Endocrine最新文献

{"title":"Examining gender, BMI, and lifestyle factors as indicators of type 2 diabetes risk in the Ukrainian population.","authors":"Jeongwon Richter, Johanna Buchcik, Adekunle Adedeji","doi":"10.1007/s12020-025-04353-1","DOIUrl":"https://doi.org/10.1007/s12020-025-04353-1","url":null,"abstract":"<p><strong>Purpose: </strong>Despite significant advances in diabetes understanding and management, it remains a major global public health challenge. This study examines the influence of gender, body mass index (BMI), and lifestyle factors on developing type 2 diabetes (T2D) in the Ukrainian population. By exploring these key risk factors, the study aims to enhance understanding of T2D determinants and contribute to targeted prevention strategies in Ukraine.</p><p><strong>Methods: </strong>This current analysis uses cross-sectional secondary data from 12,092 individuals who visited medical mobile teams (MMTs) in four Ukrainian regions (Lviv, Rivne, Dnipro, and Poltava) between April 6 and August 8, 2023. Multiple logistic regression was employed to explore various risk factors associated with T2D.</p><p><strong>Results: </strong>The results suggest that overweight individuals were 3.02 times more likely to have T2D (Wald (1) = 233.10, p < 0.001, 95% CI: 2.62-3.48), while each unit increase in BMI raised the likelihood by 1.05-fold (Wald (1) = 56.26, p < 0.001). An unhealthy diet increased the risk by 1.29 times (Wald (1) = 13.99, p < 0.001). Women had 1.16 times higher T2D prevalence than men (Wald (1) = 3.93, p <0.05). Sedentary individuals were 16.1% less likely to have T2D (Wald (1) = 8.69, p < 0.01).</p><p><strong>Conclusion: </strong>This study is significant in that self-perceived overweight status was found to be the most important risk factor associated with T2D prevalence. This provides important guidance for organisations seeking to support T2D diagnosis and management efforts in Ukraine and emphasises the need to recognise self-perceived overweight status as an important consideration.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of autoimmune comorbidities and association with glycemic control by CGM-derived parameters in type 1 diabetes.","authors":"Ana Margarida Lopes, Ana Rita Leite, Patrícia Ferreira, Inês Meira, João Menino, Mariana Lourenço, Joana Lagoa, Beatriz Viveiros, Maria João Barbosa, Sílvia Santos Monteiro, Joana Queirós, João Sérgio Neves, Celestino Neves","doi":"10.1007/s12020-025-04354-0","DOIUrl":"https://doi.org/10.1007/s12020-025-04354-0","url":null,"abstract":"<p><strong>Purpose: </strong>Type 1 diabetes mellitus (T1D) is a chronic autoimmune disease frequently associated with other autoimmune diseases. This study aims to evaluate the prevalence of additional autoimmunity in adults with T1D and its association with glycemic control, chronic complications, and other comorbidities.</p><p><strong>Methods: </strong>We performed a cross-sectional study in adult patients with T1D, followed at the Endocrinology Department of a tertiary hospital, between May 2022 and May 2024. Clinical data collected included glycemic control (HbA1c and continuous glucose monitoring [CGM] parameters), diabetes complications, and other comorbidities. These parameters were compared according to the history of autoimmune diseases. Statistical analysis was performed using parametric and non-parametric tests, ANCOVA and logistic regression models, unadjusted and adjusted for age and sex.</p><p><strong>Results: </strong>Of the 439 participants (48.8% female and mean age 36.8 ± 14.1 years), 33.8% had at least one autoimmune disease, predominantly Hashimoto's thyroiditis (28.8%) and celiac disease (3.9%), with higher prevalence in women (p < 0.001). HbA1c (7.7 ± 1.3 vs. 7.8 ± 1.4%, p = 0.53) and CGM-derived parameters, such as glucose management indicator (7.4 ± 0.9 vs. 7.4 ± 0.8%, p = 0.44) and time in range (58.7 ± 18.9 vs. 56.6 ± 16.5%, p = 0.84), were similar in patients with and without autoimmune diseases.</p><p><strong>Conclusions: </strong>Over one fourth of patients with T1D had a concomitant autoimmune disease. Our results suggest that the presence of other autoimmune diseases may not preclude the attainment of similar glycemic targets. Given the high risk of autoimmunity in T1D, systematic screening and personalized treatment should be considered. Prospective studies are warranted to explore the long-term implications on metabolic control and cardiovascular outcomes.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alterations of the pancreas in type 1 diabetes - from prior to diagnosis to long-standing disease.","authors":"Nathalia Guarienti Missima, Henrik Hill, Casian-Simon Aioanei, Per Liss, Daniel Espes","doi":"10.1007/s12020-025-04338-0","DOIUrl":"https://doi.org/10.1007/s12020-025-04338-0","url":null,"abstract":"<p><strong>Purpose: </strong>In type 1 diabetes (T1D), the loss of insulin-producing beta-cells is the hallmark pathophysiological alteration. However, volumetric and functional abnormalities of the exocrine pancreas are also observed. These changes may result from the loss of insulin's anabolic effects or reflect an underexplored aspect of T1D. Imaging techniques have enabled a better characterization of pancreatic morphology throughout T1D progression. This study examines exocrine pancreatic alterations at various stages of T1D using CT scans, including assessments conducted prior to diagnosis.</p><p><strong>Methods: </strong>The study utilized retrospective abdominal CT scans and clinical data collected from Uppsala University Hospital, including 150 T1D subjects, with 15 examined before diagnosis, and 61 age- and gender-matched non-diabetic controls. Volume segmentation and 3D reconstruction assessed the exocrine pancreas, and pancreas volume index (PVI) calculations were standardized using body weight, BMI, and body surface area (BSA). Descriptive and laboratory data were obtained from electronic medical records.</p><p><strong>Results: </strong>Pancreas volume was significantly reduced in T1D patients. The reduction was more pronounced in patients diagnosed before the age of 20. No significant volume difference was noted in patients before their T1D diagnosis compared to controls, however, a reduction was observed post-diagnosis. Pancreas volume correlated negatively with disease duration and HbA1c levels and correlated positively with body surface area and plasma amylase levels.</p><p><strong>Conclusion: </strong>Pancreas volume reduction is a consistent feature in T1D, correlating with both disease duration and markers of metabolic control. These findings support the potential of using imaging techniques as a non-invasive method for monitoring T1D progression.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Clinical efficacy of radioactive iodine therapy in multifocal papillary thyroid microcarcinoma: a tertiary center experience.","authors":"Dilek Geneş, Fulya Kaya İpek, Mehmet Güven, Berat Soylu, Halil Kömek","doi":"10.1007/s12020-025-04319-3","DOIUrl":"10.1007/s12020-025-04319-3","url":null,"abstract":"","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of diabetes mellitus and social isolation with loneliness among older Japanese adults: a cross-sectional study.","authors":"Takahiro Shimoda, Kouki Tomida, Chika Nakajima, Ayuka Kawakami, Hiroyuki Shimada","doi":"10.1007/s12020-025-04348-y","DOIUrl":"https://doi.org/10.1007/s12020-025-04348-y","url":null,"abstract":"<p><strong>Purpose: </strong>To clarify whether the combination of diabetes mellitus (DM) and social isolation is associated with loneliness among community-dwelling older adults.</p><p><strong>Methods: </strong>Data of community-dwelling older adults aged 60 years and older without initial long-term care needs from the Japanese National Center for Geriatrics and Gerontology Study of Geriatric Syndromes were analyzed. Loneliness was measured using the University of California Los Angeles Loneliness Scale. Social isolation was assessed based on four categories: lack of conversation, lack of passive support, lack of support provided to others, and lack of social participation. DM status was determined by assessing patients' medical histories. Modified Poisson regression models were employed to assess relationships between DM, social isolation, and loneliness, including interactions according to sex.</p><p><strong>Results: </strong>Data from 5876 participants (54.2% women) aged 68-77 years were included. The prevalence rates of loneliness, social isolation, and DM were 35.9%, 46.5%, and 13.1%, respectively. Among women, DM and social isolation were associated with loneliness (DM, prevalence ratio [PR]: 1.35, 95% confidence interval [CI]: 1.02-1.78; social isolation, PR: 1.98, 95% CI: 1.33-2.94). Among men, only social isolation was associated with loneliness (PR: 1.41, 95% CI: 1.09-1.84). No interaction was observed between DM and social isolation for either sex.</p><p><strong>Conclusions: </strong>Social isolation was associated with loneliness in men and women. DM was associated in women but not in men. The findings of this study may help develop strategies to maintain the mental health of older adults.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and cost-effectiveness of immediate right hemicolectomy versus active surveillance for well-differentiated appendiceal neuroendocrine tumors 1-2 cm in size: a Markov decision analysis.","authors":"Claudio Ricci, Stefano Partelli, Davide Campana, Maria Rinzivillo, Laura Alberici, Elisa Andrini, Sofia Menin, Vincenzo D'Ambra, Anna Battistella, Valentina Andreasi, Riccardo Casadei, Massimo Falconi, Francesco Panzuto","doi":"10.1007/s12020-025-04347-z","DOIUrl":"https://doi.org/10.1007/s12020-025-04347-z","url":null,"abstract":"<p><strong>Purpose: </strong>Therapeutic management of appendiceal neuroendocrine neoplasms (a-NENs) 10-20 mm in size represents a challenge for both surgeons and oncologists. We compared active surveillance after appendectomy versus immediate right hemicolectomy (RHC).</p><p><strong>Methods: </strong>A Markov decision model was developed based on literature parameters. The endpoints were the life expectancy, the quality-adjusted life expectancy (QALY), and the cost-effective ratio expressed by the incremental cost-effective ratio (ICER). A deterministic sample analysis (DSA) with one-way sensitivity analysis was performed for the base case scenario. A probabilistic sensitivity analysis (PSA) was performed to solve the uncertainty of the model. Montecarlo simulation with 100,000 replications for each arm was used. Data are reported in US$. The acceptability of the strategy was set 3 times ($130,049) the Euro area's gross domestic product per capita ($43,394).</p><p><strong>Results: </strong>The 10-year survival rates for active surveillance and immediate RHC were 98.2 and 98.9%, respectively. The DSA showed the superiority of active surveillance versus immediate RHC (10 versus 9.0 QALY). Active surveillance costs more than immediate RHC ($35,761 vs. $39,486). The resulting ICER was $4302 per QALY. The model was more sensitive to the length of follow-up (99.9% variability): the longer the surveillance, the higher the ICER (spread $302,703). PSA analysis confirmed active surveillance as the most cost-effective choice, costing an ICER + $4059 per QALY.</p><p><strong>Conclusion: </strong>Active surveillance is safe and cost-effective in patients with appendiceal NENs of 10-20 mm in size, both clinically and economically.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of mortality and cardiovascular morbidity following treatment for hyperthyroidism: A systematic review and bayesian network meta-analysis.","authors":"Artur de Oliveira Macena Lôbo, Luis Eduardo Rodrigues Sobreira, Danilo Monteiro Ribeiro, Isabela Junger Meirelles Aguiar, Francinny Alves Kelly","doi":"10.1007/s12020-025-04342-4","DOIUrl":"https://doi.org/10.1007/s12020-025-04342-4","url":null,"abstract":"<p><strong>Introduction: </strong>Therapeutic approaches for hyperthyroidism, namely antithyroid drugs, radioiodine, and thyroidectomy, aim to restore normal thyroid function while minimizing harm. However, the difference in outcomes related to mortality and cardiovascular diseases between them remains controversial.</p><p><strong>Methods: </strong>PubMed, Embase, Cochrane Central, and Web of Science were searched for randomized controlled trials and cohort studies that compared any of the three supracited therapeutic approaches between themselves. A Bayesian model estimated hazard ratios (HR) with 95% credible intervals (CrI) using a random-effects model. Treatments were ranked by surface under the cumulative ranking curve (SUCRA).</p><p><strong>Results: </strong>Eight cohort studies encompassing 172,585 hyperthyroid patients were included. Thyroidectomy was associated with lower all-cause mortality compared to antithyroid drugs (HR 0.442; 95% CrI 0.244-0.783) but not radioiodine (HR 0.675; 95% CrI 0.424-1.296). No significant differences were observed for cardiovascular mortality when comparing thyroidectomy to antithyroids (HR 0.440; 95% CrI 0.177-1.127) and radioiodine (HR 0.580; 95% CrI 0.342-1.064). For major cardiovascular events (MACE) there was no significant difference between radioiodine vs. antithyroids (HR 0.557; 95% CrI 0.265-1.006) and thyroidectomy (HR 0.784; 95% CrI 0.347-1.917). Thyroidectomy did not reduce heart failure risk vs. antithyroids (HR 0.353; 95% CrI 0.115-1.251) and radioiodine (HR 0.426; 95% CrI 0.131-1.749). SUCRA rankings suggested thyroidectomy as the best treatment concerning mortality and heart failure, while radioiodine ranked highest for MACE.</p><p><strong>Conclusion: </strong>Thyroidectomy and radioiodine may offer better long-term cardiovascular and mortality outcomes compared to antithyroid drugs. Further studies with proper designs are needed to verify the nature of these associations.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and radiological insights into secondary hypophysitis: A single-center experience with a focus on tuberculosis.","authors":"Archana Rao, Anurag Ranjan Lila, Manjiri Karlekar, Vijaya Sarathi, Anuj Ban, Anima Sharma, Rohit Barnabas, Saba Samad Memon, Virendra Patil, Wasim Khot, Shilpa Sankhe, Gaurav Malhotra, Nalini Shah, Tushar Bandgar","doi":"10.1007/s12020-025-04352-2","DOIUrl":"https://doi.org/10.1007/s12020-025-04352-2","url":null,"abstract":"<p><strong>Purpose: </strong>Secondary hypophysitis (apart from immune checkpoint inhibitor [ICI] induced) is rare and is largely described in case series. We aim to describe the distinctive characteristics of the various etiologies of secondary hypophysitis from a single center.</p><p><strong>Methods: </strong>A retrospective record review of 44 patients with secondary hypophysitis (excluding ICI) presenting to our institute between January 2002 and January 2023 was performed. The data of primary hypophysitis managed medically (n = 39) was retrieved from a prior publication and compared with common etiologies of secondary hypophysitis.</p><p><strong>Results: </strong>The most common etiologies were histiocytic disorders - Langerhans cell histiocytosis (LCH) and Erdheim Chester disease (ECD) [n = 23] and tubercular hypophysitis (TH) [n = 10]. LCH/ECD were characterized by multisystem involvement, with arginine vasopressin deficiency (AVP-D) [22/23] being the predominant endocrine presentation. TH patients presented with mass effect (9/10), focal non-enhancing areas within an enhancing sellar/suprasellar mass on magnetic resonance imaging (MRI) (10/10), with evidence of tuberculosis elsewhere in 60%. Though caseating granulomas were universal on histopathology, bacteriological confirmation was negative in all pituitary specimens. When compared to primary hypophysitis, isolated infundibuloneurohypophysitis and AVP-D were more prevalent in LCH/ECD, while the presence of a sellar/suprasellar mass with focal non-enhancing areas was more frequent in TH. Furthermore, recovery of the hormonal axis upon follow-up was more common in primary hypophysitis.</p><p><strong>Conclusion: </strong>Secondary hypophysitis in our cohort was predominantly histiocytic or tubercular in etiology, with LCH/ECD presenting largely with AVP-D and TH presenting with mass effects, focal non-enhancing areas, and paucibacillary disease.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indications for primary aldosteronism screening in people with hypertension and hyperparathyroidism: a multi-centre cohort study.","authors":"A Jones, J Tan, T Dao, J Tan, P Wong, S Sztal-Mazer, F Milat, J Yang, C Gilfillan","doi":"10.1007/s12020-025-04323-7","DOIUrl":"https://doi.org/10.1007/s12020-025-04323-7","url":null,"abstract":"<p><strong>Purpose: </strong>Parathyroid hormone (PTH) excess is associated with hypertension while elevated PTH has been observed in primary aldosteronism (PA). This study aimed to determine the proportion of patients with hyperparathyroidism who met Endocrine Society criteria for PA screening, and to assess current screening practices.</p><p><strong>Methods: </strong>Multi-centre retrospective cohort study including patients attending outpatient endocrine clinics at three tertiary health services in Victoria, Australia between 2015-2019. Patients were included if they had an elevated PTH level and excluded if they had a secondary cause of hyperparathyroidism or a prior diagnosis of PA. Demographic, clinical and biochemical data were extracted from electronic medical records.</p><p><strong>Results: </strong>Of 275 patients with hyperparathyroidism, hypertension was present in 51.6%; including 62.4% of patients with hypercalcaemia and 35.5% of those with normocalcaemia. Overall,15.6% (43/275) had a guideline indication for PA screening, including 21.8% (36/165) of those with hypercalcaemia and 6.4% (7/110) of those with normocalcaemia. Of those with hypertension, 30% (43/142) had a guideline indication for PA screening. The most common indication for screening was hypertension and hypokalaemia (16/43). Despite this, only 9.3% (4/43) were screened, with one confirmed PA diagnosis.</p><p><strong>Conclusion: </strong>Hypertension is common in patients with hyperparathyroidism. A third of patients with hyperparathyroidism and hypertension had a guideline indication for PA screening, however screening remains substantially under-utilised. A prospective study is needed to evaluate the prevalence and impact of PA in patients with hyperparathyroidism.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of dual-release hydrocortisone on disease control and metabolism in congenital adrenal hyperplasia: a retrospective cohort study.","authors":"Pierluigi Mazzeo, Irene Tizianel, Chiara Sabbadin, Giacomo Voltan, Giorgia Antonelli, Filippo Ceccato, Mattia Barbot","doi":"10.1007/s12020-025-04328-2","DOIUrl":"https://doi.org/10.1007/s12020-025-04328-2","url":null,"abstract":"<p><strong>Introduction: </strong>Congenital adrenal hyperplasia (CAH) is an autosomal recessive disorder characterized by impaired cortisol secretion and excess androgen production. The primary treatment for CAH is glucocorticoid (GC) replacement, which is essential to prevent adrenal crises and manage androgen excess. Dual-release hydrocortisone (DR-HC) is a once-daily modified-release formulation of hydrocortisone approved for adrenal insufficiency, which showed to improve the metabolic profile and reduce cardiovascular risk compared to conventional GCs. However, data on its use in CAH patients are scant.</p><p><strong>Aim: </strong>To retrospectively evaluate clinical, metabolic, and hormonal characteristics of CAH patients switched from conventional GC treatment to DR-HC.</p><p><strong>Patients and method: </strong>This retrospective study involved 17 patients (10 males and 7 females) with classic CAH due to 21-OH-hydroxilase deficiency, who were switched to DR-HC. Clinical, metabolic, and hormonal data were assessed at baseline, at six months, and at the last available visit.</p><p><strong>Results: </strong>Patients showed a tendency to a worse hormonal control, despite an overall increase in daily hydrocortisone equivalent dose; in fact, we observed a trend of increase in androstenedione and 17-OHP levels and a significant deterioration in androstenedione to total testosterone ratio in male (1.37 vs 2.10, p = 0.04); additionally, there was a decrease in the proportion of patients with good disease control [5/17 (29%) vs 1/17 (6%) at last available visit, p = 0.07]. Notably, compared to prior conventional GC regimens total and LDL-c cholesterol levels significantly improved (respectively 178 mg/dL vs 156 mg/dL, p = 0.015 and 101 mg/dL vs 83 mg/dL, p = 0.027), while there were no significant changes in glucose profile. In addition, we did not record any adrenal crises during follow-up; however, unsatisfactory disease control was the primary reason for discontinuation in 11/17 patients after a median duration of 26 months.</p><p><strong>Conclusions: </strong>While DR-HC can replicate the circadian rhythm of cortisol secretion, it offers suboptimal hormone control in CAH patients despite increasing HC equivalent doses. Nonetheless, DR-HC is a safe treatment that could improve the metabolic profile compared to conventional GCs. However, DR-HC may be unsuitable in cases requiring tight regulation of androgen excess.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}