Frontiers in Medicine最新文献

{"title":"Registration and characteristics of clinical trials on traditional Chinese medicine and natural medicines for endometriosis: a comprehensive analysis.","authors":"Yi Zhao, Yike Wang, Zhu Xue, Yuanyuan Weng, Cencan Xia, Jingyang Lou, Minmin Jiang","doi":"10.3389/fmed.2024.1432815","DOIUrl":"10.3389/fmed.2024.1432815","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the characteristics of clinical trials on traditional Chinese medicine (TCM) or natural medicines for treating endometriosis, aiming to inform future clinical practice and the development of new effective drugs.</p><p><strong>Method: </strong>The global clinical trial registration platform was searched to identify clinical trials investigating the efficacy of TCM/natural medicine in treating endometriosis. Relevant trials were selected based on stringent inclusion and exclusion criteria. Data entry was performed using Microsoft Excel, while data analysis was conducted using SPSS version 23.</p><p><strong>Results: </strong>The study encompassed 57 trials, of which ClinicalTrials.gov accounted for 18, ChiCTR for 3, ICRP for 15, and ChiDTR for 21 trials. The number of registrations showed a significant positive correlation with the years. Of the 57 clinical trials, 87.7% were randomized, 63.2% were blinded, 78.9% followed a parallel intervention model, and 56.1% had a sample size below 100. Regarding trial phases, 45.6% of clinical trials did not specify a phase, while Phase 3 and Phase 4 clinical trials accounted for 17.5%. Nine clinical trials involved drugs that are already on the market, including six Chinese patent medicines: Sanjie Zhentong Capsules, Honghua Ruyi Pills, Huayu Sanjie Enema Liquid, Kuntai Capsules, Wenjing Tang, and Xuefu Zhuyu Capsules. Outside China, Iran has the highest number of registrations for natural medicine treatments for endometriosis, with curcumin being the most registered natural medicine.</p><p><strong>Conclusion: </strong>The analysis reveals that clinical trials on TCM and natural remedies for endometriosis often utilize randomization; however, substantial deficiencies remain in blinding and sample size adequacy. These findings suggest that, despite growing interest in TCM and natural remedies, further methodological improvements are necessary to enhance the credibility of future studies. This research highlights the importance of rigorously designed clinical trials in verifying the safety and efficacy of these alternative therapies, which may influence future therapeutic approaches for managing endometriosis.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1432815"},"PeriodicalIF":3.1,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11573583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case report: How I do it? Laparoscopic hepatectomy with transcatheter arterial ICG staining for hepatolithiasis review.","authors":"Jingyi Xu, Xinye Qian, Wei Yang, Fei Yu, Yufan Yang, Wang Hu, Lu Gao, Shuang Wang, Liusheng Wu, Yutong Zhao, Lei Yang, Lin Zhang, Jun Yan","doi":"10.3389/fmed.2024.1470120","DOIUrl":"10.3389/fmed.2024.1470120","url":null,"abstract":"<p><strong>Background: </strong>Hepatolithiasis is regarded as the presence of stones in the intrahepatic bile ducts. Recurrent inflammation of bile ducts can bring many bad effects. How to completely remove stones is still a challenge.</p><p><strong>Presentation: </strong>A 66-year-old male went to our hospital because of hepatolithiasis and choledocholithiasis. Selective hepatic arteriography and transcatheter arterial embolization followed by laparoscopic watershed hepatectomy under fluorescent navigation and laparoscopic common bile duct exploration on mass removal are performed.</p><p><strong>Clinical discussion: </strong>For patients who suffer from hepatolithiasis, the main treatment principles of the operation are to remove the stones, correct the stenosis, and prevent recurrence. The laparoscopic watershed hepatectomy under fluorescent navigation can provide important support for precision liver surgery, which can give some suggestions for future hepatectomy.</p><p><strong>Conclusion: </strong>Based on the three-dimensional (3D) visual watershed analysis, trans-arterial DSA positive fluorescence navigation has some advantages, which successfully overcome the shortcomings of the reverse staining method and the positive staining method.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1470120"},"PeriodicalIF":3.1,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11573506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-related quality of life and complications of corticosteroid treatment in patients with immune thrombocytopenia in two teaching hospitals in Ethiopia: a cross-sectional study.","authors":"Dessale Abate Beyene, Eskinder Ayalew Sisay, Atalay Mulu Fentie, Amha Gebremedhin","doi":"10.3389/fmed.2024.1423161","DOIUrl":"10.3389/fmed.2024.1423161","url":null,"abstract":"<p><strong>Background: </strong>The treatment of immune thrombocytopenia (ITP) is a major clinical challenge and has a significant impact on health-related quality of life (HRQoL), and prolonged use of corticosteroids may have a negative impact on HRQoL.</p><p><strong>Objectives: </strong>To evaluate the impact of ITP on HRQoL and complications of corticosteroid treatment in patients with ITP in two teaching hospitals in Ethiopia.</p><p><strong>Methods: </strong>The institution-based cross-sectional study was conducted from November 15, 2022, to March 15, 2023, to recruit 214 study participants during the study period (4 months). The ITP Life Quality Index (ILQI) in the Amharic version was used to assess the impact of ITP. Linear regression analysis models were also used, and a <i>p</i>-value of less than 0.05 was generally considered statistically significant.</p><p><strong>Results: </strong>Regarding treatment, the majority 172 (80.4%) of study participants were taking prednisolone only, and 143 (66.8%) of study participants had at least one side effect of corticosteroids during the entire treatment period. Predictive factors for a higher impact of ITP on HRQoL; all correlated variables explained 36.5% (adjusted R-squared = 0.365, <i>p</i> < 0.0001) of the variance and had a moderate impact on HRQoL. Furthermore, predictive factors for an increasingly higher impact of ITP on HRQoL were the development of emotionally related corticosteroid side effects (<i>β</i> = 0.392, 95% CI: 5.160-9.961, <i>p</i> < 0.001), the presence of fatigue during the assessment (<i>β</i> = 0.326, 95% CI: 4.394-9.475, <i>p</i> < 0.001), patients not taking cotrimoxazole prophylaxis treatment (<i>β</i> = 0.236, 95% CI: 2.236-6.570, p < 0.001), living far from the hematology clinic (outside Addis Ababa) (<i>β</i> = 0166, 95% CI: 1.107-5.114 <i>p</i> = 0.003), having epistaxis and/or wet purpura (mucosal bleeding) (<i>β</i> = 0.191, 95% CI: 0.091-4.259, <i>p</i> = 0.001), and skin symptoms (petechiae and ecchymosis) (<i>β</i> = 0.041, 95% CI: 0.091-4.259 <i>p</i> = 0.041) during diagnosis.</p><p><strong>Conclusion: </strong>The impact of ITP on their energy levels and work life was high compared to the impact of ITP on daily life. The side effects of corticosteroids also affect the HRQoL of ITP patients.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1423161"},"PeriodicalIF":3.1,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11573527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Education in obstetrics and gynecology.","authors":"Florian Recker, Fedde Scheele","doi":"10.3389/fmed.2024.1490673","DOIUrl":"10.3389/fmed.2024.1490673","url":null,"abstract":"","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1490673"},"PeriodicalIF":3.1,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11573521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 Primary Care Assessment Tool (PCAT) and Assessment of Chronic Illness Care (ACIC): a Brazilian cross-sectional study.","authors":"Brenda Lorrana de Almeida Gomes, Renan Felipe Neves Mota, Renata Sant'ana Braga, Cynthia Assis de Barros Nunes, Rafael Alves Guimarães, Ana Paula Dos Santos Rodrigues, Sandro Rogério Rodrigues Batista, Valéria Pagotto","doi":"10.3389/fmed.2024.1374801","DOIUrl":"10.3389/fmed.2024.1374801","url":null,"abstract":"<p><strong>Aim: </strong>To analyze the association between Primary Health Care (PHC) performance and institutional ability to provide care for individuals with noncommunicable diseases (NCDs).</p><p><strong>Methods: </strong>Cross-sectional study conducted with primary care nurses and physicians in Brazil. The performance of PHC was assessed by using the Primary Care Assessment Tool (PCAT), whereas institutional ability for the care of people with NCDs was assessed through the Assessment of Chronic Illness Care (ACIC). Pearson correlation and multiple linear regression models were used to analyze the association between the PHC attributes measured in the PCAT (independent variables) and the ACIC dimensions (dependent variables).</p><p><strong>Results: </strong>In total, 308 health professionals -190 nurses (61.7%) and 118 physicians (38.3%)-at mean age 37.5 years and mean time of 6.5 years working in PHC participated of the study. On a scale of 0 to 10, the overall PCAT score was 6.74, while the ACIC score was 5.20. The PCAT score was High in only 58.8% of respondents (score ≥6.6). The ACIC scores showed basic institutional ability to care for people with NCDs. All ACIC dimensions have shown positive correlation to PCAT attributes, except for accessibility, continuity of care and care coordination.</p><p><strong>Conclusion: </strong>A positive association was found between PHC performance and institutional ability to care for people with NCDs. Results have evidenced the need of investing in PCH by providing technical, political, logistical and financial support to PHC units to improve PHC organization points and care for people with NCDs.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1374801"},"PeriodicalIF":3.1,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142666358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy of lung ultrasound to predict weaning outcome: a systematic review and meta-analysis.","authors":"Zhiyang Zhang, Li Guo, Huawei Wang, Ze Zhang, Limin Shen, Heling Zhao","doi":"10.3389/fmed.2024.1486636","DOIUrl":"10.3389/fmed.2024.1486636","url":null,"abstract":"<p><strong>Background: </strong>This systematic review and meta-analysis aim to systematically assess the diagnostic accuracy of lung ultrasound in predicting weaning failure from mechanical ventilation in critically ill patients.</p><p><strong>Methods: </strong>We searched the relevant literature up to January 2024 in the databases Web of Science, Cochrane Library, Embase, and PubMed. Two researchers independently screened eligible studies and extracted data; disagreements, if any, were resolved through discussion or consultation with a third-party expert. The quality of the included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Statistical analyses were performed using Review Manager version 5.3 and Stata version 18.0, applying bivariate random-effects models to estimate sensitivity, specificity, diagnostic odds ratios, and their 95% confidence intervals, as well as to summarize receiver operating characteristic curves. Inter-study heterogeneity was assessed using the I-squared statistic, and potential sources of heterogeneity were explored by meta-regression analysis. The study follows the guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses in reporting.</p><p><strong>Results: </strong>Fourteen studies were included in the systematic review, of which 13 studies (totaling 988 patients) were included in the meta-analysis. The meta-analysis revealed an overall sensitivity of 0.86 (95% confidence interval: 0.77-0.91) and a specificity of 0.75 (95% confidence interval: 0.66-0.83) for lung ultrasound in predicting extubation failure. The area under the receiver operating characteristic curve was 0.87 (95% confidence interval: 0.84-0.89). Meta-regression analysis identified lung ultrasound thresholds, reference standards (extubation outcomes), and study flow and time bias as significant factors influencing diagnostic accuracy.</p><p><strong>Conclusion: </strong>This systematic review and meta-analysis demonstrated that lung ultrasound has high diagnostic accuracy in predicting extubation failure in mechanically ventilated critically ill patients. Despite some study heterogeneity, lung ultrasound proved to be a reliable predictive tool for extubation failure. Future research should focus on standardizing the definition of extubation failure, exploring the impact of different thresholds on the predictive ability of lung ultrasound, and validating its application in various clinical settings to enhance its utility and accuracy in clinical practice.</p><p><strong>Systematic review registration: </strong>This systematic review and meta-analysis was registered with PROSPERO (registration number: CRD42024555909). The study adhered to the guidelines set by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Details of the PROSPERO protocol can be found in Supplementary Table 1.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1486636"},"PeriodicalIF":3.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retraction: Immunotherapies against human bacterial and fungal infectious diseases: a review.","authors":"","doi":"10.3389/fmed.2024.1518352","DOIUrl":"10.3389/fmed.2024.1518352","url":null,"abstract":"<p><p>[This retracts the article DOI: 10.3389/fmed.2023.1135541.].</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1518352"},"PeriodicalIF":3.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of tissue damage and inflammation for robotic laparoscopy and conventional laparoscopy in early endometrial cancer.","authors":"Shengnan Meng, Yanling Cao, Qingwei Shen, Ling Dong, Nan Wang","doi":"10.3389/fmed.2024.1492469","DOIUrl":"10.3389/fmed.2024.1492469","url":null,"abstract":"<p><strong>Introduction: </strong>This study was to analyze the dynamics of tissue damage and inflammatory response markers perioperatively and whether these differ between robotic laparoscopy and conventional laparoscopy in early endometrial cancer.</p><p><strong>Methods: </strong>In a randomized controlled trial conducted at SHANGHAI FIRST MATERNITY and INFANT HOSPITAL, eighty women with early-stage, low-risk endometrial cancer were randomly assigned to receive either robotic or conventional laparoscopy. Blood samples were collected at admission, immediately before surgery, 2 h after surgery, 24 h after surgery, 48 h after surgery, and 1 week after surgery. The samples were analyzed for various biomarkers associated with inflammatory processes and tissue damage. These included high-sensitivity C-reactive protein (hs-CRP), white blood cell count (WBC), platelet count, interleukin-6 (IL-6), cortisol, creatine kinase (CK), and tumor necrosis factor-alpha (TNF-<i>α</i>). These markers provide insights into the underlying physiological responses and potential tissue-level changes within the study participants.</p><p><strong>Results: </strong>There was no significant difference in clinical and preoperative data between two groups. The results showed that the patients who underwent robotic laparoscopy had a longer pre-surgical time compared to the conventional laparoscopy group. However, the robotic group had shorter operating times, quicker vaginal cuff closures, and lower estimated blood loss compared to the conventional laparoscopy group. The hospital stays, Visual Analog Scale (VAS) score and drainage volume on the first day after operation were lower in robotic group compared to conventional laparoscopy group. hs-CRP, WBC, IL-6 and cortisol were significantly lower in the robotic group, though the differences were transient.</p><p><strong>Discussion: </strong>This study demonstrated that robotic laparoscopy, used in early endometrial cancer treatment, leads to a reduced inflammatory response, less tissue damage, and lower stress levels, as evidenced by decreased levels of hs-CRP, IL-6, and cortisol, compared to conventional laparoscopy. These findings suggest that robot- laparoscopy may facilitate a quicker recovery and improve patient-reported outcomes.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1492469"},"PeriodicalIF":3.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A study of machine learning to predict NRDS severity based on lung ultrasound score and clinical indicators.","authors":"Chunyan Huang, Xiaoming Ha, Yanfang Cui, Hongxia Zhang","doi":"10.3389/fmed.2024.1481830","DOIUrl":"10.3389/fmed.2024.1481830","url":null,"abstract":"<p><strong>Objective: </strong>To develop predictive models for neonatal respiratory distress syndrome (NRDS) using machine learning algorithms to improve the accuracy of severity predictions.</p><p><strong>Methods: </strong>This double-blind cohort study included 230 neonates admitted to the neonatal intensive care unit (NICU) of Yantaishan Hospital between December 2020 and June 2023. Of these, 119 neonates were diagnosed with NRDS and placed in the NRDS group, while 111 neonates with other conditions formed the non-NRDS (N-NRDS) group. All neonates underwent lung ultrasound and various clinical assessments, with data collected on the oxygenation index (OI), sequential organ failure assessment (SOFA), respiratory index (RI), and lung ultrasound score (LUS). An independent sample test was used to compare the groups' LUS, OI, RI, SOFA scores, and clinical data. Use Least Absolute Shrinkage and Selection Operator (LASSO) regression to identify predictor variables, and construct a model for predicting NRDS severity using logistic regression (LR), random forest (RF), artificial neural network (NN), and support vector machine (SVM) algorithms. The importance of predictive variables and performance metrics was evaluated for each model.</p><p><strong>Results: </strong>The NRDS group showed significantly higher LUS, SOFA, and RI scores and lower OI values than the N-NRDS group (<i>p</i> < 0.01). LUS, SOFA, and RI scores were significantly higher in the severe NRDS group compared to the mild and moderate groups, while OI was markedly lower (<i>p</i> < 0.01). LUS, OI, RI, and SOFA scores were the most impactful variables for the predictive efficacy of the models. The RF model performed best of the four models, with an AUC of 0.894, accuracy of 0.808, and sensitivity of 0.706. In contrast, the LR, NN, and SVM models have lower AUC values than the RF model with 0.841, 0.828, and 0.726, respectively.</p><p><strong>Conclusion: </strong>Four predictive models based on machine learning can accurately assess the severity of NRDS. Among them, the RF model exhibits the best predictive performance, offering more effective support for the treatment and care of neonates.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1481830"},"PeriodicalIF":3.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11568467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypothyroidism correlates with osteoporosis: potential involvement of lipid mediators.","authors":"Pengyuan Leng, Ying Qiu, Mengxue Zhou, Yuhang Zhu, Na Yin, Mingming Zhou, Weili Wu, Min Liu","doi":"10.3389/fmed.2024.1453502","DOIUrl":"10.3389/fmed.2024.1453502","url":null,"abstract":"<p><strong>Background: </strong>Observational studies have demonstrated a correlation between thyroid dysfunction and osteoporosis (OP); however, the underlying causality has yet to be fully elucidated.</p><p><strong>Methods: </strong>The necessary dataset was sourced from public databases. Initially, instrumental variables (IVs) were selected based on three primary hypotheses. Subsequently, Cochran's Q test was employed to exclude IVs exhibiting heterogeneity. The MR-PRESSO test and the leave-one-out sensitivity test were further applied to detect potential pleiotropy. Inverse variance was utilized for the analysis. This study primarily utilized the inverse variance weighted (IVW) model for Mendelian analysis. Since Type 1 diabetes mellitus can also contribute to the development of osteoporosis, this study additionally employed multivariate Mendelian analysis. Furthermore, 249 circulating metabolites were selected for mediation analysis in the Mendelian randomization framework.</p><p><strong>Results: </strong>In this study, the two-sample Mendelian randomization (MR) analysis primarily employed the random-effects IVW model and demonstrated a causal relationship between hypothyroidism (OR = 1.092, 95% CI: 1.049-1.137, <i>p</i> < 0.001) and hyperthyroidism (OR = 1.080, 95% CI: 1.026-1.137, <i>p</i> = 0.003) with the risk of OP. No causal relationships were identified between FT3, FT4, TSH, and the risk of OP (<i>p</i> > 0.05). The results of the multivariate Mendelian randomization (MVMR) analysis indicated that hyperthyroidism was no longer a risk factor for OP (OR = 0.984, 95% CI: 0.918-1.055, <i>p</i> = 0.657), whereas hypothyroidism persisted as a risk factor (OR = 1.082, 95% CI: 1.021-1.147, <i>p</i> = 0.008). The mediated Mendelian randomization analysis revealed that hypothyroidism may exert an indirect effect on OP via triglycerides in large VLDL, mediating approximately 2.47% of the effect.</p><p><strong>Conclusion: </strong>This study identifies a potential link between hypothyroidism and OP, possibly mediated indirectly via triglyceride levels in large VLDL. Further investigations are required to elucidate the direct or indirect causal mechanisms underlying this association.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1453502"},"PeriodicalIF":3.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}