Frontiers in Endocrinology最新文献

{"title":"Comparison of children with bioinactive growth hormone, small for gestational age, and idiopathic short stature.","authors":"Esma Kaya Özdemir, Esra Döğer, M Orhun Çamurdan, Aysun Bideci","doi":"10.3389/fendo.2025.1596976","DOIUrl":"10.3389/fendo.2025.1596976","url":null,"abstract":"<p><strong>Introduction: </strong>Short stature has many causes, including rare disorders of GH function. Bioinactive growth hormone (GH) refers to a phenotype characterized by immunoreactive but biologically ineffective GH. Importantly, it should not be regarded as a separate treatment but rather as a definable subgroup within the broader population of children receiving recombinant human growth hormone (rhGH) therapy. The aim of this study was to compare the growth response to rhGH among children with bioinactive GH, those born small for gestational age (SGA), and those with idiopathic short stature (ISS).</p><p><strong>Methods: </strong>In this retrospective, single-center study, we reviewed the medical records of short-statured patients with a height ≤ -2 z-score, a normal peak GH response (≥10 ng/mL) to clonidine or L-dopa stimulation tests, and a history of rhGH treatment. Patients with chronic illness, malnutrition, syndromic or endocrine disorders, diabetes, metabolic disease, anemia, or prior pubertal suppression were excluded. Eligible patients meeting the definitions of bioinactive GH, SGA, or ISS were included.</p><p><strong>Statistical analysis: </strong>Data were analyzed with IBM SPSS Statistics 22.0 using parametric and non-parametric tests with Bonferroni correction; significance was set at p < 0.05.</p><p><strong>Results: </strong>Among 170 patients screened, 109 fulfilled the criteria for analysis (bioinactive GH, n=8; SGA, n=27; ISS, n=74). Baseline Insulin-like Growth Factor 1 <i>(</i>IGF-1) and Insulin-like Growth Factor Binding Protein 3 (IGFBP-3) levels were markedly lower in the bioinactive GH group compared with SGA and ISS (p < 0.001). During rhGH therapy, patients with bioinactive GH exhibited the greatest gains in growth velocity and Δ height z-score, despite similar GH doses and a lower proportion of pubertal subjects. By final height, all patients with bioinactive GH achieved normal stature, with most surpassing target height, whereas fewer SGA and ISS patients reached their genetic potential.</p><p><strong>Conclusion: </strong>Children with bioinactive GH form a biologically distinct and highly treatment-responsive subgroup of non-GHD short stature. Our findings highlight the diagnostic value of IGF-1 generation testing in this context. Future multicenter studies with genetic and bioactivity confirmation are essential to refine diagnostic criteria and establish international guidelines.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"16 ","pages":"1596976"},"PeriodicalIF":4.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185041","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":"Uric acid and uric acid/creatinine ratio are associated with GDM in women undergoing IVF/ICSI.","authors":"Yvonne Liu, Johann-Georg Hocher, Shujuan Ma, Liang Hu, Huijun Chen, Xiaoli Zhang, Fei Gong, Bernhard K Krämer, Ge Lin, Berthold Hocher","doi":"10.3389/fendo.2025.1647131","DOIUrl":"10.3389/fendo.2025.1647131","url":null,"abstract":"<p><strong>Introduction: </strong>With ongoing global lifestyle changes and economic development, the prevalence of hyperuricemia has steadily increased. Elevated levels of serum uric acid (SUA) have been linked to gestational diabetes mellitus (GDM); however, this relationship has not yet been specifically evaluated in women undergoing assisted reproductive technology (ART). Therefore, this study aimed to analyze the relationship between pre-pregnancy SUA as well as SUA to serum creatinine (SCr) ratio and GDM in women undergoing ART.</p><p><strong>Methods: </strong>This retrospective cohort study was carried out at the Reproductive and Genetic Hospital of CITIC-Xiangya in Changsha, Hunan, China, and included 1027 women who underwent their first ART treatment between 2017 and 2018. SUA levels were measured during the baseline visit prior to any ART procedures, and GDM incidence was recorded based on screening results from the oral glucose tolerance test.</p><p><strong>Results: </strong>GDM was diagnosed in 172 (16.7%) of the 1027 patients. When comparing SUA quintiles, significant differences were observed in GDM incidence, and several other parameters (including pre-pregnancy weight, BMI, blood glucose, blood pressure, SCr, lipid parameters, anti-Müllarian Hormone, follicle stimulating hormone, and testosterone). SUA was independently associated with GDM incidence after adjusting for potential confounding factors in multivariate analysis (OR 1.004, <i>p</i> = 0.003). Moreover, the SUA/SCr ratio displayed an even stronger association (OR 1.226, <i>p</i> = 0.003).</p><p><strong>Conclusion: </strong>Pre-pregnancy SUA levels - and particularly the SUA/SCr ratio - were significantly associated with GDM among women undergoing ART.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"16 ","pages":"1647131"},"PeriodicalIF":4.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185195","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":"Multimodal ultrasonography in the diagnosis and treatment of chronic thyrotoxic myopathy: a prospective study.","authors":"Roumei Wang, Rui Huang, Shien Fu, Yunxia Tang, Yaoli Liu","doi":"10.3389/fendo.2025.1590294","DOIUrl":"10.3389/fendo.2025.1590294","url":null,"abstract":"<p><strong>Objective: </strong>This study integrates high-frequency ultrasonography with shear wave elastography (SWE) to perform a multimodal quantitative assessment of the rectus femoris and thyroid tissue architecture in patients with chronic thyrotoxic myopathy (CTM). A novel predictive model for CTM progression was developed by quantitatively assessing biomechanical parameters, including muscle and thyroid parenchymal stiffness, providing an objective imaging-based foundation for early disease intervention.</p><p><strong>Methods: </strong>This prospective study enrolled 75 patients with hyperthyroidism and 53 healthy controls. The biomechanical parameters of the rectus femoris and thyroid tissue were quantitatively assessed using SWE. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive efficacy of rectus femoris and thyroid tissue elasticity parameters for CTM diagnosis. A multivariate logistic regression model was developed to investigate the association between muscle stiffness, thyroid stiffness, and CTM risk. Additionally, patients with CTM received pharmacotherapeutic interventions, and clinical indexes were systematically monitored along with dynamic changes in thyroid and rectus femoris correlation parameters before and after treatment to evaluate therapeutic efficacy.</p><p><strong>Results: </strong>The CTM group exhibited a significantly lower mean Young's modulus (E-mean) of the rectus femoris than the non-CTM and healthy groups (<i>p</i> < 0.01). In contrast, the CTM group had a significantly higher thyroid E-mean than the other groups (<i>p</i> < 0.01). Moreover, the rectus femoris E-mean was positively correlated with grip strength (r = 0.437, <i>p</i> < 0.01) and lower limb fatigue test (r = 0.247, <i>p</i> = 0.042) in patients with CTM. ROC curve analysis revealed that the combined diagnostic approach achieved the highest sensitivity and specificity for CTM, with an area under the curve of 92.5%. A multivariate logistic regression model revealed that, after adjusting for confounding factors, rectus femoris E-mean and thyroid E-mean were significant predictors of CTM. Following treatment with antihyperthyroid drugs, significant improvements were observed in thyroid hormone levels, upper and lower limb muscle function tests, and muscle-related parameters compared with their pretreatment levels, with all differences reaching statistical significance (<i>p</i> < 0.01).</p><p><strong>Conclusion: </strong>By quantitatively assessing the morphological and biomechanical characteristics of the rectus femoris and thyroid gland, multimodal ultrasonography can provide a reliable imaging basis for the early prediction and therapeutic monitoring of CTM.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"16 ","pages":"1590294"},"PeriodicalIF":4.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185038","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":"Endocrine complications after solid organ transplantation in childhood and adolescents.","authors":"Ji-Hee Yoon, Dohyung Kim, Soojin Hwang, Ja Hye Kim, Jin-Ho Choi","doi":"10.3389/fendo.2025.1658780","DOIUrl":"10.3389/fendo.2025.1658780","url":null,"abstract":"<p><strong>Objective: </strong>Acute or chronic metabolic derangement following solid organ transplantation (SOT) often leads to endocrine complications, which have become more common as survival rates post-SOT have improved. This study was performed to investigate long-term endocrine complications after SOT in children and adolescents.</p><p><strong>Methods: </strong>This study included 259 pediatric patients who underwent SOT, including kidney (n = 43), liver (n = 170), lung (n = 5), heart (n = 37), and multi-organ (n = 4), with a minimum follow-up period of 5 years post-transplant. Clinical and endocrinological data were retrospectively collected, including information on growth, obesity, diabetes, dyslipidemia, thyroid disease, bone health, and pubertal development.</p><p><strong>Results: </strong>Of 259 patients, 203 (78.4%) developed endocrine complications over a median follow-up period of 10.5 years (range, 5.5-16.8). Short stature was common in kidney (58.1%) and multi-organ recipients (100%), whereas the highest rates of obesity were observed in liver recipients (43.5%). Kidney or liver recipients under 13 years of age showed significant improvements in height-standard deviation scores within 5 years post-SOT. Discontinuation of corticosteroids was associated with a reduced risk of short stature 10 years after liver transplantation. Heart recipients had a high prevalence of post-transplant diabetes mellitus (PTDM, 27%). Other endocrine complications included dyslipidemia (40.2%), hypothyroidism (2.8%), and low bone mineral density (31.3%). Among liver recipients, pretransplant obesity was a significant risk factor for development of post-transplant obesity, PTDM, and dyslipidemia. Additionally, liver transplantation at 0-1 years of age increased the risk of obesity, while transplantation at 6-12 years of age, cyclosporine use, and allograft rejection were associated with an increased risk of dyslipidemia.</p><p><strong>Conclusions: </strong>This study demonstrates that endocrine and metabolic complications are common in pediatric SOT recipients. Effective surveillance and management of these sequelae are crucial to improve long-term quality of life following SOT.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"16 ","pages":"1658780"},"PeriodicalIF":4.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185101","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":"Triglycerides as a mediator in the hyperuricemia-diabetes link: insights from a hypertensive Chinese population.","authors":"Dan Lu, Xiaowen Ou, Tingjun Wang, Guoyan Xu","doi":"10.3389/fendo.2025.1645766","DOIUrl":"10.3389/fendo.2025.1645766","url":null,"abstract":"<p><strong>Background: </strong>This study investigates whether triglycerides mediate the association between hyperuricemia and Type 2 Diabetes Mellitus (T2DM) in a hypertensive Chinese population. By comparing individuals with and without diabetes and applying generalized structural equation modeling (GSEM), we aimed to clarify the indirect effects of hyperuricemia via triglyceride pathways.</p><p><strong>Methods: </strong>A total of 274 hypertensive diabetic patients were assessed for clinical and biochemical profiles. The study included clinical categorization of DM status, demographic analysis, generalized structural equation modeling (GSEM) for mediation analysis, and regression modeling to identify diabetes risk factors.</p><p><strong>Results: </strong>Diabetic individuals exhibited significantly higher triglyceride levels (P=0.005). Age ≥65 years was a notable demographic risk factor compared to those aged 32-49 years (OR=6.35, 95% CI: 1.26-31.97). Occasional smoking also increased DM risk (OR=3.92, 95% CI: 1.00-15.35), while alcohol consumption showed no significant association. Hyperuricemia was positively associated with elevated triglyceride levels (coefficient = 0.67, P=0.01), which, in turn, significantly increased DM risk (coefficient = 1.29, P < 0.001). Although the direct effect of hyperuricemia on DM was not statistically significant (coefficient = -0.61, P=0.10), the indirect effect mediated by triglycerides was substantial (coefficient = 0.87, P=0.04). BMI categorization significantly influenced both hyperuricemia and triglyceride levels, with the highest BMI category (≥27) exhibiting the greatest prevalence (60.26% and 38.46%, respectively). However, the direct association between BMI and DM was not statistically significant (P=0.407), suggesting the involvement of mediating factors.</p><p><strong>Conclusion: </strong>Triglycerides play a key mediating role in the relationship between hyperuricemia and Type 2 DM among hypertensive patients. BMI is significantly associated with hyperuricemia and triglyceride levels, although not directly with DM. These findings emphasize the need for targeted interventions focused on lipid regulation, weight control, and lifestyle modifications to prevent diabetes progression in this high-risk population.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"16 ","pages":"1645766"},"PeriodicalIF":4.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12462057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185163","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":"Physical activity as clinical practice care for patients with type 2 diabetics and its implementation in routine clinical care: an expert opinion survey.","authors":"Itai Goldfarb, Ayelet Giladi, Sharon Barak, Ishay Lev, Horesh Dor-Haim","doi":"10.3389/fendo.2025.1518285","DOIUrl":"10.3389/fendo.2025.1518285","url":null,"abstract":"<p><strong>Introduction: </strong>Physical activity (PA) is integral to type 2 diabetes (T2D) treatment, yet few national health services incorporate structured PA services as part of T2D treatment. Moreover, healthcare professionals acknowledge their role in integrating PA into the daily routines, but implementation faces notable barriers. Recognizing the pivotal role of healthcare systems and professionals in promoting physical activity-based interventions is crucial to closing the gap between guidelines and their implementation in real-world settings.</p><p><strong>Methods: </strong>The study involved 363 healthcare and physical activity professionals across diverse clinical settings. A questionnaire, developed through a focus group and literature review, assessed participants' attitudes and knowledge on PA and national practices pertaining to PA for people with T2D. The questionnaire's internal reliability was examined using Cronbach's alpha. Chi-squared tests compared participants' attitudes and knowledge prevalence in each healthcare and physical activity professionals' sector.</p><p><strong>Results: </strong>Participants (mean age = 48.00 ± 12.55) overwhelmingly supported PA inclusion in healthcare (97.8%) and reimbursement (77%). Translating PA recommendations into clinical practice remains a significant challenge due to several interrelated barriers. These include time constraints that hinder physicians' ability to provide in-depth counseling during routine visits, and patient-related factors, such as low responsiveness (43.8%) and limited awareness (33.3%). Around 70% of physicians endorsed regular PA recommendations. Exercise physiologists (30%) and physiotherapists (28%) were deemed most qualified to instruct T2D patients, followed by physicians (15.7%). A majority (57%) advocated for a multidisciplinary approach to PA prescription, incorporating aerobic, strength, and stretching training.</p><p><strong>Conclusion: </strong>The study underscores the need for the National healthcare system to prioritize infrastructure development, including multidisciplinary teams, for personalized PA programs vital to individuals with T2D.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"16 ","pages":"1518285"},"PeriodicalIF":4.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185171","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 glimpse into the pipeline of anti-obesity medication development: combining multiple receptor pathways.","authors":"Christine Park, Yushin Kim, Sawye Raygani, Eduardo Grunvald","doi":"10.3389/fendo.2025.1630199","DOIUrl":"10.3389/fendo.2025.1630199","url":null,"abstract":"<p><p>Obesity has been historically a stubborn chronic metabolic disease, resistant to multiple therapeutic modalities. Although effective in the short-term for some people, lifestyle interventions have proven difficult to maintain in the long-term. Metabolic bariatric surgery is the most effective treatment for durable weight loss and improvement of obesity-related conditions but is invasive and vastly underutilized. For decades, patients and clinicians confronted a wide gap between lifestyle modification and bariatric procedures. Anti-obesity pharmacotherapy was plagued by either safety concerns or very modest effectiveness. Recently, the availability of highly effective medications has given patients living with obesity hope for better health. These advances represent a culmination of many years of scientific progress regarding our understanding of human weight regulation and the beginning of a new era in treating metabolic diseases. In fact, many molecules are under investigation for obesity therapy, some with novel mechanisms. Since data on these putative agents are appearing at accelerated speed, the aim of this review is to provide an updated synopsis of emerging agents, highlighting the correlation between efficacy and combination strategies.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"16 ","pages":"1630199"},"PeriodicalIF":4.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185231","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":"Dual specificity phosphatase 1 as a non-invasive circulating biomarker candidate in preeclampsia.","authors":"Jonatane Andrieu, Agathe Donet, Jean-François Cocallemen, Guillaume Charbonnier, Noémie Resseguier, Julien Paganini, Jean-Louis Mège, Soraya Mezouar, Florence Bretelle","doi":"10.3389/fendo.2025.1576240","DOIUrl":"10.3389/fendo.2025.1576240","url":null,"abstract":"<p><strong>Introduction: </strong>Preeclampsia (PE) is a multisystem pregnancy complication. Factors pointing to a placental origin are the development of the pathology only during pregnancy, and its disappearance in the post-partum period.</p><p><strong>Methods: </strong>Here, we aim to identify early predictive biomarkers. Whole blood and serum samples were collected at the time of the first event of PE (V1) and same samples after remote delivery (30-60 postpartum days, V2). These two samples enabled investigation of PE markers found in V1 but absent in V2. To confirm that these candidates are associated with PE, an investigation of associated placental biopsy was also realized (J0).</p><p><strong>Results: </strong>Our study identified a specific signature of PE including five Gene Ontology clusters including \"angiogenesis and differentiation\", \"cell-cycle\", \"cell-adhesion\", \"inflammatory response\" and \"cellular metabolism\". DUSP1 (Dual Specificity Phosphatase 1) gene was found specifically modulated in PE. PE women have a higher concentration of DUSP1 in serum compared to healthy donors. Interesting, at a distance from childbirth (V2), DUSP1 finds a rate like control group showing its predictive interest as a promising predictive biomarker of PE.</p><p><strong>Discussion: </strong>The investigation of DUSP1 in a prospective study with a larger cohort, including the severity aspect of the disease, is necessary to confirm its value as a predictive biomarker in PE.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"16 ","pages":"1576240"},"PeriodicalIF":4.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185064","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":"Impact of endometrioma management strategies on ovarian reserve over the follow-up period, a prospective longitudinal study.","authors":"Kiper Aslan, Isil Kasapoglu, Bahadir Kosan, Tansu Bahar Gurbuz, Ludovico Muzii, Gurkan Uncu","doi":"10.3389/fendo.2025.1631108","DOIUrl":"10.3389/fendo.2025.1631108","url":null,"abstract":"<p><strong>Background: </strong>The effects of current treatment options for endometrioma on ovarian reserve remain controversial. Recent advancements in surgical techniques may challenge the previously established evidence regarding the detrimental effects of surgery on ovarian reserve. Additionally, whether medical suppression therapy provides a protective effect during this process remains an unanswered question. Furthermore, the impact on ovarian reserve in patients managed expectantly, without active intervention, is unclear.</p><p><strong>Objective: </strong>This study aims to evaluate the effects of endometrioma per se or its treatment modalities on ovarian reserve.</p><p><strong>Methods: </strong>In this prospective study, eighty women diagnosed with endometrioma via ultrasonography and twenty age-matched healthy women as controls were enrolled. The study group was divided into four subgroups, each consisting of twenty patients, based on the treatment modality received: expectant management, oral contraceptive pills (OCP), dienogest, and surgery. All participants underwent baseline ultrasonographic evaluations and blood sampling to determine serum anti-Müllerian hormone (AMH) levels at the time of enrollment. Follow-up assessments, including repeat ultrasonography and AMH measurements, were conducted six months after the initial evaluation.</p><p><strong>Results: </strong>The median six-month decline in serum AMH levels was 19% in the expectant management group, 26% in the OCP group, 21% in the dienogest group, 38% in the surgery group, and 8% in the healthy controls. Thus, statistically significant differences in AMH decline were observed between the OCP group and healthy controls (<i>p</i> = 0.034), and between the surgery group and healthy controls (<i>p</i> = 0.001).</p><p><strong>Conclusion: </strong>Despite advances in surgical techniques and precautions, surgical excision of endometriomas continues to pose a risk to ovarian reserve. Treatment with both dienogest and OCP is associated with a decrease in serum AMH levels, although the decline appears less significant with dienogest. Patients managed expectantly also showed a progressive decline in ovarian reserve compared to healthy controls.<b>Trial Registration Number:</b> Clinical Trials, NCT03620838.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"16 ","pages":"1631108"},"PeriodicalIF":4.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185077","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":"Current concepts of tocilizumab efficacy in active moderate-to-severe corticosteroid-resistant cases of Graves' orbitopathy.","authors":"Georgios Boutzios, Anastasia Nikolopoulou, Sofia Chatzi, Athanasios G Tzioufas, Andreas V Goules","doi":"10.3389/fendo.2025.1632531","DOIUrl":"10.3389/fendo.2025.1632531","url":null,"abstract":"<p><p>Graves' orbitopathy (GO) is an autoimmune disease affecting the orbit and the retro-ocular tissues. GO pathogenesis involves multiple complex mechanisms, including the contribution of many inflammatory cytokines, such as interleukin-6 (IL-6). GO severity ranges from mild to severe and sight-threatening cases, with the latter affecting only a small percentage of patients. A considerable number of these patients do not respond to first-line immunosuppressive therapy with weekly intravenous pulses of corticosteroids and therefore, there is an unmet need for a second-line treatment, based on immunosuppressive drugs. In recent years tocilizumab (TCZ), an IL-6 inhibitor, has emerged as an effective and safe alternative option for the treatment of active, moderate-to-severe, refractory to steroids cases of GO. This review focuses on the up-to-date concepts regarding TCZ administration for the management of these patients.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"16 ","pages":"1632531"},"PeriodicalIF":4.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185108","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}