Minerva endocrinology最新文献

{"title":"Epicardial fat tissue in metabolically healthy and unhealthy obesity: culprit or bystander?","authors":"Giulia de Alteriis, Gabriella Pugliese, Carolina DI Somma, Andrea Falco, Giovanna Muscogiuri, Luigi Barrea, Daniela Laudisio, Francesca Zumbolo, Roberta Esposito, Martina Pucci, Valentina Cossiga, Filomena Morisco, Silvia Savastano","doi":"10.23736/S2724-6507.25.04257-5","DOIUrl":"10.23736/S2724-6507.25.04257-5","url":null,"abstract":"<p><strong>Background: </strong>A uniform definition distinguishing metabolically healthy obesity (MHO) from metabolically unhealthy obesity (MUO) is lacking. MUO is characterized by higher liver and visceral fat than MHO. Epicardial fat tissue (EFT) is an index of cardiac adiposity strongly associated with risk of cardiovascular events. This study aimed to further define the MHO/MUO status by evaluating EFT and hepatic steatosis/fibrosis indices in adults presenting visceral obesity.</p><p><strong>Methods: </strong>In this monocentric, observational study, 56 patients (48 females; 43.8±13.1 years) were recruited. Clinical characteristics, anthropometric measurements, and metabolic parameters were evaluated. Hepatic fibrosis and steatosis were assessed by Fibroscan (502Touch, Echosense). EFT thickness was assessed by transthoracic echocardiography (GE Vivid E95 system). EFT thickness values of 9.5 mm in men and 7.5 mm in women were used as predictors of the metabolic syndrome (MetS).</p><p><strong>Results: </strong>Patients with MUO had significantly higher steatosis/fibrosis indices and EFT values than the MHO group (P<0.001). EFT values above the cut-off were found in 82.1% of MUO, but also in 42.9% of MHO. At ROC analysis, the specificity and sensitivity of the EFT cut-off point to predict MUO phenotype combined with hypertension, 60-min post load plasma glucose, and adiponectin, were 98.6% and 92.0%, respectively.</p><p><strong>Conclusions: </strong>As EFT thickness values above the predictive threshold for MetS were found in about half of MHO, the MHO/MUO classification may not correctly identify the cardiovascular risk of MHO. Further clinical evidence is needed to confirm EFT thickness as potential additional marker for MHO/MUO phenotypic differentiation.</p>","PeriodicalId":18690,"journal":{"name":"Minerva endocrinology","volume":" ","pages":"23-33"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600973","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":"Dose-response relationship between circulating growth differentiation factor-15 and diabetes: a systematic review and meta-analysis.","authors":"Jianshu Gao, Hongli Liu, Zhongwei Zhou, Sanqiang Hu","doi":"10.23736/S2724-6507.25.04240-X","DOIUrl":"10.23736/S2724-6507.25.04240-X","url":null,"abstract":"<p><strong>Introduction: </strong>Increasing evidence suggests that circulating growth differentiation factor-15 (GDF-15) may serve as a predictor of unfavorable clinical outcomes, but limited information is available on its relationship to diabetes risk. This meta-analysis was designed to evaluate quantitatively circulating GDF-15 in relation to diabetes prevalence.</p><p><strong>Evidence acquisition: </strong>Our search encompassed the PubMed, Embase, and Web of Science databases from the inception dates to April 2024. Studies that provided data on diabetes prevalence across at least three distinct GDF-15 categories were eligible for inclusion in this meta-analysis.</p><p><strong>Evidence synthesis: </strong>There were 27 independent studies from 25 articles included in this meta-analysis, involving 56,969 participants, 12,795 of whom were diabetic patients. The two-class meta-analysis showed participants with higher GDF-15 level had a higher diabetes prevalence [odds ratios (OR) 2.53, 95% confidence interval (CI) 2.09-3.05) than those with lower GDF-15 level. The diabetes prevalence increased by 63% (OR 1.63, 95% CI 1.47-1.80) when GDF-15 concentration was increased by 1 ng/mL, according to the dose-response meta-analysis. Nevertheless, the dose-response curve showed diabetes prevalence increased nonlinearly with increasing GDF-15 concentration (P nonlinearity <0.001), with a plateau or even a slight decrease after approximately 5.7 ng/mL of GDF-15 concentration. In the pooled estimates, considerable heterogeneity was observed and meta-regression analysis facilitated the interpretation of heterogeneity, which revealed significant correlations between diabetes prevalence and sample sizes (P<0.001) and hypertension prevalence (P=0.025).</p><p><strong>Conclusions: </strong>This meta-analysis reveals a positive and non-linear relationship between circulating GDF-15 and diabetes prevalence, which plateaus or slightly declines after reaching a certain level of GDF-15.</p>","PeriodicalId":18690,"journal":{"name":"Minerva endocrinology","volume":" ","pages":"53-62"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497494","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":"Vitamin D: beneficial effects and risk of intoxication: a public health problem.","authors":"Lucia F Stefanelli, Martina Cacciapuoti, Dorella Del Prete, Lorenzo A Calò, Federico Nalesso","doi":"10.23736/S2724-6507.25.04377-5","DOIUrl":"10.23736/S2724-6507.25.04377-5","url":null,"abstract":"","PeriodicalId":18690,"journal":{"name":"Minerva endocrinology","volume":" ","pages":"98-99"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708166","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":"Highlights of the January-March 2026 issue.","authors":"Giovanni Vitale","doi":"10.23736/S2724-6507.26.04536-7","DOIUrl":"https://doi.org/10.23736/S2724-6507.26.04536-7","url":null,"abstract":"","PeriodicalId":18690,"journal":{"name":"Minerva endocrinology","volume":"51 1","pages":"1-3"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147499127","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":"Chronic metabolic acidosis of diabetes (CMAD): clinical features, diagnosis, and therapeutic potentials of pH correction.","authors":"Hayder A Giha, Mai S Sater, Ali A Al Qarni","doi":"10.23736/S2724-6507.25.04230-7","DOIUrl":"10.23736/S2724-6507.25.04230-7","url":null,"abstract":"<p><p>pH changes are a cardinal feature in metabolic disorders. Based on published literature, chronic metabolic acidosis is a major finding in type 2 diabetes (T2D), which is recently described as CMAD (chronic metabolic acidosis of T2D). Several disorders characterized by overt metabolic acidosis are recognized as T2D co-morbidities or are dual risk factors that pertain to their unique signs and symptoms in T2D. Over time, many terms were used for chronic metabolic acidosis (CMA) in different disorders. However, the lack of a unified term for CMA, delayed the recognition of CMAD as a prime feature of T2D, and the setting of the diagnostic criteria and management protocol for this disorder. Other than the classical diabetic complications, CMAD contributes to non-classical organ-specific local diabetic complications. Here we described the likely clinical features of CMAD in general, such as fatigue, tiredness, cramps, and aches, as well as organ/system-specific symptoms of T2D related to the liver, skeletal muscles, bones and joints, lungs, nervous system, eyes, kidneys and urinary tract, oral cavity and teeth, gastrointestinal tract, immune system, and skin. Diagnostic criteria and confirmatory tests are enlisted together with the laboratory tools used for pH estimation in different body compartments. Finally, a management protocol is proposed, which covers: 1) lifestyle (exercise, stress management); 2) nutrition (drinks, foods, and supplements); and 3) therapeutic pH correction: general proton pump inhibitor (PPI) and alkaline minerals; and organ-specific therapies with different modalities of action. In addition, the therapeutic potentials of nanomedicine and immune and gene therapies for pH correction are raised.</p>","PeriodicalId":18690,"journal":{"name":"Minerva endocrinology","volume":" ","pages":"63-87"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600972","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":"Effects of low protein diet supplemented with ketoanalogues on kidney function and nutritional outcomes in a nonagenarian population with advanced chronic kidney disease: a pilot study.","authors":"Giuseppe Annunziata, Teresa Marinelli, Armando Melfitano, Francesco Aucella, Maria Nardella, Elisabetta Camajani, Giovanna Muscogiuri, Massimiliano Caprio, Filippo Aucella, Luigi Barrea","doi":"10.23736/S2724-6507.25.04416-1","DOIUrl":"10.23736/S2724-6507.25.04416-1","url":null,"abstract":"<p><strong>Background: </strong>Ageing leads to an increase in the incidence of chronic diseases, including chronic kidney disease (CKD). The increasing proportion of elderly people with reduced renal function draws attention to a sub-population of patients for whom an alternative approach to traditional pharmacological and dietary treatment may be needed. The low-protein diet (LPD) in subjects with CKD helps control complications and may contribute to slowing the progression of the disease. In the follow-up during the conservative phase, nutritional status and the LPD are key points. Of interest, ketoanalogues (KAs) in combination with a LPD significantly reduces the progression to end-stage kidney disease. The aim of this pilot study is to determine the impact at 12 months of LPD supplemented with essential amino acids (EAA) and KAs in a population of 21 over-90-year-olds with advanced CKD in the conservative phase.</p><p><strong>Methods: </strong>The protein intake of the LPD was 0.6 g/kg body weight/day. Anthropometric measurements and biochemical parameters were monitored at baseline and after 12 months of dietary intervention. The Kidney Failure Risk Equation (KFRE) was used to predict the risk of end stage renal disease.</p><p><strong>Results: </strong>Significant change in GFR (from 18.04±1.31 to 24.30±2.09 mL/min, P<0.001), azotemia (from 122.38±19.16 to 70.19±15.00 mg/dL, P<0.001) and KFRE score at 2 years (from 33.67±3.88 to 15.09±3.03%, P<0.001) and at 5 years (from 71.94±5.13 to 39.76±6.60% at 5 years, P<0.001). Laboratory parameters (azotemia, albumin, total protein, total cholesterol, transferrin, Hb, PTH, HbA1c, TSAT, CRP) improved. Two patients were hospitalized during the observation period, no cardiovascular events or deaths were reported.</p><p><strong>Conclusions: </strong>LPD supplemented with EAA and KAs has proven to be a safe and effective tool in the conservative treatment of the over-aged with advanced CKD. Dietary treatment improves renal function and management of complications, reducing the risk of terminal uremia and initiation of replacement treatment by not exposing patients to the risk of malnutrition.</p>","PeriodicalId":18690,"journal":{"name":"Minerva endocrinology","volume":" ","pages":"360-370"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200371","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 health technology assessment based on a meta-analysis including direct and indirect comparisons of 5-year weight loss outcome after metabolic surgeries versus a non-surgical approach.","authors":"Istvan B Balint, Bence T Erdodi","doi":"10.23736/S2724-6507.25.04133-8","DOIUrl":"10.23736/S2724-6507.25.04133-8","url":null,"abstract":"<p><strong>Introduction: </strong>Metabolic surgery is the best choice of treatment for patients with overweight; however, choosing an appropriate method remains a challenge for bariatric surgeons.</p><p><strong>Evidence acquisition: </strong>Based on a literature search in the PubMed database, long-term metabolic and weight loss outcomes of standard care (SC) and different metabolic interventions were collected. Descriptive statistics, initial direct pairwise comparisons using the Ivhet-method and a network meta-analysis (General Pairwise Modelling) on change in Body Mass Index (BMI) and a cost-utility analysis based on the Markov model were performed.</p><p><strong>Evidence synthesis: </strong>Analysis of the PubMed database identified 1324 unique publications. After rigorous screening, relevant publications were retrieved and 22 studies were enrolled, including a total of 12695 cases. Long-term effectiveness was unsatisfactory after SC. Surgical patients achieved good rates of resolution of comorbidities. All surgical procedures had over 25% of total weight loss (TWL%) and over 60% of excess weight loss (EWL%) at 5 years. Deterministic cost-effectiveness analysis showed the superiority of one-anastomosis gastric bypass (OAGB) (effectiveness: 4.145, cost: €22,484). Sensitivity analysis presented the absolute and relative (to SC) benefit of OAGB. Simple direct pairwise comparisons could not prove the superiority of any treatment modality; however, network meta-analysis in combination with cost-utility analysis showed OAGB to be the most efficient method (OR was 1.36, 1.24 and 1.08 for OAGB, LRYGB and LSG compared to SC, respectively).</p><p><strong>Conclusions: </strong>Metabolic surgery seems to be a more favourable approach in weight loss management than standard treatment; however, our analysis could not prove the superiority of any kind of surgery.</p>","PeriodicalId":18690,"journal":{"name":"Minerva endocrinology","volume":" ","pages":"446-458"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708164","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":"Follicle-stimulating hormone receptor gene polymorphisms influence Body Mass Index, metabolism, and bone mineral density in postmenopausal women.","authors":"Rossella Cannarella, Agnese Andaloro, Maria A Caruso, Nicolò Musso, Federica Barbagallo, Rosita A Condorelli, Sandro LA Vignera, Aldo E Calogero","doi":"10.23736/S2724-6507.24.04177-0","DOIUrl":"10.23736/S2724-6507.24.04177-0","url":null,"abstract":"<p><strong>Background: </strong>Covering a significant part of a woman's life, the postmenopausal phase is often associated with the onset of obesity, metabolic dysfunction, osteoporosis, and their most disabling complications. In this context, scant evidence from both preclinical and clinical studies suggests that single nucleotide polymorphisms (SNPs) of the follicle-stimulating hormone receptor (FSHR) gene might be involved in the etiopathogenesis of these conditions, posing them as possible molecular predictors of their development. Therefore, this study aimed to evaluate the role of the FSHR gene SNPs c.2039A>G and c.-29 G>A on Body Mass Index (BMI), metabolic parameters, and bone metabolism in postmenopausal women.</p><p><strong>Methods: </strong>To achieve this goal, 49 postmenopausal Caucasian women aged from 45 to 80 years and with no factors known to influence metabolism and/or bone mineral density (BMD) were enrolled and assessed for their medical history, medical family history, anthropometric parameters and hormonal, metabolic and lipid profiles, and BMD. Then, they were genotyped for the FSHR gene SNPs c.2039A>G and c.-29G>A. Finally, the resulting data were classified according to woman's genotypes and subjected to statistical analysis.</p><p><strong>Results: </strong>No significant differences were found between the distributions of most endpoint parameters examined by genotype. However, none of the women with the c.2039A>G FSHR GG gene SNP were affected by obesity and had the highest lumbar BMD z-score within the cohort. Additionally, those with the FSHR c.-29G>A AA genotype had the lowest serum glucose levels.</p><p><strong>Conclusions: </strong>This preliminary study suggests that the FSHR c.2039A>G GG SNP, which is associated with reduced sensitivity of the FSHR, may have a protective role against obesity, offering further evidence for the possible association among FSH, FSHR polymorphisms, and insulin metabolism.</p>","PeriodicalId":18690,"journal":{"name":"Minerva endocrinology","volume":" ","pages":"396-407"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142350173","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":"The potential implications of ATM mutations for radioactive iodine therapy in thyroid carcinoma.","authors":"Henrique C Alexandrino, Ana S Oliveira, Fernando Rodrigues","doi":"10.23736/S2724-6507.25.04340-4","DOIUrl":"10.23736/S2724-6507.25.04340-4","url":null,"abstract":"","PeriodicalId":18690,"journal":{"name":"Minerva endocrinology","volume":" ","pages":"461-462"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010908","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":"Liraglutide in the management of obesity: real world data (Portugal).","authors":"Carlos Tavares Bello, Inês Redondo Carvalho, Anabela Martins, Ana F Martins, Ana Wessling, Daniel Macedo, Diana Martins, Carlos Fernandes, Francisco Sobral DO Rosário","doi":"10.23736/S2724-6507.24.04161-7","DOIUrl":"10.23736/S2724-6507.24.04161-7","url":null,"abstract":"<p><strong>Background: </strong>Overweight and obesity are major public health issues with increasing incidence and prevalence, affecting more than 50% of the population in developed countries. Due to its complex pathophysiology and multifactorial etiology, disease understanding, diagnostic approach and management remain suboptimal. Together with a structured nutritional intervention and physical activity plan, pharmacological treatment has the potential to magnify weight loss and health related benefits. Liraglutide is one of the most effective and frequently prescribed weight loss medication. Its efficacy and safety have been demonstrated in randomized clinical trials, however, real world data in Portugal is scarce. The authors report on the experience of a University Hospital Endocrine Clinic in the management of patients with overweight and obesity with liraglutide on top of lifestyle intervention. The aim of the study was to evaluate the effectiveness of liraglutide in the management of overweight and obesity.</p><p><strong>Methods: </strong>Retrospective, longitudinal observational study. Inclusion criteria were adult patients (>18 years old) with obesity (BMI>30 kg/m²) or overweight (≥27 kg/m²) with at least one obesity related co-morbidity (hypertension, dyslipidemia, obstructive sleep apnea, non-alcoholic fatty liver disease) with at least three months of liraglutide treatment. Diabetes diagnosis and prior bariatric surgery were exclusion criteria. Demographic and clinical variables were included and weight was recorded before and after at least 3 months of liraglutide treatment.</p><p><strong>Results: </strong>One hundred forty-eight patients (85.8% females) with a mean age of 48.7±11.9 years were treated with liraglutide. Mean baseline BMI was 33.8±5.2 kg/m² and median follow-up was 13 months. At the last appointment, 85.8% were still taking liraglutide. Among patients still taking liraglutide, mean weight loss was 7.6 kg (7.9%), with significantly greater losses in patients treated for more than 6 months (8.6kg vs. 6.2 kg, P=0.016). Patients with obesity lost significantly more weight than overweight patients (8.3 kg vs. 4.5 kg, P=0.028), despite similar treatment duration. The reasons for liraglutide withdrawal were gastrointestinal intolerance (7), medication cost (2), inefficacy (10) and physician instructions (1).</p><p><strong>Conclusions: </strong>The present study documents the long-term efficacy of liraglutide in the treatment of patients with overweight and obesity, with a low rate of drug withdrawal. Mean weight loss was significant and more evident from the 6th month of treatment on. Liraglutide, along with lifestyle intervention, is a good option for weight management in the majority of patients with obesity.</p>","PeriodicalId":18690,"journal":{"name":"Minerva endocrinology","volume":" ","pages":"371-376"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141620472","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}