Indian Journal of Endocrinology and Metabolism最新文献

{"title":"What Works in Type 2 Diabetes: Intermittent Fasting or Calorie Restriction or Both?","authors":"Lakshmi Nagendra, Saptarshi Bhattacharya, Nitin Kapoor, Sanjay Kalra","doi":"10.4103/ijem.ijem_1035_25","DOIUrl":"10.4103/ijem.ijem_1035_25","url":null,"abstract":"","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"30 2","pages":"194"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13229249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156406","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":"Serial Changes in Thyroid Hormones with Oral or Intravenous Bisphosphonates.","authors":"Sandeep Kumar, Kiraninder S Brar, Kumar Kvs Hari, Jayaraman Muthukrishnan, Narendra Kotwal, Rakhi Malhotra, Naresh Bansal, Santosh K Singh, Prafull Sharma","doi":"10.4103/ijem.ijem_984_25","DOIUrl":"10.4103/ijem.ijem_984_25","url":null,"abstract":"<p><strong>Introduction: </strong>Bisphosphonates (BP) used in osteoporosis management can induce an acute phase response, their short-term endocrine effects remain unclear. This study hypothesized that initial BP exposure elicits a non-thyroidal illness syndrome (NTIS)-like pattern and that thyroid autoimmunity may amplify this response.</p><p><strong>Methods: </strong>In this prospective cohort at a tertiary centre, 336 adults (93% postmenopausal women) were enrolled: 168 received first-dose BP therapy (zoledronic acid (ZA) =129; oral alendronate (ALN) = 39) and 168 matched controls (calcium/vitamin D). FT3, FT4, TSH, and erythrocyte sedimentation rate (ESR) were measured at baseline and on days 1, 2, 3, 7, and 42 with baseline anti-TPO Ab. Linear mixed-effects models with random intercepts evaluated group × time interactions, adjusting for age, sex, and body mass index.</p><p><strong>Results: </strong>BP recipients demonstrated a clear temporal pattern, FT3 declined significantly, reaching a nadir on Day 2 (mean difference -0.47 pg/mL vs controls, <i>P</i> < 0.001), FT4 fell modestly (mean difference -0.07 ng/dL), and TSH was transiently suppressed before rebounding above baseline by Day 42 (mean difference +0.39 mIU/L). ESR peaked on Day 2 and normalized by Day 7, paralleling hormonal recovery. Group × time interactions were significant for all parameters (<i>P</i> < 0.05). Anti-TPO Ab positive individuals exhibited deeper FT3 suppression and greater TSH rebound. ALN effects were directionally similar but underpowered.</p><p><strong>Conclusion: </strong>First-dose BP therapy, particularly ZA, induces a short-lived, reversible NTIS-like response amplified by thyroid autoimmunity. Early post-infusion thyroid testing may mimic hypothyroidism, re-evaluation after six to eight weeks is recommended.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"30 2","pages":"187-193"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13229242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156456","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":"Magnitude and Determinants of Weight Loss Response to GLP-1/GIP Receptor Agonists in India: A Real-World Time-to-Event Analysis.","authors":"Godana Jarso, Shama Mahendru, Aditya Dutta, Rutuja Sharma, Abebe Megerso, Ambrish Mithal","doi":"10.4103/ijem.ijem_1085_25","DOIUrl":"10.4103/ijem.ijem_1085_25","url":null,"abstract":"<p><strong>Introduction: </strong>Obesity and type 2 diabetes (T2D) are rapidly increasing in India. Although newer glucagon-like peptide/glucose-dependent insulinotropic polypeptide (GLP-1/GIP) receptor agonists have demonstrated considerable efficacy in weight loss, real-world evidence from the Indian population is lacking. This study evaluated the response to semaglutide and tirzepatide in overweight/obese individuals in routine clinical practice.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted at a tertiary centre in New Delhi, India. Data from 150 overweight/obese participants (74 with T2D, 76 without T2D) treated with semaglutide/tirzepatide over 6 months were analysed. Outcomes included percentage weight loss, achievement of predefined weight-loss thresholds, time-to-event (≥10% weight loss), and determinants of time-to-event. Non-parametric tests and Cox proportional hazard regression were used for analysis.</p><p><strong>Results: </strong>The median weight loss was 8.2% (4.93-13.66). Participants without T2D achieved significantly greater weight loss than those with T2D (11.21% vs 5.48%, <i>P</i> < 0.001). Tirzepatide was associated with greater weight loss compared with semaglutide (8.60% vs 5.62%, <i>P</i> = 0.023). Sixty-two participants (41.3%) achieved a weight loss of ≥10%, with a median time-to-event of 9.5 months. Multivariable analysis identified younger age, tirzepatide use, and GLP1 treatment naivety as determinants of faster achievement of ≥10% weight loss. Diabetes status was not associated with faster achievement of ≥10% weight loss.</p><p><strong>Conclusion: </strong>In this real-world Indian cohort, GLP-1/GIP receptor agonists were effective means for weight loss in obese adults, with or without T2D. The magnitude and speed of weight loss outcomes may help in personalising therapy and setting expectations when initiating newer GLP-1/GIP receptor agonists.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"30 2","pages":"129-134"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13229245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156398","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":"Efficacy of Fixed Low-Dose Weekly Subcutaneous Testosterone Self-Administration in Transgender Male Patients in India.","authors":"Debmalya Sanyal, Shinjan Patra, Micol S Rothman","doi":"10.4103/ijem.ijem_926_25","DOIUrl":"10.4103/ijem.ijem_926_25","url":null,"abstract":"<p><strong>Introduction: </strong>Testosterone (T) is commonly administered intramuscularly to treat hypogonadal males and female-to-male (FTM) transgender patients. Intramuscular testosterone administration has various drawbacks, including discomfort, bruising, pain, and the need to be administered by a healthcare professional. Self-administered subcutaneous route may be a convenient, safe, and effective alternative. The current study assesses the efficacy and safety of low-dose (50 mg) weekly subcutaneous testosterone administration among FTM transgender.</p><p><strong>Methods: </strong>The current retrospective cohort study included adult FTM transgender subjects. Participants were administered T-cypionate weekly at a dose of 50 mg and followed up for 6 months. At the end of the follow-up, serum concentrations of testosterone, oestradiol (E2), and the number of participants achieving target E2 (<50 pg/mL) and testosterone (300-700 ng/mL) levels were determined.</p><p><strong>Results: </strong>The patient cohort consisted of 22 FTM transgender subjects. The average age was 29 years and body mass index was 26.3 ± 3.3 kg/m². After 6 months of follow-up, a significant rise in testosterone to 511.3 ± 204.3 ng/mL (<i>P</i> < 0.0001) and a significant decrease in E2 levels to 46.6 ± 16.2 (<i>P</i> < 0.0001) were noted in study subjects compared to baseline. Target testosterone and E2 levels were achieved (>300 ng/mL) in 81% and 68% of subjects, respectively. Ninety-one per cent of subjects had cessation of menstruation. No subject needed to stop testosterone injections or decrease dosage due to polycythaemia (PCV > 50%).</p><p><strong>Conclusion: </strong>Weekly self-administered 50 mg low-dose, subcutaneous testosterone injection was effective in achieving target testosterone and oestradiol levels in FTM transgender subjects, without significant safety issues.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"30 2","pages":"164-169"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13229254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156374","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":"Development and Validation of a Comprehensive Obesity Assessment Tool: Integrating Lifestyle, Body Image, and Past Weight Management.","authors":"Wareesha Anwar, Piyush Ranjan, Anita Malhotra, Anshul Kandpal, Gautam Kapoor, Ashish D Upadhyay, Naval K Vikram","doi":"10.4103/ijem.ijem_155_25","DOIUrl":"10.4103/ijem.ijem_155_25","url":null,"abstract":"<p><strong>Introduction: </strong>Young adulthood is a critical period for the establishment of lifelong health behaviours. However, increasing sedentary lifestyles, suboptimal dietary patterns, and weight-related body image concerns contribute to the growing burden of obesity in this age group. A comprehensive and culturally sensitive assessment tool is needed to capture these multidimensional factors. This study aimed to develop and psychometrically validate a questionnaire assessing lifestyle behaviours, weight-related body image concerns, and past weight management strategies among young adults (YAs).</p><p><strong>Methods: </strong>A mixed-method design was employed. Item generation was informed by literature review and focus group discussions, followed by expert review for content validity and pilot testing for face validity. Construct validity was assessed using exploratory factor analysis (EFA; <i>n</i> = 302) and confirmatory factor analysis (CFA; <i>n</i> = 151) within a structural equation modelling framework. Internal consistency was evaluated using Cronbach's alpha, and test-retest reliability (<i>n</i> = 102) was assessed using intraclass correlation coefficients (ICC) with 95% confidence intervals.</p><p><strong>Results: </strong>The final questionnaire comprised 30 items across three domains: lifestyle and associated barriers (17 items), weight-related body image concerns (6 items), and past weight management (7 items). Factor analyses supported a three-domain structure with satisfactory model fit indices. Internal consistency ranged from 0.72 to 0.86 across domains. Test-retest reliability demonstrated high stability (ICC range: 0.951-0.970).</p><p><strong>Conclusion: </strong>The developed questionnaire demonstrates satisfactory psychometric properties and may serve as a practical tool for assessing obesity-related behavioural and psychosocial factors among young adults in clinical and research settings.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"30 2","pages":"149-156"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13229255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156423","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":"Effect of Dapagliflozin on Liver Fat, Liver Stiffness, and Visceral Adiposity in Patients with Type 2 Diabetes Mellitus and MASLD: An Open-Label Study from a Tertiary Care Centre.","authors":"Bandana Dash, Padala Ravi Kumar, Deepak K Dash, Debasish Patro, Pradosh K Sahu, Mandapaka V K Rao","doi":"10.4103/ijem.ijem_1075_25","DOIUrl":"10.4103/ijem.ijem_1075_25","url":null,"abstract":"<p><strong>Introduction: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) is highly prevalent in individuals with type 2 diabetes mellitus (T2DM). This study evaluated the effect of dapagliflozin on liver fat, liver stiffness, and visceral adiposity in patients with T2DM and MASLD.</p><p><strong>Methods: </strong>This was a single-arm, prospective, open-label interventional study with a paired design. Sixty-three patients with T2DM and moderate-to-severe hepatic steatosis on ultrasonography received dapagliflozin 10 mg daily for six months. Liver fat by dual-echo-magnetic resonance imaging (MRI), liver stiffness measurement (LSM) by fibroscan, and visceral adipose tissue (VAT) by dual X-ray absorptiometry were assessed at baseline and after six months. Response to therapy was defined as >10% decrease in liver fat and >15% decrease in LSM, respectively (Responders). Multivariable logistic regression analysis was performed to identify predictors of response with respect to change in liver fat and LSM.</p><p><strong>Results: </strong>After six months, mean weight decreased by 2.55 kg (3.23%) and HbA1c by 0.84%. MRI-liver fat percentage, LSM, and VAT volume declined by 2.7%, 0.85kPa, and 472 cm³, respectively (<i>P</i> < 0.001 for all). Change in VAT mass (<i>r</i> = 0.546) and volume (<i>r</i> = 0.437) correlated with change in liver fat, and change in aspartate aminotransferase (AST) correlated with change in LSM (<i>r</i> = 0.351). Sixteen patients (25.4%) and 33 patients (52.4%) met the criteria for responders for liver fat and LSM, respectively. Baseline liver fat and LSM were independent predictors of decrease in liver fat and LSM, respectively in responders.</p><p><strong>Conclusion: </strong>Dapagliflozin significantly reduced liver fat, liver stiffness, and visceral adiposity in patients with T2DM and MASLD.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"30 2","pages":"157-163"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13229253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156428","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":"Ultrasound-Guided Percutaneous Ethanol Injection for the Treatment of Cystic and Predominantly Cystic Thyroid Nodules: A Single-Centre Experience.","authors":"Manjunath Goroshi, Damacharlla Venkateswarlu, Vanishri Ganakumar, Pritish Paricharak, Vikrant Ghatnatti","doi":"10.4103/ijem.ijem_663_25","DOIUrl":"10.4103/ijem.ijem_663_25","url":null,"abstract":"<p><strong>Introduction: </strong>Thyroid nodules with cystic and predominantly cystic nodules represent a significant subset. Management strategies range from observation to surgical resection, with minimally invasive options like percutaneous ethanol injection (PEI) emerging as alternative. This study evaluates efficacy and safety of PEI for treating cystic and predominantly cystic thyroid nodules.</p><p><strong>Methods: </strong>A retrospective review of 65 euthyroid patients with cystic and predominantly cystic thyroid nodules treated with PEI at a single centre (January 2018-April 2023) was conducted. Pre- and post-procedure nodule volumes were measured, and clinical outcomes were assessed at 1, 3, and 6 months. A volume reduction ratio of greater than 50% defined efficacy, while incidence and severity of adverse events determined safety.</p><p><strong>Results: </strong>Out of 65 patients, 25 patients had pure cystic nodules and 40 patients had predominantly cystic nodules. The median largest diameter cyst size was 3.7 cm (range, 1.63-10.5 cm), and the median volume of cystic nodules before PEI was 10 ml (range, 1.29-80 ml). Patients with a volume reduction ratio >50% are termed responders. Sixty (92.3%) patients were responders, and 5 (7.7) were non-responders at 3 months follow-up. The response rate of PEI at end of the study (6 months follow-up) was 100%. The total volume reduction was 86.49 ± 5.85% at the end of 6 months.</p><p><strong>Conclusion: </strong>PEI is an effective and safe modality for managing cystic thyroid nodules, offering significant volume reduction with minimal adverse effects and proving its role as a first-line alternative for patients unsuitable for surgery.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"30 2","pages":"177-180"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13229250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156409","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":"Sarcopenic Obesity in Indian Adults with Type 2 Diabetes Mellitus: Prevalence and Associated Risk Factors.","authors":"Mohd Salman, Ahmad Alam, Sana Khan, Hamid Ashraf, Lubna Zafar, Anjum Parvez, Ahmad Faraz","doi":"10.4103/ijem.ijem_111_25","DOIUrl":"10.4103/ijem.ijem_111_25","url":null,"abstract":"<p><strong>Introduction: </strong>Sarcopenic obesity, a condition combining muscle loss and obesity, is common in older adults and increasingly seen in younger individuals due to various risk factors. This study aims to assess the prevalence of SO in Indian adults with T2DM and identify key risk factors to help in early detection and prevention.</p><p><strong>Methods: </strong>This cross-sectional observational study, conducted from October 2022 to July 2024 at a tertiary care hospital of Northern India, assessed the prevalence of sarcopenic obesity in Indian adults with Type 2 Diabetes Mellitus. Participants included obese T2DM patients over 40 years, excluding those with conditions like malignancies or chronic diseases. The diagnosis of sarcopenia was made based on the recommendations of the Asian Working Group for Sarcopenia (AWGS). Key assessments involved demographic data, metabolic and physical evaluations, and the use of the International Physical Activity Questionnaire (IPAQ) to categorize physical activity levels.</p><p><strong>Results: </strong>Data from 151 patients revealed a mean age of 57.2 ± 8.4 years, with an overall prevalence of sarcopenic obesity (SO) at 44%. SO was more prevalent in males (48.38%) compared to females (40.45%). SO was significantly associated with older age, low physical activity, poor glycemic control, insulin use, and the presence of diabetes complications.</p><p><strong>Conclusion: </strong>This study identifies a high prevalence of sarcopenic obesity (SO) in older Indian adults with Type 2 Diabetes. Key risk factors include low physical activity, poor glycemic control, insulin use, and diabetes-related complications, while hypertension and dyslipidemia were not significantly linked to SO.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"30 2","pages":"142-148"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13229248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156383","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 Various Endocrinopathies Resulting from Use of Immune Checkpoint Inhibitors - A Prospective Study from a Tertiary Care Centre in India.","authors":"Alka Bishnoi, Vikram Shekhawat, Amit Nachankar","doi":"10.4103/ijem.ijem_825_25","DOIUrl":"10.4103/ijem.ijem_825_25","url":null,"abstract":"<p><strong>Introduction: </strong>Immune checkpoint inhibitors (ICIs) have revolutionised cancer treatment but are associated with agent-specific spectra of endocrine-related adverse events (irAEs). Data on prevalence of ICI-induced endocrinopathies in Indian populations remain limited. A study was conducted with an aim to determine the prevalence and spectrum of endocrinopathies resulting from ICI therapy in cancer patients at a tertiary care centre.</p><p><strong>Methods: </strong>This prospective cohort study included 100 adult cancer patients initiated on ICI therapy (anti-PD1 or PD-L1). Patients with pre-existing endocrinopathies or those diagnosed during baseline assessment were excluded. Comprehensive clinical, biochemical, and hormonal assessments were performed at baseline and during follow-up at 1, 2, 3, 6, 9, and 12 months. Endocrinopathies were diagnosed per standard criteria. Associations with demographic and clinical variables were analysed using Fisher's exact test.</p><p><strong>Results: </strong>Endocrinopathies developed in 19% of participants during 12 months of follow-up. Primary hypothyroidism was most frequent (12%), followed by hypergonadotropic hypogonadism (3%), diabetes mellitus (2%), primary adrenal insufficiency (1%), and primary hyperparathyroidism (1%). The median age of those affected was 52.6 years, with a male predominance. Endocrinopathies occurred more commonly with PD-1 inhibitors compared to PD-L1 inhibitors. Hypertension was significantly associated with endocrinopathy development (<i>P</i> = 0.044). Most endocrinopathies presented within the first six months of ICI therapy.</p><p><strong>Conclusion: </strong>ICI-induced endocrinopathies are prevalent among Indian cancer patients, with primary hypothyroidism being the most common. Early onset irAEs underscore the need for regular endocrine monitoring during and after ICI therapy.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"30 2","pages":"170-176"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13229244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156442","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":"Role of Serum Triiodothyronine-to-Thyroxine Ratio and Thyroid Colour Flow Doppler in Differentiation of Graves' Disease from Destructive Thyroiditis.","authors":"Hardeva R Nehara, Sanjay Saran, Narendra K Dara, Shinjan Patra, Sachin Banthia, Balkishan Gupta","doi":"10.4103/ijem.ijem_973_25","DOIUrl":"10.4103/ijem.ijem_973_25","url":null,"abstract":"<p><strong>Introduction: </strong>Thyrotoxicosis is characterised by abnormally elevated circulating level of thyroid hormones. The most common aetiologies of thyrotoxicosis are Graves' disease (GD) and destructive thyroiditis (DT). The correct diagnosis of thyrotoxicosis is crucial for appropriate management. Thyroid scan and thyrotropin receptor antibody (TSH-RAb) measurement are the modalities of choice for differentiating GD from DT. However, these modalities are limited by their high cost and availability. Colour flow Doppler ultrasound (CFDU) of the thyroid is inexpensive, safe, and readily available. This study was planned to evaluate the utility of CFDU and triiodothyronine (T3) to thyroxine (T4) ratio to differentiate GD from DT.</p><p><strong>Methods: </strong>Based on the clinical features, hormonal profile, thyroid scan, and TSH-RAb patients were diagnosed with DT and GD. All patients with DT and GD were subjected to CFDU.</p><p><strong>Results: </strong>A total of 158 patients of GD and 70 patients of DT were included in this study. The mean peak systolic velocity (PSV) of inferior thyroid artery (ITA), mean T3/T4 ratio, and thyroid volume were significantly higher in patients with GD in comparison to DT. Receiver operating characteristic analysis for PSV-ITA and T3/T4 ratio showed a cut-off of 38 cm/s (96.8% sensitivity and 98.6% specificity) and 19.2 (95.2% sensitivity and 92.9% specificity), respectively, to differentiate GD from DT.</p><p><strong>Conclusion: </strong>CFDU is a safe, non-invasive, inexpensive, and widely available modality. A combination of PSV-ITA and T3/T4 ratio can be useful in differential diagnosis of thyrotoxicosis and can be considered as an alternative to thyroid scan.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"30 2","pages":"181-186"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13229251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156431","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}