion. Primary outcomes included mean glucose, glycemic variability, proportion of target-range glucose (3.9 - 10.0 mmol/L), and hypo-/hyperglycemia incidence. Secondary outcomes included nosocomial infection, hyperosmolar hyperglycemic state (HHS), length of stay, ventilation duration, and hospitalization costs.</p><p><strong>Results: </strong>A total of 1138 patients were analyzed (ELGM 625; Control 513). Compared with conventional management, the ELGM model was associated with lower mean glucose (9.9 vs. 11.1 mmol/L; P< 0.001) and reduced variability (SD 4.2 vs. 4.9 mmol/L; P< 0.001). Target-range readings were higher (61.11% vs. 51.66%; P< 0.001), and severe hyperglycemia was less frequent (7.45% vs. 13.28%; P< 0.001). Severe hypoglycemia did not differ. Nosocomial infection (15.02% vs. 27.68%) and HHS (1.28% vs. 5.65%) were lower (both P< 0.001). Length of stay and costs were similar, while ventilation duration was slightly longer.</p><p><strong>Conclusion: </strong>An endocrinologist-led glucose management strategy incorporating RT-CGM was associated with improved glycemic metrics and lower rates of severe hyperglycemia and infection, supporting its feasibility in critically ill patients.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"17 ","pages":"1790977"},"PeriodicalIF":4.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Analysis of ultrasound parameters influencing endometrial receptivity and a pregnancy outcomes predictive model for patients undergoing <i>in vitro</i> fertilization and embryo transfer: a prospective study.","authors":"Chunlian Wang, Jiao Lin, Xingping Zhao, Ni Liu, Pengzi Sun, Jiaoli Yang, Xue Zhou","doi":"10.3389/fendo.2026.1840394","DOIUrl":"https://doi.org/10.3389/fendo.2026.1840394","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fendo.2025.1677593.].</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"17 ","pages":"1840394"},"PeriodicalIF":4.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}