Endocrine最新文献

{"title":"Clinical significance and risk factors of incidental parathyroidectomy after total thyroidectomy.","authors":"Mehmet Kostek, Isik Cetinoglu, Zerin Sengul, Hazal Arikan, Mehmet Taner Unlu, Ozan Caliskan, Nurcihan Aygun, Mehmet Uludag","doi":"10.1007/s12020-025-04225-8","DOIUrl":"10.1007/s12020-025-04225-8","url":null,"abstract":"<p><strong>Purpose: </strong>Postoperative hypoparathyroidism is the most common complication after total thyroidectomy(TT). The clinical significance of incidental parathyroid glands(IP) detected in pathological examination of removed surgical material is still controversial. The aim of this study was to evaluate the clinical follow-up findings and risk factors of patients with IP.</p><p><strong>Methods: </strong>Postoperative pathology results and postoperative biochemical findings of patients who underwent TT±Central Neck Dissection(CND)/Lateral Neck Dissection(LND) between September,2020 and September,2023 in single institution were retrospectively evaluated. Patients with IP were divided into Group-1, and patients without IP were divided into Group-2. Patients of Group-1 were divided as Single IP and Double IP subgroups according to the number of IP.</p><p><strong>Results: </strong>The findings of a total of 412 patients were evaluated. IP was detected in 90(21.8%) of the patients. Postoperative hypoparathyroidism was more common in Group-1 at the 6th hour, 24th hour and 1st month postoperatively (69.7% vs. 31.7%, p < 0.0001; 61.1% vs. 27.7%, p < 0.0001, 26.2% vs. 12.2%, p = 0.002, respectively). Persistent hypoparathyroidism was observed at a rate of 5.3% in Group-2 and 11.5% in Group-1 (p = 0.041). Postoperative hypocalcemia was seen more frequently in Group-1 than in Group-2 at the 12th hour (34.4% vs. 23.2%, p = 0.031, respectively). There was no difference between Single IP vs. Double IP groups for the serum levels of Calcium and PTH. Among the risk factors evaluated for the detection of IP, in the univariance analysis, operation indications(p = 0.018), CND(p < 0.0001), surgeon experience(p = 0.016), thyroid gland volume(p = 0.02), preoperative serum TSH value(p = 0.031); in multivariance analysis, operation type ( ± CND) (OR:2.785; 95% CI: 1.175-6.605; p = 0.020) and operator experience between 10-20 years (OR: 0.117, 95% CI: 0.033-0.418, p = 0.001) and >20 years (OR: 0.254, 95%CI: 0.085-0.760, p = 0.014) were found significant compared to operators experienced <5 years.</p><p><strong>Conclusion: </strong>Patients with detected IP after total thyroidectomy have lower postoperative Calcium and PTH. Significant risk factors for the IP were low level of surgeon experience and undergoing CND.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":"240-249"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065124","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":"Efficacy, safety, and risk factors of thermal ablation for follicular thyroid neoplasms: a multicentric study.","authors":"Xin-Yi Zhou, Bo-Qiang Fan, Jun-Feng He, Ying Zhou, Song-Song Wu, Shu-Rong Wang, Gang Dong, Jian-Qin Guo, Ying Wei, Zhen-Long Zhao, Jie Wu, Shi-Liang Cao, Na Yu, Yan Li, Li-Li Peng, Ming-An Yu","doi":"10.1007/s12020-025-04213-y","DOIUrl":"10.1007/s12020-025-04213-y","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the efficacy and safety of thermal ablation (TA) in managing follicular thyroid neoplasms (FN).</p><p><strong>Methods: </strong>This multicenter retrospective study involved participants diagnosed with FN across nine hospitals, undergoing microwave ablation or radiofrequency ablation from January 2014 to January 2024. Primary outcomes assessed were technical success and disease progression, with secondary outcomes including tumor size and volume changes, complete tumor disappearance, complications, and side effects. Subgroup analyses aimed to identify factors influencing tumor progression and complete disappearance.</p><p><strong>Results: </strong>The study enrolled 375 patients (mean age: 43.2 years ± 14.9 [standard deviation]; 298 women) with 482 FNs, tracked over an average of 23.6 months, achieving a 100% technical success rate. Disease progression was observed in 4.8% (18/375) of patients, with a local recurrence rate of 3.7% (14/375) and new neoplasm occurrence of 1.1% (4/375). Multifocal neoplasms emerged as an independent risk factor for disease progression (hazard ratio [HR], 3.48; 95% CI, 1.16-10.45; P = 0.026). Tumor volume significantly reduced (P < 0.001), particularly within 1-3 months post-ablation, with complete tumor disappearance observed in 10.4% (39/375) of cases, more likely in tumors smaller than 2 cm (HR, 0.11; 95% CI, 0.06-0.23; P < 0.001). Complications occurred in 2.9% of patients, with major events in 2.1% and minor in 0.8%.</p><p><strong>Conclusion: </strong>TA is a safe and efficacious method for treating FN, showing low rates of disease progression and complications. Optimal outcomes may be achieved in patients with unifocal FN and neoplasms under 2 cm.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":"125-136"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744359","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":"Efficacy assessment of repeat iodine-131 treatment in patients with papillary thyroid carcinoma assessed as biochemical incomplete response.","authors":"Zilin Wang, Chenghui Lu, Yihan Tian, Shiqi Wen, Meijing Huang, Congcong Wang, Xufu Wang, Fuxin Li, Wei Li, Yanhui Ji","doi":"10.1007/s12020-025-04232-9","DOIUrl":"10.1007/s12020-025-04232-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Although most patients with Papillary Thyroid Carcinoma (PTC) have a favorable prognosis, some continue to have elevated serum Thyroglobulin (Tg) levels after surgery and ¹³¹I treatment, classified as a Biochemical Incomplete Response (BIR). According to the 2015 American Thyroid Association (ATA) guidelines, 20% of these patients will develop a Structural Incomplete Response (SIR). Doctors often recommend ¹³¹I retreatment without imaging evidence, hoping for benefits. However, the effectiveness of this treatment strategy is still not supported by evidence. The aim of this study is to explore the potential benefits by comparing Tg levels and their changes in patients who were retreated with &lt;sup&gt;131&lt;/sup&gt;I and combining them with the results of follow-up assessment using Dynamic Risk Stratification (DRS).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective study collected clinical data from patients with PTC who underwent ¹³¹I therapy after surgery at two medical centers. All of them were evaluated for Biochemical Incomplete Response (BIR) after initial treatment. Based on whether they received ¹³¹I retreatment, they were divided into two groups: the retreatment group and the no-retreatment group. Our primary outcome measures included basic clinical data, suppressed Tg, change in Tg levels, and DRS stratification at the last follow-up. The potential benefits of ¹³¹I retreatment were analyzed by comparing the changes in Tg levels and the DRS distribution at the end of follow-up between the two groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Patients with PTC assessed for BIR after initial therapy showed a greater reduction in Tg at short-term follow-up after ¹³¹I retreatment compared to the no retreatment group (0.84 ng/mL vs. 0.72 ng/mL). The one-sample Wilcoxon signed-rank test results were T = 6.001, p &lt; 0.001 and T = 1.378, p = 0.168, respectively. At the end of follow-up, this treatment did not alter the DRS strata composition ratio (R = 3.06, p = 0.39). The area under the receiver operating characteristic curve for pre-ablation stimulated thyroglobulin (Ps-Tg) predicting non-remission status was 0.64 (95% CI: 0.55-0.73), with the highest Youden index (0.26) at a Ps-Tg cutoff of 20.5 ng/mL, corresponding to a sensitivity of 62.6% and a specificity of 63.3%. For the first suppressed Tg (sup-Tg) predicting non-remission, the AUC was 0.75 (95% CI: 0.67-0.84). The highest Youden index (0.40) was achieved at a sup-Tg cutoff of 1.85 ng/mL, corresponding to a sensitivity of 68.9% and a specificity of 70.8%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;For patients with PTC who received &lt;sup&gt;131&lt;/sup&gt;I therapy after surgery and are classified as BIR, &lt;sup&gt;131&lt;/sup&gt;I retreatment may accelerate the decline in Tg levels over time but does not change the DRS distribution. Only few of patients have structural and/or functional lesions detected on the whole-body scan after &lt;sup&gt;131&lt;/sup&gt;I retreatment. The Ps-Tg and first sup-Tg values after the f","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":"160-168"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043159","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":"Glucagon-like peptide-1 receptor agonists (GLP-1RAs) for the treatment of type 2 diabetes mellitus: friends or foes to bone health? a narrative review of clinical studies.","authors":"Antonella Al Refaie, Leonardo Baldassini, Caterina Mondillo, Sara Gonnelli, Elena Ceccarelli, Roberto Tarquini, Stefano Gonnelli, Luigi Gennari, Carla Caffarelli","doi":"10.1007/s12020-025-04253-4","DOIUrl":"10.1007/s12020-025-04253-4","url":null,"abstract":"<p><p>Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are a relatively new class of drugs for treatment of Type 2 Diabetes mellitus (T2DM). They have proven to be excellent drugs not only for the results on glycemic control but also for weight loss, cardiovascular protection and several other potential metabolic effects. In contrast, the effects of GLP-1RAs drugs on bone metabolism and bone mineral density (BMD) remain less clearly defined. This narrative review aimed to explore the relationship between GLP-1RAs and bone in T2DM patients by reviewing clinical studies which assessed the effects of GLP-1RAs on BMD, markers of bone turnover and fragility fractures. In vitro and animal studies have demonstrated that GLP-1RAs treatment promotes bone formation and inhibits bone resorption. However, in humans, GLP-1RAs therapy has been shown to primarily stimulate bone resorption, as evidenced by a significant increase in type I collagen C-terminal cross-linked telopeptide levels, while promoting new bone formation to a lesser extent. Clinical studies indicate that GLP-1RAs therapy, in both diabetic and non-diabetic patients, results in a reduction in BMD, which is more pronounced at skeletal sites subjected to higher mechanical loading, such as the femur and tibia, and appears to correlate with the degree of weight loss. Furthermore, in the studies reviewed, parameters related to bone quality and strength, such as Trabecular bone score (TBS), microindentation, High-resolution peripheral Quantitative Computed Tomography (HR-pQCT), and Radiofrequency Echographic Multi Spectrometry (REMS) remain unaffected by GLP-1RAs. Additionally, the incidence of fragility fractures does not increase.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":"30-38"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040361","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":"Interobserver agreement between artificial intelligence models in the thyroid imaging and reporting data system (TIRADS) assessment of thyroid nodules.","authors":"Andrea Leoncini, Pierpaolo Trimboli","doi":"10.1007/s12020-025-04272-1","DOIUrl":"10.1007/s12020-025-04272-1","url":null,"abstract":"<p><strong>Background: </strong>As ultrasound (US) is the most accurate tool for assessing the thyroid nodule (TN) risk of malignancy (RoM), international societies have published various Thyroid Imaging and Reporting Data Systems (TIRADSs). With the recent advent of artificial intelligence (AI), clinicians and researchers should ask themselves how AI could interpret the terminology of the TIRADSs and whether or not AIs agree in the risk assessment of TNs. The study aim was to analyze the interobserver agreement (IOA) between AIs in assessing the RoM of TNs across various TIRADSs categories using a cases series created combining TIRADSs descriptors.</p><p><strong>Methods: </strong>ChatGPT, Google Gemini, and Claude were compared. ACR-TIRADS, EU-TIRADS, and K-TIRADS, were employed to evaluate the AI assessment. Multiple written scenarios for the three TIRADS were created, the cases were evaluated by the three AIs, and their assessments were analyzed and compared. The IOA was estimated by comparing the kappa (κ) values.</p><p><strong>Results: </strong>Ninety scenarios were created. With ACR-TIRADS the IOA analysis gave κ = 0.58 between ChatGPT and Gemini, 0.53 between ChatGPT and Claude, and 0.90 between Gemini and Claude. With EU-TIRADS it was observed κ value = 0.73 between ChatGPT and Gemini, 0.62 between ChatGPT and Claude, and 0.72 between Gemini and Claude. With K-TIRADS it was found κ = 0.88 between ChatGPT and Gemini, 0.70 between ChatGPT and Claude, and 0.61 between Gemini and Claude.</p><p><strong>Conclusion: </strong>This study found that there were non-negligible variability between the three AIs. Clinicians and patients should be aware of these new findings.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":"197-201"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081618","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":"Current status, perceptions, and barriers regarding weight loss approaches in China.","authors":"Ziwei Lin, Hao Zhu, Si Si, Jiawei Xu, Esther Artime, Swarna Khare, Victoria Higgins, Andrea Leith, Yan Bi","doi":"10.1007/s12020-025-04315-7","DOIUrl":"https://doi.org/10.1007/s12020-025-04315-7","url":null,"abstract":"<p><strong>Purpose: </strong>To describe management and barriers regarding weight loss in China.</p><p><strong>Materials and methods: </strong>Data were from the Adelphi Real World Obesity Disease Specific Programme™, a cross-sectional survey between April and July 2022 in Chinese clinical practice. Physicians managing people with obesity or overweight (PwO) and PwO aged ≥ 18 years, under weight management programs, and/or with a body mass index ≥ 28 kg/m² were eligible.</p><p><strong>Results: </strong>100 physicians and 801 PwO were included. Before current clinical management, PwO had attempted self-management using their own diet (87%) and exercise (84%) programs, natural remedies/diet pills sold on the internet (26%) or over the counter diet pills (19%). Physicians reported that typical first-line weight management methods in clinical practice were diet (82%) and exercise (82%), with half (50%) using drug approaches. Only 19% of PwO reported full compliance with diet and exercise programs. Among the 78 physicians who used anti-obesity medications (AOMs), the single most important reason for initiating AOM was failure to reach the desired weight loss with diet and exercise alone (58%). Of the 78 physicians, 67% felt that most weight loss approaches always fail and 73% felt that AOM options were restricted; the top rated single most desired improvements in future AOMs were improved or greater efficacy (26%) and safer long-term use (26%). Of PwO, most (88%) had some willingness to try a new AOM.</p><p><strong>Conclusion: </strong>PwO usually self-managed initial weight loss attempts. Physicians typically initiated lifestyle interventions as first-line treatment despite low PwO compliance. Both physicians and PwO desired improved AOMs. Of note, no approved prescription-only AOMs were available in China during the time window of the study.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545783","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 admission serum calcium levels and in‑hospital mortality in acute myocardial infarction patients with cardiovascular-kidney-metabolic syndrome.","authors":"Jing Xu, Shuai Yu, Jian Huang, Li Geng, Yumiao Wei, Xin Li, Xin Gong","doi":"10.1007/s12020-025-04217-8","DOIUrl":"10.1007/s12020-025-04217-8","url":null,"abstract":"<p><strong>Purpose: </strong>Acute myocardial infarction (AMI) with cardiovascular-kidney-metabolic (CKM) condition is linked to a high in-hospital mortality. Some previous studies reported that calcium may be related with in-hospital mortality among patients with AMI. However, there is no report about the association between serum calcium and AMI patients with CKM syndrome. Therefore, this study investigated the association between admission serum calcium levels and in-hospital mortality in a cohort of AMI patients with CKM syndrome.</p><p><strong>Methods: </strong>This retrospective cohort study enrolled 2537 admitted patients with AMI including 270 patients with CKM. All the data were extracted from electronic medical records from May 2019 to April 2024. According to the reference range of serum calcium, all the 270 patients were divided into two groups, low calcium group (0-2.10 mmol/L) and non-low calcium group (from 2.11 mmol/L). The primary endpoint was in-hospital mortality.</p><p><strong>Results: </strong>The in-hospital mortality rate was significantly higher in the low calcium cohort (16.8%, n = 19) compared to the non-low calcium group (8.3%, n = 13). After adjusting for age, gender, hypertension, atrial fibrillation, stroke and smoke, patients in the low calcium group demonstrated significantly higher in-hospital mortality compared to the non-low calcium group (OR = 2.409, 95% CI: 1.105-5.249, p < 0.05). In subgroup analyses, the multivariable logistic regression models indicated that serum calcium was an independent predictor for in-hospital mortality in females (OR = 7.453; 95% CI = 1.751-31.730; p < 0.05) and elderly patients (OR = 3.122; 95% CI = 1.167-8.348; p < 0.05) after adjustments for hypertension, atrial fibrillation, stroke and smoke. Restricted cubic splines (RCS) regression analysis showed a dose-response relationship between serum calcium and in-hospital mortality (nonlinear P value = 0.067).</p><p><strong>Conclusions: </strong>Admission hypocalcemia is an independent risk factor of in-hospital mortality in AMI patients with CKM syndrome, especially in elderly individuals (aged ≥76 years) and females.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":"232-239"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744306","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 best approach to focused parathyroidectomy in an era of surgical backlogs.","authors":"P Del Rio, T Loderer, E Bonati","doi":"10.1007/s12020-025-04224-9","DOIUrl":"10.1007/s12020-025-04224-9","url":null,"abstract":"","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":"322-323"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036178","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":"Effects of timing and scheduling in levothyroxine adherence to hypothyroidism control: Meta-analysis with trial sequential analysis of Randomized Clinical Trials.","authors":"Bruno Simas da Rocha, Vitor Bock Silveira, Dimitris Varvaki Rados, André Borsato Zanella, Rafael Selbach Scheffel, Ana Luiza Maia, Jose Miguel Dora","doi":"10.1007/s12020-025-04229-4","DOIUrl":"10.1007/s12020-025-04229-4","url":null,"abstract":"<p><strong>Purpose: </strong>Treatment adherence for chronic conditions is a common clinical challenge. This systematic review aimed to assess the impact of scheduling and timing on levothyroxine adherence in patients with hypothyroidism.</p><p><strong>Methods: </strong>We searched multiple databases (PubMed, EMBASE, SCOPUS, Web Of Science, and CINAHL) using relevant terms related to hypothyroidism and medication adherence. Two independent reviewers conducted study selection, evaluation, and data extraction. The primary outcome was thyrotropin (TSH) levels, analyzed using inverse-variance meta-analysis. Trial sequential analysis (TSA) was conducted to assess the statistical reliability of the meta-analyses results.</p><p><strong>Results: </strong>Of the 706 articles initially found, 11 met the inclusion criteria: eight assessed evening administration and three evaluated weekly administration of levothyroxine. Comparison between evening and morning administration showed no significant difference in changes of TSH levels (dTSH 0.18; 95% confidence interval [95%CI] -0.29-0.65, P = 0.46). However, considering weekly administration of levothyroxine, TSH levels were higher in the experimental group (dTSH 1.14; 95%CI 0.80-1.14, P < 0.01), although the mean final TSH remained within the reference range in both groups. TSA indicated that the required information size was achieved for scheduling interventions.</p><p><strong>Conclusion: </strong>Both daily timing and weekly administration of levothyroxine were effective in maintaining TSH levels within reference values. Individualized dosing regimens may be considered based on patient convenience and preference.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":"52-61"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046908","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":"Time-divided hypoglycemia management derived by continuous glucose monitoring may reduce microvascular diseases in type 2 diabetes patients.","authors":"Yuqiong Li, Liwei Cai, Qinkang Lu, Weikun Gong, Penghao Wang, Tao Chen, Wen Ye, Bingqi Li, Hui Zhu, Zhifeng Xu, Jin Xu, Lindan Ji","doi":"10.1007/s12020-025-04250-7","DOIUrl":"10.1007/s12020-025-04250-7","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the association between hypoglycemia exposure and the risk of developing microvascular diseases (MVDs) in type 2 diabetes patients via continuous glucose monitoring (CGM), aiming to identify optimal hypoglycemia thresholds for improved glucose management.</p><p><strong>Methods: </strong>A total of 174 type 2 diabetes patients underwent 2 weeks of CGM. Binary multivariate logistic regression assessed the association between hypoglycemia exposure and MVDs prevalence at thresholds of 3.0-3.9 mmol/L.</p><p><strong>Results: </strong>After 14 days of monitoring, 79.9% of patients experienced hypoglycemia. The MVDs group had a significantly greater percentage of participants with hypoglycemia (glucose < 3.4 mmol/L: 57.6 vs. 39.8%, P = 0.023) and nocturnal hypoglycemia (glucose < 3.9 mmol/L: 62.1 vs. 46.3%, P = 0.043), with no significant difference in daytime hypoglycemia. After adjustment for confounders, only nocturnal hypoglycemia was independently associated with the risk of developing MVDs, and the prevalence of MVDs was positively associated with hypoglycemia severity. When the hypoglycemia threshold was reduced from 3.4-3.0 mmol/L, the odds ratio increased from 1.342 (1.026, 1.798) to 1.855 (1.141, 3.457). Further subgroup analysis revealed that nocturnal hypoglycemia below 3.4 mmol/L was a risk factor for the development of retinopathy and neuropathy (P < 0.05) but not for nephropathy.</p><p><strong>Conclusion: </strong>Nighttime glucose levels below 3.4 mmol/L are strongly associated with a greater risk of developing retinopathy and neuropathy in type 2 diabetes patients. Thus, blood glucose management should be time-specific, with daytime levels maintained above 3.9 mmol/L and nighttime levels maintained above 3.4 mmol/L.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":"99-110"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056286","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}