Therapeutic Advances in Endocrinology and Metabolism最新文献

{"title":"Evaluation of temporal muscle thickness in subjects with acromegaly: a follow-up study.","authors":"Víctor Navas-Moreno, Marta Araujo-Castro, María Sara Tapia-Sanchiz, Fernando Sebastián-Valles, Miguel Antonio Sampedro-Núñez, Nuria Sánchez de la Blanca, Rebeca Martínez-Hernández, Víctor Rodríguez-Laval, Concepción Blanco, Betina Biagetti, Manel Puig-Domingo, Mónica Marazuela","doi":"10.1177/20420188261441382","DOIUrl":"https://doi.org/10.1177/20420188261441382","url":null,"abstract":"<p><strong>Background: </strong>Growth hormone and insulin-like growth factor 1 (IGF-1) have recently been linked to temporal muscle thickness (TMT) in acromegaly; however, the relationship between treatment response and TMT remains unclear.</p><p><strong>Objectives: </strong>To evaluate whether TMT correlates with treatment response and may serve as a surrogate marker of disease control in patients with acromegaly.</p><p><strong>Design: </strong>Retrospective longitudinal two-center study.</p><p><strong>Methods: </strong>Patients with acromegaly and non-functioning pituitary adenomas (NFPA) were included. TMT was measured on magnetic resonance imaging scans obtained before treatment initiation and after a 3-year follow-up. Baseline TMT was compared between groups. In patients with acromegaly, TMT was correlated with IGF-1 levels at diagnosis and over time, as well as with treatment response. Mixed-effects regression models adjusted for covariates were used to assess associations.</p><p><strong>Results: </strong>Imaging studies from 58 subjects were analyzed (40 with acromegaly, 18 with NFPA). Pre-treatment TMT was significantly greater in patients with acromegaly compared with NFPA (mean 10.1 mm (9.3-10.7) vs 8.1 mm (8.0-9.2), <i>p</i> = 0.003). Higher baseline TMT was associated with higher IGF-1 levels at diagnosis (<i>p</i> < 0.01). Following treatment, mean TMT decreased from 9.6 mm at baseline to 8.8 mm at 36 months (<i>p</i> = 0.001). In covariate-adjusted mixed-effects models, higher pre-treatment TMT was independently associated with increased IGF-1 levels at diagnosis and longitudinally (β = 19.59 ng/mL, <i>p</i> = 0.022).</p><p><strong>Conclusion: </strong>TMT correlates with biochemical disease activity and decreases after treatment, suggesting it may be a useful imaging marker of clinical activity and prognosis in acromegaly.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"17 ","pages":"20420188261441382"},"PeriodicalIF":4.6,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13129339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147820695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The hidden variable in a \"neutral\" upgrade: why parameter re-tuning and perceived reliability matter after G6 → G7 in Control-IQ.","authors":"Xiaowei Zhang","doi":"10.1177/20420188261424319","DOIUrl":"https://doi.org/10.1177/20420188261424319","url":null,"abstract":"","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"17 ","pages":"20420188261424319"},"PeriodicalIF":4.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 anti-peptic ulcer disease (PUD) medications on hyperlipidemia risk in patients with PUD: a population-based retrospective cohort study.","authors":"Hui-Hsia Hsieh, Wan-Yi Lee, Cheng-Li Lin, Chi-Hua Chen, Fuu-Jen Tsai, Bang-Jau You, Ni Tien, Yi-Jen Fang, Yun-Ping Lim","doi":"10.1177/20420188261442014","DOIUrl":"https://doi.org/10.1177/20420188261442014","url":null,"abstract":"<p><strong>Background: </strong>The causes of cardiovascular disease are complex, with hyperlipidemia being a major factor in its development. The connection between peptic ulcer disease (PUD) and hyperlipidemia is unclear, and there have been no thorough studies on the effect of anti-PUD medications on the risk of hyperlipidemia, particularly in Asian populations. This study aimed to explore the relationship among PUD, anti-PUD medications, and the risk of developing hyperlipidemia.</p><p><strong>Objectives: </strong>Utilizing a population-based cohort study conducted in Taiwan, we investigated the association between PUD, the administration of anti-PUD medications, and the subsequent risk of developing hyperlipidemia.</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Methods: </strong>Using data from the Taiwan National Health Insurance Research Database, we conducted a 21-year follow-up study on patients diagnosed with PUD between 2000 and 2021. The Cox proportional hazards regression model was used to analyze the risk of developing hyperlipidemia in relation to PUD and the use of anti-PUD medications.</p><p><strong>Results: </strong>According to the multivariable Cox proportional hazards regression analysis, patients with PUD had a higher overall incidence of hyperlipidemia (80.7 vs 53.6 per 1000 person-years) than those without PUD. The adjusted hazard ratio was 1.64 (95% confidence interval = 1.62-1.67). Both men and women, as well as different age groups, showed a higher risk of hyperlipidemia among patients with PUD. Patients with PUD who undergo surgery have a higher risk of developing hyperlipidemia than those who do not. The use of anti-PUD medications, such as H2 receptor antagonists, proton pump inhibitors, antibiotics, prostaglandin analogs, anticholinergics, antacids, and carbenoxolone, but not bismuth salts, was associated with a lower risk of developing hyperlipidemia than non-use.</p><p><strong>Conclusion: </strong>Patients with PUD were more likely to develop hyperlipidemia. However, patients receiving anti-PUD medications had a lower incidence of hyperlipidemia.</p>","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"17 ","pages":"20420188261442014"},"PeriodicalIF":4.6,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of concurrent exercise training (Resistance and Interval Running) and mindful self-compassion therapy on heart rate Variability in type 1 diabetes.","authors":"Hossein Saki, Farzad Nazem, Hossein Matin, Farnaz Fariba, Omid Khaiyat, Hojjatollah Siavoshy","doi":"10.1177/20420188261433153","DOIUrl":"10.1177/20420188261433153","url":null,"abstract":"<p><strong>Background and purpose: </strong>Diabetes in adolescents is usually associated with cardiovascular Autonomic Nervous System (ANS) disorders. The aim of this study was to investigate the effect of exercise and Mindful Self-Compassion Therapy (MSCT) on heart rate variability (HRV), aerobic capacity (VO2peak), and glycemic index of adolescent boys with type 1 diabetes (T1D).</p><p><strong>Methods: </strong>A total of 60 adolescent boys (Age: 12-18 years, Body Mass Index: 19.75 ± 2.26 kg/m²) were enrolled in this semi-experimental research. The participants were allocated into four groups: Control Diabetes (CD, <i>n</i> = 15), Exercise Diabetes (ED, <i>n</i> = 15), MSCT Diabetes (MD, <i>n</i> = 15), and Exercise + MSC Diabetes (EMD, <i>n</i> = 15). The ED group received 3 sessions per week of combined resistance and interval (running) and training, the MD group received 8 sessions of 60 min of MSCT, and the EMD group received exercise training + MSCT during a 12-week intervention period. A two-way multivariate analysis of covariance (MANCOVA) was used with pre-test values as covariate variables to evaluate changes in a range of HRV variables following the interventions.</p><p><strong>Results: </strong>The ED and EMD groups showed increases in High Frequency (HF), Root Mean Square of Successive RR Interval Differences (RMSSD), Standard Deviation of NN Intervals (SDNN), Very-Low-Frequency (VLF), Low-Frequency (LF), and VO2peak. There was a decrease in resting Heart Rate (HR), LF/HF, and HbA1c levels. The MD group had a substantial increase in HF and RMSSD and a significant decrease in HR and LF/HF (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>The results support the application of combined interval/resistance exercise training and stress control method (MSCT) as an effective non-invasive intervention for enhancing the psychophysiological parameters of HRV in adolescent boys with T1D compared to exercise or MSCT alone.</p>","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"17 ","pages":"20420188261433153"},"PeriodicalIF":4.6,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13091984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antidiabetic drug and chronic respiratory disease in type 2 diabetes: a network meta-analysis and Mendelian randomization analysis.","authors":"Ikramulhaq Patel, Yin-He Chai, Zi-Qi Wang, Hui Xu, Jin-Yan Zhang, Rafael Simo, Xing-Yao Tang, Jian-Bo Zhou","doi":"10.1177/20420188261437346","DOIUrl":"https://doi.org/10.1177/20420188261437346","url":null,"abstract":"<p><strong>Background: </strong>Multimorbidity management is crucial in aging populations, particularly for chronic respiratory diseases (CRDs) and diabetes. Their coexistence increases exacerbation and mortality risks. Antidiabetic drugs may differentially impact respiratory outcomes.</p><p><strong>Objectives: </strong>To evaluate the effects of antidiabetic drugs on CRDs in individuals with type 2 diabetes (T2D).</p><p><strong>Design: </strong>Systematic review with conventional and network meta-analyses (NMAs).</p><p><strong>Data sources and methods: </strong>We conducted a systematic review with conventional meta-analysis, NMA for drug comparisons, and two-sample Mendelian randomization for genetic evidence. We assessed nine antidiabetic drug classes for associations with CRD exacerbations, incidence, and all-cause mortality in individuals with T2D.</p><p><strong>Results: </strong>Our analysis of 33 studies (<i>n</i> = 939,064) found that glucagon-like peptide-1 receptor agonists (GLP1RAs) offered the strongest protection against acute exacerbations (hazard ratio vs insulin: 0.40, 95% credible interval 0.29-0.56) and had the highest first-rank probability (72.95%), followed by sodium-glucose cotransporter-2 inhibitors (SGLT2is; 46.19%). Thiazolidinediones reduced incident CRD by 21% (odds ratio (OR) 0.79, 0.69-0.91), while metformin lowered all-cause mortality risk by 16% (OR 0.84, 0.74-0.95). Mendelian randomization confirmed GLP1R expression was associated with reduced asthma risk (OR 0.9987, 0.9979-0.9996).</p><p><strong>Conclusion: </strong>GLP1RAs provide the strongest protection against CRD exacerbations in T2D patients, with SGLT2is as the second-most effective option. These findings highlight the potential for personalized antidiabetic therapy in multimorbidity management. Further studies should validate these findings and elucidate underlying mechanisms.</p><p><strong>Trial registration: </strong>PROSPERO (ID: CRD42024542379).</p>","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"17 ","pages":"20420188261437346"},"PeriodicalIF":4.6,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13069171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147676742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors potentiating risk of higher lactate level associated with metformin therapy: a cross-sectional study in an ambulatory care setting.","authors":"Aymen Alqurain, Amani S Alrossies, Abrar A Almuayli, Ayat M Alherz, Munther S Alkhamees, Hawra Al-Ghafli, Nida Alsaffar, Mohammed Zawiah","doi":"10.1177/20420188261434647","DOIUrl":"https://doi.org/10.1177/20420188261434647","url":null,"abstract":"<p><strong>Background: </strong>Metformin is the first-line pharmacological treatment for type 2 diabetes mellitus. Metformin-associated lactic acidosis is uncommon; however, subclinical increases in lactate levels can yield considerable clinical consequences, warranting regular surveillance in high-risk patients. Limited data exist on the patterns of metformin dosing and specific patient factors that may elevate lactate levels, indicating a critical need for further investigation.</p><p><strong>Objectives: </strong>This study aimed to determine the patterns of metformin dosing and identify patient-specific factors associated with higher lactate levels.</p><p><strong>Design: </strong>A retrospective, cross-sectional study.</p><p><strong>Methods: </strong>Patients who attended the endocrinology and internal medicine clinic between January 2021 and December 2022 were included. Patients' data, including demographics, comorbidities, prescribed medications, and laboratory tests, were collected from electronic health records. Patients were categorized based on age (middle-aged <65 years and older ⩾65 years) and metformin dosage (low, medium, and high). Univariable analyses were performed to assess the difference between the comparison groups. Multivariable linear regression analysis was performed to identify factors associated with elevated lactate levels.</p><p><strong>Results: </strong>Among 3304 diabetic patients, 2329 were metformin users. Metformin users exhibited significantly higher lactate levels (1.9 vs 1.0 mmol/L, <i>p</i> < 0.001) compared to nonusers. Older patients had a higher prevalence of comorbidities such as heart failure (74 vs 55, <i>p</i> < 0.001) and renal disease (3 vs 1, <i>p</i> = 0.01) but received lower metformin doses compared to middle-aged patients. Increasing metformin dosage (β = 0.66, <i>p</i> < 0.001), renal impairment (β = 0.2, <i>p</i> < 0.001) and co-prescription of diuretics (β = 0.2, <i>p</i> < 0.001) and nonsteroidal anti-inflammatory drugs (β = 0.1, <i>p</i> = 0.001) were associated with elevated lactate level, whereas co-prescription of renin-angiotensin-aldosterone inhibitors showed negative association with high lactate level (β = -0.25, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Metformin users demonstrated higher lactate levels, with increasing doses and renal impairment being key risk factors. This study calls attention to the importance of routine lactate monitoring, particularly in older adults and patients with renal dysfunction or polypharmacy.</p>","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"17 ","pages":"20420188261434647"},"PeriodicalIF":4.6,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parathyroid carcinoma co-occurring with parathyroid adenoma and papillary thyroid carcinoma: a rare case report with comprehensive literature review.","authors":"Junming Liu, Jingting Li, Yantao Fu","doi":"10.1177/20420188261436660","DOIUrl":"https://doi.org/10.1177/20420188261436660","url":null,"abstract":"<p><p>Parathyroid carcinoma is a rare endocrine malignancy with unclear etiology, and its clinical manifestations are often difficult to distinguish from parathyroid adenoma. The concurrent occurrence of parathyroid carcinoma, parathyroid adenoma, and thyroid carcinoma is an extremely uncommon clinical scenario. This study retrospectively analyzed the clinical data of a 44-year-old female patient with this concurrent condition who was treated at the Department of Thyroid Surgery, China-Japan Union Hospital of Jilin University. The patient underwent radical resection of left parathyroid carcinoma (including left thyroid lobectomy with isthmusectomy and central compartment lymph node dissection), excision of right parathyroid adenoma, and partial right thyroid lobectomy. Postoperative pathological examination confirmed the diagnoses of parathyroid carcinoma, parathyroid adenoma, thyroid malignant tumor, and nodular goiter. Preoperative diagnosis of this concurrent disease is highly challenging, and intraoperative pathological examination is often required for confirmation. Given the overlapping endocrine tumor patterns, this condition may be associated with underlying multiple endocrine neoplasia syndromes. Therefore, personalized treatment strategies combining precise surgery and long-term endocrine monitoring are crucial to achieve both oncological control and correction of hormonal dysregulation. This study aims to provide useful insights for clinical practice; we also conducted a literature review summarizing the reported features, diagnostic approaches, and treatment options for this condition.</p>","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"17 ","pages":"20420188261436660"},"PeriodicalIF":4.6,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Type 2 diabetes mellitus as a state of altered drug pharmacokinetic-pharmacodynamic parameters: an update on recent developments and clinical implications.","authors":"Ntethelelo Sibiya, Chiamaka Onyekwuluje, Auxiliare Kuretu, Omobonlale Ayodele, Nokwanda Ngcobo, Phikelelani Ngubane, Andile Khathi","doi":"10.1177/20420188241305021","DOIUrl":"https://doi.org/10.1177/20420188241305021","url":null,"abstract":"<p><p>Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterised by hyperglycaemia. And its global prevalence is increasing at an alarming rate. Uncontrolled diabetes can progress to an alteration of tissue and organ system morphology and function, resulting in complications that affect drug pharmacokinetics (PKs) and pharmacodynamics (PDs). Diabetes is associated with several physiological changes including delayed gastric emptying, intestinal drug transporters, cytochrome P450, hypoalbuminemia and an increase or decline in glomerular filtration rate. From a PK point of view, these pathophysiological changes in 2 diabetes mellitus could lead to altered drug absorption, distribution, metabolism and clearance. Consequently, such PKs changes can lead to variability in the PD responses of many drugs, increasing the risk of treatment failure or adverse effects. Furthermore, T2DM sensitise individuals to co-morbidities, thus, necessitating polypharmacy, heightening the risk of drug-drug interactions. A diabetic state proves to be a fertile ground for PK-PD profile variability for several agents including antidiabetics, antibiotics, antifungals and central nervous system drugs. Such variability may necessitate careful patient monitoring. In many cases, dose adjustment or drug switching may be required to optimise therapeutic outcomes. Given the rising incidence and early onset of diabetes, it is increasingly important to understand the unique PK-PD profiles of drugs in this population. For these reasons, research into the PK-PD behaviour of drugs should be accelerated. Through heightened understanding, we envisage consensus and clear guidelines for the management of various conditions in a diabetic state would be sought.</p>","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"17 ","pages":"20420188241305021"},"PeriodicalIF":4.6,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics, diagnosis, and treatment of Cushing's syndrome: analysis of a multicenter registry in Antioquia, Colombia.","authors":"Wilfredo Antonio Rivera-Martínez, María Johana Ramírez Castaño, Stefanía Cruz Calderón, Néstor Andrés Díaz Posada, Johnayro Gutiérrez Restrepo, Alejandro Román-González, Natalia Aristizábal Henao, Pablo Alberto Castaño Ceballos, Catalina Isabel Tobón Ospina, Jorge Hernando Donado Gómez, Néstor López Pompey, Carlos Esteban Builes-Montaño","doi":"10.1177/20420188261434078","DOIUrl":"10.1177/20420188261434078","url":null,"abstract":"<p><strong>Background: </strong>Cushing's syndrome (CS) is a rare endocrine disorder caused by long-term exposure to excess cortisol and is linked to significant morbidity. Data from multiple centers in Latin America remains limited.</p><p><strong>Objectives: </strong>To describe the clinical, diagnostic, and treatment characteristics of patients with CS in a regional Colombian cohort and to assess surgical outcomes in patients with Cushing's disease (CD) based on neurosurgical expertise.</p><p><strong>Design: </strong>Multicenter retrospective cohort study.</p><p><strong>Methods: </strong>Medical records from six hospitals in Antioquia, Colombia, were reviewed, including adult patients with biochemically confirmed endogenous CS diagnosed between 2010 and 2024. Data collected included sociodemographic, clinical features, diagnostic tests, etiological classification, treatments, and outcomes. In patients with CD, surgical remission, recurrence, persistence, and postoperative complications were compared based on neurosurgical expertise.</p><p><strong>Results: </strong>A total of 130 patients were included; 86.9% were women, with an average age of 50.7 years. The most common presenting features were weight gain (79.2%), moon face (36.9%), and striae (29.2%). CD was the leading cause (74.6%), followed by adrenal CS (17.6%) and ectopic adrenocorticotropic hormone syndrome (1.5%). The most frequently used diagnostic tests were 24-h urinary free cortisol and the 1-mg overnight dexamethasone suppression test, while late-night salivary cortisol and inferior petrosal sinus sampling were less commonly performed. Transsphenoidal surgery in CD achieved an initial remission rate of 63.3%, with no significant differences based on neurosurgical experience. All cases of adrenal CS underwent unilateral adrenalectomy.</p><p><strong>Conclusion: </strong>In this Colombian multicenter cohort, the clinical features, etiological distribution, and surgical outcomes in CS and CD were similar to those reported in specialized international centers. These findings highlight the importance of early detection, better access to diagnostic tools, and multidisciplinary care to improve outcomes in this rare disease.</p>","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"17 ","pages":"20420188261434078"},"PeriodicalIF":4.6,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13033879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147593928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent pituitary apoplexy: experience from a national registry and review of the literature.","authors":"Betina Biagetti, Esteban Cordero Asanza, Pedro Iglesias, Rosa Camara, Queralt Asla, Almudena Vicente, Elena Martinez-Saez, Silvana Sarria-Estrada, Manel Puig-Domingo, Marta Araujo-Castro","doi":"10.1177/20420188261434641","DOIUrl":"10.1177/20420188261434641","url":null,"abstract":"<p><strong>Background: </strong>Pituitary apoplexy (PA) is a neuroendocrine emergency characterized by acute hemorrhage or infarction of a pituitary adenoma. While its initial presentation and management are well documented, data on recurrent PA remain scarce.</p><p><strong>Objectives: </strong>To determine the prevalence, clinical characteristics, and predictors of recurrent PA in a national cohort, and to contextualize findings through a structured review of the literature.</p><p><strong>Design: </strong>Multicenter retrospective cohort study complemented by a structured literature review.</p><p><strong>Methods: </strong>We analyzed 274 patients from the Spanish Pituitary Apoplexy Registry (2010-2023) with complete follow-up. Recurrent PA was defined as a new acute episode with radiological evidence of hemorrhage or infarction within a previously affected lesion. Clinical, radiological, and treatment-related variables were compared between recurrent and non-recurrent cases. A complementary literature review identified published reports of recurrence.</p><p><strong>Results: </strong>Recurrent PA occurred in 9 patients (3.3%), including 6 of 214 with nonfunctioning adenomas (2.8%) and 3 of 60 with functioning adenomas (5.0%). Compared with nonrecurrent cases, patients with recurrence had significantly larger tumors (median 35 vs 25 mm; <i>p</i> = 0.006), higher rates of cavernous sinus invasion (77.9% vs 37.3%; <i>p</i> = 0.006), and more frequent prior cabergoline therapy (33.3% vs 6.3%; <i>p</i> = 0.020). Median time to recurrence was 18 months (range, 2-108). The literature review identified 11 studies reporting recurrence rates of 2.6%-16.7%, with more consistent estimates (4%-9.6%) in larger series (<i>n</i> ⩾ 50). All recurrent cases showed a favorable clinical course and recovery.</p><p><strong>Conclusion: </strong>Recurrent PA is uncommon, affecting approximately 3% of patients with a prior apoplexy episode. Given the low frequency of recurrence, the associated factors identified should be interpreted cautiously and considered primarily hypothesis-generating. The second episode was not more severe than the initial event, and the long-term prognosis was favorable.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"17 ","pages":"20420188261434641"},"PeriodicalIF":4.6,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13033880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147593985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}