Journal of Endocrinological Investigation最新文献

{"title":"Predictors of prolonged hypogonadism in men with prolactinomas despite biochemical remission: the role of baseline luteinizing hormone.","authors":"Gokberk Gozukan, Busra Tunc Topuz, Ceren Tufan, Emre Sedar Saygili, Ersen Karakilic","doi":"10.1007/s40618-026-03043-7","DOIUrl":"https://doi.org/10.1007/s40618-026-03043-7","url":null,"abstract":"<p><strong>Purpose: </strong>Recovery of gonadal function in men with prolactinomas following dopamine agonist therapy is variable, and predictors of hypogonadism remain unclear. We aimed to identify predictors of prolonged hypogonadotropic hypogonadism (HH) in men achieving normoprolactinemia during cabergoline therapy.</p><p><strong>Methods: </strong>In this retrospective cohort study, 71 male patients with prolactinomas were screened; 51 were included in the baseline analysis, and 39 patients achieving biochemical remission with adequate follow-up were included in the longitudinal outcome analysis. Prolonged hypogonadism was defined as persistence of low testosterone levels for > 12 months after prolactin normalization. Predictors were assessed using group comparisons, univariate logistic regression, and ROC curve analysis.</p><p><strong>Results: </strong>Prolonged HH was observed in 25.6% of patients despite prolactin normalization. Baseline LH demonstrated high discriminative performance (AUC: 0.886), with a cut-off ≤ 2.47 IU/L yielding high specificity (93.1%). Baseline total testosterone (AUC: 0.829, ≤ 1.95 ng/mL [6.8 nmol/L]), prolactin (AUC: 0.802, ≥ 141.9 ng/mL), and tumor diameter (AUC: 0.780, ≥ 7.6 mm) were also associated with prolonged HH. Longitudinal trajectories demonstrated increases in LH and testosterone during the first 12 months, followed by a plateau phase. However, testosterone recovery remained incomplete in the prolonged HH group, although delayed normalization was observed during follow-up.</p><p><strong>Conclusion: </strong>Baseline LH was strongly associated with prolonged hypogonadism in prolactinomas and may serve as a marker for early risk stratification. Most hormonal recovery occurred within the first 12 months after prolactin normalization, supporting the clinical relevance of this time point. Baseline hormonal and structural parameters may help guide follow-up and testosterone replacement decisions.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117042","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":"C-reactive protein-triglyceride-glucose index and incident mild cognitive impairment among patients with cardiovascular-kidney-metabolic syndrome: a dual-cohort prediction and double machine learning analysis.","authors":"Hao Du, Ping Zhao, Zhe Yang, Benran Li, Yijun Bao, Xin Shi","doi":"10.1007/s40618-026-03042-8","DOIUrl":"https://doi.org/10.1007/s40618-026-03042-8","url":null,"abstract":"<p><strong>Purpose: </strong>Develop an interpretable machine learning model and evaluate the predictive and potential causal effects of the C-reactive protein-triglyceride-glucose index (CTI) in medium- to long-term incident mild cognitive impairment (MCI) among patients with cardiovascular-kidney-metabolic (CKM) syndrome.</p><p><strong>Methods: </strong>Models were developed and internally validated using China Health and Retirement Longitudinal Study (CHARLS) data and externally validated in the Health and Retirement Study (HRS). Participants with baseline CKM syndrome stages 1-3 were included. Following feature selection via Shapley additive explanations (SHAP) and recursive feature elimination with cross-validation, six machine learning algorithms were compared and assessed in terms of discrimination, calibration, and clinical utility, with SHAP further used for model interpretation. Double machine learning estimated the average treatment effect (ATE) of CTI and subgroup heterogeneity.</p><p><strong>Results: </strong>2658 CHARLS and 2796 h participants were included. The gradient boosting classifier, using 10 features including CTI, achieved the best performance (AUC 0.820; external 0.785). SHAP analysis identified CTI as a major predictor, second only to baseline cognitive function and educational attainment. Elevated CTI was associated with adverse estimated effects on incident MCI (ATE: 0.029 in CHARLS; 0.040 in HRS), markedly attenuated in individuals with greater cognitive reserve.</p><p><strong>Conclusions: </strong>CTI reliably predicts incident MCI in patients with CKM syndrome. The gradient boosting framework provides a robust risk stratification, and higher cognitive reserve may attenuate CTI-associated cognitive risk.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018455","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":"Body roundness index shows a short-term, sex-specific advantage over body mass index in predicting incident diabetes: a longitudinal prospective cohort study.","authors":"Yong-Hoon Kim, Ga Hyun Lee, Hee-Taik Kang","doi":"10.1007/s40618-026-03041-9","DOIUrl":"https://doi.org/10.1007/s40618-026-03041-9","url":null,"abstract":"<p><strong>Purpose: </strong>Diabetes Mellitus (DM) is accompanied by insulin resistance and excessive adiposity. The body roundness index (BRI), an emerging anthropometric measure, comprehensively reflects visceral fat derived from height and waist circumference. The purpose of this study was to evaluate the association between BRI and DM risk, and to investigate whether BRI serves as a potential predictive indicator for DM incidence.</p><p><strong>Methods: </strong>A total of 3,159 participants (1,286 men and 1,873 women) were sourced from the Korean genome and epidemiology study (KoGES) from 2001 to 2022. We used Kaplan-Meier analysis to estimate the cumulative incidence of DM across BRI quartiles. Multivariable Cox proportional hazards regression models were performed to examine the association between BRI levels and incident DM. The discriminative power of BRI and BMI was compared using the time-dependent receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>During a median 17.5-year follow-up period, 766 DM events occurred. The cumulative incidence of DM was significantly increased with higher BRI quartiles in the Kaplan-Meier curves (log-rank p-value < 0.001). Multivariable Cox proportional hazards regression analysis uncovered a dose-response association between BRI and risk of incident DM in both sexes, with higher hazard ratios (HRs) in women (Q4:Q1, adjusted HR 2.52, 95% CI 1.79-3.54). Additionally, time-dependent ROC curve proved that BRI was superior to BMI in short-term (4-5 years) discriminatory performance, particularly in women (5-year AUC: BRI 0.708 vs. BMI 0.662, p = 0.042).</p><p><strong>Conclusions: </strong>In this cohort study, baseline BRI was associated with an increased risk of DM incidence, and BRI showed superior discriminatory performance relative to BMI specifically for short-term (4-5 year) prediction, particularly among women.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002726","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":"Cumulative metabolic burden and urinary albumin-to-creatinine ratio in non-diabetic adults: a nationwide population-based study.","authors":"Xiaohan Xu, Shanhu Qiu, Xiaoying Zhou, Wei Li, Hailing Lin, Yan Liu, Miao He, Wenjuan Wang, Xiaohang Wang, Yaling Chen, Chanjuan Ma, Duolao Wang, Haijian Guo, Yang Yuan, Zilin Sun","doi":"10.1007/s40618-026-03039-3","DOIUrl":"https://doi.org/10.1007/s40618-026-03039-3","url":null,"abstract":"<p><strong>Background: </strong>Albuminuria is an established marker of kidney risk and a predictor of cardiovascular and renal outcomes. Although albuminuria assessment is commonly emphasized in individuals with diabetes or chronic kidney disease, metabolic abnormalities often cluster before the onset of diabetes. Whether cumulative metabolic burden is associated with urinary albumin-to-creatinine ratio (ACR) in adults without diabetes remains incompletely understood.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis using data from the first follow-up survey of the nationwide multi-ethnic SENSIBLE cohort in China. Among 5,664 participants, individuals with diabetes, missing data, or abnormal routine urinalysis findings suggestive of transient urinary conditions were excluded. Metabolic abnormalities including hypertension, overweight or obesity, dyslipidaemia, and prediabetes were assessed and summed to generate a clustering score ranging from 0 to 4. Urinary ACR was analysed as a continuous outcome after logarithmic transformation and as elevated ACR defined as ≥ 30 mg/g. Associations were evaluated using multivariable linear and logistic regression models with sequential adjustment, including an extended model additionally adjusted for educational level, ethnicity, and geographic region. Prespecified subgroup analyses were performed according to hypertension status, sex, and age group.</p><p><strong>Results: </strong>A total of 3,335 non-diabetic adults were included, of whom 12.1% had elevated ACR. Urinary ACR increased progressively with the number of metabolic abnormalities. In the extended fully adjusted model, participants with four metabolic abnormalities had higher ln(ACR) than those without metabolic abnormalities (β = 0.605, 95% CI 0.470-0.740) and greater odds of elevated ACR (OR = 5.96, 95% CI 3.54-10.04). When metabolic abnormalities were modelled continuously, each additional abnormality was associated with higher ln(ACR) (β = 0.163, 95% CI 0.136-0.190) and greater odds of elevated ACR (OR = 1.55, 95% CI 1.41-1.71). The associations remained consistent across sensitivity and subgroup analyses.</p><p><strong>Conclusions: </strong>Cumulative metabolic abnormality burden was independently associated with higher urinary ACR in adults without diabetes. These findings should be interpreted as hypothesis-generating and suggest that adults without diabetes but with clustered metabolic abnormalities may warrant further longitudinal evaluation for kidney risk stratification.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931728","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":"Leg fat-to-total fat ratio improves waist-to-height ratio for discriminating metabolic syndrome: a nationwide cross-sectional study.","authors":"Sena Hwang, Hyun Min Kim","doi":"10.1007/s40618-026-03031-x","DOIUrl":"https://doi.org/10.1007/s40618-026-03031-x","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate whether regional fat distribution or skeletal muscle mass provides incremental discriminative value for metabolic syndrome (MetS) beyond the waist-to-height ratio (WHtR) in a nationally representative Korean population.</p><p><strong>Methods: </strong>Data from 15,838 adults in the Korea National Health and Nutrition Examination Survey (KNHANES) 2008-2011 who underwent dual-energy X-ray absorptiometry were analyzed. Ten anthropometric indices were compared using receiver operating characteristic (ROC) curve analysis. Incremental discriminative value was evaluated using multivariable logistic regression models combining WHtR with the leg fat-to-total fat (LF/TF) ratio and the appendicular skeletal muscle mass-to-body weight (ASM/BW) ratio. Subgroup analyses were performed by sex, age, and obesity status.</p><p><strong>Results: </strong>Among the 15,838 participants, 26.4% had MetS. WHtR showed the highest area under the ROC curve (AUC) among the individual indices (0.852; 95% CI, 0.845-0.860). Adding the LF/TF ratio significantly increased the AUC to 0.876 (p < 0.001), with a greater improvement among adults aged <65 years than among those aged ≥65 years (ΔAUC, +0.027 vs. +0.016; p = 0.002). Although ASM/BW was inversely associated with MetS, adding it to WHtR produced minimal improvement (ΔAUC, +0.003) and no meaningful benefit beyond the combination of WHtR and LF/TF ratio (p = 0.964).</p><p><strong>Conclusion: </strong>WHtR was the strongest individual anthropometric discriminator of MetS, but incorporating the LF/TF ratio further improved discrimination, particularly among younger adults. These findings suggest the clinical relevance of DXA-derived lower-extremity fat distribution as a complement to central adiposity for MetS discrimination. Prospective studies in diverse populations are warranted to validate this approach.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931747","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":"Adrenal incidentalomas: 1 mg dexamethasone test result in the context of cardiometabolic risk.","authors":"Joanna Kokoszka, Marta Opalińska, Magdalena Fiema, Katarzyna Sitarz, Anna Matrejek, Aleksandra Banaś, Gabriela Pabian, Karol Musiał, Aleksandra Gilis-Januszewska, Krystyna Sztefko, Alicja Hubalewska-Dydejczyk","doi":"10.1007/s40618-026-03035-7","DOIUrl":"https://doi.org/10.1007/s40618-026-03035-7","url":null,"abstract":"<p><strong>Purpose: </strong>Mild autonomous cortisol secretion (MACS) is the most common hormonal abnormality in adrenal incidentalomas. The 1 mg dexamethasone suppression test (DST) with a cutoff of 1.8 µg/dL is used to exclude hypercortisolism, yet some \"non-functioning\" tumors may secrete cortisol at concentrations below this threshold, potentially contributing to an adverse cardiometabolic profile. The aim of this study was to evaluate this relationship.</p><p><strong>Methods: </strong>In this retrospective cross-sectional study, data from 1,077 patients with adrenal incidentalomas treated at a tertiary endocrinology center between 2017 and 2020 were analyzed. After applying the inclusion criteria, 807 patients were included. All patients underwent a 1 mg DST. Receiver operating characteristic (ROC) curves and area under the curve (AUC) analyses were used to assess associations between post-DST cortisol concentrations and cardiometabolic conditions, and to identify a threshold for a composite endpoint comprising the presence of coronary heart disease, chronic heart failure, or diabetes mellitus.</p><p><strong>Results: </strong>Patients with hypertension, coronary heart disease, heart failure, diabetes mellitus, chronic obstructive pulmonary disease, and chronic kidney disease had significantly higher post-DST cortisol concentrations. However, in multivariable logistic regression, post-DST cortisol was not independently associated with the composite endpoint after adjustment for confounders, with age and obesity remaining significant predictors. Exploratory analysis suggested that cortisol concentrations > 1.37 µg/dL were associated with a higher prevalence of the composite endpoint.</p><p><strong>Conclusion: </strong>Post-DST cortisol concentrations below the standard cutoff may be associated with cardiometabolic comorbidities in patients with adrenal incidentalomas. These findings should be interpreted with caution and require confirmation in prospective studies.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882467","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":"Practical approach to the diagnosis, management, and treatment of pediatric patients with bone fragility: an expert opinion.","authors":"Giampiero I Baroncelli, Daniele Tessaris, Tommaso Aversa, Enrica Bertelli, Pasquale Comberiati, Domenico Corica, Natascia Di Iorgi, Maria Felicia Faienza, Danilo Fintini, Roberto Franceschi, Anna Grandone, Mila Ann Karapurackal, Silvia Longhi, Marco Pitea, Andrea Secco, Giuliana Trifirò, Graziamaria Ubertini, Flavia Urbano, Francesco Vierucci, Malgorzata Wasniewska, Stefano Mora, Luisa de Sanctis","doi":"10.1007/s40618-026-02882-8","DOIUrl":"10.1007/s40618-026-02882-8","url":null,"abstract":"<p><strong>Purpose: </strong>Children and adolescents frequently experience fractures related to accidental injuries; however, fractures may also result from non-accidental trauma in abused children or from underlying bone fragility due to primary or secondary osteoporosis. In pediatric patients with fragility fractures diagnosis and treatment may be delayed. This document aims to provide clinicians with a practical approach to the diagnosis and management of fragility fractures in children and adolescents.</p><p><strong>Methods: </strong>Between November 2024 and June 2025, a group of Italian pediatric endocrinologists with expertise in bone and mineral metabolism held regular online meetings to discuss key issues related to the diagnosis and management of pediatric bone fragility and developed experts opinion statements based on clinical experience and a review of the relevant literature.</p><p><strong>Results: </strong>The expert panel formulated consensus statements on the clinical management of children and adolescents with fragility fractures. Seven main areas were addressed: 1) definition of fragility fractures and pediatric osteoporosis; 2) diagnostic approach; 3) main causes of primary and secondary osteoporosis; 4) assessment of the potential for spontaneous recovery from bone fragility; 5) management of bisphosphonate therapy; 6) other therapeutic options; 7) conservative measures.</p><p><strong>Conclusion: </strong>The diagnosis of osteoporosis in pediatric patients should follow a clinically oriented approach. Genetic testing plays a crucial role in identifying primary forms of osteoporosis. Vertebral reshaping may occur in some patients with secondary osteoporosis. Bisphosphonates represent the mainstay of treatment in children and adolescents with bone fragility. Conservative measures aimed at optimizing bone strength may be beneficial in selected cases.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":"2113-2134"},"PeriodicalIF":3.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13498659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148310034","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":"Icariin prevents ovariectomy-induced osteoporosis by modulating marrow fatty acid metabolism.","authors":"Peng Luo, Mengyao Guo, Lei Jiang, Zeyang Miao, Hong Chen, Li Lu, Xiaoyong Zuo, Hua Nian, Guanwu Li","doi":"10.1007/s40618-026-02921-4","DOIUrl":"10.1007/s40618-026-02921-4","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate icariin's regulation of marrow fatty acid metabolism and stearoyl-CoA desaturase (SCD) indices in preventing ovariectomy-induced osteoporosis.</p><p><strong>Methods: </strong>Thirty-six female Sprague-Dawley rats underwent sham surgery or ovariectomy and were treated with either icariin (125 mg/kg/day) or vehicle via oral gavage for 12 weeks, 6 days per week. Bone marrow was collected from tibias for fatty acid profiling via gas chromatography-mass spectrometry. Serum levels of bone-specific alkaline phosphatase (BALP) and tartrate-resistant acid phosphatase 5b (TRACP-5b) were measured using Enzyme-Linked Immunosorbent Assay. Tibial trabecular microstructure was assessed by micro-CT.</p><p><strong>Results: </strong>Ovariectomy significantly altered marrow fatty acid composition, marked by increased palmitic acid (C16:00) and palmitoleic acid (C16:1 n-7), decreased stearic acid (C18:00) and arachidonic acid (C20:4 n-6), and elevated SCD indices. These changes were associated with deteriorated bone microarchitecture and impaired bone turnover. Icariin treatment effectively normalized marrow fatty acid levels, suppressed SCD indices, and consequently attenuated bone loss by improving bone volume fraction, trabecular number, and thickness, while reducing trabecular separation. Additionally, icariin restored the balance of bone turnover markers, increasing BALP and decreasing TRACP-5b. Significant correlations were identified between specific fatty acids and both bone structural parameters and remodeling markers.</p><p><strong>Conclusions: </strong>Icariin attenuates osteoporotic bone loss by preventing ovariectomy-induced disturbances in marrow fatty acid metabolism, particularly through the suppression of SCD indices and normalization of C16:00, C16:1 n-7, and C18:00 levels. This study highlights the critical role of lipid homeostasis in bone integrity and identifies icariin as a promising lipid-modulating candidate for postmenopausal osteoporosis.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":"2397-2405"},"PeriodicalIF":3.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989606","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":"Serum free fatty acid profiles as novel biomarkers for disease activity in Graves' orbitopathy.","authors":"Xinyi Yang, Jun Liu, Qingyu Guo, Yixin Xu, Heng Zhao, Jiaqing Shao, Jingjing Liang, Xiaozhen Ye","doi":"10.1007/s40618-026-02913-4","DOIUrl":"10.1007/s40618-026-02913-4","url":null,"abstract":"<p><strong>Purpose: </strong>Graves' orbitopathy (GO) lacks reliable serum biomarkers for objectively evaluating disease activity and severity. In this cross-sectional study, we aimed to investigate alterations in serum free fatty acid (FFA) profiles in GO and assess their potential as novel biomarkers.</p><p><strong>Methods: </strong>We enrolled 60 patients with GO classified by Clinical Activity Score (CAS) and EUGOGO severity. Serum levels of 15 FFAs were measured. Principal component analysis (PCA) visualized group separations. Multivariable logistic regression, adjusted for age, sex, BMI, smoking, TRAb, identified independent predictors. Diagnostic performance was evaluated via ROC analysis, and clinical utility by decision curve analysis (DCA).</p><p><strong>Results: </strong>PCA showed clear separation between active and inactive GO. Active or moderate-to-severe disease was associated with significantly reduced anti-inflammatory FFAs, including docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), stearidonic acid (FFA18:4), total ω-3, and a lower EPA/AA ratio. After adjustment, decreased EPA/AA ratio (OR = 0.198, 95% CI: 0.051-0.760, p = 0.018) and FFA18:4 (OR = 0.667, 95% CI: 0.464-0.959, p = 0.029) were independent risk factors for active GO. The EPA/AA ratio discriminated active GO with an AUC of 0.847. DCA indicated its strong net clinical benefit across threshold probabilities.</p><p><strong>Conclusion: </strong>GO exhibits a distinct serum FFA profile marked by reduced anti-inflammatory fatty acids. The EPA/AA ratio represents a robust, independent biomarker for GO activity, showing great potential for objective clinical assessment and guiding targeted therapy.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":"2235-2244"},"PeriodicalIF":3.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989581","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":"Steatosis indices and penile vascular health: a metabolic association linking liver and vascular phenotypes.","authors":"Andrea Delbarba, Massimiliano Ugoccioni, Elisa Gatta, Giorgio Tiecco, Eugenia Quiros-Roldan, Andrea Graziani, Ilenia Pirola, Alberto Ferlin, Carlo Cappelli","doi":"10.1007/s40618-026-02889-1","DOIUrl":"10.1007/s40618-026-02889-1","url":null,"abstract":"","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":"2385-2395"},"PeriodicalIF":3.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13498629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647242","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}