Endocrine最新文献

{"title":"Time course of remnant cholesterol and the risk of heart failure.","authors":"Xiaoxue Liu, Yijun Zhang, Xue Tian, Qin Xu, Xue Xia, Shuohua Chen, Fen Liu, Shouling Wu, Anxin Wang","doi":"10.1007/s12020-024-04028-3","DOIUrl":"10.1007/s12020-024-04028-3","url":null,"abstract":"<p><strong>Background and aim: </strong>Previous studies have shown that remnant cholesterol (RC) was associated with heart failure (HF). However, lack of evidence regarding the long-term trend of RC with HF risk. We aimed to investigate the association between cumulative RC exposure with incident HF and to further explore the modulating effects of the time course of RC accumulation.</p><p><strong>Methods and results: </strong>We enrolled 41,168 participants free of CVD from the Kailuan Study who completed the first three health examinations from 2006 to 2010. Cumulative RC exposure included cumulative RC and time-weighted cumulative RC. The combination of cumulative RC and RC slope over time was characterized as the time course of RC accumulation. Multivariable adjusted Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for HF risk. We also considered non-HF-related death as a competing event by performing competing risk models as a sensitivity analysis. During 8.84 years, 839 participants developed HF events. Cumulative RC exposure increased the HF risk, with HRs for cumulative RC of 1.72 (1.41-2.10) and for time-averaged cumulative RC of 1.54 (1.25-1.89). There was a nonlinear relationship between cumulative RC exposure and HF risk. Participants with higher cumulative RC and negative slope had the highest HF risk (HR, 1.46; 95% CI, 1.16-1.83).</p><p><strong>Conclusions: </strong>Both cumulative long-term exposure and the time course of RC accumulation were associated with HF risk. Early RC accumulation resulted in a greater increase in risk compared to later accumulation. This finding suggests that long-term exposure to RC may be useful in identifying individuals at high risk of developing HF and highlights the need for early initiation of appropriate RC control to prevent or reduce incident HF.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":"510-521"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299417","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":"Pros and cons of surgical versus conservative management for head and neck paraganglioma: a real-world data analysis.","authors":"L Canu, L Zanatta, C Sparano, R Santoro, G Mannelli, S Zamengo, B Jance, F Amore, T Ercolino, M Mannelli, M Maggi, E Rapizzi","doi":"10.1007/s12020-025-04167-1","DOIUrl":"https://doi.org/10.1007/s12020-025-04167-1","url":null,"abstract":"<p><strong>Purpose: </strong>To compare functional deficits associated to surgery with those caused by the growth of the head and neck paragangliomas (HNPGLs).</p><p><strong>Methods: </strong>72 patients with HNPGLs were included. Patients were divided in group A (49 patients undergoing surgery) and group B (23 patients following a wait and see approach). Each patient was subjected to clinical evaluation and genetic testing. The presence of functional neurological deficits in speech or swallowing and quality of life were assessed via a dedicated otolaryngologist visit, three posted questionnaires (VHI, DHI, and MDADI), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-H&N35.</p><p><strong>Results: </strong>Thirty-four patients from group A (69.4%) and 18 from group B (78.2%) agreed to fill out the posted questionnaires. Eighteen patients from group A (36.7%) and 10 from group B (43.5%) underwent a dedicated otolaryngologist visit. A significant difference between group A and B was observed in the VHI (p = 0.001) and DHI scoring (p = 0.020), and at the otolaryngologist visit (mild neurological disabilities, p = 0.007). Patients with familial forms presented multiple HNPGLs (p = 0.011), multiple secreting lesions (p = 0.010) and underwent surgery more times for HNPGLs (p = 0.009) and for both HNPGLs and sympathetic PGLs (p = 0.015). ROC curve analysis suggests that surgery in carotid body tumors >34 mm may be more frequently associated with nerve injury.</p><p><strong>Conclusion: </strong>The management of HNPGL patients remains challenging for clinicians. This preliminary study seems to suggest that surgery still represents the first choice for patients with small lesions. An accurate clinical evaluation is mandatory to avoid non-resolving surgery and possible neurovascular long-term complications.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042978","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":"Should adrenal incidentaloma patients be evaluated for muscle mass, function, and quality? A cross-sectional study.","authors":"Samet Alkan, Sedat Can Guney, Can Akcura, Nilufer Ozdemir, Zeliha Hekimsoy","doi":"10.1007/s12020-025-04170-6","DOIUrl":"https://doi.org/10.1007/s12020-025-04170-6","url":null,"abstract":"<p><strong>Purpose: </strong>Our study evaluated skeletal muscle mass, function and quality among mild autonomous cortisol secretion (MACS) patients and non-functioning adrenal incidentaloma (NFAI) patients in comparison with the control group without adrenal mass.</p><p><strong>Methods: </strong>63 NFAI (49 female, 14 male) and 31 MACS (24 female, 7 male) patients were included in the study. As the control group, 44 patients (31 women, 13 men) who were known to have no radiological adrenal pathology on computed tomography or magnetic resonance imaging performed for other reasons were selected. After recording the laboratory parameters of the patients, anthropometric measurements, handgrip strength test with dynamometer, SARC-F survey and bioelectrical impedance analysis (BIA) measurements were performed.</p><p><strong>Results: </strong>There was no statistical difference among the groups in terms of age, gender, and BMI parameters. Handgrip strength (HGS), skeletal muscle mass (SMM) index (SMM/BMI), and skeletal muscle quality (HGS/SMM), values used to evaluate muscle strength and quality, were found to be significantly lower in both the MACS and NFAI groups compared to the control group (p = 0.004, p = 0.012 and p = 0.034 respectively). This significance was also present in women subgroup analyses (p = 0.002, p = 0.037 and p = 0.039 respectively), but these parameters lost their statistical significance in men. In the correlation analysis of the female subgroup, 24-h free urine cortisol value was inversely proportional to skeletal muscle quality (r_s = -0.417, p = 0.008).</p><p><strong>Conclusion: </strong>Our study showed that there is a decrease in muscle mass and function in female AI patients, and this decrease is more severe in MACS patients. These results may suggest that mild cortisol excess also has negative effects on skeletal muscle metabolism.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042980","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":"Subcutaneous route is a reliable alternative for ACTH-stimulated steroid profiling.","authors":"Melkunte Shanthaiah Dhananjaya, Shashidhara Revanasiddappa, Nimmi Kansal, Anurag Ranjan Lila, Vijaya Sarathi","doi":"10.1007/s12020-025-04172-4","DOIUrl":"https://doi.org/10.1007/s12020-025-04172-4","url":null,"abstract":"<p><strong>Purpose: </strong>Intramuscular acton prolongatum is most often used as an alternative for intramuscular or intravenous tetracosactide for ACTH stimulation in some countries. Intramuscular administration of acton prolongatum is cumbersome whereas intended intramuscular acton prolongatum or tetracosactide may often turn subcutaneous. Hence, we compared the subcutaneous ACTH-stimulated steroid profiling with those of the intramuscular routes.</p><p><strong>Methods: </strong>The study included 60 apparently-healthy adult females aged 18-40 years who were randomised to intramuscular tetracosactide (250 µg), intramuscular acton prolongatum (24 IU), subcutaneous tetracosactide (250 µg), and subcutaneous acton prolongatum (24 IU) groups in (1:1:1:1) ratio. Serum steroid profile consisting of 13 steroids was measured at baseline and 60 minutes after ACTH stimulation by liquid chromatography-tandem mass spectrometry.</p><p><strong>Results: </strong>Baseline steroid levels, stimulated steroid levels, and the percentage increase in all the steroids after subcutaneous tetracosactide and acton prolongatum stimulation were comparable to those after intramuscular tetracosactide and acton prolongatum stimulation, respectively.</p><p><strong>Conclusions: </strong>Intramuscular acton prolongatum, subcutaneous tetracosactide and subcutaneous acton prolongatum are simpler and reliable alternatives for ACTH-stimulated steroid profiling.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042985","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":"Adjuvant radiation therapy improves outcome of patients with surgical resected adrenocortical carcinoma.","authors":"Shuqing Ma, Luming Wu, Lei Ye, Mouhammed Amir Habra, Vania Balderrama-Brondani, Weiqing Wang","doi":"10.1007/s12020-025-04163-5","DOIUrl":"https://doi.org/10.1007/s12020-025-04163-5","url":null,"abstract":"<p><strong>Purpose: </strong>Adrenocortical carcinoma (ACC) is a rare malignancy known for high rates of recurrence and poor prognosis. Previous studies revealed controversial roles of adjuvant radiation therapy (RT) in patient management. This study aimed to investigate the role of adjuvant RT in postoperative ACC patients.</p><p><strong>Methods: </strong>Patients with histologically confirmed ACC who underwent surgical resection in the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2020 were enrolled. Propensity score matching (PSM) was used to balance baseline characteristics between patients receiving adjuvant RT and patients who did not receive RT. Overall survival (OS) and recurrence-free survival (RFS) was analyzed using the Kaplan-Meir method. Risk factors associated with survival outcome was analyzed by univariate and multivariate Cox regression analyses. Subgroup analyses were stratified by European Network for the Study of Adrenal Tumors (ENSAT) disease stage or chemotherapy. A joint retrospective analysis of stage III patients was performed based on data obtained from Ruijin Hospital and MD Anderson Cancer Center.</p><p><strong>Results: </strong>Among the 700 patients enrolled, 137 patients undergoing postoperative RT were matched with 137 patients who did not receive RT. Overall survival for patients with adjuvant RT was better than patients without RT (log-rank P = 0.015). The 3-year and 5-year OS were 55.2 and 47.1% for patients with RT, vs 42.6 and 34.0% for patients without RT. Multivariate analysis showed adjuvant RT was independently associated with lower mortality (hazard ratio [HR] 0.63, P = 0.007). Subgroup analysis stratified by disease stage demonstrated that adjuvant RT showed the most favorable effect in stage III patients (HR 0.53, P = 0.013). Furthermore, joint analysis of two centers showed a tendency of better OS and local control rate for stage III patients with mitotane plus RT than those with mitotane alone.</p><p><strong>Conclusion: </strong>Our study indicated that adjuvant RT was associated with improved prognosis for ACC patients, especially for patients with ENSAT stage III diseases. Integrating adjuvant RT into standard care of ACC may be considered.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042976","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":"Assessing the risk of heart failure in type 2 diabetes: a prediction algorithm to sustain the evaluation of NT-proBNP in primary care.","authors":"Francesco Lapi, Ettore Marconi, Gerardo Medea, Iacopo Cricelli, Damiano Parretti, Alessandro Rossi, Claudio Cricelli","doi":"10.1007/s12020-024-04157-9","DOIUrl":"https://doi.org/10.1007/s12020-024-04157-9","url":null,"abstract":"<p><strong>Purpose: </strong>Heart failure (HF) is a disease that leads to approximately 300,000 fatalities annually in Europe and 250,000 deaths each year in the United States. Type 2 Diabetes Mellitus (T2DM) is a significant risk factor for HF, and testing for N-terminal (NT)-pro hormone BNP (NT-proBNP) can aid in early detection of HF in T2DM patients. We therefore developed and validated the HFriskT2DM-HScore, an algorithm to predict the risk of HF in T2DM patients, so guiding NT-proBNP investigation in a primary care setting.</p><p><strong>Methods: </strong>Using a primary care database, we formed a cohort of patients aged ≥18 years diagnosed with T2DM between 2002 and 2022. A multivariate Cox model was adopted to assess the determinants associated with the occurrence of HF to combine them to form an individual score.</p><p><strong>Results: </strong>Within a cohort of 167,618 patients (52.3% males; mean age 64.4 (SD: 14.4); HF rate equal to 6.7 cases per 1000 person-years), we developed the HFriskT2DM-HScore. When it was applied to the validation sub-cohort we found an explained variation and discrimination value of 43% (95% CI: 42-44) and 81% (95% CI: 0.80-0.83), respectively. Calibration slope was equal to 0.93 (95% CI: 0.81-1.1; p = 0.3123).</p><p><strong>Conclusion: </strong>The HFriskT2DM-HScore might be implemented as a decision support system for primary care to appropriately ease the prescription of NT-proBNP and early identification of HF.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972976","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":"Effect of an intensive nutrition intervention of a high protein and low glycemic load diet on weight of kidney transplant recipients: a randomized clinical trial.","authors":"Elis Forcellini Pedrollo, Camila Corrêa, Bruna Bellincanta Nicoletto, Júlia de Melo Cardoso de Freitas, Júlia Roberta Buboltz, Beatriz Dorneles Ferreira da Costa, Gabriela Dos Santos Guedes, Andrea Carla Bauer, Roberto Ceratti Manfro, Gabriela Corrêa Souza, Cristiane Bauermann Leitão","doi":"10.1007/s12020-024-03978-y","DOIUrl":"10.1007/s12020-024-03978-y","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to evaluate the effect of a high protein and low glycemic load diet in preventing weight gain after kidney transplantation.</p><p><strong>Methods: </strong>We designed a prospective, single-center, open-label, randomized controlled study to compare the efficacy of a high protein (1.3-1.4 g/kg/day) and low glycemic load diet versus a conventional diet (0.8-1.0 g/kg/day of protein and no recommendations on glycemic load) in preventing weight gain (ClinicalTrials.gov identifier: NCT02883777). A total of 120 patients were evaluated. Patients were followed for 12 months, and the primary outcome was weight maintenance or weight gain lower than 5%.</p><p><strong>Results: </strong>There were no differences in total energy intake, carbohydrates, and total fats between groups. Intervention group (IG) increased protein intake to 1.38 ± 0.56 g/kg/day and decreased the glycemic load to 87.27 ± 4.54 g/day, while control group (CG) had a dietary protein intake of 1.19 ± 0.43 g/kg/day and a glycemic load of 115.60 ± 7.01 g/day. Total fiber intake was greater and trans-fat was lower in IG. Dietetic cholesterol increased in IG over time and was significantly different between groups. Overall, patients had an increase in body weight over time, with a mean increment of 4.1 ± 5.5 kg (5.75%). The percentage of patients who achieved the primary outcome was 50% of sample size, without differences between groups. The glomerular filtration rate improved over time in both groups. Considering 24-h proteinuria and albuminuria, a similar rise was observed in both groups.</p><p><strong>Conclusion: </strong>The present dietary intervention was safe, but had no effect on weight gain in kidney transplant subjects. Our findings suggest that other strategies, including alternative dietary and/or pharmacological and psychological interventions might be tested in randomized control trials in order to improve patients' body weight outcomes after transplant.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":"106-115"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890671","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":"Elucidating the effect of levothyroxine and triiodothyronine on methylglyoxal derived stress.","authors":"Hamda Khan, Safia Habib, Shirjeel Ahmad Siddiqui, Rizwan Ahmad, Arbab Husain, Moinuddin","doi":"10.1007/s12020-024-03972-4","DOIUrl":"10.1007/s12020-024-03972-4","url":null,"abstract":"<p><strong>Purpose: </strong>Methylglyoxal (MG) is the most potent precursor during the formation of the advanced glycation end products (AGEs). MG-dependent glycative stress contributes to pathogenesis of diabetes, age-related disorders, and cancer. There is a great need to study the reduction process of glycative stress for effective management of metabolic disorders. From natural compounds to synthetic drugs, each element contributes to the reduction of glycative stress. Previously, it was established that the lowering of uric acid, low-density lipoprotein cholesterol, and urine albumin excretion rate, as well as reducing total oxidative stress, were all achieved more effectively with a levothyroxine regimen. Still, there is no such study found that supports the MG-dependent glycative stress reduction with thyroid hormone compound. Our study aims to investigate the effects of T3 and T4 on MG-dependent glycative stress.</p><p><strong>Methods: </strong>The antiglycation effect was assayed through NBT assay, DNPH assay, ELISA, and fluorescence spectrophotometer. The intracellular reduction in reactive oxygen species (ROS) has been estimated through confocal microscopy.</p><p><strong>Results: </strong>The results revealed an effective reduction in the formation of AGEs adducts and intracellular ROS formation.</p><p><strong>Conclusion: </strong>The investigation concludes AGEs formation was suppressed using these compounds, although in vivo and rigorous clinical trials are required in order to verify these findings.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":"214-219"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890672","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 influence of cancer on the reprogramming of lipid metabolism in healthy thyroid tissues of patients with papillary thyroid carcinoma.","authors":"Agata Zwara, Andrzej Hellmann, Monika Czapiewska, Justyna Korczynska, Alicja Sztendel, Adriana Mika","doi":"10.1007/s12020-024-03993-z","DOIUrl":"10.1007/s12020-024-03993-z","url":null,"abstract":"<p><strong>Background and objectives: </strong>Over the years we observed changes in the metabolism of glucose, amino acids, fatty acids (FA) and nucleotides in cancer cells in order to maintain their viability and proliferate. Moreover, as the latest data show, cancer also forces a complete change in the behavior of other tissues. For instance, fat-filled adipocytes are often found in the vicinity of invasive solid human tumors. We investigated the effects of papillary thyroid carcinoma (PTC) on the lipid metabolism of healthy tissue distant from the tumor.</p><p><strong>Method: </strong>Thyroid tissue was collected from female patients immediately after surgical removal of the entire thyroid gland. Blood samples were collected from PTC patients and healthy volunteers. Real-time PCR assays were performed to analyze the expression of lipogenic genes and a broad panel of FA was determined using the gas chromatography-mass spectrometry method.</p><p><strong>Results: </strong>The concentration of lipids was higher in paratumor tissue than in healthy thyroid tissue (p = 0.005). The lipogenic genes tested were significantly increased in paratumor tissue compared to healthy tissue, especially enzymes related to the synthesis of very long-chain saturated and polyunsaturated FAs (VLCSFAs and PUFAs, respectively) (p < 0.001). The FA profile also showed increased levels of C22-C26, VLCSFAs and almost all PUFAs in paratumor tissue (p < 0.05).</p><p><strong>Conclusion: </strong>Our study suggests that a restructuring of lipid metabolism occurs in the adjacent healthy thyroid gland and that the metabolism of VLCSFAs and PUFAs is higher in the paratumor tissue than in the distant tissue of the healthy thyroid gland.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":"273-280"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11739254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983715","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":"Diagnosing and management of thyroid nodules and goiter - current perspectives.","authors":"Katica Bajuk Studen, Bartosz Domagała, Simona Gaberšček, Katja Zaletel, Alicja Hubalewska-Dydejczyk","doi":"10.1007/s12020-024-04015-8","DOIUrl":"10.1007/s12020-024-04015-8","url":null,"abstract":"<p><p>Due to the frequent diagnosis of benign thyroid nodules, it is necessary to deviate from the traditional paradigm based on frequent surgical treatment. This article highlights the evolution of diagnosis and treatment in recent years, beginning from standardization of ultrasound assessment of nodules and cytology results to minimally invasive techniques to reduce the size of symptomatic thyroid nodules. These achievements reduce the number of surgeries, enable more individualized care for patients with benign thyroid disease, reduce long-term complications, and promote cost-effectiveness within healthcare systems. Furthermore, although the use of minimally invasive techniques significantly decreases thyroid nodule volume, the thyroid nodule usually does not disappear and the challenges in this field are discussed (the efficacy of thermal ablation, a variable part of thyroid nodules that remains viable after thermal ablation, some of the nodules treated with thermal ablation may require a second treatment over time and the efficacy of thermal ablation in nodules with different phenotypes). However, although surgery still represents the \"gold standard\" for establishing the final histopathologic diagnosis, it is associated with lifelong thyroid hormone substitution need and serious complications in rare cases. Therefore, it should represent the ultima ratio only after a detailed diagnostic procedure. In the future, artificial intelligence-assisted programs for the evaluation and management of nodules are expected.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":"39-47"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11739261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113955","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}