Therapeutic Advances in Endocrinology and Metabolism最新文献

{"title":"Two threats in early life: congenital hyperinsulinemic hypoglycemia and thrombosis.","authors":"Ilkyaz Turktan, Sirmen Kızılcan Çetin, Gizem Senyazar, Seda Erisen Karaca, Sema Nilay Abseyi, Safak Demirtas, Elif Ozsu, Zehra Aycan, Merih Berberoglu, Zeynep Siklar","doi":"10.1177/20420188261459825","DOIUrl":"10.1177/20420188261459825","url":null,"abstract":"<p><strong>Background: </strong>Congenital persistent hyperinsulinemic hypoglycemia (HH) is a rare disorder that can lead to severe and recurrent hypoglycemic episodes in neonates and infants. Management often requires intensive glucose infusion via central venous catheters (CVCs), which may increase the risk of thrombosis. While case reports suggest thrombosis can occur in HH, the incidence, risk factors, severity, and outcomes remain poorly understood.</p><p><strong>Objectives: </strong>This study aimed to determine the incidence of thrombosis in children with persistent HH and to evaluate potential risk factors associated with thrombotic complications.</p><p><strong>Design: </strong>A descriptive, retrospective cohort study of patients with persistent HH followed at a university pediatric endocrinology clinic between January 2000 and December 2025.</p><p><strong>Methods: </strong>Twenty patients with persistent HH were included. Data on demographics, clinical characteristics, laboratory results, treatment protocols, CVC use, timing and location of thrombosis were collected. Patients who developed thrombosis were compared with those who did not to identify risk factors.</p><p><strong>Results: </strong>Among 20 patients, 55% were male, with a median age at diagnosis of 1 day. A total of 23 CVCs were placed in 15 patients, with a median dwell time of 38 days. Thrombosis occurred in nine patients (45%), including six catheter-related and three catheter-independent intracranial thrombosis. Median age at thrombosis detection was 74 days. Patients who developed thrombosis experienced significantly more hypoglycemic episodes and more days with hypoglycemia (<i>p</i> < 0.05). No association was found between genetic mutations (ABCC8, KCNJ11, etc.) and thrombosis development. All four patients treated with enoxaparin achieved complete resolution without complications.</p><p><strong>Conclusion: </strong>Thrombosis is a frequent and clinically significant complication in persistent HH. Recurrent and severe hypoglycemic episodes are major risk factors. Routine thrombosis screening, particularly in patients with CVCs, may allow early detection and treatment even in asymptomatic cases.</p>","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"17 ","pages":"20420188261459825"},"PeriodicalIF":7.8,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449701","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":"Lobectomy versus total thyroidectomy for unilateral multifocal papillary thyroid carcinoma (⩽4 cm) with limited lymph node metastasis: a retrospective cohort study using inverse probability weighting.","authors":"Changjiao Yan, Xin Li, Yang Wang, Yuan Qin, Lan Hou, Ting Wang","doi":"10.1177/20420188261464272","DOIUrl":"10.1177/20420188261464272","url":null,"abstract":"<p><strong>Background: </strong>The optimal extent of surgery for patients with unilateral multifocal papillary thyroid carcinoma (PTC; ⩽4 cm) and limited lymph node metastasis remains uncertain.</p><p><strong>Objectives: </strong>To compare recurrence risk between lobectomy and total thyroidectomy in this population.</p><p><strong>Design: </strong>Retrospective cohort study with inverse probability weighting regression adjustment (IPWRA) and non-inferiority analysis.</p><p><strong>Methods: </strong>This study included unilateral multifocal PTC (⩽4 cm) patients without bulky nodes (all metastatic <3 cm) treated from 2008 to 2024. IPWRA estimated the average treatment effect (ATE) of lobectomy versus total thyroidectomy on recurrence. A non-inferiority analysis with a prespecified margin of 3% was performed. Sensitivity analyses included traditional multivariable logistic regression, 1:1 propensity score matching, weighted logistic regression, and a 5-year landmark analysis. Recurrence-free survival was analyzed using Kaplan-Meier methods and multivariable Cox regression.</p><p><strong>Results: </strong>A total of 1373 patients were included (524 lobectomy, 849 total thyroidectomy). After IPWRA, all covariates achieved excellent balance. Over 52.4 months median follow-up, 36 recurrence events occurred (2.6%). The ATE of lobectomy versus total thyroidectomy was 1.19% (95% confidence interval (CI): -1.44% to 3.81%; <i>p</i> = 0.375), indicating no statistically significant difference in recurrence risk between the two procedures. The upper bound of the 90% CI (3.39%) marginally exceeded the prespecified non-inferiority margin of 3%. The 5-year landmark analysis showed a near-zero difference (ATE 0.01%, <i>p</i> = 0.994), and three of four sensitivity analyses yielded nonsignificant results. Subgroup analyses were directionally consistent but underpowered. The multivariable Cox regression was underpowered (minimum detectable hazard ratio (HR): 2.61) and yielded an inconclusive result (HR: 2.04, 95% CI: 0.91-4.62, <i>p</i> = 0.085).</p><p><strong>Conclusion: </strong>In patients with unilateral multifocal PTC (⩽4 cm) without bulky nodal metastases, lobectomy showed no significant difference in recurrence risk compared with total thyroidectomy, supporting that lobectomy may be a safe alternative in this intermediate-risk population.</p>","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"17 ","pages":"20420188261464272"},"PeriodicalIF":7.8,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13346737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148424302","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":"Be alert to hypertension caused by 17α-hydroxylase deficiency: two case reports in young patients.","authors":"Yan Zhang, Yuli Lu, Xiaohong Xie, Wei Gu","doi":"10.1177/20420188261461859","DOIUrl":"10.1177/20420188261461859","url":null,"abstract":"<p><p>This article reports on two unrelated young female patients (gender assigned female at birth) who initially presented with hypertension. Patient 1 was admitted to the hospital with an acute cerebral infarction due to poorly controlled hypertension, while Patient 2 was a first-time visitor presenting with hypertension as the initial complaint. Physical examination on admission revealed absent breast development, feminized and immature external genitalia, and no history of menarche. Laboratory investigations showed markedly elevated adrenocorticotropic hormone (ACTH) levels, significantly decreased cortisol levels and a disrupted circadian rhythm. For sex hormones, progesterone was markedly elevated, follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were mildly increased, while estrogen and testosterone levels were low. Combined with karyotype analysis and gene sequencing, Patient 1 was confirmed to have a karyotype of 46,XX, and Patient 2 had a karyotype of 46,XY. In addition, pathogenic allelic variants in the CYP17A1 gene (c.985_987delinsAA) differed between the two patients: Patient 1 harbored a heterozygous mutation, whereas Patient 2 had a homozygous mutation. Both patients were ultimately diagnosed with 17α-hydroxylase deficiency (17-OHD). During the 6-month follow-up after initiation of dexamethasone replacement therapy, the patients' blood pressure and serum potassium levels were well controlled. This case suggests that although 17-OHD is a rare disorder, clinicians should be alert to the possibility of 17-OHD in patients presenting with disorders of sex development or primary hypertension. Early and definitive diagnosis followed by appropriate glucocorticoid replacement therapy can significantly improve the patient's quality of life.</p>","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"17 ","pages":"20420188261461859"},"PeriodicalIF":7.8,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13346833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148424278","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":"Comparative 24-month cardiovascular outcomes and biomarker trajectories with semaglutide, empagliflozin, and sitagliptin in people with obesity and type 2 diabetes: a multicenter real-world study.","authors":"Jo-Ching Chen, Kai-Wen Liu, Yu-Nan Huang, Gideon Meyerowitz-Katz, Tsung-Hsun Tsai, Pen-Hua Su","doi":"10.1177/20420188261460592","DOIUrl":"10.1177/20420188261460592","url":null,"abstract":"<p><strong>Background: </strong>Comparative evidence on 24-month clinical outcomes and biomarker trajectories with semaglutide, empagliflozin, and sitagliptin in adults with type 2 diabetes (T2D) and obesity remains limited.</p><p><strong>Objectives: </strong>To compare 24-month clinical outcomes and longitudinal biomarker trajectories among semaglutide, empagliflozin, and sitagliptin in people with T2D and obesity.</p><p><strong>Design: </strong>Multicenter retrospective cohort study.</p><p><strong>Methods: </strong>Using TriNetX, we performed an active-comparator, new-user study with three prespecified 1:1 propensity score-matched contrasts: semaglutide versus empagliflozin, semaglutide versus sitagliptin, and empagliflozin versus sitagliptin. Follow-up was intention-to-treat for 24 months. Multiplicity was addressed with Benjamini-Hochberg false discovery rate correction within two prespecified families: (i) clinical time-to-event endpoints (all-cause mortality, MACE, heart failure, MAKE, MALO, atrial fibrillation, stroke) within each comparator pairing, and (ii) window-level laboratory contrasts within each biomarker at baseline, 6, 12, and 24 months.</p><p><strong>Results: </strong>Versus empagliflozin, semaglutide was associated with lower all-cause mortality (hazard ratio [HR] 0.59, 95% confidence interval [CI] 0.51-0.69), major adverse cardiovascular events (MACE; HR 0.76, 95% CI 0.66-0.88), and heart failure (HR 0.62, 95% CI 0.54-0.70). Versus sitagliptin, semaglutide was associated with lower all-cause mortality (HR 0.34, 95% CI 0.27-0.42), MACE (HR 0.64, 95% CI 0.51-0.81), and heart failure (HR 0.54, 95% CI 0.43-0.67). Empagliflozin versus sitagliptin showed lower all-cause mortality (HR 0.48, 95% CI 0.40-0.58) and MACE (HR 0.74, 95% CI 0.59-0.92), whereas heart failure did not differ significantly.</p><p><strong>Conclusion: </strong>In matched cohorts with T2D and obesity, semaglutide was associated with lower 24-month mortality and heart failure risk than empagliflozin, and both semaglutide and empagliflozin were associated with lower mortality and MACE than sitagliptin.</p><p><strong>Trial registration: </strong>Not applicable (retrospective cohort); Institutional Review Board approval CS2-24004, Chung Shan Medical University Hospital.</p>","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"17 ","pages":"20420188261460592"},"PeriodicalIF":7.8,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13332288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391445","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":"Association between dietary intake of fatty acids, central obesity, and OAB: insights from a prospective cohort for weight management and dietary prevention.","authors":"Bo Chen, Jialu Wu, Jinbao Wang, Jie Chen, Jinze Li, Qiyou Wu, Zhe Yan, Liangren Liu, Hui Huang","doi":"10.1177/20420188261461860","DOIUrl":"10.1177/20420188261461860","url":null,"abstract":"<p><strong>Background: </strong>Overactive bladder (OAB) is a common condition that affects both men and women, but its relationship with central obesity and the dietary intake has not been adequately elucidated.</p><p><strong>Objectives: </strong>Our study aims to investigate associations between central obesity replacement indices, dietary intake of sugar and lipids, and OAB risk using National Health and Nutrition Examination Survey 2005-2016 data.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>This study analyzed 24,675 adults (4848 OAB cases). Weight, body mass index, and other central obesity replacement indices (waist circumference, weight-adjusted waist index, waist-to-height ratio (WHtR), body roundness index (BRI)) and dietary nutrients intake (carbohydrate, sugars, fat, saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids (PUFAs), and cholesterol) were assessed. Propensity score matching (1:2) balanced covariates. Multivariable logistic regression and generalized additive models evaluated dose-response relationships.</p><p><strong>Results: </strong>All central obesity indices showed significant positive associations with OAB (<i>p</i> < 0.001), with WHtR and BRI demonstrating the strongest effects (adjusted odds ratio (OR) = 2.04, 95% confidence interval: 1.80-2.30). Nonlinear relationships were observed, particularly for WHtR (degrees of freedom = 3.30-6.16). Dietary analysis revealed that OAB patients had significantly higher consumption of total energy, carbohydrates, and sugars (all <i>p</i> < 0.05), and higher sugar intake increased OAB risk (OR = 1.32, <i>p</i> = 0.0016), while PUFAs were protective (OR = 0.79, <i>p</i> = 0.0159).</p><p><strong>Conclusion: </strong>Central obesity replacement indices, especially WHtR and BRI, strongly predict OAB risk. Dietary modifications, including reducing sugars and increasing PUFAs intake, may complement abdominal fat reduction for OAB prevention. These findings highlight the importance of combined weight management and dietary modifications for OAB prevention in high-risk populations.</p>","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"17 ","pages":"20420188261461860"},"PeriodicalIF":7.8,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13332302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391729","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":"Diabetes-type-specific thyroid safety of GLP-1 receptor agonists: evidence from a large real-world cohort.","authors":"Hao-I Hsieh, Yu-Nan Huang, Ya-Wen Chang, Wen-Ling Liao","doi":"10.1177/20420188261460619","DOIUrl":"10.1177/20420188261460619","url":null,"abstract":"<p><strong>Background: </strong>Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are widely used across the glycemic spectrum, yet their thyroid safety profile remains debated. Prior studies have shown inconsistent findings, and evidence across prediabetes, type 1 diabetes (T1D), and type 2 diabetes (T2D) is lacking.</p><p><strong>Objectives: </strong>To evaluate diabetes-type-specific associations between GLP-1RA therapy and thyroid outcomes, including thyroid dysfunction, autoimmune thyroiditis, nontoxic goiter, and thyroid cancer.</p><p><strong>Design: </strong>A real-world, retrospective target-trial emulation using electronic health records (EHR) from a large multicenter network.</p><p><strong>Methods: </strong>We used the TriNetX US Collaborative Network to identify adults with prediabetes, T1D, or T2D initiating GLP-1RAs. Active comparators included usual care and sodium-glucose cotransporter two inhibitors (SGLT2i). Propensity score matching with extensive covariate adjustment was applied. Participants were followed for incident thyroid outcomes for up to 5 years. Sensitivity and subgroup analyses were conducted to assess robustness.</p><p><strong>Results: </strong>Across glycemic states, GLP-1RA therapy demonstrated distinct thyroid safety patterns. In prediabetes and T1D, GLP-1RA use was associated with reduced risks of thyroid dysfunction and all-cause mortality, suggesting potential metabolic or immunomodulatory benefits. By contrast, among individuals with T2D, GLP-1RA exposure was linked to modest increases in autoimmune thyroiditis and nontoxic goiter, particularly among those with obesity or without hypertension. Importantly, no increased risk of thyroid cancer was observed in any glycemic state, providing reassuring evidence regarding long-term endocrine safety.</p><p><strong>Conclusion: </strong>In this large-scale target-trial emulation, GLP-1RAs showed favorable thyroid safety profiles in prediabetes and T1D, while modestly increasing selected nonmalignant thyroid outcomes in T2D. The absence of elevated thyroid cancer risk across glycemic states supports the overall endocrine safety of GLP-1RAs. These findings highlight the importance of individualized monitoring, particularly in metabolically high-risk T2D populations.</p>","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"17 ","pages":"20420188261460619"},"PeriodicalIF":7.8,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369776","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":"Response to the Letter by Zhang \"The hidden variable in a 'neutral' upgrade: why parameter re-tuning and perceived reliability matter after G6 → G7 in Control-IQ\".","authors":"Lía Nattero-Chávez, Mar Lorenzo, María Soledad Ruiz de Adana, Olga Simó-Servat, Mercè Abad, Carmen Quirós, María Duran Martínez, Alejandra Quintero Tobar, Ane Bayona, Teresa Ruiz Gracia, Esther de la Calle de la Villa, María José Picón","doi":"10.1177/20420188261461878","DOIUrl":"10.1177/20420188261461878","url":null,"abstract":"","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"17 ","pages":"20420188261461878"},"PeriodicalIF":7.8,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13309634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346241","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":"Association of prediabetes phenotypes with metabolic dysfunction-associated fatty liver disease and liver fibrosis: a population-based study.","authors":"Miao He, Yan Liu, Tianyun Gao, Jinjin Gu, Xiaoying Zhou, Zilin Sun, Shanhu Qiu","doi":"10.1177/20420188261457476","DOIUrl":"10.1177/20420188261457476","url":null,"abstract":"<p><strong>Background: </strong>Prediabetes comprises three heterogeneous glucometabolic phenotypes and is associated with an increased risk of metabolic dysfunction-associated fatty liver disease (MAFLD). However, the association of different prediabetes phenotypes with the presence of MAFLD and liver fibrosis remains underexplored.</p><p><strong>Objectives: </strong>To examine the association of different prediabetes phenotypes with MAFLD and liver fibrosis.</p><p><strong>Design: </strong>Population-based cross-sectional study.</p><p><strong>Methods: </strong>Prediabetes was stratified as an isolated defect (impaired fasting glucose (IFG), impaired glucose tolerance (IGT), or impaired hemoglobin A1c (IA1c)), two defects (IFG + IGT, IFG + IA1c, or IGT + IA1c), or all three defects (IFG + IGT + IA1c). Hepatic steatosis and liver fibrosis were assessed by vibration-controlled transient elastography. Multivariate logistic regression analysis was conducted to estimate the odds ratio (OR) and 95% confidence interval (CI) for different prediabetes phenotypes associated with MAFLD and liver fibrosis.</p><p><strong>Results: </strong>A total of 1599 subjects (394 with normal glucose tolerance (NGT) and 1205 with prediabetes) were included. The prevalence of MAFLD and liver fibrosis was higher in prediabetes than in NGT. The odds of MAFLD in prediabetes with two or three glucometabolic defects were increased compared with those with a single glucometabolic defect, with insulin resistance as a possible mediator. Compared with isolated IA1c, isolated IGT had an increased prevalence of MAFLD (<i>p</i> < 0.05). Moreover, glucose-defined prediabetes had higher odds of MAFLD than HbA1c-defined prediabetes (OR 1.72, 95% CI 1.00-2.96). However, there was no significant difference in the odds of liver fibrosis across different prediabetes phenotypes (<i>p</i> = 0.58).</p><p><strong>Conclusion: </strong>The odds of MAFLD but not liver fibrosis were increased with the increasing number of glucometabolic defects in participants with prediabetes.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"17 ","pages":"20420188261457476"},"PeriodicalIF":7.8,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13261032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253383","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":"NT-proBNP and its association with autonomous aldosterone production in primary aldosteronism.","authors":"No-Ting Lin, Cheng-Hsuan Tsai, Yu-Ching Chang, Uei-Lin Chen, Yi-Yao Chang, Tsung-Yan Chen, Xue-Ming Wu, Che-Wei Liao, Chin-Chen Chang, Bo-Ching Lee, Ching-Chu Lu, Zheng-Wei Chen, Jeff S Chueh, Vin-Cent Wu, Yen-Hung Lin, Hung Chi-Sheng","doi":"10.1177/20420188261448647","DOIUrl":"10.1177/20420188261448647","url":null,"abstract":"<p><strong>Introduction: </strong>Autonomous aldosterone production and mineralocorticoid receptor activation are key pathophysiologic mechanisms underlying primary aldosteronism (PA). N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a sensitive biomarker for evaluating cardiac stress and fluid status. This study aimed to investigate the association between NT-proBNP and renin-independent autonomous aldosterone production, as well as potential confounding factors.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 443 patients with PA who underwent both a captopril challenge test (CCT) and measurement of NT-proBNP. The CCT was used to evaluate the degree of renin-independent aldosterone production, and the association between NT-proBNP and renin-independent aldosterone production was assessed using multivariable regression analysis. Echocardiography was performed to evaluate cardiac structure and function.</p><p><strong>Results: </strong>After multivariable regression analysis, post-CCT plasma aldosterone concentration (PAC) and aldosterone-renin ratio (ARR) were identified as independent predictors of NT-proBNP levels. In addition, female sex and lower body mass index (BMI) were significantly associated with higher NT-proBNP levels, compared to men or individuals with higher BMI. NT-proBNP also remained a significant predictor of increased left ventricular mass index and impaired diastolic function after adjustment across multiple models, underscoring its strong association with cardiac remodeling and dysfunction in patients with PA.</p><p><strong>Conclusion: </strong>Higher post-CCT PAC and ARR were independently associated with NT-proBNP in patients with PA, indicating a pathophysiological link between renin-independent aldosterone production and cardiac stress. Sex and BMI significantly influenced NT-proBNP concentrations, underscoring the importance of considering these factors when interpreting NT-proBNP levels in clinical practice.</p>","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"17 ","pages":"20420188261448647"},"PeriodicalIF":7.8,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148017382","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":"Exploring the link between atherosclerosis indicators and QT interval in type 2 diabetes: a retrospective cross-sectional analysis.","authors":"Shunsuke Kobayashi, Mototsugu Nagao, Izumi Fukuda, Shinichi Oikawa, Masato Iwabu","doi":"10.1177/20420188261448416","DOIUrl":"10.1177/20420188261448416","url":null,"abstract":"<p><strong>Background: </strong>A prolonged QT interval is a recognized risk factor for life-threatening arrhythmias and sudden cardiac death. In patients with type 2 diabetes, identifying clinical markers associated with myocardial repolarization abnormalities is essential for risk stratification.</p><p><strong>Objectives: </strong>To investigate the association between multiple non-invasive atherosclerosis indicators and corrected QT interval prolongation in patients with type 2 diabetes.</p><p><strong>Design: </strong>Retrospective cross-sectional analysis.</p><p><strong>Methods: </strong>We evaluated 96 patients with type 2 diabetes admitted for glycemic control. The QTc interval was calculated using the Bazett (QTcB), Fridericia (QTcF), and Framingham (QTcFra) formulas. We examined the association between QTc and multiple atherosclerosis indicators, including the ankle-brachial index (ABI), cardio-ankle vascular index (CAVI), carotid intima-media thickness (IMT), and flow-mediated dilatation (FMD).</p><p><strong>Results: </strong>Among all participants, 2 women (7%) and 10 men (15%) had prolonged QTcB. In univariate analyses, FMD was negatively correlated with QTcB (<i>r</i> = -0.28, <i>p</i> = 0.0054), whereas ABI, CAVI, mean, and maximum carotid IMT did not exhibit significant associations. In multivariable linear regression analyses, FMD was independently associated with QTcB (unstandardized coefficient β = -1.95 ms per 1% increase in FMD; 95% confidence interval -3.60 to -0.30; <i>p</i> = 0.021). Subgroup analysis revealed that this association was prominent specifically in the non-obese group (body mass index, <25 kg/m²). Notably, these findings remained consistent regardless of the correction formula used.</p><p><strong>Conclusion: </strong>Vascular endothelial dysfunction, as measured by FMD, is independently associated with QTc prolongation, particularly in non-obese patients with type 2 diabetes. This suggests a significant link that may help identify individuals at higher risk for life-threatening arrhythmias.</p>","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"17 ","pages":"20420188261448416"},"PeriodicalIF":7.8,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148017438","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}