Endocrine最新文献

{"title":"Pan-immune-inflammation value is associated with thyroid autoantibody positivity in a Chinese health examination cohort.","authors":"Yunzhi Chen, Jialin Liao, Wenwen Feng, Yanlian Tan, Haixia Guan, Zixiao Wang","doi":"10.1007/s12020-026-04726-0","DOIUrl":"10.1007/s12020-026-04726-0","url":null,"abstract":"<p><strong>Purpose: </strong>Autoimmune thyroid disease (AITD) is associated with adverse health outcomes, yet routine thyroid autoantibody testing may not always be practical in general screening settings. The pan-immune-inflammation value (PIV), derived from complete blood counts, represents a simple, low-cost marker of systemic inflammation. This study investigated the association between PIV and thyroid autoantibody positivity in a health examination cohort.</p><p><strong>Methods: </strong>This cross-sectional study included 5,785 Chinese adults undergoing routine health examinations at the First Hospital of China Medical University. Associations between PIV and anti-thyroglobulin (TgAb) or anti-thyroid peroxidase (TPOAb) antibody positivity were evaluated using multivariable logistic regression and restricted cubic spline (RCS) models. Subgroup analyses explored interactions with demographic and metabolic factors.</p><p><strong>Results: </strong>RCS analyses revealed significant non-linear associations between PIV and TgAb (P for non-linearity = 0.002) as well as TPOAb (P = 0.043) positivity. In fully adjusted models, the highest PIV quartile was associated with an increased risk of TgAb positivity compared to the lowest quartile (OR 1.23, 95% CI 1.03-1.47, P = 0.026). The association with TPOAb was borderline significant (P = 0.061). Notably, the relationship was prominent in females and significantly amplified by hypertension (P for interaction = 0.038).</p><p><strong>Conclusion: </strong>Elevated PIV is non-linearly associated with thyroid autoantibody positivity, particularly TgAb, with stronger effects observed in women and hypertensive individuals. As an inexpensive index derived from routine blood tests, PIV may be a useful adjunctive marker for identifying thyroid autoantibody positivity.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663874","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 in tight range and time in range in relation to diabetic retinopathy and OCTA-derived retinal microvascular parameters in hospitalized adults with type 1 diabetes.","authors":"Ruoxuan Zheng, Cong Zhang, Xiaotong Sun, Jingjing Li, Li Wang, Shimeng Huang, Rui Hou, Siyu Dong, Shuang Wu, Hongxue Li, Linlin Zhang, Binglin Kuang, Lei Zheng, Baiwen Zhang, Changwei Yang, Hongyu Kuang","doi":"10.1007/s12020-026-04735-z","DOIUrl":"10.1007/s12020-026-04735-z","url":null,"abstract":"<p><strong>Aim: </strong>Time in Tight Range (TITR) is physiologically closer to normoglycemia than time in range (TIR) and has been linked to microvascular risk. We aimed to evaluate associations of TITR with diabetic retinopathy (DR) and optical coherence tomography angiography (OCTA)-derived retinal parameters in adults with type 1 diabetes (T1D) and to compare its performance with TIR.</p><p><strong>Methods: </strong>We retrospectively included adults with T1D who underwent continuous glucose monitoring (CGM) and OCTA. TITR-DR associations were tested using multivariable logistic regression with restricted cubic splines. Linear mixed-effects models assessed TITR/TIR associations with OCTA-derived parameters, followed by exploratory threshold-based comparisons. DR discrimination of TITR versus TIR was assessed using ROC analysis.</p><p><strong>Results: </strong>We analyzed 259,568 glucose readings from 153 participants. Each 10-percentage-point increase in TITR was associated with 29.5% lower odds of DR (adjusted OR 0.705; p = 0.004), without evidence of nonlinearity. In continuous analyses, both TITR and TIR were positively associated with deep vascular complex (DVC) vessel density and perfusion area; in exploratory threshold-based analyses, the TITR 50% cutoff showed significant DVC differences, whereas the TIR 70% cutoff showed no consistent differences. DR discrimination was similar for TITR and TIR (p = 0.635), whereas TITR was more closely related to hypoglycemia exposure (p < 0.01).</p><p><strong>Conclusions: </strong>Higher TITR was associated with lower odds of DR and more favorable DVC vessel density and perfusion area in hospitalized adults with T1D. TITR showed DR discrimination comparable to TIR but may provide complementary information on hypoglycemia exposure and DVC differences in threshold-based analyses.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664578","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 and factors associated with ultrasound-detected hepatopathy in Indian adolescents with type 1 Diabetes Mellitus.","authors":"Shruti Mondkar, Mugdha Deshpande, Sonali Wagle, Anuradha Khadilkar, Vaman Khadilkar","doi":"10.1007/s12020-026-04733-1","DOIUrl":"10.1007/s12020-026-04733-1","url":null,"abstract":"<p><strong>Background: </strong>Hepatic involvement in Type 1 Diabetes Mellitus (T1DM) is increasingly recognized, with hepatopathy emerging as an important but underexplored comorbidity. Data on its prevalence and associated factors, particularly in Indian children and adolescents, remain limited.</p><p><strong>Objective: </strong>To estimate the prevalence of ultrasound-diagnosed hepatopathy and identify its associated risk factors among Indian children and adolescents with T1DM.</p><p><strong>Methods: </strong>This cross-sectional study included 510 children and adolescents with T1DM from a tertiary care center in western India. Clinical, anthropometric, biochemical, dietary, physical activity, and resting metabolic rate (RMR) data were collected. Hepatopathy was assessed using ultrasonography. Logistic regression analysis was performed to identify independent associated factors.</p><p><strong>Results: </strong>The prevalence of hepatopathy was 10.4%. Children with hepatopathy had significantly higher waist circumference, blood pressure, insulin requirements, and lower moderate-to-vigorous physical activity (p < 0.05). They also exhibited poorer glycemic control, dyslipidemia, elevated liver enzymes, and reduced insulin sensitivity. RMR adjusted for insulin was significantly lower in those with hepatopathy. Multivariable analysis identified that higher waist circumference, higher insulin dose, elevated triglycerides, poor glycemic control, lower physical activity, and lower RMR were associated with hepatopathy (p < 0.05).</p><p><strong>Conclusion: </strong>Hepatopathy is a clinically relevant comorbidity among Indian children and adolescents with T1DM, associated with metabolic dysfunction, lifestyle factors, and altered energy metabolism. Early identification through ultrasound-based screening and targeted interventions focusing on glycemic control, adiposity, and physical activity may be critical in preventing long-term hepatic and cardiometabolic complications.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664177","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 genetic characteristics of patients with complete androgen insensitivity syndrome: an experience from a tertiary care centre of Kashmir Valley.","authors":"Raiz Ahmad Misgar, Sajad Ul Isam Mir, Shariq Rashid Masoodi, Ajaz Qadir, Imtiyaz Ahmad Bhat, Zafar Amin Shah, Mir Iftikhar Bashir, Arshad Iqbal Wani","doi":"10.1007/s12020-026-04725-1","DOIUrl":"10.1007/s12020-026-04725-1","url":null,"abstract":"<p><strong>Purpose: </strong>Complete Androgen Insensitivity Syndrome (CAIS) is a rare X-linked disorder caused by pathogenic variants in the androgen receptor (AR) gene, leading to resistance to androgens in individuals with a 46, XY karyotype.</p><p><strong>Materials and methods: </strong>This study aims to describe the clinical and genetic profile of CAIS patients from a tertiary care hospital in northern India. Thirteen consecutive patients with a clinical diagnosis of CAIS evaluated at our centre between August 2013 to May 2025 were included. The evaluation included detailed clinical assessment, hormonal evaluation and genetic analysis. Genetic analysis was performed by using a customized next-generation sequencing panel that included AR gene and nine other genes including WNT4, SRD5A2, CYP21A2, POR, HSD17B3, NR5A1, CYP17A1, SOX9, and CYP11B1. The panel covered whole genes including non-coding regions (splice-site and introns).</p><p><strong>Results: </strong>Ten patients presented at puberty with primary amenorrhea and three patients presented in the pre-pubertal period with bilateral inguinal hernias and phenotypically female external genitalia. Pathogenic or likely pathogenic AR variants were identified in 10 of 13 (76.9%) patients. These include likely three novel variants (missense variant c.2198 A > G; in-frame long deletion c.403_1420delGCGG and splice-site deletion c.1616+3_1616 + 6delAAGT) and two known variants (frameshift insertion c.239_240insGCAGCAGC and canonical splice-site variant c. 2608-1G > T). Notably, 7 of the 10 variants were splice-site variants.</p><p><strong>Conclusion: </strong>This is the largest study of CAIS patients from India. The main contribution of our study is the detection of likely three novel and two known pathogenic variants of AR gene associated with CAIS in a Kashmiri cohort. The high frequency of splice-site variants highlights the need to include non-coding regions in the analysis of AR gene for accurate molecular diagnosis.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664792","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":"Early versus delayed oral sialagogues for the prevention of salivary gland dysfunction after radioiodine therapy in differentiated thyroid cancer: a systematic review.","authors":"Andressa Frankowski Dagostin, Novel Yourdhan Rehandhika, Ana Luiza Potiguara de Souza, Soemiwati Holland","doi":"10.1007/s12020-026-04727-z","DOIUrl":"10.1007/s12020-026-04727-z","url":null,"abstract":"<p><strong>Background: </strong>Salivary gland dysfunction is a recognized complication of radioactive iodine (RAI) therapy for differentiated thyroid cancer. Oral sialagogues are commonly recommended, but their optimal timing remains uncertain. This systematic review compares early (<24 h) versus delayed (>24 h) sialagogue initiation.</p><p><strong>Methods: </strong>A literature search was conducted in Embase, PubMed, CINAHL, and Cochrane from inception to January 2026. \"Early\" protocols initiated stimulation within 24 h post-RAI, while \"delayed\" protocols initiated after 24 h. Methodological quality and risk of bias were assessed using Cochrane's ROBINS-I (Risk Of Bias In Non-randomized Studies of Interventions, 2016) tool.</p><p><strong>Results: </strong>Three observational studies were included, comprising 818 adults with reported mean ages of 43-59 years. Interventions consisted primarily of lemon candy or oral vitamin C tablets. Primary outcomes included acute sialadenitis (pain and/or swelling), taste dysfunction, and xerostomia. Findings regarding acute salivary gland outcomes were inconsistent. Two earlier studies reported higher rates of acute sialadenitis with early stimulation (54.7-63.8% vs. 34.4-36.8%), taste dysfunction (37.5-39.0% vs. 18.8-25.6%), and xerostomia (23.8-46.9% vs. 11.2-29.7%) compared with delayed initiation. In contrast, the most recent propensity score-matched study, which evaluated a composite endpoint of acute salivary gland damage, reported lower event rates with early stimulation (4.78% vs. 15.22%).</p><p><strong>Conclusion: </strong>This review underscores how evidence regarding the optimal timing of sialagogue initiation after RAI remains inconsistent. These heterogeneous findings highlight the need for high-quality randomized controlled trials to establish evidence-based recommendations for sialagogue timing after RAI therapy.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663905","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":"Association of the triglyceride glucose-Chinese visceral adiposity index with incident sarcopenia among middle-aged and older adults with diabetes: a prospective cohort study.","authors":"Yan Chen, Tingyu Gao, Jing Gao, Xiaodong Feng","doi":"10.1007/s12020-026-04734-0","DOIUrl":"10.1007/s12020-026-04734-0","url":null,"abstract":"<p><strong>Background: </strong>Longitudinal association of triglyceride glucose-Chinese visceral adiposity index (TyG-CVAI) with the risk of new-onset sarcopenia in middle-aged and older adults with diabetes remains unclear. This study aimed to investigate whether baseline and cumulative TyG-CVAI is associated with incident sarcopenia risk in middle-aged and older adults with diabetes.</p><p><strong>Methods: </strong>We included participants aged ≥ 50 years with diabetes from the China Health and Retirement Longitudinal Study (CHARLS) 2011-2012. TyG-CVAI was calculated as TyG index multiplied by CVAI. Multivariable Cox regression and logistic regression were used to examine the associations of baseline and cumulative TyG-CVAI with new-onset sarcopenia. Receiver operating characteristic (ROC) curves were employed to compare the predictive capability of TyG-CVAI with its individual components.</p><p><strong>Results: </strong>A total of 763 participants with diabetes were included in the baseline analysis. During the 4-year follow-up, 62 (8.1%) participants developed new-onset sarcopenia. Compared with the lowest quartile (Q1) of baseline TyG-CVAI, the highest quartile (Q4) was significantly associated with an increased risk of sarcopenia (HR = 2.368, 95% CI: 1.014-5.532) in the fully adjusted model, with a significant trend across quartiles (P for trend = 0.017). Compared with the low-stable group (Cluster 1, n = 198), the high-stable group (Cluster 2, n = 276) had a significantly higher risk of new-onset sarcopenia (OR = 1.100, 95% CI: 1.020-1.321). The predictive performance of baseline TyG-CVAI (AUC = 0.685, 95% CI: 0.611-0.747) and cumulative TyG-CVAI (AUC = 0.917, 95% CI: 0.845-0.962) was higher than that of baseline and cumulative TyG and CVAI.</p><p><strong>Conclusion: </strong>Elevated baseline and cumulative TyG-CVAI are associated with new-onset sarcopenia in middle-aged and older Chinese adults with diabetes.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664758","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":"STK11 c.1062 C > G germline variant in medullary thyroid carcinoma: implications for familial predisposition and genetic counseling.","authors":"Weimao Kong, Longnv Bao, Meili Wang, Xiangzhong Zhao, Haiyan Gu, Xingzhu Pan, Xinyi Zhang, Tingling Zhang, Xiaoming Xing, Jigang Wang","doi":"10.1007/s12020-026-04729-x","DOIUrl":"10.1007/s12020-026-04729-x","url":null,"abstract":"<p><strong>Purpose: </strong>Medullary thyroid carcinoma (MTC) is characterized by frequent RET mutations, while non-RET alterations remain less well studied. Previous reports have identified a recurrent STK11 c.1062 C > G (p.Phe354Leu) variant in MTC, but its clinicopathologic and functional significance remains uncertain.</p><p><strong>Methods: </strong>A total of 129 MTCs (128 families) were analyzed by Sanger sequencing to screen for the STK11 c.1062 C > G variant. Germline status was assessed in cases with available normal tissue. Targeted next-generation sequencing was performed in 30 tumors (29 families). Functional effects of the STK11 c.1062 C > G variant were evaluated using an overexpression model in TT cells, with assessment of AMPKα phosphorylation. Progression-free survival was analyzed using Kaplan-Meier methods.</p><p><strong>Results: </strong>The STK11 c.1062 C > G variant was identified in 12 of 129 MTCs (9.3%) and in 11 of 128 families (8.6%). It was significantly enriched in hereditary cases compared with sporadic tumors: 27.8% (5/18) vs. 7.7% (1/12) for individual MTC cases, and 23.5% (4/17) vs. 7.7% (1/12) for families. In evaluable cases, the variant was confirmed to be germline. Tumors harboring STK11 c.1062 C > G showed a mutational spectrum predominantly involving RET, whereas variant-negative tumors exhibited more heterogeneous alterations, including genes related to DNA repair and chromatin remodeling. No significant difference in progression-free survival was observed between groups (P = 0.54). In vitro, the STK11 c.1062 C > G variant was associated with reduced AMPKα phosphorylation compared with wild-type STK11.</p><p><strong>Conclusion: </strong>Given the population frequency and ClinVar benign/likely benign classification of this variant, our data do not support STK11 c.1062 C > G as a primary driver of MTC; rather, it may represent a recurrent germline variant that could act as a low-penetrance modifier in a subset of patients, warranting cautious interpretation and further validation.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664448","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":"Predicting hormonal deterioration following transsphenoidal surgery for non-functioning pituitary adenomas: A systematic review and meta-analysis.","authors":"Daniel Ameen, Youssef ElSabban, Dimitrios Kalaitzoglou, Jonathan Shapey, Sinan Barazi, Nicholas Thomas, Simon Aylwin, Eleni Maratos","doi":"10.1007/s12020-026-04712-6","DOIUrl":"10.1007/s12020-026-04712-6","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic transsphenoidal surgery is indicated when non-functioning pituitary adenomas (NFPAs) cause visual compromise, but its timing is less certain in patients with preserved vision and intact pituitary function, where the risk of new post-operative pituitary dysfunction influences decision-making. This systematic review aimed to determine the rate of new post-operative endocrine deficits following transsphenoidal surgery for NFPAs and to identify predictive factors.</p><p><strong>Methods: </strong>This review followed PRISMA guidelines. Studies reporting predictors of post-operative endocrine deterioration in adults undergoing transsphenoidal surgery for NFPAs were included. Predictors were synthesised narratively, with meta-analysis where at least two studies used comparable definitions. Pooled proportions estimated the overall rate of deterioration. Certainty of evidence was assessed using GRADE.</p><p><strong>Results: </strong>Eleven studies comprising 2,350 patients were included. The pooled proportion developing new post-operative endocrine deterioration was 16% (95% CI 13-20%; I² = 60%). Larger tumour volume was associated with deterioration, and gross total resection with reduced odds compared with subtotal resection. Cavernous sinus invasion and other predictors showed inconsistent associations, while age, sex, comorbidities, apoplexy, pituitary gland or stalk visibility, surgeon experience and surgical approach were not associated with risk. Overall certainty of evidence was low to very low.</p><p><strong>Conclusion: </strong>New post-operative endocrine deficits affect approximately one in six patients after transsphenoidal surgery for NFPAs. Tumour volume was the most consistent predictor of endocrine deterioration, suggesting a potential role for earlier intervention in selected patients, although evidence certainty was low to very low. Standardised reporting and prospective studies are needed to guide risk stratification decision-making.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13428792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654748","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":"Under-recognition of autoimmune polyendocrine syndromes in T1DM: results from an extended screening workup.","authors":"Valerio Velardi, Lidiana Sanson, Barbara Toffoli, Federico Favaro, Fabio Fischetti, Bruno Fabris, Riccardo Candido, Stella Bernardi","doi":"10.1007/s12020-026-04716-2","DOIUrl":"10.1007/s12020-026-04716-2","url":null,"abstract":"<p><strong>Aims: </strong>Type 1 diabetes mellitus (T1DM) is frequently associated with other autoimmune disorders, particularly autoimmune thyroid disease (AITD) and celiac disease. Guidelines recommend screening for thyroid and celiac disease in T1DM patients. Nevertheless, in case of their positivity, indicating the presence of an autoimmune polyendocrine syndrome (APS), there is a lack of guidance on how to proceed. Should we screen these patients for other autoimmune diseases? This study's aim was to evaluate the prevalence of additional autoimmune conditions in a cohort of T1DM patients with AITD and/or celiac disease.</p><p><strong>Methods: </strong>This cross-sectional study includes adult T1DM patients identified through electronic medical records. Patients with concomitant AITD or celiac disease were invited to undergo an extended screening workup for autoimmune disorders.</p><p><strong>Results: </strong>639 T1DM patients were identified, and 198 (31%) met the clinical criteria for APS (T1DM plus AITD and/or celiac disease), but only 17 (8.6%) had a formal APS diagnosis in their records. After the extended screening in 139/198 patients, 39% exhibited previously unknown autoantibody positivity, and 11.5% had new autoimmune diseases. Overall, among the patients who underwent the extended screening, 32% (44/139) were diagnosed with at least three autoimmune diseases.</p><p><strong>Conclusions: </strong>Our study shows that APS is often under-recognized and rarely formally documented in patients with T1DM. In addition, 32% of T1DM patients with AITD or celiac disease have at least a third autoimmune disease. These findings highlight that the identification of AITD or celiac disease in T1DM marks only one stage of the diagnostic journey. APS recognition should lead to a formal diagnosis and ensure heightened clinical vigilance with tailored evaluation of further autoimmune comorbidities during lifelong patient follow-up.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13428756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654846","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":"Thermal ablation of lymph node metastases in papillary thyroid carcinoma: node size impacts outcomes.","authors":"Wen-Jia Cai, Zhen-Long Zhao, Ying Wei, Jie Wu, Shi-Liang Cao, Yan Li, Li-Li Peng, Shu-Qi Li, Ming-An Yu","doi":"10.1007/s12020-026-04719-z","DOIUrl":"10.1007/s12020-026-04719-z","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy and safety of thermal ablation (TA) for cervical lymph node metastases (LNMs) from papillary thyroid carcinoma (PTC) and to assess the impact of nodal size on treatment outcomes.</p><p><strong>Methods: </strong>This retrospective single center study analyzed 87 patients (177 LNMs, ≤ 5 nodes per patient) who underwent percutaneous TA from July 2018 to July 2024. Technical success, volume reduction rate (VRR), nodule disappearance, disease progression, and complications were assessed. Kaplan-Meier, Cox regression, and decision tree analyses were performed to identify prognostic factors and optimal cut-off values for nodal diameter.</p><p><strong>Results: </strong>TA achieved 100% technical success, with a mean VRR of 98.2 ± 8.1% and node disappearance rate in 94.3% of cases at a median follow-up of 34 months. Multivariable analysis identified LNM diameter (HR 2.02; 95% CI 1.15-3.56; P = 0.014) and location (lateral vs. central: HR 2.84; 95% CI 1.04-7.76; P = 0.042) as independent predictors of progression. Decision tree and Kaplan-Meier analyses indicated LNMs ≤ 2.4 cm as a practical threshold balancing efficacy and procedural burden. Major complications were rare (2.3%, transient recurrent laryngeal nerve injury), with no permanent morbidity.</p><p><strong>Conclusion: </strong>TA is a safe and effective minimally invasive treatment for selected patients with up to five LNMs from PTC. Smaller LNM diameter was associated with a lower risk of disease progression after TA, and the data-derived 2.4-cm cutoff may serve as a preliminary reference for patient selection.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654799","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}