Journal of Clinical and Translational Endocrinology最新文献

{"title":"False negative rate and concordance of ThyGeNEXT®+ThyraMIR® testing with post-thyroidectomy histopathology","authors":"Sobrina S. Mohammed ,&nbsp;Daniel Mettman ,&nbsp;Mariana Garcia-Touza ,&nbsp;Maricel Ridella ,&nbsp;Betty Drees","doi":"10.1016/j.jcte.2025.100396","DOIUrl":"10.1016/j.jcte.2025.100396","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to assess the false negative rate (FNR) and concordance of pre-operative ThyGeNEXT®+ThyraMIR® testing in Bethesda category III-V thyroid nodules by comparing results with post-surgical histopathology in thyroid cancer.</div></div><div><h3>Methods</h3><div>A retrospective review was conducted on 19 patients with Bethesda III-V thyroid nodules who underwent ThyGeNEXT®+ThyraMIR® testing followed by total thyroidectomy with histopathology confirming thyroid cancer. Fine needle aspiration (FNA) cytology, molecular test results, post-surgical histopathology and comprehensive genomic profiling reports (when available) were examined. Concordance was assessed by comparing pre-operative test results (mutations or malignant miRNA expression) to post-surgical histopathology. Discrepancies were further explored using Tempus xT genomic profiling for additional mutations and evaluation of tumor heterogeneity. The FNR was calculated accordingly.</div></div><div><h3>Results</h3><div>FNR was 10.5 % and there was a high positive concordance with 89.5 % of cases testing positive for mutations or malignant miRNA classifiers. TERT c.-146C&gt;T, NRAS Q61R, and BRAF V600E were among mutations identified. Comprehensive genomic profiling clarified false negatives, revealing insights into the impact of tumor heterogeneity. The miRNA classifier proved effective in detecting malignancy, in cases with subthreshold and RAS mutations or without common genetic alterations. Reliable results were obtained from diverse specimen types.</div></div><div><h3>Conclusions</h3><div>The low false-negative rate and positive concordance with histopathology highlights the utility of ThyGeNEXT® + ThyraMIR® in enhancing risk stratification and guiding personalized management of indeterminate thyroid nodules and thyroid cancer.</div></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":"40 ","pages":"Article 100396"},"PeriodicalIF":4.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of hypothyroidism with the combination of levothyroxine and slow-release triiodothyronine: a randomized clinical trial","authors":"F. Azizi ,&nbsp;A.S. Moeini ,&nbsp;L. Mehran ,&nbsp;S. Masoumi ,&nbsp;H. Abdi ,&nbsp;S.M. Foroutan ,&nbsp;A.E. Saghafinia ,&nbsp;A. Amouzegar","doi":"10.1016/j.jcte.2025.100395","DOIUrl":"10.1016/j.jcte.2025.100395","url":null,"abstract":"<div><h3>Background</h3><div>Some patients with hypothyroidism lack satisfaction with levothyroxine (LT4) monotherapy, which may be related to lower serum triiodothyronine (T3) and T3/T4 ratios compared to control individuals. This study aimed to evaluate the efficacy and safety of a combination therapy of slow-release T3 (SRT3) and LT4 in patients with primary hypothyroidism compared with LT4 monotherapy.</div></div><div><h3>Methods</h3><div>Thirty-two hypothyroid women were randomized into two groups of SRT3 + LT4 combination and LT4 monotherapy. Group one received a combination of 15 µg SRT3 and 75 µg LT4, and group two received 100 µg LT4 daily for 8 weeks. Clinical and biochemical measurements were performed at baseline and 4 to 8 weeks after intervention.</div></div><div><h3>Results</h3><div>There were no significant changes in serum levels of fT4, T3, TSH, and T3/fT4 ratio in the LT4 group at the end of 4 to 8 weeks of study. A statistically significant decrease in fT4 and TSH, and an increase in serum T3 and the T3/fT4 ratio, were observed in the SRT3 + LT4 group. The T3/fT4 ratio reached comparable values to those in normal subjects, 93.63 ± 23.25 vs 95.06 ± 19.44 ng/ng, respectively. The rise in the T3/fT4 ratio 8 weeks after SRT3 + LT4 treatment was between 21 % and 90 % in 10 patients and 1 % and 13 % in 5 patients, with no change in one patient.</div></div><div><h3>Conclusion</h3><div>The novel combination of SRT3 + LT4 therapy resulted in a significant increase in serum T3 and the T3/fT4 ratio in hypothyroid patients compared to those receiving LT4 monotherapy. The rise in the T3/fT4 ratio was ≥ 21 % in two-thirds of patients; the lack of a significant increase in the T3/fT4 ratio in some patients during SRT3-LT4 combination therapy demands further investigation.</div></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":"40 ","pages":"Article 100395"},"PeriodicalIF":4.2,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143904509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of total and bioactive serum sclerostin levels with bone metabolism in type 2 diabetes mellitus","authors":"Cyril Traechslin ,&nbsp;Lilian Sewing ,&nbsp;Sandra Baumann ,&nbsp;Leticia Grize ,&nbsp;Janina Vavanikunnel ,&nbsp;Marius Kraenzlin ,&nbsp;Christoph Henzen ,&nbsp;Christian Meier","doi":"10.1016/j.jcte.2025.100393","DOIUrl":"10.1016/j.jcte.2025.100393","url":null,"abstract":"<div><h3>Background</h3><div>Sclerostin has been associated with decreased bone turnover in patients with type 2 diabetes mellitus (T2DM). The relationship with bone turnover markers (BTMs) and bone mineral density (BMD) remains unclear. We investigate the relationship between total and bioactive sclerostin measured by three different assays with BTMs and BMD in patients with T2DM compared to healthy controls.</div></div><div><h3>Methods</h3><div>Baseline data from the cross-sectional multicenter DiabOS-study in Switzerland were analysed. Total and bioactive serum sclerostin levels were measured using three different ELISA-based sclerostin assays (Sclerostin Biomedica, Sclerostin bioactive Biomedica and Sclerostin hsTECO). Sclerostin levels in patients with T2DM and controls were correlated with BTMs and BMD.</div></div><div><h3>Results</h3><div>Data were analysed from 78 men and postmenopausal women with T2DM and 37 controls (aged 50–75 years). Serum sclerostin levels, adjusted for estimated glomerular filtration rate (eGFR), were higher in patients with T2DM compared to controls with all three assays. In a gender subgroup analysis, bioactive sclerostin levels remained significantly elevated in men with T2DM (T2DM, 106.8 ± 39.9 pmol/L; controls, 88.3 ± 21.3 pmol/L, p = 0.03).</div><div>Univariate analysis showed consistent significant correlations with all sclerostin assays for age, eGFR, glycated hemoglobin A1c and diabetes duration. However, in multivariate analysis, eGFR remained the only significant determinant of serum sclerostin levels. Sclerostin levels in patients with T2DM showed significant positive correlations with BMD but no significant correlations with BTMs.</div></div><div><h3>Conclusions</h3><div>We demonstrate a significant positive association of bioactive serum sclerostin with BMD at all measured sites in patients with T2DM, which may support its utility in the assessment of bone fragility in this population.</div></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":"40 ","pages":"Article 100393"},"PeriodicalIF":4.2,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143820467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of GIP and GLP-1 infusion on bone resorption in glucose intolerant, pancreatic insufficient cystic fibrosis","authors":"Wang Shin Lei ,&nbsp;XianYan Chen ,&nbsp;Lingyu Zhao ,&nbsp;Tanicia Daley ,&nbsp;Bradley Phillips ,&nbsp;Michael R. Rickels ,&nbsp;Andrea Kelly ,&nbsp;Joseph M. Kindler","doi":"10.1016/j.jcte.2025.100392","DOIUrl":"10.1016/j.jcte.2025.100392","url":null,"abstract":"<div><h3>Context</h3><div>Diabetes and bone disease are common in cystic fibrosis (CF) and primarily occur alongside exocrine pancreatic insufficiency (PI). “Incretins,” glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide 1 (GLP-1), augment insulin secretion and regulate bone metabolism. In CF, PI dampens the incretin response. Loss of the insulinotropic effect of GIP in CF was recently identified, but effects on bone are unknown.</div></div><div><h3>Objective</h3><div>Determine effects of incretins on bone resorption markers in adults with PI-CF.</div></div><div><h3>Design</h3><div>Secondary analysis of a mechanistic double-blinded randomized placebo-controlled crossover trial including adults ages 18–40 years with PI-CF (n = 25).</div></div><div><h3>Intervention</h3><div>Adults with PI-CF received either GIP (4 pmol/kg/min) or GLP-1 (1.5 pmol/kg/min) infusion, followed by double-blind randomization to either incretin or placebo infusion. Non-CF healthy controls received double-blind GIP (4 pmol/kg/min) or placebo. Serum C-terminal telopeptide (CTX), a bone resorption marker, was assessed during the infusion over 80 (GIP) or 60 (GLP-1) minutes.</div></div><div><h3>Main Outcome Measures</h3><div>CTX (mg/dL) concentrations.</div></div><div><h3>Results</h3><div>In PI-CF, CTX decreased during GIP infusion, but not during placebo (time-by-treatment interaction P &lt; 0.01). GLP-1 did not affect CTX. In non-CF healthy controls, time-by-treatment interaction was not significant (P = 0.23), but CTX decreased during GIP (P = 0.02) but not placebo (P = 0.47).</div></div><div><h3>Conclusions</h3><div>GIP evokes a bone anti-resorptive effect in people with PI-CF. Since the incretin response is perturbed in PI-CF, and an infusion of GIP lowers bone resorption, the “gut-bone axis” in CF-related bone disease requires attention.</div></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":"40 ","pages":"Article 100392"},"PeriodicalIF":4.2,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143825630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Germline genetic variants in young-onset sporadic pituitary macroadenomas: A multigene panel analysis","authors":"Leonor M. Gaspar ,&nbsp;Catarina I. Gonçalves ,&nbsp;Ema L. Nobre ,&nbsp;Fernando Fonseca ,&nbsp;Cláudia Amaral ,&nbsp;João S. Duarte ,&nbsp;Luísa Raimundo ,&nbsp;Catarina Saraiva ,&nbsp;Luísa Cortez ,&nbsp;Olinda Marques ,&nbsp;Manuel C. Lemos","doi":"10.1016/j.jcte.2025.100389","DOIUrl":"10.1016/j.jcte.2025.100389","url":null,"abstract":"<div><div>Mutations in several genes have been associated with familial forms of pituitary adenomas. Sporadic pituitary adenomas (i.e. with no family history or coexistent endocrine tumours) are also occasionally found to result from germline mutations in these genes, especially in young patients with larger tumours. The aim of this study was to determine the frequency of germline mutations in patients with young-onset sporadic pituitary macroadenomas. A cohort of 225 Portuguese patients with sporadic pituitary macroadenomas diagnosed before the age of 40 years was studied by whole exome sequencing (WES) followed by the analysis of a virtual panel of 29 genes that have been associated with predisposition to pituitary adenomas. Pathogenic and likely pathogenic variants were identified in 16 (7.1 %) of patients. The affected genes were <em>AIP</em> (n = 4), <em>PMS2</em> (n = 4), <em>MEN1</em> (n = 2), <em>VHL</em> (n = 2), <em>CDH23</em> (n = 1), <em>MSH2</em> (n = 1), <em>SDHB</em> (n = 1), and <em>TP53</em> (n = 1). In patients diagnosed under the ages of 30 and 18 years, the frequency of pathogenic and likely pathogenic variants increased to 9.0 % and 12.0 %, respectively. This is so far the largest multigene analysis of patients with young-onset sporadic pituitary macroadenomas. We confirmed the <em>AIP</em> as the most frequently involved gene, but also uncovered rarer genetic causes of pituitary adenomas. The results may contribute to a better understanding of the genetic landscape of these tumours and help to decide which genes to include in the genetic screening of patients with young-onset pituitary macroadenomas.</div></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":"40 ","pages":"Article 100389"},"PeriodicalIF":4.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143800247","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":"Cholesterol and triglyceride concentrations following 12–18 months of clinically prescribed elexacaftor-tezacaftor-ivacaftor—PROMISE sub-study","authors":"Rosara Bass ,&nbsp;Michael Stalvey ,&nbsp;George Solomon ,&nbsp;Steven Rowe ,&nbsp;David Nichols ,&nbsp;Sarah Jane Schwarzenberg ,&nbsp;Steven Freedman ,&nbsp;Rachel Walega ,&nbsp;Andrea Kelly","doi":"10.1016/j.jcte.2025.100391","DOIUrl":"10.1016/j.jcte.2025.100391","url":null,"abstract":"<div><h3>Background/Aims</h3><div>People with CF (PwCF) have low total, high, and low density lipoprotein cholesterol (TC, HDL-C and LDL-C) and historically have had low prevalence of cardiovascular disease. More recently, cases of acute myocardial infarction are reported in PwCF. The impact of elexacaftor-tezacaftor-ivacaftor (ETI) on cholesterol and triglyceride (TG) concentrations, traditional cardiometabolic risk factors, is unknown.</div></div><div><h3>Methods/Results</h3><div>TC, LDL-C, HDL-C, and TG concentrations were analyzed from participants enrolled in the observational PROMISE study of clinically prescribed ETI prior to and 12–18 months after initiation. Pre-ETI and follow-up concentrations were compared, and relationships between TC, LDL-C, HDL-C and TG and clinical factors were tested using linear mixed-effect models.</div><div>Fasting samples were available for 51 participants (25 M/26F, median age 17.4 y) with pancreatic exocrine insufficiency at baseline and 12–18 months after ETI initiation. TC and HDL-C were higher after 12–18 mo ETI in an unadjusted model, but with adjustment for BMI-Z, only HDL-C remained significantly higher at follow up (p &lt; 0.05). Low HDL-C was the most common abnormality (&gt;50 %), but prevalence of participants meeting criteria for low HDL-C did not differ between timepoints.</div></div><div><h3>Conclusions</h3><div>In a population of youth and young adults with CF, TC and HDL-C were higher after 12–18 months of ETI, but differences in TC were attenuated with adjustment for BMI-Z. Prevalence of low HDL-C was high at both timepoints.</div></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":"40 ","pages":"Article 100391"},"PeriodicalIF":4.2,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143800194","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":"Prediction of BRAF and TERT status in PTCs by machine learning-based ultrasound radiomics methods: A multicenter study","authors":"Hui Shi ,&nbsp;Ke Ding ,&nbsp;Xue Ting Yang ,&nbsp;Ting Fan Wu ,&nbsp;Jia Yi Zheng ,&nbsp;Li Fan Wang ,&nbsp;Bo Yang Zhou ,&nbsp;Li Ping Sun ,&nbsp;Yi Feng Zhang ,&nbsp;Chong Ke Zhao ,&nbsp;Hui Xiong Xu","doi":"10.1016/j.jcte.2025.100390","DOIUrl":"10.1016/j.jcte.2025.100390","url":null,"abstract":"<div><h3>Background</h3><div>Preoperative identification of genetic mutations is conducive to individualized treatment and management of papillary thyroid carcinoma (PTC) patients. <em>Purpose</em>: To investigate the predictive value of the machine learning (ML)-based ultrasound (US) radiomics approaches for BRAF V600E and TERT promoter status (individually and coexistence) in PTC.</div></div><div><h3>Methods</h3><div>This multicenter study retrospectively collected data of 1076 PTC patients underwent genetic testing detection for BRAF V600E and TERT promoter between March 2016 and December 2021. Radiomics features were extracted from routine grayscale ultrasound images, and gene status-related features were selected. Then these features were included to nine different ML models to predicting different mutations, and optimal models plus statistically significant clinical information were also conducted. The models underwent training and testing, and comparisons were performed.</div></div><div><h3>Results</h3><div>The Decision Tree-based US radiomics approach had superior prediction performance for the BRAF V600E mutation compared to the other eight ML models, with an area under the curve (AUC) of 0.767 versus 0.547–0.675 (p &lt; 0.05). The US radiomics methodology employing Logistic Regression exhibited the highest accuracy in predicting TERT promoter mutations (AUC, 0.802 vs. 0.525–0.701, p &lt; 0.001) and coexisting BRAF V600E and TERT promoter mutations (0.805 vs. 0.678–0.743, p &lt; 0.001) within the test set. The incorporation of clinical factors enhanced predictive performances to 0.810 for BRAF V600E mutant, 0.897 for TERT promoter mutations, and 0.900 for dual mutations in PTCs.</div></div><div><h3>Conclusion</h3><div>The machine learning-based US radiomics methods, integrated with clinical characteristics, demonstrated effectiveness in predicting the BRAF V600E and TERT promoter mutations in PTCs.</div></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":"40 ","pages":"Article 100390"},"PeriodicalIF":4.2,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143767914","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":"Testicular function and fertility outcomes in males with CF: A multi center retrospective study of men with congenital bilateral absence of the vas deferens based on CFTR mutation status","authors":"Rossella Cannarella ,&nbsp;Danielle Velez Leitner ,&nbsp;Marissa Weiss ,&nbsp;Sarah C. Vij","doi":"10.1016/j.jcte.2025.100388","DOIUrl":"10.1016/j.jcte.2025.100388","url":null,"abstract":"<div><h3>Background</h3><div>Modern cystic fibrosis (CF) treatments, particularly CFTR modulators, have allowed males with CF (MwCF) to live longer, healthier lives and pursue parenthood. Approximately 98% of MwCF have congenital bilateral absence of the vas deferens (CBAVD). While research shows MwCF experience spermatogenic dysfunction alongside obstructive azoospermia, understanding male reproductive health in MwCF remains limited. This study retrospectively examines testicular function and intracytoplasmic sperm injection outcomes of the partners of males with CBAVD, stratified by CF mutation status (CF, CF carriers, no known mutation).</div></div><div><h3>Subjects and Methods</h3><div>This multicenter, retrospective study assessed sperm retrieval outcomes and testicular function in males with CBAVD. Participants were categorized into three groups: MwCF (Group 1), CFTR gene mutation carriers (CFTR carriers, Group 2), and CBAVD males without CFTR mutations (Group 3). We collected data on genetic testing, testicular hormone levels (FSH, LH, total testosterone), sperm retrieval methods, and reproductive outcomes. Statistical analysis was used to assess intergroup differences.</div></div><div><h3>Results</h3><div>Thirty subjects were included (Group 1: 14, Group 2: 11, Group 3: 5). No significant differences in demographic, anthropometric, or reproductive characteristics were found across groups. Hormone levels (LH, FSH, and testosterone) were similar among groups. In Group 1, 42 % had elevated FSH levels. The prevalence of hypogonadism was 16.7 % in Group 1. Group 3 had a significantly lower fertilization rate (p &lt; 0.01), but no differences were found in blastocyst formation, pregnancy, miscarriage, or live birth rates.</div></div><div><h3>Conclusions</h3><div>Our data support the presence of primary spermatogenic dysfunction in some MwCF. However, reproductive outcomes were similar across all groups.</div></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":"40 ","pages":"Article 100388"},"PeriodicalIF":4.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735198","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":"Variables associated with endogenous hyperinsulinism in hypoglycemia diagnosis. Could the 72-hour fasting test be shortened in low-risk patients?","authors":"Tomás González-Vidal ,&nbsp;Óscar Lado-Baleato ,&nbsp;Inés Masid ,&nbsp;Carmen Gándara-Gutiérrez ,&nbsp;Gema Martínez-Tamés ,&nbsp;Jessica Ares ,&nbsp;Carmen Lambert ,&nbsp;María Riestra-Fernández ,&nbsp;Francisco Gude ,&nbsp;Elías Delgado ,&nbsp;Edelmiro Menéndez-Torre","doi":"10.1016/j.jcte.2025.100386","DOIUrl":"10.1016/j.jcte.2025.100386","url":null,"abstract":"<div><h3>Background</h3><div>The 72-hour fasting test remains the standard for the diagnosis of endogenous hyperinsulinism. We investigated which variables could identify patients at low risk for endogenous hyperinsulinism, in whom a shortening of the 72-hour fasting test could be considered.</div></div><div><h3>Methods</h3><div>This multicenter, retrospective study included 64 individuals (46 women, median age 45 years) without diabetes who underwent 72-hour fasting tests for the etiologic diagnosis of hypoglycemia. Pre- and intra-test variables were collected, including point-of-care glucose trajectories during the test. Testing was stopped before 72 h if symptomatic serum glucose &lt;55 mg/dL or asymptomatic serum glucose ≤45 mg/dL occurred. Endogenous hyperinsulinism was diagnosed in individuals who had serum glucose &lt;55 mg/dL, serum insulin ≥3.0 μU/mL, and serum C-peptide ≥0.6 ng/mL.</div></div><div><h3>Results</h3><div>Patients with endogenous hyperinsulinism (n = 10) had steeper descending point-of-care glucose trajectories (p &lt; 0.001) than those without it. Older age and lower minimum pre-test serum glucose concentrations were independently associated with endogenous hyperinsulinism. A calculator for probability prediction of endogenous hyperinsulinism was developed including these variables and sex (AUC = 0.94). Older age, female sex, lower body mass index, and lower minimum point-of-care glucose during the first 24 h of fasting were independently associated with serum glucose &lt;55 mg/dL after the first 24 h of fasting. A calculator for predicting probability of serum glucose &lt;55 mg/dL after the first 24 h of fasting was developed including these variables (AUC = 0.84).</div></div><div><h3>Conclusions</h3><div>Pre- and intra-test variables can identify individuals at low risk for endogenous hyperinsulinism, in whom shortening the 72-hour fasting test could be considered.</div></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":"40 ","pages":"Article 100386"},"PeriodicalIF":4.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143580392","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":"Urinary DcR2/Cr level predicts renal outcomes in patients with diabetic kidney disease","authors":"Jia Chen ,&nbsp;Weidong Wang ,&nbsp;Fang Yu ,&nbsp;Xiaoyue Wang ,&nbsp;Yani He ,&nbsp;Kehong Chen","doi":"10.1016/j.jcte.2025.100387","DOIUrl":"10.1016/j.jcte.2025.100387","url":null,"abstract":"<div><div>In diabetic kidney disease (DKD), urinary decoy receptor 2 (uDcR2) levels are associated with tubulointerstitial fibrosis; however, whether uDcR2 can predict renal outcomes remains unclear. Herein, we analyzed the association between uDcR2 and renal outcomes (defined as a composite of a serum creatinine (SCr) increase of 50 % from baseline, or initiation of dialysis for end-stage renal disease) in 153 patients with biopsy-proven DKD. Patients were divided into the composite (n = 67) and no composite (n = 86) outcome groups. uDcR2 levels were measured using ELISA. The area under the receiver operating characteristic curve (AUC) for uDcR2 in discriminating DKD renal outcomes was calculated. Kaplan–Meier survival analysis and multifactorial Cox regression models evaluated the association between uDcR2 levels and renal outcomes. Renal DcR2 mRNA and protein expression were detected using in situ hybridization and immunohistochemical staining. Immunofluorescence revealed DcR2 and α-SMA colocalization. uDcR2/Cr levels were higher in patients in the composite than the no composite outcome group. uDcR2/Cr levels positively correlated with ACR, SCr, interstitial fibrosis and tubular atrophy (IFTA), and negatively correlated with eGFR. uDcR2/Cr had an AUC of 0.825 at the optimal cut-off value of 389 ng/gCr. Addition of uDcR2/Cr to ACR, eGFR, or IFTA improved renal outcome predictions. Renal survival was significantly lower at uDcR2/Cr ≥ 389 ng/gCr. Patients in the composite group had higher tubular DcR2 mRNA and protein level percentages. α-SMA was significantly increased in DcR2-positive renal tubules and their surroundings. Overall, uDcR2/Cr is an independent predictor of renal outcomes, with potential for improving the prevention and treatment of DKD.</div></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":"40 ","pages":"Article 100387"},"PeriodicalIF":4.2,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548540","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}