Endocrine最新文献

{"title":"Metabolic syndrome before 16 weeks' gestation: prevalence and haemodynamic profile in a socioeconomically disadvantaged pregnancy cohort: baseline findings from Mother's Heart Study.","authors":"A Mohebi, M Arstall, J Dalton, G Dekker, A R Alexander, M M Pathirana, M Wittwer, S Leemaqz, P H Andraweera","doi":"10.1007/s12020-026-04818-x","DOIUrl":"https://doi.org/10.1007/s12020-026-04818-x","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy provides an opportunity to identify young women at risk of future cardiometabolic diseases. We aimed to determine the prevalence of metabolic syndrome (MetS) and its components, and to assess haemodynamic profiles in early pregnancy.</p><p><strong>Method: </strong>We recruited pregnant women at Lyell McEwin Hospital before 16 weeks' gestation. Haemodynamic parameters were measured using USCOM BP+ device. Blood glucose, lipid profile, liver and renal function were assessed. We included data from 264 women aged 19-44 years in the analyses. MetS was defined using the Harmonizing the MetS criteria.</p><p><strong>Results: </strong>The prevalence of MetS was 15.1% (n = 40). Individual MetS components included high waist circumference (97.3%, n = 257), high systolic blood pressure (4.5%, n = 12), high diastolic blood pressure (1.1%, n = 3), high triglycerides (47.7%, n = 126), low high-density lipoprotein cholesterol (15.2%, n = 40), and elevated fasting blood glucose (1.4%, n = 1). Compared with women without MetS, women with MetS had higher peripheral systolic blood pressure, central systolic blood pressure (cSBP), central diastolic blood pressure, central mean arterial pressure (cMAP), pulse rate (PR), and suprasystolic pulse rate, and lower suprasystolic pulse rate variability, pressure gradient, reflected wave transit time to the reflected wave peak, and pulse pressure. After adjustment for BMI and correction for multiple testing, cSBP, cMAP and PR remained independently associated with MetS (all p < 0.05).</p><p><strong>Conclusions: </strong>MetS in early pregnancy is associated with changes in cardiovascular haemodynamics, with adiposity contributing to these changes. Early screening for MetS during pregnancy may provide an opportunity to identify women at increased risk of future cardiometabolic disease.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216729","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 course and outcomes of diabetic ketoacidosis in pregnancy: a single-center experience.","authors":"Nevda Ceren Sonu, Nazli Orhan, Sanem Ozcan Kahveci, Nihat Farisogullari, Eda Ozden Tokalioglu, Namik Nebi Ozcan, Dilek Sahin","doi":"10.1007/s12020-026-04825-y","DOIUrl":"https://doi.org/10.1007/s12020-026-04825-y","url":null,"abstract":"<p><strong>Purpose: </strong>We evaluated the obstetric and perinatal outcomes of pregnant women hospitalised with diabetic ketoacidosis (DKA) and examined the association between clinical and laboratory parameters and admission to the intensive care unit (ICU).</p><p><strong>Methods: </strong>This retrospective observational study included 32 pregnant women managed for DKA between May 2019 and December 2025 at Ankara Bilkent City Hospital, comparing those admitted to the ICU with those who were not. The association of arterial pH and serum bicarbonate with ICU admission was examined using ROC analysis and logistic regression, and biochemical severity markers were compared between pregnancies with and without DKA-related adverse outcomes. Given the sample size, all inferential analyses were regarded as exploratory.</p><p><strong>Results: </strong>Twenty women (62.5%) were admitted to the ICU. They were older and had lower arterial pH and serum bicarbonate, whereas plasma glucose did not differ between groups. Thresholds examined were ≤ 18.5 mmol/L for bicarbonate (AUC 0.80, 95% CI 0.65-0.95) and ≤ 7.33 for pH (AUC 0.72, 95% CI 0.53-0.90). In a two-variable logistic regression model, lower bicarbonate (OR 0.58, 95% CI 0.37-0.91) and older age (OR 1.49, 95% CI 1.07-2.08) were associated with ICU admission. Women with DKA-related adverse outcomes had lower pH (7.20 versus 7.34; p = 0.004) and lower bicarbonate (8.0 versus 17.0 mmol/L; p = 0.014).</p><p><strong>Conclusion: </strong>In this small single-centre cohort, the depth of maternal acidosis rather than the degree of hyperglycaemia was associated with ICU admission and with adverse obstetric outcomes. These findings are exploratory and hypothesis-generating; the thresholds reported here require validation in larger, multicentre cohorts before any clinical application.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217311","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":"Periconceptional and early-pregnancy exposure to SGLT2 inhibitors and congenital malformations: a systematic review and meta-analysis.","authors":"Deep Dutta, Kunal Mahajan, Gunjan Gupta, Meha Sharma, Swati Sugandha, A B M Kamrul-Hasan","doi":"10.1007/s12020-026-04839-6","DOIUrl":"https://doi.org/10.1007/s12020-026-04839-6","url":null,"abstract":"<p><strong>Purpose: </strong>Sodium-glucose cotransporter-2 (SGLT2) inhibitors are increasingly prescribed to women of reproductive age for type 2 diabetes and cardiorenal protection, and are commonly continued through the periconceptional period until pregnancy is recognized. Human safety data on inadvertent first-trimester exposure remain scarce, creating substantial clinical uncertainty.</p><p><strong>Methods: </strong>We systematically searched PubMed/MEDLINE, Embase, and CENTRAL from inception to 15 May 2026 for observational cohort studies comparing early-pregnancy or preconception exposure to SGLT2 inhibitors with active antidiabetic comparators among women with type 2 diabetes. Adjusted risk ratios (RRs) were pooled using random-effects meta-analysis.</p><p><strong>Results: </strong>Three cohorts, including 669 SGLT2 inhibitor-exposed pregnancies, were eligible. In the prespecified insulin-comparator analysis, SGLT2 inhibitor exposure was not associated with major congenital malformations (RR 0.94, 95% CI 0.68-1.29) or cardiac malformations (RR 0.97, 95% CI 0.64-1.48). The inclusion of a preconception sulfonylurea comparator cohort yielded a similar estimate for major congenital malformations (RR 0.98, 95% CI 0.74-1.29). In a Korean cohort, exposure during gestational weeks 4-10 was associated with congenital heart defects (RR 2.79, 95% CI 1.16-7.06).</p><p><strong>Conclusions: </strong>Based on the limited observational evidence available, early SGLT2 inhibitor exposure was not associated with an increased risk of overall major congenital or cardiac malformations; however, the estimates were imprecise and could not rule out clinically important increases in risk. Certainty of the evidence was low to very low because of residual confounding, live-birth selection, heterogeneous exposure definitions, and few exposed events. A possible timing-specific cardiac signal requires replication.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216695","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":"Relative muscle mass and grip strength as complementary correlates of metabolic syndrome: a nationwide DXA-based study of Korean adults.","authors":"Eun Young Lee, Hyun Min Kim","doi":"10.1007/s12020-026-04804-3","DOIUrl":"https://doi.org/10.1007/s12020-026-04804-3","url":null,"abstract":"<p><strong>Purpose: </strong>Both muscle mass and strength relate to metabolic health, but their separate contributions to metabolic syndrome (MetS) are unclear. Using the 2024 Korea National Health and Nutrition Examination Survey (KNHANES) with concurrent dual-energy X-ray absorptiometry (DXA)-based appendicular skeletal muscle mass (ASM) and handgrip strength (HGS), we examined the independent associations of relative muscle mass and HGS with MetS in Korean adults aged ≥40 years.</p><p><strong>Methods: </strong>We analyzed 3033 adults from KNHANES. ASM/body weight (ASM/BW) and HGS/body weight (relative HGS) served as primary indicators. Participants were classified into four groups by sex-specific medians of both indicators, and complex-sample logistic regression estimated odds ratios (ORs) for MetS with both indicators entered simultaneously.</p><p><strong>Results: </strong>In the fully adjusted joint model, ASM/BW was inversely associated with MetS in men (OR 0.79, 95% CI 0.73-0.86) and women (OR 0.86, 0.80-0.92), as was relative HGS (men OR 0.98, 0.96-0.99; women OR 0.97, 0.95-0.98). The odds of MetS were highest with concurrently low muscle mass and strength (men OR 3.04; women OR 2.42). The ASM/BW association persisted when MetS was defined without the waist criterion, whereas the relative HGS association was attenuated; ASM/BMI showed similar inverse associations, whereas ASM/Ht² showed a different pattern.</p><p><strong>Conclusion: </strong>ASM/BW showed more consistent associations with MetS across the sensitivity analyses performed than relative HGS, although associations differed by normalization method, the optimal choice of which remains uncertain. Because the design is cross-sectional, these findings indicate association only and require prospective validation before clinical application.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216918","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":"Temporal trend analysis of the global prevalence of vision impairment and blindness attributable to diabetes from 1990 to 2021.","authors":"Xiuquan Lin, Chenglin Yang, Xiaoru Lin, Chongwen Zhao, Xiaoxi Wang, Xinyan Wang, YangJiang Ou, Yefa Zhang, Fanxiang Zeng, Dong Liang, Weimin Ye","doi":"10.1007/s12020-026-04774-6","DOIUrl":"10.1007/s12020-026-04774-6","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to systematically assess the burden and temporal patterns of vision impairment due to diabetes mellitus (DM), including moderate vision loss (MVL), severe vision loss (SVL), and blindness, and to identify the demographic drivers of future changes.</p><p><strong>Methods: </strong>An age-period-cohort (APC) model was used to evaluate the effects of age, period, and birth cohort on diabetes-related vision impairment, with analyses stratified by diabetes type, including type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). Decomposition analysis was further conducted to quantify the relative contributions of population aging, population growth, and epidemiological changes to projected changes in prevalent case numbers through 2030.</p><p><strong>Results: </strong>the age-standardized prevalence rates (ASPRs) of blindness due to type 1 diabetes mellitus (T1DM) continued to rise [males: average annual percentage change (AAPC) = 0.82% (95%CI 0.40-1.23); females: AAPC = 1.31% (95%CI 0.86-1.77)]. The age effect indicated that older populations were at higher risk. Meanwhile, the cohort effect revealed that in regions with high Sociodemographic Index (SDI), high-middle SDI, and middle SDI, later-born cohorts had a significantly higher risk of diabetes-related vision impairment compared to earlier-born cohorts. Globally and in most regions, population growth was the main driver of increased in the number of prevalent MVL and SVL cases, whereas epidemiological change contributed most to increases in prevalent blindness cases. However, population aging had a particularly substantial impact in East Asia, High-income Asia Pacific, Central Europe, Eastern Europe, and Western Europe.</p><p><strong>Conclusion: </strong>The global burden of vision impairment due to DM increased continuously. Older populations represented high-risk groups, and the burden varied by sex, diabetes type, and socioeconomic development, with T2DM contributing most to the overall increase in diabetes-related vision impairment. Although population growth and epidemiological changes were major contributors, the impact of population aging in certain regions was also noteworthy.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117487","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":"Optimizing adrenal vein sampling interpretation for primary aldosteronism subtyping.","authors":"Yuan Xiong, Shengjun Luo, Shili Peng, Ying Jing, Hang Shen, Xizi Zhang, Qinglian Zeng, Ying Song, Qianna Zhen, Yifan He, Wenwen He, Qi Zhang, Jinbo Hu, Linqiang Ma, Qifu Li, Shumin Yang","doi":"10.1007/s12020-026-04806-1","DOIUrl":"10.1007/s12020-026-04806-1","url":null,"abstract":"<p><strong>Context: </strong>Guidelines recommend adrenal vein sampling (AVS) for subtyping primary aldosteronism (PA); however, the optimal sample for determining lateralization when multiple successful adrenal vein samples are obtained is unclear.</p><p><strong>Objective: </strong>To compare the impact of different adrenal vein sample-selection strategies on PA subtyping.</p><p><strong>Methods: </strong>A retrospective study was conducted in PA patients who underwent bilaterally successful AVS with multiple samples obtained from each adrenal vein. LI was calculated using four different sample-selection strategies: (1) Maximum Aldosterone (Max Aldo), the sample with the highest aldosterone concentration; (2) Maximum Cortisol (Max Cort), the sample with the highest cortisol concentration; (3) Maximum ACR (Max ACR), the sample with the highest aldosterone-to-cortisol ratio (ACR) across samples; (4) Mean ACR, the average ACR of all samples. The theoretical detection rate of unilateral PA (UPA) and diagnostic accuracy for PA subtyping were compared among the four strategies.</p><p><strong>Results: </strong>A total of 585 patients with PA were included. In the 460 PA patients who underwent non-adrenocorticotropic hormone (ACTH)-stimulated AVS, the theoretical detection rate of UPA varied significantly among the four sample-selection strategies (P < 0.001), and was highest with Max Aldo (62.0%, 285/460), followed by Max ACR (59.1%, 272/460), Max Cort (57.8%, 266/460) and Mean ACR (56.3%, 259/460). Among 206 patients with postoperative diagnoses, the accuracy also differed significantly among the four strategies (P < 0.001), and Max Aldo ranked first (85.9%, 95% CI: 80.6%-90.1%), followed by Max ACR (84.0%, 95% CI: 78.4%-88.5%), Mean ACR (82.0%, 95% CI: 76.3%-86.8%), and Max Cort (78.2%, 95% CI: 72.0%-83.4%). Max Aldo was more accurate than Max Cort (adjusted P < 0.001), whereas no significant differences were observed between Max Aldo and Max ACR or Mean ACR (all adjusted P > 0.05). In the 308 patients who underwent ACTH-stimulated AVS, Max Aldo yielded the highest numerical detection rate and diagnostic accuracy; however, no significant differences were observed among the four strategies (P = 0.078 for theoretical UPA detection and P = 0.098 for diagnostic accuracy).</p><p><strong>Conclusion: </strong>For AVS with multiple samples, calculation of the LI based on the sample with the highest aldosterone concentration on each side tended to yield the highest numerical theoretical detection rate of UPA and accuracy, particularly in non-ACTH-stimulated AVS protocols.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117456","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":"The joint association of loneliness, social isolation, and satisfaction with major depressive disorder incidence in individuals with diabetes.","authors":"Yinxi Tan, Weiwei Wang, Hexiang Peng, Huangda Guo, Yi Zheng, Haodong Zhang, Yixin Li, Hanyu Zhang, Tao Wu, Jie Huang, Mengying Wang, Lu Qi","doi":"10.1007/s12020-026-04798-y","DOIUrl":"10.1007/s12020-026-04798-y","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the joint associations of life satisfaction, loneliness and social isolation in relation to the risk of incident major depressive disorder (MDD) in diabetes patients.</p><p><strong>Methods: </strong>A total of 7712 participants with diagnosed diabetes at baseline from the UK Biobank were included. Cox proportional hazards models and interaction analyses were used to examine associations of loneliness, social isolation, and life satisfaction with MDD.</p><p><strong>Results: </strong>During a median follow-up time of 11.1 years, 442 participants developed MDD (incidence rate: 5.73%). Participants with high loneliness, high social isolation, and low life satisfaction were associated with 176%, 82%, and 493% higher risks of MDD compared to those with low loneliness, low social isolation, and high life satisfaction, respectively (all P < 0.001). Several statistically significant interactions between loneliness and different aspects of life satisfaction were identified in relation to incident MDD. Participants with both low life satisfaction and high loneliness were at 8.06 times the risk of MDD than those with high life satisfaction and low loneliness.</p><p><strong>Conclusion: </strong>In individuals with diabetes, higher loneliness and social isolation are associated with increased MDD risk, whereas higher life satisfaction was associated with a lower risk. The joint associations varied across levels and domains of life satisfaction, although interaction patterns were not consistent across all measures or statistical scales. These findings may help identify individuals at elevated risk of MDD but should be interpreted cautiously given the observational design, potential residual confounding, and measurement limitations.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117471","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 between diabetes mellitus and short-term outcomes after transsphenoidal surgery for pituitary tumor: Evidence from the Taiwan Pituitary Tumor Registry 2009-2019.","authors":"Yi-Hsien Kuo, Ying-Yun Chen, Kuan-Hao Fu, Chia-Hsien Yang, Pin-Yuan Chen, Jiun-Lin Yan","doi":"10.1007/s12020-026-04785-3","DOIUrl":"10.1007/s12020-026-04785-3","url":null,"abstract":"<p><strong>Purpose: </strong>Diabetes mellitus (DM) may affect postoperative recovery, but evidence in pituitary tumor surgery remains limited. We investigated the association between DM and short-term outcomes after transsphenoidal surgery for pituitary tumors.</p><p><strong>Methods: </strong>We retrospectively analyzed adults in the Taiwan Pituitary Tumor Registry who underwent transsphenoidal surgery for benign pituitary tumors between 2009 and 2019. Patients were categorized into DM and non-DM groups. Associations between DM, prolonged length of hospital stays (LOS), 14-day readmission rate, and complications were determined using regression analyses. Tumor-type stratified analyses and receiver operating characteristic (ROC) analyses of glycated hemoglobin (HbA1c), fasting glucose, and random glucose were also performed.</p><p><strong>Results: </strong>Data of 970 patients were analyzed, of whom 144 (15%) had DM. DM was not significantly associated with prolonged LOS or 14-day readmission, but was significantly associated with higher odds of CSF leak (adjusted odds ratio [aOR] = 3.35, 95% confidence interval [CI]: 1.18-9.51, p = 0.023) and antibiotic use for ≥ 7 days (aOR = 5.41, 95% CI: 1.13-25.87, p = 0.034) in age-adjusted analysis. In the non-functioning tumor subgroup, the association with antibiotic use for ≥ 7 days persisted (aOR 7.37, 95% CI 1.46-37.12), whereas the association with CSF leak was not statistically significant. Among patients with DM and non-functioning tumors, glycemic markers showed apparent discrimination for postoperative infection and CSF leak, with area under the curve values ranging from 0.83 to 0.93.</p><p><strong>Conclusions: </strong>DM was associated with selected short-term complications after transsphenoidal surgery, particularly CSF leak and prolonged antibiotic use. These exploratory findings require confirmation in larger prospective studies with comprehensive surgical data.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117429","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":"Baseline and cumulative Hemoglobin Glycation Index and incident cardiovascular and cerebrovascular events in adults with early Cardiovascular-Kidney-Metabolic Syndrome: A prospective CHARLS Cohort study.","authors":"Hua-Wei Chen, Jiang-Ling Wang, Li-Zhi Lin, Yan Hao","doi":"10.1007/s12020-026-04803-4","DOIUrl":"10.1007/s12020-026-04803-4","url":null,"abstract":"<p><strong>Purpose: </strong>Cardiovascular-kidney-metabolic (CKM) syndrome reflects the interrelated progression of metabolic dysfunction, chronic kidney disease, and vascular risk. The hemoglobin glycation index (HGI), a marker of inter-individual glycation heterogeneity beyond fasting glycemia, has been associated with adverse cardiovascular outcomes; however, its role in early-stage CKM syndrome remains unclear. We investigated the associations of baseline HGI and cumulative HGI (CumHGI) with incident cardiovascular and cerebrovascular events in adults with CKM stages 0-3.</p><p><strong>Methods: </strong>We analyzed 3,783 participants aged ≥ 45 years from the China Health and Retirement Longitudinal Study (2011-2018) without baseline cardiovascular or cerebrovascular disease. Baseline HGI was assessed using a residual-based approach and analyzed as quartiles and a median-based dichotomous variable. CumHGI was calculated as the arithmetic mean of HGI measured in 2011 and 2015, reflecting average long-term glycation discordance. Incident cardiovascular and cerebrovascular events were evaluated using Kaplan-Meier curves, multivariable Cox proportional hazards models, and restricted cubic spline analyses.</p><p><strong>Results: </strong>During follow-up, 904 participants (23.9%) developed incident cardiovascular or cerebrovascular events. Compared with the lowest quartile of baseline HGI, adjusted hazard ratios were 1.24 (95% CI 1.02-1.49) for Q2, 1.30 (1.08-1.57) for Q3, and 1.24 (1.02-1.50) for Q4. High CumHGI was also associated with increased risk (HR 1.26, 95% CI 1.10-1.44). Associations were approximately linear across exposure levels. In models including conventional risk factors, addition of HGI or CumHGI did not materially improve discrimination (AUC 0.658 vs. 0.659 and 0.660, respectively).</p><p><strong>Conclusion: </strong>Higher baseline HGI and higher cumulative HGI were associated with increased risk of incident cardiovascular and cerebrovascular events in adults with early-stage CKM syndrome. These findings suggest that glycation discordance is associated with cardiovascular risk in this preclinical population; however, HGI-derived metrics provide limited incremental discrimination beyond established risk factors and may be more informative as risk-associated biomarkers than as standalone prediction tools.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117511","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":"Cardiovascular safety in middle-aged and older men under testosterone replacement therapy: a systematic review and meta-analysis.","authors":"Hongzhuo Qin, Dandan Zuo, Zhan Wang, Luwei Li, Lulu Zuo, Yingying Lv, Shiqi Tu, Jiaojiao Wang, Yun Chen, Xiaosi Li, Jieyu He, Qinyu Zou, Qiong Lu, Qiyue Zheng, Zhaokai Zhou","doi":"10.1007/s12020-026-04773-7","DOIUrl":"10.1007/s12020-026-04773-7","url":null,"abstract":"<p><strong>Background: </strong>Testosterone replacement therapy (TRT) is a standard treatment for men with hypogonadism, offering potential benefits including improvements in sexual function, body composition, bone mineral density, mood, and metabolic health. However, its cardiovascular safety remains uncertain due to conflicting evidence.</p><p><strong>Objectives: </strong>To assess the cardiovascular safety of testosterone replacement therapy in middle-aged and older men.</p><p><strong>Methods: </strong>PubMed, Web of Science, EMBASE and the Cochrane Library databases were searched for randomized-controlled trials (RCTs) published up to July 25, 2024. The Cochrane Handbook for Systematic Reviews of Interventions, version 6.0, guided our meta-analysis. PROSPERO registration number 42,023,421,479.</p><p><strong>Results: </strong>This meta-analysis included 31 RCTs with a total of 9,437 participants, and treatment durations ranged from 40 days to 36 months. TRT was associated with significant reductions in total cholesterol (WMD: -10.20; 95% CI: -14.52, -5.88 mg/dL; P = 0.005), triglyceride (WMD: -7.03; 95% CI: -12.25, -1.81 mg/dL; P = 0.008), and low-density lipoprotein (WMD: -6.64; 95% CI: -8.65, -4.63 mg/dL; P < 0.00001), whereas no significant change was observed in high-density lipoprotein cholesterol (WMD: -1.39; 95% CI: -3.12, 0.35 mg/dL; P = 0.12), compared with placebo. Additionally, TRT significantly prolonged the exercise time to the onset of 1-mm ST-segment depression during treadmill exercise testing (single-dose to 14 weeks; WMD: 67.37; 95% CI: 55.05, 79.69 s; P < 0.00001), and reduced carotid intima-media thickness (12-36 months; WMD: -0.03; 95% CI: -0.05, -0.02 mm; P = 0.0003). Among nonfatal cardiovascular events, a potential arrhythmia safety signal was observed (6598 participants, OR: 1.58; 95% CI: 1.21, 2.05; P = 0.0007).</p><p><strong>Conclusion: </strong>TRT appears to reduce overall cardiovascular risk factors in middle-aged and older men with low or low-normal testosterone levels, but the clinical significance of the observed arrhythmia signal remains uncertain.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117422","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}