Frontiers in Endocrinology最新文献

{"title":"Association between thyroid hormone sensitivity and carotid plaque risk: a health examination cohort-based study.","authors":"Rui Gong, Shi Wang, Hongqiong Ding, Lixia Yu, Ming Xu, Sanping Xu, Yan Ling","doi":"10.3389/fendo.2024.1472752","DOIUrl":"10.3389/fendo.2024.1472752","url":null,"abstract":"<p><strong>Introduction: </strong>The involvement of thyroid hormone in cardiovascular disease remains debated. The aim of our research was to ascertain whether thyroid hormone sensitivity indices are related to carotid plaque (CAP) risk in the general population.</p><p><strong>Methods: </strong>We recruited 5,360 participants for health examinations to explore the correlation between thyroid hormone sensitivity indices and CAP risk. We then compared baseline characteristics of participants with CAP to those without CAP based on multivariate logistic regression analysis. Additionally, we conducted subgroup analyses stratified by gender and age to further elucidate this relationship.</p><p><strong>Results: </strong>Among the 5,360 participants, 1,055 (19.7%) were diagnosed with CAP. After adjusting for various confounding factors, our results showed a positive association between CAP risk and the indices (TFQI, PTFQI, TSHI, and TT4RI). Conversely, the FT3/FT4 ratio showed a negative correlation with CAP risk. Sex-based subgroup analysis revealed a stronger correlation between thyroid hormone sensitivity and CAP in females compared to males. In the age subgroup, the significant association was observed in older individuals (age >60) compared to middle-aged participants (age ≤60).</p><p><strong>Conclusion: </strong>Our study suggests a significant correlation between thyroid hormone sensitivity and CAP, particularly in females and participants over the age of 60.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"15 ","pages":"1472752"},"PeriodicalIF":3.9,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893323","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":"HOMA-beta independently predicts survival in patients with advanced cancer on treatment with immune checkpoint inhibitors.","authors":"Mayu Watanabe, Jun Eguchi, Atsushi Takamoto, Hiromitsu Kanzaki, Yohei Noda, Syunsuke Kagawa, Jun Wada","doi":"10.3389/fendo.2024.1439705","DOIUrl":"10.3389/fendo.2024.1439705","url":null,"abstract":"<p><strong>Background: </strong>Although immune checkpoint inhibitors (ICIs) are effective cancer drugs, ICI-induced diabetes is a rare but a life-threatening adverse event for patients. The deleterious action of ICI on pancreatic beta-cell function is a concern. However, the influence of ICI on insulin synthesis and secretion in patients with cancer without diabetes remains unknown.</p><p><strong>Methods: </strong>This study included 87 patients diagnosed with advanced cancer. Glucose metabolism markers (HbA1c, HOMA-IR) and indicators of insulin secretory capacity (HOMA-beta, C-peptide) were prospectively evaluated in patients with ICI-treated cancers to determine their association with cancer prognosis.</p><p><strong>Results: </strong>Patients with overall survival (OS) ≥ 7 months had substantially higher HOMA-beta levels at baseline (p=0.008) and 1 month after ICI administration (p=0.006) compared to those with OS <7 months. The median OS was significantly longer in patients with HOMA-beta ≥ 64.24 (13 months, 95%CI: 5.849-20.151, 37 events) than in those with HOMA-beta < 64.24 (5 months, 95%CI: 3.280-6.720, 50 events) (p=0.013). Further, the median progression-free survival (PFS) was significantly longer in patients with HOMA-beta ≥ 66.43 (4 months, 95%CI: 3.073-4.927, 33 events) than in those with HOMA-beta < 66.43 (2 months, 95%CI: 1.410-2.590, 54 events) (p=0.025). Additionally, multivariable logistic regression analysis revealed that a HOMA-beta value ≥ 64.24 independently predicted longer OS in ICI-treated patients.</p><p><strong>Conclusions: </strong>Pre-ICI HOMA-beta level is linked to longer OS in ICI-treated patients. This connection is significant and shows that insulin secretory capacity may predict ICI efficacy.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"15 ","pages":"1439705"},"PeriodicalIF":3.9,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893082","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":"Unveiling risk factors for post-COVID-19 syndrome development in people with type 2 diabetes.","authors":"Anton Matviichuk, Viktoriia Yerokhovych, Sergii Zemskov, Yeva Ilkiv, Vitalii Gurianov, Zlatoslava Shaienko, Tetyana Falalyeyeva, Oksana Sulaieva, Nazarii Kobyliak","doi":"10.3389/fendo.2024.1459171","DOIUrl":"10.3389/fendo.2024.1459171","url":null,"abstract":"<p><strong>Introduction: </strong>Post-COVID-19 syndrome (PCS) is a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection-associated chronic condition characterized by long-term violations of physical and mental health. People with type 2 diabetes (T2D) are at high risk for severe COVID-19 and PCS.</p><p><strong>Aim: </strong>The current study aimed to define the predictors of PCS development in people with T2D for further planning of preventive measures and improving patient outcomes.</p><p><strong>Materials and methods: </strong>The data were collected through the national survey targeting persons with T2D concerning the history of COVID-19 course and signs and symptoms that developed during or after COVID-19 and continued for more than 12 weeks and were not explained by an alternative diagnosis. In total, 469 patients from different regions of Ukraine were enrolled in the study. Among them, 227 patients reported PCS development (main group), while 242 patients did not claim PCS symptoms (comparison group). Stepwise multivariate logistic regression and probabilistic neural network (PNN) models were used to select independent risk factors.</p><p><strong>Results: </strong>Based on the survey data, 8 independent factors associated with the risk of PCS development in T2D patients were selected: newly diagnosed T2D (OR 4.86; 95% CI 2.55-9.28; p<0.001), female sex (OR 1.29; 95% CI 0.86-1.94; p=0.220), COVID-19 severity (OR 1.35 95% CI 1.05-1.70; p=0.018), myocardial infarction (OR 2.42 95% CI 1.26-4.64; p=0.002) and stroke (OR 3.68 95% CI 1.70-7.96; p=0.001) in anamnesis, HbA1c above 9.2% (OR 2.17 95% CI 1.37-3.43; p=0.001), and the use of insulin analogs (OR 2.28 95% CI 1.31-3.94; p=0.003) vs human insulin (OR 0.67 95% CI 0.39-1.15; p=0.146). Although obesity aggravated COVID-19 severity, it did not impact PCS development. In ROC analysis, the 8-factor multilayer perceptron (MLP) model exhibited better performance (AUC 0.808; 95% CІ 0.770-0.843), allowing the prediction of the risk of PCS development with a sensitivity of 71.4%, specificity of 76%, PPV of 73.6% and NPV of 73.9%.</p><p><strong>Conclusions: </strong>Patients who were newly diagnosed with T2D, had HbA1c above 9.2%, had previous cardiovascular or cerebrovascular events, and had severe COVID-19 associated with mechanical lung ventilation were at high risk for PCS.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"15 ","pages":"1459171"},"PeriodicalIF":3.9,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893352","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":"Management of perioperative thyrotoxicosis - what to do when standard therapy is contraindicated or fails?","authors":"Kristy Tian, Trilene Liang, Jielin Yew, Chiaw-Ling Chng","doi":"10.3389/fendo.2024.1498014","DOIUrl":"10.3389/fendo.2024.1498014","url":null,"abstract":"<p><strong>Background: </strong>Current guidelines recommend that hyperthyroid patients should be rendered euthyroid prior to surgical procedures. These guidelines rely heavily on the use of ATDs as the primary medication, and do not give recommendations for patients who have contraindications to ATDs, or for whom standalone ATD treatment is inadequate.</p><p><strong>Objectives: </strong>To evaluate the efficacy and safety of adjunctive pharmacological therapy and/or therapeutic plasma exchange (TPE) in the perioperative management of patients with thyrotoxicosis who were intolerant to ATD or for whom standalone ATD therapy was inadequate to achieve euthyroidism prior to surgery.</p><p><strong>Methods: </strong>A comprehensive search of MEDLINE, Google Scholar, Embase and CENTRAL up to 31 December 2023 retrieved 12,876 records. After screening titles, abstracts and full manuscripts, 16 reports were enrolled. The study quality was evaluated using the Newcastle-Ottawa Scale (NOS).</p><p><strong>Results: </strong>Patients were primarily female (78.5%), aged between 35 and 52 years. The predominant thyroid condition was Graves' disease (89.7%). Majority underwent thyroidectomy (99.3%). Patients treated pre-operatively with 2nd line pharmacotherapy with/without therapeutic plasma exchange (TPE) underwent surgery safely with no reports of perioperative thyroid storm. Pre-operative treatment achieved mean percentage reduction of free thyroxine and free triiodothyronine levels of 52.6 ± 8.2% and 68.1 ± 9.3% respectively. One study reported a patient who suffered from myocardial infarction and tachyarrhythmia and subsequently demised.</p><p><strong>Conclusion: </strong>Preoperative management of hyperthyroidism with second line pharmacotherapy and/or TPE can be effectively and safely implemented in patients with intolerance to or ineffective treatment with ATDs. The treatment modalities were generally safe, though some complications were observed.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"15 ","pages":"1498014"},"PeriodicalIF":3.9,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893088","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":"Editorial: Advances in targeted therapy and biomarker research for endocrine-related cancers.","authors":"Yang Wu, Zili Zhang","doi":"10.3389/fendo.2024.1533623","DOIUrl":"10.3389/fendo.2024.1533623","url":null,"abstract":"","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"15 ","pages":"1533623"},"PeriodicalIF":3.9,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893332","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":"Editorial: Rare forms of pediatric adrenal disorders: beyond congenital adrenal hyperplasia due to 21-hydroxylase deficiency.","authors":"Rosario Ferrigno, Mariacarolina Salerno, Martin O Savage","doi":"10.3389/fendo.2024.1512883","DOIUrl":"10.3389/fendo.2024.1512883","url":null,"abstract":"","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"15 ","pages":"1512883"},"PeriodicalIF":3.9,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893337","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":"The embryo stage at fresh ET does not affect the cumulative live birth rate in women with a thin endometrium: a retrospective matched-controlled cohort study.","authors":"Qiao-Song Han, Yan-Hua Chen, Bin Zhang, Jing-Yan Song, Ying Xu, Heng-Bing Li, Zi-Zhen Guo, Zhen-Gao Sun","doi":"10.3389/fendo.2024.1448138","DOIUrl":"10.3389/fendo.2024.1448138","url":null,"abstract":"<p><strong>Background: </strong>The blastocyst-stage embryo has been considered more advantageous for increasing the cumulative live birth rate (CLBR) at fresh embryo transfer (ET) compared to the cleavage-stage embryo. However, it remains uncertain whether this advantage extends to specialized subpopulations, such as women with thin endometrium (TE), who are characteristic of impaired endometrial receptivity. Thus, this study aims to evaluate the difference in the CLBR between cleavage-stage and blastocyst-stage embryos at fresh ET specifically in women with TE.</p><p><strong>Methods: </strong>A retrospective cohort comprising 1089 women from three centers, ranging from September 2017 to January 2022, was established. These women were diagnosed with TE (defined as endometrium thickness <= 8 mm) and underwent their first fresh ET. To create a comparable cohort between the cleavage and blastocyst groups while adjusting for key covariates, the propensity score matching (PSM) method was employed. The primary outcome assessed was the CLBR per woman. Both cohorts underwent Kaplan-Meier analysis, Cox proportional hazard models, cumulative incidence function (CIF) curve analysis, and Fine-Grey competing risk models to ascertain the impact of embryo stage at fresh ET on CLBR. Additionally, a sensitivity analysis was conducted within a subgroup defining thin endometrium as an endometrium thickness (EMT) < 7 mm.</p><p><strong>Results: </strong>In the matched cohort after PSM, the CLBR was comparable between groups (p=0.331). However, the cleavage-stage fresh ET was associated with an elevated risk of low birth weight (LBW) (p=0.005) and small for gestational age (SGA) (p=0.037). Kaplan-Meier analysis showed that the median number of embryo transfer cycles was 2 in the cleavage group and 3 in the blastocyst group. The CLBR for the cleavage group reached 78.1%, while the blastocyst group reached 60.0% after 5 cycles of embryo transfers (log-rank test, p=0.09). A multivariable Cox proportional hazard model indicated no significant association between the embryo stage at fresh ET and CLBR (HR=0.80, 95% CI=0.60-1.07). The CIF curve and Fine-Grey competing risk models demonstrated similar results. These analyses were repeated in the original cohort before PSM and in the subgroup with EMT < 7 mm, and the results remained robust.</p><p><strong>Conclusion: </strong>For TE women receiving fresh ET, the choice between the cleavage-stage embryo and the blastocyst-stage embryo yields comparable CLBR. However, selecting the cleavage-stage embryo is associated with increased risks of LBW and SGA births.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"15 ","pages":"1448138"},"PeriodicalIF":3.9,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893438","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":"Subclinical/overt hypothyroidism may be associated with diminished ovarian reserve in infertile women independent of thyroid autoimmunity.","authors":"Hongzhan Zhang, Han Qiu, Zhiqiang Liu, Yulian Wu, Wei Liu, Chunyu Huang","doi":"10.3389/fendo.2024.1477665","DOIUrl":"10.3389/fendo.2024.1477665","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between thyroid dysfunction or thyroid autoimmunity (TAI) and diminished ovarian reserve (DOR).</p><p><strong>Methods: </strong>A total of 2,867 women undergoing their first <i>in-vitro</i> fertilization (IVF) cycle at Shenzhen Zhongshan Obstetrics & Gynecology Hospital between January 1, 2013 and June 30, 2021, were enrolled in this study. The participants had documented thyroid and ovarian reserve metrics. They were categorized into three groups based on their thyroid function: normal thyroid function (N = 2,540), subclinical/overt hypothyroidism (SCH/OH) (N = 290), and subclinical/overt hyperthyroidism (N = 37). Anti-Mullerian hormone (AMH) and antral follicle count (AFC) were assessed and collected. Women with AMH <1.2 ng/mL and AFC < 5 were diagnosed with DOR. Basic characteristics and ovarian reserve-related parameters were compared among the three groups. The association between thyroid function and ovarian reserve function was further analyzed using logistical regression analyses. In addition, the euthyroid population was stratified using a thyroid-stimulating hormone (TSH) threshold of 2.5 µIU/mL, and the ovarian reserve-related parameters were compared among women with low-normal TSH (TSH < 2.5 µIU/mL), high-normal TSH (2.5 µIU/mL ≤ TSH ≤ 4.2 µIU/mL) and SCH/OH.</p><p><strong>Results: </strong>Women with SCH/OH had lower AMH levels (2.79 ng/mL vs. 3.41 ng/mL, <i>P</i> < 0.001) and a significantly higher prevalence of AMH level < 1.2ng/mL (17.2% vs. 12.1%, <i>P</i> = 0.015) compared to those with normal thyroid function. The prevalence of DOR was also higher among women with SCH/OH (10.0% vs. 6.5%, <i>P</i> = 0.036). There were no significant differences in ovarian reserve between women with normal thyroid function and those with subclinical/overt hyperthyroidism. Logistic regression analyses showed that the odds ratio (OR) of women with SCH/OH suffering from DOR was 1.666 (95% CI: 1.079-2.572) compared to those with normal thyroid function, after adjusting for TAI status and basic clinical characteristics. When the euthyroid group was stratified according to TSH levels, women with SCH/OH showed significantly lower AMH levels compared to women with low-normal TSH (2.79 ng/mL vs. 3.44 ng/mL, <i>P</i> < 0.001) and a significantly higher prevalence of DOR (10.0% vs. 6.0%, <i>P</i> = 0.010). Logistic regression analyses showed that the women with SCH/OH had an increased prevalence of DOR (OR: 1.819, 95% CI: 1.158-2.858) compared to those with low-normal TSH, after adjusting for TAI status and basic clinical characteristics. However, the OR for DOR among women with high-normal TSH was not significantly elevated compared to those with low-normal TSH (OR: 1.310, 95% CI: 0.936-1.832).</p><p><strong>Conclusion: </strong>SCH/OH may be associated with DOR, irrespective of TAI status.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"15 ","pages":"1477665"},"PeriodicalIF":3.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885308","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":"The association between triglyceride-glucose index and neutrophil-lymphocyte ratio and all-cause mortality in the general US population: NHANES 2001-2018.","authors":"Yifei Wang, Cheng Gu, Bingbing Chen, Binxu Qiu, Jinhai Yu","doi":"10.3389/fendo.2024.1513543","DOIUrl":"10.3389/fendo.2024.1513543","url":null,"abstract":"<p><strong>Background: </strong>The association between the triglyceride-glucose (TyG) index and mortality in the general population remains controversial, with inconsistent findings across studies.</p><p><strong>Objective: </strong>This study aims to investigate the relationship between the TyG index and mortality in the U.S. Additionally, it explores whether a new index, combining the TyG index with the neutrophil-to-lymphocyte ratio (NLR), improves the prediction of all-cause compared to the TyG index alone.</p><p><strong>Methods: </strong>Systemic inflammatory markers and the TyG index were calculated based on participants' complete blood counts and fasting triglyceride and glucose levels. The TyG-NLR index was derived by multiplying the TyG index by the NLR. A weighted Cox proportional hazards model was used to evaluate the associations of the TyG and TyG-NLR indices with mortality risk in the general population. Restricted cubic splines (RCS) were applied to explore and visualize the dose-response relationships between the indices and mortality.</p><p><strong>Result: </strong>This study included 15388 participants. During a median follow-up of 118 months, 2,333 participants died. After adjusting for potential confounders, no significant association was found between the TyG index and mortality. However, compared to the lowest quartile, participants in the highest quartile of the TyG-NLR index showed a significant association with all-cause mortality. Specifically, those in the highest quartile had a 63% higher risk of all-cause mortality.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"15 ","pages":"1513543"},"PeriodicalIF":3.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885310","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":"Bile acids as a key target: traditional Chinese medicine for precision management of insulin resistance in type 2 diabetes mellitus through the gut microbiota-bile acids axis.","authors":"Yu Wang, Jing Yu, Binqin Chen, Wenqi Jin, Meili Wang, Xuenan Chen, Mengqiong Jian, Liwei Sun, Chunli Piao","doi":"10.3389/fendo.2024.1481270","DOIUrl":"10.3389/fendo.2024.1481270","url":null,"abstract":"<p><p>Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease caused by insulin resistance (IR) and insufficient insulin secretion. Its characteristic pathophysiological processes involve the interaction of multiple mechanisms. In recent years, globally, the prevalence of T2DM has shown a sharp rise due to profound changes in socio-economic structure, the persistent influence of environmental factors, and the complex role of genetic background. It is worth noting that most T2DM patients show significant IR, which further exacerbates the difficulty of disease progression and prevention. In the process of extensively exploring the pathogenesis of T2DM, the dynamic equilibrium of gut microbes and its diverse metabolic activities have increasingly emphasized its central role in the pathophysiological process of T2DM. Bile acids (BAs) metabolism, as a crucial link between gut microbes and the development of T2DM, not only precisely regulates lipid absorption and metabolism but also profoundly influences glucose homeostasis and energy balance through intricate signaling pathways, thus playing a pivotal role in IR progression in T2DM. This review aims to delve into the specific mechanism through which BAs contribute to the development of IR in T2DM, especially emphasizing how gut microbes mediate the metabolic transformation of BAs based on current traditional Chinese medicine research. Ultimately, it seeks to offer new insights into the prevention and treatment of T2DM. Diet, genetics, and the environment intricately sculpt the gut microbiota and BAs metabolism, influencing T2DM-IR. The research has illuminated the significant impact of single herbal medicine, TCM formulae, and external therapeutic methods such as electroacupuncture on the BAs pool through perturbations in gut microbiota structure. This interaction affects glucose and lipid metabolism as well as insulin sensitivity. Additionally, multiple pathways including BA-FXR-SHP, BA-FXR-FGFR15/19, BA-FXR-NLRP3, BA-TGR5-GLP-1, BAs-TGR5/FXR signaling pathways have been identified through which the BAs pool significantly alter blood glucose levels and improve IR. These findings offer novel approaches for enhancing IR and managing metabolic disorders among patients with T2DM.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"15 ","pages":"1481270"},"PeriodicalIF":3.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885041","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}