Therapeutic Advances in Endocrinology and Metabolism最新文献

{"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":7.8,"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":"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":7.8,"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":"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":7.8,"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":"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":7.8,"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":"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":7.8,"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":7.8,"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":7.8,"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}

{"title":"Association of insulin resistance-related indicators with cardiovascular disease and cardiovascular disease mortality in individuals with MASLD: a population-based study.","authors":"Xiwen Yang, Wei Peng","doi":"10.1177/20420188261435033","DOIUrl":"10.1177/20420188261435033","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Limited studies have explored the relationship between surrogate markers of insulin resistance (IR) with both cardiovascular disease (CVD) risk and CVD mortality in individuals with metabolic dysfunction-associated fatty liver disease (MASLD). This study aimed to assess the associations of various IR surrogates with CVD risk and mortality and to identify effective predictors of cardiovascular outcomes in this population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;This study constituted a population-based cross-sectional investigation, utilizing data derived from six cycles of the National Health and Nutrition Examination Survey (NHANES) spanning from 2005 to 2016. The data were linked to the NHANES public-use linked mortality files up to December 31, 2019, to facilitate follow-up on CVD mortality. Following predefined exclusion criteria, participants diagnosed with MASLD were identified and incorporated into the study. The research assessed the associations between surrogate markers of IR and both the prevalence of CVD and CVD mortality.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The primary outcome of this study was the incidence of CVD in individuals with MASLD, and the secondary outcome was CVD mortality. Weighted multivariate logistic regression was utilized to examine the relationship between surrogate markers of IR with total CVD and other subtypes. Weighted multivariate Cox regression and Kaplan-Meier analysis were used to examine the relationship between surrogate markers of IR and CVD mortality. Restricted cubic spline (RCS) was used to explore potential nonlinear relationships. Receiver operating characteristics (ROC) and calibration curves were plotted to evaluate the discriminability and accuracy of IR surrogate markers in predicting CVD risk. Furthermore, mediation analysis was conducted to determine whether surrogate markers of liver fibrosis play a mediating role in the association of surrogate markers of IR with the risk of total CVD and other subtypes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;This study suggests that in the fully adjusted model, estimated glucose disposal rate (eGDR) was significantly negatively correlated with total CVD, congestive heart failure (CHF), heart attack (HA), and CVD mortality. Metabolic score for IR and triglyceride-glucose-body mass index were significantly positively correlated with CVD mortality, total CVD, and CHF. eGDR was best correlated with total CVD (odds ratio (OR) = 0.40, 95% confidence interval (CI): 0.25, 0.63), CHF (OR = 0.15, 95% CI: 0.06, 0.38), and HA (OR = 0.40, 95% CI: 0.22, 0.71). Weighted multivariate Cox regression indicated that for each unit increase in eGDR, the risk of CVD mortality decreased by 27%. RCS analysis showed that all surrogate markers of IR were linearly related to CVD and CVD mortality (&lt;i&gt;P&lt;/i&gt;-nonlinear relationship &gt;0.05). In addition, the ROC curve showed that eGDR had a more robust diagnostic efficacy than other IR markers, and eGDR had a higher accuracy i","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"17 ","pages":"20420188261435033"},"PeriodicalIF":7.8,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13033875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147593903","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 WATCH-DM integer-based risk score identifies risk of all-cause mortality in patients with type 2 diabetes: a retrospective cohort study.","authors":"Chin-Sung Kuo, Nai-Rong Kuo, Po-Hsun Huang, Chii-Min Hwu","doi":"10.1177/20420188261431021","DOIUrl":"10.1177/20420188261431021","url":null,"abstract":"<p><strong>Background: </strong>The WATCH-DM integer-based risk score (WATCH-DM(i)) was originally developed and validated to predict heart failure (HF) hospitalization risk in patients with type 2 diabetes mellitus (T2DM). However, its potential association with all-cause mortality in patients without HF remains unclear.</p><p><strong>Objectives: </strong>This study aimed to evaluate the prognostic utility of the WATCH-DM(i) score for all-cause mortality in a real-world outpatient cohort of T2DM patients without known HF.</p><p><strong>Design: </strong>This was a retrospective observational cohort study with national mortality registry linkage performed at a single center.</p><p><strong>Methods: </strong>We analyzed data from 449 adults with T2DM enrolled in a hospital-based cohort between 2016 and 2022. The WATCH-DM(i) score was calculated according to the original published integer-based model reported by Segar et al., using clinical and laboratory parameters. Patients were stratified into four risk groups based on their score. All-cause mortality data were obtained via national linkage. Cox regression models, Kaplan-Meier survival analysis, landmark analysis, and time-dependent receiver operating characteristic curves were used to assess mortality risk.</p><p><strong>Results: </strong>Over a median follow-up of 61 months, 39 patients (8.7%) died. Each 1-point increase in the WATCH-DM(i) score was associated with a 29% higher risk of all-cause mortality (HR: 1.287, 95% CI: 1.151-1.439, <i>p</i> < 0.001). Higher risk groups showed progressively greater mortality, especially after 24 months. The score demonstrated good discrimination for 5-year mortality (C-index: 0.751). Metformin use was independently associated with lower mortality risk (HR: 0.410, <i>p</i> = 0.019).</p><p><strong>Conclusion: </strong>The WATCH-DM(i) score is a robust prognostic marker of 5-year all-cause mortality in T2DM patients without HF and may serve as a practical tool for risk stratification in outpatient settings.</p>","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"17 ","pages":"20420188261431021"},"PeriodicalIF":7.8,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13009881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514958","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":"Thyroid function alterations after radiofrequency ablation in benign thyroid nodule management.","authors":"Yi-Han Chen, Pi-Ling Chiang, Cheng-Kang Wang, An-Ni Lin, Yen-Hsiang Chang, Chen-Kai Chou, Wei-Che Lin","doi":"10.1177/20420188261432727","DOIUrl":"10.1177/20420188261432727","url":null,"abstract":"<p><strong>Background: </strong>Radiofrequency ablation (RFA) has gained recognition as a highly effective treatment for benign thyroid nodules (BTNs). However, post-procedural thyroid function changes have been reported.</p><p><strong>Objectives: </strong>This study specifically focuses on the potential link between changes in thyroid function and the volume reduction ratio (VRR) of treated nodules. Additionally, it seeks to evaluate whether fluctuations in thyroid function at mid-term follow-up can serve as early indicators for the development of long-term hypothyroidism following RFA.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Methods: </strong>In this study, 50 euthyroid individuals (mean age = 47.1 years; 43 females, 7 males) with a total of 72 BTNs (median volume = 4.61 mL) undergoing RFA were evaluated. Comprehensive assessments, including clinical examinations, ultrasound imaging, and blood tests, were conducted at specific intervals (pre-RFA, and at 6 months, 12 months, and annually post-RFA).</p><p><strong>Results: </strong>The mean follow-up period was 22.3 months. Both medium-term and long-term follow-ups revealed significant reductions in triiodothyronine (T3) levels (<i>p</i> = 0.010, <i>p</i> = 0.036) and elevations in thyroid-stimulating hormone (TSH) levels (<i>p</i> < 0.001, <i>p</i> = 0.006) compared to baseline measurements. A negative correlation was found between medium-term T3 levels and long-term VRR (<i>r</i> = -0.475, <i>p</i> = 0.001). Furthermore, patients with lower T3 levels during medium-term follow-up demonstrated a significantly higher long-term VRR compared to those with higher T3 levels (0.89 vs 0.77, <i>p</i> = 0.030).</p><p><strong>Conclusion: </strong>Following RFA, notable alterations in thyroid function were observed, without meeting the criteria of hypothyroidism. Additionally, a lower mid-term T3 level may be indicative of a better VRR during long-term follow-up.</p>","PeriodicalId":22998,"journal":{"name":"Therapeutic Advances in Endocrinology and Metabolism","volume":"17 ","pages":"20420188261432727"},"PeriodicalIF":7.8,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515060","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}