Journal of the Endocrine Society最新文献

{"title":"Transient gonadotropin suppression by exogenous testosterone decreases INSL3 in early puberty in boys with constitutional delay of growth and puberty.","authors":"Taneli Raivio, Mila Tanner, Kirsi Vaaralahti, Matti Hero, Päivi J Miettinen, Tero Varimo","doi":"10.1210/jendso/bvag123","DOIUrl":"10.1210/jendso/bvag123","url":null,"abstract":"<p><p>We investigated circulating insulin-like peptide 3 (INSL3) in boys with constitutional delay of growth and puberty treated with exogenous testosterone (T) or oral letrozole (Lz). Twenty-eight boys were randomized to Lz (2.5 mg/day; <i>n</i> = 15) or intramuscular T (1 mg/kg every 4 weeks; <i>n</i> = 13) for 6 months and followed up to 12 months. Blood samples were collected at baseline and at 3, 6, and 12 months to measure INSL3 and other pubertal hormones (ClinicalTrials.gov NCT01797718). At baseline, INSL3 levels were similar between groups (T: 1.4 ng/mL [0.8], Lz: 1.9 ng/mL [1.8], <i>P</i> = .39). T suppressed luteinising hormone (LH), follicle-stimulating hormone (FSH), and INSL3 between 0 and 3 months (<i>P</i> < .01), and changes in INSL3 correlated with changes in LH (<i>r</i> = 0.61, <i>P</i> < .001) and FSH (<i>r</i> = 0.67, <i>P</i> < .001). Between 3 and 6 months, INSL3 and gonadotropins rose in the T group, while both increased from 0 to 6 months with Lz (<i>P</i> < .001). At 12 months, INSL3 levels did not differ between groups. Exogenous testosterone thus transiently suppresses INSL3 via gonadotropin inhibition in early puberty.</p>","PeriodicalId":17334,"journal":{"name":"Journal of the Endocrine Society","volume":"10 7","pages":"bvag123"},"PeriodicalIF":4.4,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13265132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148258442","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":"Intraoperative PTH monitoring: does sampling site or assay generation matter?","authors":"Rola Kwayess, Sara Ajjour, Maya Rahme, Mariam Assaad, Marlene Chakhtoura, Omar Kreidieh, Jaber Abbas, Samar Jabbour-Khoury, Rose T Daher, Etienne Cavalier, Ghada El-Hajj Fuleihan","doi":"10.1210/jendso/bvag109","DOIUrl":"10.1210/jendso/bvag109","url":null,"abstract":"<p><strong>Context: </strong>Primary hyperparathyroidism (PHPT) is a common endocrine disorder for which minimally invasive parathyroidectomy (MIP) is the standard surgical approach. Intraoperative parathyroid hormone (IOPTH) monitoring is commonly performed using second-generation (2G) parathyroid hormone (PTH) assay.</p><p><strong>Objective: </strong>To compare the performance of IOPTH central sampling peripheral sampling, and third-generation (3G) vs 2G assays in patients with PHPT.</p><p><strong>Methods: </strong>This is a prospective cohort study conducted at American University of Beirut Medical Center, a tertiary hospital in Beirut, Lebanon. The study included 68 subjects with confirmed PHPT who achieved surgical cure, defined as normocalcemia at ≥6 months. IOPTH levels were measured from central and peripheral venous samples using 2G and 3G assays at various time points.</p><p><strong>Results: </strong>The median age was 57 years, and 80% were female. One-fourth had osteoporosis or reported kidney stones. Median preoperative calcium was 10.8 mg/dL with PTH 104 pg/mL, and 82% had single-gland disease. IOPTH levels were significantly higher with 2G assay and central sampling vs 3G assay and peripheral sampling. The proportion of patients meeting the Miami criterion did not differ between assays or sampling sites. Median percentage drop in IOPTH was greater with the 3G assay compared to 2G, across all time points, at both sampling sites.</p><p><strong>Conclusion: </strong>Although both assays similarly identified a ≥50% intraoperative decline, 3G assays demonstrated a steeper and more consistent drop, suggesting that higher assay-specific thresholds may improve decision-making. Central and peripheral sampling showed comparable predictive performance, although central sampling may allow earlier detection of PTH decline.</p>","PeriodicalId":17334,"journal":{"name":"Journal of the Endocrine Society","volume":"10 6","pages":"bvag109"},"PeriodicalIF":4.4,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148157109","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":"Relationship between histopathological findings and RAI in non-papillary follicular cell-derived thyroid carcinoma.","authors":"Haruhiko Yamazaki, Kiminori Sugino, Ryohei Katoh, Miho Kawaida, Kenichi Matsuzu, Wataru Kitagawa, Aya Saito, Koichi Ito","doi":"10.1210/jendso/bvag120","DOIUrl":"10.1210/jendso/bvag120","url":null,"abstract":"<p><strong>Context: </strong>Detailed studies considering the distinct types of non-papillary follicular cell-derived thyroid carcinoma in terms of radioactive iodine (RAI) avidity are limited.</p><p><strong>Objective: </strong>This study aimed to investigate clinicopathological characteristics, relationship between histopathological findings, including solid/trabecular/insular (STI) components and RAI treatment (RAIT), in patients with non-papillary follicular cell-derived thyroid carcinoma.</p><p><strong>Methods: </strong>This study included 114 patients with non-papillary follicular cell-derived thyroid carcinoma who underwent first RAIT between January 2005 and August 2025.</p><p><strong>Results: </strong>Of the 114 patients, 5 (4%) were minimally invasive follicular thyroid carcinoma (MI-FTC), 41 (36%) were encapsulated angio-invasive FTC (EA-FTC), 23 (20%) were widely invasive FTC (WI-FTC), 22 (19%) were differentiated high-grade thyroid carcinoma (DHGTC), 21 (18%) were poorly differentiated thyroid carcinoma (PDTC), and 2 (2%) were others, respectively. The median percentages of STI component was 40% (range, 0%-10%) in all patients, 5% (range, 0%-50%) in MI-FTC, 30% (range, 0%-100%) in EA-FTC, 30% (range, 0%-100%) in WI-FTC, 28% (range, 5%-70%) in DHGTC, and 70% (range, 50%-100%) in PDTC, respectively. Among the 114 patients, the rate of RAI avidity was 60% (95% CI, 49%-71%) (47/78) in lung, 89% (95% CI, 79%-96%) (59/66) was in bone, 100% (13/13) in lymph node, and 100% (3/3) in other sites, respectively.</p><p><strong>Conclusion: </strong>RAI avidity was relatively high in non-papillary follicular cell-derived thyroid carcinoma, regardless of the histological type and percentage of STI components.</p>","PeriodicalId":17334,"journal":{"name":"Journal of the Endocrine Society","volume":"10 7","pages":"bvag120"},"PeriodicalIF":4.4,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13247591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148218282","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":"Allopurinol has no effect on calcitriol or other CKD-MBD biomarkers: a randomized double-blind study.","authors":"Tiago E Costa, Julia C Lauar, Mariana L R Innecchi, Luiza Karla R P Araujo, Venceslau A Coelho, Luciene M Dos Reis, Rosa M A Moysés, Rosilene M Elias","doi":"10.1210/jendso/bvag118","DOIUrl":"10.1210/jendso/bvag118","url":null,"abstract":"<p><strong>Introduction: </strong>New evidence has emerged linking uric acid levels to Chronic Kidney Disease and Mineral and Bone Disorder (CKD-MBD). However, interventional studies remain scarce. We evaluated the effect of allopurinol on CKD-MBD biomarkers.</p><p><strong>Methods: </strong>This is a randomized, double-blind clinical trial involving adult patients with stage 3-5 CKD under conservative management. Participants received either allopurinol 300 mg or a placebo for at least 90 days. Clinical data and blood samples were collected at baseline and at the end of the follow-up period to assess changes in calcium, phosphate, 25-hydroxyvitamin-D, parathyroid hormone (PTH), 1,25-hydroxyvitamin D, fibroblast growth factor 23 (FGF23), α Klotho, and bone alkaline phosphatase.</p><p><strong>Results: </strong>Forty-nine patients completed the study (25 in the allopurinol group and 24 in the placebo group). Most participants were women (53.1%), with a mean age of 71 ± 11 years and an average eGFR of 27.8 ± 11.0 mL/min/1.73 m². Uric acid levels were significantly decreased in the allopurinol group (7.49 mg/dL initial vs 3.96 mg/dL final, 43%, <i>P</i> < .001). FGF23 levels increased over time (<i>P</i> = .037), with no difference between groups. 25-hydroxyvitamin-D levels increased in the allopurinol group and decreased in the placebo group, a result that lost significance after adjusting for cholecalciferol supplementation and race. No other CKD-MBD biomarkers were significantly affected by allopurinol treatment.</p><p><strong>Conclusion: </strong>Despite its urate-lowering effect, allopurinol did not produce meaningful changes in the major CKD-MBD biomarkers over the study period. Our results strengthen existing recommendations to restrict uric acid-lowering treatment to symptomatic gout, as we did not identify any associated improvements in mineral metabolism.</p>","PeriodicalId":17334,"journal":{"name":"Journal of the Endocrine Society","volume":"10 6","pages":"bvag118"},"PeriodicalIF":4.4,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148150297","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":"Fat and lean mass association with osteoporosis and bone mineral density: the ELSA-Brasil cohort.","authors":"Thiago Bosco Mendes, Almog Shalit, Diogo Souza Domiciano, Giuliano Generoso, Virgínia Lúcia Nazário Bonoldi, Valéria de Falco Caparbo, Isabela M Bensenor, Paulo Andrade Lotufo, Marcio Sommer Bittencourt, Pouneh K Fazeli","doi":"10.1210/jendso/bvag119","DOIUrl":"10.1210/jendso/bvag119","url":null,"abstract":"<p><strong>Context: </strong>The relationship between body composition, especially fat mass (FM), and bone mineral density (BMD) is still a matter of debate.</p><p><strong>Objective: </strong>The aim of this study was to test whether FM and lean mass (LM) are predictors of osteoporosis and if the association between body composition and BMD varies by sex, age, and body mass index (BMI) status.</p><p><strong>Methods: </strong>We analyzed 1316 participants from the ELSA-Brasil Cohort who underwent dual-energy X-ray absorptiometry. Osteoporosis prevalence was stratified by BMI category and sex. Multivariable regression analyses were performed with lean and FM indexes as predictors of osteoporosis and BMD at different sites according to sex, age, and BMI category.</p><p><strong>Results: </strong>Osteoporosis was prevalent in 18.6% of postmenopausal females and 8% of males aged ≥50 years. In the fully adjusted model, LM was inversely associated with osteoporosis in the overall male population and in females with BMI ≥30 kg/m² and positively associated with BMD in males and in postmenopausal females with BMI ≥25 kg/m². FM was positively associated with BMD in postmenopausal females with BMI < 25 kg/m².</p><p><strong>Conclusion: </strong>In postmenopausal women with a BMI < 25 kg/m², BMD is positively associated with FM, whereas in postmenopausal females with a BMI ≥25 kg/m², BMD is positively associated with LM. These findings support the theory that FM is an important predictor of BMD-possibly due to its effect on estradiol levels through aromatization-up until a certain \"fat threshold\", after which other factors, including LM and its effect on mechanical loading, likely become more dominant factors affecting BMD.</p>","PeriodicalId":17334,"journal":{"name":"Journal of the Endocrine Society","volume":"10 8","pages":"bvag119"},"PeriodicalIF":4.4,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13376672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578966","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":"T cells are elevated in abdominal and femoral adipose tissue in females with type 2 diabetes.","authors":"Kerri Z Delaney, Muhammad Ilyas Nadeem, Claire Plissonneau, Natalie Khor, Jacob Delaney, José A Morais, Michael A Tsoukas, Radu Pescarus, Pierre Y Garneau, Sylvia Santosa","doi":"10.1210/jendso/bvag117","DOIUrl":"10.1210/jendso/bvag117","url":null,"abstract":"<p><p>Adipose tissue (AT) immune cells are implicated in the pathology of type 2 diabetes (T2D), and their content likely differs between abdominal subcutaneous adipose tissue (abSAT), femoral SAT (fmSAT), and visceral adipose tissue (VAT). Therefore, the objective of the current study was to develop an understanding of how immune cell presence differs between abSAT, fmSAT, and VAT depots in females who are lean (NO), have obesity (OB), or have OB + T2D. Premenopausal females were recruited from the community (NO, n = 14) or bariatric surgery clinics (OB, n = 10; OB + T2D, n = 8) in Montreal, Quebec, Canada. abSAT and fmSAT were obtained by needle aspiration biopsy in all participants, while VAT was excised from the OB and OB + T2D groups during surgery. AT immune cells were isolated from AT biopsies and stained for quantification via flow cytometry. OB + T2D fmSAT had a greater number of T cells (CD3+) than the NO group, with no difference between the NO and OB groups. We further found that abSAT CD3+, CD3+CD4+, CD3+CD8+, and CD68+CD206+ cells were greater in the OB + T2D group, followed by the OB group and then NO participants. There were no regional differences in T cells, macrophages, natural killer cells, or B cells between individuals with OB and OB + T2D. Our findings indicate that the importance of fmSAT and abSAT T cells in T2D pathogenesis should be further investigated.</p>","PeriodicalId":17334,"journal":{"name":"Journal of the Endocrine Society","volume":"10 7","pages":"bvag117"},"PeriodicalIF":4.4,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148199470","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":"Inhibiting hepatocytes MAGL alleviates osteoporosis caused by high-fat diet-induced liver fibrosis in male mice.","authors":"Qing Zhang, Zhixiang Lin, Peng Wang, Haixiang Xiao, Wenming Li, Lei Yu, Xiaolong Liang, Wentao Wang, Jing Qu, Gaoran Ge, Liangliang Wang, Hongtao Zhang","doi":"10.1210/jendso/bvag114","DOIUrl":"10.1210/jendso/bvag114","url":null,"abstract":"<p><p>Hepatic osteoporosis is mediated through the liver-bone axis, but the precise mechanisms underlying osteoporosis in severe liver disease remain elusive. A high-fat diet can induce hepatic steatosis, which may subsequently progress to liver fibrosis. Monoacylglycerol lipase (MAGL), a rate-limiting enzyme in monoacylglycerol degradation, exhibits elevated expression in the liver. The potential of hepatic MAGL inhibition to attenuate osteoclast activation and mitigate osteoporosis remains unexplored. This study demonstrated that a high-fat culture medium upregulated MAGL and CB1R expression in mice hepatocytes. Pharmacological inhibition of MAGL using MJN110 resulted in reduced CB1R expression and decreased levels of the apoptosis marker SMAD3, indicating a reduction in liver fibrosis and hepatocyte apoptosis, respectively. Furthermore, we confirmed that CB1R expression decreased in mice hepatocytes with silenced mgll gene expression, mirroring the reduction in MAGL expression. Subsequent stimulation of osteoclasts with concentrated supernatants from hepatocytes cultured in control and mgll-silenced groups revealed a significant reduction in osteoclast activation markers via Western blot and PCR analyses. In vivo, mice fed a high-fat diet to induce liver fibrosis exhibited significant alleviation of liver fibrosis following intraperitoneal injection of MJN110. Notably, osteoclast activation in the femoral germinal layer of mice with liver fibrosis was elevated, whereas this activation was attenuated in the MJN110-treated group. In conclusion, these findings suggest that hepatic MAGL inhibition can alleviate femoral osteoclast activation and bone destruction associated with high-fat diet-induced liver fibrosis, offering a novel therapeutic avenue for hepatic osteoporosis.</p>","PeriodicalId":17334,"journal":{"name":"Journal of the Endocrine Society","volume":"10 7","pages":"bvag114"},"PeriodicalIF":4.4,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13268765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148265159","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":"Adherence to daily growth hormone therapy in Japan: real-world data from the Melon Nikki™ app and device.","authors":"Akari Nakamura-Utsunomiya, Taisuke Ono, Osamu Arashin","doi":"10.1210/jendso/bvag113","DOIUrl":"10.1210/jendso/bvag113","url":null,"abstract":"<p><strong>Context: </strong>Since 2020, growth hormone (GH) therapy administered using electronic drug delivery devices (GROWJECTOR^TM L) linked to a smartphone application (Melon Nikki^TM) has been approved in Japan. Real-world data generated through this system enable evaluation of treatment adherence among pediatric patients receiving GH therapy.</p><p><strong>Objectives: </strong>To assess adherence to home-based GH self-injection using a smartphone application linked to an electronic injection device and identify factors associated with adherence.</p><p><strong>Design: </strong>Observational study.</p><p><strong>Setting: </strong>Real-world data were collected and analyzed, including home injection patterns, GH dosage, and changes in height and body mass index over the first year of therapy. Factors significantly associated with adherence outcomes were evaluated using statistical analyses.</p><p><strong>Patients: </strong>We enrolled a cohort of Japanese pediatric patients with various indications for GH therapy who used an electronic injection device connected to the Melon Nikki^TM application.</p><p><strong>Results: </strong>Injection adherence declined after the second month in patients with GH deficiency and after the fourth month in patients born small for gestational age, particularly among those with variable injection times. Multivariate analysis showed that cumulative app usage up to 24 weeks is an independent factor that significantly contributes to an increase in the cumulative injection rate. Use of the application was associated with better adherence during initial 8 weeks.</p><p><strong>Conclusion: </strong>Use of a smartphone application linked to an electronic injection device may support adherence maintenance during the early phase of GH therapy. These findings provide clinically relevant insights that may inform patient guidance and adherence-focused interventions.</p>","PeriodicalId":17334,"journal":{"name":"Journal of the Endocrine Society","volume":"10 6","pages":"bvag113"},"PeriodicalIF":4.4,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148150183","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":"Relevance of the KATP channel function for the basal insulin hypersecretion of islets from female NZO mice.","authors":"Melissa Asuaje Pfeifer, Joana Brozek, Katharina Grupe, Florian Wanitschke, Stephan Scherneck, Ingo Rustenbeck","doi":"10.1210/jendso/bvag108","DOIUrl":"10.1210/jendso/bvag108","url":null,"abstract":"<p><strong>Context: </strong>The polygenic New Zealand obese (NZO) mouse model displays the characteristics of early type 2 diabetes: fasting hyperglycemia, hyperinsulinemia, and insulin resistance. The expression of the ATP-sensitive potassium (KATP) channels in the β cells was reported to be reduced.</p><p><strong>Objective: </strong>To define at the cellular level the role of the KATP channel function for the altered insulin secretion of NZO mice.</p><p><strong>Methods: </strong>We measured the plasma membrane potential, KATP channel currents, cytosolic Ca²⁺ concentration ([Ca²⁺]_i), and insulin secretion of NZO mouse islets and β cells in comparison with those of metabolically healthy NMRI mice.</p><p><strong>Results: </strong>The potassium current of NZO β cells had half the extent of that of NMRI β cells and remained so in the presence of the KATP channel opener, diazoxide. The KATP channel blocker, tolbutamide, reduced the currents to the same low level. At low glucose and in the presence of diazoxide, the plasma membrane potential of NZO β cells was less polarized, and consequently, [Ca²⁺]_i was higher in NZO β cells than in NMRI β cells. The depolarization and [Ca²⁺]_i increase by tolbutamide were not different. Insulin secretion of the NZO islets was higher than that of NMRI islets at low glucose and in the presence of diazoxide, but was lower than that of NMRI islets in the presence of tolbutamide and of high glucose.</p><p><strong>Conclusion: </strong>The higher insulin secretion at basal glucose, but not the lower stimulated secretion of NZO islets, is at least partly due to the reduced expression of the KATP channels.</p>","PeriodicalId":17334,"journal":{"name":"Journal of the Endocrine Society","volume":"10 7","pages":"bvag108"},"PeriodicalIF":4.4,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13265134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148258424","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 acromegaly subtypes on survival: results from a large multicenter cohort.","authors":"Daniel Cuevas-Ramos, Artak Labadzhyan, Daniel Gomez, Rachel Fox, Froylan David Martínez-Sánchez, Andrea Rocha-Haro, Francisco J Gómez-Pérez, Shlomo Melmed","doi":"10.1210/jendso/bvag111","DOIUrl":"10.1210/jendso/bvag111","url":null,"abstract":"<p><strong>Context: </strong>Acromegaly, characterized by excess growth hormone (GH) and insulin-like growth factor-1 production, is typically caused by a pituitary somatotroph adenoma. Disease activity and treatment responses vary widely according to its structural-functional classification comprising clinical, pathologic, morphologic, and biochemical features, particularly adenoma size and invasiveness on pituitary MRI and GH-granulation pattern.</p><p><strong>Objective: </strong>To evaluate the association between clinicopathologic acromegaly subtypes and long-term survival.</p><p><strong>Methods: </strong>This multicenter, bidirectional cohort study assessed all-cause mortality in adults with somatotroph adenomas classified into 3 different subtypes. Patients with Type 1 acromegaly have noninvasive or invasive microadenomas that are densely granulated; Type 2 noninvasive macroadenomas are densely or sparsely granulated; and Type 3 invasive macroadenomas are sparsely granulated. The primary outcome was all-cause mortality, analyzed by subtype.</p><p><strong>Results: </strong>The cohort comprised 550 patients, including 50.5% women, with a mean age at diagnosis of 42.3 years (standard deviation 13.7) and a median follow-up after diagnosis of 11.3 years (interquartile range 4.1-19.8). 172 patients (31.2%) had Type 1, 143 (26%) Type 2, and 235 (42.7%) Type 3. Overall mortality was 12.9%. Rates varied significantly across subtypes (<i>P</i> = .003): Type 1 had the lowest mortality at 7.0%, followed by Type 2 at 12.0%, and Type 3 at 17.9%. On multivariate Cox regression, Type 2 (hazard ratio [HR] = 2.76, 95% CI: 1.86-7.81, <i>P</i> = .009), and Type 3 (HR = 4.69, 95% CI: 1.65-13.3, <i>P</i> = .004) exhibited significantly higher mortality risk vs Type 1, independent of treatment modalities and presence of comorbidities.</p><p><strong>Conclusion: </strong>Applying a structural-functional acromegaly classification enables distinction of significant differences in long-term survival outcomes.</p>","PeriodicalId":17334,"journal":{"name":"Journal of the Endocrine Society","volume":"10 6","pages":"bvag111"},"PeriodicalIF":4.4,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13220046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148138022","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}