Endocrine最新文献

{"title":"Tissue-specific alterations in ACE2 and TMPRSS2 expression following gender-affirming hormone therapy: a preliminary study.","authors":"Serhat Uysal, Emre Durcan, Didem Altindirek, Sabriye Sibel Taze, Ogulcan Karali, Oguzhan Karali, Serdar Sahin, Senol Turan, Hande Mefkure Ozkaya, Muge Sayitoglu, Pinar Kadioglu","doi":"10.1007/s12020-026-04783-5","DOIUrl":"10.1007/s12020-026-04783-5","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the effects of gender-affirming hormone therapy (GAHT) on ACE2 and TMPRSS2 expression in nasal and oral mucosa.</p><p><strong>Methods: </strong>Transgender individuals initiating GAHT at the Endocrinology and Metabolism outpatient clinic were prospectively enrolled. Nasal and oral swabs were collected at baseline, 6 months, and 12 months. Age- and sex-matched healthy cisgender individuals served as controls. The impact of GAHT on ACE2 and TMPRSS2 expression in nasal and oral mucosa was evaluated using quantitative real-time PCR.</p><p><strong>Results: </strong>The study included 35 individuals undergoing GAHT, including 19 assigned female at birth (AFAB) individuals undergoing masculinizing GAHT and 16 assigned male at birth (AMAB) individuals undergoing feminizing GAHT, with 31 completing follow-up. The control group comprised 15 cisgender males and 18 cisgender females. In AFAB individuals receiving testosterone therapy, nasal TMPRSS2 expression increased significantly from baseline at 12 months (p = 0.008), whereas oral TMPRSS2 expression remained stable (p = 0.810). Following one year of testosterone therapy, nasal TMPRSS2 expression in AFAB individuals was higher than in cisgender males, although the difference was not statistically significant (p = 0.290). Significant correlations between ACE2 and TMPRSS2 expression were observed exclusively in nasal mucosa after one year of GAHT in both AFAB and AMAB individuals (r = 0.699, p < 0.001 and r = 0.727, p = 0.007, respectively).</p><p><strong>Conclusion: </strong>Testosterone therapy was associated with increased nasal TMPRSS2 expression in AFAB individuals after 12 months, warranting further investigation of these tissue-specific transcriptional changes.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983492","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":"Validation of a thyroid malignancy risk calculator in a Portuguese cohort.","authors":"Beatriz Tavares da Silva, Liliana Fonseca, Cláudia Freitas, André Carvalho","doi":"10.1007/s12020-026-04786-2","DOIUrl":"10.1007/s12020-026-04786-2","url":null,"abstract":"<p><strong>Purpose: </strong>The Carral et al. calculator integrates clinical, laboratory and ultrasound variables to estimate thyroid malignancy risk. We independently evaluated its performance in a Portuguese surgical cohort.</p><p><strong>Methods: </strong>We conducted a retrospective study including patients who underwent total thyroidectomy between 2021 and 2023. For patients with multiple nodules, the calculator was applied to the index nodule, defined as the one with the highest EU-TIRADS score or, when equal, the largest diameter. Original predicted probabilities were compared with histopathology. Discrimination was assessed by area under the receiver operating characteristic curve (AUC); calibration by plot, Hosmer-Lemeshow test, intercept and slope.</p><p><strong>Results: </strong>Among 153 patients (mean age 52.1 ± 12.6 years; 86.3% female), 32 (20.9%) had differentiated thyroid carcinoma. Median predicted risk was 37.7% (IQR 21.8-58.6%) in malignant and 1.56% (IQR 0.37-6.2%) in benign nodules (p < 0.001). AUC was 0.877 (95% CI 0.82-0.93). Calibration was imperfect (Hosmer-Lemeshow p = 0.28; intercept 0.85, 95% CI 0.51-1.23; slope 0.78, 95% CI 0.63-0.91). At the 9.2% Youden threshold, sensitivity, specificity, positive predictive value and negative predictive value were 75.0%, 84.3%, 55.8% and 92.7%, respectively. Subgroup analyses were exploratory.</p><p><strong>Conclusions: </strong>The calculator showed excellent discrimination but imperfect calibration in this selected surgical cohort. Prospective validation and clinical-impact assessment in unselected populations are required before it is used to alter fine-needle aspiration decisions.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983524","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":"Glucocorticoids: an enemy or a friend for the dermatologist? recommendations for proper use and safe discontinuation.","authors":"Evangelia Sali, Ioanna A Paschou, Sofia M Dimopoulou, Anna Tagka, Vasiliki Chasapi, Electra Nicolaidou, Alexander J Stratigos, Melpomeni Peppa, Stavroula A Paschou","doi":"10.1007/s12020-026-04778-2","DOIUrl":"10.1007/s12020-026-04778-2","url":null,"abstract":"<p><strong>Purpose: </strong>Glucocorticoids (GCs) are steroid hormones produced by the adrenal cortex with anti-inflammatory and immunoregulating effects, thus essential for the management of numerous inflammatory and autoimmune disorders, including a wide range of dermatological conditions. The aim of our review is to summarize current data about the indications for GCs in dermatology, present the dermatological and endocrinological adverse effects and summarize current recommendations about the proper use and safe discontinuation of GCs, creating a practical guide for dermatologists.</p><p><strong>Methods: </strong>A narrative review of the literature on PubMed/MEDLINE was conducted and included articles in English, published until July, 2026. A combination of the keywords \"glucocorticoids\", \"dermatology\", \"adrenal insufficiency\", \"HPA axis\", \"adverse effects\" and \"monitoring\" was used to identify relevant literature for this review, with emphasis on recent recommendations and guidelines. The reference lists of the selected publications were also reviewed.</p><p><strong>Results: </strong>Although GCs are commonly prescribed medications in dermatology, their use is associated with numerous adverse effects, extending beyond the skin to multiple organ systems. However, some side effects, such as adrenal insufficiency and withdrawal syndrome, may even be life-threatening.</p><p><strong>Conclusion: </strong>Due to the expanded use of GCs, careful prescription and safe discontinuation is required. For this reason, we have created a practical clinical guide, summarizing the relevant recommendations to ensure proper use of GCs as well as safe discontinuation of the treatment. Optimal GC use requires individualized and careful selection of potency, duration, and route of administration to prevent any side effects and ensure the best outcome for the patient.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13582095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Growth differentiation factor-15 and body roundness index in relation to cardiometabolic risk in young adults with obesity.","authors":"Omar Jasim Mohammed, Hassanain K Mehdi","doi":"10.1007/s12020-026-04784-4","DOIUrl":"10.1007/s12020-026-04784-4","url":null,"abstract":"<p><strong>Purpose: </strong>Cardiometabolic risk in young adults is often subclinical. This cross-sectional study evaluated Growth Differentiation Factor-15 (GDF-15) and Body Roundness Index (BRI) in relation to cardiometabolic risk in young adults.</p><p><strong>Methods: </strong>Ninety adults aged 18-35 years were classified into control, low-risk, and high-risk groups using predefined criteria. Anthropometric, glycemic, and lipid parameters, hs-CRP, GDF-15, leptin, and adiponectin were analyzed using ANCOVA, partial correlation, regression, and ROC analysis.</p><p><strong>Results: </strong>GDF-15 rose progressively across groups (control 337.7 ± 82.6, low-risk 865.8 ± 76.9, high-risk 1130.7 ± 79.2 pg/mL; p < 0.001). Leptin, the leptin-to-adiponectin ratio, and adiponectin were higher in both risk groups than controls (p < 0.001), with no difference between risk groups. GDF-15 showed high discriminatory ability for controls versus obese groups (AUC 0.939-0.954), reflecting phenotypic separation, but only modest discrimination between low-risk and high-risk groups (AUC = 0.677, 95% CI 0.535-0.819; p = 0.024), the clinically relevant comparison. In exploratory subgroup regression, adiponectin was associated with GDF-15 in low-risk (β = 0.465, p = 0.011) and high-risk groups (β = 0.551, p = 0.038). Combining GDF-15 with waist-to-hip ratio gave a numerically higher AUC (0.708), although the difference was not formally tested.</p><p><strong>Conclusion: </strong>GDF-15 levels increased progressively across the study groups and remained significantly different across groups after adjustment for age. GDF-15 and adiponectin showed very high discrimination between obese participants and controls but only modest discrimination between risk groups. These exploratory, cross-sectional findings identify GDF-15 as a candidate biomarker of cardiometabolic risk in young adults, requiring confirmation in larger prospective cohorts.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984031","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":"Neoadjuvant therapy in thyroid cancer: an emerging approach.","authors":"Fabián Pitoia, Inés Califano, Marika Russell, David Shonka, Pierpaolo Trimboli, Laura Fugazzola, Gregory Randolph","doi":"10.1007/s12020-026-04797-z","DOIUrl":"10.1007/s12020-026-04797-z","url":null,"abstract":"<p><strong>Purpose: </strong>Neoadjuvant therapy in thyroid cancer has emerged as a promising strategy for selected patients with locally advanced disease, but its rationale and clinical impact vary substantially across histologies.</p><p><strong>Methods: </strong>This comment examines the current evidence and clinical rationale for neoadjuvant therapy across anaplastic, differentiated and medullary thyroid carcinomas.</p><p><strong>Results: </strong>For BRAF V600E-mutated anaplastic thyroid carcinoma, targeted therapy has created a meaningful window for surgical resection in patients previously considered unresectable, representing the clearest proof of concept. In differentiated thyroid cancer, preoperative systemic therapy remains more selective and investigational, mainly supported by case reports, small series, and early clinical trial data, with unresolved questions regarding patient selection, optimal treatment, surgical endpoints, and durability of benefit. With medullary thyroid carcinoma, evidence remains even more limited.</p><p><strong>Conclusions: </strong>Neoadjuvant therapy should not be viewed as a uniform paradigm across thyroid cancers, but as a histology-specific strategy with applicability based on tumor responsiveness amounting to improved resectability, reduced surgical morbidity, durable disease control, and real-world feasibility.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983050","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":"Homocysteine and mitophagy in diabetic retinopathy: unraveling the underlying molecular crosstalk.","authors":"Nian Tan, Yanru Chen, Min Li, Wei Liu, Xiaoyun Li, Pengyuan Li, Xunwen Lei","doi":"10.1007/s12020-026-04787-1","DOIUrl":"10.1007/s12020-026-04787-1","url":null,"abstract":"<p><strong>Purpose: </strong>Diabetic retinopathy (DR), the leading cause of blindness among microvascular complications of diabetes, remains poorly understood regarding its pathogenesis, with effective clinical interventions remaining limited. Emerging evidence indicates that hyperhomocysteinemia (HHcy) and mitochondrial autophagy dysfunction act synergistically as key pathogenic drivers in DR progression, where their interactive cascade serves as a central mechanism disrupting retinal homeostasis.</p><p><strong>Methods: </strong>This review systematically examines the complex mechanisms through which HHcy induces oxidative stress, inflammation, and endothelial dysfunction contributing to retinal injury, while elucidating the stage-specific regulatory dynamics of mitochondrial autophagy during DR pathogenesis.</p><p><strong>Results: </strong>We specifically investigate the molecular mechanism by which HHcy triggers mitochondrial autophagy dysfunction through oxidative stress-mediated regulation of the AMPK/mTOR signaling axis, thereby establishing a pathogenic positive feedback loop that accelerates DR progression.</p><p><strong>Conclusions: </strong>Given the current lack of direct causal evidence, absence of retina-specific in vivo models, and incomplete understanding of their dynamic interactions, comprehensive analysis of core molecular nodes within the \"HHcy-mitochondrial autophagy\" regulatory axis is expected to refine the theoretical framework of DR pathogenesis while providing experimental foundations for developing targeted therapeutic strategies against DR-induced retinal damage.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984034","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":"Clinically relevant depression in patients with type 1 and type 2 diabetes; a nationwide study (TEMD-2 depression).","authors":"Bagdagul Yuksel Guler, Ibrahim Demirci, Cem Haymana, Esen Akbay, Bahri Evren, Oguzhan Sitki Dizdar, Orhan Demir, Kemal Agbaht, Ilker Tasci, Canan Ersoy, Serpil Salman, Fahri Bayram, Ilhan Satman, Alper Sonmez","doi":"10.1007/s12020-026-04676-7","DOIUrl":"10.1007/s12020-026-04676-7","url":null,"abstract":"<p><strong>Purpose: </strong>Depression is a common but underrecognized comorbidity in individuals with diabetes and is associated with adverse clinical outcomes. This nationwide study aimed to determine the prevalence of clinically relevant depression (CRD) among adults with type 1 and type 2 diabetes in Türkiye and to identify clinical and metabolic factors independently associated with CRD.</p><p><strong>Methods: </strong>This cross-sectional analysis was conducted within the Turkish nationwide survEy of glycemic and other Metabolic parameters of patients with Diabetes mellitus-2 (TEMD-2), a multicenter study including adults followed in tertiary endocrinology centers across Türkiye. CRD was defined as a Patient Health Questionnaire-9 score ≥ 10 and/or current antidepressant use.</p><p><strong>Results: </strong>A total of 5.266 patients were included. The prevalence of CRD was similar in type 1 and type 2 diabetes (29.4% vs. 27.6%, p = 0.345). In both diabetes types, CRD was significantly more common among women. Patients with CRD had higher body mass index, poorer glycemic control, higher rates of hypoglycemia, and lower achievement of metabolic targets. Microvascular and macrovascular complications were more frequent in patients with CRD. In multivariable analyses, female sex, smoking, and polypharmacy were independently associated with CRD in both diabetes types, while obesity, poor glycemic control, and vascular complications were additional independent associates in type 2 diabetes.</p><p><strong>Conclusion: </strong>CRD affects nearly one-third of adults with diabetes, regardless of diabetes type, and is associated with greater comorbidity burden and suboptimal metabolic control. These findings support routine depression screening as an integral component of comprehensive diabetes care. The study is registered at ClinicalTrials.gov (NCT06347445).</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921526","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 nandrolone decanoate on lean body mass and anemia in adults with chronic kidney disease: a systematic review and meta-analysis.","authors":"Lucas Caseri Câmara, Diogo Pinto da Costa Viana, Lúcio de Sousa Monte Alto, Samara Oliveira Mattoso, Nelson Carvas Junior, Matheus Hissa Lourenço Ferreira, Zahid Khan","doi":"10.1007/s12020-026-04771-9","DOIUrl":"10.1007/s12020-026-04771-9","url":null,"abstract":"<p><strong>Purpose: </strong>Protein-energy wasting, sarcopenia, and anemia are common complications of chronic kidney disease (CKD) and are associated with poor outcomes. This systematic review and meta-analysis evaluated the effects of nandrolone decanoate on lean body mass and hematologic parameters in adults with CKD.</p><p><strong>Methods: </strong>We searched PubMed/MEDLINE, CENTRAL, Embase, and LILACS up to February 18, 2026, for randomized controlled trials of intramuscular nandrolone decanoate in adults with CKD. Primary outcomes were lean body mass, hemoglobin, and hematocrit. Risk of bias and certainty of evidence were assessed using RoB 2 and GRADE, respectively.</p><p><strong>Results: </strong>Fifteen RCTs published between 1974 and 2021 were included. Nandrolone decanoate was associated with increased lean body mass (4 trials; n = 125; MD 2.63 kg, 95% CI 1.60-3.65). Pooled estimates for hemoglobin (6 trials; n = 239; MD 0.81 g/dL) and hematocrit (7 trials; n = 198; MD 3.12%) also favored nandrolone, but were limited by substantial heterogeneity and very low certainty of evidence, precluding firm conclusions. Quality-of-life effects were inconsistent, and long-term safety data were sparse.</p><p><strong>Conclusion: </strong>Nandrolone decanoate was associated with increased lean body mass in adults with CKD. However, the evidence base is largely historical, and substantial heterogeneity and very low certainty of evidence preclude firm conclusions regarding hematologic benefits. Contemporary randomized trials are needed to clarify whether nandrolone has any role in current CKD management.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Growth hormone deficiency: craniofacial characteristics and changes after growth hormone therapy - a systematic review.","authors":"Panagiotis Pallis, Ioannis Padouvas, Evangelos Theodoros Markos, Ioanna Pouliezou, Iosif Sifakakis","doi":"10.1007/s12020-026-04763-9","DOIUrl":"10.1007/s12020-026-04763-9","url":null,"abstract":"<p><strong>Background: </strong>Growth hormone deficiency (GHD) is among the most common pituitary hormone disorders in children, causing impaired growth in children and may also affect craniofacial and dental development. Growth hormone therapy (GHT) is the main course of treatment. Despite the high prevalence of GHD, the craniofacial phenotype associated with GHD and the changes observed during therapy have been only partially reviewed in the current literature.</p><p><strong>Purpose: </strong>This systematic review aimed to compile evidence from January 2000 to April 2026 regarding the craniofacial features of children and adolescents with non-syndromic GHD, as well as the craniofacial changes observed during GHT.</p><p><strong>Methods: </strong>PubMed, Google Scholar and Scopus were searched for studies published from 2000 to April 2026 that assessed craniofacial or dental changes in non-syndromic GHD patients undergoing GHT. Two reviewers screened the studies and assessed risk of bias using the AXIS tool and the Newcastle-Ottawa Scale. Owing to methodological and clinical heterogeneity, a meta-analysis was not performed.</p><p><strong>Results: </strong>A total of 621 records were identified; after removing duplicates and applying screening criteria, 10 studies were included. Baseline data generally showed that children with GHD had smaller cranial base and jaw dimensions, retrognathic maxillary and mandibular positions, increased facial convexity, and delayed dental development or eruption compared to healthy peers. Studies on GHT mostly reported craniofacial growth approaching reference values, especially in the maxilla, mandibular ramus, and facial height. Nonetheless, the evidence was limited by small sample sizes, diverse outcome measures, mixed control groups, and generally moderate risk of bias.</p><p><strong>Conclusion: </strong>Available observational evidence indicates that non-syndromic GHD is associated with a characteristic pattern of craniofacial underdevelopment and delayed dentofacial maturation, whereas GHT may partially normalize several craniofacial parameters. These findings should be interpreted with caution because all included studies were observational and clinically diverse.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cluster-derived immunometabolic profiles: association with glycemic dysregulation in elderly postmenopausal women.","authors":"Ana Cristina Lira de Menezes, Ingrid Almeida Maciel, Eduarda Caroline Oliveira Barros, Nailza Maestá, Steven S Witkin, Fábio Lera Orsatti, Cláudio Lera Orsatti","doi":"10.1007/s12020-026-04762-w","DOIUrl":"10.1007/s12020-026-04762-w","url":null,"abstract":"<p><strong>Purpose: </strong>To identify variations in immunometabolic profiles in elderly postmenopausal women using a data-driven clustering approach and to examine differences in insulin resistance (HOMA-IR) and glycemic control (HbA1c) across the derived profiles.</p><p><strong>Methods: </strong>This cross-sectional study included 132 women with a mean age of 70.8 years. Unsupervised hierarchical cluster analysis (Ward.D2 method, squared Euclidean distance) was performed using twelve variables spanning demographic, hemodynamic, metabolic, inflammatory, and vitamin D-related domains. HbA1c and HOMA-IR were compared across clusters; HOMA-IR was not fully independent of cluster derivation because fasting glucose contributes to its calculation. Between-cluster differences were assessed using Kruskal-Wallis tests or one-way ANOVA. DSCF post-hoc tests and epsilon-squared (ε²) effect sizes were used for non-parametric comparisons.</p><p><strong>Results: </strong>Three cluster-derived profiles were identified (Cluster 1, n = 25; Cluster 2, n = 50; Cluster 3, n = 57). Cluster 1 was characterized by lower IL-10 levels and a less favorable lipid profile, while blood pressure was similarly elevated in Clusters 1 and 2 relative to Cluster 3. Cluster 2 showed an overall intermediate profile, with the lowest vitamin D concentration as its most distinctive feature. Cluster 3 exhibited lower blood pressure, higher IL-10 levels, and a more favorable lipid profile. When examining these additional glycemic measures, HbA1c showed a graded increase across clusters (p < 0.05 for all pairwise comparisons), whereas HOMA-IR differed between Cluster 3 and Clusters 1 and 2 but did not differ significantly between Clusters 1 and 2.</p><p><strong>Conclusion: </strong>The differentiation of elderly postmenopausal women into three data-driven immunometabolic profiles illustrated substantial heterogeneity. These findings suggest that HbA1c may provide complementary information to fasting-based indices when characterizing immunometabolic heterogeneity in elderly postmenopausal women.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}