Indian Journal of Endocrinology and Metabolism最新文献

{"title":"Diabetic Myonecrosis: An Under-Recognised Complication of Poorly Controlled Diabetes with a High Morbidity- A Clinico-Radiological Study.","authors":"Varun Kumar, Mohammed A Hussain, Mathews E Kurian, Neeraja Balan, Benjamin B Mathew, Madhavi Kandagaddala, Harini S Arumugam, Kripa E Cherian, Nitin Kapoor, Hesarghatta S Asha, Nihal Thomas, Felix Jebasingh","doi":"10.4103/ijem.ijem_1078_25","DOIUrl":"10.4103/ijem.ijem_1078_25","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetic myonecrosis is an uncommon and under-recognised complication of diabetes mellitus. We aimed to describe the clinical profile, imaging characteristics, management strategies, and outcomes of patients with diabetic myonecrosis.</p><p><strong>Methods: </strong>This retrospective study included 30 patients diagnosed with diabetic myonecrosis between 2002 and 2024. Diagnosis - based on clinical suspicion, supported by characteristic ultrasonography and magnetic resonance imaging. Demographic data, diabetes characteristics, biochemical parameters, imaging features, management approaches, recurrence, and mortality were analysed.</p><p><strong>Results: </strong>The mean age was 49.1 ± 11.7 years, with a mean diabetes duration of 12.6 ± 6.9 years and poor glycaemic control (HbA1c 8.83 ± 1.88%). Acute limb pain and swelling were the most common presentations (93.3%), predominantly involving the thigh and calf muscles. MRI revealed characteristic muscle oedema and infarction, frequently extending beyond the quadriceps to involve hamstrings, adductors, and posterior compartments. Diabetic nephropathy and retinopathy were present in 70% of patients. Most patients (83.3%) improved with conservative management. Recurrence occurred in 23.3% of cases, and the overall mortality rate was 33.3%. Recurrence was the strongest predictor of mortality (adjusted OR, 8.20; 95% CI, 1.45-46.40), while advanced kidney disease increased the risk, and higher serum albumin levels were protective.</p><p><strong>Conclusion: </strong>Diabetic myonecrosis should be considered in patients with diabetes who present with acute localised muscle pain; the presence of advanced CKD, significant proteinuria, or hypoalbuminemia identifies those at increased risk of adverse outcomes. MRI is the diagnostic modality of choice. Despite response to conservative therapy, high recurrence and mortality rates highlight the need for early recognition and long-term surveillance.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"30 4","pages":"313-319"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Predictors of Remission in Patients with Acromegaly Undergoing Microscopic or Endoscopic Transsphenoidal Surgery: Long-Term Outcomes from a Tertiary Care Centre.","authors":"Mintu M Baruah, Liza Das, Apinderpreet Singh, Vaishali Kaur, Siva S Dandapani, Rajesh Chhabra, Sushanta K Sahoo, Ashutosh Rai, Pinaki Dutta","doi":"10.4103/ijem.ijem_1001_25","DOIUrl":"10.4103/ijem.ijem_1001_25","url":null,"abstract":"<p><strong>Introduction: </strong>Transsphenoidal surgery (TSS) is the primary treatment of choice for growth hormone (GH)-secreting pituitary adenomas. However, surgical cure rates vary. We aimed to investigate factors determining remission and the need for adjuvant therapy after TSS in patients with acromegaly managed at a tertiary care centre.</p><p><strong>Methods: </strong>In this retrospective single-centre study, data on patients who underwent TSS at a tertiary care centre were collected from 2010 to 2022. Multivariate regression models were used to identify predictors of endocrine remission according to the 2014 consensus criteria (random GH <1 μg/L and insulin-like growth factor 1 normalised for age) and of the requirement for adjuvant therapy.</p><p><strong>Results: </strong>This study included 169 patients (56% female, mean age 37.8 ± 4.9 years), with a mean time from symptom onset to diagnosis of 4.9 ± 3.9 years. Fifty-three (31.3%) achieved remission with a mean follow-up of 5.2 ± 3.4 years. Adjuvant therapy was required in 78 patients, and redo surgery was performed in eight patients. Baseline GH levels were the only significant predictor of disease activity at the last follow-up. Baseline tumour size (<i>P</i> = 0.003) and nadir GH levels (<i>P</i> = 0.02) were the only independent factors associated with endocrine remission and the need for adjuvant therapy.</p><p><strong>Conclusion: </strong>Long-term remission in acromegaly following TSS is achieved in 31.3% of patients. Baseline tumour size and pretreatment nadir GH levels are the primary factors associated with achieving endocrine remission and the need for adjuvant therapy.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"30 4","pages":"340-345"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>CYP24A1</i> Overexpression and Vitamin D Deficiency: A Potential Prognostic Axis in Thyroid Nodules Classified by the Bethesda System.","authors":"Rijuneeta Gupta, Nivedhan Ravichandran, Anant Basotia, Jaimanti Bakshi, Uma Nahar, Sohini Banerjee, Pinaki Dutta, Sanjay K Bhadada, Pranab Dey","doi":"10.4103/ijem.ijem_829_25","DOIUrl":"10.4103/ijem.ijem_829_25","url":null,"abstract":"<p><strong>Introduction: </strong>Vitamin D, crucial for calcium balance and bone health, also regulates the cell cycle and has anti-tumour properties. Given the rising incidence of thyroid cancer, this study investigates the association between preoperative vitamin D levels and <i>CYP24A1</i> mRNA expression in thyroid nodules (TNs) classified by the Bethesda system.</p><p><strong>Methods: </strong>A prospective observational study included 40 adults with TNs. Exclusion criteria applied. Clinical evaluation involved blood tests, thyroid ultrasound, fine-needle aspiration cytology, and histopathology. Serum vitamin D, calcium, and <i>CYP24A1</i> mRNA expression were analysed for correlations.</p><p><strong>Results: </strong>Participants had a mean age of 37.3 years; 75% were female. Thyroid Imaging Reporting and Data System (TIRADS) identified suspicious nodules. Most patients (95%) had normal thyroid-stimulating hormone levels, but 52.5% showed vitamin D deficiency, and 47.5% had low calcium levels. <i>CYP24A1</i> mRNA expression was elevated, especially in papillary thyroid carcinoma (PTC). Positive correlations were found between vitamin D, calcium, and <i>CYP24A1</i> expression.</p><p><strong>Conclusion: </strong>The study highlights the role of vitamin D deficiency and elevated <i>CYP24A1</i> expression in TNs, particularly PTC. TIRADS and Bethesda classifications remain valuable diagnostic tools. <i>CYP24A1</i> may serve as a prognostic marker or therapeutic target, suggesting the need for further research into vitamin D pathways in thyroid disease.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"30 4","pages":"363-368"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatogenous Diabetes - Let us Shun the Neglect!","authors":"Nishant Raizada, Sri V Madhu","doi":"10.4103/ijem.ijem_846_26","DOIUrl":"10.4103/ijem.ijem_846_26","url":null,"abstract":"","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"30 4","pages":"271-273"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a Short-term Yoga Lifestyle Programme on Circulating Serum Klotho Levels in Patients with Type 2 Diabetes: An Exploratory Study.","authors":"Atmakur Snigdha, Vijaya Majumdar, Kalpana S Ramegowda","doi":"10.4103/ijem.ijem_831_25","DOIUrl":"10.4103/ijem.ijem_831_25","url":null,"abstract":"<p><strong>Introduction: </strong>Klotho, an anti-ageing protein involved in metabolic regulation, is downregulated in type 2 diabetes mellitus (T2DM). Prior studies suggest that enhancing Klotho expression may help manage diabetes and its complications. Yoga, with its systemic effects, may offer a promising non-pharmacological approach. The present study aimed to evaluate the effect of a 15-day structured yoga lifestyle (SYL) programme on serum Klotho levels and glycaemic parameters in individuals with T2DM.</p><p><strong>Methods: </strong>This single-arm, open-label exploratory study was conducted on 74 adults (30-65 years) with T2DM. The SYL programme included asanas, pranayama, meditation, kriyas, a satvik diet, and spiritual sessions. Pre- and post-assessments included serum Klotho, fasting blood glucose (FBG), postprandial blood glucose (PPBG), and blood pressure (BP). The Wilcoxon signed-rank test was used.</p><p><strong>Results: </strong>Serum Klotho levels increased significantly by 14.65% (<i>P</i> < 0.001). FBG and PPBG were reduced by 5.97% and 3.68%, respectively (<i>P</i> < 0.001). Systolic BP was reduced modestly (<i>P</i> = 0.025); diastolic BP showed no change. Subgroup analysis showed greater Klotho increase in those aged > 55 years, females, non-hypertensives, and those with a longer duration of diabetes (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>The findings support SYL as a potential adjunct therapy. Longer controlled trials are needed to further establish these results.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"30 4","pages":"302-305"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cinacalcet and Parathyroidectomy Outcomes in Symptomatic and Asymptomatic Primary Hyperparathyroidism: A Retrospective Observational Study.","authors":"Aditya Dutta, Praphulla Koirala, Nupoor Vaghasia, Kajal Allawadi, Ambrish Mithal","doi":"10.4103/ijem.ijem_904_25","DOIUrl":"10.4103/ijem.ijem_904_25","url":null,"abstract":"<p><strong>Introduction: </strong>Primary hyperparathyroidism (PHPT) is a common and symptomatic endocrine disorder in India. There has been a notable rise in asymptomatic PHPT (urban India), creating a dilemma in optimal treatment approach-surgery or medical management. Cinacalcet is a calcimimetic used in managing PHPT, but data regarding its use from India is limited. This retrospective study aimed to assess the prevalence of asymptomatic PHPT, compare symptomatic versus asymptomatic PHPT and evaluate the real-world outcomes among patients managed with parathyroidectomy (PTX) or cinacalcet.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 90 PHPT patients seen between January 2020 and July 2024 at a tertiary care centre in New Delhi, India. Clinical, biochemical and imaging data were collected, and real-world outcomes were assessed for PTX and cinacalcet. Statistical analysis was performed using SPSS.</p><p><strong>Results: </strong>Of the 90 patients, 64.4% were symptomatic and 35.6% were asymptomatic. Symptomatic patients had higher parathyroid hormone (PTH) levels and more frequent MIBI localization. PTX was curative and led to significantly greater reductions in calcium (<i>P</i> = 0.006) and PTH (<i>P</i> = 0.009). Conversely, cinacalcet use was associated with normalization of calcium (<i>P</i> = 0.001) and lowering of PTH (<i>P</i> = 0.001) in both symptomatic and asymptomatic patients, with minimal side effects.</p><p><strong>Conclusion: </strong>A significant proportion of cases were asymptomatic PHPT, with biochemical and radiological profiles closely resembling those of symptomatic cases. While PTX provided definitive cure, cinacalcet led to short-term normalization of calcium and reduction of PTH. Cinacalcet serves as an alternative for patients who refuse surgery, are not candidates for surgery, or prefer medical management.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"30 4","pages":"357-362"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ensuring Continuity of Gender-Affirming Care in India: Clinical and Medico-Legal Guidance in the Current Regulatory Framework: Endocrine Society of India Position Statement.","authors":"Anirban Majumder, Debmalya Sanyal, Pramila Kalra, Somabha Bandopadhay, Kaushik Pandit","doi":"10.4103/ijem.ijem_675_26","DOIUrl":"10.4103/ijem.ijem_675_26","url":null,"abstract":"<p><p>Recent amendments to the Transgender Persons (Protection of Rights) Act, 2026 have introduced changes in the legal definition, certification processes, and regulatory oversight of transgender identity in India, needing clarity on medical management of gender incongruent individuals. This position statement provides practical, evidence-based, and medico-legally sound guidance for endocrinologists to ensure continuity of care for individuals with gender incongruence within the evolving legal framework. The document emphasises the distinction between clinical care and legal certification and advocates adherence to internationally and nationally accepted standards, including World Professional Association for Transgender Health Standards of Care Version 8 and Endocrine Society guidelines, keeping in mind that the law does not forbid, prevent, or regulate through this act, as amended, the interventions by endocrinologists. It highlights strengthened penal provisions addressing coercion, inducement, and non-consensual interventions, underscoring the need for robust safeguards in clinical decision-making. Key recommendations include comprehensive clinical assessment, individualised risk-benefit evaluation, and meticulous documentation, particularly regarding informed consent, decisional capacity, voluntariness, and absence of coercion. The importance of confidentiality, alongside compliance with statutory reporting requirements, is also addressed. A practical distinction is made between continuation of established care and initiation of new interventions, with the latter requiring enhanced procedural diligence. The continuity of care in previously treated subjects is also emphasised. This guidance supports clinicians in delivering uninterrupted, ethical, and legally compliant gender-affirming care, reinforcing that patient-centred, evidence-based practice remains paramount, irrespective of legal definition concerns.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"30 4","pages":"289-296"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13609922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Congenital Adrenal Hyperplasia in South Indian Polycystic Ovarian Syndrome Women.","authors":"Anudeep Gadda, Sunanda Tirupati, Shruthi Ravindra, Manjiri Karlekar, Anurag Lila, Vijaya Sarathi","doi":"10.4103/ijem.ijem_6_26","DOIUrl":"10.4103/ijem.ijem_6_26","url":null,"abstract":"<p><strong>Introduction: </strong>Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder characterised by hyperandrogenism and ovulatory dysfunction. Nonclassic congenital adrenal hyperplasia (NCCAH) is an important differential diagnosis, but its prevalence in Indian women remains unclear. Previous North Indian studies reported variable rates using less specific assays. This study aimed to determine the prevalence and clinical characteristics of NCCAH among hyperandrogenemic South Indian women with PCOS.</p><p><strong>Methods: </strong>This cross-sectional study was conducted at a tertiary care centre in South India (January 2019 to December 2022). Women aged ≥18 years meeting Androgen Excess Society criteria for PCOS were included. Hyperandrogenemia was defined as serum total testosterone >0.55 ng/ml by chemiluminescent immunoassay. All participants underwent serum steroid profiling 60 minutes after Acton Prolongatum-stimulation using liquid chromatography-tandem mass spectrometry. The serum steroid levels of women with PCOS were compared with those of healthy volunteers.</p><p><strong>Results: </strong>Of 182 screened women, 128 were diagnosed with PCOS. Acton Prolongatum-stimulated steroid profiling was performed in 120 women. Three (2.5%) were diagnosed with congenital adrenal hyperplasia (CAH)-two with classic 21α-hydroxylase deficiency (21OHD) and one with 11β-hydroxylase deficiency. All three showed severe hirsutism, clitoromegaly and severe hyperandrogenemia (>1.5 ng/ml). None were diagnosed with nonclassic 21OHD. Compared with controls, PCOS women had significantly higher testosterone and androstenedione levels with no significant difference in other steroid levels.</p><p><strong>Conclusions: </strong>NCCAH is rare among South Indian women with PCOS, whereas the simple virilising form of classic CAH may often mimic PCOS. Severe hyperandrogenism distinguishes CAH from PCOS and helps prioritise them for CAH screening.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"30 3","pages":"241-245"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13426999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting the Thyroid-Heart Axis: Unravelling the Interplay of Hormones, Epigenomes and Precision Cardioprotection.","authors":"Naima Parveen, Sachin Chittawar, Deepak Khandelwal, Sameer Aggarwal","doi":"10.4103/ijem.ijem_24_26","DOIUrl":"10.4103/ijem.ijem_24_26","url":null,"abstract":"<p><p>Thyroid dysfunction (TD) and cardiovascular disease (CVD) commonly coexist in older adults, where age-related vascular, mitochondrial, and autonomic changes heighten sensitivity to even mild hormonal imbalance. Thyroid hormones (THs) regulate cardiac and vascular function through genomic and non-genomic pathways, but aging alters receptor sensitivity, deiodinase (<i>DIO</i>) activity, and epigenetic control, resulting in tissue-specific TH insufficiency despite normal serum levels. Subclinical hypothyroidism (SCH) and low-T3 syndrome are especially prevalent in older adults and are linked to higher risks of heart failure (HF), atherosclerosis, atrial fibrillation, and mortality. Emerging data underscore the role of epigenetic regulators and the gut-thyroid-heart axis in modulating CV responses to TH imbalance. Clinically, routine thyroid function assessment is crucial in CVD, with management tailored to age-related risks. Tissue-selective TH based therapies represent a promising frontier for precision cardioprotection.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"30 3","pages":"204-210"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13427014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Calcium Supplementation in the Indian Context: A Consensus Statement by the Endocrine Society of India Skeletal Health Taskforce.","authors":"Saptarshi Bhattacharya, Lakshmi Nagendra, Khushboo Agarwal, Durairaj Arjunan, Nitin Kapoor, Parjeet Kaur, Kripa E Cherian, Sahana Shetty, Shinjan Patra, Ana S Monteiro, Akhila Bhandarkar, Anshita Aggarwal, Preyender S Thakur, Asim M Maldar, Swayamsidha Mangaraj, Aneez Joseph, Sunetra Mondal, Anish Kar, Thomas V Paul, Sanjay Bhadada, Kvs Harikumar, Kaushik Pandit, Sanjay Kalra, Ambrish Mithal","doi":"10.4103/ijem.ijem_45_26","DOIUrl":"10.4103/ijem.ijem_45_26","url":null,"abstract":"<p><p>Optimum intake of calcium is fundamental for skeletal health and additionally plays a role in cardiovascular health, haemostasis, synaptic transmission, and several enzyme-driven metabolic reactions. In several countries, including India, dietary calcium intake is poor, and it is necessary to ensure adequate calcium intake for optimizing musculoskeletal health. Not many guidelines focus on regions where calcium in the diet is suboptimal, and supplementing calcium may be specially relevant. In view of this, the Endocrine Society of India (ESI) Skeletal Task Force has developed clinical practice guidelines on calcium supplementation. The statement emphasizes that food sources should be the preferred modality of meeting calcium needs, and supplements should be used when dietary intake is insufficient or when physiological demands are higher, such as in pregnancy, lactation, or after menopause. Additionally, calcium should be supplemented in bone mineral disorders, such as osteoporosis, osteomalacia, hypocalcaemic rickets, and hypoparathyroidism. Special precautions are necessary in chronic kidney disease and in the presence of renal stone disease, but safety in cardiovascular disease is reinforced unless the total intake crosses the recommended daily intake. The statement recommends ensuring vitamin D sufficiency but strongly recommends against supplementing activated forms of vitamin D except in special situations. This ESI statement aims to provide rationalized guidance to ensure adequate calcium supplementation while avoiding the risks associated with injudicious use.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"30 3","pages":"198-203"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13427011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}