International Journal of Endocrinology最新文献

{"title":"Gestational Weight Gain and Small for Gestational Age in Obese Women: A Systematic Review and Meta-Analysis.","authors":"Wen Chen, Beiyi Li, Kexin Gan, Jing Liu, Yajing Yang, Xiuqin Lv, Huijuan Ma","doi":"10.1155/2023/3048171","DOIUrl":"10.1155/2023/3048171","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review and meta-analysis evaluates the relationship between gestational weight gain and the risk of small for gestational age in obese pregnant women.</p><p><strong>Methods: </strong>Studies were identified by searching the Web of Science, Embase, and PubMed databases up to June 30th, 2022. The meta-analysis was carried out to determine the risk of small for gestational age with gestational weight gain (GWG) below the 2009 Institute of Medicine (IOM) guidelines compared with within the guidelines in obese women. The Newcastle-Ottawa Scale was used to assess the methodological quality. The chi-squared test, <i>Q</i> test, and I² test were used to evaluate statistical heterogeneity. Subgroup analyses were conducted, and publication bias was assessed by funnel plots and Egger's test. Sensitivity analyses were performed for three groups of obese people (I: BMI 30-34.9 kg/m², II: BMI 35-39.9 kg/m², and III: BMI ≥ 40 kg/m²) to examine the association of obesity and SGA.</p><p><strong>Results: </strong>A total of 788 references were screened, and 29 studies (<i>n</i> = 1242420 obese women) were included in the systematic review. Obese women who gained weight below the IOM guideline had a higher risk of SGA than those who gained weight within the guideline (OR = 1.27, 95% CI = 1.16-1.38, <i>Z</i> = 5.36). Both weight loss (<0 kg) and inadequate weight (0-4.9 kg) during pregnancy in obese women are associated with an increased risk of SGA (OR = 1.50, 95% CI = 1.37-1.64, <i>Z</i> = 8.82) (OR = 1.18, 95% CI = 1.14-1.23, <i>Z</i> = 8.06). The same conclusions were also confirmed for the three obesity classes (I: OR = 1.38, 95% CI = 1.29-1.47; II: OR = 1.39, 95% CI = 1.30-1.49; and III: OR = 1.26, 95% CI = 1.16-1.37). Subgroup analysis by country showed that GWG below guidelines in obese women of the USA and Europe was associated with risk for SGA (USA (OR = 1.30, 95% CI = 1.15-1.46), Europe (OR = 1.24, 95% CI = 1.11-1.40)) and not in Asia (OR = 1.17, 95% CI = 0.91-1.50).</p><p><strong>Conclusion: </strong>Our findings indicated that obese pregnant women who had weight loss or inadequate weight (0-4.9 kg) according to the IOM guideline had increased risks for SGA. Moreover, we also evaluated that gestational weight loss (<0 kg) in these pregnancies was associated with an increased risk for SGA compared with inadequate weight (0-4.9 kg) in these pregnancies. Therefore, the clinical focus should assist obese women to achieve GWG within the IOM guidelines to decrease the risk for SGA.</p>","PeriodicalId":13966,"journal":{"name":"International Journal of Endocrinology","volume":"2023 ","pages":"3048171"},"PeriodicalIF":2.3,"publicationDate":"2023-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9848811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10582307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Ovariectomy on the Anterior Pituitary Gland in Female Rats.","authors":"Aki Oride,&nbsp;Haruhiko Kanasaki,&nbsp;Tuvshintugs Tumurbaatar,&nbsp;Zolzaya Tumurgan,&nbsp;Hiroe Okada,&nbsp;Zhuoma Cairang,&nbsp;Kyo Satoru","doi":"10.1155/2023/3143347","DOIUrl":"https://doi.org/10.1155/2023/3143347","url":null,"abstract":"<p><p>Ovariectomy (OVX) causes a depletion of circulating estradiol (E2) and influences hypothalamic kisspeptin neurons, which govern gonadotropin-releasing hormone (GnRH) release and ultimately gonadotropin secretion. In this study, we examined the changes induced by OVX on the anterior pituitary gland in female rats. OVX significantly increased the mRNA expression of gonadotropin <i>α</i>, luteinizing hormone (LH) <i>β</i>, and follicle-stimulating hormone (FSH) <i>β</i> subunits within the pituitary gland compared with control (sham-operated) rats, and this was completely suppressed by E2 supplementation. High-dose dihydrotestosterone supplementation also prevented the OVX-induced increase in the expression of the three gonadotropin subunits. GnRH receptor mRNA expression within the pituitary was significantly increased in OVX rats, and this increase was completely inhibited by E2 supplementation. The mRNA expression of the receptors for adenylate cyclase-activating polypeptide and kisspeptin was unchanged by OVX. Although the mRNA levels of inhibin <i>α</i>, <i>β</i>A, and <i>β</i>B subunits within the pituitary gland were not modulated by OVX, follistatin gene expression within the pituitary gland was increased by OVX, and this increase was completely inhibited by E2 supplementation after OVX. In experiments using a pituitary gonadotroph cell model (L<i>β</i>T2 cells), follistatin itself did not modulate the mRNA expression of gonadotropin LH<i>β</i> and FSH<i>β</i> subunits, and the GnRH-induced increase in the expression of these genes was slightly inhibited in the presence of follistatin. Our current observations suggest that OVX induces several characteristic changes in the pituitary gland of rats.</p>","PeriodicalId":13966,"journal":{"name":"International Journal of Endocrinology","volume":"2023 ","pages":"3143347"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10024625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9210010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Levothyroxine Timing during Ramadan: A Randomized Clinical Trial.","authors":"Moeber Mahzari,&nbsp;Fahad Al Remthi,&nbsp;Ibrahim Ajwah,&nbsp;Mohammed Al Hazmi,&nbsp;Wesam Moafa,&nbsp;Awad Al Shahrani,&nbsp;Sameerah Al Shehri,&nbsp;Motasim Badri","doi":"10.1155/2023/2565031","DOIUrl":"https://doi.org/10.1155/2023/2565031","url":null,"abstract":"<p><strong>Introduction: </strong>Hypothyroidism requires lifelong thyroid hormone replacement with levothyroxine. For most hypothyroid patients fasting during Ramadan, compliance with the administration procedure is a challenge. This study aimed to determine the impact of different administration times of levothyroxine on thyroid-stimulating hormone (TSH) and free T4 (FT4) levels before and after the holy month of Ramadan. <i>Materials and Methodology</i>. Hypothyroid patients taking levothyroxine were randomized to 3 groups during Ramadan: group 1, 30 minutes before the iftar meal; group 2, 3-4 hours after the iftar meal, with no food taken for at least 1 hour after the meal; group 3, they were not given specific instructions for taking levothyroxine during Ramadan. Thyroid function tests were performed within 2 weeks before Ramadan and within 2 weeks after Ramadan. Pre- and post-Ramadan TSH and free T4 levels were compared. Mixed-effects analyzes were performed to identify factors associated with changes in TSH and FT4 levels.</p><p><strong>Results: </strong>Compliance was lower in patients taking levothyroxine 3-4 hours after iftar. In addition, the majority of patients who had not received a specific recommendation took levothyroxine 30 minutes before iftar. There was a statistically significant increase in TSH (<i>P</i>=0.006) and FT4 (<i>P</i>=0.044) levels after Ramadan. In multivariate analysis, the cause of hypothyroidism (Hashimoto's; postthyroidectomy; compared to postradioactive iodine) and levothyroxine dose significantly affected FT4 levels. In contrast, no variable was significantly associated with TSH level. The timing of levothyroxine intake during Ramadan did not significantly affect TSH or FT4 levels.</p><p><strong>Conclusion: </strong>TSH and FT4 significantly increased after Ramadan. However, the timing of levothyroxine intake per se had no influence on TSH or free T4 levels. Therefore, hypothyroid patients might take levothyroxine either 30 minutes or 3-4 hours after iftar with no meal for 1 hour, depending on preference.</p>","PeriodicalId":13966,"journal":{"name":"International Journal of Endocrinology","volume":"2023 ","pages":"2565031"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9937748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9330446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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 Intrapancreatic Fat Deposition and Lower High-Density Lipoprotein Cholesterol in Individuals with Newly Diagnosed T2DM.","authors":"Jianliang Wang,&nbsp;Qingyun Cai,&nbsp;Xiaojuan Wu,&nbsp;Jiaxuan Wang,&nbsp;Xiaona Chang,&nbsp;Xiaoyu Ding,&nbsp;Jia Liu,&nbsp;Guang Wang","doi":"10.1155/2023/6991633","DOIUrl":"https://doi.org/10.1155/2023/6991633","url":null,"abstract":"<p><strong>Background: </strong>Intrapancreatic fat deposition (IPFD) usually occurs in individuals with type 2 diabetes mellitus (T2DM), but its physiopathological influence remains controversial. The present study aimed to investigate IPFD and its associations with various aspects of glucose and lipid metabolism in individuals with newly diagnosed T2DM.</p><p><strong>Methods: </strong>A total of 100 individuals were included, consisting of 80 patients with newly diagnosed T2DM and 20 age- and sex-matched healthy controls. Then, we assessed IPFD using magnetic resonance imaging (MRI) and various parameters of glucose and lipid metabolism.</p><p><strong>Results: </strong>Individuals with newly diagnosed T2DM had a significantly higher IPFD (median: 12.34%; IQR, 9.19-16.60%) compared with healthy controls (median: 6.35%; IQR, 5.12-8.96%) (<i>p</i> < 0.001). In individuals with newly diagnosed T2DM, IPFD was significantly associated with FINS and HOMA-IR in unadjusted model (<i>β</i> = 0.239, <i>p</i>=0.022; <i>β</i> = 0.578, <i>p</i>=0.007, respectively) and adjusted model for age and sex (<i>β</i> = 0.241, <i>p</i>=0.022; <i>β</i> = 0.535, <i>p</i>=0.014, respectively), but these associations vanished after adjustment for age, sex, and BMI. The OR of lower HDL-C for the prevalence of high IPFD was 4.22 (95% CI, 1.41 to 12.69; <i>p</i>=0.010) after adjustment for age, sex, BMI, and HbA1c.</p><p><strong>Conclusions: </strong>Lower HDL-C was an independent predictor for a high degree of IPFD.</p>","PeriodicalId":13966,"journal":{"name":"International Journal of Endocrinology","volume":"2023 ","pages":"6991633"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9899139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10660544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Composite Dietary Antioxidant Index Is Negatively Associated with Hyperuricemia in US Adults: An Analysis of NHANES 2007-2018.","authors":"Zhenzong Lin,&nbsp;Haokai Chen,&nbsp;Qiwen Lan,&nbsp;Yinghan Chen,&nbsp;Wanzhe Liao,&nbsp;Xuguang Guo","doi":"10.1155/2023/6680229","DOIUrl":"https://doi.org/10.1155/2023/6680229","url":null,"abstract":"<p><p>Hyperuricemia and its complications are severe risks to human health. Dietary intervention is considered an essential part of the management of hyperuricemia. Studies have reported that the intake of antioxidants has a positive effect on hyperuricemia. Here, we collected data from 8761 participants of the National Health and Nutrition Examination Survey for this analysis. Daily intakes of vitamins A, C, and E; manganese; selenium; and zinc were calculated as the composite dietary antioxidant index (CDAI). The participants were divided into four groups (Q1, Q2, Q3, and Q4) according to the CDAI. Univariate analysis was used to assess the association of covariates with hyperuricemia. The association between the CDAI and hyperuricemia was evaluated using multinomial logistic regression, and its stability was determined by stratified analysis. Our results revealed that the CDAI has a significant negative association with hyperuricemia (Q2: 0.81 (0.69, 0.95); Q3: 0.75 (0.62, 0.90); Q4: 0.65 (0.51, 0.82); <i>P</i> < 0.01). The results of stratified analysis emphasize that this association between CDAI and hyperuricemia is stable. In conclusion, this study suggested a negative association between the CDAI and hyperuricemia.</p>","PeriodicalId":13966,"journal":{"name":"International Journal of Endocrinology","volume":"2023 ","pages":"6680229"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10449592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10106340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between Uric Acid to High Density Lipoprotein Cholesterol Ratio and Nonalcoholic Fatty Liver Disease in Nonoverweight/Obese Patients with Type 2 Diabetes.","authors":"Yuliang Cui,&nbsp;Zhenzhen Qu,&nbsp;Wenmei Hu,&nbsp;Haiyan Shi","doi":"10.1155/2023/2513175","DOIUrl":"https://doi.org/10.1155/2023/2513175","url":null,"abstract":"<p><strong>Aims: </strong>To investigate the relationship between uric acid to high-density lipoprotein cholesterol ratio (UHR) levels and nonalcoholic fatty liver disease (NAFLD) in nonoverweight/obese patients with type 2 diabetes.</p><p><strong>Methods: </strong>A retrospective study was designed including a total of 343 inpatients with type 2 diabetes whose BMI<24 kg/m². The population was divided into three groups as the UHR tertiles. Logistic regression analysis was performed to estimate odds ratios (ORs) of UHR for NAFLD. ROC curve analysis was used to estimate the diagnostic value of UHR for NAFLD.</p><p><strong>Results: </strong>The prevalence rat of NAFLD enhanced progressively from the tertile 1 to tertile 3 of UHR (30.70% vs. 56.52% vs. 73.68%). Logistic regression analysis showed that participants in the higher UHR groups, compared with those in the first tertile group, had higher occurrence risks for NAFLD. The positive association between UHR and NAFLD was independent of age, BMI, blood pressure, hepatic enzymes, and other components of metabolic disorders. ROC curve analysis showed that the area under curve (AUC), sensitivity, and specificity for UHR were 0.697, 0.761, and 0.553, respectively.</p><p><strong>Conclusions: </strong>In type 2 diabetic patients without overweight or obesity, UHR is significantly associated with NAFLD and can be used as a novel and useful predictor for NAFLD onset.</p>","PeriodicalId":13966,"journal":{"name":"International Journal of Endocrinology","volume":"2023 ","pages":"2513175"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10409575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10326412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunocytochemistry Profile of Benign Thyroid Nodules Not Responding to Thermal Ablation: A Retrospective Study.","authors":"Stella Bernardi,&nbsp;Silvia Taccogna,&nbsp;Martina D'Angelo,&nbsp;Fabiola Giudici,&nbsp;Giovanni Mauri,&nbsp;Bruno Raggiunti,&nbsp;Doris Tina,&nbsp;Fabrizio Zanconati,&nbsp;Enrico Papini,&nbsp;Roberto Negro","doi":"10.1155/2023/7951942","DOIUrl":"https://doi.org/10.1155/2023/7951942","url":null,"abstract":"<p><strong>Purpose: </strong>Thermal ablations (TA) are gaining ground as alternative options to conventional therapies for symptomatic benign thyroid nodules. Little is known about the impact of nodule biology on the outcomes of TA. The aim of our study was to evaluate the baseline immunocytochemistry profile of thyroid nodules that were poorly responsive to TA in order to identify potential predictors of the treatment response.</p><p><strong>Methods: </strong>From a cohort of 406 patients with benign thyroid nodules treated with TA and followed for 5 years, we retrospectively selected two groups of patients: NONRESPONDERS (patients who did not respond to TA and were later surgically treated) and RESPONDERS (patients who responded to TA). The fine-needle aspiration cytology (FNAC) slides obtained before TA were stained for Galectin-3, HBME-1, CK-19, and Ki-67.</p><p><strong>Results: </strong>Benign nodules of NONRESPONDERS (<i>n</i> = 19) did not express CK-19 (<i>p</i> = 0.03), as compared to RESPONDERS (<i>n</i> = 26). We combined the absence of CK-19 and the presence of Ki-67 to obtain a composite biomarker of resistance to TA, which discriminated between likelihood of retreatment and no retreatment with an AUC of 0.68 (95%CI: 0.55-0.81) and a sensitivity, specificity, PPV, and NPV of 29%, 91%, 71%, and 64%, respectively.</p><p><strong>Conclusion: </strong>In benign thyroid nodules, the absence of CK-19 was associated with resistance to TA, while the presence of CK-19 was predictive of response to TA. If confirmed, this finding could provide rapid and inexpensive information about the potential outcome of TA on benign thyroid nodules. In addition, as CK-19 can be expressed in adenomatous hyperplasia, it could be speculated that these nodules, rather than follicular adenomas, might be better candidates for TA.</p>","PeriodicalId":13966,"journal":{"name":"International Journal of Endocrinology","volume":"2023 ","pages":"7951942"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10113047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9740111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of IGF-1 Level with Low Bone Mass in Young Patients with Cushing's Disease.","authors":"Wanwan Sun,&nbsp;Quanya Sun,&nbsp;Qiaoli Cui,&nbsp;Min He,&nbsp;Wei Wu,&nbsp;Yiming Li,&nbsp;Hongying Ye,&nbsp;Shuo Zhang","doi":"10.1155/2023/3334982","DOIUrl":"https://doi.org/10.1155/2023/3334982","url":null,"abstract":"<p><strong>Purpose: </strong>Few related factors of low bone mass in Cushing's disease (CD) have been identified so far, and relevant sufficient powered studies in CD patients are rare. On account of the scarcity of data, we performed a well-powered study to identify related factors associated with low bone mass in young CD patients.</p><p><strong>Methods: </strong>This retrospective study included 153 CD patients (33 males and 120 females, under the age of 50 for men and premenopausal women). Bone mineral density (BMD) of the left hip and lumbar spine was measured by dual energy X-ray absorptiometry (DEXA). In this study, low bone mass was defined when the Z score was -2.0 or lower.</p><p><strong>Results: </strong>Among those CD patients, low bone mass occurred in 74 patients (48.37%). Compared to patients with normal BMD, those patients with low bone mass had a higher level of serum cortisol at midnight (22.31 (17.95-29.62) vs. 17.80 (13.75-22.77), <i>p</i>=0.0006), testosterone in women (2.10 (1.33-2.89) vs. 1.54 (0.97-2.05), <i>p</i>=0.0012), higher portion of male (32.43% vs. 11.54%, <i>p</i>=0.0016) as well as hypertension (76.12% vs. 51.67%, <i>p</i>=0.0075), and lower IGF-1 index (0.59 (0.43-0.76) vs. 0.79 (0.60-1.02), <i>p</i>=0.0001). The Z score was positively associated with the IGF-1 index in both the lumbar spine (<i>r</i> = 0.35153, <i>p</i> < 0.0001) and the femoral neck (<i>r</i> = 0.24418, <i>p</i>=0.0057). The Z score in the femoral neck was negatively associated with osteocalcin (<i>r</i> = -0.22744, <i>p</i>=0.0229). Compared to the lowest tertile of the IGF-1 index (<0.5563), the patients with the highest tertile of the IGF-1 index (≥0.7993) had a lower prevalence of low bone mass (95% CI 0.02 (0.001-0.50), <i>p</i>=0.0002), even after adjusting for confounders such as age, gender, duration, BMI, hypertension, serum cortisol at midnight, PTH, and osteocalcin.</p><p><strong>Conclusions: </strong>The higher IGF-1 index was independently associated with lower prevalence of low bone mass in young CD patients, and IGF-1 might play an important role in the pathogenesis of CD-caused low bone mass.</p>","PeriodicalId":13966,"journal":{"name":"International Journal of Endocrinology","volume":"2023 ","pages":"3334982"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10335871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9871941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of 18 Months of Growth Hormone Replacement Therapy on Bone Mineral Density in Patients with Adult Growth Hormone Deficiency: A Retrospective Study.","authors":"Ya-Yin Shen,&nbsp;Jia-Ni Ma,&nbsp;Zi-Yu Ren,&nbsp;Jie Liu,&nbsp;Xin-Yi Zhou,&nbsp;Xue-Rui Xie,&nbsp;Wei Ren","doi":"10.1155/2023/4988473","DOIUrl":"https://doi.org/10.1155/2023/4988473","url":null,"abstract":"<p><strong>Objective: </strong>The effect of physiological dose growth hormone (GH) replacement therapy on bone mineral density (BMD) in adults with growth hormone deficiency (GHD) is not well defined. We aimed to investigate the effects of 18 months of treatment with recombinant human growth hormone (rhGH) at physiological doses on BMD, body composition (BC), and quality of life (QoL).</p><p><strong>Methods: </strong>Sixty-eight patients diagnosed with adult growth hormone deficiency (AGHD) in our hospital were included in this retrospective study. All patients received individualized rhGH replacement to maintain normal serum insulin-like growth factor-1 (IGF-1) levels. BMD and BC measurements were performed by dual energy X-ray absorptiometry (DXA). Excluding those with incomplete follow-up data, we analyzed BMD in 68 patients, as well as BC and QoL in 36 of them.</p><p><strong>Results: </strong>Compared with the baseline, lumbar spine BMD decreased by 0.008 g/cm² (<i>P</i>=0.006) and increased by 0.011 g/cm² (<i>P</i>=0.045) at month 18, and total hip BMD decreased by 0.005 g/cm² (<i>P</i>=0.008) and did not change significantly from the baseline at month 18. The changes in BMD did not differ by sex, and the increase in BMD was more pronounced in patients with low <i>Z</i>-scores at the baseline (lumbar spine: <i>P</i>=0.005 and total hip: <i>P</i>=0.018). The percentage change from the baseline in BMD was greater for the lumbar spine than for the total hip (<i>P</i>=0.003). Lean body mass (LBM) increased significantly (<i>P</i>=0.012), total body fat ratio (TBF%) decreased significantly (<i>P</i>=0.011), visceral adipose tissue (VAT) decreased significantly (<i>P</i>=0.016), and QoL improved significantly (<i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>Within 18 months of treatment, bone resorption manifested first, BMD decreased to a nadir at month 6, and then it increased. The increase in BMD was greater in the lumbar spine than in the hip, and the increase was more pronounced in patients with low BMD. Eighteen months of rhGH replacement therapy significantly improved lumbar spine BMD and improved BC and QoL.</p>","PeriodicalId":13966,"journal":{"name":"International Journal of Endocrinology","volume":"2023 ","pages":"4988473"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10081901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9282787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients with Hypocortisolism Treated with Continuous Subcutaneous Hydrocortisone Infusion (CSHI): An Option for Poorly Controlled Patients.","authors":"Malene Lyder Mortensen,&nbsp;Marie Juul Ornstrup,&nbsp;Claus H Gravholt","doi":"10.1155/2023/5315059","DOIUrl":"https://doi.org/10.1155/2023/5315059","url":null,"abstract":"<p><strong>Objective: </strong>Despite appropriate oral glucocorticoid replacement therapy, patients with hypocortisolism often suffer from impaired health and frequent hospitalizations. Continuous subcutaneous hydrocortisone infusion (CSHI) has been developed as an attempt to improve the health status of these patients. The objective of this study was to compare the effects of CSHI to conventional oral treatment on hospitalizations, glucocorticoid doses, and subjective health status. <i>Patients</i>. Nine Danish patients (males: 4 and females: 5) with adrenal insufficiency (AI) were included, with a median age of 48 years, due to Addison (<i>n</i> = 4), congenital adrenal hyperplasia (<i>n</i> = 1), steroid induced secondary adrenal insufficiency (<i>n</i> = 2), morphine induced secondary adrenal insufficiency (<i>n</i> = 1), and Sheehan's syndrome (<i>n</i> = 1). Only patients with severe symptoms of cortisol deficit on oral treatment were selected for CSHI. Their usual oral hydrocortisone doses varied from 25-80 mg per day. The duration of follow-up depended on when the treatment was changed. The first patient started CSHI in 2009 and the last in 2021.</p><p><strong>Design: </strong>A retrospective case series comparing hospitalizations and glucocorticoid doses before and after treatment with CSHI. In addition, patients were retrospectively interviewed about their health-related quality of life (HRQoL) after the change of treatment modality.</p><p><strong>Results: </strong>Patients significantly reduced their daily dose of glucocorticoids by 16.1 mg (<i>p</i> = 0.02) after changing to CSHI. The number of hospital admission due to adrenal crisis decreased by 1.3 per year on CSHI, which was a 50% reduction (<i>p</i> = 0.04). All patients found it easier to handle an adrenal crisis with CSHI, and almost all patients found it easier to overcome everyday activities and had fewer symptoms of cortisol deficit such as abdominal pain and nausea (7-8 out of 9 patients).</p><p><strong>Conclusions: </strong>The change of treatment from conventional oral hydrocortisone to CSHI resulted in a reduced daily dose of glucocorticoids and a reduced number of hospitalizations. Patients reported regain of energy, achievement of better disease control, and better handling of adrenal crisis.</p>","PeriodicalId":13966,"journal":{"name":"International Journal of Endocrinology","volume":"2023 ","pages":"5315059"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10042637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9274692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}