Journal of Clinical and Translational Endocrinology最新文献

{"title":"Peripheral sensory neuropathy is associated with circulating angiopoietins in type 2 diabetes patients in Ghana","authors":"Jennifer A. Agyekum ,&nbsp;Kwame Yeboah","doi":"10.1016/j.jcte.2023.100327","DOIUrl":"10.1016/j.jcte.2023.100327","url":null,"abstract":"<div><h3>Objective</h3><p>Peripheral sensory neuropathy (PSN) is a common complication of type 2 diabetes (T2DM) that can lead to frequent ulcerations, lower extremities, and reduced quality of life. Imbalance in the circulating levels of angiogenic growth factors, notably, angiopoietin (Ang)-1, Ang-2 and vascular endothelial growth factor (VEGF) may be among the underlying mechanisms of PSN in T2DM patients. We studied the association between PSN and angiogenic growth factors, Ang-1, Ang-2 and VEGF in T2DM patients in Ghana.</p></div><div><h3>Methods</h3><p>In a case-control study design, PSN was evaluated in 160 patients with T2DM and 108 nondiabetic controls using vibration perception threshold (VPT) and diabetic neurological examination (DNE). The definition of PSN was abnormal VPT (≥25 mV) or the presence of neuropathic symptoms on examination (DNE score &gt; 3). In addition, fasting venous blood samples were collected to measure circulating levels of Ang-1, Ang-2 and VEGF.</p></div><div><h3>Results</h3><p>Compared to non-diabetic controls, patients with T2DM had a higher prevalence of PSN using abnormal VPT (20.6 % vs 2.8 %, p &lt; 0.001) or neuropathic symptoms (35.6 % vs 3.7 %, p &lt; 0.001). Compared to nondiabetic controls, patients with T2DM had increased levels of Ang-2 [597 (274 – 1005) vs 838 (473 – 1241) ng/ml, p = 0.018] and VEGF [48.4 (17.4 – 110.1) vs 72.2 (28 – 201.8), p = 0.025] and decreased Ang-1 levels [41.1 (30 – 57.3) vs 36.1 (24.7 – 42.1) ng/ml, p = 0.01]. In regression analyses, an increase in Ang-1 levels was associated with decreased odds, while an increase in Ang-2 levels was associated with increased odds, of abnormal VPT and neuropathic symptoms in T2DM patients.</p></div><div><h3>Conclusion</h3><p>In our study population, PSN was associated with reduced plasma levels of Ang-1 and increased plasma levels of Ang-2 in patients with T2DM. Therefore, an imbalance of angiopoietins may be associated with PSN in T2DM.</p></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/44/a7/main.PMC10563058.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41222229","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 relationship between diabetic ketoacidosis and suicidal or self-injurious behaviour: A systematic review","authors":"Lina Al Alshaikh ,&nbsp;Anne M. Doherty","doi":"10.1016/j.jcte.2023.100325","DOIUrl":"10.1016/j.jcte.2023.100325","url":null,"abstract":"<div><h3>Background</h3><p>It has been suggested that there may be an association between type 1 diabetes (T1DM) and suicide, with one study reporting a rate 11 times that of the general population The aim of this paper was to investigate the association between Diabetic ketoacidosis (DKA: a life-threatening acute complication of T1DM) and suicidal behaviours in people with T1DM.</p></div><div><h3>Methods</h3><p>We performed a search of the following databases: PubMed, PsychInfo, and Embase for papers which explored the association between suicidal behaviours and self-harm with DKA in T1DM. We excluded case reports and review papers.</p></div><div><h3>Results</h3><p>Only three papers explored the relationship between DKA and self-harm. One study found an association between DKA and self-harm in a national cohort of people with type 1 diabetes and schizophrenia. The second found a significant increase in psychiatric admissions for self-harm following an episode of DKA. The third study reported that patients with diabetes and a history of self-harm were at elevated risk of a range of diabetes complications including DKA. These findings indicate an association between DKA and self-harm and support the guidelines in recommending a psychosocial assessment where DKA cannot be explained.</p></div><div><h3>Conclusions</h3><p>This review suggests that DKA is associated with suicidal or self-injurious behaviours. The small number of studies and the seriousness of this issue highlight the importance of further research on this topic, to improve the evidence base for the identification and treatment of risk of suicidal behaviours in people with T1DM.</p></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10568420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41239773","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":"Novel interactive text-messaging curriculum for endocrinology board review","authors":"Priyanka Majety ,&nbsp;Ayodele Ajayi ,&nbsp;Anna M. Modest ,&nbsp;Maria Vamvini ,&nbsp;Jason A. Freed","doi":"10.1016/j.jcte.2023.100326","DOIUrl":"10.1016/j.jcte.2023.100326","url":null,"abstract":"<div><h3>Background</h3><p>The ABIM certification exam is one of the measures to ensure that physicians have the clinical skills for good care delivery. The 5-year average pass rate for ABIM Endocrinology exam is 82%. The pass rate significantly decreased to a nadir of 74% in 2021 and 2022, lowest of all medicine subspecialties.</p></div><div><h3>Objectives</h3><p>To assess the feasibility of text messaging curriculum for fellows and its utility in improving their test performance.</p></div><div><h3>Methods</h3><p>In 2021, endocrinology fellows from 51 programs across the country were invited to participate in our curriculum. They completed a pre-test, joined a texting group via Remind application and received 1 multiple choice question daily (total n = 78). After 15 weeks, they completed a post-test and survey. Paired results from pre- and post-test were compared.</p></div><div><h3>Results</h3><p>A total of 89 fellows from 27 programs responded. Of these, 82 fellows, predominantly females (n = 60; 73 %), filled out the pre-test. On an average, 42 fellows (SD = 12) responded to the questions daily and 57 % of them answered the questions within 24 h. Thirty fellows completed the post-test. The median number of correct responses on the pre-test was 5 (IQR 3–6), compared to 8 (IQR 6–9) in the post-test. There was a significant improvement (p-value &lt; 0.0001) in fellows’ performance in the post-test when compared with the pre-test following our intervention.</p></div><div><h3>Conclusions</h3><p>Text-messaging based curriculum for exam preparation is feasible and can improve test performance. Fellows find receiving a daily high yield multiple choice question via text-message as a useful tool for exam preparation.</p></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10570572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41239772","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":"Prospective effects of cholecalciferol supplementation on irisin levels in sedentary postmenopausal women: A pilot study","authors":"Luiz Phellipe Dell Aquila ,&nbsp;Armando Morales ,&nbsp;Patricia Moreira ,&nbsp;Maysa Seabra Cendoroglo ,&nbsp;Rosilene Motta Elias ,&nbsp;Maria Aparecida Dalboni","doi":"10.1016/j.jcte.2023.100324","DOIUrl":"10.1016/j.jcte.2023.100324","url":null,"abstract":"<div><h3>Introduction</h3><p>In postmenopausal women, vitamin D deficiency has been associated with disability, low muscle mass and fractures. Irisin is an important myokine that may contribute to the maintenance of muscle and bone density. Vitamin D is associated with the growth and function of muscle tissue through interactions between the vitamin D receptor and PGC-1α and activation of p38/MAPK (mitogen-activated protein kinase) in muscle, a mechanism similar to irisin action. The aim of this pilot study was to evaluate the effects of cholecalciferol supplementation on serum irisin levels in sedentary postmenopausal women with hypovitaminosis D (25(OH)D &lt; 20 ng/mL).</p></div><div><h3>Material and methods</h3><p>80 sedentary postmenopausal women with hypovitaminosis D and low sun exposure were supplemented with cholecalciferol (30,000 IU/month) for 12 months. Calcium, parathyroid hormone, alkaline phosphatase (AP) and irisin levels were measured before and after supplementation.</p></div><div><h3>Results</h3><p>25(OH) vitamin D increased in all participants. Serum levels of irisin increased (from 0.52 ± 0.27 to 0.80 ± 0.53; p &lt; 0.003), accompanied by a decrease in AP (from 80 ± 24 to 66 ± 23; p &lt; 0.001).</p></div><div><h3>Conclusions</h3><p>Restoration of vitamin D status increased serum irisin levels in sedentary postmenopausal women. Whether increased serum irisin levels may have an impact on clinical outcomes deserves further evaluation.</p></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b0/aa/main.PMC10510082.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41180665","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":"Characteristics, staging and outcomes of differentiated thyroid cancer in patients with and without Graves’ disease","authors":"Chaitra Gopinath ,&nbsp;Hanna Crow ,&nbsp;Sujata Panthi ,&nbsp;Leonidas Bantis ,&nbsp;Kenneth D. Burman ,&nbsp;Chitra Choudhary","doi":"10.1016/j.jcte.2023.100321","DOIUrl":"10.1016/j.jcte.2023.100321","url":null,"abstract":"<div><h3>Background</h3><p>The incidence of thyroid cancer has increased over the last three decades with studies showing incidence of thyroid cancer is higher among patients with Graves’ Disease (GD) when compared to Toxic multinodular goiter.¹ We conducted a retrospective study to further investigate characteristics and outcomes in patients with thyroid cancer and GD.</p></div><div><h3>Methods</h3><p>We retrospectively reviewed 62 patients with a diagnosis of Differentiated Thyroid Cancer (DTC). We compared age at diagnosis, type, size of tumor, radioactive iodine (RAI) use, and DTC recurrence amongst patients with GD, non-GD patients. We used Chi-square to test for independence among categorical variables at a nominal level of 0.05; comparison was based on <em>t</em>-test.</p></div><div><h3>Results</h3><p>Out of 62 patients, 29 patients had GD and DTC (47%). 94% had papillary thyroid cancer. Patients with GD were diagnosed with DTC at a younger age (mean 46 years) in comparison to patients without GD (mean 53 years). There was no difference in the type of DTC. Patients with GD had significantly smaller tumor size (mean size 1.035 cm; p value = 0.002), more Stage 1 and 2 compared to patients without GD (p-value = 0.009). Both groups of patients had similar rates of recurrence on follow up and RAI use.</p></div><div><h3>Conclusion</h3><p>We found patients with GD had smaller tumor size, early-stage DTC when compared to patients without GD and potentially favorable prognosis. More data is needed to understand whether this is due to pathogenesis like Graves antibodies promoting tumor formation or merely earlier detection of DTC in GD.</p></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/20/b3/main.PMC10400462.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9956318","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":"Combined CFTR modulator therapies are linked with anabolic benefits and insulin-sparing in cystic fibrosis-related diabetes","authors":"Fabian Lurquin ,&nbsp;Sophie Gohy ,&nbsp;Michel P. Hermans ,&nbsp;Vanessa Preumont","doi":"10.1016/j.jcte.2023.100320","DOIUrl":"10.1016/j.jcte.2023.100320","url":null,"abstract":"<div><h3>Aims</h3><p>Combined CFTR modulator therapies have dramatically altered pulmonary outcomes in patients with cystic fibrosis (CF). Their impact on glucose metabolism requires further investigations. This study aims to evaluate insulin requirements after initiation of combined CFTR modulator therapy in patients with CF-related diabetes (CFRD) and HOMA indices changes in CF patients without diabetes.</p></div><div><h3>Methods</h3><p>We retrospectively analyzed: 1) the effects of tezacaftor + ivacaftor and elexacaftor + tezacaftor + ivacaftor on FEV₁, weight, BMI, HbA1c, and daily insulin dose, in 17 CFRD patients and 2) the impact of tezacaftor + ivacaftor on HOMA indices in 15 CF patients without diabetes.</p></div><div><h3>Results</h3><p>Age was 37±12y in the CFRD group (70% men), 88% of whom were homozygous for F508del mutation. Diabetes duration was 15±10y. Median duration of combined CFTR modulator therapy was 16 months (IQR: 4) Thirteen patients received tezacaftor + ivacaftor, of whom 9 were switched to elexacaftor + tezacaftor + ivacaftor. Four patients received elexacaftor + tezacaftor + ivacaftor up front. A decrease in insulin needs was noticed in 88% of patients (0.85±0.3 <em>vs</em> 0.71±0.3U/kg/day; <em>p = 0001</em>). Total daily insulin dose decreased from 50±16 to 44±20U/day (<em>p = 0.017</em>). BMI improved (20.9 (IQR: 1.90) <em>vs</em> 22.1 kg/m² (IQR: 3.70); <em>p = 0.014</em>). HbA1c went from 7.3±1.1 to 7.7±1.6% (<em>p = 0.072</em>). Median age was 22y (IQR: 11) in the CF group without diabetes (67% men), 93% of whom were homozygous for F508del mutation. Duration of combined CFTR modulator therapy was 10±5 months. HOMA-B changes were not significant (129.2 (IQR: 84.8) <em>vs</em> 103.5% (IQR: 66.3) nor were HOMA-S changes (from 94±64 to 95±49%). HOMA-BxS decreased from 112±45 to 104±29% (NS). BMI rose from 21.9±3 to 23.1±3.5 kg/m² (<em>p = 0.047</em>). HbA1c was unchanged (5.0±0.5%). FEV₁ improved in both groups (+11% and + 7% of predicted value; <em>p &lt; 0.001</em>; <em>p = 0.013</em>).</p></div><div><h3>Conclusion</h3><p>Combined CFTR modulator therapies are correlated with a decrease in insulin doses and positive effects on BMI and FEV₁. HOMA indices did not change on tezacaftor + ivacaftor among CF patients without diabetes.</p></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4d/c0/main.PMC10336243.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9877690","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":"Reproducibility of in-home CFRD screening using continuous glucose monitoring and mixed meal tolerance test","authors":"Katherine Kutney ,&nbsp;Beth A. Kaminski ,&nbsp;Terri Casey ,&nbsp;MaryAnn O'Riordan ,&nbsp;Rose Gubitosi-Klug","doi":"10.1016/j.jcte.2023.100323","DOIUrl":"10.1016/j.jcte.2023.100323","url":null,"abstract":"<div><h3>Background</h3><p>Cystic fibrosis related diabetes (CFRD) is associated with insulin-remediable pulmonary decline, so early detection is critical. Continuous glucose monitors (CGM) have shown promise in screening but are not recommended by clinical practice guidelines. Little is known about the reproducibility of CGM results for a given patient.</p></div><div><h3>Methods</h3><p>Twenty non-insulin treated adults and adolescents with CF placed an in-home CGM and wore it for two 14-day periods. Participants underwent a mixed meal tolerance test (MMTT) on day 5 of each 14-day period. Glycemic data from CGM 1 and CGM 2 were compared regarding published thresholds to define abnormality: percent time &gt;140 mg/dL of ≥4.5%, percent time &gt;140 mg/dL of &gt;17.5%, and percent time &gt;180 mg/dL of &gt;3.4%. Results of the repeat MMTT were compared for peak glucose and 2-hour glucose thresholds: &gt;140 mg/dL, &gt;180 mg/dL, and &gt;200 mg/dL.</p></div><div><h3>Results</h3><p>For percent time &gt;140 mg/dL of ≥ 4.5%, five of 20 subjects had conflicting results between CGM 1 and CGM 2. For percent time &gt;140 mg/dL of &gt;17.5% and &gt;180 mg/dL of &gt;3.4%, only one of 20 subjects had conflicting results between CGM 1 and CGM 2. On the MMTT, few participants had a 2-hour glucose &gt;140 mg/dL. Peak glucose &gt;140 mg/dL, 180 mg/dL, and 200 mg/dL were more common, with 10–37% of participants demonstrating disagreement between CGM 1 and CGM 2.</p></div><div><h3>Conclusions</h3><p>Repeated in-home CGM acquisitions show reasonable reproducibility regarding the more stringent thresholds for time &gt;140 mg/dL and &gt;180 mg/dL. More data is needed to determine thresholds for abnormal mixed meal tolerance tests in CFRD screening.</p></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/98/e6/main.PMC10495624.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10252210","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":"Dysglycemia in non-functioning pancreatic neuroendocrine tumors (NF-PNET): Further insights into an under recognized entity","authors":"Esther Osher ,&nbsp;Ravit Geva ,&nbsp;Ido Wolf ,&nbsp;Karen Tordjman ,&nbsp;Joseph Klausner ,&nbsp;Yael Sofer ,&nbsp;Erez Scapa ,&nbsp;Oren Shibolet ,&nbsp;Dana Ben –Ami Shor ,&nbsp;Iddo Bar-Yishay ,&nbsp;Nir Lubezky ,&nbsp;Yaacov Goykhman ,&nbsp;Guy Lahat ,&nbsp;Oz Yakir ,&nbsp;Sharon Pelles ,&nbsp;Asaf Aizic ,&nbsp;Arye Blachar ,&nbsp;Naftali Stern ,&nbsp;Yona Greenman","doi":"10.1016/j.jcte.2023.100322","DOIUrl":"10.1016/j.jcte.2023.100322","url":null,"abstract":"<div><h3>Objective</h3><p>Pancreatic neuroendocrine tumors (PNETs) are rare, but their incidence has risen significantly in recent years. Whereas diabetes mellitus (DM) is recognized in association with chronic pancreatitis and pancreatic cancer, it has not been well-characterized concerning non-functioning (NF)-PNETs.</p><p>Study aim<strong>:</strong> <!-->to determine whether NF-PNETs are associated with DM/ Pre-DM and characterize the features of this putative association.</p></div><div><h3>Methods</h3><p>Retrospective study to evaluate rate of Pre-DM /DM in subjects with NF-PNETs.</p></div><div><h3>Results</h3><p>Study cohort of 129 patients with histologically confirmed NF-PNETs, ∼60% were men (M/F: 77/52). Abnormal glucose metabolism that preceded any treatment was seen in 70% of this cohort: overt DM in 34% and Pre-DM in 36% of the subjects. However, during follow-up, the overall prevalence rose to 80.6%, owing exclusively to newly diagnosed DM in subjects who received treatment.</p><p>Patients with DM/Pre-DM were older (65 ± 11; 54 ± 14; p &lt; 0.0001), the tumor was more commonly localized in the pancreatic body and tail (76.5% vs. 23.5% p = 0.03), while BMI (27 ± 6 vs. 28 ± 5 kg/m2), and tumor size (2.4 ± 2 vs. 2.9 ± 3.2 cm) were similar. The relative prevalence of DM in our cohort of NF-PNETs was 1.6 higher than that in the age and gender-adjusted general Israeli population (95 %CI: 1.197–2.212p = 0.03).</p></div><div><h3>Conclusions</h3><p>We found a high rate of impaired glucose metabolism, either DM or Pre-DM, in a large cohort of NF-PNETs. The high prevalence of diabetes/pre-diabetes was unrelated to obesity or tumor size. This observation should increase awareness of the presence of DM on presentation or during treatment of “NF”-PNETs.</p></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2b/82/main.PMC10470380.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10506073","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":"Symptomatic versus asymptomatic primary hyperparathyroidism: A systematic review and meta-analysis","authors":"Pallavi Kulkarni ,&nbsp;Jacqueline Tucker ,&nbsp;Tonya King ,&nbsp;David Goldenberg","doi":"10.1016/j.jcte.2023.100317","DOIUrl":"10.1016/j.jcte.2023.100317","url":null,"abstract":"<div><h3>Purpose</h3><p>Primary hyperparathyroidism (PHPT) is the underlying etiology for 90% of patients with hypercalcemia. PHPT patients have traditionally been characterized as being symptomatic or asymptomatic. However, we submit that even “asymptomatic” patients may still have clinical features, posing the idea of coining asymptomatic disease as a misnomer. This paper presents a systematic review and meta-analysis elucidating the differences between asymptomatic and symptomatic PHPT in the literature.</p></div><div><h3>Methods</h3><p>A comprehensive literature search was conducted in PubMed, Cochrane, and Web of Science databases for articles published from 2012 to 2022. Inclusion criteria consisted of all studies comparing symptomatic and asymptomatic PHPT patients. Two reviewers independently evaluated the literature using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The level of evidence was determined using the Oxford Center for Level of Evidence-Based Medicine. Data were extracted, and a meta-analysis was performed. I² <!-->index was employed for heterogeneity.</p></div><div><h3>Results</h3><p>There were 18 studies included, with a total of 4238 patients. The average age of patients included was 56.37, with 25.7% of the cohort being male. Several studies reported clinical features even for the “asymptomatic” group. Patients in the symptomatic group tended to have higher levels of PTH and calcium. The asymptomatic group had greater levels of vitamin D. There was observed heterogeneity between the studies.</p></div><div><h3>Conclusions</h3><p>More extreme PTH, calcium values, and low vitamin D levels were seen in patients with symptomatic disease. However, asymptomatic patients occasionally exhibited clinical features. Therefore, the terminology of “asymptomatic” disease is likely inappropriate for these patients.</p></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10114222/pdf/main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9386642","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":"Differences in positive expectancy of hybrid closed loop (HCL) insulin delivery systems do not explain racial differences in HCL use","authors":"Jody B. Grundman ,&nbsp;Amanda Perkins ,&nbsp;Maureen Monaghan ,&nbsp;Seema Meighan ,&nbsp;Randi Streisand ,&nbsp;Brynn E. Marks","doi":"10.1016/j.jcte.2023.100319","DOIUrl":"10.1016/j.jcte.2023.100319","url":null,"abstract":"<div><h3>Aims</h3><p>Hybrid closed loop (HCL) insulin delivery systems improve glycemia and quality of life among youth with type 1 diabetes (T1D), however there are inequities in use. We aimed to evaluate whether differences in positive expectancy of HCL systems may explain differences in use.</p></div><div><h3>Methods</h3><p>Fifteen publicly-insured, non-Hispanic Black (NHB) youth with hemoglobin A1_C (HbA1c) ≥ 10% enrolled in a study exploring changes in glycemia and person reported outcomes (PRO) during 6 months of Tandem t:slim X2 insulin pump with Control-IQ technology. At baseline youth and parents completed PROs, including Insulin Delivery Systems: Perceptions, Ideas, Reflections and Expectations (INSPIRE) survey assessing positive expectancy of HCL use, and Problem Areas in Diabetes (PAID) survey assessing diabetes-related distress. Differences between this cohort and the Tandem Control-IQ pediatric pivotal trial (DCLP5) cohort were assessed.</p></div><div><h3>Results</h3><p>As compared to the DCLP5 cohort (0% NHB, 10% publicly-insured), baseline glycemic indicators were suboptimal (M_HbA1c 11.9 ± 1.4% vs 7.6 ± 0.9%, p &lt; 0.0001; continuous glucose monitor (CGM) time-above-range &gt; 180 mg/dL 82 ± 15% vs 45 ± 18%, p &lt; 0.0001). INSPIRE scores in both cohorts were equally high among youth (80 ± 10 vs 77 ± 13, p = 0.41) and parents (88 ± 14 vs 85 ± 11, p = 0.37). PAID scores were higher among parents (68 ± 19 vs 43 ± 16, p &lt; 0.0001), but not youth (43 ± 16 vs 35 ± 16, p = 0.09) in the historically marginalized cohort as compared to the DCLP5 cohort.</p></div><div><h3>Conclusions</h3><p>Despite differences in glycemic control and diabetes related burden, positive expectancy of HCL systems is comparable among historically marginalized youth with T1D and the predominantly non-Hispanic White, privately insured DCLP5 cohort. These findings suggest that differences in perceptions of HCL technology may not explain inequities in use.</p></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/11/3d/main.PMC10238440.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9576905","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}