Endocrinologia Diabetes Y Nutricion最新文献

{"title":"Frailty and overtreatment in older adults with type 2 diabetes in an Argentine health system","authors":"Ignacio Martingano,&nbsp;María Pilar Lopez Gutierrez,&nbsp;Azul Milena Maccio,&nbsp;Mariana Andrea Burgos,&nbsp;Gastón Perman,&nbsp;María Paula Russo,&nbsp;María Florencia Grande Ratti","doi":"10.1016/j.endien.2026.501745","DOIUrl":"10.1016/j.endien.2026.501745","url":null,"abstract":"<div><h3>Objectives</h3><div>To describe the clinical and sociodemographic characteristics of people aged 65 years or older with type 2 diabetes mellitus, estimate the prevalence of frailty, and explore its association with metabolic control and pharmacological regimens used.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional study with consecutive sampling of patients, active members of an integrated health service network in Argentina as of March 1st, 2022. Frailty was assessed using the Electronic Screening Index of Frailty, considering frail those with ≥ 9 coded clinical conditions. Glycemic control was defined according to individualized HbA1c goals (&lt;7% non-frail, &lt;8% frail), and overtreatment as the use of drugs with a high risk of hypoglycemia (insulin, sulfonylureas, and/or glinides) in patients at goal.</div></div><div><h3>Results</h3><div>A total of 5,937 individuals (mean age, 78 years; 20% older than 85 years) were included. Hypertension and dyslipidemia were the most prevalent comorbidities, and 68% had polypharmacy. Frailty was 8.92% (95%CI, 8.21–9.68), doubling in individuals older than 85 years. Frail patients had more chronic complications and achieved glycemic goals more frequently (57% vs 42%), but at the expense of greater use of risky drugs (37% vs 20%) and overtreatment (23.7% vs 5.9%; aOR, 5.00; 95%CI, 3.88–6.45).</div></div><div><h3>Conclusions</h3><div>Frailty was associated with a higher risk of overtreatment. It is essential to implement individualized management strategies, deprescribing, and adjusting goals according to functional status. Based on this real-world evidence, we seek to contribute elements for a critical review of current policies and strategies in Latin America.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"73 6","pages":"Article 501745"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ectopic ACTH-producing pheochromocytoma in a patient with an APC gene mutation: A case report","authors":"Sara Gil dos Santos,&nbsp;Raquel Calheiros,&nbsp;Daniela Salazar,&nbsp;Joana Oliveira,&nbsp;Manuel Fernandes,&nbsp;Ana Luísa Cunha,&nbsp;Catarina Santos,&nbsp;Sofia Conde,&nbsp;António Verdelho,&nbsp;Ana Paula Santos","doi":"10.1016/j.endien.2026.501741","DOIUrl":"10.1016/j.endien.2026.501741","url":null,"abstract":"<div><div>ACTH-producing pheochromocytomas are rare. Familial adenomatous polyposis (FAP), caused by mutations in the <em>Adenomatous Polyposis Coli</em> (<em>APC</em>) gene, increases the risk of colorectal neoplasia, as well as adrenal lesions. This is the case of a 21-year-old male presenting with a 10<!--> <!-->cm right adrenal mass and rapidly progressive Cushing's syndrome (CS). Biochemical workup confirmed ACTH-dependent CS and catecholamine excess and a ⁶⁸Ga-DOTA-NOC PET/CT showed SSR expression limited to the adrenal mass. Methyrapone and alpha/beta blockade were initiated, followed by right adrenalectomy. Histopathology confirmed an ACTH-secreting pheochromocytoma (pheochromocytoma of the adrenal gland scaled score – PASS: 16; grading system for adrenal pheochromocytoma and paraganglioma – GAPP: 8). A truncating germline mutation in the APC gene (c.6189_6190del) was detected, associated with attenuated FAP. This is, to our knowledge, the first case ever reported of an ACTH-producing pheochromocytoma in a patient with an APC gene mutation. This case raises the possibility of a broader phenotypic spectrum in FAP and highlights the importance of vigilance for unusual tumor presentations in hereditary cancer syndromes.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"73 6","pages":"Article 501741"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corticotropin-secreting pheochromocytoma: A case report","authors":"Pedro Iglesias,&nbsp;Juan González González,&nbsp;Emiliano González-Vioque,&nbsp;Cesáreo Corbacho","doi":"10.1016/j.endien.2026.501728","DOIUrl":"10.1016/j.endien.2026.501728","url":null,"abstract":"<div><div>Corticotropin (ACTH)-secreting pheochromocytomas are rare neuroendocrine tumors that combine catecholamine and cortisol excess, posing major diagnostic and therapeutic challenges. We report the case of a 38-year-old man with hypertension, episodic adrenergic symptoms, and biochemical evidence of elevated metanephrines and ACTH-dependent hypercortisolism. Imaging revealed a right adrenal mass compatible with pheochromocytoma, but metaiodobenzylguanidine (MIBG) scintigraphy was negative. After preoperative preparation with alpha- and beta-blockade and intraoperative steroid coverage, the patient underwent laparoscopic adrenalectomy. Histopathology confirmed pheochromocytoma with focal ACTH expression and malignant potential (PASS 5). Postoperatively, he required transient glucocorticoid replacement and achieved normotension without antihypertensives. This case illustrates the complexity of diagnosing and managing ACTH-secreting pheochromocytomas, highlights the need for careful preoperative stabilization, and underscores the importance of multidisciplinary follow-up to detect recurrence and manage adrenal insufficiency.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"73 6","pages":"Article 501728"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endocrinology at the epicenter of metabolic associated steatotic liver disease","authors":"Miguel Ángel Rubio-Herrera,&nbsp;Javier Escalada San Martín","doi":"10.1016/j.endien.2026.501847","DOIUrl":"10.1016/j.endien.2026.501847","url":null,"abstract":"","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"73 6","pages":"Article 501847"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between low free T4 values and prevalence of tinnitus in US adults: 2009–2012","authors":"Weiyu Zhang,&nbsp;Yongtao Xiao","doi":"10.1016/j.endien.2026.501726","DOIUrl":"10.1016/j.endien.2026.501726","url":null,"abstract":"<div><h3>Purpose</h3><div>Tinnitus is a prevalent subjective auditory sensation affecting over 740 million people worldwide and often co-occurs with various systemic diseases. To date, the relationship between tinnitus and thyroid hormones has not been thoroughly studied. This study aimed to investigate the association between tinnitus and thyroid hormone levels in US adults.</div></div><div><h3>Methods</h3><div>We used data from the 2009–2012 National Health and Nutrition Examination Survey (NHANES). A total of 1527 participants were included and stratified by the presence or absence of tinnitus. Logistic regression analysis was performed to assess the association between thyroid hormone levels and tinnitus. Furthermore, subgroup analyses were performed to explore the relationship between FT4 levels and tinnitus in different subgroups.</div></div><div><h3>Results</h3><div>Each 1<!--> <!-->ng/dL increase in FT4 was associated with approximately 67% lower odds of tinnitus (adjusted OR, 0.33; 95%CI, 0.11–0.94, <em>p</em> <!-->=<!--> <!-->0.0387). FT3 and TSH showed no significant association with tinnitus after adjustment.</div></div><div><h3>Conclusion</h3><div>Lower FT4 levels were independently associated with higher tinnitus prevalence.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"73 6","pages":"Article 501726"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary hepatic gastrinoma as a clinical mimic: Favorable clinical outcomes","authors":"David Sanchis-Pascual,&nbsp;Luis de Miguel-Rodríguez,&nbsp;Pilar Morillas-Amat,&nbsp;Jorge Hernando,&nbsp;Alejandro García-Álvarez,&nbsp;Stefania Landolfi,&nbsp;Fernando Guerrero-Pérez,&nbsp;María Isabel Del Olmo-García,&nbsp;Jaume Capdevila","doi":"10.1016/j.endien.2026.501769","DOIUrl":"10.1016/j.endien.2026.501769","url":null,"abstract":"<div><div>Gastrinomas are functional neuroendocrine tumors characterized by autonomous gastrin secretion, which leads to acid hypersecretion and chronic diarrhea. They are most widely located in the duodenum or pancreas, while primary hepatic gastrinomas are exceptionally rare. At diagnosis, most cases already present with liver metastases.</div><div>We present the case of a 19-year-old man with a 2-year history of chronic diarrhea and epigastric discomfort. Imaging revealed the presence of a 12<!--> <!-->cm hepatic mass without extrahepatic involvement. Functional PET/CT with ⁶⁸Ga-DOTATOC showed intense uptake confined to the liver. Lab test results included markedly elevated gastrin and chromogranin A levels. Core needle biopsy confirmed a well-differentiated NET G2 positive for gastrin. Treatment with long-acting somatostatin analogs led to rapid symptom improvement, and the patient was ultimately cured following surgical resection of the hepatic tumor. Although rare, primary hepatic gastrinomas should be considered in the differential diagnosis of functional NETs with isolated liver lesions.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"73 6","pages":"Article 501769"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time in range and its association with sudomotor dysfunction in individuals with type 1 diabetes mellitus","authors":"Ismael A. Quintal-Medina,&nbsp;Rossy S. López-Prieto,&nbsp;Karen A. Romero-Torres,&nbsp;Ana Cristina Garcia Ulloa,&nbsp;Francisco J. Gómez-Pérez,&nbsp;Paloma Almeda-Valdes","doi":"10.1016/j.endien.2026.501758","DOIUrl":"10.1016/j.endien.2026.501758","url":null,"abstract":"<div><h3>Introduction</h3><div>Time in range (TIR), a novel metric to evaluate glycemic control, is relevant to predict microvascular complications of diabetes. Sudomotor dysfunction is among the earliest findings detectable in diabetic peripheral neuropathy (DPN). This study aimed to evaluate the relationship between TIR obtained from continuous glucose monitoring (CGM) and sudomotor function evaluated by SUDOSCAN in subjects with type 1 diabetes mellitus (T1DM).</div></div><div><h3>Materials and methods</h3><div>We enrolled 90 individuals with T1DM. All of them underwent SUDOSCAN and 14-day CGM. SUDOSCAN measured feet electrochemical skin conductance (FESC), and sudomotor dysfunction was defined as average FESC<!--> <!-->&lt;<!--> <!-->70<!--> <!-->μS. Logistic regressions were applied to examine the independent association between TIR and glycated hemoglobin (HbA1c) and sudomotor function.</div></div><div><h3>Results</h3><div>The overall prevalence of sudomotor dysfunction was 65.6%. Patients with sudomotor dysfunction showed a decreased level of TIR (53.3<!--> <!-->±<!--> <!-->17.4% vs 64.4<!--> <!-->±<!--> <!-->12.7%, <em>P</em> <!-->&lt;<!--> <!-->.05). No significant differences in HbA1c were observed between the groups with and without sudomotor dysfunction (median 8.1% [65<!--> <!-->mmol/mol] vs 7.6% [60<!--> <!-->mmol/mol]; <em>P</em> <!-->=<!--> <!-->.094). Correlation analysis showed that the relationship between TIR and FESC was stronger than between HbA1c and FESC. Finally, logistic regression revealed that TIR was inversely associated with the risk of sudomotor dysfunction detected by SUDOSCAN (<em>P</em> <!-->&lt;<!--> <!-->.05).</div></div><div><h3>Conclusions</h3><div>TIR is a glycemic control target inversely associated with sudomotor dysfunction assessed by SUDOSCAN in T1DM regardless of HbA1c.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"73 6","pages":"Article 501758"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum miR-21 and miR-192 levels in type 2 diabetes: Association with albuminuria and renal function","authors":"Nosaiba M. Abd Alrahim ,&nbsp;Alshaymaa A. Abd Elalim ,&nbsp;Enas A. Farrag ,&nbsp;Shimaa M. Abdel-Kareem ,&nbsp;Sahar SaadEldeen Shaban ,&nbsp;Aya A. Eldamanhory ,&nbsp;Sammar Ahmed Kasim ,&nbsp;Radwa M. Fath Allah ,&nbsp;Fatma I. Mayah ,&nbsp;Aya A. Ghamry ,&nbsp;Sabah M. Alkhawagah ,&nbsp;Emad Gamil Khidr","doi":"10.1016/j.endien.2026.501721","DOIUrl":"10.1016/j.endien.2026.501721","url":null,"abstract":"<div><h3>Background and aims</h3><div>Albuminuria is a widely used clinical marker for diabetic nephropathy (DN); however, its limited sensitivity and specificity in detecting early renal alterations highlight the need for additional indicators. MicroRNAs (miRNAs) are emerging as molecular regulators involved in the pathogenesis of DN and may provide insight into early renal involvement in type 2 diabetes mellitus (T2DM). This study aimed to evaluate the serum expression levels of miR-21 and miR-192 in normo- and microalbuminuric patients with T2DM, and explore their associations with metabolic and renal parameters.</div></div><div><h3>Methods</h3><div>This case–control study included 104 individuals, including 60 patients with T2DM and 44 age- and sex-matched healthy controls. Individuals with diabetes were further classified into 30 normoalbuminuric and 30 microalbuminuric individuals based on the urinary albumin-to-creatinine ratio. Serum levels of miR-21 and miR-192 were quantified using real-time quantitative reverse transcription PCR.</div></div><div><h3>Results</h3><div>Both miR-21 and miR-192 were significantly upregulated in Patients with T2DM vs healthy controls. Notably, miR-21 expression exhibited a stepwise increase from normo- to microalbuminuria and showed strong correlations with metabolic and renal parameters, including HbA1c, ACR, and lipid profile. In ROC analysis, miR-21 demonstrated better discriminative ability between study groups vs miR-192.</div></div><div><h3>Conclusion</h3><div>Serum miR-21 may reflect early renal involvement in patients with T2DM. Its progressive increase with albuminuria and strong associations with clinical parameters suggest potential value as a supportive molecular indicator in the early evaluation of diabetic nephropathy. Further prospective studies are needed to validate its clinical applicability.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"73 5","pages":"Article 501721"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147865393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypoglycemia in older adults with type 2 diabetes mellitus: Prevalence and associated risk factor: A systematic review and meta-analysis","authors":"Yuelin Wang ,&nbsp;Yunlan Jiang ,&nbsp;Le Li ,&nbsp;Hong Chen ,&nbsp;Jing Wang ,&nbsp;Mengjie Zhang ,&nbsp;Xiaoyu Bai ,&nbsp;Senlin Wu","doi":"10.1016/j.endien.2026.501759","DOIUrl":"10.1016/j.endien.2026.501759","url":null,"abstract":"<div><h3>Background</h3><div>Currently, hypoglycemia poses a critical challenge in managing older patients with type 2 diabetes mellitus (T2DM), threatening their long-term health and overall well-being. This meta-analysis is the first to comprehensively quantify the pooled prevalence of hypoglycemia and identify its key influencing factors specifically in the elderly population.</div></div><div><h3>Methods</h3><div>We conducted a systematic study across 11 databases to identify relevant observational studies reporting the prevalence of hypoglycemia or its influencing factors. The search was limited from database inception all the way until July 9th, 2025, and updated November 13th, 2025. In addition, we conducted a meta-analysis of the overall prevalence of hypoglycemia and its influencing factors using Stata 17.0 and RevMan 5.4, respectively.</div></div><div><h3>Results</h3><div>Among the 37 studies included, the overall prevalence of hypoglycemia in elderly patients with T2DM was 21% (95%CI, 20–23%). The results of this meta-analysis showed that age, diabetes duration, insulin treatment, hypertension, malignant tumors, renal impairment, cognitive dysfunction, and glycosylated hemoglobin were the key determinants influencing the risk of hypoglycemia in the elderly T2DM population.</div></div><div><h3>Conclusion</h3><div>Early clinical risk assessment is essential for older adults with type 2 diabetes mellitus at high risk of hypoglycemic complications, along with the implementation of evidence-based diagnostic and therapeutic protocols for hypoglycemia management.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"73 5","pages":"Article 501759"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147865419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lipodystrophies: A diagnostic and therapeutic challenge","authors":"David Araújo-Vilar,&nbsp;Antía Fernández-Pombo","doi":"10.1016/j.endien.2026.501825","DOIUrl":"10.1016/j.endien.2026.501825","url":null,"abstract":"","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"73 5","pages":"Article 501825"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147865391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}