Endocrinology, Diabetes and Metabolism最新文献

{"title":"Construction and Validation of a Long-Term Visual Prognosis Prediction Model for Proliferative Diabetic Retinopathy After Vitrectomy Based on Machine Learning.","authors":"Xiaolu Wang, Jinghua Shi, Yan Gao, Tiantian Li, Xuehong Han, Lixia Guo, Tingting Jia, Yan Wang","doi":"10.1002/edm2.70314","DOIUrl":"10.1002/edm2.70314","url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to develop a machine-learning-based risk prediction model for a long-term visual prognosis in patients with proliferative diabetic retinopathy (PDR) following pars plana vitrectomy (PPV).</p><p><strong>Methods: </strong>We analysed 609 PDR patients (609 eyes) who underwent PPV at Shanxi Eye Hospital from January 1, 2022, to January 1, 2025. The dataset was randomly split into training and validation sets at an 8:2 ratio. Candidate risk factors were identified using LASSO regression, followed by multivariate logistic regression to determine independent predictors. Machine learning algorithms were then trained to construct the prediction model, with performance evaluated by AUC-ROC, accuracy, precision, recall, and F1 score. Calibration was assessed via calibration curves, and clinical utility by decision curve analysis (DCA).</p><p><strong>Results: </strong>LASSO regression and multivariate logistic regression indicated that several factors influenced postoperative long-term visual prognosis. These included Renal Insufficiency (OR = 6.932, 95% CI: 3.394-14.158), Preoperative iris neovascularization (OR = 7.674, 95% CI: 3.699-15.920), Silicone oil tamponade (OR = 2.799, 95% CI: 1.641-4.707), Indirect bilirubin (IBIL) (OR = 0.902, 95% CI: 0.829-0.981) (p < 0.05). LightGBM was found to be the best for predicting postoperative long-term visual prognosis risk in PDR patients. The LightGBM model demonstrated good calibration in both training and validation sets. DCA of the validation set showed clinical net benefit at low-to-moderate risk thresholds, outperforming both 'treat-all' and 'treat-none' strategies.</p><p><strong>Conclusions: </strong>In conclusion, this study developed a machine learning-based prognostic model for long-term visual prognosis in PDR patients after PPV, visualized as a proof-of-concept web calculator to assist clinical staff in early risk identification and support personalised treatment planning, pending external validation and prospective evaluation.</p>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 5","pages":"e70314"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13550875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Traditional Chinese Exercise and Equipment-Based Exercise on Glycaemic Control and Vitamin D Levels in Middle-Aged and Elderly Patients With Prediabetes: A Randomised Controlled Trial.","authors":"Xu Lingzhi, Zhou Chunhua, Liu Wu, Ding Jiejin, Yuan Yimin","doi":"10.1002/edm2.70326","DOIUrl":"10.1002/edm2.70326","url":null,"abstract":"<p><strong>Background: </strong>Prediabetes is a critical window for preventing progression to type 2 diabetes mellitus (T2DM). Both vitamin D deficiency and physical inactivity are associated with impaired glucose metabolism. This study compared the effects of Traditional Chinese Exercise (TCE) and Kuanle Equipment Exercise (KEE) on glycaemic measures, lipid profiles, body composition and serum 25-hydroxyvitamin D₃ [25(OH)D₃] in middle-aged and elderly adults with prediabetes.</p><p><strong>Methods: </strong>We conducted a 12-week, single-centre, randomised controlled trial involving 62 participants with prediabetes (mean age 55.2 ± 8.4 years; 88.7% female). Participants were randomly assigned to control (usual care, n = 21), TCE (n = 20), or KEE (n = 21). Primary outcomes included fasting plasma glucose (FPG), 2-h OGTT glucose, glycated haemoglobin (HbA1c) and serum 25(OH)D₃. Secondary outcomes comprised triglycerides, total cholesterol, LDL-C, HDL-C and body composition.</p><p><strong>Results: </strong>At baseline, mean serum 25(OH)D₃ was 21.53 ± 3.90 nmol/L. At 12 weeks, both TCE and KEE improved FPG, 2-h OGTT glucose, HbA1c and 25(OH)D₃ versus control (all p ≤ 0.001). Relative changes in FPG were -9.4% (TCE) and -15.2% (KEE) versus -1.5% (control); corresponding changes were -14.6% and -21.2% for 2-h OGTT glucose, -6.7% and -12.9% for HbA1c, and +60.6% and +81.9% for 25(OH)D₃. Direct TCE-KEE comparisons were not significant (all p > 0.05). In an exploratory analysis, change in 25(OH)D₃ was inversely associated with change in 2-h OGTT glucose (partial r = -0.358, p = 0.006), but not with FPG, HbA1c, or triglycerides.</p><p><strong>Conclusions: </strong>Both TCE and KEE improved glycaemic outcomes and increased serum 25(OH)D₃ compared with usual care in middle-aged and elderly adults with prediabetes. Although KEE produced numerically larger estimates, direct between-group comparisons were not significant, and the superiority of KEE over TCE was not established. These vitamin D findings require confirmation in trials that quantify sunlight exposure and dietary vitamin D intake.</p>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 5","pages":"e70326"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Letters to the Editor Regarding 'Role of Evogliptin for Intra-Class Therapeutic Interchange in Patients With Type 2 Diabetes Mellitus: Subgroup Analysis From a Multi-Center, Prospective, Observational Study (REVISE Study)'.","authors":"Jie-Eun Lee, Jun Hwa Hong, Min Soo Song, Jong Chul Won","doi":"10.1002/edm2.70300","DOIUrl":"10.1002/edm2.70300","url":null,"abstract":"","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 5","pages":"e70300"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13521567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Cardiovascular Outcomes of GLP-1 Receptor Agonists Versus Bariatric Surgery: A Systematic Review and Network Meta-Analysis.","authors":"Erfan Shirmohammadi, Negar Ghasemloo, Navid Ebrahimi, Narjes Mohammadzadeh, Amir Ehtemami, Mahan Babaei, Shakiba Fardoost","doi":"10.1002/edm2.70311","DOIUrl":"10.1002/edm2.70311","url":null,"abstract":"<p><strong>Background: </strong>Obesity, a major global health issue, heightens the risk of cardiovascular diseases, including major adverse cardiovascular events (MACE), heart failure (HF) and myocardial infarction (MI). This study provides the first network meta-analysis (NMA) integrating direct and indirect evidence to compare the cardiovascular efficacy of bariatric surgery (BS) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) in individuals with obesity.</p><p><strong>Methods: </strong>A systematic review and NMA were performed in adherence to PRISMA guidelines. PubMed, Embase, Cochrane Library and Google Scholar were searched for studies published from January 2000 to September 2024. Eligible studies reported cardiovascular outcomes, specifically MACEs, HF and MI, in patients with obesity receiving BS, GLP-1RAs or control treatment. Fixed- and random-effects models were used to analyse hazard ratios (HRs) and risk ratios (RRs), with heterogeneity assessed with I² and consistency through node-splitting analysis.</p><p><strong>Results: </strong>Forty-three studies involving 932,380 patients were included BS was associated with significantly greater reductions in MACEs (HR 0.66; 95% CI 0.60-0.74), HF (HR 0.45; 95% CI 0.38-0.53) and MI (HR 0.53; 95% CI 0.45-0.63) compared with controls in random-effects models. GLP-1RAs reduced MACEs (HR 0.85; 95% CI 0.77-0.94) but showed non-significant effects on HF and MI. Despite high heterogeneity (I²: 66%-93%), directional consistency was observed across studies.</p><p><strong>Conclusions: </strong>BS demonstrated more consistent and statistically significant reductions in all cardiovascular outcomes compared to GLP-1RAs, which showed more variable efficacy, particularly for HF and MI. Nevertheless, GLP-1RAs remain effective evidence-based alternatives for cardiovascular risk reduction in patients who are not candidates for surgery, but future studies on newer GLP-1RAs are required. The high heterogeneity across studies highlights the need for cautious interpretation. These results may inform individualized treatment selection in patients with obesity at high cardiovascular risk.</p>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 5","pages":"e70311"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extended Use of the Omnipod 5 Automated Insulin Delivery System in Adults With Type 1 Diabetes: 12-Month Extension of a Randomized Controlled Trial.","authors":"Eric Renard, Ruth S Weinstock, Alfred Penfornis, Jean-Pierre Riveline, Charles Thivolet, Trang T Ly","doi":"10.1002/edm2.70321","DOIUrl":"10.1002/edm2.70321","url":null,"abstract":"<p><strong>Background: </strong>The Omnipod 5 Automated Insulin Delivery (AID) System is safe and effective for individuals managing Type 1 diabetes (T1D). Longer-term studies may provide additional evidence of sustained effectiveness and safety of AID system use in T1D.</p><p><strong>Methods: </strong>This 12-month extension study was conducted following a multicenter randomized controlled trial (RCT) where participants used either AID (Omnipod 5) or standard therapy (current non-automated pump therapy) for 13 weeks. Participants in France (n = 76) could transition to or continue with AID for an additional 12 months. Glycemic, safety, and psychosocial outcomes during or at the end of the extension phase were compared with baseline or end of RCT, as appropriate.</p><p><strong>Results: </strong>Seventy-five participants enrolled in the extension phase. From RCT baseline to the end of the extension phase, time in range 70-180 mg/dL increased by 17.9% (p < 0.0001) or 4.3 h/day to 62.3%. Time above range > 180 mg/dL and mean sensor glucose decreased by 17.7% and 27.8 mg/dL (both p < 0.0001), respectively. HbA1c decreased from 8.33% to 7.18% (-1.14%; p < 0.0001). Glycemic improvements were maintained for those continuing with AID from the RCT intervention group and for those transitioning to AID from standard therapy. Diabetes Quality of Life-brief and Hypoglycemia Confidence Scale scores were maintained or improved at 6 and 12 months compared to RCT baseline. Adverse events were infrequent (12 per 100 person-years).</p><p><strong>Conclusions: </strong>Findings support the RCT results, demonstrating safety and sustained improvements in glycemic and psychosocial outcomes with the Omnipod 5 System in adults in France with T1D over 12 months.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT05409131.</p>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 5","pages":"e70321"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Research Landscape on Leptin Resistance and Obesity-Related Metabolic Dysfunction: Trends, Networks and Visualisation Analysis (1995-2025).","authors":"Sa'ed H Zyoud","doi":"10.1002/edm2.70330","DOIUrl":"10.1002/edm2.70330","url":null,"abstract":"<p><strong>Background: </strong>Leptin resistance is closely linked to obesity, insulin resistance, inflammation and cardiometabolic disorders. However, the global research output on leptin resistance and obesity-related metabolic dysfunction has not been mapped in detail. This study aimed to analyse global research trends in this field from 1995 to 2025.</p><p><strong>Methods: </strong>Publications were retrieved from the Scopus database. Bibliometric indicators included annual growth, document type, productive countries, institutions, journals, highly cited publications and international collaboration. VOSviewer version 1.6.21 was used to visualise country collaboration and title-abstract term co-occurrence.</p><p><strong>Results: </strong>A total of 2162 publications were included. Publication output increased substantially across the study period but fluctuated, peaking in 2014 and remaining broadly stable thereafter. Articles were the most common document type (n = 1658; 76.69%), followed by reviews (n = 433; 20.03%). The United States ranked first (n = 741; 34.27%), followed by China (n = 255; 11.79%), Japan (n = 132; 6.11%), Spain (n = 131; 6.06%) and Germany (n = 124; 5.74%). Harvard Medical School was the most productive institution, and Endocrinology was the most active journal. Cowley et al. had the most cited publication, with 2052 citations. Term mapping revealed three main themes: 'clinical metabolic dysfunction and cardiometabolic risk,' 'hypothalamic leptin signalling and energy homeostasis,' and 'body weight regulation and developmental programming.'</p><p><strong>Conclusions: </strong>Research on leptin resistance and obesity-related metabolic dysfunction expanded substantially between 1995 and 2025, although annual output fluctuated and plateaued after its 2014 peak. The maps suggest a broadening of terminology from early leptin biology and experimental models towards inflammatory, cardiometabolic and mechanistic topics; this pattern should not be interpreted as proof of a causal or complete transition. Collaboration remained concentrated among high-output countries.</p>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 5","pages":"e70330"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13521595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Serum Homocysteine and Chronic Kidney Disease Severity in Vietnamese Outpatients With Type 2 Diabetes: A Cross-Sectional Study.","authors":"Loi Ngoc Ho, Tien Van Tran, Tinh Trung Truong Tran, Nhan Trong Le, Loc Huu Quach, Khanh Minh Thanh, Hien Ngoc Tran, Hang Khanh Hoang, Ha Hai Tran, Tuan Quoc Le","doi":"10.1002/edm2.70339","DOIUrl":"10.1002/edm2.70339","url":null,"abstract":"<p><strong>Introduction: </strong>CKD is a major complication of T2DM and a leading cause of end-stage kidney disease. Because urinary albumin-to-creatinine ratio (UACR) and eGFR have recognized limitations, additional biomarkers may help characterize kidney dysfunction. HCY is frequently elevated in CKD and may reflect pathways of renal injury. We evaluated the association of HCY with kidney dysfunction and its cross-sectional discrimination of CKD status in Vietnamese adults with T2DM.</p><p><strong>Methods: </strong>A descriptive cross-sectional study was conducted among adult outpatients with T2DM recruited at UMC HCMC (Campus 2) from December 2023 to December 2025 using convenience sampling. CKD was defined as eGFR < 60 mL/min/1.73 m² and/or UACR > 30 mg/g. HCY and other laboratory parameters were measured using standardized protocols; eGFR was calculated using the 2021 CKD-EPI creatinine-cystatin C equation. Correlation, logistic regression, and ROC analyses were performed. Albuminuria alone was examined in a sensitivity analysis, and AUCs were compared using DeLong's test.</p><p><strong>Results: </strong>Among 201 participants, 164 (81.6%) met the study-defined CKD criteria. HCY was higher in participants with CKD and increased across worsening eGFR and albuminuria categories. HCY correlated more strongly with creatinine and cystatin C (r = 0.67 for both) and eGFR (r = -0.59) than with UACR (r = 0.26). Higher HCY remained associated with CKD after adjustment for age and HbA1c (adjusted OR = 1.27, 95% CI 1.14-1.42). The HCY-only AUC was 0.79; the Youden-derived threshold was 11.35 μmol/L (sensitivity 0.76; specificity 0.78). For albuminuria alone, the association persisted (OR = 1.08, 95% CI 1.03-1.14), but discrimination was modest (AUC = 0.63). The multivariable AUC was 0.812 and did not differ significantly from the HCY-only AUC (DeLong p = 0.325).</p><p><strong>Conclusions: </strong>Higher HCY was associated with CKD and kidney dysfunction, with a stronger relationship to filtration markers than to albuminuria. These cross-sectional findings do not establish screening or prognostic utility. The 11.35 μmol/L threshold is exploratory and requires external validation.</p>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 5","pages":"e70339"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weight Regain Trajectories After Discontinuation of Semaglutide or Tirzepatide: A Reconstructed Aggregate-Data Bayesian Longitudinal Meta-Analysis.","authors":"Chia Siang Kow, Kaeshaelya Thiruchelvam, Dinesh Sangarran Ramachandram, Abdullah Faiz Zaihan","doi":"10.1002/edm2.70325","DOIUrl":"10.1002/edm2.70325","url":null,"abstract":"<p><strong>Background: </strong>Semaglutide and tirzepatide produce substantial weight loss during treatment, but the trajectory of weight regain after discontinuation remains uncertain.</p><p><strong>Objective: </strong>To estimate post-discontinuation weight-regain trajectories and explore predictors of faster regain.</p><p><strong>Methods: </strong>We used published timepoint-level aggregate data from studies evaluating weight change after discontinuation of semaglutide or tirzepatide to perform a Bayesian hierarchical longitudinal re-analysis. The model estimated weight loss at cessation, monthly regain rate, time to 50% regain, and time to return to baseline weight. Bayesian meta-regression examined medication type, magnitude of initial weight loss, and post-discontinuation behavioural or lifestyle support. Longer-term estimates assumed a constant linear regain rate.</p><p><strong>Results: </strong>Six studies comprising 10 intervention arms and 1776 participants were included, with observed follow-up ranging from 4 to 52 weeks. Estimated weight loss at cessation was 15.35 kg (95% credible interval [CrI] 11.18-19.60), followed by regain of 1.04 kg/month (95% CrI 0.80-1.29). Based on the linear model, 50% of initial weight loss was projected to be regained by 7.50 months (95% CrI 5.05-10.57), with return to baseline weight by 15.00 months (95% CrI 10.10-21.13). Tirzepatide showed numerically faster regain than semaglutide in unadjusted analyses, but no clear independent drug-specific difference was evident after adjustment. Greater initial weight loss showed the strongest directional association with faster regain, although the credible interval included zero. Behavioural or lifestyle support was directionally associated with slower regain, but the estimate was imprecise.</p><p><strong>Conclusions: </strong>Weight regain after discontinuation of semaglutide or tirzepatide was rapid and clinically meaningful. Because estimates beyond 52 weeks were model-based extrapolations, they should be interpreted cautiously. Early monitoring and proactive maintenance planning may be warranted after treatment cessation.</p>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 5","pages":"e70325"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasonography Cannot Exclude Osteomyelitis in Diabetic Foot Ulcers: A Cross-Sectional Diagnostic Accuracy Study Against Magnetic Resonance Imaging.","authors":"Maryam Haghighi-Morad, Hadi Vahedi, Arian Yousefi Fard, Behrooz Mohammadkhani Pordanjani, Seyyed Taher Seyyed Mahmoudi","doi":"10.1002/edm2.70320","DOIUrl":"10.1002/edm2.70320","url":null,"abstract":"<p><strong>Background and aims: </strong>Diabetic foot ulcers (DFUs) can lead to amputation, especially when complicated by osteomyelitis (OM) or soft tissue infection. Although MRI is the standard imaging method, ultrasonography (US) is increasingly used because it is more accessible. This study compared the diagnostic performance of US and MRI in DFU-related infections.</p><p><strong>Methods: </strong>In this descriptive cross-sectional study, consecutive adults with diabetes and suspected diabetic foot infection underwent both US and MRI. One ulcer per patient wasanalysed. US was compared with expert clinical assessment for cellulitis and with MRI for abscess and OM, following IWGDF recommendations. Diagnostic measures were calculated overall and by ulcer severity.</p><p><strong>Results: </strong>Among 127 patients, most had advanced Wagner grades (3-5) and forefoot ulcers. Cellulitis was clinically present in all cases; MRI and US concordance with the clinical diagnosis was 100.0% and 99.2%, respectively. For abscesses, US showed 100% sensitivity but low specificity, resulting in moderate accuracy. For OM, US had very poor sensitivity (17.9%) despite high specificity, especially in severe ulcers. MRI detected no OM in moderate-grade ulcers.</p><p><strong>Conclusion: </strong>US showed near-complete concordance with MRI for cellulitis, though this was assessed in a study in which cellulitis was universally present, and US performs poorly for OM and cannot reliably exclude bone infection. It is best used as an initial triage tool, while MRI remains essential when OM is suspected. Because MRI is not a perfect reference standard, the findings reflect diagnostic concordance rather than absolute accuracy and support a tiered imaging approach.</p>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 5","pages":"e70320"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The HEAT Repeat Protein MROH1 Deficiency Leads to Reduced Circulating Thyroid Hormone Levels in Mice.","authors":"Nami Ohuchi, Yoshinori Osaki, Yoshimi Nakagawa, Takafumi Miyamoto, Masaya Araki, Yuhei Mizunoe, Takaaki Matsuda, Yuki Murayama, Yoko Sugano, Hitoshi Iwasaki, Takashi Matsuzaka, Motohiro Sekiya, Hitoshi Shimano","doi":"10.1002/edm2.70348","DOIUrl":"10.1002/edm2.70348","url":null,"abstract":"<p><strong>Introduction: </strong>Systemic metabolism critically depends on thyroid hormones, whose release relies heavily on proper lysosomal function for thyroglobulin degradation. MROH1, a highly conserved mediator of lysosomal membrane fission, is predominantly expressed in the human thyroid gland; however, its physiological role within endocrine systems remains unexplored. This study investigated the impact of MROH1 deficiency on thyroid function using a novel global Mroh1 knockout (KO) mouse model.</p><p><strong>Methods: </strong>Metabolic phenotypes, including body weight and serum biochemical parameters (FT3, FT4, TSH, and cholesterol), were evaluated in male Mroh1-KO mice and their controls. Thyroid architecture and gene expression profiles were investigated via histological analysis and quantitative reverse transcription-PCR (qRT-PCR). Lysosomal function was assessed using immunoblotting and cathepsin L proteolytic activity assays in primary thyroid cells and whole-tissue lysates.</p><p><strong>Results: </strong>Mroh1-KO mice showed reduced circulating thyroid hormone levels characterized by significantly reduced serum FT4 and FT3 levels, a gradual increase in body weight, and hypercholesterolemia. Histological analysis of aged Mroh1-KO mice revealed an altered thyroid architecture, featuring smaller follicle sizes and the replacement of follicles with adipocyte-like structures. Although lysosomal biogenesis and cathepsin L protease activities remained preserved, the expression of key thyroid differentiation regulators (Nkx2-1, Foxe1) and their downstream targets (Tg, Mct8) were significantly downregulated.</p><p><strong>Conclusions: </strong>Global Mroh1 deficiency is associated with reduced circulating thyroid hormone levels, thyroid architectural remodelling, and downregulated thyroid-specific gene expression. These findings demonstrate that MROH1 is important for maintaining thyroid gland hormone homeostasis and structural integrity.</p>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 5","pages":"e70348"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}