Frontiers in Endocrinology最新文献

{"title":"SPISE for predicting the presence of atrial fibrillation in patients with coronary artery disease: a comparative analysis with TyG index.","authors":"Meng-Wei Zhang, Dan Wang, Zheng Xiong, Chun-Mei Qi","doi":"10.3389/fendo.2026.1962511","DOIUrl":"https://doi.org/10.3389/fendo.2026.1962511","url":null,"abstract":"<p><strong>Objective: </strong>Insulin resistance (IR) acts as a common pathogenic mediator underlying both coronary heart disease (CHD) and atrial fibrillation (AF). The Single-Point Insulin Sensitivity Estimator (SPISE index) and triglyceride-glucose (TyG) index are two readily available laboratory surrogates for IR. This study sought to compare their independent predictive capacities for concomitant AF among patients with CHD.</p><p><strong>Methods: </strong>Baseline clinical data and laboratory measurements were collected to calculate SPISE index and the TyG index. All enrolled patients were stratified into AF and non-AF groups according to their baseline cardiac rhythm. Intergroup comparisons of the two metabolic biomarkers were conducted. Univariate and multivariate logistic regression models were constructed to identify independent correlates of AF. Restricted cubic spline (RCS) modeling was utilized to explore the nonlinear association between SPISE index and AF. Receiver operating characteristic (ROC) curve analysis was performed to quantify and compare the predictive capacity of SPISE index and the TyG index for AF. Predefined subgroup analyses were further carried out to evaluate potential effect modification across clinical strata.</p><p><strong>Results: </strong>SPISE index levels were significantly higher in the non-AF group relative to the AF group (<i>P</i> < 0.001). After comprehensive adjustment for all confounding covariates, SPISE index was independently inversely associated with prevalent AF (OR = 0.627, 95% CI: 0.528-0.746, <i>P</i> < 0.001). Restricted cubic spline combined with segmented regression analyses identified a significant nonlinear association between SPISE index and AF with a distinct inflection point. ROC curve analysis demonstrated that SPISE index exhibited superior predictive performance for AF risk compared with the TyG index (AUC: 0.646 vs. 0.566). The difference in AUC values between the two markers reached statistical significance according to Delong's test. Stratified subgroup analyses revealed that the inverse correlation between SPISE index and prevalent AF remained stable across all predefined strata, including sex, age, smoking status, alcohol consumption, hypertension, diabetes mellitus, and BMI.</p><p><strong>Conclusion: </strong>SPISE index represents an independent correlate of prevalent AF in CHD patients. Compared with the TyG index, this convenient insulin sensitivity biomarker possesses superior screening value for identifying CHD individuals with concomitant AF.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"17 ","pages":"1962511"},"PeriodicalIF":5.7,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13692712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265174","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":"Development and validation of interpretable machine learning models for predicting cumulative live birth rates in assisted reproductive technology: a SHAP-based analysis.","authors":"XiaoQian Fu, Yisi Qin, Qianyi Huang, Huimei Wu, Li Jiang, Lidan Liu","doi":"10.3389/fendo.2026.1949824","DOIUrl":"10.3389/fendo.2026.1949824","url":null,"abstract":"<p><strong>Objective: </strong>To develop and validate interpretable machine-learning models predicting cumulative live birth rate (CLBR) in ART patients.</p><p><strong>Methods: </strong>In this single-center retrospective cohort (January 2019-June 2024), 7,773 oocyte retrieval cycles were analysed. XGBoost gain ranking, applied to all screened cycles with native handling of missing values, selected eight predictors that were complete in every cycle, so no cycle was excluded for missing data. Six algorithms were compared by stratified 10-fold cross-validation (n=5,441) and an independent test set (n=2,332). We further performed temporal validation (2019-2022 vs 2023-2024), benchmarked against a McLernon-style logistic regression and against a gradient-boosting model restricted to pre-treatment variables, and assessed age-stratified calibration, discrimination (AUC), decision-curve analysis (DCA), and SHAP interpretability.</p><p><strong>Results: </strong>Gradient boosting showed the best discrimination on the random-split test set (AUC 0.762; 95% CI, 0.743-0.781; Brier 0.185). Under temporal validation, performance remained robust (AUC 0.712; 95% CI, 0.686-0.737). The full model significantly exceeded the logistic-regression benchmark (0.761 vs 0.691; DeLong p<0.0001; NRI 0.629, 95% CI 0.550-0.712; IDI 0.105, 95% CI 0.090-0.121). However, a gradient-boosting model restricted to the same pre-treatment variables did not outperform that benchmark (0.693 vs 0.691; p=0.72), indicating that the gain was attributable to the inclusion of embryological information rather than to the learning algorithm itself. DCA demonstrated positive net benefit across thresholds 0.01-0.94. SHAP identified female age (mean |SHAP| 0.494) and embryo quality (0.451) as dominant predictors, with an inflection at 38-40 years.</p><p><strong>Conclusions: </strong>This interpretable framework delivers robust, well-calibrated CLBR prediction that remains stable under temporal validation while preserving transparency via SHAP. Its advantage over an established pre-treatment benchmark derives from incorporating embryological information rather than from the machine learning algorithm: precise estimation of cumulative live birth requires embryological data that become available only after oocyte retrieval and embryo development, rather than depending on which algorithm is used to model that information.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"17 ","pages":"1949824"},"PeriodicalIF":5.7,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13683200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149237427","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":"Coupling characteristics of endocrine regulation and system function under massage interventions.","authors":"Xiangting Lao, Jin Yang, Ting Huang, Bingcai Long, Wei Liao, Yufeng He","doi":"10.3389/fendo.2026.1885282","DOIUrl":"10.3389/fendo.2026.1885282","url":null,"abstract":"<p><strong>Introduction: </strong>Massage may influence stress related endocrine activity and systemic physiological function, but its dynamic regulatory effects remain difficult to quantify.</p><p><strong>Methods: </strong>This study develops a VariationalMotionBayesian framework to model endocrine related physiological responses under massage intervention. The framework combines mathematical formulation of coupled endocrine and systemic variables, variational latent representation learning, motion field estimation, Bayesian evidence aggregation, and physiological constraint regularization. Multimodal wearable physiological time series are used to infer latent regulatory states and predict individual stress status.</p><p><strong>Results and discussion: </strong>Experiments on WESAD and SWELL-KW show that the proposed model outperforms conventional machine learning, deep learning, and time series classification baselines in Accuracy, Macro F1, Balanced Accuracy, and AUROC. A controlled human massage intervention pilot study further shows coordinated changes in salivary cortisol, salivary alpha amylase, heart rate, RMSSD, electrodermal activity, respiration rate, and skin temperature after massage, and these measured responses are correlated with model derived latent dynamics. These results indicate that the proposed framework can capture physiologically meaningful temporal responses and provide a computational tool for analyzing endocrine related system regulation under massage intervention.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"17 ","pages":"1885282"},"PeriodicalIF":5.7,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13683012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149237429","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":"Development and external validation of a nomogram for identifying patients with thyroid eye disease who screen positive for depressive symptoms: a two-center study.","authors":"Shengzhi Jiao, Liuzi Wang, Jingwen Wang, Wenle Zhang, Jianing Li, Huanhuan Chen, Bei Wang","doi":"10.3389/fendo.2026.1942052","DOIUrl":"10.3389/fendo.2026.1942052","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To identify factors independently associated with a positive depressive symptom screen in patients with thyroid eye disease (TED) and to develop and externally validate a nomogram-based model for individualized identification in a second-center cohort as a clinically feasible screening tool for prioritizing depressive symptom screening and informing ongoing follow-up and targeted multidisciplinary management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this two-center observational study, a development cohort (n=218; October 2025-January 2026) and an external validation cohort (n=88; February-March 2026) were enrolled from two tertiary hospitals in Jiangsu Province (total 306 patients). A positive depressive symptom screen was defined as a PHQ-9 total score ≥5. Independent associated factors were selected by univariate and multivariate logistic regression. Five models were developed using the same development data and preprocessing pipeline: logistic regression, LASSO, support vector machine, random forest, and XGBoost. The entire modeling process was internally validated and corrected for optimism using 500 bootstrap resamples, and hyperparameters were optimized using stratified five-fold cross-validation. Discrimination (AUC), decision curve analysis (DCA), and external validation were assessed, and the final locked model was applied to the external cohort without updating.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Overall, 116/306 patients (37.9%) screened positive for depressive symptoms. Age, average monthly household income, stressful life events in the past 6 months, EUGOGO severity grade, standardized GO-QoL-AP score, and TRAb level were independent factors associated with a positive depressive symptom screen. The optimism-corrected AUCs of the five models ranged from 0.736 to 0.790, with no statistically significant paired differences between the corrected AUC of logistic regression and those of the other models. Logistic regression was selected and locked. Its apparent development-cohort AUC was 0.815 and its 500-bootstrap-corrected AUC was 0.776 (95% CI, 0.724-0.840; Brier score, 0.186). In external validation, the AUC was 0.742 (95% CI, 0.631-0.843), the Brier score was 0.195, the calibration slope was 0.981, and the calibration intercept was 0.007. At the locked threshold of 0.312, sensitivity was 0.771 and specificity was 0.547. DCA showed some clinical net benefit across threshold probabilities of 0.10-0.50.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;We developed a nomogram for identifying patients with TED who screen positive for depressive symptoms based on age, mean monthly household income, stressful life events during the preceding 6 months, EUGOGO severity grade, standardized GO-QoL-AP score, and TRAb level. In second-center external validation, the model showed moderate discrimination, with calibration slope and intercept estimates close to their ideal values. It may serve as an auxiliary tool for prioritizing depressiv","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"17 ","pages":"1942052"},"PeriodicalIF":5.7,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13683227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149237455","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":"Total gonadotropin dose is not associated with live birth or embryo quality in fresh cycles at equivalent levels of ovarian response: a retrospective cohort study stratified by ovarian response.","authors":"Keng Feng, Liyan Wang, Haiwen Wei, Feifei Lei, Derong Li, Yudi Luo, Xiang Li, Lingling Zhu, Jiyi Wang","doi":"10.3389/fendo.2026.1970297","DOIUrl":"10.3389/fendo.2026.1970297","url":null,"abstract":"<p><strong>Introduction: </strong>Whether the total gonadotropin (Gn) dose used for controlled ovarian stimulation is independently associated with live birth and embryo quality remains controversial, largely because the dose is individualized according to patient prognosis, which generates confounding by indication. We examined this association within homogeneous levels of ovarian response.</p><p><strong>Methods: </strong>This single-center retrospective cohort study analyzed 3,711 fresh autologous embryo transfer cycles (female age ≤35 years, follicular-phase long protocol, January 2016 to June 2025); cycles with trigger-day progesterone ≥1.5 ng/mL were excluded because fresh transfer was canceled per center policy. Cycles were stratified by oocyte yield into poor (<10, n=1,346), normal (10-15, n=1,582), and high (>15, n=783) response. The exposure was the total Gn dose. The primary outcome was the fresh embryo transfer live birth rate; secondary outcomes included clinical pregnancy, early miscarriage, and morphological embryo-quality indicators. We modeled dose-response relationships with restricted cubic splines (RCS), compared dose quartiles within strata using sequentially adjusted logistic regression, controlled the false discovery rate (FDR) by the Benjamini-Hochberg method, and prespecified five sensitivity analyses.</p><p><strong>Results: </strong>In the overall cohort, the total Gn dose showed neither a linear (P=0.871) nor a nonlinear (P=0.701) association with live birth. Compared with the lowest dose quartile (Q1), fully adjusted odds ratios for Q2, Q3, and Q4 were 1.18 (95% CI: 0.90-1.55), 1.08 (0.78-1.49), and 1.34 (0.92-1.95), and no stratum showed a significant association. In the normal-response stratum, the highest quartile was associated with reduced live birth in the crude model (OR=0.70, P=0.036), but the association attenuated and disappeared with sequential adjustment (aOR=1.08, P=0.757), which quantitatively illustrates how confounding by indication arises and how it can be corrected. No secondary outcome remained significant after FDR correction (minimum q=0.137), and all sensitivity analyses agreed with the main analysis.</p><p><strong>Conclusions: </strong>Within the same level of ovarian response, the total Gn dose was not significantly associated with fresh embryo transfer live birth or morphological embryo quality. Within the dose range studied (700-8,025 IU; interquartile range 1,650-2,725 IU), escalating the Gn dose to improve embryo quality or live birth lacks evidential support, and moderate dose increases in patients with reduced ovarian sensitivity showed no signal of harm.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"17 ","pages":"1970297"},"PeriodicalIF":5.7,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13683207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149237458","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":"Calendar month seasonality of HbA1c and its phase relationship with climatological temperature in 633,838 clinical measurements.","authors":"Kecheng Li, Fei Xia","doi":"10.3389/fendo.2026.1990386","DOIUrl":"10.3389/fendo.2026.1990386","url":null,"abstract":"<p><strong>Objective: </strong>HbA1c reflects glucose exposure over the preceding 8-12 weeks. We characterised the lagged seasonal association between monthly climatological temperature normals and HbA1c in a 12-year hospital cohort and examined whether a similar pattern was present in patient-level records.</p><p><strong>Research design and methods: </strong>We analysed 633,838 HbA1c measurements (387,678 patients; 633,737 with complete covariates) from a Chinese tertiary hospital (2014-2025). Cross-correlation was assessed for lags of 0-6 months using monthly HbA1c means and fixed monthly climatological temperature normals. Patient-level distributed-lag regression with cluster-robust standard errors and generalised estimating equations was used as a complementary analysis.</p><p><strong>Results: </strong>HbA1c was inversely correlated with the climatological temperature series most strongly at a 2-month lag (r = -0.297, P < 0.001) rather than concurrently (r = -0.127, P = 0.14). Pooled by calendar month, the lag-2 seasonal association was strong (r = -0.977, R² = 0.955), with a seasonal HbA1c amplitude of 0.235% (2.6 mmol/mol; peak March, trough September), strongest under age 60 and attenuated during COVID-19. Patient-level regression showed a similar lag pattern, with the largest coefficient at lag 2 (β = -0.0088% per °C; 95% CI -0.0093 to -0.0082; P < 0.001), and the individual-level partial R² was 0.15%.</p><p><strong>Conclusions: </strong>The study identified a reproducible seasonal HbA1c pattern that aligned most strongly with the 2-month-shifted climatological temperature series, with significant correspondence also at 1 and 3 months. Because the exposure was a fixed calendar-month normal, the findings should be interpreted as a lagged seasonal association rather than evidence of a causal temperature effect or a specific 2-month biological delay. The small individual-level partial R² (0.15%) also argues against applying the population amplitude directly to individual treatment decisions. Future research should evaluate whether seasonal contextualisation can optimise laboratory monitoring and re-testing strategies near diagnostic thresholds.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"17 ","pages":"1990386"},"PeriodicalIF":5.7,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13683058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149237460","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":"Hypertriglyceridemic waist-to-height ratio and the triple burden of hypertension, diabetes, and dyslipidemia in adults: association and network analysis.","authors":"Lanqiqi Wu, Jiaoyang Chen, Ting He, Ling Ma, Yin Cheng, Yining Liu, Jinyu Ma, Huitian Tong, Chao Shi","doi":"10.3389/fendo.2026.1932657","DOIUrl":"10.3389/fendo.2026.1932657","url":null,"abstract":"<p><strong>Background: </strong>Hypertension, diabetes, and dyslipidemia frequently co-occur, yet simple screening tools are lacking in resource-limited settings. The hypertriglyceridemic waist-to-height ratio (HTH/WH) phenotype has emerged as a potential indicator, but its utility for identifying the triple burden of hypertension, diabetes, and dyslipidemia remains underexplored, particularly in underdeveloped regions of China.</p><p><strong>Methods: </strong>This cross-sectional study included 10,796 adults (≥18 years) from the Ningxia Hui Autonomous Region, Northwest China. The HTH/WH phenotype was defined as triglycerides ≥1.7 mmol/L combined with waist-to-height ratio ≥0.5. Multivariable logistic regression was used to estimate adjusted odds ratios (ORs) for the association between the HTH/WH phenotype and coexisting hypertension, diabetes, and dyslipidemia. Mixed graphical models were employed to characterize the network associations among the HTH/WH phenotype, the three cardiometabolic disorders, and modifiable lifestyle factors.</p><p><strong>Results: </strong>The prevalence of concurrent hypertension, diabetes, and dyslipidemia was 3.99% in Ningxia, exceeding the Northwest China regional average of 2.33%. The HTH/WH phenotype was present in 21.30% of the population and demonstrated a significant, dose-response association with the triple burden (adjusted OR = 5.29, 95% CI: 4.14-6.74), as well as with two diseases (adjusted OR = 5.12, 95% CI: 4.22-6.21) and one disease (adjusted OR = 1.97, 95% CI: 1.77-2.20). Factors independently associated with the triple burden included age ≥40 years, smoking, alcohol consumption, and elevated BMI (≥24 kg/m²), while higher education and married status were inversely protective. Mixed graphical modeling revealed the HTH/WH phenotype as a central bridge node (bridge strength = 0.67) within the metabolic disorder network, with strong direct connections to hypertension, diabetes, and dyslipidemia. BMI exhibited the highest bridge centrality (bridge strength = 1.72), followed by smoking (bridge strength = 0.32).</p><p><strong>Conclusions: </strong>In Ningxia Hui Autonomous Region, concurrent hypertension, diabetes, and dyslipidemia pose a substantial health burden among adults. The HTH/WH phenotype may serve as a practical risk assessment indicator for identifying high-risk individuals with this metabolic multimorbidity.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"17 ","pages":"1932657"},"PeriodicalIF":5.7,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13683101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149237479","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":"Efficacy of preimplantation genetic testing for aneuploidy in improving pregnancy outcome among couples with azoospermia: study protocol for a multicenter, randomized controlled trial.","authors":"Yaqiong He, Jiaan Huang, Junhao Yan, Jichun Tan, Zhe Wei, Yun Sun, Yao Lu","doi":"10.3389/fendo.2026.1903245","DOIUrl":"10.3389/fendo.2026.1903245","url":null,"abstract":"<p><strong>Background: </strong>Azoospermia affects up to one in ten infertile couples and represents one of the most challenging conditions in male infertility. Although the development of intracytoplasmic sperm injection (ICSI) enables azoospermic men to achieve biological parenthood, overall success rates remain modest. Preimplantation genetic testing for aneuploidy (PGT-A) is increasingly promoted and used worldwide to improve pregnancy outcomes and enhance the efficiency of ICSI; however, its efficacy for couples with azoospermia remains uncertain. Robust evidence from adequately powered randomized controlled trials (RCTs) is still lacking to determine whether PGT-A can increase the live birth rate as the primary outcome in this context.</p><p><strong>Methods: </strong>This trial is designed as a prospective, multicenter, open-label RCT. Couples with azoospermia (female age 20-37 years; male age 20-55 years) who intend to undergo ICSI with partner's sperm will be screened for eligibility. Women who have at least two blastocysts available on day 5 of embryo culture will be enrolled and randomly assigned in a 1:1 ratio to receive either PGT-A or conventional ICSI. A freeze-all strategy with single frozen-thawed blastocyst transfer will be implemented in both groups. The primary outcome is live birth rate.</p><p><strong>Discussion: </strong>The findings of this trial are expected to provide high-quality evidence regarding the efficacy of PGT-A for couples with azoospermia, helping optimize individualized patient management and improve overall treatment efficiency.</p><p><strong>Clinical trial registration: </strong>http://www.chictr.org.cn/, identifier ChiCTR2100043421.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"17 ","pages":"1903245"},"PeriodicalIF":5.7,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149237498","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":"First-morning urinary luteinizing hormone and bone age decomposition for diagnosis of central precocious puberty in girls: a two-step prediction model study.","authors":"Miao Huang, Xiyan Lu, Peipei Liu, Guoqing Dong, Mingzhu Li, Wujin Wang, Jianxu Li","doi":"10.3389/fendo.2026.1948363","DOIUrl":"https://doi.org/10.3389/fendo.2026.1948363","url":null,"abstract":"<p><strong>Objective: </strong>The diagnosis of central precocious puberty (CPP) in girls relies on the invasive gonadotropin-releasing hormone (GnRH) stimulation test. Urinary luteinizing hormone (LH) is a noninvasive candidate biomarker, but evidence from Chinese populations and its integration into multivariable prediction frameworks remain limited. We evaluated the diagnostic accuracy of first-morning urinary LH for CPP, established sex- and pubertal stage-specific reference intervals, and developed a two-step prediction model based on a bone age decomposition.</p><p><strong>Methods: </strong>In this single-center retrospective diagnostic accuracy study, we enrolled 808 children: 295 girls with early breast development (146 CPP, 149 non-CPP), 271 healthy girls, and 242 healthy boys (reference intervals only). First-morning urine was assayed for LH, follicle-stimulating hormone (FSH), and creatinine. Diagnostic performance was evaluated primarily in the 295 symptomatic girls, with an extended analysis in 566 girls including healthy controls; multivariable logistic regression decomposed bone age into chronological age (CA) and the BA-CA difference as separate predictors.</p><p><strong>Results: </strong>Urinary LH showed moderate accuracy for CPP in the primary symptomatic cohort (AUC 0.692, 95% CI 0.630-0.752), peaking in girls aged 7-8 years (AUC 0.708, 95% CI 0.621-0.785); the extended cohort gave similar results (AUC 0.712; secondary, spectrum-extended estimate). The LH-to-creatinine ratio offered no improvement. Basal serum LH was the superior single marker (AUC 0.868 vs 0.692, P < 0.001). The noninvasive Model 1 (CA + BA-CA + urinary LH + breast Tanner stage + uterine length) achieved a C-statistic of 0.853 (sensitivity 73.3%, specificity 83.2%), with CA, BA-CA, and urinary LH as independent predictors. Adding basal serum LH and FSH (Model 2) improved the C-statistic to 0.909; urinary LH retained independent significance (aOR 1.280, P = 0.024), whereas basal FSH was inversely associated with CPP. Bootstrap-corrected C-statistics were 0.838 (Model 1) and 0.893 (Model 2). Pubertal-onset cutoffs were >1.02 mIU/mL in girls and >0.95 mIU/mL in boys.</p><p><strong>Conclusions: </strong>Decomposing bone age into CA and BA-CA enables tiered CPP risk stratification: the noninvasive model supports initial screening without blood sampling, and the complete model refines risk once serum gonadotropins become available. Urinary LH is a clinically useful component of tiered diagnostic algorithms for CPP.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"17 ","pages":"1948363"},"PeriodicalIF":5.7,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13686030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149243923","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: Cardiovascular-kidney-metabolic health, genetic susceptibility, and incident cancer risk: a prospective UK biobank cohort and machine learning study.","authors":"Xue He, Junqiao An, Chunjia Yan, Yutong Zhou, Ziyan Wu, Mengyao Xu, Qingyong He","doi":"10.3389/fendo.2026.2006958","DOIUrl":"https://doi.org/10.3389/fendo.2026.2006958","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fendo.2026.1884752.].</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"17 ","pages":"2006958"},"PeriodicalIF":5.7,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13681451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149237440","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}