Frontiers in Endocrinology最新文献

{"title":"Peritoneal neuroendocrine carcinoma of unknown primary with markedly elevated alpha-fetoprotein: a case report.","authors":"Jie Yang, Yaxin Zhang, Haifeng Que, Weibo Mao, Bitong He, Yinxia Wu","doi":"10.3389/fendo.2026.1962119","DOIUrl":"10.3389/fendo.2026.1962119","url":null,"abstract":"<p><strong>Background: </strong>Peritoneal neuroendocrine carcinoma(NEC) is primarily metastatic, with primary cases being exceedingly rare. The relationship between alpha-fetoprotein(AFP) and neuroendocrine carcinoma remains unclear. In this report, we present a patient with peritoneal neuroendocrine carcinoma who exhibited significantly elevated AFP levels. Extensive evaluation revealed no obvious primary site outside the peritoneum; however, occult gastrointestinal origin could not be entirely excluded. The tumor was thus classified as NEC of unknown primary, with a presumed primary peritoneal origin. The findings from this case suggest that markedly elevated AFP may be associated with aggressive tumor behavior and could serve as a potential marker for monitoring disease activity in peritoneal NECs, a hypothesis that warrants further investigation.</p><p><strong>Case presentation: </strong>A 51-year-old man with massive ascites and elevated AFP levels was admitted to the hospital. Liver enhanced magnetic resonance imaging and gastrointestinal endoscopy did not reveal any space-occupying lesions, while abdominal puncture did not detect tumor cells. The patient's whole-body PET-CT revealed extensive peritoneal thickening and increased FDG metabolism. Subsequent laparoscopic exploration revealed numerous nodules and masses of varying sizes with a firm texture in the greater omentum, small intestine surface, mesentery, and parietal peritoneum. Immunohistochemistry of the omentum demonstrated positive results for AE1/AE3, Syn, CgA, and AFP, leading to a final diagnosis of large cell NEC of unknown primary, with a presumed primary peritoneal origin. Due to the presence of multiple peritoneal nodules, radical surgery was not feasible, and EP combined with camrelizumab was initiated. AFP levels showed an overall progressive increase, peaking at 5315 ng/mL on May 25, with a slight subsequent decline to 4948.4 ng/mL on June 20. Unfortunately, the patient discontinued chemotherapy after two cycles due to severe nausea and vomiting; he subsequently succumbed to the disease.</p><p><strong>Conclusions: </strong>We propose the hypothesis that dynamic changes in AFP levels could reflect tumor burden and treatment response in a subset of AFP-producing NECs. However, this hypothesis requires validation in larger cohort studies. It is also important to distinguish its potential role as a monitoring biomarker from an established prognostic biomarker.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"17 ","pages":"1962119"},"PeriodicalIF":5.7,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215372","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":"Sex-specific hormone signatures in four fish species with divergent reproductive strategies.","authors":"Freya Adele Pappert, Olivia Roth","doi":"10.3389/fendo.2026.1923972","DOIUrl":"10.3389/fendo.2026.1923972","url":null,"abstract":"<p><strong>Introduction: </strong>Steroid hormones regulate diverse biological processes, including development, immunity and reproduction. Because biological sex, pregnancy, parental care, and mate competition are closely associated in most established model organisms, it remains unclear whether endocrine differences between males and females are primarily linked to gametic sex or to the reproductive roles performed by each sex. Syngnathid fish, the pipefishes, seadragons, and seahorses, provide a powerful system for disentangling these effects, because males, rather than females, carry the developing embryos. Species further differ in sexual selection and in the extent of paternal investment, ranging from externally attached eggs to incubation with an enclosed brood pouch.</p><p><strong>Methods: </strong>This study provides baseline hormonal profiles of key steroid and peptide hormones in three syngnathid species across the unique evolutionary parental care gradient of male pregnancy (<i>Nerophis ophidion, Syngnathus typhle, Hippocampus abdominalis</i>). We additionally included the female-pregnant livebearing fish Heterandria formosa as a comparative reference for a conventional separation of reproductive roles.</p><p><strong>Results: </strong>Sex-specific endocrine profiles broadly followed sexual selection differentials: species with stronger sexual heteromorphism, i.e., more extreme reproductive roles (<i>N. ophidion</i>), exhibiting stronger endocrine sexual heteromorphism. In contrast, species with higher parental care investment (<i>H. abdominalis, H. formosa</i>) show reduced endocrine differentiation between the sexes. The intermediate species S. typhle, which combines sex-role reversal with a moderately complex brood pouch, displayed tissue-specific patterns, with hormonal dimorphism retained primarily in the gonads.</p><p><strong>Discussion: </strong>By incorporating a cross-species comparative framework with both sex-role reversed and a conventional viviparous species, we can begin to understand which hormonal functions are conserved versus derived, and whether endocrine profiles are primarily aligned with biological sex or reproductive role, such as mate competition and parental care, thereby revealing how endocrine constraints and plasticity contribute to reproductive evolution.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"17 ","pages":"1923972"},"PeriodicalIF":5.7,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215392","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":"Accuracy, potential harm, weight stigma, and commercial influence in short-form social media content on incretin-based therapies for obesity.","authors":"Yeo-Jun Yoon, Amanda Velazquez, Sehej-Leen Parmar, Katayoun Lotfi, Denise Wong, Cagney Cristancho, Katherine Salim, Seongwon Jeon, Sangmo Hong, Hyungoo Shin, Caroline M Apovian, Dong Wook Kim","doi":"10.3389/fendo.2026.1844311","DOIUrl":"10.3389/fendo.2026.1844311","url":null,"abstract":"<p><strong>Background: </strong>Short-form video platforms such as TikTok and YouTube Shorts are major sources of health information, yet little is known about the reliability of what they carry on incretin-based therapies for obesity. We assessed the accuracy, safety, obesity-related stigma, and commercial nature of short-form videos on these medications.</p><p><strong>Methods: </strong>We conducted a cross-sectional content analysis on June 15, 2025. Videos were retrieved for six medication keywords on TikTok and YouTube Shorts, and the 100 most-viewed videos within each platform's retrieved pool were included (n = 200). Four physicians certified by the American Board of Obesity Medicine each coded a non-overlapping subset for clinical accuracy, hazard potential, obesity stigma, and commercial influence. A fifth senior physician reviewed all videos and issued final ratings. Six TikTok videos became unavailable before review, leaving 194 for content analysis.</p><p><strong>Results: </strong>TikTok videos had higher median view counts (964 650 [Q1-Q3 615 350-1 525 000] vs 24 526 [7 036-104 569], <i>p</i> < 0.001) and higher raw like and comment counts. Normalizing to views changed the picture. Likes per 1000 views did not differ (24.7 vs 20.4, p = 0.069), and comments per 1000 views were higher on YouTube Shorts (1.2 vs 0.8, p < 0.001), where videos were also older (720 vs 221 days, p < 0.001). Clinical accuracy did not differ significantly (23.4% [95% CI 16.0-32.9%] vs 39.0% [95% CI 30.0-48.8%], p = 0.062). Hazard potential was more common on TikTok (31.9% vs 17.0%, p = 0.015), but this came from promotion of compounded products, four times more frequent on TikTok (14.9% vs 4.0%, p = 0.009). Restricted to directly unsafe clinical content, the platforms did not differ (20.2% vs 13.0%, p = 0.176). Obesity stigma (p = 0.118) and commercial influence (p = 0.438) were comparable.</p><p><strong>Conclusion: </strong>Most short-form videos about incretin-based obesity therapies carried no accurate clinical information, and accurate videos drew only 24% of cumulative views. Promotion of compounded products clustered on TikTok and accounted for the platform difference in hazard potential. Evidence-based, bias-free communication is needed if these platforms are to educate the public about obesity pharmacotherapy.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"17 ","pages":"1844311"},"PeriodicalIF":5.7,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215496","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":"A nested case-control study on the relationship between gut microbiota and non-alcoholic fatty liver disease.","authors":"Xiangcheng Yang, Jingfeng Chen, Jianan Song, Haoshuang Liu, Lin Wang, Tiantian Li, Hang Yan, Xinxin Gao, Suying Ding","doi":"10.3389/fendo.2026.1917815","DOIUrl":"10.3389/fendo.2026.1917815","url":null,"abstract":"<p><strong>Background: </strong>The gut microbiota plays an important role in non-alcoholic fatty liver disease (NAFLD). This study aimed to explore gut microbiota-associated biomarkers for incident NAFLD and evaluate their predictive value, providing preliminary evidence for early risk identification.</p><p><strong>Methods: </strong>From an initial cohort of 1,772 participants, 404 were included in the final analysis, comprising 101 incident NAFLD cases and 303 age-matched controls (1:3). Gut microbiota composition and function were characterized by metagenomic sequencing. Microbial features were compared between participants who developed NAFLD (NAFLD -/+) and those who did not (NAFLD -/-). A CatBoost model integrating gut microbiota, functional pathways, and clinical indicators was constructed to predict NAFLD, with a random forest (RF) model on the same features for comparison. Progressively enriched feature sets assessed the incremental value of microbiota-related features beyond clinical indicators, and SHapley additive exPlanations (SHAP) values interpreted the model outputs.</p><p><strong>Results: </strong>The NAFLD (-/+) group had significantly lower species-level beneficial gut microbiota (<i>P</i> < 0.05), and the two groups differed markedly in gut microbiota metabolic enrichment. The CatBoost model achieved an area under the curve (AUC) of 0.762, indicating moderate predictive performance for incident NAFLD. We also identified significant intergroup differences in gut microbiota composition within the diagnostic model, including the key species <i>Coprobacillus unclassified</i> and the metabolic pathway PWY-5030.</p><p><strong>Conclusion: </strong>Gut microbiota alterations may serve as potential early biomarkers for incident NAFLD and contribute to its pathogenesis. The CatBoost model integrating multi-omics and clinical data shows moderate predictive ability, supporting the potential of gut microbiota-based approaches for non-invasive risk stratification.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"17 ","pages":"1917815"},"PeriodicalIF":5.7,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215461","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":"An explainable and leakage-aware machine learning model for early risk stratification of radioiodine-refractory differentiated thyroid cancer: development and single-center geographic external validation.","authors":"Gongxun Tan, Yue Zhang, Zhenwei Mao, Chuan Zhang, Jingjing Fu, Feng Wang, Canhong Zhu, Jin Zhou, Bingquan Jin, Ying Xu, Rong Qin, Xun Shao, Lele Zhang, Shaohua Li, Qian Gu","doi":"10.3389/fendo.2026.1952443","DOIUrl":"10.3389/fendo.2026.1952443","url":null,"abstract":"<p><strong>Background: </strong>Radioiodine-refractory differentiated thyroid cancer (RAIR-DTC) poses a major therapeutic challenge, with loss of radioiodine avidity, limited treatment options, and worse outcomes. Current risk stratification systems were not designed to predict RAIR transformation before clinical refractoriness.</p><p><strong>Methods: </strong>This retrospective two-center study included a development cohort of 302 consecutive patients and an external validation cohort of 122. Candidate predictors were restricted to baseline demographic, clinicopathological, molecular, and biochemical variables available at or before first postoperative RAI administration; all post-treatment, response-related, and time-dependent variables were excluded <i>a priori</i>. Six machine-learning algorithms were developed with repeated cross-validation and compared by discrimination, probability accuracy, and clinical utility. Model interpretation used SHapley Additive exPlanations (SHAP). External transportability was assessed by discrimination, calibration, decision-curve analysis, and validation of prespecified risk groups.</p><p><strong>Results: </strong>Forty-six patients (15.2%) developed RAIR-DTC in the development cohort and 18 (14.8%) in the external cohort. Random forest was selected for the most favorable balance of cross-validated discrimination and probability accuracy, despite comparable external discrimination from XGBoost and the stacked ensemble. It achieved an area under the receiver operating characteristic curve (AUC) of 0.896 and Brier score of 0.078 in the internal test cohort, with robust external discrimination (AUC, 0.892; PR-AUC, 0.597; sensitivity, 0.778; specificity, 0.798). Raw external calibration was poor (calibration slope 0.304; observed-to-expected ratio 0.613), indicating that ranking was preserved whereas absolute risk estimates required local recalibration. SHAP analysis identified age ≥55 years, TERT promoter (TERTp) mutation, vascular invasion, initial stimulated thyroglobulin (sTg), and extrathyroidal extension (ETE) as the dominant contributors. Training-derived quantile cut points generated three-tier risk groups, identifying a low-risk subgroup with zero events in the external cohort and a low event rate (3.3%) in the internal test set, while enriching the high-risk subgroup to event rates of 75.0% and 37.2%, respectively, with 95% confidence intervals of 47.6%-92.7% and 23.0%-53.3%, respectively.</p><p><strong>Conclusions: </strong>An explainable, leakage-aware random forest based exclusively on routinely available baseline variables provided robust external discrimination and clinically meaningful early risk stratification for RAIR-DTC. Preserved discrimination did not guarantee transportable probability estimates, underscoring that external calibration and site-specific recalibration are essential prerequisites for responsible clinical deployment.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"17 ","pages":"1952443"},"PeriodicalIF":5.7,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215176","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 between triglyceride-glucose index and stages of T2DM: potential indirect effects of inflammatory indicators.","authors":"Jiayi Tian, Haitao Li, Mingyi Li, Qingning Chang, Xianglong Liu, Yuhao Zhou, Yu Zhao, Feng Li","doi":"10.3389/fendo.2026.1931822","DOIUrl":"10.3389/fendo.2026.1931822","url":null,"abstract":"<p><strong>Background: </strong>The triglyceride-glucose (TyG) index is a reliable surrogate marker of insulin resistance and has been closely linked to type 2 diabetes mellitus (T2DM) risk. However, it remains unclear whether the TyG index is nonlinearly associated with cross-sectional glycemic status categories, from normal glucose to T2DM, and whether inflammatory indicators may partly account for this association. We therefore aimed to examine this nonlinear association and to estimate potential indirect associations through inflammatory indicators.</p><p><strong>Methods: </strong>A retrospective analysis of cross-sectional data was conducted, including 1,117 participants. Generalized additive models (GAM) combined with restricted cubic spline (RCS) regression were used to examine the nonlinear association between the TyG index and stages of glucose metabolism. Stage specificity analyses were performed across normal glucose, impaired fasting glucose (IFG), impaired glucose tolerance (IGT), combined IFG and IGT, and T2DM. In exploratory cross-sectional indirect association analyses, inflammatory markers accounted for part of the cross-sectional association between the TyG index and glycemic outcomes.</p><p><strong>Results: </strong>A significant nonlinear relationship was identified between the TyG index and T2DM (<i>P</i> < 0.05), with an inflection point at TyG = 9.14. The TyG index showed a progressively increasing trend across advancing disease stages. In exploratory cross-sectional analyses of potential indirect associations, only MLDLR and NLDLR exhibited significant statistical indirect associations linking the TyG index to 2-hour postprandial plasma glucose (2hPG). However, because all variables were measured concurrently, causal mediation cannot be inferred. These exploratory findings may warrant further investigation in longitudinal studies, particularly across early stages of dysglycemia.</p><p><strong>Conclusions: </strong>The TyG index was nonlinearly associated with cross-sectional glycemic categories. Exploratory cross-sectional mediation analyses further revealed statistically significant indirect associations through MLDLR and NLDLR in the TyG index-2hPG relationship. These observations suggest that inflammatory markers may be related to glycemic deterioration primarily via postprandial-related pathways in early dysglycemia, although causal inference cannot be drawn from cross-sectional data. These findings are hypothesis-generating and support the prospective evaluation of the TyG index for risk stratification in primary-care settings.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"17 ","pages":"1931822"},"PeriodicalIF":5.7,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215212","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":"Male reproductive health under environmental, pharmacological, and disease influences: a scoping review.","authors":"Sylvester Chibueze Izah, Kingsley Excel Dunga, Ebinyo Rebecca Aseibai, Nsikak Godwin Etim, Matthew Chidozie Ogwu, Vivian Ibienebakabobo Promise, Esther Ugo Alum, Irene Nneka Ohanusi","doi":"10.3389/fendo.2026.1922443","DOIUrl":"10.3389/fendo.2026.1922443","url":null,"abstract":"<p><p>Male reproductive health reflects coordinated spermatogenesis, endocrine regulation, reproductive-tract patency, sexual function, and sperm genomic integrity. This scoping review maps evidence on environmental exposures, pharmacological agents and substance use, and acute or chronic diseases that may influence these domains, with emphasis on biological mechanisms, clinical assessment, prevention, and public-health implications. PubMed was the primary bibliographic database; Google Scholar and official grey literature/guidelines were supplementary sources. The evidence map comprised 105 unique sources: 99 PubMed-indexed peer-reviewed sources and six official grey-literature/guideline sources. Google Scholar supported supplementary discovery and citation chaining, and overlapping PubMed records were counted once after de-duplication; no unique Google-Scholar-only journal source remained in the mapped set. Four additional references were used exclusively to guide scoping-review methodology and reporting, giving 109 references in the complete bibliography. Evidence was charted by exposure or condition, study design, reproductive outcome, quantitative finding where available, mechanistic interpretation, and clinical implication. The mapped literature identifies endocrine-disrupting chemicals, pesticides, metals, air pollution, occupational heat, selected medicines and gonadotoxic treatments, metabolic and infectious diseases, varicocele, genetic disorders, and systemic illness as relevant reproductive-health contexts, but the strength and causal interpretability of evidence vary substantially. Recurrent mechanisms include oxidative stress, inflammation, endocrine disturbance, mitochondrial dysfunction, vascular impairment, sperm DNA damage, and epigenetic alteration. The review supports couple-centred evaluation, source control of avoidable exposures, treatment of reversible disease, fertility preservation before gonadotoxic therapy, and specialist-led medication decisions.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"17 ","pages":"1922443"},"PeriodicalIF":5.7,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215346","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: Mortality and cardiovascular risk of triglyceride-glucose and derived indices in cardiovascular-kidney-metabolic syndrome stages 0-3: a dose-response meta-analysis.","authors":"Jun-Qiao An, Xue He, Qian-Ying Hao, Yan Wu, Qing-Yong He","doi":"10.3389/fendo.2026.2006995","DOIUrl":"https://doi.org/10.3389/fendo.2026.2006995","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fendo.2026.1927610.].</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"17 ","pages":"2006995"},"PeriodicalIF":5.7,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215180","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 between the cholesterol-high-density lipoprotein-glucose (CHG) index and albuminuria risk in diabetic patients.","authors":"Yuren Zhang, Jinting Xu, Yiping Zhang, Yinan Chen, Qiaolan Liu","doi":"10.3389/fendo.2026.1937841","DOIUrl":"10.3389/fendo.2026.1937841","url":null,"abstract":"<p><strong>Introduction: </strong>The Cholesterol-High-Density Lipoprotein-Glucose (CHG) index is a novel composite metabolic biomarker. We aimed to evaluate the relationship between the CHG index and albuminuria prevalence in patients with type 2 diabetes mellitus (T2DM).</p><p><strong>Methods: </strong>A total of 1842 T2DM patients at Jinjiang Municipal Hospital were enrolled in this cross-sectional study. Albuminuria was defined as a urinary albumin-to-creatinine ratio (UACR) > 30 mg/g. Multivariable logistic regression, restricted cubic spline modeling, subgroup analyses, and receiver operating characteristic (ROC) curve analysis were performed to evaluate the independent association.</p><p><strong>Results: </strong>Patients with albuminuria (n=324) had higher CHG index values. After full adjustment, an elevated CHG index was significantly associated with higher odds of albuminuria (<i>OR=2.097, 95%CI:1.438-3.060, P<0.001</i>). Restricted cubic spline analysis revealed a J-shaped nonlinear relationship, with an inflection point at 6.402. The association was more pronounced in patients with hypertension. The CHG index demonstrated an area under curve (AUC) of 63.28% for distinguishing albuminuria, outperforming other metabolic indices.</p><p><strong>Conclusions: </strong>The CHG index was nonlinearly associated with albuminuria prevalence in patients with T2DM; however, its cross-sectional design precludes causal inference.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"17 ","pages":"1937841"},"PeriodicalIF":5.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215184","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":"Surgical decision-making and referral patterns for adrenal vein sampling in primary aldosteronism: a national survey of endocrine surgeons.","authors":"Marisela Neff, Konrad Kozlowski, Chloe Issa, Anmol Patel, Jack Lin, Hannah Clode, Thomas Pennix, Zeina Hannoush, Alejandro Ayala, John I Lew, Zoe A Miller","doi":"10.3389/fendo.2026.1909164","DOIUrl":"10.3389/fendo.2026.1909164","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to discover and explore factors associated with endocrine surgeons' (ES) referral patterns to Interventional Radiologists (IR) for adrenal vein sampling (AVS) for patients with primary aldosteronism (PA).</p><p><strong>Methods: </strong>Following IRB approval, an electronic survey was distributed to members of the American Association of Endocrine Surgeons (AAES). This cross-sectional, descriptive survey was designed to generate hypotheses about AVS referral behavior rather than test prespecified causal relationships. Data collected included demographics, practice type, referral patterns, opinions on PA management, AVS utilization, confidence levels in AVS and Interventional Radiology (IR) proceduralists, and satisfaction with AVS results.</p><p><strong>Results: </strong>107 of 806 AAES members responded, 100 (93.5%) of which were ES. Of those surveyed, 45% (n=48) had 10+ years of practice experience, with 61% (n=74) at academic centers. Specialists managed 7.54 (± 5.71) PA patients per year. Among these surgeons, 71% reported \"always\" ordering AVS for PA, while 28% stated they \"sometimes\" ordered AVS. If bilateral adrenal nodules were identified on imaging, 100% of surgeons referred patients for AVS, whereas 78% referred patients with unilateral adrenal lesions. Among this group, 56% reported they trusted their IR physician of choice to perform AVS whereas 31% replied they trusted the associated IR group. AAES respondents \"always\" referred patients to local academic centers (71%), and \"never\" referred patients to local private IR groups (75%) or distant academic centers (75%). Among respondents, 83% were satisfied with AVS results.</p><p><strong>Conclusions: </strong>AVS plays a central role in surgical decision-making for primary aldosteronism. Endocrine surgeons (ES) demonstrate strong referral patterns favoring individual interventional radiologists at local academic centers, with referral behavior affected by institutional context, trust in proceduralists and perceptions of procedural standardization. These findings reflect self-reported referral patterns among AAES members and may not capture actual observed clinical behavior.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"17 ","pages":"1909164"},"PeriodicalIF":5.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215404","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}