Journal of Endocrinological Investigation最新文献

{"title":"Thyroid function and frailty in hospitalized older adults: the role of FT3 and FT3/FT4 ratio.","authors":"Rosaria M Ruggeri, Luca Balbo, Fabio Malacarne, Federica Bellone, Alfredo Campennì, Antonino Catalano, Giuseppe Mandraffino, Salvatore Cannavò, Angela Alibrandi, Giorgio Basile","doi":"10.1007/s40618-026-03049-1","DOIUrl":"https://doi.org/10.1007/s40618-026-03049-1","url":null,"abstract":"<p><strong>Introduction: </strong>Frailty is a crucial factor in managing older adults, given its strong predictive power for adverse health outcomes. Recent attention has focused on the relationship between frailty and thyroid function, particularly the so-called low T3 syndrome. However, the relationship between frailty and peripheral thyroid hormone metabolism remains under-investigated.</p><p><strong>Methods: </strong>This cross-sectional study included 112 patients hospitalized in a single-centre geriatric unit. Data on thyroid function, cognitive performance (MMSE), handgrip strength, and comorbidities were collected. Frailty was assessed using the Rockwood Frailty Index (FI), with FI > 0.25 indicating frailty.</p><p><strong>Results: </strong>The study population (58 men, 54 women; median age 81 years) showed mild cognitive impairment (MMSE median 22.0; IQR 18.0-26.3) and reduced handgrip strength (13 kg; 10-20 kg). Median FI was 0.304 (0.196-0.383), and 62.5% of patients were frail. Frail patients were older and had significantly lower MMSE scores, weaker handgrip strength, and poorer renal function. FT3 levels and the FT3/FT4 ratio were significantly lower in frail than non-frail patients (P = 0.001 and P = 0.005, respectively). Increasing FT3/FT4 quartiles were associated with progressively lower FI values and frailty prevalence (P = 0.032 and P for trend = 0.042, respectively). In multivariable analysis, age (P = 0.017), MMSE (P < 0.001), and the FT3/FT4 ratio (P = 0.016) were independently associated with FI.</p><p><strong>Conclusion: </strong>Lower FT3 levels and FT3/FT4 ratios were associated with greater frailty in hospitalized older adults. Prospective studies are warranted to validate their clinical utility as biomarkers of frailty.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroendocrine regulation of adipose partitioning in polyendocrine metabolic ovarian syndrome: the gut-brain-adipose axis.","authors":"Irmak Gunesli, Seren Aksun, Bulent Okan Yildiz","doi":"10.1007/s40618-026-03047-3","DOIUrl":"https://doi.org/10.1007/s40618-026-03047-3","url":null,"abstract":"<p><strong>Purpose: </strong>Polyendocrine Metabolic Ovarian Syndrome (PMOS), formerly polycystic ovary syndrome (PCOS), is a common, complex, and heterogeneous endocrine disorder characterized by reproductive and metabolic dysregulation that significantly increases long-term cardiometabolic risk. Growing evidence indicates that dysregulated adipose tissue partitioning, resulting in preferential visceral and ectopic fat accumulation, is a major determinant of metabolic dysfunction in PMOS. The presence of metabolic abnormalities in lean women with PMOS further suggests that mechanisms beyond obesity and total fat mass contribute to disease pathophysiology. This review aims to examine the potential role of gut-brain-adipose signaling in adipose tissue distribution and insulin resistance in PMOS.</p><p><strong>Methods: </strong>This narrative review synthesizes current evidence on the gut-brain-adipose axis and its potential role in adipose tissue distribution and metabolic dysfunction in PMOS, with particular emphasis on oxytocin, glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP), leptin, and other gut- and adipose-derived mediators.</p><p><strong>Results: </strong>The gut-brain-adipose axis represents a neuroendocrine network regulating appetite, energy homeostasis, and adipose tissue function. Within this framework, oxytocin and glucagon-like peptide-1 (GLP-1), alongside gut- and adipose-derived mediators including glucose-dependent insulinotropic polypeptide (GIP), leptin, and other adipokines, may also contribute to these processes. Evidence demonstrating altered fasting and postprandial oxytocin and GLP-1 responses in women with PMOS suggests that impaired neuroendocrine signaling may be associated with dysregulated adipose partitioning and could contribute to visceral and ectopic fat accumulation and increasing metabolic risk.</p><p><strong>Conclusion: </strong>This review discusses the gut-brain-adipose axis as a conceptual framework for understanding how neuroendocrine signaling influences adipose tissue distribution and insulin resistance in PMOS. Further understanding of the gut-brain-adipose axis may help identify potential therapeutic targets for improving metabolic health in women with PMOS.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Worse muscle mass loss in adrenal Cushing syndrome vs. Cushing's disease: a comparative evaluation of chemiluminescence and LC-MS/MS cortisol assessment.","authors":"Siyu Yan, Keyang Wu, Wantong Han, Lina Chang, Yian Gu, Linlin Kong, Xin Wang, Jieying Wan, Hequn Sang, Hengjie Yuan, Shaofang Tang, Ming Liu, Qing He","doi":"10.1007/s40618-026-03045-5","DOIUrl":"https://doi.org/10.1007/s40618-026-03045-5","url":null,"abstract":"<p><strong>Purpose: </strong>Muscle mass loss is a serious complication of Cushing's syndrome. This study aims to compare muscle mass loss between two subtypes of Cushing's syndrome and to evaluate the clinical value of comprehensive LC-MS/MS steroid profiling alongside chemiluminescence (CL).</p><p><strong>Method: </strong>In a retrospective cohort of 78 premenopausal women (37 Cushing's disease [CD] and 41 adrenal Cushing syndrome [ACS]), clinical features, muscle mass, and 11 steroid hormones were compared. In addition, the independent associations between muscle mass index (appendicular skeletal muscle mass/height squared, ASM/height²) and endocrine variables was analyzed. ROC curve analysis was applied to evaluate the predictive utility of CL and LC-MS/MS cortisol for muscle depletion.</p><p><strong>Result: </strong>The serum and urinary cortisol, serum ACTH, testosterone, androstenedione, dehydroepiandrosterone, dehydroepiandrosterone-sulphate and cortisone concentrations with CD were higher than those with ACS, and the muscle mass with CD was also higher compared with ACS. In the fully adjusted multivariable linear regression model, serum cortisol maintained a negative trend with ASM/height², while BMI and Cushing's subtype served as primary independent determinants. In the CL group, the AUC was 0.717. In the LC-MS/MS group, the AUC was 0.728.</p><p><strong>Conclusion: </strong>In premenopausal women, the muscle mass with CD is significantly higher than that with ACS. This may indicate a higher severity of myopathy in ACS patients. Muscle wasting in Cushing's syndrome represents a multifactorial process driven by mechanical load, subtype-specific androgen status, and cortisol exposure. Furthermore, CL cortisol offers a reliable, accessible first-line assessment tool, while LC-MS/MS provides added value through multi-steroid profiling.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between androgenic profile and cardiometabolic risk factors in young men: insights from a large observational cohort study.","authors":"Davide Menafra, Cristina de Angelis, Francesco Garifalos, Paolo Chiodini, Nunzia Verde, Mariangela Piscopo, Giacomo Galdiero, Antonio De Fraia, Alessandro Mazzarella, Nicola Di Paola, Chiara Simeoli, Mariarosaria Negri, Claudia Pivonello, Riccardo Giannella, Stefano Zarrilli, Annamaria Colao, Rosario Pivonello","doi":"10.1007/s40618-026-03037-5","DOIUrl":"https://doi.org/10.1007/s40618-026-03037-5","url":null,"abstract":"<p><strong>Purpose: </strong>The current single-center, retrospective, observational cohort study with a cross-sectional design was conducted to evaluate the association between androgenic profile and metabolic cardiovascular risk (mCVR) factors and to explore whether testosterone deficiency was associated with an unfavourable cardiometabolic profile in a large community-recruited cohort of 659 young men aged 18-35 years.</p><p><strong>Methods: </strong>Participants underwent comprehensive assessment of anthropometric, biochemical, clinical, and hormonal parameters.</p><p><strong>Results: </strong>Body mass index (BMI), expression of generalized obesity, waist circumference (WC), expression of abdominal/visceral obesity, diastolic blood pressure (DBP) and triglycerides (TG) significantly and progressively decreased and high-density lipoprotein (HDL)-cholesterol significantly increased across total testosterone (TT) tertiles. Similarly, weight, BMI, WC, systolic blood pressure (SBP), DBP and TG significantly decreased and HDL-cholesterol significantly increased across SHBG tertiles. Weight and adiposity-related anthropometric parameters, namely BMI and WC, significantly and progressively decreased across calculated free testosterone (cFT) tertiles. Spearman correlation analysis showed that TT and SHBG were significantly and negatively correlated with weight (r=-0.149, r=-0.154), BMI (r=-0.204, r=-0.165), WC (r=-0.234, r=-0.225), SBP (r=-0.112, r=-0.142) and TG (r=-0.117, r=-0.204), and significantly and positively correlated with HDL-cholesterol (r = 0.167, r = 0.251). Additionally, SHBG was significantly and negatively correlated with DBP (r=-0.173). cFT was significantly and negatively correlated with age (r=-0.108) and BMI (r=-0.132). In a multiple linear regression analysis in models adjusted for age, BMI and WC, TT and SHBG were independently associated with HDL-cholesterol (β = 0.151, β = 0.186), and SHBG was independently associated with SBP (β=-0.177) and DBP (β=-0.204). Men with testosterone below the normal range (Hypo-T group) showed a significantly higher prevalence of generalized obesity and abdominal obesity than men with testosterone within the normal range (Normal-T group). Conversely, Overweight/Obese men exhibited significantly lower TT and a significantly higher prevalence of testosterone deficiency than Normal-Weight men.</p><p><strong>Conclusion: </strong>In young adult men, androgenic profile was found to be robustly associated with mCVR factors; however, causality and temporal directionality cannot be inferred because of the cross-sectional design of the study.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing diagnosis and management of patients with ENPP1 deficiency: an expert opinion.","authors":"Irene Bruno, Luisa De Sanctis, Nadia Edvige Foligno, Federica Giambò, Stefano Mora, Mattia Parolin, Giuseppe Vezzoli","doi":"10.1007/s40618-026-02843-1","DOIUrl":"10.1007/s40618-026-02843-1","url":null,"abstract":"<p><strong>Purpose: </strong>Ectonucleotide pyrophosphate/phosphodiesterase family member 1 (ENPP1) deficiency is a rare genetic disorder caused by loss-of-function ENPP1 gene mutations. Characterized by abnormally low circulating inorganic pyrophosphate concentrations, bone hypomineralization, soft tissue calcification, and arterial stenosis, ENPP1 deficiency is associated with a phenotypic spectrum that includes generalized arterial calcification of infancy type 1 (GACI1) and autosomal recessive hypophosphatemic rickets type 2 (ARHR2). Despite phenotypic differences, patients with GACI1 and ARHR2 have a marked, lifelong physical and emotional burden, with a negative impact on quality of life.</p><p><strong>Methods: </strong>A scientific board, comprising seven specialist physicians (endocrinologists, nephrologists, and pediatricians) practicing in Italy, held two virtual meetings to exchange knowledge regarding real-world clinical experience of GACI1 and ARHR2 using case examples, and to discuss strategies on how to increase disease awareness and optimize the diagnosis and management of these patients.</p><p><strong>Results: </strong>Five real-world clinical cases are described. The specialist physicians also provide guidance for optimizing the management pathway for patients with ENPP1 deficiency. Early identification of the clinical signs of disease, in combination with comprehensive diagnostic and follow-up testing, is essential for effective patient management.</p><p><strong>Conclusion: </strong>Early and accurate identification of ENPP1 deficiency by healthcare providers and comprehensive diagnostic testing is essential for the effective management of patients with GACI1 and ARHR2. Consistent follow-up is key to preventing complications and adverse outcomes. Although treatment options are limited, novel therapies are currently under clinical development.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":"2627-2639"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of concordance between basal LH/FSH ratio and testosterone levels on pregnancy outcomes in patients with PCOS undergoing IVF-ET cycle: a retrospective cohort study.","authors":"Hongyi Xu, Jingyou Li, Si Qing Yin, Qi Chen, Jiarong Tian, Xin Chen, Xin Zhang, Xin Li, Honglu Diao, Ying Zhang","doi":"10.1007/s40618-026-02902-7","DOIUrl":"10.1007/s40618-026-02902-7","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association of testosterone levels on ovarian stimulation response in PCOS patients-stratified by serum LH/FSH ratio-undergoing IVF-ET.</p><p><strong>Methods: </strong>A total of 1,354 PCOS patients who underwent fresh embryo transfer were ultimately included in the study. we analyzed and classified it according to the basal LH/FSH ratio values into the following groups: the LH/FSH ≥ 2 group (412 cases) and the LH/FSH < 2 group (942 cases). According to the value of basal serum T level, there were 488 cases in the high T group (> 0.75 ng/ml) and 866 cases in the non-high T group (≤ 0.75 ng/ml), and the outcomes of embryo transfer cycles were compared among the patients in each group.</p><p><strong>Results: </strong>Based on the LH/FSH ratio and testosterone (T) levels, patients were divided into four groups: Group A (LH/FSH < 2, T ≤ 0.75 ng/ml), Group B (LH/FSH < 2, T > 0.75 ng/ml), Group C (LH/FSH ≥ 2, T ≤ 0.75 ng/ml), and Group D (LH/FSH ≥ 2, T > 0.75 ng/ml). There were no statistically significant differences in embryo quality among the four groups (P > 0.05). Regarding pregnancy outcomes, Group B had the lowest live birth rate (51.56%), which was significantly lower than those of Group A (61.87%), Group C (59.79%), and Group D (68.10%)(P ≤ 0.05). Meanwhile, Group B had the highest miscarriage rate (22.38%), significantly higher than the other three groups (10.98%, 12.43%, and 12.90%) (P ≤ 0.05). After adjusting for confounding factors, logistic regression analysis using Group A as the reference showed that Group B had a significantly increased risk of miscarriage (OR = 2.200, 95% CI = 1.325-3.653, P = 0.002) and a significantly lower live birth rate (OR = 0.719, 95% CI = 0.520-0.994, P = 0.046).</p><p><strong>Conclusion: </strong>In patients with PCOS, a high LH/FSH ratio accompanied by elevated testosterone levels was not strongly associated with the likelihood of achieving a live birth. However, in the subgroup with an LH/FSH ratio ≤ 2, elevated testosterone levels may be associated with a reduced likelihood of live birth and an increased risk of miscarriage.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":"2855-2864"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lactobacillus gasseri alleviates type 2 diabetes via modulation of gut microbiota-host metabolic networks.","authors":"Jiancheng Zhang, Ruixue Li, Lin Zhu, Ali Danish Alvi, Linjie Fan, Ye Zhao","doi":"10.1007/s40618-026-02962-9","DOIUrl":"10.1007/s40618-026-02962-9","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) is a multifactorial metabolic disorder characterized by insulin resistance, dyslipidemia and inflammation. Although probiotics have shown potential in improving glycemic control in T2DM, the systemic mechanisms underlying their therapeutic effects remain largely unclear.</p><p><strong>Methods: </strong>A high glucose-induced insulin-resistant zebrafish model was established to explore the interventional effects of Lactobacillus gasseri GDMCC AM63 (L. gasseri). Biochemical assays combined with untargeted metabolomics were used to comprehensively evaluate the efficacy of L. gasseri intervention.</p><p><strong>Results: </strong>L. gasseri intervention significantly reduced fasting blood glucose levels, inhibited the expression of pro-inflammatory cytokines (tnfα and il-6), and upregulated the anti-inflammatory cytokine il-10. Metabolomic profiling identified 210 shared annotated DAMs in pairwise comparisons (T2DM_vs_control (Ctrl) group, and L. gasseri intervention (LG)_vs_T2DM group), which were mainly involved in lipid, amino acid, and carbohydrate metabolism. Pathway enrichment analysis showed significant enrichment of glycerophospholipid, fructose-mannose, pentose phosphate, riboflavin, and linoleic acid metabolic pathways. After FDR correction, 27 shared annotated significant DAMs (SDAMs) were identified. Integrated metabolomics and network pharmacology analysis suggested that L. gasseri may exert a therapeutic effect on T2DM by indirectly regulating signaling pathways such as PI3K/Akt and JAK/STAT. Randomforest analysis highlighted 18R-Hepe and Azii as potential metabolic biomarkers with predictive value.</p><p><strong>Conclusion: </strong>This study systematically investigated the metabolic regulatory mechanisms by which L. gasseri ameliorates T2DM, providing experimental evidence to support its potential as an effective interventional strategy for improving insulin resistance and related metabolic dysfunctions.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":"2995-3015"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"4-Methylumbelliferone for type 1 diabetes therapy: evidence for β-cell protection via EGFR/PI3K/Akt signaling.","authors":"Shuo Yang, Shanshan Zhu, Xinwen Yu, Wencheng Zhang, Xin Wang, Yuxin Jin, Weiting Wang, Guohong Zhao, Bin Gao","doi":"10.1007/s40618-026-02964-7","DOIUrl":"10.1007/s40618-026-02964-7","url":null,"abstract":"<p><strong>Purpose: </strong>Type 1 diabetes mellitus (T1DM) results from autoimmune-mediated destruction of pancreatic β-cells, leading to absolute insulin deficiency. Current treatments rely on insulin replacement and do not prevent β-cell loss. 4-Methylumbelliferone (4-MU), an inhibitor of hyaluronan synthesis, has shown anti-inflammatory and cytoprotective effects, but its therapeutic potential and mechanisms in T1DM remain unclear.</p><p><strong>Methods: </strong>A streptozotocin (STZ)-induced mouse model of T1DM was treated with 4-MU for three weeks. Blood glucose levels and glucose tolerance were evaluated. Pancreatic islet morphology and cell composition were assessed by immunofluorescence. In parallel, STZ -injured MIN6 and βTC6 β-cells were used to investigate the effects of 4-MU on cell viability, oxidative stress, intracellular Ca²⁺ homeostasis, and glucose-stimulated insulin secretion. Network pharmacology, molecular docking, qPCR, and Western blot analyses were conducted to explore the underlying mechanisms.</p><p><strong>Results: </strong>4-MU significantly reduced hyperglycemia and improved glucose tolerance in T1DM mice, accompanied by preservation of β-cell mass, normalization of the β/α-cell ratio, and reduced islet inflammation. In vitro, 4-MU protected β-cells from STZ-induced injury by decreasing reactive oxygen species (ROS) accumulation, restoring intracellular Ca²⁺ balance, and improving insulin secretion. Network pharmacology identified 48 shared targets between 4-MU and T1DM, with KEGG pathway enrichment highlighting the PI3K/Akt signaling pathway. Molecular docking revealed stable binding of 4-MU to key regulators, including EGFR, Akt, ESR1, INSR, and IGF1R. Consistently, 4-MU enhanced the phosphorylation of EGFR, PI3K, and Akt in injured β-cells.</p><p><strong>Conclusion: </strong>4-MU exerts protective effects in T1DM by preserving pancreatic β-cells survival and function, potentially through activation of the EGFR/PI3K/Akt signaling pathway.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":"3063-3078"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolomic signatures of glycemic control in type 1 diabetes: insights from continuous glucose monitoring.","authors":"Sara de Lope Quiñones, Manuel Luque-Ramírez, Alejandra Quintero Tobar, José Manuel Ruiz Cánovas, Beatriz Dorado Avendaño, Hector F Escobar-Morreale, Lía Nattero-Chávez","doi":"10.1007/s40618-026-02973-6","DOIUrl":"10.1007/s40618-026-02973-6","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the relationship between serum metabolomic profiles and continuous glucose monitoring (CGM) metrics in adults with type 1 diabetes (T1D), given that glycaemic control differences influence distinct metabolic pathways.</p><p><strong>Methods: </strong>In this cross-sectional study, 325 adults with T1D were evaluated. CGM metrics were derived from 14-day recordings. Participants were stratified by achievement of clinical glycaemic targets [time in range (TIR70-180) > 70%, coefficient of variation (CV) < 36%, and time below range (TBR < 70) < 5%] into \"on-target\" and \"off-target\" groups. Serum metabolomic profiles were quantified using proton nuclear magnetic resonance spectroscopy (1 H-NMR).</p><p><strong>Results: </strong>Among the 325 participants (46% female; mean age 41 ± 14 years; diabetes duration 20 ± 12 years), 57 (18%) achieved all clinical glycaemic targets. These patients had higher concentrations of glutamine, valine, and isoleucine, and lower lactate levels. TIR70-180 correlated negatively with lactate, Glyc B, and Glyc B H/W. Mean glucose was positively associated with IDL-C, IDL-TG, LDL-P, small LDL-P, Glyc A H/W, and lactate, and negatively with glutamine and acetone. Hypoglycaemia metrics were associated with small LDL-P, while glucose variability correlated with alanine [β: - 0.026 (95% CI: - 0.057 to - 0.008); P = 0.013]. In logistic regression analyses adjusted for duration of T1D, glutamine [Exp(B) = 0.993 (95% CI: 0.987-0.999), P = 0.022] and lactate [Exp(B) = 1.004 (95% CI: 1.001-1.007, P = 0.003] were significantly associated with glycaemic control.</p><p><strong>Conclusions: </strong>Serum metabolomic profiles reflect CGM-derived glycaemic metrics in T1D, highlighting their potential role as biomarkers for a refined assessment of metabolic control.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":"3079-3090"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Muscle strength and HbA1c in geriatric patients with and without diabetes: a retrospective observational cohort study.","authors":"Merve Yilmaz Kars, Orhan Cicek, Ilyas Akkar, Zeynep Iclal Turgut, Mustafa Hakan Dogan, Tunahan Yakar, Muhammet Cemal Kizilarslanoglu","doi":"10.1007/s40618-026-02954-9","DOIUrl":"10.1007/s40618-026-02954-9","url":null,"abstract":"<p><strong>Background/aim: </strong>Handgrip strength (HGS) is a simple, reliable, and widely used biomarker of muscle strength and a key component in sarcopenia screening. Its potential role as an indicator of glycemic control has attracted increasing interest; however, the relationship between HGS and glycated hemoglobin (HbA1c) in older adults remains insufficiently understood, particularly in populations characterized by frailty and multimorbidity. This study aimed to explore the relationship between HGS and HbA1c levels in older adults with and without diabetes mellitus (DM) and to evaluate the potential of HGS as a clinically informative marker in the assessment of glycemic status within a comprehensive geriatric context.</p><p><strong>Methods: </strong>In this retrospective study, 573 patients aged ≥ 60 years who underwent Comprehensive Geriatric Assessment (CGA) between May 2023 and October 2025 were included. HGS was measured using a dynamometer, and sarcopenia risk was assessed with SARC-F. Participants were stratified into sex-specific low and high HGS groups. HbA1c levels were compared across groups, and associations were examined using Spearman's correlation and multivariable linear regression analyses with stepwise adjustment for clinically relevant confounders.</p><p><strong>Results: </strong>The study population had a median age of 78 years, with a high prevalence of frailty (72.8%) and sarcopenia risk (81.2%). Despite generally low HGS values, individuals in the higher HGS group demonstrated higher HbA1c levels across the overall cohort and SARC-F subgroups (p < 0.05). Correlation analyses showed statistically significant but very weak positive associations between HGS and HbA1c, particularly among individuals at risk of sarcopenia. Although these associations were consistent in direction, their magnitude was limited. Regression analyses showed that this association was maintained in an adjusted model for CCI, Yesavage geriatric depression scale, three-word recall test; however, it was no longer significant in another fully adjusted model for age, BMI, diabetes status, medications, renal function, and nutritional status.</p><p><strong>Conclusion: </strong>The findings indicate that there may be a weak association between HGS and glycemic status in older adults; therefore, they should be interpreted with caution. HGS may provide limited complementary information within a comprehensive geriatric assessment, particularly in frail populations, but its clinical relevance for evaluating glycemic control remains uncertain and warrants further investigation in prospective studies.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":"3027-3038"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}