Indian Journal of Endocrinology and Metabolism最新文献

{"title":"Trends in Presentation and Management of Endogenous Hyperinsulinaemic Hypoglycaemia Over the Last Three Decades at a Tertiary Care Centre (1992-2022).","authors":"Setu Gupta, Alpesh Goyal, Devasenathipathy Kandasamy, Shipra Agarwal, Nishikant Damle, Sujoy Pal, Nikhil Tandon, Viveka P Jyotsna","doi":"10.4103/ijem.ijem_87_24","DOIUrl":"10.4103/ijem.ijem_87_24","url":null,"abstract":"<p><strong>Introduction: </strong>Endogenous hyperinsulinaemic hypoglycaemia (EHH) is characterized by inappropriate insulin secretion from pancreatic beta cells despite low blood glucose concentrations. We aimed to evaluate the secular changes in presentation and management of EHH due to insulinoma/non-insulinoma pancreatogenous hypoglycaemia syndrome (NIPHS) at our centre.</p><p><strong>Methods: </strong>This was a single-centre ambispective study (2014-2022). The clinical, biochemical, hormonal and radiological parameters (n = 63) collected as part of this study were compared with our earlier studies (1992-2005, n = 31; and 2006-2013, n = 35) and with other centres across the world.</p><p><strong>Results: </strong>A total of 63 patients (39 males) with a preoperative diagnosis of EHH (insulinoma, n = 58; and NIPHS, n = 5) and a mean age of 40.7 years were studied. The mean lag time from the onset of symptoms to diagnosis decreased from 4.6 years during the first study period to 1.9 years during this study period. However, the majority presented with fasting hypoglycaemia of 98.4%, and both fasting and postprandial hypoglycaemia of 32%. Exclusive postprandial hypoglycaemia was present in 1.7% of insulinoma. A histopathological diagnosis of insulinoma was made in 52 patients and nesidioblastosis in two patients. Intraoperative ultrasonography (IOUS) and intraoperative palpation (IOP) yielded 100% sensitivity, while endoscopic ultrasonography (EUS) and 68Ga-DOTA-Exendin-4 positron emission tomography/computed tomography (PET/CT) yielded sensitivity of 86% and 85%, respectively, for localizing insulinoma. Resolution of hypoglycaemia was noted in 53 of 57 (93%) patients who underwent surgery with a preoperative diagnosis of insulinoma.</p><p><strong>Conclusion: </strong>We observed a trend towards earlier diagnosis of EHH, increased patient numbers and availability of nuclear imaging techniques for preoperative localization in the last decade compared to earlier.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"28 4","pages":"363-369"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380736","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":"\"Reflections on the Detection and Classification of Dyslipidemias in Pediatrics\".","authors":"Karla Morales Ampuero, Angela Ragas","doi":"10.4103/ijem.ijem_434_23","DOIUrl":"10.4103/ijem.ijem_434_23","url":null,"abstract":"","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"28 4","pages":"432"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380727","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":"Breakthroughs in Congenital Adrenal Hyperplasia Care - Hope on the Horizon.","authors":"Nishant Raizada, S V Madhu","doi":"10.4103/ijem.ijem_333_24","DOIUrl":"10.4103/ijem.ijem_333_24","url":null,"abstract":"","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"28 4","pages":"333-335"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380730","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":"Normative Data for Modified Ferriman-Gallwey Score and the Prevalence of Hirsutism in Young South Indians.","authors":"Nitya N Josyula, Sahithi Guttula, Shilpa Lakkudi, Sagar Reddy, Dhananjaya M Shanthaiah, Vijaya Sarathi","doi":"10.4103/ijem.ijem_419_23","DOIUrl":"10.4103/ijem.ijem_419_23","url":null,"abstract":"<p><strong>Introduction: </strong>The modified Ferriman-Gallwey score (mFGS) cut-offs to define hirsutism vary with ethnicity, whereas no such cut-offs are established for Indian women. Well-conducted studies that report the prevalence of hirsutism in Indian women are limited. Hence, this study was conducted to report the prevalence of hirsutism and population-specific cut-offs for mFGS in South-Indian women.</p><p><strong>Methods: </strong>In this cross-sectional, community-based study, adult women in reproductive age (18-40 years) were screened for hirsutism by two trained medical students. Hirsutism was assessed using the mFGS and case record file.</p><p><strong>Results: </strong>A total of 453 women were included in the study [age: 22.15 ± 5.27 years; body mass index (BMI): 22.5 ± 3.58 kg/m2]. The median (IQR) mFGS was 1(0-3); only eight participants (1.8%) had mFGS ≥8, and all these eight women had at least another PCOS-related feature (irregular menstrual cycles and/or topical therapy-resistant acne). The median (IQR) mFGS in the PCOS phenotype group (n = 52), non-PCOS-phenotype group (n = 401), non-obese group (<25 kg/m2), non-PCOS-phenotype group (n = 322), obese group (≥ 25 kg/m2), non-PCOS-phenotype group (n = 79), overweight group (BMI: 23-25 kg/m2), non-PCOS-phenotype group (n = 74), normal BMI group (<23 kg/m2), and non-PCOS-phenotype group (n = 248) were 4 (1-6), 1 (0-2), 1 (0-2), 2 (1-3), 1 (0-2), and 1 (0-2), respectively. The 97.5^th centile mFGS in all groups except the PCOS phenotype group and the obese and non-PCOS phenotype groups was 5.</p><p><strong>Conclusion: </strong>We propose a new mFGS cut-off of 5 in the South-Indian population for evaluation of hirsutism, and the prevalence rates of hirsutism in the South-Indian population were 1.8% and 9.9% using mFGS of ≥8 and ≥5 to define hirsutism, respectively.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"28 4","pages":"391-396"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380732","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":"Assessment of Vitamin D Status, its Determinants and Relationship with Bone Health in Indian Children and Young Adults with Type-1 Diabetes","authors":"Shruti A Mondkar, Chirantap Oza, Nimisha S. Dange, Poonam Soren, N. Kajale, Mayur Kardile, Sushil Yewale, K. Gondhalekar, V. Khadilkar, A. Khadilkar","doi":"10.4103/ijem.ijem_141_23","DOIUrl":"https://doi.org/10.4103/ijem.ijem_141_23","url":null,"abstract":"\u0000 \u0000 \u0000 Recent evidence suggests that vitamin D deficiency and type-1 diabetes (T1D) have a bidirectional cause–effect relationship. The objective of this study is to estimate the prevalence and determinants of vitamin D deficiency in Indian children and young adults with T1D and assess the relationship between vitamin D status and their bone health.\u0000 \u0000 \u0000 \u0000 It is a single-centre, cross-sectional study. Inclusion: Children, young adults aged 5–25 years with T1D duration >1 year. Exclusion: Already on vitamin D supplementation, conditions affecting bone health. Data collected: Demographic, clinical, anthropometry, biochemical, body composition, DXA, pQCT measurements.\u0000 \u0000 \u0000 \u0000 A total of 453 participants (251 girls) with T1D, mean age = 13.5 ± 4.0 years, disease duration = 5.7 ± 3.9 years. Mean 25-hydroxy vitamin D concentration of study group is 20.4 ± 11.3 ng/mL. One hundred and eleven (24.5%) were deficient in 25-hydroxy vitamin D, 141 (31.1%) were insufficient and 201 (44.4%) were sufficient. 25-Hydroxy vitamin D concentrations had significant negative correlation with BMI Z-score, diastolic blood pressure, fat percentage Z-score and positive correlation with physical activity, haemoglobin concentrations and trabecular density (P < 0.05). Risk of developing vitamin D deficiency and insufficiency was significantly lower in subjects with good/intermediate glycaemic control versus poor control (P = 0.008). Higher diastolic blood pressure and female gender were significant risk factors for development of vitamin D deficiency.\u0000 \u0000 \u0000 \u0000 Vitamin D deficiency has high prevalence in children and youth with T1D and has detrimental effect on bone geometry of these subjects. Weight reduction increased outdoor physical activity, good glycemic control are some modifiable factors that may prove useful in preventing vitamin D deficiency.\u0000","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"67 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141377351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Bioelectrical Impedance Analyser (BIA) with Dual-Energy X-ray Absorptiometry (DXA) Scan in Assessing the Body Composition of Adult Individuals with Type 2 Diabetes Mellitus","authors":"Srijoni Ghosh Dastidar, Piyas Gargari, Debaditya Das, Subhankar Chowdhury","doi":"10.4103/ijem.ijem_350_23","DOIUrl":"https://doi.org/10.4103/ijem.ijem_350_23","url":null,"abstract":"\u0000 \u0000 \u0000 Assessing the body composition is important in adult patients with type 2 diabetes mellitus to prevent and achieve optimum control during treatment. Bioelectrical impedance analysis (BIA), being a more affordable method of assessing the body composition, should therefore be compared with the gold standard dual-energy X-ray absorptiometry (DXA) to look for a correlation between the two and the potential of BIA to be used widely in this population. A cross-sectional observational study was conducted on 60 patients attending the endocrinology outpatient department (OPD) of a tertiary care centre in Kolkata, India.\u0000 \u0000 \u0000 \u0000 Body composition was measured by both BIA and DXA. Intra-class correlation (ICC) values were calculated between the two methods for fat mass and fat-free mass for three body mass index (BMI) groups and overall.\u0000 \u0000 \u0000 \u0000 DXA and BIA correlated well for both fat mass and fat-free mass in the entire study population and in the non-overweight non-obese group (BMI <23) and the obese group (BMI ≥25). However, the overweight group (23 ≥BMI <25) did not correlate well with the above-mentioned parameters.\u0000 \u0000 \u0000 \u0000 We suggest interchangeable use of the two methods in the non-overweight non-obese (BM I <23) and obese (BMI ≥25) BMI groups of adult subjects with type 2 diabetes mellitus. However, the low correlation for all parameters in the overweight group points towards exercising caution when taking such measurements by BIA and planning a further study with a larger cohort of such individuals to better evaluate the said correlation.\u0000","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"14 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141380160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resting Metabolic Rate in Indian Adolescents and Youth with Type 1 Diabetes Mellitus: A Case Controlled Study","authors":"M. Karguppikar, Shruti A Mondkar, Nikhil Shah, N. Kajale, Sarita Kulkarni, K. Gondhalekar, Shital Bhor, V. Khadilkar, A. Khadilkar","doi":"10.4103/ijem.ijem_139_23","DOIUrl":"https://doi.org/10.4103/ijem.ijem_139_23","url":null,"abstract":"\u0000 \u0000 \u0000 Energy metabolism in type 1 diabetes (T1D) is known to be different. Resting metabolic rate (RMR) accounts for the largest portion of total energy needs. The objective of our study was to assess resting metabolic rate and its determinants in adolescents and young adults with T1D in comparison with age- and gender-matched healthy controls.\u0000 \u0000 \u0000 \u0000 This cross-sectional study included 97 children and young adults (10–19 years) with type 1 diabetes having a disease duration of at least 1 year. For the control population, 95 age- and gender-matched healthy adolescents were enrolled. Clinical examination and biochemical evaluation of parameters pertaining to diabetes and body composition were estimated, and RMR was measured using indirect calorimetry for both cases and controls.\u0000 \u0000 \u0000 \u0000 Adolescents with T1D were significantly shorter, and had significantly lower calorie intake, higher RMR and volume of oxygen consumed (VO2) as compared to the healthy controls (P < 0.05). RMR adjusted for weight showed a significant positive correlation with lean body mass (LBM) percentage, and energy intake and a negative correlation with disease duration. Those with a T1D duration of less than 5 years demonstrated a significantly higher RMR, lower body fat percentage, higher LBM percentage, carbohydrate and energy intake/kg body weight and higher calculated insulin sensitivity (IS) as compared to those with greater disease duration. Muscle mass percentage and higher energy intake were found to be significant positive predictors and advancing age/diabetes duration was a negative predictor of weight-adjusted RMR (P < 0.05), whereas IS and male gender tended towards significant negative association (P = 0.06).\u0000 \u0000 \u0000 \u0000 Indian children with type 1 diabetes had a higher resting metabolic rate as compared to healthy children. Muscle mass, energy intake and diabetes duration were observed to be important predictors of RMR in T1D. Reduction in RMR with advancing age/disease duration may predispose to weight gain and subsequent double diabetes in T1D.\u0000","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"82 S360","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141377405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Clinically Significant Liver Fibrosis as Measured by Transient Elastography due to Non-alcoholic Fatty Liver Disease in Indian individuals with Type 2 Diabetes Mellitus","authors":"Rajat Deb, S. Goswami, Nilanjan Sengupta, A. Baidya, Vibhu Ranjan Khare, Joydip Datta, Kunal Jhaveri, Mousumi Das, Debes Ray","doi":"10.4103/ijem.ijem_203_23","DOIUrl":"https://doi.org/10.4103/ijem.ijem_203_23","url":null,"abstract":"\u0000 \u0000 \u0000 There is high prevalence of non-alcoholic fatty liver disease in individuals with type 2 diabetes mellitus (T2D), and available evidence suggests higher prevalence of NASH and advanced stages of fibrosis among T2D. Data regarding prevalence of clinically significant liver fibrosis (CSLF) in individuals with T2D is scarce. We investigated the prevalence of transient elastography (TE)-proven CSLF among patients of T2D attending a diabetes clinic at a tertiary care center.\u0000 \u0000 \u0000 \u0000 A cross-sectional descriptive evaluation study of 603 consecutive adults with T2D was conducted to detect CSLF using TE. Steatosis was diagnosed using a controlled attenuation parameter >237 dB/m.\u0000 \u0000 \u0000 \u0000 The prevalence of CSLF was 22.7%, and the prevalence of steatosis was 58.9% in our study. A higher body mass index (BMI) (P = 0.001), aspartate aminotransferase (AST; P = 0.0001), alanine aminotransferase (ALT; P = 0.0001), and low platelets (P = 0.0001) were independent factors associated with CSLF. Elevated ALT and AST (≥40 units/L) levels were present in only 27.7% and 37.2% of individuals with CSLF, respectively. Twenty-six (4.31%) individuals had LSM > 13.0 kPa.\u0000 \u0000 \u0000 \u0000 CSLF is highly prevalent in T2D patients attending a diabetes clinic at a tertiary care center, and the majority of such individuals have normal transaminase levels. Higher BMI, AST, and ALT values and lower platelet counts are associated with liver fibrosis.\u0000","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"30 48","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141378713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Level of Health Literacy Predict the Self-Care Activities in Middle Age with Type 2 Diabetes Mellitus","authors":"Ratna Wirawati Rosyida, Apri Dwi Sulistiyani","doi":"10.4103/ijem.ijem_239_22","DOIUrl":"https://doi.org/10.4103/ijem.ijem_239_22","url":null,"abstract":"\u0000 \u0000 \u0000 Diabetes mellitus has increased over the years. Adequate self-care activities will improve outcomes optimally. Health literacy was the important factor that affected self-care activities. The prediction of health literacy to define the capability of self-care activities need to be identified. Health literacy among adults with T2DM can be the guidance of health worker to give the intervention in improving self-care activities. To examine the health literacy as a predictor of self-care activities among T2DM. A cross-sectional analytical study conducted in 101 patients in Primary Health Center with T2DM.\u0000 \u0000 \u0000 \u0000 Self-reported questionnaires were demographic and clinical characteristics questionnaire, HLS-EU-16Q and SDSCA Indonesian Version. Research was conducted after ethical clearance has been approved. Multivariate analysis with hierarchical linear regression and all the data were managed by SPSS v. 20.\u0000 \u0000 \u0000 \u0000 Most of the respondents were in the middle age, female (68.3%), unemployed, secondary education-graduated (45.5%), having diabetes <5 years (65.3%), with no complication and history of smoking. The middle age and health literacy related to self-care activities with P = 0.03 and P = 0.02, respectively. The age and the presence of complication explained 9.8% and 2% of the self-care activities. The predictors that included age, the presence of complication and health literacy (P < 0.05) explained 15,3% of the variance in self-care activities among type 2 DM.\u0000 \u0000 \u0000 \u0000 The presence of complication, age and health literacy was significant predictors of self-care activities among people with T2DM in Indonesia.\u0000","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"73 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141376582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparison of 06:00 AM Versus 09:00 AM Serum Cortisol as a Basal Morning Cortisol in Guwahati, Assam: A Pilot Study.","authors":"Uma K Saikia, Praveen Nagarajaiah, Abhamoni Baro, Ashok K Bhuyan","doi":"10.4103/ijem.ijem_337_23","DOIUrl":"10.4103/ijem.ijem_337_23","url":null,"abstract":"<p><strong>Introduction: </strong>Cortisol secretion is regulated by circadian rhythm, which is influenced by zeitgebers like light. In India, the entire country operates under a single time zone, Indian Standard Time, which may not align with the local sunrise timing across different regions.</p><p><strong>Aims: </strong>This study aimed to compare the basal serum cortisol levels between 06:00 AM and 09:00 AM in Guwahati, Assam, where sunrise occurs earlier compared with the western part of the country. A cross-sectional pilot study was conducted from December 2022 to June 2023 in a tertiary care hospital in Guwahati.</p><p><strong>Methods: </strong>Serum cortisol samples were collected at 06:00 AM and 09:00 AM from 25 healthy adult participants once in winter and again in summer. Descriptive statistics and paired Student's t-tests were used.</p><p><strong>Results: </strong>The mean serum cortisol levels at 06:00 AM in winter, summer and overall were 13.2, 13.4 and 13.3 μg/dL, respectively. At 09:00 AM, the mean serum cortisol levels in winter, summer and overall were 8.2, 7.7 and 8.0 μg/dL, respectively. Significant differences were observed between the 06:00 AM and 09:00 AM cortisol levels in both winter and summer (<i>P</i> <0.001).</p><p><strong>Conclusion: </strong>This study highlights the importance of considering the influence of earlier sunrise on circadian rhythm, cortisol secretion and sampling protocols. Recognising the impact of earlier sunrise on cortisol secretion and adapting sampling protocols accordingly to align with the local sunrise can provide a more accurate assessment of basal cortisol levels and help avoid potential misinterpretation and diagnostic challenges associated with low values.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"28 3","pages":"250-253"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11288508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859586","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}