Reviews in Endocrine & Metabolic Disorders最新文献

{"title":"Redefining the timeline: a three-phase framework of hypothalamic microinflammation in metabolic disease.","authors":"Sebastian Zagmutt, Maria Rodriguez-Garcia, Montserrat Bolaños-Hurtado, Ana Cristina Reguera, Núria Casals, Rosalia Rodriguez-Rodriguez","doi":"10.1007/s11154-025-09992-3","DOIUrl":"https://doi.org/10.1007/s11154-025-09992-3","url":null,"abstract":"<p><p>The hypothalamus plays a central role in regulating energy balance, and its dysfunction is a key contributor to the development of metabolic diseases such as obesity and type 2 diabetes. Although peripheral inflammation has been extensively studied, hypothalamic inflammation, termed hypothalamic microinflammation, has emerged as a critical early event in the pathogenesis of these diseases. This localized, moderate, yet sustained inflammatory response involves a complex interplay between different cell types, including microglia, astrocytes, neurons, and tanycytes, which exhibit temporal and dynamic changes. Hypothalamic microinflammation is triggered by various metabolic stressors, including high-fat diets, aging, and glial priming, and occurs even before peripheral tissues show signs of inflammation. In this review, we propose a conceptual framework that divides the progression of hypothalamic microinflammation into three distinct phases: the Initiation Spark, characterized by rapid inflammatory signaling; the Adaptive Transition, where compensatory mechanisms attempt to restore homeostasis; and the Dysfunctional Phase, leading to chronic inflammation and metabolic dysfunction. Despite significant progress in understanding hypothalamic inflammation, several critical questions remain, including the precise triggers of this response, the chronology of molecular and cellular events, and the reversibility of early changes. Additionally, emerging evidence suggests that sex differences influence the susceptibility and progression of hypothalamic microinflammation, further complicating our understanding. This review examines the dynamics of hypothalamic microinflammation, its impact on brain and peripheral insulin resistance, and its role in disrupting energy balance. Understanding these processes is crucial for identifying therapeutic targets and early intervention windows to prevent or reverse metabolic diseases.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modulation of hepcidin synthesis: the core link in the bi-directional relationship between iron and obesity.","authors":"Bilal Rah, Rumaisa Rafiq, Jasmine Sharafain, Jibran Sualeh Muhammad, Jalal Taneera, Mawieh Hamad","doi":"10.1007/s11154-025-09997-y","DOIUrl":"https://doi.org/10.1007/s11154-025-09997-y","url":null,"abstract":"<p><p>Over the past five decades, clinical and experimental data have established that iron metabolism, lipid metabolism, and obesity are intricately linked and differentially influence one another through complex metabolic pathways. Iron dyshomeostasis is now recognized as a key modulator of lipid metabolism, with profound implications for obesity and related metabolic disorders. Likewise, lipid metabolism and obesity significantly impact iron absorption and recycling. Although this interplay between iron metabolism, lipid metabolism, and obesity is complex, modulation of hepcidin synthesis seems to be the core link between these variables. As the global prevalence of metabolic disorders continues to escalate, understanding their multifactorial etiology has become a public health priority. Emerging evidence highlights the dysregulation of lipid metabolism as a central driver in the onset and progression of these conditions, with iron metabolism playing a crucial regulatory role. This review explores the relationship between iron metabolism on one hand and lipid metabolism and obesity on the other with specific emphasis on the molecular mechanisms underlying this relationship. The review also explores the bi-directional relationship between iron metabolism and mitochondrial functions, mainly energy production. It concludes by outlining the pathophysiological consequences of disrupted iron metabolism, vis-a-vis lipid metabolism, obesity, and diabetes. By synthesizing current knowledge, this review aims to provide new insights that could guide the development of novel therapeutic strategies to manage obesity, diabetes, and related metabolic disorders.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-inflammatory effects of tirzepatide: a systematic review and meta-analysis.","authors":"Walter Masson, Martín Lobo, Juan P Nogueira, Leandro Barbagelata, Pedro Touzas, Juan P Frías","doi":"10.1007/s11154-025-09991-4","DOIUrl":"https://doi.org/10.1007/s11154-025-09991-4","url":null,"abstract":"<p><p>Tirzepatide, a dual GIP and GLP-1 receptor agonist, has shown significant metabolic benefits and weight reduction, but its anti-inflammatory effects have been less studied. This study was conducted in accordance with PRISMA guidelines, including observational (cohort) studies and randomized clinical trials that evaluated tirzepatide use and reported percentage changes in high-sensitivity C-reactive protein (hsCRP) and interleukin-6 (IL-6). A random-effects model was used. Seven randomized clinical trials and one observational study were included (six studies were eligible for meta-analysis). Compared to placebo, tirzepatide reduced hsCRP (mean difference [MD]: -32.9; 95% confidence interval [CI]: -33.6 to - 32.2; I²=15.3%) and IL-6 (MD: -17.8; 95% CI: -24.3 to - 11.3; I² = 1.6%). Levels of hsCRP were significantly reduced with tirzepatide at 15 mg (MD: -32.9; 95% CI: -33.6 to - 32.2; I²=4.4%), 10 mg (MD: -33.9; 95% CI: -50.3 to - 17.6; I²=41.8%), and 5 mg (MD: -20.3; 95% CI: -35.2 to - 5.3; I²=0%). Similarly, IL-6 levels were significantly reduced with tirzepatide at 5 mg (MD: -18.8; 95% CI: -32.9 to - 4.6; I²=17.2%), 10 mg (MD: -17.9; 95% CI: -28.2 to - 7.7; I²=2.1%), and 15 mg (MD: -16.8; 95% CI: -31.1 to - 2.6; I²=47.4%). This study demonstrated that tirzepatide use is associated with a significant reduction in inflammatory markers, regardless of the population studied or treatment regimen.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond satiety: unraveling the complex roles of POMC neurons in behavior and metabolism.","authors":"Victor Jouque, Cristina Miralpeix, Antonio J López-Gambero, Jean Charles Nicolas, Carmelo Quarta, Daniela Cota","doi":"10.1007/s11154-025-09993-2","DOIUrl":"https://doi.org/10.1007/s11154-025-09993-2","url":null,"abstract":"<p><p>Hypothalamic pro-opiomelanocortin (POMC) neurons are classically viewed as mediators of satiety, acting in response to metabolic and hormonal cues and in opposition to Agouti-related protein (AgRP) neurons to maintain energy balance. This model, centered on the appetite-suppressant effects of the POMC-derived neuropeptide α-melanocyte-stimulating hormone (α-MSH) through its activation of melanocortin-4 receptors (MC4R), has shaped our understanding of feeding and body weight regulation for decades. However, recent discoveries have challenged and expanded this traditional view, revealing that POMC neurons are not a uniform population dedicated solely to satiety control. Single-cell transcriptomic analyses have revealed striking molecular heterogeneity, reflected in distinct anatomical distributions, receptor expression profiles, electrophysiological properties, and projection patterns - all supporting the idea of functional specialization within this neuronal population. In this review, we propose a conceptual framework that integrates POMC neuronal heterogeneity with the regulation of appetite, metabolic physiology, and behavior beyond feeding. We highlight emerging evidence showing that discrete POMC neuronal subpopulations respond to specific combinations of interoceptive and environmental cues to orchestrate diverse adaptive responses. This perspective underscores the developmental plasticity and functional versatility of POMC neurons, offering new insights into the mechanisms of obesity and potentially paving the way for novel targeted therapeutic strategies.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging role of AgRP neurons as integrators of metabolic, sensory and environmental cues in the control of energy homeostasis.","authors":"Maya Faour, Nour Mesto, Claire Martin, Serge Luquet","doi":"10.1007/s11154-025-09990-5","DOIUrl":"https://doi.org/10.1007/s11154-025-09990-5","url":null,"abstract":"<p><p>The regulation of energy homeostasis is an essential function of every living organism. In mammals a complex interplay of neural networks has evolved to ensure proper adaptation to energy demands, availability, consumption, storage and utilization. While a large set of parallel and redundant brain networks are functionally intertwined in these processes, a specific subset of hypothalamic neurons producing the agonist and antagonist of the anorectic signaling pathway controlled by the melanocortin receptor have been extensively studied. The anorectic/catabolic pro-opiomelanocortin (POMC) producing neurons and the orexigenic/anabolic Agouti-related peptide (AgRP) producing neurons exert opposing functions of various aspects of foraging, ingestive and post-ingestive processes. Located close to circumventricular these two populations integrate circulating reflecting energy status but are dynamically controlled by food-predicting cues. This review will be focusing on recent advances in understanding the role of the hypothalamic AgRP neurons, as critical metabolic sensors and regulators. We explore the intricate mechanisms by which these neurons integrate diverse nutritional signals and coordinate autonomic and behavioral responses to maintain metabolic equilibrium.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body composition changes across a spectrum of hypothyroidism severity - a systematic review and meta-analysis.","authors":"Derrick Kretli-Souza, Nathalia Elizabete Paulino, Raiane Aparecida Asevedo, Sara Cristina Leonel Lemos, Gabriel Meireles-Oliveira, Yuri Alves-Silva, Ingrid Rodrigues Hortêncio-Medeiros, Candido Celso Coimbra, Rodrigo Antonio Peliciari-Garcia, Lucas Rios Drummond, Helton Oliveira Campos, Paula Bargi-Souza","doi":"10.1007/s11154-025-09988-z","DOIUrl":"https://doi.org/10.1007/s11154-025-09988-z","url":null,"abstract":"<p><p>This systematic review and meta-analysis aimed to investigate the impact of clinical hypothyroidism (CH) and subclinical hypothyroidism (SCH) on anthropometric parameters, such as body mass index (BMI), body weight (BW), waist circumference (WC), Hip Circumference (HC), Waist Circumference (WC) and Waist-Hip ratio (W/H). Databases including PubMed, Web of Science, Scopus, and EMBASE were searched for observational studies on hypothyroidism and body composition. The review included 38 studies (54 comparison groups, 49,427 individuals). Effect sizes (ES) with 95% confidence intervals (CI) were used to measure the effects of CH and SCH on body composition compared to healthy controls and between themselves. Effect sizes were defined as negligible (< 0.2), small (0.20-0.49), moderate (0.50-0.79), and large (> 0.8). CH showed large increases in BMI (ES = 1.092; CI: 0.755, 1.429) and BW (ES = 0.897; CI: 0.404, 1.389), and moderate increases in WC (ES = 0.759; CI: 0.419, 1.099) and fat mass (ES = 0.609; CI: 0.051, 1.167). SCH showed moderate increases in BMI (ES = 0.596; CI: 0.403, 0.789) and BW (ES = 0.712; CI: 0.287, 1.138), a small increase in WC (ES = 0.298; CI: 0.141, 0.454), with negligible fat mass changes (ES=-0.055; CI: - 0.760, 0.649). Analysis of SCH by thyroid-stimulating hormone (TSH) levels revealed greater impacts on body composition with increasing TSH. In turn, BMI (ES=-0.082; CI: - 0.577, 0.413) and BW (ES = 0.054; CI: - 0.441, 0.550) showed no significant changes at near-normal TSH (4.0-4.9 mIU/L). Moderate TSH elevation (5.0-10.0 mIU/L) led to moderate increases in BMI (ES = 0.584; CI: 0.343, 0.825) and BW (ES = 0.659; CI: 0.245, 1.073), with a small WC increase (ES = 0.271; CI: 0.077,0.465). TSH > 10.0 mIU/L resulted in large increases in BMI (ES = 1.426; CI: 0.614, 2.238) and BW (ES = 1.942; CI: 1.550, 2.334), along with a small WC increase (ES = 0.271; CI: 0.077, 0.465). The comparison regarding BMI, WC and BW showed no differences between CH and SCH. Both CH and SCH are associated with changes in body composition, mainly BMI, WC, and BW, which may contribute to metabolic risk. Body composition worsens in SCH as TSH levels rise, and stronger effects are evidenced in females and symptomatic individuals.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Childhood obesity: The threatening apprentice of the adiposity empire.","authors":"J Karina Zapata, Javier Gómez-Ambrosi, Gema Frühbeck","doi":"10.1007/s11154-025-09959-4","DOIUrl":"10.1007/s11154-025-09959-4","url":null,"abstract":"<p><p>Childhood obesity is a global health problem, with its prevalence having tripled since 1975. The increase in its prevalence has been predominantly in developing countries, but also in those with high economic status. Nowadays, there are multiple obesity definitions, however, one of the most accurate is the one which defines obesity as the accumulation of excessive body adiposity and not as an body weight excess. Nevertheless, the body mass index (BMI) is the most frequently used tool for its classification, according to the cut-off points established by the Center for Disease Control and World Health Organization tables. In children and adolescents an adiposity excess is related to the appearance of cardiovascular disease in adulthood and with many comorbidities such as metabolic syndrome, insulin resistance, type 2 diabetes, hypertension and metabolic dysfunction-associated steatotic liver disease, among others. Currently, there is still controversy about which is the ideal indicator for measuring overweight and obesity. BMI is still used as a standardized measure but may miss cases in which body composition is pathological despite a BMI within the normal-weight category. An adequate knowledge of the impact on health of dysfunctional adiposity as well as its accurate diagnosis will allow health professionals to address this condition in a more precise and comprehensive manner, and substantially improve the associated cardiometabolic risk and prognosis.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":"539-557"},"PeriodicalIF":8.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incretins and SGLT-2 inhibitors in diabetic patients with neuroendocrine tumors: current updates and future directions.","authors":"Rosaria M Ruggeri, Erika Maria Grossrubatscher, Eleonora Ciocca, Iderina Hasballa, Simona Jaafar, Monica Oldani, Manila Rubino, Flaminia Russo, Andrea M Isidori, Annamaria Colao, Antongiulio Faggiano","doi":"10.1007/s11154-025-09958-5","DOIUrl":"10.1007/s11154-025-09958-5","url":null,"abstract":"<p><p>Neuroendocrine tumors (NET) are frequently associated with glycemic disorders, such as prediabetes or diabetes, which may result from either surgical or medical treatments or hormonal hypersecretion by the tumor itself. Moreover, pre-existing diabetes is a known risk factor for NET development, with metabolic control and antidiabetic therapies potentially influencing tumor progression. The complex interplay between diabetes and NET, which share several molecular pathways, has spurred interest in the anti-cancer effects of antidiabetic medications. This is particularly relevant as new antidiabetic drugs continue to emerge, including sodium-glucose cotransporter-2 (SGLT2) inhibitors and incretin-based therapies, such as dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide-1 receptor (GLP-1R) agonists and dual GIP/GLP- 1 R agonists. This review explores the impact of these novel pharmacological options on NET development and progression through a comprehensive analysis of pre-clinical and clinical studies, with the purpose to evaluate safety and feasibility of introducing these drugs in the treatment of NETs patients. We conducted a comprehensive search of online databases, including PubMed, ISI Web of Science, and Scopus, for studies assessing the therapeutic effects and potential mechanisms of action of incretins and SGLT2 inhibitors in patients with NET. These novel antidiabetic drugs exhibit promising anticancer properties, potentially inhibiting tumor cell proliferation and inducing apoptosis, though concerns about certain cancer risks remain. Based on current evidence, the benefits of incretin-based therapies outweigh any potential cancer risks, leading to the proposal of tailored management algorithms for diabetes in NET patients, factoring in the diabetes aetiology, comorbidities, and life expectancy.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":"575-592"},"PeriodicalIF":8.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy-associated thyroid disorders: the role of genetic, epigenetic, and oxidative stress factors.","authors":"Angelika Buczyńska, Iwona Sidorkiewicz, Justyna Hryniewicka, Monika Zbucka-Krętowska, Janusz Dzięcioł, Małgorzata Szelachowska, Adam Jacek Krętowski","doi":"10.1007/s11154-025-09974-5","DOIUrl":"10.1007/s11154-025-09974-5","url":null,"abstract":"<p><p>Thyroid inflammation during pregnancy, particularly Hashimoto's thyroiditis (HT) and postpartum thyroiditis (PPT), has a strong genetic and epigenetic basis. Susceptibility to these conditions is associated with specific HLA haplotypes (HLA-DR3, DR4, DR5) and immune-regulatory genes, including CTLA-4, PTPN22, FOXP3, as well as thyroid-specific genes such as TSHR, TG, and TPO. CTLA-4 polymorphism (CT60) is linked to increased thyroid autoantibody production, while PTPN22 R620W variant disrupts immune tolerance, exacerbating autoreactive lymphocyte activation.Epigenetic modifications play a crucial role in HT and PPT pathogenesis. Dysregulation of microRNAs (miRNAs), including miR-146a, miR-142, miR-301, and miR-155, affects immune pathways by modulating T-cell responses and inflammatory cytokine production. Aberrant DNA methylation in genes regulating immune function, such as FOXP3 and CTLA-4, contributes to altered immune tolerance and disease progression.Oxidative stress further modulates disease severity by inducing DNA damage and enhancing inflammatory responses, particularly in pregnancy. Reactive oxygen species (ROS) promote thyroid autoimmunity by affecting placental function and fetal neurodevelopment. Understanding the interplay between genetic susceptibility, epigenetic regulation, and oxidative stress is essential for developing personalized management strategies. This review highlights the molecular mechanisms underlying HT and PPT and the potential of epigenetic biomarkers for early diagnosis and targeted therapies.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":"679-692"},"PeriodicalIF":8.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical outcomes of partial adrenalectomy for pheochromocytoma: A systematic review and meta-analysis.","authors":"Marta Araujo-Castro, César Mínguez Ojeda, Victoria Gómez Dos Santos, Alfonso Sanjuanbenito, Joaquín Gómez Ramírez, Enrique Mercander, Felicia Hanzu, Leire Zarain, Óscar Vidal, Alfonso Muriel García, Alberto Artiles Medina","doi":"10.1007/s11154-025-09962-9","DOIUrl":"10.1007/s11154-025-09962-9","url":null,"abstract":"<p><p>The purpose of our study was to evaluate the efficacy and safety of partial adrenalectomy (PA) in the management of pheochromocytomas. A systematic review and metanalyses of all randomized controlled trials and observational studies (comparative and non-comparative studies), including case series with at least 5 cases, reporting efficacy and safety outcomes of PA in the treatment of bilateral and/or inherited pheochromocytomas was performed. A total of 33 articles were included in this systematic review, including 22 observational comparative and 11 single-arm studies. The pooled rates of biochemical and clinical cure after PA were 99.7% (95%CI: 98.7-100) and 99.8% (95%CI: 98.8-100), respectively. The pooled complication rate was 5.9% (95%CI: 0.8-10.9). Tumor recurrence and metastatic rates were 4% (95%CI: 0-1.6) and 0% (95%CI: 0.00-0.6), respectively. Steroid supplementation was required in 7.6% (95%CI: 2.8-12.5) of patients. No significant difference was detected in acute adrenal crisis (odds ratio [OR] 0.44, 95%CI: 0.16-1.22), biochemical (OR 0.42, 95%CI: 0.05-3.85) and clinical cure (OR 0.42, 95%CI: 0.05-3.85), complication (OR 1.59, 95%CI: 0.28-9.13) and metastatic rate (OR 1.56, 95%CI: 0.59-4.15) between the group of partial and total adrenalectomy. Nevertheless, recurrence rate (OR 2.55, 95%CI: 1.24-5.23) was higher with PA, while the need for supplementation rate (OR 0.01, 95%CI: 0.00-0.01) was significantly lower than in the total adrenalectomy group. The conclusion of the study is that the probability of biochemical cure and the rate of complications is similar between the group of patients who underwent total and partial adrenalectomy, but PA is associated with a lower rate of adrenal insufficiency and a higher recurrence rate than total adrenalectomy.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":"625-640"},"PeriodicalIF":8.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}